Mercury and Toxic Metal
Effects on Kidneys, Urinary System, and Fertility
B. Windham (Ed.)
I. Introduction:
A large U.S. Centers for Disease Control epidemiological
study, NHANES III, found that those with more amalgam fillings (more mercury
exposure) have significantly higher levels of chronic health conditions(543). Among
the
conditions where incidence was significantly correlated with having more than
the average number of amalgam surfaces were diseases of the male and female
genital tracts, and Diseases of the genitourinary system (543). A 2009 study found that inorganic mercury
levels in people have been increasing rapidly in recent years(543b).
It used data from the U.S. Centers for Disease Control and
Prevention’s National Health Nutrition Examination Survey (NHANES) finding that
while inorganic mercury was detected in the blood of 2 percent of women aged 18
to 49 in the 1999-2000 NHANES survey, that level rose
to 30 percent of women by 2005-2006. Surveys in all states using hair tests
have found dangerous levels of mercury in an average of 22 % of the population,
with over 30% in some states like Florida and New York (543c).
II. Mercury exposure and mercury levels in kidneys and genitourinary
system
Dental amalgam has been documented by thousands of medical
lab tests and Government agencies to be the largest
source of mercury in most who have amalgam dental
fillings, and to be the largest source of mercury in kidneys(85,14), where it bioaccumulates (85,273,14). Studies have found number
of dental amalgam fillings, chewing on amalgam, and fish consumption were
positively associated with Urinary-HgC(85). The
number of amalgam surfaces has a statistically significant correlation to the
mercury level in the renal(kidney) cortex (14,16,19,20,85,254,273,348,366). One
study found levels ranging from 21 to 810 ppb.
A study of levels in kidney donors found an average of 3 times higher
mercury level in those with amalgams versus those without (14c,85d). Studies found the number of amalgam surfaces
has a statistically significant correlation to urine mercury level
(38,49,57,76,77,79,82,83,134,138,167,176,254,303,332,335).
Mercury levels of dental personnel average at least 2 times
that of controls for urine (25d,57,64,69,99,123,124,138,171,173,222,249,
290,362,397-399). Sweden, which voted to phase out use of mercury in fillings, is the
country with the most exposure and health effects studies regarding amalgam,
and urine levels in dental professionals
from Swedish and European studies ranged from 0.8 to 30.1 ug/L
with study averages from 3.7 to 6.2 ug/L (124,172,253,64,68). The Swedish safety guideline for mercury in
urine is 5.6 nmol Hg/nmol(11.6 ug/L). Study
averages for other countries ranged from 3.3 to 36 microgram/liter(ug/L)(69,70,171,290,397).
A large survey of dentists at the Norwegian Dental Assoc. meeting(171) found that the mean mercury level in 1986 was
7.8 ug/L with approx. 16% above 13.6ug/L, and for
1987 found an average of 8.6 ug/L with approx. 15%
above 15.8 ug/L, with women having higher levels than
men in general.
A U.S. national sample of dentists provided by
the American Dental Association had an average of 5.2 ug/L (70,290).
In that large sample of dentists, 10% of dentists had urine mercury
levels over 10.4 ug/L and 1% had levels over 33.4ug/L(290,25c), indicating daily exposure levels of over 100 ug/day. Researchers from
the Univ. of Washington School of Dentistry and Dept. of Chemistry tested a
sample of dentists at an annual ADA meeting(230). The study found that the dentists had a
significant body burden of mercury and the group with higher levels of mercury
had significantly more adverse health conditions than the group with lower
exposure. Another study of a group of 194 U.S. male dentists with mean urine
mercury level of 3.3 ug/L and 233 female dental
assistants with mean urine mercury level of 2.0 ug/L
considered effects of polymorphism in brain-derived neurotrophic
factor(BDNF) as well as mercury level(290b). The study
found significant effects of mercury level on 9 measures of neurologicial
deficits for the dentists and on 8 measures of neurological deficits for dental
assistants(290b), as well as a significant difference
relating to BDNF.
A group of dental students taking a
course involving work with amalgam had their urine tested before and after the
course was over. The average urine level increased by 500% during the course(63). But dental staff have been found to have mercury
retention and kidney effects that tend to cause lower measured levels of
mercury in urine tests(258).
III.
Toxic
Effects of Mercury (& toxic metals) on Kidneys and Genitourinary System
Mercury
has been found to be nepthrotoxic
(toxic to kidneys) (14,20,203,209c,223,254,260,268,334,438)
Mercury exposure
has been shown to adversely affect kidney function in occupational and animal
studies (20,203,211,223,260,438), and also in those with more than average
number of amalgam fillings(254,223). Richardson(Health
Canada) has estimated that about 20% of the population suffers a subclinical
impairment of kidney or CNS function related to amalgam mercury(209c).
Inorganic mercury exposure has been found to exert a dose-dependent cytotoxicity by generating extremely high levels of
hydrogen peroxide, which is normally quenched by pyruvate
and catalase(203). HgCl2 also has
been found to impair function of other organelles such as lysomones
that maintain transmembrane proton gradient, and to
decrease glutathione peroxidase activity in the
kidneys while upregulating heme
oxidase
function. The Government's toxic
level for mercury in urine is 30 mcg/L (189), but adverse effects have been
seen at lower levels and low levels in urine often mean high mercury retention
and chronic toxicity problems(258). For this reason
urine tests are not a reliable measure of mercury
toxicity(11,36,57,183,216,258,260,503).
A
survey of over 60,000 U.S. dentists and dental assistants with chronic exposure
to mercury vapor and anesthetics found increased health problems compared to controls,
including significantly higher liver, kidney, and neurological
diseases(99,193). A
recent study in Scotland found similar results(531). Some studies
have found increased risk of lung, kidney, brain, and CNS system cancers among
dental workers(14,34,99,143,283).
Mercury
causes interruption of the cytochromeC oxidase system/ATP energy function
(43,84,232,338c,35) and blocks enzymes needed to convert porphyrins to adenosine tri phosphate(ATP)
causing progressive porphyrinuria, resulting in low energy, digestive problems,
and porphyrins in urine
(34,35,69,70,73,210,212,226,232,258,260)
.
Mercury and toxic metals
have been found to be common toxic exposures that have been found to cause increased
permeability of the kidney epithelial and brush border cells(592,338).
In
men, including workers occupationally exposed to mercury, U-HgC
was positively associated with the kidney markers, especially with NAG, but to
some extent also with A1M and albumin.
The primary detoxification/excretion pathway
for mercury absorbed by the body is as mercury-glutathione compounds through
the liver/bile loop to feces(111,252,538), but some mercury is also excreted
though the kidneys in urine and in sweat. A high fiber diet has been shown to
be helpful in mercury detoxification(538). The range
of mercury excreted in urine per day by those with amalgams is usually less
than 15 ug(6,49,83,138,174,335,etc.),
but some patients are much higher(93). A
large NIDH study of the U.S. military population(49)
with an average of 19.9 amalgam surfaces and range of 0 to 60 surfaces found
the average urine level was 3.1 ug/L, with 93% being
inorganic mercury. The average in those with amalgam was 4.5 times that of
controls and more than the U.S. EPA maximum limit for mercury in drinking water(218). The
average level of those with over 49 surfaces was over 8 times that of controls.
The same study found that the average blood level was 2.55 ug/L, with 79 % being organic mercury. The total mercury level had a significant
correlation to the number of amalgam fillings, with fillings appearing to be
responsible for over 75% of total mercury. From the study results it was found
that each 10 amalgam surfaces increased urine mercury by approx. 1 ug/L. A study of
mercury species found blood mercury was 89% organic and urine mercury was 87% inorganic(349b).
In a population
of women tested In the Middle East(254,223e), the
number of fillings was highly correlated with the mercury level in urine, mean=
7 ug/L.
Amalgam has also been found to be the largest source of organic mercury
in most people(506,79,386,220,etc.). Nutrient transport and renal function were
also found to be adversely affected by higher levels of mercury in the
urine.
Significant correlations between increasing
urine mercury concentrations and prolonged motor and sensory distal latencies
were established(285g,119e). Chronic immune activation is common in CFS,
with increase in activated CD8+ cytotoxic T-cells and
decreased natural killer(NK) cells(518). Numbers of suppressor-inducer T cells and NK
cells have been found to be inversely correlated with urine mercury levels(270ad). CFS
patients usually improve and immune reactivity is reduced when amalgam fillings
are replaced(342,383,405). Neurological effects have
been documented at very low levels of exposure(urine
Hg< 4 ug/L), levels commonly received by those
with amalgam fillings(290).
Mercury
has been documented to be a common cause of hypothyroidism and autoimmune thyroiditis.
Studies
have also established a “clear association” between the presence of thyroid
antibodies in pregnant women and spontaneous abortions(511),
as well as a connection between maternal thyroid disease and babies born with
heart, brain, and kidney defects(509c).
Metals tend to
cause cellular acidic conditions which lead to disease and measuring urine
acidity is useful in this regard. Normal
acidity is PH of about 6.8(228a).
Mercury and
Reproductive System and Fertility
Mercury
accumulates in the
ovaries, testes, and prostate gland(35,99,9 19,20,25,85,
273,543b). In addition to having
estrogenic effects, mercury has other documented hormonal effects including
effects on the reproductive system resulting in lowered sperm counts, defective
sperm cells, damaged DNA, aberrant chromosome numbers rather than the normal
46, chromosome breaks, and lowered testosterone levels in males and menstrual
disturbances and infertility in women (4,9,10,23,31,37,105,146,159,395,433,27,35,38). Nickel has also been found to accumulate in
the prostate and be related to prostate cancer(581). Mercury has been found to cause decreased
sperm volume and motility , increased sperm abnormalities and spontaneous
abortions, increased uterine fibroids/endometritis,
and decreased fertility in animals(4,104,105,162) and in
humans(9,10,23,31,37,105,146,159,395,433,27,35,38). In studies of women having miscarriages or
birth defects, husbands were found to typically have low sperm counts and
significantly more visually abnormal sperm(393). It's
now estimated that up to 85 per cent of the sperm produced by a healthy male is
DNA-damaged(433).
Abnormal sperm is also being blamed for a global increase in testicular
cancer, birth defects,
and other reproductive conditions. Studies indicate an increase in the rate
of spontaneous abortions with an increasing concentration of mercury in the
fathers' urine before pregnancy(37). Studies
have found that mercury accumulates in the ovaries and testes, inhibits enzymes
necessary for sperm production, affects DNA in sperm, causes aberrant numbers
of chromosomes in cells, causes chromosome breaks, etc.- all of which can cause
infertility, spontaneous abortions, or birth defects(10,31,35,296). Subfertile males
in Hong Kong were found to have 40% more mercury in their hair than fertile controls . 'Infertile males with abnormal semen' and 'infertile
females with unexplained infertility' also had higher blood mercury concentrations
than their fertile counterparts. (55). The number of amalgam fillings was
found to be an important factor in success of treating male
infertility(55c). From clinical
experience some of the symptoms of mercury sensitivity/mercury poisoning include frequent
urination.
Studies in
monkeys have found decreased sperm motility, abnormal sperm, increased
infertility and abortions at low levels of methyl mercury(162,365). Mercury causes infertility
(4,9,10,24,38,121,146,357, 365, 367,511 /4,10,55, 162) A study by a neuroscience researcher found a
connection between the levels of pituitary hormone lutropin
and chronic mercury exposure(543b). The authors indicated that inorganic
mercury binding to luteinizing hormone can impair gonadotrophin
regulation affecting fertility and reproductive function. The
normalization of pituitary function also often normalizes menstrual cycle
problems, endometriosis, and increases fertility(9,35).
In addition to having estrogenic effects, mercury has other documented hormonal
effects including effects on the reproductive system resulting in lowered sperm
counts, defective sperm cells, damaged DNA, aberrant chromosome numbers rather
than the normal 46, chromosome breaks, and lowered testosterone levels in males
and menstrual disturbances and infertility in
women(4,9,10,23,31,37,105,146,159,395,433,27,35,38)
Tests
for Mercury Level or Toxicity and Treatment
1.
Feces
is the major path of excretion of mercury from the body, having a higher
correlation to systemic body burden than urine or blood, which tend to
correlate with recent exposure level (6b,21abd,35,36,79,80,183,278). For this reason
many researchers consider feces to be the most reliable indicator of daily
exposure level to mercury or other toxics. The average level of mercury in
feces of populations with amalgam fillings is as much as 1 ppm
and approx. 10 times that of a similar group without fillings
(79,80,83,335,386,528,25), with significant numbers of those with several
filings having over 10 ppm and 170 times those
without fillings(80). For those with
several fillings daily fecal mercury excretion levels range between 20 to 200 ug/day.
2.
The
saliva test is another good test for daily mercury exposure, done
commonly in Europe and representing one of the largest sources of mercury
exposure. There is only a weak
correlation between blood or urine mercury levels and body burden or level in a
target organ(36,157,183,258,278,11,21abd,6b). Mercury
vapor passes through the blood rapidly(half-life in
blood is 10 seconds(370)) and
accumulates in other parts of the body such as the brain, kidneys,
liver, thyroid gland, pituitary gland, etc. Thus blood test measures mostly
recent exposure.
3.
Kidneys
have a lot of hydroxyl(SH) groups which mercury binds
to causing accumulation in the kidneys, and inhibiting excretion(503). As damage occurs to kidneys over time,
mercury is less efficiently eliminated
(11,36,57,183,216,258,260,503), so urine
tests are not reliable for body burden after long term exposure. Some
researchers suggest hair offers a
better indicator of mercury body burden than blood or urine(279,21ab),
though still not totally reliable and may be a better indicator for organic
mercury than inorganic. The median daily
exposure through saliva for those with 10 or more fillings was over 10 times
that of those with no fillings(199,292,315,318). Mercury level in saliva has been found to
give much better indication of body levels than blood or urine levels(36). Most
people with fillings have daily exposure levels exceeding the U.S. ATSDR and
EPA health guideline levels (2,36,83,89,183,199,209,217,261,292,335,93). Note
that the WHO standard assumes exposure for a 40 hour week with no other
exposure, which gives large differences with standards or guidelines based on assuming
continuous exposure.
4.
A
new test approved by the FDA for diagnosing damage that has been caused by
toxic metals like mercury is the fractionated porphyrin
test(260,35), that measures amount of damage as well as likely source. Mercury
blocks enzymes needed to convert some types of porphyrins
to hemoglobin and
adenosine tri phosphate(ATP).
The pattern of which porphyrins are high gives
an indication of likely toxic exposure, with high precoproporphyrin
almost always high with mercury toxicity and often coproporphyrin.
5.
Provocation
challenge tests after use of chemical chelators such as DMPS or DMSA also are
effective at measuring body burden(57,58), but high levels of DMPS can be
dangerous to some people- especially those still having amalgam fillings or
those allergic to sulfur drugs or sulfites.
The
interruption of the ATP energy chemistry results in high levels of porphyrins in the urine(260).
Mercury,lead, and other toxics have different patterns of high
levels for the 5 types of porphyrins, with pattern
indicating likely source and the level extent of damage. The average for those with amalgams is over
3 time that of those without, and is over 20 times normal for some severely
poisoned people(232,260). The FDA has approved a test
measuring porphyrins as a test for mercury
poisoning. However some other dental
problems such as nickel crowns, cavitations, and root canals also can cause
high porphyrins.
Cavitations are diseased areas in bone under teeth or extracted teeth
usually caused by lack of adequate blood supply to the area. Tests by special equipment(Cavitat) found
cavitations in over 80% of areas under root canals or extracted wisdom teeth
that have been tested, and toxins such as anaerobic bacteria and other toxics
which significantly inhibit body enzymatic processes in virtually all
cavitations(200,437ab). These toxins
have been found to have serious systemic health effects in many cases, and
significant health problems to be related such as arthritis, MCS, and CFS. These have been found to be factors along
with amalgam in serious chronic conditions such as MS, ALS, Alzheimer’s, MCS,
CFS, etc.(35,200,204,222,292,437). The problem occurs in extractions that are not cleaned out
properly after extraction.
Also
high mercury exposures with low hair mercury or urine mercury level usually indicates body
is retaining mercury and likely toxicity problem(35). In such cases where (calcium> 1100 or < 300 ppm) and low test mercury,manganese,zinc,potassium; mercury toxicity likely
and hard to treat since retaining
mercury.
Use of urine
test:
A group of
German children with amalgam fillings had urine mercury level 4 times that of a
control group without amalgams(76), while a Canadian
study found 3.2 times as much exposure in those with amalgam with adverse
health effects(low weight and height)(76c), and in a Norwegian group with
average age 12 there was a significant
correlation between urine mercury level and number of amalgam fillings(167).
A study(169) found blood and urine mercury levels to be very
strongly related to Parkinson’s with odds ratios of approx. 20 at high levels
of Hg exposure.
Occupational
studies have found that the number of suppressor-inducer immune cells and
natural killer cells are significantly negatively correlated with urine mercury
level (270ad).
Treatment
of Mercury Toxicity
Most patients with chronic health conditions related to mercury toxicity from amalgam recover or significantly improve after amalgam replacement. www.flcv.com/hgremove.html
After replacement
of amalgam fillings, levels of mercury in the blood, urine, and feces typically
temporarily are increased for a few days, but levels usually decline in blood
and urine within 6 months to from 60 to 85% of the original
levels(57,79,82,89,196,303). Removal of
amalgam fillings resulted in a significant reduction in body burden and body
waste product load of mercury (75,82,88,89,93,95,115). Total reduction in mercury levels in blood
and urine is often over 80% within a few
months(79,82,89,93,115,57). On average
those with 29 amalgam surfaces excreted over 3 times more mercury in urine
after DMPS challenge than those with 3 amalgam surfaces, and those with 45
amalgam surfaces more than 6 times as much mercury(12b).
Recovery after amalgam
replacement: infertility(9,35,38,229,367),
endometriosis(229,35,38,9),
References: (this paper is snipped from www.flcv.com/amalg6.html
See references in www.flcv.com/amalg6.html
