Heavy Metal Detox: Why Sweating May Protect the Kidneys
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Well Mind Association Special Report - March 1994 J. Ely / Heavy Metal Detox: Sweatinq
Heavy Metal Detox: Why Sweating May Protect the Kidneys
by John T.A. Ely, Ph.D.
Summary. This article presents our opinion regarding the current status of several research questions. We list the average U.S. body burdens of three heavy metals and some health implications, especially the well established correlation with kidney disease and early death. New studies may show that the cost of this intoxication, especially by mercury (Hg), is even larger than now believed. Public demand for heavy metal detoxification may increase use of the various chelators and procedures that appeared to work well (via the kidneys!) in acute poisoning cases of the last four decades. However, for chronic exposures, we discuss reasons to expect that both the body burdens and the associated risk of kidney injury may be much greater. On the brighter side, we explain why urgently needed research may find that sweating, especially in dry sauna (180°F dry air produces 1 quart of sweat in 20 minutes!), and the use of ascorbic acid may both protect the kidney. If true, dry sauna may provide the safest, best and most economical therapy by far, for most people.
Background. Our personal experience and the daily news are filled with examples of neuro-endocrine and cognitive disorders. Examples range from the commonplace and relatively benign imbalances (anorexia, cravings, depression, forgetfulness, insomnia, irritability, PMS, shyness, etc.) to vicious and bizarre behaviors (fanaticism, pyromania, child molestation, serial killing, cannibalism, etc.). Hg alone can cause it all; other heavy metals also. The average U.S. adult body burden of lead (Pb) is known to be about 120 mg (milligrams) with >95%, reported to be in the skeleton. Our cadmium (Cd) content is estimated at 30 mg. Mercury (Hg) is listed as 13 mg by a few authors (assumed) all in soft tissue. Depending upon the chemical form and distribution, this amount of Hg might not produce symptoms in many people. However, there are at least seven reasons to expect Hg might also be stored in the skeleton (possibly in much larger amounts during chronic low level exposure). We may have some conclusive results this year from a study of skeletal Hg. We expect to learn something about what fraction of people with neurological disorders (such as Alzheimer's) have high skeletal Hg. We also hope to find what fraction of all people without occupational or other known Hg exposure (except that from dental amalgams) have a significant fraction of their Hg body burden stored in bone, and whether or not the amount of this skeletal Hg is proportional to their amalgam exposure (i.e., the area, age, copper content, etc., of their silver fillings). [In the January WMA issue, we suggested three factors that might increase Hg dose much over 1000 fold from a given set of amalgams!] One of the reasons it may be very important to know the magnitude of the body burden of Hg (and certain other heavy metals such as Pb and Cd) relates to avoidance of injury to soft tissue, especially kidney and brain, and accelerated aging. If it is found, as alleged by many researchers, that Hg does accelerate serious disorders (and even aging itself), and that some classes of people have high skeletal Hg, then, safe effective Hg excretion may become one of the most demanded procedures in medical history!
Chronic vs Acute Intoxication. Chronic intoxication by Hg or Pb, etc., implies absorption for a long time (years or decades) of a very low daily dose. But a very large body burden (100 milligrams or more) may accumulate in skeleton. Bone, unlike soft tissue, produces few detectable symptoms; but, the metal may leak out later due to osteoporosis, etc., causing kidney disease, etc. If it is found that chronic Hg intoxication does produce large body burdens (as are known to occur in Pb), we feel the problem will be very dangerously different from that of acute intoxication. In the acute case, exposure to high levels of the metal for a short time (i.e., usually months or less) produces high levels in soft tissue and dramatic symptoms (but a considerably smaller body burden that has not had time to transfer much to bone storage). We think that some methods of Hg excretion, especially sweating, may prove to be satisfactory solutions for the higher Hg body burdens of chronic Hg intoxication in most people. However, some methods (such as chelation via the kidneys) that are used safety for atherosclerosis and for acute intoxication by Hg, etc., may be unsuitable if body burden is high.
Why Might Sweating Prove Best for Most People? These articles seek to accelerate competent safe evaluation of sweating by clinicians (among and of the readers). For most people, sweating can be one of the least expensive and lowest risk activities, and has a long history of reported success in Hg excretion. This is discussed in an outstanding review by F.W. Sunderman MD, PhD.1 He cites one reference, dated 1697 AD, reporting a Danish chemist recovered from "the point of death" by using sauna. "Dry sauna" has been used for centuries to reverse symptoms in the Hg miners of Spain.2 Although primarily on acute exposure, an interesting chapter by W. Stopford, MD3 tells of a young man who was treated by daily 20-minute saunas for three years and recovered from a nearly fatal acute Hg poisoning. Dr. Lovejoy found that Hg was higher in sweat than in urine of exposed factory workers.4 Sweating can pose serious risks for unconditioned persons and especially those in pregnancy or some with vascular disease (although medical supervision may make dry sauna beneficial for many with cardiovascular disease). Other risks such as skin and lung problems due to molds, etc., might be negligible in a dry sauna which also may impose less heart stress (because of lung cooling); a study reported only 50% pulse rise in dry sauna but 130% in wet; dry air is survivable over 20 minutes at 260° F, but very moist air at 115° F is unbearable even a few minutes. Most new regimens require education and guidance. Information on saunas may be found in libraries or health clubs. Evidence suggests that the ability to sweat and excrete Hg increases with repeated use of exercise or sauna. Obviously, detailed treatment plans including consideration of rehydration, mineral replacement, stress, degree of supervision, etc., need to be properly designed by competent persons. Many patients might require only periodic checkups for supervision after such plans have been started. Since 1988, Dr. Maria Fiatarone of Tufts published at least five studies suggesting both quality and length of life are enhanced by regular planned exercise even after age 90. Similar trials are needed to evaluate the use of sweating in the elderly. A major advantage of sweating may be excretion of most of the Hg (Cd, Pb, etc.), out through the skin and liver instead of through the kidneys.
Why Concern re the Kidneys? The literature suggests heavy metals (including Pb leaking out of bone storage after childhood intoxication, or in osteoporosis, etc,) have caused much human suffering, kidney damage being one of the most widely known.5 Use of Pb in house paint in Queensland near the turn of the century resulted in a concurrent rise in nephritis deaths and widespread poisoning of children. From the 1920's through the 1950's there were increased deaths from nephritis of adults, at ages from the 20's through the 50's, who had had their exposures as children. H.L. Queen, in his excellent 1988 text (Chronic Mercury Toxicity, p.27) summarized published findings that heavy metals may have been the principal cause of endstage renal disease, costing over $2 Billion per year in the early 1980's, primarily from Medicare and mainly for dialysis and transplants. It was interpreted that attention by physicians to chronic heavy metal intoxication in every patient could greatly reduce this terrible suffering and expense. Although a three times higher number is estimated in an authoritative physiology text, there were over 24,000 U.S. kidney disease related deaths reported in 1989. This is about half the car crash toll, which concerns most of us almost every day; it seems only prudent to give some thought to the care of our kidneys. Two excellent books available through the WMA are the encyclopedic but inexpensive Let's Get Well (A. Davis, 1965) and Queen's 1988 text (above) which also discusses other matters of relevance here, including possible effects of Hg on hypertension and high cholesterol. Additional risks to the kidneys include stones, hemolysis, and immune complex disease (ICD). In Food Allergy by J.W.Gerrard MD, 1980, Chapter 6 and its 60 references summarize evidence suggesting that ICD due to food allergy can cause serious renal disease at any age but careful diet control may avoid or reverse it (as in all of these, a preventive medicine clinician should be consulted).
Why Ascorbic Acid (AA) Before Sweating? For the majority of people whose clinicians say they can take AA safely (i.e., with adequate magnesium and urine pH control to prevent stones, and enough vitamin E to prevent hemolysis, etc.), it may significantly enhance Hg detoxification. Although not yet proven quantitatively in controlled studies, there are theoretical bases (and much anecdotal evidence) to support this opinion. Three theoretical assumptions are that AA (oral or i.v.) may: (1) enhance excretion via all routes by mobilizing bound intracellular Hg (which chelators cannot); (2) protect the kidneys by reducing the nephrotoxic mercuric ion to the more readily excreted elemental form of Hg; and (3) greatly stimulate uptake of heavy metals (by the liver's phagocytic Kupffer cells) which can then be excreted through the gut, sparing the kidneys.
1 Sunderman, FW. Annals of Clinical and Laboratory Science, 18(2): 89-101,1988.
2 Putman, JJ. National Geographic 142: 506-527, 1972.
3 Stopford, W. Ch. 15, The Biogeochemistry of Mercury in the Environment, Editor J.O. Nriegu, Elsevier-North Holland Biomedical Press, New York, 1979.
4. Lovejoy, H B, et al. Journal of Occupational Medicine 15:590-591, 1973.
5. Wedeen, RP. Lead, Mercury and Cadmium Nephropathy, Neuro Toxicology 4(3): 134-146, 1983.
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