Mercury Tri-Test: Mercury Speciation Analysis and Compartment-Ratio

Analysis for Body Burden and Excretion Indices WITHOUT Provocation

Christopher W. Shade, PhDAndrew Elias, MBA, LSSBB Quicksilver Scientific, LLC

Lafayette, CO 80026(303)531-0861

www.quicksilverscientific.com

Mercury Testing• Most Common method now is the “Challenge Test”

– No information on form of mercury– Large dose of potentially harmful chelation compound– No information on excretion capacity– Misleadingly believed to reveal “Body Burden”

• Quicksilver Scientific Tri-test uses Mercury Speciation Testing (separation of forms of mercury) and comparisons of different sample types– Clearly Reveals source of mercury and bodily levels– Gives index of excretion ability for each form of mercury

Forms and Sources of Mercury

• MeHg - Methylmercury– Organomercurial; found in fish; Also formed

in gut from amalgam mercury

• Hg0 – Elemental Mercury– The metal form; liquid and gas forms; dental amalgam

• HgII – Inorganic Mercury– The salt, formed by oxidation of Hg0 in blood and mouth

• EtHg - Ethylmercury– Synthetic organomercurial; antimicrobial

– Ends up mostly as inorganic mercury

Pathways In – Dental Amalgam

Hg0 breaks down to

inorganic mercury (HgII).

Hg0 distributes throughout body and nervous

system.

Image from the International Academy of Oral Medicine and Toxicology.

HgII accumulates in the nervous system, liver,

and kidney.

Hg0 released from amalgam and inhaled with 80% uptake in the lungs.

Amalgams: Pathway of Exposure

80% Uptake

Pathways In – Fish Consumption

MeHg

MeHg

Chemical reactions in the gut add MeHg to an amino

acid.

Fish contaminated with methylmercury (MeHg) get

eaten.

MeHg diffuses out of the gut and circulates

throughout the body, because it gets mistaken

as an amino acid.

Methylmercury accumulates in

the body.

Seafood: Pathway of Exposure

95% Uptake

Pathways In – Vaccines

EtHg

HgII

accumulates in the body.

EtHg distributes throughout the body and

nervous system.

EtHg probably does not leave the body, but enters tissues and breaksdown into inorganic mercury

(HgII).

Ethylmercury (EtHg) enters the blood through

vaccination.

EtHg leaves the blood after a few days.

Vaccination: Pathway of Exposure

100% Uptake

Pathways Out – Methylmercury

Pathways Out – Inorganic Mercury

Both Intestinal and Kidneys

Mercury Speciation Testing

• Patented Mercury Analysis Technique separates methyl and inorganic mercury– Shows different sources (fish vs. amalgam)– US Patent #7,285,419 B2

• Comparison between matrices shows excretion or retention of mercury

• Only clinical lab in the world offering Mercury Speciation Analysis

Challenge Tests – What do they mean? Are They Necessary?

Mercury Industry Workers

Dentists

Controls (Amalgam)

Amalgam-free Referents

Industrial workers 3-4 yrs on job, versus dentists 10-30 yrs on the job and amalgam bearers with 10-30 yrs with fillings

Mercury Industry Workers

Dentists

Controls (Amalgam)

Amalgam-free Referents

If challenge reflected long-term body burden, the long-term dentists would have moved closer to the short-term industrial workers…but it did not

Challenged Urine correlated well with pre-challenged urine and pre-challenged plasma

Chelation therapy – Dump from blood followed by reloading from cellular

burden

Chelators drain the blood metals through the kidneys. After cessation of use, the tissues replenish the blood

Mercury Speciation Testing

• Separates the two main forms of mercury in the human body (Methyl and inorganic mercury)– Once separately measured, ambient

measurements reveal a lot without challenge tests

Testing for Hg – Forms Present in Different Samples

1. Ambient

1. Blood – MeHg + HgII (MeHg larger)

2. Hair – MeHg only

3. Urine – HgII (little bit of MeHg)

4. Stool – MeHg + HgII

2. Provoked

1. Urine – MeHg + HgII

Blood Testing

• Old Dictum – blood is only recent exposure, 3-days

• Reality– 3-day residence only the quick decay after a large

dose– For MeHg, Steady state develops after initial decay;

Then blood reflects body burden!

• Real Problem– Most labs detection limits too high to see dynamics– Need sensitive equipment!

H

HH

Hg

Fish Consumption12 hr peak and fast decay over 24hrs

Clarkson et al., Arch. Env. Health, 1980

Fish ConsumptionSlow 160 day return to baseline

After initial peak and decay, Blood reflects Body Burden!

Mercury Speciation Testing

H

HH

Hg

Mercury Speciation Testing and Compartment Ratio Testing

Ambient Measurement Suite

1. Blood – MethylHg + Inorganic Hg

2. Hair – >95% MethylHg

-Compare to blood MethylHg for excretion measurement

3. Urine – >95% Inorganic Hg

-Compare to blood inorganic mercury for excretion measurement

Blood Mercury Speciation

Methyl Hg

Inorganic Hg

Total Hg

Methylmercury levels with comparison to laboratory average

Inorganic Mercury levels with comparison to laboratory average

Sum of 2 forms = total Hg with comparison to laboratory average and color coded CDC population averages

Compartment Ratio Analysis: Patient #1 – Healthy

Low Levels and Good Excretion Profiles

Methyl Hg

Inorganic Hg

Total Hg

Low Methyl and average Inorganic Hg

Good MethylHg excretion

Good Inorganic Hg excretion

Compartment Ratio Analysis: Patient #2: Dentist with Chronic Intestinal Inflammation

I n dicat ion of M er cur y E xcr et ion A bilit y

0

4 00

-1 2 0 -1 00 -8 0 -6 0 -4 0 -2 0 0 2 0

B lo o d Me Hg (n g /mL )

Below Average Excretion of blood mercury through the hair.

Average Excretionof blood mercury though the hair (290:1).

Indication of Mercury Excretion Ability

0

400

800

1200

1600

2000

2400

2800

0 2 4 6 8 10

Blood MeHg (ng/mL)

Hai

r M

eHg

(n

g/g

)

Methyl Hg

Inorganic Hg

Total Hg

Very High Methyl and Inorganic Hg

Bad Inorganic Hg excretion

Bad MethylHg excretion

Compartment Ratio Analysis: Patient #3: Dentist – Kidney Problem from Long-term Hg vapor Exposure

0 0.5 1 1.5 2 2.5

Concentration of Mercury (ng/mL or ug/L)

HgT

Hg(II)

MeHg

Patient BloodQS Average

I n dicat ion of M er cur y E xcr et ion A bilit y

0

4 00

-1 2 0 -1 00 -8 0 -6 0 -4 0 -2 0 0 2 0

B lo o d Me Hg (n g /mL )

Average Excretionof blood mercury though the hair (290:1).

Below Average Excretion of blood mercury through the hair.

Indication of Mercury Excretion Ability

0

400

800

1200

0 1 2 3 4 5

Blood MeHg (ng/mL)

Hai

r M

eHg

(n

g/g

)

Indication of Kidney Mercury Excretion Ability

0.000.50

1.001.50

2.002.50

3.003.50

4.004.50

5.00

0 0.5 1 1.5

Blood Hg(II) (ng/mL)

Uri

ne

Hg

(II)

(n

g/m

L)

Good Hg(II) Excretion Line (7:1)

Methyl Hg

Inorganic Hg

Total Hg

Normal Methyl and Very High Inorganic Hg

Good MethylHg excretion

Bad Inorganic Hg excretion

Compartment Ratio Analysis: Patient #4 – Likely Methyl Hg Detox Enzyme Deficiency

Bad MethylHg excretion

Quicksilver Scientific Tri-test

• Clearly Reveals source of mercury

• NO provocation (chelation) agents used

• Gives index of excretion ability for each form of mercury for informed treatment options