Heavy-metal exposure is considered in the assessment of patients with fatigue. Industrial pollution can introduce chemicals and heavy metals into the air we breathe and the food we eat. The sources discussed here include paints, wood-treatment products, insecticides, pesticides, oil combustion, vaccinations, marine pollution (including heavy metals and PCBs in fish) and amalgam fillings in teeth.
Amalgam fillings mainly consist of: mercury, with a smaller amount of silver, copper, zinc and tin. Mercury from amalgam fillings is partly responsible for fibromyalgia, CFS, MS, depression and anxiety attacks. I always advise patients with severe fatigue symptoms (and also patients with autoimmune diseases such as rheumatism and MS) to have amalgam fillings removed if they have more than three.
For patients with amalgam fillings or a high intake of fish, the assessment described here uses a DMPS challenge test to investigate mercury exposure. DMPS is a chelating agent administered intravenously or orally. Urine is then collected for six hours and analysed for mercury excretion. I use this measurement to assess mercury burden. In my view, laboratory reference ranges require careful interpretation, particularly when assessing chronic exposure; elevated blood mercury is more apparent in acute poisoning.