Dr. Elizabeth Boham:
If we have some variations or some snips in our genetics that can impact how much these heavy metals are impacting our health.
Dr. Mark Hyman:
Hey, everybody. Welcome to The Doctor’s Farmacy. I’m Dr. Mark Hyman, and that’s Farmacy, F-A-R-M-A-C-Y. A place where conversations matter. And if you’ve ever felt heavy, this is a conversation you should listen to. And I’m not talking about heavy sad, I’m talking about heavy metals, which are a rampant problem, far underdiagnosed, underappreciated, and pretty much almost ignored by traditional medicine, and yet, it is driving so many of our health crises.
Dr. Mark Hyman:
And today, I’m so happy to be sharing the story of mercury with you. And it’s a very personal story for me with my colleague and medical director on this very special episode of The Doctor’s Farmacy called, House Call. And I’m going to sit down with so many of my colleagues at the UltraWellness Center in Lenox, Massachusetts. And Liz is just my number one doc.
Dr. Mark Hyman:
She’s the Medical Director of the UltraWellness Center. She teaches all over the world. She’s in the faculty of The Institute for Functional Medicine. She’s one of the best doctors I know. And we are going to talk about mercury. So, welcome, Liz.
Dr. Elizabeth Boham:
Thanks, Mark. It’s great to be with you today.
Dr. Mark Hyman:
So, let’s start with talking about why do you think this is just so ignored? Because Mercury is such a prevalent problem. And when we test people at the UltraWellness Center, we find so many people have not only high blood levels of Mercury, but high total body levels.
Dr. Mark Hyman:
In fact, we did a survey of the 10,000 tests that we’ve done at some point in time, and we looked at the number of people who had toxicity, and it was 40% of the people who came to the UltraWellness Center had high levels of mercury that interfere with their biology. So, why do you think is just so ignored? And what do we have to do to properly discover whether mercury is an issue for somebody or not?
Dr. Elizabeth Boham:
I mean, it’s a great question, Mark. Even the World Health Organization recognizes that mercury is one of the top 10 chemicals of major public health concern. But I think that toxins, in general, in conventional medicine, are often overlooked and ignored. And because we always are thinking about acute toxicity in conventional medicine. And so, often we’re not thinking about the chronic lower levels of toxicity that can have huge health effects as well.
Dr. Elizabeth Boham:
And so, I think, the other reason that sometimes it’s ignored is, we’re often not doing personalized medicine in conventional and how we were trained conventionally where heavy metals, as with any toxin, impact different people differently depending on their toxic load, all of the other toxins they have exposure to, how their body detoxifies, how their digestive system is working, how old they are, right? We know that younger kids are impacted more than some older people.
Dr. Elizabeth Boham:
So, there’s so many things that impact how we’re impacted by these heavy metals, our genetics, our microbiome. And so, I think that sometimes, we look at the whole population and say, “Oh, our mercury levels are coming down in the environment, or we’re working to have them come down,” but not take that individual person, which can be really impacted by this.
Dr. Mark Hyman:
Yeah. Well, it is one of the most important drivers of chronic disease and it’s also one of the most ignored. And, I unfortunately, had a very personal experience with this because I lived in China and was exposed to huge amounts of the pollution. They burn coal, raw coal, for 10 million people in the city. The air was black. And I had an air filter, I clean it out all the time and sucking in all this concentrated mercury.
Dr. Mark Hyman:
And when I get back to the States, the mercury caught up with me and it ended up causing total collapse of my system. So, I got chronic fatigue syndrome. I developed autoimmune disease. My gut stopped working. I diarrhea for years and years. I had severe cognitive dysfunction. I couldn’t focus. I couldn’t sleep. I couldn’t remember anything. It was like I had dementia, ADD, and depression all at once.
Dr. Mark Hyman:
And I also developed severe muscle injury. My muscles were being eaten up and damaged. The mitochondria were being damaged. I developed rashes and sores. My immune system completely screwed up. My hormones screwed up. My thyroid, my adrenal. So, everything screwed up because of the mercury. And I had a really high level.
Dr. Mark Hyman:
And I went to doctor, after doctor, after doctor, and no one could help me. I went to Harvard, I went to Columbia, all the top doctors, and no one really could figure out what’s going on, until I met a naturopath in Maui, actually, over 23 years ago, who said, “Maybe, we should test you for things,” and he said, “But maybe you have heavy metals,” and I was like, “Yeah, yeah, whatever.”
Dr. Mark Hyman:
And I tested it and I have one of the highest levels I’ve seen. Liz and I test people at a time and my level is 187, which is really high. And anything over 20 is bad on a challenge test. So, I know personally how bad mercury can be. And I can tell you practicing functional medicine for almost 30 years, it is one of those incredible things that if you find it and it’s the cause of a person’s disease and you treat it, and we’ll talk about how to treat it in a minute, it literally can transform their lives.
Dr. Mark Hyman:
So, I went from being someone who’s probably going to be on disability my entire life with chronic fatigue syndrome, to being super healthy and fit at 61 and going strong. So, I think, it’s important to understand that if you have some weird ailment and you’re not getting better, and you’ve tried everything, it’s important to look for heavy metals.
Dr. Elizabeth Boham:
Yeah. I mean, they say and we know that heavy metals, mercury, can impact the nervous system, the digestive system, our development. Definitely, our development. So, kids, as I said earlier, are impacted more because they’re young and small humans, so they get impacted by the toxic load in the environment, so that can really impact their development.
Dr. Elizabeth Boham:
It can result in memory issues for young and old, how we learn and understand. Our coordination. It can impact the immune system. It’s associated with autoimmune diseases and immunosuppression, mood issues, sleep issues, right, memory issues, changes in our kidney function, and other functions in the body. And like you mentioned, we often see it snowball like that, right, where just the body just sort of snowballs and gets worse and worse with multiple different things going on.
Dr. Mark Hyman:
Yeah, it’s so true. And I think we know that mercury is the second most dangerous toxin on the planet after plutonium. And it’s prevalent in our food, in fish, in our mouth, in fillings. It’s prevalent often in medication, thimerosal, which is a preservative. It comes from coal emissions and power plants. If you live near a cement plant or a coal plant, you’re going to get the pollution of mercury.
Dr. Mark Hyman:
It’s really prevalent and it’s a potent neurotoxin. It’s the most potent neurotoxin out there. It’s an immunotoxin. Meaning, it can cause autoimmune diseases and all kinds of other issues. And like you said, it creates this cascade of problems that seem often vague like developmental issues in kids, even autism. That’s not to say all autism is caused by mercury, because autism there’s no such thing as autism, they’re autisms. And every kid with autism is a little bit different. It has different causes and treatments.
Dr. Mark Hyman:
But I’ve definitely seen heavy metals to be a factor. And, I think, even weight metabolism, people think that how could mercury be …
Dr. Elizabeth Boham:
It affects the mitochondria like you’re mentioning, right?
Dr. Mark Hyman:
Yeah. So, we know that there’s a real link between environmental toxins and obesity. We call these obesogens and heavy metals are certainly one. I remember a very young fitness trainer, who was like 40 pounds overweight and no matter what she ate or what she did, she would not lose her weight. And we found out she had really high levels of mercury. We chelated her, detoxified her. And we’ll talk about how to do that in a minute. And we found that she was able to really drop the weight very quickly.
Dr. Mark Hyman:
What’s even more frightening, and I think this is sort of, I don’t know I can get the exact stat, you maybe remember it. But they measured the blood levels of mercury in pregnant women, this was in JAMA a number of years ago. And they found that I think it was like one in eight births were from women who had toxic levels of mercury in their blood, which was going to the fetus.
Dr. Elizabeth Boham:
Right. I know, I just looking at the EPA website and they mentioned on epa.gov, they said that more than 75,000 newborns in the US each year are estimated to have potential for developmental delays and learning disabilities because of mercury.
Dr. Mark Hyman:
And where are they getting it?
Dr. Elizabeth Boham:
Right. And that’s a conservative estimate, right? That’s a conservative estimate.
Dr. Mark Hyman:
Yeah. I think it’s more than that, yeah.
Dr. Elizabeth Boham:
Probably, more than that, but that’s a lot, that’s a lot. So, when you’re a fetus, you’re getting it through the placenta, from the mother. So, the mother eats high mercury fish, or they have exposure through the environment, or even their mercury amalgams, right? And then that can get into the developing fetus, through the placenta.
Dr. Elizabeth Boham:
Unfortunately, when we’re breastfeeding, we can share toxins with our newborn, unfortunately. It doesn’t mean that we shouldn’t be breastfeeding, but that does impact the baby.
Dr. Mark Hyman:
Yeah. So, I think that’s right. And the data, I think, was from JAMA, it was from 2003, that 8% of women had concentrations higher than the EPA’s protection recommended amount, which is 5.8, which is still too high, right?
Dr. Elizabeth Boham:
Right.
Dr. Mark Hyman:
And so, zero is the normal level. What’s the normal level of mercury in your blood? Zero.
Dr. Elizabeth Boham:
Right. You don’t want any.
Dr. Mark Hyman:
There is a normal blood sugar, there’s normal cholesterol, but there is no normal level of Mercury. So, when it says zero to 10 on the lab, and 10 is normal, that is just nonsense, because there’s an increasing risk with increasing exposures. And where is it coming from that we see so much mercury? Where are the main sources? And how do people reduce their exposures?
Dr. Elizabeth Boham:
Yeah. I mean, I think the biggest sources are coal burning facilities and mercury is emitted during that coal burning process. It goes into the air and then it gets … Then, that goes into our water supply. And then the mercury then settles at the bottom of our lakes, and rivers and oceans, and bacteria then consume it and produce this methyl mercury, which is a really toxic form of mercury for people. And then, it bio accumulates in the fish.
Dr. Elizabeth Boham:
So, a little fish might have a little bit of mercury, but then the bigger fish eat the littler fish, and then the bigger, bigger fish eat the medium-sized fish, right? And so, the bigger the fish is, the more mercury accumulates, bioaccumulates, into the fish. And so, that’s why the recommendation is to stick with the smaller fish when you’re eating fish. And so, the larger the fish, the shark, the tuna, the king mackerel, you’re going to get way more Mercury, when you eat those larger fish. And so, you want to be avoiding those large fish.
Dr. Mark Hyman:
I think that’s right. And I think the major source is fish consumption. However, the FDA, after decades and decades of evidence showing the dangers of mercury fillings, we call them silver fillings, but they’re not silver, they’re actually mostly mercury, has ruled that children and pregnant women should not be having mercury fillings.
Dr. Mark Hyman:
Now, in most other countries, in Europe and in Canada, they’ve basically already done that for years and years and years. But finally, the FDA, this year, put out a statement that we should not be putting mercury fillings in kids or in pregnant women. And conversely, even if you have them, I’m not saying taking them out. But if you have them, they do off gas, they do vaporize, and you do absorb the inorganic mercury. And we actually can test for this and we can tell whether you have mercury from fish, or mercury from fillings.
Dr. Mark Hyman:
So, it’s really important to understand that it’s not a benign thing to have mercury fillings. And it’s a little scary for people because they’re like, “What do I do, I got a mouthful of fillings.” You don’t want to just go rip them out because it can get worse. In fact, I had a friend who was a doctor, who was just … He should have known better, but he went and had all mercury taken out of his mouth. And they didn’t do it safely. And he ended up causing a massive flood of mercury in his system cause heart failure.
Dr. Mark Hyman:
And we know that heart failure can be linked to mercury. In fact, one study I read years ago looking at what we call, idiopathic heart failure. It means, we don’t know the cause. When they did muscle biopsies, they found there were like 22,000 times the level of mercury in the muscle compared to people who didn’t have heart failure when they did a biopsy.
Dr. Mark Hyman:
And also, arsenic and lead and other things. And I’ve had patients with heart failure, who I’ve literally chelated and treated, who reversed their heart failure and improved their ejection fraction, which is a measure of how much blood your heart can pump out, by simply removing the metals.
Dr. Elizabeth Boham:
So, I was just going to say, like you said, in this past September, the FDA came out with this recommendation to not use the silver fillings or silver amalgams, which contain 40% to 50% mercury in them. That’s a lot and they still do. People come to me every day, and they’re like, “Do they still have mercury in those silver fillings?” I’m like, “They still do.” And they’re still using them because they’re cheap and they’re very strong. They last a long time.
Dr. Elizabeth Boham:
But they said, the FDA said, not for women, women who are at childbearing age, who want to become pregnant, who are planning to become pregnant, who are nursing, children less than six, but also for people who have any neurological conditions or kidney function issues. So, in reality, really, who should we be for, right? Right.
Dr. Mark Hyman:
Yeah.
Dr. Elizabeth Boham:
And I remember …
Dr. Mark Hyman:
That right. I mean, if it was not safe for pregnant women and children, why is it okay for the rest of us?
Dr. Elizabeth Boham:
Exactly. I remember this, I told this story before, but I remember when I first started working with you, and you would look at my mouth and I have this full of amalgams and you would be like, “Liz, you got to get those out.” And I was like, “Yeah, really? You think so? Are you sure?”
Dr. Mark Hyman:
Yeah, yeah, yeah.
Dr. Elizabeth Boham:
And I did that test that can delineate and say, “Is this mercury coming from eating too much high mercury fish, or is it coming from these amalgams?” And the test showed that those amalgams were still emitting enough mercury vapor that was then getting out in my system. And showing up in the test and then it sort of convinced me. Okay, not that I didn’t believe you, I was listening to you, Mark.
Dr. Mark Hyman:
No, no, it’s okay. I mean, who wants to go to the dentist? It’s not like, “Oh, let’s go to the dentist.”
Dr. Elizabeth Boham:
I know. But you’re, right, it has to be done safely, right? You want to work with a dentist too who knows what they’re doing, who uses a dam in your mouth, so it doesn’t get into your mouth, puts you on oxygen, really has …
Dr. Mark Hyman:
High speed suction.
Dr. Elizabeth Boham:
Yes, so that it’s safe for you and safe for the dentist too, right?
Dr. Mark Hyman:
And they should be wearing a gas mask too.
Dr. Elizabeth Boham:
Yeah. And you know, we also, and we’ll talk about this with our cases. It’s really important that you’re in a healthy place, if you are thinking about getting them removed, not only do you want to work with somebody who knows how to do it safely, but you want your body to be healthy, to be having your digestive system working well, to be having good bowel movements, to be sweating regularly, to be eating a really good healthy diet, because even though they do it as safely as possible, this is a major procedure, and you want to make sure the body can handle that removal and replacement with some composite filling.
Dr. Mark Hyman:
Yeah. So, let’s talk about, in a minute, the ways in which we treat people that it’s different. And before we get into that, and we’re going to go through some cases, I want to talk about how we identify the problem. Because often, I read this one paper on mercury, that was hysterical to me, because it was like, well, we measured the blood level, because that’s the easiest place to test mercury.
Dr. Mark Hyman:
It reminds me of the joke of the guy who was looking for his keys under the lamppost and ended up being asked by his friend, “What are you doing?” He says, “Well, I’m looking for my keys.” He says, “Where did you dropped them?” He said, “I dropped them down the road” “So, why are you looking over here?” He said, “Well, the light is better here.” Meaning, we’re used to doing tests for things that we can test, not necessarily where the problem is.
Dr. Mark Hyman:
And so, let’s talk about how we diagnose. And when someone comes in with autoimmune issues, neurologic issues, developmental issues, digestive, whatever, chronic fatigue issues, we really check almost everybody. For me, it’s almost like getting a blood pressure on a person. It’s a basic test to see if we want to screen people for heavy metals, what’s really going on?
Dr. Mark Hyman:
So, how do we begin to think about testing, and what are the sort of different types of tests, blood, urine, and so forth? Hair that we can look at? And what do each mean? And how do we come up with a coherent assessment of someone’s total body burden of heavy metals and mercury?
Dr. Elizabeth Boham:
I mean, I always start with a good history. I mean, I think, that’s important to get a sense of somebody’s environmental history, what’s their toxic exposure over the lifetime? How much high mercury fish are they eating? How much did they eat in the past? Do they love tuna? Like, sushi or tuna? Or how many silver fillings do they have in their mouth? How old are they? When were those silver fillings placed? Over years and years, they emit less mercury, so.
Dr. Elizabeth Boham:
And then of course, you want to know what is their health issue? What are they dealing with? It’s really important to take a really good, careful, detailed history. And then, it helps us determine if evaluation for mercury makes sense to do. So, then we look at, you can look at blood levels, but like you mentioned, sometimes, blood levels don’t give us all of the information.
Dr. Elizabeth Boham:
And so, we’ll often do the Quicksilver Tri-Test, which is a great test that we had talked about before that looks at blood, urine and hair, and it tells us about methyl mercury and inorganic mercury. The inorganic, more likely coming from your silver amalgams. And that can help us determine should these amalgams be safely replaced when that person’s body is ready to have that process done.
Dr. Elizabeth Boham:
So, that’s the test I like, and it really helps me get a sense. We can also …
Dr. Mark Hyman:
Yeah. So, before you go on to the next test, the blood test is important understand because if you have a blood test, it’s what your doctor will typically do. So, I think, I have mercury issues. Well, let me check your blood. So, they checked the blood, and it’s zero. But you’ve been eating tuna when you were in college three times a day for 10 years, then you stopped. Well, if you’ve eaten no fish, over the last 90 days, or 120 days, your blood levels are going to be pretty negligible or zero, but you could have accumulated huge amounts of mercury.
Dr. Mark Hyman:
The other thing is, with silver fillings or amalgam fillings, mercury fillings, you might not have a very high blood level because it’s in smaller doses, but it’s extremely toxic. And so, you often will miss it. So, just because your blood level is normal, does not mean you do not have a problem with mercury. And that’s why we look at, for example, the QS Tri-Test where we measure urine, hair and blood, your detoxification of the metal, as well as whether it’s coming from fish or fillings, or pollution.
Dr. Mark Hyman:
But the most important test is the one you’re about to tell us about, which really tells us and it’s the best approximation we have now. I don’t think it’s a perfect test of what our total body load is, and how much we’ve accumulated over our lifetime. So, what is that test and tell us about the pros and cons and the challenges and the controversies about it?
Dr. Elizabeth Boham:
Absolutely. So, what you’re speaking about is the urine toxic metal test, which is a provoked heavy metal challenge test, where we collect somebody’s urine first thing in the morning and then we give them a chelator. Now, we are typically using DMSA. There are other chelators you can use for this test. But at our practice, we often use oral DMSA.
Dr. Elizabeth Boham:
And then, they take the chelator, which just binds to the heavy metals in the body. And then we collect urine, their urine for like six hours. And then, we get a sense of past exposure. There is a lot of controversy about this test. And it is something that I talk to every patient about, if we’re even thinking about doing the test, because they have to understand the pros and cons, as you mentioned.
Dr. Elizabeth Boham:
And there’s no really standard norm for what your provoked challenge should be. And one of the reasons for that is that, a lot of different clinicians do it differently. So, one clinician may use a different chelator or they might do it IV, or they might do it for a different amount of time or a different dose. And so, that’s one reason that you have to make sure you’re comparing apples to apples.
Dr. Elizabeth Boham:
And so, the companies often don’t give you a reference range for what is normal. So, nobody’s come up with what is normal …
Dr. Mark Hyman:
Well, normal is zero, Liz. I mean, normal is zero. We should not have mercury in our bodies, we should not have lead or arsenic or cadmium, the level is zero. So, the question is, what above zero is a problem? And I’ve seen people, for example, who had very high levels but their bodies seem to accommodate to it. And I personally had mercury for years without being sick.
Dr. Mark Hyman:
So, I was like two or three years, when I came back from China, I mean, probably two years, where I was okay. But then something happened, it tipped me over and everything just fell apart. So, I think, you can’t really just assume that any level is good. And you have to assume that if people are sick, that it’s really worth getting it out, or people are at risk for diseases. You’re at risk for autoimmune disease, you’re at risk for diabetes, you’re at risk for dementia, then it’s really important proactively to address heavy metals.
Dr. Elizabeth Boham:
That test and some other tests that we can talk about help us sort of stratify what group somebody is in, right? Like are they in a group where we just need to work on general good, healthy detoxification, eating a good healthy diet that’s rich in phytonutrients, making sure you’re eating a lot of fiber just to help the body detoxify, right? Or maybe, this person needs to be a little more aggressive, or maybe, they need to be doing a chelation type protocols.
Dr. Elizabeth Boham:
We look at all the different tests. We also look at their genetics and how they produce glutathione and how they detoxify. We can look at markers like oxidative stress that can give us a sense of how much these heavy metals have caused illness in their body. And, of course, we look at their symptoms.
Dr. Elizabeth Boham:
With autoimmunity, we can also look at antibodies against heavy metals or toxins. And that can sometimes give us a sense of, are those heavy metals creating or maybe part of the trigger for an autoimmune process going on in that person’s body? So, there’s a lot of things we look at when we’re working to stratify how aggressive our treatment approach needs to be.
Dr. Mark Hyman:
Yeah. And the important thing is people realize is that, if you do have heavy metals, you cannot just go in and start ripping out your fillings or start chelating, or doing other things. You have to really get ready for it, because it’s a big strain on the body. And if you don’t do it right, you can make people sick. And we learned years ago in functional medicine that we need to follow a couple of steps.
Dr. Mark Hyman:
One, we need to mobilize the metals, which often is using chelators, whether they’re natural chelators or medication chelators like DMSA, which pull the metal out of the cells and storage tissues. Then, we need to increase circulation and transport to the liver and kidneys. So, lots of fluids, exercise, lymphatic circulation, all really, really important.
Dr. Mark Hyman:
And then, we need to upregulate all the pathways in the liver that start to mobilize the mercury, which involves boosting glutathione. And we’re going to talk about how to do that, which is almost like the sticky fly paper that the metals bind to, and then you get rid of it. And then, we need to make sure it’s getting out of the body, so you need to poop and pee and sweat. Sauna is very helpful. And there’s a whole science to doing this correctly, which is important because if you do it incorrectly, you can really cause trouble.
Dr. Mark Hyman:
So, let’s talk about some cases, because, I think, they’re really illustrative. I can share my case a little bit, but I think I’d love to hear from you about that 40-year-old woman, who is always getting sick, and always getting infections, and always got sick after she travels. So, what clued you into that she might have metals and what did you find, and what did you do?
Dr. Elizabeth Boham:
Right. So, like you said, she was in her 40s. And she came to see me about three years ago and she picked up every virus that was going around, every stomach infection, every cold her kids brought home. She was always getting sick. She was that way when she was a kid too. She got lots of ear infections. She was on lots of antibiotics. She got strep throat all the time.
Dr. Elizabeth Boham:
And she came in frustrated with the fact that she was always getting sick. And she did, when we did a full history and I did a physical exam, I saw that she had multiple silver fillings in her mouth. She had had lots of cavities as a kid. They were quickly filled with silver amalgams. I think, she had 12 silver amalgams in her mouth that were placed when she was a kid.
Dr. Elizabeth Boham:
And so, she was also wondering, were they something she should have replaced. And I was too, I was wondering how much those amalgams were impacting her immune system, because as we talked about heavy metals and mercury, definitely can stress out the immune system. They can make the immune system not work as well. And they can also make the immune system make mistakes and fight itself like an autoimmune condition. So, they’re tied in with both ends of the immune system not working as it should.
Dr. Mark Hyman:
Yes. Yeah. And it can even increase allergies and so forth, right?
Dr. Elizabeth Boham:
Absolutely. Right. Right. Like, reacting to everything. Absolutely. So …
Dr. Mark Hyman:
When I was sick, I’m basically eating turkey, broccoli and brown rice for like six months, because I didn’t have anything and my tongue would swell up, my eyes would get all swollen, I get raccoon eyes, and my skin would get rashes. I mean, it was horrible.
Dr. Elizabeth Boham:
You’re reacting to everything.
Dr. Mark Hyman:
Everything. Now, I can eat anything. It’s like, I repaired my system. So, that’s the beauty of this, is that, when you use the science of functional medicine, which we do at the UltraWellness Center, which we really filter everything through the lens of functional medicine. We’re able to help people where no one else can be helped. And I am a perfect example of that. My life would have been totally different if I hadn’t discovered functional medicine, if I hadn’t found out I had mercury, if I hadn’t learned about how to detoxify from it, and learn how to use this in all my patients.
Dr. Mark Hyman:
So, basically, you found this woman. She had a high inorganic mercury from her fillings. And so, tell us what you did to help her heal and boost her immune function?
Dr. Elizabeth Boham:
Yeah. Yeah. So, she also had a lot of digestive issues, acne, a lot of bloating after she ate. I mean, she was on lots of antibiotics as a kid. So, she had a bunch of different things going on. We did do that test that looked at, could this mercury be coming from her fish or the air, or how much was coming from her amalgams, and it definitely showed that there was some concern about the amalgams, the silver fillings.
Dr. Elizabeth Boham:
And so, we wanted to help her get those out safely. She found a biological dentist, who could do that for her. But in the process, we also wanted to support her body, so that she would handle that process of getting them removed. So, we added things like, glutathione, like you said, talked about the sticky molecule. It’s the master detoxifier in the body, and is really necessary for the body to remove toxins and heavy metals.
Dr. Elizabeth Boham:
We really made sure her diet was rich in fiber, because that’s important. We made sure her diet was rich in those cruciferous vegetables, broccoli, cauliflower, cabbage, kale that helps the body produce glutathione. We gave her some NAC, N-acetylcysteine, which is a precursor to glutathione. We made sure she was getting enough protein in her diet, because protein is really important for detoxification.
Dr. Elizabeth Boham:
And then, she slowly had her amalgams replaced. She did, I think it was three different sessions she went in for. And before and after each session, we gave her even a little more support through some of her supplements. And then, for a while afterwards, we put her on a whole protocol that includes a binder to help with finding the toxins. Liposomal glutathione, which is a glutathione that comes through the skin, through the oral mucosa, through the mouth. And different nutrients to support that detoxification process.
Dr. Elizabeth Boham:
And she did that for three to six months. And when we rechecked her, her mercury levels were much lower. And the great thing is that, she really started to feel better in terms of her immune system. She didn’t get sick as much. She didn’t get every cold and flu around. She was kind of amazed at how well her immune system was working.
Dr. Elizabeth Boham:
And I just spoke to her recently. So, she was thrilled because with COVID going around, she was feeling so much more comfortable with how well her immune system was working. She felt like she had a really good control over not getting every single virus going around.
Dr. Mark Hyman:
That’s so great. So, basically, what we described is identifying a high level of metals are coming from her filling. She got them safely removed. And then, you went through a very methodical process of supporting her body’s own detox system. And one of the things we do is use food as medicine. And people don’t understand how powerful food is in helping detoxification.
Dr. Mark Hyman:
And personally, when I go to the grocery store, I’m looking for drugs. I’m looking for the drugs in food that help upregulate the pathways in my own body that I know I need to boost detoxification. The next case we’re going to talk about, some of the genetics involved in impaired detoxification. But for me, I have really crappy detox genes. So, I’m not great at making glutathione. So, I always make sure I eat plenty of cruciferous vegetables every day, two to three cups of broccoli, collards, kale, brussel sprouts, kohlrabi, whatever I can get my hands on, I make sure that’s a staple in my diet.
Dr. Mark Hyman:
And I also make sure that I’m eating things like garlic and onions. I’m using things like artichoke hearts and artichokes, which are great detoxifiers, and many other phytochemicals. Rosemary, lime, lemon peel, and many, many things we use every day to help us boost our own pathways.
Dr. Mark Hyman:
But in a very sophisticated way, in functional medicine, we understand how to turn on all the superhighways of detoxification using food, using amino acids, which are from protein. And you didn’t mention this, but protein is super important for detoxification because a lot of the pathways involve amino acids. We also need the right B vitamins to methylate and get rid of the metals.
Dr. Mark Hyman:
We also need certain nutrients like selenium and zinc to help us boost our detox system. And, of course, what you mentioned also is very important, it’s not just taking all these things to rev up the detox process, but also to make sure we’re getting rid of it, which means we need binders in the gut. Things like silica or alginates and other binders, pectins, which can help to bind the metal so you don’t reabsorb them and you get rid of them from your body.
Dr. Mark Hyman:
And what happens is just striking. I’m just going to kind of quickly do a few stories and then I want to hear about this last case. And I’ve seen not only myself, but I’ve seen patients, for example, autoimmune diseases like ulcerative colitis, that I tried all my normal tricks on functional medicine, nothing worked. We got rid of the metals, they got better.
Dr. Mark Hyman:
Crohn’s disease, I’ve seen people with heart failure, reversed their heart failure getting rid of heavy metals. I’ve seen people who have dementia and you’re going to talk about that, and memory issues are getting better. I’ve seen kids with autism improve. I’ve seen people lose weight in ways they couldn’t lose weight. I’ve seen depression go away, insomnia, chronic fatigue.
Dr. Mark Hyman:
I mean, all these problems, which are really difficult to treat using traditional medicine often become quite simple when you actually identify the root cause. And that’s what functional medicine is about. It’s looking at the root causes. It’s getting rid of the things that are causing the problem, like metals in this case, and providing all the things the body needs to function better. And that’s why we call it functional medicine, because it’s about how do you get to optimal function.
Dr. Mark Hyman:
I love the next case because we’re seeing basically an epidemic of dementia. We have five million people now, soon to be 14 million. There’s so many with memory loss. By the time you’re 85, you have a 50% chance of having dementia. It’s a real problem and it’s costing more than any other disease because of all the caregiving and disability.
Dr. Mark Hyman:
When you look at sort of the end-to-end cost, it’s more expensive than cancer or heart disease. And it’s getting worse and worse and worse, because we’re living in a society that’s full of what I call dementogens. Which is not only the metals, but it’s also our diet, it’s stress, it’s lack of sleep, it’s our gut microbiome damage. It’s the environmental toxins and so forth that we chatted about.
Dr. Mark Hyman:
So, I think for me, heavy metal screening is just about as important as checking your blood pressure or your blood sugar or your cholesterol, and it should be standard practice. And I still don’t quite know why it’s not. People understand the medicine lead may be an issue, although they don’t really treat it. But mercury is just this blind spot. And if anybody’s listening and they want to fund a study where you could just take 1000 people, track them, and do challenge tests on them, and see what the levels are in the background population.
Dr. Mark Hyman:
No one’s really done that. And then see how that correlates with various illnesses and issues, but this is really sort of this big black hole in medicine that if we actually were able to share what we know in functional medicine with the greater medical community and they were to listen, we would really be able to turn around so many people with difficult to treat chronic illnesses.
Dr. Elizabeth Boham:
Yeah. And like you mentioned, you know how our genetics are, if we have some variations or some snips in our genetics that can impact how much these heavy metals are impacting our health.
Dr. Elizabeth Boham:
And so, for this person, he was missing one of the glutathione producing genes. He was GSTM1 absent, which is very common, but can definitely impact how well somebody can produce glutathione and detoxify. He also had a variation in his APO E gene, which he was a 3, 4, which we know increases his risk for memory loss and dementia. But we know one of the reasons it might be doing that is because people with that genetic variation don’t handle heavy metals as well. And so that’s a kind of an interesting thing. So, we’ll look at these …
Dr. Mark Hyman:
That’s me.
Dr. Elizabeth Boham:
Yeah. Yeah.
Dr. Mark Hyman:
I think you too, right?
Dr. Elizabeth Boham:
I am also missing the glutathione gene. My APO E is okay, but my glutathione gene is not so good.
Dr. Elizabeth Boham:
Yeah. So, this guy, this gentleman who came to see me, he was 65. And he was concerned about his memory. He had a pretty intense, high powered job. He worked in New York City. He was very successful and working very hard, but wanted to be able to continue to work hard and work well. And he was noticing that his memory was not as good as it used to be. And his mom had some dementia in her 70s. And his mom’s dad, so his maternal grandfather had some memory loss too as he got older.
Dr. Elizabeth Boham:
So, he wanted to be as proactive as possible. He was somebody who made really good food choices most of the time. He was trying to eat healthy. He was exercising most days. He didn’t sleep enough. He was definitely working a little too much, but he wanted to do as much as he could to stay healthy.
Dr. Elizabeth Boham:
And so, as I said, we do a really good detailed history and in terms of environmental history when people come in to see us. And we noticed that one of the things he wasn’t doing so well is he was picking up sushi often for lunch, and he loved tuna sushi, sushi made with tuna. And so, he did it very often, many, many days at lunchtime, thinking it was a good healthy choice. But it made me concerned that maybe we should be looking at his mercury levels. He had …
Dr. Mark Hyman:
Sushi would be fine and tuna would be fine if it wasn’t for us damn humans that have put all the coal in the atmosphere, which has gone into the oceans and is taken up by the algae and then is eaten by the little fishes, that are eaten by the bigger fish, and so on until we’re at the top of the food chain. And it is a bad news situation.
Dr. Elizabeth Boham:
Yeah, yeah, you’re right. We can’t be blaming that tuna. We got to be blaming ourselves for it, right? And he had his amalgams replaced. So, he had them replaced a few years ago, because he just didn’t like the silver fillings in his mouth. And he had composite put in, but he wasn’t really sure if it was done safely. He really wasn’t really paying attention at the time.
Dr. Elizabeth Boham:
So, for him, we chose to do a provoked heavy metal challenge test. And that test we spoke about where you take a chelator and collect urine, and his mercury level was about 110. And as you mentioned, there’s no good level but that was definitely concerning to me. It made me say, “You know what, we’ve got to work to bring this down. This is too high.” And his blood level, I would say, I definitely see higher blood levels when people live in urban areas. So, I think his blood level was a little bit high too, probably from maybe recent tuna intake, but also just living in New York City, we see some higher levels, unfortunately.
Dr. Elizabeth Boham:
So, we started him on a medical food, which is a food, it’s a powder that has amino acids like you mentioned, the building blocks of protein, which are necessary for the body to detoxify. It also had a bunch of minerals in it, including selenium which is necessary for the body to make glutathione and molybdenum and zinc and just a really nutrient rich medical food. I also put him on, it had some milk thistle in it, which supports the liver and helps with detoxification.
Dr. Elizabeth Boham:
And so, we really cleaned up his diet. We gave him some greens, a green powder also. So, of course, we want people to be getting all these phytonutrients from the plant foods, but he needed a little extra support. So, we gave him greens powder and some sulforaphane, which is the component that’s in cruciferous vegetables that helps the glutathione work so much better. So, we did a bunch of things just to support his body.
Dr. Elizabeth Boham:
And then, we started him on a detoxification chelation type of a procedure, where we did it orally. But every three days out of every two weeks, we gave him some DMSA to help pull the heavy metals out of his body. But as we’ve mentioned earlier, it’s really important that we support the body, get the body ready to do this whole process. So that was one of the things we really focused on.
Dr. Mark Hyman:
I think that’s so key. And I think we have to understand that there is a science to detoxification. It’s not like, “Oh, I’m going to detox and go through a cleanse.” This is really a very sophisticated medical process that uses food and exercise and saunas, that uses tons of fiber and binders to bind the metals and in a sophisticated way knows how to upregulate all the pathways and the highways to get rid of junk in your body.
Dr. Mark Hyman:
And it requires the amino acids. It requires minerals like zinc and selenium. It requires all the B vitamins like B12, folate, and B6. It requires the supplements that can help boost glutathione like N-acetylcysteine, lipoic acid, and others. And it requires eating a lot of foods that have detoxifying properties. And when you put all that together, you can really profoundly impact the body’s load of metals.
Dr. Mark Hyman:
And on top of that, sometimes you do need a chelator, like DMSA, which is a drug. It’s an FDA approved drug approved for lead chelation in kids who are very sick, but it also works against other heavy metals. So, we often combine that with these other practices and it’s very powerful.
Dr. Mark Hyman:
And then one of the things you mentioned about this guy, I don’t want to skip over, is his APO E 3, 4 gene and the GSTM1 gene. APO E is a gene that affects lipid metabolism and many other things. But the APO E 4 variant of this gene is highly correlated with Alzheimer’s, so if you have two, four variants like in other words, if you are one from your mom and one from your dad, you have about a 75% risk of getting Alzheimer’s.
Dr. Mark Hyman:
It’s not inevitable and we’ve had patients who have a double four who don’t get it because they really focused on their lifestyle and cleaning up everything, and you can prevent it, but it makes you much more likely. And what’s interesting is that the APOE4 protein that’s made from that gene doesn’t have the amino acid cysteine on the chain. And cysteine is one of these really important amino acids, that is the building block for glutathione. It’s a sulfur containing amino acid.
Dr. Mark Hyman:
So, these people just cannot clear the metals. And there was a study that was done in Australia where they took people with APOE4 and they did challenge tests, like we’re talking about. And they found that those who had APOE4 had way higher levels of mercury.
Dr. Mark Hyman:
So, it’s another way to think about it. And the glutathione gene we talked about, I had an absolute level. And what happened to this guy is he got better, right? What happened to his memory?
Dr. Elizabeth Boham:
We did a process. We did this whole protocol for three months and then rechecked him and his levels were cut in half, they were around 54. And then we continued. We continued another three months. And then they went down to 10. And then we pulled away the chelator but continued more detoxification support for him.
Dr. Elizabeth Boham:
But what he really noticed was just feeling better. His energy was better, his focus was better, his memory was better. And he was thankful because he feels like this is going to really help him do well way into his 80s and 90s in terms of his overall health and his cognition.
Dr. Mark Hyman:
Yeah, absolutely. And I think it’s one of those uncharted territories in medicine and it breaks my heart because I see so many people suffer needlessly from this. And sadly, if you go to your traditional doctor, they’re not going to know what to test. They’re not going to do the QS Tri-Test. They’re not going to do a urine challenge test where you take a pill and get your urine for six hours and see what your load is. They’re not going to know what to do to tell you get rid of the mercury from your body except stop eating sushi.
Dr. Mark Hyman:
They probably won’t tell you to get your fillings out because the American Dental Association says it’s not an issue, even though the government and the FDA said, “Yeah, it is kind of an issue.” And I think if you have any kind of chronic ailment, it’s definitely part of a screening evaluation. And you really need to see a functional medicine doctor. Someone who’s really trained and experienced in this and you don’t want to be messing around with it if you don’t know what you’re doing because you can hurt people.
Dr. Mark Hyman:
I’ve written a lot about this. I have a couple of blogs on drhyman.com that are going at great detail about how to detoxify, how to identify things. I wrote them years ago, but they’re still pretty current. If you go in and just type in mercury in the search engine on my website, drhyman.com, you’ll find the article. There’s a lot of background, they will put them in the show notes.
Dr. Mark Hyman:
But I think this is such an important area, Liz, and I think at the UltraWellness Center, this is what we do. We are medical detectives. We look for all the factors that may be driving a disease. And the truth is, it’s so, we call it, pleomorphic. In other words, it can show up in so many different ways.
Dr. Mark Hyman:
In one person, it might cause memory issues. In another person, it might cause an autoimmune issue. Another person might cause digestive issues. Another person might cause allergies or depression or obesity. How do you know what’s causing what? So that’s what functional medicine is. It’s really a method of finding the root cause using both medical history which we learned but also looking at … we do a very detailed environmental history. Most doctors don’t do an environmental history. We want to know everything.
Dr. Mark Hyman:
You’d be surprised sometimes what you find by listening to people, “Oh yeah well.” You know, one woman, she had Parkinson’s at 50 years old and it turned out she grew up in the Bronx and had cockroaches and rats running all over her. And when she moved to Long Island to get out of the city when she was older, she was a total fanatic about spraying her house for cockroaches and rats inside and outside every month with a chemical called chlordane, which is now banned. It’s a pesticide and she got Parkinson’s from that. But unless you dig in and figure it out and then we had to detoxify her.
Dr. Mark Hyman:
So, I think it’s really important to understand that these are prevalent problems that heavy metals, environmental toxins, do cause disease. Doctors are poorly trained in that as they are in nutrition. And that if you really want to get help from a problem that you think is just hanging on, whether it’s everything from MS to digestive issues, headache, whatever it is, you’ve got to know how to think through these problems and this is really what functional medicine is all about.
Dr. Mark Hyman:
In the UltraWellness Center, we’ve been doing this for decades. And it’s so exciting to see, like the cases you shared with someone who’s getting sick all the time, someone who is having early dementia. That you can reverse these problems if you identify what the issues are. It’s pretty exciting.
Dr. Mark Hyman:
Any last thoughts about mercury, Liz, and what we should be thinking about that? Because by the way, this applies to all heavy metals like arsenic, lead, cadmium, we see a lot of that. Mercury is probably the worst.
Dr. Elizabeth Boham:
Yeah. I mean, I just want to thank you, Mark, because this is an area like you said you’ve written about for years and years and you’ve been talking about for years. And when you really encouraged me to move forward and get my amalgams replaced and support my detoxification system, it made a world of difference for my health too. My immune system got so much better. My cognition got better. I was able to focus more during the day and I didn’t get as tired, but definitely I didn’t get as sick as often.
Dr. Elizabeth Boham:
So, I really appreciate everything that you’ve helped me learn over the years in this area because and not just for myself but my patients. It is now an area where you’re like, “This person is not getting better. Why are they not getting better? I’ve got to dig deeper in terms of their detox system.” And it’s always the area where we’re like, “Oh that’s why.” We’ve got to really support that area. So, thank you.
Dr. Mark Hyman:
Yeah, that’s true. It just comes up in all kinds of ways. I remember a group of people I’ve been treating who are Special Forces soldiers. And these guys are the toughest of the tough. I mean, they can tread water in 30-degree weather for like three hours, and they tread in water for three hours. These guys do 4000 push-ups. I mean, these guys are no pushover. I mean, I’m exaggerating obviously.
Dr. Mark Hyman:
But they are superman and a whole bunch of them were getting really sick. And the military like, “Oh they’re just complainers. They’re just this,” and sort of dismissed them. And one of the key leaders was an army ranger who was a blast expert and their job was to blow stuff up. So, they would go on these blast houses and train other soldiers how to blow stuff up and they would run explosive and shoot guns. And these guys’ levels of metals were off the chart, mercury and lead.
Dr. Mark Hyman:
And no one did identify within the military and we were able to start to treat these patients, chelate them, fix their immune systems, fix their neurologic systems, and these guys who had chronic fatigue and were dysfunctional, having to go on disability, these are special forces soldiers. They got better.
Dr. Mark Hyman:
And you’ll encounter an article about how they were treated and they got better and how scientists at Mount Sinai in New York, which are lead experts said they’ve never seen anything like this. They’ve never seen measuring lead in the bone before and after and seeing it come down because it just doesn’t do that. Well, yeah it does, if you know what to do.
Dr. Mark Hyman:
And that’s really the whole point of functional medicine. It’s really getting people to the answers they need, learning how to navigate this landscape of disease in the 21st century using 21st century medicine which is functional medicine, and helping people where really other approaches really don’t work.
Dr. Mark Hyman:
So, I’m just so happy to be able to be practicing functional medicine. It has been the greatest blessing of my life and to be able to do it with you, Liz, and our colleagues at The UltraWellness Center. It’s just so fantastic and it’s so gratifying because people actually get better. Not like we were trained in regular medical school, you have to manage the diseases and people just don’t actually get better.
Dr. Elizabeth Boham:
Me too, Mark. And I’m so grateful to be with you today. So, thank you for having me.
Dr. Mark Hyman:
All right. Well, thank you everybody for listening to this week’s House Call. If you’ve enjoyed this episode of The Doctor’s Farmacy, please share with your friends and family. Subscribe to our podcast, leave a comment. We’d love to know if you’ve had heavy metals, what you’ve done, how it’s worked, what’s happened to you, and share with us your insights, and we’ll see you next week on The Doctor’s Farmacy.
