Heavy Metals And Health: The Untold Story - Transcript

Dr. Elizabeth Boham: We know there's a connection with lead and other heavy metals and hypertension, cardio vascular disease, digestive issues, and the immune system, which I think is so fascinating. Dr. Mark Hyman: Welcome to the Doctor's Farmacy. I'm Dr. Mark Hyman. That's Farmacy with an F, F-A-R-M-A-C-Y. Today, we're having a special episode of The Doctor's Farmacy called House Call with my colleague and friend, Dr. Elizabeth Boham, the medical director at the UltraWellness Center. She's on the faculty of the Institute for Functional Medical. She teaches physicians and providers all over the world about how to implement what we're doing here at the UltraWellness Center. She is just an awesome human being, and as what every doctor should, an MD, who's got a specialty in nutrition and a nutritionist, a dietician, with her RD, and an exercise physiologist, so she's like a triple threat. And she's an awesome human being. So, welcome back to The Doctor's Farmacy, Liz. Dr. Elizabeth Boham: Thank you, Mark. Thanks for having me. Dr. Mark Hyman: Okay, today we're going to talk about something heavy, heavy metals. Heavy metals, lead and mercury to start. There's lots more, but those are the two most common metals that are in our environment that we're exposed to. I don't know about you, but the only thing that I learned about toxicity in medical school was acute poisoning. We didn't even learn about chronic low level toxicity. Now there was some awareness that lead was a problem and that lead in kids caused behavior issues, developmental issues, impaired cognition, and all kinds of stuff. But we really didn't learn much how to treat it. We didn't learn how to evaluate it. We didn't learn how to test it. Dr. Mark Hyman: Yet, in my experience, and I'm curious to hear your experience, it's one of the most important and unappreciated factors in solving the puzzle of chronic disease for so many people with autoimmune disease, with depression, with dementia, with ADD, with autism, digestive issues, with so many things. It manifests in so many different ways. People are just not aware of it and doctors don't even think about it. They might check your mercury level or they might check your lead level in your blood, but that's not really that helpful most of the time. Dr. Elizabeth Boham: Absolutely. We did learn about lead and high levels of lead and lead toxicity, like you mentioned. But one of the things we really didn't focus on in conventional medical school training was the concept of toxic load and all of these toxins we're getting exposed to. Sometime small levels of multiple different toxins are really what pushes the body over the edge. So we know that a lot of lead is bad, and a lot of mercury is bad, but what we also know is a little bit of a lot of different toxins can be really detrimental for some people and can make that level of lead that isn't crazy off the charts, but be really damaging to their health. Dr. Elizabeth Boham: Like you said, we see it connected to all sorts of different neurological diseases, developmental disease, for kids, they're just doing so much growing and development, and if there's a toxin that their body has to deal with, it really impacts that growth and development, so we see it associated with autism, and kids with ADHD, and kids with other development disorders. Dr. Elizabeth Boham: Even hypertension, we know there's a connection with lead and other heavy metals in hypertension, cardiovascular disease, digestive issues, and the immune system, which I think is so fascinating. Heavy metals and other toxins have been associated with causing depression of your immune system, so getting more frequent infections. And also like you mentioned, autoimmune disease. So we know that heavy metals can be associated with triggering, one of those things we think about when somebody's got autoimmune disease and we're wondering what's going on, what is triggering this? It may be some toxin. Dr. Mark Hyman: Yeah, I remember this guy when I was at Canyon Ranch years ago. He had ulcerative colitis. He was wasting away, and I tried all my functional medicine tricks, and an elimination diet, and a gut repair, and the five hour program, and this and that. It just wasn't working. I'm like, "God, okay, I'm going to back to the basics." What are the five things that cause all disease? What am I missing? What have I not tested for? Well, heavy metals, they can be immunotoxic. His mercury levels were off the chart. We chelated him, got the mercury out of his body. His colitis went away, gained weight, and was fine. Dr. Elizabeth Boham: This is absolutely what you have taught me over the years of working with you is like when somebody's not getting better, okay what am I missing? So often, it's toxins, and a lot of times, it's heavy metals, where somebody's not getting better. I remember when you told me, you looked in my mouth after having cancer at the age of 30, and you looked in my mouth, and you're like, "You have to do something about those amalgams." I dragged my toes for a little while, but it was really helpful for my health. Dr. Mark Hyman: Who wants to go to the dentist, right? Dr. Elizabeth Boham: Right. Dr. Mark Hyman: Now the FDA has finally come out and said dental fillings are not safe for pregnant women and children. Which begs the question is, "Why are they safe for the rest of us?" Dr. Elizabeth Boham: Right, absolutely. Dr. Mark Hyman: In many countries, they're banned. In Europe, they're banned. In Canada, they're recognized as not safe. I think we are in this sea of toxins, like you said, and it's the total. So one cookie may not be bad for you and give you diabetes, but if you eat 30 or 40, you're going to get diabetes. The same thing with these toxins, and it's not just one toxin, like you said. These low level toxins that we're exposed to, the plastic, the flame retardants, the pesticides, BPA, phthalates, parabens, all the stuff that we're constantly exposed to does put a wear and tear on our detox system. Dr. Mark Hyman: But the one thing that I found is that these heavy metals are not necessarily low level toxins. They can actually be extremely high, given a patient's exposure and what's going on. So for me, and I don't know what it's like for you, but for me, we see a lot of chronically ill patients here at the UltraWellness Center. For me, it's like checking someone's blood pressure. It's just everybody gets a heavy metal test. Dr. Mark Hyman: There was one patient recently, who I just saw her, and I did not order a heavy metal test on her, although I probably should have. Because she had no fillings, and she was a vegetarian her whole life, and she never ate fish. So my gosh, she's not going to be mercury. But then I was like, "Wait, she was in the military. Maybe I should have checked because she could have lead." She didn't do a lot of blast or gun stuff, but she was probably shooting guns. I've had patients, one guy who was at King, who used to shoot guns all the time, and he had really high lead levels, and he had diabetes, and all these other issues. Dr. Elizabeth Boham: Yes, I had a hunter as well, who had high levels of lead and mercury. I'm assuming the lead came from the guns, from the shooting, right? Dr. Mark Hyman: Yeah, absolutely, the fumes from the shooting of the bullets for sure. I remember I had a young student once who wanted to do a research project with us. I asked her to work with a lab that we used to check heavy metals. Because we've done 10,000, 20,000, 30,000 heavy metal tests over 20 years. I had them pull all my patients. I had them analyze the results. We found that 40% of those patients who showed up with some chronic illness, who we tested, had significantly elevated heavy metal levels. Dr. Elizabeth Boham: I believe it. It's huge. Dr. Mark Hyman: That may not be the general population. We're talking about people who come in who have stuff wrong. Dr. Elizabeth Boham: Who are sick. Dr. Mark Hyman: It's called selection bias. But still, if you're going to the doctor and you got a problem that no one can figure out, it's got to be right at the top of the list. Gluten, [inaudible 00:07:35], gut, these are the functional medicine things that tend to get ignored with traditional medicine. Dr. Elizabeth Boham: Yeah, so we should talk a little bit about how we check. You were just mentioning that. We can check heavy metals in the blood, which is good to check for, especially for acute toxicity or acute exposure. But the blood turns over every three months, every 90 days. So when you're checking for heavy metals in the blood, you're really mostly looking at recent exposure to heavy metals. Dr. Elizabeth Boham: We can check heavy metals. There's a great test we look at a lot, we'll talk a little bit more about it, that looks at the comparison of blood, hair, and urine. It looks at not only mercury levels in each of those three components, how is the body mobilizing it, and also tells us a little bit more about the comparison of inorganic and methylmercury, we'll talk more about that. Dr. Elizabeth Boham: We also can do a provoked heavy metal challenge test, where we give a chelator and collect urine for six hours. That tells us about stores of heavy metals in the body. So if you're wondering if somebody got exposed two years ago or five years ago, because the body will hold onto heavy metals. We know that lead gets stored in the bones. So you get a sense of what exposure somebody's had in the past with doing that provoked heavy challenge test. Dr. Mark Hyman: This is really important what you're saying because most traditional docs will check your blood level. Now if you haven't eaten fish in three months, your level's probably going to be zero for mercury. If you don't have any acute on any exposure to lead, it might be very low. But it may be something that you've accumulated over your lifetime that gets stored in your organs, your bones, your muscles, your tissues. It's not going to come out unless you provoke the body to pull it out. Dr. Mark Hyman: Now traditional medicine doesn't actually do this test, and they don't even know about this test. They often are highly skeptical and questioning of this test because what's the normal reference range? You hear all these criticisms. The normal reference range for mercury is zero. The normal reference range for lead is zero. These are not biologically necessary compounds that we should have in our blood at all, ever. Dr. Elizabeth Boham: Less is more there. Dr. Mark Hyman: We used to do these lead levels on kids, 40 was considered normal. Then it was 20. Then it was 10. Now we're knowing that even down to levels of one that there's significant impairment in neurologic and cognitive development. In heart disease, and this study blew me away, Liz. There was a study looking at heart disease and lead. They found that any blood, this was just blood lead levels, any blood lead levels greater than two, which is about 39% of the population, were highly correlated with heart attacks, stroke, and death. Far more than cholesterol, which is amazing. Yet, how many cardiologists are checking lead levels? Dr. Elizabeth Boham: Yeah, and we think that's because of the process of oxidative stress and inflammation that the heavy metals can cause. Maybe because they're damaging the endothelium and impacting blood pressure, it is really an interesting correlation. So it is something we really want to look at. Dr. Elizabeth Boham: The other thing we sometimes look at is antibodies against heavy metals. So somebody's had exposure to heavy metals or toxins in their lifetime. You're wondering, could this be triggering an autoimmune disease in their body? We can also look at antibodies against those toxins and heavy metals. There's a bunch of different ways we can assess somebody's load is. We also look at oxidative stress markers. We look at genetic factors, some different snips or variations in your genes may impact how well you can mobilize and detoxify from heavy metals. So there's a lot of things we look at when we're trying to assess somebody's toxic burden. Dr. Mark Hyman: It's true. I've noticed, and these are things that are not well described or written about, but I'm sure you've seen the thing, you see patients who have heavy metals, and their bodies are trying to get rid of it. So you see all these depleted levels of things. You see depleted levels of amino acids. You see low selenium, low zinc. You see low glutathione levels. You see all these phenomena that are consequences of this constant burden on the system and the body's trying to handle it. Dr. Mark Hyman: When we start to talk about these things, and we're going to talk about lead and mercury. We've been focused on lead. If you have any chronic illness, whether it's depression, heart disease, cancer, diabetes. Diabetes is highly correlated with arsenic levels, for example, and pesticides, and chemicals. Whether it's neurodevelopmental issues, neurocognitive issues like Parkinson's or Alzheimer's, whether it's autoimmune diseases, whether it's chronic digestive issues, whether it's chronic fatigue. These all need to be triggers for you to think about heavy metals. Your doctor is just not going to do that unless they are a functional medicine doctor. Dr. Elizabeth Boham: That's true. Dr. Mark Hyman: We do something different, which is this provocative test, which is an invasive test. It's like taking a glucose tolerance test when you drink two Coca Cola equivalents and then you check your blood sugar. Well, drinking two Coca Colas is not a great idea, but it's helpful to diagnose how your body responds. Or like a cardiac stress test, you provoke someone on a treadmill, and see if their heart is working or not. We have to provoke the body to pull these metals out with a chelator, which binds to these metals, and you excrete it in your urine. You collect your urine for six hours. You can follow it over time and see people's levels improve. You see that correlate with a clinical improvement. Dr. Elizabeth Boham: Yeah, absolutely, absolutely. Dr. Mark Hyman: We're going to get into it, but the way I got into functional medicine was because I had mercury poisoning, and I told this story a little bit, but I will get into it when we talk about mercury. But let's get into a little bit about lead. What makes you think that someone has lead poisoning and how big of an issue is this in America today? Dr. Elizabeth Boham: There's always been lead around in our environment. There's a lot less now than there used to be. Some people feel that the fall of the Roman Empire was because of lead poisoning and that caused such disorders in the emperors that- Dr. Mark Hyman: They were all crazy. Dr. Elizabeth Boham: ... they were all crazy. Dr. Mark Hyman: Lead pipes, it was the plumbing and the advance of technology and sanitation essentially that killed them. Dr. Elizabeth Boham: Yeah, it's so interesting. We do have less exposure to lead now than we used to, but we still are getting exposed. It was in 1978 that we finally said in the United States no more lead in paint. For a lot of people, they have a house that was built before 1978, depending on the situation, they still might be getting, their children, and they might still be getting exposed to some lead through the dust from the paint. Lead pipes, as you mentioned, do you know there's still some lead in solder, especially in the older pipes. Then in gasoline, what was it, 1991, where we finally took all the lead out of gasoline? So we have less exposure to lead than we used to, but we still see some issues with lead toxicity. Dr. Mark Hyman: Where is it coming from now? Dr. Elizabeth Boham: In older homes, so homes that are built before 1978, or newer homes, but still have some older pipes in them, so it can still be in the water. That's why we always recommend people run their water- Dr. Mark Hyman: Like in Flint, Michigan when they started messing around with the pipes and the water, and all these kids got lead poisoning. In Cleveland, the kids there have higher lead levels than in Flint because of the old paint and all the old houses. It's prevalent. We also have the coal burning and cement plants, which use coal, and release tremendous amounts of lead and mercury into the environment. Dr. Elizabeth Boham: Absolutely, so lead can be in soil, depending on what was happening around that home that your house was built in. It may be deposited in the soil. We do find situations where kids are playing... We want them playing in the dirt and in the soil, but that can be a source, especially if their toys or their hands are then going in their mouth. Of course, kids are always putting stuff in their mouth, so that's where a lot of times they will pick up some of that dust from old paint at the house. Dr. Mark Hyman: I remember this one kid, it was severe ADD, behavioral issues, and he lived actually near Albany. They had this big cement plant there and it was right next to the school. Every day, the cars in the parking lot would be just covered with dust. It was basically lead and mercury dust. This kid had really high levels of lead and mercury from being in the school that was next to a cement plant. So, we don't think of that. Dr. Elizabeth Boham: No, and hobbies, we were talking about shooting guns, and the bullets, and stuff, but also stained glass. There still is unfortunately lead in some ceramics and depending on where pottery and ceramics are coming from, there still can be some levels. Dr. Mark Hyman: Also, wine glasses and water glasses that are made of crystal. I remember once walked into this store to buy wine glasses and there were $5 glasses and there were $50 glasses. I'm like, "Why are these Riedel crystal $50?" He said, "Well, they have lead in them, and it makes the wine taste better." Dr. Elizabeth Boham: A little sweeter, right? Dr. Mark Hyman: Oh my goodness, yeah, lead tastes sweet. It's a serious problem. Dr. Elizabeth Boham: It is. If a mom has had exposure to lead, we do know it can cross the placenta, so that can be a source for children as well. Many times when we're evaluating a child who has developmental delays, we're also thinking about the mom and what was her exposure like, what are her levels like? Because that is obviously impacting the child. Dr. Mark Hyman: Absolutely. I think the prevalence and the issues of this really got exposed by Dr. Phil Landrigan and others, Needleman, in the '70s, where they took dental samples of kids' teeth that fell out, baby teeth. They analyzed the teeth and they looked at the lead levels. They found that there was an incredible corelation with the lead levels in the teeth and these neurodevelopmental with kids, whether it was dyslexia, ADD, violence, behavioral issues, academic performance, juvenile delinquency all increased with higher levels of lead. Dr. Elizabeth Boham: Absolutely, as your blood level goes up, your IQ goes down. That correlational is significant. Dr. Mark Hyman: Pediatricians do check for it, right? Dr. Elizabeth Boham: It's interesting. I think there's some state to state requirements, like in terms of some states it's required to check at age two. But then, I think in other states it's only the "high risk" population that we're checking at age two, so there maybe some variations in state to state requirement. In my training in New York, we were checking everybody at ae two. Dr. Mark Hyman: What did they doctors do though? Like, "Oh, don't eat lead paint, and don't..." They didn't treat them. Dr. Elizabeth Boham: Unless it was crazy high, these mild elevations where we were really watching. That's how you were trained in conventional medicine. Just if it was a mild elevation, to watch and look to make sure there was not a continued source of lead exposure. Dr. Mark Hyman: But the beauty of functional medicine is that we actually can treat it and help the body eliminate the metals. Dr. Elizabeth Boham: As you were mentioning earlier, these mild levels of exposure can have significant impact on a growing developing child. We also always focus about high fiber. We know fiber will bind to lead and will help eliminate it. We're always talking to moms about giving their children lots of fiber, lots of vegetables. We talk about making sure their iron levels are sufficient because if iron levels are low in a child, then the lead has an easier time getting absorbed into the body and getting into the brain. We know we want to make sure all mineral levels are sufficient. As you were mentioning earlier, we always focus on nutrition because you need to have enough amino acids and protein to detoxify. You need to have enough phytonutrients to detoxify. Enough of those good minerals helps prevent that lead from being as detrimental for that growing developing child. Dr. Mark Hyman: What people don't realize is your body has a built-in detox system. It's designed to help your body get rid of crap. There are very specific ways to optimize that system. We've got a podcast on this, but it's something that we really focus on in functional medicine, which is foods that up-regulate your detox pathways. A lot of things you were mentioning, the right amino acids, the right mineral rich foods, things with lots of glucosinolates and things that build glutathione in the body. Fiber to help bind the metals and get them out. Dr. Mark Hyman: We have a real strategy. Then there's a lot of nutrients and supplements that we use to also help up-regulate these pathways in addition to getting rid of the source. You got to rid of the source. We even use medication to help chelate or bind the metals to get them out. These are FDA approved medications that are used for lead treatment in kids, but they don't usually use it. Dr. Elizabeth Boham: Unless the levels are really, really high in the blood, right? Dr. Mark Hyman: Right. If a level of one is bad, why wouldn't you treat that? If you wait until the level is 40 or 50, it's like it doesn't make any sense. Dr. Mark Hyman: Everybody, it's Dr. Hyman. Thanks for turning into The Doctor's Farmacy. I hope you're loving this podcast. It's one of my favorite things to do and introduce to you all the experts that I know, and I love, and that I've learned so much from. I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. In it, I share my favorite stuff, from foods, to supplements, to gadgets, to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. Dr. Mark Hyman: I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays, nothing else, I promise. All you do is go to drhyman.com/picks to sign up. That's drhyman.com/picks P-I-C-K-S, and sign up for the newsletter, and I'll share with you my favorite stuff that I used to enhance my health and get healthier, and better, and live younger, longer. Now back to this week's episode. Dr. Mark Hyman: Let's talk about a case that you had of a young boy with lots of issues. Dr. Elizabeth Boham: The mom brought him to me when he was four. He was having developmental delay. He was having language delay. He was having behavioral issues. He was hard to control. He had some attention issues. His language was significantly delayed. He had a few words, but was having a very difficult time communicating. He was diagnosed mild to moderate autism. Dr. Elizabeth Boham: She brought him to me to see what else can we do? He's somebody, which was kind of interesting, he didn't have a blood lead level that was ever checked at screening when he was two, which I was surprised about, but maybe where he was born or it just never happened. His blood lead level was 25 micrograms per deciliter. As we were talking about, we want to be under two. 25 is definitely elevated. We did that provoked heavy metal challenge test. Dr. Mark Hyman: Where was he getting this from? Dr. Elizabeth Boham: It's interesting. We never found the source. We've been looking for the last few years, and we did not find the source. He had moved, his family had moved right prior to coming to see me, so it's probable that the source was at the old apartment house. I think it was an apartment, but I think that's where it was. Or maybe some overseas travel because a couple of his brothers had some elevated levels, mildly, not as high, but elevated levels. They weren't as impacted by them. Maybe because of the age of exposure. We, unfortunately, didn't find the actual source. But luckily, we have been successful at bringing it down. We did a provoked heavy metal challenge test, and level was like 170, which is... Dr. Mark Hyman: Okay, over three is like you worry about. Over three, you worry about. 170- Dr. Elizabeth Boham: Was very high. Dr. Mark Hyman: ... I maybe have seen two or three of that in my entire 30 year career with 10s of 1,000s of tests. It's way up there. Dr. Elizabeth Boham: This was very high. We did testing on oxidative stress that was high. His glutathione levels were low based on organic acid testing. He also was low in iron, which as we mentioned, that makes the lead even more dangerous for him in his developing brain. We got some history about his diet. The family was vegetarian, so he was a little low in protein, so that's something we needed to work on as well. We really worked to support his diet first and foremost. We increased his protein. They were okay with adding in some animal protein, which helped this child, so we did do that. We gave him some- Dr. Mark Hyman: Wait, before you get... So animal protein, the reason we need animal protein, it's very high in sulfur containing amino acids and other amino acids that are part of these pathways that the body uses to get rid of junk, these detox pathways, acetylation, methylation, glucuronidation, lysine conjugation, and they all need these various amino acids to regulate these pathways. You do some need sometimes higher levels of protein to get these kids detoxed. You'll see depleted levels when you test them. Dr. Elizabeth Boham: Absolutely. It's not like everybody needs higher levels of protein, but when the body's under stress like that, it is very necessary, as you mentioned. His levels were low and he needed some extra support. We gave him n-acetylcysteine, which helps the body with production of glutathione. We gave him sulforaphane, which helps with the body's production of glutathione. We gave him a good multivitamin, a good multi-mineral. Because of his levels, I also did give him some chelation. We used with him a rectal suppository because of his age of EDTA, of calcium EDTA. Dr. Elizabeth Boham: Then made sure. When you do chelation, you have to make sure you're really repleting somebody. You have to make sure they're getting enough minerals back because it will bind to some minerals. You definitely want to be working with a physician. You have to be doing it carefully because you don't want to deplete them of nutrition as well. You need extra nutritional support. We also gave him a lot of omega-3 fats for his brain and brain health. We took him off of gluten and gave him a good multi. Dr. Elizabeth Boham: We worked to really decrease his toxic load in general. One of the things we see with heavy metals and toxins, as we were mentioned earlier that toxic load, so a lot of times, parents are using other toxins, which they don't even realize. For example, Tylenol, when kids get fevers or mild fevers, a lot of parents are quick to use Tylenol because they want their child to be comfortable. That makes sense. But we have to recognize that needs to get detoxified through the liver. Dr. Mark Hyman: Yeah, it depletes glutathione, which is the main detoxifier in the body that gets rid of metals. Dr. Elizabeth Boham: Exactly. This family was using a lot of it. He was a normal kid in terms of having a lot of low grade fevers at times, but unfortunately, they were using a lot of Tylenol, and using it around vaccinations. I really try to cut that down with parents and only use it if their child has a high, high fever. Where if they don't need it, and their child can sleep comfortably, and they're able stay hydrated, then we try not to use that too much because of the toxic load. Dr. Mark Hyman: So what happened to him? Did he start changing? Dr. Elizabeth Boham: Yeah, so after six months, we got the blood lead level down to six. Dr. Mark Hyman: From 25. Dr. Elizabeth Boham: Still high, but I figured we weren't still getting continued exposure. His provoked heavy metal challenge test, his lead level came down to 40. So we needed to continue the process, so we did another six months of it. Then he was down to three in terms of his blood and then the urine toxic metals down to 10. Dr. Mark Hyman: From 170 to 10, that's impressive. Dr. Elizabeth Boham: Yeah, we did a pretty good job. They were very compliant. Dr. Mark Hyman: How was his behavior and autism? Dr. Elizabeth Boham: His language skills were going up. His language was increasing significantly. He was able to go to a regular school. He was interacting with kids well. He was learning well. The teachers loved having him in class. He's still a little more disruptive than his brothers, but he's got a little attention issue still, so we're still working on that. But he's really improved significantly. Dr. Mark Hyman: It's incredible when you start treating these people. It's one of those massive blind spots in medicine. Nutrition is a blind spot, but it's obvious. People know, "Yeah, yeah, food has some role in disease." But metals is just absent. It's just really interesting how absent it is from any traditional medical training, understanding, evaluation, treatment. It's really what we do here at the UltraWellness Center in functional medicine. Dr. Mark Hyman: I just remember reading this study. This was published, I think, in JAMA or in the New England Journal of Medicine. These are the top medical journals in the world. There were a number of articles published. One was about kidney failure. They found that in those kidney patients who had high levels of lead, if they chelated them with IV EDTA, which is one of the things you used with this young kid and rectally, but they give it them intravenously. They literally could stop and even reverse the progression of the kidney failure and prevent dialysis. Dr. Mark Hyman: Now considering dialysis is one of the biggest drains on our healthcare system, and it's a huge personal inconvenience and it's not a fun thing. Waiting around for a kidney transplant is not a fun thing. Nobody's doing it. It's in this major peer review medical journal in a well-done, randomized, controlled trial on 1,000s of patients. Of course, it wasn't done here. I think it was in Taiwan or somewhere else. But it was published in a major journal, and yet nobody's checking that. It's striking to me. Dr. Mark Hyman: We really are in this moment where we are seeing a transformation of medicine. Where these ideas are emerging that our toxic load is now a thing, that a microbiome is a thing, that gluten and leaky gut is a thing. I think we're opening things up, but it's still too slow for my taste. So yeah, I think that lead is one of those unseen causes of so many chronic illnesses. I always think of it, and I always take a good history. Sometimes you can't tell just by the history. You have to look. You have to test. Dr. Mark Hyman: This incredible study, where they had to dig up bones from an old church 300 years ago, and they found there was 300 times more lead in the bones of people today than 300 years ago in industrial humans because of all the coal burning, the pollution, the chemicals in our environment. I just think we're so inundated. Some of us are more susceptible than others. I personally am one of those. Dr. Elizabeth Boham: Me too. Dr. Mark Hyman: I'm not so good at detoxing. I have to make sure I kick up my system all the time. We are going to come back to mercury in a much longer podcast because this is a very important topic. I think mercury toxicity is probably even more prevalent than lead because we have removed a lot of lead from the environment. Yes, we have cement plants and coal burning, and people who live to close to those are higher risk. But we've taken it out of gasoline. We've taken it out of the paint. Although if you're drinking out of crystal glasses... I had a very wealthy patient who had all crystal glasses, and crystal wine glasses, and crystal water pitchers. She was just fully lead toxic from it. It was pretty amazing. Dr. Mark Hyman: Mercury is still so prevalent because not only of coal burning, and cement plants, and all that, but also because of the fish we consume. We'll talk about that later. And the dental fillings, the amalgams, we call them silver fillings, but they're not. They're mercury fillings, over 50% mercury. We're going to get really deep into this in another podcast we're going to do. But I just want to touch briefly on mercury, and some cases, and talk about the main things that we tend to see. Dr. Mark Hyman: Talk about this case you had of this patient who was getting sick all the time, this young woman, who, while young to me, she's 42. I'm 61 next week. How did this patient present, and what was her story, and how did you address this? Dr. Elizabeth Boham: I think that one of the things like what I was mentioning earlier in this podcast, that you taught me so well with years and years of working with you, is we've got to think about heavy metals when somebody, their immune system's not working well, when they're not getting better. This woman was 42 when she came to see me. She was just somebody who always got viruses. She always got colds and flus. She was sick multiple times a winter. She got a lot of sinus infections too, so it ended up that she was on multiple antibiotics for sinus infections. She was frustrated with the fact that she was always getting colds and flus. Dr. Elizabeth Boham: When she came in to see me, I did a really good history with her, as we always do, and a physical exam. I noticed she had multiple silver amalgams, or mercury amalgams in her mouth. She had a lot of cavities as a kid and a lot of them were filled with this silver amalgam. We said, "Okay, let's just see. Let's see. Could these silver amalgams still be releasing mercury into your body?" We did a blood, hair, and urine mercury test on her, the Tri-Test. Dr. Mark Hyman: What is this Tri-Test? Dr. Elizabeth Boham: It's by a company, Quicksilver. It helps distinguish in the blood if the mercury that you have, it gives us total amount of mercury, how much is methylmercury, which is typically coming from our fish. How much is inorganic, which a lot of that can be coming from your amalgams. Then how much is in the urine and in the hair, which is important to let us know how the body is mobilizing whatever mercury it's getting exposed to every day. Because some people, they get exposed to mercury, their body just mobilizes it, and they're fine with it. Dr. Elizabeth Boham: There's other people, and I think that's really important is that we're all individuals, and really that's what we focus on in functional medicine is that we have to treat the person as an individual. A lot of times, research may not, because it doesn't focus on putting high risk people in a group that they're studying... So let's say if there was a bunch of people with some of the genetic variations that you and I have in some of our glutathione producing genes, you may have really different outcomes and the amount of toxin that may cause ill health for them may be lower than in the general population. Because some people can handle some of the toxins that they're exposed to and other people don't handle it as well for a variety of reasons that are genetic. Dr. Mark Hyman: That reminds me of a fascinating study that was done based on this large research project looking at dental amalgams in kids, and seeing if putting silver fillings or mercury fillings in these kids caused harm. They looked at 1,000s and 1,000s of kids. They looked at the whole array, and they really didn't see a huge change. Then they stratified the population based on certain detoxification genes, where they were not great at getting rid of metals. Those kids who had these impairments in getting rid of metals like mercury, they had essentially a seven year developmental delay. So like if they were 17, they were developmentally 10. That's terrifying. That's what we miss when we look at these big population studies without personalizing the story. That's what's so great about functional medicine is we individualize it. Dr. Elizabeth Boham: Yeah, that's a great example. For her, for this woman, we did that Tri-Test. We got the indication that her inorganic mercury was high, and the inorganic was high. It made me concerned that these amalgams were still releasing mercury into her body. In addition, it didn't look like she was mobilizing it very well. When we looked deeper, we found that she did have signs of oxidative stress, low levels of glutathione in a bunch of the testing we did. We saw genetically, she wasn't the best detoxifier. That is something I worked with her on. I said, "You know, I think to work to support your immune system, we need to have you safely have these amalgams removed." I that's the key is the safely part of them. If you're worried about your amalgams, you don't want to just go and have them- Dr. Mark Hyman: Rip them out, no. Dr. Elizabeth Boham: Yeah, exactly. You want to have a dentist who will remove them in a safe way, use a dam and oxygen, so the mercury doesn't get back into your body. Dr. Mark Hyman: [inaudible 00:37:25] swallow, have high speed suction. Yeah, the dentists should be wearing a filter like hazmat suit basically. Because it's serious. The vapor gets out and causes huge problems. Dr. Elizabeth Boham: We also work to support the person prior to having that procedure done. If we feel that's a necessary thing, and not everybody has to have them replaced. But if we feel that it's necessary, we work to support them nutritionally and with some supplements to make it so it's a safer procedure for them. Dr. Elizabeth Boham: So she did that, and when we repeated that Tri-Test, her levels came down beautifully. Then I did the provoked heavy metal challenge test, and I realized I needed to do more work to help release some of the mercury from her body. So we did a detox protocol that included glutathione, liposomal, vitamin C, some binders, and extra support for her body. We did that, I think it was more like six months with her. The following winter, she did so much better. Dr. Mark Hyman: She didn't get sick? Dr. Elizabeth Boham: She didn't get sinus infections. She didn't get colds or flus. I think she said she had one little cold and it got better. I think that's important in this world of COVID that we're living in is what can we do to support our immune system so it is doing what it needs to do? Dr. Mark Hyman: Yeah, so true, Liz. These things are just stresses on our system. We want to unload our body from things that are unnecessarily stressing us, whether it's a poor diet, whether it's heavy metals, environmental toxins. You can't be perfect, obviously, but you want to do the best you can. This story's really important because when you want to test someone who has fillings and see if there's an issue, you can't just do a regular blood mercury test because the inorganic mercury one is in very low doses and it's hard to detect, and it's extremely toxic. You have to fractionate the mercury to look at the inorganic versus the organic. The organic is the methylmercury that comes from fish. The inorganic is the stuff that comes at you from pollution or is from your fillings. People say, "Oh, they're stable. They're put in there for years." You're chewing all the time. They vaporize. If you chew gum, if you grind your teeth, whatever. Dr. Elizabeth Boham: Drink hot liquids. Dr. Mark Hyman: Drink hot liquids, it's a problem. Now if your dentist says, "Oh, there's no data that mercury is an issue and that fillings are safe," ask him a simple question, or her a simple question. Says, "Why is it okay to put this stuff in my mouth? But if you remove it from my mouth, you can't throw it in the garbage. You have to dispose of it as a toxic hazardous waste according to the EPA." I was like, "Ask your doctor to answer that." Dr. Mark Hyman: Now we've been doing this for decades, and we've been ridiculed for saying that these fillings are a problem. There's no data on this. You're putting people at risk by having them go to the dentist to remove their fillings. It's not safe to do it. There's all this negative blow back. But September 24, 2020, the FDA, after many decades of data that they pretty much ignored, finally came out and they said, "The agency, after finding that certain groups may be at higher risk for potential harmful effects of the mercury vapor released from the fillings, they recommend that certain high risk groups avoid getting these dental fillings whenever possible." Dr. Mark Hyman: Of course, they don't say, "Take them out." Guess who these people are? "Pregnant women and their fetuses are at risk. Women who are planning to become pregnant, nursing women, and newborn infants, and children, any children, especially under six, should never have one. People with neurologic diseases like MS, Alzheimer's or Parkinson's. People with kidney function problems. People with allergy to mercury or its components." Dr. Mark Hyman: Now if it's not good for all these people, why is it okay for us and the rest of us? It's not. Now you're right. Some people do fine. I remember one patient, who I looked in his mouth and I'm like wall to wall fillings. I'm like, "This guy's going to be in trouble." But he was a pretty healthy guy. I checked his challenge test and he really was great at rid of it. So whatever he absorbed, he processed, and cleaned out. Dr. Mark Hyman: But half of us, a good half of us, don't have the genes to help us detoxify. Why? Because we weren't exposed to all this junk before this century or last century. So the last 150 years, industrialization, we've seen so much increases in all these heavy metals and other chemicals we've had to deal with. Dr. Mark Hyman: Now finally, the FDA is come clean and said the data is there, and you just Google FDA mercury amalgams or dental amalgams, you can read it yourself. That, to me, is very satisfying because finally, the government is like there's just too much data to ignore this. It's not safe and we shouldn't be using these, even in people who don't have issues like Alzheimer's or kidney failure, or who are trying to get pregnant. Dr. Mark Hyman: I also think it brings up the question about what do you do if you have these fillings? You need to make sure you don't just rip them out with an average dentist because you can get very sick. I had a doctor friend, who should have known better, who had a mouthful of fillings. He took his fillings out and he got heart failure, and needed a heart transplant. So it's no joke. You can't do it just willy nilly with any dentist. You need to go to a special dentist. There's a website, you can go to IAOMT.org, which is the dentists who are trained in this method of dentistry to help remove it safely, so you don't get in trouble. Dr. Mark Hyman: But the good news is you can treat it. You see like with this woman, she didn't have a really serious problem. She was getting frequent infections, her immune system was suppressed. But whether you're just having something as annoying as that, or something as serious as Alzheimer's or autism, or diabetes, you can address these problems. We're going to cover this in much more detail in a followup podcast on mercury because I personally had mercury poisoning. It's what really got me into functional medicine. I've become unfortunately an expert in this, where I wish I wasn't. But I had to learn really how to address this seriously and what to do about it. The good news is from a functional medicine perspective, there's so much we can do. Dr. Mark Hyman: If you've been listening to this podcast, and you have fillings, don't freak out. But you might want to get checked. You might want to see a functional medicine doctor. You certainly can come see us here at the UltraWellness Center. We are seeing patients virtually now. You can go to ultrawellnesscenter.com to learn more about our practice. We'd love to see you. If you are concerned that you may have heavy metals or someone else might, just start to investigate for yourself because it is a real issue. It's ignored by most traditional doctors. This is really where functional medicine shines. Dr. Mark Hyman: If you liked this podcast, please share with your friends and family on social media. We would love to hear from you if you've had any issues with heavy metals, what you've done to deal with it. Leave a comment. Subscribe wherever you get your podcasts. Of course, we'll see you next week on The Doctor's Farmacy. Dr. Elizabeth Boham: Thank you, Mark.