Continuing with a review of Horowitz's book "Why Can't I Get Better", the next next 100 pages or so.
- Mercury exposure produces similar symptoms such as fatigue, joint pains, muscle pains, tingling and numbness, memory and concentration problems, and emotional problems.
- Heavy metal burden refers to exposure to metallic elements whose specific gravity is about 5 or greater, especially those that are poisonous: mercury, lead, arsenic, cadmium, nickel, aluminum.
- Blood analysis for mercury and other heavy metals are not reliable, unless there has been a recent acute exposure. Hair analysis shows a certain amount but nowhere near the more representative results of a DMSA urine challenge test.
- Urine tests with a DMSA challenge test reflects the heavy metals stored in the tissues.
- Heavy metal toxicity may explain chronic symptoms, especially those suffering from chronic fatigue, fibromyalgia symptoms, neuropathy, cognitive difficulties, tinnitus, and neuropsychiatric problems.
- Mercury may act as an hapten on the outside of the cell causing autoimmune reactions.
- Environmental toxins (xenoestrogens, pesticides, heavy metals, ETC) are very important because their effects can mimic just about every medical condition found in the doctor's office. They can cause exactly the same symptoms seen in persistent Lyme disease and co-infections.
- Mold exposure at home (such as Stachybotrys) is often a silent factor that can cause a lot of physical and neurological symptoms.
- Some toxins such as quinolinic acid are produced internally in the body and can cause devastating neurological effects. Quinolinic acid is a neurotoxic metabolite of certain biochemical pathways (i.e. nitric oxide pathway) which is produced in the brain by activated microglia and macrophages. It can be a result of co-infections and heavy metal toxicity and it is involved in neurodegenerative diseases such as Parkinson's, MS, Alzheimer's, Lou Gehrig's, Lyme's disease, etc. This toxin plays a key role in mood disorders and cognitive issues in Lyme patients and other co-infections. It could explain why patients persist with symptoms despite adequate antibiotic therapy. To suppress this neurotoxin, curcumin, green tea extracts and anti-inflammatories are necessary.
- Mercury can penetrate into the nerves and bind to acetylcholine receptors in the brain, resulting in neurological dysfunction. In the central nervous system, it can cause multiple sclerosis like syndromes, ADHD, etc.
- Lead can cause fatigue, impaired concentration, short-term memory problems, GI symptoms, insomnia, anxiety, depression, irritability, peripheral nerve dysfunction. Lead is stored in bones so it can be dumped into the blood as men and women develop age-related osteopenia. It can raise blood pressure.
- Arsenic can cause paresthesias and peripheral neuropathy among others.
- Cadmium is linked to CFS, toxic brain syndrome, emphysema, osteopenia, prostate cancer, and renal dysfunction. It competes with zinc binding sites.
- Aluminum is a potent neurotoxin which has been associated with abnormal speech, ALS, Parkinson's, etc.
- Zinc deficiency leaves you susceptible to a variety of pathogens. It impairs immune function.
- Heavy metal detox possibilities: DMSA, cuprimine, EDTA.
- Dr. Sherry Rogers suggests DMSA three days on, 11 days off, very similar to our forum protocol from Sidney Baker.
- Lyme disease patients do tend to have severe Herx reactions with DMSA though. NAC and alpha lipoic acid are needed to help chelate and palliate Herx reactions. Low doses of DMSA (like our forum protocol, designed originally for children by the Autism Research Institute) are relatively well tolerated and could easily be mixed with EDTA suppositories if a high lead level is also present. Horowitz doesn't like oral EDTA because it doesn't get absorbed very well. Neither DMSA is very well absorbed. But it has to be kept in mind that his patients are VERY sick and he needs results "fast", and these are patients who never tried detox protocols before.
- From his clinical practice, heavy metal chelation improved the symptoms of 20% of his resistant Lyme-MSIDS patients, including fatigue, joint pain and neurocognitive function.
- Oral DMSA will remove mercury, lead, cadmium, arsenic and other heavy metals. Oral and IV DMPS is more specific for mercury and rectal and IV EDTA more specific for lead. These all exist in oral forms. Cuprimine can be used in those allergic to DMSA.
- In his experience, oral DMSA with EDTA suppositories (detoxamine) if high leads are present will work well in his patients with heavy metal burden. DMSA is initially started in low doses to test for tolerance (100mg every third night), as some patients get severe Herx reactions.
- Other effective protocols, as mentioned above: DMSA 3 days on, 11 days off, using NAC, ALA and supplementing minerals and magnesium on the days off.
- If high levels of aluminum are present, adding malic acid is necessary because aluminum does not bind well to DMSA.
- Mercury increases susceptibility to chronic infections.
- MSIDS patients with heavy metals are deficient in one or more minerals such as iodine, magnesium or zinc.
- Minerals are essential for detox reactions. Undetoxed metabolites may accumulate, causing toxic brain symptoms.
- Cognitive dysfunction in chronic infections may be caused by mercury toxicity, active infections on the brain, neurotoxins such as quinolinic acid, a build up of chloral hydrate (due to a lack of zinc deficiency), etc.
- Plaquenil (hydroxychloroquine) exacerbates symptoms of psoriasis, don't use it if you have psoriasis.
- Glutathione supports detox through the phase II conjugation pathway of the liver. Glutathione takes fat soluble toxins which are not easily eliminated and helps make them water soluble so they can be removed from the body. It also helps to make hormones, new genetic material, detox enzymes, it modulates the immune system, etc. It helps people detoxify and it diminishes Herx reactions and its concurrent cytokine storm. Many antibiotics also "slow down' the liver's detox pathways, so susceptible patients might need extra support in the form of glutathione precursors such as NAC, ALA, glycline. Many people report improvement in fatigue, pain, mood swings, headaches, balance, dizziness, speech problems and cognitive function within 30 min of glutathione administration. Keep this in mind when having severe Herx reactions! I tripled my dose of NAC and ALA and saw a clear benefit. Some of us have very sluggish livers!
- Horowitz reports: "I have found that for treatment-resistant patients with symptoms unresponsive to antibiotics and other interventions, we clearly see marked clinical improvement when we enhance their detoxification pathways using glutathione. That is why we recommend a three step process of detoxification, chelation, and nutritional supplementation to all patients who come to our office."
- Important and useful measures. FIR sauna, probiotics, enough hydration, NAC, ALA.
- Patients may have difficulty tolerating new chemicals (i.e. pesticides) when they are on several different medications (i.e. antibiotics).
- Magnesium deficiency may result from an excess exposure to environmental toxins. Mg is related to 300 or so chemical detox pathways and some symptoms may get reversed just by restoring magnesium.
- Many toxic chemicals are fat soluble, so they have a direct pathway to the brain, which is comprised of 60% fat. These then disturb the brain chemistry, causing a host of "unexplained" neurological symptoms. When the detox pathways are overloaded, or when there are nutritional deficiencies affecting the phase I and II liver detoxification pathways, these chemicals back up, producing neurotoxic metabolites. This translates into brain fog, dizziness, headaches, slurred speech, exhaustion, mood swings. Chronic infections further compound this situation.
- To be continued.
Even though I had everything covered, except for my face and my hands, I'm surprised that my whole body seems to be having this reaction. Then again, clothing can't provide full protection. I've been putting aloe vera on the spots which temporarily relieves it, and I just repeat the process and things are looking a bit better now. I've also taken a short cold shower, and try to keep those areas as cool as possible, which has helped as well. I'll be using some natural sunscreen tomorrow (hopefully it'll help a bit) when I go to work and make sure to stay in the shades as much as possible. 
