Dig Deeper to Find Cause of Malaise

Dr. Julie’s column in your February/March 2013 issue prompted me to write. She was reviewing the case of a woman with fatigue and achiness driven by heavy metal toxicity in addition to food sensitivities and nutritional deficiencies. I’d like to echo her sentiment for health-care practitioners to dig deeper to find the cause of their patient’s malaise.

As the former GM of a functional medicine laboratory and medical center and someone who has battled chronic illness most of his adult life, I have become quite well versed in the treatment and causes of chronic illness. In fact, I donate much time, advising individuals who find me. They often need advice on where to go for treatment, what tests to ask their doctor for, or how to round out a treatment protocol. They are often failed even by alternative/integrative health-care providers either because the latter don’t do their homework and stay current, or only do salivary hormone assays, standard blood chemistries, food intolerance testing, and nutritional deficiency testing and don’t dig any deeper. This approach may work well for 80 of 100 patients, but the remaining 20 are not helped. As time goes on, this 80/20 situation is going to become more of a 50/50 situation as we are constantly bombarded with toxins in our air, food, water, and cosmetics.

The tests for digging deeper are available. Innovative labs such as Genova/Metametrix, Doctor’s Data, Cyrex, BioHealth, Diagnos-Techs, and IGeneX give health-care practitioners amazing tools to dig deeper into their patients’ health status. (Kudos to Metametrix for the Toxic Effects Core Panel; I look forward to the addition of flame retardant compounds to the panel.)

Regarding heavy metals, it is totally insufficient to look in a patient’s mouth for amalgams and inquire into known heavy metal exposures. So many patients have accumulated body burdens without even knowing it: the house that they grew up in, the city asphalt playgrounds, their summer job in the factory. A provocative challenge with a chelating agent should be done for those with neurological symptoms along with their fatigue and malaise. Current/ongoing exposure can be ruled in or out with a prechallenge collection or a prechallenge blood test.

My own heavy metals timeline will shed some light on this:

• 1986: became chronically ill

• 1987: approximately 15 dental amalgams removed

• 1994: provocative challenge with EDTA – mercury and copper high, no discernible lead

• 1994–1998: chelation with EDTA and later DMPS IV pushes, all heavy metals at low end of challenged reference range in late 1998

• 2006: fatigue and neurological symptoms return, provocative challenge with DMSA shows huge lead load. Blood lead level prior to challenge very low. Throughout treatment in the 1990s, no significant lead load was ever detected.