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Mercury Tri-Test: Mercury Speciation
Analysis and Compartment-Ratio Analysis for
Body Burden and Excretion Indices WITHOUT
Provocation
Christopher W. Shade, PhD
Andrew Elias, MBA, LSSBB
Quicksilver Scientific, LLC
Lafayette, CO 80026
(303)531-0861
www.quicksilverscientific.com
Mercury Testing
• Most Common method now is the “Challenge Test”
– No information on form of mercury
– Large dose of potentially harmful chelation compound
– No information on excretion capacity
– Misleadingly believed to reveal “Body Burden”
• Quicksilver Scientific Tri-test uses Mercury
Speciation Testing (separation of forms of
mercury) and comparisons of different sample
types
– Clearly Reveals source of mercury and bodily levels
– Gives index of excretion ability for each form of mercury
Forms and Sources of Mercury
• MeHg - Methylmercury
– Organomercurial; found in fish; Also formed
in gut from amalgam mercury
• Hg0
– Elemental Mercury
– The metal form; liquid and gas forms; dental amalgam
• HgII
– Inorganic Mercury
– The salt, formed by oxidation of Hg0
in blood and mouth
• EtHg - Ethylmercury
– Synthetic organomercurial; antimicrobial
– Ends up mostly as inorganic mercury
Pathways In – Dental Amalgam
Hg
0
breaks down to
inorganic mercury (Hg
II
).
Hg
0
distributes throughout
body and nervous
system.
Image from the International
Academy of Oral Medicine
and Toxicology.
Hg
II
accumulates in
the nervous system, liver,
and kidney.
Hg
0
released from
amalgam and inhaled with
80% uptake in the lungs.
Amalgams: Pathway of Exposure
80% Uptake
Pathways In – Fish Consumption
MeHg
MeHg
Chemical reactions in the
gut add MeHg to an amino
acid.
Fish contaminated with
methylmercury (MeHg) get
eaten.
MeHg diffuses out of the
gut and circulates
throughout the body,
because it gets mistaken
as an amino acid.
Methylmercury
accumulates in
the body.
Seafood: Pathway of Exposure
95% Uptake
Pathways In – Vaccines
EtHg
Hg
II
accumulates in
the body.
EtHg distributes
throughout the body and
nervous system.
EtHg probably does not
leave the body, but enters
tissues and breaksdown
into inorganic mercury
(Hg
II
).
Ethylmercury (EtHg)
enters the blood through
vaccination.
EtHg leaves the blood
after a few days.
Vaccination: Pathway of Exposure
100% Uptake
Pathways Out – Methylmercury
Pathways Out – Inorganic Mercury
Both Intestinal and Kidneys
Mercury Speciation Testing
• Patented Mercury Analysis Technique
separates methyl and inorganic mercury
– Shows different sources (fish vs. amalgam)
– US Patent #7,285,419 B2
• Comparison between matrices shows
excretion or retention of mercury
• Only clinical lab in the world offering
Mercury Speciation Analysis
Challenge Tests – What do they mean?
Are They Necessary?
Mercury Industry Workers
Dentists
Controls (Amalgam)
Amalgam-free Referents
Industrial workers 3-4 yrs on job, versus dentists
10-30 yrs on the job and amalgam bearers with
10-30 yrs with fillings
Mercury Industry Workers
Dentists
Controls (Amalgam)
Amalgam-free Referents
If challenge reflected long-term body burden, the
long-term dentists would have moved closer to
the short-term industrial workers…but it did not
Challenged Urine correlated well
with pre-challenged urine and pre-
challenged plasma
Chelation therapy – Dump from blood
followed by reloading from cellular
burden
Chelators drain the blood
metals through the kidneys.
After cessation of use, the
tissues replenish the blood
Mercury Speciation Testing
• Separates the two main forms of mercury
in the human body (Methyl and inorganic
mercury)
– Once separately measured, ambient
measurements reveal a lot without challenge
tests
Testing for Hg – Forms Present
in Different Samples
1. Ambient
1. Blood – MeHg + HgII
(MeHg larger)
2. Hair – MeHg only
3. Urine – HgII
(little bit of MeHg)
4. Stool – MeHg + HgII
2. Provoked
1. Urine – MeHg + HgII
Blood Testing
• Old Dictum – blood is only recent exposure, 3-days
• Reality
– 3-day residence only the quick decay after a large
dose
– For MeHg, Steady state develops after initial decay;
Then blood reflects body burden!
• Real Problem
– Most labs detection limits too high to see dynamics
– Need sensitive equipment!
H
H
H
Hg
Fish Consumption
12 hr peak and fast decay over 24hrs
Clarkson et al., Arch. Env. Health, 1980
Fish Consumption
Slow 160 day return to baseline
After initial peak and decay, Blood reflects Body Burden!
Mercury Speciation Testing
H
H
H
Hg
Mercury Speciation Testing and
Compartment Ratio Testing
Ambient Measurement Suite
1. Blood – MethylHg + Inorganic Hg
2. Hair – >95% MethylHg
-Compare to blood MethylHg for excretion
measurement
1. Urine – >95% Inorganic Hg
-Compare to blood inorganic mercury for
excretion measurement
Blood Mercury Speciation
Methyl Hg
Inorganic Hg
Total Hg
Methylmercury levels with comparison to
laboratory average
Inorganic Mercury levels with
comparison to laboratory average
Sum of 2 forms = total Hg with comparison to laboratory
average and color coded CDC population averages
Compartment Ratio Analysis: Patient #1 – Healthy
Low Levels and Good Excretion Profiles
Methyl Hg
Inorganic Hg
Total Hg
Low Methyl and average
Inorganic Hg
Good MethylHg
excretion
Good Inorganic
Hg excretion
Compartment Ratio Analysis: Patient #2: Dentist
with Chronic Intestinal Inflammation
I n dic a t io n of M e r c ur y E x c r e t io n A bilit y
0
4 00
-1 2 0 -1 00 -8 0 -6 0 -4 0 -2 0 0 2 0
B lo o d Me Hg (n g /mL )
B e lo w A v e ra ge
Exc re tio n
of blood mercury through
the hair.
A v e ra ge Exc re tio n
of blood mercury though the
hair (290:1).
Indication of Mercury Excretion Ability
0
400
800
1200
1600
2000
2400
2800
0 2 4 6 8 10
Blood MeHg (ng/mL)
HairMeHg(ng/g)
Methyl Hg
Inorganic Hg
Total Hg
Very High Methyl and Inorganic Hg
Bad Inorganic Hg
excretion
Bad MethylHg
excretion
Compartment Ratio Analysis: Patient #3: Dentist
– Kidney Problem from Long-term Hg vapor Exposure
0 0.5 1 1.5 2 2.5
Concentration of Mercury (ng/mL or ug/L)
HgT
Hg(II)
MeHg
Blood Mercury
Patient Blood
QS Average
I n d ic a t ion of M e r c ur y E x c r e t ion A bilit y
0
4 00
-1 2 0 -1 00 -8 0 -6 0 -4 0 -2 0 0 2 0
B lo o d Me Hg (n g /mL )
A ve rage Exc re tio n
of blood mercurythough the
hair (290:1).
B e lo w A v e ra ge
Exc re tio n
of blood mercury through
the hair.
Indication of Mercury Excretion Ability
0
400
800
1200
0 1 2 3 4 5
Blood MeHg (ng/mL)
HairMeHg(ng/g)
Indication of Kidney Mercury Excretion
Ability
0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
5.00
0 0.5 1 1.5
Blood Hg(II) (ng/mL)
UrineHg(II)
(ng/mL)
G o o d H g(II) Exc re tio n Line
(7:1)
Methyl Hg
Inorganic Hg
Total Hg
Normal Methyl and Very
High Inorganic Hg
Good MethylHg
excretion
Bad Inorganic Hg
excretion
Compartment Ratio Analysis: Patient #4 –
Likely Methyl Hg Detox Enzyme Deficiency
Bad MethylHg
excretion
Quicksilver Scientific Tri-test
• Clearly Reveals source of mercury
• NO provocation (chelation) agents used
• Gives index of excretion ability for each form
of mercury for informed treatment options

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Quicksilver Scientific Clinical Mercury Testing

  • 1. Mercury Tri-Test: Mercury Speciation Analysis and Compartment-Ratio Analysis for Body Burden and Excretion Indices WITHOUT Provocation Christopher W. Shade, PhD Andrew Elias, MBA, LSSBB Quicksilver Scientific, LLC Lafayette, CO 80026 (303)531-0861 www.quicksilverscientific.com
  • 2. Mercury Testing • Most Common method now is the “Challenge Test” – No information on form of mercury – Large dose of potentially harmful chelation compound – No information on excretion capacity – Misleadingly believed to reveal “Body Burden” • Quicksilver Scientific Tri-test uses Mercury Speciation Testing (separation of forms of mercury) and comparisons of different sample types – Clearly Reveals source of mercury and bodily levels – Gives index of excretion ability for each form of mercury
  • 3. Forms and Sources of Mercury • MeHg - Methylmercury – Organomercurial; found in fish; Also formed in gut from amalgam mercury • Hg0 – Elemental Mercury – The metal form; liquid and gas forms; dental amalgam • HgII – Inorganic Mercury – The salt, formed by oxidation of Hg0 in blood and mouth • EtHg - Ethylmercury – Synthetic organomercurial; antimicrobial – Ends up mostly as inorganic mercury
  • 4. Pathways In – Dental Amalgam Hg 0 breaks down to inorganic mercury (Hg II ). Hg 0 distributes throughout body and nervous system. Image from the International Academy of Oral Medicine and Toxicology. Hg II accumulates in the nervous system, liver, and kidney. Hg 0 released from amalgam and inhaled with 80% uptake in the lungs. Amalgams: Pathway of Exposure 80% Uptake
  • 5. Pathways In – Fish Consumption MeHg MeHg Chemical reactions in the gut add MeHg to an amino acid. Fish contaminated with methylmercury (MeHg) get eaten. MeHg diffuses out of the gut and circulates throughout the body, because it gets mistaken as an amino acid. Methylmercury accumulates in the body. Seafood: Pathway of Exposure 95% Uptake
  • 6. Pathways In – Vaccines EtHg Hg II accumulates in the body. EtHg distributes throughout the body and nervous system. EtHg probably does not leave the body, but enters tissues and breaksdown into inorganic mercury (Hg II ). Ethylmercury (EtHg) enters the blood through vaccination. EtHg leaves the blood after a few days. Vaccination: Pathway of Exposure 100% Uptake
  • 7. Pathways Out – Methylmercury
  • 8. Pathways Out – Inorganic Mercury Both Intestinal and Kidneys
  • 9. Mercury Speciation Testing • Patented Mercury Analysis Technique separates methyl and inorganic mercury – Shows different sources (fish vs. amalgam) – US Patent #7,285,419 B2 • Comparison between matrices shows excretion or retention of mercury • Only clinical lab in the world offering Mercury Speciation Analysis
  • 10. Challenge Tests – What do they mean? Are They Necessary?
  • 11. Mercury Industry Workers Dentists Controls (Amalgam) Amalgam-free Referents Industrial workers 3-4 yrs on job, versus dentists 10-30 yrs on the job and amalgam bearers with 10-30 yrs with fillings
  • 12. Mercury Industry Workers Dentists Controls (Amalgam) Amalgam-free Referents If challenge reflected long-term body burden, the long-term dentists would have moved closer to the short-term industrial workers…but it did not
  • 13. Challenged Urine correlated well with pre-challenged urine and pre- challenged plasma
  • 14.
  • 15. Chelation therapy – Dump from blood followed by reloading from cellular burden Chelators drain the blood metals through the kidneys. After cessation of use, the tissues replenish the blood
  • 16. Mercury Speciation Testing • Separates the two main forms of mercury in the human body (Methyl and inorganic mercury) – Once separately measured, ambient measurements reveal a lot without challenge tests
  • 17. Testing for Hg – Forms Present in Different Samples 1. Ambient 1. Blood – MeHg + HgII (MeHg larger) 2. Hair – MeHg only 3. Urine – HgII (little bit of MeHg) 4. Stool – MeHg + HgII 2. Provoked 1. Urine – MeHg + HgII
  • 18. Blood Testing • Old Dictum – blood is only recent exposure, 3-days • Reality – 3-day residence only the quick decay after a large dose – For MeHg, Steady state develops after initial decay; Then blood reflects body burden! • Real Problem – Most labs detection limits too high to see dynamics – Need sensitive equipment! H H H Hg
  • 19. Fish Consumption 12 hr peak and fast decay over 24hrs Clarkson et al., Arch. Env. Health, 1980
  • 20. Fish Consumption Slow 160 day return to baseline After initial peak and decay, Blood reflects Body Burden!
  • 22. Mercury Speciation Testing and Compartment Ratio Testing Ambient Measurement Suite 1. Blood – MethylHg + Inorganic Hg 2. Hair – >95% MethylHg -Compare to blood MethylHg for excretion measurement 1. Urine – >95% Inorganic Hg -Compare to blood inorganic mercury for excretion measurement
  • 23. Blood Mercury Speciation Methyl Hg Inorganic Hg Total Hg Methylmercury levels with comparison to laboratory average Inorganic Mercury levels with comparison to laboratory average Sum of 2 forms = total Hg with comparison to laboratory average and color coded CDC population averages
  • 24. Compartment Ratio Analysis: Patient #1 – Healthy Low Levels and Good Excretion Profiles Methyl Hg Inorganic Hg Total Hg Low Methyl and average Inorganic Hg Good MethylHg excretion Good Inorganic Hg excretion
  • 25. Compartment Ratio Analysis: Patient #2: Dentist with Chronic Intestinal Inflammation I n dic a t io n of M e r c ur y E x c r e t io n A bilit y 0 4 00 -1 2 0 -1 00 -8 0 -6 0 -4 0 -2 0 0 2 0 B lo o d Me Hg (n g /mL ) B e lo w A v e ra ge Exc re tio n of blood mercury through the hair. A v e ra ge Exc re tio n of blood mercury though the hair (290:1). Indication of Mercury Excretion Ability 0 400 800 1200 1600 2000 2400 2800 0 2 4 6 8 10 Blood MeHg (ng/mL) HairMeHg(ng/g) Methyl Hg Inorganic Hg Total Hg Very High Methyl and Inorganic Hg Bad Inorganic Hg excretion Bad MethylHg excretion
  • 26. Compartment Ratio Analysis: Patient #3: Dentist – Kidney Problem from Long-term Hg vapor Exposure 0 0.5 1 1.5 2 2.5 Concentration of Mercury (ng/mL or ug/L) HgT Hg(II) MeHg Blood Mercury Patient Blood QS Average I n d ic a t ion of M e r c ur y E x c r e t ion A bilit y 0 4 00 -1 2 0 -1 00 -8 0 -6 0 -4 0 -2 0 0 2 0 B lo o d Me Hg (n g /mL ) A ve rage Exc re tio n of blood mercurythough the hair (290:1). B e lo w A v e ra ge Exc re tio n of blood mercury through the hair. Indication of Mercury Excretion Ability 0 400 800 1200 0 1 2 3 4 5 Blood MeHg (ng/mL) HairMeHg(ng/g) Indication of Kidney Mercury Excretion Ability 0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50 5.00 0 0.5 1 1.5 Blood Hg(II) (ng/mL) UrineHg(II) (ng/mL) G o o d H g(II) Exc re tio n Line (7:1) Methyl Hg Inorganic Hg Total Hg Normal Methyl and Very High Inorganic Hg Good MethylHg excretion Bad Inorganic Hg excretion
  • 27. Compartment Ratio Analysis: Patient #4 – Likely Methyl Hg Detox Enzyme Deficiency Bad MethylHg excretion
  • 28. Quicksilver Scientific Tri-test • Clearly Reveals source of mercury • NO provocation (chelation) agents used • Gives index of excretion ability for each form of mercury for informed treatment options