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With the enormous amounts of toxic metal in the
environment and the widespread nutrient mineral insufficiencies of the
modern western diet, assessing patients for element imbalances and excesses
is an increasingly important tool in the diagnosis of chronic illness. Hair
Tissue Mineral Analysis of the hair can provide the healthcare provider with
important insight into treatment strategies for conditions ranging from
depression and behavior disorders to cardiovascular and neurological
illnesses. Practitioners have found the assessment extremely useful in cases
where no other etiology (cause) was readily apparent for an illness or
disease, as well as in cases where multiple causes act in synergy (in
combination together).
Accordingly, Hair Tissue Mineral Analysis is one of the most rapidly
advancing fields in medicine with applications across the treatment
spectrum. Research during the past three decades suggests that the
relationship between hair element concentrations and human health is a
complex process related to exposure, absorption, and tissue distribution of
essential and toxic elements. Studies of the relationship of mineral status
and behavioral disorders, cardiovascular disease, and cancer offer exciting
possibilities–continuing to expand the range of applications for Hair Tissue
Mineral Analysis far beyond its long-accepted use in cases of acute toxic
exposure.
Trace Elements state-of-the-art Hair Tissue Mineral Analysis assessments can
detect element levels at the level of parts per billion–and, in some cases,
even parts per trillion. Advances in sample transport make Hair Tissue
Mineral Analysis a conveniently administered test, and measures to ensure
sample integrity, such as strict quality assurance procedures in a "clean
room" facility, guarantee that results will be the most accurate available
anywhere. Colorful test reports and comprehensive commentary enable
healthcare providers to interpret and communicate results to their patients
quickly and easily. In addition, we offer individual consultation by
respected authorities in the field at no additional charge.
The vast majority of chemical reactions that govern
cellular processes are in turn regulated by enzymatic reactions. Enzyme
catalysts most often require mineral cofactors to operate. Magnesium and
zinc, for instance, are cofactors in hundreds of enzymatic reactions. Toxic
elements, on the other hand, can interfere with enzymatic reactions and
disrupt cellular activities. Thus, element insufficiencies or excesses have
a significant impact on health.
Unfortunately, nutrient element deficiencies are pandemic in our society.
Numerous government surveys have reported multiple mineral deficiencies in a
high percentage of participants. For example, studies show that more than
one-third of Americans consume less than 100% of the RDA for calcium.1 With
the enormous amounts of toxic compounds used in industry, noxious elements
are also a widespread, if less recognized, threat to health.
For more than 30 years, the significance of
measuring element concentrations in scalp hair, blood, and urine has been
studied. These biological samples reflect the body's dynamic equilibrium.
Hair acts as a depot and indicates element storage over time. Studies
correlate elements in hair with exposure to smelters and mines and with
disease and physiologic or pathologic effects of nutritional excesses or
deficiencies. Additionally, geographic variation and historical trends in
hair element levels have been published, and hair analysis is used in
forensic medicine. Consequently, hair analysis provides a long-term record
that reflects normal and abnormal metabolism, assimilation and exposure.2,3
There are numerous papers on the accuracy and efficacy of hair testing,
particularly for toxic metals such as mercury.4,5 The Environmental
Protection Agency (E.P.A.) published an authoritative study in 1979 in which
more than 400 reports on hair testing were reviewed. The authors concluded
that hair is a "meaningful and representative tissue for biological
monitoring of most of the toxic metals."6 Hair analysis is also useful as a
prognostic tool to ascertain whether an individual has a specific
biochemical uniqueness, which can then be addressed in a therapeutic or
prophylactic program.
Hair element testing is best viewed as a means to monitor element imbalances
and environmental toxicity. Follow-up blood testing or provocative urine
testing is useful to confirm hair element findings.
To understand how hair retains elements, it is
important to know the structure of hair and how hair protein is synthesized
and traps minerals.
The hair shaft is a filament formed from the matrix of cells at the bottom
of the hair follicle
deep in the
epidermal epithelium. Each follicle is a miniature organ that contains both
muscular and glandular components. Human hair is 80 percent protein, 15
percent water and small amounts of lipids and inorganic materials. The
mineral content of the hair is 0.25 percent to 0.95 percent on a dry ash
basis.7 Of the approximately 100,000 hairs in the average human scalp, 10
percent are in the resting phase. During the growth phase, the scalp
follicles produce hair at a rate of 0.2 to 0.5 mm/day-or about 1 cm each
month.
The growing hair follicle is richly supplied with blood vessels, and the
blood that bathes the follicle is the transport medium for both essential
and potentially toxic elements. As these elements reach hair follicles, they
are then incorporated into the growing hair protein. Unlike other body
tissues, hair is a metabolic end-product that incorporates elements into its
structure while growing. As hair approaches the skin surface, it undergoes a
hardening process, or keratinization, and the elements accumulated during
its formation are sealed into the protein structure of the hair. Because of
the exposure of hair follicles to the blood supply during growth, element
concentrations of the hair reflect concentrations in other body tissues.
Extensive work is underway in the realm of urine
element testing. Hamilton, Poulsen, Sabbioni, Van der Venne, and others have
undertaken the herculean task of compiling reference range data for urine
and blood elements in various European populations. Urine is an appropriate
sample to assess the excretion of potentially toxic elements, providing a
window on levels retained in the body and indicating duration of
exposure—especially significant diagnostically because of the prevailing
patterns of exposure. In most developed countries, the situation parallels
that in Denmark, where "...high-dose environmental or occupational trace
element exposure rarely occurs and health risk assessment is mainly
pertained to the health effects of long-term low-dose exposure."8 Under
certain conditions, urine samples are optimal to gauge the effects of this
long-term, low-dose type deposition of toxic elements.
Thus, urine analysis can provide important information to the clinician that
may not be readily available with blood analysis. Minerals can be stored in
various tissues where they may cause damage or metabolic interference in the
depot structures (kidney, bone, nerve tissue) without causing particularly
elevated blood levels. Toxic elements are often cleared rapidly from the
blood, leaving only a relatively brief time window in which blood levels
reflect actual body burden. Cadmium, for example, has a biological half-life
in humans of greater than 10 years. Therefore, the cumulative deposition of
cadmium and other endurant elements can be of significant concern.9
Provocative testing can help determine such instances of toxic element
deposition and provide the clinician with clear therapeutic direction and
accurate monitoring of treatment response. In this technique, a strong
excretory inducer is administered to the patient after a pre-treatment urine
sample is obtained. After a given time frame, dependent upon the agent used
and the analytical technique applied, a second urine sample is collected and
the post-treatment excretion of elements calculated. This method allows a
sampling of the stored deposits of toxic elements which have been
sequestered from the blood.
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Symptoms linked to toxic elemental exposure |
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Arsenic Fatigue, headaches, dermatitis, increased salivation, muscular
weakness, loss of hair and nails, hypopigmentation of skin, anemia, skin
rashes
Cadmium Loss of sense of smell, anemia, dried scaly skin, hair loss,
hypertension, kidney problems
Lead In children: delayed mental development, hyperactivity, delayed
learning, behavioral problems
Children and adults: fatigue, anemia, metallic taste, loss of appetite,
weight loss and headaches, insomnia, nervousness, decreased nerve
conduction, possibly motor neuron disorders
Mercury Reduced sensory abilities (taste, touch, vision and hearing),
metallic taste with increased salivation, fatigue, anorexia,
irritability and excitability, psychoses, mania, anemia, paresthesias,
tremors, incoordination, cardiovascular disease, hypertension with renal
dysfunction |
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Levels of nutrient elements in the blood and the
excreted urine are tightly controlled via metabolic, reabsorptive, and
excretory mechanisms. Consequently, most urine testing is not helpful in
nutritional element assessment. However, inclusion of nutritional elements
among the analytes reported can support the study of nutrient/toxic
interactions. This practice is encouraged by the observation made by
Hamilton, et al. that "more attention must be paid to the concentration of
the major and minor elements, as so often they control the abundances of
minor and trace elements." As is also mentioned in this important work, the
biochemical mechanisms whereby an element is elevated or depressed are
crucial to elucidate since mineral eccentricities may be a secondary effect
of metabolic defects.10
It is important to note some of the conclusions by the researchers regarding
blood sampling; "...for the elements present in man, global uniformity in
abundances seems to occur which must reflect the control exerted by the
body, i.e. the overall homeostatic process."11 This uniformity supports the
gathering of reference range data and their inclusion as useful, stable
parameters of biologic function.
The ability of the blood to counter changes in element presentation keeps
nutritional and many toxic levels within a narrow range, unless under heavy
exposure. This homeostatic response illustrates the effective clearance
mechanisms in the blood, and largely explains the short-term utility of
blood analysis. The importance of exploring the depot-storage capacities of
various elements, particularly the toxic ones, remains a vital aspect in
Hair Tissue Mineral Analysis largely met by urine and hair testing.
Human exposure to toxic metals used in
industrial processes has increased dramatically during the last 50 years.
These toxins can lead to a variety of symptoms, and evaluating hair may
uncover these relationships (see sidebar). Since hair often serves as the
primary tissue examined, most of the following discussion focuses on this
sample for toxic element evaluation.
Hair has a long history in human and animal studies of revealing chronic
exposure to toxic metals. Because hair is biologically stable, accurate
assays can be performed on hair hundreds of years old. For instance, hair
samples taken from Napoléon were tested for arsenic poisoning.12 In recent
years, hair evaluation for toxic elements such as lead, mercury, cadmium,
and arsenic has received scientific validation. Studies confirm that toxic
elements can directly influence behavior by impairing brain function,
influencing neurotransmitter production and utilization, and altering
metabolic processes. Gastro- intestinal, neurological, cardiovascular and
urological systems are susceptible to impairment and dysfunction induced by
elements.
Environmental exposure to toxic metals may be infrequent and highly
variable, and hair element concentrations are most meaningful when
cumulative intake and exposure over time is the case.13-15 Research suggests
hair metal content provides a better estimate for long-term accumulation
when compared to blood metal levels.16 Hair is an excellent medium because
concentrations often are up to 300 times higher than those of serum or
urine. Because hair stores these elements, it is a barometer of early,
chronic exposure and often reflects excess exposure before symptoms appear.
Toxic elements have detrimental effects, even at minute levels, but the
effects vary with the mode and degree of exposure and with individual
metabolism and detoxification. Mechanisms of toxicity are multiple and
include enzyme or cofactor inhibition, enzyme potentiation, disruption of
membrane and other transport processes, and decreases in neuronal
functioning or nerve conduction processes. Some of these effects are
synergistic among elements or with toxic chemicals.
The level of toxicity of these elements and corresponding adverse effects
vary among individuals. Chronic, subacute exposure may lead to subtle or
overt long-term problems in selected individuals and is of particular
concern in children. Lead and mercury in particular show deleterious effects
in children, in part due to their high growth rates and low body mass. The
toxic elements may impair various enzymatic and neurologic processes
gradually and progressively. The following page shows some relationships
that have been made between toxic elements and various types of dysfunction.
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