Essentially everyone has heavy metal intoxication at some level. That's a result of the massive amounts of environmental pollutants that human cultures have been pumping out of industrial and other processes for a couple hundred years (while metals are "natural", their being in contact with us in a purified form instead of in ore, and in high amounts, is not natural). We didn't evolve with this type or level of toxicity and while human detoxification pathways are highly adaptable, any system will break down when an excessive load gets to be too much. Further, we DID evolve in natural environments and eating diets that stimulate our detoxification pathways and bodily functions in ways that a sedentary and comfortable indoor life cannot. So our cultural lifestyles have not only increased what our bodies have to deal with physically—but they've also decreased our ability to handle all of the excess toxicity. That's a bad combination, that leads to overall decreased wellness, and in individuals who are teetering on the edge of severe illness, this can be a huge factor in their disease and a serious block to cure if unaddressed.
Problems with the Most Common Forms of Heavy Metal Testing
The most commonly seen testing is hair, urine, and blood. These are all problematic in their own ways.
Blood testing is unreliable because other than in acute poisoning or ongoing exposure cases, for the most part, the body does its best to either excrete metals or to store them somewhere relatively safe: the bones, the fat, etc. and in either case, large amounts aren't in the blood to be detected. A negative blood test doesn't mean that there isn't a lot of metals in the body somewhere.
Both hair and urine are ways in which the body excretes metals.
If we do a hair test and it comes back with high levels of lead, for example, using that test alone, we have no idea whether 1) the patient has such high levels of lead that even though the body is effectively pushing it out through the hair, they still have high lead levels in the body that need to be addressed and may have an ongoing exposure; or 2) the patient is so effectively getting the lead out through the hair, that they have very low levels in the body; the body is managing it just fine, which means both that the body doesn't need any help and that if a patient has symptoms (which they probably do, since they are undergoing testing), that lead is not likely to be the cause of them, and further assessment of the real cause needs to be done.
On the other hand, if we do a hair test with very low levels of toxic metals, we don't know whether, 1) the patient's body is effectively excreting the metals that it's exposed to via another route (stool, urine, sweat, and/or menses); or 2) the patient is struggling so much to excrete metals that there isn't even any in the hair and therefore metals are a severe problem, are likely to be causing symptoms, will cause worse symptoms as long as it's going unaddressed, and needs to be treated. But, of course, even though this may be the patient that needs the treatment the most, it doesn't make sense to start a drastic metal detoxification program with only a negative hair test
Urine testing for heavy metals is basically the same story, but with the addition of the effects of compounds used in "challenge" testing. The concept is that there are a number of chelating compounds (DMPS, DMSA, EDTA, and others) that mobilize metals from areas of the body where they are stored and out into the bloodstream. Once in the bloodstream, the liver and kidneys will filter out some of these metals and some of those molecules will be excreted in the urine and feces. The urine is collected for a few hours after the chelating agent is consumed or injected and the metals are measured there. If there are high levels of some metal, then we know that the chelating agent can mobilize that particular metal and that the kidneys are able to excrete at least some of this material.
The problems are:
1) Again, it's possible that the metal is high in the urine because the body is already good at excreting it even without the challenge test, and that therefore it's not what is causing symptoms (a solution here would be to do both a challenge and non-challenged urine test, but since even doing both tests doesn't give definitive results, the cost of that doesn't make sense).
2) If a metal does not show up in the challenge test, we don't know whether that's because there is not much of that metal in the body or if it's because the body is hanging onto it so tightly that even the chelating agents are not a strong enough treatment to shake it. In this scenario, the tightly held metals may be the most dangerous/symptom causing and what most need to be treated, even though the test results are negative. We don't know based on that test alone.
3) The kidneys are not the ideal route for metal excretion anyway. The kidneys are very sensitive and are easily damaged by modern toxic material filtering through them. This problem is hugely exacerbated when a patient is put on chelating agents for long periods of time (and long periods of time are required for effective chelation), without appropriate support. There are many patients who have developed kidney failure (a very serious issue) after poorly managed heavy metal detoxification treatment. If the patient is already on appropriate detox support, pushing the metals out through other routes, the excretion of metals through the kidneys will ideally be very low, yielding a negative test. If this is the first test done then the patient and doctor might think that detoxification treatment is unnecessary. If this is a second or third test done, in order to monitor treatment, we can't tell whether treatment is complete or if the detox support is just working well but needs to continue, since in either case we expect the urine metals to be low.
The colon is the preferred organ to excrete heavy metals. The liver, gall bladder, the ducts to the intestines, and the intestines themselves, if working properly and if they have the right support, handle these inflammatory compounds in a way that doesn't damage them.
The three main needs for effective and safe metal excretion through the colon are:
1) The patient cannot be constipated. For casual/maintenance detoxification (without moderate or strong targeted detox therapies) the patient must have at least one complete and healthy bowel movement daily, but 2-3 is better. For rapid detoxification (as in chelation and other treatments meant to drastically increase the mobilization and excretion of metals) this has to be faster, and almost always requires colonic use for the duration of the treatment.
2) The liver has to be effectively filtering the blood. How effective the liver is working and what it needs to work better is highly variable. By the time someone has a chronic illness related to poor detoxification, there is no one-size-fits-all treatment and the case has to be gone over very carefully to uncover what the patient's needs are. They do usually involve some form of vitamin deficiency (all of the B's are common deficiencies, for example, but patients are usually deeply deficient in just a few, not all) and at least one issue with the lifestyle triggering the unideal activation or deactivation of important detoxification genes. How well the liver is filtering blood can be loosely assessed by the color of the stool. Bile contains the pigment that colors poop. The more bile there is, the darker it is. The less there is, the lighter it is, even to the point of being light greyish/white. If we are trying to detox someone as effectively as possible, we want the stool to be dark brown—not black, which may indicate bleeding in the GI tract, or charcoal intake.
3) A binder, or intestinal adsorber: a material that is ingested and sits in the intestines, ready to bind up bile and the toxic material it contains, so that it is taken completely out of the body and not reabsorbed somewhere along the 7 meters or 23 feet of intestines on the way. Without a binder, up to 90% of the toxic material and bile is reabsorbed.
If any of these three needs are not met or not met sufficiently, the patient is very likely to be made sicker from detox treatment because the metals were mobilized out of wherever the body had stored them—some of those metals were excreted, some were put back into a relatively safe storage place, like the fat (making it difficult to lose weight) or the skin (often yielding rashes and skin lesions of different kinds), and some end up in a less safe place than they were originally and where they can have severe risk to the patient's health: the brain, the heart, the kidneys, etc.
More Accurate Heavy Metal Testing
Since these testing methods are all faulty, and because there are few other commercial options, we have to use a combination of techniques to diagnose metal toxicity and be sure that it's an important cause of symptoms that needs to be addressed. In general, these are, though they vary on the case: spectrographic analysis of metals in the tissue, history of known exposures on both a personal (like the patient or their mother having mercury amalgams) and societal (as when lead was in gasoline; people who lived in that time and in a city or other area with high exhaust exposures are likely to be lead toxic) level, clinical symptoms known to correlate with metal toxicity, and ART (Dr. Klinghardt's Autonomic Response Testing).
More Effective Heavy Metal Detoxification than Chelation
While in some cases, especially with good support, chelation can yield good results, sometimes quickly, and in a few cases that's the best option. But in many other cases either the chelation is damaging/hard on the body and/or never seems to be effective or to be completed. In these cases, there is a better way.
When possible, it's better to work with the human body towards a goal than it is to force the it to do something. If the body is not excreting metals by itself, there is always a reason, sometimes several, and it can be harmful to go into treatment assuming that we know better than the body and that it's best to force it to drop the heavy metals via harsh chelation.
A few of the most common reasons that a body is hanging onto metals are these:
1) Intestinal inflammation. Many people who have studied physiology know about phase I and II detoxification. These are chemical processes in the body, constantly working to detoxify metabolic waste from the cells (basically: cells poop too) and toxic material from outside the body that have somehow gotten in. In around 2000, phase III was discovered (but is still not taught in most medical schools, either conventional or naturopathic, because of how slowly research moves into curricula). It's worth knowing a little bit about these three phases to understand what we need to do in order to optimize the body's own natural detoxification processes.
Phase I takes toxic molecules and alters them slightly so that they can be bound to a carrier molecule and moved out of whatever cell they are in. The side effect of these toxins being altered is that they are more toxic; they are deliberately made by the body into free radicals and they can damage nearly anything they touch. This is a calculated risk and it's not a problem, so long as both phase II and III are working.
Phase II takes these free radicals and binds them up with a safe carrier molecule, like glutathione, making them less toxic and able to move around the body (an excess of phase I activity and not enough phase II, which can happen for many many reasons, is often why liposomal glutathione can offer such fast, but temporary if root causes are unaddressed, relief of symptoms). This is necessary because in order to get a toxin out, we have to get it to where it can be filtered: the liver, kidneys, etc.
Phase III is also about moving toxins to where they need to be in order to get physically out of the body: mostly through the cells of the kidney, liver, and intestines, BUT the key here is that inflammation in the small intestines sends a chemical signal to all the cells of the body to stop detox processes: phase III and II. Another key point is that there is no feedback loop telling phase I to stop, so it continues on, producing free radicals, without the appropriate mechanism (II and III) to mop them up and get them out.
We can imagine it this way: if the small intestines are inflamed (usually from some toxic material there: unbound toxins from doing detox without an appropriate binder, waste products from dysbiosis, pesticides/herbicides in non-organic or contaminated "organic" food, poorly digested food, poor intestinal mobility causing food to sit in place and rot, mold biotoxins, etc.), the intestines "know" that they already have potentially damaging levels of inflammation, and tell the rest of the body to not send them any more inflammatory material until this is managed. Unfortunately, most patients are not getting the treatment they need to deinflame the intestines, because of almost constant exposure to pesticides/herbicides in food and because that is either/both not prioritized or not addressed sufficiently in conventional medicine, and even not in many alternative models, so phase III never works properly, which means phase II never works properly, and the patient goes into a spiral of worsening illness.
On the other side of that, if the intestines are properly deinflamed, and if the body has the nutrients it needs to mobilize toxins and filter the blood effectively, immense dumps of heavy metals and other toxins can occur, on a much greater level than with chelation, simply with these inflammation reducing and nutrient repletion treatments. AND the toxins are going through the correct route, instead of through the kidneys. This is the benefit of working with the body instead of forcing it via pharmaceuticals.
2) Mineral deficiency (and a reminder that this is the second reason that a body hangs onto heavy metals). The body prefers to use certain minerals in its chemical reactions, like iron in a hemoglobin protein in your red blood cells. But, if that mineral is not available, it can and will use metals in its place, if those are available. Though the metals don't work as well as the minerals do, they can keep a person functioning better than they would without, though ultimately we want their mineral levels back at a good level. Using the hemoglobin example, the body will use lead if needed, if not enough iron is available. In this case, it can be dangerous to force the body to drop the lead via chelation, and even that high amount of force will have minimal effect compared to what the practitioner might expect, because the body will resist releasing the lead. The proper way to handle this type of case is to provide the mineral that the body needs while making sure that it is both being absorbed well and taken where in the body it needs to be in order to be useful. When this is done, again, the body starts dumping metals quickly and without any direct treatment of the metals.
3) Psychological trauma and/or unhealthy subconscious associations between metals and things that the body actually needs. The most common type of example here is when a child grows up in a home with tobacco smoking parents, or with a parent who does extensive work as a mechanic, etc. The body and subconscious psyche can come to associate even these toxic materials with love, because the odor/inhaled metal particles and solvents were associated with the parent, and because seeking connection and love is a primal survival instinct in mammals, the physical body will sometimes hang onto these molecules, even though they are damaging. These are the patients in which even years of chelation therapy has not touched the metal toxicity. In these cases, the right route is to identify the metal and the associated emotional state or connection, and to treat that via methods like flower essences, EMDR, psychokinesiologie (PK/APN), etc. With these treatments too, I have seen cases undergo dramatic shifts and removal of metals in days/weeks that did not respond to years of pharmaceutical therapy.
As in every other disease or symptom, the cause and treatment of heavy metal intoxication is highly individual and giving all patients who appear to have the same diagnosis the same treatments is guaranteed to have some failure and even expose patients to dangerous circumstances. Even doing it in the most correct way we know is often a long and difficult road. Because of that, we have to look at the roots of this toxic issue and do what we can there. We also have to be reminded that as much as we are struggling with toxicity, so to are the plants, animals, and other natural resources that play a big part in our ability to really be well. This means speaking and acting whenever possible to reduce personal and societal toxicity sources via political action and personal choices.
The material above is not meant to be taken as medical advice, nor is the information here nearly complete enough by itself to make accurate or wise treatment decisions. Please talk with an appropriately trained healthcare provider before doing any detoxification treatment.