Heavy Metal Toxicity leads to Immune Mediated Inflammatory Disease leads to Immune System Dysregulation.

This blog endeavors to synthesize a broad range of information into a cohesive package. The impetus for this is relatively recent articles on Autoimmunity inductioin by heavy metals (I have recently included the citation) and a current article in Pain that describes that in the US population chronic pain has increased over the last decade form 18% in the adult population to 23 %. In this latter article they have attributed much of this to chronic Covid.

When reading articles on health, since so many people write them with a knowledge base range from zero to a great deal. There should be a rating scale, so the reader has a sense if the author has the wisdom to write it. Scholar GPS rates my accomplishments over my career as in the top 0.05%. This includes approximately 400 peer-reviewed articles that are themselves cohesive. What many may not appreciate, is that one thing that writing many peer-reviewed articles teaches an author is that you have to dampen your enthusiasm about your observations and not consider them too expansive. EVen though at times I have disliked having to do this, nonetheless this is in general a wise concept. Everyone who writes articles on health should start with the introduction of what their scholar GPS score for career accomplishment in scholarship. Mine is in the top 0.05% of all scholars on all subjects.

Starting from the top and narrowing the focus down:

Health reflects a combination of 3 properties: genetics, environment, and diet... We could add in luck.

Management of disease involves 3 strategies: avoidance, detoxification (I include active treatment here), and removal. Luck could also be added here.

So when we then consider Health and Management of disease what is presently most under our control where-ever we live is Diet and Detoxification, and the simplest and most clear approach for this is choosing wisely the foods we eat. Environment and Detoxification is the next most manageable strategy, but this may involve moving to a less toxic environment and still combined with diet modification. For many people the physical moving where they live is not so readily achievable. In all these cases avoidance is also wise, but for most things the best we can do is minimization. The general category of stress can probably be placed under the heading of environment, although often this reflects the environment we create in ourselves and not just the external environment. Removal is in general terms the best way to manage most invaders or toxins, but is achievable in only a few of them (I highlight heavy metal in this category) Genetics has been a topic that has been considered immutable (unalterable), but ofcourse now this can be done with gene remodeling with CRISPR technology and gene substitution. This latter topic has been the subject of why federal funding should not be interrupted for Harvard This latst subject is the most fascinating and exciting, but it is also futuristic, and in that future are also robots that will eliminate all of us.

This has been the two-edge sword of American health care, the love and pursuit of modern treatment approaches (read expensive) but neglecting the most affordable and impactful approaches which are prevention. This is why we are by far the highest paying nation per individual on health care, at least double the second highest countries, and at the same time ignoring the basic, most effective approaches: prevention

So why is chronic pain becoming more and more prevalent in the population. The broadest category is from Immune System Dysregulation caused by the increased number and amount of agents that cause Immune Mediated Inflammatory Diseases (IMID). Toxins are by far the most common cause of these.

Among the broad categories of IMID causing toxins are the following:

Heavy Metals

Microplastics

PFAS

Glysophates

Air Pollutants

Endocrine Disruptors

Agricultural chemicals (beyond glysophates)

General disruptors

In many of these categories there are numerous if not 100s of species.

Industrial Solvents

The primary management for all these things is ofcourse avoidance, but also unfortunately in the modern world the most we can hope for is minimization. I highlight heavy metals, as this is the area of my expertise, which I am expanding further into, and microplastics, because this worries me the most.

So all of the list can result in IMIDs and all contribute to our overall Immune System Dysregulation. It is fair to say that all of is have some amount of Immune System Dysregulation, but what we want to do is keep it under control so that it stays the size of a ping pong ball, and we try to avoid it continuing to grow to soft ball size (at which chronic pain arises) to basketball size, at which point unfortunately the medical term for what has happened is that we are f'ed. Think of the near final scene of the movie Indian Jones and the Raiders of the Lost Ark, where the villains open the Ark on the remote island.

Once the Immune system dysregulation has become soft ball sized then suddenly all the toxins we have trapped in various biological systems in our body come into play, and can be released in various forms. What I term Abyssus Abyssum Invocat (one hell calls forth another). So the circumstance I often describe is once one gets GDD from a GBCA, then suddenly other heavy metal that are stored in our body, such as lead and mercury, are no longer stored but now contribute to disease.

Microplastics I find most frightening. What we need is some combination of the US Preventive Services Task Force and the NY Times Wirecutter to inform us of the worst settings and worst kinds for microplastic introduction in our bodies. In the mean time we want to employ the tactic of minimization, use less plastic in things we consume. In my sphere of medicine, as I describe the issue with Gd in GBCAs, unlike essentially all other heavy metals, Gd we main line (using a drug addict term) into our body by intravenous injection. So we bypass the probably atleast 4 layers of protection we have evolved to with our skin and digestive tract. The same applies then to microplastics. For years now I have avoided using unnecessary iv's and iv infusions, which are essentially everything that is not DTPA, for basically everything, starting with iv's for hang-overs, prefering to take in supplements, etc by oral route, this strategy therefore has by good circumstances avoided too much microplastic introduction. The next step for me is to look at using even in the limited numbers we do of plastic elements (mainly bags, also iv tubing) that is less likely to introduce microplastics. These microplastics include DEHP/PVC/latex.

Now to put this all together into a Health Plan and Disease Management. This starts with things that are relatively affordable, do-able, and important.

Stress Management:

This is also Marcus Aurelius first rule: Possess a calm spirit.

My interpretation of all various approaches: meditation, hypnosis, prayer, yoga, listening to calm music, silence - all of these relate to keeping stress low. The impact of stress on health is under-recognized in general, but is of huge importance, and some level of this is under our control. I do not agree that any one of these can cure anything completely, as a number of gurus in these areas maintain, but this is also not to say this is not important, it certainly is, and if it contributes 15% towards getting healthier, then we should all do this.

Socialization with nice people. Owning a dog, are in this category

Diet and the Microbiome.

Some version of the Mediterranean Diet is the best type of diet. I prefer to consider that one should strive for Healthy Foods locally sourced. Depending on the time of year ofcourse some foods have to be from Chile (for example) , so as with everything I recommend wise management of the overall plan, there are no absolutes. There are many gurus on various forms of diets, and fad-seekers seeking the latest diet, but no. What however is critical: pay attention when foods that are supposed to be healthy, no longer are healthy, which often is a reflection of the ambient pollution. The poster child for this is kale. Unfortunately by and large avoid kale, because it often has accumulated Thallium and cesium. As the most effective of the cruciferous at concentrating sulfur (in healthy form) it is also the most effective at concentrating the pollutants Thallium and Cesium. Substitute in broccoli instead.

Microbiome. I have blogged on this before. Restore the microbiome with sensible strategies. Employ a broad range of microbiome restorative products.. but nothing crazy It is worth highlightin that although diatomaceous earth does have health benefitting properties, it also contains rare earth metals like Gd. So if heavy metal toxicity is a principle devil in your immune system dysregulation, do not take it.

Exercise

Exercise is extremely important. But the age-old adage of everything in moderation applies here. So walking, swinging your arms, yoga, Tai Chi, dancing by yourself, pickle ball, little jogging, light cycling all apply here. It should not surprise you that a number of extreme athletes die young. The Goldilocks principle applies here. This includes doing it regularly.

Physical managements such as sauna, Hyperbaric Oxygen Therapy (HBOT), and ozone treatment have all been tried with heavy metal toxicity and GDD. Sauna may have the most experience, and should be tried. However if the individual has lost the ability to sweat from Gd or other heavy metals, this can be a very damaging treatment, as the body will heat up, with the sweating off-ramp, and be put into metabolic acidosis and severe Flare. HBOT also has a fair amount of experience. There are advocates for ozone, and I am not there yet.

Prevention:

Prevention essentially entails avoidance. This by far the most cost-effective strategy for improving the health of the population, and yet what we do the worst.

On a national basis what should happen is that even as we move forward, and maybe especially as we move forward, the most important instruction children should get from preschool through lower grades (really all grades) is the focus on diet and physical activity. These are the most essential instructions of all instructions that can be given. Interestingly these are also instructions that Benjamin Franklin described and Aristotle before him.

In my opinion the most beneficial and arguably the most justifiable form of restitution the nation may owe to anyone is to ensure that children in underprivileged neighborhoods get nutritious food, and instructions of nutritious food purchase and preparation in school. Free healthy lunches, and in some cases and communities, free healthy breakfasts and dinners should be offered, and the elements of why the meals they are served are nutritious serve as part of the teaching. We often think of saving millions on various changes, even billions, this simple modification would save trillions. This would have the largest impact on the (Splanchnic) Metabolic Syndrome, which half of the adult population sufferers from, with the massive healthcare costs stemming from all the consequences of obesity.

So school should focus on instruction on diet, exercise, and tolerance for other people. Those are the elements DET... the DET we owe are children and the children of others. So exercise should not be things that children detest, like rope climbing or running a long distance, but things that the individual child likes - so permit more individualization. Something like pickle ball may be good for many. Not so technically challenging, you can run around, out in sunshine and fresh air, and having fun hitting a ball with a paddle. Soccer too is very good and this has been broadly applied throughout the USA,

Children taught to accept diversity - it doesn';t have to be some weird celebration of diversity that many, especially parents may object to. I have written before on my opposition to the concept that there are no genders, this is folly. Acceptance for different types of individuals. O have also written before that the perception of being transgender in my opinion likely in the modern age is from toxins causing decrease in the natural forms of children, testosterone in boys, estrogen in girls. Assessing these levels and treating them if they are very low is the first step for true gender affirmation.. Read thes above two sentences a few times as you gloss through my treatise.

Prevention/ avoidance/ minimization of heavy metals:

One relative success story is the minimization of the amount of lead exposure the American public sustains presently by removing/decreasing the amount of lead in gasoline and in paint. On the other hand there are more and more reports of lead in many products we use routinely. from baby food to tampons.

Similarly removing arsenic from chicken feed a few years back has reduced our exposure to Arsenic. Mercury and cadmium have also experienced recognition of sources of exposure.

The one metal that we can theoretically avoid for the future is Gd. This is why I have taken as my major stance with GBCAs, practitioners must recognize when GDD has started in a person, because the primary treatment is avoidance for all future MRIs. This simple strategy would reduce the number of meaningful cases by atleast 75%, and reduce serious/ untreatable cases by atleast 95%.

The reality for most things is the best we can hope for is to minimize future exposure, but that said we do have to take this minimization very seriously, as this will have an enormous impact. If we can juist reduce the exposure to heavy metals and all other toxins this will greatlyu impact our level of national and global poor health and chronic pain.

Detoxification:

I have a different view on detoxification than many. I don't see detoxification as taking supplements for a few months, I see detoxication as a life long pursuit. I certainly don't lie as a whole individual pills and capsules, but food sources and preferably whole foods. I also never liked iv supplements much, and now even less because of the risk of microplastics.

Also the problem that our bodies experience in amplifying polluted environment is excess inflammation.The immune system is not necessarily depleted, but rather dysregulated, which is a more challenging problem. Dysregulation means the immune system still works, but may at times work in an unpredictable fashion, such that things that in principle be good, like a vaccine for a virus, are in fact harmful because the immune system is reacting in a different fashion than desired to its introduction. The net result is I favor supplements, dietary additions that are anti-inflammatory in nature, and not immune boosting. Boosting an abnormal immune response may be then more deadly. The point is it is unpredictable. So I focus on anti-inflammatory foods. supplements. I have also focused on elements that suffers of GDD have described as helpful.

So the diet has to include whole foods that have anti-inflammatory properties. I favor blueberries, fresh pineapple, nuts, and the reader should look up and continue to follow the legitimate literature. In general I am fond of olives, avocadoes, spinach, and whole beets. As far as supplements Turmeric, chlorella, and ginger. The inclusion of alkaline water with some frequency.

I have not been impressed that supplements like glutathione or NAC show benefit. It may be they do, but the amount appears to be < 1%. It is clear that poor quality supplements that don't contain what they claim to contain or contain other toxins, like lead, can be harmful.

Disease Treatment:

The majority of health care dollars are focused on treatment. Again I consider this overwhelming extent of this misplaced. This includes various forms of surgery and various forms of drugs. The complaint that many have with drugs is the focus appears on disease maintenance rather than cure. Ofcourse the focus of antibiotics is cure of infections.

Removal:

Total removal is generally the best treatment, if it can be done. Killing things in the body and leaving it there, expecting the immune system can be fraught with problems, such as overwhelming the immune system ability to clean up. This can be observed in blood cell malignancies.

Classical treatment of cancers has been surgical removal. This often in the present age supplemented with prior treatment with drugs and/or radiation (termed neoadjuvant) and post surgery (adjuvant). Removal with no other treatment still is done with small tumors that may be renal cancers or colon polyps for example.

Of all the toxin groups listed above, the only group that is amenable to removal is the heavy metals. The method of removal us with binding to a chelator and the metal therapy being removed bound to the chelator. The current emphasis of my work has expanded beyond Gd removal, and applying the same principles manage other heavy metals. I have written other blogs describing the essential features of a metal chelator. In brief it has to have high stability with the metal of interest (which is experienced as toxic), and that the chelator can bind effectively inside the body under physiological conditions. Obviously the chelator has to be fundamentally safe.

At the present time our strategy of DTPA combined with steroids/antihistamines is the most effective approach available for Gd, but the exact protocol is most effective for lead, and likely Cadmium. It also has to be appreciated that each heavy metal has their own stability with a particular chelator, so the same chelator may not be ideal for all heavy metals. So the first plan is maximize the use of chelators for heavy metals, by better understanding properties like stability, and developing new chelators using these principles for metals not as well removed. This may include chromium. Obviously creating oral chelators will greatly improve cost, accessibility, convenience, and safety, recognizing the potential for more plastic introduction in the body from plastic iv components like iv bag, tubing, and syringes.

Complexity of Immune System Dysregulations

It must also be understood, that doing chelation does not obviate the other strategies described above. This largely reflects that heavy metal toxicity forms part of the larger picture of immune system dysregulation. Attempt to determine if a certain IMID is the initiation or entry point to Immune System Dysregulation or the consequence to IMID. As example, if GDD is the initiation of Immune System Dysregulation, and the overall condition is mild, then simple chelation with DTPA and steroids/antihistamines will have rapid and near complete cure to the entire dysregulation. If however it is the consequence of pre-existent severe Immune System Dysregulation, then more complex treatment will be required, with near cure less certain. Nonetheless chelation should still be performed. All the other approaches must also be done: prevention, detoxification, microbiome restoration, etc.

Additions to chelation therapy that can address the complexity of GDD on its own, and as part of a larger picture of Immune System Dysregulation are drugs that act by serving as an anti-inflammatory or immune system dampening. Low DOse Naltrexone is an example of the former, and has been shown to exhibit benefit in GDD sufferers. An example of an immune system dampening agent would be low dose Rapamycin. The use of Rapamycin has been described in a small study with Nephrogenic Systemic Fibrosis, and others have suggested it for the general public at large to serve as an anti-inflammatory/ anti-oxidant for everyone in a highly toxic world. In my opinion there is no data yet, and I have no personal experience with this, but it seems like a medication worth trying in an individual refractory (not responding) to all other treatment.

Future Research:

1. In discussing heavy metals, why do only a few people who have these metals in them also experience toxicity? This reflects that most of these deposition disease states actually represent a combination immunologic/toxicity one-two combination. Why do some individuals immune systems allow for the toxicity to occur, while many their immune system prevent or block this. Answering this question would unlock tremendous knowledge for not only heavy metal toxicities, but likely for all disease which are essentially invader based (infections and cancers)

2. Are there genes that predispose to Heavy metal toxicities.

3. Newer, better chelators. Better defined combined treatments for IMIDs of all types.

4. Other treatments. CRISPR, mRNA based treatments to alter genetics and epigenetics.

5. What about chelators for other toxins, so they also can be removed, and not just the uncertain management of detoxification. Binding antibodies, also bound to other molecules that can facilitate elimination. This doubel binding strategy with an antibody in the midle is currrently under development for cancers.

Summary:

To bring in a concept described in earlier blogs: two tracks of thought are necessary:

1. understanding an expanded body of knowledge of all the entities and risks described above,

2. remain calm

   
   

   This does seem an impossible task but is necessary. A broad understanding of the above, and keeping up-to-date on it, but to not be consumed by it. This often means striving to do the best you can, but don't make the good be the enemy of the perfect. A calm good is much better and healthier than a stressed near perfect.

   
   

   Richard Semelka, MD

   
   

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