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Toxic Metals and Inflammation

Karina is a 61 year old woman who came to my office after being diagnosed with polymyalgia rheumatica. She appeared healthy and fit and expressed confusion about the diagnosis and upset about her treatment plan from the rheumatologist. Karina had been on 10-20mg of Prednisone daily for almost 1 1/2 years. Her pain was tolerable on that dose but without it and even at a reduced dose, she described incapacitating pain throughout her joints.

She described a very active and healthy lifestyle leading up to the sudden onset of painful joints. She had never taken any medications and had never been hospitalized. She exercised regularly and ate a healthy whole foods diet her entire life. She was eager to get off the Prednisone and to find an explanation for her illness.

Karina had seen several specialists, including a Lyme disease specialist. We reviewed pages of labs results and radiographic studies. Without a clear direction, I asked her to keep a diet journal for me and fill out other dietary questionnaires. I started her on Vital Nutrients Ultra Pure High Potency Fish Oil at 1 teaspoon three times daily with food and ordered the only test I did not initially see had been done: a serum level of 25-OH Vit D.

Two weeks passed and Karina returned to go over her lab result. Her Vit D level was significantly below normal and I advised her to start Vital Nutrients Vitamin D3 2,000iu/cap -1 capsule daily with food. She had kept up with her fish oil, yet reported only a slight decrease in pain and stiffness, but said her skin was softer and her occasional afternoon headache had not occurred since she started the fish oil.

While reviewing her diet information, I noticed she had eaten tuna fish every day that she recorded her diet. I asked her about her fish intake in general. Karina stated that she loved fish and had eaten it 5-7 days a week for most of her life. Without hesitation, I discussed with her the concept of heavy metal toxicity and the idea of taking a DMSA challenge and testing her urine for toxic elements (Doctor's Data (800) 323- 2784 or www.doctorsdata.com).

Karina's urine test results showed the highest levels of mercury and arsenic that I had seen. Using the standard protocol, she underwent two rounds of DMSA therapy before we evaluated her levels again. Although her pain symptoms had only reduced about 50% after the 2 rounds of DMSA, she had been able to also wean entirely off her Prednisone. When the repeat test showed about a 60% reduction in the levels of Arsenic and Mercury, we discussed repeating another round of DMSA treatment and did so. Currently, Karina has been off her Prednisone for 4 months and completed her DMSA treatment 6 weeks ago. She is virtually pain free and has started exercising again. She is happy to get the benefit of essential fatty acids from the Fish Oil she is taking without worrying about the potential heavy metal hazards of eating fish and admits she is so overjoyed by her comfort. Her energy has returned and she is happy to eat fish once a year, on her birthday, if she feels the need.