1

Detoxing Heavy MetalsIntegrative Approaches in Medicine

Harold Ravins, DDSHarold Ravins, DDSThe Center for Holistic DentistryThe Center for Holistic Dentistry

2

Advances in Holistic DentistryAdvances in Holistic Dentistry

Find hidden infections in the mouth– Not considered usual dental problems– Not the primary indicator of a health problem

How?– Good quality X-rays Bite analysis T-scan– Comprehensive exam Bio-electrical Impedance– Dental acupuncture Heavy metal fecal test– Energetic testing Other detection methods

3

Determination of Hg ToxicityDetermination of Hg Toxicity

Practical experience– 200 patients tested for heavy metals – 99% showed toxic levels of Hg

Discuss harmful effects of Hg to patients Give them educational literature Recommend fecal test Patients usually decide for themselves to have

amalgams removed

4

Mercury Situation in DentistryMercury Situation in Dentistry

ADA claims no scientific proof of leakage into the body

However:– FDA agrees that Hg is very toxic– Dentists are required comply with hazardous

waste remove for Hg– Test show high levels with amalgams– Amalgams banned in Europe– $2500 fine by EPA if office windows are opened

5

Shouldn’t we be concerned about the established relationship between toxins, cancer, heart disease, and other chronic illnesses?... Especially now that cancer is the #1 cause of death and the #1 cause of death among our children ages 1-15!

Why are we not addressing TOXINS!

Toxins?Toxins?

6

What can we do?What can we do? Inform ourselves as health care providers

what toxins are and how they damage biological systems

Develop ways to evaluate, measure and inform our patients

Develop simple, safe and effective means to do this

Let’s practice healing …Not Medicating

7

In the NewsIn the News 45 States Have Issued Mercury Advisories: coal-fired

power plants– Source: News-Leader.com – Quoted from the EPA and Department of

Natural Resources

Mercury and Fish Advisories Issued for Nine More Waterways– Source: De Ridder Beauregard Daily News –Quoted from The Louisiana

Department of Health and Hospitals Environmental Quality

Dangerous Lead Levels Found in More Homes– Source: Cincinnati Enquirer – Quoted from the EPA

Lead Linked to Premature Deaths in Adults: Early Exposure = 46% Higher Mortality– Source: The Baltimore Sun – Quoted from the CDC

8

In the News In the News (Cont’d)(Cont’d)

California Sues Over Heavy-Metal Fish– Source: Business Report – Quoted from the California Attorney General

Lead Poisoning Alert– Source: pediatrics.about.com – Quoted from the FDA

Mercury Air Level is Worry for Ohio– Source: Akron Beacon Journal – Quoted from the EPA

EPA Doubles Estimates of Children with Mercury in Blood

– Source: Access North Georgia – Quoted from the EPA

Mercury List Longer Each Year– Source: The News-Press – Quoted from Dept. of Environmental Protection

9

In the News In the News (Cont’d)(Cont’d)

CDC Vaccine Data Leads Scientists to Shocking Discovery: Possible Autism/Neurological Link– Source: Yahoo News – Quoted from the CDC

Chromated Copper Arsenate: CCA-Treated Lumber Poses Danger from Arsenic– Toxicol Sci. 2004 Jun;79(2):287-95

EPA: Amount of Toxins in Air, Water and Land Increased at Record Rate…– Source: Axis of Logic – Quoted from the EPA

FDA Warns Pregnant Women to Limit Tuna– Richard Simmons -Los Angeles Times 3/2004

10

Major Heavy Metal ToxinsMajor Heavy Metal Toxins

Mercury Lead Cadmium Aluminum Arsenic Nickel

11

Metal Toxicity MechanismsMetal Toxicity Mechanisms

Neurotoxic: damage brain structures; lower IQ; down-regulates dopamine activity

Nephrotoxic Immune dysregulation Cardiovascular Bone & tissue deposits Dysbiosis; fungal mycotoxins Endocrine disruption; thyroid, adrenal, sex h Cognitive problems; ADHD, Alz, depression Metabolic dysregulation; energy decline, etc

12

Health Care ProfessionalsHealth Care Professionals Education for your patients’ sake

– A plea to stay abreast of new modalities for patient care

• Be informed of what our industrialized society is doing to our patients’ health

• Be open to complementary treatments

• New diagnostic tests to assess toxicity

• Know that your patients are more informed and asking for our help for treatment and prevention of toxic pollutants

• Look toward innovation, science, research and validation of the best methods

to give your patients what they demand

13

Time-Lapse Microphotography of Toxic Effects Time-Lapse Microphotography of Toxic Effects on Human Cellson Human Cells

Normal Cell GrowthNormal Cell Growth Toxic Cell Damage and DeathToxic Cell Damage and Death

14

Lead-induced Hypertension: Lead-induced Hypertension: Role of Oxidative StressRole of Oxidative Stress

Chronic, low-level lead exposure causes hypertension in both animals and humans

Inactivation of endogenous nitric oxide Reactive oxygen species (ROS) lowers enzyme activity Functional deficiency in nitric oxide Increase sympathetic activity & plasma norepinephrine Lead-induced inhibition of vascular smooth muscle ACE, angiotensin II, aldosterone, thromboxane

Ref: Vaziri ND, “Lead-induced Hypertension: Role of Oxidative Stress,” Ref: Vaziri ND, “Lead-induced Hypertension: Role of Oxidative Stress,” Curr Hypertens Rep. 2004 Aug;6(4):314-20Curr Hypertens Rep. 2004 Aug;6(4):314-20

15

Random Blood Sampling of Dr. Ellithorpe’s Random Blood Sampling of Dr. Ellithorpe’s Patients: Presence Excessively High Heavy MetalsPatients: Presence Excessively High Heavy Metals

Per

cent

of

Pat

ient

s

N=251100

2217

0

25

50

75

100Presence of Heavy Metals

Elevated Heavy Metals

Potentially Toxic Heavy Metals

16

Sources of Toxic Metals - Sources of Toxic Metals - AluminumAluminum

Eating small amounts of aluminum in food Breathing aluminum dust in air Drinking contaminated water near:

– Waste Sites– Manufacturing plants– Areas naturally high in aluminum

Antacids Cooking utensils - minimal

Source: Agency for Toxic Substances & Disease RegistrySource: Agency for Toxic Substances & Disease Registry

17

Sources of Toxic Metals - ArsenicSources of Toxic Metals - Arsenic

Eating food, drinking water or breathing air containing arsenic

Breathing contaminated air Breathing sawdust, burning smoke Living near hazardous waste sites Living near high levels of arsenic in rock

Source: Agency for Toxic Substances & Disease RegistrySource: Agency for Toxic Substances & Disease Registry

18

Sources of Toxic Metals - CadmiumSources of Toxic Metals - Cadmium

Breathing contaminated air– Battery manufacturing– Metal soldering or welding

Eating foods containing cadmium:– Shellfish, Liver, Kidney meats

Breathing cigarette smoke Drinking contaminated water Breathing contaminated air

– Burning of fossil fuels, municipal waste

Source: Agency for Toxic Substances & Disease RegistrySource: Agency for Toxic Substances & Disease Registry

19

Sources of Toxic Metals - MercurySources of Toxic Metals - Mercury

Eating fish or shellfish Breathing vapors from:

– Spills, incinerators, industry

Dental work, medical treatments Breathing contaminated air or skin

contact:– Dental, health services, chemical, other

industries using mercurySource: Agency for Toxic Substances & Disease RegistrySource: Agency for Toxic Substances & Disease Registry

20

Sources of Toxic Metals - LeadSources of Toxic Metals - Lead

Eating food, drinking water that contains lead Lead base paints Working where lead is used Health care products containing lead Hobbies which lead is used:

– Glass staining

Source: Agency for Toxic Substances & Disease RegistrySource: Agency for Toxic Substances & Disease Registry

21

Global Chronic Low Level Metal ToxicityGlobal Chronic Low Level Metal Toxicity

Recognized by:– US Environmental Protection Agency (EPA)– Food & Drug Administration (FDA)– Centers for Disease Control (CDC)– State Health Departments

Treatment standards are needed– Preventative measures– Comprehensive medicine with proven results– Reduction of crisis management

22

There are NO Safe Levels of There are NO Safe Levels of Heavy MetalsHeavy Metals

Low levels are becoming dangerous Low levels accumulate Low levels become stored Low levels become higher Multiple toxins compound the danger

23

Death Rates of Participants with Low Death Rates of Participants with Low Pb Levels in NHANES III SurveyPb Levels in NHANES III Survey

17

39

46

68

46

0

10

20

30

40

50

60

70

80

10 20 30

All CausesCardiovascular Diseases Cancer

Per

cent

Incr

ease

in M

orta

lity

Ref: Lustberg, Mark and Silbergeld, Ellen. Blood lead levels and mortality. Arch Intern Med, 2002, 162: 2443-2449

Blood Lead Levels (µg/dL)

24

NHANES-III Survey ResultsNHANES-III Survey Results

Estimated 29 million people (15% of adult population over age 20) had Pb levels of at least 20 µg/dL from 1976-1980.

30 µg/dL Pb is considered toxic

Ref: Lustberg, Mark and Silbergeld, Ellen. Blood lead levels and mortality.Arch Intern Med, 2002, 162: 2443-2449.

25

Heavy MetalsHeavy Metals

Heavy metals and other toxins cause cell membrane damage through the production of free radicals and oxidative stress.

26

Human Cell SchematicHuman Cell Schematic

Cell Membrane

Mitochondria

Nucleus

Cytoplasm

27

The cell contains all of Life’s processes. Of particular importanceIs the mitochondria , which are the sites of energy production

28

The Cell and Mitochondria Membrane

29

Cell MembraneCell Membrane

Mitochondria MembraneMitochondria Membrane(Outer)

Mitochondria MembraneMitochondria Membrane(Inner)

30

Oxidative DamageOxidative Damage

31

Oxidative Damage to Cell Oxidative Damage to Cell MembranesMembranes

Healthy MembraneHealthy Membrane Oxidative Stress DamageOxidative Stress Damage

32

Lipid layer repaired

33

Chelation TherapyChelation Therapy

Modes– DMPS; IV, transdermal– DMSA; oral– Penicillinamine– EDTA

• IV• Oral• Rectal Suppositories

– Others • Oral supplements

34

Recommended ModalityRecommended Modality

CaNa2 EDTA Chelation Suppositories

35

DetoxaminDetoxamin®® CaNa CaNa2 2 EDTA EDTA SuppositoriesSuppositories

36

Why CaNaWhy CaNa2 2 EDTA Suppositories?EDTA Suppositories?

Non-invasive Safe Broad specificity metal chelation Easy to use Low cost Less time consuming Convenient

37

CaNaCaNa22 EDTA Chelation (Detoxamin) EDTA Chelation (Detoxamin)

FDA approved for lead detoxification Also chelates other metals

– Suppository form• Can be used in combination with IV, oral,

transdermal, topical or as stand alone therapy

– IV Chelation• Expensive• Time consuming – 3-5 hours• Invasive• Greater risk

38

Pharmacokinetic Pre-clinical ResultsPharmacokinetic Pre-clinical Results

Over 8 hoursOver 8 hours1.5 hours1.5 hoursHalf-LifeHalf-Life

13.613.63.73.7Blood to Blood to Tissue RatioTissue Ratio

36.3 %36.3 %100%100%Absolute Absolute Bioavailability Bioavailability

Rectal Rectal (Suppositories)(Suppositories)

IntravenousIntravenous

39

Specimen Collection SummarySpecimen Collection Summary

Pre-Detoxamin CaNa2-EDTA Suppositories– Comprehensive stool analysis with Fecal Metals analysis

Post-Detoxamin CaNa2-EDTA Suppositories– Comprehensive Stool Analysis with Fecal Metals analysis

after the 90th suppository

40

ProtocolProtocol

Challenge for Heavy Metals– 1.5 gm CaNa2 EDTA Detoxamin suppositories

• 2 - 750 mg suppositories at night– Fecal test - send to Doctors Data, St Charles, Illinois,

(800-323-2784) Typically several heavy metals are present

– Average 6-12– Elevated 1-4

Recommend Detoxamin suppositories at bedtime– Monday through Thursday nights x 90 suppositories– Consistently used – will be finished in 6 months

41

Protocol (Cont’d)Protocol (Cont’d)

Repeat the same challenge and compare results

Maintenance – 1 suppository last 5 nights of each month

Recommend Vitamin/mineral supplement– RepairACell or one of your choice

42

Why Detoxamin: CaNaWhy Detoxamin: CaNa2 2 EDTA EDTA Suppositories?Suppositories?

Clinically proven Unparalleled safety EDTA - US FDA approved for Pb detox Consumer friendly Low cost Can treat large patient population, home use Less time consuming than IV chelation Broad specificity metal chelation Easy to use and convenient Effective in children, adolescents and adults

43

Comparison of IV Chelation and Comparison of IV Chelation and DetoxaminDetoxamin

YesYes Clinically proven

NoYes Easy to administer

NoYes Greater risk

NoYes Expensive

NoYes Time consuming

NoYes InvasiveDetoxamin

IV Chelation

44

Detoxamin SafetyDetoxamin Safety

Comprehensive Metabolic Panel– Albumin - Total Protein– Total Bilirubin - Sodium – Calcium - AST (SGOT)– Chloride - Urea Nitrogen (BUN)

– Creatinine, Serum - Bicarbonate (CO2)

– Glucose - ALT (SGPT)– Alkaline Phosphatase - C-Reactive Protein– Potassium

No statistical difference in above lab parameters between pre and post treatment with Detoxamin in all subjects

45

Practical Clinical Case StudyPractical Clinical Case Study

NiPbHgCdDate

1327181.02/05

17272.61.02/04

9.543301.75/03

55 y/o 55 y/o • • W • F • 131 lbs. • School Teacher • Chronic LBP • Fatigue • HypothyroidW • F • 131 lbs. • School Teacher • Chronic LBP • Fatigue • Hypothyroid

Outcome: 7/04 – Excellent energy • Exercise 3x/day – water Outcome: 7/04 – Excellent energy • Exercise 3x/day – water aerobics • Back pain stable • Reduced need for medications.aerobics • Back pain stable • Reduced need for medications.

Patient K.MPatient K.M..

46

Practical Clinical Case StudyPractical Clinical Case Study

42 y/o 42 y/o • W • W •• F • 145 lbs. • Photographer • Fibromyalgia • Chronic Fatigue F • 145 lbs. • Photographer • Fibromyalgia • Chronic Fatigue •• HypothyroidHypothyroid

Outcome: 11/04 – Energy good • Exercises daily (45 min.) with Outcome: 11/04 – Energy good • Exercises daily (45 min.) with mild to moderate pain of fibromyalgia • Increased daily activitiesmild to moderate pain of fibromyalgia • Increased daily activities

NiHgPbCdArDate

188.9123.2455/03

25157.42.14.512/02

4924202.52208/02

F.K.F.K.

47

Practical Clinical Case StudyPractical Clinical Case Study

7.7163.80.75/04

1.6209.81.410/03

12121.61.012/04

3.6184.40.92/03

NiPbHgCdDate

8.4275.21.210/02

52 y/o 52 y/o • • M • 175 lbs. • Electrician • Chronic Anxiety Panic Attacks • Hypertension • LBPM • 175 lbs. • Electrician • Chronic Anxiety Panic Attacks • Hypertension • LBP

Outcome: 10/04 – Anxiety greatly improved • Reduced need for Outcome: 10/04 – Anxiety greatly improved • Reduced need for auxiolytic medication • Improved BP • Reduced anti-hypertensive auxiolytic medication • Improved BP • Reduced anti-hypertensive medication • LBP improved • Exercises daily (30 min.)medication • LBP improved • Exercises daily (30 min.)

Patient M.O.Patient M.O.

48

Detoxamin Excretion of Toxic Metals in FecesDetoxamin Excretion of Toxic Metals in Feces

.1

.5

.31

.37

.15 .16

.72*

.56

.93*

.44*

0

0.2

0.4

0.6

0.8

1

Arsenic Lead Mercury Cadmium Uranium

Day 0 Cumulative Day 3 + Day 90

*Significantly different from Day 0 (p<0.05)

Mea

n V

alue

sm

g/kg

49

Detoxamin Excretion of Toxic Metals in Detoxamin Excretion of Toxic Metals in FecesFeces (Cont’d)(Cont’d)

6.2

12.7*

0

2

4

6

8

10

12

14 Day 0

Cumulative Day 3 + Day 90

Mea

n V

alue

mg/

kg

*Significantly different from Day 0 (p<0.05)

NickelNickel

50

Detoxamin Excretion of Toxic Metals in UrineDetoxamin Excretion of Toxic Metals in Urine

5.5

15.6

1.8 1.73.6

5.84.9

1.3.5

10.1

13.5

36.6

0

5

10

15

20

25

30

35

40

Aluminum Arsenic Lead Mercury Cadmium Nickel

Day 0

Cumulative Day 3 + Day 90

Mea

n V

alue

sµ

g/g

crea

tinin

e

*Significantly different from Day 0 (p<0.05)

*

**

* *

*

51

Detoxamin SafetyDetoxamin Safety

Comprehensive Metabolic Panel– Albumin - Total Protein– Total Bilirubin - Sodium – Calcium - AST (SGOT)– Chloride - Urea Nitrogen (BUN)

– Creatinine, Serum - Bicarbonate (CO2)

– Glucose - ALT (SGPT)– Alkaline Phosphatase - C-Reactive Protein– Potassium

No statistical difference in above lab parameters No statistical difference in above lab parameters between pre and post treatment with Detoxamin between pre and post treatment with Detoxamin in all subjectsin all subjects

52

Detoxamin Safety Detoxamin Safety (Cont’d)(Cont’d)

Observations within study– Dosage form is gentle– Little biological burden– In general, very well tolerated

Historical events– Over 450,000 doses administered within the past

five years• Minor complaints with first few applications

– Loose stools– Rectal gas – Headache – Lethargy– Joint pain

53

Detoxamin Clinical Pilot Study SummaryDetoxamin Clinical Pilot Study Summary

Significant excretions observed– Fecal

• Ar, Pb, Cd, Ni

– Urine• Ar, Pb, Hg, Cd, Ni

Average change in pre and post DMSA– Fifty percent for Al, Ar, Pb, Hg, Ni – No difference with Cd

54

NHANES-III Survey ResultsNHANES-III Survey Results

Estimated 29 million people (15% of adult population over age 20) had Pb levels of at least 20 µg/dL from 1976-1980.

30 µg/dL Pb is considered toxic

Ref: Lustberg, Mark and Silbergeld, Ellen. Blood lead levels and mortality.Arch Intern Med, 2002, 162: 2443-2449.

55

Effects of Detoxamin on Elevated Effects of Detoxamin on Elevated Lead Urine Levels in ChildrenLead Urine Levels in Children

In connection with Columbia and Fordham U Purpose: To demonstrate gradual lead reduction

in blood and urine Conducted in Dominican Republic

– Residential neighborhood near battery recycling plant– 20 children identified with blood levels over 10 µg/dL– Initial mean blood determination of 66.6 µg/dL Pb– Note: Blood levels of > 10 µg/dL are of CDC concern– Treatment with 1000mg Detoxamin suppositories

56

Effects of Detoxamin on Elevated Lead Effects of Detoxamin on Elevated Lead Urine Levels in ChildrenUrine Levels in Children

4.2

61.45

9

22.7

0

20

40

60

80

100

0 1 10 20 30

Pre-Treatment Baseline

After 1st Suppository 10 Days of Suppository

10 Days After Suppository 10 Days Additional Suppository

325.6

µg/

dL

Treatment Day

N=20

57

Effects of Detoxamin on Elevated Lead Effects of Detoxamin on Elevated Lead Urine Levels in Children - SummaryUrine Levels in Children - Summary

Significant excretion of Pb was observed after only one initial dose of Detoxamin (325.6µg/dL or 78 times more Pb excreted above baseline of 4.2µg/dL)

Gradual Pb excretion occurred continually of a 30 day period

58

Detoxamin Instructions for useDetoxamin Instructions for use

Administration– Self application rectal suppository– One per evening or one every other evening– Evacuate bowels before application– Three to six months duration

Recommendations– Eat evening meals 3-4 hours prior to Detoxtamin

• Protein rich with low sugar content– Take quality multi-vitamin/mineral supplement in AM

Maintenance– Six Detoxamin suppositories per month

For more information call 1-877-656-4553 – www.Detoxamin.com

59

Effects of Detoxamin on Elevated Effects of Detoxamin on Elevated Lead Urine Levels in ChildrenLead Urine Levels in Children

In connection with Columbia and Fordham U Purpose: To demonstrate gradual lead

reduction in blood and urine Conducted in Dominican Republic

– Residential neighborhood near battery recycling plant

– 20 children identified with blood levels over 10 µg/dL– Initial mean blood determination of 66.6 µg/dL Pb– Note: Blood levels of > 10 µg/dL are of CDC

concern– Treatment with 1000mg Detoxamin suppositories

60

Comparison of IV Chelation and CaNaComparison of IV Chelation and CaNa2 2 EDTA EDTA SuppositoriesSuppositories

YesYes FDA approved

YesYes Clinically proven

YesYes Broad spectrum metal removal

YesNo Increased safety

YesNo Inexpensive

YesNo Quick and easy to use

YesNo Non-Invasive

Rectal

Suppositories

IV

Chelation