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IV Chelation Therapy: Finding a Doctor Who Will Test for and Treat Heavy Metal Toxicity

Posted By University Health News, January 17, 2017, Monday, February 20, 2017

VIEW ORIGINAL PUBLICATION by UHN

Excessive toxic metal exposure from the air, food, water, dental amalgams, and other sources is becoming a recognized and established underlying cause of both acute and chronic disease. With ongoing medical research validating the link between chronic diseases like heart disease and environmental exposure to toxic metals, it is more important than ever for doctors and patients to be well-informed about the detrimental effects of toxic metals and the potential treatments for heavy metal toxicity, including IV chelation therapy.

What is chelation?

The Greek word “chele” means claw. Chelation is the binding of metals (like lead) or minerals (like calcium) to a protein “chelator” in a pincer-like fashion, forming a ring-like structure. Chelation is an important treatment protocol for the removal of toxic metals such as lead and mercury from the body’s bloodstream and tissues. Natural chelation, although weak, regularly occurs from eating certain foods such as onions and garlic. A stronger chelation effect can be induced when certain supplements, such as some amino acids, are taken orally. The strongest chelation effect is achieved with intravenous chelation. 

What is chelation used for?

Intravenous chelation therapy is used and accepted within conventional medicine as an FDA-approved treatment for the removal of toxic minerals such as lead from the body in cases of severe poisoning. However, it is also used in a  less conventional way: the repeated administration of intravenous chelating agents is used to reduce blood vessel inflammation caused by specific toxic metals and to reduce the body’s total load of those metals, especially lead. It has been shown that the risk of dying from cardiovascular events begins when a person’s blood level of lead is still well within the established normal reference range.[1]

IV chelation therapy often utilizes the chelating agent disodium ethylene diamine tetraacetic acid (EDTA) and is sometimes referred to as EDTA chelation. EDTA chelation is being used in the treatment of all forms of atherosclerotic cardiovascular disease, especially heart disease and peripheral artery disease. Although there is less published research in these areas, chelation therapy is also being used to treat macular degeneration; osteoporosis; mild to moderate Alzheimer’s disease associated with heavy metal toxicity; autoimmune diseases, especially scleroderma; and fibromyalgia or chronic fatigue syndrome with high levels of toxic metals detected with a challenge test.[4]

Does chelation really work?

The most recent study to examine the effects of EDTA chelation therapy showed compelling value for preventing cardiovascular events, especially in people with diabetes who had a history of heart attack. The controversial Trial to Assess Chelation Therapy, or TACT, found an amazing 40% reduction in total mortality, 40% reduction in recurrent heart attacks, and about a 50% reduction in overall mortality in patients with diabetes who had previously suffered from a heart attack.[2] TACT was a large, randomized, placebo-controlled study published in JAMA that randomized patients to a series of IV chelation using EDTA or placebo.[3]

What kinds of doctors offer IV chelation therapy?

Doctors must be well-trained in chelation therapy in order to utilize the correct tests and treatments. Testing for toxic metal exposure is not straightforward since blood tests typically identify only those with severe and acute toxicity but fail to identify those with toxic metals stored in the tissues due to chronic exposure. Applying the appropriate chelating agent to properly treat toxic metal accumulation is also not a straightforward endeavor. Different chelating agents bind with different affinity to different metals. Some chelating agents may be taken orally, while others are administered intravenously.

Chelation therapy is not taught in conventional medical school but rather through various professional medical organizations. The most recognized leader in educating and certifying healthcare professionals, including MDs and NDs, in chelation therapy is the American College for the Advancement of Medicine (ACAM). ACAM’s chelation therapy training teaches doctors how to diagnose and treat patients with heavy metal toxicity as well as how to use diet and nutrients to optimize toxic metal chelation strategies and protocols.

 

[1] ACAM website. Detoxification / IV Chelation. Downloaded Jan 7, 2014.

[2] Medscape Heartwire. 2013, Nov 19. ‘Extraordinary’ Chelation Effects…. Downloaded Jan 7, 2014.

[3] JAMA. 2013;309(12):1241-1250.

[4] Townsend Ltr. 2013 Aug/Sept. Report on the Proceedings of a Summit…. Downloaded Jan 7, 2014.

This article was originally published in 2014 and has been updated.

Tags:  chelation  chelation therapy  detoxification  toxins  university health news 

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NIH Study Finds Two Pesticides Associated with Parkinson's Disease

Posted By Administration, Monday, February 14, 2011
Updated: Friday, April 18, 2014

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New research shows a link between use of two pesticides, rotenone and paraquat, and Parkinson's disease. People who used either pesticide developed Parkinson’s disease approximately 2.5 times more often than non-users.

The study was a collaborative effort conducted by researchers at the National Institute of Environmental Health Sciences (NIEHS), which is part of the National Institutes of Health, and the Parkinson's Institute and Clinical Center in Sunnyvale, Calif.

"Rotenone directly inhibits the function of the mitochondria, the structure responsible for making energy in the cell," said Freya Kamel, Ph.D., a researcher in the intramural program at NIEHS and co-author of the paper appearing online in the journal Environmental Health Perspectives. "Paraquat increases production of certain oxygen derivatives that may harm cellular structures. People who used these pesticides or others with a similar mechanism of action were more likely to develop Parkinson's disease.

The authors studied 110 people with Parkinson’s disease and 358 matched controls from the Farming and Movement Evaluation (FAME) Study (http://www.niehs.nih.gov/research/atniehs/labs/epi/studies/fame/index.cfm) to investigate the relationship between Parkinson’s disease and exposure to pesticides or other agents that are toxic to nervous tissue. FAME is a case-control study that is part of the larger Agricultural Health Study (http://www.niehs.nih.gov/research/atniehs/labs/epi/studies/ahs/index.cfm), a study of farming and health in approximately 90,000 licensed pesticide applicators and their spouses. The investigators diagnosed Parkinson's disease by agreement of movement disorder specialists and assessed the lifelong use of pesticides using detailed interviews.

There are no home garden or residential uses for either paraquat or rotenone currently registered. Paraquat use has long been restricted to certified applicators, largely due to concerns based on studies of animal models of Parkinson's disease. Use of rotenone as a pesticide to kill invasive fish species is currently the only allowable use of this pesticide.

"These findings help us to understand the biologic changes underlying Parkinson’s disease. This may have important implications for the treatment and ultimately the prevention of Parkinson's disease," said Caroline Tanner, M.D., Ph.D., clinical research director of the Parkinson’s Institute and Clinical Center, and lead author of the article.

The NIEHS supports research to understand the effects of the environment on human health and is part of NIH. For more information on environmental health topics, visit www.niehs.nih.gov. Subscribe to one or more of the NIEHS news lists (www.niehs.nih.gov/news/releases/newslist/index.cfm) to stay current on NIEHS news, press releases, grant opportunities, training, events, and publications.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visitwww.nih.gov.


Reference: Tanner CM, Kamel F, Ross GW, Hoppin JA, Goldman SM, Korell M, Marras C, Bhudhikanok GS, Kasten M, Chade AR, Comyns K, Richards MB, Meng C, Priestly B, Fernandez HH, Cambi F, Umbach DM, Blair A, Sandler DP, Langston JW. 2011. Rotenone, paraquat and Parkinson’s disease. Environ Health Perspect; doi:10.1289/ehp.1002839 [Online 26 January 2011].

Source: National Institutes of Health (NIH). February 11, 2011. NIH study finds two pesticides associated with Parkinson's Disease. http://www.nih.gov/news/health/feb2011/niehs-11.htm?

Tags:  NIH  parkinson's disease  toxins 

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Cancer Causing Chemicals: Dangerous Exposures Everyday

Posted By Administration, Thursday, January 27, 2011
Updated: Friday, April 18, 2014

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by Nalini Chilkov, LAC, OMD

More than 80,000 chemicals now in use have never been fully assessed for toxic impacts on human health and the environment. Many of these chemicals are linked to increased incidence of cancer. Watch this shocking and disturbing video by expert Linda Greer, the Director of the Health Program at NRDC, the Natural Resources Defense Council, one of the most effective environmental protection groups. She clearly states that there is a lack of government oversight by the, EPA, the U.S. Environmental Protection Agency, the very department that is supposed to be protecting us, but protects corporate interests instead, putting our lives and our children’s health and wellbeing at risk.

The chemical industry should have to demonstrate that a chemical isn’t dangerous before it’s used in everyday products. But the Toxic Substances Control Act (TSCA) has no such requirements.  These regulations have not been updated since 1976.  It’s time to require that all chemicals be tested for safety and grant the EPA the authority to protect the public from toxic chemicals. But chemicals are “innocent until proven guilty”. This means chemicals are in use that have no proven safety record. Watch the video

 

The Breast Cancer Fund has a comprehensive report on the link between environmental toxic chemicals and breast cancer. The President's Cancer Panel released a report in April 2010  detailing the link between cancer and toxic exposures including chemicals used in industry, in the military and in medicine.  The report states that “the link between exposure and cancer is strong” and  ”the risk of cancer increases with more exposure”. Children, the unborn fetus and pregnant women are at greatest risk.

If you wish to be informed about the chemicals in products that you use at home and work, visit the website of the Environmental Working Group. They also have another website devoted to the many unregulated toxic chemicals found in personal care products such as shampoos, lotions, toothpaste and cosmetics.  Another educational site that shows you how to  feed your family safe and healthy food and reduce your chemical exposures at home is Organic Authority.

Dr. Sanjay Gupta, MD, a medical doctor and medical journalist produced a television series "Toxic America" which reveals the most common chemicals that are linked to a multiplicity of health problems, including many cancers that are ubiquitous in our daily lives.  This report brings to light the many chemicals that find their way into the womb and into newborns who are come into life on day one with high levels of toxic chemicals in their tiny and developing bodies and then nurse on toxin laden breast milk increasing their body burden of dangerous chemicals.

Tags:  cancer  toxins 

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Toxic!

Posted By Administration, Thursday, December 2, 2010
Updated: Friday, April 18, 2014

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by Joel Lopez, MD, CNS

Ebola, AIDS, MRSA, Vancomycin-resistant Pseudomonas, chloroquine-resistant Plasmodium (cause of Malaria). These are just a few of the super bugs that we could all possibly encounter in our world that’s rapidly getting smaller every day due to air travel. In recent times when sea travel was the main mode of transportation, people who were still asymptomatic would usually show signs and symptoms before they arrive at their destination. In today’s world of faster air travel, people infected may not show signs and symptoms until they arrive somewhere. This can cause the rapid spread/transmission of communicable diseases. This is especially true in a stressed-out, nutritionally-deficient, and unhealthy population.

What is the traditional answer to this issue? I think that we all know the answer to that. Suffice it to say, this reactionary approach (the race to find cures) doesn’t work well because these bugs are smarter than we think. By the time so-called cures are available, they’ve already mutated to a form that’s resistant to the “cure”. That’s one of the reasons why we have MRSA and Vancomycin-resistant Pesudomonas, among many others.

There is no one to blame for this scenario. Health care practitioners (by indiscriminate use) and patients (by insisting that they be given a medication) alike are responsible for the proliferation of super bugs.

What then can we do about it? I would say that we adopt what the traditional Chinese medicine practitioners did in earlier times. A doctor at the time would only get paid or compensated when their clients are healthy. If their clients get sick, the doctors don’t get paid. It does make a lot of sense to do this. This preventive approach would save billions of dollars in health care.

What are the things we can do to fortify our immune system? Let’s start with the basics before we even discuss specifics. Having a healthy diet, adequate water intake, enough exposure to sunlight and the earth’s electromagnetic energy, rest, exercise, good relationships and stress reduction all go a long way in building our immune defenses.

There are ways to strengthen the immune system with the use of dietary supplements. Here are just a few examples;

  • mixed carotenoids (natural vitamin A)- good for the mucous membranes (respiratory and intestinal tract protection)
  • vitamin C complex (natural vitamin C with bioflavonoids)- traditionally used to boost the immune system against infections and tumors but also good for formation of collagen, along with L-lysine and L-proline
  • vitamin D3- studies show that it could protect against the flu (low levels of exposure to sunlight during the winter months make one vulnerable to the flu) and against certain forms of cancer
  • selenium- one of the co-factors in the formation of glutathione, which is abundant in the spleen and lymphocytes, both involved in immune system health
  • zinc- has antimicrobial properties and also good for prostate health in men
  • manganese- helps in the production of SOD, one of the antioxidants endogenously produced in our bodies
  • probiotics- an essential nutrient especially if one has taken antibiotics in the past, helps prevent bacterial and fungal overgrowth in the intestine
  • clove- has the highest ORAC (antioxidant levels) level among all natural substances, has antimicrobial properties as well
  • thyme- its constituent thymol has antifungal properties
  • lemon- has d-limonene which has anti-carcinogenic properties, has anti-viral properties as well (along with other citrus oils)
  • cinnamon- has antibacterial properties, also regulates blood sugar
  • rosemary- antimicrobial and anti-inflammatory
  • oregano- antimicrobial
  • chlorella and spirulina- immune stimulants
  • raspberries- rich in ellagic acid, which has anti-carcinogenic properties
  • apricots- rich in vitamin B 17, also has anti-carcinogenic properties
  • wolfberries- stimulates release of HGH from the pituitary
  • broccoli and other cruciferous vegetables- lowers xenoestrogens, cleanses liver
  • frankincense- helps repair DNA

 

Tags:  toxins 

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Case Study on Autism Severity Associated with Toxic Metals

Posted By Administration, Friday, October 1, 2010
Updated: Friday, April 18, 2014

Abstract 624138171_f262cd06cb_b

This study investigated the relationship of children's autism symptoms with their toxic metal body burden and red blood cell (RBC) glutathione levels. In children ages 3–8 years, the severity of autism was assessed using four tools: ADOS, PDD-BI, ATEC, and SAS. Toxic metal body burden was assessed by measuring urinary excretion of toxic metals, both before and after oral dimercaptosuccinic acid (DMSA). Multiple positive correlations were found between the severity of autism and the urinary excretion of toxic metals. Variations in the severity of autism measurements could be explained, in part, by regression analyses of urinary excretion of toxic metals before and after DMSA and the level of RBC glutathione (adjusted R2 of 0.22–0.45, P < .005 in all cases). This study demonstrates a significant positive association between the severity of autism and the relative body burden of toxic metals.

Background

Autism is a severe developmental disorder which involves social withdrawal, communication deficits, and stereotypic/repetitive behaviour. The pathophysiological etiologies which precipitate autism symptoms remain elusive and controversial in many cases, but both genetic and environmental factors (and their interactions) have been implicated. One environmental factor that has received significant attention is the body burden of mercury, lead, and other toxic metals [1-5].
 
Bernard et al. [1] discussed the many similarities between the symptoms of children with autism and children poisoned by mercury. An epidemiology study by Windham et al. [2] found that the amount of airborne pollutants, and especially mercury, correlated with an increased risk for autism. A study by DeSoto and Hitlan [3] found that blood levels of mercury did significantly correlate with the diagnosis of autism. A small study by Adams et al. [4] found that children with autism had a 2-time higher level of mercury in their baby teeth than typical children. A study by Bradstreet et al. [5] investigated the body burden of toxic metals by giving dimercaptosuccinic acid (DMSA), an oral chelation medication approved by the FDA for treating infantile lead poisoning. They found that the children with autism excreted 3.1 times as much mercury into their urine (which is where DMSA is excreted), P < .0002, but lead and cadmium levels were not significantly different. Overall there is some evidence to suggest that mercury and possibly other toxic metals are related to the etiology of autism.
 
This study investigates the possible relationship of the severity of autism to the relative body burden of toxic metals. The severity of autism was assessed using four tools, a professional evaluation based on the Autism Diagnostic Observation Schedule [6], and parental evaluations based on the Pervasive Developmental Disorders Behaviour Inventory (PDD-BI) [7], the Autism Treatment Evaluation Checklist (ATEC) [8], and the Severity of Autism Scale (SAS). The individual burden of toxic metals was assessed based on urinary excretion, both before and after taking oral dimercaptosuccinic acid (DMSA). DMSA is a licensed medication for treating lead poisoning and indicated in cases meeting toxic criteria. DMSA is, however, widely used off-label for other metal exposures, for example, mercury. It acts by forming sulfhydryl linkages to divalent metal cations, forming a chelated metal complex which is then excreted in the urine [9]. Urine measurements before and after taking DMSA provide an indication of both ongoing environmental exposures (before DMSA provocation) and the accumulated or relative body burden (postprovocation with DMSA). Red blood cell (RBC) glutathione was measured because it is one of the body's primary means for excretion of toxic metals.
 
This paper investigates the possible relationship of the severity of autism to the body burden of toxic metals and RBC glutathione levels. This paper is part of a larger study which investigates the safety and efficacy of DMSA therapy, including both the biological consequences [10] and the DMSA associated behavioural effects [11]. The larger study involves a 3-day round of DMSA, to screen for admission into a 3-month DMSA treatment study; only children with high levels of urinary toxic metals were admitted into the long-term 3-month treatment study.


 
Methods
The methodology is discussed in detail in the companion paper [10]. Briefly, this study was conducted with the approval of the Human Subjects Institutional Review Board of Southwest College of Naturopathic Medicine. All parents and (where possible) children signed informed consent/assent forms. The study participants were recruited in Arizona, with the help of the Autism Society of America—Greater Phoenix Chapter and the Arizona Division of Developmental Disabilities.
The entry criteria were the following.
  • Children with autism spectrum disorder, diagnosed by a psychiatrist, psychologist, or developmental pediatrician.
  • Age 3–8 years.
  • No mercury amalgam dental fillings (due to a concern of their interaction with DMSA).
  • No previous use of DMSA or other prescription chelators.
  • No anemia or currently being treated for anemia due to low iron.
  • No known allergies to DMSA.
  • No liver or kidney disease.
  • Children are well hydrated (receiving adequate daily intake of water).
Four metrics were employed to assess the severity of autism: the PDD-BI, ATEC, SAS, and ADOS. Multiple assessment instruments were selected because they each provide insights into various aspects of autism. The ATEC was completed approximately 2-3 weeks prior to taking the DMSA, and the other three instruments were completed approximately 2–4 weeks after the initial 3-day round of DMSA, for children whose excretion of toxic metals was deemed high enough to warrant continuation in the long-term treatment study. The ATEC, PDD-BI, and SAS were assessed by the participant's parents, and the ADOS evaluation was performed by a certified ADOS evaluator. It should be noted that the ADOS was developed primarily for diagnosing autism, whereas the other tools were developed for assessing changes in autistic symptoms during treatment studies.
 
DMSA was administered orally in 9 doses of 10 mg/kg, 3 times daily, over 3 days. Urine was collected for approximately 8 hours prior to taking the DMSA, and for approximately 8 hours immediately after the 9th dose, in a process similar to a previous retrospective study of relative body burden of heavy metals [2]. RBC glutathione was measured approximately 1-2 weeks prior to taking the DMSA. The details of measuring the urinary metals and RBC glutathione are given in [10].
 
The PDD-BI is composed of many subscales. One of the subscales, the Semantic/Pragmatic Problems (SPPs), was difficult to interpret, since children with no spoken language inappropriately scored as less severely affected than those with limited language. Therefore, we exclude the SPP subscale in the Autism Composite score, resulting in a modified Autism Composite score consisting of Sensory/Perceptual Approach, Ritualisms/Resistance to Change, Social Pragmatic Problems, Social Approach Behaviors, Phonological and Semantic Pragmatic subscales. This modified Autism Composite score was discussed with I. Cohen, the developer of the PDD-BI. We believe that this modified subscale is more useful because several children initially without speech began talking after DMSA treatment in the study. The development of speech led to a worsening of their score on the SPP, because a nonverbal child is given a score of zero (indicating no semantic/pragmatic problems, which is the same score a typically developed child would receive) compared to a child with limited speech but major semantic/pragmatic problems who would receive a high score on the SPP. Thus, we think the modified Autism subscale (without the SPP) is more useful for children with very limited or no language.
 
In order to assess global changes in autism severity, a new metric was developed for this study. The Severity of Autism Scale (SAS) is introduced for the first time in this series of papers. It is essentially a Clinical Global Impression scale using a 0–10 severity scale, with the difference being that the scale was made specific to autism by defining the numeric values (see below). The purpose of the tool is to provide a simple, overall assessment of the severity of the symptoms of autism. In this study we will analyze the correlation of this scale with the other more established assessment tools.
Severity of Autism Scale:
  • 0: normal,
  • 1: slight symptoms of autism,
  • 2–4, mild symptoms of autism,
  • 5–7, moderate symptoms of autism,
  • 8–10, severe symptoms of autism.
63 participants were assessed with the ATEC, and 49 participants were assessed with the PDD-BI, SAS, and ADOS. Fewer participants were assessed for the latter three tests because some participants had low urinary excretion of toxic metals and were not eligible to continue, and some participants dropped out. Table 1 lists the characteristics of the participants.
 
Table 1
Characteristics of participants. The second number is the standard deviation.
 Total
Total participants 63
Male 57
Female 6
Age (years) 5.6 ± 1.6
Diagnosis 62 autism, 1 Asperger's

ATEC (total) 62 ± 28
SAS 5.1 ± 2.2
ADOS (communication + social) 15.8 ± 6.5
PDD-BI (modified autism score) −54.3 ± 62

RBC glutathione (pre-DMSA) 501 ± 246 micromolar
 
Table 2 lists their average urinary excretion of toxic metals before and after taking DMSA.
 
Table 2
Urinary excretion of toxic metals in Phase 1, at baseline and after 9th dose of DMSA, in mcg/g creatinine. Creatinine values have units of mg/dL. N = 63. The metals are listed in approximate order of effect of DMSA on excretion. Significant results are highlighted in bold font.
ElementBaselineAfter 9th doseAfter 9th dose versus baseline
Pb 1.3 ± 2.3 9.2 ± 7.8 638%****
Sn 2.3 ± 3.4 9.7 ± 24 314%**
Bi 0.18 ± 0.45 0.41 ± 1.0 128%**
U 0.015 ± .04 0.031 ± .1 111%
Hg 0.86 ± .92 0.97 ± 0.88 13%
Tl 0.15 ± 0.12 0.21 ± 0.19 42%***
Sb 0.10 ± 0.10 0.14 ± 0.20 42%*
W 0.3 ± 0.29 0.46 ± 0.50 18%**
Al 16 ± 21 19 ± 33 21%
Ni 6.7 ± 5.1 7.6 ± 4.3 12%
Cd 0.38 ± 0.24 0.3 ± 0.23 −14%
As 32 ± 20 25 ± 18 −19%**
Creatinine 94 ± 52 80 ± 43 −15%**
*P < .1, **P < .05, ***P < .01, ****P < .001

2.1. Regression Analysis
Regression analysis was employed to examine the relationship between the severity of autism (assessed by the ATEC, PDD-BI, SAS, and ADOS) and the urinary excretion of toxic metals, (both before and after taking DMSA), and further with the initial glutathione (in the red blood cells). For the selected dependent and independent variables, stepwise linear regression analyses were conducted: initially all independent variables were included in the regression; then at each step, the variable with the highest P-value was eliminated, and this process was continued until the adjusted Rvalue began declining. Thus, the goal was to determine the best fit to the sample data for the selected model, taking into account the correlation among the independent variables. Since the data had several missing values (due to missing lab or behavioural data), the regression analyses were conducted in two slightly different ways which generally yielded very similar results: ( 1) eliminate all participants with missing data for any of the variables in the model at the beginning of the analysis, and ( 2) eliminate participants on an as-needed basis (i.e., only where there is missing data for any variable in the current step in the analysis). Since these two methods yielded very similar results, for brevity we only report the results for method 1.
 
Results
3.1. Correlations of Severity Scales
Table 3 shows the correlations among the assessment scales. There is a high correlation between the ATEC and the PDD-BI (r = 0.87), and a good correlation of the SAS with the ATEC (r = 0.70) and the PDD-BI (r = 0.72). The correlation of the ADOS with the other scales is somewhat lower (r
 = 0.60–0.67), probably since the ADOS evaluation was done by a professional evaluator, whereas the other assessments were done by the same parent.
 
Table 3
Correlation of autism severity scores.
 
 ATEC totalSASADOS (social + communication)PDD-BI (modified autism score)
ATEC 1      
SAS 0.70 1    
ADOS 0.60 0.60 1  
PDD-BI 0.87 0.72 0.67 1
 
3.2. Correlation Analysis
Table 4 shows the results of a simple correlation analysis of severity of autism versus toxic metal levels. Correlations with a P-value of less than .05 are shown in bold. Baseline excretion of antimony (Sb) and excretion of lead (Pb) after the 9th dose of DMSA are the two most consistent factors, although other metals also haveP < .05 for some of the severity scales. In all cases for P < .05, the correlations are positive, so that high levels of toxic metals correlate with higher severity of autism, as expected. Also, the initial glutathione correlates positively with two of the severity scales at P
 < .05.
 
Table 4
Correlation analyses of initial autism severity versus urinary metal excretion and initial glutathione. The metal excretion is measured both at Baseline (before DMSA) and after the 9th dose of DMSA. The first number in each cell is the correlation coefficient (r) and the second number is the P-value. Correlation coefficients with P < .05 are in bold. The last 2 rows list the total number of positive and negative correlation coefficients, respectively.
 
 ATEC totalADOS (social + communication)SASPDD-BI (modified autism score)
PbBase −0.00 (0.96) 0.11 (0.47) 0.50 (0.0002) 0.22 (0.12)
SnBase 0.16 (0.32) −0.11 (0.47) 0.12 (0.41) 0.09 (0.52)
TlBase 0.13 (0.32) 0.10 (0.49) 0.21 (0.15) 0.25 (0.077)
HgBase 0.13 (0.33) 0.05 (0.76) 0.15 (0.31) 0.18 (0.19)
SbBase 0.40 (0.002) 0.35 (0.02) 0.51 (0.0002) 0.42 (0.0023)
Wbase 0.16 (0.23) 0.07 (0.67) 0.26 (0.07) 0.17 (0.22)
AsBase 0.04 (0.74) −0.05 (0.73) 0.00 (0.98) 0.04 (0.76)
CdBase 0.00 (1.00) 0.11 (0.48) 0.03 (0.83) −0.10 (0.48)
AlBase −0.06 (0.65) −0.19 (0.20) −0.05 (0.73) 0.02 (0.87)
Pb9 0.27 (0.04) 0.34 (0.02) 0.36 (0.01) 0.42 (0.0027)
Sn9 −0.02 (0.88) 0.00 (0.98) 0.02 (0.87) −0.12 (0.42)
Tl9 0.26 (0.046) 0.11 (0.51) 0.27 (0.064) 0.24 (0.098)
Hg9 0.09 (0.52) 0.20 (0.18) −0.02 (0.91) 0.07 (0.59)
Sb9 0.03 (0.84) 0.20 (0.19) 0.38 (0.008) 0.26 (0.065)
W9 0.11 (0.42) 0.34 (0.02) −0.00 (0.99) 0.19 (0.18)
As9 0.19 (0.16) −0.24 (0.12) −0.24 (0.11) −0.04 (0.79)
Cd9 0.07 (0.58) 0.34 (0.024) 0.08 (0.57) 0.15 (0.29)
Al9 0.06 (0.65) 0.28 (0.059) 0.25 (0.089) 0.17 (0.24)
Glut1 0.25 (0.04) 0.34 (0.024) 0.25 (0.09) 0.26 (0.70)
Number of positive coefficients 17 15 15 16
Number of negative coefficients 2 4 4 3
 
However, because we are analyzing many correlations, a traditional 
P-value of < .05 is not a rigorous guide. Since we are analyzing 76 possible correlations, random chance alone would result in approximately 4 results at P < .05. We found 13 instances of P < .05 for toxic metals, and the probability of that occurring randomly is 7 × 10−5, so it is very likely that most, but probably not all, of the correlations represent actual relationships.
One way to deal with the problem of multiple correlation analyses is the Bonferroni approach. Using this approach involves dividing the nominal P-value by the number of tests, so that for 95% confidence one needs a P-value less than .05/76, or P < .0007. Using the Bonferroni approach, the correlations between initial Severity of Autism Scale (SAS) and baseline excretion of lead (Pb) and antimony (Sb) are significantly different from 0 at the 95% confidence level, and these are the only pairs that meet the Bonferroni criterion for the 5% significance threshold. Again, it should be noted that this is a conservative approach, designed to ensure that very few nonsignificant correlations are misrepresented as significant.
False discovery rate (FDR) is a less conservative method for performing multiple hypothesis tests, based on controlling the expected number of false positives among the cases declared significant. If we use FDR on the summary severity scores, then in addition to the results obtained from the Bonferroni analysis, the correlation between Initial ATEC Total and baseline excretion of antimony (Sb), and the correlations between Initial PDD-BI Autism Total and baseline excretion of antimony (Sb) and 9th dose excretion of lead (Pb) are significantly different from 0; we will term these findings “marginally significant.”
Next, consider the numbers of positive and negative sample correlation coefficients in the table. If there were no statistically significant correlations between autism severity and biological measures then we would expect on average about equal numbers of positive and negative sample correlation coefficients. For the summary severity measures, we observed 63 positive sample correlation coefficients (r's) and 13 negative r's. This corresponds to a P-value of 3 × 10−9 for the hypothesis that there is no correlation between the severity measures and biological measures. Thus it is extremely likely that there is a high overall positive correlation between the severity measures as a group and the biological measures taken as a group.
 
Finally, the average of all of the 76 sample correlation coefficients is 0.14. If there were no statistically significant correlations between autism severity and the biological measures, the average of 76 sample correlation coefficients (each of which was taken form a sample of size 40 or more) would come from a distribution with mean 0 and standard deviation equal to 0.02. Under those conditions, the P-value for a mean correlation coefficient of 0.14 is less that 10−10, so again it is extremely likely that there is a high overall positive correlation between the severity measures as a group and the biological measures taken as a group.
 
Since multiple correlations were obtained, it was decided to conduct regression analyses, which are discussed in the next section. Basically, a regression analysis allows for the simultaneous consideration of multiple factors, such as how well certain combinations of different toxic metal excretions can predict values of a specific autism severity measure.
 
3.3. Regression Analyses of Initial Severity of Autism
Tale 5 shows the results of stepwise linear regression analyses for the various autism severity scales as a function of urinary excretion of toxic metals (at baseline and after the 9th dose of DMSA) and initial glutathione. All of the analyses found that the variations in the severity of autism could be partially explained by the urinary excretion of toxic metals and initial glutathione, with adjusted R2 values ranging from 0.22 to 0.45, and P-values all below .005. For the ADOS (which had the highest adjusted R2), the most significant variables were mercury (Hg) and antimony (Sb) at baseline and mercury and tungsten (W) at the 9th dose.
 
Table 5
Regression analyses of initial autism severity versus urinary metal excretion and initial glutathione. In the regression equation, the suffixes for the metals refer to the value at Baseline (B) and after the 9th ( 9) dose of DMSA in Phase 1.
 
 AdjustedR2P-valueEquationMost significant variables
ATEC 0.22 .003 24.1–6.17 HgB + 76.6 SbB + 0.593 Pb9 + 3.97 Hg9 + 0.27 As9 SbB**, Pb9*
SAS 0.36 .002 4.81 + 1.70 PbB + 4.87 TlB − 0.640 HgB + 5.48 SbB − 1.87 CdB − 0.0237 AlB − 0.114 Pb9 − 3.14 Tl9 + 6.07 Sb9 PbB**
ADOS (comm. + social) 0.45 .0003 13.19–4.29 HgB + 24.1 SbB − 3.67 WB − 0.0673 AlB + 2.75 Hg9 + 6.60 W9 − 0.0539 As9 + 0.0054 Glut HgB**, SbB*, Hg9*, W9*
PDD-BI (modified autism score) 0.25 .004 −131.8 + 70.4 WB − 0.789 Sn9 + 18.8 Hg9 + 255 Sb9 + 21.8 W9 Sb9**, WB*, Sn9*
 
**P < .01, *P < .05

Since the ADOS score had the highest adjusted R2 values, we also conducted a similar regression analysis on the subscales—(a) language and communication; (b) reciprocal social interaction; (c) play; (d) stereotyped behaviors and restricted interests (SBRIs). Those results are show in Table 6. The variation in all four of the ADOS subscales could also be partially explained by urinary excretion of toxic metals and RBC glutathione (adjusted R2 of 0.21–0.41, P < .02 in all cases). The ADOS Sociability and the ADOS Communication subscales had the highest adjustedR2 (0.41 and 0.37, resp.). For the ADOS Sociability subscale, the most significant variable was tungsten at the 9th dose, followed by tungsten, aluminum, and thallium at baseline and lead and thallium at the 9th dose. For the ADOS Communication subscale, the most significant variables were mercury (at baseline and 9th dose) and antimony (Sb) at baseline.

Table 6
Regression analyses of initial ados subscales versus urinary metal excretion and initial glutathione. In the regression equation, the suffixes for the metals refer to the value at Baseline (B) and after the 9th ( 9) dose of DMSA in Phase 1.
 
 AdjustedR2P-valueEquationMost significant variables
ADOS-Sociability 0.41 0.004 8.70 + 1.20 PbB + 0.217 SnB + 12.7 TlB − 1.64 HgB − 10.2 SbB − 2.61 CdB − 0.631 AlB − 0.186 Pb9 − 7.13 Tl9 + 6.27 Sb9 +6.15 W9 +3.62 Cd9 W9***, AlB**, TlB*, HgB*, Pb9*, Tl9*
ADOS-Commun. 0.37 0.0003 2.39–2.57 HgB + 23.1 SbB + 2.32 Hg9 + .0048 Glut HgB**, Hg9**, SbB**
ADOS-Play 0.24 0.004 1.20 + 0.540 PbB + 4.23 Sb9 + 0.0017 Glut PbB*
ADOS-SBRI 0.21 0.02 4.64–0.897 HgB − 2.63 CdB − 0.26 AlB + 0.050 Pb9 + 0.730 Hg9  
 
***P < .001, **P < .01, *P < .05

 

Since the toxic metal excretions exhibit considerable correlation amongst themselves [10], one should refrain from reading too much into the relationships between specific metals and severity of autism and instead should interpret the results as indicating a general relationship between autism severity and urinary excretion of toxic metals.

Discussion

The different assessment tools were found to be highly correlated, which generally supports the validity of each of the assessment tools. The correlations were the highest between the modified PDD-BI and the ATEC, suggesting that those scales are very consistent. The ADOS had a lower correlation with the other scales; this at least partly due to different evaluator for the ADOS (assessed by a professional certified in the ADOS) versus the ATEC, modified PDD-BI, and SAS which were assessed by the same person (the parent who was the primary care giver).
 
The various correlation analyses found that overall there were multiple positive correlations between the severity of autism and the urinary excretion of some toxic metals (both before and after taking DMSA). Lead (after DMSA) and antimony (at baseline) had the most consistent effect, but other metals were also important. The existence of multiple positive correlations suggested that a regression analysis was appropriate.
 
The regression analysis found that the body burden of toxic metals (as assessed by urinary excretion before and after DMSA) was significantly related to the variations in the severity of autism, for each of the four scales. The metals of greatest influence were lead (Pb), antimony (Sb), mercury (Hg), tin (Sn), and aluminum (Al). Different metals are significant for the different scales, and this partial disagreement is probably due to two factors. First, the severity scales are not identical, having somewhat different questions and evaluating symptoms somewhat differently; as pointed out in Table 3, the correlations between the scales are good but not identical. Second, it should be noted that the high correlation between urinary excretion of many of the metals (see Adams et al. [10]) makes it difficult to separate the effect of one metal from another. This makes it improper to assign too much meaning to specific regression variables and their coefficients. Thus, it is probably best to not overinterpret the results in terms of a particular metal, but to instead interpret them as evidence of the general role of toxic metals in relation to the severity of autism. Since oxidative stress and thiol metabolic disturbances have both been described in the autism population [12, 13], it is likely that these play a role in both relative burden and susceptibility to heavy metals. And since heavy metal exposure generates oxidative stress and thiol depletion, the potential etiological role of metal cations in generating autism symptoms should be further studied. Similarly, prior depletion of thiols and increased oxidative stress makes it more likely the individual will accumulate metals.
 
It should also be noted that each severity scale assesses a somewhat different aspect of autism; for example, the ATEC has a major section on physical health, which is not assessed by the other scales. So, that may also explain why the different scales have somewhat different relationships with different metals.
 
The ADOS had the highest adjusted R2 value, suggesting that it is a very useful scale for assessing the severity of autism and for inclusion in correlation and regression analyses with biological factors. This may be due to the fact that, of the four tools we used, only the ADOS involves a trained professional making a quantitative assessment of many children, whereas the other tools are assessments by parents of only their child.
 
The strong correlation of the SAS with the other scales, and the high adjusted R2value (0.36), suggests that the SAS is a useful tool for simple assessment of the severity of autism.
We are aware of two other studies which found a relationship between the severity of autism and a biomarker related to heavy metal toxicity. One study by Geier et al. [14] found that elevations in urinary porphyrins (associated with mercury or lead and mercury toxicity) were significantly associated with Childhood Autism Rating (CARS) scores. A second paper to report a relationship of the severity of autism with a biomarker was a study which found a strong inverse relationship of the severity of autism with the amount of mercury in the baby hair of the subjects [15]. However, a replication study [16] did not reproduce that correlation with severity. So, while two studies [14, 15] do support a possible relationship of variations in the severity of autism with body burden of toxic metals, as was found in this paper, additional research is needed to confirm this finding.
 
This paper has focused on the possible relationship between toxic metals and the severity of autism. It has not included an examination of the source of those metals. Mercury, lead, and other toxic metals come from many sources. There has been particular interest in the possible relationship of autism and thimerosal (a mercury-based preservative once used in many childhood vaccines, but removed from most vaccines after 2003). However, this study was not designed to determine the sources of the toxic metals found in children with autism.
 
4.1. Limitations of this Study
The original study was designed primarily for evaluating the safety and efficacy of DMSA therapy. It was not primarily designed for investigating the relationship of the severity of autism to toxic metals, but that was an interesting outcome, so we felt it worthwhile to report it. Some limitations of the study design include the following.
  • The PDD-BI, SAS, and ADOS were assessed 2–4 weeks after the first round of DMSA, whereas the ATEC was assessed before. However, the strong correlation of the ATEC and PDD-BI suggests that this was a minor issue, and that the initial round of DMSA did not significantly affect the assessment.
  • The ATEC involved the largest number of participants (n = 63), whereas the other assessments involved somewhat smaller numbers (n = 49).

Conclusions

Overall, the correlation analysis found multiple significant correlations of severity of autism and the urinary excretion of toxic metals, such that a higher body burden of toxic metals was associated with more severe autistic symptoms. The results of the regression analyses (P < .005 in all cases) indicate that variations in the severity of autism may be partially explained in terms of toxic metal body burden. However, the finding of a relationship does not establish causality.

Acknowledgements

First and foremost, the authors thank the many autism families and their friends who volunteered as participants in this research study. They thank the Wallace Foundation and the Autism Research Institute for financial support of this study. They thank Nellie Foster of SCNM for help with blood draws. They thank Women's International Pharmacy for assistance with compounding the DMSA individually for each child. They thank Spectrum Chemicals for providing the DMSA. They thank Doctor's Data and Immunosciences for providing testing at reduced cost. They thank the Autism Society of America—Greater Phoenix Chapter and the Arizona Division of Developmental Disabilities for their help with advertising the study.

References

1. Bernard S, Enayati A, Redwood L, Roger H, Binstock T. Autism: a novel form of mercury poisoning.Medical Hypotheses. 2001;56(4):462–471. [PubMed]
2. Windham GC, Zhang L, Gunier R, Croen LA, Grether JK. Autism spectrum disorders in relation to distribution of hazardous air pollutants in the San Francisco Bay area. Environmental Health Perspectives. 2006;114(9):1438–1444. [PMC Free Article] [PubMed]
3. DeSoto MC, Hitlan RT. Blood levels of mercury are related to diagnosis of autism: a reanalysis of an important data set. Journal of Child Neurology. 2007;22(11):1308–1311. [PubMed]
4. Adams JB, Romdalvik J, Ramanujam VMS, Legator MS. Mercury, lead, and zinc in baby teeth of children with autism versus controls. Journal of Toxicology and Environmental Health Part A.2007;70(12):1046–1051. [PubMed]
5. Bradstreet J, Geier DA, Kartzinel JJ, Adams JB, Geier MR. A case-control study of mercury burden in children with autistic spectrum disorders. Journal of American Physicians and Surgeons.2003;8(3):76–79.
6. Lord C, Rutter M, Goode S, et al. Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. Journal of Autism and Developmental Disorders.1989;19(2):185–212. [PubMed]
7. Cohen IL, Schmidt-Lackner S, Romanczyk R, Sudhalter V. The PDD behavior inventory: a rating scale for assessing response to intervention in children with pervasive developmental disorder.Journal of Autism and Developmental Disorders. 2003;33(1):31–45. [PubMed]
8. Rimland B, Edelson S. Autism Treatment Evaluation Checklist: Statistical Analyses. San Diego, Calif, USA: Autism Research Institute; 2000.
9. Zalups RK. Influence of 2,3-dimercaptopropane-1-sulfonate (DMPS) and meso-2,3- dimercaptosuccinic acid (DMSA) on the renal disposition of mercury in normal and uninephrectomized rats exposed to inorganic mercury. Journal of Pharmacology and Experimental Therapeutics. 1993;267(2):791–800. [PubMed]
10. Adams JB, Baral M, Geis E, et al. Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: part A—medical results
11. Adams JB, Baral M, Geis E, et al. Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: part B—behavior results
12. James SJ, Cutler P, Melnyk S, et al. Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism. American Journal of Clinical Nutrition.2004;80(6):1611–1617. [PubMed]
13. James SJ, Melnyk S, Jernigan S, et al. Metabolic endophenotype and related genotypes are associated with oxidative stress in children with autism. American Journal of Medical Genetics Part B.2006;141(8):947–956.
14. Geier DA, Kern JK, Garver CR, et al. Biomarkers of environmental toxicity and susceptibility in autism. Journal of the Neurological Sciences. 2009;280(1-2):101–108. [PubMed]
15. Holmes AS, Blaxill MF, Haley BE. Reduced levels of mercury in first baby haircuts of autistic children. International Journal of Toxicology. 2003;22(4):277–285. [PubMed]
16. Adams JB, Romdalvik J, Levine KE, Hu L-W. Mercury in first-cut baby hair of children with autism versus typically-developing children. Toxicological and Environmental Chemistry. 2008;90(4):739–753.

Source: J Toxicol. 2009; 2009: 532640. Published online 2009 August 26. doi: 10.1155/2009/532640. The Severity of Autism Is Associated with Toxic Metal Body Burden and Red Blood Cell Glutathione Levels. J. B. Adams,1* M. Baral,2 E. Geis,3 J. Mitchell,1 J. Ingram,3 A. Hensley,3I. Zappia,3 S. Newmark,4 E. Gehn,3 R. A. Rubin,5 K. Mitchell,3 J. Bradstreet,2, 6 and J. M. El-Dahr7

1Division of Basic Medical Sciences, Southwest College of Naturopathic Medicine, Tempe, AZ 85282, USA
2Department of Pediatric Medicine, Southwest College of Naturopathic Medicine, Tempe, AZ 85282, USA
3Autism Research Institute, San Diego, CA 92116-2599, USA
4Center for Integrative Pediatric Medicine, Tucson, AZ 85711, USA
5Department of Mathematics, Whittier College, Whittier, CA 90601-4413, USA
6International Child Development Resource Center, Phoenix, AZ, USA
7Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA 70112, USA

 

Tags:  autism  heavy metal  toxins 

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Do You Have a Toxic Workplace?

Posted By Administration, Tuesday, June 29, 2010
Updated: Friday, April 18, 2014

by, Holly Lucille, ND, RN

74046939_7b6c18ce63_bI am not talking about the "toxic workplace" often reported when a work environment is full of backstabbing, gossiping co-workers, a controlling boss or demanding clients. I am talking about toxic substances in your workplace that might be making you physically sick.

It is bad enough that we live in a society that is extremely dependent on harmful chemicals. We are exposed to these ubiquitous and devious substances everyday, hiding in plastics, pesticides, car exhaust, soaps, emulsifiers, health and beauty aids, household cleaning products and a number of other places. They are in the food we eat, the water we drink and the air that we breathe. However, depending on where you work, your exposure to toxic substances could be intensified, contributing significantly to your health issues.

Occupational allergies are becoming an extremely common concern with cases increasing in numbers and severity in recent years. There have been countless articles written on both "Sick Building Syndrome" and "Occupational Asthma." Under these two modern diagnoses, people have complained of a variety of symptoms including watery eyes, runny nose, headaches, dizziness, nausea and tightening sensation in the chest. The curious thing about most of these symptoms is that they have a distinct pattern of getting worse while in the work environment and significantly better over vacations or weekends.

If you work in an enclosed office space, you might feel falsely safe and protected from environmental allergens at work. Modern office buildings are not only being built with toxic chemicals but, in order to conserve energy, they are also built tight as a drum with poor ventilation, leaving allergens and irritants with no place to go. Common sources, such as malfunctioning or inappropriate, inefficient use of heating devices, can produce irritating pollutants such as carbon monoxide, nitrogen dioxide and sulfur dioxide at harmful levels. Formaldehyde exposure is widespread and found in resins in finishes, plywood, paneling, fiberboard and particleboard, and in some backings and adhesives for carpets. Biological air pollutants like dander, molds, and dust mites are carried by animals and people into and throughout buildings.

Scents and hairsprays, construction products such as finishes, heavy duty cleaners, paints, thinners, dry cleaning fluids, some copiers and printers, some glues and adhesives, markers, and photo solutions are among some of the common office products that emit harmful volatile organic compounds (VOC). New installations, carpet, wall coverings, paint or construction can all heighten problems with VOCs. If that isn’t enough to worry about, almost everyone has heard of the dangers of toxic mold thriving in cool, damp, dark places behind walls and under carpeting.

Some occupations that are even higher risk for exposure include: industrial workers handling paints, chemicals, solvents, and plastics; beauticians who work daily with hair dyes, perms, and nail polish/removers; people who are in the farming industry dealing with fertilizers and pesticides; photocopier technicians and dry cleaning merchants working with machines emitting potentially harmful gases.

If you feel that your workplace is making you sick, there are things you can do, short of quitting your job. Reducing exposure is important but it is also important to remember that having an allergic response to something often has less to do with the trigger and more to do with our body’s inability to respond to it appropriately. Make sure you are protecting your immune system by choosing healthy, organic foods in your diet for adequate nutrients and fiber, drink plenty of filtered water, exercise regularly, choose non-toxic products for your home and consider partnering with a qualified healthcare practitioner to partake in a comprehensive body detoxification. Enzymatic Therapy’s (www.enzy.com) Whole Body Cleanse is a very effective and easy cleanse that you can get at a health food store near you.

In your workplace, consider talking with both your supervisor and your OSHA or union representative regarding the air exchange system in your building. Interior landscaping can help absorb some of the off-gassing from VOC and formaldehyde. Buying plants like a Dwarf date palm, Bamboo palm or Janet Craig is an inexpensive, efficient method of cleansing the air. Keep your work area free of clutter, dust regularly and use a HEPA-type table top air purifier. Even though we cannot completely escape the toxins that surround us, we can make a difference for us as individuals and, little by little, the environment as a whole!

Tags:  toxins  work 

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Have We Abandoned Our Children to Toxins?

Posted By Administration, Friday, March 19, 2010
Updated: Friday, April 18, 2014

Many of us are aware of the recent Centers for Disease Control (CDC) report indicating that 1 in every 110 children has some form of autism. Fewer know the work of Dr. Philip Landrigan, of Mt. Sinai Medical School, who was quoted in a February 25, 2010, New York Times editorial by Nicholas Kristof: "Do Toxins Cause Autism?"  According to Landrigan, 1 in 6 American children is currently learning or behaviorally disabled. childwithmaskAnother excellent resource is the work of ACAM member, Dr. Kenneth Bock, chronicled in his recent book Healing the New Childhood Epidemics: Autism, ADHD, Asthma and Allergies The Groundbreaking Program for the 4-A Disorders.

As the following, recent news stories indicate, our nation’s children live in an environment that is increasingly toxic:

  • Studies show danger of even small amounts of lead in children's blood
  • Dust bunnies tainted with toxins? Household dust consists of a potpourri that can include lead, arsenic, and other potentially harmful substances
  • Phthalates (plastics softeners used in children's products) predispose mice to allergies

Add to these the fact that our children are exposed to more vaccinations than ever before. In 1985, children were vaccinated for seven diseases; that number has swelled to 16. And vaccinations are grouped together solely to make children more likely to get them, even though the risks increase to an unknown degree.

Parents deserve to know that vaccines are neither 100 percent effective nor 100 percent safe. A 16-year old girl lost her vision following vaccination against the HPV virus. Do we have to wait until most children are autistic or otherwise damaged before we try to do something about this situation?

Published March 16, 2010 at ANH-USA.org. Have We Abandoned Our Children to Toxins?

Tags:  toxins 

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