Mercury toxicity is not often included in the differential diagnosis of common subjective complaints such as fatigue, anxiety, depression, odd paresthesias, weight loss, memory loss, and difficulty concentrating, but these are the symptoms of low-grade chronic mercury exposure described by the investigators cited previously. Given the ability of the various forms of mercury to deposit in most parts of the human body, the range of symptoms potentially caused by mercury is quite large.

Animal studies linking mercury toxicity to neurodegenerative diseases. Raise clinical concern, as do a series of associations between mercury and neurodegenerative diseases in humans.

Diagnosis of mercury overload is difficult. The commonly used modalities (blood, urine, and/or hair levels) do not correlate with total body burden and offer little diagnostically useful information. Provocation with dmps appears to offer a more accurate assessment of body burden.

Is there a significant history of mercury exposure: multiple amalgam fillings, high seafood intake, and history of multiple thimerosal-containing vaccinations or significant occupational exposures? Is there a family history of alzheimer’s, parkinson’s, or other diseases with postulated links to mercury exposure? Is there a history of known glutathione transferase (gst) polymorphisms, which decrease the body’s ability to clear heavy metals like mercury?

There are currently no consensus criteria for the diagnosis of mercury overload, nor for overload of other toxic metals. Clinicians who specialize in this area generally consider a provoked urine metal output more than 2 standard deviations above the nhanes reference range a positive result.

Further research is required to clarify the relation between provoked urine results and clinical disease and to document clinical outcomes.

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