August 19, 2015

Chronic Mercury Poisoning


After a ten-year quest to understand my twenty years of health issues -- vision problems, increasing fatigue, intolerance to fragrances and fumes, digestive problems, and daily spells of acute physical and cognitive dysfunction -- I read Amalgam Illness:  Diagnosis and Treatment, a technical book on chronic mercury poisoning by Andrew Cutler, an independent chemical engineer.  Although amalgam illness is unrecognized by conventional medicine, my symptoms and lab anomalies were remarkably consistent with those described by Cutler.  His work unites many bits of existing knowledge and experimental evidence on how mercury affects humans, lab animals, cells, and molecules, into an elegant hypothesis explaining the toxicity of chronic, low-dose mercury exposure and how this manifests as illness.  Thus, when the results of a porphyrin profile -- a little-known lab test with high specificity for heavy metals -- confirmed mercury poisoning, I had my ten mercury dental amalgams removed and began chelation.

Cutler’s chelation protocol is used by a small number of people across the globe, with anecdotal success.  Since chelation can be dangerous when blood levels fall (causing redistribution of heavy metals), the protocol involves frequent low-level dosing to keep blood levels constant.  This means taking pills every three hours around the clock including at night, typically for three days per week, for several years.

After more than a year on the Cutler protocol, many of my symptoms are gone, others are vastly reduced, and I'm looking forward to a full recovery.
Introduction
Ironically, I'd considered the mercury issue previously -- enough to concur with the authorities who unanimously dismissed its risk.  And my neurologist had also ruled out mercury, based on a blood test.  Eventually I would learn that there is a wide misunderstanding, even among physicians, about the meaning of mercury blood levels.  In fact, mercury resides only briefly in the blood before migrating to fatty tissues like the brain, where it cannot be measured except on autopsy.  Thus the many epidemiological studies based on blood levels are of little value.

This misunderstanding has deep roots.  Due to its interesting chemical and biological properties, mercury has been widely used in medicine and dentistry for two hundred years.  And although the acute toxicity of mercury is undisputed, small exposures are still assumed to be harmless by most physicians, dentists, and health authorities.

Indeed, there is little direct evidence of harm -- many large epidemiological studies show no association between chronic mercury exposure and disease.  But epidemiology (analysis of populations outside the controlled lab environment) is a crude tool, and epidemiological studies of a low-dose poison that takes years or decades to cause non-specific symptoms no matter how serious, are unlikely to detect this association.

Dental amalgam, once believed to be non-volatile, is now known to release mercury vapor that is absorbed in small amounts.  And ample evidence exists from autopsy, animal, and in-vitro studies to suspect that chronic, low-dose mercury exposure may cause or exacerbate many neurodegenerative diseases.  However, a major missing link in understanding mercury's toxicity is the role of detoxification enzymes and their genetic variability.  In summary, when chronic diseases are the result of a dynamic interplay between multiple toxins and their gene-dependent detox enzymes, plus enzyme cofactors (nutrition), then population-based studies are unlikely ever to indict the toxin.  Meanwhile, from a cynical perspective, these negative studies provide cover for the toxic status quo.
Illness
After good health through young adulthood, minor symptoms slowly progressed into a debilitating illness affecting four organ systems -- the brain, hormones, digestion, and immunity.

Initial symptoms

By my twenties, what seemed like blood sugar problems had become severe.  Often overcome by a groggy weakness, some functionality could be restored by caffeine or food, triggering a vicious roller coaster.  The doctors I saw had no answers.  Adopting an ultra-low-carb diet was slightly helpful, but it was still necessary to time my food and caffeine intake to keep the inevitable crashes private.

Retinopathy (macular degeneration)

At age 30, I developed wet macular degeneration (also called subretinal neovascularization), diagnosed as Presumed Ocular Histoplasmosis Syndrome.  This retinal disease is found in the elderly, diabetics, people with immune activations, and neonates receiving oxygen.  Thought to be due to hypoxia (low oxygen), in my case it was probably caused by immune cells clogging tiny capillaries.  By age 33, the sharp, central vision in both eyes was gone.

Functional hypoglycemia

Within my family -- mother and brother -- we called our ongoing spells "hypoglycemia" or "our genetic metabolic defect", or simply, "a crash".  A mild crash with a slow onset could be addressed with a preemptive nap when feasible.  But a sudden or bad crash could be terrifying – as if my starving brain were screaming for fuel, despite a recent meal.  Without immediate food or caffeine, the torture would last about half an hour, when the symptoms would pass as quickly as they'd come, leaving me exhausted.

With a blood pressure cuff and a glucometer, I learned that such crashes involved normal blood sugar but low blood pressure, e.g., 85/55.  The low blood pressure certainly explained the physical and cognitive collapse, but since it was transient, my doctors had no advice.  Slowly, through proactive efforts to eat, sleep, and exercise well, to avoid stress, and to avoid scheduling anything in the mid-afternoon, the acute functional hypoglycemia subsided into mere variations in my increasing fatigue.

Neuropathy

In my mid-thirties, some numb spots had developed on my back, along with infrequent but disconcerting loss of strength in my arms.  I saw two neurologists to investigate MS, but neither could be certain.  Since the only treatments were expensive drugs with uncertain efficacy and probable side effects, and since the literature indicated that mild MS need not progress, I didn't pursue a diagnosis or treatment.
Certain nutritional supplements were suggested for MS, thus I began a growing regime of supplements.  Indeed, high-dose oral B-12 seemed to alleviate the numb spots (despite high serum B-12), and certain anti-inflammatory supplements seemed to control the arm weakness.

Multiple chemical sensitivity

For years I'd been sensitive to perfume, cigarette smoke, and auto fumes.  But after foolishly exposing myself to noxious textbook printing ink (held close so I could read it) for several days to prepare for finals, the resulting respiratory damage kept me bedridden for weeks and ill for months.  Recovery was never complete; I remained fatigued, hypersensitive, and generally unwell.

Too ill to get a life

After graduating, I briefly looked for a low-stress job, but openings were scarce and the commutes were daunting.  My vision disability provided some income, and my long-time boyfriend needed help with his home business anyway.  I postponed the job issue for a few years while we looked for a house and then oversaw a full remodel.
Quest For a Cure
During those years, the ill health that I'd tried to keep hidden had reached a crisis.  At age 42, I felt almost dead -- living to age 50 would be impossible unless I learned what was wrong.  Having already quit sugar and wheat in my quest for health, I now quit anything sub-optimal -- including decaf and all grains.  I spent my limited energy studying metabolism and genetics, forming hypotheses to explain my symptoms, and experimenting with the corresponding biochemical nutritional treatments.

My first failed hypothesis involved B-12.  I.e., my blood MCV (mean cell volume of red blood cells) had always been high, suggesting a folate or B-12 deficiency, but since the serum folate and B-12 lab results were high due to supplements, the hematologists I'd seen had dismissed the issue.  An organic acids test indicated good status for most nutrients but reiterated a possible problem with folate or B-12.  Since a defect in B-12 or folate metabolism or transport could cause symptoms in many organ systems, and since B-12 supplements had already addressed my neuropathy, I experimented with additional B-12 and folate, but neither helped.

Next, I considered the open-ended world of mitochondrial DNA defects, trying supplements like coenzyme Q-10 with only minor benefit.  Meanwhile, another treatment option emerged.

Growth hormone wonder drug

An endocrinologist (for whom I'd waited over a year to see) found abnormally low growth hormone and gave me a prescription for daily injections.  This hormone apparently improves the function of other hormones and enzymes.  The drug was expensive but the drug company had a generous charity program and I received it free for several years due to low income.

The injections were miraculous.  My health returned, albeit tenuously.  My fatigue was gone, and like a normal person I was limited only by hours in the day.  But when I no longer qualified for charity, my out-of-pocket costs for this wonder drug soared to $4000 per year.

Alpha lipoic acid backfire

Although growth hormone was great, I needed a cheaper way.  Studying metabolic chemistry and nutritional supplements, I tried many products -- not just vitamins and minerals, but essential oils, herbs, amino acids, etc..  The literature on alpha lipoic acid was intriguing -- it was a super anti-oxidant, both water-soluble and fat-soluble, and was alleged to help neuropathy among other things -- so of course I added it to my regime.  Later I would learn that alpha lipoic acid is a mercury chelator that can transfer mercury from existing dental amalgams into the brain.

Over the weeks as I slowly began to feel worse, I assumed the growth hormone was no longer working.  I continued this harmful supplement for at least a year before stopping it as part of stopping all supplements to reevaluate.

Decline

My gut problems began with gurgling, gas, constipation, and diarrhea.  Food intolerances became more numerous, and I lost weight.  A gastroenterologist did an endoscopy and colonoscopy but found nothing.  My bones felt fragile -- as if they might snap.  My joints rattled.  At age 48, I was falling apart.
My life had sunk to the basics -- preparing healthy food and researching health theories, while relying on my husband for shopping and errands.  At that time, Chronic Fatigue Syndrome was becoming recognized as a failure to detoxify the normal metabolic byproducts despite adequate rest, resulting in cognitive as well as physical dysfunction.  Indeed, my poor memory and slow brain were becoming more intractable than my fatigue.  The future was frightening.  A friend took me to a local assisted living facility for a look-see, and to my relief it seemed okay.

For a year or two I existed in limbo -- trying to get healthy, waiting to feel better, and trying to enjoy easy activities while avoiding stress.  Feeling only 25% alive, what I really wanted was to move to assisted living and just rest, but since this might be a one-way trip I resolved to stagger through each day at a time.

Supplements

My supplement regime had evolved into a complicated program that would be incredible to anyone unfamiliar with mercury poisoning.  It included vitamin A, many types of vitamin B, vitamins C, D, E, and K, calcium, magnesium zinc, chromium, molybdenum, manganese, selenium, iodine, fish oil, borage oil, whey protein, 5-HTP, acetyl l-carnitine, arginine, carnitine, glycine, histidine, NAC, taurine, DHEA, 7-keto DHEA, melatonin, betaine HCl, ox bile, digestive enzymes, ubiquinol, and a number of herbs.  Typically I took a subset of these, four to six times a day.  Trying to cut down made me feel worse.  In retrospect, this dependency on nutritional supplements is a good indicator of late-stage mercury poisoning, which blocks metabolic enzymes and mineral transport proteins.

CFS specialist

There were no chronic fatigue specialists in my area, so after waiting six months for an appointment I traveled to a neighboring state to see a renowned expert who accepted insurance.  New findings included immune dysregulation -- many cell counts were off -- as well as leaky gut, dysbiosis, and many food allergies.

He had few answers but planned to treat each problem one-by-one, starting with the gut.  Patients in his waiting room raved about his thoroughness, but it would be a slow process.

He first prescribed an expensive gut sterilizer.  While fighting the drug insurance company for coverage, I learned that the drug may not kill all pathogens, and drug-resistance was a risk.  While looking into natural alternatives, I found many allegations of a link between dysbiosis and dental amalgams, but the arguments were poorly reasoned, so I dismissed them.

Diet -- nothing to eat

During this low point, there was almost nothing I could eat.  The food allergy test results showed IgG antibodies to almost everything, and my abdomen was constantly sore.  I lived on broth, chicken, and non-starchy vegetables, with a lot of butter for calories.

New direction

In January 2008, a free class called Graceful Aging at the local adult school was a turning point.  The subject was digestion, and the teacher was surprisingly good.  She held the same obscure nutrition philosophy that I'd developed after years of study, trial, and error -- exemplified by the Weston A. Price Foundation's philosophy of nutrient-dense, easy-to-digest, local, sustainable food, with emphasis on fat-soluble vitamins (from animal fats) and minerals.

During the class, the teacher mentioned a number of issues including dental amalgams, and referenced books by Huggins.  I was aware that crazy people get their filings removed in hopes of restoring health, but as an avid science reader and news junkie, and with degrees in environmental health and public policy, I knew that the authorities had found no credible evidence linking dental fillings with health problems.  Nonetheless, I reviewed two Huggins books, but found them short on logic and evidence, so once again I dismissed the issue.

I booked a consult with the teacher, hoping to determine which of my dozens of supplements were really necessary.  She ordered an organic acids test and concluded that most of my supplements were probably helpful.  She again asked me about dental amalgams and I told her that Huggins' arguments lacked credibility.  She noted that Huggins is for lay readers, and she offered me a technical manual -- Andrew Cutler's Amalgam Illness:  Diagnosis and Treatment.
Blindsided
At home I couldn't put the book down.  It described all my symptoms, all my lab clues, and all the supplements that I'd found helpful.  Cutler's explanation was comprehensive and plausible on many grounds.  First, because of mercury's high affinity for reduced sulfur, which is ubiquitous throughout the body, mercury is uniquely capable of blocking a myriad of reactions.  Thus, in addition to causing general oxidative damage, mercury blocks enzymes and transport proteins, causing non-specific symptoms across many organ systems -- neurological, endocrine, gastroenterological, and immune -- which would be hard to explain by any agent except mercury.  Surprisingly, chronic mercury poisoning is almost impossible to detect in lab tests; doctors don't know about it; and they certainly don't know how to treat it.

In addition to describing in eerie detail my myriad symptoms, the book described my personality -- called erethism -- a combination of shyness, diffidence, irritability, anxiety, and hypersensitivity to stimuli and to criticism.  While I found this subjective description rather unscientific, my husband found the close fit remarkable.
 
Cutler's hypothesis was strong, yet the possibility that my health problems could be blamed on a culprit I'd dismissed repeatedly was almost unthinkable.  So once again I researched amalgam safety, this time seeking evidence rather than hearsay.  To my surprise, I found shocking gaps in the science.  For example, population studies exonerating amalgam merely show that it probably does not cause overt symptoms in the general population -- but does not rule out health effects to genetically susceptible individuals or long-term health effects to the general population that resemble aging.  Yet regulators rely on such studies to set health policy.  Thus, it appears that amalgam has been deemed innocent until proven guilty -- and a high burden of proof will be required to indict such a useful and entrenched substance.

Since the evidence and reasoning behind the Cutler hypothesis was far stronger than that behind amalgam safety, I was forced to acknowledge that dental amalgam was for the time being the best explanation for my illness.

On the bright side, mercury could apparently be removed through chelation, and Cutler described an allegedly safe protocol.  In summary, I'd been thrown a bizarre life-preserver for which the potential benefits seemed by far to outweigh the risks.
Corroboration
Hair test

Cutler’s book suggested a hair test, which I'd assumed was unreliable since it hasn't been recognized by conventional medicine or insurance.  But Cutler's explanation was plausible:  Hair results appear counterintuitive when mineral transport proteins are blocked by mercury -- i.e., mercury itself may appear low, while the essential minerals may appear abnormal.  Indeed, my results contained many extremes, and my hair mercury was low.

Porphyrin profile

The book also described a little-known test called a porphyrin profile that can detect the heavy-metal footprint in cases of late stage toxicity.  I ordered the Metametrix test and it came back positive for mercury.

Incidentally, while waiting for the results I requested a similar test from my neurologist, covered by insurance, using the usual large, commercial lab.  The results for three of the five porphyrins requested were below the detection limit, which was set surprisingly high compared with the Metametrix results.  Since Cutler had indicated that careless handling at some labs can easily destroy the delicate porphyrins, and since the literature had indicated that the porphyrin profile has high specificity but low sensitivity, the positive Metametrix test seemed more credible.
Reflections
Exposures

The main sources of mercury are: maternal exposures (prenatal and breast milk), vaccines, dietary fish, and dental amalgams.  Minor sources are air pollution and food contaminants.  Other exposures may arise from certain occupations and from accidents.  In my case, not being a fish eater, my twelve dental amalgams were prime suspects.

Early signs

In retrospect, although I felt healthy through early adulthood, some mercury indicators were present long before.  Absent-minded and self-involved, I resented interruptions and preferred ample down time.  Lack of physical energy was a problem, but I assumed laziness was a demon everyone must fight.  Reading and learning were my pleasures.

Signs of oxidative stress began in childhood.   Mosquitoes gave me large, persistent welts while leaving others alone.  Sunburn was a regular problem.  My fragile skin and thin hair were always oily.  Teenage acne would have been severe if not for daily antibiotics.  My teeth felt unclean and my gums itched.  My fingernails were weak and prone to chipping.  Severe spring allergies began in my twenties and grew worse every year.

Siblings

On a side note, my brother was diagnosed with heavy metal at about the same time as I'd adopted the Cutler's hypothesis.  His primary-care doctor had given him a challenge test, which found a number of heavy metals including off-the-chart arsenic.  A test of his private well revealed he'd been drinking arsenic at fourteen times the standard for ten years.  But my brother's health problems predated his well exposure -- he'd had "our genetic metabolic problem" since his teens.
In retrospect, he also had earlier signs possibly caused by maternal exposures.  As a baby, he had a gut problem -- colic with projectile vomiting.  He had spooning fingernails and toenails, a sign of mineral deficiencies.  As a child, he had allergies and asthma, indicating oxidative stress.  But as a smart child, he was a joy, and we viewed him as reasonably healthy.  Although sensitive and shy, he lacked the outward irritability comprising erethism.  He matured into a quiet, philosophical, responsible young man, afflicted with allergies, oily skin, and metabolic crashes.

Our sister died long ago of a blood clot overseas at age 24.  We'll never know what caused this, but she did have the mercury personality.
Safe Amalgam Removal
My first step was to remove known exposures – my ten remaining amalgams.  Because amalgam removal can involve significant exposure if not done properly, I selected a local mercury-free dentist, and sadly dropped the sweet, careful, capable dentist that I’d seen for twenty years.

Since the new dentist was booked two months out, I passed those weeks in misery, repulsed by my mercury-filled mouth.  I chewed very little, put nothing hot in my mouth, and spit as much as possible.  Finally, August 21, 2008, I had half of my ten amalgams removed, and the next day had the other half out, leaving the existing two gold crowns.  Such an intensive schedule is perhaps not recommended, but it seemed better than waiting.  Recovering from the Novocain took several days of bed rest, probably due to poor liver function.
Chelation
DMSA

A few days after amalgam removal, I started DMSA chelation on the Cutler protocol -- a 6 mg capsule every four hours, including at night.  Although DMSA is over-the-counter, the low doses are not -- I'd ordered it compounded from overseas.

The DMSA was energizing.  On my first day, I bussed over to campus to complain that the environmental health curriculum failed to cover the dental amalgam issue.  (And for years I'd avoided unnecessary conflicts).  Unfortunately I couldn't find any of my old professors except one who brushed me off, asking me to call or e-mail.  I did both but she never responded.

At 6 mg, the DMSA felt a bit rough, so I tried 3 mg, which felt like nothing, so I returned to 6 mg and shortened the timing to every three hours, which felt better.
The DMSA feeling progressed from good-energy to wired-and-tired, either due to the drug itself or to sleep deprivation.  The drug was so energizing that I couldn't always fall asleep after the midnight or 3 am dose.  The protocol requires as many days off as on, so three days per week on this regime seemed the right schedule.  Night dosing was a problem for several months until I learned various sleep-improvement techniques.

On DMSA, the skin along my spine initially erupted into large patches of rough skin having a dry, scabby, woody texture, which subsided after a few days.

By the end of my second round I developed a bad case of apparent systemic yeast -- a known side effect of DMSA -- including much gut noise and gas, athlete’s foot, a yeast infection, and a disgusting slime in my mouth that would not wash out.  Lamisil was reasonably effective but inappropriate for long-term use.

Mercury specialist

To obtain prescription-only DMPS, which has fewer side effects, I called an out-of-state mercury specialist recommended on an Internet resource.  Although she didn’t take Medicare, she had reasonable rates, and she was familiar with chronic mercury poisoning and the Cutler protocol.  She required one in-person visit; follow-ups could be done by phone.  Being a poor traveler due to fatigue and chemical sensitivities, it was an arduous one-day trip, but it was a relief to find a practitioner knowledgeable about my health problems.  Also, she was interested in treating the secondary issues -- low hormones, poor immune function, and gut dysbiosis, as well as the primary problem of mercury poisoning.

For mercury, she prescribed DPMS, as I'd hoped.  For the gut dysbiosis, she recommended some herbal antimicrobials, saying I could try the prescription treatments if the herbs didn't work.  She recommended high-dose iodine to displace the inevitable chlorine, fluorine, and bromine load.  She also recommended hydrocortisone trials, with specific dosing and breaks, and sustained-release T3 on a rigorous protocol.

DMPS

DMPS was wonderful -- not only were there no side effects, but it actually cleared my head.  Although some insurance companies cover DMPS, Medicare does not, and I would be out $250 a month.
 
Despite a clearer head, I felt ill for several weeks, and just as I was about to stop all new treatments (DMPS, herbal antimicrobials, and high-dose iodine), it passed.  In retrospect, I suspect the illness was due to halogen detox by iodine.

DMPS dosing went well -- I started at 10 mg every six hours and ramped up every week, till reaching 35 mg.

I've taken DMPS continuously since then, except for a week or two.  

Alpha lipoic acid

Per the protocol, three months after amalgam removal, I started ALA chelation, at 6 mg every three hours, with rounds lasting three days.  Symptoms included a slight headache plus aches and pains.  Adding 1000 to 1500 mg of vitamin C with every dose helped.  Eventually I shortened the timing to every two hours during the day and three hours at night, which was more comfortable.

After six months I'd reached 25 mg dosing, and after a year, 50 mg.  I continue to need high-dose antioxidants with each dose.

Adrenals and thyroid

For poor adrenal function (as revealed in a four-point saliva test) the mercury specialist recommended a hydrocortisone taper followed by a 5-day on, 2-day off dosing schedule.  But this drug failed to provide the feeling of well-being or dynamic stress response for which I'd hoped, and it seemed to deplete my immune system, so I opted for the herbal alternatives, which did provide some improvement.  Perhaps the growth hormone I was already taking precluded the need for hydrocortisone.    

For my low body temperature and low T3 despite normal T4 and high-normal TSH, the mercury specialist recommended sustained-release T3, but the dosing schedule was at first too difficult for me.  After about six moths I tried the drug, ramping up to 45 mcg every twelve hours, and watched my average body temperature climb to 98.6, at which point I ramped off.  Later, when my labs revealed high TSH and low T3, I did another course of sustained-release T3.  However, I never felt good on this drug -- perhaps because it burdens the adrenals.
Issues
Money

Chronic mercury poisoning has many dimensions, perhaps the most important of which is money.  The Internet is full of tragic stories by ill people who either suspect or know they have mercury poisoning but can't afford to have their amalgams removed, and therefore can't chelate.

My gold replacements cost over $8000.  (Composites cost much less, but their safety is more uncertain).  My supplement regime is about $8000 annually.  (That's not a typo).  For this, I get reasonable day-to-day energy, but no stamina or resilience.  Medicare and Medigap premiums are $4000.  Non-covered doctors and labs have been about $3000 annually, but perhaps now will be $0.  Growth hormone co-pays are $4000.

If one can afford these huge outlays, the long road to recovery is possible.  If amalgam removal is not affordable, the only course is to try to improve the natural detox systems with healthy food and supplements.  If one can afford amalgam removal but little else, one can slowly detox with inexpensive alpha lipoic acid alone.

I'm grateful to have a hard-working husband who doesn't seem to resent my expenses -- they're uncomfortable but not beyond reach.

Cutler notes that the treatment for chronic mercury poisoning is actually inexpensive, relative to treatments for other conditions, and this is true.  But treatments for other conditions are not fully out-of-pocket, like this one.

Doctors

Over the years I've seen many different doctors.  They’ve included:  a primary-care doctor; an ophthalmologist; two endocrinologists; three hematologists; an allergist; a pulmonologist; two neurologists; a gastroenterologist; and an out-of-state chronic fatigue specialist, all covered by insurance.  Not covered were:  an alternative thyroid specialist; an alternative metabolic specialist, a Chinese medicine doctor, and finally the mercury specialist.   Most were helpful in terms of ordering labs, but only the chronic fatigue specialist ordered anything unusual.  All seemed to want to treat what they knew and no more.  None but the mercury specialist could diagnose my problem.

Family and friends

Chronic mercury poisoning is not yet recognized by conventional medicine or by insurance, and this situation is unlikely to change, as described in the introduction.  Having a serious illness unrecognized by conventional medicine or society has unique problems.

To others I appear to be a self-absorbed hypochondriac and know-it-all who will happily dispense advice on health food and supplements, yet who seems unable to cure herself and unwilling to consider approaches other than her own.  Although to others I look perfectly healthy, over the years I've complained of endless symptoms and developed endless theories, each of which has fallen by the wayside -- why should the mercury theory be different?  My problem is obviously psychological.

If I really wanted to feel better I'd drop all the pills, since they surely can't be healthy.  Yet not only will I not consider this, I also won't try testing them in any objective way.  

Despite never working in a medical or research field, I'm arrogant and delusional enough to think I know more than the health authorities.  Yet I seem unable to defend my unconventional positions with any scientific rigor, impatiently resorting to concepts like "common sense" or "common knowledge".

I'm unwilling to read anything that doesn't agree with my position.  For example, when asked to read studies that show no association between mercury and health problems, I dismiss them after a brief perusal, impatiently claiming that the flaws are so obvious that discussing them would waste my time.

Finally, I have little interest in friends or family who do not support my position or share my views, and I'm willing to write people off for these or other minor provocations.

From my view, I feel ill, exhausted, and barely functional, yet few know or care.  My illness has a political dimension, thus it's usually best not to discuss it.  Some friends and family have been supportive -- inquiring about my progress and not expecting much of me.  But my ongoing outrage about the mercury issue sometimes makes it hard to enjoy normal people or light conversation.  On the other hand, I can't handle debate either -- especially about mercury -- I feel weak, my brain is slow, and I can't articulate my thoughts.

From my view, daily diet is the most important determinant of health, yet so many people consume junk with reckless abandon.  I'm both jealous and appalled.  Many people of normal health seem to view health food as boring or ridiculous.  But with a chronic illness, one feels the effects of one's diet, for good or bad, almost immediately.  Sharing a healthy meal with like-minded friends and family is a true pleasure, while sharing a conventional meal with a conventional group is stressful.

A view of etiquette held by some can preclude discussing health -- even though much can be learned by discussion.  And certain friends and family view some people as "enjoying ill health" -- including me, no doubt.  Sick people just need a kick in the pants, or a change of scene, or some pie and coffee.  But I've never met a person who enjoys being ill -- the ones I know are searching doggedly and rationally for a means to feel better, but perhaps make the mistake of sharing too much.

After several requests, my husband had his five amalgams removed, in part because once I learned that amalgams contain mercury, I wouldn’t get near his face.  Although I asked him not do it "for me", but rather based on his own evaluation of risks and benefits, it’s clear he did it for us.  As an aside, he was unhappy to learn that BPA was a primary ingredient in his new composites, even though my dentist assured him beforehand that they would contain no BPA.

What really bothers me about my husband is that although he believes my problems likely have a physiological cause, he's unsure that mercury is the only explanation.  Rather, he thinks that mercury is a strong possibility, and that trying the Cutler protocol is a good idea. Thus, when he mentions my illness to others, he conveys an uncertainty that I don't appreciate.
While I’m grateful that he has helped me in many ways regarding my vision impairment and many health issues, and that he has never balked at the high costs or at the many inconveniences, I wish he were more “on board”.

If it weren't for the mercury specialist, my brother, and my nutritionist friend who is familiar with mercury, I'd feel quite alone.  Early on, my friend referred me to a man who had been chelating mercury on the Cutler protocol for several years.  Through him I learned of the Internet Yahoo group for people on the Cutler protocol, and this group became my lifeline for many months.  The stories related by these people about friends and family are tragic -- especially when the naysayers are medical professionals who inevitably influence other family members, further isolating the ill person in time of need.

On a webcast, alternative doctor Mark Hyman was asked how he dealt with patients for whom their health problems were apparently psychological.  He responded that even in cases in which he'd suspected psychology played a role, he found that when physiologic factors, often heavy metals, were identified and treated, the psychological issues vanished.