Introduction

Analysis of elements in faeces provides indirect information about the potential for toxic metal burden. For many toxic metals, faecal (biliary) excretion is the primary natural route of elimination from the body. Faecal elemental analysis also provides a direct indication of oral / dietary exposure to toxic metals. Specimen collection is convenient for the patient and only requires a single-step procedure.

Environmental Exposure vs Liver Clearance

Analysis of elements in faeces provides a comprehensive evaluation of environmental exposure, potential for accumulation in the body (Hg), and possibly endogenous detoxification of potentially toxic metals. For many toxic elements such as mercury, cadmium, lead, antimony and uranium, biliary excretion into the faeces is the primary natural route of elimination from the body. The primary process by which the body eliminates the insidious sulfhydryl reactive metals is through the formation of metal-glutathione complexes, of which greater than 90% are excreted into the bile. Evidence for the extent of exposure to mercury from dental amalgams is provided by the fact that faecal mercury levels are highly correlated with the number of amalgams in the mouth. It also clear that faecal mercury levels for people with dental amalgams are remarkably similar from day to day, and approximately ten times higher than in people who do not have mercury amalgams.

Monitoring Natural Detox Patients

Administration of pharmaceutical metal binding agents results in excretion of toxic metals primarily through the kidneys into the urine. In contrast, support of natural detoxification processes enhances the rate of excretion of toxic metals into the faeces. Elemental analysis of faecal specimens can provide a valuable tool to monitor the efficacy of natural detoxification of metals in infants or patients who are on very limited and defined diets that do not contain contaminated solid foods. A preliminary study performed at Doctor’s Data indicates that biliary/faecal excretion of mercury and lead may be markedly enhanced following high dose intravenous administration of ascorbic acid. Other orthomolecular or nutraceutical protocols may also enhance the faecal excretion of metals and hence potentially decrease burden on the kidneys.   Further research to identify and validate such therapies is warranted.

Oral Load = Primary Burden

A primary objective of preventive medicine is avoidance or removal of exposure to toxic substances. The rate of oral absorption of toxic metals varies considerably among elements, and among subspecies of a particular element. Faecal elemental analysis can provide a direct indication of dietary exposure. Orally, the percent absorption of nickel, cadmium and lead is usually quite low, but varies significantly in part due to the relative abundance of antagonistic essential elements in the diet. That is particularly evident for lead and calcium, and cadmium and zinc. Chronic, low-level assimilation of the toxic metals can result in significant accumulation in the body. The results of faecal elemental analysis can help identify and eliminate dietary exposure to toxic metals.

The faecal metals test was not developed to replace the pre and post urinary toxic metals provocation test, but rather provides an alternative for infants, children or adults for whom urine collection is problematic, or for individuals who do not tolerate the available pharmaceutical metal detoxification agents. Elements are measured by ICP-MS and expressed on a dry weight basis to eliminate variability related to water content of the specimen.

Test Uses

• For assessing the degree of Phase II Liver glutathionation of Heavy Metals.
• For monitoring the increase in toxic metal clearance due to natural detoxification support programs (efficacy and progress) over time.
• For assessing ‘oral load’ of toxic metals (partly those coming from diet, but predominantly those from oral amalgam dental fillings).