DEAR DR. ROACH: Would you please comment on chelation therapy? A urine test for mercury, lead and arsenic was done that showed abnormal elevations after I was given DMSA. I also was prescribed a long list of vitamins and supplements. This testing and treatment have caused me great confusion. — Anon.
ANSWER: Chelation is the process of using a medication to rid toxic chemicals, especially the heavy metals you mention, from the body. DMSA is a chemical that binds to mercury and lead, and is then excreted into the urine.
We all have some amount of these metals in our bodies, because they are present in the environment, but few people have toxic amounts. Toxicity happens mostly in people with industrial exposure to the heavy metals. Toxic levels usually, but not always, are associated with symptoms.
The DMSA you took before the urine test will cause these small amounts to be rapidly excreted by the kidney. The problem I have with this type of testing is that comparing your urine toxin levels after DMSA with urine toxin levels in healthy people who have not had DMSA is not valid, and I would not recommend treatment based on this faulty analysis. Unfortunately, the analysis you had is commonly done, so that nearly everybody tested will show falsely abnormal results. Thus, I recommend strongly against testing without a clear reason to do so, and never using this method.
Chelation treatment of heavy metals is appropriate only if there are symptoms and a history of exposure, and if blood levels not obtained after administration of a chelating drug are high (or urine, for mercury). An occupational medicine physician has expertise in this area and would be a good consultant if you still are confused.
DEAR DR. ROACH: My relative is a 69-year-old who has smoked for 55 years. She has a terrible cough. I want her to cover her mouth with a hankie or tissue when she coughs. The coughing can go on for a few minutes. She insists that she is not sick, and that it’s just allergies. I say she is spraying her sputum, and I might catch what she doesn’t know she has. — S.B.
ANSWER: You don’t need to be worrying about yourself. Although it is possible that she has pneumonia, most pneumonias are not transmitted from person to person, so the risk to others is low.
You need to be worrying about your relative. With this degree of cough, it is very likely that she has chronic obstructive pulmonary disease. What’s worse, a small number of smokers with a cough like this have lung cancer. In all probability, she is fooling herself that she has only allergies. She needs to quit smoking, now, and also get evaluated.
The booklet on COPD explains in detail both emphysema and chronic bronchitis, the two elements of COPD. Readers can obtain a copy by writing: Dr. Roach — No. 601W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow 4-6 weeks for delivery.
Readers may emai l questions to ToYourGood- Health@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803. ©2016 North America Synd.