Mercury: A Hidden Driver of MS and Neuroimmune Issues

Mark Hyman, MD

Thanks so much, Terry, for having me. I am Dr. Mark Hyman. I am a physician that focuses on functional medicine. I helped established start the Center for Functional Medicine at Cleveland Clinic. I have my UltraWellness center in Lenox, Massachusetts. I am an author. And I am also very active in policy work. And have a food fix campaign designed to transform our food policies. And also the host of The Doctor’s Farmacy podcast which talks a lot about functional medicine and related issues.

Terry Wahls, MD

Great. Now, Mark, let us talk a little bit about your healing journey. Because like me it was your personal transformation that taught you so much about mercury and its impact on the brain.

Mark Hyman, MD

That is right. Yeah, for sure. When I was young I ate a lot of tuna fish sandwiches, I had fillings. And I lived in China which I think topped off and ended up being in the most polluted city in the world where they have 10 million people using coal, raw coal to heat their homes in the winter. Coal is a primary source of atmospheric mercury. And I had an air filter, cleaned it out every day, and ended up breathing from the concentrated Beijing air that I ended up getting mercury poisoning and I did not know until I came back. 

And there was a trigger that happened where I actually had some stomach bug or something happened and all of a sudden my system collapsed. And I went from riding my bike 100 miles a day to barely being able to walk up the stairs. I would be able to see 30 patients and not take notes and know all their medical history at the end of the day and be able to dictate it and not be able to remember where I was at the end of a sentence. So I had a really massive shift in my health at 36 years old and did not know what it was. I developed chronic fatigue syndrome, had severe cognitive impairment, could not think, function, depressed, could not sleep, had severe myalgia, elevated CPK, digestive issues, immune issues, and autoimmune stuff going on and I did not know what it was and took me a couple of years to sort through it. But then I did a challenge test for heavy metals and found I have extremely high levels of mercury. I think my post-challenge test, the chelation challenge was 187 or something which is just off the chart and you and I are getting worried of people over 20. That is how I began the journey. And then I had to learn how to work on myself, to detoxify by myself from heavy metals, to work with my patients and the rest is kind of history.

Terry Wahls, MD

You went from great health to this abrupt decline. How rapidly did that happen? Was that.

Mark Hyman, MD

One day. It was like little I was fine, the next day I was like, what is going on? Something is.

Terry Wahls, MD

Shifting catastrophic.

Mark Hyman, MD

Yes. And my gut kind of went out of whack and I do not know what it was exactly, maybe I ate something, maybe I got some bug in a lake. I was swimming in Maine. I do not really know, and that led to severe Sebo, we did not even call it that back then, and severe digestive issues, and then everything just started collapsing and within a very short time I was practically debilitated. And I look at myself now and I look at pictures of myself then and it is like I just looked worse than I do now. I do not think I look bad, but I think I am so sick and so awful.

Terry Wahls, MD

And I am curious, once you began to piece things together and you are working on your healing program, how long did it take you to get back to good health?

Mark Hyman, MD

Well, here is the problem, Terry. This was almost 30 years ago and functional medicine was in its infancy and I did not have all the information, tools, and knowledge that I needed and it took me a long time to reset my system and uncover layers of other things like Lyme and Mold and everything else that was sort of going on at the same time. I would say it took me five years to start feeling better in figuring out how to do this and then took me probably ten years to fully recover. And I would say I still maybe have a few residual symptoms from it but I think I had to be more careful of my energy management or I used to go, go go, go, go. But I think it really took a long time. And I think for now when I see work with patients I can get them better much, much faster because I know exactly what to do, though.

Terry Wahls, MD

But it is parallel. It was a long time for my recovery as well. There are parts of it that went very fast and parts of it that take a long, long time. I am still tinkering. And I am very excited because I have finally gotten well enough that I can jog on my treadmill.

Mark Hyman, MD

Amazing.

Terry Wahls, MD

And truly, truly, so remarkable. So for the listeners, for everybody with MS and Neuroimmune issues, lead and mercury are risk factors. Are there other heavy metals that we should be thinking about?

Mark Hyman, MD

Yeah. I mean, it is really an accumulative toxic load. I think mercury and lead are the most significant for severe cognitive problems in children, especially with ADD and behavioral issues and violence, and cognitive impairment on many levels, I think it is social autism. And I think we know across the spectrum page from that all the way to Alzheimer’s that there are severe consequences for exposure to both lead and mercury. I think arsenic is also a potential issue. There may be other metals that come to play here and there but I think those are the big ones.

Terry Wahls, MD

And what are the sources? You mentioned mercury from coal, where else can this come from?

Mark Hyman, MD

Well, yeah. So mercury is ubiquitous in our environment now. I mean, really it was buried in the ground. It was basically either from volcanic eruptions that happened and kind of put up these big plumes and then bring down mercury on the earth or it would come from now coal burning which is where we have taken out of the earth. We all this mercury we burn it and it goes into the atmosphere. We do not have, we call that acid rain, we had heavy metal rain basically. And every single water source in the world is contaminated whether you go into the Arctic Circle or you go to Antarctica or you go to any remote river in America, Montana, they are all completely contaminated with heavy metals and lakes. I mean, the EPA says that there is no single body of water, lake River in America where it is safe to eat the fish. 

Yeah. I mean, it is not in my opinion because of the levels of mercury. Mercury goes into the oceans, it is taken up by the algae, the little fish eat the algae, the bigger fish eat a little fish and it goes on up the food chain. Fish consumption is a huge source of mercury exposure. Also, dental fillings are another one. I think it is some controversy about that. But there is a way to really look at the speciation of mercury whether it is inorganic or organic. Methylmercury is obviously from fish whereas it is an organic, it is from direct coal exposure, pollution, or from fillings. And you can see based on someone’s blood test what their levels are. And we can remove the fillings, you see go down and we see it impact your health. I think that there is a controversy about that. But if in my mind there really is a, I think the other thing we see is lead, and lead is a big factor, it is in a lot of the soil, it is we had leaded gas, we have leaded paint. And it is a lot of background still in there, it does not go away, it does not dissipate, it does not dissolve. And whether you are having vegetables grown in soil that might be contaminated or whether you are exposed too often household things that we do, like leaded glaze on plates, leaded crystal glassware. I have seen people very sick from this stuff. 

So I think those are the main source. The arsenic comes from chicken, rice, and pressure-treated lumber. Mostly I think chicken this method to the grain that went from getting mold on it. The rice actually takes up arsenic from the soil. It is natural arsenic groundwater has a lot of arsenic in it, sometimes fish but it is shellfish. I do not think that is such a big issue, though. I think we have really a lot of exposure. And some of us for better or worse at detoxifying. We need to make sure we kind of understand our own biology.

Terry Wahls, MD

So I was thinking listening to all this, I am wondering should we be eating fish? Do we need to not eat fish anymore? 

Mark Hyman, MD

Honestly, every time I have a bite of fish, I worry. And I think I tend to do things to help my body detoxify. When I ate fish I often, take chelators afterward. And I think there is a company that I found recently called seatopia.fish. You can go to their website. And they basically have a process of aquaculture that is basically regenerative aquaculture. The fish are very clean there, there are very, very, very low levels of any toxins or metals and they are incredibly tasty and yummy. It is quite amazing. And they are sourced from around the world. There are different kinds of fish you might be used to some that you might not be but it is a powerful model for sort of reclaiming fish into our diet. They have got sardines or anchovies or small mackerel or small fishes. Yeah.

Terry Wahls, MD

That is called Seatopia?

Mark Hyman, MD

Yes, seatopia.fish.

Terry Wahls, MD

Okay. I got to check that out.

Mark Hyman, MD

The fish is so yummy too. 

Terry Wahls, MD

Yeah, definitely to check that out. Should we be filtering our water, filtering the air, what do you think?

Mark Hyman, MD

Absolutely. Absolutely. I mean, I think we should all have water filters in our house. Tap water, I mean, it is just and Philadelphia just said that they should not drink the tap water because there was some contaminant chemical spill. I think most tap water is pretty full by chlorine fluoride or lots of wastewater contaminants. There are 38 wastewater contaminants in the average tap water that include everything from medication to environmental chemicals and pesticides to heavy metals so I think filtering water is key. Air, also, I think if you live in an urban environment or where there are a lot of industrial factories, some coal-burning plants, I mean, your risk is really high. I think having an air filter in your house is really important.

Terry Wahls, MD

Let us talk a bit more about water filtration. Do you have thoughts about what type of filtration we should be using?

Mark Hyman, MD

Yes, sure. I think the reverse osmosis is the one I typically use. I think it goes for us multiple filters that actually helps to correct a lot of the problems we see with water. I think it is really important to do that now. There is others like the Berkey filter, there is carbon filters, there is other things that can be very effective. I am not opposed to those, I just think we need to be making sure we have really clean water. And then you obviously need to take minerals and things to actually help and replace some of the things you remove. But I think as long as you are having a mineral diet and actually taking minerals that is good.

Terry Wahls, MD

A reverse osmosis I have put that in my house. Yes, I completely agree. Now I see some water treatment systems that also do this alkaline water. Do you think that is a useful additional step or not worthwhile?

Mark Hyman, MD

Yeah. I mean, I think we want to be more alkaline. And I think we eat a plant-rich diet if we do not eat processed foods instead of sugar we are going to be more alkaline in general. You can measure urinary pH, you should be like probably about six and a half, maybe seven. And if it is under five that means you are more acidic. And you can do that with our pH strip you buy from the drugstore for your urine, I mean, basically urine strip. And I think alkaline water, I do not I have not seen overwhelming evidence that it makes that much of a difference, but I am not against it.

Terry Wahls, MD

Okay. Let us talk about the air filtration systems. What do you think there?

Mark Hyman, MD

Well, I think HEPA filters are really important. There is something called the AirDoctor which I like which is a really well-made HEPA filter that filters mold and carbon of particles, particularly in your bedroom or if you have allergies or health issues.

Terry Wahls, MD

That is a smaller unit, you could just put it in your bedroom. We have been able to add an ultra-filtration system to our air conditioning and heating system. I just have that changed every few months and that is worked out pretty well. Yeah. And would it be fair to say that for perhaps the majority of folks with MS and neuroimmune symptoms that heavy metals may be part of why they have developed some cognitive issues if?

Mark Hyman, MD

I mean, honestly, Terry, I think there are some really big factors that are driving neuroimmune and neurodegenerative and neurocognitive issues, everything from autism to ADD to Parkinson’s to Alzheimer’s to MS to all of the things that we kind of worry about. And I think that gluten is a huge one. Leaky gut with gluten is a huge one. I think sugar is the biggest one in some resistance. And I think in environmental toxins, infections, obviously like Lyme and tick infections, those can all play a role. 

But I think on a very short list of differential diagnoses you have to include environmental toxins and particularly heavy metals. Basically, from my perspective, there is not a patient that I see that does not get weight and blood pressure and a heavy metal challenge. To me, it is like a CBC or a chem panel. It is the most fundamental, one of the most fundamental things to deal with screening patients for future risk and for current things that are driving their poor health. And mercury is like gluten. It can cause a myriad of symptoms and diseases that people ascribe to other things but it is a huge, it is a huge factor. And I do not mistake taking that diagnostic test on any one of my patients because it is so important.

Terry Wahls, MD

Now for people who are listening to this, who may be seeing their neurologist and they go to them and say, look, I want to be screened for blood and mercury. What kind of tests should they be asking for? Because I am betting their conventional neurologist will like well, we do not need that, we know you have MS, we know you have whatever the neuroimmune condition.

Mark Hyman, MD

Oh, God. Well, I think that this is so frustrating, honestly, Terry, because most doctors that get no training in environmental toxins except for acute toxicology, most doctors do not know how to diagnose that or including how to treat it. I think most doctors say, well, let me check your blood levels, so I will check out blood level and they will look at that and that is fine. The whole blood levels are heavy metals are useful for current exposure but they only detect current exposure, for example, tuna fish for ten years every day, and then you stop fish for a year your blood level would be zero. That does not mean you have heavy metal stored in your body. That is not really the best thing. I think urine testing is done by doctors. They will do a 24-hour urine test but that only looks for acute exposure. If you are in an industrial accident or work in a factory, or you have a high level of exposure you see an increased urinary excretion. But the only real test that I think is valid for looking at your body burden is that heavy metal challenge. 

That is where we take a chelating drug like the MSA. You take a loading dose and you basically collect your urine for six hours and then send it off to the lab for urinalysis and that will give you a really good idea of what your body burden is. Now, sometimes it does not all pull out because it is stuck in there, it can fluctuate over time and you have to learn how to interpret these tests, but it is a really important test. I think there are also tests that look for speciation of mercury, so you can do a blood, hair, and urine test that looks at it, it is called the Mercury Tri-Test. And that looks at the level of methylmercury from fish in your blood as well as where inorganic mercury from fillings and pollution and then also looks at your ability to detoxify them and through urine and other methods you get a good sense of if you are a good or bad detoxifier. And I think those are the most important diagnostic tests looking at mercury.

Terry Wahls, MD

As I am listening to this, for everyone who is out there listening MS and neuroimmune you can try with your conventional doc, with your primary care doc, they are likely to not understand how to investigate this as thoroughly as possible. And so finding some functional medicine testing to investigate and then help you deal with that, that would be super helpful. What are the things that people can do right now in terms of reducing exposure or beginning to improve their ability to clear these toxins?

Mark Hyman, MD

Yeah. I think in terms of reducing exposure, I think the number one thing is to only eat small little fish or fish from a company like Seatopia where there are just super low levels of metals, sardines, mackerel, and anchovies, herring think even salmon has fairly high levels of mercury, believe it or not, lower than tuna and swordfish. But eliminate all those to make sure you filter your water with reverse osmosis 3. Ideally, get an air filter, for people living in an urban environment. For I would say to also look at your potential lead exposure such as your dinnerware, and your glasses. 

There is glaze plates or crystal you are going to be exposed to at high levels if your hobby is stained glass making kind of high levels of lead. You shall be aware of those things. I think as far as arsenic, making sure. I think wine, in particular, American wine is treated off, there is often pressure-treated lumber in the soil they used to kind of for steaks, and that pressure the lumbers full of arsenic, and that can get in the wine. I think chicken, that was the only pastured chicken as far as a water filter, the water. If you have a pressure-treated lumber deck that is also an issue potentially. Let me just be aware of these things that kind of reduce your exposure.

Terry Wahls, MD

Wow. Well, there is a lot that we can be doing. Is there anything that we can do to improve our ability to clear mercury and lead?

Mark Hyman, MD

Absolutely. I have written a lot about this and people can go to Google and go to Dr. Hyman and Mercury – drhyman.com all the articles I have written. But I did tell in great length about how to treat it. And in terms of lifestyle things you can do diet plays a huge role and you talk a lot about this caring about certain foods as medicinal foods that can actually activate different enzymes and pathways. The cruciferous vegetables should be a staple. Broccoli, collard greens, kale, cabbage, brussels sprouts, all that stuff, at least a couple of cups a day, a couple of days at least. I think garlic and onions are also important. Cilantro, people have gotten really amazing results by juicing cilantro and having cilantro juice every day to get their metals down as a detoxification strategy. That is another kind of nice tip. 

I think upregulated a lot of the pathways that we need to boost glutathione, we need to make sure we are properly, properly boosting those with the right kind of protein like whey protein. Also, things like and as you know, cysteine, lipoic acid, we need extra selenium, zinc which activates TRPA1 which is a really important intracellular enzyme that actually helps mobilize metals out of the cell. We need to make sure we are methylating properly to help also eliminate the detox pathways are recycled glutathiones, B12, and fully B6. And we make sure we are taking binders whether it is alginate or silica are the kinds of things that bind the metals in the gut when they are excreted. Drinking a lot of water, the sauna is really important, and so is exercise, all those things are really key to help mobilize your detox pathways. And it is just a fair bit. I have written about it. You can go check in more detail.

Terry Wahls, MD

Again, anyone who is listening, I hope you get the core message here that Mark’s just given us. It is there is so much that we can do that we can add to our self-care routine. Now, I do not think you have to do everything all at once but you can look for a trusted physician with whom to work who can help you add a detox program step by step. There is a lot that we can do with supplements, with food, with sweating. What about detox baths? And does it do anything with clay baths or an Epsom salt bath?

Mark Hyman, MD

Yeah, absolutely. I mean, I think for me, Epsom salt baths are great. It is one of my favorite things to do just for lifestyle hacks and night to sleep. Magnesium is important. It helps you to relax our nervous system. But also Epsom salt has got magnesium sulfate. Sulfur is the building block for glutathione. And I think we need to boost our sulfur intake and so we can do that transdermally as well. I think it is a great way to help protect you have a sauna or something like that. A hot Epsom salt bath is great.

Terry Wahls, MD

Yeah. I am with you, right there with you. And again if he has a problem an Epsom salts bath to the temperature that feels good for you is super helpful. Do you have any preference Epsoms or dead sea salt?

Mark Hyman, MD

I think Epsom salts are pretty good. I do not know.

Terry Wahls, MD

I have gone back and forth and I have done some of both. Now have you done anything with clay masks or a clay bath, Mark?

Mark Hyman, MD

I do. There is sometimes we do that. I think that is another factor that I think people can potentially use clay to help draw things detoxifying, that is for sure.

Terry Wahls, MD

Yeah. And it is a fun activity putting on a clay mask. I have done that with my family, we have lots of fun with that. Very interesting fun activity. Do we have to worry about if we put a little bit of clay in the bath? Is that a problem with your sewer or septic system?

Mark Hyman, MD

That is a good question. I actually do not know.  Might gone get up but I do not know.

Terry Wahls, MD

I do not really know. I tell people that if you are going to do that it better keep it very dilute. And if you have a private septic system, I would just do a clay foot soak instead so you can avoid that particular risk. I have seen some people do brush their teeth with clay and take dilute clay by mouth. What is your thoughts on that, Mark?

Mark Hyman, MD

I mean, yeah. I mean, I think people can do all kinds of stuff. I do not think those are the most important things. I think that when I mentioned in terms of diet and exercise, the nutritional support, the supplements, and potentially even chelating agents are really important.

Terry Wahls, MD

Are absolutely the most helpful. If you are going to pick one thing that people could take from our conversation, what would be the one action you would like to have them do?

Mark Hyman, MD

Well, I think, first of all, I think it is important to realize that there is, as you have shown so well, Terry, that these problems are treatable but they are not treatable in an effective way with conventional therapies but using a functional medicine approach they are very treatable. It would give people hope. Second, I would say you really want to be focused on reducing your exposure to all environmental toxins and breaking of your body’s ability to detoxify. Environmental Working Group has a great website ewg.org to look at where you get exposure from household products, skin care products, your food, and everything else. I think it is a great, really important guide for you to look at how to reduce your overall toxic exposures. And then lastly, I would say, to make sure you can kind of really focus on getting ready for the intake and exposure of heavy metals from fish is a big one in fillings and then light is less of an issue, but mercury is definitely a huge issue.

Terry Wahls, MD

This is brilliant. This is absolutely brilliant. Now, Mark, where can people? Well, I have a couple of questions. Can people come see you and your team? Do you guys see patients?

Mark Hyman, MD

Yes, we do. We have a clinic at the UltraWellness Center in Lenox, Massachusetts. We receive patients from all over the world. And we have a great team of five physicians in the whole health support team. We have a team at Cleveland Clinic, also we have got ten positions at the Center for Functional Medicine there as well. And you can find me online drhyman.com. On social media, it is Dr. Mark Hyman. And then obviously my podcast is Doctor’s Farmacy, you can listen to me there. And would not have trouble finding me.

Terry Wahls, MD

It is wonderful. And certainly, if you have a complex chronic health problem, Mark and his team are just amazing resources.

Mark Hyman, MD

Yeah. Thank you.

Terry Wahls, MD

Mark, Thank you so much. This has been absolutely fabulous.

Mark Hyman, MD

Thanks, Terry.