Clinical Metal Toxicology
Introduction from chairman of the Medical
Scientific Education and Research Committee
of the International Board of Clinical Metal
Toxicology
Historical Perspective
• Concept of ligand theory proposed over a
century ago – Swiss Nobel physicist Alfred
Werner .
• Metal ligand theory –foundation for the usage
of chelating agents to bind heavy metals.
• Dr.Norman Clark – usage of EDTA to treat
plumbism ( lead poisoning ) post WW2 ; the
beginnings of chelation medicine.
st
21
Century Perspective
• There exist over fifty years of research in metal
binding medicine and science; arguably the
oldest and most establish field of medical
specialty.
• There exist over a thousand scientific papers on
one of the chelating agent -EDTA!
• The systemic effects of excessive free radical
reactions catalyzed by excessive heavy metals
causing free radical pathology is well established.
IBCMT
• The IBCMT was set up for the purpose of establishing
a gold standard for the practice of clinical metal
toxicology .
• The IBCMT protocol is a comprehensive medical and
scientific methodology on the optimal clinical
management of patients in this specialty field .
• Optimization of physiological, biochemical ,physical
and mental health and precise nutrient distribution via
detoxification of toxic metals and chemicals are
fundamental to the desired medical outcomes.
Environmental Health
• The EPA ( USA ) has sounded the dire necessity of
addressing the pollution of our environment and the
serious toxic metal poisoning of the community.
• Recent research has shown that accelerated age-related
degenerative and neuro-degenerative diseases are linked
to heavy metal poisoning .
• IBCMT and the physician members of the sponsoring
teaching colleges /chapters are poised critically in the
position to address the EPA concerns and to play a
crucial role in metal toxicology public health issues .
Current clinical tools
• Well established laboratory tests- spot urines
,provocative urines ,plasma and cellular
biochemistry, hair analysis are utilized as baseline
measurements and monitoring of treatment
progress.
• Current neuro-toxicity measurements are limited
to subjective and semi-quantitative psychological
testing and indirect inference from standard
laboratory tests.
Neuro-toxicity Assessment
• Traditional radiological investigations – Plain
films, CT scan, ultrasound, MRI mainly address
anatomical issues .
• Functional assessment of brain function is
clinically critical for the measurement and
monitoring of medical outcomes .
• The BRC brain function testing involves a
screening tool – the Integneuro assessment and
a Comprehensive Psychological Test Battery.
Memorandum of Understanding
• Milestone signing of MOU between IBCMT
and BRC .
• IBCMT agree to adopt the BRC Integneuro
system as one of the “gold” standards for the
assessment of brain function.
• This is an objective measurement of brain
function based on the Brain Resource
International Database ( BRID ).
Key Factors of the MOU
• The establishment of an embedded research
program in clinical metal toxicology.
• The availability of touch screen based kiosk to
carry out screening assessment of brain
function.
• The distribution of research funding at the
IBCMT , college and clinician level based on
proceeds of brain function assessments.
Embedded CPD
• Continuing medical education is crucial to keep abreast
of any medical field .
• Current IBCMT re-certification requires all candidates
to attend an advance metal toxicology workshop and to
discuss two clinical cases of merit.
• Participating in the embedded research is one way of
achieving continue professional development ( CPD)
and will raise the standards of our specialty field by
another notch.
Future of Clinical Metal Toxicology
• The addition of BRC “gold” standard clinical tools and
the availability of continued research funding at all
levels would ensure an optimistic future for all
concerned.
• The research would yield information on specificity of
brain function toxicity as caused by various toxic metals
based on the BRID reference population.
• IBCMT would utilize this database to enrich its
protocol that would assist us in optimal clinical
management of systemically toxic individuals.