What is Mercury Poisoning?
Actor Jeremy Piven, best known as loudmouth talent agent Ari Gold on HBO's
Entourage, has made an early exit from the Broadway play Speed the Plow, blaming a
mercury-rich sushi diet and possibly use of herbal medicine. His doctor says tests
revealed Piven has mercury levels five to six times higher than normal, and has ordered a
fish-free diet and rest.
“I talked to Jeremy on the phone, and he told me that he discovered that he had a very
high level of mercury,” playwright David Mamet told Variety. “So my understanding
is that he is leaving show business to pursue a career as a thermometer.”
Piven's doctor, Carlon Colker, told the showbiz publication that
“insensitive comments like that are not only unkind and unfair,
they reflect a profound lack of understanding of a problem that can
actually kill.”
What do you
think etiology
means?
“The etiology is unclear, but his level of mercury was
uncharacteristically high, one of the highest we’ve seen,” Colker, an
internist at Greenwich Hospital in Connecticut, told Variety. “We’re
not sure if this is from his diet, which is high in fish, or Chinese herbs,
which he’s been a fan of in the past, or a combination of both. He needs convalescence
and rest and treatment, and this will clear his body and he will be back in action very
soon."
Colker told the Wall Street Journal Health Blog that Piven's treatment would include
dietary restrictions, nutritional supplements and antioxidants.
What is mercury?
There are three kinds of mercury. Depending on what the exposure is, you could have
different symptoms and disease states.
What are the 3 types of
mercury? Describe each
Elemental, or metal mercury, is found in thermometers.
The problem with that is the inhalation of fumes that
come off that mercury. Playing with it and ingesting it
is not as toxic. That kind of mercury causes
significant amounts of neurological damage. As the
exposure gets longer, there may be additional changes
in the bone marrow that affect the ability to produce
blood cells, infertility and problems with heart rhythm.
Mercury salts, which are basically industrial, if you
breathe in or ingest them, gravitate more toward the kidney
and not so much the nervous system.
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The organic mercury is what gets into the food chain. It's put into the water by
chemical plants that are manufacturing things and they get into shellfish and fish, or
elemental mercury that gets into the water is changed into organic mercury by sea life;
we eat fish or shellfish and we get mercury exposure. That organic mercury acts very
similarly to the elemental form. It affects a lot of nervous system damage. If a woman is
pregnant, this can also cause birth defects and loss of the fetus if the levels get high
enough.
Safe Levels of Mercury
No level is of mercury is normal. It doesn’t have a specific reason to be in our body. As
long as we live on this Earth, because it's in Earth's crust and in the atmosphere, we're
going to be exposed. But there is no specific function for that metal in our body.
The issue is one of looking at the total body burden: How much mercury is in the body
and what's known to be a normal background? Theoretically, there's going to be a
baseline level, a general population average, but depending on where you live, that level
may be higher or lower. If you live near a coast, you're more up to eating seafood. Or you
may be in an industrial area where mercury is put into the water or the air.
Mercury Exposure vs. Mercury Poisoning
A lot of this has to do with numbers versus symptoms. Just because you're exposed to a
toxin doesn’t mean you get poisoned. You can build up a blood or tissue level but not yet
manifest symptoms related to poisoning. This is a
threshold.
Discuss the differences
A person with no symptoms, no changes physically or
chemically, we just say they've been exposed and
have a high mercury level. It doesn’t become
poisoning under the true definition unless someone
has had physical or chemical changes in his or
her body. It's a very fine distinction, but one person is
symptomatic and the other asymptomatic. The person
who is symptomatic is poisoned. The one who is
asymptomatic has a high blood level consistent with
exposure.
between mercury exposure
and poisoning
That doesn’t mean it's safe to have levels without symptoms. Over
time, even if you're exposed at low levels, the symptoms may not manifest until weeks or
months later.
A person can find out if they had a higher-than-normal exposure — the urinary level is
the most specific way. Blood levels can also be used, and we plot those against your
geographic area.
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Symptoms of Mercury Poisoning
Symptoms can occur in many ways. Unfortunately in mercury, symptoms can look like
many disease states. When levels are building up, there could be a variety of symptoms
that a physician may interpret as another illness. Only when the physician can't find a real
cause or gets a toxicologist involved will they do blood tests and say, "Yes, this is
probably due to mercury exposure."
It's a difficult diagnosis. You have to know by history that a person has been exposed to
this and put two and two together. No specific set of symptoms will say, "Ah, this is
mercury poisoning."
Describe 3 symptoms of
mercury poisoning.
If it's mercuric salts the person has been poisoned by, it may
just be a problem with the kidneys, issues with the
ability to urinate, or they're feeling out of whack
because of renal dysfunction.
If someone is inhaling fumes from elemental
mercury, that can show up as an upper respiratory
illness, like a flu, at first. They might find they can't
concentrate well, have trouble with fine motor
control or their perception of smell, eyes or touch. If it
was affecting their heart, it could be palpitations or just
in general not feeling well. If something is not going well
with their blood cells forming, they may have issues similar to
anemia, feeling very tired, easy bleeding or bruising.
With organic mercury exposure, the symptoms are pretty much the same, but probably
not respiratory. The nervous system effects are what someone would see first.
Treatment for Mercury Poisoning
What is used, when, and how is decided by a doctor on case-by-case basis in consultation
with a toxicologist. If you do have high levels, the first thing to do is stop the exposure.
Chelating agents make metals more water-soluble so
they can be excreted by the kidneys. That works
fairly well for inorganic salt forms of mercury
poisoning but not so much for neurologic forms
from the elemental.
What is a chelating
agent?
There are old World War II antidotes, actually:
Injectables are used when we have high levels and
only when we don’t have the organic form of mercury
poisoning; it's the elemental and inorganic poisonings that we
use them in. British anti-Lewisite (BAL), or dimercaprol, is one of these agents: it's an
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antidote the British developed against lewisite gas, and it's a potent chelator used against
mercury, arsenic and lead.
If it's eating too much fish, we stop them from eating the fish and get the levels to come
down naturally. Otherwise, there's nothing we can do.
How long treatment takes has to do how high the level is and how chronic the exposure
is. If it's somewhat low levels, chelating might happen relatively quickly. If it's exposure
for many years, it may take longer for those levels to come out.
Recovery from Mercury Poisoning?
You can and cannot recover from mercury poisoning. If the symptoms just started and
you haven’t been exposed for years and years, it's very possible that those symptoms will
dissipate. If it's occupational — you've been exposed to this for many, many years and
you've physically damaged the nervous system — that may or may not reverse. It may if
the nervous system can repair itself. If not, you may end up with a residual or permanent
problem.
Mercury Poisoning and Fish
There are certain types of fish that can accumulate higher levels of mercury than others.
If you exist on a diet of that fish, you can mount some very high levels.
Tuna, depending on the type, may be higher in mercury content. It doesn’t matter how
you cook it; whether raw or by cooking, it's [the levels] going to be similar.
Herbal Remedies and Mercury Poisoning
Herbal medicines made outside the country can potentially contain toxic quantities; it
depends where they're coming from and how they're being made. These products aren’t
controlled by the FDA and don’t need to adhere to any general standard of purity or
potency so you end up with voluntary adherence to what the company says is in the
bottle. You're always at risk when taking significant amounts of herbal products or
remedies that have decent levels of this and other agents.
Based on what you read in the article, do you think Jeremy Pivin had mercury
poisoning? Use EVIDENCE from the article to support your argument.
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