When evaluating new clients with any chronic healthcare condition, we try to dig into their history and current routines to discern if there may be a chemical exposure or pharmaceutical that may be negatively impacting their health. Sometimes this may only require minute amounts of exposure. Arsenic and cyanide for example, can rapidly destroy enough cells to cause death of an individual, but other exposures, such as air pollution, insecticides, and herbicides can destroy cells over time leading to chronic illness. Over-the-counter drugs and prescribed drugs can also cause cell injury and is one of the leading causes of death in the United States. The leading cause of child poisoning is now medication and acetaminophen is one of the most common causes of poisoning across the world.
As a functional medicine provider, my goal is to dig into the history of each client and identify, then remove any offending agent. However, as I transition into a family practitioner and consider children among my clientele, I can’t help but assume more concern over the role medications play in childhood poisoning. Each year, more than half a million children experience potential poisoning related to the various medications on the market, and I suspect the damages of these events are grossly unappreciated. One in every 150 2-year-old children are treated in emergency rooms for unintentional overdose, and while 95% are caused by unsupervised accidental ingestions, 5% are from providers prescribing the wrong dose! More and more calls to the Poison Control Center regarding overdose by a child is from consumption of narcotics and cardiovascular medications. Half of all deaths involve analgesics, antihistamines, and sedatives (McCanse & Heuther, 2014).
I can only think of two times within my lifetime in which the Poison Control Center was called, and the first was when one of my step-brothers got gasoline in his eye while filing the lawn mower, and the other was when my daughter got into her diaper genie and for whatever reason, consumed a great deal of its contents. Neither required follow-up with a medical professional. Today however, as the development of medications has grown, so has their availability to children within the home. Oxycodone, morphine, and methadone prescriptions have increased between 159% and 559%, but more medications are prescribed to children as well, such as those utilized for attention-deficit disorder and diabetes.
Medications are often a band-aide and do not actually fix the underlying problem, particularly with pain, but when prescribed, it is important to store them safely. Where are you storing your medications, including over-the-counter pills and supplements?
Excessive lead exposure still exists in our culture in spite of government regulations prohibiting its use in paint and gasoline, and it is still considered a primary hazard for children. More recently the CDC has cut in half the ceiling of tolerance for lead levels in children because they are recognizing harm at even the lowest levels. Unborn babies are at the greatest risk because they can readily absorb the lead even though scientists have not identified the exact transport mechanisms. Exposure to the child during neurologic development can have significant effects on neurobehavioral and intellectual performance, resulting in learning disorders, hyperactivity, and attention problems (McCance & Heuther, 2014, p 65).
Homes built prior to 1978 pose risk to children as the paint prior to this time contained lead. Oddly enough, lead-based paint has a sweet taste and is often ingested by children when they have access to surfaces painted with it, or if it has gotten into the soil. Toys, jewelry, imported candies, baby formula mixed with lead-contaminated tap water, cosmetics, dust, and some supplements also may have lead. Water that flows through lead pipes, hair dyes, food stored in soldered tin cans or eaten off of pottery made with lead-based glazes, and newsprint are additional sources of lead that might pose risk to children. If their diet is poor or they are low in iron, calcium, zinc or vitamin D, lead’s toxic effects are enhanced (McCance & Heuther, 2014).
Adults are primarily exposed at work, generally in battery factories, secondary smelting and refining of nonferrous metals, and painting and paper hanging. The most common source outside of occupational exposure are shooting firearms, remodeling old buildings, renovating, painting, possessing retained bullets in the body, and lead casting (McCance & Heuther, 2014). The nervous system, reproductive system, gastrointestinal system, cardiovascular system, musculoskeletal system and the production of blood cells are the greatest affected systems within the body.
Exposure occurs through inhalation, ingestion and on occasion, skin contact. Children can consume it through their mouth, nose or eyes, and through cuts in their skin. Tetraethyl lead, which is still used in aviation fuel, can be absorbed by the body through the skin, but inorganic lead which is found in the more common sources such as paint, food, and consumer products is only minimally absorbed through the skin (McCance & Heuther, 2014).
Lead will be absorbed and stored by the body and persist for months and years. In adults, 94% is deposited in bones and teeth. The estimated length of storage is 20 to 30 years and it can move from bone into the bloodstream years after the initial exposure, or even reintroduced continuously to the blood from the bone (McCance & Heuther, 2014).
It’s toxicity is due to its ability to mimic other metals such as calcium, iron, and zinc in biologic processes because it acts as a cofactor in several enzymatic reactions. A primary consequences is its ability to interfere with the synthesis of hemoglobin, but it can also alter development of synaptic connections causing neuronal death. This interferes with neurotransmitters and can lead to hyperactive behavior and proliferation of capillaries of the white matter and intercerebrayl arteries (McCance & Heuther, 2014).
Our practice has tested a number of children as a resource for the state, and we’ve also tested a number of clients within our functional medicine consults. We have identified a limited number with high levels of lead and worked to correct these levels through a variety of options. If you are concerned about your family’s potential exposure, please schedule an appointment for further evaluation.
Poisoning by carbon monoxide is a leading cause of unintentional deaths in the United States with more than 50,000 emergency department visits per year and about 500 deaths per year. Those greatest at risk are those who may breathe air polluted by gasoline engines or defective furnaces and appliances, those who work in coal mines or welding or firefighters, and those who smoke cigarettes, cigars or pipes. Unborn babies however, have the greatest risk of all, or those over the age of 65 (McCance & Heuther, 2014).
Our practice has been impacted by a family who was tragically poisoned by carbon monoxide. It directly reduces the oxygen-carrying capacity of blood and promotes tissue hypoxia because it shifts the oxyhemoglobin curve to the left. Normally hemoglobin carries oxygen, but because carbon monoxide has such a high affinity for hemoglobin, it will prevent hemoglobin from carrying the necessary oxygen for tissue oxygenation. Minute amounts can be deadly and sadly when pregnant mothers are exposed, they may be asymptomatic because their unborn child will bind the carbon monoxide.
Do you have a carbon monoxide monitor in your home? Symptoms of poisoning may be headache, giddiness, ringing in the ears, nausea, weakness, and vomiting. Contact the emergency department if you suspect you’ve been exposed.
Ironically, this metal has been used medically and commercially for centuries. At one point it was a common component in medications, and is still present in some thermometers and blood pressure cuffs and batteries, switches, and fluorescent light bulbs. Most people are exposed today through fish consumption and dental amalgams. The inactivated influenza vaccine still utilizes mercury as a preservative, but the industry denies utilizing it in any other vaccine since 2001 (McCance & Heuther, 2014).
Dental amalgams have been used for more than 150 years, because they are believed to be durable and easier to use, but they are are thought to release mercury vapors into the mouth in concentrations that are higher than those deemed safe. Brain, blood, and urinary mercury concentrations correlate with the number of amalgam surfaces present in a person, and removal can temporarily elevate blood mercury concentrations, but for some this is necessary to avoid advancing disease and continued inflammatory responses within the body (McCance & Heuther, 2014).
The greatest exposure though is through fish. The FDA has recommended pregnant women, nursing mothers, and young children avoid eating fish with a high mercury content, such as shark, swordfish, tile fish, king mackerel, and whale meat (McCance & Heuther, 2014, p 69). More extensive lists have been provided by other agencies which include avoiding fish sticks, haddock, wild salmon, shrimp, trout and others.
These levels are important to functional providers as their impact on your health can be significant, not only in diseases late in life, but prior to overt disease when your body is trying to give you warning signs – acne, insomnia, irritability, weight gain, anxiety, and bowel issues. Our practice has discovered a variety of tests for assessing these levels, and a plethora of others, and can recommend treatments based on results. Contact our office if you’d like to schedule an appointment for consultation.