This is the outline of the new paradigm in clinical mercury analysis for integrative medicine.

1. Mercury Tri-Test: Mercury Speciation
Analysis and Compartment-Ratio Analysis for
Body Burden and Excretion Indices WITHOUT
Provocation
Christopher W. Shade, PhD
Andrew Elias, MBA, LSSBB
Quicksilver Scientific, LLC
Lafayette, CO 80026
(303)531-0861
www.quicksilverscientific.com

2. Mercury Testing
• Most Common method now is the “Challenge Test”
– No information on form of mercury
– Large dose of potentially harmful chelation compound
– No information on excretion capacity
– Misleadingly believed to reveal “Body Burden”
• Quicksilver Scientific Tri-test uses Mercury
Speciation Testing (separation of forms of
mercury) and comparisons of different sample
types
– Clearly Reveals source of mercury and bodily levels
– Gives index of excretion ability for each form of mercury

3. Forms and Sources of Mercury
• MeHg - Methylmercury
– Organomercurial; found in fish; Also formed
in gut from amalgam mercury
• Hg0
– Elemental Mercury
– The metal form; liquid and gas forms; dental amalgam
• HgII
– Inorganic Mercury
– The salt, formed by oxidation of Hg0
in blood and mouth
• EtHg - Ethylmercury
– Synthetic organomercurial; antimicrobial
– Ends up mostly as inorganic mercury

4. Pathways In – Dental Amalgam
Hg
0
breaks down to
inorganic mercury (Hg
II
).
Hg
0
distributes throughout
body and nervous
system.
Image from the International
Academy of Oral Medicine
and Toxicology.
Hg
II
accumulates in
the nervous system, liver,
and kidney.
Hg
0
released from
amalgam and inhaled with
80% uptake in the lungs.
Amalgams: Pathway of Exposure
80% Uptake

5. Pathways In – Fish Consumption
MeHg
MeHg
Chemical reactions in the
gut add MeHg to an amino
acid.
Fish contaminated with
methylmercury (MeHg) get
eaten.
MeHg diffuses out of the
gut and circulates
throughout the body,
because it gets mistaken
as an amino acid.
Methylmercury
accumulates in
the body.
Seafood: Pathway of Exposure
95% Uptake

6. Pathways In – Vaccines
EtHg
Hg
II
accumulates in
the body.
EtHg distributes
throughout the body and
nervous system.
EtHg probably does not
leave the body, but enters
tissues and breaksdown
into inorganic mercury
(Hg
II
).
Ethylmercury (EtHg)
enters the blood through
vaccination.
EtHg leaves the blood
after a few days.
Vaccination: Pathway of Exposure
100% Uptake

7. Pathways Out – Methylmercury

8. Pathways Out – Inorganic Mercury
Both Intestinal and Kidneys

9. Mercury Speciation Testing
• Patented Mercury Analysis Technique
separates methyl and inorganic mercury
– Shows different sources (fish vs. amalgam)
– US Patent #7,285,419 B2
• Comparison between matrices shows
excretion or retention of mercury
• Only clinical lab in the world offering
Mercury Speciation Analysis

10. Challenge Tests – What do they mean?
Are They Necessary?

11. Mercury Industry Workers
Dentists
Controls (Amalgam)
Amalgam-free Referents
Industrial workers 3-4 yrs on job, versus dentists
10-30 yrs on the job and amalgam bearers with
10-30 yrs with fillings

12. Mercury Industry Workers
Dentists
Controls (Amalgam)
Amalgam-free Referents
If challenge reflected long-term body burden, the
long-term dentists would have moved closer to
the short-term industrial workers…but it did not

13. Challenged Urine correlated well
with pre-challenged urine and pre-
challenged plasma

15. Chelation therapy – Dump from blood
followed by reloading from cellular
burden
Chelators drain the blood
metals through the kidneys.
After cessation of use, the
tissues replenish the blood

16. Mercury Speciation Testing
• Separates the two main forms of mercury
in the human body (Methyl and inorganic
mercury)
– Once separately measured, ambient
measurements reveal a lot without challenge
tests

17. Testing for Hg – Forms Present
in Different Samples
1. Ambient
1. Blood – MeHg + HgII
(MeHg larger)
2. Hair – MeHg only
3. Urine – HgII
(little bit of MeHg)
4. Stool – MeHg + HgII
2. Provoked
1. Urine – MeHg + HgII

18. Blood Testing
• Old Dictum – blood is only recent exposure, 3-days
• Reality
– 3-day residence only the quick decay after a large
dose
– For MeHg, Steady state develops after initial decay;
Then blood reflects body burden!
• Real Problem
– Most labs detection limits too high to see dynamics
– Need sensitive equipment!
H
H
H
Hg

19. Fish Consumption
12 hr peak and fast decay over 24hrs
Clarkson et al., Arch. Env. Health, 1980

20. Fish Consumption
Slow 160 day return to baseline
After initial peak and decay, Blood reflects Body Burden!

21. Mercury Speciation Testing
H
H
H
Hg

22. Mercury Speciation Testing and
Compartment Ratio Testing
Ambient Measurement Suite
1. Blood – MethylHg + Inorganic Hg
2. Hair – >95% MethylHg
-Compare to blood MethylHg for excretion
measurement
1. Urine – >95% Inorganic Hg
-Compare to blood inorganic mercury for
excretion measurement

23. Blood Mercury Speciation
Methyl Hg
Inorganic Hg
Total Hg
Methylmercury levels with comparison to
laboratory average
Inorganic Mercury levels with
comparison to laboratory average
Sum of 2 forms = total Hg with comparison to laboratory
average and color coded CDC population averages

24. Compartment Ratio Analysis: Patient #1 – Healthy
Low Levels and Good Excretion Profiles
Methyl Hg
Inorganic Hg
Total Hg
Low Methyl and average
Inorganic Hg
Good MethylHg
excretion
Good Inorganic
Hg excretion

25. Compartment Ratio Analysis: Patient #2: Dentist
with Chronic Intestinal Inflammation
I n dic a t io n of M e r c ur y E x c r e t io n A bilit y
0
4 00
-1 2 0 -1 00 -8 0 -6 0 -4 0 -2 0 0 2 0
B lo o d Me Hg (n g /mL )
B e lo w A v e ra ge
Exc re tio n
of blood mercury through
the hair.
A v e ra ge Exc re tio n
of blood mercury though the
hair (290:1).
Indication of Mercury Excretion Ability
0
400
800
1200
1600
2000
2400
2800
0 2 4 6 8 10
Blood MeHg (ng/mL)
HairMeHg(ng/g)
Methyl Hg
Inorganic Hg
Total Hg
Very High Methyl and Inorganic Hg
Bad Inorganic Hg
excretion
Bad MethylHg
excretion

26. Compartment Ratio Analysis: Patient #3: Dentist
– Kidney Problem from Long-term Hg vapor Exposure
0 0.5 1 1.5 2 2.5
Concentration of Mercury (ng/mL or ug/L)
HgT
Hg(II)
MeHg
Blood Mercury
Patient Blood
QS Average
I n d ic a t ion of M e r c ur y E x c r e t ion A bilit y
0
4 00
-1 2 0 -1 00 -8 0 -6 0 -4 0 -2 0 0 2 0
B lo o d Me Hg (n g /mL )
A ve rage Exc re tio n
of blood mercurythough the
hair (290:1).
B e lo w A v e ra ge
Exc re tio n
of blood mercury through
the hair.
Indication of Mercury Excretion Ability
0
400
800
1200
0 1 2 3 4 5
Blood MeHg (ng/mL)
HairMeHg(ng/g)
Indication of Kidney Mercury Excretion
Ability
0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
5.00
0 0.5 1 1.5
Blood Hg(II) (ng/mL)
UrineHg(II)
(ng/mL)
G o o d H g(II) Exc re tio n Line
(7:1)
Methyl Hg
Inorganic Hg
Total Hg
Normal Methyl and Very
High Inorganic Hg
Good MethylHg
excretion
Bad Inorganic Hg
excretion

27. Compartment Ratio Analysis: Patient #4 –
Likely Methyl Hg Detox Enzyme Deficiency
Bad MethylHg
excretion

28. Quicksilver Scientific Tri-test
• Clearly Reveals source of mercury
• NO provocation (chelation) agents used
• Gives index of excretion ability for each form
of mercury for informed treatment options