Heavy Metal Toxicity: Separating Real Risks From Influencer Scams | Dr. Eryn Russo

Welcome to the Docs Who Lift podcast, where we distill and simplify the complexities of a healthy lifestyle, exercise, medicine, and weight loss. We're excited to bring you a podcast that's a prescription for clinical practice, scientific recommendations, and just real life. This is the Docs Who Lift podcast. Today, we have a special guest, Dr. Erin Russo. She is board certified in preventive medicine, occupational health, and environmental medicine. She's PrevMed. Really cool. So today, my brother was on her podcast, and we're going to have her on kind of dispel some of these myths around like heavy metal toxicity and a few of these other things. So welcome to the podcast, Dr. Erin. Thank you so much. And I mentioned this before, but I'm a big fangirl of you guys. I think you guys are doing great work. And thank you so much for having me on your podcast. I appreciate it so much. We appreciate the kind comment to help boost our fragile egos here at the document podcast. So, okay, I want to hear. So you did PrevMed. Can you explain this? We were talking before the podcast. I actually have an interesting story. So I did a lot of things in my medical training, if you will. um i started medical school really young i thought i wanted to be a surgeon i actually did my internship in general surgery um and was like oh damn this is way too much call i i want to sleep sometimes that sounds cool yeah so then i switched gears and did um i actually went into imaging and it was mostly because uh i had a lot of radiology friends and and they were into imaging. And so I did research. I did cancer research actually in nuclear medicine, which is a form, a specialized form of, or I guess a specialized section of radiology where they do a lot of PET CTs and stuff like that. A lot of cancer imaging, cancer staging, that sort of thing. I did research in that first. And then I actually went to Harvard and And the residency. Yeah. Yeah. I actually came back from that residency a little bit disappointed. And so I feel like, you know, if any residents out there or physicians are listening to this, this is kind of my my little plug for for my specialty. But so I came back pretty disappointed in how medicine felt like a business, more like a business. I felt like I was turning out scans, kind of like a product. And, you know, a lot of physicians are on social media now talking about the insurance issues and patient frustrations and in that space. And so I was really lucky. I went and spoke to my dean at the time and said, listen, I'm really interested in staying in medicine. I don't my whole life. I wanted to be a doctor. I really want to help people in the best way possible. At the time, I was very interested in health policy. I was interested in research. And I was also interested in actually face-to-face time with patients. And so I needed something that kind of was an intersection of all those things. And the reason I'm telling you this is because my specialty is pretty rare. Um, so out of all the board certifications, I think my specialty makes up less than 1% of all the, um, physicians out there practicing that are board certified. Um, anyway, she suggested, listen, um, if you go into occupational environmental medicine and preventative men, you'll be able to have some patient care. If you want to work for the government, you can work for the government. If you want to work for industry or corporations, you can work for big industrial places, for example, like BP Oil or Caterpillar, for example. So you can work in industry, you can do health policy, or you can do clinic and do some preventative medicine stuff and actually treat toxic exposures. And so long story short, I ended up doing my residency here at the University of Utah, finishing up here. I'm from Utah originally. And I worked at Hill Air Force Base as a resident. They hired me on and I've been there for almost 20 years. And so I wear a preventative medicine hat sometimes, but my real bread and butter, my day-to-day is working with toxic metals, toxic exposures, toxic chemicals, you name it, as far as what is in the environment that might be affecting you as a patient or as a worker. That's what I deal with every single day. And I think what's interesting is that somehow social media influencers have started to infiltrate this very tiny space, which is very niche. And they've started to manipulate people into thinking that maybe the answer to their problems is that they are being poisoned by toxic metals. They start there. I think it's starting to evolve a little bit more. But I also have to mention that I was on the patient side. And so this, I guess it almost infuriates me how much social media has taken people's vulnerability as patients and really manipulated that in order to sell them something. Sell them something that's totally useless. And I think it really does a lot of harm to our patients. And so that's why I'm here today, because I really feel strongly that this is a niche area where if a patient has kind of vague symptoms, they might be prone to, i.e., find the root cause of their symptomology and say, well, maybe it is a toxic metal exposure. and yeah I just I just feel passionately about this I I see this happen a lot I have patients that show up in in my clinic often saying you know an influencer told me to get this toxic metal panel I got let I paid a lot of money for labs I got my urine tested I got sometimes it's blood testing sometimes they'll go to their primary cares and unfortunately primary cares may or may not be trained in this area. And so sometimes they are not even equipped to kind of give the right information or to steer this person in the right direction. Right. But they're talking about vague symptoms like brain fog and they're blaming on toxic metals or, you know, fatigue. My favorite one that's really recent that I actually just found out about was weight gain. So, obesogenes, which I just, I kind of cringe. The toxic metals I'm going to talk about today don't have anything to do with any of these symptoms in particular. So, a lot of the clinical presentation is very specific depending on the toxic metals, and it's not just a generalized brain fog or fatigue. You have, if you are indeed having a problem with a toxic metal where there is actual exposure, that the symptoms are serious and the treatment is serious. And so any influencer out there that's like trying to sell you chelation or a detox based on some dumb urine panel that they did and saying that you're poisoned and now they're trying to sell you something, this is malpractice in my eyes this is just purely malpractice yeah they're not actually yeah we've been down this route for all sorts of parts of the preaching the choir here what happens is that yeah they're not expected to uh practice standard um scope of medicine like it doesn't matter you can't even do anything wake up whatever they want to make up and people like they could get sued if something harmful happens to them but it never happens because it oftentimes gets thrown out you can't even make an argument yes because because the the government officials would be like well they're not expected to know that so it doesn't really they yeah that's a crazy part this is a cut 22 you can do whatever you want apparently yeah that's nuts and the fact that they're selling clinical tests that aren't um you know supported by the science out there, essentially, or any medical societies or any, sometimes even the CLIA certification that they have to get for their labs. They're not, they don't even have these certifications to actually do these laboratory tests. And then they're giving patients results. I call them patients, but they are people on the other end that are actually getting these results. And then they're telling them that they are being poisoned. And then they're giving them treatment, essentially. They're sometimes in some extreme cases, they're telling them to do some kind of chelation therapy. Chelation therapy is a serious medical treatment and there are specific diagnostic criteria associated with it. So you don't just want to throw it around and it can cause real harm. I think that the one thing that I want to mention at the very beginning before I forget is, you know, even some physicians out there that do some of these. and I know this because I talked to a couple people out there. They'll do some of these functional medicine provider trainings. And I guess this is like embedded in their training, but they do these provoked urine tests. I was going to ask about this provoked urine. What the hell is this? Yes. They actually give, so they'll send you a kit in the mail, for example, and they'll actually give you a chelator. What chelation does is it actually concentrates. So we're all exposed to metals all the time. We're exposed to toxins all the time. Again, the dose makes the poison. We all hear that. But also we look at routes of exposure. Anyway, I digress. But they give you a medication essentially that concentrates those toxic metals in your urine. Okay? Because you are exposed. And so when you pee them out, they actually artificially look higher. And then they say to you, you are being exposed and look how much toxicity you have. And then they sell you the same chelation that they just gave you to concentrate it in your urine. So it's a complete artifact. It's not supported by any medical standards at all out there. It's just, it's such BS that they're doing this to people. And these are people that are vulnerable that think that maybe something might be wrong with them. Right. And so I want to make that disclaimer at the front because I feel like this test is going around and it's very clever how they it's very visually appealing how they do the test results. they'll put like uh for example i saw one has like a green yellow and then a red and if you're in the red you're being you know there's there's some toxin that you're being very exposed to that now you need to get rid of you need to do some um you buy their supplements yeah always there's supplements i see it always send this stuff to me too i'm like this is nothing what do you do what is this yeah yes yeah crazy all right i want to i want to know two things i want to know what are First, what are the top five myth things that you see out there? Then we're going to go into the actual top five things you actually see in your clinic and what they are from and what are the risks of those things. And maybe this includes your story if you're up for telling everyone. Yeah. Your personal story. Yeah. So I think – well, I want to start with a little bit of as far as myths go. So an influencer out there might say to you, you are being poisoned. Here is the lab test that we recommend Just to give you an idea of how my specialty works is one we would never send you a kit in the mail and say go test yourself for anything Typically what we doing with a patient is we're sitting down in an exam room and we're actually interviewing them. And the reason we do that is because we want to know what the source of their exposure is. So not only are we looking at the dose makes the poison, but we need to know what the sources, what the potential sources are. And we call them potential exposures because they are potential exposures. They're not an actual exposure until we actually get some data on that. And I'll talk about that in a minute. So the source of the exposure, the dose, the duration, the route of the exposure is very important. So depending on the different chemical, depending on the route could completely change the clinical picture and the testing that we do as well. And so we're looking at all of that. Then we're getting a very detailed medical history. So we're asking them about any chronic diseases because a chronic disease state can also affect how they might process a toxin, for example. and then we're also asking about like their work history what kind of work that they do because they might be exposed to this potential toxin in their work history or in their in their work and then their hobbies what they're eating what they're drinking so we get a very very detailed history and this is the part where the influencers miss the boat I think in a big way our my specialty is very multi-discipline. And so we actually, part of our residency training is with engineers. And these are special engineers that go into industrial hygiene or bioengineering. And what these guys do is they actually are very trained in going to test the source. So I can tell you right now that no influencer is sending a tester who is trained in this event to go test the source of where the potential exposure might be. Usually they're doing air sampling or swipe sampling. Swipe sampling is not that great. There's not a lot of data on that. So a lot of times we're going to use air sampling. And then we look at what the standards are. I have to say, I don't have a lot of nice things to say about the government, but OSHA does exist to our benefit here in the United States. And the reason that it exists is because there have been so many public health disasters that have taught us, unfortunately, about these exposures, right? And so OSHA came to be because of all these public health disasters, wanting to protect workers that work with toxic chemicals. And usually workers are going to be the frontline of people that might be exposed to some of these things because they're in industry. And so they're working with that day to day. And that's where my specialty comes in. And then also, as a caveat, I do work for the Air Force. We do have bad toxic chemicals that our active duty work with, that our civilian worker population work with. They actually do work with, you know, chrome six, cadmium, lead. And these are the things I'm going to digress into. But yeah, so then we look at the OSHA legal standards to see, is this person being overexposed? And these standards, like I said, came about because there have been public health disasters. So we kind of do know where the levels are that would affect you. And then also we look at, you know, EPA standards. We look at CDC. We look at the different standards to make sure, you know, if it's in our purview. Then we initiate biological monitoring, okay? And the biological monitoring is going to depend on the toxic metal and also end organ effects. So sometimes we don't have good blood tests or urine tests for the different toxic metals that somebody might be exposed to. And so we will look at different organ systems. So sometimes we're doing chest x-rays, pulmonary function tests, because a lot of these toxic metals can be inhaled. And so they might affect your lungs, for example. And so we are going to look at different things. We might do even CT scans. So it kind of depends on what the exposure is, how much of the exposure, and then what the appropriate test is going to be for that exposure. So, again, this is like a huge area where somebody can throw a test at you that is totally ill-informed, not well-trained, tell you that you're being poisoned when, in fact, nothing is wrong. I will say that we do a really good job of protecting the general population. And like I said, with my workers, we have to make sure that they're even being further protected from these toxic chemicals that they work with. anyway i don't know if that named all your your myths but that's kind of the big premise of where i'm coming from yeah absolutely so yeah so what are the what are the real things that what are you what do you actually care about what about the amalgam in your tooth in the real world yes yes let's talk about mercury um well let me start with lead so i think lead is kind of an interesting one um it's one that again all of the things i'm going to talk about um can be bad right? And we'll talk about the clinical presentation, but lead. So your sources are going to be old paint, contaminated soil, water pipes. We saw this, you know, recently even. And then certain jobs like battery manufacturing, police officers that work with lead bullets, people that work at firing ranges, recycling facilities. Even in the construction industry, we might see some lead. I will say in paint, most of the paint, the lead was banned from paint in 1978. And so a lot of paint, newer paint products won't have lead. A lot of products we've tried to move away from. Clinically, lots of effects, right? Really bad things. If you are truly exposed to lead, you're going to see neurologic issues, hematologic issues, GI issues, renal damage. Inorganic lead is going to be the culprit usually. The testing here, the gold standard, so if somebody's sending you a urine detox trip, no. The gold standard for lead is going to be blood, okay? And so we look at the lead levels in the blood, but also it does interfere with heme synthesis. So you can get anemias, that sort of thing. So we look at other markers in the blood that might accumulate because it's an early sign that heme synthesis is being impaired. So ZPP, FEP. So we're going to look at different markers as well. We're not just going to throw one test at you and say, yep, you're being exposed to lead. We might do the initial test and then that would prompt further testing. Also, the population, children seem to absorb lead at a higher rate. So if they ingest it, for example, they're absorbing 40 to 50 percent of the lead so their uh levels need to be lower than an adult an adult will only absorb 10 to 30 percent for example um the other thing is we test kids yes i have a one-year-old she's just got her lead test and and we do test lead because a lot of you know kids put everything in their mouth and they might put paint chips in their mouth And sometimes you live back east and maybe your paint wasn't de-leaded. And so we do test lead in children as well. This is a very routine screening. This is a preventative medicine side of things to make sure that nothing like that's going on. And it can affect children a lot differently. Usually acutely, they'll get abdominal colic and cephalopathy. And they can, all these toxins hit the kidneys. And so kidneys are very, very important for us as far as looking for toxicity, acute toxicity, acute tubular necrosis can occur. The other fragile state are pregnant women. So if they're ingesting lead, any time where you're hypermobilizing calcium, for example, because lead behaves like calcium, you're more susceptible to lead poisoning. And so, you know, a pregnant woman, for example, that might be exposed to lead, unfortunately, could, you know, suffer miscarriage or stillbirth. If they do have the baby, that baby could be very effective with delayed cognitive development. But we know a lot about lead, right? Because lead was used in paint. The painters used to lick their paintbrush and they would actually get motor neuropathy. They'd get wrist drop. And so that was one of the classic signs of lead poisoning. It tasted good, though. Yeah, exactly. So, yeah, so there's very specific things. So if somebody is sending you a urine test for lead, no. That's just simply that's not it. What about all the lead in the vegan protein powder? I was just going to ask because I caught a lot of hell after the Consumer Reports thing came out. I was like, geez, I guess we better take it easy on plant proteins. And then people were like, they're not using the right standards and consumer reports as a, what do they call it, a political action sort of thing. I'm like, oh, my God. OK, I guess I maybe misunderstood consumer reports. But what do you are you familiar with that whole thing? Yes. So the consumer reports that came out, they were using that. So California actually has their own state standards of. So so we have federal OSHA and then we have state OSHAs and we have state level regulations. California actually has stricter standards there for contaminants. And even those, like if you actually look at the data from the consumer reports, those were actually below those levels. So it was more of a, I feel like it was a premature alarm of like, hey, these might be contaminated where they're really not. They still fall within the standards. Soil. Yes, yes, exactly. And so they are safe. And again, they were using a standard that I feel like is a lower standard. Even at that lower standard, they were still meeting that requirement. They weren't anything that needed to be pulled from the market. But again, this kind of pulls to the fact that supplements aren't well regulated. And so why is, first off, why is consumer reports giving this kind of data when it should be, if it was actually regulated well, it would be probably a randomized control study or some kind of well-structured epidemiological study in a medical journal versus a consumer report saying, hey, by the way, there is this red flag out there. They didn't sort of wait for that ivory tower. Well, so, so then, so in all reality though, cause, cause I kind of took it as well, geez, I mean, you know, weight, weight protein and all that stuff is, you know, pretty well established as safe and all that. And it usually tastes better and it's really good. So I was kind of like, well, to me, I was kind of like, well, maybe, maybe we shouldn't just plow the plant protein all the time. And I personally would stick with whey protein. And then what about kids? I was like, well, geez, maybe kids shouldn't be drinking a plant protein shake every day. Is there any rationale to that or is the RMI just completely bamboozled by consumer reports? Well, I like whey protein first off, so I'll make a plug for that. I don't think so. I think they're still within that safe range, like I said. So yes, there might be a slightly higher level in the plant proteins because, like we said, lead is found in soil. Is it going to affect your children? Probably not. Again, these are within the standards of regulation. And so they're not anything that needs a market pool. But not just a market pool, but does it, I mean, should parents, let's just say, because if we're going to talk about the most vulnerable, should pregnant people and kids not consume daily plant protein? Not that they would, I'm just saying, should they not? Well, I would say, what would be the safe amount? I think we'd have to do some calculations right now. I feel like that's going to be hard to do. I mean, I guess like to me, it was just like, well, geez, I guess like I don't think we put in a way it doesn't matter. But yeah. Yeah. Well you know I think as a parent we try to always Yeah Yeah We always try to be careful in children I can tell you that you want to be under five micrograms per deciliter in blood In adults that a little bit higher so they can tolerate more 10 micrograms per deciliter if you're just measuring blood levels of lead. Now, that being said, as a parent, if I had that information, even though it's within the regulations, would I be careful? Maybe. I don't love plant protein. Yeah. Yeah. Maybe I would be careful. Did they pull anything? No. There's not a lot of data in children drinking whey protein and plant-based protein drinks. You know, again, this is a supplement. We don't have a lot of data there. So if you wanted to be on the more cautious side, maybe do more whey protein. As far as like, should I be concerned? The only thing I can point to is NHANES data where they have measured lead, So this is a cross-sectional study for the people that don't know. It's a surveillance study that's been done for many years, and they've measured different toxic metals in these people in blood and urine. And they're actually using the measures that we use on the medicine side, right? Not just an influencer who says, like, this is a bad level or something like that. They're actually using what we use in our medical literature. If you look at NHANES data, our lead levels have actually decreased over the years since the 90s. And so I would think that in the random sampling that there's probably children that are consuming different products. And so I would point to that as far as data. I don't think there's a real danger in that. Now, if you want to be on the safe side, yeah. Don't do as much plant-based protein. Cool. All right. So what are these organs? We should just go get a chelator cells or something like that. Yeah, yeah. Or take some kind of detox. Okay. After lead, what's the next one? What's the next real exposure? Mercury? You want to do mercury? Yeah, yeah. So mercury is another interesting one. Again, a lot of public health disasters. One of the biggest one happened in Japan in the mid-1920th century. And this is where there was industrial dumping of methylmercury. It's basically organic mercury into the water source. And then the plankton ate it, fish ate it. And then there was this classic bioaccumulation. And the people that we saw that were most susceptible were pregnant women, actually. Their infants developed problems, right? So they had cerebral palsy-like symptoms, severe developmental delay, microcephaly, sometimes stillbirth. It was a real problem. That's why we know a lot about mercury, actually. But again, you got to look at the source. So sources are going to be fish, seafood, certain industrial processes, obviously, if there's a big industrial factory, water sources, that sort of thing. But also with mercury, you've got to be very, very, very careful about the form of mercury that you're potentially exposed to. So again, the clinical presentation for the form is going to be different depending on what you're exposed to. So, for example, inorganic mercury can cause acute tubular necrosis and GI necrosis, whereas elemental mercury, this is what they used to call the mad hatter's disease because the people that would make hats would also use mercury to help kind of with the fur around the hats. And so they would often get poisoned by this. But they can get gingivitis, erythroism, tremor. And then the organic mercury looks more neurologic. So you're looking at ataxia, spasticity, visual field defects, hearing loss. So again, this is going to be more of the neurologic picture, the serious neurologic picture. OSHA doesn't have a specific permissible exposure level. This is the legal standard that we're held to. But clinically, we want blood levels in general. And we only look at blood for organic mercury. It's going to be less than 10 micrograms per liter. But again, we look at the whole, we don't take anything in a vacuum. And so we look at the whole clinical picture. It's going to hit your kidneys first. And so we look at proximal tubule damage. So you might have low molecular proteins that start spilling into the urine because the mercury is affecting your kidneys. And so it might be beta 2 microgram, RBP, or NAG. So we're looking at different, the entire clinical picture. So if it's just organic mercury, we're going to look at blood, but we might also look at urine. For inorganic exposure, we are going to focus on that urine instead of just the blood. A quick vaccine note, too, on this. I feel like I should make a quick note about this on the public health side. So vaccines are very safe. I highly recommend getting vaccinated, especially if you have children. Make sure they get their MMR. Mercury was in vaccines. They took out mercury in 2001. The type of mercury that was in vaccines was ethyl mercury. It is non-toxic. It is eliminated from a child's body within three to seven days in their stool, essentially. So this is nothing like the actual mercury that we worry about, like the organic mercury that actually has like a longer half-life and hangs around and has bad effects. Also, I'd like to make a note that there is no tie to autism with this. If anything, if you look at the data of it being pulled out in 2001, and if anything, I feel like our cases of autism have actually increased since then. So there's no even, I think, a correlation between those two. So, um, negative correlation. So how often are we allowed to eat shark? Isn't that the, isn't shark the big one? Yeah, exactly. So it depends, right? Again, it depends on the population. So if you're a pregnant female, for example, the recommendation is probably two, two times. I will say for farmed fish as well, usually their mercury levels are a lot lower. so we're we're looking at more predatory uh fish that are you know um that are your fresh catches that aren't farmed that might have higher mercury levels than um than something that's uh farmed that you're probably find at your local costco um but usually you don't want to eat you know you do want to be careful you don't want to eat more than you know fish every single day farm fish probably better than, you know, your predatory fish. But I'd say the recommendation is more for pregnant females. You want to, you know, keep that maybe to twice a week. Yeah, that makes sense. Okay. What about teeth? Amalgam? Amalgam, we don't have to worry about. I mean, it's, again, this is the non-toxic form of the mercury. And so, again, it's kind of like the vaccine stuff where it's like, you know, we don't really need to worry about these things, especially if, man, it just reminded, like, I just got this flash of these influencers being like, yeah, I had all the mercury removed from my teeth. But yeah, again, you don't have to worry about this. This is a very low worry issue if you are in the general population, unless you're working with specific industries, like I said, or you're eating, you know, a lot of predatory fish all the time. But yeah, you're not going to also just get a urine test, test yourself. You want to make sure that you go to a physician if you are particularly worried about this and so that they do the appropriate testing because the one that you're going to worry about is the one that's likely going to be in your blood, not in your urine. All right. What's the next highest one? We've got lead, mercury. What else? So now we have cadmium is one of my favorite ones. Cadmium is actually one that where we can test for blood and urine. And again, it's the whole clinical picture sources. So let's talk about cigarette smokers. cigarettes, there's 60 micrograms of cadmium in each pack of cigarettes. So, you know, you're putting that into your body, essentially. So if you are a smoker, you might have a concern for cadmium, amongst others, right? You should put smoking. No smoking. Yeah, no smoking. And it can be in food or water, certain industrial processes. Cadmium hits the kidneys first. And this is one that I work with a lot because cadmium are in some of the paint products that they use in the aviation industry. So it causes kidney damage, bone demurization, respiratory disease, prostate cancer, for example. What I think is interesting and maybe kind of intercedes with your specialty is we actually end up diagnosing a lot of diabetics because cadmium basically hitches a ride on beta-2 microglobulin, which is reabsorbed in the proximal tubule. And a lot of diabetics will actually get one of the first things that glucose damages is their proximal tubule. And so we'll actually see a lot of early diabetics that will have elevated beta-2 microglobulin in their urine, for example, and then, you know, may not have the cadmium levels that correspond with that. And so they're actually, we're referring them to their endocrinologist and saying, hey, you probably have, you know, early diabetes. That being said, we do a lot of testing for this. So we do, since it can hit the pulmonary system, we do pulmonary function tests. We get baseline chest x-rays. We're looking at their CBC because it can cause anemias. We're looking at their kidneys, BUN, creatinine urine analysis. And then we're getting the cadmium levels. So it's a bunch of testing, not just, you know, here's a urine cadmium. And for example, the blood cadmium levels that we're looking at are going to be less than five micrograms per liter. And then the urine cadmium, we're not just looking at the cadmium levels alone. We're looking at that compared to creatinine. And then again, the same thing with beta-2 microglodulin as well. So yeah, cadmium is a complicated picture. Arsenics is another one that we talk about. My favorite thing about arsenic is the faux pas that Dr. Oz made a long time ago. Yeah. So again, arsenic is one of those that you need to be really careful about speciation or the form of arsenic that you're exposed to. Inorganic arsenic is the one that's actually bad, right? So arsenic three and five actually bind to sulfahydral groups and cause problems with cellular metabolism. So that's the actual bad one is the inorganic one. But Dr. Oz had a show where he took apple juice samples of various kids' drinks and actually tested the arsenic levels. And then he said the arsenic levels in all of them were very high because arsenic is in food sources, period. It's in our soil. It's in food sources. And it's organic arsenic. Organic arsenic is non-toxic. So again, this is where the seafood thing comes in again where they are in fish sources, but it might be that it is organic arsenic and they're non-toxic. So if somebody is sending you a urine test for arsenic, not knowing all these things, they might falsely be diagnosing you with some toxicity that you actually don't have. And we do look at urine arsenic, obviously, and it is going to be the inorganic form that we're looking at. We're looking at for a very high level. So it's going to be 50 micrograms per gram of creatinine, for example. So again, you've got to be very, very careful about what the form is, what the speciation is. And a lot of times that's what is missed in these tests, right? They're not even doing speciation. They're just giving you a level and saying, you're being poisoned. And the last one I want to talk about is chrome, chrome sex. So, CHROME 3 is in food sources. You're going to find that everywhere. CHROME 6 is actually interesting. There's no blood test for CHROME 6. So, when people come in and say, I'm being poisoned by CHROME 6, and they did this blood test there no blood test for CHROME 6 because we don know what a normal level is and what an abnormal level is And so we can reasonably say oh well you know this is a bad level or this is a good level because we all being exposed, like I mentioned. And so Chrome 6 is actually bad. I don't know if you remember the movie Erin Brockovich. It became famous because of PG&E dumping Chrome 6 in the water sources and people ingesting it. Yeah. Yeah. So there's a whole movie about this. But yeah. So Chrome 6 can be bad things. But we look at the clinical picture. So a lot of times it's going to affect the pulmonary system actually and the skin. And it's actually very, it can cause ulcerations and nasal septal perforation, for example, a dermatitis. It's very irritant. It's an irritant to the skin so it can cause chrome holes. So we're looking at skin. We're looking at the pulmonary system long term. So we'll do pulmonary function tests, for example, and then we're monitoring because it can cause lung cancer long term. But we're not getting a blood test for chrome sex. And so if anybody is telling you there's a urine or a blood test for this, they're just simply wrong. Like that's not how we test for it. That's not a thing, you know. Yeah, so I think, again, I just want to emphasize that, like, if somebody is giving you a panel and saying, you know, you are being poisoned by this heavy metal, I would run. In general, you're not going to be poisoned from this. Even our standards, our EPA standards, our OSHA standards keep our general population pretty healthy. Like I said, we have data to prove that with NHANES. We have followed people. We have followed children, adults. We have tested them to make sure that our regulatory standards stand up to healthy general populations. So in general, most people don't have to worry about this unless they work with specific things or, you know, they're doing crazy things like, you know, loading leaded bullets, for example, all the time and not using not using correct hygiene, not trying to protect themselves. Yeah, your specific population, you probably have a higher level of concern versus somebody that's going about day-to-day, drinking their whey protein. You're probably going to be fine. Okay. So the scam out there is basically they're selling tests that are BS, and then also they're selling the detoxes, right? Is that kind of the thing? That's the scam? That's the basic marketing scam? Yeah. So then they're selling detoxes. And then in some cases I've seen chelation being sold. Right. Well, yeah, we hear that all the time. All the time. It's crazy. And so what are the risks if it's even real chelation at all? I mean, because. Yeah, exactly. Because maybe some of these things are. Who knows what it is. Right. So are some of these detoxes just complete BS? They're harmless, but they're a waste of money? Or are some quasi legitimate, but then what are the risks of a real treatment like actual chelation? So chelation is, like I said, a real medical treatment. So if they actually are saying, hey, do this chelation therapy, that can cause a lot of electrolyte problems, a lot of renal problems, essentially. So it's not something that should be taken lightly. And then also, you know, the fear of something that might be wrong with you is crazy. And it can cause a lot of renal shifts. And so you want to be very careful because one, you don't know if you're actually getting chelation therapy or if it's, you know, some bogus thing that they're giving you. I don't know. So just to give you an idea of like my specialty, I have never in my 20 years of workers who actually work with the stuff. Okay. They're working with all these bad chemicals, if you will. I have never recommended chelation therapy one time. So they've never even made it to the threshold at which you need to do that. Correct. Yeah. So if somebody is trying to sell you chelation therapy and you're in the general population, I would think that was a huge, huge red flag. And yeah, it can cause problems, right? And I don't know if influencers even, we look at chronic disease states. And so, you know, if somebody is diabetic, maybe they already have proximal tubule issues. And then if you throw chelation therapy at them, you know, what kind of shifts might they have in their renal physiology that might cause major problems because of that? So, you know, again, this is not something that should be taken lightly. I don't think I wouldn't take any recommendation from any influencer for any medical or something. Yeah. Right. I know. I mean, in our world, it's like, you know, it's like the Dutch testing. You know, they're selling BS, Dutch testing for that are completely inappropriate methods of hormone testing that have nothing to do with anything. And then people get scared and then they buy their supplements and then who knows what happens. it might be the wrong thing. So it's very similar, it seems like. Yes, very, very similar. It's a bunch of BS, basically, right? It's a market. I think it's not medicine, it's marketing. And I think when you become a product, that's where I get really upset. Because like I said, on the patient end of things, these people are vulnerable, like they're trying to find answers. They're trying to find their why, like, why is this happening to me? Why do I have these symptoms? And I think it's just, it's almost like a form of extreme manipulation to be, to approach these people and say, hey, the reason that you might, you know, be experiencing these symptoms might be because of toxic metal exposure. I think it's just, oh, like it just makes my skin crawl because it's like they've infiltrated every aspect of medicine. And now this is like their last little niche that they're going to be like, you know what, because people don't know enough about these toxic metals and maybe they don't trust the government, they don't trust doctors. And now they're going to say this is the reason that they might be having these particular symptoms. And people buy into this. And sometimes the other thing they're buying is like filtration systems for water and stuff like that. Again, we do a pretty good job with EPA standards, the Safe Water Drinking Act that was passed in the 90s, to protect general population against a lot of the things that a lot of the metals or a lot of the contaminants that might be in water. We really do a good job, if anything, and I can digress, but, you know, there are these other forever chemicals that I think that needs, there needs to be more studies on. And there are starting to be more studies on, you know, endocrine disruptors, obesogens, that sort of thing. With obesogens, I always worry about reverse causality. But, you know, with these other chemicals that are kind of emerging on the scene, you know, if I was an influencer trying to fear monger, I'd probably start there. But I want to give any recommendations there. But, you know, we are starting to collect data on that. But these toxic metals that have been around forever, you know, since the early 19th century, we know about them. We've seen bad things happen. And so in general, you are not going to be poisoned by any of these things. Now, the newer stuff, you know, microplastics, PUFAs, PFAS, those are things that we know little about. And so, you know, those are things that probably like when we had this conversation at the beginning is, you know, if you can minimize your exposure, since we don't know, that's probably a good place to start. But to be fair, our whole population is exposed to these things. and it'll be interesting how it plays out. And, you know, for example, in my base, firefighters, PFASs and firefighting foam. And at this point, we're just collecting data and they know about it, right? So the worker populations are going to be the ones that are exposed the most. And those are, if you're looking at data, those are the people you want to kind of look at to see how that's going to play out, what kind of effects that they might have first, because those will be degraded in the general population because Gen Pop's not going to be as exposed as somebody that works with it day to day. So the whole detox, I mean, the other detox is not the chelation stuff, but whatever these people are making up, I mean, is there, I don't even know, like they're just kind of BS, but like, Is there any like harm to those things or are they just wasting their money on whatever teas that are out there? Well, I can't speak for everybody. I think most of it is just a waste of money. But like I said, if you do have a chronic disease and they're selling you some kind of detox, usually it's going to hit your kidneys. And so at some point, right? And so I would just be careful, especially if I would assume that a lot of the people that are looking for answers probably do have some underlying pathology. Right. That's the other problem is that what happens is that then the real issue goes undiagnosed and untreated when they go. Oh, yeah. And, you know, like the adrenal fatigue. Well, their fatigue's real, but they don't have a real diagnosis now and they're taking their line supplements. And so it's the same sort of thing. It is. And some of the supplements might do them more harm than health, right? And that's what I'm saying. It's all the time. If you buy one of these supplements and maybe you have an underlying early kidney issue, it's going to make it worse. If anything, it's not going to help you. So, yeah, I think the point is there could be real harm associated with some of the recommendations that they are giving you, especially when you get into chelation or detoxes. Again, we don't know what's in them. They're not regulated. This is a very unregulated market that they can kind of sell to you. And then there's no responsibility, right? Because at the end of the day, that patient might have a problem and they're going to end up in a doctor's office, not in the influencer's office who recommended the said treatment. And then the doctor is going to have to deal with the consequences of what that person, what that influencer told them. And so I think that's the vulnerable part. I just, it makes me so upset because I've seen this in my clinic, which is such a niche area, right? And for me to see it, I can't imagine what my colleagues are, you know, in family practice and primary care, how much they see of it. There is really doing harm to people. Very good. Well, I think we got the gist is that pretty much you're going to get scammed if anybody else is trying to sell you this other than a four certified environmental health. preventive medicine, occupational health certified doctor or any other doctor, but just make sure like probably go to someone. I probably go docs selling that stuff. That's because they are real doctors and they're selling this stuff. Yeah, it's really. Yeah. I've seen some real docs doing this too. And it's sad. Very sad. Okay. Where can people find you? Well, so I also wear my preventative hat of things. And so I recently got into social media. My husband's all over it. Our podcast is the Balance Bodies Blueprint. We're both on Instagram. I'm Dr. Aaron, Balance Bodies. And he's Vinny and he's at Balance Bodies too. We do have website. Again, we do the preventative side of medicine. This is my day-to-day. This is what I do actually for the Air Force. And that's where you can find us. very cool thanks so much for joining us do a nice job yeah thank you for having me this podcast is for entertainment and education and information purposes only remember the physicians on this podcast are not your physician it should not be considered professional or personalized medical advice it should not be used to replace speaking with your physician or medical professional to discuss your specific health concerns the topics discussed should not be used solely to diagnose or treat any condition as a result we are not responsible for any unwanted medical outcomes. The views and opinions discussed are of those of the host only and do not represent those of any other entities.