---------- Forwarded message ----------
From: Nick Miller <[log in to unmask]>
Date: 8 September 2010 18:30
Subject: Re: alternative paractitioners anda heavy metal poisoning
To: "Ryan, Michael" <[log in to unmask]>
OK Michael, it's a bit of a headache converting micrograms per gram of
creatinine in urine to the molar metal/creatinine ratio at 6.15 pm
after a long day! Also I am not sure what advice you are looking for.
A spot urine is a bad place to start, as it is unlikely to be
representative sample from which to work out excretion rates.
1) Palladium - no comment
2) Lead - I quote less than 2.20 micromoles per mole of creatinine as
the acceptable range for urine lead. This converts to less than 51.6
micrograms per gram of creatinine (in old money). So at 21.3 that's
not a high urine lead level
3) Nickel - I quote less than 27.2 micromoles per mole of creatinine
as the acceptable range for urine nickel, which converts to 180.6
micrograms per gram of creatinine. So at 6.85 that's certainly not a
high urine nickel.
Of course the precise sample handling procedure and ICP MS technique
affects the reference interval (i.e. whether or not it's the best
technique).
If anyone's interested I can supply "referenced" reference intervals
for 18 urine elements based on ICP-MS analysis. The paper quoted below
and the latest Tietz are the place to start.
1. Komaromy-Hiller G, Ash KO, Costa R, Howerton K. Comparison of
representative ranges based on US patient population and literature
reference intervals for urinary trace elements. Clin Chim Acta
2000;296:71-90.
2. Burtis CA, Ashwood ER, Bruns DE. Tietz Textbook of Clinical
Chemistry and Molecular Diagnostics 4th Ed. 2006, P. 1904
Regards,
Nick Miller
London
On 8 September 2010 17:04, Ryan, Michael
<[log in to unmask]> wrote:
> Dear All,
>
> I have patient with bizaare symptoms who has been tested by an alternative practitioner who sent samples to a laboratory in Germany. The patient is now convinced she has lead, palladium, and nickel poisoning. She was initially treated with 'chelating agents' at synergy healthcare, and the urinary mineral analysis was carried out by Microtrace Minerals Gmbh.
>
> The levels of these metals appear to be within acceptable limits for the UK. The results are reported as 21.93ug/g creatinine (lead), 6.85ug/g creatinine (Nickel) and 2.05 ug/g creatinine (palladium) in a spot urine sample (0.3g creatinine per litre).
>
> All advice gratefully received.
>
> Michael Ryan
>
>
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