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Metals Testing Blog 2 – Finding a Safer Way to Test for Heavy Metals: Why Challenge Testing Isn’t the Answer

Challenge testing has long been considered the “gold standard” for heavy metal testing, but a growing body of research indicates it may not be so optimal after all.

What is Challenge Testing?

We are all exposed to heavy metals daily, in differing amounts, and through various exposure routes. While our bodies have systems in place to process and eliminate heavy metals, there comes the point where our body’s natural detoxification systems become overburdened, leading to declines in health.  

Suppose heavy metals are suspected as a contributing factor in your health issues. In that case, it is crucial to accurately identify the problematic metals so you and your practitioner can implement specific, effective detoxification strategies. For many years, the “challenge test” has been considered the gold standard for assessing an individual’s body burden of heavy metals. Functional medicine practitioners, in particular, have jumped on the challenge testing bandwagon, routinely using this test to identify an elevated body burden of heavy metals.  

Challenge testing was developed at a time in the 20th century when the sensitivity of analytical equipment was not advanced enough to measure ambient levels of heavy metals, such as mercury, inside the body. Therefore, “challenge testing” was developed to pull metals out of tissues using chelating agents – chemical compounds that bind tightly to metal ions so they can be excreted and then measured in the blood or urine.

Many healthcare practitioners continue to recommend challenge testing. The most common method of challenge testing involves a “pre-provocation” test and a “post-provocation” test. The pre-provoked test involves collecting one’s urine with no chelating agent involved; this measurement is intended to provide a “baseline” assessment of the individual’s heavy metal status. Next, a synthetic chelating agent, such as DMSA (dimercaptosuccinic acid) or DMPS (Sodium 2,3-dimercaptopropane-1-sulfonate), is administered to draw metals out of tissues, shuttling them to the kidneys. In the post-provoked portion of the test, urine is collected for 24 hours post-administration of the chelating agent. At this point, the mobilized metals have presumably been shuttled through the kidneys and into the urine. The difference in metal concentration between the pre-provoked and post-provoked tests is purported to represent the individual’s body burden of metals.

Advocates of the challenge test assert that the pre-and post-provoked tests reveal one’s body burden of heavy metals together. (1) At first glance, this reasoning seems perfectly rational. However, the catch is that metals are not “stored” in the human body in the traditional sense, but rather move down a concentration gradient from regions of the body with a high metal concentration to areas with a low concentration. Challenge testing thus has unpredictable effects because metals will not move out of tissues if the concentration gradient isn’t just right.

Furthermore, emerging evidence indicates that the challenge test is not scientifically validated for assessing chronic heavy metal exposures and may even cause harm by redistributing metals to sensitive tissues and organs. (2, 3)

Heavy Metal Challenge Testing is Potentially Harmful and Provides Misleading Results

According to the American College of Medical Toxicology, heavy metals challenge testing is appropriate only when there has been a known significant exposure to a toxic metal with symptoms consistent with exposure or as part of biomonitoring for occupational exposure to heavy metals. Challenge testing is not appropriate for assessing chronic exposure and body burden, particularly in the case of mercury, for several reasons:

  • Challenge testing does not differentiate between the various forms of mercury, including methylmercury and inorganic mercury. It thus does not allow the healthcare practitioner to distinguish the source of a patient’s mercury exposure.
  • Challenge testing only detects short-lived peaks of mercury in the blood. It is not sensitive enough to detect ambient levels of the metal. The detected level may also be skewed in people with kidney dysfunction because the test dumps a large amount of mercury into the urine.
  • There is no standardization of challenge conditions for the challenge test, leading to wildly different results from one patient to the next.
  • The challenge test may cause the redistribution of mercury and other heavy metals into tissues and organs and deplete the body of essential minerals. (4, 5)
  • The test does not assess the individual’s elimination capabilities for heavy metals.

The pervasiveness of heavy metal exposure in our modern world and the shortcomings of challenge testing were the impetus for Dr. Chris Shade’s development of the Quicksilver Scientific Mercury Tri-Test®, designed to assess the body burden of mercury. The Mercury Tri-Test (MTT) utilizes next-generation mercury speciation to accurately ascertain your mercury level and guide practitioner treatment decisions.

About the Mercury Tri-Test

When it comes to mercury, challenge testing provides an incomplete picture of the body’s burden of mercury and may even be harmful, redistributing mercury to sensitive tissues and organs. Quicksilver Scientific’s ground-breaking Mercury Tri-Test is the solution to ineffective challenge testing. The Mercury Tri-Test uses a patented mercury analysis technique to separate the biologically relevant forms of mercury – methyl and inorganic mercury – from hair, urine, and blood samples.  

MTT offers multiple benefits over challenge testing:

  1. It does not require the administration of a synthetic chelating agent.
  2. The test’s high sensitivity allows for the detection of ambient (aka, “baseline”) mercury levels, unlike challenge tests that only detect short-lived peaks in mercury.
  3. The test’s mercury speciation technology gives practitioners insight into their patients’ source of mercury exposure, rather than just demonstrating the total mercury level.
  4. The test provides a measure of the magnitude of mercury exposure.
  5. The test provides information on the individual’s ability to excrete each form of mercury.

Together, these features make the Mercury Tri-Test superior to heavy metal challenge tests without putting the body at risk for heavy metal redistribution or essential metals depletion. The test also provides more useful information that practitioners can use to guide the detoxification process, if necessary.

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