Research Biomarker Category Toxic Metals; stool (Doctor's Data)

Toxic Metals; stool (Doctor's Data)

Fecal elemental analysis provides a direct indication of dietary exposure to toxic metals and indirect information about the potential for toxic metal burden. Chronic, low-level assimilation of toxic metals can result in accumulation in the body. For many toxic metals, fecal (biliary) excretion is the primary natural route of elimination from the body. Specimen collection is convenient for the patient and only requires a single-step procedure. Elements are measured by ICP-MS and expressed on a dry weight basis to eliminate variability related to water content of the specimen.

Antimony

Optimal range: 0 - 0.05 mg/kg Dry Wt

Fecal antimony (Sb) provides an indication of recent oral exposure to the element, and to a much lesser extent Sb that has been excreted from the body in bile. Sb is a nonessential element that is chemically similar to but less toxic than inorganic arsenic. Like arsenic, Sb is conjugated with glutathione and excreted in urine and feces.

Arsenic

Optimal range: 0 - 0.2 mg/kg Dry Wt

Fecal Arsenic (As) provides an estimate of a very recent oral exposure to the element, and to a much lesser extent, As that has been excreted from the body in bile. Inorganic As accumulates in hair, nails, skin, thyroid gland, bone and the gastrointestinal tract. Non-toxic organic As (shellfish) is rapidly excreted, primarily in the urine and to a lesser extent in the feces.

Beryllium

Optimal range: 0 - 0.011 mg/kg Dry Wt

Fecal beryllium (Be) provides an estimate of a recent oral exposure to the element. Be is poorly absorbed in the gastrointestinal tract, but is readily absorbed across the lungs and skin. Inhalation is the primary route of significant exposure to Be, and may be associated with dyspnea, cough and pulmonary distress (berylliosis). Berylliosis, is an occupationally acquired lung disease that is associated with primary production, metal machining, and reclaiming scrap alloys. Other high-exposure occupations are in the nuclear power, aerospace, and electronics industries. Fecal Be is not diagnostic for berylliosis.

Bismuth

Optimal range: 0 - 0.1 mg/kg Dry Wt

Fecal bismuth (Bi) provides an estimate of a recent oral exposure to the element. Bi is a non-essential element of relatively low toxicity. Absorption is dependent upon solubility of the Bi compound, with insoluble Bi excreted in the feces while soluble forms are excreted primarily in the urine. Sources of Bi include: cosmetics (lipstick), Bi containing medications such as ranitidine Bi-citrate, antacids (Pepto-
Bismol), pigments used in colored glass and ceramics, dental cement, and dry cell battery electrodes.

Several organometallic Bi compounds are used for bactericidal and fungicidal applications.

Symptoms of moderate Bi toxicity include constipation or bowel irregularity, foul breath, blue/black gum line, and malaise. Unusually high levels of Bi retention in the body may result in nephrotoxicity (nephrosis, proteinurea) and neurotoxicity (tremor, memory loss, monoclonic jerks, dysarthria, dementia). Urine elements analysis may be used to corroborate Bi absorption for a period of days or a few weeks after
the exposure.

Cadmium

Optimal range: 0 - 0.5 mg/kg Dry Wt

Fecal cadmium (Cd) provides an estimate of very recent oral exposure to the element, and to a much lesser extent the biliary excretion of Cd from the body. Cd absorption is suppressed to some extent with appropriate intake of zinc, calcium, and selenium. Cd is found in varying amounts in foods, from very low for some fruits to high in some shellfish (oysters, anchovies) and organ meats. Root vegetables tend to have higher Cd content than other vegetables. Refined carbohydrates have very little zinc in relation to the Cd. Other sources of Cd include human biosolids, pigments and paints, batteries (Ni-Cd), plastics and synthetic rubber (tires).

Cesium

Optimal range: 0 - 0.1 mg/kg Dry Wt

Fecal cesium (CS) provides an indication of recent oral exposure to the element, and to a much lesser extent Cs that has been excreted from the body in bile. Naturally occurring Cs is not radioactive and is referred to as stable Cs (Cs133). Cesium is a naturally occurring element found combined with other elements in rocks, soil, and dust in low amounts. Humans may be exposed to Cs at relatively low levels from air and diet. Cesium-chloride is used as a lubricant to facilitate drilling for oil and natural gas. As such Cs may contaminate surface and ground water, and certain crops in close proximity to drilling sites.

Copper

Optimal range: 0 - 60 mg/kg Dry Wt

Fecal copper (Cu) provides an estimate of very recent exposure to Cu, and to some extent biliary Cu excretion. The biliary / fecal route is the main route of excretion for Cu from the body.

Gadolinium

Optimal range: 0 - 0.03 mg/kg Dry Wt

Fecal gadolinium (Gd) provides an indication of Gd that has been excreted from the body in bile, and to a lesser extent oral exposure. Gadolinium can be found in the environment in geographically variable amounts, and usually at very low levels. Gadolinium is widely used in industrial and household applications such as radar technologies, compact discs, and microwaves; direct exposure from such sources is not a concern. However disposal of Gd-containing devices contributes to greater potential for human exposure.

Lead

Optimal range: 0 - 0.3 mg/kg Dry Wt

Fecal lead (Pb) provides an indication of recent oral exposure to the element, and to a much lesser extent Pb that has been excreted from the body in bile. Absorbed Pb is excreted primarily in urine (76%) and bile (16%). Lead remains the most common clinically problematic toxic metal despite long past termination of its use in gasoline and paint. However, high levels of Pb have been found in soil under older bridges and overpasses due to sand blasting and refurbishing.

Manganese

Optimal range: 0 - 200 mg/kg Dry Wt

Fecal manganese (Mn) provides an indication of recent oral exposure to the element, and to a much lesser extent Mn that has been excreted from the body in bile. Manganese is an essential trace element that is naturally present in many foods and available as a dietary supplement. Oral absorption is very low (< 3%), so the vast majority of fecal Mn represents unabsorbed Mn from foods and beverages. Low oral absorption is protective because excessive retention of Mn in the body may have neurological consequences.

Mercury

Optimal range: 0 - 0.05 mg/kg Dry Wt

Fecal mercury (Hg) provides a good indication of recent or ongoing exposure to elemental Hg, and to a much lesser extent Hg that has been excreted from the body in bile. Data collected at Doctor’s Data indicates a linear association between fecal Hg concentration and the number of amalgams currently in the mouth. Fecal Hg for subjects with 9 to 11 dental amalgams in place was 20-times greater than that
of subjects without any dental amalgams in place (0.60 and 0.03 g/gram dry weight, respectively). Dental amalgams typically contain about 50% elemental Hg, and constant abrasion associated with chewing and bruxism releases very small particles of Hg which are poorly absorbed (about 5%) in the gastrointestinal tract. A direct association between fecal Hg levels and health has not been established, but a land mark study of amalgam placement in monkeys indicated there was an associated induction of co-resistance to both Hg and antibiotics by pathogenic bacteria in the gastrointestinal tract, particularly for species in the Enterobacteriaceae family. Such was also reported for miners exposed to elemental Hg while working in gold mines.

Nickel

Optimal range: 0 - 8 mg/kg Dry Wt

Fecal nickel (Ni) provides an estimate of very recent or ongoing oral exposure to the element. One to 10% of dietary Ni is be absorbed from the gastrointestinal tract into the blood; that which is not absorbed is excreted in the feces. Nickel is present to a minor extent in most dietary items and food is considered to be a major source of nickel exposure for the general population.

There is substantial evidence that Ni is an essential trace element which may be required in extremely low amounts. However, excessive assimilation of Ni has been well established to be nephrotoxic, and carcinogenic. With the exception of specific occupational exposures, most absorbed nickel comes from food and beverages, and intakes can vary due to a multitude of factors depending upon geographical
location and water supply.

Platinum

Optimal range: 0 - 0.003 mg/kg Dry Wt

Platinum (Pt) is a nonessential element that is sometimes detected in feces. However, the clinical significance of high levels of Pt in feces has not been well studied. Platinum is poorly absorbed in the gut and high level of oral exposure is unusual. Since it is a relatively rare element, most Pt exposures are of occupational origin. There may have been a slight increase in environmental Pt due to the use of Pt in automobile catalytic converters. Pt is a byproduct of copper refining and used as an alloy in some dental and orthopedic materials.

Thallium

Optimal range: 0 - 0.02 mg/kg Dry Wt

Fecal thallium (Tl) provides an indication of Tl that has been excreted from the body in bile, and to a lesser extent recent oral exposure to the element. The biliary fecal route is the primary route of Tl excretion from the body, although about 35% is excreted in urine. Tl is rapidly and near completely absorbed when ingested, inhaled or brought into contact with skin.

Thallium is a highly toxic heavy metal which is generally tasteless and odorless, and doesn’t have physiological functions in the body.

Tungsten

Optimal range: 0 - 0.13 mg/kg Dry Wt

Fecal tungsten (W) provides an indication of recent oral exposure to the element, and to a much lesser extent W that has been excreted from the body in bile. About 50% of W appears to be rapidly absorbed from gastrointestinal tract, and excretion from the body is primarily via the urinary route.

Tungsten is highly absorbed via inhalation. W doesn’t have physiological functions in the body. In the body W is antagonistic to the essential element molybdenum which is important for the conversion of sulfite to essential sulfate, and for the production of uric acid.

Thereby, excess W may impair physiological reactions and be associated with sulfite sensitivity (wine, eggs, etc.) and/or low levels of uric acid in blood. Low uric acid is not necessarily consequential, but rather may be an indicator of functional molybdenum insufficiency.

Uranium

Optimal range: 0 - 0.1 mg/kg Dry Wt

Fecal uranium (U) provides an indication of recent oral exposure to the element, and to a much lesser extent U that has been excreted from the body in bile. The levels of U in feces has been used to estimate total daily intake of U. Most U passes through the intestine unabsorbed. Excretion of U from the body occurs via bile and urine.