Lead toxicity causes paralysis and pain in the extremities due to effects on demyelinization, axonal degeneration, and presynaptic block.
Lead toxicity commonly affects sensory, visual, auditory, and cerebellar (coordination) functions, reflecting its impact on the nervous system. Normocytic, sideroblastic anemia is the consequence of lead’s inhibiting effects on enzymes in the heme biosynthesis pathway.
Other clinical signs associated with lead toxicity are kidney damage, epigastric pain and nausea, and male and female reproductive failure. Hyperactivity, anorexia, decreased play activity, low intelligence quotient and poor school performance have been observed in children with high lead levels.
Sources of lead include lead pipes, painted toys, some red lipsticks, lead paint or its dust, soil around old cars, old homes, or highways (past leaded gasoline contamination).
Hair lead is a sensitive measure of lead exposure. For those in apparent steady-state lead balance, hair levels were well correlated with blood lead. Normally, hair lead content is < 5 μg/g. Lead levels > 25 μg/g indicate severe lead exposure. Some hair darkening products contain lead acetate and may elevate lead levels in hair.
Whole blood is concentrated about 75-fold greater than that of serum or plasma and it has the highest correlation with toxicity. For this reason, whole blood lead is defined by the CDC as the preferred test for detecting lead exposure. The World Health Organization has defined high whole-blood lead levels as > 20 μg/dL in adults and > 10 μg/dL in children. As of 2007, the CDC acceptable level of whole blood lead was 10 μg/dL. Some have proposed to lower reference values for whole blood lead.
Urinary lead concentrations increase with lead poisoning, although urinary elimination of lead is a process that occurs for many days after a single exposure.
References:
– Lead Fact Sheet, Center for Disease Control and Prevention [L]
– Biomonitoring Summary, Center for Disease Control and Prevention [L]
– Chelation Medical Center, Comprehensive Digestive Stool Analysis [L]
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Sources:
– Certain supplements
– paint
– contaminated soils (and plants grown in them)
– plumbing
Specific Examples:
Some red lipsticks and painted toys, Leaded house paint, Drinking water from lead plumbing, Vegetables grown in Lead-contaminated soil, Canned fruit and juices, canned evaporated milk, boxed wines, Certain Chinese and Ayurvedic herbal preparations, Milk from animals grazing on Lead-contaminated land, Bone meal, Organ meats such as liver, Lead-arsenate pesticides, Leaded caps on wine bottles, Rainwater and snow, Improperly glazed pottery, Painted glassware, Painted pencils, Toothpaste, Newsprint, Colored printed materials, Curtain weights, Car batteries, Cigarette ash, tobacco, Lead shot, firing ranges.
Associated Symptoms and Diseases:
– Microcytic hypochromic anemia
– renal dysfunction
– hypertension
– anorexia
– muscle discomfort
– constipation
– metallic taste
– low IQ (children)
Prevention:
Prevention continues to be the best route for reducing toxic effects of lead. Nutritional and adjunctive support includes promoting gastrointestinal integrity and supplementing with calcium, magnesium, iron, and vitamins C and D. Carotenoids have also been found to be lower in leadexposed workers. Nutrients with demonstrated benefit when used with or without chelating agents include alpha lipoic acid, zinc, taurine, selenium—which is able to bind lead directly— and N-acetylcysteine.
Protective Measures:
– Alpha lipoic acid
– protection against toxicity
– iron (reduces intestinal absorption)
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