Mercury Exposure and Hashimoto’s

We know that toxins are particularly impactful to people with Hashimoto’s, who often have a reduced ability to naturally detox and clear them out. With accumulations in the body over time, heavy metals like mercury can cause stress on the liver, kidneys, and thyroid, and can impair the brain and nervous system.

Some of my clients, while looking for their root cause triggers for Hashimoto’s, have discovered that mercury toxicity is a problem for them. Often, a lifetime of having dental amalgams (silver fillings) placed and replaced in their mouth, is found to be the culprit. Dental amalgams contain over 50 percent of mercury by weight and release tiny amounts of mercury vapor every time people chew.

One colleague, Carrie, discovered how a cracked dental amalgam’s removal triggered her Hashimoto’s. The dental procedure launched her into a year of misery, with rashes and other allergic reactions that could not be resolved. A year later, she was finally diagnosed with Hashimoto’s. It was only then that she pin-pointed her unprotected amalgam removal as the last time she had felt well. With testing, she discovered her thyroid had absorbed mercury from the amalgam filling. 

Other clients have been surprised to learn they have mercury sensitivity, which can result from exposure to small amounts of mercury from cosmetics, or contaminated seafood like tuna, negatively impacting their thyroid health.

Research has shown that some forms of mercury are readily absorbed in the gastrointestinal tract and can easily cross both the blood-brain and placental barriers. And mercury has been found stored in the thyroid gland. In one study, the more silver fillings a person had, the higher amount of mercury was found deposited in their thyroid gland. Mercury exposure also affects the conversion of T4 to T3. Higher levels of thyroglobulin antibodies have been found in people who have higher levels of mercury in their bodies.

Could mercury be one of your root cause triggers of Hashimoto’s?

Find out more in this article, where you will learn:

• How we get exposed to mercury
• Symptoms of mercury exposure and toxicity
• Mercury as a trigger for Hashimoto’s
• Testing for mercury toxicity
• Treatment options and natural solutions

How Do We Get Exposed to Mercury?

The two main ways that humans are exposed to mercury are through dental amalgams (silver fillings) and consuming contaminated fish. There are, however, a number of other possible exposures that can occur, given that this naturally-occurring heavy metal is found throughout the environment (soil, water and air). It is also a component or ingredient in a number of consumer products.

Mercury exists in three chemical forms (elemental, organic and inorganic). Each form can expose people in specific ways, and each has its own profile for toxicity.

Elemental Mercury

Elemental (metallic) mercury can cause mercury exposure to humans through both liquid and vapor forms.

In liquid form, elemental mercury is the shiny, silvery liquid found in older thermometers, electrical switches, some batteries (button cell) and fluorescent light bulbs (including compact fluorescent lights – CFLs). The level of mercury found in these items is small, and there is generally no health risks if the item and mercury are kept intact. It is during the production or disposal of these items, or if they break, that they can be toxic to people and the environment.

I have heard stories of how decades ago, kids were actually allowed to touch and play with liquid mercury in elementary school! Thankfully, we now know much more about the risks of this type of direct exposure, as well as the additional impact on the environment if we don’t dispose of mercury-containing items properly.

Elemental mercury is also released into the air as vapor, and this is one of the primary ways humans are exposed to toxic levels of mercury. Dental amalgams (silver fillings) contain over 50 percent elemental mercury by weight, and a small amount of ongoing mercury exposure comes from mercury vapor outgassing from such fillings. Mercury is released every time a person chews. The vapor is absorbed through the lungs and tissue lining the mouth. It then enters the blood, and can rapidly pass through cell membranes, which include both the blood-brain barrier and the placental barrier.

Mercury vapor can also be a side-effect of occupational exposure. People working in mines, automotive industries, or factories where the above mentioned products are manufactured, can all be exposed to unhealthy levels, which is why the National Institute of Occupational Safety and Health (NIOSH) have strict protocols for managing mercury safety in the workplace. People working in dental offices need to follow strict protocols when working around amalgams, as well as when discarding dental products and debris containing mercury. Gingivitis, excessive salivation, and stomatitis (inflammation of the mouth) are symptoms associated with high occupational exposure.

Low-dose or chronic inhalation of mercury vapor can affect the nervous system. Elemental mercury toxicity symptoms may include fatigue, anorexia, insomnia, weakness, tremors, memory problems, skin rash, changes in vision and hearing, and personality and behavioral changes, including irritability and excessive shyness.

Organic Compounds of Mercury

Methylmercury is one of the most common sources of mercury exposure in humans as the result of eating contaminated fish and seafood. You may know that tuna is a food associated with mercury toxicity (it was one of the first – and often repeated – things I was told not to eat during my pregnancy, although I had already been aware of it)… but, perhaps, you never knew how the mercury made its way into the tuna. Mercury is naturally off-gassed into the ocean through the earth’s crust, and additionally, industrial pollution containing mercury also makes its way into the ocean. Once there, bacteria and algae methylate (chemically convert) the mercury, resulting in methylmercury. This substance then makes its way through the food chain into shellfish, fish, and eventually humans. Bigger fish (like tuna), that eat lots of contaminated smaller fish, typically contain much higher levels of mercury.

Methylmercury is also a form of mercury that is readily absorbed in the gastrointestinal tract and has been shown to cross both the placental and blood-brain barriers in rat studies.

The effects of methylmercury can include sensory disturbances in the arms and legs, loss of peripheral vision, “pins and needles” sensations, cognitive disturbances, and muscle wasting.

Inorganic Mercury Compounds

These compounds are found in medical use and cosmetics (primarily in eye creams, skin-lightening creams and soaps). Contaminated products typically contain mercury and mercury salts. Ingredients to be on the look-out for include: ammoniated mercury, mercury iodide, mercuric iodide, mercurous chloride, mercurous oxide, cinnabaris (mercury sulfide), amide chloride of mercury, quicksilver, hydrargyri oxidum rubrum (mercury oxide), and mercuric chloride. Some foreign companies may not necessarily list mercury as an ingredient.

Believe it or not, the FDA still allows inorganic mercury compounds in certain cosmetics, in particular those meant for the eye area.

Exposure to inorganic mercury can result in an irritant or corrosive effect on the gastrointestinal tract. Mood swings, mental disturbances, memory loss, muscle weakness and skin rashes can occur. The highest concentration of inorganic mercury is found in the kidney, so there can be damage over time.

Symptoms of Mercury Exposure and Toxicity

Once mercury is absorbed, it has a very low excretion rate and tends to accumulate in the kidneys, neurological tissue, fatty tissue, the liver and other organs (such as the thyroid). All forms of mercury should be considered toxic with their effects, including gastrointestinal toxicity, neurotoxicity, and nephrotoxicity (kidney poisoning).

When thinking about exposure, we all need to think about the accumulation of mercury in our bodies over time.

We also need to be aware that some of us may be better genetically adapted to detoxify mercury than others, which I’ll talk about in a moment. Those of us with Hashimoto’s may have more issues with this than the general population.

Here is a summary of the symptoms that I have seen that can occur with chronic mercury exposure:

• Loss of peripheral vision
• “Pins and needles” sensations
• Metallic taste in mouth
• Mood swings, irritability, anxiety and/or depression
• Excessive shyness
• Headaches
• Fatigue
• Brain fog, memory loss or decreased concentration
• Ataxia (nervous system issues such as slurred speech and stumbling)
• Insomnia
• Allergies, dermatitis
• Gastrointestinal issues
• Multiple chemical sensitivity
• Hearing loss
• Muscle tremors or other movement disorders
• Muscle wasting (muscle weakness)
• Loss of balance
• Salivation
• Anorexia
• Hair loss
• Hormonal dysregulation; abnormal menstrual cycles and infertility

I realize this is a very exhaustive list (partly due to the fact that mercury can affect so many different body organs), which may make it tricky to immediately correlate your symptoms to mercury toxicity. Many of the symptoms related to mercury exposure also overlap with those seen in Hashimoto’s.

So you may need to dig a little deeper than simply evaluating symptoms and look at your health history timeline (which should include a focus on your dental health history as well) for more specific clues. I find that many of my clients will identify that earlier dental work, such as having dental amalgams put in/removed/replaced, was a key point of symptom development for them. Others have identified that a high fish/seafood diet (especially eating the most offending types of fish) was a trigger for their thyroid issues. I know from my own personal history that a mouth full of dental amalgams was a trigger for me.

Mercury as a Trigger for Hashimoto’s

Mercury has been found to be stored in the thyroid gland as well as to affect the conversion of T4 to T3, resulting in high T4 with low T3 levels. Associations between positive thyroid antibodies and total blood mercury have also been identified; for example, in women who were evaluated in an NHANES study done between 2007 and 2008, they found higher levels of thyroglobulin antibodies in those with higher levels of mercury.

A 2006 forensic study found that the more mercury amalgams (silver fillings) a person had, the higher amount of mercury was found stored in their thyroid gland. Mercury levels in the renal cortex and the thyroid were respectively about four and five times higher in people with twelve occlusal amalgams or more, compared with those with only three occlusal amalgams. It has been estimated that there are currently over 1,000 tons of mercury in the mouths of Americans!

Another study found that the removal of inorganic mercury-containing dental amalgams resulted in significantly decreased levels of thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb).

There is another interesting mercury-thyroid connection. Mercury can deplete the body of selenium, a vital nutrient required in the synthesis of thyroid hormone. We know that most people with Hashimoto’s will be found to have selenium deficiency, and that this is a widely recognized trigger of autoimmune thyroid conditions.

Finally, many people with Hashimoto’s have issues with clearing toxins, referred to as having poor methylation. Some also have genetic variations (polymorphisms) that put them at even greater risks relating to their body becoming a toxic waste dump. Two common polymorphisms are the MTHFR gene variation and Glutathione Transferase (GST) polymorphism. Read more about how common the MTHFR gene mutation is in Hashimoto’s, how it can affect the body’s ability to get rid of heavy metals, and how you can test for these polymorphisms in this earlier article. I also provide information on additional methylation support at the noted link. 

Clearly, our genetics can both predispose us for thyroid issues as well as, potentially, impact how sensitive we are to metals such as mercury. In my clinical practice, I have found that mercury sensitivity is a problem for many of my clients. Given that most people have amalgams, this is an obvious initial concern for people with sensitivities. Thus, one of the first things I usually recommend is that people get tested for sensitivity to metals. Not everyone with Hashimoto’s has a hypersensitivity to heavy metals, but if they do, that can point us to how to prioritize next steps (such as removing amalgams).

Testing for Mercury Toxicity

My recommendation to clients if they suspect mercury toxicity (due to symptoms, dental history, direct mercury exposure or having had a high fish/seafood diet) is to do the following testing:

• Test for the earlier mentioned polymorphisms (How well can you detox mercury?)
• Test for mercury sensitivity (Are you hypersensitive to mercury?)
• Test for levels of mercury in your body (How much mercury is your body storing?)

So how do you know if you have mercury sensitivity?

You can take a test known as the MELISA (Memory Lymphocyte Immunostimulation Assay) test. The MELISA test will tell you if your body has an immune reaction to mercury. If you do, that tells us that a priority for you may be to remove any silver fillings you may have. Remember, based on what the research – and my own clinical data – tells us, if you test positive on the MELISA test, you will likely see a reduction in antibodies if you remove your mercury amalgams. One 2010 study found that thyroid antibodies were normalized in about 70 percent of patients with a positive MELISA test, after replacement of their silver fillings.

Once you find out if you have one or more of the genetic variations that can diminish your body’s ability to detoxify itself from heavy metals, and you know if you have mercury sensitivity, you can check how much mercury is currently stored in your body. Tests used to measure mercury levels typically involve samples of blood, urine or hair.

The difficulty in measuring mercury levels in your body, however, is that different types of measures are only optimal for specific types of mercury. Measurements are also sensitive to the timing of the mercury exposure. (Did you recently eat contaminated seafood?)

That’s why I like a more complex test to identify a more accurate reading for mercury levels. The test I like is the Doctor’s Data – Urine Toxic Metals – Mercury Kit for mercury testing. This is a provoked urine test, which involves taking a chelating agent (DMSA or DMPS; your doctor will need to provide this along with prescribing/ordering the test for you) that will bind to the mercury and detox it through your urine. The urine is then collected and measured over the following 6 hours (or whatever period of time your doctor wants to see).

Once you’ve done this testing, you and your practitioner can put a plan in place to reduce your existing mercury toxicity, as well as minimize future exposure and detox issues.

Treatment Options and Natural Solutions

Along with testing, there are a number of things you can do to lower your existing and ongoing mercury load.

Dietary Changes

Some seafood and fish are higher in mercury than others, so continue incorporating healthy seafood into your diet, but look for lower-mercury sources. Remember that the larger, predatory fish are typically more mercury heavy. So avoid ahi tuna, bigeye tuna, king mackerel, orange roughy, shark, swordfish, tilefish, and marlin. Stick with lower-mercury sources like rainbow trout, salmon, sardines, mussels, and Atlantic mackerel. Do not eat anything from a known contaminated lake. I look for wild-caught and always ask where my fish is sourced as well.

The Environmental Working Group (EWG) has an excellent guide to making the most-informed seafood choices. Here is a helpful wallet card from the National Resources Defense Council (NRDF) that can also help you. It is important for people with autoimmune conditions to get adequate fatty acids in their diet, so please be sure to supplement with fish oil if you aren’t getting enough healthy seafood in your diet.

Liver Support

Supporting the liver’s own detoxification pathways may be a really helpful intervention for anyone with mercury toxicity. In particular, NAC is a super supplement that can be helpful for people with Hashimoto’s who are dealing with all types of toxicity, including mercury toxicity. N-Acetyl Cysteine (NAC) supports detoxification pathways and healthy gut function, can reduce thyroid antibodies, and helps with oxidative stress and chronic inflammation. In the body, NAC turns into the antioxidant glutathione, supporting liver function and helping the liver clear out toxins such as heavy metals. You can read more about NAC, including drug interaction information and cautions (such as not taking it if you have sulfur sensitivity), at the linked to article.

NAC is just one recommendation in my Liver Support Protocol. Most people with Hashimoto’s are prone to having liver congestion, and heavy metal toxicity can add to this liver backlog. I have found that liver support helps many of my clients feel better, some in as little as two weeks. You can read more about the importance of liver support – and why liver congestion can be particularly common for those having thyroid issues – in this earlier linked to article.

I have found that chelation, a more aggressive intervention for getting rid of toxins, is often not necessary if people add appropriate liver support.

I personally used my own liver support protocol for arsenic toxicity, and this cleared the arsenic and got rid of my symptoms with no side effects (that story is for another day!). I later utilized the chelating agent DMSA for copper toxicity, and this worked really well at first… but then I developed a really angry rash all over my body, as well as a sulfur intolerance from the DMSA (I have found this to occur in clients as well, especially those with the CBS gene mutation).

Naturally, I ended up having to learn how to overcome copper toxicity without using DMSA, and then also learned how to start tolerating sulfur again! I will share more details on these protocols in future articles, but for now, they’re described in my book, Hashimoto’s Protocol. #thingsilearnedthehardway

Amalgam Evaluation, Removal and Replacement

If you are mercury sensitive, you may want to prioritize the safe removal of your existing amalgams. Even if you are not mercury sensitive, if you test at a high level for mercury in your body, you should consult a biological dentist regarding their recommendation on removing dental amalgams. Improper removal can cause a large exposure to mercury all at once and lead to worsening symptoms. Again, I would recommend a liver support protocol similar to the one I’ve outlined in Hashimoto’s Protocol and other articles before and after amalgam removal.

Chelation Options

I prefer to use a more gentle herbal chelation protocol versus the more “powerful” prescription chelation therapy when possible, but I’ll talk about both here. These therapies involve mobilizing the toxins, absorbing them (so they don’t recirculate in the body), and removing them from the body.

Herbal Metal Detox Protocol:

1. Use concentrated cilantro to mobilize the heavy metal toxins.
   • Take 2 drops twice per day before meals (or 30 minutes after charcoal or psyllium mixture) for 1 week on/3 weeks off; may repeat for 1 week each month
   • Please note: no matter how “gentle,” chelating agents will displace mercury from where it’s stored, and without using a binding agent to remove the mercury from the body, the mercury can end up moving to a different organ and causing more issues. This is why step 2 below is crucial.
2. Use a fiber (psyllium, rice bran or apple pectin) mixture, with activated charcoal, to absorb heavy metal toxins from the gut.
   • Add 1 teaspoon of psyllium husk fiber to 8 ounces of water and drink; follow up with another 8 ounces of water. Ingest the mixture 2 hours apart from food and other supplements, and do this 1-3 times per day. If using apple pectin or rice bran, take 7-10 g per day.
   • Start with 1 capsule of activated charcoal daily (mid-day, around 3:00 to 4:00 pm); work up to 3 capsules. This helps absorb toxins from the intestinal tract.
   • Be sure to utilize both the fiber and activated charcoal, as activated charcoal can be constipating.
   • A note about fiber: Ideally, you will have already cleared out any gut infections you may have had, especially SIBO. Detoxification protocols that contain fiber can aggravate SIBO as well as other types of gut imbalances.
3. Supplement with magnesium citrate, as activated charcoal can deplete the body’s stores.
4. Take 100-300 mg of alpha-lipoic acid (ALA) daily to increase glutathione production (avoid this if you have a CBS mutation as ALA is a sulfur containing supplement; you can find out if you have this mutation using the 23andme test).
5. It may help to continue taking vitamin C, a multivitamin, betaine with pepsin (heavy metals deplete stomach acid), probiotics, magnesium, zinc, selenium, and NAC as you work on clearing toxins out of your body.
6. Ensure the alkalinity of your urine is optimal for detoxing; a recommended pH is greater than 7. You can use pH testing strips to measure the pH. If it is consistently acidic, supplementing with magnesium can help raise the pH.
7. The duration of treatment will depend on the overall toxic load.

Prescription Chelation:

Prescription chelation is a more powerful therapy, which can be very effective, but it should not be undertaken without the involvement of a medical professional who is fully versed in chelation. If not done properly, chelation can lead to toxins recirculating and taking up residence in other parts of the body, leading to other adverse reactions and even more autoimmune reactions. Side effects of chelation are common, as drawing out the toxins too fast can overwhelm the detox pathways that are already overburdened due to having Hashimoto’s in the first place.

Chelation uses substances (called chelators) that bind the metals and pull them out of the body. Different chelators are used, which include DMPS, EDTA, and DMSA. I recommend DMSA, as I feel it is the safest, can be taken orally, and the dose can be adjusted to match the best/safest “detox speed” for you. Note that people with sensitivities to sulfur containing compounds should not use DMPS and DMSA, as these agents are sulfur based.

Chelation protocols may last anywhere from a few months to a couple of years. Your practitioner will provide supplements such as magnesium and will likely have you do additional liver support. Sweating can help with detox, and your practitioner may have you incorporate hot yoga, infrared sauna, and detox baths as well.

Potential chelation side effects include: further buildup of toxins, altered liver and/or kidney function tests, dehydration, low blood calcium, nutrient depletions (they bind up all kinds of things… including nutrients), and rashes.

Note that people with Hashimoto’s often report feeling worse, rather than better, after prescription chelation agents. I feel that part of the reason why this could be the case could be due to sulfur overload. Furthermore, practitioners often do not use the chelating agents with fiber, use them before healing the gut and supporting liver pathways (thus toxins recirculate instead of being eliminated), and do not replenish lost nutrients (this results in new nutrient deficiencies).

This is why I prefer liver support and my fundamental Hashimoto’s protocols that focus on liver, adrenals and gut, before jumping into chelation.

Supplements to Displace Toxins

There are various nutrients that may aid with clearing toxins via displacing them from their receptor sites through competitive binding, through alkalizing the urine, and through producing detoxifying molecules within the body.

• Zinc, molybdenum, and B vitamins – One school of thought on why toxins accumulate in the body focuses on receptor competition between toxins and nutrients. According to this theory, if receptor sites are occupied with adequate nutrients, then toxins will not be able to bind to those receptors and will be excreted. In pharmacy school, I had an entire year of medicinal chemistry classes focused on how different receptors interacted with various substances, and this theory makes a lot of sense to me based on what I know about competitive receptor binding. This mechanism has been described in great detail between copper and zinc. Zinc deficient individuals tend to become copper toxic due to copper accumulation. Taking zinc (in higher doses >30mg per day) can displace toxic levels of copper.

• Magnesium Citrate, Magnesium Glycinate, or Potassium Citrate  – These can alkalize the urine, making certain toxins more likely to be eliminated via that pathway.
• Selenium and NAC – These can ensure adequate levels of glutathione (an important molecule that detoxifies heavy metals and helps support overall liver function).

Reducing Ongoing Exposures

There are several ways you can be proactive in protecting yourself from excessive mercury exposure:

• Detox your personal care routine! Check the labels of your personal care products and cosmetics for ingredients that include the mercury substances referenced earlier. Typically, products that are labeled “skin-lightening,” “whitening” or “anti-aging” are more likely to contain these ingredients. Note that, while many of these products may have been brought in by foreign manufacturers, they are often sold on everyday sites we shop at, like Amazon.
• Be wary of commercially-prepared Ayurvedic medicines, especially those purchased on the internet. One study found that nearly 21 percent of these types of medications contained detectable levels of mercury, lead, and/or arsenic. Many rasa Shastra medicines, manufactured in India, were found to contain significantly more heavy metals than acceptable limits.
• Find a biological dentist for removal or addition of amalgams.
• Be smart when it comes to shopping for seafood – think small and wild-caught!
• Follow safety protocols if handling broken thermometers, CFLs or other products containing mercury.

Additional Helpful Resources

For more ways to protect yourself from mercury exposure, I encourage you to take a look at the following resources:

• What to do if a mercury thermometer breaks
• Cleaning up a broken CFL safely
• MELISA Foundation and testing info
• How to find a mercury-safe dentist (Questions to ask when looking for a biological dentist)
• Clifford Materials Reactivity site
• Smart Seafood Buying guide
• Mercury levels in commercial fish and shellfish (reference sheet)
• Monterey Bay Aquarium Seafood Watch List (making healthy and ocean-friendly choices); you can also get their app

What You Can Do Today

One of the best initial steps you can take when attempting to figure out what might be making you feel worse is to document your health history timeline. Answer the question, “When was the last time you felt well?”. Then assess what occurred right before that time frame, including dental procedures and potential mercury exposures. If you have a diet high in fish and seafood, are you eating the little fish or the predators? All of this info can help you determine if mercury toxicity might be a trigger for your symptoms.

If it is, follow my recommendations to improve your body’s detoxing capabilities and get tested. That will help point the way to where you should prioritize your efforts, such as whether removing existing dental amalgams might be time-sensitive for you.

Support your liver as a priority. There are so many ways you can do that. Please refer to the earlier mentioned article on liver support for recommendations.

Finally, focus on changing even a few things that could be impacting your ongoing mercury exposure, such as reading cosmetic labels, eating healthier fish, and using greater caution when handling products containing mercury (and please help the environment, too, by disposing of mercury-laden products such as CFLs appropriately). After all, we don’t want our children to have even greater issues with mercury contamination in their lifetime!

I hope this information helps you on your journey!

P.S. For continued updates and interaction, please become a part of our Facebook community and sign up for my newsletter to get a free book chapter from my first book, recipes, a Thyroid Diet start guide, and notifications about my latest research.

References

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