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QUESTION: Should I have hair analysis because the blood test "is only effective when there has been recent exposure to lead"? 21/02/09   Victoria, Australia

Lead Group,

Reading through your information on hair analysis vs blood testing for lead, I understand that you favour the blood test rather than hair analysis. (for a number of reasons).

I have been receiving treatment from a naturopath in regards to gout, which I have been suffering from for most of my life. To eliminate the possibility of various causes, the naturopath has recommended a number of tests ie synovial fluid and ANA (anti-nuclear anti body) tests, and hair analysis.

The reason the naturopath recommends the hair analysis test is that the blood test "is only effective when there has been recent exposure to lead". Something I have not discussed with the naturopath is that I may have been exposed to lead in my occupation, (oil industry), however this would have been a number of years ago.

 Is there any updated evidence to say that hair analysis has become more accurate? And would you suggest that perhaps I should have both tests if hair analysis has improved?

Thank you for your very informative website. I for one now know how widespread this problem has become.

Kind Regards,

David.

EMAIL TWO Sent: Monday, February 23, 2009 11:21 AM

Dear Elizabeth,

The lead and nutritional information you have sent me is much appreciated, and I will consider sending it on to my naturopath.

Thank you muchly.

Kind Regards

David

EMAIL THREE Sent: Thursday, April 09, 2009 7:42 PM

 Dear Elizabeth,

Today I received a response from Interclinical Laboratories (forwarded from my naturopath) in reference to the lead testing queries we have made. As you will see in the response, a Dr. Watts, whom I assume is from Trace Elements Inc.(perhaps the parent company of Interclinical) and employs the same testing procedures as Interclinical (I further assume). I think it is a natural strategy for an organisation to defend itself on occasions where questions are raised concerning possibly flawed procedures, and this is not surprising. However I generally expected their defence to address the main issue we originally questioned, and this was the preparation of hair prior to analysis to prevent the possibility of contamination. The note merely says the contamination issues have been overcome without stating how they have been overcome, only saying the lead-in-glassware issue has been rectified. To me this is a cursory glance at the issue. Dr. Watts says the accuracy of lead testing has not been in question for decades. However a "cursory" glance at the Trace Elements Inc. website shows the company defending itself recently on this very subject, and this is published in their latest 2009 newsletter. The issue of the false positive is discussed in the response. It would be interesting to know how many false positives there are in HTMA testing. It is always safe to err on the side of safety and this is what Trace Elements appear to be doing and I do not have a problem with this. The conclusion that the false  positive is caused by cosmetics, hair dyes etc. from hair and  subsequently proves chronic accumulation makes sense.  And I agree that there will be false positives in regards to most tests whether they are lead tests or not. However this argument appears to me to mean that it is acceptable to leave contaminants in hair preparation just to prove that people are affected by the chronic accumulation. I hope it does not mean this for sake of good health. Would it not be more efficient to prepare the hair correctly beforehand then see the result, perhaps then there would be less false positives, even though the false positives are of value?

Looking back on the original question my naturopath sent, (unless the remainder of your original response to me has been sent to Trace Elements in the interim) all that was covered was the hair preparation issue. The response received here today discusses the fact that blood testing is the test of choice for acute and ongoing lead exposure i.e. recent exposure. There is no indication of the provocation you have mentioned where lead could return to the bloodstream under force. Are Trace Elements aware of this occurrence and as you say the blood test should be used for this?

I am grateful for having this information sent to me and I must pay respect by thanking all involved.  However the information sent does not really address the hair contamination issue except to say HTMA is an efficient test without evidence and that false positives have some value. The remainder of the note, with the exception of provocation, repeats what you have already informed me of in your correspondence to me.  All the information regarding young children is already on your website at GLASS which is great. From my way of thinking, you are "well ahead of the game". Having said that,  and as I have informed my naturopath, I will go ahead with the HTMA test at  her clinic, but on the same day I will be doing a blood test with Peter  Holsman in Ashburton. The test results obviously may not prove very much, but nonetheless will be interesting to say the least. The deeper I  dig in regard to not only lead testing but a lot of other tests, the  more I believe how difficult it must be for those who work in the health  field, as there appears to be a prevalence of guess work.  Which is acceptable as long as there is a high level of safety and adherence to the "err on the side of safety principle". I hope you all enjoy your Easter break.

Kind Regards,

David.

ANSWER: Feb 20 2009

 Dear David,

thankyou for your thoughtful questions.

I have developed an Info Pack to answer the question as to how the extent of lead exposure from long ago is best tested, and it still does not include hair trace mineral analysis. I shall email the Info Pack separately, along with one on nutrition for lead poisoned people.

I am assured by many alternative medicine professionals, and their patients, that hair trace mineral analysis, in the hands of an experienced interpreter, can provide good information on your general nutritional status, as well as on your exposure to some heavy metals (eg arsenic) during the period of growth of the hair sample, ie the last 4-6 months. It is not the test of choice, even by these professionals, when the worst exposure to heavy metals likely occurred some years prior. I am not aware of any information to say that hair lead analysis has become more accurate although I am aware that certain labs claim that they have overcome the lead-contamination-on-the-outside-of-the-hair issue. Until all the labs that offer this service can get their act together and develop and stick to a standard protocol for hair preparation, and provide the results in a standardised unit along with information on valid populations of people for whom health outcomes (short and long-term) have been associated with particular hair lead levels in that standardised unit, I would not recommend a hair analysis for the purpose of determining past lead exposure.

To summarise my Info Pack, the best tests for lead exposure which occurred some years prior are: current blood lead (because lead taken in years ago can move out of the body's storage compartments and back into the blood under certain provocations); tooth lead (if a tooth that has fallen out or been extracted, is available); bone XRF (only available in the United States or Canada) and the urine chelation challenge test.

You are welcome to forward this email and the Info Packs to your naturopath. It would be more true to say that the blood lead test is informative when there has been either recent exposure to lead (ie the last 2 months or so) AND, when you need to assess whether any much earlier absorbed lead is currently moving around the body in the bloodstream. Thus, a low blood lead level is just as informative / "effective" / useful, as a high blood lead result. A low blood lead result (I define "low" as less than 2 micrograms per decilitre) tells you that you have not had significant recent lead absorption and any long-ago lead absorption was either low or is still in storage (mainly in bones, and, to a lesser extent, in other organs).

In every case, if your blood lead result is low now, I recommend a re-test at least every 5 years as you age, or, in response to any change in regard to "the provocations". The type of change that can move lead out of bone storage, includes, but may not be limited to: treatments for lead poisoning (eg saunas, chelation therapy etc including mega doses of Vitamin C, which is known as "the natural chelator"), some drug treatments for other conditions (eg cortisone), bone breaks, drastic changes in exercise level (eg suddenly training for a marathon without previous running experience, or suddenly being immobilised in hospital for a period), the bone demineralisation associated with pregnancy, lactation, menopause and ageing, and possibly excess sun exposure.

I truly wish you all the best in finding the cause and best treatment for your gout, and thank you for your kind comments about our website.

Yours Sincerely

Elizabeth O'Brien

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