Urine Elements are traditionally used to evaluate exposure to potentially toxic elements and wasting of nutrient elements. Additionally, the comparison of urine element concentrations before and after administration of a chelator can be used to estimate net retention of potentially toxic elements. Subsequent urine element analyses, also following the administration of a chelator, are useful for monitoring the efficacy of metal detoxification therapy. Results are expressed per 24 hours or creatinine corrected to account for urine dilution effects.
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2 to 4 days
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Early signs of excessive Hg exposure include: decreased senses of touch, hearing, vision and taste, metallic taste in mouth, fatigue or lack of physical endurance, and increased salivation. ymptoms may progress with moderate or chronic exposure to include: anorexia, numbness and paresthesias, headaches, hypertension, irritability and excitability, and immune suppression/dysregulation. Advanced disease processes from excessive Hg assimilation include: tremors and incoordination, anemia, psychoses, manic behaviors, possibly autoimmune disorders and renal dysfunction or failure. Note that in Hg exposure of long duration, renal excretion of Hg (and normal metabolites) may become impaired, and the urine level of Hg might be only mildly elevated or not elevated at all due to renal failure. Mercury is used in: dental amalgams (50% by weight), explosive detonators; some vaccines, pure liquid form in thermometers, barometers, and laboratory equipment; batteries and electrodes,some medications and Ayurveic herbs, fungicides and pesticides, and in the paper industry. The fungicide/pesticide use of mercury has declined due to environmental concerns, but Hg residues persist in the environment. Emissions from coal-fired power plants and hospital/municipal incinerators are significant sources of mercury pollution. Methylmercury, the most common, organic form of Hg, occurs by methylation of inorganic Hg in aquatic biota or sediments (both freshwater and ocean sediments). Methylmercury accumulates in aquatic animals and fish and is concentrated up the food chain reaching highest concentrations in large fish and predatory birds. Except for fish, the human intake of dietary mercury is negligible unless the food is contaminated with one of the previously listed forms/sources. Daily ingestion of fish can result in the assimilation of 1 to 10 micrograms of mercury/day. Depending upon the extent of cumulative Hg exposure, elevated levels of urine Hg may occur after administration of DMPS, DMSA or D-penicillamine. Blood and especially red blood cellelemental analyses are useful for assessing recent or ongoing exposure to organic (methyl) Hg.