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This week's topic: Impact of Arsenic on Health
Are you well-versed in the health effects of chronic arsenic exposure and how this can impact your patients?
- In which common diagnoses might it be good to evaluate for chronic arsenic toxicity?
- Which is more toxic: inorganic or organic forms of arsenic?
- What is the top source of arsenic in the U.S.?
- What is a key biological process that is required for effective arsenic excretion?
I took a deep dive into the literature, especially with regards to arsenic in rice. Read the email for answers to the above questions, and some of my findings from my research!
Overview of today's email:
- Arsenic and human health
- Practical clinical tips
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1. Arsenic and human health
Some key things to know about arsenic:
- Half life in blood (inorganic arsenic) = 1-6 hours (best way to evaluate for recent arsenic exposure is via urine testing due to the short half life of arsenic in blood)
- Half life in urine (methylated metabolites) = 3-5 days
- The metabolites of the inorganic form are the most toxic, but both forms are class 1 human carcinogens
- The primary sources of exposure in the U.S. are from water and cigarette smoke; fish and rice are also sources (depending on where it's grown)
- The primary toxicity mechanism in humans = generation of oxidative stress and liver damage
- Arsenic toxicity induces a thiamine deficiency (source)
Beyond known exposure, consider evaluating chronic arsenic burden in those with the following symptoms and conditions:
- Neurotoxin to peripheral nerves (e.g. symmetrical peripheral neuropathy) and CNS (e.g. Parkinson's Disease, encephalopathy, cognitive changes)
- Prostate cancer (highest risk with exposure)
- Lung cancer (second highest risk); consuming water with more than 20 mcg/L, PPM, 83% increased risk of lung cancer
- Diabetes
- COPD and chronic respiratory problems
- CVD, HTN (up to 74% increased risk with exposure; STRONG heart study)
- Hypopigmentation/hyperkeratosis/melanosis
Note, acute arsenic exposure is usually intentional (e.g. suicide, homicide attempts).
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3. Practical Clinical Tips
Per the research I found, the efficacy of using chelators in chronic arsenic toxicity is not well-studied or established.
Best way to approach arsenic exposure is:
- Reduce risk (filtered water, cooking rice like you would cook pasta, purchasing rice that is grown in locations that have less arsenic in the soil)
- Support methylation (the primary way we excrete metabolites of arsenic)
Nutraceutical support, literature resources, and a more detailed discussion on arsenic in rice can be found in the extended version of this article (via Substack, which is just $8 a month)!
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I hope this was clinically useful!
I will conclude this series with the next email, and move to the topic of MCAS in the new year (which will include an optional 6-week deep dive workshop via the mentorship app and platform!). If this topic (MCAS) interests you, respond to this email with any specific requests on what you would like me to cover!
Stay well, and thank you for your continued support.
Meg
P.S. These emails take a lot of time to create (and I don't receive a lot of feedback on whether they are useful to those that receive them), so I've moved to Substack for an extended version of these at a low monthly cost (available within 24 hours of releasing this email). Why Substack? It has the benefits of being able to comment and ask questions about the posts, you're not bombarded with ads, I'm using the platform as a "micro-mentorship", and it's low cost!
Additional resources that may be helpful:
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