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发表于 前天 13:55 | 显示全部楼层 |阅读模式 来自 广东深圳
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本平台医疗信息及相关内容(含个案及研究结论)仅供参考,不构成诊疗、医学建议或疗效保证,相关结论可能存在争议。补剂/药品仅限成分分析(不涉品牌),用户自担使用相关内容、产品及外部链接风险;干预或用药前请咨询执业医师。



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总结:

📌 ​​铅中毒:症状、检测与螯合治疗指南​​作者​​:Brian McBlain
​发布日期​​:2017年9月17日(周日)
​版权声明​​:© 2017 Andrew Hall Cutler & Brian McBlain
​“Get the lead out”​​(字面意为“排出铅”)是英语习语,指“加速行动”。有趣的是,成人长期铅中毒的主要症状恰似行动迟缓:
​典型症状​​:体重略超重、肤色偏深、表情呆滞、轻度注意力缺陷、频繁肠绞痛与消化紊乱;习惯早起、无法熬夜;可能伴斜视或暴力行为史。
​简言之​​:铅中毒者显得“迟钝”,排出铅后应更“敏捷”。

🔍 ​​一、铅暴露来源与诊断依据​
注:若存在铅或其他有毒金属(如汞),建议常备《毛发检测解读》。谷歌图书预览页数有限,自备完整版可无限制阅读。

⚕️ ​​二、螯合治疗核心方案​✅ ​​前提条件​
  • ​必须移除汞合金补牙材料​​:DMSA会移动汞合金中的汞,治疗前需确保口腔内无汞合金填充物。
  • ​起始时间​​:末次补牙移除后第4天开始治疗。
💊 ​​治疗阶段与药物​阶段药物剂量与周期关键说明
​初期​​DMSA4-8轮(清除细胞外铅),​​最大剂量50-60mg​​原建议100mg,因获取限制与成本调整
​中期​​DMPS替代DMSA(减少酵母感染风险)与ALA联用提升效果20-30%
​长期​​DMSA+ALA每月1轮×2年 → 改为双月1轮95%铅储存于骨骼,需持续清除

⏱️ ​​周期依据​
  • ​骨骼代谢特性​​:
    • 快循环骨(18个月周期);
    • 慢循环骨(10年周期)→ ​​全程需2-7年​​(依初始浓度而定)。
  • ​案例参考​​:
    • 初始铅含量低黄色区域者,5.5年降至10-15%;
    • 高红色区域+长期暴露者,7年后仍在治疗。

⚠️ ​​三、关键注意事项​
  • ​重金属交互作用​
    • 铅+汞:相互加剧毒性;
    • 镉+铅+汞:DMSA联排时副作用更强,需调整剂量至耐受范围。
  • ​儿童铅中毒​
    • 显著降低智商,即使毛发检测“中绿区”也需干预;
    • 若同步螯合汞,可直接纳入治疗流程。
  • ​检测局限性​
    • 头发铅检测准确性有限,实际浓度可能高于报告值;
    • 螯合治疗6-12个月后,发铅值可能暂时升高。

🧪 ​​四、毒性机制与健康影响​
  • ​骨骼损伤​
  • ​神经系统渗透​
    • 铅可穿透血脑屏障(砷/汞难穿透),直接损害中枢神经(讨论)。

📚 ​​五、必备资源与工具书​
  • ​核心工具书​​:
    《Hair Test Interpretation: Finding Hidden Toxicities》(购买链接
  • ​延伸阅读​​:
    • 铅对儿童智力的不可逆损害机制 ;
    • 家庭铅污染防控实操指南 。

💎 ​​结语​
铅螯合是长期工程,需个体化方案与耐心。定期检测(如毛发跟踪)可评估进展,但“结果因人而异”(Your mileage may vary)。





原文翻译:
布莱恩・麦克布莱恩・2017 年 9 月 17 日(周日)
版权所有 2017 年,安德鲁・霍尔・卡特勒与布莱恩・麦克布莱恩
“Get the lead out”(字面意为 “把铅排出去”)是一个表示 “大大加快事情进展” 的短语。有趣的是,成人长期铅中毒的主要症状是 “体重略超标、皮肤黝黑、表情呆滞、轻度注意力缺陷、频繁肠绞痛及消化紊乱,习惯早起、熬不了夜,可能有弱视或举止粗鲁、暴力的过往”。简言之,铅中毒者看起来或确实有点 “迟钝”。所以,“把铅排出去” 至少能让他们显得更 “敏捷” 一些。
铅的来源:《头发检测解读》第 73-74 页(网址:noamalgam.com/hairtestbook.html
铅的症状:《头发检测解读》第 97-101 页(网址:https://noamalgam.com/product/hair-test-interpretation-finding-hidden-toxicities/
铅的治疗:《头发检测解读》第 244-245 页(网址:https://noamalgam.com/product/hair-test-interpretation-finding-hidden-toxicities/
家庭灰尘铅污染检测http://onibasu.com/archives/am/18435.html
(如果有人体内有铅或其他有毒金属及汞,这本书理应在他们的书架上。谷歌图书的预览模式能查看部分内容,但拥有一本属于自己的书,就能不受限制地阅读所有页面。)
降低铅含量的基本方法是二巯基丁二酸(DMSA)螯合疗法。由于 DMSA 会促使汞从汞合金中排出,因此在开始使用 DMSA 之前,体内必须不存在汞合金。如果已移除汞合金,螯合治疗的第一天应是最后一次移除汞合金(实现无汞合金)后的第 4 天。
一般建议进行 4-8 轮 DMSA 螯合治疗,以在很大程度上清除细胞外液中的铅。95% 的铅存在于骨骼中。骨骼的循环有两种周期:快速循环的骨骼周期为 18 个月,而像骨干这类慢速循环的骨骼周期则长达十年。因此,在进行 4-8 周的 DMSA 螯合治疗后,每月进行一轮治疗可能就足够了,不过有些人会先每月进行两次,之后改为每月一次,再往后,每两个月一次可能就足够。
对于曾有汞合金的人,典型的治疗方案是使用 DMSA 螯合治疗 4-8 周(如果过去有酵母菌问题,还需辅以抑制酵母菌的补充剂)。之后可尝试二巯基丙磺酸钠(DMPS)(对大多数人来说,这种药物感觉更好,且不会促进酵母菌滋生)。至少在两年内,每月至少用 DMSA 进行一轮治疗,之后改为每两个月一次,三个月后可加入 α- 硫辛酸(ALA)。DMSA 和 DMPS 都能使 ALA 的效果提升 20-30%。如果只有铅的问题,可能不需要 ALA,但通常还会有一些汞需要螯合排出。
铅和汞会相互加剧不良影响。如果体内还有镉,DMSA 对其螯合效果最佳,因此在一轮 DMSA 治疗中同时螯合镉、铅和汞时,不适感可能会比使用同等剂量的 DMPS 和 ALA 时严重得多。只需将剂量控制在可忍受的症状范围内即可。尽管《汞合金病》一书建议 DMSA 的最大剂量为 100 毫克,但由于其可获得性降低且成本相应增加,安迪表示 50-60 毫克的 DMSA 作为最大剂量就足够了。
在儿童中,铅会显著影响智商,因此在我看来,当铅含量处于 “高正常” 水平(中等绿色级别或更高)时,或许就有必要考虑对儿童使用 DMSA 螯合治疗。如果已经在螯合排出汞,这就不是什么大问题了。
我的铅含量处于低黄色级别,安迪说最高读数是最准确的。他还提到,头发中的铅含量并非那么准确,实际铅含量可能更高,而正常水平(DDI 检测中的绿色级别)可能已经是过高的铅含量了(网址:http://onibasu.com/archives/am/92751.html)。
通常在螯合治疗进行 6 到 12 个月时,头发检测中的铅含量会更高,但遗憾的是,我当时没有进行取样检测。安迪说,螯合排出铅大约需要 2-3 年时间。我大部分时间使用的 DMSA 剂量远低于 100 毫克,因此花了更长时间才将铅含量降至初始水平的 10-15%(耗时 5.5 年)。一个铅含量处于高红色级别且有长期暴露史的人,在 7 年后仍在进行铅的螯合排出治疗,但这可能与那些花十年时间排出体内高含量汞的人情况类似。
讨论铅对骨骼强度和骨质疏松症影响的链接:https://link.springer.com/chapter/10.1007/978-1-59259-740-6_22
讨论铅能以一定速率穿过血脑屏障,而砷和汞一样会被困在血脑屏障后的链接:http://onibasu.com/archives/am/29340.html
我随时间变化的头发铅含量(以第一次 DDI 头发检测结果为基准的百分比)。具体情况可能因人而异。




+ Lead


Brian McBlain·2017年9月17日周日·



Copyright 2017, Andrew Hall Cutler and Brian McBlain
“Get the lead out” is an expression meaning to speed matters up significantly. Funny that the primary symptom of long-term lead toxicity in adults is “being somewhat overweight, tanned, with a dumb look on their face, modestly attention deficit, with a lot of intestinal cramping, and digestive disturbances, who likes to get up early in the morning, can’t stay up late, and who may have a lazy eye or a history of rough or violent behavior.” In short, the lead toxic person appears to be or is a little “slow”. So getting the lead out should at least make them appear to be a but more “swift”.
Lead Sources: Pages 73-74 in Hair Test Interpretation (noamalgam.com/hairtestbook.html)
Lead Symptoms: Pages 97-101 in Hair Test Interpretation (https://noamalgam.com/product/hair-test-interpretation-finding-hidden-toxicities/)

Lead Treatment: Pages 244-245 in Hair Test Interpretation (https://noamalgam.com/product/hair-test-interpretation-finding-hidden-toxicities/)

Testing house dust for lead contamination:
http://onibasu.com/archives/am/18435.html

(If a person has lead or other toxic metals and mercury, this book should be on their shelf. Some pages are accessible in Google Books in the preview mode, but having your own copy does not restrict the pages you can read. )

The basic approach to lower lead is DMSA chelation. Since DMSA will move mercury out of amalgams, there must be none before DMSA is started. If amalgams were removed, the first day of chelation is Day 4 following the last amalgam (amalgam-free) removal date.

Four to eight rounds of DMSA are suggested to clear the lead in extracellular space to a great degree. 95% of lead is in bones. Bones recycle on two schedules, fast recycling bone is on an 18-month cycle and slow cycling bone like bone shafts are on a decade-long cycle. So monthly rounds can be adequate after the 4-8 weeks of DMSA chelation, though some do it twice monthly for a time, then switch to monthly, and later, bimonthly can be enough.

A typical program for someone who had amalgams is to chelate 4-8 weeks with DMSA (including supplements to keep yeast at bay, if it has been a problem in the past). Then try DMPS (which for most feels better and does not boost yeast). Doing at least a round a month with DMSA for at least 2 years, then doing it bimonthly, ALA is added after three months. DMSA and DMPS both boost ALA effectiveness 20-30%. ALA is not needed if lead is the only issue but usually there is some mercury to chelate.

Lead and mercury make each other feel worse. If some cadmium is present, it also chelates best with DMSA so that cadmium, lead, and mercury chelating on a DMSA round can feel much worse than the same dose of DMPS and ALA. Just keep the dose where symptoms are tolerable.  While Amalgam Illness suggests 100 mg of DMSA as a maximum dose, with the greater restriction in availability and concomitant increase in cost, Andy has said that 50-60 mg of DMSA is enough for a maximum dose.

In children, lead impacts IQ significantly, so in my view high normal (mid green level or higher) may be sufficient to consider DMSA chelation in children. If you are already chelating mercury, this is not a big issue.
My lead was in the low yellow, and Andy says the highest reading is the most accurate. He also said that hair lead levels are not that accurate and that lead may well be higher and normal (green on a DDI test) may be too much lead. (http://onibasu.com/archives/am/92751.html).

It is often higher on a hair test taken 6 to 12 months into chelation, but unfortunately I did not sample at that time. Andy says it will take about 2-3 years to chelate lead. I spent most of my time at much lower than 100 mg of DMSA so it took me longer to get lead down to about 10-15% of the starting level (5.5 years). A person with lead in the high red and a long history of exposure is still chelating lead after 7 years, but that is likely comparable to those who take a decade to get their high levels of mercury out.

A link discussing lead’s effect on bone strength and osteoporosis:https://link.springer.com/chapter/10.1007/978-1-59259-740-6_22

A link discussing that lead crosses the BBB at a reasonable rate, and that arsenic, like mercury is trapped behind the BBB:
http://onibasu.com/archives/am/29340.html

My lead levels on hair tests over time as a percent of the first DDI hair test.  Your mileage may vary.


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