Purpose: Chronic diseases can develop through metabolic disturbances in trace elements and vitamins, and be maintained by environmental toxins. In order to gain more insight into these complex interactions and evaluate therapeutic regimens, we collected and analysed blood and urine from patients.
Design: Laboratory- and clinical-based survey.
Materials and Methods: Serum samples were obtained at the beginning of and during from 489 patients (17-86 years; 308 males, 181 females; >75% outpatient care, 1995-1997). Besides routine blood analyses, blood concentrations of trace elements, vitamins and environmental toxins were evaluated. The medical histories, analysis of metal ion serum concentrations (e.g. aluminium, mercury, lead, selenium, zinc) and urine analyses of metal excretions are reported and correlated.
Results: Serum aluminium concentrations were below 20 mu g L -1 in only 17% of initial analysis. Serum lead concentrations were below 20 mu g L -1in only 1.6% and between 20-50 mu g L -1 in only 52.1%. Serum selenium concentrations were above 100 mu g L -1 in only 14.5%. Serum zinc concentrations were below 70 mu g L -1 in 4.7%. Serial determinations during various diseases are reported, e.g. lymphoma, cirrhosis of the liver, pancreatitis, Crohn's disease, ulcerative colitis, tumours and neurological disorders. The medical history and biochemical findings, including heavy metal excretions of a patient with neurological complaints related to dental amalgam, are reported.
Conclusions: The results of the long-term observations suggest that serial determinations, e.g. of trace elements and environmental toxins, are essential because of the observed fluctuating serum concentrations. This is especially necessary in the pathophysiological evaluations and analyses of chronic disease development. Furthermore, serial determinations are necessary in order to adapt the appropriate therapeutic interventions and the doses of trace element .