Seven top takeaways from the Integrative Practitioner Summit on environmental medicine

7. Standardizing lead testing in primary care could prevent serious illness and death.

According to Pizzorno, lead is the second most common cause of chronic disease in the world. He said a blood lead level of five to nine microgram per deciliter (ug / dL) has been associated with an increased risk of death from all causes, cardiovascular disease, and cancer. In addition, lead levels have been associated with brain cancer, infertility, amyotrophic lateral sclerosis (ALS), attention deficient/hyperactivity disorder (ADHD), and juvenile intelligence quotient (IQ).

Lead in blood has a half-life of around 30 days, and only indicates recent exposure. For a test that measures cumulative exposure, Pizzorno suggested bone lead tests because most lead is stored in bone. He recommended bone lead tests over blood tests when trying to predict hypertension, electrocardiogram (ECG) disturbances, pulse pressure, renal function, cognition, and cataracts.

Blood lead levels for children should be below 3.0 ug/dL, said Pizzorno. For adults, blood lead levels should not surpass 5.0 ug/dL. However, he said he encouraged practitioners to challenge these results with further tests like bone tests and provoked urine tests.

To prevent increased lead levels, Pizzorno said patients should maintain their bone health and test their water at home, especially if their home was built, or the water supply to the home was installed, before 1987.

For lead intervention, Pizzorno suggested supplements including, 500 milligrams (mg) of calcium bidaily (bid), 500 mg bid of vitamin C, and 500 mg bid of N-Acetyl Cysteine (NAC). In a patient has a high blood lead level and symptoms, Pizzorno suggested using ethylenediaminetetraacetic acid (EDTA) orally or intravenously and dimercaptosuccinic acid (DMSA), 250 mg, three times a day, orally.

“Lead affects at least one quarter of people in North America,” said Pizzorno. “And lead to the worst diseases, the things that kill people, like heart disease, cancer, and stroke. So, I believe that makes the case that regular screening of blood for lead should be a part of the standard of care in primary medicine.”