Case Study: Josh Presents Muscle Pain and Fatigue
Josh was sitting in the waiting room of my clinic, sitting on the floor in a corner. He was very well muscled, dressed in leather, and wore a red bandana around his head. He was talking quite loudly, and I admit to being a bit nervous as I led him into the examining room.
At the time, Josh was 36 years old and had been a construction worker, housepainter, and autobody worker. At 18, he experienced what sounded like a severe viral illness with a high fever, fatigue, severe muscle pain, sweating, and headaches. He was quite ill for approximately 3 months, after which the muscle and joint pains migrated throughout his body. In his various jobs, he had been exposed to several heavy metals and chemicals. Also, during his childhood he began getting mercury amalgams (silver fillings), and these had all been removed and replaced with further mercury amalgams. He also had a number of gold crowns interspersed amongst his fillings. Josh told me that for many years severe fatigue had prevented him from working. His sleep was interrupted and he awoke each morning feeling unrefreshed.
When he was 30 years old, Josh was admitted to hospital for 3 months, suffering from severe depression and psychosis. During the next six years, he was readmitted to the psychiatric unit several times. There was no family history of mental illness, and a large number of medications were tried, including antidepressants, antipsychotics, tranquilizers and sedatives, but these brought about very little improvement. Josh also had recurrent ulcers in his mouth, chronically swollen gums, a burning sensation in his tongue, and a constant metallic taste. His short-term memory was not as sharp as it had been, and he admitted to erectile dysfunction. He denied previous use of street drugs and he consumed alcohol only occasionally. His speech was quite animated, and he jumped erratically from topic to topic. Several times during the interview he asked me if I would prescribe gold for him to take orally (Josh is the only person who has ever made this request and I interpreted it as a delusion he was having).
On examining him, I found his blood pressure was elevated at 170/104. He had 13 mercury amalgams, 2 gold crowns and 1 porcelain crown present. He demonstrated exaggerated response to painful stimuli, and all 18 tender points for fibromyalgia were positive. His neurological examination was within normal limits, as was his blood work. I then performed a DMPS challenge test which revealed elevated mercury (89 mcg, with normal less than 3), lead (20 mcg, with normal less than 15), and tin (14 mcg, with normal less than 6). Josh’s mercury level is especially significant because a reading of 50 or greater is considered proof of toxicity.