Resource Article

We live in an extremely toxic world.

Numerous studies using different types of samples have revealed that children with autism have greater levels of toxic metals in their bodies than neurotypical controls.  Additionally, some kids with autism may have a decreased ability to detoxify metals from their bodies. 

In fact, symptoms of heavy metal toxicity may mimic autism symptoms. It is well known that exposure to lead can cause developmental delay or cognitive regression. For this reason, pediatricians test for lead exposure in toddlers at 12 months and 24 months of age.

Heavy metal exposure of all types can lead to developmental disorders, including autism; therefore, awareness of metal sources, types of testing for exposure, and treatment possibilities is important.

This article will cover:

• Symptoms of heavy metal toxicity 
• Testing for heavy metal toxicity

• Treatment for heavy metal toxicity
• Sources of heavy metals – Lead, Aluminum, Mercury, and Arsenic

Symptoms of Heavy Metal Toxicity

There are numerous symptoms of heavy metal toxicity, including:

• Behavior and learning problems
• Fatigue
• Digestive issues, including diarrhea and constipation 
• Mood changes 
• Lower IQ
• Hyperactivity
• Slowed growth
• Anemia

Testing for Heavy Metals

Unfortunately, there is no perfect way to identify the presence of heavy metals in the body. Most functional medicine doctors will do a combination of these tests (blood in addition to other testing) to look for markers.

Blood level testing 

How it is done: This is a blood test for metals.

Pros: Easily done through your regular pediatrician. 

Cons:  It only shows recent exposure (of about 30 days). Metals do not stay in your bloodstream. If they are not excreted, they go into the tissues and organs. 

Note: If elevated levels of lead, mercury, or other heavy metals are detected in the blood, it is imperative to find and remove the source.

Hair Elements Test 

How it is done: Cut a piece of hair close to the root and mail it back to the lab.

Pros: This test will help you understand which heavy metals the person is excreting and what minerals are deranged. 

Cons: This test only shows what the body is excreting. The body should excrete metals if encountered. Therefore, it can be construed as a good thing if metals in the hair are elevated. By contrast, if the child has low levels on hair testing, it doesn’t mean the child is healthy. It could mean that the child is not properly excreting metals. For this reason, most practitioners do not use this test.

Urinary Porphyrins Test 

How it is done: This is a functional medicine urine test where your child’s first morning urine sample is sent to the lab. Specific urine porphyrin profiles are associated with high-level exposure to mercury, arsenic, lead, and some chemicals and drugs.

Pros: Several companies do this test. It is fairly easy to execute. 

Cons: Markers on this test can be associated with inflammation and not metals, and there is no way to determine the difference. 

Single-dose chelator challenge test

How it is done: A functional medicine doctor conducts this test.  First, urine is collected to get a baseline reading. Then, a dose of chelator (which is a medicine that removes metals) is given (via IV or pill). Next, a second urine collection is performed after the chelator dose. This gives the doctor two urine tests to compare and reveals what metals the person excretes when given a chelator. 

Pros:  Provides the most accurate reading of what heavy metals the body is holding onto. For this reason, this is the test that most doctors rely upon over all others. 

Cons: Most of us (neurotypical or not) have heavy metals and will chelate some metals when given this substance. Therefore, it is important to look at how high the levels are.

Treatment for Heavy Metals

Step 1: Locate & remove the source of the metal

This step is critical.  Be aware of sources and eliminate them from your child’s environment or diet. 

When chelating (or removing metals from the body), the body can lose minerals and become more susceptible to metal absorption. Therefore, if you try to remove the metals without removing the source, the child’s symptoms can worsen.

This PDF by Genova Labs lists types of metals, sources, nutrient interactions, effects, and significance.

Step 2: Make sure nutrient levels are optimal

Nutrition is important: Children need iron and calcium because they compete with lead for absorption in the body. Anemic children absorb lead at a much faster rate than non-anemic children. Additionally, zinc competes for absorption with metals like lead and arsenic. Research shows that children with autism have significantly lower blood levels of magnesium, copper, and zinc.

Please see this TACA article on Nutritional Deficiencies in Autism.

Do not attempt to remove metals from the body if steps 1 & 2 are not complete.

Step 3: Consider different detoxification strategies

Nutrient Therapy:

There are powerful nutrient-dense foods, such as spirulina, cilantro, wild berries, and seaweed, that can help the body rid itself of metals naturally.  
Daily detox smoothies can help the body function optimally. Using diet strategically is always the safest route to health. 

Herbal Supplements:

Several herbs and dietary supplements, such as chlorella, spirulina, and cilantro, are traditionally used to help the body eliminate heavy metals, and some studies suggest they may have protective and mild chelating properties. These are often combined with liver support and are available as capsules or tinctures.  
Please source your supplements carefully.  Some tinctures can have their own heavy metals. 

Chelation (heavy metal removal) using medication

Most mainstream practitioners will only suggest metal removal therapy as an active treatment if a heavy metal level is extremely high in the blood, which is how they determine toxicity. 

However, more progressive physicians recognize that over time, metals that are not properly excreted will move out of the blood into the tissue, causing damage. Therefore, they prescribe chelators to get them out. Examples of chelators are DMSA, DMPS, and Calcium EDTA. 

Forms of chelation treatment include IV, oral, or suppository doses of DMSA, DMPS, or CaNa2 EDTA.  Be aware that this form of chelation mobilizes a lot of metals into the bloodstream, and the child needs to be able to excrete all of that at once. That means they need to be pooping and hydrating well. Some kids do very well with this therapy. Interestingly, it is speculated that some kids do well with chelation because most chelators also support the mitochondria and lower inflammation, which are other prominent issues in autism. 

Frequent, low-dose oral Alpha Lipoic Acid and/or DMSA (otherwise known as ACC):

This is a much slower, gentler method of giving tiny doses of DMSA or ALA every 3-4 hours (depending on the substance chosen) over a period of 72 hours. Every 72 hours is called a round. Many people simply use Alpha Lipoic Acid in tiny doses, which is a known antioxidant and mitochondrial support. 

Many kids do very well on this protocol as well. The drawback is that it takes a long time because doses are so tiny. 

Additionally, success using ACC may have less to do with removing metals and more to do with ALA as a potent antioxidant, mitochondrial support, and agent to reduce excess glutamate.

Detoxification enhancement:

The body’s detoxification pathways need to open and be able to excrete metals.
This TACA article discusses the best ways to detoxify, including supporting liver detoxification and cellular function, using binders as necessary, and more. 

Sources of Heavy Metals

The source will depend on the metal itself. As you read through sources, you will find that air pollution, food, and water are major contributors.  That’s why clean air, organic food, and purified water are extremely important for kids… and especially kids diagnosed with autism. 

Again, this PDF by Genova Labs lists types of metals, sources, nutrient interactions, effects, and significance.

Lead

Most kids get lead poisoning via ingestion, not from touching things. Lead is SWEET tasting. The sweetness of the lead makes it tempting for young children to chew, lick, etc. Lead creates a chalky dust that gets on their hands. Kids love to put their hands (and feet) in their mouths. Be sure to wash hands!

3M Lead Test Swabs are helpful to find the source. 

Lead sources include:

Deteriorated lead-based paint (dust/chips)

• Pressure washing the outside of the house can yield blasted lead paint chips all over the yard.
• If the house was built before 1978, assume lead paint was used & test before and after.
• Be careful of windowsills. Kids love to teethe on windowsills.

Imported vinyl miniblinds from before 1996.

• Interestingly, old vinyl miniblinds are a big source of lead.
• Throw away old blinds.

Water contamination

• Older pipes contribute to lead in the water.
• Test your water. Holistic Heal has a good test.
• Aerate your water. (Run water a bit before using it after it has been sitting unused for 6-9 hours)
• Before 1996, when it became illegal, plumbers sometimes used lead solder when piping a home.

Some toys/jewelry

• Inexpensive, imported, or vintage items can contain lead in their paint, plastic, or metal components.
• These pose a serious risk to children who might put them in their mouths.

Imported food and spices 

• Imported chili powder, tamarind, turmeric, and dried fruits have all been shown to contain high levels of lead.
• This includes imported candy that includes these ingredients. 

Dishes

• Some older dishes are painted with a lead-based paint and a lead-based glaze. 
• When you put acidic or hot food on/in that plate/bowl/cup, the paint breaks down into your food.

Chinese herbals or tinctures

• Please make sure your supplements are independently tested for purity. (This includes zeolites.) 
• Chinese herbals are specifically susceptible to toxicity. 

Garden Hoses

• The Ecology Center at Ann Arbor discovered 30% of hoses tested positive for lead at levels above the standard prescribed by the Consumer Product Safety Commission for children. 

Fruit Juices 

• Numerous fruit juices have been found to contain both arsenic and lead.

Ceramic tile glaze 

• Although lead was banned in paints in the 1970s, ceramic glazes still allow it.
• Dust sprayed into the air when cutting tile for installation may be contaminated with lead. Always cut tiles outdoors.

Hobbies

• Melting bullets, fishing weights, antiquing, remodeling homes, making stained glass, etc. 
• Keep your work clothes separate from your other clothes. 
• Parents should change their work clothes before interacting with children. 
• Take shoes off at the door.

Contaminated soil

• Unfortunately, lead contaminates soil, and kids who play outside get it on their hands and under their nails.
• Oftentimes, kids put it in their mouths. 

Aluminium 

Aluminum is a relatively light metal, although it is still categorized as a “heavy metal”. Sources include:

Food packaging

• Beverage cans, foil wraps, yogurt lids, aerosol cans, and beverage cartons. 

Medication

• Antacids (such as Tums or Rolaids) and some anti-diarrheals have aluminum.

Anti-perspirant

• Most antiperspirants have aluminum.  
• Try to use deodorant products instead and look at the ingredients.

Cookware

• Aluminum pots, pans, and foil can leach aluminum into food.

Vaccine adjuvants

• Some vaccines, such as DTaP, Hep B, and HPV, use aluminum as an adjuvant to spur the immune system to mount a response and enhance effectiveness. 
• Make sure the body is prepped with nutrients such as vitamin C and D, and verify that there is no anemia. 
• Do not give Tylenol before or after a vaccination because it lowers the body’s master antioxidant, glutathione.
• Discuss any concerns with your child’s doctor. 

Water

• Water treatment facilities use aluminum sulfate, so it can be found in tap water.

Air pollution

• Power plants and incinerators emit aluminum in the air. 
• Specifically, coal-burning plants emit large amounts of aluminum in the air. 

Mercury

Mercury is dangerously toxic.  Exposure can cause neurological, digestive, and immune system damage. Especially in children whose bodies are smaller and more vulnerable. Sources include:

Coal-burning power plants

• Power Plants are a major source of mercury in the US.
• Coal naturally contains mercury. Combustion releases it as vapor into the air.
• Then, in the environment, microbes convert mercury into methylmercury, a highly toxic form that accumulates in fish and birds.
• Humans also breathe in this toxic air pollution.

Fish

• Large fish are the most common source of mercury. 
• Large, predatory fish (shark, swordfish, tuna) contain higher levels because they eat smaller fish, and that drives up their levels of mercury.

Amalgam dental fillings 

• These are the “silver colored” fillings that are approximately 50% mercury. 
• Thankfully, their use is declining in dental practices. 
• (These are not to be confused with stainless steel crowns, which are often used in pediatric cases)

CFL light bulbs

• These ‘twisty’ light bulbs aren’t completely banned yet, but regulators are phasing them out nationwide because they contain mercury.
• If they break within your home, follow these detailed instructions.

Old thermometers

• Use care when handling old thermometers because most contain mercury. 

Arsenic

Kids encounter arsenic mainly through food and water. Sources include:

Fruit Juices

• Numerous studies have shown the toxic arsenic levels in commercial juice.  

Baby food

• Shockingly, studies have revealed high levels of arsenic, lead, and other metals in baby food.

Rice

• Rice is high in arsenic & many kids on a gluten-free and casein-free diet consume a lot of rice.
• Cooking rice this way “removes over 50 % of the naturally occurring arsenic in brown rice, and 74 % in white rice.”
• Additionally, rice types lower in arsenic are jasmine, basmati, and sushi grown in California.

Water

• Groundwater contains high levels of arsenic, so if your house uses well water, please get your water tested.
• The U.S. EPA sets a standard of 10 parts per billion (ppb) for public water systems, but even lower levels can pose risks, so be aware of levels in your water. 

Pressure-treated wood

• Manufacturers treated lumber with arsenic until the early 2000s. Therefore, older playground equipment and decks might contain arsenic.

Air pollution

• Air pollution can cause arsenic to enter the human body primarily through inhalation of arsenic-containing dust or particles from sources like coal-fired power plants, industrial emissions (smelting), mining, and volcanic activity. 
• Additionally, children are especially susceptible to air pollution. 

Conclusion

Since kids diagnosed with autism have more difficulty detoxifying metals, it is important to avoid exposure to heavy metals. If exposure occurs, you need to find it and remove it. Additionally, there are numerous methods to slowly reduce levels of metals in the body. 

Research

Autism spectrum disorder prevalence and associations with air concentrations of lead, mercury, and arsenic (2016) 

“Our results suggest a possible association between ambient lead concentrations and ASD prevalence and demonstrate that exposure to multiple metals may have synergistic effects on ASD prevalence.”

Exposure to Aluminum, Cadmium, and Mercury and Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis (2020)

“Levels of Hg in hair, urine, and blood were all positively associated with ASD. Levels of Al in hair and urine were positively associated with ASD, while levels of Al in blood were negatively associated.”

Metal and essential element concentrations during pregnancy and associations with autism spectrum disorder and attention-deficit/hyperactivity disorder in children (2021)

“Results from the present study show several associations between levels of metals and elements during gestation and ASD and ADHD in children. The most notable ones involved arsenic, cadmium, copper, mercury, manganese, magnesium, and lead. Our results suggest that even population levels of these compounds may have negative impacts on neurodevelopment.”

Aluminum in brain tissue in autism (2018) 

“Herein we have used transversely heated graphite furnace atomic absorption spectrometry to measure, for the first time, the aluminium content of brain tissue from donors with a diagnosis of autism. We have also used an aluminium-selective fluor to identify aluminium in brain tissue using fluorescence microscopy. The aluminium content of brain tissue in autism was consistently high. The mean (standard deviation) aluminium content across all 5 individuals for each lobe were 3.82(5.42), 2.30(2.00), 2.79(4.05) and 3.82(5.17) μg/g dry wt. for the occipital, frontal, temporal and parietal lobes respectively.”

Aluminium in Brain Tissue in Multiple Sclerosis (2018)

“ The aluminum content of brain tissue in MS was universally high, with many tissues bearing concentrations in excess of 10 μg/g dry wt. (10 ppm) and some exceeding 50 ppm.”

The Effect of Lead Exposure on Autism Development (2021)

“Considerations of the current data and trends suggest a potentially strong role for lead in ASD.”

Early life metal exposure dysregulates cellular bioenergetics in children with regressive autism spectrum disorder (2020)

The study suggests that early exposure to certain metals — both nutrients (like zinc and copper) and toxic ones (like lead and manganese) — might affect how children’s cells generate energy, especially in those with autistic regression.