Hair analysis can also be very useful in evaluating heavy metal content in the body and should be done along with the provoked urine challenge. For example, autistic children had significantly higher levels of mercury, lead, arsenic, antimony, and cadmium compared to controls. [229] In another study, DMSA was shown to be effective in increasing mercury and antimony excretion in children with autism spectrum disorders. [230]
Heavy metal chelation is still rarely done, although it should logically become part of the standard-of-care treatment protocols for most medical conditions and diseases, even in the absence testing for heavy metal accumulation.
Antimony bears some additional attention, as its levels inside IDCM hearts were stunningly elevated as well. [48] Generally given little attention, antimony is as toxic, or even more toxic, than arsenic. [231] Finding IDCM heart muscle with 22,000 times the normal level of mercury and 12,000 times the normal levels of antimony must not be disregarded as a curiosity, but must be regarded as the major reason for the decreased heart function, and treated with that in mind. Significant antimony exposure is difficult to avoid, as levels in the air and water continue to increase due to multiple sources, including the significant leaching of antimony from plastic containers. [232-235]
Until definitively established otherwise, an enlarged and poorly-contracting heart (advanced congestive cardiomyopathy) must be assumed to be secondary to mercury and antimony accumulation in the heart muscle.
As discussed at length above, the evidence indicates that cardiomyopathies can been assumed to have significant heavy metal accumulation and/or ongoing low-grade chronic inflammation. Also, toxin presence in the form of spike protein accumulation will be encountered with increasing frequency in this continuing COVID pandemic.
Regardless of any test results, all cardiomyopathy patients should be taking one or more chelating, or toxin-mobilizing, agents. Furthermore, follow-up blood, urine, and/or hair testing should be done to establish that toxins are being mobilized because of the chelator administration. When testing clearly indicates high levels of one or more heavy metals in the heart, potent prescription chelation administration is often advisable, especially when heart failure is advanced. Such agents include, but are not limited to, the following: [236]
• EDTA (orally, intravenously; calcium disodium EDTA best choice)
• DMSA (orally; especially good for mercury and antimony) [237,238]
• DMPS (intravenously-very potent, can cause substantial detox symptoms)
• Dimercaprol (British anti-Lewisite [BAL]) [239]
• Penicillamine
• Deferoxamine
• Trientine (especially copper)
Important nutrient chelators or toxin mobilizers:
• Organic acids, including alpha lipoic acid, citric acid, and ascorbic acid [240-243]
• NAC (N-acetylcysteine)
• Glycine
• IP6 (inositol hexaphosphate)
• Carnitine [244]
• As much of a wide variety of antioxidants as is feasible, including bioflavonoids, amino acids, and any supplement or food with a high organosulfur content. [245] Most chelators, including the prescription agents, are synthetic amino acid derivatives . [246]
Cellular Energy Production: All cardiomyopathies have deficient to severely deficient mitochondrial production of ATP. While a broad spectrum of quality supplements is always beneficial for any disease or medical condition, specific supplementation with a sufficient dosage is required to optimize ATP production in the cells of the heart. A suggested regimen of supplementation to achieve this goal would be as follows:
• Vitamin C as ascorbic acid or sodium ascorbate, three to nine grams daily
• Magnesium, any of multiple forms, one to three grams daily
• Vitamin D3, 3,000 to 10,000 units daily, with a blood level target of 50 to 100 ng/cc
These three supplements are essential baseline supplements, as each one works to lower intracellular calcium levels, decrease oxidative stress in all cells, and to decrease all-cause mortality. [247-252]
Supplements to stimulate and support mitochondrial ATP production:
• Niacinamide, one to three grams daily (or NAD supplementation)
• Riboflavin, 200 to 400 mg daily
• Coenzyme Q10 (ubiquinone or ubiquinol), 300 to 900 mg daily
• Methylene blue, 10 to 25 mg daily
The seven supplements above should be taken by all cardiomyopathy patients. As ATP is important in all cells of the body, these seven supplements can also produce significant clinical benefits in nearly all other medical conditions as well. The following nutrient supplements also support mitochondrial ATP production and can be added to the overall chelation/supplementation protocol as desired:
• Tyrosine (a CoQ10 precursor)
• Selenium (often depleted in cardiomyopathy)
• Succinate [253]
• 5-aminolevulinic acid (supports cytochrome c oxidase function) [254]
• Glycine (helps produce 5-aminolevulinic acid) [255]
• Ribose (rate-limiting precursor for adenine nucleotide synthesis and ATP production) [256]
• Carnitine (increases ATP; its deficiency also induces cardiomyopathy) [257,258]
All dosing of prescription and supplemental agents should be under the guidance of the healthcare practitioner managing the care of the patient. The above agents are intended to be a general guide only. Clinical response and serial changes in laboratory testing are the main ways to determine how well a given patient is responding.
Recap
The heart muscle in all cardiomyopathies is depleted in ATP, the most important energy-producing molecule in the body. The worse the cardiomyopathy, the more severe the depletion. Nearly all the time, this ATP-depleted state is precipitated and maintained by heavy metal accumulations, often accelerated by earlier pathogen-provoked myocardial inflammation (myocarditis). Such myocarditis is typically undetectable on routine chemistries, and only more invasive testing can clearly document it.
When a patient presents with an enlarged, poorly contracting heart, it must be assumed that significant heavy metal accumulations are present and the treatment protocol must include chelation/toxin mobilization therapy.
Depending on the patient history and laboratory findings, the clinician needs to decide whether chronic COVID with low-grade spike protein-mediated inflammation is a major (or entire) part of the pathology involved. If this is confirmed, or if clinical suspicions are high, measures to eradicate the spike protein should be vigorously pursued. [80-83]
In addition to the heavy metal/toxin removal measures, targeted supplementation designed to directly support and heal the failing ability of the cardiac mitochondria to produce normal levels of ATP is essential for an optimal cardiac and clinical response.