Urine challenge test reference ranges

[Guest guest]

Hi,

I did a DDI urine toxic metals challenge test a few weeks ago and the results

came back somewhat elevated for lead and aluminum. However, the test sheet

mentioned that it was a random test with no challenge, instead of a 24 hour DMSA

challenge test, so I thought the results were erroneous and called the lab about

it. They apologized for their mistake and said they would fax the results for a

24 hour DMSA challenge test.

Well the test results came back the same, so I called DDI and asked them what

they use for a reference range. They told me they are comparing the metals in

my urine after a DMSA challenge against the metals content in urine from the

general population with no DMSA challenge. This doesn't make sense to me as it

would be like comparing someone's heart rate after they just ran 10 miles with

that of someone at rest and saying they have tachycardia. Am I missing

something here or are they comparing apples to oranges with this test?

[Guest guest]

>

> Subject: Re: Urine challenge test reference ranges

> To: frequent-dose-chelation

> Date: Sunday, September 7, 2008, 7:29 AM

> I submitted a 24 hour urine sample to DD a couple of days

> ago, done

> while chelating with DMSA and ALA.

>

> There are no established reference ranges for challenge

> tests. You

> are on your own in interpreting them.

If that is true then I would have to agree that their usefulness is extremely

limited if not completely non-existent other than for the reasons you state

regarding insurance.

> Cutler says that challenge tests are not diagnostically

> useful, but

> in both books, and in some posts, says that serial tests

> can be used

> to track progress; in other posts, he says that they are

> hard to

> interpret. I recently posted quotes from his books

> regarding using

> urine tests to decide when it is OK to add ALA, and how

> often to use

> DMSA to chelate lead. He also mentions that one can be very

> ill and

> show low metals in tests, because one can be unusually

> sensitive to

> metals.

Is it a fact that some can be unusually sensitive to metals and how is it

proven? Some people have unusual sensitivities to seafood, peanuts, etc and

these are easily proven. I would have thought that if one were unusually

sensitive to metals that it would show up in other ways as well, say when

wearing jewelry made of base metals, or getting ill immediately following an

amalgam filling or removal etc. Is there a difference between an allergy and a

sensitivity?

> Dr. Quig from DD did a presentation at Autism One that had

> some

> interesting material on challenge tests. Both normal,

> healthy people

> and autistic children have huge increases in lead excretion

> with EDTA

> or DMSA, and lesser increases in other metals.

Not sure what this indicates. Did Dr Quig draw any conclusion from this?

> Theoretically, I guess that no metals at all should come

> out in a

> challenge test. And as Cutler points out, lots of people

> have more

> lead than they should; I assume I do.

I can't imagine no metals coming out since we will absorb various metals from

the atmosphere, food and water as part of our environment. I think no metals is

a goal that would be difficult and pointless to pursue.

> My tests from 2005 show low toxic metals, even on high

> doses of DMPS

> and ALA, but the variations in mercury seem to correlate

> with what

> was going on, and made me feel comfortable adding ALA after

> a few

> months, and comfortable that ALA was doing something

> useful. I

> recently gave a few more details in another post.

Not sure how large the variations were, but I would imagine that with a test

like this there is already a high variability in the results due to the way the

body absorbs and excretes metals and DMSA and all the other factors involved.

> Your test in isolation probably means nothing, other than

> that, like

> most people, you have some amount of lead and aluminum in

> you, which

> may or may not be a problem.

Yes it is certainly looking that way.

> If serial urine tests while chelating with DMSA show an

> orderly

> progression of reduced lead under similar challenge

> conditions, I

> would take it to mean that the body burden of lead is

> successfully

> being reduced. If the results fluctuate randomly, I would

> take it to

> mean that the tests are not useful.

Unless they change the reference ranges between tests which I believe they do as

more tests are done. I also wonder if there is enough variability in the

results that even serial testing is almost useless.

> For me, although symptoms and side effects are the best

> guide, I like

> the idea of occasional urine tests to try to get some sort

> of

> quantitative window into what is going on. If my past urine

> test

> results were random and meaningless, I probably would not

> feel this

> way. I realize that what appeared orderly and meaningful

> may have

> been noise, and that future results may or may not be

> meaningful.

I like the idea as well, but don't want to be fooled by bad data which to me is

worse than no data. I have little confidence that the challenge test is

meaningful for diagnostic purposes due to the way the reference ranges work. If

they tracked the results according to no challenge, and a structured challenge

test then that might make it more useful but they don't. At least at DDI, it

seems ALL results are part of the reference ranges challenged or not, random,

6-hour or 24-hour etc, and I guess its a moving average type calculation so I

can't really see how the result would be meaningful at all and that is worrisome

if people use this as a basis for treatment as they could ignore other medical

problems that aren't metal related.