Diagnostic Lead Testing: Pubic Hair Preferred
Tuesday, 20 May 2014 16:32

The name of Dr. Linus Pauling brings up an immediate association to his recommendation of vitamin C for the common cold.  Of even greater impact, however, is his endorsement of nutrition as a fundamental approach to health and treatment of disease, a concept for which he coined the name, orthomolecular.  In the past four decades the young specialty of orthomolecular medicine has advanced in large part because of the tremendous improvement in laboratory technology.  By now it is possible to obtain laboratory measurement of vitamins, minerals, amino acids, fatty acids, enzymes and hormones in almost any body tissue at a price that is relatively modest.  

In keeping with the spirit of science I incorporated laboratory measurement of vitamins and minerals into my medical-psychiatric practice way back in 1968, beginning with computer analysis of dietary nutrient contents.  It became obvious at once that my patients were deficient in vitamins and minerals and the blood tests confirmed this.  Nutrient deficiencies, which were supposed to be rare in the American people, turned out to be epidemic in my patients.  Measurement of vitamins and minerals was quite expensive however, averaging about $50 per test, and so it was impractical to measure more than a few of the fifty known nutrients.

When I heard about the hair test, which measured over twenty minerals for the price of one, I was quite excited.  The first champion of the hair test was the biochemist, Dr. John J. Miller, former editor of Chemical Abstracts and therefore extremely well versed in biochemical research throughout the world.  By 1971 the medical research literature included a number of studies which established hair analysis as a valid approach to diagnosis of heavy metals, such as lead, arsenic, cadmium and mercury.  It was also becoming clear that many of the nutritional minerals, particularly calcium, magnesium, zinc, manganese, chromium, selenium, boron and molybdenum are concentrated and therefore more readily measured in hair than any other tissue.  By now it is known that hair mineral content reflects actual tissue levels for aluminum, arsenic, barium, calcium, cadmium, cobalt, chromium, copper, fluoride, mercury, lithium, magnesium, manganese, molybdenum, nickel, lead, silver, selenium, strontium, sulfur, vanadium and zinc.

The hair test is actually a mineral biopsy, just as valid as if taken by surgical procedure but without the invasive, painful and damaging effects of a surgical biopsy.  However every medical test is subject to error and because hair is often treated with cosmetics, conditioners, dyes and shampoos, many of which contain metals and chemicals that can react and stick to the hair, contamination errors are a major drawback.  Because of external contaminants, hair analysis must be regarded as a screening test.  It always requires confirmation by additional testing--but that is no different than any other laboratory procedure:  no single test makes a diagnosis.  It is the doctor's job to interpret the total picture of history, physical examination and laboratory findings in order to come up with the correct diagnosis and treatment.  

Pubic hair is less likely to be contaminated: it is seldom subject to cosmetics, conditioners, dyes and shampoos except as run-off from scalp and body lather in the shower and in case talcum powder, which contain minerals, is applied.  The use of pubic hair instead of or in tandem with scalp hair is a simple way to solve the problem of environmental contamination in hair mineral analysis.  

I explained this to the seemingly sincere and responsible journalist who sought my help for an article about my work in nutrition medicine back in 1971.  He agreed to omit any reference to pubic hair because we agreed that it could only distract the public from the real value of the hair test.  However, the newspaper editor had the final say and that was a time of sexual exploitation in the service of rivalry between the two major San Francisco daily papers  Science was sacrificed to greed and sensationalism and history will note that the newspaper captioned my picture with the unforgettable title: "pubic hair preferred."  

Needless to say, the medical community was not pleased about the role model that I seemed to be setting and I soon was called before a review committee, where I had to face a room-full of sober-faced doctors, none of whom felt that hair could be a useful tool for medical diagnosis.  I was accused of being "unscientific" and though that charge was dropped, the tawdry headline didn't help me or the hair test to gain credibility in San Francisco.  Worse yet it is obvious now that hair analysis has been cast aside--to everyone's great loss.  

One of the main road-blocks against the hair test was an official action by the House of Delegates of the American Medical Association in 1984:  "Resolved,...oppose chemical analysis of the hair as a determinant of the need for medical therapy; and be it further Resolved,...inform the American public...of this unproven practice and its potential for health care fraud."  Eight months later the AMA unleashed their chief quackbuster, Dr. Stephen Barrett, usually identified with The National Council Against Health Fraud.  In an article published in the AMA Journal, Barrett said that "The reported levels of most minerals varied considerably between identical samples sent to the same laboratory and from laboratory to laboratory."  "...commercial use of hair analysis in this manner is unscientific, economically wasteful, and probably illegal."

He based this on hair samples from just two women.  "Each was...cut into 1 to 2 cm lengths and mixed thoroughly."  Thirteen of these samples were sent each to different laboratories and then after three weeks another thirteen samples from this same batch were sent again so as to compare the results on repeat testing.  Of these thirteen laboratories six had a concordance that averaged 0.80, which is considered a high level of agreement between the initial and the repeat test.  A value of 1.00 would be perfect agreement.  Six of the other seven laboratories reached an agreement level 0.45 between matched pairs for each mineral, which is considered moderate accuracy.  Only one laboratory was clearly producing grossly unreliable results.

I feel the conclusions by Dr. Barrett are untrustworthy for a few reasons.  First of all he, himself, was inexperienced in the use of hair analysis.  He was only responding to an already established AMA mandate against hair analysis.  Second, the samples were said to be well mixed, but there was no mention of how this was accomplished.  Try to mix a bunch of inch long almonds in a glass container of pecans and you will see what I mean:  it takes a lot to get them mixed evenly.  Was this mixture done by a machine or was it done by the author?  No mention of that in the article.  Thousands of my patients have had hair tests and repeat tests are convincingly accurate to less than a millionth of a gram.   Proficiency testing by state agencies demand accuracy to maintain licensing.

Despite the hatchet job on hair testing, the actual data in this small study shows considerable reliability.  Nevertheless, a number of hair test laboratories went out of business after this and research interest in hair analysis appears to have left this country and moved overseas.  What a pity for all of us, for in my experience, there is no better screening test for toxic metal poisons, such as lead, mercury, arsenic, cadmium and aluminum.  Everyone should have it done at least once, just to rule out the possibility of accidental and unsuspected toxic exposure--even if you think you are healthy.  In addition the hair test often uncovers critical nutrient imbalances that are otherwise missed.

Back in 1971, when I was defending my scientific position on hair analysis before my peers, I had just that month taken a teaspoonful of hair from my seemingly healthy baby boy, just a year old.  What a shock!  His hair was loaded with lead, 71 mcg per gram (71 parts per million).  Naturally I called on our pediatrician, only to be shocked again: he displayed his ignorance by saying that this amount of lead was insignificant and that the hair test wasn't a recognized test.  

I was inexperienced in lead poisoning at the time so I began to review the medical literature in a hurry.  A week later I ordered a blood lead test and felt my heart stop when the result came in at 24 mcg per 100 ml, significantly more than the zero level that it should have been. This was much less than the 80 mcg level that the text-books gave as the cut-off point for treatment at that time.  The text recommendations were based upon industrial exposures in adults and overlooked the extra susceptibility of children to brain damage from low levels of lead.  Since then the tolerance level has been reduced to 10 mcg, the level below which no adverse effects can be detected.  

I also tracked down the source of lead poisoning in my son: a painted wooden toy imported from an iron curtain country.  The cold war was a secret war against our children: the paint contained 6000 parts per million lead, over ten times the legal limit in this country.  Even now after the cold war is over and our health authorities are alerted to lead, it is still not safe to assume that fresh paint is safe, especially if the object is imported from overseas

When informed of the confirmatory blood level, our pediatrician still held to the view that no treatment was necessary.  Luckily I knew enough to treat with orthomolecular supplements of methionine, minerals and extra vitamin C for the next several years.  I opted against the use of EDTA chelation because of fear of mobilizing lead beyond the capacity of his kidneys, thus making things worse.  

Within a year my son recovered from the effects of lead poisoning that had begun to show up, ie. waddling gait, severe constipation and spells of abnormal anger.  Without treatment he would have been severely damaged and mentally retarded.  No one would have ever known why such a perfect baby turned out to be so disturbed.  It probably would have led to speculation that my being a psychiatrist was a bad influence on his personality development.  In those days, when children had mental and emotional disturbances, the parents were often blamed.

So there I was, being castigated by my medical peers for my use of the hair test for my patients at the very same time that the test had saved the life of my son.  What irony!  Don't tell me that the test is a fraud!  My resentment of the criticism leveled at me was tempered by sympathy as I realized how vulnerable every family was to a similar disaster.  I wondered how many of my medical colleagues were facing a similar tragedy or maybe even worse--but in total ignorance.  Due to the lucky path of my career I was able to save my son.

Now it is 40 years later and lead is getting a lot of publicity: peeling paint is still a threat, plumbing and faucets are still dripping lead and our children are at risk.  Public health officials have admitted that blood lead at levels as low as 10 ppm lower the intelligence of children.  And with that insight, large scale blood testing of children is being done.

And I say: for shame!  Blood testing is misleading and likely to totally miss the diagnosis.  For example, a group of painters were studied by daily blood tests while working with leaded paints and then tested again after a time off work.  Within a week, the blood levels of all, which were high in lead while they were actually on the job, returned to normal.  It should be obvious that blood tests are only useful in the presence of very high or continuing exposure to lead.  Hair, on the other hand, contains a record that can be dated relative to the distance from the scalp: a segment six inches from the root represents a year earlier; while a sample cut close to the roots measures more recent exposure.

Wake up your public health officials.  Tell them to look beyond AMA reactionaries and stop wasting our taxpayer's money on the large-scale surveys of blood lead in children.  Blood testing is almost certain to give false negative results in the children who are in contact with lead intermittently rather than every day. The hair test is more informative, more accurate and less expensive.  And it doesn't hurt.  All children under age 6 should get a hair test for lead at least once a year.  Such an investment protects both the intelligence and emotional stability of the child at a cost  below that of any other medical or educational expense.  The hair test, for lead is the best possible investment in the health of our children.  
 

© 2014 Richard A. Kunin, M.D.

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