Testing

Blood is merely a transport system, it is not where minerals get stored.

Imagine a highway leading through a busy town. On an overhead bridge is a camera. If the camera takes a snapshot of the highway at a busy time, is that proof that the town itself is crowded? Not necessarily. What if all those cars are simply passing through town and never stopping? Likewise, if the camera takes a snapshot of the traffic and the highway is empty, does that mean the town is empty? Of course not!  The snapshot could be taken at night when the crowded town is sleeping, or there could be construction on the highway which has closed the access road. In both scenarios, the snapshot of highway traffic is a very poor indicator of what is truly happening in the town.  Blood is similar. It carries the various metals / toxins / minerals / nutrients either to where they're needed, or it will take them to be excreted. However, along the way, and especially if the body's detox pathways are not perfectly efficient, some of those minerals and metals and toxins get stored in the cells and tissues.

Let's take lead for example. If a person were to have a significant acute exposure to lead, and he were to be tested for lead within a week of exposure, likely his blood test would show a high level of lead, and doctors would catch it. Now let's say the blood test instead was done two months after his lead exposure. Do you think the blood test will still show a high level of lead? While it's possible some small elevation may appear, more likely than not the blood serum will show normal, in other words - the lead is gone. Is it really though?  Has is magically all disappeared? Of course not! This is because, not only is blood merely a transport system, it is also homeostatic.  The blood must return to a tight nutrient range in order to protect the body; if it didn't, we would die.  With too much of a mineral or metal the blood will attempt to remove it, either through excretion, or by storing it away in tissue.  And so, 30 to 40 days after that acute lead exposure, the serum can appear completely normal even though toxic levels of lead have been deposited and stored away in tissues of the liver, bones, hair, teeth, etc.​

Another very obvious example would be with potassium. Let's say you were to eat a bag of bananas the morning of your blood test. Likely your blood serum would show high potassium. However, that's just a snapshot in time, when in reality your cellular potassium may be dangerously low. We can see the caution here in how looking at a blood test to determine mineral needs can be dangerous - based on the blood test the practitioner would say avoid potassium as your level is too high, while the person wise enough to look at the tissue level (through HTMA as we'll discuss later) will clearly see the body's true deficiency of, and requirement for, potassium.

The same warning is true for the body's two most important minerals, calcium and magnesium.  Severe osteoporosis can develop without significant calcium changes appearing in the blood.  Meanwhile, the magnesium level can be affected by something as simple as how long or tight the tourniquet is applied - magnesium will rise due to tissue hypoxia. Not only that, but the body will rob the cells, tissues, and bones of magnesium in order to maintain a 'healthy' blood level of magnesium. What this means is that the blood status of magnesium can appear completely healthy even when the cells are completely starved of magnesium.  Similarly, when the blood level of calcium drops to low, calcium is robbed from the bone to boost the blood level – the blood level still appears fine even though deficiency is happening in the bone.  It is insanity that doctors continue to rely on the blood level of these nutrients, especially when you add to the fact that less than 1% of the body's magnesium is even in the blood to begin with! 

In terms of copper - blood's homeostatic nature will ensure that excess copper is quickly removed from the blood, but this doesn't mean it magically disappears from the body. If a patient is being exposed to an immediate source of copper, such as a copper IUD, chances are the blood may show an elevated level.  But once that IUD is removed (or the immediate source of exposure taken away), the blood will naturally return to normal, even though loads of toxic bio-unavailable copper is now stored in the body's tissues. In fact, we might even see the blood serum level of copper being low in a copper-toxic person. If copper has accumulated and is tightly stored in the tissues, and adrenal function is too weak to mobilize that stored copper, it's not going to show up in the blood! 

With this background, why on earth are so many practitioners still so reliant on the mineral level that shows up in the blood, without ever stopping to examine the tissue level? As a direct result of such practice, misdiagnosis runs rampant, and the lack of awareness to copper toxicity simply persists.  Not only is such tunnel vision ignorant and irresponsible, but also dangerous, and as long as people continue to focus just on serum blood results, the mass confusion surrounding this epidemic will only continue.  Even several so-called 'experts' online are just saying to get a blood panel, and their trusting audience then spends a fortune in time and money getting all the suggested blood panel lab tests - serum this, plasma that, ceruloplasmin - only to discover even more confusion as they try to interpret the results, once again ignoring that copper excess is stored in tissue, not blood. Blood is certainly invaluable for many markers of disease and health conditions, but NOT when it comes to measuring overall mineral status! At best, if the timing is right, a blood test may catch copper toxicity, but certainly far more often than not it will miss it. Copper toxic individuals very often receive blood test results that show 'normal' and are falsely diagnosed as 'healthy'.  As Dr. Eck points out, "If you have high levels of a certain mineral, like copper, held tightly in storage, why on earth would you expect the copper to show up in the blood - unless it is being released?!"  

Copper needs to be bound to a transporter protein (either ceruloplasmin or metallothionein), otherwise it becomes bio-unavailable, does not enter the cell where it needs to be, and instead gets accumulated in a bio-unavailable form in the body's tissues. The problem again with the standard blood serum testing procedure is that it ignores not only the accumulated bio-unavailable copper stored in the tissues, it also ignores the copper content within the cells.  The following quote is by Dr. Carolyn Dean, MD, ND speaking about the inadequacy of serum tests. While in the quote she is referring to magnesium, the same is very much true for copper:   "A serum test for magnesium is actually worse than ineffective, because a test result that is within normal limits lends a false sense of security about the status of the mineral in the body. It also explains why doctors don't recognize magnesium deficiency; they assume serum magnesium levels are an accurate measure of all the magnesium in the body."

It's not uncommon either to see women in forums struggling with copper issues, yet their blood copper level comes back normal, or sometimes even low, and they're led to believe then that copper toxicity isn't the issue at all. Once again, a person can have normal or low copper in blood and yet have elevated levels in tissue! 

Furthermore, people are commonly told to simply calculate their free vs bound copper to understand their copper status. Not only is this confusing for most people, but it is also largely unreliable.  Consider the following:  

"Serum free copper concentrations have historically been calculated, often cited as the copper index or non–ceruloplasmin-bound copper. The calculation is based on the total serum copper concentration less the product of the serum ceruloplasmin concentration and a factor correlating to the amount of copper bound per milligram of ceruloplasmin. A reference interval for the index is routinely identified as less than 10 µg/dL (1.6 µmol/L).  Limitations of the calculated copper index include the assumption that ceruloplasmin is saturated, that ceruloplasmin and copper methods are not defined by the calculation, and that the proportion of copper bound to proteins other than ceruloplasmin is not considered in the calculation. Analytic methods for ceruloplasmin are known to produce variable results that will contribute to significant errors in the calculation of the copper index, making it unreliable and insensitive." [3]

A central issue of copper toxicity is that copper ends up getting stored in cells and tissue. If we want to know the stored tissue level therefore, blood tests and urine tests both fall short.  That is not to say they are without benefit, as indeed they can sometimes pick up the imbalance.  However, in most cases, the homeostatic nature of blood, and the tightly stored nature of copper, means that copper toxicity more often than not gets overlooked in those tests.  

Ultimately, there is no singular test that is perfect for detecting copper toxicity.  The best, most evidenced-based marker, would be through liver biopsy, however such a test is both expensive and invasive and thus not a viable or realistic option for most people.  Furthermore, even with liver biopsy, it too could potentially miss the issue because copper does not deposit evenly through all the cells of the liver.  A liver can have some areas of higher copper concentration than others, and so if the biopsy happens to use a sample from a lower concentration location, then the toxicity again could be missed (or under-represented).  

Hair, however, is a biological tissue that is easily accessible, affordable to obtain, and provides a useful window into understanding biological processes within the body. As toxic metals and essential trace minerals tend to deposit in hair at levels higher than in other tissue, it provides a good “microscope” into being able to view toxicities (along with deficiencies) of both metals and trace elements. 

As copper passes through the blood, either to be utilized, excreted, or stored, it gets picked up in the hair follicle. An inch or so of hair taken closest to the scalp provides approximately a three-month window into the mineral and metal status of the body. As such, it’s not prone to the hour-to-hour fluctuations that affect the blood reading.  More importantly, the hair provides an indication of the tissue level, which is especially important to know when it comes to minerals status, including that of copper. 

Another major advantage that Hair Tissue Mineral Analysis offers (as long as it’s done properly with specific numerical values provided instead of just ranges) is data on the key ratios between mineral pairs.  When it comes assessing mineral status and understanding the effects of imbalances, looking at any one mineral level in isolation explains very little.  Take magnesium, for example. If the hair chart shows a “good” level of magnesium (right in the middle of the reference range), one might erroneously assume that magnesium status is ideal.  Is it really though?  This is where the other mineral levels and ratios provide us the real answers.   For one, stress depletes magnesium.  If we look at the ratio between sodium and potassium, known as the stress ratio, and we see a high Na/K ratio, we know that the individual is under a lot of stress, and that the high magnesium level is representing an intracellular loss of magnesium showing up elevated in the hair but indicating an impending magnesium deficiency.  Another clue could be high tissue calcium, causing magnesium loss at the cellular level.  In that case again, the increased circulating magnesium then gets picked up by the hair follicle and shows up falsely elevated in the hair test.  In other words, the true cellular magnesium level in both these examples is lower than it appears.  This could not be determined simply by looking at magnesium in isolation, but becomes apparent when other levels are considered. 

Similar can be said for assessing the copper status. A copper toxic individual can have a high copper level showing in the hair (in which case the conclusion is pretty obvious – so long as contamination factors are ruled out).   However, often a person with a high copper load can have their HTMA level appear low, or normal.  This “hidden” copper toxicity occurs when high levels of copper are stored in various body tissues but have not yet been released into circulation in order to show up in the hair. Therefore, we must look at what’s happening with the other mineral levels and ratios in order to better determine copper status. For example, when copper appears low in the HTMA, we can look at other key indicators that can suggest if a hidden toxicity may be occurring:  Some of these key indicators include:

•    high calcium
•    low potassium
•    a high Ca/K ratio 
•    very low molybdenum
•    low Na/K
•    low zinc
•    low manganese
•    presence of mercury

This underscores the importance of the HTMA practitioner understanding these various markers, as well as giving personal consideration to the patients’ health history and other factors that could contribute to the way levels appear.  For example, contamination, and medications, are two factors that can throw off certain mineral levels.  When HTMA is overly automated, these personal factors typically get missed, and so often the patient is led to the wrong conclusion (or supplement suggestions that may indeed not be ideal for the person).

Copper toxicity may be one of the most misunderstood conditions in the world today, certainly in part due to the resistance by many in the medical field to adopt HTMA into their toolbox, along with tactics that have been used to scare the public away from using HTMA.  The very fact that blood testing is still done so prolifically as the primary determinant of toxicity - with almost no mention of HTMA - goes to show a most basic lack of understanding behind copper toxicity on the part of practitioners.  As long as blood remains the primary go-to screening tool for mineral imbalance, the true extent of copper toxicity will never be recognized. 

Sadly, HTMA has a history of vicious smear campaigns directed against it, aimed at suppressing this most important of screening tools, and as a result has cost people who could have otherwise benefited from proper testing.  In 1985 and again in 2001, JAMA published two studies which, on the surface, seemed to dismiss the accuracy and reliability of HTMA.  These results were widely publicized, and to this day are still being widely referenced (by those who aren't aware of the history explained in the next paragraph) as justification for not using HTMA. 

The tragic irony is that, even though the hard data from the studies validated the excellent accuracy of HTMA, as well as copper toxicity in the samples, neither the author nor the editors were able to recognize it as they themselves did not understand how to use HTMA or what to look for.  The studies, when using the data from approved labs, in fact validated the very opposite of what the authors claimed - excellent accuracy (>99%).  However, to arrive at the finding that HTMA was not reliable, the authors of the studies, in one case used a mere 2 person sample size; in another they used an illegally operating lab to obtain skewed results, and in both cases violated almost all proper sampling and testing protocol.  In fact, the doctor behind the first study, who continues to run a number of websites disguised to mislead the public and attack the consumer's right to informed choice, has been shown to have little credibility, and in fact, a California Appeals Court declared him to be "biased and unworthy of credibility”. However, given his title as a ‘doctor’, those that don’t take the time to research further fall victim to his writings. 

The authors of the aforementioned studies (and the media) also largely ignored the ​ thousands of peer-reviewed references[4] that support HTMA, or the fact that HTMA is used routinely by various heads of government and world class athletes who have access to the very best medical care.  Those who dismiss HTMA are doing so based on their own lack of understanding, reluctance to learn, or ulterior motive. Dismissing HTMA as pseudo-science shows complete ignorance on the person making such a claim, and begs the question 'what is their agenda?'. Though human hair has been accepted as an effective tissue for biological monitoring of toxic heavy metals by the US Environmental Protection Agency and is being used for this purpose throughout the world, when it comes to copper toxicity, suddenly this fact becomes ignored.

Those who dismiss "hair analysis" as being unreliable are also making a broad and very erroneous generalization that all "hair analysis" is the same.  All "hair analysis" is not the same - there are many types of hair analysis on the market, with various methods of testing, and all looking at different things. Some forms of hair analysis have a lot more scientific backing than others, and for the purpose of understanding copper toxicity, the correct form of hair analysis must be employed.  Unfortunately, when the "HTMA is unreliable" message gets spread either intentially or inadvertently, it only further holds back those struggling with copper toxicity from health-saving (even potentially life-saving - as some cases have shown) information.  

When correcting any condition through nutrition, or when taking supplements, we must recognize that nutrients do not operate independently from other nutrients. Having a clear picture, as presented through HTMA, is invaluable prior to supplementation, and makes supplementation and corrective guidance much more practical, meaningful, manageable and safer.   Understanding one's various mineral levels should be an essential first step to any dietary, weight loss, or health restoration program. Hair Tissue Mineral Analysis, tested through either ARL or TEI labs (labs that do NOT pre-wash the hair samples), and assessed by a practitioner trained in understanding mineral ratios, is the best approach. Other labs that wash the hair sample (which most other labs do) are not recommended here as the washing procedure throws off  several key levels and ratios.   

HTMA provides essential indicators that, when properly interpreted, can show the presence of a hidden copper toxicity problem, and provides the evidence-based information necessary to properly detox copper while balancing other mineral levels at the same time - a necessary part of the process. Any other approach to treating copper toxicity without this 'bigger picture' of other various minerals is really taking a blind approach to treatment, and dangerously exposes the patient to other mineral levels being thrown off in the process which in turn could exacerbate the psychological and physical changes that occur in the patient. This underscores the importance of frequent monitoring of mineral levels throughout the detoxification process, something that can only be accurately achieved via HTMA. [Click here to learn more about HTMA or to order an HTMA test].  While the HTMA will tell you what's happening in your body, you can also get your tap water tested here to see if your drinking water is contributing to your load of copper and other heavy metals).

MORE ON THE CONFUSION BEHIND HTMA THAT KEEPS COPPER TOXICITY OFF THE RADAR IS EXPLAINED HERE.