QUESTION:  I have a 53 yo F patient who is ANA+ (homogeneous pattern – associated with SLE, drug induced SLE and connective tissue diseases), with progressively increasing liver enzymes (ALT and GGT > 200 U/L most recently), and a normal liver biopsy. CRP < 3 mg/l, rheumatoid factor wnl, and protein electrophoresis wnl. The gastroenterologist is ‘done with her’ and sees no problem with the trend in liver enzymes, but has recommended a rheumatologist. No polyarthritis, fever, or malar rash; however does report some fatigue. Urine toxic metals showed a significant elevation in bismuth (provocated with DMSA 500mg, DMPS 300mg). I’m thinking the source may be hair dye as she is a hairdresser – she is not a pepto bismol abuser. From what I’ve read, bismuth is thought to have a 5 day half-life but can accumulate in the liver and kidneys. Is bismuth a contributor here? Or is it just a red herring? Basically I’m wondering what your approach might be for this case.

ANSWER: In hair dressers the toxicity is epic regardless of testing, and the chemicals and mito damage are always 10X what metals are.

If bismuth is showing up she is full of other stuff that just couldn’t get in line when the challenge drug went through her.
I’d do the following:
1.  Chemical detox via sauna and liver support
2.  Mito support (same stuff as I write about)
3.  Adrenal and thyroid support, and if needed E/P/T support (especially P and T in these kinds of cases)
4.  Do a periodic but regular metal chelator (I like DMSA 500 mg Sat and Sun bedtime weekly)
5.  90% of these have occult infections so support immunity and consider looking there
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