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The Failings of Doctors, and their Damage to My Health — High Blood Lead (Pb) Level, Ferritin

re: ethics in medicine
re: medical incompetence

I’ve been damaged in at least 4 ways in my lifetime by serious medical incompetence. I won’t go into those here, but here’s the latest.

Have you had issues because of blood lead level? Maybe not, since I seem to be in the worst 1th percentile. But the tale here might apply to some other aspect of your own health.

Background

Years ago, I wanted a blood lead test. I had good reason for it; the details do not matter here.

The atomic symbol for lead is Pb. I wrote that in on the slip, wanting to add it, which I explained to the doctor later, and was not believed. So I never got the results instead I got phenobarbitol test. That doctor wrote to another doctor suggesting that I might have a problem eg “Lloyd may be hiding something” eg a drug habit (never!), and that ad-hominem attack became part of my permanent medical record, undeletable by law. I then had to explain it to the other doctor, who clearly did not believe me either. Both doctors did not even know atomic symbols and call themselves doctors. Fucking morons, fucking assholes. So I never got a lead or mercury test. I gave up, having nothing but those jackasses to work with.

UPDATE: I was incorrect, apparently I must have insisted and forgotten about it—I did hfinally get that lead test on Sept 28 2009 (14 years ago, a little concerning that the state of California keeps that info but useful now): the level was 2, which I’m told indicates that childhood lead exposure can be ruled out as the source of the blood lead level today eg it’s not coming from my bones, at least not from childhood.

Today

Here I sit in 2022 having battled health issues for 2.5 years from my April 2020 COVID infection. Which looks to be EBV (very high antibody levels of 3 kinds just confirmed again), and auto-immune thyroid disease (Hashimoto’s Thyroiditis) with TPO at record high as of this week.

My current doctor (not involved in the clusterfuck discussed above) is pretty good as doctors go, other than being ultra-terse and saying very little. I had mentioned lead suspicions to him more than once over the past few years. Yet he never ordered a test. I guess doctors are not good listeners?

I finally insisted last week. He agreed and I had the test done.

It surely can’t help to have a high blood lead level 4.2X the cutoff value. The mercury (Hg) test is pending.

Chelation therapy to bring down levels of lead in my body warranted? Dunno. Online sources suggest that treatment may be warranted at 40 ug/dL or higher, so I am seemingly in an unhealthy but non-critical middle range at “only” 14.6 ug/dL (vs typical of 0.96 ug/dL)—15X higher than typical.

Of course, clinical symptoms of lead poisoning are scarcely a defensible treatment cutoff. All sorts of degradations can happen short of some arbitrary cutoff value.

Might explain a few things...

I’ve wondered why my Vitamin D levels have been stubbornly low even with lots of summer sun, and why my ferritin is also very low, and why I still have some neurological issues which stemmed originally from Metronidazole. On Wikipedia:

High lead levels cause decreased vitamin D and haemoglobin synthesis as well as anemia, acute central nervous system disorders...

Wow. Are doctors so clueless that they cannot put two and two together, particularly when a patient stresses past lead exposure? It was not a random guess, and I made that clear.

I’ve also had increasing hypertension issues, might these be lead related? Because there is no other credible explanation given my diet and lifestyle. Maybe not related, the evidence is poor.

Chocolate?

CDC recommendations

I don’t trust the CDC in general, but maybe they can be cited on CDC lead recommendations. These state that my BLL is 15.8X higher than the typical level.

“Talk to your doctor...”—what good is that when they do not hear you while taking their damned electronic notes to protect their ass? No one can take notes and pay attention properly.

According to these guidelines, I should be tested every 2 months. Yet it took 20 years to get the first test, thanks to medical carelessness, even prompted by my requests.

0.92 µg/dL — In 2015-2016, this was the typical BLL among adults in the United States.

5 µg/dL — Five µg/dL is the case classification ABLES uses to indicate an elevated BLL for surveillance purposes.3

If the BLL is between 5 to 9 µg/dL, California Department of Public Health (CDPH) recommends repeating BLLs every 3 months for adults until their BLL is less than 5 µg/dL.4

If pregnant, women should not exceed this level because the National Toxicology Program (NTP) concluded that mothers with BLLs even lower than this level can result in reduced fetal growth.2

The American College of Occupational and Environmental Medicine (ACOEM) also states it is inadvisable to allow pregnant workers, or those who are trying to or may become pregnant, continued exposure if BLL is >5 µg/dL and medical removal is recommended; pregnant workers may return to work when two repeat BLLs are <5 µg/dL.5

10 µg/dL — Below 10µg/dL, the NTP concluded lead increases blood pressure, the risk of hypertension, and the incidence of essential tremor. [WIND: the medical literature does not support the blook pressure/hypertension statement]

ACOEM and CDPH recommend repeat BLL tests every two months if a person’s BLL results are between 10 to 19 µg/dL.

15 µg/dL — Michigan Occupational Safety and Health Administration (MIOSHA) requires BLL testing every 2 months for employees found to have a BLL of 15 µg/dL or higher.
20 µg/dL — ACOEM and CDPH recommend medical removal if a worker has two consecutive BLLs between 20-29 µg/dL.

The American Conference of Governmental Industrial Hygienists (ACGIH®) guideline states that the typical worker can experience a BLL of 20 µg/dL without adverse health effect.7 This guideline is intended for use in the practice of industrial hygiene, but others may wish to use these guidelines as supplements to occupational safety and health programs.

25 µg/dL — ACOEM and CDPH recommend medical removal if a worker has two consecutive BLLs between 20-29 µg/dL.

Anon cardiologist writes:

Are you anemic? If so, is there evidence of basophilic stippling of the RBC’s in the peripheral blood?

Since there is no money in it for Big Pharma, the paper is probably pretty “clean”. I need to crawl through my attic and see if I can find my old hematology text book. The last time I treated someone for lead intoxication was in 1974. He was painting bridges on the interstate highways.

WIND: since I am not training hard currently, maybe I would not notice anemia? Doubtful that I am anemic.

My Ferritin is at an all time low (66, used to be 130 range)—so it is half what it used to be as recently as 2018. Hematocrit is at 45.2% (range 40-52%), hemoglobin at 15.3 (range 13.5-18).

Ferritin levels, 2016 through 2022
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