When I first undertook the topic of itching and IBD (Crohn’s and colitis), I did it out of frustration. I had itched so badly for almost five years—I didn’t sleep well, my skin was always dry, and my legs looked like I’d been attacked by a badger. So I set out to write about it, which is how I figure things out. I thought it would be just another series, and that my process for writing would apply: Generate topic; research and find lots of articles; apply noggin; write, relieve itching, help others to do the same.

Not so this time.

Sure, I found lots of studies on puritis (itching), chronic Urticaria (hives and friends), and other histamine related skin conditions, but I didn’t find anything that fit what I was searching. I didn’t find any researchers who seemed interested in the root cause of these conditions in a way which could be beneficial for me or for anyone who reads this blog.

So I was stumped; I was forced to think outside of my box. And that took a long, long time.

That is what makes this post different from lots of the other posts I’ve done. The information I have to give to you is solely from my experience, and what has worked for me. As usual, I’ll give you the theory behind why I did what I did, and why I think it worked, but they are just theories, and you should take them with a grain of salt. I’ve learned a few things about theories in my time trying to heal from colitis. The chief of them is this: I don’t always need to have the right theory to have the right treatment. A good example is with the infection approach to IBD. I’ve written in other posts about the pathogenic shift in the collective gut bacteria being a likely cause for IBD. Whether I am right or not, whether IBDs are due to one pathogen, a suite of pathogens, or a pathogenic shift in the entire community of bacteria in your gut matters less than the fact that the treatments which shift the gut bacterial community, like diet, natural antibiotics, probiotics, and fecal transplants, are extremely effective in helping IBD and IBS.

So, if you take exception to my theories, that’s fine, please help us all by adding your helpful theory to the comments below, and by writing your comments in a way that is the most helpful to the most amount of people who might read them.

Now on to the meat of the issue…

Itchy, you ain’t my itchy no more.

A note of caution: The subject matter below is complex. If I had a lifetime of posts, I couldn’t do it justice or figure it out completely. I’m an incorrigible do-it-myselfer, and I needed help with this. I hired a specialist to help me with mercury removal and balancing my endocrine system. It’s serious stuff with serious repercussions if you do it wrong. Don’t start mercury removal, and don’t mess with adrenal and thyroid hormones without help. Please.

A Friend’s Suggestion to Investigate Mercury

Almost two years ago, I was meeting with a coaching client, a man in New York about my age, who was about to do Fecal Transplants for a gut that had been terribly out of whack for years. He didn’t (and doesn’t) have IBD, but we both thought that fecal transplants would really help him. Over the course of several very interesting coaching conversations, he and I became friends and continued to stay in touch even though fecal transplants did not help his gut issues. One afternoon on the phone, after venting to him that my gut had gotten so much better over the last five years, but that I was still left with other frustrating symptoms like itching, brain fog, energy problems, and several other things, he suggested that I look into mercury toxicity and an underperforming endocrine system (adrenals and thyroid, mostly).

I was polite, but I kind of blew it off. I thought, even though he was really bright and had become a good friend and resource, that maybe he had gone a little far afield with the mercury thing. But he persisted. Finally he gave me a photocopy of the diagnosis section of a book called, Amalgam Illness, Diagnosis and Treatment…, by Dr. Andrew Cutler. In that section, the doctor uses a scoring system to rate symptoms, and clinical observations to give the reader a probability that mercury toxicity is an issue for them.

My probability? 43/44. If someone told you that you had a 97.7 percent chance of winning the lottery, would you buy a ticket? So I called my friend and asked how I should get started. I will write more about mercury in other posts, so those of you itching for more (ok, that was funny, admit it) will have to wait. The point of this post is to get at why I was itching, and it had something to do with a metal called mercury. My body was evidently overburdened with it and it was throwing things out of whack.

Sulfur, Mercury, and Itchiness.

The solution for mercury toxicity is chelation. Chelation is the intentional and careful use of certain sulfur compounds (DMSA, DMPS, glutathione, thiolized silica) to bind heavy metals and bring them out of the body. The two main elimination pathways are the kidneys and the gut. Without chelation, your body naturally removes the majority of your heavy metal exposure and other toxins through the liver, into the bile, and excretes them out of the gut, through your stool. (The kidneys do some work here too, so does the skin.) But what happens when the gut elimination pathway is damaged by inflammation? For a variety of reasons, not the least of which is reabsorption from leaky gut, the elimination of heavy metals slows or in some cases stops, which leads to an unnatural accumulation of, in my case, mercury (and to a lesser extent, arsenic, but I will focus on mercury here).

Well, crap.

Chelation compounds aren’t the only compounds which move mercury in the body. In theory, any sulfurous compound will mobilize mercury. A good example of this for me was that sulfurous supplements and foods (garlic, and onions are the worst) would trigger rashes that lasted 6-8 weeks. At the minimum. They left me with a sleepless night of scratching. It took a while for me to figure this out, and it took even longer for me to believe this is what was happening. Over the past 18-20 months, I have put myself through more misery than was needed because of my natural skepticism and desire for research. Had I just called my friend in New York, he probably could have told me (or maybe he already had) to stay away from sulfurous foods until my mercury levels had lowered significantly.

So if mercury was causing or strongly contributing to my lingering issues, why did it make me itch? What was happening?

Genetics, Chelation, Glutathione, the Endocrine System, and My Itchy Skin

On my friend’s suggestion, and on the direction of a specialist I hired, I got a hair test, which confirmed my mercury diagnosis (See Dr. Cutler’s book on hair test interpretation). I also got a genetic profile done which showed several mutations in the liver methylation (detoxification) pathways. It’s not my intention to get into the weeds of methylation epigenetics (a big, scientific term for how your DNA affects the way your liver clears toxins) here. That’s for another time, and plenty of people are writing about it.

What is important here is that these mutations made me a naturally slow detoxifier; my liver clears toxins more slowly than the ‘average’ person. It also meant that I have naturally low glutathione levels. Glutathione is a sulfur-based antioxidant (indeed, it’s your body’s main and most powerful antioxidant) that your liver needs in sufficient quantities to continue detoxification and clearance of toxins. These mutations (called SNPs, Single Nucleotide Polymorphisms), combined with leaky gut, meant that my bucket was full—all the time.

Since my liver was overburdened (it’s likely that it wasn’t just mercury that was overburdening my liver, but waste products from leaky gut, all of the supplements I was taking, and normal city-living toxicity all contributed—but mercury is especially burdensome, and by clearing it, many people can alleviate their symptoms), and since the kidneys are a minor elimination pathway for mercury (with the exception of DMSA chelation), the body can start to push it out of the skin.

Doctors have observed this phenomena for a long time, and have noted it in the literature and in case studies of acute metal poisoning. But chronic mercury toxicity is controversial because it is hard to measure. The body, if it can’t get rid of mercury in a reasonable amount of time, sequesters it in fatty tissue (yes, including the brain), carotenous tissue (like hair and nails), and some metals like lead are sequestered in the bones. In my case, I was itching wildly because my body was pushing out the mercury (and other substances) through my skin.

This elimination-by-skin theory was further reinforced by this: When I got a rash (which was very often of over the past two years), that rash upon receding would take with it the pigment from my skin, leaving me with vitiligo. When they asked, I would tell people that I was part snow leopard. It is interesting and not a little coincidental that the main ingredient in skin lightening creams is mercury—it destroys the pigment in skin. Sure, there may be other explanations, but I like this one. Eighteen months of chelation later, and my vitiligo patches are beginning to re-pigment themselves.

Endocrine Function (adrenals and thyroid)

Before I started any chelation, I got an adrenal stress profile done, and began tracking my basal temperature. Chelation is hard on the body, and often people’s adrenals and thyroids are weakened going into chelation, so need to be supported before starting the process of mercury removal.

Basal temperature, your body’s temperature first thing in the morning before you get out of bed, is a good indicator of adrenal and thyroid function. A consistent temperature indicates good adrenal function, and a normal (not high or low) temperature indicates good thyroid function. By tracking basal temperature, you can easily and accurately understand which gland needs support and you can regulate your dose using temperature too. This is how I am regulating my adrenal and thyroid functions during chelation—first addressing the adrenals (as thyroid can recover once adrenals are supported), then if needed after time, the thyroid. My adrenal stress profile showed that my adrenal glands were putting out only 20 percent of what my body needed (which explains why I was so tired among other things), and my basal temperature graph was all over the place—one day it would be 98.4, another 97.0, another 97.3, then 98 and so on. My adrenals were in trouble. So Before I started chelation, I needed to support my adrenals.

This took a long time. First my Naturopath started me on cortisol, because my adrenals were so weak. I self-regulated the dose based on my temperature and soon it was the same (97.7) ± 0.2 degrees every morning. Great, but my temperature was low, and I was eager to bring it up using thyroid support, but my chelation specialist encouraged me to wait a few months to see if the temperature would recover, since my thyroid blood tests were normal. Indeed it did recover with time, to 98.4, which is within normal. No thyroid support needed for the moment and I could begin chelation. Over time, I was able to transition safely, using my temperature readings, away from the cortisol (very powerful) to dried adrenal gland (still powerful, but less so). That’s where I am today. I am using dried porcine adrenal gland to regulate my adrenals during chelation. My hope is to downsize eventually to herbs, and then to nutritional supplements. Some people can do that, and others never quite get there. I am curious to see into which group I fall.

Dr. Rind in Bethesda, MD, has a detailed and easy to read explanation on his website about regulating adrenals and thyroid using temperature. For even more information, you can read the book, Your Thyroid and How to Keep it Healthy, by Dr. Barry Durrant-Peatfield (talks about both adrenals and thyroid and how to use the basal temperature method).

What I Did About All of This

Now you have the basics, an outline of what I think was going on with my wacky body: mercury. Yes, there are other possibilities. Yes, there other good theories that might match. That’s why it took me so long to write this post: the only way to test those theories was to test their recommended treatments. The only theory that has held up for me over time, and the one which has produced dramatic improvement, is the mercury theory. So I present it here, and what I did about it.

Here was (and still is) my strategy. I layered on each strategy over time in the order presented below, and over time my itching, brain fog, tiredness, sinus swelling, and yes even my vitiligo have all healed or begun to heal. (FYI, I’m generally following Quicksilver’s IMD detox protocol)

  1. Regulate, support adrenals and thyroid.
  2. For a time, remove sulfurous foods (onions, garlic, reduce egg consumption), caffeine, and chocolate (full disclosure: I failed to eliminate chocolate—It is one of the few non-SCD indulgences my gut will allow. Chocolate for me is a lifelong moment of indulgent weakness. I’m human.)
  3. Begin chelation: For this, I turned first to a homeopathic dilution (1:10) of a product called IMD, by Quicksilver. IMD (intestinal metals detox) is a very fine silica, each grain of which has bound to it thiol groups (sulfurous groups). Since sulfur groups bind metals, as this silica passes through your intestine (the grains are too large to be absorbed), it binds metals (it has a special affinity for mercury, though it does bind other metals too). Using the 1:10 dilution, I started very slowly, hoping not to cause another rash.

Incidentally, mercury accumulates in the epithelial wall of the large intestine, and causes inflammation of its own, which blocks or slows the normal elimination pathways for mercury, among other things. You may already be able to see the perpetual accumulation cycle that develops if the main elimination pathway is damaged or blocked. This is why it is important to remove mercury from the gut, and why I chose IMD instead of DMSA, the traditional chelator of choice.

  1. Build to a full dose of IMD: Build to 2-4 scoops of IMD/day
  2. Add the proper cofactors: These are outlined in Quicksilver’s protocol in detail. For me, it meant a mix of B-vitamins, proper amounts of selenium (through Brazil nuts) and molybdenum, and regular chelation pauses with a good multivitamin to ensure my body was continuing to accumulate the necessary minerals (which can be depleted by chelation).
  3. Boost glutathione levels: Because of the way my methylation mutations are expressed, I have naturally low glutathione, and because of the mercury and leaky gut, my levels are were especially low. I have two strategies for raising glutathione:
    1. Intake the proper amino acids: The key amino acid people write about for glutathione production is cysteine. There are others, but boosting cysteine seems to be key. So, how can I do that in a natural way? For me, I found a great Whey Protien Supplement that doesn’t bother my gut. Whey protein is well known to encourage increased glutathione production (some studies report almost 30% increase). Yes, there are caveats to this: some people cannot tolerate whey. In that case, they can substitute a quality pea protein—not as good as whey, but better than nothing. Also, some people with certain genetic mutations in liver pathways can get an unhealthy buildup of cysteine. This is why I used a complete protein supplement rather than buying a cysteine powder.
    2. Supplement directly with glutathione: This is tricky, because the studies show that glutathione supplements are notoriously bad at increasing intra- and intercellular glutathione levels. There is quite an argument about the efficacy of glutathione supplements because they are broken down in the gut, not well absorbed sub-lingualy, and tend to degrade quickly. There is one exception that has good absorption: Reduced glutathione suppositories. I have been using these suppositories for three months now. These are expensive, and that stinks, but they work. By the time I tried these my itching and other symptoms were lessened greatly (itching was down from an 8 on a 1-10 scale, to a 2, sometimes a 3), but they were still there and they still woke me at night. Ten days after I started the glutathione suppositories, my itching disappeared entirely. Three months later, my itching is still gone. As a reality check, even though these work wonders for me, I still have to be careful. If I eat raw onions or garlic, or have high mercury fish, I will itch again, but it is mild and short-lived whereas a year ago, those things would have meant another 6-8 week, sometimes full body, rash. I don’t know for how long my body will need these suppositories, but for now, I’m glad I have them. I think the long term solution is mercury removal, adrenal support, and probably amino acid supplements like whey protein.

Where I Am Now

I am 15 months into chelation, and it has been just over 24 months since I started working on my adrenals. I don’t know how long it will take to finish the protocol, and I don’t know how well my body will recover, long-term. For full disclosure, I’ve listed below the symptoms that have resolved and those that still linger.

Partially or fully resolved:

  • Food sensitivities (itching, rashes) to apples, cooked onions, caffeine, bananas, avocado, bone broths, chocolate, cooked garlic, cheese (resolving), wine (partially resolved)
  • Itching (98% resolved)
  • Brain fog, forgetfulness (mostly resolved)
  • Vitiligo (recovering slowly)
  • Energy (increasing, more consistent, but still lower than normal)
  • Depression (less severe, less often)
  • Sensitivity to cold (less severe, less often)
  • Gut (most days I feel ‘gut normal’. I can eat corn and rice now, but must watch my diet and stay on probiotics and other gut supplements)
  • Dry cracking skin (resolving)

Yet to resolve:

  • Sense of smell (still totally absent)
  • Adrenals (still dependent on supplementation)
  • Food sensitivities to raw garlic and raw onion

 

Onward to Health,

Matt