My initial interest is largely attributed to a
Swedish book . Although I remain skeptical to many suggestions given
there (and in many other "saved patient's books"), I am not so certain
that this aspect can be regarded unimportant. The mercury load may not
be so impressive in most cases - and may indeed be so in singular ones.
Amalgam is widely dissepated among people and can only be considered one among several factors which worsens MS in predisposed persons but not strictly a causative factor. It has been used in dentristy since its invention in 1833 (mercury already since 1819 in other combinations), was forbidden the first time in New York in 1839 but returned in 1855. In 1898, a case of mercury neurosis caused by amalgam fillings was published. In Germany, 1928, Alfred Stock tried to get amalgam fillings prohibited - as we know in vain . In 1966, Baasch suggested a connection between amalgam and MS and thereby opened an emotional discussion pro-&-contra [2,3]; for discussion is referred to some review articles [4,5]. In a Swedish publication, Ahlot-Westerlund found an 8-fold increase in the mercury levels in MS. Firnhaber et al.  found that 51 MS patients suffered more recently from carious teeth than a "control group" of 51 epileptics. Ingalls  suggests the amalgam causality and makes aware that a second heavy metal, lead, may operate almost interchangeable with mercury. Siblerud et al.  found a depressed red blood cell picture, decreased thyroxine and se-IgG levels, increased blood urea nitrogen level and fewer T-lymphocytes and T-8 (CD8) suppressor cells in MS patients with amalgam fillings preserved compared to MS patients who had their amalgam removed. Hair mercury was higher in the amalgam group. In the amalgam group there were 33.7% more exacerbations during the last 12 months.
Huggins and Levy  found dramatic changes of photolabelling of cerebrospinal fluid proteins following these dental interventions. They gave an exellant explanation of mercurys neural toxicology which is reproduced in the following:
" ... mercury is released from dental amalgam in the form of Hg0 ... [this] is more likely than Hg2+ to concentrate in the CNS after it has passed the blood-brain barrier ... Once in the brain, it is oxidized by the intracellular hydrogen peroxide-catalase system to its divalent cation, Hg2+. Since the Hg2+ form cannot diffuse out of the different nerve cells after this transformation, mercury gradually accumulates in the brain.
"Mercury has a number of mechanisms leading to toxicity in biological systems. These include the following:
"Mercury is unevenly distributed in the brain and spinal chord, with the heaviest deposits found within the motor nuclei of the rhomboencephalon ...".
In contrast, in a recent publication, Brieger et al.  warned against the error performed by MS patients in seing their disease as a result of mercury poisoning. Fung et al.  found that the concentrations of mercury and the mercury/selenium molar ratios in autopsy brain preparations were significantly lower in the hippocampi of multiple sclerosis patients as compared to age-matched controls. No statistically significant differences were detected for the concentrations of mercury and the mercury/selenium molar ratios for the remaining six brain regions among these groups. In a similar study, Clausen  found no significant differences between the deceased patients with and without MS concerning total mercury. However, the lipid-soluble mercury (preferably methyl-mercury) expressed per cell unit (DNA) was found significantly decreased in MS. These data may be explained either by a wash-out of lipid soluble mercury due to break-down of the blood-brain barrier in MS or to abnormalities in methylation processes probably related to the vitamin B12-metabolism in MS. In some contrast to these observations, McGrother et al.  found excess dental caries among MS cases as compared to controls in a case-control study. (Unknown position: ).
In conclusion, this question (as most other
ones) cannot be solved in the contradictory literature, unless these
selected according to the bias of the seacher. Small studies on a
amount of patients are as little impressive as enthusiastic claims of
with amalgam removal. Although the toxicity of mercury is out of
its pathological role in MS remains speculative. Even if it plays a
in some patients (accepting MS as a group of diseases rather than a
entity), it is still not proved that removal of ancient amalgam
causes any improvement. As almost usual in medical reasoning, also the
opposite remains unproved.
Various measures have been suggested in order to avoid too large serum-mercury levels exactly in connection to the removal of dental amalgam. They may include the ingestion of various antioxidants and penicillamine both before and after this measure. More important are especially "physical measures" to be taken by the dentist, in order to avoid swallowing off amalgam particles - aparently not an easy topic.
As a scavenging agent of various heavy-metal
including mercury and lead, the drug d-penicillamine has gained a
position. Indeed, some studies suggest a positive effect of
in MS [14,15,16], including a recent experimental study , whereas
turned out negatively . This is, however, no proof that heavy
are ethiologically important in MS: penicillamine has been found
in rheumatoid arthritis and other autoimmune diseases, and quite
for different reasons. Both the tissue-type plasminogen activator
and the metalloproteinase gelatinase B (MMP-9) are interconnected in an
enzyme cascade which contributes to destruction of the blood brain
and demyelination, and both enzymes are inhibited by d-penicillamine
Moreover, additional antiviral properties have been attributed to this
drug, thus providing similarity to interferon-beta (IFB) which was
used in MS due to the infectious theory and later preferred for its
of the immune system, including inhibition of MMP-9. However, the
effects of penicillamine are much more pronounced than those of IFB and
will probably not allow a prolonged therapy. For "pulsation therapy" of
a few weeks duration in response to relapses of the disease, it remains
an interesting, though currently insufficiently studied alternative.
Finally, the American FDA admitted what was long a
fact in other nations (e.g. Sweden, Canada and France) where the use of
amalgam is forbidden or restricted: "The mercury
contained in silver dental fillings may pose neurological risks to
children and pregnant women" . The first step on a strangely
neglected way of who are else exposed to the risk of amalgam.
Back to homepage-index
Revised Jan. 6, 2009