SYMPTOMS AND DIFFERENTIAL-DIAGNOSIS OF PATIENTS FEARING MERCURY TOXICITY FROM AMALGAM FILLINGS

Clinical signs, somatic symptoms reported by patients, and mercury exc retion in urine were studied for 348 patients selected by odontologist s or internists as amalgam-free referents, or as subjects with unexpla ined clinical findings or who were self-selected due to their fear of mercury intoxication from their amalgam fillings. Sixty patients were excluded because other explanations could be given for their complaint s. The age distribution was bimodal, with peaks between 30 and 35 year s and between 45 and 50 years. Mercury was determined in a morning uri ne sample and 30 minutes after the injection of 300 mg of 2,3 dimercap to-1-propane sulfonic acid (DMPS), a mercury-chelating agent. The pati ents were followed for 1-3 years. Among the patients there were 26 who had had their amalgam fillings removed and who, at the time of the fo llow-up, were subjectively cured. When the patients were classified ac cording to the excretion of mercury after the DMPS challenge, those wh o belonged to the upper quartile had an odds ratio of 7.2 (95% confide nce interval 3.1-15.2) for becoming cured after amalgam removal. The s ymptoms of the cured patients had been predominantly mental. No consis tent clinical picture could, however, be found among the other patient s, as various types of mental and physical distress were reported.