From the Guidelines
Mercury poisoning from consuming contaminated fish poses serious health risks, particularly to the nervous system, kidneys, and developing fetuses, and the most effective way to mitigate these risks is to limit consumption of high-mercury fish and choose lower-mercury options, as recommended by the FDA and supported by recent studies 1. The main risks associated with mercury poisoning include neurological damage, kidney damage, and developmental issues in children exposed prenatally.
- Neurological damage: tremors, memory problems, cognitive impairment
- Kidney damage: impaired renal function, increased risk of kidney disease
- Developmental issues: birth defects, developmental delays, cognitive impairment Treatment for mercury poisoning typically involves removing the source of exposure and chelation therapy with medications like dimercaptosuccinic acid (DMSA, also called succimer) or dimercaprol (BAL) 1.
- DMSA: 10 mg/kg per dose given three times daily for 5 days, then twice daily for 14 days
- Dimercaprol (BAL): 3-5 mg/kg per dose given intramuscularly for more severe cases Prevention is crucial and includes limiting consumption of high-mercury fish (shark, swordfish, king mackerel, tilefish), choosing lower-mercury options (salmon, shrimp, pollock, catfish), and following local fish advisories, as recommended by the American Heart Association 1.
- Pregnant women, nursing mothers, and young children should be particularly cautious about fish consumption and follow FDA guidelines to eat 2-3 servings/week of a variety of fish lower in mercury 1.
- The benefits of fish consumption, particularly the omega-3 fatty acids, can be obtained while minimizing the risks associated with mercury poisoning by choosing a variety of fish and following local advisories 1.
From the Research
Risks of Permit Fish Toxicity
- Mercury poisoning is a significant risk associated with consuming permit fish, as they can accumulate methylmercury in their bodies 2, 3.
- The risks of mercury poisoning include damage to the developing brain and nervous system, as well as adverse health effects in adults due to chronic low-level exposure 3.
- Manifestations of methylmercury poisoning can be variable and may be difficult to detect, making it essential to consider this specific diagnosis and conduct appropriate tests, such as blood or hair analysis 3.
Treatment Options for Mercury Poisoning
- There is no specific treatment for mercury poisoning, but physicians can provide guidance on reducing exposure to methylmercury from fish and seafood consumption 3.
- Patients who eat fish frequently (once a week or more often) and pregnant women are advised to choose low-mercury fish to minimize the risk of overexposure 3.
- In cases of acute mercury intoxication, treatment with dimercaprol, penicillamine, and intensive supportive care may be necessary, but the outcome can be poor, as seen in a case of a gold prospector who died despite treatment 4.
Prevention and Monitoring
- Establishing a monitoring system for mercury levels in fish and humans can be useful in evaluating potential neurotoxic effects 5.
- Physicians should ask patients about their fish consumption habits, including frequency, amount, and types of fish consumed, to assess the risk of methylmercury exposure 3.
- Studies have shown that hair mercury levels can increase significantly with the amount and frequency of fish consumption, highlighting the importance of monitoring and prevention strategies 5, 6.