Use table 2.

Remember that it is very easy for sample handling errors to lead to
lower numbers than are really there.

BTW, which lab did you have the test done at?

Andy

--- In Autism-Mercury@y..., john.gilfillan@a... wrote:
> I am confused about interpreting my 4 year old's porphyrin results.
> We have been chelating (DMSA + ALA) since September last year and
> have had his porphyrins checked 3 times - a baseline figure for
> August 2000 and 2 subsequent tests.
>
> Table 1 shows one way of presenting the results.
>
> Aug 2000 Nov 2000 Mar 2001 Ref range
> Creatinine
> (mmol/l) 4.7 L 2.0 L 11.2 5-20
> Total porphyrins
> (nmol/l) 184 148 502 High 0-300
> Porph/creat 39 H 74 H 45 High 0-35
> Uroporphyrin
> (nmol/l) 22 18 40 0-40
> Coproporphyrin
> (nmol/l) 162 H 127 452 High 0-150
> …copro I
> (nmol/l) 24 16 70 0-105
> …copro III
> (nmol/l) 138 111 387 High 0-240
>
> L = Low H = High reference ranges for adults
>
>
> The lab commented that urine collections and results in August and
> November 2000 were not reliable because the creatinine levels were
> too low - ie below the (adult?) reference range. Just recently, for
> the March 2001 results, I purposely collected urine first thing in
> the morning to try and get the creatinine level up to "normal".
> They were prepared this time to confirm that the liver is under some
> disturbance.
>
> I presume that a toxic individual will show elevated porphyrins both
> before and while chelating. This table seems to show some toxicity
> before chelating (August 2000) – slightly elevated coproporhyrins -
> and then a reduction in toxicity (in November 2000) and then a major
> increase in coprporphyrins 6 months into the chelation (March 2001) –
> well over the upper limit of the reference range.
>
> Is this normal with chelation? I take it that some increase in
> coproporhyrins to levels above normal is to be expected as the metals
> are sequested from the brain and elsewhere and transported to the
> liver for excretion. I presume the trick is to ensure that the liver
> is not being over-taxed. Do these porphyrin levels indicate that the
> liver is being over-taxed? Can porphyrin levels provide an
> indication of the how well the chelation is going and whether it
> should be modified – too high an increase implies that less chelation
> is needed and vice-versa?
>
> Table 2 shows another way of presenting the same data but which
> suggests a different interpretation. This table calculates
> porphyrins per unit of creatinine using the data from Table 1.
>
> Aug 2000 Nov 2000 Mar 2001 Ref
> range
> Uroporphyrin
> (umol/mol creatinine) 4.7 8.9 3.6 0-5.7
> Coproporphyrin
> (umol/mol creatinine 34.5 63.5 High 40.4 0-46
> …copro I
> (umol/mol creatinine 5.1 8.1 6.3 0-10.3
> …copro III
> (umol/mol creatinine 29.4 55.5 High 34.6 0-35.7
>
> The reference ranges are drawn from the article referred to by Andy
> in the "Files" section and are for 4 year olds.
>
> Using this methodology shows a baseline coproporhyrin (August 2000)
> measure which is above average but nor above the reference range and
> then a major increase in coproporhryins (implying greater toxicity
> while chelating in November 2000) and then a reduction to a level
> below the upper limit in March 2001 but still above the baseline
> figure.
>
> I don't know which interpretation to rely upon nor whether the
> chelation therapy is going OK.
>
> Can Andy or anyone who has experience with porphyrin tests while
> chelating help with this?