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Signs and Symptoms of Arsenic Poisoning

October 4, 2016

Tags: water, herbs, movement, food, order, abdominal discomfort, abdominal pain, aches and pains, acrocyanosis, acute respiratory failure, acute tubular necrosis, adult respiratory distress syndrome, agitation, Aldrich-Mees's lines, alopecia, altered mental status, anemia, anemia – aplastic, anhidrosis, anorexia, anxiety, aplastic anemia, arrhythmia, arsenic, ascites, ataxia, atherosclerotic disease, autonomic neuropathy, basal cell carcinoma, basophilic stippling, birth defects, blackfoot disease – black, mummified dry gangrene, bladder cancer, blood in urine, bone marrow suppression, Bowen disease, brittle nails, bronchitis, bronchospasms (inhaled arsenic), burning in mouth/esophagus/stomach/bowel, cancer – lung/liver/kidney/bladder/skin/colon/larynx/lymphoid system, capillary dilation with fluid leakage and third spacing, cardiac arrhythmias, cardiac arrest, cardiomyopathy, carotid atherosclerosis, cerebral infarction, cerebrovascular disease, chills, cholangitis, cholecystitis, chronic lower respiratory diseases, cilantro, cirrhosis, clear skin lesions suddenly from such as acne, CNS depression, colitis, colon cancer, coma, concentration – poor, confabulation, confusion, congestive heart failure, conjunctivitis, convulsions, coordination difficulties, corneal necrosis, corneal ulcerations, cough with/without expectoration, cramps, cramping muscles, cyanosis of the fingers, death, dehydration, delirium, depression, dermatitis, dermatitis - allergic-type, dermatitis – exfoliative, desquamation of skin, diabetes, diarrhea - often severe and/or bloody, disordered thinking, disorientation, disseminated intravascular coagulation, drinking water, drowsiness, dyspnea (when inhaled), dysphagia, eczema, edema – non-pitting of hand and feet, EKG changes: ST changes/QT prolonged/torsades de pointes/T wave inversion, encephalopathy – acute, enzyme inhibition, esophagitis, eyes blood-shot, eyes burning, facial edema, fatigue, fatty liver, fever – low grade, fibrillation – ventricular, fingernail pigmentation, fingernails with white marks, fluid loss, flushing, folate, folic acid deficiency, gallbladder inflammation, gangrene of limbs, garlic, garlic-smelling breath or body fluids, gastritis, gastro-intestinal bleeding, generalized muscle aches and body pains, gingivitis, global trade, goiter, Guillain-Barré syndrome – resembling, hair loss, hallucinations, headaches, hearing loss, heart disease, heavy metals, hematuria, hemoglobinuria, hemolysis, hepatomegaly, herpes, hormone imbalance, hyperesthesia, hyperpigmentation of nails and skin, hyperpyrexia, hyperkeratosis - thickening of the skin of the palms and soles, hypersalivation, hypertension, hypertension-related cardiovascular disease, hypopigmentation – “raindrop” areas of lost skin color, hypotension, hypovolemia, imbalance, immune functioning impaired, immune suppression, impaired healing, inhibition of sulfhydryl enzymes – garlicky odor to breath/stool, insomnia, irritability, ischemic heart disease, jaundice, karyorrhexis, keratosis, kidney cancer, kidney damage, kidney failure, Korsakoff’s psychosis, lack of appetite, Landry-Guillain-Barré syndrome – resembling, larynx cancer, laryngitis, leg cramps, lens opacity, lethargy, leukemia???, leukocyturia, leukonychia striata, leukopenia, lightheadedness, listlessness, liver cancer, liver - central necrosis, liver congestion, liver dysfunction and elevated liver enzymes, liver - fatty degeneration, low grade fever, lung cancer, lung - chronic restrictive/obstructive disease, lungs - inflammation of respiratory mucosa, lung irritation, lymphoma???, major depression – mimicking, malabsorption, malaise, medicinal herbs, Mees's lines, melanosis of the eyelids/areolae of nipples/neck, memory loss, memory – poor, mental retardation, mental status altered, metallic taste in mouth, methionine, microcirculation abnormalities, mitochondrial dysfunction, movement disturbances, muscle aches, muscle fasciculations, muscle tenderness, muscle twitching, muscle wasting, muscle weakness, muttering, myocardial depression, myocarditis, nasal mucosa irritation (when inhaled), nasal septum perforation, nausea, neuralgia, neuritis, night blindness, nightmares, numbness, oliguria, oral burns (acute, when taken by mouth), pancreatitis, paralysis, paranoia, paresthesia – symmetrical, stocking-glove, pedal edema, pericarditis, peripheral neuritis, peripheral neuropathy, peripheral vascular insufficiency, personality change, pigmentation changes – hypo and hyper, pins and needles in hands and feet, pneumonia, bronchial pneumonia, polyneuritis, portal fibrosis, proteinuria, psychosis, pulmonary edema, pulmonary insufficiency (emphysematous lesions), pulse – irregular, QT prolonged, quadriplegia, Raynaud’s syndrome, renal cortical necrosis, respiratory failure – acute, respiratory muscle insufficiency, respiratory tract infection, rhabdomyolysis, rhino-pharyngo-laryngitis, rice, rouleaux formation of red blood cells, salivation excessive, sauna, seizures, selenium, sensorimotor peripheral axonal neuropathy, sensory changes, shock, Signs and Symptoms of Arsenic Poisoning, singing, skin bronzed, skin cancer, skin lesions and rashes including vesiculation, skin pallor, sleep, sore throat, spasms, splenomegaly, squamous cell carcinoma, ST changes, stomach pain, stomatitis, stroke, stupor, suicidal ideation, swallowing difficulty, sweating, sweating – excessive, sweet metallic taste, tachycardia, tea, throat constriction, thirst, thrombocytopenia, tingling, torsades de pointes, tracheobronchitis, tremor, tubular necrosis – acute, T wave inversion, unsteady gait, uremia, vasodilation, vasospasm, vegetables, vertigo, visual hallucinations, vitamin A deficiency, vitamin B12, vitamin C, vitiligo, vomiting, vomiting blood, weakness of distal muscles – hands and feet, weight loss, well, wobbliness, zinc

Most arsenic poisoning is chronic: Through global trade, we are ingesting more and more arsenic-contaminated products – mainly rice, tea, medicinal herbs. Acute arsenic poisoning usually is accidental or occupational (mainly workers in pest control, electronics manufacturing industry and pressure-treated carpentry). Few are homi- or suicidal. Earlier this year I have been diagnosed with arsenic-induced ataxia. Ataxia means imbalance, wobbliness.

For me, I am glad that I have “just” ataxia, and not more. The list below contains Latin as well a common names to make it easier to find things.

Here is the short of what I have been doing to reduce my arsenic levels:
1. Stop using tainted products; look for safer sources.
2. Sauna as often as possible to sweat out heavy metals. Sweating through exercise and summer heat also helps.
3. Eating fresh garlic and cilantro bind and expel heavy metals
4. Vitamin C, selenium, vitamin B12, zinc, folate and methionine add to the elimination of arsenic.
5. And, of course, all the other lifestyle goodies: A healthy diet heavy on vegetables. Movement. Enough sleep. Plenty of water (some areas of the US have arsenic-contaminated drinking water from wells – careful!).


Signs and Symptoms

The myriad manifestations of arsenic intoxication do a roller coaster through all medical specialties, it seems. Since there are so many overlapping features with many diseases, it will take an open mind and special alertness to make a diagnosis. Just to show the enormous scope of signs and symptoms, I have thrown together acute and chronic arsenic intoxication. The list is not thought for diagnosing yourself - consult your physician. Here is the list:

Abdominal discomfort
Abdominal pain
aches and pains
Acrocyanosis
Acute respiratory failure
Acute tubular necrosis
Adult respiratory distress syndrome
Agitation
Alopecia
Altered mental status
Anemia
Anemia, aplastic
Anhidrosis
Anorexia
Anxiety
Aplastic anemia
Arrhythmias
Ascites
Ataxia
Atherosclerotic disease
Autonomic neuropathy: unstable blood pressure, anhidrosis, sweating, flushing
Basal cell carcinomas
Basophilic stippling
Birth defects,
Blackfoot disease – black, mummified dry gangrene
Bladder cancer
Blood in the urine
Bone marrow suppression
Bowen disease
Brittle Nails
Bronchitis
Bronchospams (inhaled arsenic)
Burning in mouth/esophagus/stomach/bowel
Cancer – lung, liver, kidney, bladder, skin, colon, larynx, lymphoid system
Capillary dilation with fluid leakage and third spacing
Cardiac arrhythmias
Cardiac arrest
Cardiomyopathy
Carotid atherosclerosis
Cerebral infarction
Cerebrovascular diseases
Chills
Cholangitis
Cholecystitis
Chronic lower respiratory diseases
Cirrhosis
Clear skin lesions such as acne
CNS depression
Colitis
Colon cancer
Coma
Concentration - poor
Confabulation
Confusion
Congestive heart failure
Conjunctivitis
Convulsions
Coordination difficulties
Corneal necrosis
Corneal ulcerations
Cough with/without expectoration
Cramps, cramping muscles
Cyanosis of the fingers
Death
Dehydration
Delirium
Depression
Dermatitis
Dermatitis allergic-type
Dermatitis, exfoliative
Desquamation of skin
Diabetes
Diarrhea, often severe and/or bloody
Disordered thinking
Disorientation
Disseminated intravascular coagulation
Drowsiness
Dyspnea (when inhaled)
Dysphagia
Eczema
Edema – non-pitting of hand and feet
EKG changes: ST changes, QT prolonged, Torsades de pointes, T wave inversion
Encephalopathy, acute
Enzyme inhibition
Esophagitis
Eyes blood-shot
Eyes burning
Facial edema
Fatigue
Fatty liver
Fever - lowgrade
Fibrillation, ventricular
Fingernail pigmentation
Fingernails with white marks
Fluid loss
Flushing
Folic acid deficiency
Gallbladder inflammation
Gangrene of limbs
Garlic-smelling breath or body fluids
Gastritis
Gastro-intestinal bleeding
Generalized muscle aches and body pains
Gingivitis
Goiter
Guillain-Barre syndrome - resembling
Hair loss
Hallucinations
Headaches
Hearing loss
Heart disease
Hematuria
Hemoglobinuria
Hemolysis
Hepatomegaly
Herpes
Hormone imbalance
Hyperesthesia
Hyperpigmentation of the nails and skin
Hyperpyrexia
Hyperkeratosis thickening of the skin of the palms and soles
Hypersalivation
Hypertension
Hypertension-related cardiovascular disease
Hypopigmentation – “raindrop” areas of lost skin color
Hypotension
Hypovolemia
Immune functioning impaired
Immune suppression
Impaired healing
Inhibition of sulfhydryl enzymes – garlicky odor to breath/stool
Insomnia
Irritability
Ischemic heart disease
Jaundice
Karyorrhexis
Keratosis
Kidney cancer
Kidney damage
Kidney failure
Korsakoff’s psychosis
Lack of appetite
Landry-Guillain-Barré syndrome - resembling
Larynx cancer
Laryngitis
Leg cramps
Lens opacity
Lethargy
Leukemia???
Leukocyturia
Leukonychia striata
Leukopenia
Lightheadedness
Listlessness
Liver cancer
Liver: central necrosis
Liver congestion
Liver dysfunction and elevated liver enzymes
Liver: fatty degeneration
Low grade fever
Lung cancer
Lung: Chronic restrictive/obstructive diseases
Lungs: Inflammation of respiratory mucosa
Lung irritation
Lymphoma???
Major depression – mimicking
Malabsorption
Malaise
Mees's lines, or Aldrich-Mees's
Melanosis of the eyelids, areolae of nipples, and neck
Memory loss
Memory – poor
Mental retardation
Mental status altered
Metallic taste in mouth
Microcirculation abnormalities
Mitochondrial dysfunction
Movement disturbances
Muscle aches, spasms, weakness
Muscle fasciculations
Muscle tenderness
Muscle twitching
Muscle wasting
Muttering
Myocardial depression
Myocarditis
Nasal mucosa irritation (when inhaled)
Nasal septum perforation
Nausea
Neuralgia
Neuritis
Night blindness
Nightmares
Numbness
Oliguria
Oral burns (acute, when taken by mouth)
Pancreatitis
Paralysis
Paranoia
Paresthesia – symmetrical, stocking-glove
Pedal edema
Pericarditis
Peripheral neuritis
Peripheral neuropathy
Peripheral vascular insufficiency
Personality change
Pigmentation changes – hypo and hyper
Pins and needles in hands and feet
Pneumonia, bronchial
Polyneuritis
Portal fibrosis
Proteinuria
Psychosis
Pulmonary edema
Pulmonary insufficiency (emphysematous lesions)
Pulse – irregular
Quadriplegia
Raynaud’s Syndrome
Renal cortical necrosis
Respiratory failure, acute
Respiratory muscle insufficiency
Respiratory tract infection
Rhabdomyolysis
Rhino-pharyngo-laryngitis
Rouleaux formation of red blood cells
Salivation excessive
Seizures
Sensorimotor peripheral axonal neuropathy
Sensory changes
Shock
Singing
Skin bronzed
Skin cancer
Skin lesions and rashes, including vesiculation
Skin pallor
Sore throat
Splenomegaly
Squamous cell carcinoma
Stomach pain
Stomatitis
Stroke
Stupor
Suicidal
Swallowing difficulty
Sweating, excessive
Sweet metallic taste
Tachycardia
Throat constriction
Thirst
Thrombocytopenia
Tingling
Tracheobronchitis
Tremor
Tubular necrosis, acute
Unsteady gait
Uremia
Vasodilation
Vasospasm
Vertigo
Visual hallucinations
Vitamin A deficiency
Vitiligo
Vomiting
Vomiting blood
Weakness of distal muscles – hands and feet
Weight loss

Weighing In

June 21, 2010

Tags: order, anorexia, bulemia, cancer, common sense, cravings, faintness, French Paradox, heart attack, lobster, medical school, morning sickness, overweight, nerds, pregnancy, scale, stuffiness, Weighing in, weight

How often should you jump on the scale?

For many years, I never recommended to patients to weigh themselves daily (first thing in the morning). The prevailing medical opinion was that weighing oneself triggered anxieties that might end in eating disorders like anorexia and bulimia.

Contrary to what I said to my patients, however, I have weighed myself my whole life (nearly) every morning – and have kept the same weight since age twelve. Except for pregnancies, gaining twenty pounds with my daughter, forty with my son. The difference? In both cases, relentless morning sickness. With my daughter, eating or even thinking of food made me throw up; with my son, eating calmed the sickness. During pregnancy, I did not care what I weighed and how I looked; all I cared was the baby I was expecting. So I followed my body’s whims and cravings. Including the incredible craving for a lobster at a very inconvenient time…

My body feels well only within a very tight margin: Two pounds less, and faintness grips me. Two pounds more, and stuffiness prevents me bending forward.

My personal weight story made me absolutely unacceptable for several overweight patients who stated that I had never been in their shoes and could therefore not advise them. I respect that view. But it would also mean that one can’t be a good doctor for a cancer patient if one didn’t have experience with the dreaded disease. Or could couldn’t treat a heart attack because … you are getting the idea. (On the other hand, the notion that better doctors come from personal experience with serious illness, is worth spinning out. The A+ nerds who populate our medical schools – half of them should be replaced with compassionate, common-sensical young men and women).

A study showed that people who weigh themselves more often also lost more weight. That takes this discussion beyond my personal story – and here it becomes interesting.

French women supposedly don't gain weight as they age. Which means if the scale tells them they have gained a pound or two, they take action. And responsibility. That might be part of the French Paradox - that the French live longer but eat more fat. Might be they eat fat - and then put in a salad day.

A scale is a reality check. If you want to avoid looking the facts in the face – your decision. I like to confront bad situations – weight gain, disease, divorce, death (why do nearly all adverse events start with a "d"?). That led me one time to lie down in a casket and pull the lid shut, just to see how it was. It was surprisingly peaceful. What I found out in the coffin: It was nothing to fear.
Aspen eyes, by Peggy Peters

Iguazu Falls, by Xin Liu

Alexa Fleckenstein M.D. 2012, by Lolita Parker jr.

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