Context decides everything. For confirmed metal poisoning, binding drugs are well proven and can be life-saving. For healthy adults carrying everyday metal levels, proof of benefit is thin. Detox reliably lowers metal levels but carries real risks — stripped minerals, kidney strain, rare deaths — and untested, sometimes contaminated supplement cleanses temper enthusiasm. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Blood lead | < 2 µg/dL (ideally < 1) | Primary marker of recent and circulating lead burden |
| Whole-blood mercury | < 5 µg/L | Tracks recent mercury, often from fish |
| Speciated urine arsenic | Inorganic + methylated < 10 µg/L | Distinguishes toxic inorganic arsenic from harmless seafood arsenic |
| Blood or urine cadmium | Blood < 0.5 µg/L; urine < 0.5 µg/g creatinine | Marker of cumulative cadmium from smoking and diet |
| Serum zinc | 90–120 µg/dL | Detects depletion caused by chelation |
| Serum copper / ceruloplasmin | Copper 90–120 µg/dL | Chelation depletes copper; deficiency impairs connective tissue and immunity |
| Magnesium (RBC) | 5.0–6.5 mg/dL | Guards against arrhythmia and poor sleep during chelation |
| eGFR / serum creatinine | eGFR > 90 mL/min/1.73 m² | Confirms kidneys can safely clear chelated metals |
| Serum ferritin / iron studies | Ferritin 40–100 ng/mL | Low iron increases lead and cadmium absorption; high iron redirects strategy |
| Complete blood count | Within lab reference range | Screens for lead-related anemia and marrow effects |
Cadence: Baseline; every 1–2 weeks during active oral chelation; every 3–6 months during maintenance; every 6–12 months once levels normalize