My FM doc wants me to do a Doctor's Data provoked heavy metal test, so I'm reviving this thread with some questions and concerns that I did not see covered:
1. I'm concerned that test results could be misleading. How accurate and meaningful is provoked testing? Has anyone complemented the provoked test with other tests, such as using a separate kit to test unprovoked urine or doing a hair mineral analysis? Basically, I'm trying to figure out the best evidence-based approach to testing heavy metals and trusting the results, and this seems to be highly controversial, and the more I read, the more confused I get?
Here's a Quackwatch article that addresses some potential problems with heavy metal testing:
https://www.quackwatch.com/01QuackeryRelatedTopics/Tests/urine_toxic.htmlThis is what Chris Kresser has to say (
https://chriskresser.com/heavy-metals-and-behavioral-disorders-in-children/"Heavy metal testing is a controversial topic because each of the currently available methods of testing—hair, urine, and blood—has some drawbacks.
Hair testing. Hair testing has become a popular method for assessing heavy metal status. However, using hair testing alone, we cannot know for certain whether a high level of a metal in the hair reflects a significant body burden of that metal or indicates that the patient is efficiently eliminating the metal through the hair and thus has a low level of it in the body.
Urine testing. Urine heavy metal provocation tests, which use a chelating agent such as DMSA to provoke a release of heavy metals into the circulation, present problems similar to those with hair testing; it is possible that a metal may be high in the urine because the body is efficient at excreting it, or it may reflect a high body burden of the metal. Another problem is that reference ranges for provoked urine results have not been developed or validated.
Blood testing. Blood testing is problematic for assessing heavy metal status because heavy metals typically circulate in the blood for only a short time before becoming sequestered in tissues.
While each of these testing methods is faulty when used alone, combining a couple of techniques may be a more accurate way to assess heavy metal toxicity. For example, you could do a provoked and an unprovoked urine test, or a hair test and a provoked urine test. Combining two tests may paint a more accurate picture of the body’s total heavy metal burden."2. I'm fearful of the prep! What is involved in the prep? My doctor mentioned that the chelation agent used for the test might make me feel sick. Did anyone experience this? Will anything about the test tax an already-confused immune system?
3. First morning pH? My doctor mentioned that my first morning urine pH should be above 6.4. I've been testing this, and no matter what I do, it's always below 6. Is this really necessary? Any suggestions?
Any thoughts are appreciated.

And yes, I will be asking my doctor some of these questions too.