Aluminum is the third most abundant mineral in the earth’s crust. It is present in most animal and plant tissues and almost all natural water sources. Aluminum is a very reactive trivalent cation, which means it binds with other elements easily. In nature, the mineral is almost always combined with other elements such as oxygen, silicon, and fluorine. Aluminum poisoning or aluminum toxicity occurs when excessive levels build up in the body.
Exposure to Aluminum
Exposure to aluminum is nearly unavoidable. The mineral is present in tap water because many water purification facilities use aluminum sulfate. Suspended particles of dust in the air contain aluminum. The levels of airborne aluminum vary depending on weather conditions, location and urban or industrial activity. Most people inhale very little aluminum but small amounts have been found in lung tissue and nearby lymph nodes.
Orally Ingested Sources
Manufacturers process flour, baking powder, and food coloring agents with aluminum. Table salt almost always contains aluminum as an anti-caking agent. Adults generally consume between seven and nine milligrams of aluminum per day. Other sources include cans, food containers, and cooking utensils made with aluminum. Some medications and certain antacids contain up to 600 milligrams of aluminum per dose. We can absorb the mineral through our skin from antiperspirants, but most medical experts consider this form of exposure negligible.
Anyone can develop aluminum toxicity when too much aluminum builds up in their bodies, but people with impaired kidney function, especially those on hemodialysis, are at greater risk. Those living or working near locations where aluminum is mined or processed are also more susceptible. Other risk factors include dusty environments, working or living near hazardous waste disposal sites, receiving long-term IV nutrition, and eating or drinking food and beverages containing excessive amounts of aluminum.
Initial symptoms of aluminum toxicity include confusion, seizures, speech problems, and muscle weakness. Emotional instability, mood swings, insomnia, and anxiety are common. Anemia occurs due to damaged red blood cells and poor iron absorption. Impaired kidney and liver function, ulcers, heartburn, rapid heart rate, and excessive sweating can also develop. In some cases, children experience learning difficulties.
The effects of aluminum toxicity on the nervous system lead to poorly executed voluntary actions involving fine motor skills and increased occurrence of involuntary movements. Excessive levels of aluminum interfere with absorption of calcium, phosphorus, and fluoride. This leads to weak and painful bones prone to breaking and tooth decay. Too much aluminum can may slow growth in children.
Aluminum and Renal Failure
The body needs very little aluminum, so the body removes most of it through excretion. People in later stages of kidney failure or those on hemodialysis have extremely high levels of aluminum, built up over time. Dialysis is not as efficient as functioning kidneys, and essential medications for people using dialysis contain relatively large amounts of aluminum, which can cause two conditions. Dialysis encephalopathy results in dementia and osteomalacia refers to an abnormal increase of bone content.
Toxicity in Premature Infants
Premature babies in neonatal intensive care units often require intravenous fluids and total parenteral nutrition or TPN for weeks or months, depending on overall health. This means they are hydrated and receive nutrition through IV infusions. Researchers have studied high levels of aluminum in premature infants because toxicity is a known risk of TPN. Acute kidney failure is also associated with TPN. Research on a possible link between aluminum toxicity and long-term damage to the nervous system and renal system is ongoing.
Aluminum levels in the brain and lungs increase with age, while levels in other tissues appear not to follow any age-related pattern. The mineral may interfere with neurotransmitters, especially dopamine and norepinephrine. Aluminum toxicity related to Parkinson’s disease is of interest because individuals with this condition frequently have elevated levels of aluminum in their brain tissue. Medical professionals also find elevated aluminum accumulation in individuals with dementia. However, it is important to note that there are no official recommendations or no conclusive evidence to support a cause and effect relationship between these conditions and aluminum content, though research is ongoing.
Doctors diagnose aluminum toxicity through physical examination, medical history, and assessment of symptoms. Diagnostic tests include stool and urine analysis. Tests of hair, blood serum, sweat, and an oily substance produced by glands, sebum, can also indicate aluminum levels. If those relatively non-invasive invasive tests show significant levels of aluminum, the doctor may perform a bone biopsy. Elevated aluminum levels in bone marrow confirm a diagnosis of toxicity.
Treatment for Aluminum Toxicity
Medications can help remove aluminum from the body through a process called chelation. Chelating agents were developed and first used to treat iron and other heavy metal toxicity but can now remove excess lead, mercury, copper, iron, arsenic, aluminum, and calcium from the body. The treatment is controversial; while medical practitioners use a variety of chelating agents, some lack the support of peer-reviewed research. The chelation process must be strictly monitored because it can have severe side effects or cause deficiencies in important minerals.