As reported by the Stamford Advocate, January 3, 2009.

High Mercury Levels Tied to Sushi

By Christina Hennessy

It is not often an actor's diet stirs up the kind of controversy that Jeremy Piven's has.

But his often twice-daily intake of sushi has been cited as one of the likely factors that contributed to the high levels of mercury found in his system - nearly six times the tolerable amount - prompting the symptoms, among them extreme fatigue, that led the 43-year-old to bow out of the Broadway revival of David Mamet's "Speed-the-Plow," according to his physician, Dr. Carlon Colker.

Colker, who is on the staff at Greenwich Hospital and chief executive officer and medical director of Peak Wellness in Greenwich, says he also is looking into Piven's use of Chinese herbs.

The internist says the good that has come out of his patient's case is the renewed attention to the potential dangers of eating fish with high mercury levels. A high mercury toxicity in the body can result in extreme fatigue, muscle weakness, memory loss and organ damage, among other health issues. In unborn babies and young children, it can cause impaired neurological development and damage the central nervous system.

"I don't want to scare people," Colker says. "But you do have to be careful."

But at least one group questions the diagnosis and thinks the story will scare people needlessly.

The story will "whip up another round of public fear," says David Martosko, the Washington, D.C.-based Center for Consumer Freedom's director of research. "The health benefit you get from eating fish blows the hypothetical risks out of the water."

Most advisories issued by federal, state and local agencies recognize the benefits of eating fish, particularly for omega-3 fatty acids, which have been found to have numerous health benefits. But certain species can have high levels of methylmercury, as well as polychlorinated biphenyls, or PCBs, which can pose a health risk, particularly among high-risk groups, including women who are or could become pregnant, women who are nursing and young children.

So just how concerned should people be about the fish they eat?

Some choices are better than others, says Brian Toal, an epidemiologist with Connecticut's Department of Public Health.

"Fish is good for you," he says. However, he adds most of the cases of elevated mercury levels that are reported to the state office are typically caused by fish consumption rather than occupational hazards.

"This is a problem, but it can easily be avoided," he says, adding it is a matter of following the advisories. "You can eat a lot of fish very safely."

The most recent consumer advisory, released in 2004 by the Environmental Protection Agency and Food and Drug Administration, is primarily aimed at those in the high-risk groups. It is advised that members of that group eat up to 12 ounces - about two meals a week - of seafood low in mercury. However, certain species are to be avoided, including shark, swordfish, king mackerel and tilefish. In Connecticut, striped bass is added to that list.

Recently, the Washington Post reported that the Federal Drug Administration may recommend adjustments to its advisory, urging those in the high-risk groups to eat more than 12 ounces of fish a week. But until then, the current advisory is what the state and area health agencies provide to consumers.

Toal says the advisories can be found on the department's Web site, and posted in supermarkets throughout the state. The department also recently added a warning for avid sushi eaters, encouraging them to eat a variety of fish and limit their consumption of tuna sushi, with its higher levels of mercury than some of the other types of sushi, to once a week.

There are different kinds of mercury poisoning, according to Dr. Charles McKay, associate medical director of the Connecticut Poison Control Center at the University of Connecticut Health Center in Farmington. The mercury contained in fish is methylmercury, also labeled organic, which is formed when mercury mixes with bacteria in the water. Most fish contain amounts of methylmercury, but the larger and older fish at the top of the food chain tend to have more.

People also can be exposed to elemental mercury and inorganic mercury while working with chemicals and other substances, he says.

Treatment for those with high levels of methylmercury in their system can range from removing the cause of the elevated levels and allowing the body to naturally flush out the mercury or using chelating agents, such as the drug penacillamine, which binds to the mercury and carries it out of the body, depending on the severity of the toxicity.

The latest flap over Piven's case has not caused an increase in calls to the local health departments, officials say.

Tom Closter, director of environmental services for the Norwalk Health Department, oversees the inspection and permitting of more than 500 food establishments in the city. During the 10 years he has headed that department, out of a total of 28 years with the department, he says he has not received any complaints about the level of mercury in fish.

However, he encouraged those who are concerned about mercury levels to refer to the state advisories and guidelines.

The Piven story seemingly hasn't spurred an increase in questions to the Stamford Health Department, according to Anne Fountain, the emergency response coordinator.

Though, from time to time, the agency fields some questions.

Fountain says advisories and state guides on fish consumption can be accessed via the city's Web site, www.ci.stamford.ct.us.