Can metallic silver cause argyria? [References appear in the bibliography below.]
©Rosemary Jacobs 1999
I believe the evidence indicates that it can. Look and decide for yourself.
There are two kinds of argyria. The first kind is the generalized kind that I have in which the entire body or a large portion of it are discolored. The discoloration almost always includes the face and other areas exposed to the sun. The second kind of argyria is the localized type in which just a small area of the body is slate-gray.
Harker and Hunter found silvesmiths with many areas of localized arygria which they described as circular or elliptical spots resembling tattoo marks that they believed resulted from silver particles entering skin puctured by the sharp pointed tools the craftsmen worked with. [p 446.]
If you go to MEDLINE and do a search using the term argyria, you will find many reported cases of localized argyria caused by imbedded pieces of silver such as the posts of earrings, acupuncture needles and appliances used in dentistry. A letter in THE LANCET by Legat reports on a case from Austria in which the acupuncture needles were not in the skin for any longer than three hours. Yet ten years later localized argyria manefested itself at the site. The authors theorized that while the needles themselves had been removed a particle of silver had probably broken off and eventually spread into the surrounding tissue.
On p. 445 Harker & Hunter cited a case of generalized argyria in a silver worker reported in the literature in 1872. On p. 446 they cited two cases mentioned by Koelsch in 1912 in which two patients who cut and hammered silver sheets had generalized argyria. After checking to make sure that they had not taken silver medicinally, Koelsch analyzed dust samples in the workshop and calculated that in one such sample one gram of dust contained 0.0003 gm. of silver and concluded that the skin discoloration was due to swallowing silver dust in the air or from the hands.
Gaul and Staud reported that the deep discoloration on the forehead of a 49 year old patient was caused by a silver filling stating that, "The origin of silver was traced to the electrolytic action between a gold and a silver filling in contact in the mouth. Electrical measurements in additional patients and a subsequent biospectrometric analysis proved that the gold and silver fillings in a medium of saliva form a galvanic cell the action of which causes the silver to go into solution. The rate of solution is determined by such factors as the pH value of the saliva, the surface area of the fillings and electrode potentials." [p. 1389]
Gettler reported the case of the the "blue man", a curiosity at the Barnum and Bailey circus, who was very sick and in his late sixties on August 13, 1923 when he was admitted to Bellevue Hospital in New York City. He subsequenly died there and his body was autopsied. His was one of the worst cases of argyria ever reported in the medical literature. Gettler stated that, "The color of the skin was of an unusually deep blue and from a distance appeared almost black. This deep color was almost uniform throughout the entire body, although it was more intense over the exposed skin areas." The patient refused to answer questions. The story he told at the cirus was that he had been suffering from congenital heart disease which became worse when he fell from a horse while he was an officer in the British army fighting in India. A friend who had known him for thirty years said that he had been discolored for all that time adding that he had seen a photo of him taken about thirty-five years before his hospital admission. In it his skin appeared to be a normal white color. He said that the blue man had worked in silver mines. There are several reports in the medical literature stating that silver miners developed argyria. As far as I can tell, those reports are all based on this one unreliable report. [p.636]
I have wondered whether or not there were any, or many, cases of argyria in silver miners. If I ever get the chance, I will contact historical societies in old silver towns to see. However, it is quite possible that, if there were cases, they were never reported. Then again I have no idea what the exposure level would be for the average miner. I seem to remember reading something about the huge ratio of ore that must be mined to retrieve a small amount of silver. If I remember correctly, it was tonnes to ounces. If any of you know, please tell me.
Jintan Silver Pills®
Shimamoto reported on a case in which a woman developed argyria by taking an excessive amount of the popular Japanese breath freshener, Jintan Silver Pills®. He noted that while they are widely used in Japan, there have only been ten reported cases of argyria from their use between 1973 and the time that he wrote his article in 1987. He said that, "Their major components are natual extracts, such as licorice, gambir, sweet hydrangea and more than 10 other kinds of raw materials, and they are coated with silver. Silver is employed to keep the coating thinner. The mean silver content of its coating is 0.1 mg per pill." I assume that silver means metallic silver, but I do not know for sure. I will investigate. If anyone reading this has further information, please let me know. The author also said that one Japanese writer had previously calculated that the minimal oral dose of silver that will cause argyria at 90 grams. The patient in this report was estimated to have ingested 350 grams. [p. 246]
In March 1998 Hanada wrote a letter to THE LANCET telling about a man who had taken "sugar particles coated with silver (Arazan)" which are used in homemade cakes in Japan. He too developed argyria. The doctors calculated that the dose that turned him gray was 55 grams. This is one of the reasons why I refuse to estimate the minimal dose of silver that will produce argyria. Others who have tried have been so very wrong. My refusal to do this has made several people very angry, but I just don't feel that there is anyway to accurately estimate that dose. I do believe that with the evidence available one can get a good idea of the amount of silver that can be safely ingested by most people. However, since there are no known benefits for ingesting silver, I don't think it is worth taking the risk. You may be one of those who is highly susceptible to silver toxicity. If you want to take the risk even though there are no known benefits, you are free to do so. It is your face and you are the one who will have to live with it for the rest of your life if you loose the gamble.
I have been told that Indians eat very expensive candies coated with a very thin layer of silver foil. They are purportedly often served at rich people's wedding celebrations. I don't know if this information is accurate. I do know that I have never come across a report of argyria in India or in a person identified as an Indian. That could be because very few people eat enough of the candy to ingest a sufficient amount of silver to turn gray or it could be that given the wide range of skin tones that Indians have the discoloration is not apparent. I have never found reports in the medical literature of black people developing abnormal skin shades as the result of ingesting silver and suspect that is because the gray is masked by their natural skin color.
I believe that the evidence that localized argyria has been caused by metallic silver is conclusive. I think the evidence that generalized argyria has been caused by metallic silver is strong, especially since we know from the localized cases that metallic silver imbedded in the body goes into solution and forms strong, unbreakable chemical bonds with tissue surrounding the sweat glands. Generalized argyria is caused by the same bonds in the same locations. If it can be confirmed that the Japanese products which have caused generalized argyria are in fact coated with metallic silver - such as foil or particles that stick to the sugar in the pills that they coat - that will show conclusively that metallic silver does cause generalized argyria. I have no idea how orally ingested metallic silver would pass out of the gut.
In my opinion the evidence appears to indicate that some individuals are far more susceptible to silver poisoning than others and that if in fact metallic silver ingested orally can cause generalized argyria that the amount of silver required to produce it in most people is probably very large. What do you think?
Since there are no known benefits that result from ingesting silver in any form, the only reason to wonder whether or not the metallic kind can cause generalized argyria or not is because many promoters claim that they are selling tiny bits of "pure" silver suspended in water. Scientists who have studied their products disagree. (Link to be posted.) So do the doctors at FDA who state that, "CSP are prepared by mixing silver nitrate, sodium hydroxide, and gelatin and diluting this mixture with water to the desired concentration." CSP refers to colloidal silver protiens. The doctors note that historically there have been many colloidal silver suspensions. Two of the common ones were Mild Silver Protein and Strong Silver Protein. The doctors conclude that, "The currently promoted health food store products appear to be further dilutions of these two forms of CSP." Since the agency has analyzed some of these products, I assume, but am not certain, that their statements are based on the results of their analyses. [p. 120]
Some manufacturers of products now marketed with the "colloidal silver" labels on them state that excessive use can cause argyria. Many others insist that their products are completely nontoxic, incapable of turning anyone's skin gray. If that is true, I don't think that it is because of the type of silver used or the way in which it is manufactured. If it is true, I think it is so because the product has been either produced in such a way or diluted to such a degree that it either doesn't contain any silver at all or else it only contains a trace - just like some tap water. If you put 10 ppm (parts per million) of alcohol in grape juice and call it wine, people drinking it wouldn't get drunk, but, of course, you won't be able to call it wine either because wine and most every other commercial product is regulated. Silver, on the other hand, is sold as a "dietary supplement". Dietary supplements are not regulated in the US. Over the border in Canada colloidal silver is illegal. Of course, I suspect that if someone presented evidence to Health Canada demonstrating that it offered health benefits and that the benefits outweighed the risks, they would approve it for sale.
Fung, MC, Bowen, DL "Silver Products for Medical Indications: Risk-Benefit Assessment CLINICAL TOXICOLOGY, 34(1), 119-126 (1996).
Gaul, LE, Staud, AH "Clinical Spectroscopy Seventy Cases of Generalized Argyrosis Following Organic and Colloidal Silver Medication, Including a Biospectrometric Analysis of Ten Cases" JAMA Vol. 104 #16 Ap. 1935 p1387-1390.
Gettler, AO, et. al. "A contribution to the pathology of generalized argyria with a discussion of the fate of silver in the human body" AM J PATH 1927, 3, 631-52.
Hanada, K, et al "Silver in sugar particles and systemic argyria" THE LANCET Vol 351 March 28, 1998 p. 960
Harker, JM, Hunter, D: "Occupational Argyria" THE BRITISH JOURNAL OF DERMATOLOGY AND SYPHILIS Vol. XLVII #11; Nov. 1935 p. 441-55.
Legat, FJ, et. al. "Argyria after short-contact acupuncture: THE LANCET Vol 352 July 4, 1998 p.241.
Shimamoto, Y "Systemic Argyria Secondary to Breath Freshener "Jintan
Silver Pills" HIROSHIMA J. OF MED. SCIENCES Vol 36, #2, 245-7, June
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