Book Review: Diagnosis: Mercury Money, Politics & Poison by Jane M. Hightower

Review by Janet Raloff

This is a fish tale, of sorts. It starts when the author, a San Francisco internist, encounters a surprising number of educated professionals with perplexing, nonspecific symptoms: chronic intermittent upset stomachs, headaches, hypertension, fatigue, trouble concentrating and even hair loss.


Hightower eventually traces the symptoms to diets rich in big fish such as tuna and swordfish, the types that accumulate high concentrations of methylmercury. Her cure: Forgo eating fish for up to a year.

In a 2003 paper in Environmental Health Perspectives, Hightower first outlined her data from her case reports, as well as her frustration at failing to get regulators and policy makers to accept that current fish advisories may not be keeping people safe.
Now Hightower takes readers along on her eight-year journey of discovery. She describes mercury’s extensive use through human history, even as an antiseptic and for other medicinal purposes.

Explains Hightower: “What began as an investigation to help me diagnose mercury-related symptoms in my patients grew into another diagnosis — that of a broken, misused, and abused regulatory system.” She charges that the Food and Drug Administration’s permissible limit on mercury in fish “is not adequate and not enforced, and it was derived using data that was flawed as well as misrepresented.”

Mercury poisonings can be prevented, this physician ultimately contends, and her book suggests both lifestyle and policy changes to help people safely coexist with this near-ubiquitous toxic constituent of the human environment.

Island Press, 2009, 307 p., $24.95.