Gold (Au) is a heavy metal with no known biological role in the body. Blood gold testing is used to monitor therapeutic gold levels in people taking gold-based medications for inflammatory conditions, and to assess for gold toxicity in those with significant occupational or medical exposure.
Gold compounds, particularly injectable sodium aurothiomalate and oral auranofin, were historically used as disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis. While largely superseded by modern biologic therapies, some patients remain on gold therapy. At therapeutic doses, gold can cause side effects including skin rashes, kidney damage (proteinuria), and rarely blood disorders, making monitoring important.
FAQs
Is gold still used to treat rheumatoid arthritis?
Gold compounds were widely used as DMARDs before the development of methotrexate, leflunomide, and biologic therapies. They are now rarely prescribed as first-line treatment, but some patients who responded well to gold and are stable may remain on it. Monitoring requirements make gold therapy more complex to manage than newer DMARDs.
What are the side effects of gold therapy?
The most important side effects are nephrotoxicity (presenting as proteinuria and potentially nephrotic syndrome), thrombocytopenia (low platelets causing bleeding risk), and dermatitis. Less common effects include stomatitis and pulmonary reactions. Regular urine and blood count monitoring is essential during treatment.
Can dental gold cause health problems?
Dental gold alloys very rarely cause significant systemic gold elevation. In a small number of patients, gold dental work can cause contact sensitivity reactions. If you suspect a reaction to dental materials, an allergy specialist review is appropriate.
Why is gold measured in the blood rather than urine?
Blood gold reflects circulating therapeutic gold levels more accurately for monitoring purposes. Urine gold also accumulates and 24-hour urine gold is sometimes measured. Both tests provide complementary information about gold body burden and excretion.
