Jeremy Piven's Fishy Excuse

When the Entourage star walked away from a starring role on Broadway because he’d been eating too much sushi, something didn’t smell right. But it turns out mercury poisoning is real—at least in L.A.

Kevork Djansezian / Getty Images

When, in late December, actor Jeremy Piven exited his Broadway role in David Mamet’s Speed the Plow citing ill health caused by a “very high level of mercury,” more than a few eyebrows were raised. Piven’s mercury poisoning, which his doctor claimed was caused by the actor’s voracious tuna-sushi and Chinese-herb habits, seemed to many like the sort of made-up diagnosis frequently offered by a malingering celebrity, a bizarre 21st century gloss on “exhaustion.” (A line of argument Piven had apparently tried first by claiming Epstein-Barr virus.)

“My understanding is that he is leaving show business to pursue a career as a thermometer,” David Mamet remarked sharply to Variety. On Sunday night, suspicions about Piven’s unusual diagnosis were again aroused, as, less than a month after his Broadway departure, he was well enough to walk the red carpet at the Golden Globe Awards. “You know what else makes people sleep all day? Snorting a lot of cocaine and then staying up all night sending booty-call text messages to bevies of models,” blog Gawker snarked, in response to an interview Piven gave, in which he outlined the contours of his fatigue.

Unless he had swallowed a thermometer, say, or consumed a massive hunk of ultra-toxic fish, Piven’s mercury overload would have been chronic rather than acute—built up over years of dining at Nobu.

Yet for those who have made even a cursory journey through the world of alternative medicine, heavy metal poisoning, or, as some doctors call it, “toxic metal overload,” is familiar. On both coasts, but particularly, it seems, in Los Angeles, there exists a handful of high-end doctors practicing “complementary medicine”—an amalgamation of Eastern alternative and conventional Western approaches—that view mercury as one of several toxic metals (lead, cadmium, and arsenic also receive some blame), that can give rise to myriad health problems ranging from fatigue to suppressed immunity to cognitive difficulties (the colloquially termed “brain fog”).

These are the kind of non-specific symptoms that don’t necessarily indicate a diagnosable disease but that can seriously compromise quality of life; they are the symptoms people turn to alternative medicine to solve. Many such doctors also believe that mercury plays a contributing role in chronic disease, perhaps because it ignites inflammation in the body. As a result, most test for mercury, usually with a urine test, as a matter of course. (Blood tests only measure recent mercury exposure.)

While the accuracy of various forms of testing is debated, and the role mercury may or may not play in disease remains inconclusive, it has long been known that too much mercury in the body can create physical disturbances. Mercury was for centuries employed as a treatment for syphilis, though doctors often advised that its administration be stopped if excessive salivation or tenderness of the gums, two of the many symptoms of toxicity, were observed. In the nineteenth century, mercurous nitrate was used to soften fur during the hat-making process; the term “mad as a hatter” was coined to describe the severe neurological symptoms many milliners experienced.

And indeed, Piven is not the first public person to suffer from mercury poisoning. A 2001 study published in Perspectives in Biology and Medicine noted that the “little blue pills” Lincoln took for depression contained the metal and were likely the source of his insomnia, tremors, and angry outbursts. (He is said to have quit taking them shortly after his inauguration in 1861 because they made him “cross.” Good thing, with the Civil War yet to come.) And in 1693, Sir Isaac Newton experienced a nervous breakdown of sorts, during which he struggled with insomnia and poor digestion, and wrote intemperate letters to friends; he is thought to have developed mercury poisoning from handling metals—it is said he tasted them—during his alchemical work.

Even the rather non-alternative Environmental Protection Agency lists the symptoms of mercury toxicity on its website, noting that physical effects vary with the source of the mercury. Elemental mercury, or “liquid mercury”—found, perhaps most notably, in thermometers, dental amalgam fillings, and fluorescent lights—can disrupt the central nervous system, causing tremors and slowed motor function. Methylmercury, which most of us are regularly exposed to through the consumption of fish, can cause impaired neurological development in fetuses, infants, and children.

This is why the Mayo Clinic advises that pregnant women, nursing mothers, and those trying to conceive should limit their intake of most seafood to no more than 12 ounces per week and completely avoid fish that have extremely high levels of mercury, such as swordfish and mackerel. In adults, symptoms of methylmercury poisoning include malaise; paresthesia (a sensation of “pins and needles” or pricking on the skin); difficulties with speech, vision, and hearing; and neuromuscular changes, such as lack of coordination and muscle weakness—all consistent with the ailments cited by Piven and his doctor, Carlton Colker, a diet-book author and director of the Peak Wellness Center in Greenwich, CT: dizzy spells, “trouble with his lines,” and “difficulty lifting his arms and legs off the bed.”

There has been some speculation about whether a man could eat enough tuna to cause such extreme symptoms. “The entire medical literature doesn’t contain a single documented U.S. case of mercury poisoning from eating fish sold in restaurants and supermarkets,” David Martosko, Director of Research for the nonprofit Center for Consumer Freedom, told the press.

Still, many experts, such as Joanna Burger, a mercury researcher from Rutgers University, have argued that it is possible: “In general, if people are eating eight to twelve pieces of sushi every single day, with tuna, they’re likely to develop those kinds of symptoms,” Burger told the Chicago Tribune.

A few press reports trumpeted the idea that, according to an online calculator at MercuryFacts.org, a website sponsored by the Center for Consumer Freedom (“all the information you need to know to find out how much fish you can safely eat”), Piven would have had to consume 108 pieces of tuna sushi roll per week to reach a toxic level. But not all researchers and physicians agree on how much fish is safe.

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“There is a controversy over how much mercury is okay,” Dr. Ronald Hoffman, Medical Director of the Manhattan-based Hoffman Institute, said, “Some people can tolerate it, and some people don’t have a good pathway for getting rid of it.” A 2003 study conducted by researchers at Johns Hopkins on Brazilian villagers living downstream from gold mines (mercury is used to extract gold) found that even supposedly “safe” mercury levels—about 4 micrograms per gram of hair—could cause cognitive and neurological deficits in adults.

Attempts to sniff out the fishiness of Piven’s story have focused on tales of his late-night carousing and rumors that he had been attempting to exit the play for weeks. Yet even if one treats Piven’s mercury poisoning as a legitimate issue, his story doesn’t quite add up.

For one, prior to his Sunday night appearance, he was supposedly recovering in Thailand. The doctors I interviewed for this piece noted that bed rest alone would do next to nothing to improve Piven’s toxicity (though they also said simply abstaining from fish would cause his mercury levels to fall). It’s not clear why he wouldn’t have treated his condition domestically; in this country, plenty of medical professionals who believe in mercury poisoning offer a process called chelation in which patients are given a chelating agent either orally or intravenously—this binds to mercury and shuttles it from the tissues, allowing it to be excreted through the urine.

Then too, Piven’s own doctor spoke dramatically of mercury poisoning as a “problem that can…kill,” a statement that is technically true, though not very likely. Unless he had swallowed a thermometer, say, or consumed a massive hunk of ultra-toxic fish, Piven’s mercury overload would have been chronic rather than acute, an accumulation built up over years of dining at Nobu. In other words, the symptoms, if uncomfortable, were probably not life threatening.

“I don’t know that I would have written the guy out of a Broadway play for it,” Dr. Hoffman said of mercury toxicity, in which he is himself a believer, “It’s not a garbage diagnosis, it’s an important thing to check for, but it’s not extremely dangerous either.” It’s no secret, however, that many doctors are susceptible to celebrity. At least as susceptible as celebrities are to exhaustion—or to mercury, as the case may be.

An earlier version of this article incorrectly stated that the Mayo Clinic advises pregnant women, nursing mothers, and those trying to conceive to limit their intake of seafood to no more than 12 ounces per week and completely avoid fish that have extremely high levels of mercury, like tuna. In fact, Mayo suggests pregnant women can safely eat up to 12 ounces per week of canned light tuna, limiting albacore tuna and tuna steak to no more than 6 ounces per week. Mayo does advise that pregnant women avoid swordfish, king mackerel, shark, and tile fish.

Amanda Fortini has written for The New Yorker, Slate, Elle, and New York, among other publications. She lives in Los Angeles.