The following data was extracted from Amalgam Illness, Andrew Hall Cutler PhD, Self Published.
Buy Andy Cutlers book, Amalgam Illness Diagnosis and Treatment by contacting him at andycutler@aol.com
The information below is an extract for information purposes only. It is not a substitute for medical care by a suitable practitioner.

Legend:
LA = lipoic acid
DMSA = Dimercaptosuccinic acid, or DMSA, is the chemical compound with the formula HO₂CCH(SH)CH(SH)CO₂H. This colourless solid contains two carboxylic acid and two thiol groups, the latter being responsible for the mildly unpleasant odour of this dicarboxylic acid. It occurs in two diastereomeric forms, meso and the chiral dl forms. The meso isomer is used as a chelating agent.

Lipoic acid challenge test for Arsenic

…reduction in the sense of taste. Red blood cell copper is a good measure. Standard serum iron, serum ferritin and total iron binding capacity tests are useful.
Elevated uric acid, hair lead, urinary lead or basophilic stippling of blood cells suggests lead. This can be checked by a blood test for ALAD, free erythrocyte protoporphyrin and zinc protoporphyrin, or a urine test for aminolevulinic acid. Lead is synergistic with mercury and other heavy metals, so lead or lead marker levels that would not otherwise be considered quite high enough to be clinically significant should be viewed with great suspicion if there is evidence of significant levels of other heavy metal toxins.
Any reason to suspect cadmium poisoning suggests testing for urine 13-2 microglobulin.
No challenge test is really all that good a diagnostic tool for chronic mercury intoxication. However challenge tests are often accepted as proof of intoxication for a variety of reasons - e. g. determination of insurance coverage.
The mercury section of the 1998 edition of Harrison’s Principles of Internal Medicine describes a challenge test using a 2 gram oral dose of succimer (DMSA) to check for past exposure to mercury. It is towards the end of the section.
This challenge test described in a widely used medical textbook will be considered legitimate proof of intoxication by people not thoroughly familiar with the subject - especially if they are shown a highlighted copy of the relevant section.
Elevated urine porphyrins or other. markers of intoxication without indications of heavy metals on hair, urine and blood testing suggest the toxin is either arsenic or an organic material. You should decide based on your history and symptoms whether to test for arsenic or organics first. Arsenic is tested for by mobilization with lipoic acid as described below. DMSA may be omitted if only arsenic is being tested for, though it will increase the amount of mercury observed if a significant amount of mercury was deposited in your brain long ago during some unrecognized exposure.
What you do is : first, you do an “unchallenged” 24 hour urine mercury test. I strongly recommend that you actually do a “toxic and essential elements” test just to be sure to catch other stuff that might be odd - like copper. No matter what the doctor says, you MUST use a competent lab, and the ones I KNOW are competent are Doctor’s Data, Great Smokies and Metametrix.
Now you will need another test order for a 24 hour urine mercury test. You will also need a prescription for DMSA. If you want to get it from more or less any pharmacy, you have this prescription written for Chemet 100 mg #20. This is about $90-100 worth. if you want to keep the cost down, you use either that prescription or have one written for DMSA 250 mg #8 and fill it at the cheapest compounding pharmacy you can. Call for quotes. Some charge shipping, some don’t. This is about $30 worth of compounded
DMSA.
Now you do the challenge test. The textbook says take ALL the DMSA at once. You won’t do that. It is a lot safer and a lot more comfortable to spread it out. Spreading the DMSA out makes somewhat more mercury come Out in the sample. This should not change the interpretation, If the physician or insurance company is concerned they can use the pharmacokinetics given in another appendix to correct the result. If you just say “I took all the DMSA and collected the 24 hour urine sample like I was supposed to” it won’t occur to them that exactly how you took it might be important.
To collect a 24 hour urine specimen and do the challenge test, you get up in the morning, pee in the toilet, not the container, and note the time on the collection container. Now you take two of the 100 mg capsules if that is what you have, or one of the 250 mg capsules if that is what you have. From now on, you put your pee in the container. All of it. For the next 24 hours.

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.179

Lipoic acid and Mercury, Copper and Zinc – LA dosing.

…penicillamine in any form. Supplementary cysteine, glutathione, or a “high sulfur” diet, or chlorella should not be used. All of these “therapies” will be very harmful to you.
The idea that essential minerals are depleted by chelation and require routine replacement via intravenous therapy is not correct. It is in effect a superstition believed among some in the “alternative medicine” community. This has been demonstrated both by direct measurements of blood levels and by mass balance calculations. DMPS and DMSA do not significantly alter the body’s inventory of nontoxic materials under the conditions of use discussed in this book. Lipoic acid actually INCREASES the body’s inventory of zinc and copper, and the chelation protocols as given here account for that fact. Oral supplementation of certain minerals is helpful in altering the body’s metabolism in favorable ways or making up for common deficits - but they are not being administered to make up for materials removed by chelation and an increase in urinary excretion of a mineral during chelation is not an indicator it should be supplemented or injected.
DMPS and DMSA are used as described above in the early phase of detox to clear the bloodstream of mercury. Once blood mercury has been reduced adequately lipoic acid (LA) is added to remove mercury from internal organs - especially the brain.
Taking 50-100 mg of DMSA + 50-200 mg of LA every 3-4 hours will remove mercury from the brain and internal organs. You will want to do this for 3-4 days in a row and then skip several days. It removes about 1/2 to 1% of the mercury in the brain every day that you chelate. Thus in order to reduce brain mercury by 50%, you have to chelate for 70-140 days.
You can also take DMPS 50-100 mg ever 8 hours plus LA 50-200 mg every 3-4 hours. It is a bit more difficult to keep track of but works fine and feels a little better. Mercury is removed at about the same rate. You will want to do this for 3-4 days in a row and then skip several days.

If you can’t get DMSA or don’t want to, you can just use 25-200 mg of LA every 3-4 hours. You may want to do this for a week or so and then skip a week or so.
You do not want to chelate with lipoic acid more than half the time or your body levels of zinc and copper will increase a lot and other minerals may also go out of balance.
You select the dosages of DMSA and LA to use based on how you feel when you take them. Taking a high dose that makes you uncomfortable does not speed up detox all that much - it is best to select a dose that allows you to get on a schedule and do some chelation every week or two. You can raise the dose later if you become more comfortable as you detox.
Figure 15 earlier in the book gives a schematic illustration of where mercury comes out of and how you feel as this chelation process goes on.
For most people the proper chelation protocol using DMSA and LA is:
• Starting 4 days after the last filling is replaced, 50-100 mg DMSA every 4 hours (including getting up at night to take a dose) for 2-6 months, until urine mercury is reduced 80%.
• Then DMSA 50-100mg + LA 50-200 mg every 3-4 hours (including getting up at night to take a dose) for about 3 days per week. When you feel all better, keep going for a few months. You may need to do this anywhere from 6 to 36 months depending on how sick you were to start and how hard your body holds on to the mercury.
• It is important to keep taking your supplements and medicines during the whole time you are chelating.

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.90

Descriptions of things you can take

…symptoms of being low, take a bit of supplement. Otherwise avoid it.
Kava kava. take 45-70 mg kavalactones 3-4 times per day or for sedative use. Take 180-210 mg kavalactones 1 hour before retiring as a sleep aid. Kava kava reduces anxiety, induces muscle relaxation, and facilitates sleep. It does not act in a manner biochemically similar to GABA or benzodiazepines. People do not develop a tolerance to kava - it does not lose effectiveness with continuing use. Since kava kava is a CNS depressant and does have some side effects that are similar to common mercury poisoning symptoms’, I recommend that you not use it unless you have used it recently and know you tolerate it, or the other medical and herbal options do not seem like they are appropriate for you. Kava kava is discussed in more detail by Murray (1995).
Ketoconazole - is a systemic yeast fighting drug which keeps yeast from growing. Strongly blocks liver 2C19 and 3A phase 1 metabolism. Thus fluconazole is preferable if you are taking tricyclic antidepressants or indomethacin. Ketoconazole is most toxic of the systemic agents. It is quite hard on the liver.
Kionopin® (Rx). See benzodiazepines.
Leukotriene inhibitors (Rx) - are considered antiasthma medicines. They also work against the inflammatory part of allergies. In some cases Accolate® appears to cause an overall down-regulation of allergies if taken for at least a month. When discontinued allergies may or may not remain reduced. Singulair® is the most popular but does not appear to down regulate allergies.- it may however promptly relieve symptoms somewhat. These two are pretty safe and are well worth a trial in any patient with lethargy, malaise and fatigue that may be immune mediated. Accolate® inhibits the liver phase 1 3A4 and 2C9 enzymes. Accolate®’s absorption is reduced about 30% if taken with food. Theophylline also decreases absorption about 30%. Aspirin increases absorption about 45%. Accolate® should be taken twice a day about 12 hours apart. Singulair® need only be taken once daily.
Licorice - adrenal (mineralocorticoid) stimulant. It loosens mucus and helps with asthma and upper respiratory infections. It should not be taken continuously. Licorice accelerates liver phase 1 metabolism. One week per month is appropriate. Licorice is discussed in more detail by Murray (1995).
Lipoic acid - also alpha lipoic acid - is a chelating agent able to cross cell membranes and remove mercury from the brain and internal organs. Side effects are reduced and mercury removal enhanced if it is used with a water soluble agent 111cc DMSA or DMPS. It must be taken every 3-4 hours because your metabolism uses it up. LA is effective at removing intracellular arsenic as well as mercury. LA increases the liver’s secretion of bile and nonprotein sulfhydryl groups. This is irritating to the bowel and anus, and may cause anal itching especially. if hemorrhoids are present. Extra bile causes loose, dark stools. LA can exacerbate gall bladder problems or other bile duct blockages. Lipoic acid is sometimes recommended for the heart. DO NOT USE IT FOR THIS PURPOSE if you are mercury toxic!!!!!!! It will move mercury all over the place and make you incredibly sick! You have to use it in a careful and controlled manner as a chelating agent at the appropriate time!
Lithium (Rx). One of two effective drugs available for manic-depression (bipolar illness) or complications of other personality disorders characterized by euphoria alternating with depression. In these cases treating the depression alone is ineffective. Carbamazepine (Rx) is the other drug that is sometimes effective.
Liver flush: Dandelion and beet green are often used in “liver flushes,” as is a high

[1 These include dry, scaly skin, a possibility of worsening depression, and accommodative and motor difficulties with the eye. It is also known to interact with other medications that cause lethargy and sedation.]

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.157

Amalgam Illness: Diagnosis and Treatment

• Inositol or inositol hexaphosphate 2-12
grams
• Lysine 2 grams
• Arginine 6 grams
• Magnesium 750 mg
• Chromium 1,000 meg
• Acetyl-L-carnitine 1-2 grams
• “B-lOO” multiple B vitamin supplement
• Zinc 50-100mg
• Molybdenum. 1,000 mcg
Unless you know you don’t need them or shouldn’t take them, you should also try forskolin, DHEA, pregnenolone, cortisol (Rx), desiccated thyroid (Rx), vitamins B-6 and B-12, folic acid, trimethylglycine, histidine, Accolate® (Rx) and taurine.
If you have a REALLY restricted budget and can’t get a doctor to do anything for you, see if you can do this each day:
• Vitamin C: 4 grams, 1 with each meal, 1 at bedtime.
• Vitamin E 400-800 1IJ
• Milk thistle extract one capsule with each meal
• Flax oil 1 tbsp
• Magnesium 1/4-1/2 tsp epsom salts with each meal
• “B-50” or “B-lOO” multiple B vitamin supplement
• Zinc 50 mg
• Molybdenum 250-500 mcg
• Chromium 200 mcg with each meal
Vinpocetine 5 mg 3 times a day
If you have a specific problem they would help, consider 1-carnitine, forskolin, DHEA, pregnenolone, vitamins B-6 and B12, folic acid, trimethylglycine, histidine, and taurine.

CHELATING AGENTS
BAL or dimercaprol (Rx)
Cilantin
Citrate
Cysteine
DMPS (Rx) 1. or Dimaval® (US) or Initol® (US)
DMSA or Chemet® (Rx)
DMSO
EDTA (Rx)
Lipoic acid or alpha lipoic acid or LA
MSM
Penicillamine or Cuprimine® (Rx)

PAIN RELIEF (ANALGESICS)
Acetaminophen or Tylenol® or paracetamol Aspirin
Celebrex®
Ibuprofen
Magnesium
ANTIOXIIANTS
• Carotenes (beta,
• Coenzyme Q10
Garlic
Lycopene
Selenomethionine
Selenite
• Vitamin C
•VitaminE

Anti-Anxiety Agents (Anxiolytics)
Benzodiazepines: Diazepam (Rx) or Zanax®
(Rx) or Klonipin® (Rx) or Valium® (Rx)
etc.
Buspar® (Rx)
Desyrel® (Rx)
GABA
GHB - gamma hydroxybutyrate
Gotu kola
Kava kava
Niacinamide (Vitamin B-3)
Taurine
Vitamin B-6

1. Not fully FDA approved. Currently an
investigational new drug.

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.134

What to do about mercury poisoning

…the licensing authorities. Within reasonable limits, try to be cooperative. If they try to talk you into voluntary commitment, don’t agree. If they are going to commit you involuntarily, neither sign nor refuse to sign agreements1. Then tell them you can’t decide whether to sign or not without having your attorney go over it with you - and write that on the forms. Don’t let them give you an attorney ‘for free.’ You can always take them up on that later if you wish to. The point now is to tie their hands as much as possible so it is inconvenient to hold you and convenient to let you go. If they say you “have” to take some medicine, ask what happens if you refuse. Ask why you have to take it. Be very reasonable. A lot of times you don’t actually have to take it, they just say that because they want you to go along. If they don’t want to let you go after the minimum hold period and you can’t wait out their statutory maximum hold time, having an attorney sue the doctor who committed you (and the one who can release you, if different) personally for violating your civil rights may be necessary to convince them to let you go right away.
People who talk about suicide are not likely to commit it unless they can answer all the following questions: when are you going to do it, how are you going to do it, where are you going to do it, what means do you have right now to do it with? Make sure people you might talk to when you are feeling really really down know to ask all these questions before deciding whether to call
911.
WHAT WILL HAPPEN - - PROGNOSIS
Both you and your doctor need to know how long it takes before you get well, and what do you expect along the way.
1 If you refuse to sign things the doctors usually gain
a lot more legal leeway than if it is left ambiguous.
If you don’t REFUSE to sign, but simply demand
your legal right to counsel before deciding, it gives
them less freedom to do what they want to you.

Using a proper protocol, e. g. DMSA every 3-4 hours on alternate weeks: 2-6 months to feel better. Then DMSA + LA every 3-4 hours 3 or 4 days every week or two to clear the brain and internal organs, 2- 6 months to feel better. Continue supplements and diet control with continuing DMSA + LA chelation while healing takes place, another 4-30 months to good physical and mental health. Total time: 1 to 4 years if you stick with the program.
The big determiner of how long it takes is the DMSA+LA phase. That depends on how seriously poisoned you got.
• You feel depressed, tired, icky. You are moderately poisoned. 6-11 months of DMSA+LA treatment will be required. You will FEEL cured immediately if you take the right supplements and medicines, but you have to chelate to get rid of the mercury.
• You are starting to get stuff like chronic fatigue, fibromyalgia, environmental sensitivities, severe allergies or asthma, emotional disturbances. 14-25 months of DMSA-LA will be required. You will feel MUCH better with the proper supplements and medicines and be able to get on with life pretty quickly.
You have multiple chemical sensitivities, chronic fatigue syndrome, and serious emotional disturbances. You really are not able to participate in life. You are very seriously poisoned. You will need
• 20-36 months of DMSA+LA to get well. You will need proper supplements and medications to be at all functional and will need to pay careful attention to continuing them and adjusting them for 2-3 years
• until you are detoxed enough that your health isn’t coming out of a pill bottle.
If you continue to chelate with DMSA+LA for 6 months to a year after you are sure you are well you will remove more mercury from your brain and greatly reduce the chances of future problems, neurological disease, or premature aging.

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.131

Amalgam Illness: Diagnosis and Treatment
…oxidase inhibitors, tricyclic antidepressants, amphetamines, and drugs that act similarly to dopamine.
All of these emotional, or “psychiatric” problems will be cured when you finally detoxify your brain enough by using lipoic acid. Everything else you do is to help make you happier and more comfortable until that is finally done.
Mercury can do enough brain damage to create standard neurological problems. Hearing loss, tremor, and difficulty concentrating are the most bothersome. Tremor is the most obvious sign and anything that controls it will likely help with the others. Note that the tremor mercury poisoning victims experience is not caused by anxiety if they are anxious at the time - so if you find yourself arguing with a physician who insists your tremor is just anxiety and all you need to do is go talk to a psychiatrist, what you really need to do is find a doctor less brain damaged than you who will figure out something to help.
Tremor, particularly intention tremor, can be controlled by the prescription drug hydergine® (generic: ergoloid mesylates) in doses of 15-20 mg/d rather than the 3 mg/d more typically used in US practice. If you find hydergine helps with tremor, concentration, depression, etc. but you need further improvement, try increasing your dose.
Tremor is also a symptom of Parkinson’s disease, caused by oxidative stress as it is in mercury poisoning. Drugs such as selegiline that are effective in that case are helpful for many mercury poisoned people as well.
Other things that may control tremor are glycine, and eating a ketogenic diet - one of the low carbohydrate, high fat, high protein diets that used to be popular for weight loss. E. g. steak, salad, no bread or potatoes.
Some people find they can control tremor or peripheral neuropathy by eliminating wheat and gluten containing foods from their diet. This can be explored by measuring antigliadin antibodies, and if they are not unequivocally low, eliminating these foods from their diet for a week long therapeutic trial.
If you are very poisoned, you may have extreme problems with how your brain controls your body. During serious chronic mercury toxicity autonomic nervous system dysfunction is common. This causes you to have cold, sweaty hands and feet, a fast heartbeat (tachycardia) alternating with a slow one (bradycardia), not to sweat, to have low immune reactivity, and to find even the lightest activities overwhelmingly fatiguing. These can be brought under control for a period from days to weeks, and sometimes permanently corrected, by administration of large amounts of procaine. The most effective protocol involves intravenous administration of enough (e. g. 10 cc 1% procaine) to promptly render the patient unconscious for a period of time. Intramuscular administration of 3-5 ml of (epinephrine and preservative free) procaine may lead to an improved feeling of well being for a few days.
Mercury causes chemically induced brain damage. This is why amalgam illness victims have emotional changes, memory problems, and endocrine problems. Once the mercury is gone, there are a number of things that can be done to promote brain healing. Taking steroids like pregnenolone and DHEA which are involved in brain development and function is helpful, as are ergoloid mesylates, and vinpocetine. Learning something completely new and different is also helpful. Activities that involve active use of balance are help too, as do certain types of vision therapy (offered by developmental optometrists). Cranial sacral therapy by an experienced therapist (a DO or a chiropractor trained in it with some experience) is also effective. Speculative medical therapies that leading evidence in the literature suggests may be effective are relatively high doses of lipoic acid,

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.128

WILSON’S DISEASE
Wilson’s syndrome is not to be confused with Wilson’s disease, a rare aberration of copper metabolism described in standard medical textbooks that has symptoms similar to amalgam illness. In Wilson’s disease, hair, urine and RBC copper will be greatly elevated, but serum copper and serum ceruloplasmin will be low. Treatment is with penicillamine (conventional), DMPS or lipoic acid, for life. Taking 100 mg zinc + 1 mg molybdenum daily to reduce copper absorption is also expected to be helpful. Taking antioxidant supplements as for

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.117

What to do about mercury poisoning

Lipoic acid and Copper and Zinc – plus dosing.

…increase if thyroid supplement is given. Vasopressin, the antidiuretic hormone that your pituitary releases to keep your urine volume down, also helps your kidneys keep magnesium in.
People who have high-normal or high serum potassium and/or magnesium but low- normal or low red blood cell potassium and/or magnesium have trouble getting these into their cells. It is important that enough potassium and magnesium be inside the cells, so magnesium and/or potassium should be supplemented at fairly high levels under these circumstances despite serum or plasma levels. It is important to have potassium supplementation followed by a physician if it is done for this purpose since high potassium can cause dangerous heart conditions. If supplementing with more than 1 gram of potassium chloride per day physician supervision is mandatory for safety. If you keep taking the same amount of magnesium and potassium and your cells start to absorb them better your serum levels will go
DOWN.
If copper or iron are elevated they should be excluded from diet and supplements and things taken to interfere with their absorption. The ideal levels of both are in the lower part of the normal range. Iron can also be lowered by giving blood regularly. If they are LOW, modest amounts of supplements should be given until they are normal. If you have rheumatoid arthritis or another inflammatory disease you might respond well to some supplementary iron even if your levels are normal. It has to be tried for a week to tell.
Copper increases the symptoms of PMS. Lowering copper levels will reduce PMS. Excluding high copper foods and taking 10- 20 mg of zinc plus 250-1000 mcg of molybdenum with each meal will reduce copper absorption.
Many people have impaired excretion of copper. This may be genetic or acquired. Normally, 80% of copper excretion is via the bile, 16% via intestinal secretions, and 4%

via urine. Biliary and intestinal secretions are ultimately excreted in the feces.
A normal person’s copper half life is about 35 days. For a person who is not excreting any copper in their bile, the half life increases to about 175 days and body concentrations of copper increase about 5 fold. This can bring copper levels into the toxic range. The symptoms are usually psychiatric.
In addition to genetic problems, anything that interferes with bile secretion, such as gallstones or other liver disease, will cause elevation of body copper.
Lipoic acid increases copper in urine and somewhat in intestinal secretions but eliminates copper secretion in the bile. Thus for a copper toxic person lipoic acid may be helpful or harmful, and the correct measurement is fecal copper1 rather than urinary copper. If fecal copper increases with lipoic acid, it is helpful in clearing the body of copper, but if it decreases the LA is a hindrance and will further increase body levels.
The normal intake of copper is 2-5 mg per day of which 40-60% or 1-3 mg is absorbed. Someone who is not secreting copper in their bile needs to limit absorption to 0.2 to 0.6 mg daily to keep tissue copper within normal limits.

Dosing
Vitamin C in large amounts, zinc, and molybdenum hinder copper absorption from the intestine. Taking 10-20 mg of zinc, 250- 1000 mcg of molybdenum, 250-500 mg of calcium and 2 grams of vitamin C every time you eat will greatly reduce copper absorption. Taking zinc and manganese in a ratio of 20:1 will increase the urinary excretion of copper. High copper foods are given in the appendix.
Low levels of thyroid hormone increase body copper, and increased thyroid hormone as well as cortisol lower it. Ensuring that…

1 This test is available from Doctor’s Data, Inc. Sec appendix.

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.99

What to do about mercury poisoning

…likelihood of a favorable outcome is much higher. If there is regression after vision therapy it is usually a sign that further detoxification is necessary.
Increasing mercury correlates with childhood intelligence (Marlowe et a!. 1986). Since intelligence correlates with success at school, in social circles, at work, and ultimately at life, it makes sense to detox children as early as possible so they don’t have a lot of catching up to do once they have full use of their brain back. It is not known whether artificially induced intelligence deficits during the formative years lead to permanent deficits that cannot be caught up on later.
The opportunity to make your child smarter, healthier, more emotionally stable and give them the opportunity to catch up on past problems through natural growth and development it is well worth taking.
It is common for more than one family member to be mercury poisoned. In this case it is best not to delay detoxing everyone. If both adults are poisoned, it is best for the healthier of the two to delay detox, or begin it very slowly, while the other adult and the children detox aggressively.
CHELATION
Chelation takes the mercury out of you and makes you healthier. Everything else in this chapter corrects the problems mercury causes and makes you feel better while you are detoxing, but it does not cure you. Chelation is what cures you. Chelation is the most important part of your treatment.
In the few months post amalgam removal, you may patiently wait for your fast body pool to drain while taking minimal chelating agent to suppress symptoms, or you may take large amounts of oral DMPS or DMSA to reduce it faster. DMPS is MUCH more effective for this purpose. Symptoms relieved by chelation are brain fog, attention deficit, inability to concentrate, anxiety, and

other emotional disturbances. Allergies may or may not be suppressed.
Distributing the chelating agent over a couple of months (with breaks) is more effective at removing mercury than is taking a bunch over a short period. Under ideal circumstances the total amount of chelating agent used would not be limited and high doses would be used to cure the patient quickly. A typical dose would be 200-400 mg DMSA every 4 hours, or 400-800 mg DMPS every 8 hours. The dosage used in high dose regimens is 10 mg/kg of body weight (DMPS) or 5 mg/kg (DMSA).
Some highly poisoned patients may want to get well quickly through aggressive chelation. Even the most well optimized protocol will cause side effects as the dose is increased. Thus high dose chelation followed by intravenous vitamin C (a vitamin/mineral drip) to cut short the prolonged recovery from side effects may be appropriate early in therapy.
If chelating at high dosages it is wise to get a routine urinalysis every few weeks and to stop if red blood cells start to show up. At high doses, occasional blood Counts are more important than otherwise.
Several months after amalgam removal, the ‘fast’ body pools of mercury should be much reduced and it is time to mobilize the ‘slow’ body pools. This can be done with lipoic acid, 30-200 mg every 3-4 hours (0.18-1.2 grams per day). Unlike the other chelating agents lipoic acid will not suppress symptoms. DMPS or DMSA in the low doses mentioned above should be taken with the lipoic acid to suppress symptoms. This regimen must be pursued continuously for 6 months to 2 years to rid the body of mercury.
Therapeutic approaches currently offered by some practitioners but which should never be used include: DMPS by injection except when oral administration is contraindicated and dosage is low, DMPS or DMSA on any schedule not involving frequent administration of equal doses for at least several days in a row, EDTA chelation, or…

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.89

Amalgam Illness:
Copper and Mercury poisoning

If mercury poisoning is apparent, the mobilization test for arsenic can be deferred until chelation with lipoic acid is appropriate therapy for mercury removal since the order of therapeutic interventions will not be altered by the presence or absence of arsenic.
Copper versus mercury poisoning
The symptoms of copper poisoning are very similar to the symptoms of mercury poisoning (amalgam illness) and a significant number of people who believe they have amalgam illness turn out to actually be copper poisoned and have no problem with mercury.
There are a wide variety of abnormalities in copper metabolism, one of which is the rare textbook condition Wilson’s Disease. There are many more less rare problems with copper metabolism that haven’t made it into standard texts yet. It is well worth checking RBC copper, hair copper and urine copper if corresponding tests for other elements are to be performed. Serum copper and ceruloplasmin are not informative tests as they are normal in many of the more common forms of copper poisoning even though they are low in Wilson’s disease. As copper is an essential element, LOW copper can also cause problems.
Typically hair analysis for a copper toxic person will show everything fairly normal except that copper will be vastly elevated. This is in contrast to, a mercury poisoned person where calcium will be vastly elevated and the essential elements will vary widely from the norm. Urinary copper excretion will also be vastly elevated.
In copper intoxication it is important to perform a stool analysis for toxic and essential elements. In normal individuals, 96% of copper is excreted in the feces. If no copper is excreted in the feces then lipoic acid can be used therapeutically since it increases urinary copper excretion. However LA decreases fecal copper excretion and will make matters worse if it is given to someone who is excreting significant amounts of copper in the feces.

The traditional treatment for copper poisoning is penicillamine, which many people do not tolerate well. DMPS does increase urinary copper excretion significantly. DMSA does not. LA increases urinary copper excretion and decreases biliary copper excretion.
Copper absorption can be reduced by excluding high copper foods, scrupulously avoiding copper in supplements, and taking 10-30 mg of zinc and 250-1000 mcg of molybdenum with each meal. Vitamin D supplements may increase metallothionein formation and thus copper excretion. Selenium supplements may increase the binding of copper to metallothionein which sequesters it safely inside the cells.
The antioxidant, liver support and brain support medications given in the treatment section will be helpful for copper toxic individuals and they will also have imbalanced fatty acids and need to take flax oil. Other sections, e. g. on allergy, will also be helpful if relevant. Copper poisoning acts similarly to mercury poisoning in that both metals are oxidation catalysts.
The Carl Pfeiffer Center has extensive experience in treating copper toxic individuals and may be willing to cooperate with your doctor to help him know how to treat you best. They also accept patients who go there in person for a few days and can usually be managed by telephone thereafter. The Pfeiffer center can be reached at:
Pfeiffer Center
1804 Diehl Road
Naperville, IL
(630) 505-0300.
Before the initial visit it is helpful if you can have the following tests available so they can determine whether they can get insurance to cover your treatment, and get some idea of what you have: Zinc, copper, lead and manganese in blood and a hair analysis heavy metal screen, kryptopyrrole urine analysis, blood histamine, thyroid panel, ABO blood type and an extensive blood chemistry panel equivalent to Chemzyme® Plus.

Diagnosis and Treatment

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.66

Amalgam Illness:
DMSA chelation
Every two hours after you started, you take your 2 x 100 mg caps (DMSA) or your 1 x 250 mg cap, depending. You do that until they are all gone (about bedtime - 14 hours later for the 250’s, 18 hours later for the 100’s).
Make sure to wake up in time so that EXACTLY 24 hours after you started collecting your urine, you can pee, put it in the container, and stop the collection. You now have a 24 hour urine sample that needs to be mixed, put in a little bottle, and sent to the lab.
The sample kits have instructions about collecting samples, using the preservative that has to go in with the pee when you start to collect it, etc. Your doctor will decide whether you should prepare the sample and ship it or her office staff should. You should measure the volt me in-the container(s) using the graduations on the side and keep your own record of it. If the report comes back with different volume, talk to the doctor about it. Something is wrong. It is unfortunately very common for the staff at physician’s offices to mishandle urine specimens, confuse them with other people’s, etc. It is best if you prepare your own specimen (since you will be very concerned and thus very careful to follow instructions) or if you watch the technician prepare it and have them explain what they are doing and why as they do so.

Also calculate the amount of creatinine that ought to be in the sample by using the formula or table in the “tests” appendix and make sure the number on the lab report is the number you calculated. If it isn’t, something is wrong. Talk to the doctor about it and insist on redoing the test1.
Women have to make sure not to collect the sample during their menstrual period.
1 If your doctor argues that an incorrect volume or creatinine are not significant, or that you didn’t get them right, or that you shouldn’t worry about it because doctor knows best, you have just performed the most important possible test. Can this doctor help you. Result: no. Therapeutic measure: find another doctor.

Diagnosis and Treatment
If you go through all this and the ‘challenged’ sample still shows low mercury and you are pretty sure you got poisoned by it but don’t have current exposure, you can repeat the challenge test and take lipoic acid 50-100 mg with the DMSA. This will mobilize mercury from your brain and internal organs. It will also cause significant side effects. If you are emotionally volatile or have mood disturbances you need to tell everyone these might get a LOT worse when you do this test.
Of course, if you start to do this and are feeling really really bad after a few doses of the chelating agents, STOP TAKING THEM. One of the reasons this is a safer protocol than taking all the chelating agents at once is that you can STOP before you get the whole day’s worth into you if you are having an adverse reaction!
If your post challenge - prechallenge number is greater than 20 micrograms, you ‘pass’ the textbook challenge test and according to Harrison’s Textbook of Internal Medicine you have mercury poisoning. Most physicians will interpret a post challenge result of close to 20 mcg/day as indicating mercury poisoning, due to individual variability - some people are more sensitive than others. As a rule, women are more sensitive to toxins than men and women are also usually smaller than the large and muscular male factory workers these “challenge test” results came from.
If you have to pee more than about 8 times per day you should get two collection containers so you don’t run out of space. The containers are usually 3 liters and “normal” people supposedly make less than 2.5 liters per day. Most mercury toxic people need 2 containers. Some need 3. By doing the unchallenged measurement first you can determine the number of containers you need without having to take the medicines. If you filled a container most of the way up, get an extra container for use during the challenge test since people usually urinate somewhat more during chelation.

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.180

 Amalgam Illness: Diagnosis and Treatment
Hair levels - copper
…must be made on the basis of signs and symptoms.
LEAD:
Gout, glaucoma, paleness, weakness and drooping of the wrists and ankles, wasting of the shoulder girdle muscles, low sex hormones (with the corresponding pituitary hormones elevated, unlike for mercury where both pituitary factors and hormones are relatively low), fear of being murdered. The victim will feel worse at night, and better during exercise.
The victims will also have a lot of gastrointestinal pain (colic) and gas.
There are many laboratory test abnormalities that are distinctive for lead poisoning that can be used to see how much of a problem lead is versus mercury for a particular person. Results in the high end of the normal range are significant for a person who also has some mercury in them because lead and mercury are synergistic in their effects.
COPPER:
The behavioral effects of copper poisoning are indistinguishable from those of mercury. The symptoms of copper poisoning are readily confused with those of mercury and there are no distinctive differences. Blood, hair or urine elements distinctively show high copper in the presence of poisoning, and do NOT show other patterns characteristic of mercury.
How mercury hurts you
Mercury catalyzes oxidation of important parts of your body. The part it messes up the most is the membranes around and inside cells. It sticks to sulfhydryl groups that are present on membranes. Then it catalyzes oxidation of the unsaturated compounds in the membranes. This destroys the essential fatty acids that your body can’t replace. It also destroys the phospholipids (like phosphatidylcholine and phosphatidylserine) that hold the membrane together. Since the membrane is damaged, it does not perform its function of passing signals along properly so lots and lots of messages your body needs to pass around become garbled. This is why it affects the brain so severely - the message center of your body is the most sensitive to garbled messages. This is also why it affects the endocrine system so much - your hormones are really part of a complicated communications system that carries messages around to make your body do the appropriate physiological thing.
Mercury also oxidizes the proteins inside your cells. These hold the cell together, keeping things like your DNA in the right place, they are enzymes that catalyze reactions, and they are receptors that receive signals. Many enzymes work because they hold a particular metal atom in their “active site” so that it is in just the right place to catalyze the particular reaction that enzyme causes. Mercury likes to sit in these active sites, so it kicks the proper metal atom out and deactivates the enzyme.
By catalyzing oxidation, mercury also creates free radicals that attack your DNA and mutate it. These mutations make your cells work less efficiently, and if enough happen, the cells die, or worse yet turn cancerous.
Mercury concentrates in and near a part of your brain called the hypothalamus. The hypothalamus is responsible for your memory, moods and emotions, and how your hormones, breathing and heartbeat work. It also concentrates in your liver, which is responsible for getting rid of natural and synthetic chemicals in the food you eat and from other sources. Mercury is also absorbed by the immune system, and makes it attack innocent bystanders like pollen or your body parts instead of the bacteria and viruses it is supposed to fight.
You can protect yourself against mercury by taking antioxidants to prevent the damage it is doing, essential fatty acids and other things that sit in membranes to repair the damage, and chemicals with lots of …

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.30

Do you have mercury poisoning?
Arsenic, Lead and Mercury – synergistic toxicity
Lipoic acid chelation of.

…outcome1 (prognosis) is a legitimate candidate for a lipoic acid/DMSA therapeutic trial. People who are mercury toxic ought to respond positively to antioxidants (minimally, vitamins C, E, selenium and hydergine), ought to have some symptom exacerbation during LA ÷ DMSA therapy followed by temporary improvement about 1 week afterwards, and ought to show an unexpected increase in urinary mercury excretion during chelation. In addition, urine volume may increase and pituitary factors fall during and shortly after chelation even if they are normal otherwise. All of these should be reproducible. At least one urine sample taken during chelation should be analyzed for lead and arsenic as well as mercury.
Arsenic, cadmium, lead and copper
Arsenic and lead are synergistic poisons with mercury. They may complicate mercury poisoning, and may lead to serious intoxications when none of the individual toxins are present at levels where they would individually cause overt illness.
Symptoms or history may suggest any of these toxins be considered.
There are a variety of laboratory tests for the metabolic effects of lead. In addition, certain changes observed in a blood count are typical of lead and not of the other toxins. Lead levels in hair, urine and blood are representative of body burden. Free erythrocyte protoporphyrin, zinc protoporphyrin and urinary aminolevulinic acid are specific tests for lead intoxication.

Coexistence of gout is diagnostic for lead.
Wrist or ankle drop is diagnostic for lead.

Chronic mercury intoxication can be difficult to diagnose because large quantities of mercury can be sequestered in the internal organs yet most of the mercury in the extracellular compartment may have been excreted long ago. Thus a “low” mercury excretion may mean someone is fine, or it may mean someone was poisoned to the gills so long ago it is no longer apparent by measuring excretion. Unlike mercury, lead has a long excretion half life, so lead excretion will be indefinitely elevated if lead poisoning has occurred and no chelation treatment has been given in the meantime.
Cadmium concentrates in the kidneys and the most sensitive test for it is 13-2 microglobulin in urine. Like lead and mercury, cadmium is ubiquitous and may be encountered from rechargeable batteries, artists’ paints, the pink pigment in denture plates, etc. as well as from industrial sources.
Arsenic is the most difficult to test for since hair, blood and urine levels are NOT representative of body burden. Arsenic is the only case where a provocative test is necessary.
Exclude seafood from the diet for a week, and perform a 24 hour urine collection to analyze for arsenic while administering 50-100 mg of lipoic acid ever 3 hours during the waking period (administering 50-100 mg of DMSA with the lipoic acid will reduce side effects and protect the patient somewhat from mercury entry into the CNS if this is a concern). A substantial rise in arsenic concentration when compared to a prior collection is diagnostic of an elevated body burden. This test should not be performed simply for informational purposes if the patient is to be treated for mercury poisoning anyway, since the treatment is the same and will cure both conditions at the same time. If mercury detox is performed this test can be combined with it at an appropriate phase of treatment if curiosity gets the best of everyone involved.

Extracellular chelators like DMPS and DMSA do not mobilize arsenic from its stores without the aid of lipoic acid.

Behavioral changes as described above under symptoms may be diagnostic for arsenic to an experienced practitioner.

[1 such as Parkinson’s disease, Alzheimer’s disease, schizophrenia, borderline personality disorder, or bipolar disorder.]

Ref : Amalgam Illness, Andrew Hall Cutler PhD, P.65