If you mention ‘Chelation’ in modern, main-stream medical circles you are likely to generate a firestorm of discussion. I was talking with a colleague of mine about our use of Prolotherapy & PRP and he said “well, its not like you’re doing chelation or anything.”
Yeah, this is a seriously provocative topic!
With all of that being said, I do believe that some patients benefit from chelation as toxic metal exposure is far too common in our modern age.
The word ‘chelation’ stems from the greek word meaning ‘claw’. The idea is that these chelating substances can claw, or grab on to, these toxic metals and assist with elimination from the body. There are several compounds that are commonly used for chelation and DMSA is a pretty safe and common chelator. It is available commercially as:
- dimercaptosuccinic acid
DMSA is generally given orally.
There is a test called a Provoked Urine Heavy Metal Test but this will be the topic of another post.
We generally give DMSA 30 mg/kg as a capsule and then begin the urine collection for 6-8 hours.
DMSA provocation test Instructions:
- Immediately after waking, empty your bladder completely. Do not eat any food for 1 hour except for a small amount of food if you need in order to take the capsules.
- Take the prescribed amount of DMSA with an 8 oz glass of water or other fluid immediately after you have emptied your bladder. The capsules may be opened up and added to food for children or adults who have trouble swallowing capsules.
- Collect all of your urine in the provided collection jug for 6 hours after taking the DMSA capsules.
- you may eat breakfast one hour or more after taking the DMSA capsule
- drink only a moderate amount of fluid during the 6 hour collection period
- At the end of the 6 hours, empty your bladder of all urine into the collection jug one last time.
- If you know from experience that you cannot collect your urine for 6 hours or if you weren’t able to collect it for 6 hours for any reason the mark the requisition with the number of hours you were able to collect.
- Follow the regular instructions for shipping urine samples.
There are definitely arguments for and against using a provoked urine test. Dr Cranton discusses some of this on his website. There is also some very interesting information about the use of provoked urinalysis for the purposes of chelation on quackwatch.com. I recommend reading both of these sources as they bring up some good points.
But, lets say that your provocation test is abnormal. This suggests that your total body load of heavy metals is higher than it should be and you MAY benefit from chelation therapy. DMSA is one option for this therapy.
DMSA is often used for treatment as follows:
- DMSA 10 mg/kg every 8 hours for 5 days. This is a total of 30 mg/kg per day
- Decrease the dose to 10 mg/kg every 12 hours for the next 14 days to complete a 19 day course of treatment
- Repeat courses may be necessary if indicated by weekly monitoring of heavy metals. There should be a minimum of 14 days in between courses of treatment.
- As always, be sure to remove yourself from any source of toxicity. You should also have your Calcium, Magnesium, and Zinc monitored as you may need to supplement with them. Lipoic Acid is a very good adjunct to help with mercury detox.
This information is for educational purposes only and should not be used as a substitute for advice from your personal physician.