Download Chelation Information 1-10

Developmental Spectrums/Optimal Health Spectrums
Chelation/Heavy Metal Detoxification Information
Chelation is the process of taking a medication that has a strong binding affinity for toxic
metals in the body. Once the medication is absorbed into the bloodstream, it seeks out the
metal and binds to it very tightly. The complex of [chelator + metal] can then be excreted by
the body into the urine and stool. Chelation actually mimics the body’s own natural Phase
Two detoxification pathways, where transport molecules are attached to toxins in order to
excrete them. Research is pointing to the fact that people on the autistic spectrum are not
good excreters of metals, and metal toxicity is implicated in many chronic diseases including
heart disease, cancer, and dementia. There are genetic differences in how well a person
detoxifies, just as there are genetic differences in everything else. Avoidance of further
exposure to toxic metal is also very important – such as not eating seafood, avoiding certain
vaccines, or putting amalgam fillings into teeth.
There are three prescription medications that can be used to detoxify heavy metals – DMSA,
DMPS, and EDTA. Developmental Spectrums/Optimal Health Spectrums has individual
informed consent forms listing potential side-effects for each medication. A signed informed
consent form and a good level of understanding of the use of the medication is needed
before a prescription is written.
DMSA is FDA approved for removing lead in children and adults – but it also removes
mercury and other toxic metals. It has been on the market in this country for about 50 years,
and was originally used to detoxify children who had been exposed to lead. DMSA can be
used orally, transdermally, in a shot, and as a suppository. DMSA is “off-patent” and is
therefore relatively inexpensive compared to DMPS, however, it has more gastrointestinal
side-effects than DMPS, including yeast flares.
DMPS is not FDA approved. Its use is therefore considered “experimental” in this country.
However, there are well over 20 years of documented safe and effective use of DMPS in
many other parts of the world. In some countries, it is considered so safe that it is available
over the counter. It is manufactured in Germany, Russia, China, and other countries. It is
imported into the USA, checked for purity, and compounding pharmacies dispense it in
many forms (including IV’s) based on a doctor’s prescription. DMPS is much more
expensive than DMSA, but generally is slightly better tolerated (not always), and is
considered to be somewhat superior to DMSA in chelating mercury.
EDTA is a chelator that can come in two forms – either bound to sodium or calcium. It is an
FDA approved drug for lead poisoning in adults and children. It has been on the market in
this country for many years, and is even used in small amounts as a food additive. EDTA is
most effective if used as a rectal suppository or given IV. It is relatively ineffective if used
orally or transdermally. The sodium form of EDTA is generally only used in slow, threehour IV drips in adults who are being treated for heart disease. Only the calcium EDTA, or
CaEDTA is used at Developmental Spectrums/Optimal Health Spectrums. CaEDTA is very
good at chelating lead, and also gets cadmium and arsenic, among other metals, but is not
good at getting mercury. Many patients have lead in addition to mercury, and it is helpful to
remove the lead first. EDTA is generally very well tolerated.
Chelation can be done five ways – intravenous (IV), intramuscular (IM) which is a “shot”,
rectal suppository (PR), oral (PO), or transdermal (TD). IV chelation is by far the most
effective and gives the strongest “pulls” of metals, because the medication is going straight
into the blood where it can go to work. IV chelation is also the most expensive, due to the
need to use sterile solutions and have medical staff administer it. The intramuscular route is
generally too painful for routine use. Oral chelation is usually only practical for those who
can swallow pills because the medications taste really bad, but they can be mixed with
flavored syrups for those who will tolerate it. However, oral chelation is most likely to
exacerbate gut problems by increasing bad “gut bugs” such as yeast. Transdermal chelation is
the most “user friendly” and is better tolerated by the gut, but is generally considered to be
the weakest or least effective method. Transdermal is therefore most often used only in very
young children. Rectal suppository takes some getting used to, but is usually not painful and
is very effective. Inside the rectal area, there are many blood vessels. A suppository
containing a chelator will melt from body heat within minutes, and the medication is
absorbed directly into the blood. Suppositories are therefore only second to IV’s in
effectiveness, are less expensive than IV’s, and can easily be done at home. It is important to
explain this procedure to a child before it is done however, so that the child does not feel that
they are being inappropriately invaded. A separate instruction sheet is available on how to
correctly insert a suppository.
All forms of chelation are given in “on/off” cycles. This is important to give the body a rest
between cycles, and to allow adequate time for re-mineralization. Oral chelation is usually
given in an on/off schedule of 5 days off - 2 days on, or 11 days off - 3 days on. The oral
medication is usually given three times a day on the “on” days. IV chelation is usually not
done more than once a week. Suppositories are often done 2-3 times a week. Transdermal
chelation medications are sometimes given every other day.
The biggest risk of chelation is mineral depletion, so minerals must be supplemented
carefully during the chelation process. Signs of low minerals can be lethargy, increased
chewing or mouthing behavior, dark circles under the eyes, or crankiness, among others.
Usually, a patient’s mineral dose will need to be increased when chelation is started to make
up for the minerals that will be lost. All chelators bind weakly to minerals, so some minerals
are lost as the metals are being excreted – especially zinc. It is usually necessary to take
minerals even on chelation days, and this is probably fine since the medications have a much
stronger binding affinity for metals than minerals. It is hypothesized that even if the chelator
did bind to a mineral first, it would drop the mineral to grab a toxic metal, if one is available.
Some patients will have an exacerbation of gut dysbiosis (especially yeast), which can cause
behavioral symptoms such as hyperness, excessive silliness, spaciness, or stimming. If this
occurs, it might be necessary to take a break from chelating to get the gut back in order, and
then resume.
Now for the “worst case scenarios”. Potential side-effects of chelating include liver or kidney
problems, bone marrow suppression (low white blood cell count), or rash. Sometimes a rash
can signal an allergy to the medication, or it may be a mild “mercury rash” from mobilizing
the mercury. Extremely rare types of severe rashes called SJS or TEN can occur and can be
life-threatening. These types of rashes are not unique to chelators, are possible with almost
any prescription medications, and again, are extremely rare. Just to be safe, be sure to report
any rashes to Dr. Mielke, and stop using the medication until you have discussed it with the
doctor. Sometimes the mobilization of the metals in the body can cause a temporary
exacerbation of autistic-like symptoms in ASD patients, and can even cause temporary
regression. If this occurs, generally lowering the dose and proceeding more slowly solves the
problem. This is a sign of how sensitive the child may be to the metals (and an example of
the connection between mercury and autism). If a patient becomes ill for any reason,
chelation should be temporarily discontinued until they have fully recovered. If unusual
lethargy or symptoms of abdominal pain, nausea, or vomiting occur, discontinue as well and
report to Doctor Mielke. It is important to understand that overall, the vast majority of
patients tolerate chelation with no major adverse effects.
Prior to beginning chelation, blood mineral levels must be checked and be adequate, and the
major bodily organs must be functioning properly (based on a blood CBC and chemistry
panel). Also, the patient should not be dehydrated or constipated when chelating, because the
metals will be exiting the body in urine and stool. If the metals sit in the gut for too long,
they could be reabsorbed, and they have a longer time to cause dysbiosis (an imbalance in
the gut flora). Blood tests must also be checked periodically throughout the chelation process
to ensure that the patient is progressing safely. A blood test for CBC, chemistry panel, and
intracellular mineral levels, and a urine toxic metal test are done every one - three months to
monitor for safety and progress.
A “challenge test” is when a dose of a chelating medication is given to the patient and then
urine and/or stool is collected to measure the output of metals excreted. Sometimes the
“challenge” dose of chelator will be double the usual dose to see a more obvious result. Other
times the collection is done after a usual dose, to see what is coming out routinely. It is not
always necessary to do a challenge test at all. This test only measures what is being excreted
at that time, and is not a quantitative measure of total body stores of metal. However, it can
provide a useful record of the metal excretion, and can give an idea of when we are “done”.
However, sometimes the initial tests look like there is little metal coming out, and some
people wrongly conclude that there is not an excessive amount of metal in their body. It is
not uncommon for a person to chelate for many months before mercury is accessed and
begins to be excreted. Other people will show a big “dump” of mercury immediately.
Chelation results, like everything else, are very individual. If no metals are being excreted
with a certain chelator or with a certain method, often we will change medications, routes of
administration, or doses to achieve adequate metal excretion.
People often wonder when to stop chelating. There is no definitive marker on when to stop
chelating, but when the patient has plateaued in their progress, or no further metals are
coming out, or the patient has fully recovered, then it is time to stop. However, even after
metals stop coming out, it is often a good idea to take a break from chelating for several
months to allow metals in the body that are in deep storage to redistribute from “hard to
grab” locations to “easier to grab” locations, and then re-do a challenge test.
Chelation often needs to be done for a minimum six months - two years or more, depending
on the child. Younger children seem to get better results from chelating, and when begun
early enough and done in combination with all the other major biomedical treatments, can
result in dramatic improvements in some patients. It may be that in older patients the brain
damage from mercury exposure is more permanent, or that the mercury is in deeper storage
– we don’t really know. But any aged person can functionally improve and will be healthier
from removing toxic metals from their body.
It is also important to remember that there is no “safe” amount of mercury or lead or other
toxins, and that sensitivity to heavy metals can vary hugely between individuals. Because of
genetic differences between people in glutathione production among other things, a given
amount of mercury may not cause any discernible symptoms in one person, but the same
amount could cause major health problems in another person. Children on the spectrum are
extremely sensitive to mercury and other toxic metals, and are often glutathione deficient.
Also, estrogen protects against mercury toxicity, while testosterone enhances mercury
toxicity, possibly contributing to the 4:1 ratio of boys to girls affected by autism.
It is important to remember that mercury and other toxins can and do actually kill some brain
cells (neurons), and it is not possible to predict in advance how many neurons in a given
patient are already dead and gone, and how many are still alive but toxic. The neurons that
are still alive are potentially recoverable, but a dead neuron will remain dead no matter how
much chelation or other treatment is done. The best hope for that type of brain injury may be
future stem cell infusions, or other treatments such as hyperbaric oxygen treatments which
can increase the production of the body’s own stem cells which may be able to create new
neurons.
Adding nutrient supplements- such as vitamins and minerals - improves the body’s own
natural ability to detoxify. Giving glutathione - either transdermally, in an IV, suppository,
or in oral lipoceutical form - also helps the body detoxify.
There are other ways to detoxify metals as well. Many people have had success with the
FAR-IR sauna. Since the body naturally excretes metals through urine, stool, hair, skin, nails,
and SWEAT – the sauna uses a natural pathway to excrete metals. Chemical toxins are also
removed this way, so there is a double bonus from sauna therapy. The FAR-infra red sauna
induces sweating at a much lower temperature than traditional saunas, and is safe for use with
children. Protocols vary, but are often to start at 110 – 120 degrees F, for 20-30 minutes. All
sweat should be toweled off, and afterwards take a shower. This can be done every day.
Minerals are lost through the sweat as well, so must be supplemented as in chelation. These
saunas can be purchased for home use, generally costing around $3000. Some patients like
it, but some hate going into the “hot box”. I recommend that patients try it out at a center
before purchasing their own unit.
Others are using clay baths to remove metals. The purity of the clay is very important here,
because we wouldn’t want to soak a patient in more metals! Some are using ionic foot baths,
but I can’t vouch for their usefulness, and they are expensive. Others are using chlorella
algae, but again the purity of the product is hard to certify. Algae grow in water, and all
major bodies of water on earth now have toxic metals in them. Other "natural" products are
available over the counter, but they are not actual chelators, and are not very effective in my
opinion.
Although not every patient will improve from chelating, overall chelating and/or detoxifying
in combination with full biomedical treatment protocols can cause significant improvement
in the health of many patients.
(Revised 7/5/11)