What is Chelation?
The term chelation comes from the Greek for “crab’s claw” – a reference to how the chelating agent grabs onto the metal ions in the body. The chelating agent chemically bond to metals, which allows them to be excreted from the body naturally. The three most common metals that cause toxicity are lead, arsenic, and mercury. Exposure to these metals can occur from a variety of sources in the environment, workplace, and home. Chelators are the only way to mobilize and expel these metals from the body. Chelation therapy should be initiated as soon after exposure as possible to reduce the risk of health problems.
Types of Metal Poisoning
There are different types of metals – some that are essential to the body’s processes but can be toxic at high levels and others that are always considered toxic. Lead, for example, can be toxic at any level and is not essential to any process of the body. However other metals like zinc and copper are essential to maintaining good health when they are taken in the right amounts.
Contamination in houses, like lead based paint, is often a cause of metal poisoning. This is especially dangerous for children who may ingest lead paint chips. Industrial runoff that contaminates a water supply can also lead to metal exposure. Certain unregulated cosmetic products can contain ingredients like mercury, which is also found in varying levels in fish. However, the most frequent cause of heavy metal poisoning is occupational exposure for those who work with metals on a daily basis. Heavy metal toxicity can occur in workers exposed to metal oxide fumes, which leads to metal fume fever.
Mercury fillings are a common reason individuals seek treatment for metal toxicity. Although the FDA and CDC have stated that amalgam fillings are safe and effective, many patients do not feel comfortable with the idea of having a potentially toxic metal in their mouths. If an individual chooses to have mercury fillings removed and replaced, it is important they have the removal done first before attempting to use any kind of chelation therapy.
Causes of Metal Toxicity:
Heavy metal toxicity can come from a variety of sources including:
- Occupational exposure to metal dust
- Runoff from industrial facilities
- Building materials like lead-based paint
- Fish that contain mercury
- Cosmetics and household products that contain metals
- Mercury-containing amalgams
- Wilson’s Disease (interferes with metabolism of copper)
Chelators and Other Ingredients for Chelating Therapy
Dimercaptosuccinic Acid (DMSA or succimer): DMSA is a chelating agent used for treating poisoning from lead, mercury, arsenic, and other metals. It is one of the safest and most effective chelating agents available. It was first used in the 1950s for metal toxicity and is now used throughout the world. DMSA is most often made into oral capsules but may also be made into a transdermal form. The transdermal version can help avoid gastrointestinal side effects and make it easier to administer for pediatric patients.
Alpha Lipoic Acid (ALA): ALA is an antioxidant that helps with mercury and arsenic toxicity and binds and mobilizes heavy metals from tissue. A main contributor to metal toxicity is oxidative stress, and the use of antioxidants like ALA as well as N-acetylcysteine can help improve recovery. Antioxidants have been shown to have a synergistic effect with chelators and increase their effectiveness.
Ethylenediaminetetraacetic Acid (EDTA): EDTA is a chelating agent that can remove a variety of metals. It has a number of uses besides metal chelation. Our pharmacy also compounds EDTA in nasal spray form to break through biofilm that harbor bacteria in the sinuses.
Penicillamine: Penicillamine is effective for treating toxic levels of copper, gold, arsenic, and lead. It is most frequently used for treating Wilson’s disease, which causes problems with copper metabolism that lead to toxic copper buildup in the body.
Bismuth subnitrate: Bismuth subnitrate has anti-nausea and anti-diarrhea effects. This can be included in a formulation along with chelating agents to reduce gastrointestinal side effects that are common with these drugs and the chelation process.
One of the services a compounding pharmacy specializes in is combining multiple medications into one formulation. For example, we are able to compound EDTA, DMSA, ALA, and bismuth subnitrate into one capsule. Studies have shown that when chelating ingredients are combined they can lead to a greater improvement in symptoms. One study concluded that “an earlier dose of EDTA may increase lead excretion after a subsequent dose of DMSA.” Sometimes combining medications can just make taking them easier. For patients following the Cutler protocol for metal chelation, DMSA and ALA can be combined into one capsule. Not every chelator is good for all kinds of metal toxicity. It is always best to work with your doctor based on your unique condition and what kind of metal toxicity is being treated.
Chelating agents can be compounded into capsules, creams, and suppositories in multiple dosages. A compounding pharmacy has the ability to make dosages based on an individual’s requirements. For example, DMSA can be compounded in capsules as small as 0.5mg and up to 500mg per capsule.
The chelation process can take anywhere from a few months to a year. When following a chelation protocol patients should drink plenty of water and eat a diet high in fiber. The chelating agent will mobilize the toxic metal so that it can be excreted mostly through urine. Essential vitamins are often taken in combination with chelation therapy to ensure that they are not depleted along with the heavy metals. It is essential to take a multivitamin that includes vitamins C, E, and B, zinc, magnesium, and any other supplements recommended by your doctor.
Andy Cutler Protocol
One of the more popular protocols for treating mercury toxicity is one developed by Dr. Andrew Cutler. The Cutler protocol for treating metal toxicity involves taking DMSA and ALA together starting with low dosages of DMSA and moving up to higher ones. ALA can be added after several weeks of treatment with DMSA. Together DMSA and ALA have a synergistic effect that increases the mobilization of metals so they can be removed from the body.
According to the Cutler protocol, a “round” is three days on chelators and three days off. For “on” days, 12.5mg of DMSA should be taken every four hours, even at night. Three to four rounds should be completed before increasing the dose. After three to four rounds, 12.5mg of ALA can be added with each dose of DMSA. Patients then regularly increase their dosages until the metals are completely removed from the body. The Cutler protocol is often prescribed to be used for treating mercury toxicity from amalgam fillings. The amalgam fillings must be removed before chelating therapy can start and ALA should not be started until three months after the fillings have been removed. To view the full protocol and more details visit this website.