Chelation: The Andy Cutler protocol

Oral chelation for mercury

Importantly, the hair elements test will NOT always show high levels of mercury, especially for ‘long-ago’ exposures, if your body cannot excrete it via the hair. It can however give you an accurate idea about the state of your ‘mineral transport system‘, which in turn can be used to indirectly determine if you have mercury toxicity, since mercury is the only metal known to cause widespread deranged mineral transport, as diagnosed by Andy Cutler’s ‘counting rules’. The mineral transport system is almost ALWAYS defective in mercury toxicity affecting how you move, use and transport your minerals. Andy Cutler advises you to get a DDI Hair Elements Test and follow his ’counting rules’ to assess your mineral transport system.  Please obtain his Hair testing book for more information.
Consistant with Andy’s advice, we advise you to send away for ‘The DDI hair test’ to maintain consistency in lab assessment. Since hair doesn’t deteriorate it doesn’t need to be refrigerated or sent via express, but can be posted by registered letter (especially important for those overseas wishing to save on costs).
“If you want to use “the counting rules” then you need to get a HAIR ELEMENTS TEST, run through DOCTOR’S DATA INC. DO NOT get their “hair toxic exposure” test — it does not include the essential elements. The essential elements are essential if you want to use the counting rules”. For more information see here…
Hair elements tests give you other important information besides indicating ‘deranged mineral transport‘. It can give you indication of how well your metabolism functions. It is highly accurate at assessing adrenal function, and also thyroid function and sugar/carbohydrate handling ability. These patterns appear in the hair long before blood tests can pick them up, making hair testing a very valuable screening tool. See some examples on our Hair testing page.

WARNING: Do not do challenge tests!
Many medical practitioners are now offering ‘challenge tests’ to supposedly measure heavy metal levels in the body. This is very dangerous to mercury toxic people and should be avoided at all costs.
The most common one suggested is the DMPS challenge test, whereby a large amount of DMPS, usually 250mg, is delivered via a single-dose IV injection (Intra-Venous). This causes the body to mobilise a lot of mercury (and other metals) that was previously bound safely within storage sites in the tissues. It is drawn out of the tissues like a sponge and thrown into the blood. If your body is unable to deal with this unexpected toxic load long-term consequences can follow.  Many people have had terrible adverse effects and others have experienced permanent damage from these tests. Andy Cutler advises strongly against this test and encourages hair testing instead. For more information of the dangers of the challange test visitDMPS Backfire and Dr Cranton’s website.

DMPS is recognised to have excellent use in cases of acute metal toxicity, but when used as a ‘challenge test’ the results do not yield a lot of valuable information and even if you do decide to do a  ‘challenge test’ after properly researching it, the overall test results cannot be considered as meaningful in any case, since mercury is mobilised and ‘redistributed’ throughout the body in indiscriminate patterns making scientific comparisons impossible. DMPS does not cross the blood-brain barrier or cell membranes, so it yields NO information about levels in the brain, organs and cells.

The safer DMPS oral challenge test: If, after researching the issue, you or your Doctor is insistent on doing a challenge test, then rather do it as safely as possible. This requires that you do careful pre-testing for intolerance. For intolerance testing, some advise a small oral dose (not more than 100 mg., which is often way too much for some) be taken with a 14-day waiting period for possible side effects. Should you test ‘tolerant to this’ then you can continue the oral challenge test in the form of an oral chelation round (rather than IV). A round implies using small dosages of 50mg DMPS, taken orally every 8 hours for three days with a urine collection at the end of the third day. If you have any negative effects on this smaller oral dose you can stop immediately without further damage being done.
But, challenge tests in general are discouraged as the results are not informative anyway. The readings will come from mobilizing mercury which is not released in any consistent manner. Each test result can vary in the extreme, skewing information.

More importantly: Never, ever take any chelator in any form if you have any mercury still inside your mouth! Many doctors/dentists advise this prior to removal.

EDTA challenge tests for mercury toxic people are also not informative for the same reasons. EDTA is extensively used as an IV chelator with positive effects for other metals, but EDTA will not chelate mercury to any great degree and instead has a strong affinity for lead and cadmium. It should therefore only be used after mercury has been removed safely with oral chelation.
DMSA, DMPS and ALA are the only agents that will chelate mercury well. DMSA even chelates lead better than EDTA, but EDTA is good in certain situations for lead, such as when you have no mercury. But, if you are mercury toxic then IV EDTA can possibly make you much worse and it is advised to follow the oral chelation program as recommended by Andy Cutler to bring your mercury levels down safely first, thereafter IV EDTA can be considered, but can be used orally also for greater safety. EDTA was previously promoted as being good for removing calcium plaques in blood vessels. It is now suggested that it does not remove calcium plaques, but instead removes metals from the vessel lining (epithelial) receptor sites, thereby freeing up receptor sites to receive more nitric oxide, which was previously blocked by metals.
24 hour fractionated urine porphyrin tests can also be used to gather information on mercury toxicity. Elevated urinecoproporphyrin is suggestive of mercury poisoning (or another toxin) or possibly a genetic disorder. Finding elevateduroporphyrin also indicates toxicity rather than genetics. The urine must be collected in a very specific way and handled in a very specific manner for accurate results (see pg.182 Amalgam Illness diagnosis and treatment). You cannot be certain that the labs will take the proper testing precautions e.g. keeping the sample on ice at all times, never exposing it to light and never shaking it. This is what makes a hair elements test much ’safer’ for diagnosis.

CHELATION PROCEDURE AFTER DENTAL REVISION
There are two types of chelation, oral chelation and intravenous (IV) chelation.
Oral chelation is much, much safer for mercury. It is also much less expensive and can be done by yourself, or monitored by a medical practitioner informed of Andy Cutler’s research. IV chelation can only be performed by a medical practitioner. The safest approach is to bring your mercury levels down slowly and safely with the Cutler protocol.
Andy Cutler (www.noamalgam.com ) developed these safe and effective protocols for chelation based on pharmacological properties of chelators and using them according to their half-life. He advises the use of oral chelators every 3-4 hours in order to keep the blood levels of the chelators stable without gross fluctuation. If you don’t keep blood levels stable you will induce more ‘redistribution’ of mercury and cause more damage. Andy Cutler’s oral chelation program is designed specifically for mercury, but his book describes how you can deal with other metals should they present.
Chelators MUST be used correctly in accordance with their pharmacological half-life in order to be safe and effective. During the Cutler protocol, chelation is done in rounds. An average round consists of three days chelating and three days rest. This allows for safe mobilisation and chelation of mercury and a time for your detoxification channels to ‘catch-up’ during rest days. You start with very low doses and build up SLOWLY!

Again, you cannot chelate metals OUT that you are still taking IN! For that reason it is essential that you complete the dental revision. We suggest you consider the full dental clean-up as described by Dr Clark and Dr Huggins which ensures that you remove ALL metals from your mouth first. Dr Cutler only suggests that you remove mercury.
Do your own research and make informed decisions. You never know what is hiding underneath a metal crown until you remove it. X-rays cannot penetrate metal crowns and many people have mercury amalgams there. If you chelate with ANY mercury amalgam still in your mouth you will make matters much worse. This is a common occurance.
Once you are sure that all your mercury amalgams (and preferably all metals) are removed, you can start with a DMSA round at least four days after the last amalgam is removed. Wait another three months before adding  ALA. DMPS can be used immediately.
DMSA and DMPS reduce the body-burden of mercury and are used soon after removal. ALA cleans the brain (and organs) by crossing the Blood Brain Barrier (BBB). ALA can get mercury ‘in and out’ of the brain. During mercury amalgam removal a lot of mercury is released, thus, it is best to wait three months and lower the mercury in the body with DMSA or DMPS before adding the ALA to prevent released mercury from moving into the brain with ALA (this happens if there is a high concentration in the blood). ALA and DMSA are thought to exert a synergistic effect and should be used together when you begin ALA. DMSA also reduces side-effects of ALA.

Oral chelation needs to be done correctly with low dosages taken on schedule to avoid problems. Typically, oral chelation can take between one and five years to complete depending on how toxic you are and how well you excrete metals.
Follow Andy Cutler’s protocols and build-up doses slowly. DO NOT follow the advice on the bottles of many supplements for chelation – you can get into trouble if you use compounds incorrectly and bounce your blood levels around! This is a serious concern. Please do not get arrogant with chelation, appropriate care MUST be taken. Keep the dose low and go slow.
Slow equals fast with chelation. Take your time. Letting your ‘ego’ force things along will only cause trouble as you begin moving the metals out faster than you can cope. Some supplements, such as chlorella, will only mobilize it rather than bind strongly to it and pull it out the body. If you only mobilize mercury but fail to pull it out of the body, you can get very sick. Most of the deleterious effects of mercury happen when it is being mobilised without it being properly bound.

ALA and DMSA are used most commonly to chelate mercury with Andy Cutler’s protocol. Other chelators may be better with other metals, but not when the focus is on mercury. Again, a lot of people, including your dentist, may assume that all the mercury is out, only to find an amalgam hidden under a metal crown when removed at a later stage, or in an ‘appecectomy’ of a root canal tooth. You will feel a lot worse if you attempt to chelate with ANY amalgam still in your mouth. This includes doing ill advised challenge tests with mercury still in, that your doctor may attempt on you. Chelators must NEVER be taken with mercury still in the mouth! (check your supplements to make sure ALA is not in them – it is becoming more and more common in supplements. However, most people are unaware that it is an anti-oxidant AND a chelator.

DMSA – start with this four days after mercury removal

DMSA chelates specifically lead and mercury. It is a man-made substance and was introduced initially to chelate lead for children.
DMSA doesn’t cross the blood brain barrier to any clinical degree. DMSA only chelates extracellular mercury, in the rest of the body. DMSA has a half-life of four hours. DMSA is used early in treatment to lower the blood/body levels before adding ALA, due to ALA’s ability to go into and out of the brain. For this reason ALA should NOT be added too early. Many need to start with very small dosages of DMSA for long periods to test tolerance and reduce the body burden before increasing the dosage or using ALA (this can be done for as long as a year for some mercury-toxic people that cannot tolerate ALA early, or at all). It is generally recommended to do several rounds (at least three or four) on DMSA at low dosages before changing dosage or adding ALA. Each component is changed separately so you know which (dose or substance) is causing resultant side-effects/problems. If you use both chelators simultaneously and have problems you won’t know which one is causing them. DMSA is not a sulphur-based drug. The molecule is based on succinic acid. DMSA is a synthetic (man-made) compound, while ALA is a naturally occurring compound. Both release and bind toxins which means you should make certain you are taking sufficient antioxidants to support the detoxification process. Consult a medical practitioner aware of the Cutler approach if possible.        DMSA has the effect of reducing the side effects after beginning ALA, especially for those with a supposed lower body burden and higher brain burden. DMSA can help reduce symptoms after recent final amalgam removal, as mercury is mobilised during the process. DMSA, or any chelator, can exacerbate existing symptoms, so it is advised that oral chelation is begun with low doses and close attention paid to symptoms. Start with doses of 12.5mg and increase slowly over a number of rounds. Some people believe they have an allergy to the DMSA compound itself, but it is actually the incorrect dosage or timing of dose that is causing problems. If you are having side-effects with 12.5mg you can lower the dose further to 5mg. It is of course possible, that you cannot tolerate DMSA no matter what the dose.
DMSA is excreted through the kidneys which means this pathway of elimination must be flowing well.
Purchasing DMSA. DMSA can be obtained in specially compounded quantities from here. mercury and need to be avoided, while proper chelators.

ALA – ALPHA LIPOIC ACID (Also known as LIPOIC ACID or THIOCTIC ACID)
ALA is the most important ingredient in oral chelation. ALA chelates both intracellular and extracellular mercury (and arsenic) – in the brain and in the body – making it essential to successful detox, while DMSA and DMPS are optional components to help reduce side-effects and open up an accessory route of elimination via the urine. ALA is a disulfide. It is water and fat soluble which makes it able to pass the Blood Brain Barrier (BBB) and is thus able to clear mercury from the brain and inside the organs. Many people have successfully detoxed with ALA alone (often because they couldn’t tolerate the other common chelating agent DMSA for some or other reason). ALA has a half-life of three hours.
Again: ALA is essential to detox, while DMSA/DMPS is not. Pulling mercury out of the blood and soft tissues is relatively easy, but pulling it out of the inside of cells is much harder.

Start ALA at low doses of 12.5mg to ensure few or no adverse effects, and add only after many rounds of DMSA. ALA can really increase side effects in a mercury toxic person and you may need to reduce the dose to 6.25mg. The maximum dose of ALA per day is about 1200mg over twenty-four hours (that is very high and can cause bad or intolerable side effects in some, so work up SLOWLY. It can take you years to get to this point). Starting low and working up is the safest way to proceed to avoid exacerbating symptoms. The higher dosage seems to make a more dramatic difference ultimately, but it takes a long time to get there safely. ALA is not usually as ‘easy’ as DMSA, as you are mobilizing mercury from the brain and inside the cells. So it is difficult to ‘expect’ a symptom-free round with it, and especially the day after the round has finished. Usually side-effects are worse when coming off of an ALA-round when the mercury is redistributing. If the side effects are too harsh lower the dosage before proceeding with your next round.
If you have removed your mercury amalgams a long time ago, you should still use DMSA on its own for a few months before adding ALA. In this way you can know which supplement is causing a problem if it occurs. The brain will not detox mercury on its own and only over a lifetime would it be able to eliminate it to a small degree. Only ALA is able to allow mercury to be excreted from the brain. People with significant brain mercury will not be able to improve unless they use enough ALA for a long enough time. Those that improve greatly on DMSA alone, do not usually have as much brain toxicity. ALA is excreted mainly through the biliary system (bile ducts) from the liver and into the gastro-intestinal tract and also through the kidneys. This means these pathways of elimination should be flowing well to assist detoxification.
ALA should be avoided until the body burden is reduced, as it can move more mercury into the brain if the body burden is too high and redistribution is initiated.
ALA is available from most health shops in far too high a dosage without appropriate warnings or directions of usage. Do not use R-ALA.
Purchasing ALA. ALA can be obtained in specially compounded quantities from here.

DMPS
DMPS, is a powerful chelator especially beneficial during times of acute toxicity. It is a synthetic compound. Taken without caution and in high dosages, as with challenge tests, can cause too much mercury to be pushed into the kidney and liver (especially if these organs are not working well), and can permanently damage them. You should NOT take DMPS, or any chelator, intravenously. Taken orally however, in according to Andy Cutler’s protocol, it can prove very beneficial, especially for those that do not tolerate DMSA or ALA well. It is taken according to its half-life every six to eight hours.
DMPS is used for mercury, but will also chelate arsenic . It chelates extracellular mercury or body burden.
DMPS is not available in oral form in South Africa, but is used when performing a DMPS challenge tests by some doctors. They may allow you to use the IV vials orally for oral chelation.
Most people do fine without DMPS, however if you have a problem with DMSA, then use oral DMPS at frequent low dosages and then later add ALA.

The article is continued here…  Please read on for supplement advice while chelating.