Interview with the Experts in Biological Dentistry

Identify the most promising methods to be used to remove mercury and other toxic metals from the body?

Klinghardt:

"After amalgam fillings are removed, the problem of mercury (Hg) toxicity is not solved. The Hg goes into the cells, into the nerve axons."

"EDTA does not work for Hg removal. Amalgam patients who have had 50 chelations with EDTA after amalgam removal can still have large pools of Hg in their bodies.

"DMSA should be used only at the end of treatment to get further into the nervous system. If you use it in the beginning, the patient can get much worse."

"IV vitamin C is highly overrated and has not produced the clinical improvement you get with DMPS."

Aposhian:

"DMSA and DMPS are water soluble chemical analogs of dimercaprol (British Anti-Lewisite, BAL). In contrast to BAL, they have less toxicity, greater water solubility, and limited lipid solubility, and are effective when given orally."

"The efficacy of DMSA >DMPS >NApen = D-pen for removing methylmercuric chloride from erythrocytes, in vitro, was confirmed in vivo by Planas-Bohne ... DMSA was most effective in removing the mercurial from all organs except the kidneys, for which DMPS was better. NApen showed only marginal effectiveness. DMSA removed more of the organic Hg while DMPS removed more of the inorganic Hg. A combination of DMPS and DMSA removed mercury from most organs."

"The influence of DMPS and DMSA on the distribution and excretion of mercuric chloride in the rat has been compared. DMPS was more efficient in removing inorganic Hg from the body. If maximum tolerated dose is used as the criterion, however, DMSA > BAL > DMPS for increasing the urinary excretion of 203HgCl2 according to the Ding group."

GonzaIez-Ramirez:

"DMPS has been distributed and used in Europe since 1976. In fact, as stated by Schiele et al. in 1989, DMPS 'has been the approved treatment of choice for more than ten years in West Germany and is valued for its negligible side effects.'"

"Although calcium disodium EDTA mobilizes lead, it is not an effective mobilizer of mercury and is thus useless as a mercury challenge test."

"DMSA, however, unlike DMPS, is primarily extracellularinits distribution."

Wallach:

"Dr. Todd took patients with elevated hair levels of lead, mercury or cadmium for his studies on mineral substitution. Blood tests were performed to determine blood levels of the toxic metals. The participating patients were given three ounces of liquid plant derived colloidal minerals daily and the hair analysis was repeated at three month intervals.

The results of Dr. Todd's study were very revealing. Initially, many participants of the study showed low levels of the toxic minerals in their hair. In fact, the three-month repeat hair analysis showed that in the majority of patients with measurable levels of lead, cadmium and mercury in their hair at the onset of the experiment there was an increase in hair levels of the toxic minerals. Since the levels of toxic minerals are increased in the hair during the first few months, use of Todd's protocol may be an effective method of unmasking latent (hidden) body stores of lead, cadmium or mercury.

In the subsequent three month hair analysis there was a significant drop in the hair levels of lead, cadmium and mercury. Todd translated his findings to mean that there is a mobilization of tissue stores of the toxic minerals by the plant derived colloidal minerals that resulted in the initial hair analysis increase at the three month test repeat. Repeated hair analysis at six to 16 months demonstrated that the rate and degree of toxic mineral reduction in the hair appears to be time and dose related.

Which agent will be most effective at penetrating the blood-brain barrier to effect the release of the toxic metals from the neurons within the brain?

Klinghardt:

"Even though DMPS does not cross the blood brain barrier, major improvements in neurological disease are often seen. This is easily explained through the laws of osmosis: If the connective tissue and vascular system is free of heavy metals and the brain and nervous system has a high heavy metal burden, given enough time, the heavy metals will shift from the brain into the other tissues where the body can excrete them. However, we like to finish the treatment (when no more heavy metals are detected through the urine challenge test) with a three day regimen of DMSA. The patient is given 250 mg capsules of DMSA: Take two capsules three times a day for three days in a row. Patients can experience severe side effects with DMSA due to the tremendous shift of minerals within the nervous system caused by this agent. We have found that moderate amounts of alcohol such as wine or beer counteract some of these side effects. We also recommend that each patient undergoing the DMPS treatment is on the Williams/Klinghardt detox program (Chlorella, antioxidants, etc.). Recently, we have found that moderate doses of odorless garlic appear to tremendously help the excretion of heavy metals while the patient is undergoing this intense detox program. Saunas, exercise, and colonies are also helpful."

"After DMPS treatment, the patient will first feel better, then worse. This is the result of the heavy metals moving from intercellular to extracellular. Toxic metals travel through the cell wall by the osmotic gradient. The symptoms of intercellular toxicity are fatigue and chronic disease. The symptoms of extracellular toxicity are more readily apparent. It takes from 61012 months to get somebody clean with DMPS treatment every 4 weeks. At the end of treatment, all aspects of vitality improve."

Aposhian:

"The activities of DMSA, DMPS, and NApen in mobilizing MeHg in the mouse have been compared by Aaseth & Friedheim" ".... DMSA accelerated Hg elimination from the brain, but DMPS had no effect. Hg in the blood, kidneys, and liver decreased the most in the DMSA group and least in the DMPS group. The cumulative urinary excretion of Hg was greatest in the DMSA-treated mice and least in the DMPS group."

The most effective agent for removing mercury from the brains of rats given 203Hg-MeHg iv was DMSA, which was better than NApen, which was better than D-pen."

GonzaIez-Ramirez:

"A number of questions remain to be answered. First, does DMPS given under the conditions of the challenge test mobilize mercury only from the kidney or does it also mobilize mercury in other tissues and then allow the kidney to concentrate and excrete the mercury?"

Note: Dr. Aposhian has stated that there is no agent which is proven to remove Hg from the brain (personal communication).

Note: Dr. Haley has suggested that DMSA together with large doses of Vit C may be the best way to eliminate Hg from the brain, (personal communication).

Daunderer:

"DMPS, in contrast to all earlier chelators, reduces the accumulated mercury in the brain, also when the starting blood- and urine values are with normal limits (normal up to 4 ug/l in urine). The effect is only extracellular. Therefore, detoxification is only possible by diffusion."

What is the mechanism by which neuronal detoxification proceeds?

Klinghardt:

"Electron microscopy studies have aided study of the nerve cells and the autonomic nervous system. The autonomic nervous system is connected to every cell in the body. Hg gets dumped into the "ground" system and then gets picked up by the autonomic nervous system. The nerve cell is continuously sampling it's environment. It picks up nutrients and other materials at the end plate by pinocytosis for transport up the axon in structures called microtubules. These microtubules are also necessary to discharge materials out of the cell. When the cell picks up Hg, the Hg impairs the formation of tubulin which is a protein which must be present for the formation of the microtubules. Thus, the cell has no way to transport the Hg back out. The cell continues to absorb Hg and other toxins until it looses the ability to absorb or eliminate. The cell becomes sick from starvation. The axon transport system is shut down. The nerve cell can only store the Hg. This leads to chronic disease."

"Neural therapy is the process of opening the cell membrane and bathing the nerve cell with an anesthetic which opens the ionic channels. This allows the toxic metals to be released from the cell by a mechanism other than axon transport. This is a process you are going to hear a lot cause a redistribution of Hg to the brain or other organs of the body."

Klinghardt:

"Intravenous DMPS should not be used in patients that still have silver amalgam fillings. DMPS seems to appear in the saliva and desolves the surfaces of the existing amalgam fillings. This process occurs over a series of several days. However, the blood concentration of DMPS lessens very quickly. Therefore, the patient with amalgam fillings can become acutely toxic from heavy metal injury to the mucosa of the gut following a DMPS shot. The DMPS should be given however immediately after the last amalgam filling in the patient's mouth has been removed."

What is the danger that the selected agent will remove beneficial metals from the brain and other parts of the body? How can this concern be addressed?

Ziff:

"One work of caution about the use of DMPS and DMSA; they will also remove zinc. Zinc deficiency should be corrected prior to starting any chelator treatments and zinc should be supplemented during treatments."

Aposhian:

(DMPS) "is more specific than CaNa2EDTA in that at diagnostic doses it would not be expected to increase the urinary excretion of essential metals such as copper and zinc (25) at clinically important levels."

Aposhian:

"A fair summary of many results seems to be t hat when used in therapeutically reasonable amounts, neither DMPS nor DMSA appears to change drastically the amounts of trace elements excreted. The greatest effect appears to be on Cu excretion. Vakhnitsky (98) studied a group of workers who had been treated with 5 ml of a 5% DMPS solution twice a day for 2 days. In their occupations, 37 had been exposed to Hg and 34 to Pb. After the DMPS therapy, the average Cu excretion increased 13-fold and Mn excretion 2-fold. There was a small, statistically insignificant

"We believe that treatment with zinc complex (linked to B - globulins) to correct AM-induced zinc deficiency may regularize DNA metabolism and cerebral protein synthesis, thereby preventing PHF-NFT formation and other neuritic changes, and allowing AM-SP to remain a symptomatic. If PHF-NFT have already been formed, this treatment may still be useful by normalizing cerebral detoxification and neurotransmitter metabolism."

What would be a protocol for treatment of AD by removal of toxic metals from the brain?

Daunderer:

"When after giving DMPS (1 ampule 250 mg i.v.), the urine value increases to more than 50 ug/l, it is definite proof of the accumulation of mercury in organs and brain. The elimination can be carried out successively, e.g. every 4th week. The therapy can also be necessary several years after amalgam removal. After repeated DMPS administration, the substitution with zinc aspartate and possibly iron is necessary.

Procedure:

More dangerous than narrow, deep fillings are occlusal fillings with a large surface area. One large amalgam filling gives after chelation levels of 40 ug/l for each year of presence. Our experience is that values over 50 mg/l give neurological disturbances like headaches and neurasthenia.

More than 10 fillings (--> up to 2565 ug/l after DMPS) leads generally to fermenting problems."

Klinghardt:

"Toxicity is suspected if the urine Hg is greater than 1 microgram per 24 hours. After Hg comes out of the system, other heavy metals come out."

"Our protocol is similar to the one developed by German toxicologist, Max Daunderer, M.D.2,19 On the day of the last amalgam removal, the first treatment is given. In patients that had the amalgam taken out months, years, or decades before, this diagnostic test and treatment method should still be used as soon as the problem of heavy metal toxicity is suspected.

"The content of the ampoule (or 3 mg/kg body weight) is drawn up into a 5 cc syringe and slowly injected into the patient with a 25 gauge butterfly over a 5 minute period of time (1 cc per minute). The patient is then asked to collect all urine for 24 hours in the container provided by Dr's Data. On the lab slip, the doctor has to mark off the following urine tests: "special mercury" and "elements". The patient will fill the provided mailing tube with a sample from the urine collected over the 24-hour period. After voiding the first urine into the container, the provided ampoule of nitric acid is added to the urine in the container. The patient is responsible for the mailing of his own urine. A mailing container is provided by Dr's Data. Paravenous infiltration of DMPS is harmless, but creates an itching sensation at the injection site for half an hour or so. DMPS appears to clear the vascular system and the connective tissue of heavy metals. However, as the connective tissue becomes "cleaned up" more heavy metals move from the intracellular space into the extracellular space (if the body burden of 'heavy metals is high). Therefore the following reactions are often seen: The patient feels better for several days after the injection, then starts feeling bad again. Often the patient will have feeling of "emptiness in his head" and difficulty concentrating for a few days. I attribute this to a lack of "good minerals" in his system. No mineral supplements should be given 24 hours before and 48 hours after the test. Otherwise DMPS will bind to calcium, magnesium, and other "good" minerals and not get to the mercury. The urine test results come back after three weeks or so. The patient is instructed to come back after four weeks. If any of the toxic metals are elevated above normal or mercury excretion is more than 1 mcg/24 hours, the next injection is given. I recommend to repeat the urine test at the time of the third shot (two months after beginning of treatment). By mobilizing mercury, copper, nickel, etc. from the intracellular space to the extracellular space and from there out of the system, the heavy metal related symptoms of the patient can be temporarily aggravated (i.e. joint pains, depression, fatigue, etc.)(. However, this is transient. In my experience, the patient will always feel better within three to four weeks following the shot (that means better than before beginning of treatment). In my experience, dentists have required six to eight treatments to get the heavy metal burden down to "normal". They then require a shot every four to six months or so to stay current. Alternately, they can use oral chelation with chlorella (8 caps/day). People that had exposure to amalgam through their fillings will typically require three to five injections. People that have never had amalgam fillings, but show evidence or suspicion of heavy metal toxicity through other sources typically require one to two injections.

"I have not observed any serious side effects. Side effects are occasionally observed such as temporary lowering of blood pressure, allergic reactions, and skin rashes. DMPS is not mutagenicis, seems to have no teratogenic effects, and is not carcinogenic2. Max Daunderer, M.D., prefers the Russian made version of DMPS called Unithiol, which comes in a 5 ml 500 mg ampoule. This agent is preferably injected intramuscularly, half ampoule in each buttock. The excretion of heavy metals caused through this approach is much more gradual than after the IV DMPS and not suitable to use in conjunction with the urine challenge test. However, it is good to use this approach at times when no urine test is planned for. I am not aware of sources for Unithiol in the U.S. A. However, in Europe this agent is much less costly than the German made product18.

"I firmly believe at this point in time that there are no alternatives in the DMPS treatment. I have not seen any clear evidence that any of the other proposed detox programs result in the same clinical improvements including the use of DMSA, BAL, and D-penicillamine2. Chlorella speeds up the cleaning-up process, but can temporarily lead to detox-related unpleasant symptoms. Chlorella seems to be the ideal agent to stay current with a low toxic metal burden and helps to survive these times of toxic overexposure from so many different sources."

"Metals come out in sequence during DMPS treatment. First come Zn and Cu, then Hg, then the other heavy metals. Hg is like the gate keeper of the other toxic metals and must be reduced before they can come out.

"Chlorella is of incredible value during DMPS treatment. The patients ability to tolerate Chlorella is a very good indication of their level of toxicity. If 3 caps per day makes them sick, they have large pools of toxic metals. If they can tolerate 10 caps per day without getting sick, there are no toxic pools. Reactions to Chlorella may include nausea, flu- like symptoms, inability to get out of bed."

"When the heavy metal analysis comes back negative, one can often still find "nests" of heavy metal toxicity in various tissues using neural kinesiology. The patient will then benefit from further injection of DMPS locally using the neural therapy approach (segmental injections, paravertebral injections, autonomic ganglion blocks with lidocaine and a small amount of DMPS- 10 parts lidocaine, 1 part DMPS). If the DMPS is given often enough, the clinical improvements of the patients are dramatic and often miraculous. If DMPS is given too few times, the patient will sometimes not experience any lasting clinical improvement (since the heavy metal burden of the body is not yet sufficiently decreased). The most consistent observation that we have made is that each patient treated several times with DMPS seems to become biologically younger (hair grows back, skin looks more supple and rosy, lab parameters shift back to normal). Chronic pain and neurological disease appear to be the most gratifying indications."

What diet and supplementation guidelines have been proposed for reducing Hg and other toxic metals?

Ziff:

"In some people the addition of some of the key nutrients affected by mercury and lead may produce some beneficial health effects through the reduction of some symptomatology related to existing health problems....

Glutathione (GSH)....protects against mercury toxicity.... 50 milligrams three times a day on an empty stomach.... Take only glutathione for the first 3-4 days before you add the next nutrient."

N-Acetyl-L-Cysteine (NAC)....has the ability of being able to stimulate your own body to produce large amounts of cysteine and glutathione.... try NAC three or four days after starting glutathione to insure you do not have any type of reaction to it."

Methylsulfonylmethane (MSM)....provides bioavailable sulfur...It is being provided as a nutritional supplement by Advanced MedicalNutrition, Inc.

Vitamin B6 (Pyridoxine)....critically involved in the metabolism of the sulfur amino acids....50 mg B6 tablet per day with your breakfast meal."

Zinc.... stimulates the production of metallothionein in the body....one zinc tablet per day with a meal....15-30 milligram. After you have been taking the glutathione and vitamin B6 for 3-4 days, add .... to your regimen.....closely observing for any changes."

Vitamin C....should help restore and/or maintain adequate adrenal levels....start out with 500 milligrams per day, taken with a meal. After 3-4 days, start increasing your dosage until you are taking 1500 milligrams per day in divided doses."

Vitamin B1....to be added, 3-4 days after vitamin C. Use a 50-milligram tablet and take one tablet with each meal for a total of 150 milligrams per day. ....contains a sulfur group and has been used to treat mercury poisoning.....has a rapid turnover in the brain and the levels are reduced by mercury exposure (mercury oxidizes thiamine to thiochrome).(14) The symptoms of B1 deficiency and mercury poisoning are almost identical.

Selenium.... binds with mercury and will start to cause a redistribution of tissue mercury....should also precipitate some excretion of mercury from the body..... It is suggested that you start with a 50-microgram tablet three times a day for a total of 150 micrograms daily.
PLEASE NOTE; Selenium should not be taken with vitamin C. Take your selenium between meals or whenever possible, two hours before or after you have taken vitamin C.

For those who are allergic to yeast derived products, sodium selenite in tablet or liquid form is available. (Liquid selenium is available from Nutricolgy, Inc. (Allergy Research Group) ....Do not take more than 50 micrograms per day until you have established that you are experiencing no adverse allergic reaction."

"Assuming you have achieved some beneficial effects from your supplementation program, what else can you do to help your body cope more effectively with the stress of heavy metal exposure?

"........discretion dictates avoiding tuna during any mercury detoxification program. Intake of shellfish should also be eliminated or greatly reduced...depending on the mercury content of the fish ....fish meal, chickens and eggs can exacerbate symptoms in individuals with known sensitivities to mercury.

"....eat a high fiber diet....oat bran....adequate amount of water.... 6-8 glasses of non-fluoridated water daily.... "....maintenance of your intestinal flora (is important)."
Dietary Sources of Particular Nutrients Foods are listed in decreasing order of content:

Selenium: Butter, smoked herring, Brazil nuts, cashew nuts, wheat germ and bran, scallops, barley, whole wheat bread, milk, brown rice, brewers yeast, oats, garlic, Cheddar cheese, and molasses.

Zinc: herring, sunflower seeds, pumpkin seeds, ground round steak, lamb chops, pecans, Brazil nuts, beef liver, egg yolk, whole wheat bread, oats, almonds, sardines, and chicken.

Thiamine: Wheat germ, rice bran, yeast, ham, dried raisins and prunes, asparagus, beans, broccoli, cauliflower, corn, lentils, brown rice, almonds, cashews, and eggs.

Methionine and Cysteine; NOTE: The determination of sulfur-amino acid content of various foods is not readily available. As a general rule, recommendations as good food sources of sulfur-containing amino acids have been wheat germ, yogurt, cottage cheese, pork, sausage meat, turkey, eggs, beans, brussel sprouts, onions, garlic, hot red peppers, horseradish, cabbage, brown rice, sesame seeds, pumpkin seeds, oat flakes, granola and avocado."

Dietary intake of refined carbohydrates, sugars, and saturated fats should be reduced. These types of foods have high energy requirements for metabolism and may well reduce the availability of essential enzymes and nutrients required for more beneficial purposes."

"....reduce stress....physical exercise at least three times a week....each session at least thirty minutes duration."

UltraClear is a therapeutic food composed o f white rice protein concentrate, medium-chain triglycerides, high molecular weight rice dextrins, and mercury-detoxifying nutrients including ascorbate, glutathione, selenomethionine, and N-acetylcysteine. It is a 7-21 day program and patients whose amalgams have been replaced take UltraClear three to five times per day as a beverage, along with foods specified in the UltraClear metabolic detoxification program booklet. ....HealthComm, Inc.