http://www.mercola.com/article/mercury/mercury_elimination.htm

Mercury Toxicity and Systemic Elimination Agents
 
The following paper has been a long time in the making. I first wrote it nearly
three years ago and it was initially rejected by the Lancet and the British
Medical Journal but was published last month in the Journal of Nutritional and
Environmental Medicine (March 2001).
The end of the article has the bibliography which took quite awhile to compile
and has 124 of the best literature documentation I could find on mercury
detoxification.

For a practical summary of the paper and exactly what one should do, please
review my mercury detoxification protocol.

Dr. Klinghardt is widely recognized as one of the most knowledgeable physicians
in mercury detoxification and it was a privilege to be able to help him with
this paper.

The timing is especially appropriate in light of the mercury lawsuit that was
filed last week

Later this month on April 24 I will be involved in a press conference that will
announce massive additional lawsuits relating to the toxicity of mercury. These
lawsuits have the potential to make the tobacco issue look like small potatoes
as the liabilities could run in the trillions of dollars.

Abstract

This paper reviews the published evidence supporting amalgam toxicity and
describes practical and effective clinical techniques that facilitate mercury
elimination. A literature review is provided which documents effective mercury
elimination strategies to reduce mercury toxicity syndromes.

Considering the weight of evidence supporting mercury toxicity, it would seem
prudent to select alternate dental restoration materials and consider effective
mercury elimination strategies if mercury toxicity is present.

Mercury Exposure And Toxicity Is A Prevalent And Significant Public Health
Threat.

Chronic mercury exposure from occupational, environmental, dental amalgam, and
contaminated food exposure is a significant threat to public health.1

Those with amalgam fillings exceed all occupational exposure allowances of
mercury exposure of all European and North American countries. Adults with four
or more amalgams run a significant risk from the amalgam, while in children as
few as two amalgams will contribute to health problems.2 In most children, the
largest source of mercury is that received from immunizations 3 4 5 6 or that
transferred to them in utero from their mother.7 8

Dental Amalgams Are A Major Source Of Mercury Toxicity

A single dental amalgam filling with a surface area of only 0.4 sq.cm is
estimated to release as much as 15 micrograms of mercury per day primarily
through mechanical wear and evaporation.1 9 10 11

The average individual has eight amalgam fillings and could absorb up to 120
micrograms of mercury per day from their amalgams. These levels are consistent
with reports of 60 micrograms of mercury per day collected in human feces.12 By
way of contrast, estimates of the daily absorption of all forms of mercury from
fish and seafood is 2.3 micrograms and from all other foods, air and water is
0.3 micrograms per day. 13 Currently, Germany, Sweden and Denmark severely
restrict the use of amalgams.1

A "silver" filling, or dental amalgam, is not a true alloy. Amalgams are made
up of 50% mercury. The amalgam also consists of 35% silver, 9% tin, 6% copper
and a trace of zinc.6 More than 100 million mercury fillings are placed each
year in the U.S. as over 90% of dentists use them for restoring posterior
teeth.14

The mercury vapor from the amalgams is lipid soluble and passes readily through
cell membranes and across the blood brain barrier. 15 The vapor serves as the
primary route of mercury from amalgams into the body. It is clear that amalgam
mercury transfers to human tissues, accumulates with time, and presents a
potential health threat. The mercury escapes continuously during the entire
life of the filling primarily in the form of vapor, ions but also abraded
particles.16 17 Chewing, brushing, and the intake of hot fluids stimulates this
release.18 19 20

Statements made by dental authorities which claim that the amount of mercury
exposure encountered by patients from dental amalgams is too small to be
harmful, are contradicted by the literature.21

Animal studies show that radioactively labeled mercury released from ideally
placed amalgam fillings appear quickly in the kidneys22, brain and wall of the
intestines.23 The fact that mercury amalgam fillings are banned in some
European countries is strong evidence of the clinical toxicity of this
material.

Any metal tooth restoration placed in the mouth will also produce
electrogalvanic effects. When dissimilar metals are placed in the oral cavity
they exert a battery-like effect because of the electroconductivity of the
saliva. The electrical current causes metal ions go into solution at a much
higher rate, thereby increasing the exposure to mercury vapor and mercury ions
manyfold. Gold placed in the vicinity of an amalgam restoration produces a
10-fold increase in the release of mercury.24

Mercury's Long Half-Life In The Central Nervous System

Mercury in the central nervous system (CNS) causes psychological, neurological,
and immunological problems in humans.25 26 27 Mercury bonds very firmly to
structures in the CNS through its affinity for sulfhydryl-groups on amino
acids. Other studies have shown that mercury is taken up in the periphery by
all nerve endings and rapidly transported inside the axon of the nerves (axonal
transport) to the spinal cord and brainstem.28 29 30 Unless actively removed,
mercury has an extremely long half-life of somewhere between 15 and 30 years in
the CNS.1 31

Mercury Toxicity Symptoms

The overt clinical effects resulting from toxic exposure to mercury have been
clearly described.32 33 The scientific literature shows that amalgam fillings
have been associated with a variety of problems such as Alzheimer's Disease,34
35 autoimmunity,36 37 38 kidney dysfunction,39 infertility,40 41 42 polycystic
ovary syndrome, 43 neurotransmitter imbalances,44 food allergies,45 multiple
sclerosis,46 thyroid problems,47 and an impaired immune system.48

Patients with many amalgam fillings will also have an increase in the
prevalence of antibiotic resistant bacteria.49 Subclinical neuropsychological
and motor control effects were also observed in dentists who had documented
high mercury exposure levels.50 51 Amalgam use may also be related to fatigue,
poor memory and certain psychological disorders.52

There has been a recent epidemic of autism in the US53 54 and many
investigators believe that this may be partially related to the increased
exposure infants have had to mercury through the preservative thimerosal that
was included in nearly all vaccines until recently.55

The nervous system is more sensitive to mercury toxicity than any other organ
in the body. Mercury has recently been documented to be associated with
arrhythmias and cardiomyopathies as hair analysis showed mercury levels to be
20,000 higher in those with these cardiac abnormalities.56 Mercury exposure has
also been associated with other neurological problems such as tremors,57
insomnia, polyneuropathy, paresthesias, emotional lability, irritability,
personality changes, headaches, weakness, blurred vision, dysarthria, slowed
mental response and unsteady gait.1 58 59

Systemic Mercury Elimination

There are a number of agents that have been demonstrated to have clinical
utility in facilitating the removal of mercury with someone who has
demonstrated clinical signs and symptoms of mercury toxicity. The urine and
feces are the main excretory pathways of metallic and inorganic mercury in
humans.1 60

The most important part of systemic elimination is to remove the source of
mercury.

For most this involves amalgam removal. Individuals should seek a dentist who
is specially trained in this area as improperly removed amalgam may result in
unnecessarily high exposure to mercury.61 The following is a summary of the
most effective agents that have been documented in the peer-reviewed
literature.

DMPS

DMPS (Sodium 2,3-dimercaptopropane-1-sulfonate) is an acid-molecule with two
free sulfhydryl groups that forms complexes with heavy metals such as zinc,
copper, arsenic, mercury, cadmium, lead, silver, and tin. DMPS was developed in
the 1950s in the former Soviet Union and has been used to effectively treat
metal intoxication since the 1960s there.62 It is a water-soluble complexing
agent.

Because it had potential use as an antidote for the chemical warfare agent,
Lewisite, it was not available outside of the Soviet Union until 1978, at which
time Heyl, a small pharmaceutical company in Berlin, Germany started to produce
it. It has an abundance of international research data and an excellent safety
record in removing mercury from the body63 and has been used safely in Europe
as Dimaval for many years.64 65 66 67

DMPS is registered in Germany with the BGA (their FDA) for the treatment of
mercury poisoning but is still an investigational drug in the United States.68

The best and only brand of DMPS that should be used is Heyl from Germany. Great
care should also be exercised in making certain the DMPS is compounded properly
from the pharmacist. If the DMPS contacts metal during it will be oxidized, so
the compounding pharmacist must use nonmetal needles must be used in preparing
the product.

DMPS Can Be Used To Eliminate Mercury Systemically

The use of DMPS to treat mercury toxicity is well established and accepted. 69
70 71 DMPS has clearly demonstrated elimination effects on the connective
tissue.72 73 The DMPS dose is 3-5 mg /kg of body weight once a month which is
injected slowly intravenously over five minutes. DMPS-stimulated excretion of
all heavy metals reaches a maximum 2-3 hours after infusion and decreases
thereafter to return to baseline levels after 8 hours.74

DMPS Safety

DMPS is not mutagenic, teratogenic or carcinogenic.75 Ideally intravenous DMPS
should never be used in patients that still have amalgam fillings in place,
although investigators have done this as diagnostically, as a one-time dose,
without complications.76 DMPS appears in the saliva and may mobilize
significant amounts of mercury from the surface of the fillings and precipitate
seizures, cardiac arrhythmias, or severe fatigue.

One should use DMPS with great caution and NEVER use it in patients with
amalgam fillings. Ideally DMPS should be administered after 25 grams of
ascorbic acid administered intravenously. This will minimize any potential
toxicity from the DMPS.

Even though DMPS has a high affinity for mercury, the highest affinity appears
to be for copper and zinc77 and supplementation needs to be used to not avoid
depleting these beneficial minerals. Zinc is particularly important when
undergoing mercury chelation.78 DMPS is administered over a five-minute period
since hypotensive effects are possible when given intravenously as a bolus.79
80 Other possible side effects include allergic reactions and skin rashes.

DMSA

DMSA (meso-2, 3-dimercaptosucccinic acid) is another mercury chelating agent.
It is the only chelating agent other than cilantro and d-penicillamine81 that
penetrates brain cells. DMSA removes mercury both via the kidneys and via the
bile.82 The sulfhydryl groups in both DMPS and DMSA bind very tightly to
mercury.

DMSA has three distinct disadvantages relative to DMPS.

First, DMPS appears to remain in the body for a longer time than DMSA.83

Secondly, DMPS acts more quickly than DMSA, probably because its distribution
is both intracellular and extracellular.84

Thirdly, preparations of DMPS are available for intravenous or intramuscular
use, while DMSA is available only in oral form.85 Since succinic acid is used
in the citric acid cycle inside the cell, DMSA has been suspected for
displacing mercury towards the inside of the cell86 after binding mercury
somewhere on its way from the intestine to the succinic acid deficient cell.

We propose therefore that DMSA be used late in the mercury elimination process,
after the connective tissue mercury load has been reduced with DMPS. The
standard dose of DMSA is 5-10 mg/kg twice a day for two weeks. The DMSA is then
stopped for two weeks and then the cycle is repeated.

Chlorella

Algae and other aquatic plants possess the capacity to take up toxic trace
metals from their environment, resulting in an internal concentration greater
than those of the surrounding waters.87 This property has been exploited as a
means for treating industrial effluent containing metals before they are
discharged, and to recover the bioavailable fraction of the metal.88

Chlorella has been shown to develop resistance to cadmium contaminated waters
by synthesizing metal-binding proteins.89 A book written for the mining
industry, Biosorption of Heavy Metals,90 details how miners use these organisms
to increase the yield of precious metals in old mines. The mucopolysaccharides
in chlorella's cell wall absorb rather large amounts of toxic metals similar to
an ion exchange resin.

Chlorella also enhances mobilization of mercury compartmentalized in
non-neurologic structures such as the gut wall,91 muscles, ligaments,
connective tissue, and bone.

High doses of chlorella have been found to be very effective in Germany for
mercury elimination.92

Chlorella is an important part of the systemic mercury elimination program, as
approximately 90% of the mercury is eliminated through the stool. Using large
doses of chlorella facilitates fecal mercury excretion. After the intestinal
mercury burden is lowered, mercury will more readily migrate into the intestine
from other body tissues from where chlorella will effectively remove it.

Chlorella is not tolerated by about one-third of people due to gastrointestinal
distress. Chitosan can be effectively used as an alternative in these
individuals. Chitosan makes up most of the hull of insects shellfish and also
bind metals like mercury from the lumen of the intestines.93 94 95

Cilantro

Omura determined that cilantro could mobilize mercury and other toxic metals
rapidly from the CNS.96 97

Cilantro mobilizes mercury, aluminum, lead and tin stored in the brain and in
the spinal cord and moves it into the connective tissues. The mobilized mercury
appears to be either excreted via the stool, the urine, or translocated into
more peripheral tissues.

The mechanism of action is unknown. Cilantro alone often does not remove
mercury from the body; it often only displaces the metals form intracellularly
or from deeper body stores to more superficial structures, from where it can be
easier removed with the previously described agents. The use of cilantro with
DMSA or DMPS has produced an increase in motor nerve function.98

Potentiating Agents

Adequate sulfur stores are necessary to facilitate mercury's binding to
sulfhydryl groups.

Many individual's sulfur stores are greatly depleted which impairs sulfur
containing chelating or complexing agents, such as DMPS or DMSA, effectiveness
as they are metabolized and utilized as a source of sulfur. Sulfur containing
natural substances, like garlic99 100 and MSM (methylsulfonylmethane) may also
serve as an effective agent to supply organic sulfur for detoxification.101
Fresh garlic is preferred as it has many other recently documented benefits.102
103 104 The garlic is consumed just below the threshold of social
unacceptability, which is typically 1-2 cloves per day.

Antioxidants

Vitamin E doses of 400 I.U per day have been shown to have a protective effect
when the brain is exposed to methyl-mercury.68 105 Selenium, 200-400 mcg
daily,106 107 108 109 is a particularly important trace mineral in mercury
elimination and should be used for most patients.

Selenium facilitates the function of glutathione, which is also important in
mercury detoxification.110 111 112 Some clinicians find repetitive high dose
intravenous glutathione useful, especially in neurologically compromised
patients.

There is a suggestion in a rat model that lipoic acid may also be useful,113
but some clinicians are concerned about the potential of lipoic acid to bring
mercury into the brain early in the stages of chelation, similar to DMSA and
N-acetylcysteine (NAC), which has also been used in mercury chelation.114 Doses
larger than 50-100 mg per day should be used with caution.

Vitamin C is also a helpful supplement for mercury elimination as it will tend
to mobilize mercury from intracellular stores.115 116 117 118 119 120

Some clinicians will use it intravenously in doses of 25-100 grams IV in
preference to DMPS and DMSA.

Hyaluronic acid (HA) is a major carbohydrate component of the extracellular
matrix and can be found in the skin, joints, eyes and most other organs and
tissues.121 HA is utilized in many chemotherapy protocols as a potentiating
agent.122 HA is also being utilized for many novel applications in medicine.123
124 Personal experience has shown that the addition of 2 ml with the DMPS tends
to improve the excretion of mercury by two to four fold with virtually no
toxicity.

Conclusion

We have described the significant toxicities associated with mercury amalgams
and treatment agents that both authors have used successfully over the past two
decades to eliminate mercury and resolve many chronic health complaints.
Considering the weight of evidence supporting amalgam toxicity it would seem
prudent to select alternative dental restoration materials.

Joseph Mercola, DO.
Medical Director
Optimal Wellness Center
1443 W. Schaumburg
Schaumburg, IL 60194

Dietrich Klinghardt, M.D., Ph.D.
Medical Director
American Academy of Neural Therapy
2802 E.Madison #147
Seattle, WA 98112