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DMSA for Heavy Metals & Mercury Poisoning

Updated 1/10/2021

Medically reviewed by Dr. Atmika Paudel, PhD - Written by Dan Jackowiak Nc, HHP and Dr. Vibhuti Rana, PhD


Dr. Atmika Paudel, PhD says... The facts about DMSA and its possible safety issues in this article are medically correct.


DMSA, or Dimercaptosuccinic acid, is a sulfhydryl-containing substance that binds to mercury, lead, cadmium and zinc. It is a water-soluble, non-toxic, orally administered metal chelator that has been in use as an antidote for heavy metal toxicity and mercury poisoning treatment since the 1950s.

Research confirms that it is effective, yet safe for removing mercury and other heavy metals from the body. The convenience of oral dosing and low toxicity often make it the chelator of choice for many applications.

20% of orally administered DMSA is absorbed through the gastrointestinal tract, which is two to four times the amount of EDTA that is absorbed.

DMSA-Bottle

DMSA treatment for mercury poisoning results in the greatest urinary excretion of mercury, compared to other heavy metal chelators, as well as being the most effective at removing mercury from the blood, liver, spleen, lungs, large intestine, skeletal muscles and bone. Mercury excretion is highest in the first 8 to 24 hours after ingestion.

For mercury removal in the brain, it is best used with other chelating agents such as DMPS or with the SH–dextran–British anti-lewisite (BAL) combination.(Source)


Dr. Vibhuti Rana, PhD says...

I agree with the information stated in the above section regarding mercury poisoning. Mercury poisoning can be attributed to a number of environmental, occupational, or contaminated diet-based exposure. Another major cause is dental amalgams in adults as well as children. Long term exposure may cause psychological, neurological, and immunological issues in the body due to alterations in the central nervous system (1). The list of problems includes neurological disorders like Alzheimer's Disease and neurotransmitter imbalances, autoimmunity, kidney dysfunction, infertility, PCOS, food allergies, multiple sclerosis, and thyroid (2). Unless it is removed actively from the system, it can contaminate the nerve cells, and create numerous health problems. Mercury has a half-life of 15-20 years in the CNS.

DMSA, or meso-2, 3-dimercaptosucccinic acid, has been found to be an effective treatment for combating mercury poisoning, since their sulfide groups chelate strongly with mercury. Not only is it useful for excretion of mercury via kidneys and bile ducts, but it has also shown great results for lead, bismuth, antimony, and tungsten (3). Medical and behavioral studies conducted by Adams et al. in 2009 state that DMSA-mediated heavy metal reduction greatly led to normal levels of RBC glutathione and platelets, along with dramatically reducing inflammation in Autistic children. Moreover, oral DMSA therapy was found to reduce the symptoms of autism spectrum disorder in autistic children (3, 4). Studies have also shown a greater efficacy of DMSA over EDTA in terms of heavy metal secretion (5). DMSA therapy also supports in reversing the effects of heavy metals like mercury and lead on stem cell metabolism (6). Therefore, it is quite evident that chelation therapy works well for restoration of the circulating stem cells, improving the vascularization of the system, and detoxification.

1. Rafati-Rahimzadeh, M., Rafati-Rahimzadeh, M., Kazemi, S. et al. Current approaches of the management of mercury poisoning: need of the hour. DARU J Pharm Sci 22, 46 (2014). https://doi.org/10.1186/2008-2231-22-46. https://link.springer.com/article/10.1186/2008-2231-22-46

2. https://www.harborcompounding.com/dmsa-and-heavy-metal-toxicity

3. Adams JB, Baral M, Geis E, et al. Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: Part A--medical results. BMC Clin Pharmacol. 2009;9:16. Published 2009 Oct 23. doi:10.1186/1472-6904-9-16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774660/

4. Adams JB, Baral M, Geis E, Mitchell J, Ingram J, Hensley A, Zappia I, Newmark S, Gehn E, Rubin RA, Mitchell K, Bradstreet J, El-Dahr J. Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: part B - behavioral results. BMC Clin Pharmacol. 2009 Oct 23;9:17. doi: 10.1186/1472-6904-9-17. PMID: 19852790; PMCID: PMC2770991. https://pubmed.ncbi.nlm.nih.gov/19852790/

5. Mikirova et. Al, Translational Biomedicine. https://www.transbiomedicine.com/translational-biomedicine/efficacy-of-oral-dmsa-and-intravenous-edta-in-chelation-of-toxic-metals-and-improvement-of-the-number-of-stem-progenitor-cells-in-circulation.php?aid=2543

6. Flora SJ, Pachauri V. Chelation in metal intoxication. Int J Environ Res Public Health. 2010;7(7):2745-2788. doi:10.3390/ijerph7072745. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922724/


Dmsa Safety & Dosage Recommendations


DMSA causes very few side effects, the most common being intestinal discomfort, loss of appetite, throwing up or itching. It can cause deficiencies of copper, manganese, molybdenum, magnesium, and zinc if they are not replaced by supplementation so make sure you take multimineral supplement daily.

Dosage recommendations vary widely for treatment for mercury poisoning. The Physicians Desk Reference recommends 10mg per 2.2 pounds of body weight every eight hours for 5 days, then reduce the dose to twice daily for two more weeks, off for two weeks, and repeat as necessary. This is the high dose that commonly causes the intestinal distress.

Others suggest to take 100 to 250 mgs three times a day before meals for 3 days then take 10 days off. Continue this cycle for 6 months then retest with the urine challenge test. It should be taken on an empty stomach, one hour before or two hours after a meal.

It is best to be under a doctor’s supervision when taking DMSA but not required.

I suggest that on the 10 day off periods you take zeolite. By doing so you will greatly speed up the chelation process.


Dr. Vibhuti Rana, PhD says...

The general safety issues and side effects of DMSA therapy have been discussed in the above section. Though DMSA has a number of benefits in treating heavy metal intoxication, it's exact role for treating neurological disorders is not well established since it is unable to cross the blood-brain-barrier. Papular rash, pruritis and mucocutaneous reactions, or high hepatic transaminases have occurred during clinical trials. Oral DMSA therapy has also resulted in increased urinary secretion of zinc and copper which are otherwise important minerals in the human body (1, 2).

1. https://www.who.int/selection_medicines/committees/expert/18/applications/4_LeadOralChelators.pdf

2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/019998s021lbl.pdf


Medical Review by Dr. Atmika Paudel, PhD

Dimercaptosuccinic acid (DMSA), also known as succimer, has been used in the treatment of mercury poisoning as the article above mentioned. It has also been used in the cases of lead and arsenic poisoning. (1) It has been included in the list of Essential Medicines by the World Health Organization. (2)

DMSA was found to be reasonably safe with few adverse effects such as lethargy and decrease in appetite. (3) DMSA was used in inorganic lead poisoning, and was shown to have lead excreted in urine with relief from symptoms such as headache, constipation and lethargy. (4)

The facts about DMSA in the above article are correct and as mentioned in the article above, it is non-specific and also chelates other metals from the body and excretes them, some of which are of importance to our health such as iron and calcium. Metal chelation is sometimes necessary in cases of severe overloading of metals and acute poisoning, however; one should consult a physician and the physician is responsible for considering the case and using a chelator if it is necessary. In summary, metal chelators should be taken in close supervision of physician. Identifying the source of heavy metal, and getting away from that source is the best way to avoid metal overload in the body.

1. Dimercaptosuccinic Acid (DMSA), A Non-Toxic, Water-Soluble Treatment For Heavy Metal Toxicity. Alternative Medicine Review ◆ Volume 3, Number 3 ◆ 1998
2. WHO Model List of Essential Medicines 19th List (April 2015) (Amended November 2015)
3. Safety and efficacy of oral DMSA therapy for children with autism spectrum disorders: Part A - Medical results. BMC Clin Pharmacol. 2009; 9: 16. Published online 2009 Oct 23. doi: 10.1186/1472-6904-9-16
4. S. Bradberry, T. Sheehan, A. Vale, Use of oral dimercaptosuccinic acid (succimer) in adult patients with inorganic lead poisoning, QJM: An International Journal of Medicine, Volume 102, Issue 10, October 2009, Pages 721–73


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Article Reference

1. Chelator combination as therapeutic strategy in mercury and lead poisonings. JanAaseth, Olga P.Ajsuvakova, Anatoly V.Skalny, Margarita G.Skalnaya, Alexey A.Tinkov. Coordination Chemistry Reviews Volume 358, 1 March 2018, Pages 1-12



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