December 5, 2005
I. DMPS Transdermal
- Dosage 1.5 mg/kg every 48 hours. Example: 20 kg child equal 30 mg equals 30 drops. Start with one fifth of the recommended dosage and increase if tolerated. Available in a 4:1 Glutathione to DMPS ratio. Angie at the Wellness Pharmacy 1-800-227-2627.
- Conjugated with amino acids in a micro-encapsulated liposomal (lipid) base (PLO base).
- Wellness Pharmacy $45.00 a month regardless of dosage. Effective for 70 days until expiration.
- Can be shipped directly to family.
- Maximum 50 drops every other day.
- Give minerals, especially zinc, in double dosage on off days, or give zinc in AM - regular dosage
- Start Methyl B12 64.5 mg/kg every three days before Transdermal DMPS. Also consider adding Transdermal Glutathione .5 ml q d under 30 pounds, and .5 ml b.i.d. for > 30 pounds or Oral Liposomal Glutathione, ¼ tsp twice daily/30 pounds.
- Zinc, selenium, C, E, zinc, B6
- Oral Lipoceutical Glutathione: 100 mgm, ¼ tsp. twice a day. Dosage: ¼ tsp. per 30 pounds. Wellness Pharmacy-$40.00. For increased self-stim behaviors.
- Consider calcium, magnesium, melatonin, taurine.
- Consider transdermal NAC, Methionine.
- Consider Epsom salt baths.
- Consider MinerAll www.vitalitywellness.com
- Multi mineral complex – Prosupport or calcium magnesium liquid from www.kirkmanlab.com
- Treatment - probably one to two years.
- Not FDA approved as a chelator for children. Is approved as a compounding agent.
- Excreted through kidneys
- Garlic-type skunk smell
- Place the drops in patient’s hands and have child rub it on their forearms, biceps, or back of knees, thighs, not the stomach. Do not touch the medicine yourself. Do not use gloves.
- Start low and go slow. I am starting with approximately 1/5 the recommended dosage.
- Consider dye-free benadryl one hour before application.
- Consider magnesium during on days.
- Consider L-Lysine to help suppress viral infections.
- Rotate application site to decrease sensitivity.
- Wipe DMPS off after 30 minutes due to skin sensitivity.
- Children with Autism often have decreased Glutathione and Cysteine levels.
- CBC, platelets, iron, liver function, kidney function, TSH, RBC Trace Minerals.
- Consider serum copper, plasma zinc and iron levels.
- Urine DMSA, hair analysis, fecal metals.
- GI panel, organic acids.
- 2. Repeat approximately every three months: CBC, platelets, iron, liver and kidney functions.
- Testing of hair, fecal, urine, trace mineral, GI panel and Organic acid levels will be individualized for each patient.
- Watch closely kidney and liver function, WBC and platelets.
- Provocation testing
- DMSA – 10 mg/kgm per dose 3x daily for 3 days. Before administering the last dose, void the bladder and then collect urine for the next 8 to 10 hours.
- Oral single dose DMSA 20-25 mg/kgm x 1. Void bladder and collect urine 6 to 10 hours.
- Rectal DMSA – 25 mg/kgm. Collect urine 12 to 24 hours.
- DMPS challenges – Oral DMPS 5-10 mg/kgm, single dose. Collect urine 6 to 12 hours. Transdermal DMPS 3mg/kgm. 12 to 24 hour urine collection. Co-administration of Glutathione with DMPS may increase urinary excretion of toxic metals.
III. Supplementations to Consider
- Methyl B12 64.5 mcg/kgm q 3 days
- Glutathione: Transdermal .5 ml b.i.d. >30 pounds, once daily < 30 pounds Hopewell, Coastal or Wellness or Lipoceutical Glutathione.
- Zinc: 1-2 mgm/kgm/day. Maximum 50 mgm/day.
- Selenium: 1-4 micrograms/kgm/day
- Vitamin E: as a mixed tocopherols – dosage 2-4 mgm/kgm/day or 3-6 i.u./kgm/day
- Vitamin C: buffered preparation or Ester C – 5 mgm/kgm/day to tolerance.
- Multi-mineral supplement: Citramins – includes magnesium, molybdenum, manganese, vanadium and chromium
- B6(Pyridoxine): up to 15 mgm/kgm/day or P5P 3 mgm/kgm/day. Maximum B6: 500 milligrams P5P: 100 mgm. Use copper-free preparation. (Consider Super Nu Thera)-(Optional)
- Melatonin: 0.1 mgm/kgm at bedtime sleep/wake cycle. (Optional) An antioxidant, protects mitochondria from oxidative damage.
- Taurine: 250-500 mgm/day. Maximum 2 grams/day. (Optional)
- Transdermal NAC 10%: 100 mgm/gram ½ gram b.i.d. Hopewell (1-800-792-6670) Note: DAN is concerned with this supplement.
- Alpha Lipoic Acid: Start 1-3 mgm/kgm/day. Consider after 6 months of DMPS-TD. (Optional) Note: DAN is concerned with this supplement.
- Epsom Salt baths: If increased stimming consider adding probiotics, natural antifungals, Therbiotic Complete (1-858-350-7880) and/or Xymogen IgG2000 (1-800-647-6100)
- TMG/Folinic Acid/B12 or DMG/Folinic Acid/B12
IV. Possible Side Effects
- Increased self-stimulatory behavior
- Regressions between one to three months
- Skin burns and rashes
- Most severe reaction is an oxidative reaction like a burn. This is less likely to happen with the AMT preparation.
- Transdermal local burn. This is minor.
- Mercury mobilization rash that does not have to be treated.
- Yeast flare-ups. Treat with probiotics, natural anti-fungals and IgG2000.
- Elevated liver enzymes
- Increased white blood cell count
- Stevens-Johnson Syndrome (rare)
- Dietary restriction and correcting Gut Dysbiosis should precede chelation.
- More effective under the age of 9, although it can be used even in adults. May see growth spurts.
- DMPS is not thought to cross the blood/brain barrier
- DMPS is also thought to chelate lead and cadmium, silver, tin and arsenic – not just mercury.
- To reduce mercury exposure
- Avoid amalgams
- Avoid certain fish and shellfish (especially shark, swordfish, tuna).
- Purify water
- Organic foods preferred
- Use only Thimerosal-free vaccines.
- Gut Dybiosis – may occur with Alpha Lipoic Acid, NAC, oral DMSA – rarely with Transdermal DMPS.
VI. Main Concerns
- DMPS is not FDA approved as a chelator for children; however, it is ok to use when compounded.
Appendix A: Detoxification Regime
|Child’s Weight |
|10||15 mgm/kgm||1-3 mgm/kgm/day||10 mg||30 mcg|
|20||Every other day||after 6 months||20 mg||50 mcg|
|40||AMT Pharmacy||12.5- 25 mgm||40 mg||100 mcg|
|60||1-866-828-2803||QOD||60 mg||150 mcg|
|80||Melanie or Wellness Pharmacy |
|gradually increase||80 mg||200 mcg|
|100||Start 1/5 of dosage|
and increase as
|80 mg||250 mcg|
|120||80 mg||200 mcg|
|140+||80 mg||250 mcg|
||or in AM |
(1/2 of above)
|or in AM |
(1/2 of above)
*Do not give Alpha Lipoic Acid until Urine Mercury <1 and only after my medical recommendation
|Child’s Wgt. (in lbs)||Vitamin C1|
|10|| 100 mg ||50 IU ||75 mg ||0.25 mg ||50 mg ||.5 ml q.d.|
|20|| 200 mg ||100 IU ||150 mg ||0.5 mg ||100 mg ||.5 ml q.d.|
|40|| 400 mg ||200 IU ||300 mg ||1 mg ||200 mg ||.5 ml b.i.d.|
|60|| 600 mg ||300 IU ||450 mg ||1.5 mg ||300 mg ||.5 ml b.i.d.|
|80||800 mg ||400 IU ||600 mg ||2 mg ||400 mg ||.5 ml b.i.d.|
|100||800 mg ||400 IU ||750 mg ||2.5 mg ||500 mg ||.5 ml b.i.d.|
|120|| 800 mg ||400 IU ||900 mg ||3 mg ||600 mg ||.5 ml b.i.d.|
|140+|| 800 mg ||400 IU ||1000 mg ||3 mg ||750 mg ||.5 ml b.i.d.|
|or 50 % dosage |
|or 50 % dosage |
Glutathione: Oral Glutathione 250-500 mg per day may help gut-oxidant function.
- Vitamin C: Use the buffered preparation of the ester to minimize GI upset. Begin with the starting dose and increase to the maximum tolerated. Be sure to keep well-hydrated. Dividing the dose may decrease GI upset.
- Vitamin B6: If you choose to use pyridoxal-5 phosphate (P5P) instead of B6, divide the dose by 5.
- Vitamin B6: Be sure to choose a copper-free preparation. Since Vitamin B6 is very bitter, consider the use of Super Nu Thera (flavored B6 and magnesium) or Nu Thera capsules from Kirkman Labs: 1-800-245-8282 / www.kirkmanlabs.com.