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DMSA

Description

DMSA, otherwise known as meso-2,3-dimercaptosuccinic acid, is a term derived from the Latin phrase “mercurius captans”, meaning literally seizing or capturing mercury. It is the sulfur atom in the thiol group that provides the ability of these compounds to seize heavy metal toxins. DMSA mobilizes lead (Pb) mainly from soft tissues, especially the blood, brain, kidney and liver. “With respect to redistribution of mobilized Pb to critical organs and the magnitude of decline in soft tissue Pb concentration, DMSA appears to be a safe and particularly effective chelator and thus may be a viable alternative to CaNa2EDTA” (Cory-Slechta DA, Mobilization of lead over the course of DMSA chelation therapy and long-term efficacy. J Pharmacol Exp Ther 1988 Jul; 246(1):84-91).

Signs and Symptoms for Nutrient Applications

Heavy metal detoxification

Clinical Applications/Research

DMSA administration is considered safe and effective in children in recommended doses. DMSA “is labeled for use in children with blood lead concentrations in excess of 45 micrograms/dL.” Evidence exists that DMSA is effective in lowering the blood lead concentrations in children with levels between 25 and 45 micrograms/dL (Berlin, CM Jr, Lead poisoning in children. Curr Opin Pediatr 1997 Apr;9(2): 173-7). DMSA is recommeded as a single oral agent or in combination with other chelating agents for the detoxification of a number of heavy metals, including mercury, lead, cadmium and arsenic. Chelation therapy with DMSA in adults with moderate to severe lead poisoning is effective and safe (Lifshitz M, et al, The effect of 2,3 dimercaptosuccinic acid in the treatment of lead poisoning in adults. Ann Med 1997 Feb; 29(1):83-5). Dialkyltin compounds have been widely used in industry and agriculture, mainly as biocides, catalysts and plastic stabilizers. Toxic effects occur in the immune system, the bile duct, liver and pancreas. In a manner similar to organoarsenic, the toxicity of the dialkyltin compounds is related to reactions with biological dithiol groups. DMSA diminishes the production of bile duct, pancreas and liver lesions and inhibits the development of fibrosis of the pancreas and cirrhosis of liver in lab animals exposed to these toxic chemicals. The decrease in the biliary excretion of these compunds by DMSA seems to be the reason for the pronounced protective effects of DMSA on the bile duct, pancreas and liver. For these reasons DMSA has been recommeded for the treatment of poisonings with dibutyltin compounds (Merkord J, et al, Antidotal effects of 2,3-dimercaptopropane-1-sulfonic acid (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) on the organotoxicity of dibutyltin dichloride (DBTC) in rats. Hum Exp Toxicol 2000 Feb; 19(2):132-7).

Precautions to minimize adverse effects of DMSA administration include: * Consume large quantities of pure water throughout treatment. * Reduce dosage if patient has compromised renal function. * Check liver function. * Add fiber to make sure colon is functioning properly. * Do colonic irrigation as needed. * Make sure to take mineral supplements – Multi-Minerals and Magnesium * Take minerals away from DMSA administration * Take 1000-2000 mg Vitamin C three times daily

Suggested Dosage

*500 mg TID (three times per day) for three days *On 3rd day, collect urine for 24 hours *Have diagnostic lab analyze urine for creatinine clearance and heavy metals

*10mg/kg body weight daily in 3 divided doses for five days *10 mg/kg every 12 hours for an additional 14 days Give a break period of 14 days OFF DMSA before repeating the next cycle.

*On last day of 2nd cycle, repeat 24 hour urine collection and analyses for heavy metals.

*Repeat DMSA treatment cycle(s) as indicated by clinical and diagnostic criteria.

Contraindications/Toxicology

Not recommended during lactation or pregnancy. Uniterrupted use beyond 3 weeks is not recommended. Allergic or skin reactions must be watched for on initial and repeat courses. Watch for gastrointestinal reactions such as nausea, vomiting, diarrhea, loose stools, loss of appetite or metallic taste in mouth.

Disclaimer: The statements above have not been evaluated by the FDA. The nutritional suggestions and research provided are for informational purposes only and are not intended to diagnose, treat, cure or prevent disease and should not be used as a substitute for sound medical advice. Please see your health care professional in all matters pertaining to your physical health.

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