Urinary Chelation & Testing Protocols - Science Based Nutrition

Urinary Chelation &
Testing Protocols
Van D. Merkle, DC
DABCI, DCBCN
What is Chelation?
A chelation agent is a chemical
agent that, like a claw, grabs and
chemically bonds with metals or
other minerals and toxins.
Simply put, chelation is the process
in which chemicals bind with minerals.
While chelation is a naturally occurring biological process
(Hgb binds with Fe to provide O 2 to tissues), synthesized
chelation agents were first developed during WWII as a
way to clear toxic metals from the body.
Chemists discovered they could create a heterocycling
ring of molecules which surround or "sequester" mineral
molecules and carry them from the body through normal
elimination.
1

What is Chelation?
The chelate finds and forms a
single attachment to the toxin
with one reversible ionic bond.
With that bond intact, the toxin is
grabbed onto, pulled off the cell and
carried from the body.
However, the toxin is not neutralized during this
process and is potentially able to attach to other
cells on its way out.
This process of chelation actually
removes unwanted metals from the
bloodstream.
In fact, chelation therapy is the
only way to treat lead poisoning.
A chelation agent will also bind with most metals,
mineral deposits, calcium-based plaques and
other chemical toxins.
Because of its positive impact on the
bloodstream, chelation therapy has proven to
benefit a number of medical conditions, including
atherosclerosis and arteriosclerosis.
Chelation Continued
2

Oral Chelation
Oral chelation therapy a vital
step toward cleansing the body
of contaminants.
Laboratory studies have shown it to effectively
clear heavy metals, toxins, plaque, pesticides,
chemicals, and residuals from prior bacterial and
viral infections.
It also seems to target the liver for detoxification
and to lower both Elevated enzyme counts and
mercury levels in children with autism.
Common Chelators
More Popular
1. dimercaptosuccinic acid (DMSA)
2. dimercaptopropane sulfonate (DMPS)
3. ethylene diaminetetraacetic acid (EDTA)
Less Popular
PCA
Zeolite
3

Other Natural Chelators
Chlorella- has great affinity for mercury.
◦ Chlorella binds to mercury and helps remove
it from the soft tissues, especially the colon.
◦ Some people take 3 tablets a day or more for several months;
however, if one has high levels of cysteine, the Chlorella can hurt (due
it's sulfites); therefore, one might consider favoring other approaches,
unless they know the cysteine level. This is very rare.
◦ Warning: Chlorella from ocean sources often contain
high levels of mercury, which will show up on hair
and urine chelation testing.
Milk Thistle, ALA, Cilantro, C, E and B
Calcium, zinc and other nutrient minerals
Zeolite
Heavy Metals and
Pathology
4

Food Intake, Air, Water,
Toxic Metals
Xenobiotics,
Parasites,
GMO,
Radiation,
Vaccination,
Medications
Genes, Vitamins,
Minerals;
Exercise, Heat;
Excretion; Organ
dysfunction;
Toxic overload
Healing, Repair, Growth, Genes
Endocrine & Exocrine Systems
DNA, RNA, Cell Wall
Nervous System, Adipose Tissue
GI, Lungs, Hormones, Liver,
Skeletal, Reproductive Organs,
Thyroid, Kidney,
Metabolism…everything!
Metabolites
Fatty Acids,
Amino Acids
Lungs
Hormones
Saliva
Toxic Metals
Kidneys
Xenobiotics
Waste
products
Skin
Fluids
Nails
Stool
Hair
Brain
Heart
Liver
Lungs
Pancreas
Kidneys
Nervous System
GI System
Highest Priority Systems
5

Secondary or Lessor Systems
Thyroid
Adrenals
Hormones
Ovaries, Testis
Skeletal
Muscle
Joint
Skin
Heavy Metals
Displace your nutrient minerals and cause
deficiency.
There is no positive metabolic function for these
metals in the body.
6

How they harm
Non-essential metals may mimic the essential
metals causing a disruption in cellular and
enzymatic mechanisms.
Cadmium can replace zinc
Thallium can replace potassium
Arsenic can replace phosphates
Diagnosis Depends on Laboratory Testing
Exposures to toxic elements can be acute (one time,
short-term) or chronic (many times, long-term).
Clinical signs and symptoms of toxicity are often
different for acute vs chronic exposures but may be nonspecific.
Due to non-specific signs and symptoms of toxicity, as
well as the fact that the duration and extent of exposure
is often not known, diagnosis of most toxic element
exposures depends on laboratory testing.
7

Typical ADD symptoms
ADD/ADHD Plus in
12 year old boy
Skin rash all over body would occur 2 times per
month and last for 2-3 days.
Swollen inflamed gums all the time
Cleared of all symptoms when the intake of 5-6
cans of soda were stopped
ALUMINUM
Any Aluminum is too much.
Aluminum toxicity is associated with Alzheimer's and Parkinson's
disease, behavioral/learning disorders such as ADD, ADHD and
autism.
High levels of aluminum have been found in the hair of delinquent,
psychotic, and prepsychotic boys, and in juvenile offenders.
Aluminum has neurotoxic effects at high levels, but low levels of
accumulation may not elicit immediate symptoms.
Early symptoms of Aluminum burden may include fatigue, headache,
and other symptoms.
Aluminum is a heavy metal that displaces your other good minerals,
such as magnesium, calcium, zinc and phosphorus.
8

Aluminum
Fluoride and Fluoridation increases the
absorption of Aluminum.
Chlorella and Magnesium with Malic Acid have
been reported to be quite effective in lowering
Aluminum.
Aluminum
Symptoms
◦ Alzheimer’s
◦ Parkinson's
◦ behavioral/learning disorders such as ADD, ADHD, and
autism
◦ Fatigue
◦ headache
9

Sources
◦ anti-perspirants
◦ aluminum cookware
◦ Antacids
◦ Vaccines
◦ some baking sodas
◦ baking powder
◦ some breath mints
◦ some skin lotion
◦ some cosmetics
◦ aluminum foil
◦ canned goods
Aluminum
◦ emulsifiers in
processed cheese
◦ table salt – anticaking
compound
◦ bleaching agent in
white flour
◦ buffered aspirin
◦ some toothpaste
◦ dental fillings
◦ cigarette filters
◦ contaminated water
Arsenic
Ingestion of large amounts of soluble Arsenic
compounds effect the myocardium, causing
death within a few hours.
10

The current EPA standard for
arsenic in public water systems is
10 ppb, reduced from 50 ppb in
2006. The standard applies only to
drinking water sources that serve
more than 20 people.
Arsenic, Water, Cancer
Even small amounts of arsenic might cause cells to
lose some of their ability to repair genetic damage
The results help explain why arsenic contamination
in drinking water can lead to certain cancers.
Without the ability to repair its DNA, a cell could be
vulnerable to damage from pollutants such as
cigarette smoke.
Dartmouth Medical School, International Journal of
Cancer 4/2003
11

Arsenic
Symptoms
◦ bone marrow depression
◦ Anemia
◦ skin discolorations
◦ neurological symptoms
◦ liver and kidney
degeneration
◦ Cancers
◦ Agitation
◦ learning impairment
◦ confusion
◦ Malaise
◦ Vomiting
◦ Diarrhea
◦ Eczema
◦ muscle weakness
◦ hair loss
◦ stomach pain
◦ respiratory issues
Case: D. P.
Extreme high Arsenic
Severe abdominal pain and rectal bleeding.
12

D. P.
3/14/03
2 nd Hair Test
Arsenic
Sources
◦ tobacco smoke
◦ metal smelting
◦ production of glass
◦ Ceramics
◦ Artificial Colors
◦ Insecticides
◦ Fungicides
◦ Herbicides
◦ drinking water
◦ wood treatments
13

Cadmium
Cadmium (Cd) is a toxic, heavy metal with no positive
metabolic function in the body, and is relatively rare but
more toxic than lead.
Moderately high cadmium levels are consistent with
hypertension, while very severe cadmium toxicity can
cause hypotension.
Cadmium absorption is reduced by zinc, calcium and
selenium.
Alkaline Phosphatase is commonly elevated with
Cadmium toxicity.
Cadmium
Cadmium toxicity is common among welders
and construction workers (cement dust).
Contamination may come from perms, dyes,
bleach and some hair sprays, and can cause
false highs for Cd.
14

Cadmium
Symptoms
◦ Hypertension
◦ Fatigue
◦ muscle and joint pain
◦ low back pain
◦ Atherosclerosis
◦ affects the kidneys
◦ Lungs
◦ Testes
◦ arterial walls
◦ Bones
◦ interferes with many
enzymatic systems
◦ leads to anemia
◦ protein and glucose
in the urine
◦ depletes calcium,
phosphorus and zinc.
Cadmium
Sources
◦ refines foods [white
flour, white sugar, etc]
◦ acidic drinks left in
galvanized pails
◦ super phosphate
fertilizers
◦ some cola drinks
◦ tap water
◦ atmospheric pollution
in the burning of coal
and petroleum
products
◦ Margarine
◦ canned foods
◦ cigarette smoke
◦ FD&C colors and dyes
◦ common among
welders and
construction workers
[cement dust]
◦ Perms
◦ Dyes
◦ bleach and some hair
sprays
15

Lead
Physiologically, the renal, nervous, reproductive, endocrine,
immune, and hemopoietic systems are affected.
Sub-toxic oral exposure to lead and cadmium increases the
susceptibility to bacterial and viral infections.
Lead is known to damage the kidney, the liver, and the
reproductive system, as well as to interfere with bone marrow
function, basic cellular processes and brain functions.
It is known to be responsible for convulsions, abdominal pain,
paralysis, temporary blindness, extreme pallor, loss of weight
and appetite, constipation and numerous other problems.
Lead
Lead causes nerve and mental problems,
especially affecting learning ability in children.
It was reported that the IQs of middle-class
children dropped five to seven points after lead
exposure, and Moon, et. al., demonstrated that
lead levels also related to decreased visual and
motor performance.
Lead interferes with utilization of Calcium,
magnesium, vitamin D and zinc
16

Lead
Symptoms
◦ abdominal pain
◦ Colics
◦ severe and repeated
vomiting
◦ Irritability
◦ Hyperactivity
◦ Anorexia
◦ loss of appetite
◦ mental disturbances
◦ Anemia
◦ gastric distress
◦ Fatigue
◦ weight loss
◦ Headaches
◦ Vertigo
◦ Tremor
◦ joint pain
◦ poor coordination
◦ Neuritis
◦ poor memory
◦ Constipation
◦ Interferes with
calcium, magnesium,
vitamin D and zinc.
Lead
Sources
◦ lead based paints
◦ Crystal
◦ Ceramics
◦ canned food
◦ food crops
◦ Artificial colors
◦ water contamination
◦ industrial pollution
◦ some fertilizers
17

Nickel
Its widespread presence in environmental pollution and
its toxic effects on human health warrant its
classification as toxic.
High nickel tissue levels have been associated with
myocardial infarction, and are often present in patients
who suffered strokes, dermatitis, chronic rhinitis,
hypersensitivity reactions, hypersensitive the immune
system, hyper allergenic responses to many different
substances, pulmonary inflammation (due to smoke and
dust), liver necrosis and toxemia.
Nickel
It is well established to be nephrotoxic and
carcinogenic.
Early symptoms of toxicity include: apathy,
diarrhea, dermatitis, dyspnea, fever, insomnia,
tachypnea, vertigo, vomiting, headaches, gastrointestinal
pain and eczema.
Other symptoms: Allergies,
immunosuppression, vitiligo.
18

100 Warts
14 year old girl with over 100 warts on the back
of each hand and fingers for the last 12 months
Dermatologist - burning, acid, freezing- a futile
painful effort, no help
Patient had been in braces for 15 months
Nickel
Symptoms
◦ myocardial infarction
◦ Strokes
◦ Dermatitis
◦ chronic rhinitis
◦ hypersensitivity
reactions
◦ autoimmune
reactions
◦ liver necrosis
◦ toxemia
Early symptoms
◦ Apathy
◦ Diarrhea
◦ Dermatitis
◦ Dyspnea
◦ Fever
◦ Insomnia
◦ Vertigo
◦ Vomiting
◦ Headaches
◦ gastrointestinal pain
◦ Eczema
◦ Vitiligo
19

Nickel
Sources
◦ atmospheric
pollution
◦ burning of coal and
petroleum products
◦ FD&C colors and dyes
◦ cigarette smoking
◦ costume jewelry
◦ hydrogenated oils
[margarine]
◦ Orthodontic braces
Silver
Toxicity: Silver is deposited in the skin and organs, causing
gray discoloration.
Silver occurs naturally in very low concentrations in soil,
plants, and animal tissues.
◦ also found in food that comes from silver plated vessels, silver solder,
silver foil (used in decorating cakes), jewelry, electronic equipment,
dental fillings and photographic materials.
◦ Silver is found at hazardous waste sites and in water.
◦ Some water treatment systems including water filters use silver
compounds to kill bacteria.
◦ Silver has been used extensively for medicinal purposes particularly in
the treatment of burns.
20

Colloidal Silver
There is much controversy over the long term
safety of consumption of colloidal silver.
Very high intake of colloidal silver has been
reported to give rise to tumors in the liver and
spleen of laboratory animals.
Silver
Symptoms:
◦ Skin disorders
◦ organ system
function
◦ deposited in the skin
and organs and
interferes with their
function
◦ causes gray
discoloration.
Sources:
◦ food in silver plated
vessels
◦ silver solder
◦ silver foil
◦ Jewelry
◦ dental fillings
◦ water contamination
◦ used for medicinal
purposes particularly in
the treatment of burns
◦ Intake of colloidal silver
has been reported to give
rise to tumors in the liver
and spleen in laboratory
animals.
21

Tin
Organic Tin has appreciable toxicity.
Experiments have shown that increased tin
ingestion causes depressed growth and reduced
hemoglobin levels and liver function in rats.
Elevated tin resulted in elevated losses of
calcium, selenium and zinc.
Tin
Symptoms:
◦ depressed growth
◦ low hemoglobin
◦ decreased liver function
◦ skin, eye, GI tract
irritation
◦ muscle weakness
◦ Anemia
◦ testicular degeneration
◦ Vomiting
◦ Diarrhea
◦ abdominal cramps
◦ tightness of chest
◦ metallic taste
Sources:
◦ tap water
◦ canned foods
◦ asparagus packed in
glass
◦ dental fillings
◦ Cosmetics
◦ Preservatives
◦ pewter, bronze, and
anticorrosive platings
22

HA Case Study: K. S.
2 years old
Doctors had told her parents she has asthma
Parents thought she was having allergic reactions
K. S.
11-15-2002
23

Mercury
Some people exhibit symptoms at 3-5ppm.
On average a 1ppm mercury was found to
correlate with a 9% increase in acute myocardial
infarction risk.
Mercury
Symptoms:
◦ hyperactivity
◦ mental and
emotional changes
◦ neuromuscular
disorders
[Alzheimer’s and
Parkinson's]
◦ loss of appetite
◦ chronic fatigue
◦ depression
◦ poor memory
◦ emotional instability
◦ peripheral numbness
◦ sleep disturbances
◦ persistent infections
including yeast
Why yeast
infections?
24

Mercury
Sources:
◦ large fish
◦ pesticide residue
◦ mercurial fungicides
on seed grains
◦ coal burning
◦ FD&C colors and dyes
◦ Paints
◦ Pharmaceuticals
◦ manufacture of
paper, pulp and
plastic products
◦ water contamination
What are the 2 most common sources for
exposure to Mercury?
#1 Amalgams
◦ After dental amalgams are used, elevated hair mercury
may be observed for 6 months to over a year.
◦ Find a dentist who is trained in the removal of mercury
fillings.
◦ Don’t do all at once.
25

What are the 2 most common sources for
exposure to Mercury?
#2 Vaccines
◦ In the mid-1980s, one in 2,500 children had autism
compared with one in about 300 children in 1996
an increase of over 800 percent in 20 years.
◦ As the government has increased the number of
mandatory vaccines, some recent studies suggest the
rate of autism has had comparable increases
◦ Some say the cause may be mercury poisoning.
The study found a two- to six-fold increased
occurrence of neurodevelopment disorders
after an additional 75- to 100-microgram
dosage of mercury from thimerosalcontaining
vaccines as compared to
thimerosal-free vaccines.
Journal of American Physicians and Surgeons
Spring 2003
26

Mercury and Vaccines
Other disorders linked to vaccines:
◦ asthma, Diabetes, auto-immune disorders [rheumatoid arthritis]
We’ve traded infectious disease for chronic disease.
Approximately 12 out of the 18 vaccine doses the average
American child receives before the age of two contain
Thimerosal.
◦ Cumulatively, that's more than 200 micrograms of mercury, which
would fit on the head of a pin.
Think about the idea of injecting your own child with levels of
mercury that are 30-40 times what's considered safe for an
adult
Still Think Vaccines Have Nothing To Do With
Autism and other Neurological Disorders?
Compare the symptoms of autism vs. the
symptoms of mercury poisoning
Meningitis, Encephalitis and Seizures
Does MMR cause Autism?
27

Alzheimer’s and Flu Shot
If you take 5 flu shots in a row
It increases your chances of developing
Alzheimer’s Disease by 8-fold!
The Law
Vaccines are “mandated”
Exemptions in Ohio
Email us and we can send you our Vaccine
Packet
28

Mercury Video
Autism and ADD/ADHD
Dr. Van D. Merkle
29

Autism: a national health emergency
1 in 150 children
◦ roughly 1 in 65 families
36,000 otherwise normal toddlers will regress
into autism in this year alone
Harvard Study: $3.2 million/child over a
lifetime
◦ Society costs: Approx. 2 TRILLION dollars
Insurance seldom pays because treatments
aren’t “research-based”
Families devastated both economically and
emotionally
Murder/suicides are on the rise
Laura Bono- NAA (National Autism Association)
Autism: environmentally induced
If it is environmental, then it is treatable and
preventable.
It is NOT HOPELESS and lifelong.
It is HOPEFUL, with a possible cure.
30

What is autism?
Developmental Disorder
Must onset before age 3 years
Development affects symptom expression
Symptoms exacerbated/alleviated by
development
One of several Pervasive Developmental
Disorders or Autism Spectrum Disorders
Autism Pervasive Developmental Disorder –
Not Otherwise Specified
Asperger Syndrome
Rett Disorder
Childhood Disintegrative Disorder
Autism is characterized by:
Deficits in Social Interactions (2 or more)
Impairment in use of nonverbal behaviors
Failure to develop peer relationships
Lack of spontaneous seeking to share
enjoyment
Lack of social or emotional reciprocity
Communication deficits (verbal & nonverbal) (1
or more)
Delayed/lack of spoken language
Inability to converse with others
31

Characterizations continued…
Stereotyped and repetitive or indiosyncratic
language
Lack of make-believe or social imitative play
Fixated interests and/or repetitive behaviors (1 or
more)
Preoccupation with one or more restricted
interests
Inflexible adherence to specific nonfunctional
routines
Stereotyped and repetitive motor mannerisms
Persistent preoccupation with parts of objects
Autism: a whole-body problem
Immunological dysregulation with a unique inflammatory bowel
disease
Oxidative stress, systemic inflammation, and severely disordered
urine and serum chemistries
Decreased methylation capacity, limited transsulfuration and
glutathione deficiency
Increased toxic body burdens – primarily of heavy metals esp.
mercury and lead
Chronic viral, fungal and bacterial infections
Central nervous system hypofusion/abnormal regulation of blood
supply to the brain
Microglial activation, lipid peroxidation, mitochondrial dysfunction,
inactive enzyme systems and exitotoxicity
32

Clinical Clues: Regressive Subtype
Normal development until 12 – 30 months age
and then loss of language and social skills
15-50% of autism has regressive features (rate
depends on definition of regression)
Reported prognosis for regressive autism is
poor
Regression can be acute or slow and subtle
Videotapes often show that development
wasn’t completely normal before regression
occurred, but obvious loss of acquired skills.
Pathogenesis of Regressive Autism
ADHD
AUTISM
ADD
Damage
Neuronal Dysfunction
Genetic Susceptibility in the Host
Environmental Trigger
33

Autism is treatable.
The research paradigm needs to shift from
“autistic children are genetically defective” to
“autistic children are sick”.
Study the children’s biochemical imbalances and
find more effective ways of intervening medically
and nutritionally
Identify toxicities or triggers
Toxic and Essential
Elements in Autism and
Childhood Behavior
David Quig, PhD and Meghan Higley, ND
34

A Case-Control Study of Mercury Burden in
Children with Autistic Spectrum Disorders
Evaluations of mercury excretion
levels
3 day treatment with an oral
chelating agent, (DMSA) was
undertaken.
Results showed urinary mercury
concentrations among 221 cases
of children with autistic spectrum
disorders in comparison to 18
normal controls.
no association was found between
urinary cadmium or lead levels
and autistic spectrum disorders
among the children examined.
The mercury measured in this
study is compatible with exposure
to mercury in childhood vaccines,
while the contribution of
thimerosal in Rho-D immune
globulin and other potential
environmental sources of mercury
exposure, both acute and chronic,
may be contributory.
Analysis of post- DMSA urinary
Mercury excretion found a strong,
statistically significant association
between greatly urinary mercury
concentrations and
the presence of autistic spectrum
disorders in vaccinated children.
J. Bradstreet, D. Geier, J. Kartzinel, J.
Adams, M. Geier JAPS 2003; 8(3): 76-
79
Analyses of Toxic Metals and Essential Minerals in
the Hair of Arizona Children with Autism and
Associated Conditions, and their Mothers
This study assesses the levels of toxic metals and
essential minerals in hair samples of children with
autism spectrum disorders and their mothers
compared to controls.
Iodine
◦ levels were 45% lower in the children with autism (p=0.005).
Chromium
◦ Autistic children with pica had a 38% lower level of Chromium
(p=0.002).
Lithium
◦ The mothers of young children with autism had especially low
levels of lithium (56% lower, p=0.005), and the young children
(ages 3-6) with autism also had low lithium (30% lower,
p=0.04).
J.B. Adams, C.E. Holloway, F.
George, D.W. Quig TEBR Jan, 2006
35

Reduced Levels of Mercury in First Baby
Haircuts of Autistic Children
First baby haircut samples were obtained from 94 children diagnosed with
autism using Diagnostic and Statistical Manual of Mental Disorders, 4th
edition (DSM IV) criteria and 45 age- and gender-matched controls.
Information on diet, dental amalgam fillings, vaccine history, Rho D
immunoglobulin administration, and autism symptom severity was collected
through a maternal survey questionnaire and clinical observation.
Hair mercury levels in the autistic group were 0.47 ppm versus 3.63 ppm in
controls, a significant difference.
The mothers in the autistic group had significantly higher levels of mercury
exposure through Rho D immunoglobulin injections and amalgam fillings
than control mothers.
Hair mercury excretion patterns among autistic infants were significantly
reduced relative to control.
A.F. Holmes, M.F. Blaxill, B.E. Haley
IJT 2003; 22: 277-285
Mineral Status, Toxic Metal Exposure
and Children’s Behavior
237 children attending grades K-4
in Victoria, British Columbia schools.
Children were classified on the basis
of behavioral status.
Amongst all of the elements
considered,calcium in particular
appears to be of importance, with
significant positive associations
observed between low hair levels of
this macro-mineral and problematic behavior.
With respect to specific problem behaviors, distractibility
may be the most affected by mineral status, significant
associations were observed between problem behavior
of this type and low calcium, high manganese, and high
cadmium.
J.A. LeClair, D.W. Quig
JOM 2001; 16(1): 13-32
36

Hair Lead and Cadmium Levels and Specific Depressive and
Anxiety-Related Symptomology in Children
*p

What we don’t know about
environmental triggers---quite a bit!
53,000 commercially important chemicals
NTP survey of 49,000 industrial chemicals
◦ ~80% lack adequate toxicity data (especially DNT)
3,400 pesticides are more heavily regulated
◦ ~64% lack adequate data for risk assessment
3,400 cosmetic ingredients
◦ ~74% lack adequate data for risk assessment
8,600 food additives
◦ ~80 % lack adequate data for risk assessment
National Toxicology Program Report (1992)
Environmental Toxicants and Neurobehavioral
Development Future Challenges
82,000+ industrial chemicals (~40% polymers)
◦ Food additives, ~8600
◦ Cosmetic ingredients, ~3400
◦ Pharmaceuticals, ~1800
◦ Pesticides (active), ~1000
Developmental toxicology data available on
only 200
Human neurodevelopment toxicology data
available for fewer than 10
Almost no information available on toxicity of
mixtures…the chemical cocktail effect
38

Chlorinated hydrocarbon
Lindane (head lice, scabies)
Hepatchlor (1988)
Chlordane (1988)
Dieldrin (1987)
Kepone (1978)
Toxaphene (1990)
To appreciate the effectiveness of these materials as
termiticides, consider that wood and wooden structures
treated with chlordane, aldrin, and dieldrin in the year of
their development are still protected from damage--more
than 55 years!
Subclinical Lead Poisoning
Decreased IQ
Altered behavior
Slowed nerve conduction
39

The EPA Decision on
Lead in Gasoline
Decline in Blood Lead Levels
Greatly Exceeded Expectation
40

Lead and Behavior
Lead Affects more than intelligence
At age 7, Needleman et al. found a borderline
association between teachers’ ratings for
aggression, delinquency, social problems and
lead levels
By age 11, increased delinquent and
aggressive behavior were clearly evident in
children with higher lead levels
By age 18, young adults with higher lead levels
at age 7 were more likely to be dyslexic and to
have quit school
Boys with higher lead levels were more likely
as young men to be incarcerated
Neurotoxicity of
Organophosphate Pesticides
Research stimulated by 1993 NAS Report
◦ Children are not little adults
◦ Proportionately greater exposures
◦ Unique windows of vulnerability in early development
41

Common Environmental Exposures
METALS
◦ Mercury
◦ Cadmium
◦ Aluminum
◦ Lead
◦ Nickel
◦ Arsenic
◦ Cobalt
◦ Manganese
SOLVENTS
◦ Alcohol
◦ Chlorinated Solvents
◦ Benzene
INDUSTRIAL
CHEMICALS
◦ PCBs
◦ Pesticides
◦ Herbicides
All induce oxidative
stress and Glutathione
(GSH) depletion
Multiple exposures are
additive/synergistic!
Thimerosal
mercury based preservative
◦ Developed by Eli Lilly in 1929
◦ Added to drugs in 1931 as an antibacterial, anti fungal
agent
◦ An organic compound that is 49.6 % ethyl mercury
42

Result
Autism first diagnosed in 1943
Autism didn’t exist before thimerosal was added
to vaccines
◦ Coincidence?
◦ Diagnosis changes?
Autism has increased significantly as more and
more children’s immunizations are required.
43

Vaccine Ingredients
Present in trace or
large amounts
depending upon
the vaccine
◦ Lab altered virus’ and
bacteria
◦ Aluminum
◦ Mercury
◦ Formaldehyde
◦ MSG
◦ Gluteraldehyde
◦ Sodium chloride
◦ Hydrochloric acid
◦ Antibiotics
◦ Hydrogen peroxide
◦ Bovine serum
albumin
◦ Human serum
albumin
What’s Gluteraldehyde
Glutaraldehyde can sensitize your skin, lungs
and respiratory system.
Once sensitized, further exposure to even very
small amounts can lead to:
◦ Dermatitis
◦ Rhinitis, conjunctivitis, hay fever.
◦ Asthma
44

Impact of Mercury Exposure
Impacts brain development
◦ Disrupts division and migration of brain cells
◦ Oxidative stress can kill brain cells
◦ Mercury moves easily through the blood-brain barrier
Collects in the cerebellum which controls movement and
cognition
The cerebellum is the region of impairment in autistic
children
Mercury Levels Above EPA Standard
Day of birth
◦ Hepatitis B
12 mcg
30 times safe level!
4 months
◦ DTaP & HIB
50 mcg
60 times safe level!
6 months
◦ Hepatitis B, Polio
62.5 mcg
78 times safe level!
15 months
◦ 50 mcg
◦ 41 times safe level!
By 2 years of age, a
child has received
237 mcg of
mercury!
Case: 18 month old
neighbor’s grand
daughter
45

52% of American dentists
now are mercury-free.
FACT Email Newsletter by Dr. Garry Gordon
www.toxicteeth.org/Mercury%20survey.pdf
Studies
Journal of American Physicians & Surgeons Dr.
Mark Geier 2003
◦ thimerosal doses vs guidelines
◦ Incidence of autism with & without thimerosal
◦ Mercury dose vs disabilities
46

“This study provides
strong
epidemiological
evidence for a link
between increasing
mercury from
thimerosalcontaining
childhood
vaccines and
neurodevelopment
disorders….”
-Dr Mark Geier
47

Amish Study
2005 study of Amish community
As a “control” Amish don’t immunize their
children
In population of 22,000 only 4 autistic children
where there should have been 130
All had been exposed to mercury outside of the
Amish community
Joint Statement
July 1999
◦ Joint statement from the American Academy of
Pediatrics & US Public Health Service called for removal
of thimerosal from vaccines.
2004
◦ Iowa was the first state to ban thimerosal followed by
California
Similar bans are being considered in 32 other
states.
48

June 2000
Top Level Meeting
a hand picked group of government officials and
scientists from the Center for Disease Control
(CDC), Federal Drug Administration (FDA) World
Health Organization (WHO) and pharmaceutical
companies met to discuss a study which showed
a link between thimerosal in vaccines and autism
Doctor Comparison
Vaccine Experts
◦ Dr Mark Geier
MD with PHD in Genetics
Studied vaccines for 30 years
Published 50 peer-reviewed papers on
vaccines
◦ Dr George Lucier
Toxicology expert
Published over 200 papers on toxicology including 10
articles on mercury.
49

Doctor Comparison
Drug company “experts”
◦ Dr Phillip Wang
Expert in depressants
No training in vaccines or mercury
◦ Dr Chris Johnson
Zero experience with the effects of mercury exposure on
the human body
There was great fear of lawsuits against the drug
companies
There was also fear that if thimerosal was removed
that autism would decline making a connection hard to
dispute.
Outcome
◦ This is already happening in California
A cover-up was initiated
◦ CDC paid for a study to debunk link between thimerosal and
autism
◦ Incriminating findings were hidden by claiming data was “lost”
◦ To prevent Freedom of Information, the CDC gave their giant
database to a private company and said it was off limits to
researchers.
50

Each autistic child can cost
the school system $30,000
500,000 children = $15 billion
Present Situation
Thimerosal has been removed from many
childhood immunizations
It still remains in flu vaccines, tetanus shots and
some multi-dose shots
◦ Therefore, one should get shots in single doses if at all.
51

Food Colors and Sodium Benzoate
Artificial food colors and additives were seen to
exacerbate hyperactive behavior in children at least up
to middle childhood.
Some additives have been allowed for as long as 30
years, without regulatory consideration of science
conducted since the original approvals were granted.
“The additives were tested as a mixture is not how
they are used in everyday products.”
◦ Julian Hunt, director of communications at the Food and Drink
Federation (FDF).
◦ Resource: J Stevenson, Food additives and hyperactive
behaviour in 3-year-old and 8/9-year-old children in the
community: a randomised, double-blinded, placebo-controlled
trial“ The Lancet, 06/08/2007
Looking at the
Damage the Fire
Has Caused
Instead of the
CAUSE of the
Fire!
52

Biomarkers Tested
Autoantibodies
Free fatty acid response to
insulin and glucose
stimulation
Hair amino acids
Plasma and RBC
cholinesterase activity
Serotonin
Plasma dopaminebetahydroxylase
Thyroid hormone
Plasma elements
Plasma amino acid
Hemaglutination-inhibition
antibody titer
Plasma levels of folates,
riboflavin, vitamin B6, and
ascorbate
Urine peptides
CSF monoamine
metabolites
Plasma c-AMP and c-GMP
Hair minerals
Brain opiods
Catecholamines
CSF indoleacetic acid
Homovanillic acid (HVA)
Lactic Acid
Plasma growth hormone
response to hypoglycemia
More biomarkers…
Plasma growth hormone
response to oral l-dopa
Platelet size and number
Whole blood tryptophan
Antiserotonin antibodies
Growth hormone
Immunoglobulins
Plasma and urinary levels of
biopterin, neopterin, and
related pterins and plasma
levels of folate
Plasma norepinephrine
Oxytocin
Plasma beta-endorphin
ACTH
Carnitine
FMR1 protein
N-acetyl galactosaminidase
deficiency (Schindler
disease)
Neuropeptides and
neurotrophins
PKU
Secretin
Serum neural cell adhesion
molecule (NCAM)
Cortex S6 Ribosomal
Protein Phosphorylation
Mitochondrial Markers
Urine Arginine Vasopressin
(AVP)
CSF beta-endorphin
IL-2 receptors
Plasma androgens
53

Consider the obvious
AUTISM, ADD/ADHD
Mercury, Lead
Environmental Toxin
Alterations of brain development
affecting the higher brain functions
Shift in metabolism
Known effects of
toxic elements
on nerve structure
and nerve function
Affect on DNA
Genetic Expression
Autism Testing
Environmental effects on metabolism is
widespread and can be missed by existing
reference ranges
Autism’s sensitive physiology may mean trouble
for the individual even when labs are within the
population “normal” range
54

Autism and the World
“We.. …question the universality of Infantile
Autism…Our research of the literature has
convinced us that infantile autism appears to be
an illness of Western Civilization…the illness
seems to be quite infrequent in Latin American
countries, Africa, and India…” -VD Sanuna
Int J Soc Psychiatry, 1984
http://www.iom.edu/Object.File/Master/42/435/News
chaffer%20final%2004_19_07.pdf
Statistics
In the U.S.
◦ 1980s
1 Child in 2500 was
autistic
◦ Today
1 child in 166 is autistic
1 in 80 for boys
In China
◦ 1998
No cases of autism
◦ Today
1.8 million cases of
autism following
introduction of drugs
from U.S.
55

Statistics (cont)
Based on study of flu shots from 1970 thru
1980
◦ Individuals that received five consecutive flu shots
were ten times more likely to develop Alzheimer’s
disease
Why Some Are Autistic
Autistic children have lower levels of mercury in
their hair due to a decreased ability to excrete
the substance
The less ability to excrete mercury, the more
likely a child is to become autistic
The inability to excrete mercury can be caused
by glutathione depletion
Boys are 4 times more likely to become autistic
than girls
56

Autism
Medical treatment: antibiotics
Alternative treatment focus:
◦ Correct Gut dysfunction and gut toxicity from
pathogenic bacteria and chemicals
◦ Reduce or eliminate toxic exposures
◦ Eliminate toxic load
◦ Enhance healing capacities of the body
Possible Diagnostics for Autism
Comprehensive blood test including
inflammatory markers
Urine testing including Amino Acids
Stool testing for pathogens and Fatty acids
Heavy Metal Chelation testing- urine
Hair testing
Celiac disease and food sensitivities
57

Possible nutrients
Calcium
Vit D
EPA/DHA
GLA
Vit C
Glutathione
B Vitamins
Trace minerals
Other chelating
nutrients including:
◦ EDTA
◦ DMSA
◦ Chlorella
◦ Cilantro
Get tested
Before Pregnancy
Eliminated environmental exposures
Improve nutritional status
Exercise
58

Avoid
Vaccinations
Prevent Autism
Artificial colors, preservatives and sweeteners
Environmental exposures to lead, mercury,
pesticides and other chemicals
Improve essential mineral and antioxidant status
What to do for your Autistic Child
Stop vaccinations
Reduce environmental exposures
◦ Be persistent!
Get tested
Improve nutritional status
59

Dr. Cutler’s DMSA protocol
Andy Cutler’s Chelation Protocol
April 29th, 2009 Mom
Before I get into the protocol we’re using to recover Nicholas, I just want
to mention that Andy’s books, Amalgam Illness and Finding Hidden Hair
Toxicities have been two of the most helpful books I have purchased yet.
Amalgam Illness has a wonderful section all about supplements and I’ve
referenced this section more times than I can count. He explains the
plateau many parents experience while chelating – and why you should
continue because you will start seeing gains again.
The Protocol:
Dosing – 1/8 to 1/2 mg of DMSA (and then add in ALA after a few
rounds or months if there was recent mercury exposure) per pound of
body weight. So, a 50 pound child’s dose would be 6.25 – 25mg per
dose.
Dose Frequency – Every 3 hours from Friday through Monday (including
overnight – you can stretch to 4 hours while asleep, but no more)
We chelate every weekend unless I need to sleep through the night
without getting up to give him his dose or if we have something else
going on. Some parents do every other weekend.
Dr. Cutler cont.
Many people ask me how I possibly get up in the middle of the
night to give him his dose. Well, I have no other choice.
After researching other protocols, I felt that this was the one that
was safest. I know there are others who give their child DMSA
every 8 hours and still see gains, however, I have also heard from
many others that this worked for a while and then they hit a wall
and their child regressed.
The problem with infrequent dosing protocols is that the half-life
of the chelator is not taken into account. For example, when you
give doses of dmsa every 8 hours for 3 days, this is what is
happening:
◦ dose > redistribution > dose > redistribution > dose > redistribution > dose
> redistribution > dose > redistribution > dose > redistribution > dose >
redistribution > dose > redistribution > dose > redistribution.
When you dose properly in 3-4 hour intervals, this is what is
happening:
◦ dose > dose > dose > dose > dose > dose > dose > dose > dose > dose >
dose > dose > dose > dose > dose > dose > dose > redistribution.
◦ You want to minimize redistribution as much as you possibly can.
60

Dr. Cutler cont.
Getting up does get easier, I can assure you. On these
weekends, my husband and I take turns with the night doses
– I take the first one (and sometimes I stay up researching,
then go to bed) and then he takes the 6am dose – so at least
we both got a descent stretch of uninterrupted sleep.
Many people have also asked me about yeast during oral
chelation because they have been made to believe that yeast
would be uncontrollable. We were told by a DAN that our only
choice for chelation would be IV because my son is a gut and
yeast kid.
Well, in our case, he could not have been more wrong and
unfortunately the strong-arm technique to get me to subject
my son to IV’s (when taking him for bloodwork was a
nightmare) and not even agree to oversee my son’s case for a
trial of this protocol just ended up in him losing a patient –
and a recovery story.
Dr. Cutler cont.
The yeast has not been what I thought it would be – and in 31
rounds, we haven’t skipped weekends because of yeast or gut
issues – NOT ONCE.
I have Nicholas taking 40mg of Biotin every day split into 4
doses of 10mg. Nicholas is also taking 900mg of Enhansa
now (best supplement EVER!) and 2 caps of Klaire’s detox
probiotic, 2 culturelle and a dropperful of Living Streams
probiotics. That’s it.
The key here is to start slow – making your child sick or
intolerable does not mean you are going to recover him/her
faster. Giving larger doses increases your chances of gut
issues, yeast flares, etc – and you will have to stop chelating
to deal with these issues – so in the end, it’s just not worth it.
You want to find a dose they are comfortable with so you can
continue to live your life while chelating. This is not a race –
and this process can take you 1 or more years, so keep telling
yourself… This is not a sprint, this is a marathon.
61

Dr. Cutler cont.
How do you split up 25mg capsules? Well, some folks open the
capsule out and dump it onto a clean surface and split the
piles into equal sizes (using a razor blade, credit card, etc.). If
you want a 5mg dose, you split a 25 capsule into 5 equal piles.
Exact measurement is not required — the dosing frequency is
more important than having a 5.25mg dose and then a 4.75mg
dose.
Others, myself included, will take 5 teaspoons of juice (I use
four 25mg dmsa caps and two 25mg ALA caps now for 5
doses) and will mix all of these capsules up very well.
I will then put one dose in a syringe that hold’s a teaspoon and
do this 5 times. I put the syringes, tip up, in the refrigerator
until I am ready to give the dose. (I do this when I need to give
dose 1, so that the last dose has only been in the fridge 12
hours. Longer than this, you can start losing potency from
what I understand. Then when you are ready to give it, squirt it
in a cup or whatever you are giving it in and you’re done.
Using an acidic juice, like orange, works best.
Dr. Cutler cont.
There are suggested (required, really) supplements that your child should be on
prior to starting. They are probably getting many of them in their multi-vitamin,
but check just to be sure. As with all supplements, add one at a time so you if
your child is reacting to one supplement in particular.
◦ Calcium: 5-20 mg/pound divided into four doses over the day
◦ Essential Fatty Acid (fish oil or flax, see notes above) 1 to 3 tbsp/day
◦ Magnesium: 10 mg/pound divided into four doses over the day
◦ Milk Thistle: ¼-1 cap (20-80 mg) per dose/ 4 times a day
◦ Molybdenum: 5-20 mcg/pound divided into four doses over the day
◦ Selenium: 1-2 mcg/pound/divided into four doses over the day
◦ Vitamin A: 5 RDA’s/day. Be sure to consider if your EFA is a source
◦ Vitamin B: 12.5-25 mg/4 times a day
◦ Vitamin C: 5 to 20 mg/pound per dose/4 times a day
◦ Vitamin E: 500 IU/day
◦ Zinc: 1 mg per 2 lbs + 20 mgs divided into four doses over the day.
Want support from other parents using this protocol?
Join us on this group:
http://health.groups.yahoo.com/group/AndyCutlerChelationForAutism/
A great post from Andy:
Andy’s post about recovery percentages, etc.
62

Dr. Cutler cont.
March 21, 2010 – Edited to add:
Change the variables and you’re not doing Cutler’s protocol…
Cutler’s protocol is not just simply dosing dmsa & ala every 3-4
hours. If you change any of the variables, you are not necessarily
following Andy’s protocol.
I’m getting more and more feedback lately from parents that
concern me, so I just want to clarify a few things in hopes that it
helps…
1. Night dosing IS required. Skipping the night doses or deciding to
dose at midnight, then 8am – is NOT this protocol. Eliminating the
dose in the middle defeats the purpose of doing the protocol as you
are now creating several opportunities for the redistribution of
metals versus the one per round stated on Andy’s protocol.
2. If you start with high doses, versus the 1/8th -1/4 mg per pound,
you are not increasing the amount of metals that are going to be
pulled as much as you might think. The whole point of the protocol
is to dose low so as few side effects are experienced as necessary,
not to make yourself or your child miserable. You DO NOT start a 40
pound child on a 25mg dose. We saw results with 8mg! Have a little
faith before you go overboard with the dose.
Dr. Cutler cont.
3. The top dose is 1/2mg per pound. Again, you are not
increasing the amount of metals that are going to be pulled as
much as you might think. The whole point of the protocol is to
dose low so as few side effects are experienced as necessary, not
to make yourself or your child miserable.
4. Giving a “sprinkle” of ala or dmsa is not Cutler’s protocol.
Capsules should be divided into the doses you intend to give. I
hear of parents opening capsules and just giving a sprinkle of
each not knowing how much they are or aren’t giving. If you
cannot eyeball the contents of the capsule to divide into the
appropriate dose, ask your dr for a script and get them
compounded to the correct dose.
5. Starting an aggressive anti-viral protocol at the same time you
start chelating is not recommended. Most find that waiting to
start addressing viruses until after round 50 makes life so much
easier for all involved.
63

Dr. Cutler cont.
6. Do not assume that your child does not have yeast issues. If
you are chelating and not seeing gains, it could be that any gains
you would see are hidden by yeast. Get on a good anti-fungal,
whether it’s natural or rx and see if that clears it up.
7. Adding products like NDF, NDF+, chorella, cilantro, etc.Adding
any of these to Cutler’s protocol is not a good idea. You can
search Autism-Mercury’s archives for Andy’s explanation if you
so choose and I would actually recommend you doing just that.
For me, there is not enough research about any of these being a
true chelator doing more than just moving metals around. Using
dmsa and ala have worked very well here
NH…Male, Age 4
Height: 3’0” Weight: 38lbs
Has had all shots, was nursed for 18 months, mother avoided
soy & dairy or he would get diarrhea
Thrush since 18 mo.
Had lot of antibiotics prior w/ ear infections, is on anti-fungals
now but not working so well, a lot of food allergies
behavior changes (hyperactivity) w/ yeast/thrush infections;
4 sinus infections in 4 months, eats meat but no dairy, ear
tubes x3, frequent oral thrush
In past year has taken-Fulvicin, Diflucan, Previcid, Pepcid,
Claritin, Zyrtec, Zithromax, Gentian Violet.
Identifying and removing the toxins is the first step.
Providing proper nutrition is crucial for the safe elimination of
the toxic elements and for regeneration and development of
the nervous system and the whole body.
64

NH…Male, Age 4 Hair Elements 5/23/2007
NH…Male, Age 4 Urine Challenge
65

Yeast and fungus have the unique ability to
bind and hold toxic elements at very high
levels without killing the fungus.In some way
this is protective of the body, by binding the
toxins up; it keeps them from going into the
body. (When anti fungal drugs are used, this
can or often does release the toxic elements
back into the body.) I believe that this is the
case with GH that the fungus is binding up the
toxic elements. When the toxic elements are
properly reduced and eliminated, the fungus
will go away.
NH…Male, Age 4 Supplement Therapy
6/12/2007
66

NH…Male, Age 4 Hair Comparative Retest
NH…Male, Age 4 Urine Comparative Retest
67

Conclusion
Autism is epidemic in the United States
There is a direct and proven link to thimerosal
based vaccines
There has been a massive cover-up by the
agencies that should be protecting us
Everyone has a choice to investigate and decide
if their children should be immunized.
Osteopetrosis Case
Dr. Van D. Merkle DC, DABCI, DACBN, CCN, DCBCN
Vice President of CBCN
Dr. Andrew R. Dyer, DC
68

Initial Contact – 11/3/05
Lori,
I received an email today. I would normally delete any that I don't know.
Anyway, I opened it and there was Kaleb's story.
I am located in Dayton, Ohio, and it may seem strange to get a response from a
Nutritionist and Chiropractor, but I am an expert in Health and have been in
practice for over 20 years. You can look at my website www.3000health.com for
some cases that I did several years ago. I haven't had time to update it. I am
usually scheduled 3-4 months in advance for people to see me for
nutritional/health help. I have seen a few rare conditions and helped some.
There may be no 'cure' for Kaleb, but are there things that can be done to
improve his health? That is what I may be able to provide. Maybe if his system
can be optimized, his symptoms will stabilize. I offer no cure for Kaleb; just the
possibility to get healthier.
I use laboratory testing to determine the course of nutritional therapy and
nutrients and then retest to determine effectiveness.
I guarantee nothing, but I would be willing to do the laboratory testing that I
need at my expense. I would also donate our time that would be necessary to
implement what may be needed.
You may contact me by this email address. If you are not interested then no
response is necessary.
I wish you well and will pray for you and Kaleb.
Sincerely,
Van D Merkle DC, CCN, DACBN, DABCI
Initial Contact cont.
Dr. Merkle-
Thank you so much for your email today. It actually made my day! Yes, we are very interested in
working with you. After years of trying to help Kaleb and watching him suffer so much....we are
willing to try this and see if it helps. The testimonials were very helpful on the site. And we
completely understand there is no cure...but if we can help nutritionally, we'd be very pleased.
We will be out of town from Nov 8-11. We will be going to Shriners in St. Louis to see what there
recommendations are for his hip.
Thank you again....even though that doesn't feel like near enough to say to you.
You definitely made a difference in a family's life today, and we appreciate it so much.
Please let me know what we need to do next.
Lori
69

History of Osteopetrosis
Albers-Schönberg Disease, or type II autosomal
dominant osteopetrosis (ADO2), was described
for the first time in 1904 by the German
radiologist, Heinrich Albers-Schönberg.
ADO2 is the most common form of
Osteopetrosis with an estimated prevalence of
up to 5.5 per 100,000 inhabitants.
Disease results from ineffective osteoclastmediated
bone resorption.
How is ADO2 diagnosed?
Diagnosis is usually made from radiographs, which
demonstrate widespread osteosclerosis and the presence
of endobones (bone-within-a bone appearance), most
commonly noted in the vertebrae (sandwich vertebrae),
pelvis, and at the ends of the long bones.
NBCE Pathology buzzwords = Rugger-jersey spine,
Bone-in-Bone, Sandwich Vertebra, Marble Bone disease,
Chalk Bone appearance, Albers-Schönberg disease,
Erlenmeyer flask deformity.
70

About Kaleb
Kaleb is a bright 9 year old who suffers
from the extremely rare combination of
both the dominant form of
osteopetrosis and osteonecrosis. This
site is dedicated to spreading the word
about his condition and finding that
one gifted doctor who can save him
from a life in a wheelchair.
Internet-Pioneer Moms’ Group Fights to
Connect a Brave Boy with a Cure
www.helpkaleb.com
Family History
of Osteopetrosis
Mother’s paternal uncle in his sixties, wheelchair bound...currently in a
nursing home due to what they first believed was a broken neck. Now they
are attributing the pain to Osteopetrosis.
Maternal grandfather, 57. Underwent total hip replacement in April
2005. Still having problems because they didn't cut the 'tendon' or 'ligament'
as much as they should have and they believe that is the source for the
pain. He will be having a subsequent surgery soon.
Maternal uncle, 37. Has had NUMEROUS broken bones, including the neck,
back, arms, legs, ribs, jaw, shoulder, etc.
Maternal cousin, 33. Has had a number of pins/plates, etc in her
hips. Although it has been difficult, she lives a very active, productive
life. She is a registered nurse and wheelchair bound.
Patient’s mother has positive radiological findings.
71

What is TRAP?
TRAP is an isoenzyme of the nonspecific acid phosphatases
that is expressed by both erythrocytic and macrophagic cells.
In bone, it is highly associated with the osteoclast. It is
postulated that most of the serum activity of TRAP is derived
from osteoclasts, and physiologic increases in serum levels are
observed in children, presumably secondary to increased
osteoclastic activity related to bone growth. Besides
osteopetrosis, pathologically elevated TRAP levels are
observed in the lysosomal storage disorder, Gaucher’s
disease, and conditions of increased bone resorption.
◦ --Journal of Clinical Endocrinology and Metabolism 2002
What Do The Journals Say?
“In the pediatric group, TRAP is 100% sensitive and specific if a
diagnostic cutoff of 35 U/L is used.”
◦ --Journal of Clinical Endocrinology and Metabolism
“The results indicated that in ADO2, serum TRAP reflects the
number of osteoclasts and that the extremely high serum
TRAP activity is a specific indicator of the disease. In the
pediatric group, both total TRACP and TRACP 5b were 100%
sensitive and specific for the diagnosis of ADO2 when the
diagnostic cutoffs of 35 and 60 U/L were used.”
◦ --Clinical Chemistry 2004
72

REFERENCES
Waguespack et al. Measurement of Tartrate-Resistant Acid
Phosphatase and the Brain Isoenzyme of Creatine Kinase Accurately
Diagnoses Type II Autosomal Dominant Osteopetrosis but Does Not
Identify Gene Carriers.
The Journal of Clinical Endocrinology and Metabolism 87(5) 2212-
2217
Alatalo et al. Osteoclast-Derived Serum Tartrate-Resistant Acid
Phosphatase 5b in Albers-Schönberg Disease (Type II Autosomal
Dominant Osteopetrosis) Clinical Chemistry 2004, 883-890
www.Helpkaleb.com
www.caringbridge.com/oh/kalebdavis/history.htm
Doctors around the World
During the Davis
family’s search for
the cause, they have
spoken to doctors in
the following areas:
◦ Ohio (Columbus,
Cleveland, Loudonville)
◦ Baltimore
◦ Boston
◦ South Carolina
(Charleston and
Columbia)
◦ Texas
◦ Illinois
◦ St. Louis, Missouri
(Shriner’s Hospital)
◦ Toronto, CANADA
◦ California (UCLA Med
School)
◦ Utah
◦ Beijing, CHINA
◦ Dayton, OH
Back to Health Center
Dr. Van Merkle and
Dr. Andrew Dyer
73

KALEB’s results
August, 2000.
TRAP - 71.0 (4.3-21.2)
CPK - 202 (50-180)
CPK - BB 60% (0%)
Kaleb and Lori (mom)
Test Results
LORI’s results
August, 2000.
TRAP - 41.4 (3.5-9.1)
CPK - 138 (50-180)
CPK-BB - 68% (0%)
Creatine Kinase is an enzyme
found primarily in the heart
and skeletal muscles, and to
a lesser extent in the brain.
Significant injury to any of
these structures will lead to
a measurable increase in CK
levels.
There are three Isoenzymes.
Measuring them is of value in
the presence of elevated
levels of CK to determine the
source of the elevation.
Normal levels of CK/CPK are
almost entirely MM, from
skeletal muscle.
CK: Creatine Kinase
Isoenzyme MM BB MB
Synonym CK3 CK1 CK2
Found in: Skeletal M.
Heart M.
CK/CPK Isoenzymes
Brain
GI Tract
GU Tract
Normal Values for CK
Heart M.
Normal Values for CK Isoenzymes
MM 97%-100%
MB 0%-3%
BB 0%
Healthy Range 64.00 – 133.00
Clinical Range 24.00 – 173.00
Units
u/l
74

Kaleb D. Past Medical History
Medical History
Birth to 1 year old, 1996
Kaleb's medical history has been quite complex from the very
beginning. He was never a “sick” baby, but he never had a good
immune system. Everything got him down including the normal
colds, ear infections, pneumonia, extended periods of diarrhea and
other illnesses that don't normally knock babies for a loop.
In June of 1996, we found out that his eyes were not aligned.
Strabismus surgery was suggested, and he had a CT scan to rule out
Osteopetrosis due to family history. This scan indicated no
Osteopetrosis.
An additional CT scan was
ordered in August 1998, and
the diagnosis of
Osteopetrosis was made
from that CT scan.
1997-1998
75

Imaging
January 12th, 2006: We did a bilateral DEXA scan
on Kaleb in our office.
T-score on the R heel = -0.39
T-score on the L heel = 0.00
About Kaleb
Kaleb's eyesight was degrading, so he underwent optic canal decompression
(to widen optic canals) on Feb 1 and Feb 24 of 1999 in an effort to save what
vision Kaleb had left.
We found Dr. Lyndon Key from Medical University of South Carolina and made
the first visit in May 1999.
At this time, Kaleb started Rocaltrol treatment (extremely high doses of active
ingredient in vitamin D in hopes to stimulate Kaleb's osteoclasts).
Unfortunately this resulted in the beginning signs of kidney calcification, so
Rocaltrol treatments were stopped in November 2001.
Kaleb has not been on any medication for the Osteopetrosis since that date,
but he has undergone numerous MRIs, CT scans, bone scans, bone marrow
scans, X-rays, and blood draws.
◦ Excerpt taken from helpkaleb.com
76

Radiographic and Advanced Imaging for KD
Lumbar AP 1-12-2003
Lateral 1-12-2003
AP Pelvis 3-8-2005
Lumbar Lateral 1-12-2006
AP Pelvis 1-12-2006
Osteopetrosis Pt
77

Osteopetrosis Pt
78

Osteopetrosis Pt
1-12-2006
79

Radiographic Studies for Lori Davis
(Kaleb’s mother)
Lateral Skull 12-31-2002
Cervical Oblique 12-31-2002
Cervical Lateral 12-31-2002
Osteopetrosis Pt’s Mother
80

Osteopetrosis Pt’s Mother
81

Disease Experts
The last ‘Experts’ on Osteopetrosis they saw in
November of 2005 were from St. Louis and after
several days of testing their final report to Kaleb
and his family was that they will have to live with
the fact that Kaleb will not get better and will be
in a wheel chair the rest of his life.
HEREDITY
Does Kaleb have the ability to be as healthy as
someone without the genetic predisposition??
Are there environmental factors that trigger or
accelerate the Osteopetrosis?
82

Blood Test
Results
83

Hair
Test
84

Aluminum
Aluminum toxicity has been recognized in many
settings where exposure is heavy or prolonged,
where renal function is limited, or where a previously
accumulated bone burden is released in stress or
illness.
In aluminum-related bone disease, the predominant
features are defective mineralization, aplastic bone
disease ( associated with painful spontaneous
fractures, hypercalcemia, tumorous calcinosis ), and
osteomalacia that result from excessive deposits at
the site of osteoid mineralization, where calcium
would normally be placed.
Osteomalacia is a disease characterized by a gradual
softening and bending of the bones with varying
severity of pain; softening occurs because the bones
contain osteoid tissue which has failed to calcify
Aluminum/Osteomalacia References
Becaria, A, Campbell, A, Bondy, SC: Aluminum as a toxicant. Toxicology and Industrial Health 2002; 18: 309-320.
Domingo, JL: Reproductive and Developmental Toxicity of Aluminum: A Review. Neurotoxicology and Teratology 1995;
17: 515-521.
Gilbert-Barness E, Barness LA, Wolff J: Aluminum toxicity. Arch Pediatr Adolesc Med 1998 May; 152(5): 511-2[Medline].
Graske, A, Thuvander, A, Johannisson, A: Influence of aluminum on the immune system - an experimental study on
volunteers. Biometals 2000; 13: 123-133.
Key, L, Bell, N: Osteomalacia and disorders of vitamin D metabolism. In: Internal Medicine. 4th ed. 1994: 1526-1527.
Kosier, June Hannay: Aluminum Toxicity in the 1990s. Journal of the American Nephrology Nurses Assn 1999; 26: 423-
4.
Priest, ND: The biological behaviour and bioavailability of aluminum in man, with special reference to studies employing
aluminum-26 as a tracer: review and study update. J. Environ. Monit. 2004; 6: 375-403.
Ward MK, Feest TG, Ellis HA: Osteomalacic dialysis osteodystrophy: Evidence for a water-borne aetiological agent,
probably aluminium. Lancet 1978 Apr 22; 1(8069): 841-5[Medline].
Yokel, Robert A, McNamara, Patrick J: Aluminum Toxicokinetics: An Updated MiniReview. Pharmacology & Toxicology
2001; 88: 159-167.
85

Lead
Lead poisoning
◦ Manifestations may be highly varied, with multisystem
involvement common.
Gastrointestinal - Colic, anorexia, nausea, vomiting, and
constipation
Neurological - Headache, tremor, dizziness, malaise, extensor
paralysis, mononeuritis, mental impairment, convulsions, and coma
Kidney - Fanconi syndrome, azotemia, isolated proximal tubular
defects, rickets, or osteomalacia, delayed nephrotoxicity
Hematological - Anemia
Miscellaneous - Muscle weakness
Complications:
◦ Bone disease
Lead can interfere with bone development, leading to the formation
of lead lines at bone metaphyses. These lines represent periods of
growth arrest, not lead, per se.
Lead interferes with the conversion of 25-hydroxy vitamin D to
1,25-dihydroxy vitamin D and causes rickets or osteomalacia.
MayoClinic.com, Lead Poisoning, March 15, 2005
Lead cont.
Additional Complications
Nervous system and kidney damage
Learning disabilities
Speech, language and behavior problems
Poor muscle coordination
Decreased muscle and bone growth
Hearing damage
Memory and concentration problems
Muscle and joint pain
Damage to sperm-producing organs in men
High blood pressure (hypertension)
Infertility
Exposure to even low levels of lead can cause permanent damage. The greatest
risk is to brain development, where irreversible damage may occur. High lead
levels in children may cause seizures, unconsciousness and possibly death. Death
by lead poisoning in children is rare, but it can happen.
◦ Centers for Disease Control and Prevention: Blood lead levels in young children--United States and selected states,
1996
◦ 1999. Morb Mortal Wkly Rep 2000 Dec 22; 49(50): 1133-7.
◦ Centers for Disease Control and Prevention: Update: blood lead levels--United States, 1991-1994. Morb Mortal
Wkly Rep 1997 Feb 21; 46(7): 141-6.
◦ Centers for Disease Control and Prevention: Blood lead levels in young children--United States and selected states,
1996-1999. Morb Mortal Wkly Rep 2000 Dec 22; 49(50
◦ Hu H, Aro A, Payton M, et al: The relationship of bone and blood lead to hypertension. The Normative Aging Study.
JAMA 1996 Apr 17; 275(15): 1171-6.
◦ Landrigan PJ, Todd AC: Lead poisoning. West J Med 1994 Aug; 161(2): 153-9.
86

Mercury
One disease symptom of Mercury poisoning: Osteomyelitis
What Is Osteomyelitis?
◦ Osteomyelitis (pronounced: os-tee-oh-my-uh-lie-tus) is a bone infection often
caused by a bacteria called Staphylococcus aureus (pronounced: sta-fuh-low-kahkus
are-ee-us). Depending on how the bone becomes infected and the age of the
person, other types of bacteria can cause it, too. In kids and teens, osteomyelitis
usually affects the long bones of the arms and legs.
Bacteria can infect bones in a number of ways. Bacteria can travel into
the bone through the bloodstream from other infected areas in the body.
This is called hematogenous (pronounced: heh-meh-tah-gen-us) (hema
refers to the blood) osteomyelitis, and is the most common way that
people get bone infections.
Another way is by direct infection, when bacteria enter the body's tissues
through a wound and travel to the bone (like after an injury or trauma).
Open fractures - breaks in the bone with the skin also open - are the
injuries that most often develop osteomyelitis.
Mercury poisoning has a long list of mild to extremely severe symptoms.
For more information, please visit the following websites:
Sam Queen and Betty A. Queen, Chronic Mercury Toxicity, New Hope Against an Endemic Disease, 1996.
Stock, "Die Defaehrlichket des Quecksilberdampfes"; F. Gasser, "Quecksilberbelastung im Menschlichen Korper durch
Amalgam," Med.-Biol. Arbeits und Forschungsgemeinsch (Baden-Baden, Germany: Dtsch. Zahnarzt., 1976): K. D. Jorgensen,
"The Mechanism of Marginal Fracture of Amalgam fillings," Acta Odont. Scan. 23 (1965): 347.
Cadmium
Cadmium is a toxic heavy metal with no positive metabolic function
in the body, and is relatively rare but more toxic than Lead.
Hair cadmium levels provide an excellent indication of body burden.
Moderately high cadmium levels are consistent with hypertension,
while very severe cadmium toxicity can cause hypotension.
Cadmium affects the Kidneys, lungs, testes, arterial walls, bone and
interferes with many enzymatic systems and depletes glutathione,
leads to anemia, proteinuria, glucosurea, depletes calcium,
phosphorus and zinc.
Cadmium absorption is reduced by zinc, calcium and selenium.
Alkaline Phosphatase is commonly elevated with Cadmium toxicity.
87

Copper
Copper could be called a nutritive paradox, since its merit also forms
the basis of its detriment. When it comes to helping or hindering
health, the metal’s equivocal nature lies in the fact that copper is a
pro-oxidant.
That means that its good reputation for doing good deeds—aiding
the transport of iron, preventing the transformation of good fat into
bad fat (lipid peroxidation), helping wounds to heal—is sullied by its
association with spurring on free radical activity and its subsequent
oxidative damage at the cellular, tissue and organ levels.(1)
Oxidative damage has been implicated in aging, as well as the
development of cancer, heart disease and many other diseases. Some
evidence points to patients with Wilson’s disease (an inherited
genetic defect that causes a buildup of copper and the inability to
release the metal), have signs of lipid peroxidation in their livers.
◦ 1. Dameron CT, et al. Mechanisms for protection against copper toxicity. Am J Clin Nutr 1998 May;67(5
Suppl):1091S-1097S.
◦ 2. Trace elements in prognosis of myocardial infarction and sudden coronary death. Journal of Trace Elements in
Experimental Medicine (USA), 1996, 9/2(57-62).
◦ 3. Multhaup G. Amyloid precursor protein, copper and Alzheimer’s disease. Biomed Pharmacother
1997;51(3):105-11.
Copper cont.
Wilson’s disease can result in damage to the liver, kidneys, brain and
eyes, as well as anemia (due to compromised iron absorption),
jaundice and softening of the bones. Some patients have also been
known to develop cirrhosis of the liver as a result of the coppermediated
oxidative damage.
Myocardial infarction (MI) patients have been found to have high
levels of plasma copper too.(2) It seems that copper may heighten
the inflammatory response through oxidation that may lead to
atherosclerosis.
Meanwhile, other evidence, such as a study from the University of
Heidelberg, Germany, suggests that copper-induced oxidation may
play a role in the development of Alzheimer’s disease. That’s
because copper-mediated oxidative damage has been implicated in
promoting the toxicity of beta A4 (A beta) and the metabolization of
amyloid precursor protein (APP), two contributing factors to the
neurodegenerative pathology.(3)
◦ 1. Dameron CT, et al. Mechanisms for protection against copper toxicity. Am J Clin Nutr 1998 May;67(5 Suppl):1091S-
1097S.
◦ 2. Trace elements in prognosis of myocardial infarction and sudden coronary death. Journal of Trace Elements in
Experimental Medicine (USA), 1996, 9/2(57-62).
◦ 3. Multhaup G. Amyloid precursor protein, copper and Alzheimer’s disease. Biomed Pharmacother 1997;51(3):105-11.
88

Copper Toxicity
Copper Toxicity: excessive copper levels that have been associated with
physical and mental fatigue, anxiety, depression and other mental
problems, schizophrenia, learning disabilities, hyperactivity/ADD,
moodswings (sometimes violent, criminal or psychotic behavior) and
general behavioral problems, memory and concentration problems,
postpartum depression, spinal and vascular degeneration, headaches,
increased risk of infections, insomnia and other sleep disorders,
arthritis, spinal/muscle/joint aches and pains, seizure, delirium,
stuttering, hyperactivity, arthralgias, myalgias, hypertension, gingivitis,
dermatitis, discoloration of skin/hair, preeclampsia, weight gain,
hemangiomas and several cancers.
Toxicity is not the only concern; Just having an improper balance of
copper, iron and zinc can result in poor copper status, which over time
may lead to heart and circulatory problems, bone abnormalities and
complications in the immune system.
◦ Jensen LS. Precipitation of a selenium deficiency by high dietary levels of copper and zinc. Proc Soc Exp Biol Med 1975;149(1):113-116.
◦ Avery SV, Howlett NG, Radice S. Copper toxicity towards Saccharomyces cerevisiae: dependence on plasma membrane fatty acid composition. Appl Environ Microbiol
1996;62 (11) :3960-3966.
◦ “Copper and Human Health and Safety,” George A Cypher, International Copper Association Limited, 260 Madison Avenue, New York, NY 10016, USA.
◦ “Copper in Human Health,” Technical Note TN 34, Copper Development Association, Orchard House, Mutton Lane, Potters Bar, Herts EN6 3AP, UK.
◦ “Copper in Plant, Animal and Human Nutrition,” Technical Note TN 35, Copper Development Association, Orchard House, Mutton Lane, Potters Bar, Herts EN6 3AP, UK.
◦ “Copper, The Directory of Nutritional Supplements,” The Vitamin Connection, January/February 1992
◦ “Dietary Reference Values for Food Energy and Nutrients for the United Kingdom – Report on Health and Social Subjects 41,” Department of Health, HMSO, London 1991.
Copper – Ceruloplasmin
Ceruloplasmin is a test that measures the amount of ceruloplasmin (a coppercontaining
protein) in blood serum.
Test Results:
◦ Copper values are low in cases of Wilson's disease, Menke's kinky hair syndrome, malabsorption,
cystic fibrosis and malnutrition.
◦ Elevated values are associated with infections, pregnancy, estrogen or anti-seizure drug use,
inflammation, tissue necrosis, trauma, cancer, anemias, excessive dietary intake, and with
systemic lupus erythematosus. The majority of serum copper is bound to ceruloplamsin and the
remaining copper is bound to albumin, metallothionein or other proteins.
Copper excess lowers serum ceruloplasmin (CP) oxidase activity, which results in
compromised free radical scavenging capacity and potentially an increase in oxidative
damage.(19)
- Medline Plus, Ceruloplasmin, Feb 9, 2005.
* It is important to note that these toxic elements carry a wide range of mild to severe
side effects and complications that are not bone-related.
89

Ceruloplasmin
Ceruloplasmin testing was performed on Kaleb
to rule out the possibility of error in the initial
findings of copper toxicity in his hair test and
urinary analysis due to external contamination
or lab error.
The ceruloplasmin test confirms that excess
copper is present within the blood serum.
DMSA pre-test results for Kaleb Davis
(Dec. 2005)
90

DMSA post-test results for Kaleb Davis
(Dec. 2005)
Well Sample
91

First Draw Sample (Pipes)
The Take-Home Message
This case is in the early stages, but in just three
weeks we saw results/progress in fact he was
able to stop all pain medication.
92

TRAP Results for Kaleb Davis
TRAP = 71 August of 2000
TRAP = 37.6 (4.3-21.2) February 17, 2006
TRAP = 32.1 U/L on 3-13-2006.
TRAP = 24.6 U/L on 5-23-2006
Excerpts from Lori Davis’s Website
Thought it was time to give another update. We went to Dayton
yesterday to see the nutritionist and chiropractor. This man and his staff
have been wonderful to our family and we feel very blessed that they
“found” us! Amazing story.
We have completely changed the majority of our eating habits lately. The
blood/hair/urine/stool samples that we took in December indicating
heavy metal toxicity. We are trying to eliminate these metals from
Kaleb's system so we are changing our diet as well as many other things
in his environment (including type of shampoo, etc). This is a huge
change for us but it's something we should have been conscious of all
along, now it's catching up with us. So, lots and lots of changes.
On a down note, the X-rays definitely showed scoliosis which is very
concerning. Right now we are doing exercises to try to reverse the curve
and we are continuing total non-weight bearing on the hip. The other
down note was the X-ray showed possible fractures of the hip which is
not something we want to hear. And, the amount of cartilage and joint
space is very, very small in the hip area. This is very concerning. The
doctor said "Miracles do happen". We're praying for that miracle.
http://www.caringbridge.com/oh/kalebdavis/history.htm
94

Web Update from Lori 2/3/2006
On Thursday, we went to Dayton to see Dr. Merkle. Can I say one
more time Thank You God for bringing this man into our lives?
Do I think that he will cure Kaleb....no. That is NOT my expectation.
But I do believe that if we can get the metals out of his body,
continue with the organic foods/soaps/etc...and get his body in the
best shape possible, that this will definitely NOT be detrimental to
him. I am just so very thankful we have this man working with us. I
am still amazed.
http://www.caringbridge.com/oh/kalebdavis/history.htm
1-7-2007 update
Ceruloplasmin and serum copper were
chronically elevated.
◦ How can these be lowered?
Copper chelation with tetrathiomolybdate, penicillamine
and triethylene tetramine dihydrochloride
Ceruloplasmin currently improved to 30.10…was 39.00
Healthy Range: 22.60 - 29.50
Clinical Range: 16.20 - 35.60 mg/dL
95

The Slippery Slope of Genetic Testing
Ethics: Pregnancy-fetal traits, abortion Jobs, Insurance, Schools
◦ Abortion of less than perfect genetic traits
Dwarfs, too short, not enough hair, not smart enough, not athletic enough
Medical Mentality
◦ No need to look further
◦ Not the patients fault- relieved of responsibility
◦ Patient options- Surgery, drugs, futility
Natural/alternative
◦ Genes load the gun…environment pulls the trigger.
◦ Are there now environmental exposures that are allowing or causing these genes to be
activated?
◦ If it is a dominant gene, why didn’t it die out already?
◦ We can improve health- can we get patient as healthy as they were before the genetic
disease started?
Osteopetrosis:
Kaleb Davis: age 13 as of 7-2009
3/2009 scans and exams at Cleveland Medical
Center revealed that the necrosis of the joints and
bones is healing and regenerating, which they have
never seen before.
Because so much healing has occurred and there are
no new fractures or deterioration they are planning
on doing hip joint replacements so that he can walk
better. Yes, he is not in a wheel chair all the time
now. He is improving. PTL
96

Osteopetrosis: Kaleb Davis
TRAP is still zero from 71
CK BB is down to 80% from 94%
CK reduced to 324 High from 464 EH
LDH reduced to 351 High from 525 EH
His main problem now adhesions and
contractures of his hip joints, pelvis and low
back
Main findings: High Aluminum, Cadmium, Lead,
Arsenic, Nickel; Extreme high hair copper, serum
copper and ceruloplasmin
Just 2 Possibilities With My Care
1. The patient gets better
2. The patient doesn’t get better, they
won’t/can’t get worse.
NOTHING TO LOSE TAKING CARE OF THIS TYPE
OF PATIENT.
97

Chelating Agents
FDA Approved Chelation
98

The Only Approved Chelating Agent
So what is a proven chelating agent?
Why not turn to the FDA and see what they
approved.
Turns out they have only approved ONE
substance as a scientifically proven chelating
agent, that is dimercaptosuccinic acid, or DMSA.
DMSA was approved as being safe and beneficial
for use in children to remove lead.
It also removes 22 other toxic heavy metals
without removing any beneficial minerals.
It only chelates substances that are foreign to the
human body.
DMSA in the Media
Think you have never heard of DMSA?
The TV show House mentions it all the time.
Sure it is just a show but they use actual doctors
as medical advisers.
Yes the show is sensationalistic or people would
not watch it.
It is also accurate medically.
House will often prescribe ‘captomer’ or ‘chemet’
or ‘succinic acid’ to deal with cases of heavy
metal poisoning. These are all different words for
DMSA. Next time you watch House listen for
these words.
99

Obtaining DMSA:
A Real Chelating Agent
Contrary to popular belief DMSA is available without a
prescription in many countries including the United States.
You can get it with a prescription but it is very expensive as it
often has to be ‘compounded’ by your local pharmacist.
The usual price is about $2 per pill. You can buy DMSA online
from a reputable site such as dmsachelation.com for MUCH
less per pill.
DMSA is an over the counter product so there are no problems
getting it delivered to your house.
Medically diagnosed heavy metal poisoning
Some common chelating agents are EDTA
(ethylenediaminetetraacetic acid), DMPS (2,3-
dimercaptopropanesulfonic acid), TTFD (thiamine
tetrahydrofurfuryl disulfide), and DMSA (2,3-
dimercaptosuccinic acid).
Calcium-disodium EDTA and DMSA are only approved for
the removal of lead by the Food and Drug Administration
while DMPS and TTFD are not approved by the FDA.
These drugs bind to heavy metals in the body and prevent
them from binding to other agents. They are then excreted
from the body.
The chelating process also removes vital nutrients such as
vitamins C and E, therefore these must be supplemented.
More than 30 deaths have been recorded in association
with IV-administered disodium EDTA since the 1970s.
100

Heart disease
The use of EDTA chelation therapy as a treatment for coronary artery
disease has not been shown to be effective and is not approved by the
U.S. Food and Drug Administration (FDA).
Several possible mechanisms have been proposed, though none have
been scientifically validated. The US National Center for Complementary
and Alternative Medicine began conducting the Trial to Assess Chelation
Therapy (TACT) in 2003.
Patient enrollment was to be completed around July 2009 with final
completion around July 2010, but enrollment in the trial was suspended
on September 26, 2008 for an investigation by OHRP after complaints
about ethical concerns such as inadequate informed consent.
The trial has been criticized for lacking prior Phase I and II studies, and
particularly because previous controlled trials have not indicated
benefits.
The American College for Advancement in Medicine, a controversial
organization created to promote chelation therapy, has played a part in
the adoption of the TACT clinical trial, which has led to further criticism
of the trial.
Atwood et al. have argued that methodological flaws and lack of prior
probability make this trial "unethical, dangerous, pointless, and
wasteful."
Heart Disease cont.
The final results of TACT, published in November 2012, showed no
support for the use of chelation therapy in coronary heart disease,
particularly the claims to reduce the need for coronary artery bypass
grafting.
The American Heart Association states that there is "no scientific
evidence to demonstrate any benefit from this form of therapy" and
that the "United States Food and Drug Administration (FDA), the
National Institutes of Health (NIH) and the American College of
Cardiology all agree with the American Heart Association" that "there
have been no adequate, controlled, published scientific studies using
currently approved scientific methodology to support this therapy for
cardiovascular disease."
101

Heart Disease cont.
Like other scientific commentators, they note that any improvement
among heart patients undergoing chelation therapy can be attributed to
the placebo effect and lifestyle changes discovered in conventional
medicine but recommended by chelationists; "quitting smoking, losing
weight, eating more fruits and vegetables, avoiding foods high in
saturated fats and exercising regularly". They note their concern that
patients could put off proven treatments for heart disease like drugs or
surgery.
A 2005 systematic review found that controlled scientific studies did
not support chelation therapy for heart disease. It found that very small
trials and uncontrolled descriptive studies have reported benefits while
larger controlled studies have found results no better than placebo.
The Mayo Clinic states that 'chelation studies have found that chelation
didn't work as a heart disease treatment.
In 2009, the Montana Board of Medical Examiners issued a position
paper concluding that "chelation therapy has no proven efficacy in the
treatment of cardiovascular disease, and in some patients could be
injurious.”
Chlorella
Chlorella, a unicellular green alga that grows
in fresh water, contains high levels of
proteins, vitamins, minerals, and dietary
fibers.
102

Chlorella supplementation decreases dioxin and
increases Ig A concentrations in breast milk.
Dioxins have been detected at high concentrations in breast
milk, raising concerns about disorders in nursing infants
caused by breast milk containing dioxins in Japan.
Toxic equivalents were significantly lower in the breast milk of
women taking Chlorella tablets than in the Control group (P =
.003).
These results suggest that Chlorella supplementation by the
mother may reduce transfer of dioxins to the child through
breast milk.
IgA concentrations in breast milk in the Chlorella group were
significantly higher than in the Control group (P = .03).
Increasing IgA levels in breast milk is considered to be effective
for reducing the risk of infection in nursing infants.
The present results suggest that Chlorella supplementation not
only reduces dioxin levels in breast milk, but may also have
beneficial effects on nursing infants by increasing IgA levels in
breast milk.
Nakano S, Takekoshi H, Nakano M.
J Med Food. 2007 Mar;10(1):134-42.
Maternal-fetal distribution and
transfer of dioxins in pregnant
women in Japan, and attempts to
reduce maternal transfer with
Chlorella supplements.
Total toxic element status in breast milk were
approximately 30% lower in the Chlorella
group than in controls (P=0.0113).
Nakano S, et.al.
Chemosphere. 2005 Dec;61(9):1244-55. Epub 2005 Jun
27.
103

Protective effects of Chlorella in lead-exposed mice
infected with Listeria monocytogenes.
Chlorella was examined for its chelating effects on the
myelosuppression induced by lead in Listeria
monocytogenes-infected mice.
The reduction in the number of bone marrow granulocytemacrophage
progenitors (CFU-GM) observed after the
infection was more severe in the groups previously
exposed to lead.
Treatment with Chlorella, given simultaneously or
following lead exposure, restored to control values the
myelosuppression observed in infected/lead-exposed
mice and produced a significant increase in serum colonystimulating
activity.
The benefits of the Chlorella treatment were also evident
in the recovery of thymus weight, since the reduction
produced by the infection was further potentiated by lead
exposure.
Queiroz ML , et.al.
Int Immunopharmacol. 2003 Jun;3(6):889-900.
Protective effects of Chlorella vulgaris on liver
toxicity in cadmium-administered rats.
Rats in the Cadmium-no Chlorella group had significantly higher
hepatic concentrations of Cd and metallothioneins (MTs) than in
the Cd-5% Chlorella or Cd-10% Chlorella group.
The hepatic MT I/II mRNA was expressed in all experimental rats.
MT II was more expressed in the Cd-5C and Cd-10C groups than
in the Cd-0C group.
◦ Metallothioneins form complexes with heavy metal ions.
Metallothioneins bind physiological metals such as zinc and copper, but
also xenobiotic heavy metals such as cadmium, mercury and silver.
Morphologically, a higher level of congestion and vacuolation was
observed in the livers of the Cd-0C group compared to those of
the Cd-5C and Cd-10C groups.
Therefore, this study suggests that Chlorella has a protective effect
against Cd-induced liver damage by reducing Cd accumulation and
stimulating the expression of MT II in liver.
Shim, et.al.
J Med Food. 2008 Sep;11(3):479-85. doi: 10.1089/jmf.2007.0075.
104

Effect of Chlorella on Cd metabolism in rats.
Cadmium was accumulated in blood and tissues (liver, kidney and
small intestine) in the Cd-exposed groups, while the
accumulation of Cd was decreased in the Cd-exposed chlorella
groups.
Fecal and urinary Cd excretions were remarkably increased in Cdexposed
chlorella groups.
Thus, cadmium retention ratio and absorption rate were
decreased in the Cd exposed chlorella groups.
In addition, metallothionein (MT) synthesis in tissues was
increased by Cd administration. The Cd-exposed chlorella groups
indicated lower MT concentration compared to the Cd-exposed
groups.
Moreover, glomerular filtration rate (GFR) was not changed by
dietary chlorella and Cd administration.
According to the results above, this study could suggest that Cd
toxicity can be alleviated by increasing Cd excretion through
feces.
Therefore, when exposed to Cd, chlorella is an appropriate source
which counteracts heavy metal poisoning, to decrease the
damage of tissues by decreasing cadmium absorption.
Shim, et.al.
Nutr Res Pract. 2009 Spring;3(1):15-22. doi:
10.4162/nrp.2009.3.1.15. Epub 2009 Mar 31.
Zeolite
105

Zeolite in a nut shell
Doctors Alexey V. Yablokov, Vassily B.
Nesterenko, and Alexey V. Nesterenko agree
with Dr. Gordon saying:
◦ “Natural zeolite (i.e., that found in volcanogenic
sedimentary rocks) is a mineral possessing
attractive properties that contribute directly to their
use in the extraction of Cesium and Strontium from
nuclear wastes and the mitigation of radioactive
fallout.
◦ It is also as a dietary supplement for heavy metal
detoxification, it has anti-bacterial properties, and
it stimulates the immune system.
◦ It was used successfully during Chernobyl.”
Zeolite
Aka: Clinoptilolite, Erionite, Phillipsite and
Mordenite
Zeolites are a group of chemically related mineral
substances that contain mainly hydrated aluminum
and silicon compounds.
They occur naturally in volcanic rock and ashes.
Synthetic forms are available for industrial uses.
They are also used as additives in animal feed.
106

Zeolite
Zeolites have a fine porous cage-like structure and
are often used as adsorbents, desiccants, detergents, and
as water and air purifiers.
They are used in medicine as an external hemostatic
dressing, for diarrhea, diabetes and as suspending agents.
The effect of zeolites on autism is under investigation.
Zeolites have been marketed as dietary supplements for
hangover and as adjuvant therapy for cancers.
It is unclear if they are absorbed in the intestine or have
any systemic effects.
Since zeolites have chelating properties and may increase
the pH in the gastrointestinal tract, they can potentially
interact with many prescription drugs when consumed
together.
Exposure to airborne zeolite dust has been associated
with high incidence of malignant mesothelioma.
Uses:
◦ Diarrhea
◦ Anticancer therapy
◦ Antioxidant
◦ Immuno-enhancer
Zeolite
107

Zeolite- how they work
Having ion-exchanging abilities
Absorption properties
Stops bleeding on external wounds and
promotes clotting
Thought to absorb pathogenic microbes,
glucose and alcohol and be beneficial in
diarrhea, diabetes and hangover.
Zeolites- how they work
Buffering effect due to their alkaline nature
Precise mechanisms of action remain largely
unknown
May have immunosuppressing and
immunostimulating effects
Increase mineral utilization
108

Zeolites- Absoprtion
Zeolites are stable structures are not broken
down in the GI tract when taken orally.
Zeolites- Warning
Zeolites are carcinogenic when inhaled
Vulkansandkuren, a Zeolite product marketed in
Europe, contained high levels of arsenic, lead,
mercury, cadmium, nickel, copper and
chromium
109

Zeolites- drug interaction
Shown to absorb aspirin, theophylline,
propanolol and phenobarbital
Zeolite and Japan
Zeolite absorbs radiation and used at Chernobyl
and Three Mile Island
Absorbs it and won’t release it till 5000 degrees
centigrade
110

Zeolite- Wikipedia
Zeolites are microporous, aluminosilicate minerals commonly
used as commercial adsorbents.
The term zeolite was originally coined in 1756 by Swedish
mineralogist Axel Fredrik Cronstedt, who observed that upon
rapidly heating the material stilbite, it produced large
amounts of steam from water that had been adsorbed by the
material.
Based on this, he called the material zeolite, from the Greek
ζέω (zéō), meaning "to boil" and λίθος (líthos), meaning
"stone".
As of October 2012, 206 unique zeolite frameworks have
been identified, and over 40 naturally occurring zeolite
frameworks are known.
Zeolites are widely used in industry for water purification, as
catalysts, for the preparation of advanced materials and in
nuclear reprocessing.
They are used to extract nitrogen from air to increase oxygen
content for both industrial and medical purposes.
Their biggest use is in the production of laundry detergents.
They are also used in medicine and in agriculture.
Zeolite- wikipedia
Currently, the world’s annual production of natural
zeolite is about 3 million tonnes. The major
producers in 2010 were China (2 million tonnes),
South Korea (210,000 t), Japan (150,000 t), Jordan
(140,000 t), Turkey (100,000 t) Slovakia (85,000 t)
and the United States (59,000 t).
The ready availability of zeolite-rich rock at low cost
and the shortage of competing minerals and rocks
are probably the most important factors for its largescale
use.
According to the United States Geological Survey, it is
likely that a significant percentage of the material
sold as zeolites in some countries is ground or sawn
volcanic tuff that contains only a small amount of
zeolites.
◦ Some examples of such usage are dimension stone (as an
altered volcanic tuff), lightweight aggregate, pozzolanic
cement, and soil conditioners.
111

Synthetic Zeolite
Synthetic zeolites form by a process of slow
crystallization of a silica-alumina gel in the presence of
alkalis and organic templates.
One of the important processes used to carry out
zeolite synthesis is sol-gel processing.
The product properties depend on reaction mixture
composition, pH of the system, operating temperature,
pre-reaction 'seeding' time, reaction time as well as the
templates used.
In sol-gel process, other elements (metals, metal
oxides) can be easily incorporated.
The silicalite sol formed by the hydrothermal method is
very stable.
The ease of scaling up this process makes it a favorite
route for zeolite synthesis.
Nuclear industry
Zeolites have uses in advanced reprocessing methods,
where their micro-porous ability to capture some ions
while allowing others to pass freely, allowing many fission
products to be efficiently removed from nuclear waste and
permanently trapped.
Equally important are the mineral properties of zeolites.
Their alumino-silicate construction is extremely durable
and resistant to radiation even in porous form.
Additionally, once they are loaded with trapped fission
products, the zeolite-waste combination can be hot
pressed into an extremely durable ceramic form, closing
the pores and trapping the waste in a solid stone block.
This is a waste form factor that greatly reduces its hazard
compared to conventional reprocessing systems.
Zeolites are also used in the management of leaks of
radioactive materials.
For example, in the aftermath of the Fukushima Daiichi
nuclear disaster, sandbags of zeolite were dropped into
the seawater near the power plant to adsorb radioactive
cesium which was present in high levels
112

Detergents
The largest single use for zeolite is the global
laundry detergent market.
This amounted to 1.44 million metric tons per
year of anhydrous zeolite A in 1992
DMSA vs. EDTA vs. DMPS vs. PCA
A comparative guide
113

What is DMSA? Dimercaptosuccinic Acid
DMSA chelating an
atom of mercury.
Dimercaptosuccinic Acid, or DMSA
Chemicaal compound with the formula
(HO2CCH(SH)CH(SH)CO2H.
This colourless solid contains two carboxylic
acid and two thiol groups, the latter being
responsible for the unpleasant odor of this
compound.
It occurs in two diastereomeric forms, meso and
the chiral dl forms.
114

Think you have never heard of DMSA?
The TV show ‘House’ mentions it often.
Sure it is just a show but they use actual doctors
as medical advisers. Yes the show is
sensationalistic or people would not watch it. It
is also accurate medically.
House will often prescribe ‘DMSA’ or ‘chemet’ or
‘succinic acid’ to deal with cases of heavy metal
poisoning.
These are all different words for DMSA.
Dimercaptosuccinic Acid, or DMSA
The meso isomer is used as chelating
agent.
Meso 2,3-dimecaptosuccinic acid is
used to sequester heavy metals such
as mercury and lead for excretion.
DMSA can cross the blood-brain
brain
barrier, and thus is useful for
extracting heavy metals from the brain.
115

Commonly used DMSA Protocols
Protocols for DMSA Provocation Challenges
stop mineral and SH-containing supplements 24
h before and during dosing.
Have patient take DMSA @ 10 mg/kg t.i.d for
three consecutive days.
Collect urine for 24 hrs during the third day of
dosing; start collecting urine on day three after
the first morning void through the first morning
void on day 4.
As an alternative, a recent study (J. Nutr Envir
Med 1998; 8, 219-231) suggests that better
yields may be attained with DMSA if given at 30
mg/kg as a single oral bolus dose on an empty
stomach, followed by a 6 hour urine collection.
Some patients will experience gas, bloating
and/or diarrhea with this protocol. Start with an
empty bladder, with hold food for about 2 h and
encourage consumption of about 1-1.5 liters of
purified water. Mix specimen well before taking
off the 50 ml aliquot for submission to Doctor’s
Data for analysis.
Protocol for DMSA Therapy
Two week cycle; 3 days on DMSA @10
mg/kg t.i.d., 11 days off.
Supplement 24-48 hours after last dose
(essential elements, SH-containing amino
acids: DMSA depletes cysteine).
As with any chelating/complexing agent,
do not co-administer minerals 24 hours
prior to or during DMSA administration
(except for Mg).
Re-challenge as described above to
monitor progress after about every 5 cycles
of oral DMSA..
Note: ONE SIZE DOES NOT FIT ALL! It is
prudent to give patients a trial dose of ≤
100 mg DMSA prior to an initial challenge.
Therapeutic dosage should be adjusted
according to tolerance, but it is important
to divide the total daily dose as described
above.
DMPS
DMPS ( iv or oral) is the most productive agent
for the provoked urine toxic elements challenge,
particularly when mercury is of concern. Only
about 20% of DMSA is absorbed from the G.I.
tract. Studies performed at D.D.I. indicate that
oral DMSA (30 mg/kg/day) for 1 to 3 days only
yields about 1/5-1/10 the amount of Hg in the
urine as does a single i.v. or oral dose of DMPS.
Therefore many physicians use DMPS rather than
DMSA as the initial challenge and monitoring
agent for assessment of toxic metal burden.
116

Standard Challenge DMSA Dosing
for 6 hour urine
1 lb = 0.453592 Kg X 30mg
50lb = 22.6796 Kg X 30mg
100lb = 45.3592 Kg X 30
120 lb = 54.4311kg X 30
150 lb = 68.0389 kg X 30
180 lb = 81.6466 kg X 30
200 lb = 90.7185 kg X 30
220 lb = 99.7903 kg X 30
250 lb = 113.393 kg X 30
300lb = 136.078 kg X 30
= 13.60mg
= 680 mg
= 1360 mg
= 1,632 mg
= 2,041mg
= 2,449 mg
= 2,721 mg
= 2,993 mg
= 3,401 mg
= 4,082 mg
When to Use Chelation
Problems with chelation
◦ Conventional chelation also has a harder
time clearing heavy metals from cells
(due to having only one method of
bonding to the toxin) and some chelating
substances even remove needed minerals
from the body with the toxins, resulting
in some adverse side effects.
117

Why Use DMSA?
The human body continuously eliminates mercury
and other toxins in urine, feces, hair, sweat, nails
and skin.
If excessive exposure is avoided, the body will
efficiently eliminate most toxins.
Mercury, for example, has a half-life in the body of
only two to three months with no treatment at all.
DMSA by mouth is the preferred treatment for
excessively high levels, although avoidance of
undesirable exposure is the most important aspect
of any treatment plan.
DMSA
315.00
9.20
► DMSA also speeds the elimination of lead, and
arsenic, antimony, bismuth, and gold. Lead is
preferentially stored in bones and for that reason
elimination is slower- as long as 12 years.
Mercury, lead, arsenic, and other metals have been known to
be potential toxins for many centuries.
When body levels become elevated to a point higher than a
safe threshold for tolerance, mercury, lead, and other metals
can lead to illnesses and can exacerbate existing diseases.
Unfortunately, symptoms of heavy metal toxicity are relatively
non-specific and non-diagnostic.
118

DMPS - 2,3-Dimercapto-1-Propanesulfonic Acid
2,3-Dimercapto
Dimercapto-1-propanesulfonic propanesulfonic acid, or its sodium
salt DMPS are chelating agents that form complexes
with various heavy metals.
DMPS
The synthesis of DMPS was first reported
in 1956 by scientists in the Soviet Union.
The effects if DMPS on heavy metal
poisoning, including with polonium-210
were investigated in the following years.
DMPS was found to have some protective
effect, prolonging the survival time.
◦ Annual Reviews Pharmacology and Toxicology
30:279-306 (1990).
119

DMPS
This is a mercury chelator, like DMSA,
yet is more dangerous since it can pull
other useful metals out of the body
(e.g. zinc and copper) and it can dump
much mercury into the kidney and liver,
and permanently damage them.
If you use DMPS, it is recommended that
you work with a Doctor that has used it with
more than 20 patients in the past and that
you first take several small test doses to
make sure you can tolerate it (e.g. 10mg 1st time, 50mg
2nd time, 250mg 3rd time; and wait 2wks between each
test).
It is recommended that you NOT take DMPS unless you
have a very compelling reason to do so, since it is very
dangerous and has damaged many people. This safety
protocol was developed by R.A. Saarela.
DMPS is Generally NOT
for IV Use
►UNLESS you have a medical legal need to
prove mercury is in the body, as it will dump
out more MERCURY than DMSA IV but who
cares since detoxification is a LONG TERM
PROBLEM NOT SOLVED BY IV DMPS.
►Since DMPS is absorbed orally extremely
well and is safer orally, I do not like the
benefit risk ratio of using it IV EXCEPT to get
DATA with a TEST!
►I do not even like it for long term oral as the DMSA is far safer and
over time we get everyone well without RISK if you are patient,
remember first DO NO HARM!
►Garry Gordon MD, DO
120

DMSA vs. DMPS
SUMMARY: The organic mercury species with
greatest toxicity are methylmercury compounds, which have
a high affinity for the brain and nervous system.
DMSA is shown to cross the blood brain barrier and remove
mercury from that organ.
DMPS is much less effective. DMPS is also 3 times more
toxic than DMSA, based on LD-50.
Animal studies show DMSA to be almost 3 times more
effective than DMPS in removing brain mercury.
DMSA has the added advantage that it is taken by mouth in
capsule form. DMPS is usually given by injection.
◦ Presented at the 5 th Nordic Symposium on Trace Elements in
Human Health and Disease, Loen, Norway, June 19-20, 1994.
Nordic Symposium
Author's conclusion: "DMSA may now be
considered as the treatment of first choice
in cases of acute or subacute lead
poisoning and in methylmercury
poisoning. . . All experimental and clinical
experiences show a low toxicity for this
drug."
121

Ca EDTA
The article in the New England Journal of
Medicine on January 23, 2003 proves that
there are long term benefits from using CA
EDTA intravenously in early renal failure in
patients with increased lead levels.
This lead lowering effect is also well documented
to be readily achievable with ORAL calcium EDTA
(400 references).
The article proves both long term SAFETY AND
EFFICACY of Ca EDTA.
PCA (Pepti-Clath)
PCA uses Clathration
Clathration is a unique form of chelation therapy in which
the clathrating substance finds and encloses the toxin in a
three-dimensional cage-like inclusion complex (also known
as a lattice structure or matrix) using three different types
of irreversible bonds.
These bonds attach to and completely envelop the toxin -
essentially neutralizing it - to keep it from coming into
contact with any other bodily tissues as it is carried from
the body.
In this way, the unnatural contaminant has no way of reattaching
to and damaging the body as it is flushed out.
This method is especially effective against heavy metals.
122

PCA (Pepti-Clath) FAQ’s
Ingredients: Distilled water, Micro-activated algae
extracts, lipopoly saccharides, Algenic, Ferulic and
Lipoic acids, 12 beneficial flora ferments including
lactobacillus bulgaricus, acidophilus salivarus,
strep. Hemophilus subspecies and beneficial soil
bacteria and hydrated silica in a colloidal matrix.
PCA is generally the easiest to tolerate of the
chelating agents
PCA (Pepti-Clath)
Laboratory Claims
Naturally, effectively, and gently removes all Heavy
Metals, Toxins, Plaque, pesticides, Triclosimines, PCB’s,
chemical and Pesticide Residues, Yeast Forms, Parasites,
Infectious Prions, Viral Residues, MycoPlasmas,
Vaccination Residues, and anything that is NOT naturally
supposed to be a part of the Blood, Lymphatic Fluid, or
Cerebral Spinal Fluid
promotes healthy liver function, and has been used very
effectively by persons suffering from various Liver
ailments, congestions, and Diseases
123

PCA (Pepti-Clath) FAQ’s
Laboratory test have shown Toxin removal
to be 85% through the stool, 10% through the Urine and 5%
through the skin and breath.
Dosing: 1 or 2 sprays for the first day or two, and gradually
work up to a higher dose i.e. 4 to 8 sprays per day and to
drink at least 1oz of water per pound of body weight each
day to help with toxic elimination.
Each 30 ml bottle contains approximately 240 sprays. At 4
sprays a day that’s a 60-day supply.
Some sensitive people have reported excellent results at 2
sprays a day, making a bottle last for 4 months.
The body only has so many pathways for toxic elimination.
Less is usually better.
PCA (Pepti-Clath)
“Releases” Mercury
PCA "releases" mercury from the
neuron and allows it to become free floating.
Then the clathrating molecule surrounds the heavy
metal and removes it.
As PCA removes the toxin from the receptor it gives
up a molecule to the damaged receptor, this is to
keep other toxins from reattaching.
This nutrient molecule then remains in place until
the healing process is complete.
The toxin is completely engulfed by the PCA and is
safely removed without chance of reattachment.
124

Chelation: PCA (Pepti-Clath)
Luke XXX 11y/o; consult on 11-9-2004
◦ Poor memory/concentration, difficulty concentration, not
doing well in school.
◦ Behavioral problems at home and school
◦ Medications were recommend/required by the school
◦ Parents would not accept a diagnosis of ADD or ADHD
AFTER TREATMENT 3-25-2005 consult; comments by
parents:
◦ “Luke’s concentration and memory have greatly improved, his
grades are better now mostly A’s and B’s now from mostly C’s
and D’s… His attitude and behavior are better. He is much
better overall with more energy and active, better controlled
and less ‘Zoning out’.”
◦ The parents are very relieved and excited how well he is doing
especially in Luke’s school work. Instead of being in the
bottom of the class, he is now in the top, in just 4 months and
he has grown at least 3 inches during this time.
PCA vs. DMSA vs. DMPS
DMSA and DMPS draw out
valuable elements like Calcium and Zinc
while also drawing out mercury.
Understanding that clathrating agents, such
as PCA, work on a "lock and key" principal,
which makes them target metals more
particularly, hence leaving valuable other
elements.
PCA is targeted to all toxic and excessive elements in
the blood, lymphatic fluid, and CSF.
Any toxin that is not natural to the cell structure and
cell integrity is removed.
125

DMSA, DMPS, EDTA,
PCA ,Chlorella and Cilantro
DMPS DMSA EDTA PCA Chlorella Cilantro
Aluminum X X X X X
Antimony X X X
arsenic X X X X X X
Bismuth X X
Cadmium X X X X X X
Chromium X
Cobalt X X
Copper X X X X
Lead X X X X X X
Mercury X X X X X
Nickel X X X X
Uranium X X
Silver X
Tin X X
Zinc X X
When To Use?
I will use DMSA challenge for several
conditions or when I want to rule out heavy
metal toxic elements. Some conditions that will almost
always use the DSMA challenge are:
◦ ADD/ADHD
◦ Parkinson’s disease
◦ Alzheimer’s
◦ Lupus, MS, ALS
◦ Cancer
Some of these will have a direct connection to heavy metal
toxicity but in others like cancer, I want to see if there are
toxic levels of heavy metals that could burden the
immune system.
126

Special Considerations for Chelation
Do not use DMPS, DMSA or EDTA
◦ Critical illness/acute severe illness
◦ Liver disease
Elevated: CK, LDH, SGPT, SGOT,
GGT, Alk Phos
◦ Kidney disease or elevated kidney values
Elevated: BUN, Creatinine
◦ Advanced anemia
◦ Cancer especially during chemo or radiation
◦ Advanced cancer
◦ During acute phase of patients with cancer
There are no “drug”
contraindications using
DMSA
Only the state of health of the patient to be
able to handle chelation.
127

Dr. Merkle’s Guidelines for Chelating Agents
DMPS is available currently only by prescription
and is the most likely to have side effects, some
serious. It is available transdermal, IV and oral.
DMSA is available without prescription and is safer
and available IV and oral.
◦ I use only the oral form of DMSA. Oral is safer.
NOTE: there were several deaths in 2006 from
using IV chelation (both DMSA and DMPS). In fact,
several doctors that used to use IV chelation are
now using mostly oral chelation.
Testing for Toxic
Elements
128

Hair Elements
Hair is intracellular and often can be an
indicator of exposure in the last 4-6 months
or the amount that has been excreted in the
last 4-6 months.
Hair testing results have been
used to implicate lead poisoning
in the death of Ludwig van
Beethoven, and arsenic poisoning
in the death of Napoleon.
Shamberger RJ. Validity of hair mineral
testing. Biol Trace Elem Res. 2002;87:1-28.
129

WHY do Hair Analysis?
While there are instances where patient
compliance interferes with expected results, it is
also quite common that toxic elements have not
been assessed by the provider.
A very simple example of this is anemia. If you
do only blood work and find a client is anemic…
barring known blood loss what other reasons
could there be for the anemia?
If that client is getting exposed to arsenic or
lead, it doesn’t matter how much B12 and Folic
acid you have them take.
Unless you address the lead/arsenic, the anemia
will be resistant.
Testing toxic elements in the blood is albeit
useless unless one is aware of a very recent,
acute exposure/poisoning.
If it’s chronic, mild long term exposure, you
won’t see it in the blood…and blood does not
evaluate EXCRETION RATE/POTENTIAL.
WHY do Hair Analysis? Cont.
130

Concerns Regarding Laboratory Standards
There is no question that ineptness has been
observed at some commercial laboratories for
hair analysis.
The issue of interlaboratory differences is not
sufficient reason, however, to conclude that hair
analysis is not of value.
It is simply a question of tightening up
sampling/analytical protocols.
Hair Washing
131

Should you clean the hair before analyzing?
Hair Washing Causes Erratic Results?
“I would suggest using the supplement suggestions on this
site rather than those from Dr. Wilson.
Dr. Wilson wrote to me saying, "Your readers might want
to know that hair analysis tests from Great Smokies Lab,
King James Laboratory, and Doctors Data will give
significantly different results because they wash the hair in
acetone and detergent.
Analytical Research Labs and Trace Elements, Inc do not
wash the hair. In the JAMA study referred to by Dr.
Mercola, the labs that wash the hair produced erratic
results. This is also what was found in earlier studies.
Hair is biopsy material and harsh washing chemicals
damage it. That is a main reason I use ARL (Analytical
Research Labs).“
◦ http://www.ithyroid.com/hair_analysis.htm
132

Hair washing
From: David Quig, PhD
Fascinating quote.
It was actually ARL that had about 10 outlier values!
Use of a standardized wash procedure, like
standardization of any laboratory method, is why the
National Institute of Standards and Technology (NIST)
exists and strives to get consistency among labs.
A simple response- does ARL have any legitimate data
(published) other than their own self published paperback
book to support their claims about the meaning of all of
those ratios that they report?
The utility of hair analysis is to evaluate exposure to toxic
elements (see the interpretation sections for hair mercury,
lead and arsenic on the Mayo Medical Laboratories web
site and the CDC).
Its labs like ARL that over interpret hair elemental analysis
and give the entire industry, and CAM a bad rap.
Why hair washing?
Put pictures of something like:
Dreadlocks
Gerry curls, oily gels that blacks sometimes use on
hair,
Very sweaty person/guy
Colored/dyed hair
Industry with dust in hair
Etc.
133

Why hair washing?
Hair grows from within the cell and a hair
sample gives a 3-6 month indication of
exposure
Most people wash their hair everyday
Hair washing
You want to test hair, not stuff on the hair.
Maybe ingredients of hair products:
Men’s hair products to color it darker use or
used to use lead.
134

Go With a Provider Who’s
Ahead of the Game
Doctor's Data has been pressing for the
establishment of standardized procedures for
hair analysis under CLIA and the Health Care
Financing Administration.
Doctor's Data only accepts hair samples from
licensed physicians or for research purposes.
Hair Elements Reference Ranges
Reference ranges are not based exclusively on
small data pools which is one of the major critics
for use of hair analysis.
Available reference ranges are based on 28 years
of doing hair analysis.
As methods improve, so will reference ranges.
If you have been doing blood work for any
length of time, you’ll also note the blood
reference ranges change as new data arises.
135

It must be emphasized that the actual toxic
threshold for an individual is not equivalent
to exceeding the reference interval.
Development of heavy metal toxicity
depends on many factors, such as genetic
vulnerabilities, as well as whether the
exposure is acute or chronic, age, and any
co-morbidities.
LABMEDICINE ■ Volume 42 Number 12 ■ December 2011
136

The Perfect Test…
As a screening tool, no one laboratory test exists
that is absolutely definitive.
It is critical that hair analysis results be looked at in
careful consideration of patient symptoms and
exposures. Hair analysis is not a test to end all
tests.
The confusion typically comes from the way many
doctors/nutritionists use or interpret the data from
the hair/urine elements.
Many tend to use only the hair elements to try to
assess diet and supplement modifications.
What does one test tell you?...Nothing definitively.
This is where combining the
blood work with the toxic
element testing gives you
the best overall picture and
plan of action.
137

Long-Term Excretion Rate
The hair root is in constant contact with blood
vessels, allowing both essential and toxic
elements to enter the hair shaft continuously as
hair grows.
Toxic element deposition requires approximately
2 weeks after an exposure to appear in hair
◦ LABMEDICINE ■ Volume 42 Number 12 ■ December 2011
In other words, hair analysis reflects long-term
excretion rates of the various elements.
Excretion is “good”
One must understand that hair is an excretory
tissue so any results that are “high” in the hair
tissue are being excreted…when it comes to
toxic elements, if one is getting exposed, we
wan to see them coming out.
However, it does indicate exposure to the toxic
element along with nutrient depletions it can
cause.
138

The Sickest Have Little to No Excretion Rate
Just because it’s not being excreted in the hair,
doesn’t mean one is not being exposed to that
toxic element.
Many times the clients that show no toxic
element elimination in the hair will be your
sickest clients.
It can indicate one has an inability to excrete the
toxic element which can cause many health
disorders from high blood pressure to memory
and concentration issues.
In our industrial society and with the very real
problem of pollution, it is well understood one
will get exposed to many toxic elements.
Some People Need Higher Levels of
Supplementation Because of Their Environment
We want to try to assess what our clients are
being exposed to and if they’re excreting
efficiently.
This is where some clients will need higher levels
of supplementation due to the environment they
live.
Toxic elements via hair and/or urine and blood
testing can give one a bigger picture of where
they stand with regards to optimal health.
139

High Hair Calcium
There are several factors that can cause an
elevation (or excessive excretion) of calcium and
magnesium in the hair including external
contamination, but also toxic elements.
When I see elevated levels in the hair they are
often low levels in the blood.
Blood levels are more critical and the body will
take from the tissues to maintain blood levels.
Why then are the hair levels high?
Why then are the hair calcium levels high?
This is the main question.
No absolutes here but I often see a high hair and
low blood with some of the clients who present
with more chronic problems.
I usually assume that a high hair level indicates
that there are some reserves and that the body
will use calcium and magnesium more than
other essential elements to attach a toxic
element to a calcium buffer to safely carry it out
of the system.
140

Neurological Disorders
Now when the hair levels of nutrient elements go
low and the blood levels are low and results
show there are no significant levels of toxic
elements coming out in the hair…
this is often seen with MS, ALS, CFS, Parkinson’s
etc…I have never had a problem recommending
magnesium even if it is high in the hair and
“normal” in the blood.
Usually because they’re “dumping” so much
magnesium in the hair, a little supplementation
can be helpful.
Hair Test vs. Urinary Challenge
Some things that I have noticed is that the hair test and DMSA
challenge seldom “agree”.
I will see high or very high levels of Aluminum or Arsenic in the
hair but almost none in the DMSA urinary challenge.
But the DMSA urinary challenge of the same patient will show
high or very high levels of Lead and Mercury and no Arsenic or
Aluminum.
Hair test shows the excretions for about a 4-6 months period as
well as mineral rates and ratios.
The Urine Challenge is more of an “acute” daily excretion
rate. The Day 1 urine collection determines what the individual is
excreting within that 6 hour period (vs the slow 6 months period
via hair). The Day 2 Urine collection is showing what we’re able
to purge (quickly) using the chelating agent.
141

Hair vs Urine cont.
There are many benefits (and some limitations) to both tests but
doing both tests (just as testing more broadly with the blood) give
you a better overall picture of that individuals excretion abilities
as well as our ability to improve excretion rates.
With hair, you typically see lighter weight elements (like arsenic or
aluminum) being excreted because they are easier to
excrete…rarely see lead and mercury being excreted unless the
person is a generally health conscious person who has a good
ability to excrete those toxic element BECAUSE they supplement
already OR if the person is getting exposed to a lot of
lead/mercury it will spill over into the hair.
Urine challenge…we almost always see a big purge of lead and
mercury (on the Day 2 test).
Other Considerations for Urinary Challenge
I will order the DMSA urinary challenge
thru Doctor’s Data if nearly all of the toxic
elements in the hair are yellow or
clear/optimal.
In this day and age, everyone has at
least some significant levels of toxic
elements.
This is a sign to me that these people
do not have efficient systems to easily
eliminate the toxic elements.
I see this commonly in autoimmune
diseases like Lupus, MS, Parkinson’s,
Alzheimer’s, autism, ADD, etc.
It is also known that children with autism
have impaired ability to easily eliminate
Mercury.
I am using DMSA urinary challenge testing
on over 50% of new nutrition patients.
Hair Test Results
142

Creatinine Clearance
Creatinine
The word 'creatinine' comes from the Greek word
'kreas', which means flesh.
Formed after breakdown of creatine. Creatine is naturally
produced in the human body from amino acids primarily in the
kidney and liver. It is transported in the blood for use by
muscles. Approximately 95% of the human body's total creatine
is located in skeletal muscle.
Creatinine is a chemical waste molecule generated during muscle
metabolism.
It makes its way into the kidney through the bloodstream.
Creatinine is flushed out of the body through the kidneys into
the urine. There is a little or no reabsorption of creatinine in the
body.
In case the kidneys are not functioning properly, due to a kidney
infection or due to kidney diseases the levels of creatinine in
blood increase while the levels in the urine decrease
143

Levels of Creatinine in Urine
To find the creatinine level in urine and
blood, creatinine clearance tests are used.
These tests find out the exact working of the kidneys by
comparing the level of creatinine in urine with that of
creatinine in blood.
The creatinine clearance value is found from the amounts of
creatinine in the urine and blood and from the amount of
urine, which is passed in the last 24 hours.
When the kidneys are not working to their optimum best, it
causes low creatinine levels in urine, but high creatinine levels
in blood, because creatinine is not flushed out of the body.
Creatinine Clearance Ranges
90-140mL/min for men.
87 -107 mL/min for women
normal values of creatinine go down with age.
◦ The values normally go down by 6.5 mL/min for every
10 years, after the age of 20.
144

High Urine Creatinine
High creatinine levels in urine are often caused due to
strenuous exercise, muscle injury, more so - crushing
injuries, burns, pregnancy, hypothyroidism or carbon
monoxide poisoning.
It is a common indicator of serious damage to the kidney
or presence of some disease.
If the levels are on the higher side, the most common
symptoms include dehydration, fatigue, shortness of
breath, confusion or other non specific symptoms.
Low Creatinine
Low creatinine levels in the urine can
also indicate damage to the kidney.
◦ The damage can be caused due to a life-threatening infection,
shock, cancer, low flow of blood to the kidneys or urinary tract
blockage.
Alcoholic beverages can lower creatinine in the urine as
they interfere with the ability of the kidneys to filter
creatinine from the blood.
Vigorous exercises which can increase muscle mass will
in turn will help to increase creatinine levels.
145

How Do I Do It?
Cost
Supplies
Patient Support forms
Initial Testing…
The first time you ever test a patient, you will
need a “pre” and “post” test kit.
◦ Pre = is a 6 hr urine collection with NO provoking
agent.
◦ Post = is a 6 hr urine collection after the intake of a
provoking agent (DMSA/DMSA).
So…to do the initial Urinary Challenge, you
will need TWO test kits and one bottle of
DMSA
146

Cost
SBN Suggested Retail Price:$95.00
◦ SBN Member Cost: $60.00
Each Test Includes:
◦ Aluminum Urine Toxic Elements
◦ Arsenic Urine Toxic Elements
◦ Beryllium Urine Toxic Metals
◦ Cadmium Urine Toxic Metals
◦ Lead Urine Toxic Metals
◦ Mercury Urine Toxic Metals
◦ Nickel Urine Toxic Metals
To perform the initial Urinary Challenge your patient would
need a pre-test-kit and a post-test-kit
$190 total Suggested Retail Price
Urinary Challenge Supplies
147

Contents
Collection cup
Storage
container
Requisition
form and
directions
Shipping
supplies
Contents
Storage
Container
Collection
cup
Requisition forms and
directions
148

While the patient waits
Preparing the Test Kits
Determining the Common Standard Challenge
and Standard Therapy Dosage
To calculate the dosage for your patient
based on weight, you first need to change
their weight from pounds to kilograms.
◦ To do this, divide their weight in pounds
by 2.2 and this will give you their weight
in kg.
◦ Then multiply their weight in kg by 30mg
(the common recommended dosage per kg).
Example for a 150 pound individual:
◦ 150 pounds / 2.2 pound per kg = approximately 68 kg
◦ 68 kg * 30mg per kg = 2040 mg of DMSA
149

Dosage for the Urinary Challenge
test SBN guidelines:
For the Challenge or treatment, I never go above
2000mg/day.
For the patient that cannot tolerate sulfur drugs, DMSA
can still often be used but we will lower the dose by half and be sure to do
the test dose.
DMSA urinary challenge basic guidelines:
Challenge dose
Daily Therapy dose for 3 days
◦ 30-50 lbs: 100 mg 100 mg
◦ 50-75 lbs: 200 mg 200 mg
◦ 75-100 lbs: 500 mg 250 mg
◦ 100-110 lbs: 1000 mg (1500mg standard dose) 600 mg (300mg bid)
◦ 110-120 lbs: 1100 mg 600 mg
◦ 121-130 lbs: 1200 mg 600 mg
◦ 131-140 lbs: 1300 mg 600 mg
◦ 141-150 lbs: 1400 mg 600 mg
◦ 151-160 lbs: 1500 mg (2045mg standard dose) 600 mg
◦ 161-170 lbs: 1600 mg 600 mg
◦ 200+ lbs: 2000 mg (2727mg standard dose) 600 mg
◦ 250 lbs:
2000 mg (3409mg standard dose)
PRE-KIT
Complete
Sections 1 & 2
Section 3:
◦ Fill out ONLY:
Patient Height
Patient Weight
Collection Period
– 6 Hours
Select “Pre”
DO NOT fill out
any other
information in
this section
150

Section 4:
◦ Fill out ONLY:
Patient Name
Patient Date of Birth
Sex
Mailing Address
City
State
County
Zip
DO NOT fill out any
other information in
this section.
Section 5 –
◦ NY, NJ, & RI
members MUST
complete Section
5.
◦ Please note –
this will be the
PATIENT’S
payment
information.
◦ If you are NOT a
NY, NJ or RI
member, DO
NOT fill out
Section 5.
Section 6 –
DO NOT FILL
OUT SECTION 6.
PRE-KIT
NY, NJ & RI
151

Fill out:
◦ Patient Name
◦ Date of Birth
◦ Choose “Pre”
PRE-KIT
Specimen Vial
POST KIT
Fill out Sections 1 & 2
Section 3:
◦ Fill out ONLY:
Patient Height
Patient Weight
Collection Period – 6
Hours
Select “Post”
Provoking Agent – Enter
“DMSA” and write the
patient’s dosage
(determined by the doctor)
DO NOT fill out any other
information in this section
152

Section 4:
◦ Same as PRE-KIT
POST-KIT
NY, NJ & RI
Section 5 –
◦ Same as
PRE-KIT
Section 6 –
DO NOT FILL
OUT SECTION 6.
153

Fill out:
◦ Patient Name
◦ Date of Birth
◦ Choose “Post”
POST-KIT
Specimen Vial
ONCE THE TESTING SUPPLIES ARE
PREPARED, WE LIKE TO TAKE SUPPLIES
INTO A CONSULTATION ROOM TO DISCUSS
TESTING EXPLANATIONS FOR PATIENTS.
154

Before the patient leaves
Explaining Test Procedure
Give the patient the
pre kit, post kit,
DMSA and Toxic
Urine Challenge
Instructions all
together in a bag.
Pull out each item
as you explain the
testing.
155

First thing in the morning, patient urinates but does not collect specimen.
Upon next urination, collect the specimen in the collection cup then pour it
into the storage container.
◦ This is done for the next 6 hours.
◦ Keep the clear container refrigerated.
After completing the 6-hour collection, mix the urine by shaking the clear
container for at least 30 seconds. Pour the urine into the specimen vial all of
the way up to the top of the label and tighten the screw cap securely.
◦ Patient needs to:
Urinary Challenge Instructions
DAY ONE using the PRE-KIT
Write the collection date on the vial.
Write the collection date on the pre-test requisition form.
Place the vial in the zip-lock bag. Place the bag in the cardboard shipping box.
Store in the refrigerator until it is ready to be shipped.
At the end of the 6-hour urine collection, take the trial dose of DMSA (1
tablet) to test for sensitivities.
Process
First thing in the
morning, patient
urinates but does not
collect that urine.
Afterward, the patient
collects urine
156

Pours sample in the
collection jug.
Patient continues to
collect urine for 6
hours and pours all
of it in the jug.
Keep refrigerated.
Process
Process
After all collections for
that day are finished,
shake the jug to mix
contents and pour into
the specimen tube.
Document collection
date on the label on the
specimen tube and the
requisition form.
157

Wrap collection
tube in the sanitary
paper provided in
the kit.
Put it back into the
plastic bag
Process
Put wrapped
specimen
tube and
requisition
form back
into the box.
Process
+ Requisition form
158

Process
Put box into the FedEx
Clinical Pak.
Write name and
address in space
provided on the Billable
Stamp.
Tear off the customer
receipt for your
records.
Affix the Billable Stamp
to the Clinical Pak.
Keep refrigerated until
pick up.
Schedule Pick Up
Call FedEx toll free: 1-800-238-5355
Follow prompts
Tell rep that you need a pickup for a shipment
using a prepaid “BILLABLE STAMP” and give the
address location of the pickup.
DO NOT USE A DROP BOX.
159

End of
At the end of the 6-hour urine
collection, the patient should take
their trial dose of DMSA to test for
sensitivities.
◦ Captomer by Thorne
◦ CapturClean—same and cheaper.
NY, NJ & RI
Patient will also need to include payment in each
test kit.
They can either add a check for the amount to
EACH kit before shipping or fill out section 5 on
the requisition form.
Do not fill out section 6 or any other
information. This lab cannot bill your insurance.
160

Urinary Challenge
DAY TWO using the POST-KIT
Upon rising empty the bladder but do not collect urine.
DO NOT eat before taking DMSA supplements.
DO NOT take ANY other supplements on this day.
Take the full DMSA dose that has been assigned
Do not eat for 2 HOURS after taking the DMSA.
The next time the client urinates, they collect the specimen in the
collection cup then pour it into the storage container.
◦ This is done for the next 6 hours.
◦ Keep the clear container refrigerated.
◦ The urine will have a strong smell.
During the 6 hour collection, they need to completely drink 1 to 1
½ liters of reverse osmosis water. Commercial brands include
Aquafina or Dasani.
Urinary Challenge
DAY TWO using the POST-KIT continued
After completing 6-hour collection, mix urine by
shaking the clear container at least 30 seconds. Pour
the urine into the specimen vial and tighten the screw
cap securely.
◦ Patient needs to:
Write the collection date on the vial.
Write the collection date on the post-test requisition form.
Place the vial in the zip-lock bag. Place the bag in the cardboard
shipping box.
Store in the refrigerator until it is ready to be shipped.
161

Caution to patient
NOTE: Some patients will experience gas,
fatigue, bloating and or diarrhea when
taking the DMSA supplement; this is to be
expected and is not cause for any alert or
alarm; other symptoms may occur
These symptoms are now very rare due to
our new protocols using lower doses of
DMSA.
Also remember that DMSA has a half life of
6 hours so it is mostly out of their system
in 4 hours.
Important
Patient must wait 7 days after taking DMSA Supplement to
have blood drawn.
Remind the patient: “Do not dispose of your DMSA. You
will use it again at a later date.”
162

Package and Ship the
same as for Day 1
Day 2
Toxic Urinary Challenge Packing and
Shipping Procedures
We give the patient 2 options
1. They can bring the boxes directly to our office during
office hours.
2. They can ship them on their own using the
instructions included in the package.
You do not need the storage containers
returned. We ask the clients to recycle these
containers.
163

Toxic Urine Test Results
take 7-10 business days.
Determining the Therapy Dose
600mg/day DMSA is Maximum THERAPY Dose.
Take 300mg twice a day (for a total daily dose of 600mg)
◦ If they are very sick, I will cut the dose by 1/3
3 days on
◦ Take DMSA and magnesium only
◦ No other supplements.
◦ Take away from food.
◦ Be sure to drink plenty of water.
11 days off
◦ Take regular supplement recommendations.
Typically go thru 5 Cycles and then retest
164

If you have to use PCA
Take at night on empty stomach or first
thing in the morning
140lb adult = 3-4 sprays all at once BID
Have to use DMSA for the challenge
◦ If you used PCA for the treatment/therapy, you’ll
still need to use DMSA for the test.
Retesting
Do not retest the blood work during a day
the patient is taking Captomer. Wait 7 days after
they finish a round of Captomer to retest the blood.
The Captomer could temporarily raise or lower certain tests.
165

Retesting
Always use the same dose of DMSA as the first
challenge even if they lose weight.
Do only the post-challenge [Day 2 protocol]
Have to use DMSA for the post-challenge
Retest Results
Therapy Depends upon:
◦ Patient tolerance
◦ Liver, Kidney and Thyroid function
◦ Mineral levels
◦ Presence of anemia
◦ Were test results a bigger purge or smaller purge?
166

Progress not Perfection
Keep in mind…there is no hurry!
Slow progress is better than no progress.
The testing will guide your recommendations.
Dr. Merkle’s Personal
Comments
Chelation experience…
167

GI Upset from DMSA
Note: we have had no problems with the new lower doses.
For the patient that gets GI upset from the DMSA then I
will use other chelating agents.
I like EDTA and PCA for the therapy.
◦ The challenge has to be done with DMSA.
These are much milder and PCA drives toxic elimination
through the stool instead of the urine.
◦ I did a urinary challenge with PCA and had negative results but
many patients and my personal experience notice a metallic smell
to the stool after taking the PCA.
DMPS, DMSA and EDTA are eliminated through the
kidneys out the urine and the PCA is eliminated through
the bile and out the stool.
PCA and EDTA
PCA and EDTA can be taken daily at the same time
on a long-term basis usually without problem.
I take these both nearly every day, PCA at night
and EDTA in Cardio Flow during the day.
I use PCA and EDTA treatment for children, long
term care, fragile systems, people with any liver or
kidney problems and those with other serious
health conditions and that do not tolerate well the
DMSA.
168

DMSA
Many people can and do tolerate the DMSA quite well.
The DMSA works faster and more aggressively than the PCA
and I prefer to use it at least in the initial weeks or months
with patients with Parkinson’s Alzheimer's, Lupus to get the
most benefit in the shortest amount of time and to get some
good results, results can be dramatic.
The most common side effects from the DMSA is upset
stomach and skin rash.
DMSA has a half like of 4 hours, drink more water, take
500mg of calcium and 200mg of magnesium if symptoms
are extreme.
More water is very helpful as it is eliminated through the
kidneys.
More common side effects
We have noticed muscle cramps, spasms, flu like
symptoms and weakness with DMSA.
This is rare with the lower dosages we now use.
We will lower the dosage of treatment by half and
increase calcium, magnesium and water, if
symptoms persist, we will go to PCA and or EDTA.
◦ DMSA still must be used for the challenge.
169

Chelation and your practice
It can add another dimension to
your practice, expand your ability
to more effectively take care of
more people with various
conditions and you will be able to
do it safely with the testing that
we recommend.
There are many doctors and people doing chelation,
even IV chelation that do not do blood, hair and DMSA
urine challenge to know if they are creating a problem.
You will be better and get better results if you test
properly.
DMSA weekly
I take DMSA nearly every Monday morning
600mg all at once.
170

Case Studies
Urinary Chelation & Testing Protocols
Clinton L - Dx with Ankylosing Spondylitis.
14 years old.
Complained of ankle and knee swelling.
No longer able to play sports
Has seen several specialists in the area
including a gastroenterologist and
rheumatologist.
171

Clinton L
Hair Results
Clinton L -
Initial Chelation
Results
Post
Pre
01/08/2006
Challenge 04/15/2006 10/16/2005 01/08/2006
Challenge
172

Clinton L
• Lead over time can be especially damaging on the
kidneys and is associated with or can cause high
blood pressure.
• Mercury is well known for its toxicity, nerve
damage and contributing or causative factor in
Alzheimer's adding Lead to the picture and more
neurological involvement, chemical toxicity,
arthritis and organ dysfunction will likely occur.
Kammie B.
Hair Test Results
Blood Test Results
35y/o female 5’4” 174 lbs
Chief Complaints:
1. Hyperinsulinism
2. Depression
3. High Cholesterol
4. CFS
5. Can’t lose weight
173

Kammie B. – Chelation Tests
10/09/2005 Post 02/09/2006 07/19/2006 01/05/2007
Challenge 07/21/2005
Pre 10/09/2005
02/09/2006
07/19/2006
Challenge
Peggy K.
Hair Test Results
51 y/o female 5’5” 122 lbs
Primary Complaints:
1. brain fog,
2. Poor memory and concentration
3. Osteoporosis
4. Fibromyalgia.
Blood Test Results
174

Peggy K. Chelation Tests
Post 11/21/2005 Challenge Pre 08/23/2005 Challenge
Herbert H.
Hair Test Results
Primary Complaints:
1. High Blood Pressure
2. High Cholesterol
3. Gastro/Intestinal Dysfunction
4. Anemia
Blood
Test
Results
A DMSA urinary challenge was ran ran on on
this patient because nearly all all of of the the
toxic elements in in his his hair results were
yellow or or clear/optimal.
175

Herbert H. Chelation Tests
Post Challenge
Pre Challenge
Ken C.
69 year old, male
Presented on April 19, 2005
Primary Complaint: Parkinson’s Disease
176

History- Patient Diagnosis
Neurosurgeon diagnosed Parkinson’s disease
August of 2004, via the proper radiological
exams and physical exams 6 months prior to
seeing us and unusual symptoms were noted.
History:
Adrenal Fatigue/ “Alternative Healer”
There was no improvement noticed for the
treatment of Adrenal Fatigue after being on the
following nutrients for one year.
◦ Lecithin
◦ Heavy Metal Detox
◦ Cortisol
◦ Adrenal Support
◦ Siberian Ginseng
◦ Super Antioxidant
◦ Unadegada? Homeopathic?
177

Signs and Symptoms
Parkinson's Symptoms
◦ Dizziness and balance
problems
◦ Slow guarded gait, uses
hand on wife to steady
himself
◦ Problems focusing eye sight
◦ Shaving is difficult
◦ Started stuttering and
stammering in the last 3
months due to a constant
tongue ‘quivering’ making
speaking difficult
◦ Can no longer preach
◦ Reduced: Personality and
character are different
◦ ‘Cries’ or feels like crying
‘all of the time’
Nervous and agitated for
last 6 months
Heart disease
◦ 5 heart catheterizations
◦ 2 balloons
Allergies
History of Prostate cancer
◦ Radiation treatment 2004
Depression
Takes Atavan for anxiety
Surgical removal of Uvula
years ago for sinusitis
resulting in constant
drooling, choking and
problems drinking fluids.
Ken C
Bloodwork
04/21/2005
Most significant
findings:
◦ low thyroid
◦ Low grade infection
◦ Mild low protein
◦ Mild low minerals
178

Ken C
Hair Analysis
Toxic Elements
No significant levels of toxic
elements.
This is bad.
Essential Elements
The essential/nutrient elements
are mostly all low and some very
low.
◦ These findings support the
blood findings.
There are either toxic elements
that are depleting the body of the
nutrient elements and/or there is
just a deficiency.
Because of these findings I
recommended a DMSA Challenge.
◦ Toxic elements commonly or
can accumulate in the brain
causing symptoms like this
patient has.
Pg 155
Diet and Supplements
The diabetic factors are a little
high.
◦ This is not primary and may be
associated with infection, fast
food or just eating too much
fruit this time of year.
Patient was recommended he
follow a standard whole foods
diet and Category 3 diabetic
diet.
Calcium MCHC 1500mg.
Inflavanoid (Turmeric) 2 per day
Iodoral 24mg.
Lithinase 2 per week
Magnesium Glycinate 200mg.
MLK 1000 2000mg.
Seacure 3 per day
Spectramin Chelate 900mg.
Sublingual B12 Plus 2 per day
Thyrostim 2 / day
GLA (Ultralinic) 240mg.
Lauricidin 2 tsp./day
179

Ken C - Chelation Tests
Post
08/10/2005
Challenge Pre 05/30/2005 Challenge
DMSA comments
My staff informed me that this patient had some good
improvement using the DMSA. He noticed immediate
improvement in the shaking, unsteadiness and speech just
from the challenge, therefore on his own he continued to take
the DSMA on a daily basis.
180

40% improvement
Patient Progress
4 months on his program
Energy and allergies are better
No shaking
Walking better…can jog now which he wouldn’t do
before because of unsteadiness, weakness and angina.
Better with people and emotions are much better
◦ Doesn’t feel like crying all the time
Talks better…stutters much less!
“More with it.”
Back to Preaching
Ken C
4 Month Blood
Work Re-test
The thyroid and Lipid values are
worse. This is not an uncommon
finding during DMSA therapy.
Especially when Mercury is involved
that will directly affect the thyroid.
Retesting on 11-10-2005:
T4
3.50 Improved
T3 Uptake 49 Improved
T7
1.70 Improved
He had been taking synthroid after the
8/16/2005 test. “It didn't seem to do
anything so I went to an Endocrinologist. I
took all the tests you had done on me and
he studied them and also looked at the test
my Family Dr. had taken on my
thyroid. The Endocrinologist determined
that my thyroid is now working fine so that
was good news.” The patient went off of
the Synthroid.
181

Supplements from Initial Re-test
Calcium MCHC 1500mg
Inflavonoid (Turmeric) 2 per day
Iodoral 24mg.
Lithinase 2 per week
Magnesium Glycinate 200mg.
Meda-Stim 600mg.
MLK 1000 2000mg.
Seacure 3 per day
Spectramin Chelate 900mg.
Sublingual B12 Plus 2 per day
Thyrostim 6 per day
GLA (Ultralinic) 240mg.
Vitamin C 3000mg.
Lauricidin 2 tsp./day
6 month
Hair Retest
Ken C
Toxic Elements:
This hair test shows good
progress even though the Arsenic,
Aluminum and Mercury are higher.
There were so many deficiencies
and imbalances before starting
the program, that his body
could not eliminate these toxic
elements. The DSMA is
involved with this too.
Essential Elements:
The nutrient elements are showing
progress but there are still many
deficiencies.
182

Urinary Chelation &
Testing Protocols
To find out more about Dr. Merkle’s Computerized
Lab Diagnosis Program visit:
www.NutritionPracticeBuilder.com
937-433-3140
Mail@ScienceBasedNutrition.com
Van D. Merkle, DC, DABCI, DCBCN,
183