By Dr Amtul Qudoos Farhat, MBBS, DCH (UK), FCPS (Pakistan) Assistant Professor, Fatima Jinnah Medical College, Pakistan

DMPS-Dimaval Dimercapto Propane Sulfonate
DMPS is the drug used to chelate or remove Mercury from body. It is agreed to be a powerful chelating agent for mercury(1, 12). It is given intravenously and has to be injected under medical supervision.

DMPS mobilizes Mercury from different organs and channels it to Kidney to be excreted. To prevent the small risk of spill over of Mercury during this process we need to take special precautions.

Where we get the Mercury from in our body?

1. We are all exposed to Mercury since it is a naturally occurring elemental liquid mental the amount of which remains constant. Being liquid it evaporates and the atmospheric vapours may be drifted away across long distances. We all inhale as well as absorb this atmospheric mercury through our skin.
2. Atmospheric Mercury is oxidised 15and deposited in the lakes where it enters the food chain primarily through fish and other seafood. A portion of the oxidized mercury is ingested by bacteria in the water, some of which, in turn, generate methane. These bacteria “methylate” the mercury changing it to Methyl mercury which is the most toxic form of mercury. It accumulates in the tissues of fish since the fish feed on the higher end of the food chain. This is another way of getting Methyl Mercury in to our body- by eating fish and sea foods.
3. Mercury makes 35% of the Alloy which is being used as dental Amalgam since 18302, 4. Even though there was huge concern and controversy right from the beginning, the silver fillings continued to be the norm of dentistry. Unfortunately more than 90% dentists still feel comfortable putting this hazardous material right in to your mouth. These ‘silver’ fillings leak mercury especially during grinding, chewing and with hot drinks and meals16. Dental amalgams are a big source of mercury in humans10.

What does Mercury do to our body?

We absorb mercury through gut, skin and respiration. Absorbed mercury does not stay in circulation. Instead it is quickly cleared from the circulation and is deposited in to different organs such as brain, bones, liver, skin, nerves, intestine, stomach and practically every organ of the body. That is why a random blood sample does not show any Mercury except in acute exposures. Wide distribution of mercury in the body leads to wide spread effects which are slowly progressive in nature.

1. Nervous System: Foggy brain, poor memory, short attention span, depression, excessive anger(8, 13). It is a probable factor in the aetiology of Multiple Sclerosis(14).
2. Kidney: blood in the urine, poor kidney functions and kidney failure.
3. Bowel disturbances including diarrhea, constipation, malabsorption, inflammation, pain and food intolerance.
4. Nerve involvement may lead to neuropathies which can give numbness, funny sensations, poor smell, poor hearing and poor vision
5. It has been recognized to affect the nerves supplying heart giving arrhythmia or irregular heart beat.
6. Skin rashes of variable types and shapes.
7. Alters the immune system(9, 18).
8. Miscarriages and foetal abnormalities during pregnancy(11, 17).
9. Passed to your baby through lactation.

Why it is ignored as a causative factor in disease?
The body burden of mercury increases parallel to advancing age. Therefore the symptoms are attributed to an aging process rather than to chronic metallic toxicity. Also the exposure is universal although the amounts vary widely depending upon the intensity of the exposure therefore the problem is nullified as a problem.

Should we treat it?
Yes! If we are diagnosed with the Mercury overload in our body we should take care of it as follows.

1. Stop further exposure. Learn the level of Mercury in water and fish you use through local health advisories. See if you have work or household exposures through paints6, fungicides, cosmetics and cleaners.
2. Cut down on house hold chemical cleaners.
3. Let your silver fillings be removed by dentists who practises naturopathy and is trained to deal with such extractions under protective masks and who knows the Pre and Post Extraction Protective protocols to prevent redistribution of dental spill over during amalgam removal. If you need help and advice in this regard please let us know.
4. Finally get rid of your Body over burden!

How to get Rid of the body Burden of Mercury:
Before we embark on treatment we need to find out if we have an over loaded body or not. This is done by DMPS Challenge Test.
DMPS Challenge test:

The test is done in our clinic. It is done by challenging your body with an intravenous injection of DMPS and then collecting the urine for next 24 hours. A urine sample from this collection is sent for estimation of Mercury load.

What if your Mercury is high?
If your mercury level is high, we will make a treatment or detoxification plan according to the level of mercury you have.
Detoxification protocols will involve a dietary advice and supplement program along with DMPS Treatments. During this process the excretory channels of the body including kidneys, liver and skin should be functional and active. This requires supplementation to support your liver kidney and skin. You should not have constipation. Regular Exercise and Sauna help regulate these channels. If you need help in this regard please ask us in the clinic.

Some of these treatments are as follows:

1. Glutathione: Glutathione is a general but powerful Antioxidant. It has a specific mechanism to handle high level of mercury in our body3, 7. Glutathione cannot be taken orally and has to be given intravenously. We prepare it in a bag of normal saline mixed with Hyaluronic Acid. Hyaluronic Acid, being a targeting molecule, helps enhance the bio availability and penetration even when smaller doses of DMPS are used. This helps avoid any side effects. We can also help you to decide on the most suitable oral precursors of Glutathione which you may take on regular basis at home.
2. High Dose Vitamin C: We recommend high dose of Vitamin C prior to amalgam extraction, after the Challenge test and in between DMPS treatments. You may not be able to take a high enough dose of Vitamin C by mouth. We give a high dose of vitamin C intravenously in the clinic.
3. DMPS infusion: There is lot of controversy regarding use of DMPS. It is considered an experimental dug and not approved by FDA. Also that it lacks scientific studies. These are the general allegations against many other useful and effective drugs being used widely for decades now. DMPS is the most powerful chelator for Mercury. One needs to follow the right protocol in accurate dose. The only side effect which we have noticed is tiredness on the day of treatment, and very occasionally a skin rash which may occur in patients with known sulpha sensitivity. . The DMPS skin rash is easily identifiable and it is not the cause of serious skin rashes such as Steven Johnson syndrome.
4. Removal of dental amalgam. We will refer you to a naturopathic Dentist who is knowledgeable and has experience of removing silver fillings.

References:

1. Aposhian HV, Maiorino RM, Gonzalez-Ramirez D, et al. Mobilization of heavy metals by newer, therapeutically useful chelating agents. Toxicology. 1995; 97:23-38.
2. Berry TG, Nicholson J, Troendle K. Almost two centuries with amalgam: Where are we today? J. Am. Dent. Assn. 1994; 125:392-9.
3. Bose S, Mukhopadhyay B, Chaudhury S, Bhattacharya S. Correlation of metal distribution, reduced glutathione and metallothionein levels in liver and kidney of rat. Indian J Exp Biol. 1994; 32:679-81.
4. Dexter JE. A History of Dental and Oral Science in America. In: Science AAoD, ed. Philadelphia: S.S. White; 1876.
5. Hargreaves RJ, Evans JG, Janota I. Persisent mercury in nerve cells 16 years after metallic mercury poisoning. Neuropath Applied Neurobiol. 1988; 14:443-452.
6. Lorscheider FL. Mercury exposure from indoor latex paint. N Engl J Med. 1991; 324:851-852.
7. Meister A, Anderson ME. Glutathione. Ann. Rev. Biochem. 1983; 52:711-60.
8. 8. O’Carroll R, Masterton G, Dougall N, Ebmeier K, Goodwin G. The neuropsychiatric squeal of mercury poisoning. The Mad Hatter’s disease revisited. Br J Psychiatry. 1995; 167:95-8.
9. Queiroz M, Perlingeiro R, Dantas D, Bizzacchi J, De CE. Immunoglobulin levels in workers exposed to inorganic mercury. Pharmacol Toxicol. 1994; 74:72-5.
10. Richardson MG. Assessment of mercury exposure and risks from dental amalgam. . Ottawa: Medical Devices Bureau, Environmental Health Directorate, Health Canada; 1995.
11. Rowland AS, Baird DD, Weinberg CR, Shore DL, C.M. S, Wilcox AJ. The effect of occupational exposure to mercury vapours on the fertility of female dental assistants. Occup. Environ. Med. 1994; 51:28-34.
12.  Schiele R, Schaller KH, Weltle D. Mobilization of mercury reserves in the organism by means of DMPS (Dimaval). Med. Soc. Med. Prevent. Med. 1989; 24:249-51.
13. Siblerud R, Motl J, Kienholz E. Psychometric evidence that mercury from silver dental fillings may be an etiological factor in depression, excessive anger, and anxiety. Psychol Rep. 1994; 74:67-80.
14. Siblerud R. A comparison of mental health of multiple sclerosis patients with silver/mercury dental fillings and those with fillings removed. Psychol Rep. 1992; 70:1139-51.
15. Stohs S, Bagchi D. Oxidative mechanisms in the toxicity of metal ions. Free Radic Biol Med. 1995; 18:321-36.
16. Vimy MJ, Lorscheider FL. Intra-oral air mercury released from dental amalgam. J. Dent. Res. 1985; 64:1069-71.
17. Vimy MJ, Takahashi Y, Lorscheider FL. Maternal-fetal distribution of mercury (203-Hg) released from dental amalgam fillings. Am. J. Physiol. 1990; 258:R939-R945. AND Wild L, Ortega H, Lopez M, Salvaggio J. Immune system alteration in the rat after indirect exposure to methyl me