Here is a site I found, that has a paper by Baker among others, detailing the mercury detox regimen for autistic children.
Keep in mind that this for autistic children, and has their health issues in mind.
Most interesting was the discussion in Appendix B
"Appendix B: Treating gut dysbiosis"
which relates to the treatment of digestive germ imbalance resulting in poor digestion/absorption
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http://www.autismangelspurse.com/MERCURY%20DETOXIFICATION.html_
Some info pulled from the paper as regards the components used (DMSA, vitamins, minerals, etc) follows:
"DMSA should be given in doses of no more than 10 mg/kg/dose and no more than 30 mg/kg/day
with a
maximum dose of 500 mg (1500 mg/day maximum). Exceeding these limits has been
associated with a significantly higher incidence of side effects and toxicity. The dosing interval
can be any convenient period, as long as the dose limits are not exceeded. There is no convincing
evidence to suggest that dosing intervals shorter than eight hours provide any inherent benefit,
although
a lower dose given more frequently may help to reduce troublesome side effects. In
addition, the subset of children who experience improvement only while receiving DMSA may
benefit from more frequent dosing. Clinical experience supporting 3- or 4-hour dosing intervals is
matched by equally good results with 8-hour dosing. As always, the dosing interval should be
based on the clinical response of the individual patient."
"The treatment period can last from three to five days with a “rest period” of at least as long as the
treatment period.
A treatment of three days followed by a rest period of eleven days provides
adequate time for bone marrow suppression to resolve and yet is short enough for rapid removal
of tissue mercury. A three-day treatment period allows the drug to be administered over theweekend (Friday evening through Monday morning), which can be a tremendous convenience.Common side effects of DMSA are nausea, diarrhea, anorexia, flatulence and fatigue. If thesebecome serious enough, reducing the dose will usually make the symptoms tolerable."
"Mineral supplements
Because of poor nutrition (often due to idiosyncratic food preferences), poor absorption, andother, poorly understood factors, autistic children usually have numerous mineral deficiencies.Chief among these deficiencies is zinc. Zinc supplements should be given prior to, during andafter detoxification therapy. Zinc given with DMSA will complex with it and will be more readilyabsorbed as a consequence29,30. Supplementation with 1 – 2 mg/kg/day of zinc is recommended(maximum of 50 mg/day unless guided by laboratory evidence of marked deficiency); more maybe needed and plasma, erythrocyte or platelet zinc levels can be used to guide doses higher thanthis.Autistic children are also often deficient in selenium. Since this mineral is one of the few that cancause a significant toxicity if it is present in excess, caution should be exercised. In the absence oflaboratory evidence of a profound deficiency, selenium supplementation should be limited to 1 –4 mcg/kg/day.Magnesium, molybdenum, manganese, vanadium and chromium are all among the minerals thatare deficient in autistic children; these can be supplied by a multi-mineral supplement. Be surethat this supplement does not contain copper. Copper is the one mineral that autistic childrenoften have in excess and additional supplements will only worsen the excess.
Vitamin supplements
Although the conventional wisdom is that the “average American” receives all the vitamins andnutrients they require in a balanced diet, there are several reasons why this is not true in autisticchildren. First, autistic children rarely eat a balanced diet. They often have an extremely limitednumber of foods they will accept and these rarely encompass all of the major food groups.Additionally, some of the vitamins are anti-oxidants and are depleted in autistic children. Finally,many autistic children are deficient in vitamin B6, vitamin B12, folate and niacin, either from poordiet, poor absorption or both.Vitamin C: An important anti-oxidant, vitamin C can be a great benefit to autistic children. Sinceit is a water-soluble vitamin, it is rare to see true toxicity, although ascorbic acid crystals in theurine (and the potential for renal stones) will result from sustained use of extremely high doses.More commonly (and usually at doses over 2000 mg/day), gastrointestinal distress and diarrheaare the only side effects from vitamin C. Using the buffered preparation or vitamin C esters cansignificantly reduce the incidence of gastrointestinal side effects, as will dividing the dose.Vitamin C supplementation should start at 5 –10 mg/kg/day and gradually increase to tolerance.Some may tolerate and, in fact, need more than 50 mg/kg/day.Vitamin E: Another of the anti-oxidant vitamins, vitamin E has received more press lately thanvitamin C. Since it is fat soluble, it can accumulate if given to excess. Dosing in the range of 2 – 4mg/kg/day (3 – 6 IU/kg/day) is within safe limits. Mixed tocopherols are the preferredpreparation. Many vitamin E supplements are prepared from soybeans and may be a problem inchildren who are sensitive to soy products. Since vitamin E is important in preventing fatty acidoxidation and peroxidation, more may be needed if the child is also receiving essential fatty acidsupplements.Vitamin B6: Vitamin B6 can be found as B6 (pyridoxine), pyridoxal-5-phosphate (P5P), or amixture of the two (rare). Up to 15 mg/kg/day of B6 or 3 mg/kg/day of pyridoxal-5-phosphateshould be used (to a maximum of 500 mg B6 or 100 mg P5P). Be aware that many of thepyridoxal-5-phosphate preparations contain supplemental copper to prevent pyridoxal retinopathyin copper-deficient people. Since autistic children are typically high in copper, be sure to use acopper-free preparation.
Other supplements
Alpha-Lipoic acid: A dithiol fatty acid, alpha-lipoic acid is a native chelating agent but is also apowerful anti-oxidant. It has been extensively used in Germany to treat diabetic neuropathy withexcellent results31. Its anti-oxidant effects may be particularly helpful in autistic children, sincemany of them show clear evidence of anti-oxidant depletion.Start with 1 - 3 mg/kg/day of alpha-lipoic acid and increase to 10 mg/kg/day as tolerated. Alphalipoic acid is a natural product of human cells and so has minimal toxicity; doses of up to 25 mg/kg/day given over more than three years have been studied in adults with no detectabletoxicity32. There is a theoretical concern that alpha-lipoic acid may bind to DMSA and reduce theavailability of both, but this has not been seen clinically. Another concern is that alpha-lipoicacid reduces the removal of methyl-mercury by glutathione, which is a reason why it should begiven with DMSA. There is also evidence that alpha-lipoic acid reduces copper excretion33. SinceDMSA increases copper excretion34 (it has been used to treat the copper intoxication of Wilson’sdisease35), this should not be a problem if alpha-lipoic acid is used with DMSA.A serious concern with alpha-lipoic acid is that it can facilitate the movement of mercury out ofand into the cells. It can be very useful in mobilizing mercury from within the cells and making itavailable for DMSA to chelate. Without the DMSA to “grab” the mercury from lipoic acid, itmay readily enter other tissues.Melatonin: The pineal hormone that helps to regulate the sleep/wake cycle, melatonin is also ananti-oxidant. It is relatively unique among natural anti-oxidants in that it is a terminal antioxidant:once oxidized, it cannot be reduced36. This characteristic means that melatonin cannotparticipate in destructive redox cycling, where an oxidized compound is reduced by oxidizinganother compound. One study has found that neurons are protected from mercury damage byhormonal levels of melatonin37. Melatonin is also concentrated in the mitochondria and protectsthem from oxidative damage.38Aside from its anti-oxidant properties, melatonin helps to regulate the sleep/wake cycle, which isoften seriously deranged in autistic children. Its long-term use in institutionalized children hasestablished its safety39. Doses of up to 0.1 mg/kg at bedtime should be adequate to help with sleepdisturbances. Some clinicians have noted that smaller doses of melatonin (0.3 mg in adults) arejust as effective for sleep and may cause fewer problems with nightmares and/or night terrors. Asustained release form of melatonin is currently under development and should help with thosechildren who awaken four to six hours after the dose of melatonin.Taurine: Taurine is a sulfur-containing amino acid which is important in the production of bilesalts and, therefor, in the native excretion of toxins and absorption of fats and fat-solublesubstances. Many autistic children are deficient in taurine and benefit from a supplementation of250 – 500 mg/day. A maximum dose of 2 grams/day in adults and adult-sized children isrecommended.Glutathione: Glutathione is the keystone of the cellular anti-oxidant system and is often deficientin autistic children. Despite numerous rodent studies that show good systemic absorption of oralglutathione, the two human studies looking at oral absorption have shown it to be nil40.In humans, oral glutathione is readily absorbed by the gut mucosa, repleting its glutathione supply; the mucosa then breaks down the remaining glutathione. This may explain why oral glutathione has been of help to autistic children even when there is apparently no systemic absorption. Given the gut dysfunction found in many autistic children, oral glutathione 250 – 500 mg/day may be of significant help.
Supplements to be wary of
Cysteine/cystine: As sulfur-containing amino acids (cystine is the dimer of cysteine), both canbind to and mobilize mercury. Like alpha-lipoic acid, cysteine and cystine may worsen mercuryintoxication by spreading it to other tissues. Furthermore, cysteine and cystine are excellentculture media for the Candida genus of yeast and can promote or worsen intestinal candidiasis. Inaddition, many autistic children have high blood levels of cysteine.N-Acetyl-L-Cysteine (NAC): NAC should not be used initially or by itself with anyonesuspected of having a significant body burden of mercury. Like alpha-lipoic acid, cysteine andcystine, NAC can bind with mercury and carry it across cell membranes. NAC is also a goodculture medium for yeast, like its parent molecule, cysteine. Since many autistic children alsohave high cysteine levels, giving them NAC will only exacerbate this problem.NAC is often recommended because it can rapidly increase intracellular glutathione levels41,42.For that reason, it can be tremendously useful in treating the antioxidant deficiencies seen in somany autistic children. NAC should be used either in conjunction with DMSA or after mercurydetoxification is well under way. In addition, NAC should be used with extreme caution inchildren with elevated cysteine levels.Chlorella/other algae: Often touted as an herbal remedy for mercury poisoning, chlorella has agreat affinity for mercury and other heavy metals. Unfortunately, it will also readily extractmercury from the water it is grown in. Analysis of at least one specimen of commerciallyavailable chlorella has shown high levels of mercury.Other unicellular algae preparations are available on the market, advertised as a remedy for avariety of problems. They should also be viewed with caution, not only because of possiblemercury content but also because of the potential for contamination with toxic dinoflagellates."
"Disclaimers: 1. The therapies outlined in this monograph should not be used except by and under the
supervision of a physician.
2. This is not a “stand-alone” protocol and must be preceded by correction of intestinal
dysbiosis and nutritional deficiencies."
