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Chelation


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#1 Guest_Tom_*

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Posted 15 March 2003 - 04:26 PM

Hi Dr. McCandless:

We loved your book and are eagerly awaiting the arrival of your second volume which we just ordered. Maybe you cover this in the new edition, but in case not, how do you decide which type of chelation to do for your particular child? Our doctor has basically offerred us three options, and said it is up to us to pick: DMSA, TTDF/B-12/Glutithione, and MT promoter.

Is one better than another for certain kids depending on their specific situation (older, younger, more toxic, higher functioning, lower functioning, etc.)? What criteria should we use to choose? Is there any reason to rotate DMSA and TTDF? Our doctor seemed to think that DMSA has a longer safety record and may work faster, but admitted to not knowing that much about TTDF or MT promoter yet. How should we decide?

Glad you are in our court on this battle. Wish we had a dozen more just like you! Good health to you and keep up the good work!

Tom

:)


#2 dr_mccandless

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Posted 15 March 2003 - 05:31 PM

Dear Tom: All three have pros and cons. I have done DMSA/ALA for almost three years now, and have had many improved kids on it, a few even losing their diagnosis. Like Amy Holmes I run into a multitude of problems with overgrowth of gut bugs as they love the sulfur-providing compounds like DMSA and ALA. However, I can say that other than the gut pathogen issue, this is a safe process done properly and I have never seen any irreversible medical problems with it. Big delays in the process are often necessary because benefits actually plateau or even reverse with severe yeast overgrowth. I believe this is why Amy was so vigorously pursuing the MTP nutritional program with Bill Walsh at Pfeiffer, and many of her children were converting to that from DMSA around the time she abruptly retired. I was on several lists following progress of these MTP kids, and there were many side effects and questionable good effects for quite a while, with plasma zinc measurements preceding and during the treatment needing to be monitored regularly and carefully to achieve proper plasma zinc, serum copper ratios. It seemed to me it took a long time for any parents to start reporting good benefits. To their credit, (and I believe they are wonderful people who believe totally in what they do) the Pfeiffer group was very willing to change as more information came in, such as at first not emphasizing the GF/CF and finally coming around to it being extremely important for success, as I had discovered with DMSA chelation. They also removed cysteine from their patented amino acid mix to glutathione when too many kids had bad reactions to it. Then Dr. Walsh seemed to me to move from his position that it was primarily a genetic deficiency of metallothionein to agreeing with most of the rest of our community that even with the genetic predispostion, the triggers (like thimerosal in vaccines) were important also. Recently patients at Pfeiffer reported that they were told that if the kids were heavily mercury toxic, a course of DMSA to decrease the load of heavy metals made the MTP course more successful faster with less side effects, and I believe that when they first started the idea was that their protocol would replace chelation to their nutrition based therapy. I have only recently started hearing more parents report good results from the MTP protocol, and I'm sure it is quite safe; I know less about that than the other two options you were given. In an older child with very heavy metal poisoning, I would probably still opt for the DMSA to start, as I know it can work very quickly to get a lot of mercury out. Also, many older children do not seem to have the same degree of gut problems as the little guys, so age and level of toxicity will play a role in my decision.
While I was watching and waiting for all this to clarify, I started using TTFD after the last DAN! think tank, inspired by Dr. Lonsdale's work using this substance and finding clinical benefit as well as excretion of heavy metals. The children I had on transdermal glutathione were noted to excrete even more heavy metals and benefit even faster than the kids who weren't on it or couldn't tolerate it. Also at the DAN!, Dr, Jim Neubrander talked about the success he was having with the IM concentrated injections of B12, so I added that to my protocol of the transdermal GSH and TTFD, and I have been seeing so many excellent improvements in so many kids I am amazed. Kids I have been working with for a long time with many, many months of DMSA or DMSA/ALA work have been losing their diagnosis on this new protocol. I certainly cannot say that all their other work was not an important precursor to this; that is a difficult question to answer. Though this may be a newer treatment, Dr. Lonsdale has been researching and using thiamine for many years and says he has never experienced any negative side effects, so we all feel it is very safe. I am starting to use it now on my newer patients totally by-passing the DMSA and seeing very good benefits so far.
I do talk about all of these new treatments in the 2nd Edition, and as you can see am very enthusiastic about this protocol. I suspect the combination of the GSH (which all the kids need as much as they can handle), the TTFD, and the B12 are setting into motion some metabolic processes that somehow got waylaid very early from the kids' toxic injuries, and they are working to help the child actually start detoxifying on his/her own. I say this because TTFD is not technically a "chelator" in the sense that DMSA and DMPS are, but sets something into motion that makes the metals be excreted by the body naturally as neurotypical children do. Biochemically this probably has to do with the methylation/transulfuration cycles and will be an importnant theme in the May DAN! conference in Philadelphia. A lot of research needs to be done on these issues and research plans are in the works. (Important research into pertinent and practical clinical issues is very difficult to get money for, because the big glamor groups spend millions on genetics research which may help some children years from now after this present epidemic has long subsided, while clinical treatment issues that could help our children right now are shunned and research money usually has to be personally financed by those passionate about it-one of my chief gripes!!). However, I must say over and over, this as all detoxifying regimes should be preceded by proper targeted nutritional balancing and great care to get the gut in as good a shape as possible, so it is by no means the first thing I do when I start treating a child whichever protocol I choose. Jaquelyn
Jaquelyn McCandless, MD
Author, Children with Starving Brains

#3 Guest_Ada_*

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Posted 15 March 2003 - 07:51 PM

Dear Dr. McCandless: The above response has clarified many of my concerns and uncertaintities about detoxification and chelation. Thank you for this information. Would you recommend laboratory workup to check for metals excreted while on glutathione, B12 inj, and allithiamine? Which tests and how often? Thanks!

#4 Guest_Tom_*

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Posted 15 March 2003 - 11:54 PM

Dr. McCandless:
Thank you so much for your informative reply. That clarifies a lot of issues. You mention that you often start with DMSA on older kids with very heavy metal poisoning. What is your cut off for older (our son is 5 yrs & 1 week)? Which test do you use to decide if the metal poisoning is heavy? Our son has had quite a few tests (hair test, blood test for metals, then a DMSA challenge, all at Great Smokies, OAT at MM) and maybe we already have the data if you can give a general guideline that our doctor can look at.

We did have some clostridium on the OAT and subsequently took two anti-gut bug drugs (and still take lots of probiotics) but have not retested, although our son still has gas and lots of burping, sometimes severe and foul-smelling. We started transdermal GSH from Kirkman's late last fall, but our son got a terrible rash, eventually screamed when we applied the cream like it was buring him, and he had lots of stimming and hyperactivity. We quit the GSH on the advice of the doctor until we had a few months of epsom salt baths under our belt and next time, we'll try the Coastal compound. Now we are ready to move ahead with one or more of the chelation protocols. I guess the question we will have to decide is DMSA, TTDF, or rotate them and are hoping you might give some information on how we might chose. (To put your mind at ease, we have been gfcfsf and corn free for quite a while, and taking lots of supplements based on RBC minerals, OAT, zinc, and cysteine tests). Thanks and keep up the good work.

Tom




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