The goals with this page are to help others understand mercury toxicity and to share my experiences on the Cutler protocol.
Disclaimer
The information presented here is for information only, and should not be used or relied upon for diagnostic or treatment. It should not be used as a substitute for medical counseling, advice, diagnosis and treatment.
Please consult with a doctor for medical advice and before making any health-care decisions.
The author assume no responsibility or accountability for any damages, loss, injury, or liability caused directly or indirectly as a result of information provided here.
Cutler's protocol
Andy Cutler went through mercury toxicity himself and came up with a protocol to cure mercury toxicity.
The protocol is based on frequent dosing of a chelating agent in rounds of 3+ days: DMSA, DMPS and/or ALA.
One of the protocol's main goal is safety. Side effects on rounds should be minimal, if at all noticeable. Strong side effects point to too high a dose, too large a dosing interval or hidden amalgams.
Infrequent, intravenous and intramuscular injections of chelating agents can be very dangerous and should never be used.
Timeline
I have had mercurytoxicity, together with copper and arsenic toxicity secondary to mercury toxicity. Mercury causes the body to accumulate some metals, including copper and arsenic.
I have addressed copper toxity the first 3 years.
Then I addressed mercury in the extra-cellular space and arsenic with DMSA starting at 4 mg every 3h in rounds of 3.5 days.
Signs of mercury toxicity
Symptoms are subjective, while signs are objective. Therefore I prefer to focus on signs. Signs are evidence. Symptoms can be dismissed as "it's all in your head" while signs cannot.
Low uric acid: 3.6 mg/dL [3.7-8.6] in Feb 2015. Taking molybdenum 3 mg per day to raise it.
Low neutrophils: 3.3 [2-8] in May 2017, 4.8 [2-8] in Jan 2016, 1.7 [1.4-7.0] in Feb 2015, 1.87 [2-8] Oct 2014, 1.9 [1.4-7.0] in Mar 2014, 1.92 [2-8] Feb 2014, 1.42 [2-8] Mar 2013. OKG can raise it. Neutropenia (low neutrophils) is a sign of both mercury and arsenic toxicity.
Low testosterone together with low LH and FSH indicative of pituitary problems. Mecury is know to concentrate in the pituitary. Testosterone 11 [10-30], Biologically active testosterone 5.7 [6.3-16], LH 2 [1.2-9.6] and FSH 2.5 [1-12.5] in Mar 2015. Taking testosterone injections.
Low cortisol: 8.9 [12-22] at 8am, 2.3 [5-9] at +4/5h, 3.3 [3-7] at +4/5h, 0.4 [1-3] prior to sleep in Oct 2015
Low triglycerides: 0.38 [0.45-2.6] in Aug 2012
High precoporphyrin: 10 [3-7] in Aug 2011
Hair lithium < 0.005 ppm
Dental history
First amalgam when 12 years old in 1994.
Two amalgams at most, last one removed in 2011.
Amalgams are presumed to be the largest source of mercury in my case.
The level of mercury in the brain correlates with the number of amalgams in the mouth. Mercury vapors from amalgams are metallic mercury Hg0. When oxidized to Hg++ in the brain it remains trapped there as Hg++ does not cross the blood-brain barrier. The level of mercury in the pituitary is 800 times more in dentists than in controls.
Vaccines
Vaccines are presumed to be the second source of mercury in my case. Somes vaccines contain thimerosal which is ethylmercury. Ethylmercury is organic mercury which, when converted to the toxic Hg++ form in the brain and remains trapped there.
2009 Hepatitis A (Havrix II, never contained thimerosal)
1999: DTaP (Infanrix Tetra, <1 mcg thimerosal per dose)
1994: DTP (unknown)
1994: DTP (unknown)
1982, 1982, 1982, 1983, 1989: DTP (Tetracoq)
Estimated burden: 155 mcg thimerosal.
Mercury toxicity diagnosis
The only way to know for sure if there is mercury poising is brain autopsy.
Challenge tests are dangerous and should never be used. They are not reliable either. They cannot show how much mercury there is in the brain.
The most reliable ways to diagnose mercury toxicity are symptoms and reaction to a chelating agent.
Supplement and medications
The list of supplements and medications have changed considerably over the years, taking into consideration symptoms, test results and how I responded. A lot of time has been spent in educating myself on supplements, which also resulted in many changes in the supplementation regimen.
I cannot seem to tolerate glutamine. I causes sore throat and sneezing especially on high doses. The same goes with too much glycine.
Tests below are done with supplementation to see impact of supplementation. As mentioned in Culter's book, it is more interesting to see the current state rather than stop supplements abruptly and test an artificial state.
Cortef 30 mg in 10, 7.5, 7.5, 5 mg every 3 hours
T3 140 mcg in 4 doses
DHEA 50 mg
Testosterone undecanoate every 10 weeks
Thorne Betaine HCl 504 mg x4 (per meal)
Thorne Biogest x2 (per meal)
Innate Flora-50
Jarrow CarotenAll 2,500 IU x2
Now A 25,000 IU
LEF Gamma E tocopherol/tocotrienols 325 mg/145 mg x2
Bars in a hair test do NOT necessarily correlate well with body inventory. Some minerals do, some do not. When mineral transport is deranged due to mercury, almost none of them correlate with body inventory.
There are 5 rules defined to find out if mineral transport looks messed up.
When rule 1 is met, toxic elements are underreported.
Ca/P=1.29, 1.35, 1.48, 1.49 in DDI tests suggests fast metabolizer and a lower dose interval of chelator to keep blood levels constant: 3h for DMSA, 6h for DMPS and as low as 2h for ALA.
Undetectable lithium in hair tests common with mercury toxicity.
Interpreting urine toxic elements tests
These tests are commonly used as "challenge" tests, where a chelating agent is given in a single dose at a very high dose.
These tests have not so much value in the Culter protocol. Due to the nature of the protocol based on frequent dosing of small doses of chelators, the amount of toxic metals in urine is not expected to be dramtically high.
These tests can however show what toxic metals where being excreted at a given in a given round. This can vary from round to round.
Note that these tests should not be used when using ALA. DMSA and DMPS excrete metals mainly in urine, when ALA does not.
Interpreting RBC elements tests
With deranged mineral transport, this test can shed
some light on tissue mineral levels. Hair test cannot be used for that
purpose.
Interpreting AA tests
Mercury interferes with the body's regulatory mechanisms to maintain appropriate amino acid levels
Interpreting the results of a urine Amino Acid (AA) test (24h
collection) can be difficult as a high reading can be due to high value
in blood or a high rate of loss in urine.
A plasma AA test done after collection of the 24h urine AA test can
add valuable information with respect to AA levels in the body.
The plasma test done after a 12h fast are closer to baseline levels, with less food interactions.
The interpretation of AA test results is complex. There can be
multiple causes to a high or low reading, so multiple readings need to
be looked at a time to draw meaningful conclusions. Also, impact of food should be considered.
Interpreting MELISA test
The MELISA test is not so informative for mercury toxicity. It can however show what the immune system reacts the most to, and can give a hint of the source of toxicity.
Interpreting porphyrin tests
Porphyrins are intermediates in heme synthesis. Mercury interfere with some steps in the pathway at very specific steps.
Elevated precoproporphyrin is an indicator of mercury toxicity. Other toxic metals will elevate other porphyrins.
2018 August: DDI Hair test
7 years of supplementation.
6 years post amalgam removal.
4 years of chelation.
Completed 147 equivalent rounds of 4 to 25 mg DMSA every 3 hours
Completed 46 rounds of 2 to 6 mg ALA every 2/2.5 hours
5 bars in the red zone. Rule 3 met (4+).
1 rule met. This could be caused by chelation with ALA moving some mercury into the extra-cellular space.
2017 September: DDI Hair test
6 years of supplementation.
5 years post amalgam removal.
3 years of chelation.
Completed 129 equivalent rounds of 4 to 15 mg DMSA every 3 hours
Completed 39 rounds of 2 to 3 mg ALA every 2/2.5 hours
4 bars to the right. Rule 1 met (5-)
9 bars in the green zone. Rule 4 met (11-)
2 rules met. This could be caused by chelation with ALA moving some mercury into the extra-cellular space.
Antimony has increased from undetectable to 0.13
Arsenic increased from 0.031 to 0.053
Silver increased from 0.01 to 0.27
Lithium above undetectable levels for the 1st time.
2017 April: Urine toxic elements
68 months (5 years) of supplementation.
66 months (5 years) post amalgam removal.
32 months (2,5 years) of chelation.
Completed 107 rounds of 4+ mg (reached 9 mg) DMSA every 2 or 3 hours.
Completed 36 rounds of 2+ mg (reached 3 mg) ALA every 2 hours.
Urine collected during 8h for 3 nights in a row for a total of 24h.
All results in the reference range. Very first time mercury is under detection limit on such a test.
Mercury was undetectable. Could be due to a lower extra-cellular mercury load after the chelation rounds.
Arsenic lower than on previous tests: 11 mcg/g creatinine compared to 23 mcg/g (2016) and >163 mcg/g (2015)
Cesium constant at 5.8 mcg/g creatinine, compared to 6.5 mcg/g (2016) and 6.9 mcg/g (2015)
Nickel lower than on previous tests: 2.5 mcg/g creatnine, compared to 6.7 mcg/g (2016) compared and 6.19 mcg/g (2015)
Thallium constant at 0.236 mcg/g creatinine compared to 0.3 mcg/g (2016) and 0.203 mcg/g (2015)
2016 August: DDI Hair test
5 years of supplementation.
4 years post amalgam removal.
2 years of chelation.
Completed 84 equivalent rounds of 4 or 6 mg DMSA every 3 hours
Completed 19 rounds of 2 mg ALA every 2/2.5 hours
3 bars to the right. Rule 1 met (5-)
4 bars in the red zone. Rule 3 met (4+).
10 bars in the green zone. Rule 4 met (11-)
3 rules met. This could be caused by chelation with ALA moving some mercury into the extra-cellular space.
Arsenic dropped significantly, from 0.069, 0.050, 0.057, 0.066 in previous tests to 0.031. This confirms what was observed in the urine toxic element test in March.
Selenium back in green from 1.2 to 1.1 after changing from 400 mcg every day to 400 mcg on rounds and 200 mcg off rounds.
Zinc has decreased again, from 160 to 150
2016 March: Urine toxic elements
56 months (4 years) of supplementation.
54 months (4 years) post amalgam removal.
20 months of chelation.
Completed 68 rounds of 4+ mg DMSA every 2 or 3 hours.
Completed 8 rounds of 2 mg ALA every 2 hours.
Urine collected for 24h in a row on the 9th day of a long chelation round on DMSA 6mg every 3h
On this chelation day mostly lead, barium, cadmium, cesium, nickel and thallium very excreted. All of these metals were also excreted in one of both previous tests indicating that these may have been accumulated in the body over time. Mercury and arsenic were much lower than on previous tests, suggesting that a significant amount of arsenic and of extra-cellular mercury were removed in previous rounds, or just that other metals got chelated on that day. Some metals are chelated on some days, some others on some other days. Which metals get chelated on a specific day is unpredictable.
Lead 2.1 mcg/24h compared to <dl in 2015 and 1.9 mcg/24h in 2014. Bones recycle slowly. It take 5 years for bones to recycle completely so some lead is expected for at least 5 years.
Mercury very low on this chelation day: 0.3 mcg/g creatinine (0.6 mcg/24h) compared to 1.5 mcg/g creatinine in 2015 (and 3.58 mcg/24h in 2014)
Arsenic low on this chelation day: 23 mcg/g creatinine (50 mcg/24h) compared to >163 mcg/g creatinine 2015 (and 463 mcg/24h in 2014)
Barium a tad high: 8.6 mcg/24h compared to 4.4 mcg/24h in 2014
Cadmium high on this chelation day: 1.6 mcg/g creatinine (3.4 mcg/24h) compared to 0.22 mcg/g creatinine in 2015 (and 0.61 mcg/24h in 2014)
Cesium at 6.5 mcg/g creatinine (14 mcg/24h) compared to 6.9 mcg/g creatinine in 2015 (and 16.93 mcg/24h in 2014)
Nickel at 6.7 mcg/g creatinine (14 mcg/24h) compared to 6.19 mcg/g creatinine in 2015 (and 2.38 mcg/24h in 2014)
Thallium at 0.3 mcg/g creatinine (0.7 mcg/24h) compared to 0.203 mcg/g creatinine in 2015 (and 0.588 mcg/24h in 2014)
2016 January: RBC elements
54 months (4 years) of supplementation.
52 months (4 years) post amalgam removal.
18 months of chelation.
Completed 59 rounds of 4+ mg DMSA every 2 or 3 hours.
Completed 3 rounds of 2 mg ALA every 2 hours.
Selenium high red due to supplementation at 400 mcg. Changed to 200 mcg every day and 400 mcg after finishing a round.
Zinc increased from 10.7 to 11.2 ug/g. This can be a sign of reduced zinc wasting thanks to chelation.
2015 July: DDI Hair test
4 years of supplementation.
3 years post amalgam removal.
12 months of chelation.
Completed 31 rounds of 4 mg DMSA every 3 hours.
5 bars to the right. Rule 1 met (5-).
Still one rule met. DMSA clears mercury in the extra-cellular space and therefore from transport proteins on cell walls. It is expected for deranged mineral transport to become normalized after enough mercury is eliminated from the extra-cellular space. It can be that it arsenic was what elimated the most on rounds so far.
Copper down from high yellow to low green. High copper makes rounds harder as copper is synergistic with mercury. This is true for arsenic and lead too which are also synergetic with mercury.
Zinc has decreased substantially from (200, 190 and 190) to 160 despite no change in supplementation. This suggests less zinc wasting due to mercury.
2015 June: Urine toxic elements test
4 years of supplementation
3 years post amalgam removal.
11 months of chelation.
Completed 31 rounds of 4 mg DMSA every 3 hours.
Test was done in the 32th round. Urine collected during 8h for 3 nights in a row for a total of 24h.
Shipping took more than one month, but the specimen was still valid.
Lead and platinum were undetectable in the specimen. This makes sense as both are chelated with DMSA. After 31 rounds lead is cleared and the only remaining lead is in the bones. Lead comes out from the bones as they recycles, but very slowly over a span of several years. The primary use of DMSA is actually lead poisoning, for which it is very effective.
Arsenic is still very elevated, even over the detection limit. Arsenic was the toxic element that was eliminated the most on this round.
2015 February: RBC elements
3 year of supplementation.
3 years post amalgam removal.
8 months after starting chelation.
Completed 22 rounds of 4 mg DMSA every 3 hours.
Manganese increased to mid-range after changing from 15 to 30 mg per day.
Selenium high yellow due to supplementation at 400 mcg. Mercury binds to selenium. It is therefore preferable to have high selenium but of course not enough to cause toxicity.
Arsenic high, which confirms suspicions about arsenic toxicity. This is the arsenic that was moved around during chelation with DMSA.
Zinc mid-range despite aggressive supplementation at 120 mg per day in 4 doses. This confirms mercury toxicity, which severely affects zinc absorption, utilization and retention. This level of supplementation would be toxic to non-mercury toxic people.
2014 October: Urine toxic elements test
3 years of supplementation.
3 years post amalgam removal.
4 months after starting chelation.
Completed 11 rounds of 4 mg DMSA every 3 hours.
Test was done in the 12th round. Urine collected during 8h for 3 nights in a row for a total of 24h.
Lead, mercury, antimony, arsenic, cesium, platinum, ribidum, thallium are all elevated.
DMSA is known to chelate lead, mercury, antimony, arsenic, platinum and thallium so it makes sense to find elevated levels on round. Chelation works and these toxic metals were excreted on this round.
Note the very high level of arsenic.
2014 October: Hair tests
3 years of supplementation.
3 years post amalgam removal.
4 months after starting chelation.
Completed 11 rounds of 4 mg DMSA every 3 hours.
6 bars to the right. Rule 1 not met (5-).
12 bars in the green and white zone. Rule 4 not met (11-).
Rule 1 and Rule 4 both one short, Rule 5 is met.
Copper still high yellow: increased molybdenum from 1 to 3 mg per day.
2014 May: DDI Hair test
3 years of supplementation.
2 years post amalgam removal.
6 bars in the red zone. Rule 3 met (4+)
5 bars in the green and white zone. Rule 4 met (11-).
Copper high yellow. This shows copper toxicity is not over yet, or continued predisposition for copper accumulation due to mercury toxicity.
2014 March: RBC elements
Manganese in the reference range with
15 mg per day. AA test suggests blockage in urea cycle from arginine to
ornithine and a potential functional manganese deficiency.
Low zinc despite supplementation at 60 mg per day in 2 doses. Confirms mercury toxicity.
2014 March: Amino Acid test
High threonine both in urine and plasma tests points to insufficient metabolism to due to lack of P5P
High cystathionine in urine can be caused by lack of P5P.
P5P supplementation indicated. Already on 30 mg P5P during test (10 mg with every meal). More than 10 mg x3 gave me peripheral neuropathy so holding to 30 mg.
Low isoleucine in urine. Low Isoleucine, leucine and valine in plasma.
BCAA supplementation indicated. Already on 5g per day (5g at breakfast) during the test. BCAA seems most needed at night (low in fasting test). Spread after the test to 1g before every meal and 2g before bed.
Low BCAAs can be caused by low stomach acid. Already on 5x620 mg Betaine HCl per meal. Low BCAAs can cause hypoglycemia and an inability to build muscles.
High taurine in urine together with high beta-alanine. Low taurine in blood indicates that the high taurine in urine is due to
impaired renal retention (wasting), and not due to high taurine in blood. Taurine wasting in urine can be caused by elevated beta-alanine.
Did not take taurine at that time. Added 3g per day after the test
Low beta-alanine in plasma so it is most likely not caused by gut bacteria.
High beta-alanine in urine points to excess protein or lack of P5P.
Beta-alanine inhibts carnosinase and anserinase, therefore the high reading for carnosine and anserine. This can also be due to lack of zinc, which is invariably a problem with mercury toxicity.
High arginine, asaparagine and glutamine in urine test, and high asparagine in both tests reflect limited capacity for ammonia detoxification.
High arginine and low ornithine in plasma suggests problems specifically with the arginase enzyme which may be the rate limiting factor in ammonia deotxification. Arginase depends on manganese, so a deficiency of manganese is possible. On 15 mg manganese glycinate during test. Increased to 30 mg divided in 2 doses per day.
AAKG can help reduce ammonia.
1-Methylhistidine is high in both tests and can indicate a high rate of catabolism or problems with methylation.
Proline low as in urine test. Started to supplement with proline after this test. Proline is the main precusor for collagen and lack of proline can cause connective tissue problems.
2013 November: DDI Hair test
2 years of supplementation.
2 years post amalgam removal.
5 bars to the right. Rule 1 met (5-).
8 bars in the green and white zone. Rule 4 met (11-).
Copper low green! Copper eliminated after 2.5 years of supplementation.
Arsenic close to yellow in rule 1 test suggesting arsenic toxicity.
2013 September: TEI Hair test
2 years of supplementation.
2 years post amalgam removal.
5 bars to the right. Rule 1 met (5-).
Copper still high but going down confirming excess copper is being eliminated coming back to normal levels.
2013 February: Hair test
1 year of supplementation.
1,5 years post amalgam removal.
5 bars to the right. Rule 1 met (5-).
Copper still high but going down
Arsenic increasing again and relatively high for a rule 1 suggesting arsenic toxicity.
2012 February: Hair test
9 months of supplementation.
6 month post amalgam removal
No rule met on this test. This is the only test where no rule is met. However, with 7 bars to the right the hair test is "unusual".
Copper very high due to elimination while supplementing.
Arsenic and mercury increased. Mercury causes the body to accumulate arsenic.
2011 September: MELISA test
The MELISA tests shows a strong reaction to nickel, inorganic mercury and titanium dioxyde.
Reactions to methylmercury and thimerosal are lower. It can be a hint that the source of toxicity is mainly from amalagams (inorganic mercury) and not fish (methymercury) or vaccines (thimerosal).
Copper high indicating copper toxicity. Copper toxicity can be due to mercury toxicity which causes the body to accumulate copper and dump zinc.
Started supplements.
Note the low mercury level (0.05 pre-amalgam removal, 0.09, 0.09, 0.12 post-amalgam removal). The higher levels post-amalgam removal can be due to higher mercury load after unsafe removal. Or it can be that the level pre-amalgam removal was low and made me a non-secretor. Mercury impairs the body's ability to eliminate mercury.
