What is DMSA?
DMSA is an over-the-counter nutritional supplement that provides succinate, a substance found in every cell of the body.

What does DMSA do?
DMSA helps the body rid itself of harmful minerals and metals, and it has been used in many studies involving both adults and children.

What are the potential risks and benefits?
The vast majority of studies have shown DMSA to be safe and highly effective.  In healthcare, we always look at treatments in terms of the “risk-to-benefit ratio”, and in the case of DMSA the risks appear small, and the potential benefit is large when we are talking about removing toxic heavy metals. Side-effects are very rare, but have been reported to include temporary liver damage and mild gastrointestinal upset.  Some doctors and companies mention that bone marrow suppression can also be a temporary side effect, but this appears very rare.

What are the uses for DMSA?
DMSA has been safely and effectively used in the treatment of people who have been either acutely or chronically poisoned with toxic metals such as lead and mercury.  It has been used in children and adults.  DMSA has been approved by the FDA for the treatment of lead poisoning in children.  DMSA is also used by doctors to assist in the diagnosis of heavy metal toxicity-in this case, a “provocation” dose of DMSA is administered by mouth to increase the excretion of mercury in the urine; a urine sample is then sent to the laboratory for analysis.

An example of DMSA use:
Environ Health Perspect. 2000 Jun;108(6):575-7. Related Articles, Links

A cluster of pediatric metallic mercury exposure cases treated with meso-2,3-dimercaptosuccinic acid (DMSA). Forman J, Moline J, Cernichiari E, Sayegh S, Torres JC, Landrigan MM, Hudson J, Adel HN, Landrigan PJ. Department of Pediatrics, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.

Nine children and their mothers were exposed to vapors of metallic mercury. The source of the exposure appears to have been a 6-oz vial of mercury taken from a neighbor’s home. …At diagnosis, urinary mercury levels in the children ranged from 61 to 1,213 microg/g creatinine, with a geometric mean of 214.3 microg/m creatinine. All of the children were asymptomatic. To prevent development of neurotoxicity, we treated the children with oral meso-2,3-dimercaptosuccinic acid (DMSA). …. Thus, oral chelation with DMSA produced a significant mercury diuresis in these children. We observed no adverse side effects of treatment.

DMSA appears to be an effective and safe chelating (method of removing heavy metals from the bloodstream) agent for treatment of pediatric overexposure to metallic mercury.

DMSA treatment
For testing, most experts recommend doses range from 10 mg/kg up to 30mg/kg with a limit of 2,000 mg per day.  These doses appear safe and effective and are well supported by the research.

For treatment, a reasonable plan would be 200 mg per day for 5 days then discontinue for 9 days, then repeat for 5 days. Some experts might consider this to be under-treatment.

Additional articles and sources of information

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