From the Guidelines
The most effective approach to detoxifying heavy metals involves a combination of medical chelation therapy and supportive dietary changes, with zinc being a key component in the treatment of heavy metal toxicity, particularly for copper, as evidenced by its mechanism of action and efficacy in patients with Wilson's disease 1.
Key Considerations
- Medical chelation therapy should be supervised by a healthcare professional and may include agents like DMSA or DMPS for serious metal toxicity.
- Zinc therapy is particularly useful for maintaining a negative copper balance and has been shown to induce metallothionein, which preferentially binds copper, preventing its absorption and promoting its excretion 1.
- Dietary approaches include consuming fiber-rich foods, staying hydrated, and eating foods rich in antioxidants and sulfur compounds to support natural detoxification pathways.
- It is crucial to only pursue heavy metal detoxification if testing confirms elevated levels, as chelation therapy can have side effects and remove essential minerals alongside toxic metals 1.
Treatment Details
- Zinc treatment can generate a negative balance for copper and remove stored copper, with its efficacy judged by clinical and biochemical improvement and measuring 24-hour urinary excretion of copper 1.
- The use of zinc for maintenance therapy after initial treatment with a chelator is recommended for stable patients, given its selectivity for removing copper and association with few side effects 1.
- Treatment should never be terminated indefinitely, as discontinuation can lead to intractable hepatic decompensation 1.
Important Considerations for Treatment
- Monitoring of 24-hour urinary copper excretion and nonceruloplasmin-bound copper concentration is essential to assess the adequacy of treatment and ensure that copper levels are within a safe range 1.
- Patients undergoing zinc treatment should be monitored for compliance and potential side effects, although zinc has been shown to have very few side effects, with gastric irritation being the main issue 1.
From the FDA Drug Label
Penicillamine is a chelating agent recommended for the removal of excess copper in patients with Wilson's disease Treatment has two objectives: (1) to minimize dietary intake of copper; (2) to promote excretion and complex formation (i.e., detoxification) of excess tissue copper. The best way to detox heavy metals, specifically copper, is by using a chelating agent like penicillamine, in combination with a diet that minimizes copper intake and promotes excretion of excess copper.
- Dietary restrictions include avoiding foods with high copper content, such as chocolate, nuts, and shellfish.
- Penicillamine is used to promote excretion and complex formation of excess tissue copper. 2 2
From the Research
Detoxification Methods
- Chelation therapy is a commonly used method to treat heavy metal poisoning, as it can efficiently excrete heavy metals from the body 3, 4, 5, 6.
- The choice of chelating agent depends on the type of heavy metal, as each metal has a different reactivity with a ligand 3, 4.
- Combination therapy with a chelating agent and an antioxidant can lead to improved outcomes 3.
Chelating Agents
- DMSA (meso-2,3-dimercaptosuccinic acid) and DMPS (2,3-dimercapto-propanesulphonate) are less toxic and more efficient than BAL (2,3-dimercaptopropanol) in the clinical treatment of heavy metal poisoning 4.
- D-penicillamine is still widely used in the treatment of copper overload 4.
- Deferiprone and desferasirox are new oral iron antidotes that have entered the clinical arena 4.
Heavy Metal Toxicity
- Heavy metals can induce oxidative stress by generating free radicals and reducing antioxidant levels 3, 5.
- Heavy metals can alter the confirmation of protein and DNA and inhibit their function 3.
- The toxicity of heavy metals depends on the properties of the given metal, dose, route, duration of exposure, and extent of bioaccumulation 5.
Treatment Approaches
- Oral administration of DMSA or DMPS can increase survival and reduce intestinal metal uptake in oral cadmium or mercury poisoning 6.
- Prussian Blue or resins with fixed chelating groups that are not absorbed can offer chelation approaches for decorporation after oral exposure to various metals 6.
- Combined chelation with more than one compound may offer extensive advances in the treatment of heavy metal poisoning 6.