Chronic mercury toxicity, especially from long-term low-level exposure (often from mercury vapor, contaminated fish, or dental amalgams), can affect multiple body systems. Symptoms may be subtle and develop over time, making it hard to diagnose without proper testing. Some combination of symptoms without other plausible explanation, combined with the presence of mercury upon testing leads to consideration of mercury toxicity.
Neurological and Cognitive Symptoms
- Memory loss
- Brain fog or difficulty concentrating
- Irritability or mood swings (“erethism”)
- Anxiety or depression
- Tremors or muscle twitching
- Headaches
- Peripheral neuropathy (numbness, tingling, or burning in hands/feet)
- Insomnia
Physical and Systemic Symptoms
- Fatigue or weakness
- Metallic taste in the mouth
- Poor coordination
- Muscle aches or joint pain
- Digestive issues (bloating, nausea, diarrhe
- Weight loss or appetite changes
- Increased salivation
Immune and Hormonal Effects
- Autoimmune-like symptoms
- Thyroid dysfunction
- Menstrual irregularities
- Infertility or libido changes
Sensory Disturbances
- Vision changes
- Tinnitus (ringing in ears)
- Hearing loss
- Light or sound sensitivity
Oral and Gum Symptoms
- Bleeding gums
- Gum discoloration
- Loose teeth
Testing for Mercury Toxicity
We prefer “provoked” testing which means testing after taking a chelating agent. Our preference is to do one IV chelation treatment with DMPS and then collect urine for about 6 hours. If a patient has silver/mercury dental amalgams then we don’t use DMPS in testing as they will obviously test positive for mercury and there is no sense in provoked testing or chelation treatment until the amalgams are removed.
Another option for testing is the Mercury Tri-Test from Quicksilver Scientific. This test is the only clinical test that utilizes blood, hair, and urine to measure excretion abilities and exposure of inorganic and methyl mercury. It also separates methyl mercury (mostly from seafood or amalgam-based mercury) from inorganic mercury (the most toxic form) and measures each directly. Sometimes we will use this test as well as provoked testing.
Treatment of Mercury Toxicity
Intravenous chelation therapy is arguably the most efficient and quick way to remove mercury. Done under the supervision of an experienced provider this is a safe and effective therapy. Infusions every 1-2 weeks can be done and often require 10-20 infusions, or more. We generally repeat test for mercury after about 10 infusions.
DMSA (dimercaptosuccinic acid) is one of the most commonly used and better-tolerated oral chelating agents for mercury detox, particularly in cases of chronic exposure. The exact dosage and protocol should always be tailored by a healthcare professional, but here’s a general overview.
Standard DMSA dosage of 10-30mg/kg/day, divided into 2-3 or more doses. For an adult (~70 kg), this translates to 500–2000 mg/day total, usually started on the lower end. A low dose protocol may use doses 5 to 50mg.
There are two major styles of DMSA use: pulsed (intermittent) and continuous low-dose. Both have their place depending on tolerance, symptoms, and goals.
Andrew Cutler Protocol (Frequent Low Dose)
- Dosage: 12.5 to 50mg every 3-4 hours, including overnight.
- Cycle: 3 days on, at least 4 days off (to allow recovery and rebalancing).
- Key Feature: Frequent dosing keeps blood levels stable to avoid redistribution of mercury.
- Important: Must follow round-the-clock dosing—skipping doses mid-cycle can lead to symptoms from redistribution.
Standard Intermittent Protocol
- Dosage: 500-750mg every 8 hours for 5 days, then 9 days off (5-on/9-off cycle).
Supportive Measures During Chelation
To reduce side effects and support detox:
- Hydration – 2+ liters of water daily.
- Binders – chlorella, charcoal, or modified citrus pectin to bind toxins in the gut.
- Mineral support – zinc, magnesium, selenium, and trace minerals (DMSA depletes essential minerals).
- Liver support – NAC, milk thistle, or glutathione.
Warnings and Precautions
- DMSA is not recommended during pregnancy or breastfeeding.
- Monitor kidney and liver function regularly during therapy.
- Do not combine DMSA with high-dose alpha-lipoic acid unless under expert supervision (ALA can cross the blood-brain barrier and mobilize mercury from the brain, which needs to be carefully handled).
Author
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.
