DMSA-FYI

[Guest guest]

DMSA

 

&

 

Heavy Metal Toxicity

 

 

 

 

 

 

 

 

 

 

 

 

 

Description:

 

 

 

Meso-2.3-dimercaptosuccinic acid (DMSA, or succimer) is an oral chelating

agent for heavy metal poisoning. While studying the urinary elimination of

unaltered DMSA, altered DMSA (i.e., its mixed disulfides), and lead in

children with lead poisoning, we observed a pattern of urinary drug

elimination after meals suggestive of enterohepatic circulation. The

excretion of lead in urine patterned the elimination of altered DMSA rather

than the parent molecule. In addition, the half-life of elimination of DMSA

via the kidney was positively associated with blood lead concentration.

Two addition cross-over studies of DMSA kinetics were conducted in normal

adults to confirm the presence of enterohepatic circulation of DMSA after

meals; in one, increases in plasma total DMSA concentration were observed

after meals in all six subjects; these increases were prevented by

cholestyramine administration 4, 8, and 12 hours after DMSA. In the second,

the administration of neomycin also prevented increases in DMSA after meals.

These studies indicate that: 1) A metabolite(s) of DMSA undergoes

enterohepatic circulation and that microflora are required for DMSA reentry;

2) In children, moderate lead exposure impairs renal tubular drug

elimination; and 3) A metabolite of DMSA appears to be an active chelator.

 

 

 

 

 

Availability:

 

 

 

Oral capsules in 250 mg and 500 mg.

 

 

 

 

 

Protocols:

 

 

 

There are many protocols for the use of DMSA. We will list all that we have

and where the protocol came from. It also depends on whether DMSA is being

used for challenge purposes, a treatment program or during amalgam removal.

 

 

 

 

 

 

 

Doctors Data Challenge:

 

 

 

10 mg/kg or maximum of 500 mg t.i.d. for 1 day. Start collecting urine

after the first void of the 1st day of dosing DMSA and continue for 24

hours.

 

 

 

 

 

Treatment-as per Dr. Ted Rozema:

 

 

 

2 week cycle-3 days on DMSA (10 mg/kg, in divided doses (t.i.d.) then 11

days off the drug. 24 hour urine sampling can be done with this therapy.

Also, supplement orally/IV essential elements and sulfur containing amino

acids can be performed after last dose of DMSA is given. Also, remember not

to co-administer any sulfhydryl-containing supplements such as garlic,

chlorella, NAC or glutathione and to stop these supplements 24 hours prior

to DMSA administration.

 

 

 

This cycle is then repeated 5-10 times for the average patients. For the

sensitive or ill patient, give DMSA 500 mg daily 3 times a week for 6 weeks,

off 2 weeks, and repeat. Perform challenge test every 4th cycle to monitor

results.

 

 

 

 

 

Amalgam Removal Protocol:

 

 

 

We suggest DMSA 50 mg (t.i.d.) the day of and the day after amalgam removal.

 

 

 

 

 

 

 

DMSA CHELATION

 

 

DMSA chelation is sometimes referred to as DMAS chelation. Chelation comes

from the Greek word meaning to bond. Simply put, DMSA chelation involves

taking capsules that are rich in Sulphur-containing amino acids, which are

the building blocks of protein. Sulphur is like a magnet for the metals and

flushes them out of the body via the feces and the urine.

 

 

 

The day after all the metals have been removed from your mouth, you should

see your practitioner for a DMSA or a DMPS provocative. The provocative is

a short course of the sulphur-rich amino acids that will give you an idea if

your tissue has accumulated toxic levels of metals. I was toxic with 8

metals: aluminum, arsenic, cadmium, copper, lead, mercury, nickel and tin.

DMPS is a 7-10 minute IV push that provokes the metals to show themselves.

DMPS is very useful for diagnostic purposes but since it should be used, in

most cases, for only the initial provocative test. Thereafter, DMSA should

be used because it takes the metals out of the lower body and also crosses

the blood-brain barrier to pull the metals out of the brain. It is also

very cheap and very easy to take in capsule form.

 

 

 

In order to discover your metal levels, you must send a urine sample to a

reputable lab. For the DMPS, you do a 24-hour urine collection from which a

sample is taken and sent to the lab. For the DMSA, you simply collect a

urine sample which is sent off to the lab. A few weeks later, the results

will come back from the lab and you will then discuss them with your

practitioner. Correct interpretation of lab results cannot be

overemphasized. Reference values do not necessarily mean, and sometimes

absolutely do not mean, normal values. They may define the lower and upper

end of values that have been reported to the lab. Lower and upper values

may represent extremes, not normal values. It is extremely important to

understand this distinction so that you can discuss all this with your

practitioner on his or her level as a fully informed participant in the

treatment process. Your life may depend on your ability to discuss and

understand all this, so be informed.

 

 

 

Your test results may not show the whole story, however. This is because

the metals are intracellular and different metals bond with the chelating

agent at different times. The metals are in the cells in layers, and it

takes time for each layer to reveal itself. So it may, for instance, take

many months for lead or arsenic to show up in the urine because copper and

mercury are being chelated out and eliminated first.

 

 

 

One other very interesting and useful aspect to all this is that the urine

test results will also show your mineral levels. The chelation process also

affects your mineral levels so that as the chelating agent is removing

metals from your body, it is also removing minerals as well. If the test

results show low levels of some minerals, for example magnesium, calcium,

manganese, zinc or selenium, then you would want to remineralize between

courses of chelation. If your mineral levels are severely depleted, you

would probably be well advised to take one to three months to remineralize

before the next course of chelation.

 

 

 

Mitochondrial Support Factor plus DMSA

 

Protocol by Apothe' Care

 

 

 

 

Each capsule contains:

 

 

 

lipoic Acid ascorbyl

palmitate

 

l-glutathione AKG

 

chlorphyllis sodium copper citric acid

 

germanium sesquioxide malic acid

 

calcium EAP succinic acid

 

calcium hydroxyapatite DMSA (12.5mg)

 

magnesium glycinate rubidium CI

 

manganese aspartate cesium CI

 

chromium polynicotinaze horsetail

 

boron citrate molybdenum

aspartate

 

 

 

The principal is to develop a heavy metal base line from 24-hour urine

analysis post DMPS challenge then chelate the heavy metals out with the

above formulation. 15 caps per week for 8 weeks (5 capsules daily three

times a week). Then, re-test with DMPS and continue using DMPS as a

diagnostic only and the DMSA formula as the chelator until heavy metals are

at a desired level.

 

 

 

Parasites will often flare up during this therapy, as several current

practitioners have found, and this is a good time to administer an

anti-parasite protocol of which we have several.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION FROM FACTS AND COMPARISON

 

 

SUCCIMER

 

 

Pharmacology: Succimer is an orally active, heavy metal chelating agent; it

forms water-soluble chelates and, consequently, increases the urinary

excretion of lead.

 

 

Toxicology: In oral toxicity studies up to 28 days, doses up to 200

mg/kg/day did not produce significant overt toxicity in rats and dogs.

However, in 6 and 28 day oral toxicity studies, does >=300 mg/kg/day were

toxic and lethal to some dogs. The kidney and GI tract were the major

target organs for toxicity. Toxicity was manifested by anorexia; emesis;

muccid of bloody diarrhea; increased BUN concentration, AST, ALT, and

alkaline phosphatase levels; renal tubular necrosis; purulent nephritis,

severe GI bleeding and ulceration. Deaths were due to renal failure.

 

 

 

Pharmacokentics: In a study in healthy adult volunteers, after a single

dose of 16, 32 or 48 mg/kg, absorption was rapid but variable, with peak

blood levels between 1 and 2 hours. Approximately 49% of the dose was

excreted; 39% in the feces, 9% in the urine and 1% as carbon dioxide from

the lungs. Since fecal excretion probably represented non-absorbed drug,

the kidneys excreted most of the absorbed drug. The apparent elimination

half-life was about 2 days.

 

 

 

In other studies of healthy adult volunteers a single oral dose of 10 mg/kg,

succimer was rapidly and extensively metabolized. Approximately 25% of the

dose was excreted in the urine with peak blood level and urinary excretion

occurring between 2 and 4 hours. Of the total amount of drug eliminated in

the urine, approximately 90% was eliminated in an altered form as mixed

succimer-cysteine disulfides; the remaining 10% was eliminated unchanged.

 

 

 

Clinical Trial: Studies were performed in 18 men with blood lead levels of

44 to 96 mcg/dl. Three groups of 6 patients received either 10, 6.7 or 3.3

mg/kg every 9 hours for 5 days. After 5 days, mean blood levels of the

three groups decreased 72.5%, 58.3% and 35.5% respectively. Mean urinary

lead excretions in the initial 24 hours were 28.6, 18.6 and 12.3 times the

pretreatment 24-hour urinary lead excretion. As the chelatable pool was

reduced during therapy, urinary output decreased. A mean of 19 mg lead was

excreted during a 5-day course of 30 mg/kg/day. Clinical symptoms, such as

headache and colic, and biochemical indices of lead toxicity also improved.

Decrease in urinary excretion of d-aminolevulinic acid (ALA) and

coproporphyrin paralleled the improvement in erythrocyte ALA dehydratase.

Three control patients with lead poisoning of similar severity received

edetate calcium disodium (EDTA) IV at a dose of 50 mg/kg/day for 5 days.

Mean blood levels decreased 47.4%, and mean urinary lead excretion was 21 mg

in controls.

 

Effect on Essential Minerals: In the above studies, succimer had no

significant effect on the urinary elimination of iron, calcium or magnesium.

Zinc excretion doubled during treatment. The effect of succimer on the

excretion of essential minerals was small compared to that of EDTA, which

can induce more that a tenfold increase in urinary excretion of zinc and

doubling of copper and iron excretion.

 

 

 

Succimer vs. EDTA - A study was performed in 15 children ages 2 to 7 years

with blood levels of 30 to 49 mcg/dl and positive EDTA lead mobilization

tests. Each group of five patients received 350, 233 or 116 mg/m 2 succimer

every 8 hours for 5 days. These doses corresponded to 10, 6.7 and 3.3

mg/kg. Six control patients received 1000 mg/m 2/day EDTA IV for 5 days.

Following therapy, the mean blood lead levels decreased 78%, 63% and 42 %

respectively, in the three groups treated with succimer. The response of

the 350 mg/m 2 every 8 hours (10 mg/kg every 8 hours) group was

significantly better than that of the other succimer-treated groups as well

as that of the control group, whose mean blood level fell 48%. No adverse

reactions or changes in essential mineral excretion were reported in the

succimer-treated groups. In the EDTA-treated group, the cumulative amount

of urinary lead excreted was slightly but significantly greater than in the

succimer group. After EDTA, the urinary excretion of copper, zinc, iron and

calcium were significantly increased.

 

 

 

 

As with other children, both adults and children experienced a rebound in

blood lead levels after discontinuing succimer. In these studies, after

treatment with 350 mg/m 2 (10 mg/kg) every 8 hours for 5 days, the mean lead

level rebounded and plateaued at 80% to 85% of pretreatment levels 2 weeks

after therapy. The rebound plateau was somewhat higher with lower doses of

succimer and with IV EDTA.

 

 

 

In an attempt to control rebound of blood lead levels, 19 children, ages 1

to 7 years, with blood lead levels of 42 to 67 mcg/dl were treated with 350

mg/m 2 every 8 hours for 5 days and then divided into three groups. One

group was followed for 2 weeks with no further therapy; the second group was

treated for 2 weeks with 350 mg/m 2 daily, and the third with 350 mg/m 2

every 12 hours. (The remainder of this was not present on the page.)

 

 

 

Indications: Treatment of lead poisoning in children with blood lead levels

>45 mcg/dl. Not indicated for prophylaxis of lead poisoning in a

lead-containing environment; always accompany succimer use with

identification and removal of lead exposure.

 

 

 

Unlabeled Uses: Succimer may be beneficial in the treatment of other heavy

metal poisonings (e.g., mercury, arsenic); further study is needed.

 

 

 

Contraindications: History of allergy to the drug.

 

 

 

Warnings: Keep out of reach of children.

 

 

 

Pregnancy: Category C. Succimer is teratogenic and fetotoxic in pregnant

mice when given in a dose range of 410 to 1640 mg/kg/day during the period

of organogenosis. There are no adequate and well-controlled studies in

pregnant women. Use during pregnancy only if the potential benefit

justifies the potential risk to the fetus.

 

 

 

Lactation: It is now known whether this drug is excreted in breast milk.

Discourage mothers requiring therapy from nursing their infants.

 

 

 

Children: Refer to the Indications and Administration and Dosage sections.

There is no therapeutic experience in succimer in children <1 year of age.

 

 

 

Precautions: Carefully observe patients during treatment due to limited

clinical experience with succimer. Elevated blood lead levels and

associated symptoms may return rapidly after discontinuation of succimer

because of redistribution of lead from bone stores to soft tissue and blood.

After therapy, monitor patients for rebound of blood lead levels by

measuring the levels at least once weekly until stable. However, use the

severity of lead intoxication (as measured by initial blood level and rate

and degree of rebound of blood lead) as a guide for more frequent blood lead

monitoring.

 

 

 

Renal Function: Adequately hydrate all patients undergoing treatment.

Exercise caution in using succimer therapy in patients with compromised

renal function. Limited data suggests that succimer is dialyzable, but that

the lead chelates are not.

 

 

 

Hepatic Function: Transient mild elevations of serum transaminases have

been observed in 6% to 10% of patients during the course of therapy.

Monitor serum transaminases before the start of therapy and at least weekly

during therapy. Closely monitor patients with a history of liver disease.

No data are available regarding the metabolism of succimer in patients with

liver disease.

 

 

 

Repeated Courses: Clinical experience is limited. The safety of

uninterrupted dosing > 3 weeks has not been established and is not

recommended.

 

 

 

Allergic Reactions: The possibility of allergic or other mucocutaneous

reactions must be borne in mind on re-administration (and during initial

course). Monitor patients requiring repeated courses during each treatment

course. One patient experienced recurrent mucocutaneous vesicular eruptions

of increasing severity affecting oral mucosa, external urethral areas and

perianal areas on third, fourth and fifth courses. The reaction resolved

between courses and on discontinuation of therapy.

 

 

 

Drug Interactions: Chelation therapy (e.g., EDTA); Co-administration of

succimer with other chelation therapy is not recommended.

 

 

 

Drug/Lab Test Interactions: Succimer may interfere with serum and urinary

laboratory tests. In vitro, succimer caused false-positive results for

ketoses in urine using nitroprusside reagents such as Ketostix and falsely

decreased measurements of serum uric acid and CPK.

 

 

 

Adverse Reactions: The most common events attribute to succimer (i.e., GI

symptoms or increases in serum transaminases) have been observed in about

10% of patients (see Precautions). Rashes, some necessitating

discontinuation of therapy, have occurred in about 4% of patients. If rash

occurs, consider other causes (e.g., measles) before ascribing the reaction

to succimer. Rechallenge with succimer may be considered if lead levels are

high enough to warrant retreatment. One allergic mucocutaneous reaction has

occurred on repeated administration of the drug (see Precautions). The

following table presents adverse events reported with the administration of

succimer for the treatment of lead and other heavy metal intoxication.

 

 

 

Succimer Adverse Reactions (%)I:

 

 

 

Body System/Adverse Reaction Children Adults

(n=191)

(n=134)

 

 

 

Digestive:

 

Nausea, vomiting, diarrhea;

 

Appetite loss, hemorrhoidal symptoms:

 

Loose stools, metallic taste in mouth 12

20.9

 

 

 

Body as a Whole:

 

Back, stomach, head, rib, and flank pain;

 

Abdominal cramps, chills, fever;

 

Head cold, headache, moniliasis 5.2

15.7

 

 

 

Metabolic:

 

Elevated AST, ALT;

 

Alkaline phosphatase;

 

Serum cholesterol 4.2

10.4

 

 

 

CNS:

 

Drowsiness, dizziness;

 

Sensorimotor neuropathy, sleepiness;

 

Parasthesia 1.0

12.7

 

 

 

Skin and Appendages:

 

Papular rash, herpetic rash;

 

Mucocutaneous eruptions; pruritus 2.6

11.2

 

 

 

Special Senses:

 

Cloudy film in eye, ears plugged;

 

Otitis media, watery eyes 1.0

3.7

 

 

 

Respiratory:

 

Sore throat, rhinorrhea;

 

Nasal congestion, cough 3.7

0.7

 

 

 

Body System/Adverse Reaction Children Adults

(n=191)

(n=134)

 

 

 

GU:

 

Decreased urination;

 

Voiding difficulty, poteinuria increased 0

3.7

 

 

 

Other:

 

Arrhythmia 0

1.8

 

Increased platelet count

 

Intermittent cosinophilia 0.5

1.5

 

Knee cap pain, leg pain 0

3.0

 

 

 

 

 

 

 

Incidence Regardless of Attribution or Dosage

 

 

Overdosage: Doses of 2300 to 2400 mg/kg in the rat and mouse produces

anorexia, convulsions, labored respiration and frequently death. Induction

of vomiting or gastric lavage followed by administration of an activated

charcoal slurry and appropriate supportive therapy are recommended. Refer

to General Management of Acute Overdosage. (Reference) Limited data

indicate that succimer is dialyzable.

 

 

 

Patient Information: Instruct patients to maintain adequate fluid intake.

If rash occurs, patients should consult their physicians. In young children

unable to swallow capsules, the contents of the capsule can be administered

in a small amount of food (see Administration and Dosage).

 

 

 

Administration and Dosage: The FDA approved Succimer in February, 1991.

 

 

 

Start dosage at 10 mg/kg or 350 mg/m 2 every 8 hours for 5 days; initiation

of therapy at higher doses is not recommended (see table). Reduce frequency

of administration to 10 mg/kg or 350 mg/m 2 every 12 hours (two-thirds of

the initial dosage) for an additional 2 weeks of therapy. A course of

treatments lasts 19 days. Repeated courses may be necessary if indicated by

weekly monitoring of blood lead concentration. A minimum of 2 weeks between

courses is recommended unless blood lead levels indicate the need for more

prompt treatment.

 

 

 

Succimer Pediatric Dosing Chart

 

 

 

Weight Dose Number of

 

Lbs. Kg. (mg)1 Capsules

 

 

18-35 8-15 100 1

 

36-55 16-23 200

2

 

56-75 24-34 300

3

 

76-100 35-44 400 4

 

> 100 >45 500 5

 

 

 

 

 

To be administered every 8 hours for 5 days followed by dosing every 12

hours for 14 days.

 

 

 

In young children who cannot swallow capsules, succimer can be administered

by separating the capsule and sprinkling the medicated beads on a small

amount of soft food or putting them in a spoon and following with a fruit

drink.

 

 

 

Identification of the lead source in the child's environment and its

abatement are critical to successful therapy. Chelation therapy is not a

substitute for preventing further exposure to lead and should not be used to

permit continued exposure to lead.

 

 

 

Patients who have received EDTA with or without BAL may use succimer for

subsequent treatment after an interval of 4 weeks. Data on the concomitant

use of succimer with EDTA with or without BAL are not available and such use

is not recommended.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DMSA Heavy Metal Challenge for 24-Hour Urine Testing

 

 

 

 

 

Day 1: Give DMSA capsules 500 mg (2 x 250 mg) TID

 

 

 

Day 2: Give DMSA capsules 500 mg (2 x 250 mg) TID and start collecting

urine AFTER the first urination of the day.

 

 

 

Day 3: Continue collecting urine but just the first void in the AM.

 

 

 

Number of DMSA 250 mg to order per test is 12.

 

 

 

 

 

 

 

Apothe' Cure, Inc.

 

1-800-969-6601 or 972-960-6601.

 

-

" " <

<traditional_Chinese_Medicine >;

 

Cc: <gearoidr; <likemlist >; <pA-L >;

<pVA-L >; <swynndvm

Sunday, February 20, 2005 9:37 AM

CORRECTION: DMSA therapy and Doses

 

 

 

Hi Alon, Chris & All,

 

Susan, please post to VBMA if you judge chelation therapy a suitable topic.

 

I wrote:

> I have not used DMSA, but a Google suggests circa 10mg/kg

> bodyweight/d. See: http://tinyurl.com/555tn

 

NOTE: My bald statement, " circa 10mg/kg bodyweight/d " , was not

accurate. Apologies: I should not have made a simplistic statement like

that. I based it on a brief Google search, without spending sufficient time

reading the small print. See more accurate [but non-expert and

incomplete] comments below.

 

Chris replied:

> I guess ... if we want to use the reference ranges of the lab that does

> the sample, we get to follow the dosage set by the lab. Otherwise, the

> results will be less meaningful.

 

Chris, IMO, the LAB role is to TEST samples and report results,

including the normal reference ranges. Clinicians should ensure that the

lab holds a current International Standard ISO Certificate for EACH

TEST of interest. Few labs hold such certificates. One should avoid

using labs that do NOT hold the relevant Certificates.

 

IMO the role of the LAB does NOT extend to recommending therpeutic

dosages. IMO, that role should rest with clinicians (physicians, or other

qualified therapists) and clinical researchers who have published the

data to support the recommended doses.

 

DMAS dose varies depending on the PURPOSE (diagnosis or therapy)

for which it is used, the ROUTE of administration (oral, rectal or

parenteral), and on the AUTHORITY (reference sources) that one

follows.

 

For example, the most important and most recent Consensus Position

Paper by the AUTISM RESEARCH INSTITUTE

http://autismwebsite.com/ari/dan/treatmentoptionsmercurymetal.pdf

" Treatment Options for Mercury/Metal Toxicity in Autism and Related

Developmental Disabilities: Consensus Position Paper (February 2005)

AUTISM RESEARCH INSTITUTE, 4182 Adams Avenue, San Diego,

CA 92116 www.AutismResearchInstitute.com says [re TESTING

whether or not there is an undesirable mercury load to be stripped]:

 

Oral DMSA (9-dose): Dosage of 10 mg/kg-dose, 3x/day, for 3 days. Just

before administering the last dose, void the bladder, and then collect all

urine for the next 8-10 hours. This test has the advantage that

Bradstreet et al.1 have established a reference range for typical

children, based on a study of 18 typical children vs. 221 children with

autism. Using Doctor's Data Laboratory, they reported levels of 1.29 +/-

1.54 mcg Hg/g-creatinine, 15.0 +/- 9 mcg Pb/g-creatinine, and 0.46 mcg

Cd/g-creatinine in typical children given DMSA. Children with autism

had, on average, 3x higher levels of Hg excretion. 6

 

Oral DMSA (single dose): Dosage of 20-25 mg/kg-dose, 1x. Void

bladder and then administer DMSA, and collect all urine for 6-10 hours.

(Do not use only 10 mg/kg, as a study by Adams et al. found no major

difference between 15 children with autism vs. 15 controls). Some

physicians do not recommend this higher single dose due to concerns

about adverse reactions, and prefer the series of lower doses

mentioned previously.

 

Rectal DMSA (single dose): 25mg/kg of body weight as a single bolus

dose with urine collection beginning the next morning in potty trained

children and through the night with pediatric urine collection bags in

those children who aren't. Collection time varies between 12-24 hours

depending on the physician's preference and family logistics

 

As regards DMSA THERAPY to strip mercury away after adequate

testing that this is desirable, reference 52 at

http://www.nationalautismassociation.org/pdf/tbinstockcitations.pdf says

that the therapeutic dose was 10mg/kg bodyweight, 3 times/day for 3

days (for one course), with 11 days off before the next course:

 

Ref 52: " A. Holmes, S. Cave, and J.M. El-Dahr. OPEN TRIAL OF

CHELATION WITH MES0-2,3- DIMERCAPTO SUCCINIC ACID

(DMSA) AND LIPOIC ACID (LA) IN CHILDREN WITH AUTISM. As

submitted to IMFAR, June 2, 2001. " Over 400 patients with autism are

currently undergoing treatment for removal of heavy metals. Patients

are treated with DMSA alone at doses of 10 mg/kg/dose 3 times a day

for 3 days in a row (shorter duration than lead protocol to decrease side

effects) with 11 days " off " to allow metals to re-equilibrate. After at

least

2 rounds of DMSA alone, the thiol antioxidant lipoic acid (hypothesized

to aide in removal of heavy metals across the BBB) is added to each

dose of DMSA at 2-3mg/kg/dose. In general, noticeable improvements

in language, self-help skills, interaction, and core autistic features are

not seen until the patient has been on DMSA with LA for 2-3 months. "

 

In summary, chelation therapy using DMSA is a most valuable way to

strip undesired or toxic trace-metals from the body BUT it carries some

risks. Therefore, DMSA therapy should be monitored carefully and

communication between patient, guardians, DMSA therapist and the

family physician should be open and total.

 

Best regards,

 

 

Tel: (H): +353- or (M): +353-

WWW:

" Man who says it can't be done should not interrupt man doing it " -

Chinese Proverb

 

 

 

 

[Guest guest]

For the DMPS, you do a 24-hour urine collection from which a

sample is taken and sent to the lab.

>>>We do 6 hours for DMPS

 

 

 

 

[Guest guest]

I seem to get better results with 24 ...great smokies HMT

-

" " <alonmarcus

<Chinese Medicine >

Sunday, February 20, 2005 10:20 AM

Re: DMSA-FYI

 

 

>

> For the DMPS, you do a 24-hour urine collection from which a

> sample is taken and sent to the lab.

>>>>We do 6 hours for DMPS

>

>

>

>

[Guest guest]

great smokies

>>>Great smokies is one of the labs we are testing