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Health and Drug Alerts

Facts on mercury and fish consumption

Eric Wooltorton
CMAJ October 15, 2002 167 (8) 897;
Eric Wooltorton
CMAJ
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  • Methylmercury Antidote
    Bill D. Misner Ph.D. C.S. M.T.
    Published on: 05 December 2002
  • Published on: (5 December 2002)
    Methylmercury Antidote
    • Bill D. Misner Ph.D. C.S. M.T., Director R & D

    Meso-2, 3-dimercaptosuccinic acid (DMSA) is a sulfhydryl-containing, water-soluble, non-toxic, orally administered, metal chelator which has been in use as an antidote to heavy metal toxicity [1]. The ability of sulfhydryl-containing compounds to chelate metals is well-established. DMSA is a dithiol (containing two sulfhydryl, or S-H, groups) and an analogue of dimercaprol (BAL, British Anti-Lewisite), a lipid-soluble c...

    Show More

    Meso-2, 3-dimercaptosuccinic acid (DMSA) is a sulfhydryl-containing, water-soluble, non-toxic, orally administered, metal chelator which has been in use as an antidote to heavy metal toxicity [1]. The ability of sulfhydryl-containing compounds to chelate metals is well-established. DMSA is a dithiol (containing two sulfhydryl, or S-H, groups) and an analogue of dimercaprol (BAL, British Anti-Lewisite), a lipid-soluble compound also used for metal chelation. DMSA's water solubility, oral dosing, large therapeutic window, and low toxicity [1, 2, 3] make it an excellent chelating agent. Approximately 20% of an oral dose of DMSA is absorbed from the gastrointestinal tract. Ninety-five percent of the DMSA that makes it to the bloodstream is bound to albumin. It is suggested that one of the sulfhydryls in DMSA binds to a cysteine residue on albumin, leaving the other S-H available to chelate metals [4, 5]. Dimercapto Succinic Acid (DMSA) binds efficiently to mercury, lead, zinc, or cadmium. Taking 100 mg/day or as high as a divided dose 100 mg t.i.d. on an empty stomach may remove partial deposited accumulates from food-bourn methylmercury poison. Taking an oral dose is not a chronic protocol without the supervision of a healthcare physician. Temporal periodic dose has been reported safe though unwanted side effects may occur in a small percentage of patients.

    As with any supplement avialable over the counter,the physician attending should be consulted prior to dose application.

    Bill Misner Ph.D. C.S.M.T.

    I have no conflicing, nor competing interests in supplemental DMSA applications.

    REFERENCES [1] Aposhian HV. DMSA and DMPS? Water-soluble antidotes for heavy metal poisoning. Ann Rev Pharmacol Toxicol 1983;23:193-215.

    [2] Muckter H, Liebl B, Reichl FX, et al. Are we ready to replace dimercaprol (BAL) as an arsenic antidote? Hum Exp Toxicol 1997;16:460-465.

    [3]Graziano JH. Role of 2,3-dimercaptosuccinic acid in the treatment of heavy metal poisoning. Med Tox 1986;1:155-162.

    [4] Aposhian HV, Maiorino RM, Rivera M, et al. Human studies with the chelating agents, DMPS and DMSA. J Toxicol Clin Toxicol 1992;30:505-528.

    [5] Maiorino RM, Bruce DC, Aposhian HV. Determination and metabolism of dithiol chelating agents. VI. Isolation and identification of the mixed disulfides of meso-2,3-dimercaptosuccinic acid with L-cysteine in human urine. Toxicol Appl Pharmacol 1989;97:338-349.

    Show Less
    Competing Interests: None declared.
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Vol. 167, Issue 8
15 Oct 2002
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