This lecture was presented by Dietrich Klinghardt, M.D., Ph.D., at the Annual Meeting of the International and American Academy of Clinical Nutrition, San Diego, CA, September 1996.

Amalgam/Mercury Detox as a Treatment
for Chronic Viral, Bacterial, and Fungal Illnesses

On the Amalgam "Controversy"

From a scientific point of view there is no more "controversy" about the ill health effects of the metals contained in and released by the typical dental amalgam fillings.

The sheep and monkey studies conducted at the University of Calgary, Canada under the guidance of Dr. Murray Vimy DDS showed that radioactively labeled mercury released from freshly and correctly placed amalgam fillings (in a monkey study)1 appeared quickly in the kidneys, brain and wall of the intestines. Through its affinity for sulfhydryl groups mercury bonds very firmly to structures in the nervous system. Other studies showed that mercury is taken up in the periphery by all nerve endings (i.e., the hypoglossal nerve of the tongue,2 the autonomic nerves of the lung or intestinal wall and connective tissue) and rapidly transported inside the axon of the nerves (axonal transport) to the spinal chord and brainstem.3

On its way from the periphery to the brain, mercury immobilizes the enzyme that is essential for "making" tubulin.4 Tubulin forms tubular structures within each nerve, along which the nerve cell transports metabolic waste from the nerve cell into the periphery and along which the nutrients required by the nerve cell are transported from the periphery to the cell. Once mercury has traveled up the axon, the nerve cell is impaired in its ability to detoxify itself and in it’s ability to nurture itself. The cell becomes toxic and dies or lives in a state of chronic malnutrition. The mercury that has entered the nerve cell can no longer be excreted in the normal axonal transport routes (some can exit through the Ca++ and Na+- channels) and begins to exert its more well known ill effects on the mitochondria, nucleus and other organelles of the cell. A multitude of illnesses, usually associated with neurological symptoms, result.

Mercury and Chronic Infections
Practitioners have long observed that patients diagnosed with chronic viral illnesses (EBV, CMV, HIV, herpes zoster and genital herpes, CFIDS, etc.), chronic fungal illnesses (Candidiasis and others) and recurrent episodes of bacterial infections (chronic sinusitis, tonsillitis, bronchitis, bladder/ prostate infections, HIV related infections) often have dramatic recoveries following an aggressive mercury/amalgam detoxification program.

The fact that the presence of mercury in the tissues represses the immune system has long. been known and is supported by the literature. 5,6,19,20 This would explain a general immune enhancing effect of any solid mercury detoxification program. It has also been shown that the presence of amalgam fillings conveys immunity to antibiotics to various bacteria and also impairs the body's own defense system.7 Mercury is therefore the only substance ever shown that induces antibiotic resistance in bacteria, other than an antibiotic itself. It is known that periodontal disease is caused by bacteria and that the removal of amalgam fillings can often be curative.21 No studies have tested the mercury hypothesis in other infections, even though the clinical evidence is overwhelming.

In chronic fungal syndromes, the scientific literature gives only circumstantial evidence that mercury fosters those infections. The most valuable clinical pearls I found in a book written for the mining industry: “Biosorption of Heavy Metals.” 17 To increase the yield of precious metals in old mines, so called ‘biomasses’ are sprayed into the mine shaft, washed out with water, and collected on ion exchange membranes. A biomass is a sludge of membranes from usually mono cellular organisms that have a tendency to accumulate metals that they are exposed to in their outer cell wall. The list of organisms that have the highest affinity for toxic metals reads like a "who's who" of our typical human infectious diseases: fungi of the candida species, streptococci, staphylococci, amoebas, etc., etc.

The list is topped by two algae: chlorella pyreneidosa and chlorella vulgaris (not spirulina or super blue green algae!). This list prompted me to state what in Germany is now referred to as the "Klinghardt Axiom":  Most if not all chronic infectious diseases are not caused by a failure of the immune system, but are a conscious adaptation of the immune system to an otherwise lethal heavy metal environment. Mercury suffocates the intracellular respiratory mechanism and can cause cell death. So, the immune system makes a deal: it cultivates fungi and bacteria that can bind large amounts of toxic metals. The gain: the cells can breathe. The cost: the system has to provide nutrition for the microorganisms and has to deal with their metabolic products ("toxins"). That does not imply that the tolerated guest cannot grow out of control, as it sometimes clearly does.

Therefore, there is still a limited place for antifungal/antibacterial treatment but only for the acute phase of the disease. A so-called "die off effect" (the sometimes severe crisis or even lethal reaction a patient can have in the initial stages of aggressive pharmaceutical antifungal or antibacterial treatment) is often nothing else but acute heavy metal toxicity metals released from the cell walls of dying microorganisms as suggested by my own correlation of clinical syndromes and urinalysis for metals. Colleagues in Germany are working on a study at this time. Preliminary results show a dramatic improvement in clinical and scientific parameters in chronic Candidiasis using the Klinghardt protocol for heavy metal detoxification.

When it comes to chronic viral conditions, our evidence is even more circumstantial. There are several articles in the chlorella literature showing remarkable effects on chronic viral illnesses.8 Since the chief effect of chlorella is to bind and remove toxic metals, one has to speculate that the reduced amount of toxic metal load was the curative factor. Clinical experience shows often dramatic improvements of chronic viral illnesses during a metal detox program. Omura observed that the Japanese that contracted Minamata disease from eating mercury contaminated fish had by far more grave symptoms when they also simultaneously had a chronic viral illness.9

I suggest, however, that it is more likely that many mercury toxic patients not all tend to contract viral illnesses secondary to the mercury exposure. In other words, Omura's observation can be interpreted differently: when mercury toxic patients develop these typical secondary viral infections, their prognosis is poor. Any mercury toxic person is at high risk for chronic viral illnesses. A proper detox program significantly improves the health in these patients (which are really all of us with a history of dental amalgam fillings, and those of us whose mothers had amalgam fillings before conceiving us 22).

The Diagnostic Dilemma
Since mercury, soon after entering the body (naturally or iatrogenic) is firmly bound in the nervous system (brain, spinal chord, peripheral motor and sensory ganglia, autonomic ganglia), it does not appear in the blood, hair, urine, feces, sweat or any other body fluids (except for a short period after acute exposure). Therefore, a regular trace element analysis of these body "compartments" will not show any mercury toxicity. There are to my knowledge currently four types of tests which can demonstrate CNS mercury toxicity:

(1) Placing fillings with radio labeled mercury and subsequently scanning the brain/spinal chord for radioactive emissions. l

(2) Brain/spinal chord tissue biopsy and analysis.

(3) New MRI technology, that scans the brain for spectral emissions typical for mercury (based on resonance principles. 9

A current research project studying amino acids is under way at the University of Washington, Seattle using the same MRI technology. The author has modified this technique into a low tech manual approach referred to as "autonomic response testing' (A.R.T.) which uses the same resonance principles.

(4) Challenge tests with complexing or chelating agents (administration of appropriate agent followed by mercury urinalysis).   Our clinical experience has shown that when a patient is mineral deficient (especially sodium, calcium or potassium), the body is unable to mobilize toxic metals with a challenge test!!!  The mineral status has to be corrected before successful mobilization for mercury should be attempted.

All four approaches have demonstrated significant levels of mercury in patients with a history of dental amalgam fillings.

There is no controversy about the fact that mercury in the CNS causes psychological, neurological and immunological problems in all humans. The symptoms and literature are carefully reviewed in the 1994 publication by the U.S. Department of Health and Human Services entitled "The toxicological profile of mercury."10   The symptoms of mercury toxicity can be significantly amplified by the often accompanying presence of mercury sensitivity ("allergy").

Recent studies with the M.E.L.I.S.A. test, developed by Vera Stejskal at the Karolinska Institute in Sweden,11 show that most humans become rather rapidly allergic to virtually all metals placed in the human body (mercury leads the list, gold is #3!). Skin testing appears to be completely inappropriate with large numbers of "false negative" findings and should be discontinued because the results are misleading.

More about the challenge tests
There are currently 3 challenge tests available:
(1) The R. Taffe protocol with Penicillamine.
(2) The Daunderer protocol, modified by D. Klinghardt and L. Williams, using DMPS. This program is currently investigated in a multi center study coordinated by Paula Bickle, Ph.D.
(3) A mineral based protocol using a product developed in Australia called "CH7." There is a lack of research and safety data at this time about this product.

The DMPS study
DMPS is a complexing agent developed in Russia with an abundance of international research data and an excellent safety record.l2 Preliminary results of the U.S. multicenter study show that mercury toxicity is very prevalent in the United States and appears to be a cofactor in a large variety of illnesses, especially illnesses associated with compromised function of the immune system (such as chronic viral and fungal syndromes). DMPS appears to be extremely safe when used appropriately.

Protocol: 3 mg DMPS/kg of body weight is injected slowly i.v. followed by a 24 hour urinalysis for heavy metals and trace elements. This injection is given once/month. l3

None of the above mentioned agents (including D.M.S.A., which is not mentioned here) cross the blood brain barrier nor the barrier into certain body areas which are "compartmentalized" (areas of low perfusion). Therefore, these challenge tests are also inadequate to rule out CNS mercury toxicity. However, they can demonstrate connective tissue toxicity and vascular toxicity, which an unchallenged urine test cannot.

New developments
The autonomic response testing, developed by D. Klinghardt and L. L. Williams, which was used to develop the current I.R.B. guided DMPS detox program has led to new developments which allow the researcher to mobilize compartmentalized mercury in the CNS and other compartments.

(1) The Chlorella Enhanced Challenge (C.E.C)
Chlorella pyreneidosa, an algae, is one of the most studied nutritional supplements, if one considers the vast number of publications from the Asian countries.14 Chlorella appears to have 2 significant mechanisms of action that make it an ideal agent to be used in a toxic metal diagnostic and treatment protocol.

(a) The algal cell wall absorbs rather large amounts of toxic metals (similar to
an ion exchange resin).l5

(b) Either the specific combination of amino acids, the Chlorella derived growth factor or some yet unknown other mechanism leads to mobilization of some mercury from within the cell, but mostly mobilization of mercury compartmentalized in non neurologic structures (muscles, ligaments, connective tissue, bone). It definitely appears to mobilize some mercury inside the brain as shown by ART and suggested by the dramatic effect of high Chlorella doses in some brain cancer patients (16-20 gr/day).16 Combining high doses of Chlorella with DMPS (before, during and after the challenge test) can dramatically increase the amount of mercury mobilized by the challenge (excreted both via stool and urine).

(2) The Cilantro Challenge (C.C)
Dr. Y. Omura has found that Chinese parsley (Cilantro) can mobilize mercury and other toxic metals rapidly from the CNS when appropriate amounts are consumed daily.9 The mobilized mercury appears to be either excreted via the stool, the urine, or translocated into more peripheral tissues. This is a revolutionary discovery and makes Cilantro the first known substance that mobilizes mercury from the CNS. The active principle is unknown. Dried Cilantro does not work in my experience, which suggests that the active substance is in the volatile fat soluble portion of the plant (probably an aromatic substance). When autonomic response testing is used, rapid changes in the brain and spinal cord after Cilantro consummation can be demonstrated, also the appearance of mercury in tissues where it was not previously found, i.e., liver, intestines (as a result of mobilization in the nervous system). Parsley also works, but often has G.I. side effects at appropriate doses.

(3) Mobilization of compartmentalized mercury with Neural Therapy (Klinghardt's compartment mobilization technique KCMT).
The author could show that two Neural Therapy techniques autonomic ganglion blocks and segmental therapy with preservative free procaine when applied to areas that showed high levels of mercury using autonomic response testing (ART), can lead to massive increases in the urine mercury levels, suggesting mobilization of mercury from the treated tissues. By adding appropriate amounts of DMPS, the mercury yield can be further increased. The author could demonstrate that by injecting the parasympathetic ganglia in the face/neck region it was possible, to mobilize compartmentalized mercury in the brainstem, by injecting perivascular sympathetic networks of the face/neck region, mercury in the brain could be mobilized very effectively and rapidly. The suggested neurobiological mechanism is that procaine opens the cell wall and the axonal membrane of the autonomic nerves. Remaining intact undamaged tubulin structures inside the nerve's axon transport the DMPS retrograde to the nerve cell, complex the intracellular mercury, which can be transported (1) either anterograde down the axon into the periphery, or (2) through ionic sodium or calcium channels into the surrounding connective tissue, where it can be transported via the lymphatic or venous system to the kidneys. By using the peripheral terminals of the cranial nerves as access points, detoxification of the brainstem and spinal cord until now believed impossible is the obvious outcome. This procedure using much less DMPS than for the conventional challenge test can yield extremely high amounts of mercury in the urine. Repeated treatments, dependent on the total tissue burden of mercury are required. If other metals are involved (i.e., iron in the pituitary) other appropriate agents can be used in appropriate access points.
(4) Avoiding the entero hepatic reabsorption of fecal mercury. 

Even though there is currently no commercial mercury stool test available A.R testing has shown that following the above procedures rather large amounts of mercury are not only excreted via the kidneys but also appear in the small intestine/upper colon (especially when Chlorella and Cilantro are used). They are excreted both via the livern gall bladder small intestine pathway, as well through direct active and passive transport from the intestinal vessels into the lumen. However, the excreted stool contains a much lesser amount of mercury than the lower part of the small intestine/upper part of the large intestine. This suggests reabsorption of mercury during its passage through the colon. To increase the fecal excretion of mercury, three principles should be applied:

(1) Load the food with mercury absorbing/ binding substances (Chlorella).

(2) Increase bowl transit time (usually about 24 hours). Vitamin C, magnesium, and fiber laxatives work well.

(3) Follow the mercury mobilization procedure with colon hydrotherapy or high enemas (best: one "colonic" within 24 hours after DMPS or Neural Therapy, another one within 24 hours of the first one. Give one colonic per week during the entire length of the detox program, up to 20 times). Supplement bowl flora.

Therapy
The therapeutic suggestions are based on the discussed neurobiological principles. The details and success of the suggested treatment does not depend so much on the condition of the patient but mostly on the level of diagnostic skills of the practitioner. The most rapid and effective treatment regimen, which is the addition of Neural Therapy to the list of other less effective procedures, can be performed by any skilled Neural Therapy practitioner. However, the NT treatment is best guided by detecting the most significant body compartments burdened with mercury by using autonomic response testing (until other diagnostic tools become more widely available).

Protocol
(1) Two months prior to removal of amalgam fillings, obtain a hair mineral status (any hair mineral lab) and supplement all elements that are low (watch sodium and chloride often low in the mercury toxic patient).

(2) Start patient on Chlorella (from Nature's Balance or Beacon). Establish highest tolerated level (TL). If too much Hg is mobilized, patient becomes symptomatic: nausea, heartburn, diarrhea, flu like illness, headache, etc. The lower the tolerated amount, the more intracellular Hg toxicity. The TL ranges often from 1/2 - 14 capsules. Give no more that 14 caps/ day initially. Stay on the daily dose day 1- 8. On day 9 and 10 take ten fold that amount, but no more than 60 caps/day. Day 11 and 12 pause. Then start over. Take with meals in divided doses.

(3) Garlic titration test/garlic therapy.  Find the highest tolerated garlic dose (just under the "smell detection level"). Take with meals in divided doses. The sulfhydryl groups help transport mercury, especially through the kidneys.

(4) Cilantro-Pesto:  Buy fresh organic Cilantro. Wash. Put in blender with small amount of water, good amount of sea salt (Celtic salt is good) and olive oil. Blend until creamy. Take 1 tablespoon 3 times/day with meals. More often, if brain severely compromised (depression, Alzheimers disease, "foggyness;" etc)

(5) Colonics/enemas once a week (or 2 after each DMPS or D-Penicillamine use)

(6) The day of the dental work (amalgam removal) take 20 caps Chlorella immediately before dentistry. After fillings are removed, open 2 capsules, sprinkle onto teeth, mix with saliva, keep in mouth for 10 minutes to mop up metal residues. Don't swallow; spit out and rinse mouth. Repeat both steps after procedure is over. Repeat at night. Then resume regular program. Take extra garlic and Chlorella.

(7) The mercury/tin/silver antibody titer may rise over 2 - 6 weeks after the first removal. Don't remove more fillings during this time, to avoid acute "immune breakdowns." Either finish a114 quadrants in 2 weeks or have a session every 2 - 3 months.

(8) After the last amalgam filling is removed, DMPS should be used as soon as possible. I recommend that practitioners in the U.S. use DMPS under the established IRB protocol. Elsewhere I recommend the DMPS use in combination with Neural Therapy. Smaller doses can be used, usually 1 time/week. DMPS should be diluted 1:9 with local anesthetic for the use in autonomic ganglion blocks and segmental therapy. In the treatment of severe neurological disorders no significant progress can be made without the addition of this modality.

(9)  Some practitioners have found vitamin E, Thioctic, and N-acetyl-cysteine (2,000 mg/day)18 to be helpful supplements in addition to the Williams/Klinghardt protocol for substitution therapy (see below).

(10)  A high protein diet is essential. Saunas and excessive exercise can shift mercury from extracellular to intracellular with sometimes catastrophic effects.  Four to six eggs a day help enormously.

(11)  Don't stop detox program until patient is asymptomatic. This can be as long as 3 - 4 years in some cases. DMSO has been shown to repair tubulin and can be used safely just like DMPS along with Neural Therapy, preferably at the later stages of treatment (especially in M. Alzheimer, Parkinson, polyneuropathies and chronic pain).

Ray G Behm Jr., DDS •  Natural Dentistry
127 No Garden Ave, Clearwater FL 33755  tel 727 446.6747