Treatment Strategies (Final episode in Heavy Metal Series)

(audio transcript below)

Welcome to AIM For Health: Root-Cause Conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition.

All right – so we are back talking about heavy metal chelation and treatment of toxic metals.  This is Ask Dr. Jim Bob, I am James Robert Biddle.  I run Asheville Integrative Medicine and our new patient coordinator Joy is here to help me out.


And today is the 10th of September 2020.  We just talked about testing strategies for heavy metals and now we are going to talk about treatment strategies.

Yes, what do we finally do with all this information?

The first thing I have to decide when I find somebody with heavy metals is Do they also have vascular disease?

And what sort of impact does that play?

Well, because if you have clogging of the arteries to your heart, your neck and head, your pelvis, your lower extremities – then that really increases our desire to do IV long chelations on you.  The magnesium-EDTA chelations which are 1 ½ to 3 hours, because those will open up those arteries by making the plaque lay down flatter.

Compressing it.

Yes.  It doesn’t get rid of the plaque, but it compresses the plaque by making vulnerable fluffy plaque into stable plaque, and that has been shown to decrease the risk of plaque rupture, and therefore heart attacks.  Now people will often get very disappointed, because they will do a calcium score which is a CT scan of your heart to see how much plaque is in your arteries.  Then they will do chelation for a while, and then do another calcium score and they will be in a rage that their calcium score went up, even when they are doing chelation.  I try to explain to them in advance it does not stop the progression of the heart disease.  It just keeps you from having an event.  What stops the progression of the heart disease is your lifestyle.


How you eat and how you exercise, and then working on your risk factors.  Treating blood pressure, sleep apnea, diabetes, and What is the biggest risk factor ever studied for heart disease?  It’s elevation of heavy metals.  So it does treat that risk factor also, but it is only one risk factor among many.  So if you have heart disease also, then it makes IV chelation a lot more attractive.  If you don’t have heart disease, IV chelation may be unnecessarily expensive and inconvenient.  Because you have to come here and pay extra and all that.  So we can often do chelation orally for heavy metals.

Something you can take at home.

Something you can take at home.  So again, starting with EDTA – until recently EDTA was not very useful orally because only about 7% is absorbed.


Only about 7%.  If I give you 100 mg of EDTA, 93% comes out the other end and only about 7% goes into you.

Because it’s going through the digestive system.

Yes.  It is just not a very absorbable molecule, but in the last few years a liposomal form has come out.

And what is liposomal?

It’s where you take that molecule and surround it with a fat molecule, you put it right in the middle of a fat globule, and that then makes that highly absorbable to where you are getting more than 50% absorption.  And so now we are able to use a liposomal oral EDTA to take out all the heavy metals except for mercury.  So that is one of our prime strategies now.

If someone is very sensitive to chelating and they have a lot of toxins and they get the brain fog and all of the symptoms at first, until they get some of these metals out and get used to it, would it be preferable for them to use not the liposomal EDTA, if they are only absorbing less of it to reduce that reaction.

Yes.  We have a non-liposomal form of EDTA called Cardio-Chelates to help treat the heart.  And you take it regularly.  It does work some I believe, and it is more gentle because you are getting a lower dosage.  So you can use that first to start scraping off the excess and then more to the liposomal once you get that scraped off, because people become more resilient.  So that is very useful and if people have mercury also, then my favorite thing to use is called IMD – intestinal metal detox – and this is from a company called Quicksilver Scientific, quicksilver being the other word for mercury.  And this is basically a silica molecule that was roughed up and had 2 sulfhydryl groups put onto it by a guy named Crushade who is a chemist who had mercury toxicity and was too sensitive to take all the usual mercury chelators like DMSA and DMPS.  So he made this to be not absorbed.  So this little powder, you take very tiny amounts like 1/64th of a tsp. up to 1/8 tsp. at maximum dose per day on an empty stomach.  And that goes in your mouth and then out your rectum, but pulls mercury out of your gut wall.  And by doing that day after day for long periods of time, like a couple of years, you can reduce your total body burden of mercury, especially your gut level, but even in your whole body because it goes down in concentration gradients over time.

A question I have had about the IMD from a lot of people is – is it worth doing it and trying to get the mercury out if I still have amalgam fillings?

It is, but the first rule of treating toxicity is to get rid of the source of toxicity.  So you want to get rid of the source of toxicity as quick as you possible can –

Safely too.

Safely.  And so you need to have a biological dentist.  If you have a lot of work to do, until the Covid-19 pandemic we sent people to American trained biological dentists, but they are in Mexico or in Costa Rica, and they could have it done for ¼ of 1/5 of the cost.  And even one of our nurses went down there and had that done and got very good results.  Rather than spending $10,000.00 to have the dental work done, was able to have it done for $2,000.000 and had a nice weeklong vacation.

Nice vacation to boot!

That’s right.  So it is important to get the dental work done and get the source of the toxicity out of your teeth if you are dealing with mercury and stop eating big fish like tuna fish and shark and swordfish.

Little fish are better.

Little fish are better, lower on the food chain, that’s right.  So we will use the IMD, we will use the DMSA, again if people can tolerate it.  DMSA for 70 years was over-the-counter.  Last year the FDA took it away and made it only available through compounding pharmacies, so that unfortunately usually triples or quadruples the price of things.


So it is not as affordable as it used to be, but it is still useful.  There are many different ways to do that.  There are protocols where you take it 4 x a day for 3 days and then take 11 days off, and then 4 x a day for 3 days, and – those protocols are interesting.  There is no scientific data behind this, it’s just that some doctor 50 years ago started doing it that way and other doctors kind of copied that.

Followed suit?

Yes.  You can take a tiny dose once a day – I generally do a moderate dose 3 x a week for people as kind of a compromise between that.

Is that to give the body some time off in-between?

Yes.  But there are lots of different ways to do it, and I will have people read different people and decide for themselves what they want to do.  So, one of the problems with fields of medicine that have not very good funding is the scientific rigor has not been applied the way we would like it to be for different treatment protocols.  So we do the best we can and then observe through time and keep evolving that way.  We can use the IVs of the calcium-EDTA, even the magnesium-EDTA, the DMPS.  Now I have found that if you use IV DMPS too often people become allergic to it.

Really – why so?

Well , because it has sulfhydryl groups on it.  You have to have sulfhydryl groups – that is what makes rotten eggs smell like rotten eggs.

Right, the sulfury smell.

The sulfury smell, garlic, onions, all that – to bind mercury.  So lead is pretty easy to bind.  Mercury is one of the trickiest metals to bind and arsenic not far behind it, because you have to have sulfhydryl groups to do that.  And what are the most common antibiotics people become allergic to?  Well, the sulfa antibiotics because of those sulfhydryl groups.  So I have limited it that people can only have an IV DMPS every 6 weeks; then I find people don’t get allergic to it.  But it used to be we would give it as often as every 2 weeks.  Now the EDTA we can give up to twice a week and nobody ever becomes allergic to that because there are no sulfhydryl groups on it.

Interesting!  I didn’t know that.

Yes.  So we can give the DMPS, we usually give it by IV.  You can get oral DMPS through compounding pharmacies.  The main reason we usually don’t is that it is almost just as expensive to take it orally as it is to give it by IV.  It’s generally like tenfold more expensive than DMSA.

And if you are taking it orally would it be less effective than the IV because it has to go through the gut?

Not necessarily.  I think it has pretty good absorption and pretty good tolerance, and I will occasionally use it that way.  You could use it again like 3 times a week or once a week, depending on how you wanted to work that.  Some people will just chelate on the weekends because they get the brain fog from chelating, so they don’t want to have that when they are going to work.

Sounds like it might be a nice option for our long-distance clients too.  Sometimes it is difficult to travel just to get in here for IVs all the time.

Right.  And then there is the whole list of natural things which I don’t think I am going to go into too much, but all the way from cilantro, and chlorella, and lipoic acid, NAC – all the things that boost your own glutathione which is kind of your own basic common pathway of detoxification, so all those things we may use on an individual basis, but people get overwhelmed with taking too many things.  What is interesting is people will come in overwhelmed from taking too many things and two-thirds of the things on their list are not things that I told them to take – it is things they added on their own by looking articles on the web site or newsletters that they are getting.

Dr. Google!

Yes.  And we have got to start thinning out their supplement list because they can grow; we start with 5 or 6 of the main most important supplements, and then all of a sudden they are taking 56 different things –

Right.  Well and if you are taking a lot of stuff, we first of all can’t know what you are responding to, and you don’t want to stress the body out by doing too much at once.

Right.  So I find myself simplifying people’s supplement list an awful lot that way.

Now can you take the oral and the IV chelators in conjunction with each other?

Sure, and I myself – if you know how you respond to them, I would take oral DMSA on the same day I would take IV EDTA and IV DMPS and do it all at the same time and then chase it with binders like charcoal and chlorella and get great results.  Now you asked me to tell this one story – when I had those really high lead levels and started doing IV chelation, it was back in the mid 90s when we had a drought in Asheville so we weren’t flushing the toilets and so I was peeing in my yard.  And I went out and peed in my yard after an IV chelation and I had a dead spot in the yard for 2 years.

From the lead.

I had that much lead coming out in my urine, that you could see for 2 years where I peed that one time.  So I learned not to do that anymore.

Yes – then the whole yard would just die!

Yes, so when you are chelating don’t use your urine on the compost pile.


And I will say another thing about chelation is you don’t try to detoxify if you’re pregnant or if you’re trying to get pregnant.

Now why is that?

Well, you don’t want to be moving heavy metals around in the body when there is a fetus because it will concentrate into the fetus.  So when we have a woman who is trying to get pregnant and she needs to be detoxifying, what I will do is have her wait until she starts her menstrual period and then start detoxifying for 2 weeks and then stop.  And then at the end she has a pregnancy test to make sure she is not pregnant before she starts chelating again.

Hum, that’s clever.  Now with all of the chelating and detoxification, what sort of timeframe are we looking at for one to expect to be able to actually reduce and get close to eliminating their metal burden?

Well you never get to zero because it is stored deep in your body – right?  So it is about scraping it off.  And people feel better when you get just a little bit off.  People with say that their vision clears up, they think better, they feel better, their emotions stabilize – all those things.  Seeing the results of the chelation challenge is really quite variable.  It took me about 5 years to get mine from very high levels down to really close to normal.  A lot of that has to do with how persistent and consistent you are working at it.  I was pretty on it because I run a clinic that works on this.

And you are here every day.

I am here every day, so it is easy and relatively inexpensive for me to do all that.  But it is harder for other people.  This woman who had that suicidal problem for 3 days after the chelation challenge?  Twenty years later she is still working on detoxifying her mercury, because she is very fragile and it is very hard for her to get a handle on it.  She feels better every year, but it is still a challenge, so it can take a long time.  I think – I have a concept of getting it down to a reasonable level by working on it aggressively for one to three years and then going onto a maintenance program where you just kind of keep scraping it off.  I will still take some chelating agents every once in a while.  Every few months I will take a burst of them and kind of scrape off what is leaking out of my bones.

Right.  Now is there a preferable age to start into this venture of dealing with your metals?  Is there an ideal range?

Well, when you are motivated.  That is really the time is when you are motivated.   As young as possible.  We love to work with women before they get pregnant – to detoxify them before they choose to get pregnant because we know they are going to dump the toxins into their fetus six-fold compared to mom’s body.


But the classic age is midline because you know you are building your bones up until age 25-30, but certainly after age 50 it is all downhill from there –

For your bones!

Especially for your bones, but for everything.  I have already lost an inch in height.  But especially when women go through menopause.  You know, we talked about in one of our earlier episodes that lead leaking out of their own bones is the leading cause of high blood pressure in postmenopausal women, so then you show up as high blood pressure, that is a good time to look at heavy metals.


So, it is when you are coming down with health challenges is when most people are motivated.  Most people are not going out there and proactively investing in their health when they feel fine.

But that would be great to do.

That would be great to do, but I am as guilty as everybody else.  Frankly, the only reason I did it is because I started this clinic and I figured I should test myself.


I didn’t really have any issues.  I mean I never would have connected loss of photographic memory and gum recession to oh, that must be lead toxicity.


But it turns out it probably was.  And I think we talked about my mother’s birth mark that disappeared when she chelated out her lead and mercury.

And it just went away completely?

It went away completely – that’s right.  So what is fascinating is that we see all kinds of things get better when we lower the burden of heavy metals in the body, and we see all kinds of things refuse to get better when we don’t do that.  And I have especially worked with people with chronic infections all the way from Lyme disease to reactivated mono to walking pneumonia, and we find a number of people that will go after those infections, try to get them suppressed, will get partial results and then as soon as you back off, the people are sick again.  And it is not until we go after the heavy metals that they can they suppress their reactivated chronic infections.

Well you said that the metals really do affect every cell in our body – it matters.

That’s right.  One of my teachers, Dietrich Klinghardt wrote a very interesting paper about this.  He says it goes two ways – not only are the infections reactivated because your immune system is being inhibited by the metals, but your body actually lets for example candida yeast grow in your gut because it helps bind the mercury for you.  It is actually your ally in reducing mercury toxicities.  So he says one of the best ways to clean up a spill of mercury is to pour a vat of candida on top of it.


Kind of like putting kitty litter on an oil spill.  I used to be a remodeler’s assistant, so sometimes you spill something and we would always just throw a bunch of kitty litter on it and then you scrub it around and then you pick up the kitty litter and you have picked up the oil spill.  Well that is how you can pick up mercury is with candida.  Because it binds mercury very well.

So could that be a cause of candida overgrowth for some people?

Exactly.  We find that repeatedly.  Especially women with recurrent yeast and it will never really stay away until you get rid of their mercury burden.

That’s incredible.  I had no idea.

Yes, I see that over and over again.  That’s right, you might say well why didn’t Joy know that, she works in the clinic.  Well Joy is a new patient coordinator, she is a clerical person in the clinic, not a medical person in the clinic, so our nurse practitioner would know that, but not our clerical staff necessarily.

That’s part of why I love doing these podcasts is I get to learn with everyone else all these things that I didn’t know.

The medical side of it – that’s right.  So what else should we say about heavy metals?  I tell people don’t be in a hurry.  If you try to hurry chelation you will suffer more adverse side effects.  You have to start really slow and gentle, go into it gradually and see how you respond.  It is fairy predictable if you are clinically fragile, you are going to have a harder time.  If you are clinically robust you are going to have an easier time, but you are less likely to be in my clinic as a patient.


So the majority of people that we treat are somewhat fragile, so we want to treat them with kid gloves and we have learned to help them through that over the years.  And binders – let’s talk more about binders.

Yes – what are binders?

Well binders are things that you take to put into your gut to prevent reabsorption.  So let’s say I take some oral DMSA, that goes into my body, it absorbs pretty well.  It goes into my body and pulls out mercury, then it gets cleared through the liver, and then that mercury and lead get dumped into my bile and get excreted into my small intestine and travel down to my colon, and I am supposed to poop it out.  Now some of it I will pee out and some of it I will poop out – right?  But the colon, its job is to reabsorb water.  It turns the liquid from the small intestine into your poop which hopefully is not constant diarrhea.  It is the colon’s job of reabsorbing the water why its not, why you have formed bowel movements rather than loose ones all the time, hopefully.  But while it is reabsorbing the water it is very good at reabsorbing all kinds of toxins from estrogens to heavy metals, and that enterohepatic circulation or the circulation from your gut to your liver and then around to your body is what causes a lot of the side effects of brain fog.  So you notice it will be 6-12 hours after you take the chelating agents that you really start to get those adverse side effects and it is when you are reabsorbing the metals from your colon.  So the more fiber and binders you can put into your bowel, the less you are going to reabsorb and the more you poop out, so you can use everything from eating apples for fiber to oatmeal to ground flax seeds – just more fiber in your diet, but then specifically we will use things like charcoal which is a universal binder, and zeolites which is like kind of fossilized rock dust that is shaped the right way to cage all these things.  And we will have people take that on an empty stomach anywhere from ½ hour to 2 hours after the chelating agent to kind of chase those out, and that can reduce a lot of the symptoms.

I used to struggle a lot when you and now Kamila have me going through these chelation protocols, with the brain fog and kind of headaches and wooziness, and just kind of almost felt like a hangover.


And now that I have gotten on that routine – I like the new Ultra Binder we have.  I take that ½ hour after I take the liposomal EDTA and it just knocks it all out.  The headaches aren’t there anymore, the fogginess – it makes such a difference.

And the Ultra Binder comes from that same company that makes the IMD, the Quicksilver Company, and besides the charcoal, it also has gum, zeolites, bentonite clay, chyasin which is the outer shell of like crawdads and lobsters and such, ground up in aloe and silica.  So all those things kind of help bind all the different things.  And then also you don’t want to be constipated.  You want to be pooping well, so magnesium, probiotics, lots of fiber, lots of water, and even a laxative if you need it.  You just don’t want to be constipated when you are chelating because you get more reabsorption.

Right, it negates the purpose.

Yes, and again, we have talked about this before, but the average American poops 3 times a week and we want the average patient to poop 3 times a day – food in, food out.


Maybe twice a day if you are only eating twice a day and doing intermittent fasting, but for the most part 3 times a day.  So the solution for that is exercise, water, magnesium, and supplemental fiber.


Those are the best ways to go about that.  All right – any last things about treating heavy metal toxicity?  I have to say, it has to be individualized.  People can try to do this on their own, but you really can’t test yourself on your own, so it’s hard to know what kind of progress you are making, and you have to get some good guidance on it generally.

Right, because depending on what your metal burden is, that determines what chelators we need to use, how sensitive you are, what other factors you have going on – there is just so much to put it altogether that you need support.

That’s right, and the next point I will make is you are never really done.  You have to have some sort of maintenance program.  I’ve seen people who saw another doctor in Florida and that was 10-15 years ago and then they haven’t done much, and then you test them again and the levels are back up again because it has leaked out of their liver and their bones, so you have to kind of go at it again.  The older you get the more is going to be coming out of your bones.  So the corollary of that is to keep exercising and working your bones so that you don’t get osteoporosis, because you would rather keep that lead locked into your bones than having it go to your heart and brain.

Yes, exactly. 

All right – well thanks Joy.

Thanks Dr. Jim Bob.

Thanks everyone!


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