DMPS protocols

Note: There are a number of protocols recommended for the use of oral DMPS by Aposhian, Daunderer, Nerodova and Quig. Some make use of the 24-hr urine, others use a 6hr collection period. Our rational for using the 3hr collection time is based on the bioavailability of oral DMPS, and supporting studies.[i

• Peak metal excretion time is approximately 2-3hrs after intake.
• At least one day before the test no mineral supplements, chlorella and/or fish shall be consumed.
• The patient should not smoke after 10PM the night before the test. Ask to list how many cigarettes are smoked on a daily basis.
• Prior to ingesting the DMPS capsule(s), patient should void bladder. Approximately 20ml of that should be collected in a urine collection cup. This will be the baseline urine

The Oral Provocation Test:

• The general recommendation for adults is 10mg/kg BW, half or less of that dose for children. Aposhian and others recommended 300mg to max 500mg DMPS for adults.
• Oral DMPS is best given on an empty stomach with 200-500ml of water taken during the urine collection time.
• Urine collection time is 2-3hrs. If the patient cannot hold the urine in the bladder for the duration of the collection time, all urine must be saved in a urine collection container.
• Of the collected urine, 10ml is transferred to the laboratory tube, which should be market with the patient name and the chelating agent used i.e. Mary Miller, DMPS Provocation. This is the Provocation Urine.
• After the collection time, ample of water should be consumed. Normal meals can be eaten.

[i] Gerhard I et al. Diagnostik der chronischen Quecksilberbelastung. Clin Lab 43(7+8)637-647 (1997)

• Peak metal excretion time is approximately 1hrs after injection
• At least one day before the test no mineral supplements, chlorella and/or fish shall be consumed.
• The patient should not smoke after 10PM the night before the test. Ask to list how many cigarettes are smoked on a daily basis.
• Patient should void bladder prior to injection. Approximately 20ml of that should be collected in a urine collection cup. This will be the baseline urine.
• Dose administered: 3-4mg/kg. Inject DMPS slowly (minimum of 5 to 10 minutes). Rapid injection may cause a drop in blood pressure.
• Experience teaches that a high toxic load is more likely to cause adverse effects.
• Fluid consumption during total urine collection time: 200-500ml of water
• Urine collection time is 1hr. Patient should remain in clinic during that time.
• It is best to collect urine in the bladder. If this is not possible, urine is voided into a clean urine collection container.
• Of the collected urine, 10ml is transferred to the laboratory tube, which should be market with the patient name and the chelating agent used i.e. Mary Miller, DMPS Provocation. This is the Provocation Urine.
• The patient must drink ample water for the remainder of the day.

For more information, see Patient Submission form under Urine Profiles

[1] VanderSchaar P. Textbook of Clinical Metal Toxicology, IBCMT (2012).