Binders, infusions, sulfur protocols, gut binders, and sweating target metals. Confirmed poisoning: drugs lower blood lead and raise urine mercury. Calcium-form infusions slowed kidney-filter loss in extra lead stores with reduced filter function. Heart-event split: not a settled yes or no. Calcium-free infusions have killed children via low blood calcium. People without documented poisoning: not shown to extend life. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Blood lead | As low as practicable; many clinics target <1 µg/dL | Body burden; treatment threshold |
| Blood mercury | <5 µg/L often cited as a functional ceiling | Recent methylmercury (fish) exposure |
| Urine mercury (unprovoked) | <5 µg/g creatinine commonly used | Inorganic mercury excretion |
| Urine cadmium (unprovoked) | Lowest quartile of survey norms; often <0.5 µg/g creatinine | Cumulative cadmium (kidney) |
| eGFR / creatinine | eGFR ≥90 mL/min/1.73 m² when possible | EDTA and DMSA clearance; nephrotoxicity |
| ALT / AST | Within the lab range, preferably low-normal | DMSA hepatotoxicity |
| CBC | Neutrophils within the lab reference interval | DMSA neutropenia |
| Ionized calcium | ~1.15–1.30 mmol/L | Hypocalcemia from disodium EDTA |
| Plasma zinc | Many functional ranges ~90–110 µg/dL | Chelator-induced loss |
| Plasma copper | Mid-normal for the lab | Co-depletion or imbalance with zinc |
| Serum magnesium | Functional often ≥2.0 mg/dL | Urinary loss on EDTA |
| Ferritin | Track vs baseline; avoid deficiency or overload | Iron can be chelated; deficiency raises cadmium absorption |
Cadence: Baseline before the first dose; after the first cycle (~1 week for oral DMSA; after infusion 1 and 5 for EDTA); at ~4 weeks; every 3 months while treating; after stopping