Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Disturbed Sleep Pattern While On DMSA?
Question: Hi. I was given DMSA capsules (250mg) for lead toxicity. I took 5 capsules per day for 5 days. I took my last capsule 4 days ago. I'm worried because I feel "out of it" and while it's probably just my sleep pattern or diet changes I'm making, I'm worried the DMSA hurt me even though I was only one-third or so of the way through my treatment. I'm worried about permanent damage. Help, please.
Brief Answer:
Do not think it's related to DMSA
Detailed Answer:
I read your question carefully and I understand your concern.
The dose of DMSA is not a high one (dosage can reach 30mg/kg) and the duration for which you have been taking it as you yourself say is a short one, treatment is continued for more than 5 days. So that in itself is an argument against DMSA causing any serious side effects.
Furthermore most common side effects are digestive ones like diarrhea and nausea which you do not mention. It does not cause the brain blood barrier so it doesn't cause any brain damage if that is what you fear. When taken at high doses (not your case) it may cause some kidney damage and elevation of liver enzymes. However these effects would be transitory, not permanent no worry. I do not think that likely for your dosage anyway, but if you really can't help thinking about it, a routine blood test for liver and kidney function would help put your mind at ease. Also if the symptoms were already present before should consider them being due to the lead toxicity which can cause anemia (but probably you were already tested for that I guess).
I remain at your disposal for other questions
Do not think it's related to DMSA
Detailed Answer:
I read your question carefully and I understand your concern.
The dose of DMSA is not a high one (dosage can reach 30mg/kg) and the duration for which you have been taking it as you yourself say is a short one, treatment is continued for more than 5 days. So that in itself is an argument against DMSA causing any serious side effects.
Furthermore most common side effects are digestive ones like diarrhea and nausea which you do not mention. It does not cause the brain blood barrier so it doesn't cause any brain damage if that is what you fear. When taken at high doses (not your case) it may cause some kidney damage and elevation of liver enzymes. However these effects would be transitory, not permanent no worry. I do not think that likely for your dosage anyway, but if you really can't help thinking about it, a routine blood test for liver and kidney function would help put your mind at ease. Also if the symptoms were already present before should consider them being due to the lead toxicity which can cause anemia (but probably you were already tested for that I guess).
I remain at your disposal for other questions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The thing is, I got the test done using a DMSA-provoked "challenge" urine test. I did not have "lead poisoning" per se. The results were elevated but I see nothing validating the urine test where you take DMSA first. I am instead going to use natural means to detox of heavy metals.
I also read research showing DMSA could in fact breach the blood-brain barrier in certain individuals. Would that be a concern for the amount of DMSA I used?
I'm currently withdrawing from gluten and dairy and I just feel "out of it." I've also had very little exercise the last few days. Could those factors be a cause?
I also read research showing DMSA could in fact breach the blood-brain barrier in certain individuals. Would that be a concern for the amount of DMSA I used?
I'm currently withdrawing from gluten and dairy and I just feel "out of it." I've also had very little exercise the last few days. Could those factors be a cause?
Brief Answer:
Read below
Detailed Answer:
Thank you for the additional information.
The provocative chelation test (with dmsa in your case) is an accepted test, at times in chronic past exposure it can be even more sensitive than the blood test. However it would be preferable if you also had had the lead blood levels measured, the two tests complement each other, it is a little unusual to have been diagnosed only with the provocative test.
As for the blood barrier breach that does not happen at those doses and usually happens in children not at your age, so I do not believe you should be concerned much about it.
As for whether it can be related to your diet and lifestyle changes, yes it certainly can. However as I said before some routine blood tests such as blood count, liver and kidney function should be done (if not done already) as they can be affected both by liver exposure as well as DMSA and their alteration could certainly make you feel out of it as well , all metabolic and blood changes do.
I hope to have been of help.
Read below
Detailed Answer:
Thank you for the additional information.
The provocative chelation test (with dmsa in your case) is an accepted test, at times in chronic past exposure it can be even more sensitive than the blood test. However it would be preferable if you also had had the lead blood levels measured, the two tests complement each other, it is a little unusual to have been diagnosed only with the provocative test.
As for the blood barrier breach that does not happen at those doses and usually happens in children not at your age, so I do not believe you should be concerned much about it.
As for whether it can be related to your diet and lifestyle changes, yes it certainly can. However as I said before some routine blood tests such as blood count, liver and kidney function should be done (if not done already) as they can be affected both by liver exposure as well as DMSA and their alteration could certainly make you feel out of it as well , all metabolic and blood changes do.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
How urgent are the blood count, liver and kidney function tests? Could that much DMSA damage my organs? You did not sound that concerned over that.
Secondly, my urine test came back at "14" for lead and all else normal. I was told the normal range is "2." Does that sound right?
Thirdly, is it possible to feel "off" from that much DMSA "reorganizing" metals in my body? I took care to follow all the right steps, including taking DMSA every four hours.
Would you recommend DMSA chelation for a finding of "14" based only on a urine test? Can you tell me how why a person takes DMSA before a urine test? I read that this makes it look like you have way more metals in your body than you really do.
Secondly, my urine test came back at "14" for lead and all else normal. I was told the normal range is "2." Does that sound right?
Thirdly, is it possible to feel "off" from that much DMSA "reorganizing" metals in my body? I took care to follow all the right steps, including taking DMSA every four hours.
Would you recommend DMSA chelation for a finding of "14" based only on a urine test? Can you tell me how why a person takes DMSA before a urine test? I read that this makes it look like you have way more metals in your body than you really do.
Brief Answer:
Read below
Detailed Answer:
Regarding the blood count and kidney/liver tests it is true that I do not sound urgent as I do not think that dose of dmsa is likely to have caused any damage, as I said I consider it unlikely for that dose and recommended the tests only to make sure. On the other hand I kept stressing they might already have been done, as they should have been done already in my opinion, for the complete evaluation of lead toxicity, before even beginning dmsa.
Normal ranges may differ among different laboratories, but that value of 2 makes perfect sense to me as it coincides with the normal values of the laboratory I use as well, it does sound right. So an elevation of 14 is indeed significant.
I do not believe dmsa to cause any damage by reorganizing the lead, the lead was already in your body, the purpose of dmsa is to excrete it to remove it from your body, it lowers the lead quantity and blood level.
Whether I would recommend based only on urine test, personally I always recommend the blood test as well not only, but that value of 14 is pretty significant so I can understand the doctor for deciding that way, especially if there are typical manifestations and lead expose.
As for the last question on why a person takes dmsa before the test, the purpose is to enhance lead excretion in urine. If there is no lead in the body there will not be anything to excrete from the dmsa, but if there is, the dmsa will evidence it for us by excreting it in the urine. So I do not agree that it gives a false impression of lead presence, it can only do that when the lead is actually there. Perhaps what those sources you've read mean is that it shows the lead which might have been deposited in the bones from chronic exposure which might be missed by blood levels, but make no mistake, that lead is there in our body, dmsa doesn't make it appear out of nothing.
Read below
Detailed Answer:
Regarding the blood count and kidney/liver tests it is true that I do not sound urgent as I do not think that dose of dmsa is likely to have caused any damage, as I said I consider it unlikely for that dose and recommended the tests only to make sure. On the other hand I kept stressing they might already have been done, as they should have been done already in my opinion, for the complete evaluation of lead toxicity, before even beginning dmsa.
Normal ranges may differ among different laboratories, but that value of 2 makes perfect sense to me as it coincides with the normal values of the laboratory I use as well, it does sound right. So an elevation of 14 is indeed significant.
I do not believe dmsa to cause any damage by reorganizing the lead, the lead was already in your body, the purpose of dmsa is to excrete it to remove it from your body, it lowers the lead quantity and blood level.
Whether I would recommend based only on urine test, personally I always recommend the blood test as well not only, but that value of 14 is pretty significant so I can understand the doctor for deciding that way, especially if there are typical manifestations and lead expose.
As for the last question on why a person takes dmsa before the test, the purpose is to enhance lead excretion in urine. If there is no lead in the body there will not be anything to excrete from the dmsa, but if there is, the dmsa will evidence it for us by excreting it in the urine. So I do not agree that it gives a false impression of lead presence, it can only do that when the lead is actually there. Perhaps what those sources you've read mean is that it shows the lead which might have been deposited in the bones from chronic exposure which might be missed by blood levels, but make no mistake, that lead is there in our body, dmsa doesn't make it appear out of nothing.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
