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Practical information for parents researching autism, children's health, biomedical approaches, environmental health, gut health, heavy metals, and chelation.
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 If you've been researching mercury, heavy metals, chelation, or biomedical approaches for autism, you've probably encountered the name Andy Cutler. Andrew Hall Cutler, Ph.D., P.E. developed a specific approach to oral chelation that became known as the Andy Cutler Frequent-Dose Chelation Protocol. If you're new to it, the terminology can be confusing: ALA. DMSA. DMPS. Half-life. Redistribution. Hair testing. Chelation rounds. The good news is that the basic idea isn't difficult to understand once you know what those terms mean. This article explains what the Cutler protocol is, why frequent dosing is central to it, how the different chelating agents fit in, how hair testing and challenge testing are viewed, and what makes this approach different from other chelation methods. The detailed practical information, including preparation, supplements, dosing, and implementation is covered in Fight Autism and Win. This article is educational in nature and is not medical advice. Chelation involves medications and potential risks. Discuss your child's individual circumstances with an appropriately qualified healthcare professional. Who Was Andrew Hall Cutler? Andrew Hall Cutler, Ph.D., P.E. (1958–2017) was a chemist and chemical engineer who developed a systematic approach to oral chelation based heavily on pharmacokinetics. He wrote extensively about mercury toxicity, amalgam illness, chelation, and hair testing. His major books include:
You'll see his approach referred to as the Andy Cutler Protocol, Cutler Protocol, Andy Cutler Chelation, Frequent-Dose Chelation, or ACC. These names generally refer to the same overall approach. What Is the Andy Cutler Frequent-Dose Chelation Protocol?The Cutler protocol is an approach to oral chelation based on taking relatively small doses of a chelating agent at intervals determined by the agent's pharmacokinetic properties. The central idea is simple: The timing of the doses matters. Rather than taking a large dose and then allowing the amount of chelator in the body to fall dramatically, the Cutler approach emphasizes maintaining a relatively consistent level of chelator during active chelation. This is the reason for the term frequent-dose. Why Does Half-Life Matter? Half-life is the amount of time it takes for the concentration of a substance in the body to decrease by approximately half. Different chelating agents have different half-lives. That means they don't all remain active for the same amount of time, so they aren't simply taken on the same schedule. The Cutler approach uses these pharmacokinetic properties to determine how frequently a chelator should be taken. The goal is to avoid large peaks and valleys in chelator levels. What Is Redistribution? Redistribution is one of the most important concepts in understanding why Cutler emphasized frequent dosing. A chelating agent binds metals and helps move them toward elimination. Within the Cutler framework, the concern is what can happen when the chelator level falls substantially while mobilized metal is still present. The metal may move from one location in the body to another rather than being eliminated. The Cutler approach therefore emphasizes keeping the chelator level relatively steady throughout a period of active chelation. This is the basic reasoning behind: small doses + appropriate intervals + attention to half-life. It is also one of the major differences between the Cutler approach and chelation methods that rely on large, widely spaced doses. Which Chelating Agents Are Used? Three chelating agents are commonly discussed in the Cutler framework: ALA — Alpha-Lipoic Acid ALA is particularly important in Cutler's work because of its ability to enter the tissues that some other chelators do not reach as readily. It is especially associated with the discussion of mercury. DMSA DMSA is another oral chelating agent discussed in the protocol and can bind several metals, including mercury and lead. DMPS DMPS is another chelator discussed in Cutler's writings. These agents have different chemical properties and pharmacokinetics. They are therefore not interchangeable, and the dosing interval used for one chelator cannot simply be applied to another. How Does Hair Testing Fit Into the Protocol? Hair mineral analysis is another important part of the methodology described in Cutler's work. Cutler devoted an entire book--Hair Test Interpretation: Finding Hidden Toxicities—to interpreting hair mineral and metal results. The Cutler approach does not simply ask: “Is the mercury number high?” Instead, the methodology looks at patterns in the mineral results and interprets those patterns according to the system Cutler described. If you're researching this approach, understanding hair testing is important because it is one of the ways Cutler's methodology differs from simply measuring a single metal concentration. The detailed interpretation method is beyond the scope of this introductory article and is covered in Cutler's book. What About Provoked or Challenge Testing? You will also encounter provoked urine testing, sometimes called challenge testing. The basic idea is to give a chelating agent and then collect urine to see how much metal is mobilized. This is not part of the Andy Cutler approach. Cutler warned against using chelation challenges as a way of determining whether someone has mercury toxicity. There is also an important mainstream medical reason to be cautious here: the American College of Medical Toxicology states that post-chelator challenge urinary metal testing has not been scientifically validated, has no demonstrated benefit, and may lead to unnecessary or harmful treatment. If you encounter a website telling you that you need to take a large dose of a chelator and then test your urine to “prove” a heavy-metal burden, understand that this is not necessary, and has risks. It's not how the Cutler approach evaluates the mercury or other metals. What Is a Chelation Round? Another term you'll encounter is round. A round is a period of active chelation followed by a period without chelators. The purpose is to approach chelation as a gradual process over time, rather than as one large treatment. Parents following the approach may keep records of:
Tracking these things can make it easier to identify patterns over time. The detailed organization of rounds is one of the practical subjects covered in Fight Autism and Win. What Makes the Cutler Approach Different? The easiest way to understand the protocol is to remember its defining principles:
These principles are what distinguish the Cutler protocol from many other approaches you'll encounter when researching chelation. What Does This Have to Do With Autism? Most parents don't discover Andy Cutler because they're fascinated by pharmacokinetics. They discover the subject because they're trying to understand their child. The search might begin with:
From there, the research often expands into environmental exposures, nutrition, gut health, supplements, methylation, testing, and other biomedical subjects. The Cutler protocol is one specific approach within that larger biomedical landscape. For parents who believe heavy metals may be relevant to their child's health, understanding exactly what the Cutler protocol means is important before comparing it with other approaches. What Should You Learn Before Going Further? If you're seriously researching the Cutler protocol, the basic concepts to understand are:
These are the concepts that turn the protocol from a confusing collection of abbreviations into something you can actually understand. Why Fight Autism and Win Goes Further Understanding the basic theory is only the beginning. Once parents start researching the Cutler protocol, they quickly encounter practical questions:
Continue Your Research New to heavy metals? Read Heavy Metals and Autism: What Parents Should Know About Exposure and Testing
Investigating environmental exposures? Read Environmental Toxins and Autism: What Parents Should Know About Common Exposures Researching gut health? Read Gut Health in Autism and the Gut-Brain Connection Wondering about yeast? Read Chronic Yeast Overgrowth in Autism: What Parents Should Know Want to hear what other families report? Read Parent Experiences With Biomedical Approaches and the Andy Cutler Protocol Ready for the complete guide? Learn more about Fight Autism and Win Comments are closed.
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