Hi TW. Yes, ALA should be used with DMSA and/or B5/molybdenum.

I seem to finally have gotten something thrown together that actually works (for me). I have made the following categories of how supplements work:
1) histamine reducers
2) candida/mercury chelators
3) acetaldehyde detoxers

High histamine means high adrenaline, and this is uncomfortable (who hasn't had heart palps etc.), and so I'm using magnesium, calcium, taurine and Co-Q10 for heart protection + reducing histamine (400 mg + 400 mg + 500 mg + 30 mg). Taurine also has a calming effect, which is good. Magnesium and calcium lowers histamine. One can also try methionine to lower histamine.

Main chelator is ALA for me, but i also do rounds on selenium + vit C + E, because these work differently than ALA, but nevertheless they too stir up toxins. The acetaldehyde that comes out must be from the candida, I have learnt that, and ALA in particular stirs up a lot of that for me, but in a more controlled way, than other anti-oxidants. Mercury detox has never been high up on my priority list, whatever comes out in the process, that's good enough.

The acetaldehyde detox support is B5 + molybdenum for me (100-200 mg + 300 mcg per day). B5 has also the very important benefit of being essential to adrenal hormone production, I at least can't live without this, without feeling too miserable.

You can add DMSA or succinic acid to this to maximize the acetaldehyde detox, but this is untested for my part. So yes, I consider B5 + molybdenum as a replacement for DMSA, because DMSA is actually an acetaldehyde detoxer too. The most potent acetaldehyde detoxers that I know use succinic acid in some form (remember DMSA = dimercapto succinic acid), however, the natural way of supporting acetaldehyde detox is B5/pantethine/molybdenum, this is also more liver friendly than using DMSA, and seems to be effective enough too, at least for me.

When chelating I always get the adrenaline rushes, its quite obvious, and when pushing too hard and I may get some hives, which is clearly a sign that histamine is high, and that toxins are leaking out. Can't be helped though, but this puts stress on the adrenals, so just give them what they want (B5), and they are happy. If you dont do it, the adrenals will still give out adrenaline, but you'll end up with having less of cortisol etc., resulting in adrenal fatigue, on the top of it.