It is necessary to wait 3 months after amalgams have been removed before starting ALA because Andy Cutler has found it takes about that long before blood levels of mercury are reduced enough.

Using ALA too early when blood levels are still high, increases the risk of more mercury being carried into the brain, because it crosses the blood brain barrier. It would be better to either wait out that 3 months or use DMSA.

DMSA is good at reducing blood levels of mercury. It makes detoxing extracellular mercury much more efficient than if you left the body to do it by itself (in my personal experience anyway). In fact, DMSA alone was chelating much more than I had expected and I continued using it for a long time, because that alone was causing enough detox symptoms to let me know that it was still working!

Though some who maybe reactive to DMSA itself, or find it too expensive, do not have to use it. They can simply wait it out for 3 months and then use ALA at the appropriate time on its own.

DMSA chelates extracellular mercury (mercury on the outside of cells), but it is not essential. ALA chelates intracellular mercury (mercury on the inside) and IS essential (because it chelates the organs/brain). This is what I learned from Cutler.

They can be used together for those who find DMSA helps with the symptoms of mercury and the symptoms created from using ALA (which is very powerful). Or ALA can simply be used alone.