it is a personal choice. starting out slow with cilantro and iodine, keeping the kidneys flushed with water and salt, and all the attendent yuckiness of having this crap moving through your body is a matter of choice and how operational you need to be. cilantro threw me for a loop and was most debilitating. i chose not to do much chelating until they were out. i think that is easier. starting a low dose of Iodine is something i think anyone should do at any time they can start.
sorry i cant be more help than that. youre the doc. be cautious but move forward. the number one rule is not to give up, of course. personally, i have been hit so hard before in the past on a constant basis that a hard spike of detox symptoms for me is nothing, expected, almost welcome(knowing i am removing the junk out).