Table of Contents > Alternative Modalities > Chelation therapy Print

Chelation therapy

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Also listed as: EDTA therapy
Related terms
Background
Theory
Evidencetable
Tradition
Safety
Attribution
Bibliography

Related Terms
  • CaEDTA, calcium disodium versenate, calcium ethylenediaminetetra-acetate, calcium versenate, CaNa (2) EDTA, CaNa2 ethylenediamine tetraacetic acid, CaNa2EDTA, disodium EDTA, disodium ethylenediaminetetraacetate, edetate, edetate calcium disodium, edetic acid, EDTA, Endrate, ethylene diamine tetraacetic acid (EDTA) therapy, ethylenediaminetetraacetic acid.
  • Note: The term "chelation" refers to the use of any chemical in the blood to remove toxins. This bottom line focuses on EDTA, the most commonly used substance.
  • Note: EDTA is also known as calcium versenate, disodium ethylenediaminetetraacetate, calcium disodium versenate, CaNa (2) EDTA, CaNa2EDTA, CaEDTA, CaNa2 ethylenediamine tetraacetic acid, ethylenediaminetetraacetic acid, edetate calcium disodium, and calcium ethylenediaminetetraacetate.
  • Not included in this review: Other substances believed to be useful in chelation include BAL (British Anti-Lewisite or dimercaprol), deferoxamine, dexrazoxane, DMPS (2,3-dimercapto-1-propanesulfonic acid), DMSA (meso-2,3-dimercaptosuccinic or succimer), 2,3-dimercaptosuccinic acid, penicillamine (b,b-dimethylcysteine), deferoxamine (Desferol, used to treat iron overload from multiple transfusions), and some herbal substances.

Background
  • Ethylene diamine tetraacetic acid (EDTA) chelation was first used in the 1940s for lead poisoning and was approved by the U.S. Food and Drug Administration (FDA) for this use in 1953.
  • Some clinicians who used EDTA for lead poisoning have reported possible side benefits in people with heart disorders. However, there is conflicting data on this use.
  • Evidence is lacking in support of the use of chelation therapy for clogged arteries, diabetic kidney disease, eye disorders, ovarian cancer, scleroderma (the build-up of scar tissue on the skin), and hexachlorobenzene toxicity. It has also been used to treat kidney dysfunction.
  • EDTA chelation therapy is rejected by the conventional medical community, including the American Medical Association, American Hospital Association, National Institutes of Health, and Food and Drug Administration, due to a lack of scientific evidence.
  • In 1998, the U.S. Federal Trade Commission (FTC) secured a consent agreement barring the American College for Advancement in Medicine (ACAM), the main organization that supports chelation therapy, from making unproven advertising claims that chelation therapy is effective against any other disease of the circulatory system.

Theory
  • Chelation is the bonding of an agent, such as Ethylene diamine tetraacetic acid (EDTA), to a metal.
  • EDTA is marketed under several names, including edetate, disodium, and Endrate. It is used in heavy metal poisoning (such as lead or mercury), as it binds these metals and creates a compound that can pass out of the body in the urine. If EDTA is injected into the vein, it is mostly found in the blood and appears unable to enter cells. It is believed that EDTA may help bind calcium and reduce its build-up in artery walls.
  • Conventional blood and urine tests are used to determine whether there are materials that may respond to chelation by EDTA.
  • The EDTA mobilization test involves collecting urine samples after chelation therapy to analyze metal content in people who have heavy metal toxicity. This test may detect heavy metals in the urine even if blood levels are normal. It is one of the only ways to diagnose kidney disease caused by lead toxicity. However, it has been reported that a drawback of this test may be that it underestimates total lead burden in the body.
  • Chelation therapy uses repeated injection of EDTA into the vein, usually in combination with vitamins (commonly vitamin C), trace elements, and iron supplements as a treatment for a variety of diseases. Chelation therapy has been taken by mouth, but this technique is rarely used.
  • For heavy metal or lead toxicity in adults, 1.5 grams of EDTA in 1,000 milliliters of 5 percent glucose has been injected into the vein daily for five days to 52 weeks, after which the following doses of disodium EDTA were taken by mouth daily: 1.5 grams for 16 weeks, 1 gram for 10 weeks, 0.5 grams for eight weeks, no treatment for four weeks, and finally 1 gram for 10 weeks. Courses of chelation with EDTA have been injected into the vein once, daily, weekly, four times, or in five-day cycles for up to five years. Chelation therapy with 1 gram of EDTA has been injected into the vein weekly for two months. A dose of 25 milligrams per kilogram of EDTA in 500 milliliters of saline has been injected into the vein every 12 hours for 10 consecutive doses, every 12 hours for five days, or five times in one day. Chelation with EDTA has been given before dialysis or added to dialysis fluid weekly. Chelation therapy with EDTA at a dose of 1 gram in 24 hours has been injected into the vein, then stopped, and EDTA was then given again at 250 milligrams to 1 gram in 24 hours in an increasing dosage.
  • For peripheral vascular disease (blocked arteries in the legs), chelation with 20 infusions containing 3 grams of sodium EDTA dissolved in 1,000 milliliters of sterile water has been injected into the vein for 5-9 weeks. Chelation with 20 infusions at 500 milliliters, each containing 3 grams of disodium EDTA plus 0.76 grams of magnesium chloride and 0.84 grams of sodium bicarbonate in normal saline has been injected into the vein for 5-9 weeks. A dose of 10 milliliters of sodium EDTA has been injected into the vein for 10 treatments.
  • For diabetic kidney disease, a two-hour infusion of 200 milliliters of normal saline solution containing 1 gram of EDTA has been injected into the vein weekly for five weeks to three months.
  • For eye disorders (calcium build-up on eye), EDTA has been placed in the eye before and after eye surgery.
  • For heart disease, chelation with 20 injections of placebo or EDTA into the vein over a three-month period has been used. Twenty treatments were given every third day and consisted of 3-4 grams of sodium EDTA. A dose of 500 milliliters of EDTA solution or 500 milliliters of saline solution has been injected into the vein over a three-hour interval, once weekly for 30 weeks, followed by an additional 10 infusions given 2-8 weeks apart.
  • For kidney dysfunction, a dose of 1 gram of EDTA dissolved in 200 milliliters of normal saline has been injected into the vein for two hours weekly or intermittently for four weeks to 24 months. Chelation therapy with EDTA at a dose of 1 gram in 24 hours has been injected into the vein, then stopped, and EDTA was then given again at 250 milligrams to 1 gram in 24 hours in an increasing dosage.
  • For ovarian cancer (used with chemotherapy), a continuous infusion of EDTA (25 milligrams per kilogram per 12 hours x 6) has been injected into the vein immediately before delivering a radiolabeled antibody into the abdominal cavity lining.
  • For heavy metal or lead toxicity, chelation with EDTA has been injected into the vein in newborns within 28 days of birth, and in children for 2-3 courses for up to 12 months.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


EDTA has been used to diagnose and treat toxicity caused by heavy metals such as manganese, mercury, arsenic, cadmium, iron, cobalt, and lead. Chelation has also been used for poisoning with compounds containing lead and carbon. However, consistent results are lacking, and treatment responsiveness may vary based on the degree of contamination. More studies will help define more clearly who will benefit most and under what conditions.

B


Several studies support the use of EDTA chelation for reducing lead toxicity associated with chronic kidney dysfunction. They suggest that it may slow the progression of the disorder. However, more studies are needed to confirm these findings. EDTA chelation may be considered as a useful additional therapy in the treatment of chronic renal dysfunction.

B


There is conflicting evidence on the use of EDTA chelation for clogged arteries. Early study suggests that the technique may improve chest pain. Further research is needed before a conclusion may be made.

C


EDTA is commonly used to for calcific band keratopathy, a disorder in which calcium builds up on the cornea of the eye. However, there is a lack of evidence for this use. More research is needed before a conclusion may be made.

C


There is a lack of evidence to support the use of EDTA chelation therapy in heart disease, even though there is strong popular interest. In general, reviews have concluded that there is a lack of effectiveness. There is conflicting evidence at this time, and further high-quality research is needed.

C


Early research suggests that chelation therapy may improve kidney function in people who have diabetic kidney disease. Further research is needed before a firm conclusion may be made.

C


Early study suggests that EDTA chelation therapy given with chemotherapy may benefit people with ovarian cancer. More high-quality research is needed before firm conclusions may be made.

C


Early study suggests that chelation therapy lacks effectiveness for scleroderma. Further research is needed before a conclusion may be made.

C


Chelation may be somewhat effective for the treatment of porphyria (a disorder of the skin and nervous system) that is induced by hexachlorobenzene. Further research is needed before a conclusion may be made.

C


EDTA chelation therapy has been found to lack effectiveness for blocked leg arteries. More high-quality studies are needed in this area.

F
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Abnormal heart rhythms, Alzheimer's disease, anemia, arthritis, blood disorders, cataracts, chronic lung conditions, circulation, dementia, diabetes, disease diagnosis, emphysema (lung damage causing shortness of breath), endocrine disorders, gallstones, gout, hemochromatosis (too much iron in the body), high blood pressure, keratitis (inflammation of the cornea of the eye), leg cramps, macular degeneration (eye disorder leading to vision loss), memory loss, nerve damage, nervous system disorders, osteoarthritis, osteoporosis, Parkinson's disease, Raynaud's disease (blood flow disorder), rheumatoid arthritis, seizure (caused by drug intolerance), soft tissue injuries, sickle cell disease, snake poisoning, stroke, systemic lupus erythematosus (disease leading to long-term inflammation), ulcers, vision, Wilson's disease (too much copper in the body).

Safety

Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

  • Chelation therapy is likely safe in people who have heavy metal poisoning.
  • Use cautiously in people who have deficiencies of platelets or white blood cells, eye disorders, kidney conditions, liver conditions, musculoskeletal conditions, serious mineral deficiencies (such as zinc), skin conditions, and stomach or intestine disorders.
  • Chelation therapy may affect the risk of bleeding when taken with drugs, herbs, or supplements that increase the risk of bleeding. Some examples of drugs include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
  • Chelation therapy may interact with agents that affect the nervous system, agents that affect the liver, agents that improve breathing, calcium, digitalis, dimercaprol, eye agents, glutathione, heart agents, iron, kidney agents, sodium hypochlorite, stomach and intestine agents, tetrahydroxyquinone, and zinc.
  • Chelation therapy may cause abnormal heart rhythms, bone marrow depression, burning sensation or pain at infusion site, changes in blood pressure, changes in blood serum components (including bone alkaline phosphatase and osteocalcin), changes in liver enzyme levels, changes in parathyroid hormone levels, changes in platelet amounts, changes in white blood cell amounts, decreased calcium and zinc levels, diarrhea, excessive sweating or thirst, eye problems (blocked blood flow, irritation, and swelling), faintness, fatigue, fever, formation of calcium deposits in tissues, headache, insulin shock, kidney damage or toxicity, lead absorption from the stomach and intestine, metallic taste, narrowing of the lung airways, nausea, Raynaud's phenomenon (a blood flow disorder), skin inflammation and itching, stroke, urine excretion (of calcium, copper, lead, proteins, and zinc), vein inflammation at infusion site, and vomiting.
  • Avoid in people with bleeding disorders or those taking drugs that may increase the risk of bleeding. Avoid in people with heart conditions or those taking agents that improve breathing. Avoid using in root canal therapy, due to possible interference.
  • There is a lack of scientific evidence on the use of chelation during pregnancy or breastfeeding.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Bamonti F, Fulgenzi A, Novembrino C, et al. Metal chelation therapy in rheumathoid arthritis: a case report. Successful management of rheumathoid arthritis by metal chelation therapy. Biometals 2011;24(6):1093-1098.
  2. Baxter AJ and Krenzelok EP. Pediatric fatality secondary to EDTA chelation. Clin.Toxicol.(Phila) 2008;46(10):1083-1084.
  3. Bradberry S and Vale A. A comparison of sodium calcium edetate (edetate calcium disodium) and succimer (DMSA) in the treatment of inorganic lead poisoning. Clin.Toxicol.(Phila) 2009;47(9):841-858.
  4. Chen KH, Lin JL, Lin-Tan DT, et al. Effect of chelation therapy on progressive diabetic nephropathy in patients with type 2 diabetes and high-normal body lead burdens. Am.J.Kidney Dis. 2012;60(4):530-538.
  5. Corradi M, Goldoni M, Sabbadini F, et al. [Acute lead poisoning: a singular case of hemolytic anemia and lead colic]. Med.Lav. 2011;102(3):243-249.
  6. Crinnion WJ. EDTA redistribution of lead and cadmium into the soft tissues in a human with a high lead burden - should DMSA always be used to follow EDTA in such cases? Altern.Med.Rev. 2011;16(2):109-112.
  7. Cristante AF, de Souza FI, Barros Filho TE, et al. Lead poisoning by intradiscal firearm bullet: a case report. Spine (Phila Pa 1976.) 2-15-2010;35(4):E140-E143.
  8. Cristante AF, de Souza FI, Barros Filho TE, et al. Lead poisoning by intradiscal firearm bullet: a case report. Spine (Phila Pa 1976.) 2-15-2010;35(4):E140-E143.
  9. Gil HW, Kang EJ, Lee KH, et al. Effect of glutathione on the cadmium chelation of EDTA in a patient with cadmium intoxication. Hum.Exp.Toxicol. 2011;30(1):79-83.
  10. Lamas GA, Goertz C, Boineau R, et al. Effect of disodium EDTA chelation regimen on cardiovascular events in patients with previous myocardial infarction: the TACT randomized trial. JAMA 3-27-2013;309(12):1241-1250.
  11. Lamas GA, Goertz C, Boineau R, et al. Design of the Trial to Assess Chelation Therapy (TACT). Am.Heart J. 2012;163(1):7-12.
  12. Madureira PR, De Capitani EM, Vieira RJ, et al. Lead poisoning due to gunshot bullet in contact with cerebrospinal fluid: case report. Sao Paulo Med.J. 2009;127(1):52-54.
  13. Mikler J, Banovcin P, Jesenak M, et al. Successful treatment of extreme acute lead intoxication. Toxicol.Ind.Health 2009;25(2):137-140.
  14. Ogata A, Sueta S, and Tagawa M. [Case of lead nephropathy due to chronic occupational lead exposure]. Nihon Jinzo Gakkai Shi 2011;53(2):207-211.
  15. Ogawa M, Nakajima Y, Kubota R, et al. Two cases of acute lead poisoning due to occupational exposure to lead. Clin.Toxicol.(Phila) 2008;46(4):332-335.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.


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