Chelation therapy
Chelation therapy | |
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Chelation therapy is a medical procedure that involves the administration of chelating agents to remove heavy metals from the body.[1] Chelation therapy has a long history of use in clinical toxicology[2] and remains in use for some very specific medical treatments, although it is administered under very careful medical supervision due to various inherent risks, including the mobilization of mercury and other metals through the brain and other parts of the body by the use of weak chelating agents that unbind with metals before elimination, exacerbating existing damage.[3] To avoid mobilization, some practitioners of chelation use strong chelators, such as selenium, taken at low doses over a long period of time.
Chelation therapy must be administered with care as it has a number of possible side effects, including death.[4][5] In response to increasing use of chelation therapy as alternative medicine and in circumstances in which the therapy should not be used in conventional medicine, various health organizations have confirmed that medical evidence does not support the effectiveness of chelation therapy for any purpose other than the treatment of heavy metal poisoning.[4] Over-the-counter chelation products are not approved for sale in the United States.[6]
Medical uses
Chelation therapy is the preferred medical treatment for
Chelating agents
There are a variety of common chelating agents with differing affinities for different metals, physical characteristics, and biological
The German Environmental Agency (Umweltbundesamt) listed DMSA and DMPS as the two most useful and safe chelating agents available.[13]
Chelator | Used in |
---|---|
Dimercaprol (British anti-Lewisite; BAL) |
|
Dimercaptosuccinic acid (DMSA)
|
|
Dimercapto-propane sulfonate (DMPS)
|
|
Penicillamine | Mainly in:
Occasionally adjunctive therapy in: |
Ethylenediamine tetraacetic acid (calcium disodium versenate) (CaNa2-EDTA) | |
Deferoxamine, Deferasirox and Deferiprone |
Side effects
When used properly in response to a diagnosis of harm from
History
Chelation therapy can be traced back to the early 1930s, when
Following World War II, chelation therapy was used to treat workers who had painted United States naval vessels with lead-based paints.
In 1973, a group of practicing physicians created the Academy of Medical Preventics (now the American College for Advancement in Medicine).[19] The academy trains and certifies physicians in the safe administration of chelation therapy.[21] Members of the academy continued to use EDTA therapy for the treatment of vascular disease and developed safer administration protocols.[19]
In the 1960s, BAL was modified into
Since the 1970s, iron chelation therapy has been used as an alternative to regular
Calcium-disodium EDTA chelation has been studied by the U.S.
Society and culture
In 1998, the U.S. Federal Trade Commission (FTC) charged that the web site of the American College for Advancement in Medicine (ACAM) and a brochure they published had made false or unsubstantiated claims. In December 1998, the FTC announced that it had secured a consent agreement barring ACAM from making unsubstantiated advertising claims that chelation therapy is effective against atherosclerosis or any other disease of the circulatory system.[25][27]
In August 2005, doctor error led to the death of a five-year-old boy with autism who was undergoing chelation therapy.[3] Others, including a three-year-old nonautistic girl and a nonautistic adult, have died while undergoing chelation therapy.[3] These deaths were due to cardiac arrest caused by hypocalcemia during chelation therapy. In two of the cases hypocalcemia appears to have been caused by the administration of Na2EDTA (disodium EDTA) and in the third case the type of EDTA was unknown.[28][29] Only the three-year-old girl had been found to have an elevated blood lead level and resulting low iron levels and anemia, which is the conventional medical cause for administration of chelation therapy.[30] According to protocol,[31] EDTA should not be used in the treatment of children.[32] More than 30 deaths have been recorded in association with IV-administered disodium EDTA since the 1970s.[3]
Use in alternative medicine
In
Cancer
The American Cancer Society says of chelation therapy: "Available scientific evidence does not support claims that it is effective for treating other conditions such as cancer. Chelation therapy can be toxic and has the potential to cause kidney damage, irregular heartbeat, and even death."[4]
Cardiovascular disease
According to the findings of a 1997 systematic review, EDTA chelation therapy is not effective as a treatment for coronary artery disease and this use is not approved in the United States by the US Food and Drug Administration (FDA).[37]
The American Heart Association stated in 1997 that there is "no scientific evidence to demonstrate any benefit from this form of therapy." The United States Food and Drug Administration (FDA), the National Institutes of Health (NIH) and the American College of Cardiology "all agree with the American Heart Association" that "there have been no adequate, controlled, published scientific studies using currently approved scientific methodology to support this therapy for cardiovascular disease."[37] They speculate that any improvement among heart patients undergoing chelation therapy can be attributed to the placebo effect and generally recommended lifestyle changes such as "quitting smoking, losing weight, eating more fruits and vegetables, avoiding foods high in saturated fats and exercising regularly." They also are concerned that patients could put off proven treatments for heart disease like drugs or surgery.
A systematic review published in 2005 found that controlled scientific studies did not support chelation therapy for heart disease.[38] It found that very small trials and uncontrolled descriptive studies have reported benefits while larger controlled studies have found results no better than placebo.
In 2009, the Montana Board of Medical Examiners issued a position paper concluding that "chelation therapy has no proven efficacy in the treatment of cardiovascular disease, and in some patients could be injurious."[39]
The U.S.
The US
The final results of TACT were published in November 2012. The authors concluded that disodium EDTA chelation "modestly" reduced the risk of adverse cardiovascular outcomes among stable patients with a history of
Autism
See also
- List of ineffective cancer treatments
- Detoxification
References
- ^ ISBN 978-0-12-803072-1.
- ^ "Chelation: Therapy or "Therapy"?". poison.org. National Capital Poison Center. 6 May 2013 [2010]. Retrieved 9 October 2013.
- ^ PMID 18596934.
- ^ a b c "Chelation Therapy". American Cancer Society. 1 November 2008. Archived from the original on 5 July 2010. Retrieved 14 September 2013.
- ^ "Deaths Associated with Hypocalcemia from Chelation Therapy - Texas, Pennsylvania, and Oregon, 2003-2005". www.cdc.gov. Retrieved 2016-10-13.
- ^ a b Food and Drug Administration (FDA) (14 October 2010). "FDA issues warnings to marketers of unapproved 'chelation' products" (Press release). Archived from the original on January 11, 2017.
- PMID 20717537.
- PMID 29737522.
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- ISBN 978-0-12-418688-0, retrieved 2020-12-07
- S2CID 21793727.
- ^ Bridges, Sarah (January 2006). "The promise of chelation". Mothering. No. 134. pp. 54–61.
- S2CID 30922256.
- ^ ISBN 978-0-07-148869-3.
- )
- ^ ABIM Foundation, American College of Medical Toxicology and American Academy of Clinical Toxicology, retrieved 5 December 2013, which cites
- Kosnett, M J (2010). "Chelation for Heavy Metals (Arsenic, Lead, and Mercury): Protective or Perilous?". Clinical Pharmacology & Therapeutics. 88 (3): 412–415. S2CID 28321495.
- Medical Letter consultants (September 20, 2010). "Nonstandard uses of chelation therapy". The Medical Letter on Drugs and Therapeutics. 52 (1347): 75–6. PMID 20847718.
- Food and Drug Administration (14 October 2010). "Consumer Updates - FDA Warns Marketers of Unapproved 'Chelation' Drugs". fda.gov. Retrieved 3 July 2014.
- Kosnett, M J (2010). "Chelation for Heavy Metals (Arsenic, Lead, and Mercury): Protective or Perilous?". Clinical Pharmacology & Therapeutics. 88 (3): 412–415.
- ^ a b c d e "Chemistry in its element: compounds". Royal Society of Chemistry. Retrieved 30 June 2014.
- ^ Heidi Braun Grebe; Philip J. Gregory (2002). "Inhibition of Warfarin Anticoagulation Associated with Chelation Therapy". 22 (8). Pharmacotherapy.
{{cite journal}}
: Cite journal requires|journal=
(help) - ^ PMID 3144646.
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- ^ Ronald L. Hoffman (February 2014). "The facts and fictions of chelation therapy". The Clinical Advisor. Retrieved 30 June 2014.
- ^ PMID 15703449.
- ^ "Treatment & Management: Monitoring Treatment", Hemochromatosis for healthcare professionals, Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, U.S. Dept. of Health and Human Services, 1 November 2007, archived from the original on 2008-02-24, retrieved 29 March 2008
- ^ National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health, U.S. Dept. of Health and Human Services. March 2007. Archived from the originalon 2007-10-15. Retrieved 11 November 2007.
- ^ a b "American College for Advancement in Medicine: Case Timeline" (FTC Case Timeline with links to documents). Federal Trade Commission (FTC). 13 July 1999. Retrieved 1 July 2010.
- ^ "United States of America Federal Trade Commission In the Matter of American College for Advancement in Medicine, a corporation. File no. 962 3147. Agreement Containing Consent Order". Federal Trade Commission. 12 January 1998. Retrieved 1 July 2010. "Attachment A" (Notification letter).
- ^ Federal Trade Commission (8 December 1998). "Medical Association Settles False Advertising Charges Over Promotion of 'Chelation Therapy'" (Press release). Retrieved 17 January 2014.
- S2CID 28656831. Archived from the originalon 2009-07-27. Retrieved 2007-11-13.
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- ^ Van der Schaar, Peter J. (2011). Textbook of Clinical Metal Toxicology (10th ed.). Leende, Netherlands: International Board of Clinical Metal Toxicology.[unreliable medical source?][full citation needed]
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- ^ PMID 18061787.
- ^ "Boy with autism dies during 'chelation therapy'". Behavior News. Behavior Analysis Association of Michigan. 30 August 2005. Archived from the original on 29 November 2016. Retrieved 4 August 2010.
- ^ ABIM Foundation, American College of Medical Toxicology and American Academy of Clinical Toxicology, retrieved 5 December 2013
- ^ PMID 9264515.
- PMID 16262904.
- ^ Montana Board of Medical Examiners (BME) (14 May 2009). "EDTA Chelation for Cardiovascular Disease" (PDF) (BME Position Paper). Business Standard Div., Montana Dept. of Labor and Industry. Archived from the original (PDF) on 2010-02-04.
- ^ a b c Md, Gervasio Lamas (August 2013). "Trial to Assess Chelation Therapy (TACT)". ClinicalTrials.gov (ClinicalTrials.gov identifier NCT00044213). U.S. National Library of Medicine, National Institutes of Health, U.S. Dept. of Health and Human Services.
- National Center for Complementary and Alternative Medicine; National Heart, Lung, and Blood Institute (7 August 2002). "NIH Launches Large Clinical Trial on EDTA Chelation Therapy for Coronary Artery Disease". NIH News (Press release). (NIH). Archived from the original on 28 December 2014. Retrieved 28 December 2008.)
{{cite press release}}
: CS1 maint: multiple names: authors list (link - ^ a b "Government probes chelation-heart disease study". Washington Post. Washington, DC. Associated Press. 2008-09-25. Retrieved 2008-09-26.[dead link]
- Science-Based Medicine. Retrieved December 5, 2014.
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- ^ "Chelation therapy doesn't alter quality of life in heart attack patients". American Heart Association. 4 November 2012. Archived from the original on 9 November 2012. Retrieved 30 November 2012.
- ^ "Why Chelation Therapy Should Be Avoided". Quackwatch. 15 May 2004. Retrieved 7 October 2013.
- ^ .
However, given the significant methodological limitations of these studies, the research reviewed here does not support the use of chelation as a treatment for ASD
- ^ S2CID 206581219.
- ^ "FDA links child deaths to chelation therapy". NBC News / Associated Press. February 3, 2006. Archived from the original on August 30, 2018. Retrieved August 30, 2018.
- ^ "Aspies For Freedom". Aspies For Freedom. Archived from the original on 2010-01-17. Retrieved 24 February 2009.
- ^ Blakeslee, Sandra (19 May 2004). "Panel finds no evidence to tie autism to vaccines". New York Times. Retrieved 2008-02-01.
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