Should chelation therapy be abandoned?

Abstract

The year 2013 marks a new era in understanding the clinical importance of low-level xenobiotic heavy metal intoxication on human disease, and the efficacy and safety of ethylene diamine tetra acetic acid (EDTA) chelation for athero sclerotic disease. It is, therefore, the singular worst moment in over 50 years to consider abandoning this therapy. At present, in the face of emerging data, the use of chelation therapy still remains controversial. The US FDA approves chelation therapy only for the treatment of heavy metal poisoning and toxicity – such toxicity is defined by levels higher than those associated with clinical illness in epidemiological studies. Complementary and alternative medicine practitioners, however, utilize chelation therapy for a wide spectrum of clinical conditions, including cardiovascular diseases. According to the 2009 National Health Statistic Report, approximately 111,000 adult Americans received chelation therapy annually [1]. If an average of ten infusions per patient were received, the out-of-pocket costs might be as high as US$200 million. Yet these are likely bare minimum estimates. The American College of Advancement in Medicine, the leading organization of chelating physicians, estimated that over 500,000 US adults underwent chelation treatments each year, with 800,000 patient visits and significantly higher total out-of-pocket costs [2]. US surveys convincingly demonstrate that, in spite of the controversy over chelation therapy, or perhaps because of it, the use of chelation therapy has increased over the years. There are no clear data that identify which diagnoses – vascular or nonvascular – are being treated. EDTA remains the most commonly utilized and certainly most controversial chelation agent. This compound was synthesized in 1935 and extensively used for lead poisoning after the second world war. The first report that suggested new potential uses of EDTA chelation was published in 1955 by Clarke et al. [3]. While studying medical therapies for lead intoxication, the authors observed that EDTA chelation improved circulation in patients with known Natalia V Solenkova & Gervasio A Lamas* Editorial