Chelation - A Dangerous approach
::: {.callout-caution} Chelation is not recommended for autism. It can have dangerous side effects. :::
What is chelation?
In chelation, the aim is to administer medications (chelators) that bind with metals in the body and remove it from the system via urine when the medicine itself is excreted. This has been useful to treat heavy metal toxicity. Most commonly used medications are dimercaptosuccinic acid (DMSA) or ethylenediaminetetraacetic acid (EDTA). This treatment is typically administered intravenously or orally under medical supervision following a detailed baseline assessment of metal content in the system, usually with a urine test.
History of chelation
Chelation process dates back to 1935 when it was used as binding and extracting agent of calcium in the dyeing industry. The use of Chelation therapy in humans started between the 1950s and 1960s when it was used in patients with hypercalcemia and lead poisoning, consequently showing improvements in their cardiovascular condition. Since then it has been established as an effective treatment for lead poisoning or any heavy metal toxicity for that matter and as anticoagulants. Between 2002 and 2007, despite several warnings and prohibitions by the FDA (Food and Drug Administration), chelation gained popularity in the U.S. for treating heart conditions and other health issues.
However, due to its intensity and potential harmful side effects, it is strictly administered under medical supervision. In 1989, a "Protocol for the Safe and Effective Administration of EDTA" was established and later updated. This comprehensive protocol establishes strict criteria for patient selection and urges clinicians to conduct an initial assessment of renal function using the Cockcroft-Gault equation. It further emphasizes the continuous monitoring of renal function throughout a series of chelation treatments. Additionally, emergency procedures are outlined in case of adverse reactions during the process.
Why was Chelation tried for autism?
It gained attention in the context of autism due to concerns about heavy metal toxicity in the systems of individuals in the spectrum, but scientific research hasn't supported the theory that autism is caused by heavy metal toxicity. Some studies have suggested that children with autism may have higher levels of certain heavy metals in their systems, but the direct cause between heavy metal exposure and autism has not been established. One hypothesis that autism is caused due to exposure to heavy metals (mercury) through vaccines has been studied thoroughly and research suggests no causal link between vaccines and autism. Other theories of autism being caused due to intrauterine or environmental exposure to heavy metals is still under study and there is no established link as of now.
On the other hand, scientific research investigating the effectiveness of chelation therapy for autism remains limited and inconclusive. Clinical trials investigating the impact of chelation on autism symptoms have shown mixed or inconclusive results, and many of these studies have methodological limitations.
Caution
Chelation therapy can be risky and has the potential for serious side effects such as hypocalcaemia (level of calcium in blood is too low), renal impairment and reported deaths. The presence of certain metals like calcium, copper, iron, magnesium, manganese, molybdenum, chromium, potassium, sodium, and zinc is essential to facilitate normal biological functioning of the human body. It is a cause for concern if there are lower or higher levels of these metals than what is required. It necessitates meticulous and supervised administration of medications to avoid excessive removal of metals. Medical organizations do not recommend chelation therapy for autism due to safety concerns.
Some researchers also suggest that due to the greater risks associated with chelation compared to its efficacy as a treatment for autism, it is advisable to first establish a definitive causal link between heavy metals and autism. This approach emphasizes the need to first validate the relationship between heavy metal exposure and autism before further studying on chelation as a treatment.
Therefore, it is crucial for anyone, whether medical professionals or families, considering chelation therapy to conduct a thorough baseline assessment and cost-benefit analysis of the treatment before proceeding with it. There is no medical organization that is in favor of using chelation therapy for autism.