Chelation Therapy

ByDenise Millstine, MD, Mayo Clinic
Reviewed/Revised Dec 2023
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In chelation therapy, a biologically based practiceGuidelines for Chelation Therapy). (See also Overview of Integrative, Complementary, and Alternative Medicine.)

Heavy metal toxicity, usually due to environmental exposure, may be a risk factor for dementia (1), cardiovascular disease (2), and chronic kidney disease (3).

Chelation therapy with EDTA (ethylene diamine tetraacetic acid) has also been suggested as a way to remove calcium and thus treat atherosclerosis. However, despite > 50 years of study, researchers have not identified any mechanism to explain how chelation therapy could treat atherosclerosis or prevent heart attacks or strokes (4).

In 2012, a large randomized, placebo-controlled trial of chelation (the Trial to Assess Chelation Therapy [TACT]) found a significant benefit for chelation over placebo for composite outcomes (26.5% versus 30% for placebo), but not for individual outcomes (eg, death, cardiovascular events, stroke, hospitalizations) (5). This study had methodological flaws and did not end the controversy over chelation therapy; however, a post-hoc review of the data showed a significant reduction in the composite endpoint in patients with diabetes and peripheral artery disease in the chelation group compared to the control group, as well as a reduction in mortality (6).

A subsequent systematic review of 38 studies showed possible but unclear benefits of chelation in regard to secondary prevention of recurrent cardiac events (7).

Risks of chelation therapy include

  • Hypocalcemia (which is potentially serious)

  • Infusion site reaction, fever, nausea, vomiting

  • Kidney damage

  • Delay of more effective treatment

  • Death

References

  1. 1. Killin LO, Starr JM, Shiue IJ, et al: Environmental risk factors for dementia: a systematic review. BMC Geriatr 16(1):175, 2016. doi: 10.1186/s12877-016-0342-y

  2. 2. Chowdhury R, Ramond A, O'Keeffe LM, et al: Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis. BMJ 362:k3310, 2018. doi: 10.1136/bmj.k3310

  3. 3. Farkhondeh T, Naseri K, Esform A, et al: Drinking water heavy metal toxicity and chronic kidney diseases: a systematic review. Rev Environ Health. 2020 Nov 2:/j/reveh.ahead-of-print/reveh-2020-0110/reveh-2020-0110.xml. doi: 10.1515/reveh-2020-0110

  4. 4. Seely DM, Wu P, Mills EJ: EDTA chelation therapy for cardiovascular disease: a systematic review. BMC Cardiovasc Disord 5:32, 2005. Published 2005 Nov 1. doi:10.1186/1471-2261-5-32

  5. 5. 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. 309(12):1241–50, 2013. doi: 10.1001/jama.2013.2107

  6. 6. Ujueta F, Arenas IA, Escolar E, et al: The effect of EDTA-based chelation on patients with diabetes and peripheral artery disease in the Trial to Assess Chelation Therapy (TACT). J Diabetes Complications 33(7):490-494, 2019. doi: 10.1016/j.jdiacomp.2019.04.005

  7. 7. Ibad A, Khalid R, Thompson PD, et al: Chelation therapy in the treatment of cardiovascular diseases. J Clin Lipidol 10(1):58-62, 2016. doi: 10.1016/j.jacl.2015.09.005

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