Chelation Therapy

In chelation therapy, a biologically based practice Biologically Based Practices Five categories of complementary or alternative medicine are generally recognized: Whole medical systems Mind-body medicine Biologically based practices not usually used in conventional medicine... read more , a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from the bloodstream. In conventional medicine, chelation therapy is a widely accepted way to treat lead and other heavy metal poisoning (see table Guidelines for Chelation Therapy Guidelines for Chelation Therapy ). (See also Overview of Integrative, Complementary, and Alternative Medicine Overview of Integrative, Complementary, and Alternative Medicine Integrative medicine and health (IMH) and complementary and alternative medicine (CAM) include healing approaches and therapies that historically have not been included in conventional, mainstream... read more .)

Heavy metal toxicity, usually due to environmental exposure, may be a risk factor for dementia (1 References In chelation therapy, a biologically based practice, a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from... read more ), cardiovascular disease (2 References In chelation therapy, a biologically based practice, a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from... read more ), and chronic kidney disease (3 References In chelation therapy, a biologically based practice, a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from... read more ).

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 yr of study, researchers have not identified any mechanism to explain how chelation therapy could treat atherosclerosis or prevent heart attacks or strokes.

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) (4 References In chelation therapy, a biologically based practice, a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from... read more ). 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 (5 References In chelation therapy, a biologically based practice, a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from... read more ).

A subsequent systematic review of 38 studies showed possible but unclear benefits of chelation in regard to secondary prevention of recurrent cardiac events (6 References In chelation therapy, a biologically based practice, a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from... read more ).

Risks of chelation therapy include