Chelation Therapy

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