Choosing Wisely:

Don’t recommend chelation except for documented metal intoxication, which has been diagnosed using validated tests in appropriate biological samples.

Rationale and Comments: Chelation does not improve objective outcomes in autism, cardiovascular disease, or neurodegenerative conditions like Alzheimer’s disease. Edetate disodium is not U.S. Food and Drug Administration–approved for any condition. Even when used for appropriately diagnosed metal intoxication, chelating drugs may have significant side effects, including dehydration, hypocalcemia, kidney injury, liver enzyme elevations, hypotension, allergic reactions, and essential mineral deficiencies. Inappropriate chelation, which may cost hundreds to thousands of dollars, risks these harms, as well as neurodevelopmental toxicity, teratogenicity, and death.
Sponsoring Organizations:
  • American Academy of Clinical Toxicology
  • American College of Medical Toxicology
  • Sources:
  • Expert consensus
  • Disciplines:
  • Alternative medicine
  • References: • Nonstandard uses of chelation therapy. Med Lett Drugs Ther. 2010 Sep 20;52(1347):75-6.
    • Kosnett MJ. Chelation for heavy metals (arsenic, lead, and mercury): protective or perilous? Clin Pharmacol Ther. 2010 Sep;88(3):412-5.
    • Nissen SE. Concerns about reliability in the Trial to Assess Chelation Therapy (TACT). JAMA. 2013 Mar 27;309(12):1293-4.
    • Risher JF, Amler SN. Mercury exposure: evaluation and intervention the inappropriate use of chelating agents in the diagnosis and treatment of putative mercury poisoning. Neurotoxicology. 2005 Aug;26(4):691-9.
    • U.S. Food and Drug Administration. FDA warns marketers of unapproved ‘chelation’ drugs. FDA Consumer Health Information. 2010 October;1.

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