How does chelation therapy work?

Chelation therapy represents the administration of chelating agents, substances capable of removing heavy metals from the body. In case of lead, arsenic, or mercury poisoning, which are actually the most common forms of heavy metal intoxication, patients are administered dimercaptosuccinic acid (DMSA).

But apart from being used in heavy metal poisoning, chelation agents are also used in alternative medicine. Still, there are no approved data related to the benefits of chelation therapy used in alternative medicine.

How Does Chelation Therapy Work

The basic concept of chelation therapy is the binding of heavy metals and their elimination from the body by feces or urine. These agents create neutral chemical compounds with heavy metals and prevent their accumulation in the body which can be rather disastrous and damaging. Heavy metal poisoning requires prompt administration of a specific chelation agent. If left untreated the patients may even die.

In case of heavy metal is ingested its absorption can be successfully prevented if chelation agents are taken orally. They bound the heavy metal and allow its elimination with feces.

Medical Use of Chelation Therapy

As has been already mentioned, chelation therapy is used in a variety of heavy metal poisonings such as acute mercury, iron, arsenic, lead, uranium, plutonium, and other heavy metal poisonings. These agents can be administered intravenously and intramuscularly or are taken orally which actually depends on the chelation agent and the very type of intoxication.

There are several chelation agents and not all of them are used in the same type of heavy metal poisoning. For example, dimercaprol (BAL) is administered in acute arsenic and mercury poisoning as well as lead poisoning when it is administered together with EDTA.

Furthermore, dimercaptosuccinic acid (DMSA) is given to patients suffering from lead, arsenic, and mercury poisoning. Dimercapto-propane sulfonate (DMPS) is given to patients suffering from severe acute arsenic and mercury poisoning. Penicillamine is basically administered in case of copper poisoning while sometimes it may be given to patients with gold, lead, and arsenic poisoning. Penicillamine is also administered to patients suffering from rheumatoid arthritis.

EDTA (ethylenediamine tetraacetic acid) is a very powerful chelation agent administered in lead poisoning and finally, deferoxamine and deferasirox are used for the treatment of acute iron poisoning and in case of iron overload. Not all of the previously mentioned chelation agents are approved by FDA.

EDTA is an intravenous chelating agent with high affinity to divalent cations (lead, cadmium, and calcium) that may be beneficial in the treatment of cardiovascular disease (CVD). Although a large randomized clinical trial showed benefit, smaller studies were inconsistent. We conducted a systematic review of published studies to examine the effect of repeated EDTA on clinical outcomes in adults with CVD.

We searched 3 databases (MEDLINE, Embase, and Cochrane) from database inception to October 2021 to identify all studies involving EDTA treatment in patients with CVD.
Predetermined outcomes included mortality, disease severity, plasma biomarkers of disease chronicity, and quality of life. Twenty?four studies (4 randomized clinical trials, 15 prospective before/after studies, and 5 retrospective case series) assessed the use of repeated EDTA chelation treatment in patients with preexistent CVD. Of these, 17 studies (1 randomized clinical trial) found improvement in their respective outcomes following EDTA treatment.
The largest improvements were observed in studies with high prevalence of participants with diabetes and/or severe occlusive arterial disease. A meta?analysis conducted with 4 studies reporting ankle?brachial index indicated an improvement of 0.08 (95% CI, 0.06–0.09) from baseline.
Overall, 17 studies suggested improved outcomes, 5 reported no statistically significant effect of treatment, and 2 reported no qualitative benefit. Repeated EDTA for CVD treatment may provide more benefit to patients with diabetes and severe peripheral arterial disease.
Differences across infusion regimens, including dosage, solution components, and number of infusions, limit comparisons across studies.

✓ Fact confirmed: Chelation Therapy in Patients With Cardiovascular Disease: A Systematic Review Filippo Ravalli, Xavier Vela Parada, Francisco Ujueta, Rachel Pinotti, Kevin J. Anstrom, Gervasio A. Lamas and Ana Navas?Acien; 1 Mar 2022

There are several side effects of chelation therapy, and they include headache, deficiency of vitamin B6, nausea, diarrhea and cramps, faintness, fever, fatigue, and joint pain. Some patients may even develop local skin irritation.