I was recently asked to respond to a question on Quora regarding autism and chelation. The responses that had been provided to the question were combative to say the least, and that, along with the fact that we frequently receive calls at our practice from individuals asking whether or not we offer chelation therapy, compelled me to write a more detailed response based on scientific evidence and my professional experience.
The question that sparked so much debate pertained to the effectiveness of heavy metal chelation in cases of autism. As I mentioned, our front desk frequently takes calls from people inquiring about chelation. Just two weeks ago, we had two inquirers call within 30 minutes of each other seeking chelation therapy on behalf of loved ones.
It’s not surprising that we receive calls regarding chelation so frequently. Parents with children who have been diagnosed with autism spectrum disorders love their kids and are desperately searching for a viable solution, a promising therapy, that has the potential to help their child. Before making a decision to put your child through chelation, however, it’s important to educate yourself and make sure that you understand the unbiased facts.
Before making a decision to put your child through chelation, however, it’s important to educate yourself and make sure that you understand the unbiased facts.
As a part of what’s known in the medical field as “informed consent,” all doctors should provide you with the potential benefits and drawbacks/risks of any proposed therapy or procedure so that you can make an educated decision. As may have been your experience, however, visits are sometimes rushed with various practitioners and some of this information gets lost in the shuffle. That being said, here is what we know about chelation and, more specifically, chelation within the context of autism.
What Exactly is Chelation Anyway?
Chelation is a process through which a chelating agent such as EDTA (ethylene diamine tetra-acetic acid) or DMSA (Dimercaptosuccinic acid, also known as succimer or succimic acid) is administered, most commonly via IV or taken by mouth, in an attempt to remove heavy metals from the body. Chelating agents bind to the metals and remove them from the body through the urine and/or bile.
Why all the Controversy?
Chelation is generally an accepted treatment for heavy metal poisoning, but its use for removing metals that are found in the body at less-than-toxic levels or for any other reason, is hotly disputed. This is because, while chelating agents do attach to heavy metals in the body, some also strongly bind to minerals and amino acids such as calcium, iron, copper, and cysteine and remove them from the body as well. When calcium is removed from the body by a chelating agent, blood calcium levels fall outside of the normal range. This unwanted effect of chelation has led to death in a few cases.
Although the chelating agent used in one case is inconclusive, the agent that appears to be responsible for the remaining deaths is disodium EDTA. DMSA binds calcium as well, but not as strongly as disodium EDTA and the administration of calcium EDTA does not appear to have the same effect as disodium EDTA as it tends to result in higher blood calcium levels, not decreased levels.
Although the chelating agent used in one case is inconclusive, the agent that appears to be responsible for the remaining deaths is disodium EDTA.
EDTA chelates metals from the bones while DMSA chelates metals from soft tissue. In some individuals with high metal levels, EDTA has been found to successfully remove metals like lead and cadmium from the bones, but has led to these toxic metals being deposited in the soft tissue. Because of this phenomenon, chelation with EDTA alone may not always be the appropriate route for treatment.
Chelation and Autism
Studies indicate that the severity of symptoms in children with autism correlates directly with the level of toxic metal body burden, specifically lead, mercury, aluminum, antimony, and tin. In other words, the higher the levels of these metals present in the body, the more severe the symptoms tend to be and the lower the levels of glutathione (a potent antioxidant in the body) in the red blood cells.
DMSA is an oral chelating agent that is FDA-approved for treating lead toxicity in children. Studies indicate that chelation of metals using oral DMSA may be helpful in improving certain behaviors in autistic children. This improvement, however, is only seen if the metal burden was at toxic levels to begin with. In fact, one study showed that oral chelation with DMSA helped improve learning, attention, and alertness in lead-exposed rats (only somewhat in those with severe lead exposure and more significantly in rats with moderate lead exposure). However, when the DMSA was administered to rats that did not have toxic levels of metals in their bodies, the result was that their mental functions and moods/affects were permanently negatively affected.
Furthermore, absorption of orally-administered DMSA may be limited by the person’s gut bacteria. Because many children with autism have abnormal gut bacteria and other flora, some research suggests that oral DMSA may not be as effective at chelating metals from their bodies as would be the case in a child with healthy, normal gut flora.
Wrapping it All Up
If you skipped to the end, here’s the summary: Because heavy metal burden is positively associated with increased severity of symptoms in autism, chelation is used by some practitioners in an effort to clear heavy metals from the body more quickly. Chelation, however, can be dangerous and can even lead to death, particularly if used inappropriately. Studies suggest that chelation may be of benefit to children with actual toxic levels of heavy metals in their body, but if chelation therapy is undergone by individuals who do not have toxic levels of metals in their bodies, there may be lasting negative mental and emotional consequences.
In my private practice, I choose not to utilize chelation as a therapy. Instead, I utilize a variety of safe, effective, evidence-based methods to reduce absorption and re-absorption of toxic metals and to support and enhance the body’s own natural “detoxification,” anti-oxidation, and chelation pathways.