Journal of Medical Toxicology

, Volume 9, Issue 4, pp 370–372 | Cite as

Commentary on the Abuse of Metal Chelation Therapy in Patients with Autism Spectrum Disorders



Approximately half a million patients with autism spectrum disorders are subjected to chelation therapy in the US annually. The overwhelming majority of such cases are chelated for non-accepted medical indications. These patients may seek evaluation when a urine sample is assayed after the administration of a chelating agent and the values obtained have been improperly compared to references ranges for non-chelated urines, causing falsely elevated results. Legitimate practitioners confronted with such data must decide, preferably in consultation with the patient or their guardian(s), whether to do further testing using legitimate methodology or to simply dismiss the results of the improper testing. Bayesian principles tell us that further testing is likely to yield results within normal reference ranges. However, under some circumstances, it is useful to do such testing in order to demonstrate that there is no need for chelation therapy. Unnecessary chelation therapy is expensive, can cause significant acute adverse effects, and may be associated with long-term consequences.


Autism spectrum disorder Chelation therapy Mercury Metal toxicity Elevated body burden of metal 


ATSDR Disclaimer

This publication was supported by the cooperative agreement award number 1U61TS000117-04 from the Agency for Toxic Substances and Disease Registry (ATSDR). Its contents are the responsibility of the authors and do not necessarily represent the official views of the Agency for Toxic Substances and Disease Registry (ATSDR).

Conflict delineations

For the work under consideration for publication, Dr. Brent received an honorarium and reimbursement for travel through the ACMT/ATSDR Cooperative Agreement. Relevant financial activities outside the submitted work: Dr. Brent has been a consultant to the US National Vaccine program and was a witness, on behalf of the US Government, in the National Omnibus Vaccine Hearings.


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© American College of Medical Toxicology 2013

Authors and Affiliations

  1. 1.University of Colorado School of Medicine and, Colorado School of Public HealthDenverUSA

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