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

Proceedings

Abstract

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.

Keywords

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

Notes

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.

References

  1. 1.
    Schultz ST (2010) Does thimerosal or other mercury exposure increase the risk for autism? Acta Neurobiol Exp 70:187–195Google Scholar
  2. 2.
    Institute of Medicine. Immunization Safety Review Vaccines and Autism. National Academies Press. Washington, D.C. 2004. http://images.nap.edu/openbook/030909237X/gifmid/RI.gif Accessed 15 July 2013
  3. 3.
    Green VA, Pituch KA, Itchon J, Choi A, O’Reilly M, Sigafoos J (2006) Internet survey of treatments used by parents of children with autism. Res Dev Disabil 27:70–84PubMedCrossRefGoogle Scholar
  4. 4.
    Harrington JW, Rosen L, Garnecho A, Patrick PA (2006) Parental perception and use of complementary and alternative medicine practices for children with autistic spectrum disorders in private practice. J Dev Behav Peds 27:S156–S161CrossRefGoogle Scholar
  5. 5.
    Davis TN, O’Reilly M, Kang S, Lang R, Rispoli M, Sigafoos J et al (2013) Chelation treatment for autism spectrum disorders: a systematic review. Res Autism Spect Dis 7:49–55CrossRefGoogle Scholar
  6. 6.
    Stauber JL, Florence TM, Mail P (1989) Manganese in scalp hair: problems of exogenous manganese and implications for manganese monitoring in Groote Eylandt Aboringines. Sci Total Environ 83:85–98PubMedCrossRefGoogle Scholar
  7. 7.
    Buckley RA, Dreosti LI (1984) Radioisotopic studies concerning the efficacy of standard washing procedures for the cleansing of hair before zinc analysis. Am J Clin Nutr 40:840–846PubMedGoogle Scholar
  8. 8.
    Mikasa H, Suzuki Y, Fujii N (1988) Adsorption and elution of metals on hair. Biol Trace Elem Res 16:59–66PubMedCrossRefGoogle Scholar
  9. 9.
    Shannon M, Grace A, Graef J (1989) Use of urinary lead concentration in interpretation of the EDTA mobilization test. Vet Human Toxicol 31:140–142Google Scholar
  10. 10.
    Charlton N, Wallace KL. American College of Medical Toxicology Position Statement on post-chelator challenge urinary metal testing. 2009. http://www.acmt.net/cgi/page.cgi/zine_service.html?aid=2999&zine=show Accessed 17 July 2013
  11. 11.
    Goldman RH, Woolf A. Chelation therapy–guidance for the general public. 2012. http://www.clintox.org/documents/publicinformation/PEHSU_AACTchelationPublicFactsheet2012.pdf Accessed 17 July 2013
  12. 12.
    Brown MJ, Willis T, Omalu B, Leiker R (2006) Deaths resulting from hypocalcemia after administration of edetate disodium: 2003–2005. PEDS 118(2):e534–536CrossRefGoogle Scholar
  13. 13.
    Mitka M (2008) Chelation therapy trials halted. J Am Med Assoc 300:2236CrossRefGoogle Scholar
  14. 14.
    Beauchamp RA, Willis TM, Betz TG, Villanacci J, Leiker RD, Rozin L et al (2006) Deaths associated with hypocalcemia from chelation therapy—Texas, Pennsylvania, and Oregon, 2003-2–5. J Am Med Assoc 295:2131–2133CrossRefGoogle Scholar
  15. 15.
    Baxter AJ, Krenzelok EP (2008) Pediatric fatality secondary to EDTA chelation. Clin Toxicol (Phila) 46(10):1083–1084CrossRefGoogle Scholar
  16. 16.
    Doja A, Roberts W (2006) Immunizations and autism: a review of the literature. Can J Neuro Sci 33:341–346Google Scholar
  17. 17.
    Moel DL, Kumar K (1982) Reversible nephrotoxic reactions to a combined 2,3 dimercapto-1-propanol and calcium disodium ethylenediaminetetraacetic acid regimen in asymptomatic children with elevated blood lead levels. PEDS 70:259–262Google Scholar
  18. 18.
    Stangle DE, Smith DR, Beaudin SA, Strawderman MS, Levitsky DA, Strupp BJ (2007) Succimer chelation improves learning, attention, and arousal regulation in lead-exposed rats, but produces lasting cognitive impairment in the absence of lead exposure. Enviro Health Persp 118:201–209Google Scholar

Copyright information

© 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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