Chelation Therapy benefit and risks, Do EDTA and DMSA work? by Ray Sahelian, M.D.
March 20 2014

Chelation therapy is being promoted as a form of alternative medicine in the treatment of atherosclerotic cardiovascular disease. It has been recommended as a safe, relatively inexpensive and non-surgical method of restoring blood flow in atherosclerotic vessels. The benefit of chelation therapy remains controversial at best. At present there is insufficient evidence to decide on its effectiveness or ineffectiveness in improving clinical outcomes of patients with atherosclerotic cardiovascular disease. This decision must be preceded by conducting randomized controlled trials that would include endpoints that show the effects of chelation therapy on longevity and quality of life among patients with clogged heart arteries.

Heart Disease
I prefer using more proven and simpler approach to reducing the risk of heart disease and atherosclerosis.
   Removing metals from the body through chelation treatment has little effect on the long-term health of people who've previously suffered a heart attack. No benefit was found in how many of 1,708 participants died in the four years after they received either so-called chelation therapy or drug-free placebo infusions, and only a small decline in the proportion that needed stents or other heart procedures following chelation. Journal of American Medical Association, online March 26, 2013.

EDTA and DMSA benefits and risks
Since heavy metals are now present in higher amounts in certain fish such as tuna steaks, manypeople are concerned about heavy metal exposure. Over-the-counter chelation agents are promoted as a way to bind heavy metals and flush them out of the body. Chelation products are available several ways, including DMSA (dimercaptosuccinic acid) and EDTA (ethylene diamine tetra-acetic acid). DMSA and EDTA are traditional medications. A prescription version of DMSA -- brand name Chemet -- is used (rarely) to treat severe overdoses of lead. Some poisoning centers treat metal poisoning by giving EDTA through an IV. EDTA is not absorbed well when ingested as a supplement. DMSA is also sold over the counter as oral pills. So is EDTA. But there may be a risk to using these chelation products. DMSA and EDTA may bind to many types of metals including iron, calcium and manganese along with mercury and lead. Chelation agents may also harm the liver.

Q. Please give me your opinion on the benefits and risks of DMPS IV chelation. I have a mouthful of amalgams but no symptoms of mercury poisoning.
   A. I am not a big proponent of this treatment at this time unless absolutely necessary.

Oral chelation
Prevention of cardiac mortality is the most important beneficial effect of iron chelation therapy. Unfortunately, compliance with the rigorous requirements of daily subcutaneous deferoxamine (DFO) infusions is still a serious limiting factor in treatment success. The development of orally effective iron chelators such as deferiprone and ICL670 is intended to improve compliance. Although total iron excretion with deferiprone is somewhat less than with DFO, deferiprone may have a better cardioprotective effect than DFO due to deferiprone's ability to penetrate cell membranes. Recent clinical studies indicate that oral ICL670 treatment is well tolerated and is as effective as parenteral DFO used at the standard dose of 40 mg/kg of body weight/day.

Chelation treatment - Heavy metal chelation
Human exposure to a number of metals such as lead, cadmium, mercury, manganese, aluminum, iron, copper, thallium, arsenic, chromium, nickel and platinum may lead to toxic effects, which are different for each metal. Similarly the pharmacokinetic data, clinical use and adverse effects of most of the chelating drugs used in human metal poisoning are also different for each chelating drug. The chelating drugs with worldwide application are dimercaprol (BAL), succimer (meso-DMSA), unithiol (DMPS), D-penicillamine (DPA), N-acetyl-D-penicillamine (NAPA), calcium disodium ethylenediaminetetraacetate (CaNa(2)EDTA), calcium trisodium or zinc trisodium diethylenetriaminepentaacetate (CaNa(3)DTPA, ZnNa(3)DTPA), deferoxamine (DFO), deferiprone (L1), triethylenetetraamine (trientine), N-Acetyl-L-Cysteine (NAC), and Prussian blue (PB). Several new synthetic homologues and experimental chelating agents have been designed and tested in vivo for their metal binding effects. These include three groups of synthetic chelators, namely the polyaminopolycarboxylic acids (EDTA and DTPA), the derivatives of BAL (DMPS, DMSA and mono- and dialkylesters of DMSA) and the carbodithioates. Many factors have been shown to affect the efficacy of the chelation treatment in metal poisoning.

Emails
Please advise as to what your opinion is on chelation drip therapy? Will it lower blood pressure? I met you many years ago and you were not in favor of it then and actually compared it to a Drano flush of the veins. I have high blood pressure and medication has not helped. I have been on Calcium channel blockers, Diovan and Lopressor, all with very poor results, out break of hives, overall sluggishness, feeling bad. What is a good way to reduce BP?.
   I have not studied chelation therapy enough to have a strong opinion about it.

I have read about chelation therapy and how good it is for you. But it is expensive and you have to do it for several weeks. I have also read  about a pill form that can be taken in place of the other. Can you give me any information on this, how well it works-if it does work, which if any would be a good one to try and where it could be ordered.
   There is not enough research with oral chelation pills to make any good recommendations.

A recent heart calcium screening detected build up of plaque. Results LMA.O : LAD.89 : LCX. 56 : RCA.91 : PDA. 0 total score 236. I have been taking 400 mg SAM-e for Mood for several years and have just learned of the importance of lowering homocystine levels. I have been taking a multi vitamin which includes the B vitamins and folic acid but probably not enough and plan to supplement with a higher dose of same. I also have been on a 5mg dose of Crestor for the past 2 years. My question has to do with the plaque build up could the SAM-e and possible homocystine build up be part of the Calcium plaque build up. Also what do you advise for trying to break down this Calcium build up. Will the higher dose of B complex and folic acid help or do the just help. And what can you tell me of cChelation treatment and will it help in eliminating the calcium plaque build up?
    There is not enough research with SAM-e long term use to determine whether it plays a role in plaque build up, positive or negative.