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Ethylenediaminetetraacetic acid
Chelation therapy; EDTA
Chelation therapy is a treatment that involves repeated intravenous (IV) administration of a chemical solution of ethylenediaminetetraacetic acid, or EDTA. It is used to treat acute and chronic lead poisoning by pulling toxins (including heavy metals such as lead, cadmium, and mercury) from the bloodstream. The word "chelate" comes from the Greek root chele , which means "to claw." EDTA has a claw-like molecular structure that binds to heavy metals and other toxins.
The U.S. Food and Drug Administration (FDA) approved EDTA chelation therapy as a treatment for lead and heavy metal poisoning. It is also used as an emergency treatment for hypercalcemia (excessive calcium levels) and the control of ventricular arrhythmias (abnormal heart rhythms) associated with digitalis toxicity.
Studies by the National Academy of Sciences/National Research Council in the late 1960s suggested that EDTA might be effective in the treatment of arteriosclerosis (blocked arteries). However, most well-designed studies have found that EDTA is not effective for heart disease. In fact, many medical organizations, including the National Institutes of Health (NIH), the American Medical Association (AMA), the American Heart Association (AHA), and the American College of Cardiology (ACC), have publicly criticized and denounced the practice of EDTA chelation therapy for heart disease.
Proponents of chelation therapy for heart disease claim that EDTA, combined with oral vitamins and minerals, helps dissolve plaques and mineral deposits associated with atherosclerosis (hardening of the arteries). Most reports about using chelation therapy for heart disease have been based on case studies and a few animal studies that may not apply to people. Also, several large-scale clinical trials published in peer-reviewed journals have found that EDTA chelation therapy is no better than placebo in improving symptoms of heart disease. Some medical experts note that theories about why chelation might help treat atherosclerosis depend on an outdated understanding of how heart disease develops. Finally, and probably most importantly, the safety of EDTA chelation therapy for people with heart disease is not known.
Uses
Lead poisoning and heavy metal toxicity
Chelation therapy using EDTA is the medically-accepted treatment for lead poisoning. Injected intravenously and once in the bloodstream, EDTA traps lead and other metals, forming a compound that the body can eliminate in the urine. The process generally takes 1 to 3 hours. Other heavy metal poisonings treated with chelation include mercury, arsenic, aluminum, chromium, cobalt, manganese, nickel, selenium, zinc, tin, and thallium. Chelating agents other than EDTA are also used to clear several of these substances from the bloodstream.
Heavy metal toxicity in humans has been associated with many health conditions, including heart disease, attention deficit/hyperactivity disorder (ADHD), Alzheimer disease, immune system disorders, gastrointestinal disorders (including irritable bowel syndrome, or IBS), and autism.
Digoxin toxicity
EDTA has also been used to treat digoxin toxicity, although most doctors prefer to use other methods. In this case, EDTA helps remove excess levels of digoxin, a medication that is used to treat abnormal rhythms of the heart.
Atherosclerosis
Evidence that EDTA chelation therapy is effective for heart disease is mixed. Proponents believe it may help people with atherosclerosis (hardening of the arteries) or peripheral vascular disease (decreased blood flow to the legs) by clearing clogged arteries and improving blood flow. However, the few studies that show it may help have been poorly designed, making the results questionable.
The theory that EDTA clears clogged arteries and improves blood flow is based on an outdated model about what causes heart disease. Newer theories include the possibility that EDTA functions like an antioxidant, preventing damaging molecules known as free radicals from injuring blood vessel walls and allowing plaque to build up. In fact, studies suggest that EDTA chelation therapy in combination with oral high-dose vitamins and minerals significantly reduced the occurrence of cardiac events compared to placebo. Other studies suggest EDTA chelation reduces further cardiac events among people who have diabetes, who have already had a heart attack.
Dentistry
EDTA is used in dentistry as a chelating agent for smear layer removal from root canal walls.
Available Forms
EDTA is a synthetic chemical and not found naturally. Because there is concern that EDTA may deplete important vitamins and minerals, EDTA chelation therapy is often given with essential nutrients (including calcium, B vitamins, vitamin C, and magnesium).
There are advertisements for oral chelating agents available on the market, some of which contain EDTA. However, they have not been studied in clinical trials. Some manufacturers promote topical EDTA solutions as well. These also lack substantial research. Speak with your physician.
How to Take It
Pediatric
For the treatment of lead poisoning: A doctor may give EDTA intravenously (IV) in a clinic or hospital. The dose depends on the amount of lead in the child's blood, as well as the child's height and weight. Daily treatment for up to 5 days may be required.
Adult
For heavy metal toxicity: EDTA chelation therapy is often given intravenously with calcium, magnesium, and vitamins B and C over a period of 1 to 3 hours. The recommended adult dosage varies depending on the size of the person and the amount of lead or other metal in the body. The amount used would be determined in a hospital setting.
Precautions
The most common side effect is a burning sensation at the site of the injection. In addition, some people may have an allergic reaction to EDTA. Other serious side effects that have been reported include low blood sugar, diminished calcium levels, headache, nausea, dangerously low blood pressure, kidney failure, organ damage, irregular heartbeat, seizures, or even death.
According to the Centers for Disease Control and Prevention (CDC), there have been deaths associated with hypocalcemia (low levels of calcium) from intravenous chelation therapy.
A qualified health care provider will monitor blood pressure, blood glucose, cholesterol, organ function, and other vital statistics during treatment with EDTA. EDTA may lower levels of nutrients such as calcium, zinc, and potassium. Your provider will perform blood tests to monitor vitamin and mineral levels before, during, and after EDTA chelation therapy. Your doctor may recommend supplemental vitamins and minerals, either orally or intravenously.
Possible Interactions
Antibiotics, Cephalosporins: Animal studies suggest that EDTA may increase the absorption of cefmetazole, an antibiotic in a class known as cephalosporins.
Vitamins and minerals: EDTA chelation therapy may decrease levels of certain vitamins and minerals in the body, including vitamin C, magnesium, iron, and calcium.
Warfarin (Coumadin): EDTA has been reported to decrease the effectiveness of Warfarin. Decreasing the effectiveness of Warfarin can increase the risk of infection.
Insulin: EDTA can decrease blood sugar, as does insulin. Together they may dramatically reduce blood sugar levels.
Supporting Research
Ballal NV, Tweeny A, Baumgartner JC, Ginjupalli K, Saraswathin V. Effect of maleic acid and theylenediaminetetraacetic acid on the shear bond strenth of RealSeal SE sealer to root canal dentin. Eur J Prosthodont Restor Dent . 2013;21(4):152-6.
Centers for Disease Control and Prevention (CDC). Deaths associated with hypocalcemia from chelation therapy--Texas, Pennsylvania, and Oregon, 2003-2005. MMWR Morb Mortal Wkly Rep . 2006;55(8):204-7.
Chappell LT. Should EDTA chelation therapy be used instead of long-term clopidogrel plus aspirin to treat patients at risk from drug-eluting stents? Altern Med Rev . 2007 Jun;12(2):152-8. Review.
Escolar E, Lamas GA, Mark DB, et al. The effect of an EDTA-based chelation regimen on patients with diabetes mellitus and prior myocardial infarction in the Trial to Assess Chelation Therapy (TACT). Circ cardiovasc Qual Outcomes . 2014;7(1):15-24.
Evans DAP, Tariq M, Sujata B, McCAnn G, Sobki S. The effects of magnesium sulphate and EDTA in the hypercholesterolaemic rabbit. Diabetes Obesity & Metabolism . 2001;3:417-422.
Knudston ML, Wyse DG, Galbraith PD, et al. Chelation therapy for ischemic heart disease, a randomized controlled trial. JAMA . 2002;287(4):481-486.
Lamas GA, Ackermann A. Clinical evaluation of chelation therapy: Is there any wheat amidst the chaff? [editorial]. Am Heart J . 2000;140(1):4-5.
Lamas GA, Boineau R, Goertz C, et al. EDTA chelation therapy alone and in combination with oral high-dose multivatamins and minerals for coronary disease: The factorial group results of the Trial to Assess Chelation Therapy. Am Heart J . 2014;168(1):37-44.e5.
Lin MC, Nahin R, Gershwin ME, Longhurst JC, Wu KK. State of complementary and alternative medicine in cardiovascular, lung, and blood research: executive summary of a workshop. Circulation . 2001;103(16):2038-2041.
Pajak B. Ethylenediaminetetraacetic acid affects subcellular expression of clusterin protein in human colon adenocarcinoma COLO 205 cell line. Anticancer Drugs . 2007;18(1):55-63.
Pitoni C, Figueiredo M, Araujo F, Souza M. Ethylenediaminetetraacetic acid and citric acid solutions for smear layer removal in primary tooth root canals. J Dent Child (Chic) . 2011;78(3):131-7.
Poudyal S, Wei-Hong P. Effect of ethylenediaminetetraacetic Acid (EDTA) gel on removing smear layer of root canal in vitro. Chin Med Sci J . 2012;27(3):190-1.
Rakel. Integrative Medicine . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012.
Roussel AM, Hininger-Favier I, Waters RS, Osman M, Fernholz K, Anderson RA. EDTA chelation therapy, without added vitamin C, decreases oxidative DNA damage and lipid peroxidation. Altern Med Rev . 2009 Mar;14(1):56-61.
Seely DM, Wu P, Mills EJ. EDTA chelation therapy for cardiovascular disease: a systematic review. BMC Cardiovasc Disord . 2005;5:32.
Shrihari JS, Roy A, Prabhakaran D, Reddy KS. Role of EDTA chelation therapy in cardiovascular diseases. Natl Med J India . 2006;19(1):24-6.
Sinha Y, Silove N, Williams K. Chelation therapy and autism. BMJ . 2006;333(7571):756.
Soleimani M. Comparison of natural humic substances and synthetic ethylenediaminetetraacetic acid and nitrilotriacetic acid as washing agents of a heavy metal-polluted soil. J Environ Qual . 2010;39(3):855-62.
Review Date: 8/5/2015
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M Editorial team.
