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Chelation is a medical procedure that involves the removal of heavy metal toxins in the body and is implanted for children on the autism spectrum “based on a theory that heavy metals such as mercury lead to autism-like symptoms.”77 Specifically, the removal of toxic metals through chelation treatment can increase levels of glutathione, which can be greatly decreased by toxic metals like mercury.35 There are several hypotheses as to why higher levels of mercury are present in the body including exposure from eating fish, coming in contact with quicksilver, through the use of certain skin-lightening creams,78 environmental air pollutants, and even through mercury-based preservatives in certain vaccines.79 Chelation has been used by medical professionals for decades on the elderly and children with lead-poisoning.80 The therapy can be implemented intravenously, through an oral supplement, absorbed through the skin via a cream81 or suppositories.82 The use of chelation therapy raised some safety concerns when the improper use of EDTA (a type of chelation treatment) led to the deaths of 2 children in 2005, but according to a 2006 publication of the Autism Research Review International, the “risks of chelation therapy, properly done, are few.”80 However, in 2010 the FDA warned eight companies that were selling unapproved, over-the-counter chelation products that had not been evaluated by the FDA and were indicated as having “serious safety issues….Even when used under medical supervision, these products can cause serious harm, including dehydration, kidney failure, and death.”83 To date, there are no FDA approved over-the-counter chelation products.83 Parents should exercise caution and should only consider the use of chelation when all other treatment avenues have been exhausted and after consulting multiple medical professionals.
A 2009 systematic review of novel treatments for ASD awarded chelation a grade C, since the method was supported by multiple case studies, but a placebo-controlled study has yet to be conducted.22 The Autism Research Institute (ARI) has collected over 27,000 surveys from parents that rate the effect on behavior of a myriad of different autism treatments. Of the 1,382 parents who have implemented detoxification through chelation, 74% claimed that their child “Got Better”, which is the highest percentage of all listed treatments.21
Despite the strong anecdotal evidence from parents, the research concerning the efficacy and safety of implementing chelation therapy is sparse.84 In 2008, the National Institute of Mental Health (NIMH) terminated a trial of chelation because they felt resources were better directed towards testing the efficacy of other potential therapies and the NIH International Review Board “determined that there was no clear evidence for direct benefit to the children who would participate in the chelation trial and that the study presents more than a minimal risk.”85 A case study of a 67-year-old Italian “affected by neurological symptoms of apparently unknown origin,” was successfully treated after two years of chelation therapy.86 A pilot study of 10 children on the autism spectrum involved the use of a chelator known as thiamine tetrahydrofurfuryl (TTFD), and found that treatment “with TTFD containing suppositories for 60 days improved 8 out of 10 children with symptoms attributed to autistic spectrum disease.”82 Although these preliminary results are promising, the study was hindered by its small sample size and lack of control group.
There is no scientific evidence to solidify chelation therapy as an efficacious and safe treatment for individuals on the autism spectrum disorder. Moreover, the different chelation drugs have possible side effects including irritation of the skin, headaches, fever, stomach cramps, damage to the liver or kidneys87 hepatotoxicity, and anaphylaxis.17
*Parents should consult their physician before implementing any biomedical intervention for their child.