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Over-the-counter chelation agents are unproven, risky

Rating

5 Star

Over-the-counter chelation agents are unproven, risky

Our Review Summary

This is a well-written piece about over-the-counter chelation therapies.  The writer does a nice job of making it clear that there are true medical indications for chelation therapy – to treat severe cases of heavy metal (lead, mercury) poisoning. This is distinguished from chelation therapies taken OTC as a supplement, in the absence of any finding of toxic levels of heavy metals. 

Heavy metal poisoning is rare and is most commonly treated with IV chelators under supervision of a doctor specializing in treatment for poisoning.  Despite this, over-the-counter chelation therapy in the form of pills are being marketed to eliminate heavy metals from the blood by making the claim that this can treat many illnesses including heart disease, cancer, autism amd others.  These claims are classic cases of disease mongering. Consensus from notable medical and science agencies including the FDA, the American Medical Association, and American Heart Association, is that there is no evidence supporting benefits of chelation therapy and that there are some significant risks. 

This story addresses the unsubstantiated claims made for the benefits of chelation therapy through comments made by (somewhat) independent experts.

Overall, a good job, as we’ve noted with several of these "Healthy Skeptic" columns in the Los Angeles Times. 

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

Cost of treatment from several sources was researched and is accurately presented.  A month supply of pills costs between $20 and $60 depending upon the manufacturer and the other compounds that are included in the formulation. 

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

This story does distinguish the benefits claimed by the manufacturers, that chelation therapy can help treat autism, blood clotting problems, and vascular disease, from the one benefit that can be credibly documented: treatment of severe heavy metal poisoning.  It cites a randomized controlled trial published in the journal Pediatrics that showed no benefit of IV chelation treatment with EDTA on cognitive or behavior among children with high levels of lead in their bloodstream.  However, this information is provided by an expert that is potentially biased by the fact that she has an autistic child and is troubled by the claims that chelation can treat autism.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

This story uses comments from an independent expert to provide some limited information on risk.  These harms include washing out important metals such as iron, calcium, and magnesium along with the toxic heavy metals, and liver toxicity.  Chelation therapy is described as "too risky to use without close guidance from a physician" and that it is only used in the "most dire cases of metal poisoning".  However, important information that should have been included is the risk of permanent kidney damage, bone damage, irregular heart beat, and death.

Does the story seem to grasp the quality of the evidence?

Satisfactory

This story indicates that chelation agents are mainstream medications to treat heavy metal poisoning, but it could have gone further in discussing other alternative uses that are not supported by sound science.  This article could have been better researched to provide the reader with some of the following background information. 

Chelation therapy is also promoted as an alternative treatment for heart disease (clearing clogged arteries) and cancer and for many other unrelated conditions including arthritis, diabetes, and multiple schlerosis, to name a few.  In 1998, the Federal Trade Commission charged the American College of Advance in Medicine, the principal group promoting chelation therapy with false advertising about the benefits of treatment.   The lack of scientific evidence has prompted major medical and scientific groups, including the FDA, the American Medical Association, American Heart Association, and the National Institutes of Health, to speak out about against this treatment.  Currently, the National Center for Complementary and Alternative Medicine and the National Heart, Lung and Blood Institutes are conducting a rigorous (large scale, multi-site, placebo controlled, double-blind) randomized controlled trial to examine whether chelation therapy is safe and effective in people with coronary heart disease.  For more information see www.nccam.nih.gov/chelation/.

 

 

Does the story commit disease-mongering?

Satisfactory

The manufacturers of these chelation agents are clearly engaged in disease mongering and ignore accepted medical uses of these products and risks ofthese prdcuts.  This article confronts disease mongering subtly in the choice of words used to decribe the products and their health claims.  For example, "you might be tempted to try one of the many over-the counter chelation agents that promise…", "Chelation products come in many guises…" and "…illnesses that supposedly…", provide background to the facts presented later in the article that dispute these claims.  The article’s headkube, "Over-the-counter chelation agents are uNPRoven, risky", is on point. 

Does the story use independent sources and identify conflicts of interest?

Satisfactory

This article did interview different independent sources, but it could have provided information on chelation therapy from a reputable source such as the National Center for Complimentary and Alternative Medicine. 

Does the story compare the new approach with existing alternatives?

Not Applicable

We rule this one not applicable because there’s no need to talk about treatment options for conditions that don’t really require treatment. This story could have have made a direct statement saying the potential treatment options are really not needed (see Disease Mongering).  High levels of lead in the blood are no longer common for most Americans due to regulations limiting lead in paint and gasoline.  The story points out that while levels of mercury in the blood are increasing, toxic levels are very rare.  The story could have been strengthened by explicity stating that there is no need for or health benefits from chelation therapy.  People concerned about excessive mercury from the diet, mainly from fish such as shark, tuna, swordfish, and orange roughy, can rest assured that eating one serving a week will benefit their health without raising mercury in the blood stream to unsafe levels. 

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

Chelation agents in pill form, DMSA and EDTA, are available over-the-counter in many health food stores and via websites, as indicated in this article.  Brief mention is made of the fact that chelation therapy is most often given by IV in medical settings to treat heavy metal poisoning. 

Does the story establish the true novelty of the approach?

Satisfactory

This story accurately presents chelation agents as mainstream.  Chelation therapy has been used for decades.  The FDA approved the use of DMSA, one of the two oral chelators mentioned in this story in 1991, for the use in children with high levels of lead in their blood.

Does the story appear to rely solely or largely on a news release?

Satisfactory

There is no evidence that this story relied on a news release.

Total Score: 8 of 9 Satisfactory

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