Some Questions on Chelation

[jcampos]

I was quite interested in the most recent video on "How To Detox Heavy Metals" since I have been dealing with some of the symptoms Leo mentioned. Given that I think the topic is important and the protocol is quite intensive, I began doing some preliminary research which raised questions that I would like to mention here for discussion.

Caveat: I haven't done extensive research.

1. Inadequacy of provoked urine tests

I came across this video: https://nutritionfacts.org/video/heavy-metal-urine-testing-and-chelation-for-autism/, which cites these two papers on provoked urine tests: https://pubmed.ncbi.nlm.nih.gov/24113861/, https://www.mdpi.com/2305-6304/2/3/403, and https://pubmed.ncbi.nlm.nih.gov/20354920/.

In summary, the articles state that the reference ranges in provoked (post-chelation) urine tests are inadequate because they were made for non-provoked tests. Naturally, if you take DMSA you'll have higher values of heavy metals in your urine, so showing the reference ranges for non-provoked tests is misleading. In fact, there seems to be no standardization for provoked tests. In the bottom of Leo's test (2:05:07), one can read: "Reference intervals and corresponding reference values are representative of a healthy population under non-provoked reference conditions. Chelation (provocation) agents can increase urinary excretion of metals/elements."

So, this makes me skeptical that provoked tests are be the most reliable way of testing for heavy metals (as said by Leo). The "American College of Medical Toxicology" even issued a statement stating their position against the use of such tests (second article above).

Note that I am not stating that it is ok to excrete any quantity of heavy metals --- I haven't researched this enough.

2. Study on children with autism

Leo cites this study (Safety and efficacy of oral DMSA therapy for children): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774660/. There was a 2013 review on chelation for Autism, which thoroughly analysed the study Leo cites  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457964/). They mention:

"Quality of the evidence

The quality of the evidence is poor. Only one trial was included in this review, and we judged it to have high or uncertain risk of bias and methodological problems that limited the interpretation of outcomes presented. Of particular concern are the trialists’ questionable data analytical approach and interpretation of findings. It is interesting that trialists found differential directions of heavy metal excretion and change in ASD indices, yet they attempted to convince the reader not to read too much into these differences. Given the deleterious effects of chelation, misinterpretation and misuse of the study of Adams et al to justify the use of chelation for ASD is unethical and potentially places children unnecessarily in harm’s way. Moreover, if these findings are in fact valid, they actually undermine the heavy metal toxicity theory and the rationale for chelation treatment, suggesting that it should not be used in the first place.

The inclusion of only one study, which had a relatively small sample size and a high likelihood of carry‐over effects and other biases, precludes confidence in the findings. Further well‐designed studies from multiple locations and using larger numbers of participants are needed to better ascertain the effects of chelation for ASD.

Implications for practice

This review found no high‐quality evidence to suggest that chelation is an effective treatment for improving ASD symptoms. Cochrane reviews typically avoid making recommendations for practice; however, given that harm resulting from the use of chelation therapy has been reported, and that no proven benefits have been found, it seems reasonable to conclude that use of chelation for the treatment of individuals with ASD symptoms should not be recommended.

Key results

Currently no clinical trial evidence suggests that pharmaceutical chelation is an effective intervention for ASD. Given prior reports of serious adverse events, such as changes to calcium levels in blood, kidney impairment and reported death, risks of using pharmaceutical chelating agents for ASD currently outweigh proven benefits."

 

Edited December 17, 2021 by jcampos

[Leo Gura]

1 hour ago, jcampos said:

In summary, the articles state that the reference ranges in provoked (post-chelation) urine tests are inadequate because they were made for non-provoked tests. Naturally, if you take DMSA you'll have higher values of heavy metals in your urine, so showing the reference ranges for non-provoked tests is misleading. In fact, there seems to be no standardization for provoked tests. In the bottom of Leo's test (2:05:07), one can read: "Reference intervals and corresponding reference values are representative of a healthy population under non-provoked reference conditions. Chelation (provocation) agents can increase urinary excretion of metals/elements."

So, this makes me skeptical that provoked tests are be the most reliable way of testing for heavy metals (as said by Leo). The "American College of Medical Toxicology" even issued a statement stating their position against the use of such tests (second article above).

This criticism is itself misleading because it foolishly assumes that pissing out heavy metals is healthy.

No one said to trust the reference ranges. Urine tests do not show your total toxic load. All they show is that you are pissing out high levels of metals. Which shows you that chelation is working.

All the reference ranges will be misleading because our environment and food supply is full of heavy metals. So even the "normal" ranges are not really normal or healthy.

Quote

2. Study on children with autism

Leo cites this study (Safety and efficacy of oral DMSA therapy for children): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774660/. There was a 2013 review on chelation for Autism, which thoroughly analysed the study Leo cites  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457964/). They mention:

"Quality of the evidence

The quality of the evidence is poor. Only one trial was included in this review, and we judged it to have high or uncertain risk of bias and methodological problems that limited the interpretation of outcomes presented. Of particular concern are the trialists’ questionable data analytical approach and interpretation of findings. It is interesting that trialists found differential directions of heavy metal excretion and change in ASD indices, yet they attempted to convince the reader not to read too much into these differences. Given the deleterious effects of chelation, misinterpretation and misuse of the study of Adams et al to justify the use of chelation for ASD is unethical and potentially places children unnecessarily in harm’s way. Moreover, if these findings are in fact valid, they actually undermine the heavy metal toxicity theory and the rationale for chelation treatment, suggesting that it should not be used in the first place.

The inclusion of only one study, which had a relatively small sample size and a high likelihood of carry‐over effects and other biases, precludes confidence in the findings. Further well‐designed studies from multiple locations and using larger numbers of participants are needed to better ascertain the effects of chelation for ASD.

That study was not cited as proof that chelation will cure autism. That study was cited to show that DMSA is even safe for children to take.

I said that I knew a doctor who had a lot of success with autistic kids and chelation. This is not a scientific study. This is the experience of his practice.

Curing autism is cutting edge science so you should not expect any clear-cut studies here.

The problem is you turn to science for clear answers but if science had clear answers on this matter then you wouldn't be sick in the first place and we wouldn't be talking about this.

[jcampos]

Thanks for replying, Leo.

24 minutes ago, Leo Gura said:

This criticism is itself misleading because it foolishly assumes that pissing out heavy metals is healthy.

No one said to trust the reference ranges. Urine tests do not show your total toxic load. All they show is that you are pissing out high levels of metals. Which shows you that chelation is working.

All the reference ranges will be misleading because our environment and food supply is full of heavy metals. So even the "normal" ranges are not really normal or healthy.

That's why I mentioned "Note that I am not stating that it is ok to excrete any quantity of heavy metals". I didn't mean to say that it was ok to excreet heavy metals, just that the reference values were meaningless and that there is no standardization in place for provoked urine tests.

The point is that you referred to this test as a way to check whether you need to do chelation or not. So the question still stands: Given the values, how do we actually determine if we need to do chelation or not? I don't think having non-zero values is a good criteria since probably everyone will excreet heavy metals given how contaminated the environment is. (Should everyone be doing chelation?)

 

24 minutes ago, Leo Gura said:

That study was not cited as proof that chelation will cure autism. That study was cited to show that DMSA is even safe for children to take.

I said that I knew a doctor who had a lot of success with autistic kids and chelation. This is not a scientific study. This is the experience of his practice.

Curing autism is cutting edge science so you should not expect any clear-cut studies here.

I understand your point.

 

Edited December 17, 2021 by jcampos

[Leo Gura]

9 minutes ago, jcampos said:

Thanks for replying, Leo.

That's why I mentioned "Note that I am not stating that it is ok to excrete any quantity of heavy metals". I didn't mean to say that it was ok to excreet heavy metals, just that the reference values were meaningless and that there is no standardization in place for provoked urine tests.

It's not meaningless because you're testing not relative to others but relative to your past self.

For example, my early urine tests showed me pissing out twice as much mercury and lead as I piss out today. This is valuable information. My goal is to be pissing out very little mercury and lead in the years to come even if I take a big dose of DMSA. This tells me that I have cleaned out my system.

Quote

The point is that you referred to this test as a way to check whether you need to do chelation or not. So the question still stands: Given the values, how do we actually determine if we need to do chelation or not? I don't think having non-zero values is a good criteria since probably everyone will excreet heavy metals given how contaminated the environment is. (Should everyone be doing chelation?)

If you have health problems and you're pissing out a lot of heavy metals, it would be wise to do chelation.

If your urine test shows you pissing out very little heavy metals, then that tells you that your health problem is probably not heavy metals.

[jcampos]

1 minute ago, Leo Gura said:

It's not meaningless because you're testing not relative to others but relative to your past self.

For example, my early urine tests showed me pissing out twice as much mercury and lead as I piss out today. This is valuable information.

Yes, I understand the relative comparison is valuable, of course.

But the question is precisely what is "a lot" of heavy metals, i.e., when I test myself for the first time how should I use the test to assess whether I need chelation or not.

[Leo Gura]

5 minutes ago, jcampos said:

Yes, I understand the relative comparison is valuable, of course.

But the question is precisely what is "a lot" of heavy metals, i.e., when I test myself for the first time how should I use the test to assess whether I need chelation or not.

If you are in the yellow or red zone, that suggests "a lot".

You should compare a non-provoked urine test result with a provoked result. That delta tells you which chemicals DMSA is pulling out of you. If DMSA is pulling out a bunch of lead, mercury, arsenic, etc. how is that not a good thing?

You have to appreciate that we don't great tests. We must work with the best we got. If you have stubborn chronic health problems then this is better than doing nothing.