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Friday, August 26, 2005

Chelation therapy has critics, champions

Reports of success have caused a surge in the use to treat autistic children

By Virginia Linn, Pittsburgh Post-Gazette

For autism scientists, the growing popularity of chelation therapy is reopening a heated and frustrating debate on the origins of the condition.

Chelation (pronounced key-LAY-shun) has been used for decades to detoxify people with dangerous levels of heavy metals. With the standard treatment, a synthetic amino acid called EDTA latches onto heavy metals so they can be excreted with the urine.

Since the late 1990s, chelation has emerged as a treatment to address metal toxicity in autism patients.

Autism, which traditionally has been described as a complex neurobiological disorder characterized by impairments in social interaction and communication, is now being described by those who advocate chelation as a curable condition caused by some patients' sensitivity to toxins.

Chelation is approved by the Food and Drug Administration for use only after blood tests confirm acute heavy-metal poisoning. But some foes of the treatment are concerned that doctors are skipping the tests for autistic children.

Officials at the National Institutes of Mental Health contend the use of drugs to remove metals from the body could cause liver and kidney damage and other problems.

But interest in chelation for autism is exploding.

"It's not a treatment for autism," said Laura Hewitson of Pine, a University of Pittsburgh researcher who founded the FightingAutism.org Web site with her husband Dan Hollenbeck. "It's a treatment for heavy metal detoxification."

After J.B. and Lisa Handley in San Francisco experienced dramatic success with chelation treatments for their son Jamison, now 3, they founded an international advocacy group called Generation Rescue. They launched the organization on May 24 in a full-page advertisement in USA Today with this stunning message:

"Autism is preventable and reversible. Generation Rescue parents are successfully treating their children biomedically and removing mercury from their bodies through a safe and proven detoxification treatment known as chelation therapy."

The group seeks to connect parents with "rescue angels," parents in their own communities who it claims are successfully treating their own children with the therapy. Handley believes 4,000 to 6,000 families have begun the treatment since his organization began. The Web site so far has received 250,000 hits.

The Autism Research Institute in San Diego, directed by Bernard Rimland, Ph.D., who has a child with high-functioning autism and was a technical consultant on the movie "Rain Man," has been a leader in promoting chelation to address autism symptoms. One of its projects, Defeat Autism Now!, has set up treatment protocols for chelation, and provides training for doctors.

"For years we have heard the experts say that autism is a lifelong disability," Rimland has said. "This simply is not true anymore."

In addition to intravenous methods, detoxifying drugs can be administered by pills, nasal sprays, skin creams, suppositories and sauna baths. Along with the drugs, patients are given high doses of vitamins and minerals to supplant what may be lost in the chelation process.

Most insurers will pay for chelation therapy if a child or adult meets the threshold of being contaminated with heavy metals, J.B. Handley said. This involves tests on urine, hair and blood samples to confirm contamination.

Many doctors who give chelation treatments, however, use a "challenge" or "provocation test."

Dr. Dennis Courtney of Bridgeville has treated autism patients with chelation for several years. The challenge involves "administering a dose of a given chelating agent, then collecting the patient's urine over 24-hour period" to see whether high levels of metals turn up. Courtney said the metals are not in the blood, but are bound up in the tissue, but will come out in the urine.

Those opposed to this kind of testing say that it produces falsely high levels of toxins found naturally in the body.

For intravenous treatments, at least, each of the required five to 30 sessions can take two to four hours and cost $75 to $125. Costs for the other methods vary widely.

A review by the U.S. Institute of Medicine and several studies have found there is no basis to the claim that autism is triggered by a mercury preservative that has been used in childhood vaccines.

Dr. Nancy Minshew, a pediatric neurologist and autism researcher at the University of Pittsburgh School of Medicine, said chelation therapy is misguided because there are no links between mercury and autism.

"The connection is absolutely not accepted in the scientific community. That's the sad thing," she said, lamenting all the research dollars being spent on a futile debate.

"Should parents embark on a therapy that's invasive? Absolutely not," she said.

Further, the chelation therapy used is often of a type more geared to lead than mercury, several doctors said.

Chelation has a history as a miracle cure.

It was successful in detoxifying patients with high levels of dangerous metals, most due to industrial accidents or other causes. Later, practitioners believed that the solution was helpful in treatment of cardiovascular disease. The EDTA, they contend, reduces the damaging effects of oxygen and removes calcium to break up the plaque that clogs arteries, acting like a "chemical Roto-Rooter," but those claims are not supported by the American Heart Association and other mainstream medical groups.

Dr. Ralph Miranda, who has performed chelation therapy at his Wholistic Health Center in Greensburg since the early 1980s, is one of 100 practitioners across the country participating in a $30 million, randomized federal clinical trial that is examining its effectiveness in treating cardiovascular disease.

Over the years chelation also has been pitched as a treatment for cancers, kidney disease, AIDS and polio.

(Staff writer Lillian Thomas contributed. Virginia Linn can be reached at vlinn@post-gazette.com or 412-263-1662.)

Posted by Becca

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