Major Research Findings

Chelation therapy is a treatment that removes excess metals from the blood by binding them and excreting them from the body. Various studies have been conducted, and its effectiveness varies. 1 investigated the long-term effects of hormone replacement therapy (HRT) and iron chelation therapy on glucose homeostasis and insulin secretion in female β-thalassemia major (β-TM) patients with acquired hypogonadotropic hypogonadism (AHH). This study reported that chelation therapy improved glucose homeostasis and insulin secretion. 2 compared the effects of calcium channel blockers plus iron chelation therapy versus chelation therapy alone on iron overload in children and young adults with transfusion-dependent thalassemia (TDT). This study suggested that combining calcium channel blockers with iron chelation therapy may be more effective in reducing iron overload than chelation therapy alone. 3 examined the effects of dual chelation therapy with deferasirox and deferoxamine in patients with beta-thalassemia major. This study suggested that dual chelation therapy may provide more aggressive iron chelation. 4 evaluated the curative effects of ethylene diamine tetra-acetic acid (EDTA) chelation therapy in treating atherosclerotic cardiovascular disease. This study concluded that further research is needed to determine whether EDTA chelation therapy is effective in treating atherosclerotic cardiovascular disease. 5 analyzed aggregated case reports to assess the effects of iron chelation therapy on the clinical course of aceruloplasminemia. This study suggested that iron chelation therapy may be effective in improving neurological symptoms, but further research is needed. 6 investigated the effects of iron chelation therapy on hematopoietic reconstitution and related complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myelodysplastic syndrome (MDS). This study suggested that iron chelation therapy may have a beneficial effect on hematopoietic reconstitution and related complications in allo-HSCT. 7 investigated whether targeted chelation therapy with EDTA-loaded albumin nanoparticles could regress arterial calcification without causing systemic side effects. This study suggested that albumin nanoparticles loaded with EDTA could target calcified elastic lamina when administered intravenously. 8 briefly reviewed the literature about the positive effects on hematopoiesis in patients with myelodysplastic syndrome receiving deferasirox as oral iron chelation therapy. This study suggested that ICT may induce hematologic improvement that leads to significant reduction or complete interruption of blood transfusions. 9 reported the long-term effects of deferasirox on cardiac iron overload in a case series of five patients with transfusion-dependent beta-thalassemia major. This study suggested that deferasirox may decrease cardiac iron overload and maintain stable LVEF over the long term. 10 reported the updates on thalassemia treatment in Taiwan, including bone marrow transplantation, chelation therapy, and cardiomyopathy treatment effects. This study suggested that Taiwan has seen striking improvements in the life expectancy of its beta-thalassemia major patients due mainly to adequate transfusion regimens and effective iron chelation therapy. 11 explored the effect of chelation therapy with succimer (DMSA) in male rabbits of moderate lead poisoning during the juvenile stage. This study suggested that succimer may be effective in reducing lead accumulation in young rabbits with moderate lead poisoning. 12 reviewed the literature and Taiwanese experience on the effects of chelation therapy on cardiac function improvement in thalassemia patients. This study demonstrated that deferoxamine and deferiprone can normalize cardiac function in patients with iron overload-induced cardiac disease. 13 examined the efficacy of combined deferoxamine (DFO) and deferiprone (L1) chelation therapy on iron load indices in beta-thalassemia. This study suggested that combined L1 and DFO therapy may be effective in reducing iron excess in organ iron-overloaded thalassemic patients. 14 described a thalassemia major patient who had been treated with combination therapy with desferrioxamine and deferiprone and who was referred for faintness and dizziness associated with electrocardiographic ST-T changes and arrhythmia. This study raised questions about the time of application of this therapy, the regimen dosages, and follow-up of such patients. 15 investigated the acute prooxidant effects of vitamin C in EDTA chelation therapy and the long-term antioxidant benefits of therapy. This study concluded that multiple sessions of EDTA chelation therapy protect lipids against oxidative damage but standard high amounts of vitamin C added to EDTA chelation solutions also display short-term prooxidant effects. 16 examined the effects of succimer chelation therapy on auditory function in rhesus monkeys. This study suggested that succimer may be effective in improving auditory function in monkeys with lead poisoning. 17 examined the effects of elevated blood lead levels and succimer chelation therapy on physical growth in developing rhesus monkeys. This study suggested that succimer may be effective in improving growth in monkeys with lead poisoning. 18 explored the “iron shuttle” hypothesis in chelation therapy. This study suggested that combined deferoxamine and deferiprone treatment may be more effective in managing transfusional iron overload. 19 investigated the epidemiology and chelation therapy effects on glucose homeostasis in thalassemic patients. This study suggested that the prevalence of glucose metabolism abnormalities has decreased and the mean age of diagnosis has increased over the years in thalassemic patients. 20 examined the effects of chelation therapy on hepatic glutathione, lipid peroxidation, and phospholipid contents in lead-poisoned rats. This study suggested that chelation therapy may be effective in reducing lipid peroxidation in the liver of lead-poisoned rats. 21 described an adolescent with Wilson’s disease who developed florid psychosis that improved as copper levels were decreased. This study suggests that early detection and chelation therapy can be crucial in treating Wilson’s disease. 22 evaluated the effects of chelation therapy with time following strontium exposure to mice. This study suggests that the length of time before initiating chelation therapy may influence the effectiveness of the treatment. 23 investigated the effects of deferoxamine on lung preservation in a canine model of single lung transplantation. This study concluded that deferoxamine improves lung preservation and early posttransplantation function in canine single lung transplantation. reported the adverse effects of chelation therapy. This study suggests that chelation therapy should be performed with caution due to potential side effects. 24 investigated the effects of intensive iron chelation therapy on iron metabolism and blood transfusion dependence in patients with beta-thalassemia major. This study suggested that subcutaneous infusions of Desferal (DF) rarely induce negative iron balance in thalassemia major patients younger than 6 years old. 25 investigated the biological effects of the enhanced excretion of zinc after calcium diethylenetriaminepentaacetate chelation therapy. This study suggested that an enhanced, uncompensated excretion of zinc may be responsible for unwanted side-effects that could develop after prolonged chelation therapy. examined the biochemical effects of chelation therapy using deferoxamine mesylate on experimental porphyria in rats. This study suggested that deferoxamine may be effective in reducing liver iron accumulation in rats with experimental porphyria.

Benefits and Risks

Benefits Summary

Chelation therapy is a treatment that removes excess metals from the blood by binding them and excreting them from the body. Various studies have been conducted, and its effectiveness varies. 12 showed that iron chelators deferoxamine and deferiprone can normalize cardiac function in patients with iron overload-induced cardiac disease. This therapy may be effective in treating iron overload, which can cause various health complications. It has shown potential in treating cardiac diseases related to iron overload. 10 Additionally, it has shown promise in treating lead poisoning. 16 However, chelation therapy is a relatively new treatment, and further research is needed to fully understand its benefits and risks.

Risks Summary

Chelation therapy can have various side effects. For instance, iron chelation therapy can cause low blood pressure, fever, headache, nausea, vomiting, digestive problems, skin rash, and other side effects. 13 Succimer, used to treat lead poisoning, can cause rash, abdominal pain, vomiting, and diarrhea. 16 EDTA chelation therapy can cause low blood pressure, fever, headache, nausea, vomiting, muscle aches, joint pain, and other side effects. 15 Moreover, chelation therapy can potentially deplete essential minerals from the body, so careful monitoring is required. 25

Comparison Between Studies

Commonalities

These studies suggest that chelation therapy may be beneficial for treating various diseases and conditions, particularly metal overload disorders like iron overload and lead poisoning. 12 Also, these studies suggest that chelation therapy may carry the risk of side effects.

Differences

These studies differ in terms of chelation therapy types, administration methods, target diseases, and research methods. This makes it challenging to directly compare their findings. For example, while some studies suggest that chelation therapy is effective in treating specific diseases or conditions, others have not found such effects. Moreover, the reported side effects of chelation therapy also vary among studies.

Consistency and Contradictions in Results

These studies suggest that chelation therapy may be effective in treating various diseases and conditions, but its effectiveness varies. While some studies suggest that chelation therapy is effective in treating specific diseases or conditions, others have not found such effects. Similarly, the reported side effects of chelation therapy also vary among studies. Therefore, further research is needed to clarify the effectiveness and safety of chelation therapy.

Practical Application Notes

Chelation therapy should be administered under the supervision of a healthcare professional. Consulting a physician about your medical history and current medications is crucial before undergoing chelation therapy. Understanding the risks of chelation therapy side effects is also important. Chelation therapy is not suitable for self-treatment.

Limitations of Current Research

These studies have limitations, including small sample sizes, varying research methodologies, making it difficult to generalize their results. Some studies lack a control group, making it challenging to assess the effectiveness of chelation therapy. Moreover, these studies do not assess long-term effects, requiring further research to evaluate long-term outcomes.

Future Research Directions

Further research is needed to clarify the effectiveness and safety of chelation therapy. Studies should focus on evaluating long-term effects and side effects. Conducting studies with standardized chelation therapy types, administration methods, target diseases, and research methodologies is important.

Conclusion

Chelation therapy shows promise in treating metal overload disorders like iron overload and lead poisoning, but it has potential side effects and requires careful monitoring. Consult a healthcare professional before undergoing chelation therapy and understand the risks associated with it. Self-treatment with chelation therapy is not recommended.