# Lead Chelation Treatment - why not routine in adults over a certain age **URL:** \ **Category:** Factual Questions\ **Created:** [November 1, 2024, 1:13pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541 "2024-11-01T13:13:14Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![BwanaBob](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bwanabob/32/2985_2.png) [@BwanaBob](https://boards.straightdope.com/u/BwanaBob)\ **Post date:** [November 1, 2024, 1:13pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/1 "2024-11-01T13:13:14Z")
I’ve been reading where low level lead is still a medical issue, particularly in adults who were children during the age where lead paint exposure was more widespread. Also mentioned was the lead chelation is helpful to rid the body of this heavy metal. So, why aren’t lead levels routinely tested for during annual exams, and why wouldn’t chelation be routinely performed. Surely the chemicals involved are way past patent protection and so shouldn’t be expensive. ---
**Author:** ![Telemark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/telemark/32/372_2.png) [@Telemark](https://boards.straightdope.com/u/Telemark)\ **Post date:** [November 1, 2024, 2:11pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/2 "2024-11-01T14:11:45Z")
It can have serious side effects: > Side Effects > When chelation therapy is used the right way and for the right reason, it can be safe. The most common side effect is burning in the area where you get the IV. You might also experience fever, [headache](https://www.webmd.com/migraines-headaches/default.htm), and [nausea](https://www.webmd.com/digestive-disorders/digestive-diseases-nausea-vomiting) or [vomiting](https://www.webmd.com/children/ss/nausea-vomiting-remedies-treatment). > Chelating drugs can bind to and remove some metals your body needs, like calcium, copper, and zinc. This can lead to a deficiency in these important substances. Some people who’ve had chelation therapy also have low [calcium](https://www.webmd.com/drugs/2/drug-1575/calcium+oral/details) levels in the blood and [kidney](https://www.webmd.com/a-to-z-guides/understanding-kidney-disease-basic-information) damage. > **[Chelation Therapy for Metal Poisoning](https://www.webmd.com/balance/what-is-chelation-therapy)** > > Chelation therapy is used to treat different types of metal poisoning. Some alternative health care providers also use it for Alzheimer's and other conditions. But is it safe? WebMD investigates. And it isn’t that cheap. > **[Cost of lead poisoning drug jumps from $3,500 to $32,000, making it hard for...](https://www.cnn.com/2023/12/06/health/lead-poisoning-drug-price/index.html)** > > In August, the US Food and Drug Administration greenlit a new maker of an old drug used for the most severe cases of lead poisoning, ending a shortage and stopping the need for importation of the medicine from France. The only problem: The new... ---
**Author:** ![xtenkfarpl](https://avatars.discourse-cdn.com/v4/letter/x/c2a13f/32.png) [@xtenkfarpl](https://boards.straightdope.com/u/xtenkfarpl)\ **Post date:** [November 1, 2024, 5:16pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/3 "2024-11-01T17:16:28Z")
> [@BwanaBob](#): > > I’ve been reading where low level lead is still a medical issue, particularly in adults who were children during the age where lead paint exposure was more widespread. Do you have a reliable medical cite? How long does lead persist in the body… is this really a significant issue? I can imagine use of chelating agents for acute lead poisoning, but for adults who have not been exposed for decades, this seems rather irrelevent? ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [November 1, 2024, 5:24pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/4 "2024-11-01T17:24:32Z")
> [@xtenkfarpl](#): > > How long does lead persist in the body… is this really a significant issue? Anywhere from months to decades, depending on where it ends up in the body. Once it gets into the teeth or bones it can stay there as long as 30 years. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [November 1, 2024, 6:26pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/5 "2024-11-01T18:26:01Z")
I’ve read that lead leaching out of the bones of old people who are losing bone mass can be a medical problem in the elderly. But i dunno if chelation even helps remove lead that’s been bound up in bones. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 2, 2024, 6:05pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/6 "2024-11-02T18:05:06Z")
> [@xtenkfarpl](#): > > Do you have a reliable medical cite? @BwanaBob? Bumping because I am honestly curious. Also to @puzzlegal above the lead leaching out of bones in the elderly. That makes some sense to me as a possible issue (not that chelation preemptively would help or would be warranted during) but my brief searches aren’t coming up with much more than [this](https://pubmed.ncbi.nlm.nih.gov/11083332/) from 24 years ago. > Researchers have learned that lead can hibernate within bone for decades. Although lead within bone is of uncertain toxicity to bone tissue, conditions of bone resorption, such as osteoporosis, can cause bone lead to reenter the bloodstream where it can then re-expose the soft tissue, and, potentially, exert delayed deleterious effects. Evidence is emerging that blood and bone lead levels, reflecting relatively modest exposures, are associated with hypertension, renal insufficiency, and cognitive impairment. Medical treatments that now exist to slow the rate of bone resorption may maintain lead within bones. On-going studies evaluating the relationship between body lead stores and both cognitive and renal impairment, as well as the potential modifying effect of bone resorption, will help determine whether bone resorption should be retarded specifically to preserve organ function. That was a potentially and an on going studies 24 years ago. Which sounds to me like the ongoing studies didn’t find much so never got published? I’ll look some more if I have time to kill but if either of you have some where to point for more than a someone saying I’d be interested. ---
**Author:** ![BwanaBob](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bwanabob/32/2985_2.png) [@BwanaBob](https://boards.straightdope.com/u/BwanaBob)\ **Post date:** [November 2, 2024, 6:45pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/7 "2024-11-02T18:45:02Z")
I don’t recall where I read about this, but it was recent. Possibly BBC health or CNN, or even science daily. Those are my usual haunts for medical news. If I find it I will list it. ---
**Author:** ![BwanaBob](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bwanabob/32/2985_2.png) [@BwanaBob](https://boards.straightdope.com/u/BwanaBob)\ **Post date:** [November 2, 2024, 6:45pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/8 "2024-11-02T18:45:56Z")
Found it [Lead news](https://www.sciencedaily.com/releases/2024/10/241030171917.htm) ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 2, 2024, 6:59pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/9 "2024-11-02T18:59:12Z")
Thank you. Reading the NEJM article cited now. Honestly it frustrates me that a prestigious journal allows unsubstantiated statements past their editors. Here’s a critical claim: > In adults, low-level lead poisoning is a risk factor for chronic kidney failure, hypertension, and cardiovascular disease[35-37](https://www.nejm.org/doi/full/10.1056/NEJMra2402527#core-r35) [Here’s](https://scholar.google.com/scholar_lookup?title=Contribution+of+lead+to+hypertension+with+renal+impairment.&publication_year=1983&journal=N+Engl+J+Med&pages=17-21&doi=10.1056%2FNEJM198307073090104&pmid=6406892#d=gs_qabs&t=1730574039853&u=%23p%3D5Rs5x9hxFFAJ) the citation for it. A small study from the 80s that only shows high past exposures that caused kidney damage may contribute to hypertension??? Inadvertently hit send. Will return. Ah. Here’s one that may make their case better. I’ll have to see if I can get to more than the abstract. > **[Lead and Cardiovascular Mortality: Evidence Supports Lead as an Independent...](https://ageconsearch.umn.edu/record/312233/?v=pdf)** > > Lead is a highly toxic metal that remains a public health concern worldwide. Even at historically low blood lead levels, lead exposure results in adverse health effects in adult populations, including mortality. The mode of action of lead in... ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [November 2, 2024, 7:26pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/10 "2024-11-02T19:26:55Z")
> [@DSeid](#): > > That was a potentially and an on going studies 24 years ago. Which sounds to me like the ongoing studies didn’t find much so never got published? I may have heard about it 24 years ago, so if there’s been no follow-up, yeah, maybe it proved not to be too important. Can you summarize the studies you just linked? ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [November 2, 2024, 7:46pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/11 "2024-11-02T19:46:42Z")
I’ve seen some articles about certain foods, vitamins, and minerals having some relative chelative properties. (Note: I’m not a doctor. Don’t try to cure yourself of lead poisoning with zinc and cilantro. Go see a doctor.) That would imply to me that, short of something like the lead becoming encased in your bones, most of it will be slowly leached out over time. Any childhood exposure may, plausibly, already be dealt with as good as can be by this point on time. Either it’s gone already or it’s there to stay, regardless of any more hardcore chelative remedy you might try. But if I was traveling through a region that was noted to have environmental lead at sub-critical levels all over the place, I might try to target that sort of diet during and for a while after that trip. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 2, 2024, 11:01pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/12 "2024-11-02T23:01:50Z")
What I did was follow the path. The last one lead to some information about a trial specific to the question of the OP: the Trial to Assess Chelation Therapy, TACT, which had findings that were suggestive of benefit in those with previous heart disease, especially the highest risk group, those with diabetes, and of age such that historically they were likely exposed to significant lead burdens earlier in life. They stated a follow up trial was being done to potentially confirm. That trial TACT2, is recently completed: > **[Trial to Assess Chelation Therapy 2 - American College of Cardiology](https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2024/04/05/04/40/tact2)** > > Amit Saha, MD > [@](#): > > The TACT2 trial showed that in patients with prior MI and diabetes, intravenous chelation therapy with EDTA was not associated with a reduced risk of death or cardiovascular events compared with placebo. … > > … Interpretation: > > The original TACT trial demonstrated a modest reduction in death and cardiovascular events associated with EDTA, driven largely by lower rates of coronary revascularization. Given the historically contested reception to chelation therapy for atherosclerotic disease, TACT2 was designed to replicate its predecessor’s findings in patients with DM, who derived the greatest benefit compared with placebo in the original study. Surprisingly, no difference in clinical outcomes was observed in this cohort despite similar adherence over a similar follow-up period. > > The authors note that this may reflect a smaller potential treatment effect size as blood lead levels in the US and Canada have continued to decrease since the TACT cohort was studied and were even lower in the study cohort compared with contemporary population data. Moreover, a greater proportion of patients in TACT2 were not only taking statins or antiplatelet therapies but also sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, agents with proven cardiovascular benefits that were not available during TACT. The current findings therefore do not support chelation therapy for post-MI patients with DM. Given the outsized benefit original seen with TACT in this subset further implies that chelation therapy is not indicated regardless of DM status after MI. So the answer to the OP is that the most recent evidence is that chelation does not help, at for heart disease or overall mortality. Blood levels are a poor proxy of overall burden. The NEJM article acknowledges the spotty at best track record of chelation. It was more covering the history of lead exposure and making a convincing case that despite great reductions from peak levels there is still a very large global public health burden associated with lead exposures: > The inconsistent findings regarding the efficacy of chelation indicate that primary prevention is critical. … … the solution to protecting people from lead poisoning is to identify and eliminate environmental sources of lead, wherever they are found ([Figure 1](https://www.nejm.org/doi/full/10.1056/NEJMra2402527#f1)). In the United States, that means eliminating lead acid batteries and secondary lead smelters, replacing lead service lines, banning leaded aviation fuel, reducing lead in foods, abating lead paint in older housing, and further reducing lead-contaminated soil and other legacy sources The harms with lead are, they state, front loaded, the most harm per unit elevation is at the lowest levels. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [November 2, 2024, 11:36pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/13 "2024-11-02T23:36:07Z")
> [@Sage\_Rat](#): > > That would imply to me that, short of something like the lead becoming encased in your bones, most of it will be slowly leached out over time. Just fyi, it’s not that lead is “encased” in bones, it’s that it can replace calcium in the structure of bones. [Lead - an overview | ScienceDirect Topics](https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/lead#:~:text=Once%20the%20lead%20is%20ingested,ions%20are%20similar%20in%20size). > Once the lead is ingested by humans, it initially presents in blood and then distributes to the whole body and organs, particularly the soft tissue, including the brain [142]. Ultimately, lead deposits in the bone and replaces calcium since Pb2 + and Ca2 + ions are similar in size. Also, the below suggests that lead that’s accumulated in bones is still considered a hazard today [Lead (Pb) Toxicity: What is the Biological Fate of Lead in the Body? | Environmental Medicine | ATSDR](https://www.atsdr.cdc.gov/csem/leadtoxicity/biologic_fate.html#:~:text=The%20bones%20and%20teeth%20of%20adults%20contain%20more%20than%2095,total%20lead%20in%20the%20body). (But does not mention chelation) I found a lot of other references to higher lead levels in bones being linked to poorer health outcomes. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 3, 2024, 12:09am UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/14 "2024-11-03T00:09:22Z")
The relationship of heavy metals, lead and also cadmium, associated with copper mining, is possibly worse than you suggest. Biggest body of work I can find is the other direction: higher exposure especially early in life is associated with greater risk for osteoporosis and frailty later. So the people with the greatest likelihood to have a larger reservoir of heavy metals in their bones, are most likely to have it turned over into their bloodstreams later in life. For cadmium I can find that vitamin D and calcium in individuals with osteoporosis increased urinary excretion of cadmium. [Vitamin D](https://pmc.ncbi.nlm.nih.gov/articles/PMC8133370/) helps decrease bone turnover of lead into blood in diabetics decreasing blood lead levels. FWIW. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [November 3, 2024, 12:41am UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/15 "2024-11-03T00:41:51Z")
Article about a survivor of the Virginia Tech shooting who will be on chelation therapy for the rest of his life. > **[They Survived Mass Shootings. Years Later, The Bullets Are Still Trying to...](https://time.com/longform/gun-violence-survivors-lead-poisoning/)** > > Shooting survivors across the country suffer a lesser-known and often unrecognized side effect of gun violence: lead poisoning ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [November 3, 2024, 12:44am UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/16 "2024-11-03T00:44:31Z")
nmind ---
**Author:** ![Everlong88](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/everlong88/32/17800_2.png) [@Everlong88](https://boards.straightdope.com/u/Everlong88)\ **Post date:** [November 3, 2024, 12:49am UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/17 "2024-11-03T00:49:41Z")
When I was a child there was an incident where I swallowed multiple lead pellets not sure how many probably at least ten. I always wonder if it caused any permanent damage, I guess I’ll never know. Maybe my IQ got lowered a few points, haha. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 3, 2024, 1:09am UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/18 "2024-11-03T01:09:31Z")
If retained. It’s happened! > **[Intoxication from an Accidentally Ingested Lead Shot Retained in the...](https://pmc.ncbi.nlm.nih.gov/articles/PMC1278491/)** > > A 45-year-old woman was referred to the Department of Occupational and Environmental Health in January 2002 because of increased blood lead concentrations of unknown origin. She suffered from malaise, fatigue, and diffuse gastrointestinal symptoms.... ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [November 3, 2024, 1:33am UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/19 "2024-11-03T01:33:24Z")
Huh, i guess those fragments are really dispersed. Because i would have thought that careful surgery to remove them would be better than lifelong chelation. I get not doing it in the ED, when he was probably in critical condition due to blood loss, etc. But removing stuff after people stabilize medically is somewhat common. But i guess if there’s lead smeared all over his bones or something that might just be impractical. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [November 3, 2024, 12:26pm UTC](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541/20 "2024-11-03T12:26:40Z")
One of the doctors interviewed for that article addressed this point: > Oftentimes going in to get the bullet causes more harm than good,” says Cone. “We cut through healthy tissue, blood vessel and nerves, and it can cause a lot of scarring or other issues down the road.” [Next page](https://boards.straightdope.com/t/lead-chelation-treatment-why-not-routine-in-adults-over-a-certain-age/1009541.md?page=2)