In the early 1950s several
deaths occurred from nephrotoxicity after EDTA treatment. At that
time the dosage used was around 10 grams per infusion, whereas
the recommended dose now adays is 3 grams.
Halstead (1979) states:
The problem in EDTA nephrotoxicity
is based upon two fundamental principles of toxicology: dosage and route of administration. Dosage is concerned with both the amount administered and the rate
of administration, or the time period in which the EDTA is given.
It appears that toxicity for
the kidneys may relate directly to too large a dose infused at
too fast a rate. In general, if no more than 3 grams is infused
in any 24hour period (diluted with 500 ml sterile Lactated
Ringer's solution or-except in the case of diabetes-5 per cent
dextrose solution), with a 24hour rest period between chelation
infusions (23 per week) and if the infusion of these 3 grams (less than 50 milligrams per kilo of body weight) is timed to take around three hours, little if any danger exists of producing toxicity for the kidneys.
Indeed, research has shown
that in general chelation therapy improves kidney function, particularly
if any impairment to these vital organs relates to circulatory
Improved kidney function
McDonagh, Rudolph and Cheraskin
(1982d) have investigated the alleged toxicity of EDTA in relation
to kidney function and their results are worth some consideration.
They examined the results
of treating 383 people with a variety of chronic degenerative
disorders (primarily occlusive arterial disease) with EDTA chelation
therapy (plus supportive multivitamin/mineral supplementation)
for 50 days.
The measurement of the levels
of creatinine in the blood is commonly used in medicine as a guide
to kidney efficiency.
Creatinine is the end breakdown
product of muscle activity which is cleared from the body by filtration
through the normal kidney. The levels found in the bloodstream
are known to correlate well with the rate and efficiency of clearance,
giving a simple way of judging kidney function. The researchers
made specific measurements of the levels of creatinine in the
blood of these patients at the first visit (fasting levels) and
then gave 10 infusions of 3 grams of EDTA in a solution of 1000
cc normal saline with an interval of five days between each infusion
(supplementation was also given). After this the serum creatinine
was again assessed.
They found that a very interesting
balancing effect could be seen when the overall picture was revealed,
very similar to that noted when cholesterol ratios were examined
(see Chapter 4). Those people who initially had low levels of
serum creatinine showed a very slight increase; those in the midrange
(normal?) showed no change and those above the midrange
of normal and actually with a creatinine excess (therefore indicating
poor clearance by the kidneys) showed a drop towards normal.
Overall the total measurement
showed an average decline in serum levels (indicating improved
kidney function), but far more significant, according to the judgement
of the researchers, is the homoeostatic effect in which
whether high or low to start with a tendency towards the
midrange (between 0.5 and 1.7 milligrams/decilitre) is observed.
It seems that EDTA therapy
may actually improve kidney function if it is applied slowly
with normal dosages.
These researchers make note
of one exceptional case amongst nearly 400 patients tested in
this way, and the progression of events is worth noting as an
example which highlights both the initial concerns which some
patients might produce and the longterm benefits of chelation
This was an 86yearold
female in whom the initial measurement of creatinine was 1.9 mg/dl,
which is regarded as abnormally high and therefore indicative
of poor kidney function. After starting chelation every five days,
a rise was seen in the creatinine levels by day 25 (fifth infusion)
to a very unhealthy 3.5 mg/dl. As treatment progressed, it dropped
to 2.8 mg/dl by day 60 and had dropped to 1.8 mg/dl by day 100,
some time after the course of chelation therapy had finished.
As the researchers point out:
'this emphasizes the need to follow renal function during EDTA
therapy, and, one might add, for a while after, as the benefits
frequently are not fully manifest before about three months after
treatment is over.
age, heavy metals or parathyroid deficiency
If the patient is very elderly,
or has low parathyroid activity or is suffering from heavy metal
toxicity which is damaging kidney tubules, treatment should be
modified to use less EDTA less frequently (once weekly perhaps).
Heavy metals damage the kidneys and too rapid infusion can overload
them. Heavy metals most likely to produce kidney damage during
infusion therapy (if this is done too rapidly, that is) are lead,
aluminium, cadmium, mercury, nickel, copper and arsenic.
Renal function tests should
always be performed before chelation therapy is started in which
serum nitrogen (BUN) and serum creatinine is examined. In any
case of significant renal impairment, lower dosage EDTA infusions
should be used with extreme caution with suitable periods of rest
Too much calcium removed
If, through inexperience or
error, there is too rapid an infusion (or too much EDTA used),
levels of calcium in the blood can drop rapidly, resulting in
cramps, tetany, convulsions, etc. An injection of calcium gluconate
will swiftly control such abnormal reactions. This hypocalcaemia
reaction is almost unheard of where the guidelines given above
are followed as to dosage, speed of infusion and spread of treatments.
Inflammation of a vein
If an infusion into a vein
is performed too rapidly, inflammation may occur (thrombophlebitis).
This is unlikely in the extreme if guidelines as described above
are followed concerning dilution of EDTA with Ringers solution
or dextrose solution and slow infusion.
Should the needle carrying
the infusion slip, a local soft tissue irritation may develop.
This may best be treated with use of alternate hot and cold packs.
Supplementation with antioxidant nutrients such as vitamins C
and E (make sure of a good source) and the mineral selenium should
protect against such an incident.
Care regarding insulin
shock and hypoglycaemia
During EDTA infusion it is
possible for blood glucose to drop, leading to insulin shock.
This is more likely amongst diabetics in whom no dextrose solution
should be used. Patients having EDTA infusions are advised to
have a snack before or during the three hours plus treatment period.
Walker and Gordon (1982) recommend the following strategy:
You should eat something before
the three to four hour infusions, but not highcalciumcontaining
foods such as dairy products. Rather, eat adequate unrefined complex
carbohydrates and avoid most sugars, including overripe bananas.
During an infusion they recommend
In diabetic individuals, using
zincbound insulin involves a risk of too rapid a release
of insulin, leading to hypoglycaemia and shock. A rapid introduction
of sugar is needed in such an instance and a change in the form
of insulin used before further EDTA infusions are tried. Most
people with known diabetes find that with chelation therapy their
requirement for insulin declines.
Congestive heart failure
If the heart is already unable
to cope adequately with movement of fluids, and there is evidence
of congestive heart failure (extreme shortness of breath, swollen
ankles) and/or if digitalislike medication is being taken,
extreme care is needed over chelation infusions, since EDTA prevents
digitalis working adequately. Sodium EDTA would appear to be undesirable
in such people as it could increase the fluid retention tendency.
However, Halstead is adamant that:
Na2 EDTA does not appear to
have any significant deleterious effects in congestive heart patients
since the sodium (Na2) is apparently excreted intact with the
metal chelate. However, the use of 5 per cent dextrose and water
is recommended in such cases.
A number of variable sideeffects
have been observed with use of intravenous EDTA infusion, including
which often relate
to the same phenomenon discussed above, of low blood sugar. Eating
before treatment, or during it, will usually prevent this possibility.
It is reported that a common recommendation which prevents 'EDTAheadaches'
is that a banana, not overripe, be eaten during the first hour
- Diarrhoca this
unusual sideeffect should be treated with rest and a bland
diet with plenty of liquids for a day or so. Urinary frequency is common
as kidney efficiency improves and a weight loss (from fluid excretion)
of 35 pounds (1.32.2 kg) is common after an infusion
if fluid retention was previously evident.
- Local skin irritation
may result and
is usually associated with a reduction in zinc and vitamin B6
(pyridoxine). For this reason supplementation of these nutrients
is usually suggested during chelation therapy.
- Nausea or stomach upset
may also be related
to vitamin B6 deficiency in the less than one patient in 100 receiving
chelation therapy who feels this sideeffect. It is best
treated by B6 supplementation, although shortterm relief
(up to eight hours) from nausea can be achieved by applying thumb
pressure to a point two thumbwidths above the wrist crease
on either forearm (acupuncture point P6) for a minute or so whenever
the symptom is felt.
- Feeling faint may
relate to a drop in blood pressure. It is common for those who
start treatment with high blood pressure to see a return to more
normal levels. If it were normal to start with, it could drop
slightly as well as leading to feelings of faintness on standing
after sitting or lying. Treatment is to rest for an hour or so
when this happens, ideally with the feet slightly higher than
the head. The amino acid tyrosine can safely be supplemented to
help restore normal pressure levels if this symptom persists.
- Fever may
develop in a very few people during the day after chelation therapy
sessions (approximately one in 5000). Whoever is in charge of
the treatment should be told, although the condition normally
resolves on its own.
- Extreme fatigue may be felt in some people and this is usually the result of a general
nutrient deficiency in minerals such as magnesium, zinc or potassium.
Taking a potassiumrich supplement and/or the regular eating
of potassiumrich foods is suggested before and during chelation
(grapes, bananas, peaches, potato skins), as this mineral may
be removed by the process itself.
- Pains in the joints
are more likely
where infusions are frequent (three weekly). An immediate reduction
to once weekly is suggested, and also possibly a reduction in
dosage of EDTA being used, if strong flulike aches develop.
The symptoms should pass fairly soon if these strategies are adopted.
- Cramps in
the legs are not uncommon (one patient in 20), usually at night.
The supplementation of magnesium (either by mouth or in the El)TA
will usually prevent this happening. If it is added to the infusion
this could be in the form of magnesium chloride or magnesium sulphate.
Such additions also reduce the chance of local skin irritation
at the site of the infusion.