Evidence-Based Clinical Chelation

A Textbook with Protocols for the Treatment of Chronic Metal Exposure

Dr. Eleonore Blaurock-Busch, PhD, Dr. Swaran J.S. Flora, PhD, Dr. Ebrahim Sulaiman, MD

• Publisher: Books on Demand
• Year: 2020
• Print ISBN: 9783750428676
• eBook ISBN: 9783750458109
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

This is an easy-to-read manual about chelation therapy. It contains specific protocols for the treatment of chronic metal overexposure, all of which are evidence-based, aiding the inexperienced and the experienced therapist in selecting the optimal chelating agent for the metal(s) in question. Expert chemists and chelation therapists have contributed invaluable knowledge and experience to this book.Most importantly, this is not a book promoting personal views or preferences. In fact, the information presents and explains different approaches, and allows the reader to draw his own conclusion. All the protocols listed have been modified for the treatment of chronic metal intoxication, included are oral and intravenous treatment plans. The authors explain in simple terms how a chelating agent´s bioavailability affects metal binding and how various protocols such as the Cutler Protocol affect the detoxification process, why DMPS binds mercury and which chelators are useful for the detoxification of certain organ system. Also discussed is the importance and effect of treatment pauses.Diagnostic tests are discussed, and which are useful under certain conditions. Shown are tables comparing the average metal binding ability of the various EDTAs, DMPS, DMSA and other chelating agents. Detailed information explains which chelator binds which metal and why, all of which aids the therapist in finding optimal treatment schedules.Novel chelating agents are presented such as MIADMSA, a new oral chelator specifically designed for arsenic intoxication, or how natural Pectin may be used an alternative for gadolinium intoxication, which metals are bound by lipoic acid and why a slightly alkaline environment supports metal binding, even preventing the often-feared metal redistribution.All in all, this evidence-based chelation "cookbook" should be in medical libraries and on the bookshelf of every physician treating environmental disease.

Chapter 1

Short History of Antidotes and chelating agents

An antidote is a remedy to counteract the effects of a poison or toxin, or something that prevents or counteracts injurious or unwanted effects.

The antidotes listed here are by no means all the chelating agents available in metal toxicology. We listed only those that have been approved by governmental agencies such as the FDA (Food and Drug Administration) of America, the German BfArM (Bundesinstitut für Arzneimittel und Medizinprodukte), or the Europäische Arzneimittel-Agentur (EMA). For a product to receive approval, the manufacturer or distributor has to prove the drug’s quality, its safety and effectiveness.

A drug becomes approved after the appropriate federal agency ensures that it is safe and effective. Such an agency does not test drugs, but requires documentation in the area of drug quality, safety and effectiveness. Any company applying for government approval must supply appropriate documentation. A drug may be approved for a limited time, after which a renewal process needs to be followed.

The antidotes listed here are useful in the treatment of a chronic metal overexposure.

History of approved chelating agents in metal toxicology

1935	EDTA was synthesized and patented by the German scientist F. Munz of the Hoechst Chemical Company in Germany.
1945	First synthesis and patent of EDTA in the USA.
1940	BAL is first synthesized in a British laboratory in Oxford as a potential antidote for chemical warfare.
1941	S.Kety used sodium citrate for the experimental treatment of lead poisoning.
1942	British Anti-Lewisite (BAL, Dimercaprol, also dimercaptopropanol) is approved for intoxication of Arsenic, Gold, Mercury and later is used in the management and diagnosis of Wilson's disease.
1950	DMPS is developed in the former Soviet Union as a potential antidote for chemical warfare.
1950	Oral DMSA is used for the detoxification of arsenic, lead and mercury.
1956	D-Penicillamine was developed, as a chelating agent for copper, iron, mercury, lead and arsenic. Walsh reported about its application for Wilson’s disease.
1960	DMPS is being used to treat metal intoxication, particularly mercury and lead.
1960	CaDTPA + ZnDTPA are officially approved to treat radioactive exposure to plutonium, americium, californium, curium and berkelium.
1968	Deferoxamine (Desferal®) was approved for medical use in the United States.
1982	EDTA (Edetate Disodium, Endrate®) is approved for the emergency treatment of hypercalcemia and for the control of ventricular arrhythmias associated with digitalis toxicity.
1982	British Anti-Lewisite (BAL, Dimercaptrol, also dimercaptopropanol) receives approval as an injectable in the treatment of Arsenic, Mercury, Lead and Gold intoxication.
1991	DMSA (Dimercaptosuccinic Acid) is FDA-approved as an oral chelating agent for lead-intoxicated children.
1997	Radiogardase®-Cs (also called Prussian Blue) is approved by the German federal agency as antidote for radioactive Cesium-137 intoxication.
1999	The German Environmental Agency (Umweltbundesamt) lists DMSA and DMPS as two antidote that are indispensible in the treatment of acute metal toxicities.
2003	Radiogardase® (Prussian Blue) is FDA approved for treatment of patients with known or suspected internal contamination with radioactive cesium and/or radioactive or non-radioactive thallium.
	Zn-DTPA (Zinc-trisodium-pentetat) is re-approved in Germany.
2004	Deferasirox, FDA approved oral iron chelator.
2005	Ca-DTPA (Ditripentant-Heyl) is re-approved in Germany.
2012	FDA approval of Sodium Thiosulfate for cyanide poisoning.

List of Antidotes in Metal Toxicology

Poison Center around the world store antidotes or chelating agents for emergency treatments, usually in hospital pharmacies. As the following table demonstrates, chelating agents are not equally available in every country or every state of a country, and there is not a universal agreement on indicatio...

Table of contents

• Table of Contents
• Preface
• Introductions
• Chapter 1
• Chapter 2
• Chapter 3
• Chapter 4
• Chapter 5
• Chapter 6
• Chapter 7
• Chapter 8
• Chapter 9
• Chapter 10
• Chapter 11
• Copyright