August 27, 2005

Kirby on Abubakar

Autism and Chelation: Where is the Science?
David Kirby

Nearly four years ago, the Institute of Medicine recommended
research into chelation therapy and autism. But that never happened,
and now a little boy in Pennsylvania is dead.

The heartrending tragedy of Abubakar Tariq Nadama, an autistic five-
year-old who died while undergoing chelation this week, is one of
the saddest chapters in the very sad saga of autism in America.

But even as the grieving immigrant mother makes funeral arrangements
for her beloved boy, opponents of the theory that drew the family to
America (the theory that mercury triggers autism, and removing it
through chelation may improve symptoms) are holding his death up as
proof that the idea is bogus. They claim that the use of chelation
to treat autism is foolishly dangerous, and should be shut down at

Some people have come perilously close to exploiting this tragedy to
further their own political or personal agendas. Some blame the
boy's death on his mother, who has been labeled as reckless
and "desperate." Others blame the Pennsylvania doctor -- and any
autism doctor willing to try chelation (the use of certain chemicals
to remove heavy metals from the body) – for the tragedy. Some fault
me, for writing a book that dared to include the topic of chelation
and autism within its pages.

It's time to take a deep breath and look at the facts.

First of all, only an autopsy will reveal the actual cause of death,
and I think it is prudent to wait before jumping to any conclusions
about the general safety of chelation and autism. That said, the boy
did die while undergoing the procedure, and it's possible the
controversial treatment is what killed him.

But here is where things get more complicated. Abubakar was given a
substance known as EDTA, and he was receiving it intravenously. EDTA
is used mostly (and legally, I might add) for the treatment of lead
poisoning. EDTA is not typically used in mercury cases, and it is
not clear why it was used to treat autism here.

In fact, I am unaware of any autistic child who's been chelated with
EDTA, nor am I familiar with any autism cases where IV chelation was
employed. The chelation methods I have written about (I do not, and
cannot recommend treatments, for the record, I only report on them)
were either oral or trans-dermal, and they used substances that are
significantly different than EDTA.

Furthermore, I cannot find any reference in the medical literature
about any patient dying from chelation. (Please post them if you
have them).

Does chelation therapy work? We just don't know. Could it be
dangerous, even deadly, for children with autism? Perhaps, but
there's no hard science available one way or the other. And if
chelation does improve symptoms, what are the best agents, at what
doses and timing, and through which route of administration? No one
can say, of course, because no one has bothered to study these
questions in double-blinded trials.

Which brings us back to the IOM recommendation of 2001. The
committee assigned to look into thimerosal (the mercury containing
vaccine preservative) noted that some autism practitioners
report "clinical improvements following chelation." And though the
committee said that chelation "is not a benign treatment," it
nonetheless recommended "careful, rigorous, and scientific
investigations of chelation when used in children with
neurodevelopmental disorders, especially autism."

That report was issued on October 1, 2001, nearly four years ago.
But few paid attention to the recommendation, and no one did the
hard science on chelation. This left parents and doctors flying half-
blind in pursuit of chelation -- not out of "desperation," but out
of strong evidence their children had suffered from mercury exposure.

Just think, if the government had listened to the very IOM report it
commissioned back in 2001, we might know a lot more about chelation
and autism than we know today. If clinical trials had gotten
underway then, we would know with certainty whether chelation could
heal, or kill.

If hard scientific proof had been uncovered that chelation was 100-
percent worthless in the treatment of autism, no parent or doctor
would still be pursuing the therapy today. If evidence had surfaced
in clinical trials that children could be harmed or even killed by
chelation, no one would be using it today. The doctor in
Pennsylvania would have halted chelation therapy long ago, and this
poor grieving family would never have crossed the ocean from the UK
in pursuit of its false promise.

But what if the opposite were true? What if the "rigorous science"
recommended by the IOM had yielded proof that chelation can indeed
help some kids -- provided that it's done with the safest agents, at
the safest doses, and through the safest routes of administration
(not to mention in combination with other therapies)?

Either way, if America had done its scientific homework, as
recommended by its top science professors, Abubakar might still be
alive today.

If chelation is quackery that kills, let's outlaw it today. But if
it can be done safely, with demonstrated clinical benefit to some
autistic patients at a minimum of risk, then it should be approved
by the FDA for the treatment of autism.

Does chelation in autism kill or cure? Only hard science will answer
that question. What a shame we have wasted four long years not
finding out.


hollywoodjaded said...

"Kirby: On Wanting All of the Accolades and None of the Responsibility"

Anonymous said...

I thought that after I read David Kirby's article, I would have a better understanding of the situation. Instead, I feel sad.

If government agencies will not admit thimerosal can lead to autism (mercury poisoning), how will they ever find that chelation can treat autism (mecury poisoning)?

Mother of a 4 y/o ASD child who began DMSA this week