Critics, backers weigh in on chelation therapy

Avis Favaro, Elizabeth St. Philip, CTV News

Sep 5/05:-   Desperate parents of some Canadian children with autism are turning to a radical and unproven treatment, using drugs to remove often disturbingly high levels of toxic environmental chemicals being found in their bodies.

They claim that it's helping their once incommunicative, unsociable children act and learn more normally. But some doctors worry that these well meaning parents may be unwittingly endangering the health of their children with medications that carry serious risks.

For the parents of 9-year-old Nathan Cromie, the decision to try chelation therapy was made out of desperation. He was diagnosed with mild to moderate autism when he was three years old. He spent his days rocking back in forth, unable to respond to requests.

"His language was limited. He made noises �?He would [make the same noises] over and over and over again," said Nathan's father Charles Cromie.

"I found him hard to manage. It was like talking to a wall. He wasn't just unresponsive. He was unreachable," said his mother, Julie Cromie.

Doctors told Julie and her husband Charles that Nathan would likely never be able to dress himself.

When they went looking for a cause for the autism, there was none. Treatment programs to help with Nathan's language and behavioural problems had long waiting lists.

The Cromies tried a number of approaches, including special diets, vitamin supplements, self-administered programs to improve his attention skills. With each program, they saw small improvements but nothing they considered significant.

Then they discovered the theory that some children with autism may have a genetic abnormality that allows their bodies to store unusually high levels of toxic environmental chemicals, like mercury and lead.

It's part of a highly-debated question that suggested mercury -- which until recently was included as a preservative in childhood vaccines -- caused autism. Studies have consistently found no link between vaccines and the illness.

But some doctors suspect environmental chemicals being dumped into the air and water may be playing a role in autism.

"In the autistic group, there seems to be a higher incidence of heavy metals -- mercury, cadmium, lead, arsenic," said Dr. Paul Cutler, a family doctor working in Burlington Ontario.

That's why he and a small group of Canadian doctors are trying out chelation therapy on autistic children found to have high levels of metal.

Chelation therapy has been used for decades to treat metal poisoning. Drugs are administered in pill form or in intravenous solutions to bind to the metals in the body and them flush them. They are excreted in the urine.

"You don't know until you remove the metals and then you see what improves," explains Cutler.

One of Cutler's patients is Nathan. His first blood and urine tests three years ago showed mercury levels that far exceeded recommended minimum limits and high levels of lead and arsenic.

According to Cutler, lead levels should be less than 20 micrograms per deciliter of urine. Nathan had over 100 micrograms. Mercury levels, meanwhile, should not be over 5 micrograms per deciliter; Nathan's were in the 20s.

Where the chemicals came from, his parents don't know. But they do know that as soon as Cutler began administering the chelation therapy, Nathan started making progress they had never seen before.

"Within a couple of weeks, it was like a penny dropped. All of a sudden, he wasn't afraid to go to the toilet anymore," said his mother Julie.

"You have to realize how dramatic that is for a parent. You have a six-year-old and it's hard to find diapers," said Charles.

Subsequent tests have shown that the levels of these chemicals in Nathan have been dropping, from 51 units of mercury to 5.4 in the latest test. Aluminum is all but gone in his system, although there are still significant levels of lead.

Autism occurs in 5 per 1,000 children, making it one of the most common childhood illnesses -- more common than Type 1 diabetes and Down's syndrome. There are treatments to improve behaviour and social skills. But there are often long waiting lists for therapy and not all children improve.

The chelation movement is in part being pushed because parents simply have few options in the standard medical world. Its advance is fuelled by anecdotal reports by parents who say it's helped their children and by some preliminary studies.

But autism specialists aren't impressed with the data so far and consider chelation dangerous.

"We absolutely do not have any of what I consider scientifically sound evidence that chelators are going to make a difference for children with autism," said Dr. Wendy Roberts, who treats autistic children at the Bloorview MacMillan Children's Centre in Toronto.

The drugs can cause damage to the liver and kidney, as well as to bone marrow.

Last month, a five-year-old autistic boy went into cardiac arrest and died after receiving intravenous chelation treatment of EDTA at the Advanced Intergrative Medicine Center in Portersville, Penn.

The coroner's office has performed an autopsy. Results will be known in a month. Though a link hasn't been confirmed, the news unnerves some autism specialists.

"I don't think it is a good idea. There is no clinical benefit of chelation therapy for autism and clearly a proven risk," said Dr. Donna Seger, Medical Director of the Tennessee Poison Center and past president of the American Academy of clinical toxicology

Dr. Cutler agrees. Chelating drugs can have side effects, but says accredited practitioners order regular blood and urine tests to watch for problems.

Still, researchers say there's no evidence heavy metals are linked to autistic symptoms. What's more, many children improve on their own -- advances that parents may attribute to autism. Finally, there have been no gold-standard studies to convince experts the therapy works.

Julie Cromie says chelation hasn't completely cured Nathan. He still has some symptoms of autism, but he has improved to where he is a social talkative nine-year-old who will enter a main-stream school program this fall. Her faith in chelation, she feels, has been rewarded.

"The thing is there is hope for us now, whereas before it felt hopeless. We now feel there is hope he will have a normal life if he continues to make the progress he is making," said Cromie.

From:   http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20050905/chelation_autism_050905/20050905/