In fulfillment of the Oregon Medical Board's mission to protect the health, safety and wellbeing of Oregon citizens, the Board looks to the standard of care in determining whether a patient received appropriate medical care. In some cases, medical techniques for diagnosis and treatment of conditions vary greatly and may include alternative treatments. However, patient safety must always be the primary concern when employing any diagnostic or treatment technique.
Chelation therapy is a medical treatment used to remove toxic heavy metals such as lead, mercury, and arsenic from the body. It involves the administration of chelating agents, most commonly ethylenediaminetetraacetic acid (EDTA), which bind to positively charged metal ions through their negatively charged functional groups. These metal complexes are then excreted via renal or biliary pathways.
While chelation therapy has been utilized for a variety of medical conditions, the FDA has approved chelation therapy only for treating metal toxicity. The TACT (2014) and TACT2 (2024) trials, funded by the National Institutes of Health (NIH), investigated the potential benefit of chelation therapy for coronary artery disease (CAD), but results were inconclusive and contradictory.
A provider who treats a patient with chelation therapy for any medical condition first must verify the toxic levels of heavy metals. Post-chelator challenge urinary metal testing does not meet the standard of care for diagnosis of heavy metal toxicity. Further, the American College of Medical Toxicology has concluded that post-chelator challenge urinary testing “has not been scientifically validated, has no demonstrated benefit, and may be harmful when applied in the assessment and treatment of patients in whom there is concern for metal poisoning."1 The Board cautions providers to use chelation treatment only after a diagnosis of heavy metal toxicity, which includes a blood test or other accepted unprovoked test confirming the presence of heavy metals, and a careful determination that chelation therapy is appropriate for the particular patient.
The Board evaluates all diagnostic and treatment techniques using the standard of care and continues to consider the potential benefits and risks of chelation therapy.
- Adopted October 2013; Amended April 2025
1. American College of Medical Toxicology Position Statement on Post-Chelator Challenge Urinary Metal Testing. July 27, 2009.