12:01am

Mon January 3, 2011
Health

Flushing Out Lead, Metals With Chelation Therapy

Originally published on Wed May 23, 2012 10:36 am

Sherri Oliver lives in a small town on the Eastern Shore of Maryland. It's a two-hour bus ride to get to the Mount Washington Pediatric Hospital in Baltimore -- and she has brought her daughter, Katie Dail.

Katie has dangerously high levels of lead in her blood.

She's a fast-moving first-grader with copper-colored hair. Katie has bright brown eyes but has trouble making eye contact. She also has autism -- and she doesn't really speak, but she makes a kind of whooping sound when she's happy.

But Katie is not here for autism treatment. The treatment she has been getting -- chelation therapy -- is to get her lead levels down. Although hospitals offer the treatment, some desperate parents are turning to home-based chelation kits and over-the-counter pills, which doctors say can be more dangerous.

Lead can cause serious behavioral problems in kids and lower their IQs. When Katie's lead levels are high, she gets irritable and has more trouble learning, her mom says.

"She takes all my time," Oliver says.

Katie was first diagnosed with an elevated lead level at age 2.

Lead in the body is notoriously hard to get rid of. It seeps into the bones to hide, and sneaks across the blood-brain barrier, affecting mood, focus and sleep.

Last year, Katie stayed in the hospital for 19 days while nurses worked to bring her lead levels down through chelation.

'Nasty Stuff'

Chelation puts a special chemical into the body that binds to lead and other heavy metals, and helps flush them out. But it's not pleasant. And it has to be given repeatedly over the course of the hospital stay.

"It's nasty stuff. But it had to be done," Oliver says.

Nasty, Katie's mom says, because the chelation pill smells really bad.

"You ever been near a building when they're getting their roof done, you know, and the smell just gets in your mouth? That's what it smells like," she says.

They had to grind up Katie's pills and hide them in apple juice. She still won't drink apple juice, Oliver says.

But nurse practitioner Barbara Moore, who runs the lead clinic at Mount Washington, says getting past the smell is just one of the challenges of chelation.

"A child during chelation needs close monitoring to make sure their kidneys are able to handle the lead burden as it's being metabolized in the body, make sure their liver is OK, make sure their white blood cell count is OK," she says.

Plus, the chelation process doesn't clear all of the metal out at first -- it only brings it out from the bone to the blood. Some people test higher for lead after the treatment until it flushes from their system.

And, importantly, it doesn't cure the damage the metal has already done to the brain.

"What we try to do is prevent any further damage," Moore says.

Less Common Today

In the U.S., about 250,000 kids a year under age 5 have high levels of lead in their blood. Only a small percentage of them test high enough to need chelation.

While the overall numbers of lead poisoning and chelation therapy are going down, it's still a problem in cities with old homes like Baltimore, and when people get secondhand toys that may contain lead. It's also a problem in some rural areas where lead persists in the soil, Moore says.

Moore sees between five and 10 chelation patients a year in her hospital.

"Things that we look at is how long had they been exposed to lead, and how high was their lead level," she says.

She says kids who put a lot of non-food items in their mouths have an increased chance of developing the classic symptoms of lead poisoning: behavioral problems, headaches and sleeplessness.

The clinic helps educate families on what to do to decrease their risk of lead poisoning.

"We really do a lot of education on cleaning toys, cleaning household items ... using vacuums that have HEPA filters," Moore says.

Extra Challenge With Special-Needs Kids

Moore says it's especially hard to keep an eye on the symptoms of kids with learning disabilities like Katie. Katie puts nearly everything in her mouth, from the coffee cup that a stranger left on a table to the corners of walls in her home.

When Moore brings Katie and her mom into an exam room, Katie watches TV while Moore listens to her breathing and reads her chart. Moore talks to Katie's mom.

Moore suggests giving Katie ice cubes to keep her mouth busy and says Katie's blood count is slowly going down.

But there's still a chance that Katie might have to go into the hospital for more chelation if things don't improve.

Fly-By-Night Alternatives

Recently, a new challenge has cropped up for Moore and her staff -- chelation kits for sale on the Internet. These products -- which run the gamut from clay baths to pills to test kits --  claim to let consumers cure autism or Alzheimer's or hardening of the arteries without professional medical help.

One website claimed its chelation product corrects neurological damage and gets rid of mercury. Some autism advocates say mercury causes autism, but there is no scientific proof of that. Experts say chelation is not an effective autism treatment.

Moore says the products aren't safe.

"I don't recommend the oral chelation that you can get over the Internet or over the counter. We don't know what the safe level is of administering to a child or to anybody else, really," she says.

These products haven't been properly tested for any diseases other than heavy metal poisoning. In fact, the National Institutes of Health halted a study of chelation as an autism treatment, citing too much patient risk. But the NIH is studying chelation for hardening of the arteries. Results are expected to be announced in 2012.

Recently the Food and Drug Administration sent warning letters to eight companies that were selling illegal chelation therapies. FDA labeling compliance chief Michael Levy says the agency is cracking down.

"We are very concerned that the marketers of these products are preying on the most vulnerable of consumers," he says.

He's talking about consumers like Sherry Oliver who have very sick kids without many treatment options. The FDA is concerned that people will put their health at risk by using the therapies and delay seeking appropriate medical treatment.

'Can't Risk It'

Before Oliver left the clinic, I asked her if she ever considered one of those online chelation kits.

"I actually looked into that and, no, absolutely not. Most of them -- I couldn't find out what was in them, where they were from, who made it, nothing," Oliver says.

She doesn't want to give her daughter something she can't check out, and she doesn't want to make Katie's developmental problems worse.

"I can't risk it," she says.

Katie and her mom bundle up for the long ride home. They'll be back to the hospital in a month to get Katie's lead levels checked again.

Copyright 2012 National Public Radio. To see more, visit http://www.npr.org/.

Transcript

STEVE INSKEEP, host:

It's MORNING EDITION from NPR News. I'm Steve Inskeep.

RENEE MONTAGNE, host:

And I'm Renee Montagne. Good morning.

Today in Your Health, a look at therapies being sold online for children with autism. We'll hear in a moment about a hormone that's being advertised as a way to improve the social skills of autistic children. We begin with a therapy that's not proven to cure autism, though it's being pedaled that way online. It does work to bring down dangerously high levels of lead. NPR's April Fulton followed one young patient.

APRIL FULTON: Sherri Oliver lives in a small town on the eastern shore of Maryland. It's a two hour bus ride to Mount Washington Pediatric Hospital in Baltimore, and she's brought her daughter, Katie.

Ms. SHERRI OLIVER: We're here for the lead clinic. Katie's got a seriously high lead level.

FULTON: Katie Dail is a fast-moving first grader with copper-colored hair. Katie has bright brown eyes but has trouble making eye contact. She doesn't really speak.

(Soundbite of yelling)

Ms. OLIVER: She has autism, okay? But she makes progress and sometimes she doesn't.

FULTON: Now, six-year-old Katie's not here for autism treatment. The treatment she's been getting, chelation therapy, is to get her lead levels down. Lead poisoning can cause serious behavioral problems and lower IQs in any child. Oliver says when Katie's lead levels are up she gets irritable and has more trouble learning.

Ms. OLIVER: She takes all of my attention.

FULTON: Lead in the body is notoriously hard to get rid of. Last year, Katie was in the hospital 19 days while nurses gave her chelation. Chelation puts a chemical into the body that binds to lead and other heavy metals and helps flush them out. But it's got a lot of drawbacks.

Ms. OLIVER: It's nasty stuff. But it had to be done.

FULTON: Nasty, Katie's mom says, because the chelation pill smells really bad.

FULTON: You ever been near a building when they're getting their roof done, you know, and the smell just gets in your mouth? That's what it smells like.

FULTON: Nurse Practitioner Barbara Moore runs the lead clinic here at Mount Washington. She says there's a worse problem with chelation. Even in the right hands, chelation can cause serious health issues.

Ms. BARBARA MOORE (Nurse practitioner): A child during chelation needs close monitoring to make sure their kidneys are able to handle the lead burden as it's being metabolized in the body, make sure their liver is Okay, make sure their white blood cell count is Okay.

FULTON: Plus, it doesn't cure the damage the metal has already done to the brain.

Ms. MOORE: What we try to do is prevent any further damage.

FULTON: In the U.S., about 250,000 kids a year under age five have high levels of lead in their blood. Only a small percentage have levels high enough to need chelation. Barbara Moore sees between 5 and 10 chelation patients a year in Baltimore.

She says the more lead-filled paint chips, dirt and toys that go into children's mouths the more likely they are to develop behavioral problems: headaches, sleeplessness - classic symptoms of lead poisoning. It's especially hard to keep an eye on the symptoms of kids with developmental difficulties like Katie.

Ms. MOORE: Katie, look at me for a minute.

(Soundbite of laughter)

Ms. MOORE: Good job. Okay.

FULTON: Moore brings Katie and her mom into an exam room. Katie watches TV while Moore listens to her breathing and reads her chart. Moore talks to Katie's mom.

Ms. MOORE: So her last lead level was 36. So it came down - what we were hoping for - slowly coming down.

FULTON: But there's a chance Katie might have to go into the hospital for more chelation if her levels get worse. Recently, a new challenge has popped up for Moore and her staff - chelation kits for sale on the Internet. The kits claim to cure autism or Alzheimer's or hardening of the arteries without professional medical help. Moore says the products aren't safe.

Ms. MOORE: I don't recommend the oral chelation that you can get over the Internet or over the counter. We don't know what the safe level is of administering to a child or to anybody else, really.

FULTON: These products haven't been shown to cure autism or treat any diseases other than heavy metal poisoning.

Recently, the Food and Drug Administration sent warning letters to eight companies selling illegal chelation therapies. FDA's Michael Levy says the agency is cracking down.

Mr. MICHAEL LEVY (Food and Drug Administration): We are very concerned that the marketers of these products are preying on the most vulnerable consumers.

FULTON: Consumers like Katie's mom, Sherry Oliver, with very sick kids. Before Oliver left the clinic, I asked her if she ever considered one of those online chelation kits.

Ms. OLIVER: I actually looked into that. And, no, absolutely not. Most of them I couldn't find out what was in them, where they were from, who made it, nothing.

FULTON: She says she doesn't want to make Katie's problems worse.

Ms. OLIVER: I just can't. I can't risk it.

FULTON: Katie and her mom bundle up for the long ride home. They'll be back in a month to get Katie's lead levels checked again.

April Fulton, NPR News.

MONTAGNE: To see photos of Katie Dail and learn more about chelation visit our website at npr.org. Transcript provided by NPR, Copyright National Public Radio.