As already mentioned, EDTA chelation is the treatment of choice in heavy metal toxicity. Other primary conditions in which EDTA therapy is indicated are cerebral, peripheral, or coronary vascular disease. Many patients with scleroderma, rheumatoid arthritis, and other autoimmune diseases may benefit. Healthy persons may use chelation therapy as preventive medicine. Because chelation removes the heavy metals to which most people are exposed, it may be reasonable to treat such patients with EDTA.

Allergy to EDTA, which is rare, is the only absolute contraindication for EDTA. It can aggravate renal impairment if too much is given or it is given too fast. Patients with a poor creatinine clearance should be treated only with low-dose EDTA and only by experienced specialists. Severe liver disease with significant liver enzyme elevation is another contraindication. EDTA chelation is contra-indicated in pregnancy except in the presence of severe lead toxicity. Some patients have had their congestive heart failure aggravated by EDTA therapy because of the fluids received during IV infusion of the EDTA. These patients must have their fluid status as well as their electrolytes monitored. Typically, these patients receive an adjustment in the IV fluid infusion rate and a diuretic.

Potential side effects of sodium EDTA therapy are low blood calcium (hypocalcemia) possibly leading to tetany, seizures (usually due to too rapid of infusion), kidney damage (nephrotoxicity), local vein infection (thrombophlebitis), low blood pressure (hypotension), and low blood sugar (hypoglycemia). Low blood calcium is easily reversed with IV calcium infusions. Low blood pressure is usually mild, and slowing the infusion is usually adequate to prevent any significant problems. Patients typically eat before treatment begins, and since the infusions last two to three hours, they bring a snack. This prevents episodes of low blood sugar. We use calcium EDTA and these side effects are prevented.

Besides chelating unwanted heavy metals, EDTA also removes several good minerals from within the body. Patients usually receive oral supplements to help return lost minerals. Iron supplements should be avoided unless there is a documented iron deficiency.