Evidence supporting the use of: Sodium Thiosulfate
For the health condition: Heavy Metal Poisoning
Synopsis
Source of validity: Scientific
Rating (out of 5): 2
Sodium thiosulfate has some scientific basis for use in treating certain types of heavy metal poisoning, but its application is limited and the supporting evidence is not robust. Primarily, sodium thiosulfate acts as a chelating agent, forming less toxic complexes with metals such as arsenic, mercury, and potentially cyanide (where its use is best established). Its use is most prominent in cyanide poisoning, where it serves as a sulfur donor to enhance conversion of cyanide to the less toxic thiocyanate, which is excreted in urine. For other heavy metals, such as arsenic and mercury, there is some historical and experimental evidence that sodium thiosulfate can bind these metals and facilitate their excretion, but it is not considered a first-line or standard antidote. Modern clinical practice favors chelators such as dimercaprol (British anti-Lewisite), dimercaptosuccinic acid (DMSA), or ethylenediaminetetraacetic acid (EDTA) for most cases of heavy metal poisoning, as these agents show superior efficacy and safety profiles based on clinical trials and case reports. Overall, while there is a scientific rationale and some documented (mostly historical or in vitro) use of sodium thiosulfate in heavy metal poisoning, contemporary use is rare and only considered when preferred chelators are unavailable. Major toxicology and pharmacology references do not list sodium thiosulfate as a mainstay of heavy metal detoxification.
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