Dr. John Gannage — CPSO Takes No Action on Chelation for Autism

Dr. John Gannage: How Ontario's Regulator Cleared a Physician Offering Chelation for Autism — No Injury, No Discipline

Case summary — CPSO complaint and Health Professions Appeal and Review Board (HPARB) decision, Markham, Ontario

In brief: Unlike Dr. Roy Kerry in Pennsylvania — whose chelation "autism cure" killed a 5-year-old boy through a medication error — Dr. John Gannage of Markham, Ontario has continued to offer chelation and related "biomedical" therapies to autistic children for over two decades with the College of Physicians and Surgeons of Ontario's tacit approval. When an advocate filed a complaint, the College found no misconduct, and the province's appeal board upheld that finding — not because the treatment is sound, but because Ontario law and CPSO policy don't let regulators discipline a physician merely for using a non-traditional therapy, absent proof that a specific patient was harmed.

Note on this entry: Dr. Gannage has not been found guilty of professional misconduct, incompetence, or any wrongdoing by the CPSO or any tribunal. Both the College and Ontario's Health Professions Appeal and Review Board considered a formal complaint against him and closed the matter in his favour. This page is a case study in a regulatory gap — how a therapy with no supporting evidence can be lawfully offered to vulnerable families — not an allegation that Dr. Gannage broke any rule.

Further reading: This case is drawn largely from Steven Novella, MD, "Chelation Therapy for Autism is Quackery" (Science-Based Medicine, September 5, 2018), which lays out the CPSO/HPARB decision in full and the broader argument for why Ontario's regulatory framework leaves this kind of practice untouched.

Who is Dr. Gannage

John Gannage is a family physician who founded and directs Markham Integrative Medicine, practicing "prevention and treatment of chronic disease through nutrition, detoxification, immune system modulation and reduction of oxidative stress" since 1998.
He holds active licences with both the College of Physicians and Surgeons of Ontario (CPSO) and the College of Physicians and Surgeons of British Columbia.
He has administered chelation therapy since 1999 and was a principal investigator for TACT (the Trial to Assess Chelation Therapy), enrolling Canada's first participant in that cardiovascular trial.
He is a longstanding member of MAPS (the Medical Academy of Pediatric Special Needs — formerly associated with the "Defeat Autism Now!" movement) and holds a MAPS Fellowship for work with autistic children and families. Multiple practitioner profiles also list him as a "Defeat Autism Now! clinician," though the DAN! protocol and its practitioner-certification registry were formally discontinued by the Autism Research Institute around 2010-2011 amid sustained scientific and regulatory criticism.
Beyond chelation, his special focus is "assisting children and families affected by developmental issues, including autism, using biomedical therapy" — the same broad framework (heavy-metal toxicity, gut health, "detoxification") that underlies chelation-for-autism practice generally.
Separately from the events described on this page, he also holds a role as a CPSO Peer Assessor and has acted as a preceptor for other physicians — standard CPSO volunteer roles held by many practicing physicians in good standing; nothing in the public record suggests this role had any bearing on how his own complaint was handled.

The complaint and the College's response

Autism advocate Sarah Borden King, who runs an autism advocacy organization, learned Gannage was offering chelation therapy to autistic children and searched for any regulation preventing it — and found none. "It's this Wild West," she told CBC News. "There is no law that says that you can't do these things."
Referred to the CPSO, Borden King filed a formal complaint against Gannage.
A CPSO committee determined no action needed to be taken, finding Gannage in compliance with the College's Complementary/Alternative Medicine policy.
The CPSO's written response to the complaint stated that while it "does not take a position on individual therapies or treatments," physicians offering complementary treatments must base diagnosis on clinical assessment, sound clinical judgment, evidence, and a risk-benefit analysis — and must obtain informed consent.

The appeal: HPARB upholds the College

Borden King appealed the College's decision to the Health Professions Appeal and Review Board (HPARB), Ontario's independent tribunal for reviewing regulatory-college complaint decisions.
HPARB ruled the CPSO was correct not to act against Gannage, because there was no evidence his use of chelation therapy had directly resulted in injury or other harm to a child.
The decision noted Gannage appeared to be in compliance with CPSO policy stating that patients have a right to pursue alternative treatments, and that physicians should not be punished for providing them unless there is evidence the therapy is riskier than the conventional approach.
Gannage declined an interview request to discuss the case.

"Although the [College] does not take a position on individual therapies or treatments, we have developed policies to guide physician conduct while supporting patient autonomy. If physicians offer complementary treatments to patients, their diagnosis must be based on their clinical assessment, be supported by sound clinical judgment and informed by evidence and a risk-benefit analysis." — CPSO statement, as reported by CBC News

The regulatory gap: why Kerry and Gannage were treated so differently

Ontario's Medicine Act, 1991 states physicians "shall not be found guilty of professional misconduct or incompetence solely on the basis that they practice a therapy that is non-traditional or that departs from the prevailing medical practice."
The CPSO's Complementary/Alternative Medicine policy builds on that statute: it evaluates whether a physician followed a defensible process (clinical assessment, informed consent, risk-benefit reasoning) rather than whether the treatment itself has any scientific basis.
Practically, this means Ontario's regulator has no mechanism to intervene before harm occurs — it can only respond after a specific patient is demonstrably injured, and even then must show the treatment itself (not just poor administration) caused it.
By contrast, Dr. Roy Kerry's 2005 chelation death in Pennsylvania involved a concrete, provable medication error (the wrong EDTA salt given the wrong way) — a discrete act of documented harm the kind that regulatory and criminal systems are built to act on. Gannage's ongoing practice, with no reported injury tied to a named patient, falls outside what either the CPSO or HPARB is willing or able to touch.
Tim Caulfield, Canada Research Chair in health law and policy at the University of Alberta, said the HPARB decision casts doubt on the ability of regulatory bodies governing doctors and other health professionals to properly police the use of unproven or unscientific treatments before harm occurs. (See also [[timothy-caulfield]]'s broader critique of complementary/alternative medicine regulation, cross-linked from QuackeryWatch's WHO/CAM strategy page.)

The underlying science

Chelation therapy is FDA/Health Canada-approved only for acute heavy metal poisoning. Its use for autism rests on the discredited theory that autism is caused by mercury exposure from the vaccine preservative thimerosal — a link that has been thoroughly disproven.
A 2015 systematic review found only 10 studies of chelation for autism; nine were uncontrolled and therefore not informative. The single controlled trial found no benefit, and its authors concluded the risks of chelation for autism — including hypocalcaemia, renal impairment, and reported death — currently outweigh any proven benefit.
Despite this, a 2013 U.S. study estimated roughly half a million children are given this treatment for autism each year; use is common in Canada and Europe as well as the U.S.
Dr. Rosalind (Evdokia) Anagnostou, a Toronto pediatric neurologist who treats autistic children, told CBC News she draws a firm line at chelation therapy even though she's open to discussing many other alternative approaches parents raise with her.

Claims vs. evidence: side by side

The left column draws from Dr. Gannage's own practitioner profiles and promotional materials (Markham Integrative Medicine, ISOM, MedMaps.org, IHR Magazine). The right column is what pediatric bodies, regulators, and the clinical trial literature have actually found.

Claim made (Gannage / his profiles)	What the evidence / regulators say	Verdict
Offers "biomedical therapy" for autistic children, addressing "environmental factors," "detoxification," and heavy-metal burden.	The theory that autism is caused by heavy metal (mercury/thimerosal) toxicity has been thoroughly disproven. AAP, CPS, and RCPCH all list chelation among treatments with no supporting evidence for autism.AAP, Pediatrics 2020;145(1); CPS position statement, Oct 2019; Lagan & Balfe, Arch Dis Child 2018;103(9):910-911.	Debunked
Has been "administering Chelation Therapy since 1999" — implying an established, safe track record.	CDC documented 3 deaths from EDTA-related hypocalcemia in 2003-2005 alone, including a child chelated for autism. FDA and CDC have both issued formal warnings about chelation's risks (kidney damage, hypocalcemia, fatal arrhythmia).CDC, MMWR 2006;55:204-207; FDA consumer update on autism treatment claims.	Contradicted by documented deaths
Was "a principal investigator for TACT," cited in his bio as a credential establishing scientific legitimacy for chelation.	TACT (2013) was itself methodologically compromised (run largely at CAM sites, 11 unplanned interim analyses, high lopsided dropout). Its intended replication, TACT2 (JAMA, 2024), found no cardiovascular benefit at all. Neither trial tested chelation for autism — TACT was cardiovascular-only.Nissen SE, JAMA editorial, 2013; Lamas GA et al., JAMA 2024;332(10):794-803.	Refuted (TACT2) / not applicable to autism
Is a Fellow of MAPS (Medical Academy of Pediatric Special Needs) and a "Defeat Autism Now!" (DAN!) clinician, presenting this as specialist pediatric credentialing.	DAN!/MAPS-affiliated chelation practice was the direct subject of a 2010 lawsuit (Usman/Rossignol, Chicago) alleging medically unnecessary and unjustified chelation on an autistic child. The DAN! program itself was formally discontinued by its founding organization, the Autism Research Institute, around 2010-2011 — ARI shut down the DAN! protocol and its practitioner-certification registry after years of scientific and medical criticism that its treatments (including chelation) were unproven, unsafe, and unsupported by controlled evidence. The AAP issued a formal 2011 statement warning against the DAN! protocol on the same grounds. No mainstream pediatric body recognizes DAN!/MAPS biomedical protocols as evidence-based.ABC News/GMA, "Father Sues Doctors Over 'Fraudulent' Autism Therapy," March 2010; American Academy of Pediatrics statement, 2011.	Discontinued by its own founding body
Practice is licensed and "in good standing" with the CPSO and CPSBC — often presented as implying the treatment itself is sanctioned.	The CPSO's own statement is explicit that it "does not take a position on individual therapies or treatments." Licence-in-good-standing reflects a process check (informed consent, clinical judgment), not a finding that chelation for autism works or is safe.CPSO statement, as reported by CBC News; CPSO Complementary/Alternative Medicine policy.	Misleading if read as endorsement

Wider context: other documented harms from chelation therapy

Nadama's death was not an isolated pharmacological event. The same CDC report that documented his case also described two other deaths from EDTA-related hypocalcemia in the same 2003–2005 window: a 2-year-old Texas girl being treated for confirmed lead poisoning, who died after a hospital pharmacy dispensed the wrong chelating agent, and a 53-year-old Oregon woman with no diagnosed heart disease who died after a naturopath gave her IV EDTA for presumed cardiovascular disease. Neither was a chelation-for-autism case, but both fed into the same CDC safety review and FDA scrutiny of the drug.
In 2010, a Chicago father filed what was reported as the first lawsuit of its kind against two physicians associated with the "Defeat Autism Now!" movement, Dr. Anjum Usman and Dr. Daniel Rossignol, alleging they chelated his autistic son 37 times alongside 30 vitamin supplements with no proven benefit. No death was involved, but the suit specifically targeted the same treatment framework — DAN!/biomedical autism therapy — that Gannage's MAPS/DAN! affiliation places him within. The DAN! program itself did not survive this period of scrutiny: its founding organization, the Autism Research Institute, formally discontinued the protocol and closed its practitioner registry around 2010-2011.
In 2008, the U.S. National Institutes of Health cancelled a planned clinical trial of chelation for autism on ethical grounds, concluding there was "no clear evidence for direct benefit to the children who would participate" and that the study "presents more than a minimal risk" — a decision made explicitly in light of Nadama's death three years earlier.

Was DAN! ever held accountable?

No lawsuit against the DAN! program or its founding organization, the Autism Research Institute (ARI), as an entity has been documented. Accountability instead came through individual malpractice suits, regulatory board actions, and one landmark federal court proceeding that rejected the theory DAN! was built on.
The Coman v. Usman/Rossignol malpractice suit (Cook County, 2010) targeted two DAN!-affiliated physicians directly over unnecessary chelation and supplements; it was reportedly voluntarily dismissed in October 2014, though the only account of that outcome comes from a source sympathetic to the defendants, so the reasons for dismissal are not independently confirmed.
Stephen Barrett, MD's Quackwatch audit of DAN!'s own clinical registry (2001–2011, ~447 listed practitioners) found that 67 — about 15% — had been subject to government licensing board actions. Seven were tied directly to core DAN! practices: Roy E. Kerry, MD (the same physician covered on this site's Kerry case page), Richard E. Layton, MD, Seshagiri Rao, MD, Alan Schwartz, MD, Stephen L. Smith, MD, Kenneth P. Stoller, MD, and Anjum Usman, MD. At least 18 more registry physicians were disciplined for other nonstandard or pseudoscientific methods.
The theory underlying DAN! — that vaccine-derived mercury causes autism — was tested and rejected in the U.S. Court of Federal Claims' Omnibus Autism Proceeding (2007–2010). ARI's own medical director, Dr. Elizabeth Mumper, testified in support of the vaccine-injury theory but admitted under cross-examination that no controlled outcome studies existed for any DAN! treatment. The Special Masters ruled against the MMR-thimerosal theory in 2009 and against thimerosal alone in 2010.
Separate government (not civil-suit) actions against DAN!-adjacent figures: a 2009 FBI raid closed a Texas DAN! clinic (CARE Clinics/Center for Autistic Spectrum Disorders) over suspected insurance fraud; the UK's General Medical Council struck Andrew Wakefield from its register in 2010; and Maryland revoked Mark R. Geier, MD's licence in 2012 for inappropriate chelation and precocious-puberty (Lupron) treatments of autistic children.
ARI itself acknowledged in 2010 that the DAN! registry was a liability: it froze and removed the clinician list, noting that although it merely recorded seminar attendance, many people mistook it for a list of vetted, recommended doctors — and ARI "did not certify doctors and could not assure that every practitioner on the list provided high-quality service."

What is he currently advertising? (2025-2026 findings)

Note on scope: we have no way to view Gannage's physical office — signage, posters, brochures on-site. The following is drawn entirely from his clinic's current public website (integrative-medicine.ca) and its dated pages, current as of this writing.

His clinic's "Detoxification Therapies" service page, live in 2026, states plainly that "chelation therapy may be used as part of a carefully monitored protocol" and cites that "chelation therapy has been studied in several areas of medicine, including cardiovascular disease, where clinical trials have demonstrated potential benefit in selected patient populations." The page cites TACT's positive 2013 result but does not mention TACT2 (JAMA, 2024), which retested that exact patient population and found no cardiovascular benefit at all. As of this writing, his own clinical marketing has not been updated to reflect the trial that refuted the evidence he cites.
His "Biomedical Treatment for Autism Spectrum Disorder" service page markets him as "a nationally recognized leader" whose approach combines "evidence-based biomedical approaches" and "science-backed protocols," and states his goal is to provide "actionable, science-based solutions." These characterizations rest on the same unproven biomedical/detoxification framework already documented on this page.
A blog post dated October 23, 2025 — "Understanding FRAT and Leucovorin: What Parents Should Know Before Testing," authored by Gannage himself — shows his practice has pivoted to a new trend: folate receptor autoantibody testing (FRAT) and leucovorin (folinic acid) for autism, following a wave of "political attention and patient demand." He credits Dr. Richard Frye, a MAPS faculty member, as central to the recent surge in interest, and states MAPS itself "did not provide advance guidance on messaging or logistics" — showing his practice continues to look to the DAN!-successor organization for direction on new unproven interventions.
In that same post, Gannage describes presenting "before-and-after video footage" of a single patient's response to B12 and leucovorin at a 2024 medical conference — an anecdotal case testimonial, not controlled trial data, presented to an audience of health professionals as part of his "comprehensive PowerPoint series on the biomedical approach to ASD."
To his credit, the same post includes real hedging language: he calls leucovorin "not a silver bullet," warns that "the size and quality of trials still limit the extent to which leucovorin can be labeled as standard of care," and cautions parents against "impulsive dosing." This is more caveated than his chelation marketing, which cites TACT's outdated positive result with no such caveat at all.
His clinic maintains active Facebook, Instagram, and YouTube channels (linked directly from the clinic website) as of 2026; we did not review individual posts on these channels for this page.

Should the CPSO know about this?

We can't speak to what is in Gannage's mind, or whether he is personally aware of DAN!'s 2010-2011 discontinuation or TACT2's 2024 result — that would be speculation about his state of mind, which we can't support from the record.
What we can say is that his own clinic's current, public-facing clinical marketing (not just a practitioner directory bio) continues to cite TACT as supporting evidence for chelation therapy without acknowledging TACT2's negative result — a fact that is directly relevant to the CPSO's own stated standard, that complementary treatments be "supported by sound clinical judgment and informed by evidence and a risk-benefit analysis."
Whether the College's original review of the complaint against Gannage accounted for this specific, current marketing content is an open question. A regulator applying its own "informed by evidence" standard would presumably want to know that the evidence being cited to patients has since been superseded by a definitive follow-up trial.

General resource: Anyone with a concern about the care or conduct of any Ontario physician — not specific to this case — can raise it with the College of Physicians and Surgeons of Ontario through its Complaints and Concerns process. The College encourages trying to resolve the issue directly with the physician first, where appropriate.

Status

As of recent professional listings, Gannage continues to hold active, unrestricted licences in both Ontario and British Columbia, continues to operate Markham Integrative Medicine, and continues to treat autistic children with chelation and related biomedical therapies.

Sources: "Body governing Ontario doctors takes no action against physician offering unproven treatment for autistic children," The Globe and Mail; Steven Novella, "Chelation Therapy for Autism is Quackery", Science-Based Medicine, September 5, 2018 (citing CBC News reporting and a 2015 systematic review); CPSO Policy, "Complementary/Alternative Medicine"; Markham Integrative Medicine, ISOM, and MedMaps.org practitioner profiles; CDC, "Deaths Associated with Hypocalcemia from Chelation Therapy — Texas, Pennsylvania, and Oregon, 2003–2005," MMWR 2006;55:204-207; "Father Sues Doctors Over 'Fraudulent' Autism Therapy," ABC News/Good Morning America, March 2010; National Institutes of Health statement on the 2008 cancellation of a chelation-autism clinical trial; Stephen Barrett, MD, "A Critical Look at Defeat Autism Now! and the 'DAN! Protocol'", Quackwatch, June 1, 2015 (registry audit, Omnibus Autism Proceeding, CARE Clinics/Wakefield/Geier government actions); Markham Integrative Medicine, "Detoxification Therapies" and "Biomedical Treatment for Autism Spectrum Disorder" service pages (accessed 2026); John Gannage, "Understanding FRAT and Leucovorin: What Parents Should Know Before Testing", Markham Integrative Medicine blog, October 23, 2025.