Q:I've been reading a lot about a promising new method of treating heart disease called chelation therapy. How established is it? Has it been proved safe to use? S F, Washington, DC.....
A:Chelation therapy is so named because it employs molecules called chelators which have the ability to zero in on stray atoms and chemically grab them in a tight grip. Their particular forte is to remove metals in the body.
One of the most common agents used is ethylenediamine tetra acetic acid, or EDTA, a cluster of four acetic acid groups with two nitrogen atoms. Whenever this cluster bumps up against a metal ion, the molecules form a tight ring around the metal.
EDTA has been licensed by the US Food and Drug Administration since the 1950s for patients with toxic metal overload, particularly lead, mercury and aluminium, or abnormally located nutritional metals, such as copper or iron. It is administered via a slow drip into the bloodstream. However, one of the byproducts of chelation is to improve metabolic and circulatory function of arteries formerly blocked by plaque. Some believe that accumulation of heavy metals in the body as well as substances like calcium is responsible for atherosclerosis (hardening of the arteries). By removing metals and calcium deposits from the body, chelation therapy removes the source. As the EDTA moves through a patient's blood system, it binds with artery clogging deposits; as the acid passes out of the body, so the deposits are excreted.
Many organizations in the US and the UK have enthusiastically taken up chelation therapy notably the Arterial Disease Clinic in London and Lancashire and the American College of Advancement in Medicine, which provides a protocol for chelation therapy use in the States as well as a list of participating clinics.
To date, there have been no scientific (that is, randomized, double blind) studies proving the benefit of chelation therapy.
Nevertheless, the American Institute of Medical Preventics (AIMP) holds a permit issued by the US Food and Drug Administration to investigate chelation therapy for future licensing and is co-sponsor of ongoing FDA approved studies of EDTA chelation therapy to treat arteriosclerosis.
A recent, supposedly scientific study, conducted by a Danish vascular surgeon and his cohorts, apparently showed that intravenous disodium EDTA is not effective in the treatment of hardening of the arteries (American Journal of Surgery 1991; 162: 122-5; the Journal of Internal Medicine 1992; 231:261-7).
However, AIMP's President James Frackelton, writing in the Townsend Letter for Doctors (July 1992), maintains that the Danish study contains a number of serious flaws. For one thing, the Danes used disodium EDTA, which is "less effective" than magnesium EDTA used in the US and in the FDA licensed studies. Although the study claimed to be double blind, "the investigators themselves admitted that the study was not properly blinded," charges Frackelton. "The investigators instructed patients to chew and swallow a mineral supplement containing a substantial amount of iron during the course of each infusion. . . . EDTA has a very high affinity for iron and the iron in those tablets would have reacted irreversibly with a larger percentage of the infused EDTA, thus neutralizing any potential benefit." He also cites what he claims were other flaws with the study.
The reports that have shown positive results with chelation therapy are mostly clinical observational studies by private physicians. In a retrospective study of 470 patients given chelation therapy, 80-91 per cent demonstrated improvements. "Of 92 patients referred for surgical intervention, only 10 required ultimate surgery after or during their chelation therapy. . ." said the report (Journal of Advancement in Medicine, Fall 1993).
A similar study (Journal of Holistic Medicine, Spring/Summer 1985) of 77 elderly patients with narrowed arteries in the lower extremities showed that intravenous EDTA chelation therapy with "supportive multivitamin supplementation" improved arterial blood flow "significantly" after 60 days and 26 infusions.
Most significantly, a meta analysis of 19 articles on chelation therapy covering nearly 23,000 patients showed that 87 per cent demonstrated improved cardiovascular function by objective testing (Journal of Advancement in Medicine, Fall 1993).
Chelation therapy has also been used successfully to improve chronic lung disorders (Health Consciousness, April 1990); to treat cancer, where it reduced mortality 90 per cent during an 18 year follow up (Journal of Advancement in Medicine, Spring/Summer 1989); and to remove the toxic effect of aluminium in kidney dialysis patients (The Lancet, 7 May 1988).
The attempts of the cardiac establishment to discredit chelation therapy were fuelled by the deaths of 13 patients at Meadowbrook Hospital in Belle Chasse, Louisiana in the mid 1970s. John David Spence of Victoria Hospital in London, Ontario, Canada, a professed opponent of chelation therapy, conducted an audit of the Meadowbrook Hospital for the US Department of Health, Education and Welfare. Chelation therapy can cause kidney damage and so should not be used on people with kidney disease. Any patient placed on intravenous EDTA should be carefully monitored for renal damage. After reviewing the charts, Spence found that a number of patients continued to receive EDTA even after they'd had kidney tests with results above the hospital's cut off point for continuing with the therapy. A number of patients subsequently died of kidney failure.
At Meadowbrook, Spence discovered that patients with congestive heart failure had been given a higher solution of EDTA than they were supposed to and that patients weren't being closely monitored.
In defending the late Dr Ray Evers, who headed Meadowbrook at the time, Dr Michael B Schachter, president of the ACAM, says that Dr Evers often accepted patients with advanced disease whom conventional medicine had virtually given up on.
He also maintained: "Virtually no deaths are reported from EDTA chelation therapy when the ACAM protocol is followed" (Townsend Letter for Doctors, Aug/Sept 1991).
Nevertheless, Spence's audit does demonstrate that chelation can be dangerous if the therapy is administered without strict adherence to protocol. If you do wish to try chelation therapy, it is vital that you go to a highly experienced doctor or clinic which strictly follows ACAM protocol. It's also vital that you follow a full programme for cardiovascular disease, including an optimal diet, appropriate nutritional supplements, regular exercise program, and stress management.
In the US, the best bet is to contact the ACAM (23121 Verdugo Dr, Suite 204, Laguna Hills, CA 92653, Tel: 714 583 7666), for recommendations on clinics following ACAM protocol. In the UK, the Arterial Disease Clinic is in London (Tel: 071 935 6604) and Lancashire (0942 676617). Individual doctors carrying out chelation include Dr Hugh Cox at the Sozo Clinic in Aylesbury, Bucks, Dr Fritz Schellander at the Liongate Clinic in Tunbridge Wells, and Dr Patrick Kingsley in Osgathorpe, Leicestershire.
Of course, the potential problems of this unstudied but promising procedure must be weighed against the known problems of the medical alternatives drug therapy, bypass surgery and angioplasty. According to the US National Institute of Health, 90 per cent of American patients who undergo bypass surgery receive no benefits. (Send in for our new booklet, The WDDTY Guide to Your Heart, lb4.95, for the full story.)