Articles

Jonathan Collin, MD: EDTA Chelation Therapy in the Treatment of Arteriosclerosis and Atherosclerotic Conditions

DrCby Jonathan Collin, MD
(Data Submission to the Public Health Service, May 1981, unpublished report)
Reprinted from Townsend Letter with permission

One approved usage of EDTA (di-sodium-ethylene-di-amine-tetra-acetic acid) sanctioned by the Food and Drug Administration is in the treatment of acute lead poisoning. Most of the clinical reports documenting EDTA Chelation as an appropriate tool in lead intoxication originated in the early 1950s (Belknap, 1952; Butler, 1952; Foreman, 1953). Not until 1955 did Clarke, Clarke and Mosher report the clinical observation of EDTA influencing the process of atherosclerosis. This observation was a medical serendipity: the Clarke team was not seeking a change in the cardiovascular process. They were involved in the clinical therapy of lead detoxification and made the observation that older patients with known atherosclerotic disease changed vascularly under EDTA chelation.

The initial Clarke, Clarke, Mosher report of 1955 was followed by further clinical documentation in 1956 of EDTA’s use to treat angina pectoris. Other medical investigators made similar observations of EDTA’s role in the treatment of cardiovascular disease (Bechtel, 1956; Bessman, 1957; Perry, 1961; Szekely, 1963; Wenig, 1958: and Wilder, 1962). In the midst of the research work on chelation therapy’s role in clinical medicine, Seven (1960) discussed toxicology problems with a variety of chelating agents. Nephrotoxicity (kidney poisoning) had been observed by some workers in the usage of EDTA (Foreman, 1956). Chelation therapy investigation slacked off during the mid-sixties to some extent. However, the Clarke team pursued chelation therapy as a primary cardiovascular therapy throughout this period and into the seventies at Providence Hospital in Detroit. Recent clinical activity with EDTA has led to extensive literature reviews on chelation and more fundamental documentation of its use in atherosclerosis (Harper and Gordon, 1975; Halstead 1919).

The United States Public Health Service, in collaboration with the National Institutes of Health, organized a study of EDTA Chelation in 1981. This study was relegated to an office in the Public Health Service dealing with modern health technologies. Substantial data was offered to this department by many members of the American Academy of Medical Preventics (Los Angeles) for scientific review. Although no formal explanation was given, none of the reports submitted were properly examined by any scientific boards, nor was the data published. At a later date, without any well-documented summary, the Public Health Service concluded that EDTA Chelation Therapy for arteriosclerosis should be considered experimental and without substantial evidence to support its clinical use. This decision came, apparently, without the support of double-blind studies or peer-review publications. It was based on the opinions of various spokespersons of the American Heart Association, the American College of Cardiology, the AMA, and the National Institutes of Health. The Medicare decision of 1982, to deny reimbursement for EDTA chelation therapy, was based primarily on this Public Health Service study. In large part, then, the medical community and national health agencies have done very little serious scientific study on EDTA Chelation therapy.

The purpose of this report is to provide documentation of the experiences of one clinic using EDTA Chelation in the treatment of arteriosclerosis. The research design does not control for EDTA and placebo; it is simply gathering clinical results using each individual patient as his/her own before and after. Criticism concerning lack of scientific control and statistical analysis are granted. However, recent comments by the medical community in the peer-review journals and to the press indicate a pervasive opinion that EDTA Chelation has no validity whatsoever. This report establishes significant pre- and post- chelation changes, suggesting that orthodox medical opinion of EDTA may be seriously wanting.

Clinical Design
EDTA Chelation Therapy is administered to individuals with documented arteriosclerotic disease of the heart, head and neck, or peripheral circulation. The diagnosis of circulatory disease, using invasive and non-invasive cardiovascular techniques, is made prior to accepting the patient for consideration of the therapy. Once the lesion(s) in the circulation have been defined, the patient is apprised of all medical and surgical therapies appropriate to manage the disease. Consultation with the cardiologist and cardiovascular surgeon is advised, and follow up with the medical specialist is recommended. If the individual decides to consider EDTA Chelation therapy, laboratory testing must be undertaken to identify potential toxicity risks. All EDTA patients need to show adequate kidney and liver functioning, stable electrolyte levels, normal blood count, and no evidence of underlying tumor. Evident tuberculosis or infectious disease contraindicates chelation. The patient is scrutinized for any factors that present undue risks that would make EDTA treatment inappropriate.

Once these steps have been satisfactorily attended to, a thorough evaluation of the individual’s nutrition and metabolic status is undertaken. A thorough physical and history establishes deficiencies and dietary excesses. Insufficient calories, protein, fat, carbohydrates, vitamins, mineral elements, and amino acids are defined through dietary survey and history, and laboratory testing of the serum, urine, and blood cell. Nutritional deficiencies are corrected as expediently as possible and monitored. Equally likely are dietary excesses of fat, cholesterol, refined carbohydrates, and salt. Individuals are strongly encouraged to increase their unrefined food stuffs, vegetables and whole grains to build up their fiber ingestion while restricting their intake of animal fat, sugar and salt. Obvious over-indulging in caffeine, nicotine, and alcohol is eliminated to the best of the patient’s ability.

Supplementation with vitamin and mineral food supplements, usually in the form of tablet or capsule, is ordered to make up for difficult deficiencies. In view of the aggressive effect EDTA has on the biochemistry, particularly in chelating minerals that may already be potentially deficient, mineral supplementation is advised in mega-quantities. The use of analyses to monitor minerals in the body is supported in spite of literature arguing against this clinical testing. In short, every effort is made to thoroughly analyze the nutritional and metabolic function and to correct the diagnosed shortcomings before initiating the chelation treatment.

Certain cardiovascular studies are completed prior to initiating the chelation including electrocardiogram (ECG), and the plethysmogram of the peripheral pulses end carotids. The plethysmograph provides a non-invasive study of the pulse contour, showing reduction in the pulse amplitude and alteration in the upslope and downslope of the pulse. An obstruction in the artery, a plaque-induced restriction in the blood flow, will usually be observed on plethysmography. Invasive studies can then be ordered to precisely define the lesion. The chemistry SMA-18 specifies kidney and liver function: BUN and SGOT can be used as markers for each system respectively. Since EDTA Chelation actively binds metal elements, the excretion of lead and arsenic can be studied by a 24-hour urinary study. Increases in such 24-hour excretions suggest heavy metal intoxication.

The EDTA Chelation itself is administered to the patient on an out-patient basis in the office during the morning or afternoon. One session of EDTA is given in a two to three hour period. A patient can have one to three chelations in a one-week period. Rules on the frequency of EDTA chelation are required to ensure that the possibility of nephrotoxicity is reduced. Peer-review literature concerning EDTA Chelation’s toxic effect on kidneys does not, however, call for a restriction on the quantity of EDTA a person may be given in a specified time. Recent studies by Halstead (l979) and others clarify that the earlier problems with toxicity are totally negated when EDTA Chelation is given slowly and less frequently.

The quantity of EDTA given is 1 to 3 grams depending on the weight, sex, age, and condition of the patient. The EDTA is diluted in a buffered solution such as Ringer’s Lactate, Fructose or Dextrose in Water, Half Normal Saline, etc. Because EDTA has substantial ligand-forming activity in living systems, every EDTA solution receives at least 1,000 milligrams of magnesium chloride (or magnesium equivalent). This brings about an initial binding of much of the EDTA to magnesium, lessening the pain of administering EDTA. Other additives to the EDTA solution include 5,000 IU of heparin, one to ten grams of ascorbic acid, and one to two milliliters of 2% lidocaine. Usually vitamins are also added to the EDTA solution, including thiamine, pyridoxine, B-Complex and B-12. Other additives, appropriate for the patient’s management, may be injected.

The patient receives the solution under the observation of the nurse and doctor while sitting in the office, reading or talking to a fellow patient. Blood pressure, weight, pulse, and other vital signs are measured at each visit. During the chelation process, alterations are made in the rate of infusion depending on the patient’s condition. Relaxing background music, comfortable chairs and pillows to prop the patient’s arms on, nice lighting, and nursing TLC help in reducing the anxiety of having an infusion. Patients are encouraged to snack on wholesome food and drink during the process. In the rare circumstances when patients experience reactions, intranasal oxygen is usually administered, and this suffices to bring about stabilization. It is extremely rare when resuscitation procedures are necessary (probably no higher than the number experienced in any general practice office during non-surgery treatment).

The usual arteriosclerotic patient is recommended a series of twenty to thirty chelations over several months. In the course of this treatment, repeat cardiovascular and laboratory testing is made to study changes in blood flow and metabolic functioning. Further, the possibility of toxicity is studied in these blood tests. Any patient having abnormal liver or kidney functions has his chelation discontinued, and thorough investigation of toxicity is made. Our protocol demands that monitoring is made continuously to ensure that no harmful effects go undetected.

Clinical Summary
Twenty-six patients, fourteen males and twelve females, aged from 34 to 85 years of age, underwent EDTA Chelation Therapy at the clinic from 1975 through 1981. All patients receiving this therapy were diagnosed with atherosclerosis or some significant cardiovascular process (Table 1).

Of the twenty-six patients, twenty-three received at least 20 separate chelation treatments. Fifteen patients received thirty or more individual infusions. Each of the twenty-six patients underwent non-invasive plethysmograph before EDTA chelation. Understandably, the plethysmogram demonstrated arteriosclerotic disease in each of the patients; all twenty-six were previously diagnosed with arteriosclerotic heart, peripheral, or cerebral disease. Plethysmography carried out following chelation revealed at least 20% improvement in cardiovascular functioning in all twenty-six patients. In fourteen of the twenty-six patients, the plethysmogram demonstrated 50% improvement in pulse amplitude and contour. Ten of the twenty-six patients showed a continued documentation of this improved circulatory plethysmogram when the test was repeated yearly over five years. (Table 2).

A review is made of evidence of nephrotoxicity and hepatotoxicity. In zero of twenty-six patients was the BUN found to change from a normal to abnormal elevation. In only one patient of twenty-six was there a change in the SGOT; evidence to support hepatotoxicity in chelation patients was insignificant. To the contrary, the data strongly suggests that EDTA improved both hepatic and renal functioning in these patients (Table 3).

Table 4 confirms the expected activity of EDTA in inducing an effective diuresis of lead. It also substantiates the ability of EDTA to chelate arsenic.

 Conclusion
The data charted on these twenty-six individuals receiving EDTA chelation therapy strongly suggests that EDTA is efficacious in the treatment of arteriosclerosis. Through the use of an effective, cautious protocol, no incidents of toxicity were observed in this group of chelating patients. No evidence was found for significant nephrotoxicity, a key criticism against the medical use of EDTA. Inasmuch as the EDTA was observed to bring about a significant diuresis of lead and arsenic, while improving the cardiovascular status of most patients by at least 20%, the original observations of the Clarke and Clarke group (1955) has been again confirmed in 1981. This report argues for the role of EDTA in treatment of cardiovascular diseases and calls for serious scientific study of EDTA chelation to be initiated at the university level in the near future.

References
1. Bechtel, JR, White, JE, Estes, EH Jr. (1956). The electrocardiographic effects of hypocalcemia induced in normal subjects with edathamil sodium. Circ 13:837.

2. Belknap, EL (1952). EDTA in the treatment of lead poisoning. Ind Med Surg21(6):305.

3. Bessman, SP, Doorenbos, NJ (1957), Editorial. Chelation. Ann IntMed47(5):1036.

4. Butler, AM (1952), Use of calcium ethylene-diaminetetraacetate in treating heavy-metal poisoning. Arch IndHygOcc Med 7:137.

5. Clarke, NE, Clarke, CN, Mosher, RE (1955). The “in vivo” dissolution of metastatic calcium. An approach to atherosclerosis. Am J Med Sci 229:142.

6. Clarke, NE, Clarke, CN, Mosher RE (1956). Treatment of angina pectoris with disodium ethylene diaminetetraacetic acid. Am J Med Sci 232:654.

7. Foreman, H, Finnegan, C, Lushbaugh, CC (1956). Nephrotoxic hazard from uncontrolled edathamil calcium-disodium therapy. J Am Med Assoc160(12):1042.

8. Foreman, H, Hardy, HL, Shipmen, TL, Belknap, EL (1953). Use of calcium ethylenediaminetetraacetate in cases of lead intoxication. Arch IndMedx 7:148.

9. Halstead, B (1979). The Scientific Basis of EDTA Chelation Therapy.Colton (CA): Quill Publishers.

10. Harper, HW, Gordon, GF (1975). Reprints of Medical Literature on Chelation Therapy. Los Angeles: American Academy of Medical Preventics.

11. Perry, Jr. HM (1961). Chelation therapy in circulatory and sclerosing disease (discussion). Fed Proc 20(3), Pt II Suppl 10:254.

12. Seven, MJ (1960). Observations on the toxicity of intravenous chelating agents in: Metal-binding in Medicine (Ed. Seven, MJ and Johnson, LA). Philadelphia: Lippincott.

13. Szekely, P, Wynne, NA (1953). Effects of calcium chelation on digitalis-induced cardiac arrythmias. Br Heart J 25:589.

14. Wenig, E, Schwerd, W (1958). Nil noarelGafahrenbei der Behandiung der Bleintoxikationmit Calcium versenat. Munch Med Wsch 100:1788.

15. Wilder, LW, DeJode, LR, Milstein, SW, Howard, JM (1962). Mobilization of atherosclerotic plaque calcium with EDTA utilizing the isolation-perfusion principle.Surg 52(5):793.

Trowbridge, MD: Cardiovascular Chelation

John 2by John Parks Trowbridge, MD
Reprinted from the May 2010 Townsend Letter with permission

Personal Pollution and Matters of the Heart
“This can’t be happening” is often the first thought. Gripping, gnawing chest pains give way to a heavier, crushing feeling that generates fear. The idea of “indigestion” soon gives way to “impending doom.” In this setting, 9-1-1 is sometimes a reluctant last resort, after antacids and resting produce only a pitiful response.

The arrival of paramedics brings reassurances from technicians who methodically start oxygen, apply EKG leads, and prepare for transport. Nurses and doctors in the emergency room go about their duties calmly and with dispatch – starting IVs, administering medications that relieve the urgent worry. Transfer to the coronary care unit is swift and easy, and monitors beep with the soothing monotony of a metronome.

From A to Z, everything about the medical team responses engenders trust and dependence in the patient: “These folks really know what they’re doing. Thank God I got here in time.” Trusting eyes gaze into the cardiologist’s face, searching for any clues that the situation is worse than it might appear. Again, reassurance: “You’re here, you’re safe – we need to do some tests to figure out how best to fix you now.”

Slippery slope? Conveyor belt? One-way road to a “dead” end? Many terms have been applied to the “work-up” and “treatments” offered in modern cardiology and cardiovascular surgery. In point of fact, major studies 30 years ago showed that one in six bypass operations are life-saving, when high-grade blockage is worsening in the left main artery or early in the left anterior descending (LAD) artery (the “widow-maker” or “artery of sudden death”).1

Then what of the other five in every six patients? Therein lies the rub.

‘Treating’ with Tests
Everyone knows about the routine resting heart tracing: 12-lead EKG, often with a “rhythm strip” of several seconds. The predictive value is minimal in the absence of symptoms or an irregular pulse.2 A 24-hour (or longer) Holter monitor gives valuable insights into rhythm disturbances but has little use in confirming “ischemic” disease, where blood flow to regions of the heart muscle is becoming compromised. Worthy of comment is that ischemic patterns can be documented in patients without blockage in the heart arteries but with magnesium deficiency or other conditions creating episodes of heart artery spasm. Vasospasticity can constrict blood flow transiently, and chest pains, shortness of breath, weakness, pale complexion, and sweating can mimic heart “angina pains” or even “myocardial infarction (MI).”

Angina simply means reversible chest pain events, often responding to nitroglycerin-type medications. The success of these drugs produces further patient trust that the cardiologist “knows how to treat me.” Myocardial infarction results from sudden blockage of blood flow to a (small or large) portion of the heart muscle. A heart artery already narrowing from deposits of plaque is more easily blocked completely by sudden formation of a platelet plug, also called a “thrombosis” (ACS or “acute coronary syndrome”). More recent studies show that the gunk in plaque is more likely to break off if a smooth hardened surface has not formed (so-called vulnerable plaque). Such free-floating chunks will always find a smaller arteriole and lodge there, blocking blood flow beyond … a heart attack.3

Vasospastic episodes can occur in patients who have artery blockage disease and in those who do not. When tests show minimal blockage that should not be causing angina episodes, cardiologists are sometimes stumped and nevertheless recommend “revascularization” procedures: balloon angioplasty, stents, even heart artery bypass. Each of these operations is based upon a “Roto-Rooter” plumbing concept of heart disease: open the plugged pipes or simply route around them.

This “conventional cardiology concept” comes from the tests upon which they rely in figuring out how to fix heart disease.4 Simply stated, “If the only tool you have is a hammer, then all the problems you see look like nails.” Since many cardiology tests look at the “plumbing,” the treatments advised are designed to address flow blockages that can be seen. That viewpoint creates the fundamental restriction – blinders, if you will – preventing well-trained cardiologists from being able to see the value of treatments other than those in their “plumber’s toolkit.”

One of the most widely known heart tests is the “stress EKG.” A blood pressure cuff is applied, patches with electrical leads are placed on your body, you begin to walk on a treadmill, and the workout is gradually increased to a jog.5 If your legs become fatigued, if you become short of breath, or if the heart tracing shows certain changes – “flags” that indicate problems – then the test is concluded; otherwise, you race along to a calculated heart rate. Comparing your blood pressure changes to the exercise heart tracing gives a hint of how well your heart muscle is working; in other words, how well your blood is flowing to your heart and other muscles.

Even a “negative” (“normal”) stress test is often followed by a “nuclear stress test,” simply because your cardiologist “wants to be sure.” This examination starts with a stress test followed immediately by a radioactive “tracer” injected just as a fancy Geiger counter is placed over your heart. About four hours later, you are placed under the Geiger counter again. Images “after exercise stress” and “at rest” are compared – if the tracer pictures after exercise show “holes” that later “fill,” you have blockage disease restricting the blood flow. If the “holes” don’t “fill” later at rest, then you have had one or more heart attacks where muscle tissue has been replaced by thickened scar. No “holes” after exercise? Then you appear to have adequate blood flow to your heart muscle.

Even a “negative” (“normal”) nuclear stress EKG is often followed by a “coronary angiogram” (heart artery “pictures” – also called an “arteriogram” or “catheterization”), simply because your cardiologist is “being complete” in your evaluation after being admitted for chest pains. Trusting your doctor – and reassured by your test reports so far – you naïvely consent to this much more invasive test. A catheter (tube) is placed into a large artery (as in your groin) and advanced to your heart, where X-ray dye can be injected to outline the pattern of your heart arteries. One tiny technicality: the severity of diameter narrowing is commonly overestimated by 30% to 60%.6 [As the “gold standard” for coronary artery disease, angiograms have several limitations. Recently developed computerized coronary angiography instruments (not yet widely available) will help to work around some of these errors of interpretation.]

Bingo! Narrowing is likely to be identified, since you did come in with chest pains. Now your cardiologist has a reason to recommend “balloon angioplasty” (another tube, this one with a blow-up tip that crushes blockage against the wall of the artery), often with placement of a “stent” (sort of a Chinese finger-trap in reverse, where it is inserted stretched out then “springs open” to press against the wall of the blood vessel). Modern stents are “radioactive” or coated with “chemotherapy,” to reduce your body’s attempt to cover over this strange device, thereby narrowing the artery again.

Balloons? Chemotherapy? Radio­activity? You might have a few questions, but your cardiologist is reassuring that you’ll probably be able to avoid “open heart surgery” (a bypass operation). Now that’s appealing! Once again, you innocently consent to another procedure, hoping that your future will be bright and comfortable. But the results from surgery can’t ever be guaranteed.

Speaking of surgery – what happens if your cardiologist invites a cardiovascular surgeon to discuss a bypass operation with you? For the vast majority of patients, the answer is simple: your lack of knowledge about options will mean that you trustingly agree to have the surgery. Americans are suffering in droves, like lemmings to the sea: in the US in 2005, 469,000 coronary artery bypass procedures were performed on 261,000 patients. An estimated 1,265,000 “stent” procedures were performed; approximately 69% of these were performed on men and approximately 50% on people aged 65, according to the National Center for Health Statistics. During 2006, some 2,192 heart transplantations were performed.7

But What If You’re ‘One of Those Five’?
If only one in six patients has a heart bypass operation8 that is life-saving or life-extending, what is the situation for those other five patients who also often undergo the surgery? Most survive, some do not, many feel better … but their improvements might well have been possible with modern medications and lifestyle changes alone.9 Virtually every “open-heart” patient will suffer some slight or significant degree of “pump syndrome,” neurological or mental changes associated with the heart-lung pump.10 About 1 in 20 bypass patients will die during or soon after surgery. Of those who survive, over half can be expected to suffer fairly dire concerns over the next 12 months: heart attack, stroke, heart rhythm disturbance, congestive heart failure, or rising blood pressure. And each of these events will force these patients back into the trusted arms of their cardiologists and consulting medical specialists.

Perhaps one of the best reviews of the limitations, side-effects, and outright hazards of angioplasty, stents, and bypass surgery can be found in several chapters of the book, Is Heart Surgery Necessary? What Your Doctor Won’t Tell You, by Julian Whitaker, MD.1 Before undergoing any of these procedures, every patient owes his family – and him- or herself – the time to read and understand these risks, in order to question his doctors appropriately and be able to give an actual informed consent, should he so choose.

What About Treating the Patient?
Wait! Can you actually afford to wait, do you have the time – the luxury – to read this and other books, to get the true details for yourself? While doctors sometimes give the impression that “you’re a ticking time bomb, we’ve got to move quickly,” published studies have shown quite the opposite conclusion. Harvard cardiologist Peter Graboys showed, 20 years ago, that patients who chose to wait before having bypass surgery suffered no deaths from heart disease over the next 2½ years.11 A second study showed only a 1.1% annual death rate from heart disease over the following five years for those who politely (or not so!) declined to have an angiogram, likely concluding that this was just “a map for surgery” that they were reluctant to undergo.12 This rate is far below an estimated up to 5% death rate for bypass surgery. Balloon angioplasty surgery offers an estimated 1% deaths, but recurrent procedures are quite likely.

Recognize that Harvard’s cardiology staff used only routine medications available at that time, along with “usual” lifestyle changes – diet, exercise, and so on. As conventional physicians, they had little interest (or faith) in integrative technologies such as nutritional supplements or chelation therapy. The combined use of (even more modern) medications now, along with specific “orthomolecular nutrition” and chelation, would be predicted to enhance further the startling results that they obtained with minimal effort, and clinical experience supports that expectation.

Rather than progressing rapidly to invasive and potentially risky tests, an integrative physician sometimes will order a set of echocardiograms, basically “sonar” ultrasound pictures of heart muscle performance. When valves and heart muscle function appear reasonably normal and the “ejection fraction” (percentage of blood pumped from the heart with each beat) is normal or almost so, then performance has been preserved even though blockage disease might be present. Activity or exercise might display reduced capacity, consistent with blood flow reduction. A patient with frequent angina, and especially with chest pains at rest, is more likely to have blockage changes best treated first by surgery unless he or she refuses and an aggressive nonsurgical treatment program is pursued.13

The recent availability of “heart scanners” (EBT, or electron beam tomography) has helped to quantify the degree of blockage present as well as its location. This 10-minute test uses minimal radiation and gives reasonably reliable pictures, from which a heart artery diagram of calcium-hardened blockage can be constructed. Again, “high-grade” (severe) blockages early in the left-side heart arteries can move a patient toward the “surgical option” for best survival, with follow-up chelation to treat the underlying cause.

An integrative physician offering chelation therapy will, of course, review and consider cardiology tests available from other specialists in order to best plan a treatment program. Angiogram pictures, though, will rarely be required.

Nonsurgical Treatment of Heart Disease?

Can blockage disease be effectively and safely treated without surgery? The answer, as demonstrated by dozens of clinical studies and case reports over the past 50 years, is an unreserved “Yes!”

However, reduction of blockage should be considered only a possible and desirable side effect and not the goal of a chelation treatment program. An early thought in the late 1950s was that chelation “worked” by removing artery blockage. This seemed a logical way to explain observed improvements in heart function, EKG patterns, congestive heart failure, chest X-ray images, angina chest pains, shortness of breath, and activity levels.14 Without question, some patients do show reduced blockage, as demonstrated by before-and-after-treatment heart scan images in two patients reported to the American Chemical Society in 1994.15 Of interest is that virtually 9 out of 10 patients show improved heart performance – but not all of those show reduced blockage disease by any test performed.16

Another factor to recognize is that our tests are less than precise in quantifying the degree of blockage present, whether improving or worsening patterns. Several assumptions are made in each test setting (heart, carotid neck arteries, abdominal aorta, legs, and so on). The presumed “gold standard” – such as heart angiograms – are difficult to interpret at best … and the same test can be read differently on different days … by the same cardiologist. If blockage doesn’t disappear with chelation, then what could explain the obvious and dramatic clinical improvements in the vast majority of patients? In actual fact, blockage probably is reduced in many arteries: a 10% to 15% increase in “cross-sectional diameter” (the area through which blood can flow, where larger diameters have less resistance to flow) produces double (or more) blood volume delivered to tissues downstream.17 Current tests fail to reliably detect such small reductions in blockage with increases in blood vessel diameter – but the patients can clearly feel and enjoy the improvements, as overwhelmingly noted with chelation therapy. The use of artery bypasses and stents is based upon increasing the diameter of a “feeding” vessel, but such operations involve many risks and the duration of improvements can be limited. Indeed, the diameter increases of bypasses and stents are noted only at the operation site and not generalized throughout the arterial system as with chelation therapy.

Studies documenting patient improvements with chelation are well summarized elsewhere.18-20 What has received very little attention is how much these improvements can be attributed to decreased toxic metal burdens – coincidentally reducing inflammation – and other mechanisms. When platelets have less free radical inflammatory injury, they become less “sticky,” less likely to form sudden “clots” or “plugs” and completely block ailing arteries. When magnesium is provided in large doses, blood vessels more readily dilate to increase flow volume and have less spastic tendency to restrict flow. Vitamins B6 and C, amino acids lysine and proline, essential fatty acids, zinc – these and other nutritional supports that are provided during a series of chelation treatments clearly help to stimulate improved clinical function, detoxification, and tissue repair. Even nattokinase (or lumbrokinase), which lowers blood flow “viscosity” by reducing free-floating monomer fibrin strands, might help explain some of the benefits seen in advanced chelation programs.

What About ‘Personal Pollution’?
All chelating medications share in common one key property: forming a particular chemical bond with certain positively charged ions (metal atoms).21 This drug–metal complex allows for easier removal of the metals through the kidneys. In many cases, the chelating drug prefers to bond with so-called heavy metals that are toxic to the body. Reducing the presence of toxic metals allows for usual “physiologic” chemical reactions to proceed more normally.

Toxic metals insert themselves in place of appropriate metals (such as magnesium or zinc), “sitting” on active sites in enzymes and blocking needed chemical reactions. In addition, they stimulate a tremendous increase in the rate of production of “free radicals” (also described as “oxidants” or “ROTS,” “reactive oxygen toxic species”) that inflict lasting damage to body cell structures, especially those involved in the mitochondria, the tiny “energy-factories” that produce the ATP that powers all cell processes in all cells. (Antioxidant vitamins – such as vitamins C and E and beta-carotene – glutathione, and other molecules help to protect vital molecules from free radical injury.22) Another concept to describe free radical production is inflammation, the destructive and powerful process that creates the pain of arthritis, of heat and chemical burns, and basically all departures from normal function and physiology. Blockage within blood vessels, of course, is one of these “departures.”

A better understanding of how toxic metals lead to suffering and death is found in several observations over the past 40 years, almost from the time humans began in earnest to poison the planet. Animal studies have shown that heavy metals are uniformly neurotoxic, immunotoxic, carcinogenic, and directly harmful to all vital organ systems. The onset and severity of suffering depends, of course, on the dose and exposure patterns as well as cellular compartmentalization and tissue equilibration. Death follows slowly or rapidly based on the same criteria. Toxic heavy metals are throughout the environment (air, food, water, objects) and there is no way to avoid them entirely. Since they come into your body easily but leave much more slowly, all of them accumulate over time and increasingly interfere with body metabolism.

Every person will suffer some (slight or increasingly significant) degree of impairment among his or her many organ systems, based upon his or her exposures, nutritional status, biochemistry, physiology, and so on. Basically, the “weakest link” in each individual will begin to show toxic damage first. In a more global wholistic view, virtually all human ailments (including expression of genetic aberrations) can be aggravated by – or even directly attributed to – increasing burdens of toxic heavy metals.23 Since bioaccumulation from the environment cannot be avoided, attention must be directed to minimizing exposure and removing those that have gained entry. The medical procedure of removing them, of course, is called “chelation therapy.”

A general idea of the magnitude of “toxicity” can be gleaned from providing tainted cage water to rodents, where their only liquid source is laced with a heavy metal. Daily water intake is based on animal weight. Thus, calculations can be made regarding how much of a particular toxic metal was required to kill any individual animal. The lowest dose that killed the first one is noted. Amounts are recorded all the way up to the highest dose, the one that finally killed the last remaining animal in a group of 100. These name for this group of concentrations is lethal dose (LD), and a number is appended, to indicate the population percentage that has succumbed to that amount of toxic metal. For example, the LD1 is the concentration to kill the first animal; LD50 is enough dosage to kill half of the subjects (50 out of the 100). The LD100 dose is the amount that will kill all of the animals.

Of greater concern to people who think they have only minimal exposure to toxics is that small amounts of different toxic heavy metals can combine to create ever more destructive changes. The overwhelming majority of people are lulled into a false sense of security that they “don’t have too much toxics on board, their levels are really ‘low.'” One rodent study showed that combining the LD1 level of mercury with 1/20th the LD1 level of lead in the cage water did not kill just 2 animals (addition), it did not kill 4 or even 8 animals (multiplication) – this seemingly inconsequential combination killed all 100 of the rodents (amplification).24 Extending the implications to human beings is sobering, particularly when we are making our environment increasingly toxic. Modern medicine has no other method to remove toxic metals (as or after they enter) than the chemical process of chelation. Indeed, this is the only FDA-approved method of detoxifying from this heavy-metal toxic body burden.

Treating the ‘Personal Pollution’
The question, does chelation work? was well answered in the very earliest studies, in the 1950s, by Norman E. Clark Sr., MD, the “father of chelation therapy in America.”25 Subsequent studies have confirmed his early observations, with rare exception (and those often criticized as having faulty scientific design or controls). But two questions arise: first, will chelation help all blood vessel problems? And second, what about over-the-counter oral products that might work just as well as the intravenous treatments?

The range of occlusive (blockage) blood vessel disorders – in the heart, neck, brain, central core (including kidneys), and legs – has been widely studied. The results are uniformly positive, though the percentages of those areas that improve rise with increasing distance from the brain. As a clinical rule-of-thumb, “brain” and “eye” problems improve significantly about 75% of the time, heart problems about 88%, and leg problems about 92%. (Some studies have suggested even better results.26,27) The differences deserve further investigation, but suffice it to say that they probably relate in some degree to different forms of calcium deposition (“hardening”) in the different artery walls.

The most common diseases causing significant blood vessel blockages are diabetes (both types, especially when poorly controlled) and high blood pressure (“hypertension”). In both conditions – as in most others – the improvements with chelation can be startling. Legs scheduled for amputation – a frequent conclusion for diabetics – have been largely saved by chelation treatments.28,29 Clinical experience confirms that blood sugar control is often improved, sometimes dramatically, and dosages of insulin or oral hypoglycemics can be reduced for many patients … reducing side effects, of course.

The sugar-control implications for “metabolic syndrome” (an inaccurate title for “insulin resistance syndrome”) are overwhelming. Also misnamed “cardiometabolic syndrome,” this pattern shows elevating blood pressure, blood sugar, and triglycerides, lowered HDL (“heart protective”) cholesterol, along with enlarging waistline. This cluster of disease findings is associated with higher incidences of heart attacks and strokes, two of the top three leading killers in the US. Chelation therapy produces impressive results in these patients. Results in other disease conditions (such as Raynaud’s phenomenon, scleroderma, sys­temic lupus, rheumatoid arthritis, Parkinson’s, and so on) are similarly encouraging.30

So the second question – “over-the-counter” items that might help – raises some interesting concerns. For example, when people order the latest hyped-up bottle from a newsletter or other brochure, are they really worsening inside while they delay seeking actual, scientific, evidence-based chelation therapy? Younger people, with lesser exposures to toxics and fewer degenerative issues, might “buy some time” with such readily obtained “nutritionals.” Older folks – especially those with degenerative diseases or (even unknown) history of prolonged or extraordinary exposures – are walking straight into the lions’ den. While any one individual might live a long and fruitful life without actual chelation, the vast majority are likely to succumb to the common killers, usually at the common ages. Even sequential “negative” (“normal”) test reports showing minimal blockage changes in arteries are no protection against sudden blockage from “sticky” platelets or other results of localized inflammation.

The longer-lived European (especially Mediterranean and Baltic) societies, particularly those whose citizens remain vital and active late in life, can offer some hints as to useful dietary counsel. Sulfur – found in onions, garlic, many grains, legumes, red meats, eggs, nuts and seeds, broccoli, cabbages, even milk and asparagus – readily binds with toxic heavy metals, but only weakly. Selenium – found in brazil nuts and a variety of meats – also can bind to heavy metals. When foods are grown (or animals are raised) in sulfur- or selenium-deficient soils, they have minimal amounts of these valuable minerals. Their use as significant “chelators” – even in the form of alpha-lipoic acid or methyl-sulfonyl methane (“MSM”) or N-acetyl-cysteine (“NAC”) – has not been adequately studied.

Some publicly promoted products have cilantro, chlorella or other algae, and other botanical nostrums and are widely touted as helping to remove toxic metals. Again, their use as significant “chelators” has not been persuasively studied. Claims are made for EDTA in various products administered orally, but none of these have been subjected to rigorous scientific studies in any ways that successful intravenous EDTA chelation has been evaluated. Indeed, a number of formulas also have the nutritional element chromium listed as an ingredient in the same capsule or tablet. Once EDTA “finds” the included chromium, it binds more strongly than with almost anything else and is only slowly released. So, you get virtually no benefit from the chromium or chelation value from the oral EDTA.

If neither foods nor over-the-counter “oral chelators” offer much prospect of demonstrable lasting improvement, then what options exist other than intravenous chelation therapy? Here we are treading on “unstudied ground” once again. Heavy toxic metals interfere in so many ways – blocking enzyme and other metabolism reactions, creating inflammation, making “sticky” platelets, “rusting” the inner linings of blood vessels and thereby encouraging blockage, damaging brain and nerve functions, impairing immune defenses, encouraging the development of cancer, and so on. Theoretically the reduction of the total body burden, by any means, should aid the restoration of more normal functions.

Several chelation medications – such as D-penicillamine and DMSA – have been given orally, safely, for many years. Perhaps the detoxification of heavy metals cannot work nearly as successfully as intravenous EDTA. However, speculation can be offered: carefully prescribed use of various oral chelation medications might, over long periods of time, offer important benefits to people unable or unwilling to take in-the-vein treatments; however, they might forego some (possibly critical) improvements with artery blockage disease. In the near future, this would be a fruitful area for study by the National Center for Complementary and Alternative Medicine (in the US National Institutes of Health).

When Hot Dogs Are Banned …
Based on the studies available over the past 60 years, should we be optimistic regarding chelation therapy – whether intravenous EDTA or various oral chelator medications – finally becoming available for the majority of Americans? Absolutely not.

At a recent trial, where I was serving as an expert witness for the defense, the state medical board attorney noted: “Since EDTA and other chelation medications are approved by the FDA for removal of toxic metals, then really their use is ‘conventional’ medicine practice, not ‘alternative’ or ‘integrative,’ right?” My reply: “Well, yes, except for one teeny-tiny technicality.” “What’s that?” asked the prosecutor. “The state medical boards.” “Why do you say that?” he asked, surprised. “Isn’t that why we’re in this trial? All of the medical boards ignore approval by the FDA, ignore the clear evidence found in the medical literature, and ignore the overwhelming reports of patient benefits from chelation – and they prosecute the doctors offering the treatment, just as you are today.”

A recent pediatrics study claims that 10,000 emergency-room visits are made each year for children who are choking on hot dogs. Some six dozen reportedly die. Each year. If that many patients suffered death as a result of chelation therapy properly administered, the treatment would have been banned several dozen years ago. In sharp contrast to the “wiener losers,” whenever any single patient complains of “side effects” or – as happens every few years, when a patient ill enough to finally seek chelation treatments dies anytime during the therapy program – the state launches a full-scale investigation, usually seeking to remove the “offending” doctor’s license to practice medicine.31 As a society, we tolerate dozens of deaths from the lowly hot dog – at the same time we tolerate dozens of millions of preventable deaths and untold suffering from heart attacks, strokes, high blood pressure, kidney failure, macular degeneration, and amputations for gangrene, among the many disease conditions that could have been helped by chelation. When will the public demand a change of policy that we can believe in?

Trowbridge, MD: Stepping Into the Next 60 Years, A Historical Commentary

caduceus-1245442-639x903Chelation Therapy: Stepping Into the Next 60 Years A Historical Commentary
by John Parks Trowbridge, MD

To preview or purchase this as an audio lecture from an ICIM conference, click here

Reprinted from the May 2013 Townsend Letter with permission

Mind-body medicine, a term well known in medicine, has major roots in observations made in the 1960s by one of my lab directors at Stanford, George Solomon, MD. Intensive study of the “relaxation response,” “healing touch,” “acupuncture,” and similar “soft science” technologies has led to widespread acceptance in the medical and lay communities. At about the same time, startling observations were being made of reversals of increasingly prevalent coronary and peripheral vascular maladies by chelation therapy with intravenous EDTA. Despite “hard science” showing that these beneficial discoveries have been replicated time and again, chelation remains largely unknown or, at worst, vigorously defiled. Paul Dudley White, MD, President Eisenhower’s cardiologist, encountered similar resistance for over two decades to his introduction of the EKG. René Laënnec was more fortunate in securing wide acceptance of the scientific results available with his new “stethoscope” within a decade in the early 1800s. Given a world increasingly aware of pollution with toxic heavy metals, and given a population with younger onset of serious degenerative diseases, and given 60 years of overwhelmingly successful results, why have conventional medicine and regulatory government tossed chelation aside, onto the trash heap of so-called fraudulent diversions?

Going to the Dogs – and Nowhere Else?
What we now unquestioningly call “modern medicine” was largely invented since the late 1940s. Houston cardiovascular surgeon Denton Cooley, MD, studied pediatric procedures in postwar Europe, and his research efforts have saved countless children. Coronary endarterectomy was tried for occlusive disease, but most patients had diffuse involvement and were poorly qualified. Other partners of Houston cardiovascular surgeon Michael Debakey, MD, were Ed Garrett Sr., MD, and Jimmy Howell, MD. In the early 1960s, they were in the forefront of perfecting a technique of removing a peripheral vein and inserting it as an aortocoronary bypass on the heart … of dogs. Endless hours spent in the dog lab led to skills and procedures hitherto unknown. Other complementary technologies were arising at the same time, including selective coronary angiography (to identify and locate high-grade occlusion), the cardiopulmonary bypass “pump” (“heart/lung” machine), and startling advances in anesthesia and antibiosis. Still, the dogs were their only bypass “patients,” and their survival was not the object of the research.

Despite sharing with their cardiology colleagues the potential for success of their new surgical approach, no patients were forthcoming. Finally, cardiologist Ed Dennis, MD, endorsed a last-ditch effort to salvage patients moribund after their infarction. In 1964, Garrett led the team to perform the first successful coronary artery bypass procedure, at Baylor University. The early patients, already preterminal, failed to survive. With the prospect of revascularization too tantalizing to resist, stable patients with severe angina were then referred for surgery. The first two died. The third survived. And a new era of surgical success emerged.

But … Banished Forever to the Pound?
Intravenous EDTA chelation therapy was welcomed directly into patient practice in a most unusual way: in the emergency room. A child presented to the Georgetown University Hospital in 1952, clearly suffering with lead poisoning (from chewing paint off a window sill?). Pediatrician S. P. Bessman, MD, recalled a recent conference wherein neurology researcher Martin Rubin, PhD, described exchanging lead for calcium by a new “chelating” compound … in the test tube. “Can I use it in this kid? How do I dose it?” Serendipity led to clinical success and the child recovered. The case was reported in the Medical Annals, District of Columbia, later read by Norman E. Clarke Sr., MD, a cardiologist in Detroit. He was seeing plumbism (lead intoxication) in battery-factory workers, and thought to try this new chelation treatment. Soon, his patients were reporting less use of nitroglycerin, fewer angina pains, and increased activity without dyspnea. Why not, he thought, try this on “heart patients” who were not suffering with lead toxicity. They, too, dramatically improved with chelation. And a new era of medical success emerged … and was soon to be banished like an old dog.

The NIH TACT Results
Almost 60 years after the first discovery that EDTA chelation therapy could be effective in the treatment of heart and blood vessel diseases, results of the first large randomized double-blind trial were reported at the American Heart Association meeting in November 2012. A number of commentaries have identified “problems” with the 7-year-long National Institutes of Health (NIH) study, under the direction of cardiologist Gervasio Lamas, MD, of the Mt. Sinai Medical Center, Miami Beach, Florida. An 18% reduction of cardiovascular events in the entire treated group suggests a beneficial effect. However, one cadre accounted for substantial improvements: diabetic patients enjoyed a 39% decrease in adverse events compared with placebo (usual medical treatment) controls.

Given the increase in diabetes in the American population – including the younger age of onset for many victims – any treatment offering significant benefit should, in the best of possible worlds, be readily embraced.

Diabetic Complications
Research at the NIH in diabetics during the 1970s showed that normalization of blood sugars preserves endovascular and end-organ tissues, approaching the baseline health seen in normoglycemic populations. Over the past 30 years, there has been an alarming increase of obesity. Enlarging girth is often accompanied by the ominous signs of cardiometabolic syndrome, emphasizing the critical need for early and aggressive control of blood sugar. Nevertheless, ingrained societal patterns – including nutritional debasement in daily food selections – complicate efforts to achieve the lifestyle changes essential for nondrug hyperglycemic control. Drugs, of course, impose the risk of side effects and even hypoglycemic episodes, so many physicians are comfortable allowing patients to float with higher-than-normal fasting and postprandial patterns … and thus tolerating the commensurate development of occlusive changes affecting end organs.

Chronic renal dialysis is one of the most expensive repetitive procedures in modern medicine, and diabetics claim an inordinate volume of these resources. The NIH TACT trial excluded renal failure patterns in order to simplify data analysis. A seminal 2003 study by Lin and Lin-Tan, published in the New England Journal of Medicine, matched patients developing nondiabetic renal failure and carefully treated the intervention group with intravenous EDTA chelation. While the untreated observation group devolved toward dialysis, the treated patients improved toward normal kidney function, presumably due to reduction of lead in the kidneys. Many experienced chelation physicians have seen serum creatinine levels reduce over time in both their diabetic and nondiabetic patients, but a conclusive study remains to be done – and is sorely needed and could be done easily with pooled data.

Beyond Diabetes
Reports of chelation improvements in diabetics have been peppered throughout the medical literature over the past 50 years. In 1964, Carlos P. Lamar, MD, offered his diabetic patients a real chance at a more normal life, saving limbs scheduled for amputation, saving vision in those going blind, and lowering insulin dosages. Kansas City, Missouri, chelation specialists Ed W. McDonagh, DO, and Charles J. Rudolph, DO, PhD, were joined by research professional Emanuel Cheraskin, MD, DMD, to publish 31papers documenting their clinical practice experience over the 1980s and 1990s. Topics included significant improvements of vital importance to diabetics and nondiabetics alike: blood sugar, cholesterol, HDL cholesterol, triglycerides, kidney function and serum creatinine levels, artery blockage disease (even of the aorta), severe heart artery blockage, blockage of neck carotid arteries, hardening of the arteries, platelet clotting functions, fatigue, pulse rate and blood pressure, serum calcium and iron levels, trace element patterns in degenerative diseases, psychological status, and general “clinical change” (improvements) observed in chelation patients. Perhaps of more interest to many readersis the demonstrated reversal of macular degeneration (commonly seen in diabetics) reported by McDonagh and Rudolph’s group in 1994. Their evidence included retina photographs, documenting improvement consistent with increased circulation to the eyes. Pooled objective data from practicing ophthalmologists could easily document a pattern of improvement, offering hope where there is no other treatment.

Coronary Occlusive Disease
The “end organ” of most concern for diabetics and nondiabetics alike is the cardiac muscle. Heart disease “statistics” 60 years ago were generally reported as reduction in symptoms, in angina and infarction, and improvement in EKG patterns. For the past 20 years, we’ve had benefit of the ultrafast CT “heart scan,” helping outline the anatomy of calcified plaque in coronary vessels and allowing for earlier identification of those at risk. For over 50 years, selective coronary angiography has provided “a map for surgery” – but its extensive use in postoperative bypass patients has created an industry ripe for challenge as generally unnecessary and sometimes fallible. For almost 50 years, coronary artery bypass grafting (CABG) has been shown to provide a life-saving alternative for those with significant diffuse disease or “left main” or “left anterior descending” artery occlusion. The 50-year-old technologies of coronary “ballooning” and “stenting” – now impregnated for drug elution – remain popular despite the frequency of restenosis or other complications. The question of whether ultrafast CT is suitable for documenting improvements with chelation remains elusive, since some symptomatically successful patients continue to show advancing calcium scores. Collateral channels are not readily seen in these pictures or even in angiograms, so perfusion studies with stress-and-rest thallium scans can be more revealing.

Salvage of cardiac muscle is the sine qua non of all interventions. Indeed, kinase infusions within the early hours of acute infarction have preserved countless organs with minimal or no damage. Various drugs have found popularity in the conventional cardiology community as possibly reducing or delaying development of coronary occlusions. These include, of course, the “statin” drugs and antithrombotics such as clopidogrel. A number of concerns have been raised regarding their extensive side effects, including interruption of physiologic biochemistry (such as with statins, impaired synthesis of vitamin D, bile acids, coenzyme Q10, and so on). Chelation avoids these challenges to normal functions. Further, chelation has greatest success when occlusion has not progressed to tight stenosis or to the point where unstable plaque threatens to block distal flow. Coronary angiography is still risky, especially with regard to vulnerable plaque. Additionally, it is limited in not being able to discern plaque reduction that yields very slight increases in cross-sectional vessel caliber, a situation wherein fluid dynamics produces a much greater increase in flow volumes. Once again, clinical improvement is one of the best measures of success.

So the question remains: besides lifestyle changes to minimize risks, what actual treatments could enhance myocardial salvage? The almost 60-year history of consistent reports suggests that EDTA chelation has already established itself as an unrecognized but viable alternative, with patient satisfaction and clinical improvements routinely in the 90% range in published studies.

EDTA Chelation and Cardiac Disease
Beginning with Clarke’s initial reports in 1955, anecdotal papers have repeatedly documented that “heart patients” improve with a wide variety of symptoms. Angina episodes, dyspnea on exertion, blood pressure elevations, rhythm disturbances, electrocardiogram patterns – all these were shown to improve in reports over the first 10 years. Other small group reports over the past 50 years have continued to confirm these early findings. The usual critique is that they involve a small number of patients or that double-blinding is absent. These criticisms, of course, ignore that proposed CABG surgery was canceled in the majority as no longer needed, and that people are still walking on limbs scheduled for amputation.

The importance of a nonsurgical alternative for coronary disease is highlighted by a recent report on war fighter deaths over 10 years in the Middle East. Autopsies on 3832 service members, killed at an average age of 26, showed that almost 9% had some blockage forming in their heart arteries. About a quarter of these had severe blockage, yet they were asymptomatic and deployed into combat. As more sensitive diagnostic modalities are developed and widely employed, an increasing percentage of the population will “qualify” for treatment of their clinically silent diseases. In such cases, early and consistent use of chelation might dramatically lower medical care costs while improving overall health outcomes.

Anatomy vs. Microphysiology
Perhaps of greatest interest is the effort to understand why – or how – EDTA chelation is responsible for such dramatic cardiac (and other) benefits. Borrowing from the engineering concept of “opening the pipes,” such as with bypass or stenting, early explanations focused on a “Roto-Rooter” effect of “dissolving” the atherosclerotic blockage. While this effect has been observed and documented in some chelation patients over the years, such a view is probably severely limited.

Much more likely is that chelation acts in just exactly the way that it is “approved” by the Food and Drug Administration: it reduces the body burden of toxic heavy metals such as lead, arsenic, cadmium, mercury, and so on. Sadly, the conventional medical community sets the standards and those lab parameters are for acute intoxication (as reflected in blood levels) rather than for total body burden (as reflected in hair or nail clippings or by collecting urine after challenging with a chelating drug). Since the “acute exposure” tests fail to “show toxicity,” insurance carriers decline claims for reimbursement.

The significance of reducing toxic metals cannot be overstated. But the mechanisms by which this result could produce dramatic improvements remain open to rampant speculation.

An early explanation suggested that, in states of impaired antioxidant levels, cholesterol serves as an electron sponge to help protect the endothelium. Oxidized cholesterol, being a “sticky” molecule, then deposits along the vessel margin, especially at sites of branching or disrupted flow. Having a weak activity similar to that of vitamin D, oxidized cholesterol invites calcium to be deposited in a noncovalent binding. Over time, accretion of more cholesterol, calcium, and cellular detritus results in a discrete volume of occlusive plaque, subintimal and medial. Pathologist Rudolph Virchow, MD, called this metastatic calcium, since it was out of the bones and teeth but not bonded in place. Accordingly, EDTA was thought to “pinch” these available calcium atoms and thereby initiate dismantling and dissolution of the plaque. A more sophisticated view might relate to lowering of ionized calcium in circulation, stimulating release of parathyroid hormone, leading indirectly to mobilization of “releasable” calcium in hardened plaque and body tissues.

One fascinating result of such speculation is the inclusion of calcium as a toxic element when it is abnormally deposited in organs through a variety of aging and degeneration mechanisms. While babies are “soft and rubbery,” aging individuals are increasingly hardened and brittle. This one feature – reduction of metastatic calcium depositions, peppered throughout organelles and cells and interstitium as well as in plaque – might be “the key” to results with intravenous EDTA chelation. This speculation receives support from the realization that “sick mitochondria” accumulate excessive calcium and swell (especially in magnesium deficiency), disrupting the stereochemical alignment of the electron transport chain on the cristae shelves, markedly reducing the efficiency of oxidative phosphorylation and, hence, the health of the cell. One way that mitochondria “get sick” is through the selective deposition of lead and other heavy metals, disrupting mitochondrial DNA expression as well as energy production. Reversal of these mitochondrial modifications could explain many (if not most) of the clinical improvements demonstrated with EDTA treatments.

Chelation patients often report significant symptom improvement within the first half-dozen or dozen treatments, long before a major improvement in blood flow “through the pipes” is likely. When reviewing organ failings – as seen with liver, kidneys, and brain in addition to heart – such mitochondrial inefficiency might be a primary mechanism. Similarly, removal of toxic heavy metals by chelation is much more biologically cost effective than the body’s detoxification effort that leads to depletion of intracellular glutathione. Thus, chelation can help to preserve cellular antioxidant status and a more robust ability to regenerate vitamins C and E as electron donors.

Recall also that all other toxic metals are accumulating throughout the tissues as well – mercury, lead, cadmium, arsenic, and so on – with their separate contributions to free radical production and functional impairment. Iron is an essential element that can be present in excess (iron “storage” disorders, even polycythemia), where it also stimulates the generation of free radicals, which are especially toxic in metabolically active tissues such as liver and heart. Jukka T. Salonen, MD, PhD, MScPH, of Finland, reported in 1992 a large prospective study of men with no symptoms of heart disease. Over the next 3 years, the lifetime total of cigarettes smoked was the primary risk factor in those suffering myocardial infarction. The second factor was an elevated blood ferritin level (possibly correlated with a shift toward tissue acidosis). This provides an easy laboratory test to discover those at higher risk – levels rising higher above 100 ng/ml are directly associated with an increasing incidence of coronary events. The iron story is, however, complicated, and ferritin only slowly declines over dozens of EDTA chelation treatments.

A side issue is coming to the forefront: the expanding use of injectable diagnostic imaging contrast agents, such as gadolinium, iron (Feridex), and manganese (Teslascan). Urinary challenge tests with D-penicillamine in some patients have shown very high excretion levels of gadolinium. The clinical significance of these findings is unclear, but the use of chelation treatments in patients who have had repeated contrast studies might prove valuable. Gadolinium use has been linked to onset ofnephrogenic systemic fibrosis.

Another factor deserving study is the effect that chelation might have on the improvement of tissue perfusion by reducing constriction of the tiniest arterioles, which serve as a large bed of peripheral resistance vessels. Where increased arteriolar resistance opposes the systolic pressure, relaxation of these “flow-limiter” muscles can raise tissue perfusion volume considerably. Increasingly sensitive vascular lab studies and digital thermography are two inexpensive and noninvasive methods that can be used to document improved perfusion.

McDonagh and Rudolph, among others, have shown that chelation produces a more normal reduced platelet volume and increased pliability. Ease of flow through capillary beds provides increased perfusion and oxygenation help to maintain normal tissue alkalinization. Reduction of acidotic microenvironments slows the production of free-floating single fibrin fibrils from fibrinogen, further lowering viscosity in the narrow capillaries. Any combination of these microphysiologic changes could explain improved tissue viability and marked improvement in clinical symptoms and organ function.

Peripheral Vascular Disease
Being listed as a “labeled indication” by the Food and Drug Administration usually allows for insurance approval and reimbursement of treatment for a particular condition. Few people know that EDTA was listed in late-1950s editions of the Physician’s Desk Reference (PDR) as “indicated” for the treatment of peripheral vascular disease. A study with about half a dozen patients showing marked improvement had led to labeling approval. Then came the 1962 Kefauver-Harris Amendment to the Federal Food, Drug, and Cosmetic Act, requiring a review of both safety and efficacy in the approval process. When studies were considered insufficient to conform to the new standards, the indication was dropped from the label.

While early studies concentrated on cardiac improvements, concurrent benefits for occluding leg arteries attracted attention. Carlos P. Lamar, MD, in 1964 reported on legs saved from amputation. H. Richard Casdorph, MD, and Charles H. Farr, MD, PhD, confirmed these improvements in a small series in 1983, as did James P. Carter, MD, DrPH, and Efrain Olszewer, MD, in a double-blinded study published in the Journal of the National Medical Association in 1990. McDonagh and Rudolph in the 1980s documented marked enhancement of the ankle/brachial index in 117 patients with occlusive disease. Carter and Olszewer reported in 1988 on a 28-month retrospective analysis of 2870 patients treated with intravenous EDTA: peripheral arterial disease patients showed marked improvement in 91% and good improvement in another 8%. Given that surgical success is lessened with smaller vessels and when near or crossing joints, chelation as a nonsurgical alternative offers hope to thousands.

Thermography specialist Philip P. Hoekstra III, PhD, reported privately to me in 2009 the results of his 13-year study of 19,147 patients with peripheral (leg and arm) artery stenosis, not yet severe enough to require amputation. Arterial perfusion of all extremities demonstrated significant “warming”in 86% of chelated patients.

Carotid Arteries
Carotid arteries act as a special case of the peripheral vascular bed – and their improvements with chelation have been documented repeatedly. Rudolph and McDonagh described in 1991 the striking and highly significant reversal of atherosclerotic stenosis of bothinternal carotid arteries in 30 patients treated with only 30 EDTA infusions over a 10-month period. Ultrasound imaging showed that overall obstruction was decreasedby 21% – and those who showed more severestenosis had even greater reductionof blockage. Their study had been planned after their 1990 case report of one patient having an original 98% occlusion reduced to only 33% after just 30 chelation therapy treatments. Given that strokes can occur as a complication of otherwise successful carotid endarterectomy, chelation can reduce such misadventures for many. Where surgical intervention is warranted, pretreatment with chelation theoretically can improve the postoperative result. Again, more sophisticated equipment can allow easy, inexpensive, and noninvasive documentation of improvement.

Intracranial circulation responds less well. Casdorph in 1981 documented marked improvement in brain arterial flow in a small series of patients. Carter and Olszewer’s 1988 retrospective review showed markedimprovement in 24% and goodimprovement in 30% of patients with cerebrovascular and other degenerative brain diseases. Surprising results are possible. One patient presented to me 18 months poststroke, still severely limited despite constant physical therapy. After 8 chelation treatments, he proudly showed that he could walk down the hall with an assistant holding his belt in the back, and he described having gotten into and out of the tub (with assist) for the first time since his CVA. “Small-vessel ischemic disease,” with or without dementia changes, generally shows stabilization or some improvement. Alzheimer’s dementia, especially when associated with significant toxic heavy metal patterns, can show encouraging benefits when treated early with chelation.

A Potpourri of Problems
Macular degeneration is a special case of vascular supply directly to a central nerve. Direct ophthalmic observation can show gradual deterioration … and gradual improvements. The most rewarding part, though, is having a patient resume reading or once again being able to thread a needle. I asked one patient, who received several dozen chelation treatments, to read this note on a chart cover: “PATIENT IS LEGALLY BLIND.” I then asked him to read whose chart … “Why, that’s mine!” Without glasses.

Atrial fibrillation is the most common arrhythmia, and its frequency elevates with advancing age. The risk of stroke increases considerably, so rhythm control has benefits beyond rising perfusion efficiency. Alfred Soffer, MD, reported on chelation for various heart rhythm disturbances in his 1964 monograph; results were variable but promising. Long-experienced chelation physicians have their anecdotal stories of patients reverting to and maintaining sinus rhythm.

Cardiac valvular sclerosis, sometimes proceeding to calcific stenosis restricting flow and allowing regurgitation, is a troubling problem. Although new percutaneous operations (using technology similar to angiography) are growing in popularity, their risks and success rates are still being evaluated. Theoretically, the decalcifying effect of EDTA chelation therapy should slow (perhaps even reverse?) sclerotic-to-stenotic change. At the very least, chelation should be expected to aid the intended surgical result by increasing the pliability of tissues. Neither angiography nor echocardiography is yet sensitive enough to detect slight reductions in calcium deposits.

Scleroderma is another special case, where distinctive arteriolar changes (in all organs but especially the skin) are associated with autoimmune patterns. Raynaud’s phenomenon appears to be prodromal in many patients. Conventional medications are often frustrating, and the addition of EDTA chelation therapy has been quite successful for many patients. Similarly, other autoimmune patterns – rheumatoid arthritis and systemic lupus erythematosus – have shown promising improvements with chelation. Benefits with “fibromyalgia” have routinely been reported by patients. These observations raise speculation that EDTA might be affecting membrane pathology, possibly related to or amplified by toxic heavy metals – induced through the mechanism of free radical attack? D-penicillamine, loosely called a “chelator” but acting by means of paired thiol groups, has long been used in conventional medicine to help with scleroderma and rheumatoid patterns.

Mitochondrial pathology has been recognized in many forms over the past decade, but the contribution of toxic heavy metals has been poorly appreciated. In the 1990s, laboratory studies by the Environmental Protection Agency showed startling changes in mitochondrial protein production seen in isolated organelles after exposure to “physiologic” levels of lead. Research into toxic heavy metal effects on mitochondria, endoplasmic reticulum, nuclear membranes, and cell-limiting membranes might offer the most fruitful future explanations for pathology and chelation benefits – but the laboratory funding required would be substantial.

Along Came A Spider …
A little-known effect of chelation is to neutralize biological venoms from snakes, spiders, scorpions, and the like. These poisons are a mixture of metalloenzymes, and inactivation occurs with displacement or removal of the critical metal cation. Appropriate research could lead to treatment protocols (intravenous, oral, topical) far more effective – and dramatically less expensive – than current antivenom preparations, which can cost thousands of dollars.

Venoms, as metalloenzymes, bring up a whole realm of possible treatments aimed at specific induction and function of enzymes throughout the body. In perhaps a third of instances, physiologic cations (magnesium, zinc, iron, manganese, molybdenum, copper, others) are positioned in the active site and help establish the functional conformation of the protein. As research shows which enzyme clusters are more sensitive to inhibition by toxic heavy metals displacing the expected cation, the prospect of targeted chelation could become a reality. One factor complicating targeted treatment is that chelators need to penetrate through the interstitial space into the cytoplasm and into mitochondria and even into the nuclear space. Similar concerns arise with penetrating the blood–brain barrier. Nanoparticle delivery systems, being developed for targeted chemotherapy, might be designed to enhance chelation efficiency at the “end-organelle” level rather than merely the “end-organ.” Again, laboratory and clinical expenses could be a major barrier.

Nutritional physiology is still poorly understood, and studies might reveal new ways to increase the benefits of chelation treatments. Mildred S. Seelig, MD, MPH, confirmed in the 1980s that higher blood levels of magnesium are correlated with reduced complications of myocardial infarction. Chelation therapists have long added extra magnesium to intravenous EDTA in order to amplify many of the cardiovascular benefits of treatment. Realizing that lower magnesium levels are common in diabetes, hypertension, atherosclerosis, cardiomyopathy, and a panoply of other pathologies opens an interesting door: what minerals (and vitamins), when supplemented specifically, might enhance the effectiveness of chelation treatments in particular clinical settings? Incidentally, in patients who appear to have an “allergic” reaction to a chelating drug, supplementation with molybdenum might blunt that response for the future.

Stem cell implants offer special considerations here – could they be more effective when combined with certain minerals … or after bathing in selective chelation solutions? Rotifers are primitive multicellular microscopic waterborne “animals” that accumulate calcium over their lifespan. Alfred M. Sincock, PhD, reported in 1975 on almost doubling the lifespan by bathing the organisms in various calcium-binding chelators. Similarly, the length of DNA telomeres – hence, the potential number of cell replications before genetic losses – might also be preserved by chelation treatments. The possible interactions of hormones and EDTA or other chelators is a field ripe for investigation. These cell physiology studies are technical and expensive, but the benefits might be unexpectedly rewarding.

Cost/Benefit Comparisons
Given the socioeconomic impact of medical and health choices, no discussion is complete without highlighting the “competing therapies” for cardiovascular and other diseases. Chelation treatments reasonably cost about $5 to $10,000 to produce outstanding benefit for about 90% of patients with coronary, carotid, or peripheral vascular disease. Or all three at the same time. While surgery addresses only a few inches of “blockage” with each operation, chelation works throughout the body – a real bargain for the majority of patients, who have diffuse disease. Charges for CABG range about $75 to $150,000 – for each operation – assuming no serious complications requiring extended hospitalization. A small but certain percentage of bypass patients (perhaps 2% to 3% or more, depending on many factors, especially comorbidities or more profound blockage) never return home. Many patients suffer with postoperative morbidity, including myocardial infarction, stroke, rhythm disturbances, worsening high blood pressure, and neurocognitive changes (“pump syndrome”). Repeat operations are frustratingly common, often within 10 years. (If it worked so well the first time, why is another operation needed?) Aorta and peripheral vascular operations usually cost one-third to one-half of heart bypass procedures. Balloon angioplasty and stenting are increasingly popular (with a failure rate of about 5%), reducing the need for open surgery of the chest or limbs except for those with critical ischemia. Perhaps 20% of patients require repeated angioplasty procedures, dramatically changing the cost profiles with each session ranging from about $30 to $50,000. L. Terry Chappell, MD, and John P. Stahl, MD, in 1993 published a meta-analysis of 19 carefully qualifying studies, concluding that almost 90% of cardiovascular patients showed objective clinical improvements. The savings possible with the early choice of chelation rather than the later choice of repeated operations will become increasingly important for an aging population.

Intracranial small vessel ischemic disease is virtually untreatable by conventional means, so even slight improvements with chelation therapy are a bargain at any price. Similarly, degenerative patterns such as scleroderma, rheumatoid arthritis, macular degeneration, distal peripheral arterial occlusion, and nondiabetic chronic renal failure are poorly treated with traditional approaches, making chelation appealing and very cost effective. Perhaps the “greatest value” is seen in vague or poorly diagnosable medical conditions – including fatigue, asthenia, delayed healing, a sense of “unwellness,” multiple sclerosis – wherein chelation can provide benefits not seen with aggressive drug treatments or even surgery. Stubborn infectious diseases, such as Lyme disease or even MRSA, can show improvement with chelation. While the mechanisms of action often remain obscure, the clinical benefits can be quite obvious in patients’ lives. A “chelation registry” might document improvements across a broad range of pathologies, but the effort would be expensive and likely of little value in convincing skeptics.

One other factor should be addressed: cancer prevention. Walter Blumer, MD, in Switzerland reported his experience in 1980 with calcium EDTA intravenous treatments administered over 10 years, showing a 90% reduction in cancer incidence in the 59 patients. His follow-up report showed a 90% reduction in cancer deaths over 18 years, compared with the untreated controls similarly exposed to lead from automobile exhaust, industrial pollution, and other carcinogens. When treating heart and vascular disease, magnesium EDTA is preferred, in order to “mobilize calcium and reduce blockage.” In a private communication related to me by Garry Gordon, DO, MD(H), Blumer noted that his patients “didn’t suffer with heart attacks.” These delightful results are most likely related to removal of toxic heavy metals, since calcium EDTA does not perturb ionized calcium levels, but unknown effects of EDTA might contribute as well. Considering that cancers of all cell types are the third leading cause of death in the US, what could be the true prevention benefit when the cost of chelation treatment is compared with that of traditional oncology care?

Any review of environmental toxic metal exposures shows the alarming explosion of pollution concentrating up the food chains in the biosphere. One area where unexpected progress is coming is with mercury exposure from dental amalgams. The just-completed World Mercury Treaty, a three-year project of the World Health Organization, proposes that countries completely phase out their reliance on mercury restorations in both children and adults. Controversial studies have related mercury to autism and Alzheimer’s dementia, among other problems. The startling fact is that many adults are unknowingly carrying around their primary source of the world’s most potent neurotoxin, in their “fillings” or root canals. This raises the specter of worsening environmental pollution through the water effluent from dental offices as these restorations are replaced, because mercury scavenging units – to be disposed of as biohazard waste – are not yet in widespread use. Boyd Haley, PhD, emeritus chair of chemistry at the University of Kentucky, assures us that newer chelating compounds are in development and that they could be used not only orally in humans but also to remediate mercury-contaminated rivers and bodies of water.

Blumer’s study, among others, provokes a critical question: If removal of toxic heavy metals is the most important factor in producing clinical results, how much can be accomplished by using oral “chelating” drugs, alone or in combination with intravenous chelation? Oral administration is much easier, has fewer risks, and can be applied across broad populations, especially in a preventive context or to address early pathophysiology. Since 1995, I’ve used customized combined programs of oral chelators along with intravenous EDTA. Our early studies suggested more rapid reductions in the body burden of toxic heavy metals. Further research into dithiol compounds as well as classical chelators might be very cost effective and exceptionally fruitful. If taste-enhancing technology can mask the noxious sulfur aroma of oral chelators, the potential exists for design of prescription “chelator foods,” vastly expanding the access for this treatment approach. These would be “drug-supplemented” foods, not merely sulfur-rich onions and garlic.

Some Final Thoughts
The great majority of our “medical” problems are directly related to “personal health choices,” known as lifestyle issues: tobacco use, alcohol excess, caloric surplus, nutritionally bereft foods, poor choice of food variety, sedentary habits, dental deterioration, limited sleep, unlimited stress, and so on. Unsuspected toxic heavy metal and chemical exposures challenge our organ performance at a rapidly expanding pace. Where personal responsibility fails to minimize our survival threats, what should be the societal commitment of resources to restore function and comfort?

The future face of medical care is difficult to predict. An enlarging patient base in the US poses increasing financial demands on already stressed budgets. Technological advances can be expected in virtually every arena, from diagnostic testing through treatment planning. CT scans, MRIs, and PET scans have sharpened our accuracy and understanding to allow earlier diagnosis and treatment, for better outcomes and longer survival. Same-day surgicenters and endoscopic procedures dramatically reduced the costs associated with many common procedures, such as cholecystectomy and most knee repairs. Will the changes still to come bring similar cost savings or will they, like organ transplant procedures, impose greater economic strains on a nation unprepared to ration “high-tech” care?

Victor Fuchs, PhD, in his seminal book Who Shall Live?, claimed in 1974 that we must deliver the very best care to the president because of his critical position in the society – but he cautioned that we simply cannot afford to deliver “presidential medicine” to the people. Just because we can do it – CABG surgery, angioplasty, total joint replacement, organ transplants – challenges us with the ethical question of whether we should do it. Or do it for some but not for others. Or do it for younger adults but not for “the elderly.” The reasonable cost and minimal resources required to offer chelation therapy “to the masses” suggest that this largely ignored treatment might soon evolve to play central roles in both preventive and therapeutic spheres in our emerging care system.

Gerber, MD: Thirty Years of Progress in Cardiovascular Health

dr-michael-gerberby Michael Gerber, MD, HMD, MD (H)
Reprinted from the February/March 2006 Townsend Letter with permission

We are living during an exciting time in the evolution of medical practice. Building upon our medical school understanding of heart disease, drug therapeutics, and surgical interventions, we can now add a vast armamentarium of relatively non-toxic therapies to prevent and reverse our country’s number one killer: heart disease. Our medical world is made more difficult by insurance providers who restrict access to integrative medical care and by legislators and regulatory boards, who are becoming more responsive to the popular demand for complimentary care and yet are still unsure of what these practices mean in terms of patient safety and efficacy. It is now more important than ever to reach out to the medical community and promote a healthy dialog. Medical practitioners should all attend each other’s conventions and become more integrative for humanity’s sake.

A lot has happened in cardiovascular health since my first experience with EDTA chelation in 1976. After going to an American Academy of Medical Preventics convention – now called, the American College for Advancement in Medicine (ACAM) – and rubbing shoulders with the pioneering greats of Garry and Ross Gordon, Harold Harper, Robert Vance, Ed McDonaugh, and others, I went home, underwent a proper work-up for chelation by another AAMPS doctor, and began a series of intravenous (IV) chelations. I immediately felt sensations in my head as if I had more blood flow, and I noticed a big improvement in my memory. Names, phone numbers, scientific articles and their authors’ names jumped into my mind much more quickly. As time rolled on, I learned about heavy metals and their relationship to disease. Certainly the 13 large, mercury amalgam fillings (placed in my teeth when I was a college freshman) that out-gassed mercury with every sip of hot liquid and every bite of food weren’t helping my brain. Memories of my grandfather in four-point restraints in the state mental hospital during the last years of his life — swearing violence to the staff and his grandchildren, whom he’d taught to hunt and fish — filled me with worries about my genetic heritage of senile dementia. I soon learned that I was reversing the aging and disease process with chelation by removing the metals that led to arteriosclerosis. This was a revolutionary, evolutionary process, and it was just the beginning.

Thirty years later, after performing many thousands of chelation treatments, my respect for chelation therapy has only grown. Chelation therapy is clearly an indispensable part of a comprehensive vascular treatment program. The increase in our understanding of the importance of identifying and treating other sources of inflammation, toxicity, and infection that effect vascular disease has been dazzling. Treatments that support the vascular system health have emerged from a myriad of disciplines, including herbal therapy, homeopathy, nutrition, enzyme therapy, dental detoxification, Chinese medicine, neural therapy, isopathic therapy, far infrared sauna therapy, oxidative therapies, intravenous phospholipid exchange, new surgical approaches, umbilical cord blood stem cell therapy, RNA therapy, extracorporeal counterpulsation therapy (ECCP), Laser Energetic Detoxification, EMF avoidance and Bau Biology cleanup, bioidentical hormone replacement therapy, blood rheology assessment, blood clotting assessment, genetic assessment, neurotransmitter assessment, exercise program supervision, cranial/sacral therapy, chiropractic therapy, mental/emotional detoxification, drug therapy and drug detoxification, organic diet counseling, toxic foods and products-avoidance counseling, water purification counseling, and many more.

Chelation History
Chelation therapy can be traced back to 1938, when a German chemist, identified as F. Munz, first synthesized ethylene diaminetetraacidic acid (EDTA). Herr Munz was working for Hochst, Farbwerke, Frankfort, a member company of the I.G. Farbenindustrie. He developed EDTA for the purpose of removing calcium from the water in textile plants so their mordant dyes wouldn’t stain when contacting hard water. Martin Rubin, et al, first used EDTA in the United States in 1950 for the treatment of patients with lead toxicity, who had been working in a battery factory in Michigan. When treating a patient with lead poisoning, who, coincidentally, also had coronary artery disease and angina pectoris, Norman E. Clarke observed that the patient’s symptoms of angina pectoris disappeared. In standard medical school curricula, EDTA is still the agent of choice in lead and other heavy metals poisoning as well as in the treatment of hypercalcemia. Norman E. Clarke, MD, conducted the first trials using intravenous EDTA for vascular disease in Detroit. He achieved good results, which he published in 1956 in the American Journal of Medical Science. He later published the results of 283 more patients in 1960.1-2 Like many medical innovators, he encountered resistance from the medical establishment over EDTA. Nevertheless, dozens of physicians were convinced of the efficacy of treating cardiovascular disease (CVD) with chelation. They spent years refining safe dosage protocols and established the aforementioned American Academy of Medical Preventics in 1973.

Human Studies in Chelation Therapy
Since that time many landmark studies have been published that provide data supporting the safety and benefits of using chelation therapy in humans. In 1993, Drs. L. Terry Chappell and John P. Stahl published their excellent paper of the meta-analysis of 22,765 patients who had taken EDTA chelation therapy. They had to leave out several highly positive papers because of the design of the study, and yet they found a .88 highly positive correlation coefficient. Eighty-seven percent of the patients included in the meta-analysis demonstrated clinical improvement by objective testing.3

Majid Ali, et. al, showed improved myocardial perfusion in a study of 26 patients with advanced ischemic heart disease, and a 91% overall improvement in their symptoms after chelation therapy with nutritional supplements and dietary counseling.4

C.J. Rudolph and E.W. McDonaugh, along with Emanuel Cheraskin, measured improvements in carotid artery stenosis by ultrasound measurements of 30 patients before and after 30 chelations. Patients with mild disease had an intra-arterial diameter increase of 20.9 % +/- 2.3%. Those with greater than 33% stenosis averaged 35.0% +/-4.3 % decreased obstruction. Applying Poiseuille’s Law of fluid dynamics, this improvement leads to an average of 620% improvement in blood flow. No side effects from the treatments were evident at follow up.5

Claus Hancke and KnuteFlytlie published a retrospective study of EDTA chelation in 470 patients and found through mostly objective measures an 80% to 91% improvement, depending on the parameter. Of 92 patients referred for surgical intervention, only ten required surgery after or during their chelation therapy. Of 65 patients referred for bypass, 58 did not require it after chelation therapy. In the claudication group, 24 of 27 patients scheduled for amputation were spared following chelation therapy. Of 207 patients using nitroglycerine, 189 reduced their consumption with most able to discontinue it altogether. Angina improved in 91% of patients and claudication patients walking distance improved an average of 88%. Some of these patients could walk several miles without pain. No morbidity or serious side effects due to the treatment were reported.6

In 1985, Efrain Olszewer, MD, and James Carter, MD, published a study in Medical Hypotheses of 2870 patients in Sao Paulo, Brazil treated with 81,000 chelations for their coronary artery disease. They found marked improvement in 76.89% of patients, with 16.58% having good improvement and 3.79% moderate improvement. Only 2.5% of patients were unchanged and .1% became worse, with associations of heart failure.7

H. Richard Casdorph and Charles Farr, both MD-PhD’s, published a little gem in 1983 that concerned four patients with gangrenous extremities scheduled for amputation. All four cases were resolved without amputation after chelation therapy. Two patients were diagnosed diabetics and suffered small vessel disease, and one patient was post-occlusion of a femoral-popliteal bypass graft.8 I will say that saving an extremity from amputation for the first time has a profound impact on the doctor as well as the patient.

For the convenience of the reader, I have collected these previous articles in their entirety and 15 other important articles on EDTA chelation therapy in humans. These articles contain more history, mechanisms of action, and extensive, invaluable bibliographies. These are available from my office and soon will be on my website.3-23 It is important to note one double-blind study done by Sloth-Nielsen and others, Danish cardiovascular surgeons, on peripheral vascular disease. This study shows a negative outcome of chelation therapy.29. Two rebuttals30-31 of this study were published noting that 29 of the patients studied were smokers (and most continued to smoke), and magnesium EDTA was not used. The patients were also given iron tablets, which would decrease the anti-oxidant value of the therapy. The outcome data also appeared to had been unfairly manipulated.

Causes of Vascular Disease
With proper counseling and treatment, we should be able to avoid vascular problems. We inherit heavy metals from our mothers and fathers and absorb them from the air we breathe and the foods and drugs we consume. We can minimize this damage by avoiding exposures and using the appropriate chelation substances such as EDTA, DMPS, DMSA, penicilliamine, and other non-drug chelators preventatively. The environmental and lifestyle causes of vascular disease are myriad and require a multifaceted approach for optimum prevention and treatment. Nutritionally depleted and toxic foods, including excessive sugar, refined foods and trans fat; tobacco, alcohol, and other stimulants; as well as undiagnosed food sensitivities, obesity, and unrelenting stress all prematurely age our vascular system. As the immune system becomes suppressed, the body makes more vulnerable plaque that can become infected with Chlamydia and viruses and are very dangerous in heart disease. The production of cellular energy at the mitochondrial level is subject to the same stressors, especially blockades from environmental toxins such as volatile organic hydrocarbons, plastics, heavy metals, pesticides, and PCBs, along with deficiencies of important micronutrients such as magnesium, CoEnzyme Q10, Lipoic Acid, L-carnitine. and ribose. The cardiac muscle contains 25 times more mitochrondria per cell than skeletal muscles and normally manufactures ten or twelve pounds of ATP per day. As ATP levels fall, so does heart health especially in those with congestive heart failure. Steven Sinatra in his book, The Sinatra Solution, gives an excellent review of mitochondrial dysfunction and how CoQ10 reduces LDL oxidation in heart disease.24

Far Infrared Sauna
A great toxicity primer is Detoxify or Die by Sherry Rogers, MD.25 At first I thought the title was a little dramatic but after a couple of years of experience with Far Infrared (FIR) saunas, I think it is right on. She makes the point that we are all toxic, containing hundreds of pollutants, many of which are extremely damaging to the cardiovascular system. She mentions a couple of studies from the Mayo Clinic that cite improvement in congestive heart failure (CHF) patients following FIR sauna therapy to sweat out environmental toxins. That got my attention because I have lost a number of wonderful patients over the years to end-stage CHF, despite the best efforts of local cardiologists and myself. Regular sauna is contraindicated in CHF patients, but low temperature (90o to 140o F), FIR sauna, gradually employed, is well tolerated and life-saving. This year I have had two tough CHF patients remarkably improve following FIR sauna therapy. Everyone needs to sweat out their environmental toxins, especially the phthalates found in our plastic food and beverage packaging, because they concentrate in the heart and thyroid and are not subject to removal by any other means. FIR sauna has also proven effective in eliminating heavy metals, and Dr. Rogers also reminds us that CHF patients have vastly more mercury in the heart than healthy young individuals and that cadmium is a particularly virulent cardio toxin.

Homeopathy and Herbs
Constitutional homeopathy is very helpful in vascular disease, especially for those with emotionally broken hearts. Acute remedies with special focus on the heart and vascular system can be very impressive. Remember Hawthorne Berry (Crataegus) and Cactus for chest pain, and Crotalus (Rattlesnake venom) for chest pains and bleeding problems. Herbal tinctures of Crataegus can be used for heart support as well as for angina and arrhythmias. Cayenne pepper is used for angina, stroke, bleeding, and hypertension. Peppermint oil is also wonderful for fainting, shortness of breath, and chest pain.

Neural Therapy
Neural therapy from Germany utilizes procaine, a local anesthetic, for many therapeutic needs. Injecting procaine intradermally in wheals over acupuncture points on the chest and neck, and over vertebral dermatomes that enervate the heart and tender scapular points, can relieve chest pain. Injecting scars, especially midline heart surgery scars, can relieve heart pain instantly and sometimes permanently. German Biological Dentistry relates the teeth to different body organs and structures. Injecting procaine next to the heart-related teeth (wisdom teeth, retro molar areas, and canines) with procaine has immediately relieved heart pain and improved congestive heart failure in a few minutes. Relief of distant pain by procaine injections is called the Hunecke Lightening Reaction. Procaine injections are also diagnostic in that they show which teeth may have chronic infections. Bone infections under the teeth can have profound influence on distant structures, like the heart, as well as promote cancer by suppressing P53 and P21 proteins. A new diagnostic instrument called the Cavitat (www.cavitat.com), an FDA-approved, ultrasound diagnostic device, can demonstrate these areas of soft or missing bone usually infected with bacteria and fungi that form many bacterial toxins. The NewTom cat scan of the maxilla, mandible, and sinuses can also pinpoint hidden infections. Digital X-rays and digital Panorex X-rays are helpful, but can miss some bone infections.

Dental Detoxification
Dental toxicity is almost always involved with chronic illness, and vascular disease is no exception. Periodontal disease, frequently the result of nutritional deficiencies, including subclinical scurvy (vitamin C deficiency), and niacin, B3, and CoQ10 deficiencies is known to cause vascular disease. Infected gum tissue has been well documented to shed bacteria, that can attach to heart valves, into the blood. Mercury vapor escaping from amalgam fillings, aggravated by electro-galvanism from neighboring metal restorations, can attack any nerve tissue in the body, and will also attach to inflamed tissue such as the heart and vessels. Likewise, the above-mentioned bone cavitations can cause inflammation of the vascular endothelium through the release of pathogens and other inflammatory factors that then attract mercury and other metals to the vascular endothelium. These infections can raise the C-reactive protein levels in my experience. Having the amalgams replaced with ceramic, porcelain. or gold restorations is worthwhile if done safely following IABDM (International Academy of Biological Dentistry and Medicine) or IAOMT (International Academy of Oral Medicine and Toxicology) protocols. Some patients cannot tolerate any metal restorations. After performing hundreds of DMPS (dimercaptopropanesulphonate) challenge tests, everyone, in my experience, has mercury toxicity. Whether or not this causes clinical symptoms varies from individual to individual, depending on the strength of their detoxification mechanisms. It is ideal to have a vitamin C IV going during amalgam removal or, as they do in German biological medicine clinics, a selenium IV. Since both are rarely available in most communities, it is important to have a drip as soon possible after amalgam replacement to minimize changing addresses of the mercury in the body. Using buffered vitamin C, GMS-Ribose buffered C, or Liposomal vitamin C is also very helpful to achieve higher plasma levels of vitamin C.

Phosphatidylcholine
Phosphatidylcholine makes up the bulk of cell membranes in young individuals. Young cell membranes contain six parts phosphatidylcholine to one part cholesterol/sphingomeyelin and, with aging, these ratios reverse. All our body’s business is done crossing cell membranes — getting nutrients in and toxins out — and this process depends on the health and integrity of membranes. Free radicals, and other toxic processes associated with aging, damage the cell membranes. This is especially true of the linings of our arteries. Studies in Switzerland and Germany are supportive of using intravenous phosphatidylcholine, especially when combined with EDTA Chelation therapy, to restore vascular cellular membrane integrity (see www.plaquex.ch).

Enzyme Therapy
Digestive and proteolytic enzyme therapy is important in vascular disease prevention and treatment. Pancreatic enzymes, lipases, proteases, trypsin, chemotrypsin, as well as bromelain and papain and Aspergillis sp. plant enzymes, all help reduce inflammation in the body and the vascular system. Serropeptase has been touted to digest plaque and nattokinase – derived from a ferment of soy and lumbrokinase – from earthworms digest fibrin. Lumbrokinase seems especially effective in reducing fibrin levels and the viscosity of blood. Urokinase, of course, is famous as a clot buster when used after heart attack and stroke.

Oxidative Therapies
Oxidative therapies, intravenous ozone, intravenous peroxide, and hyperbaric oxygen all have long histories of utility in vascular disease. Intravenous ozone infused in saline, and peroxide in saline with magnesium and manganese following IBOM (International Bioxidative Medical Association) protocols, change the red cell membranes and allow more oxygen to be released into the tissues, as well as pump up the immune system by stimulating white blood cells’ production of cytokines and lymphokines. Peroxide also reduces inflammation by killing viruses and bacteria that can live in infected plaque. Since most pathogens are anaerobic or partially anaerobic, hyperbaric oxygen therapy can also reduce inflammation, as well as enhance a number of other healing mechanisms, including rehabilitation after strokes.

Nutritional Support
Nutritional support for vascular disease is steadily improving. The anti-inflammatory effects of the EPA/DHA omega-3, -6 and -9 fatty acids are now known to protect against vascular disease. Several brands of “burpless” fish oils now exist, derived from deep sea fish that have had their fish proteins distilled off to avoid the fish burps and aftertaste that has deterred many patients over the years. Oils rich in omega-6, such as primrose, borage, and currant oils, have been shown to be efficient at reducing platelet aggregation.

Vitamin C, so critical for the connective tissue matrix of arteries and veins, is available in many new, more easily tolerated, forms. Buffered C, Tapioca C, Cassava C, and vitamin C combined with ribose and methyl sulfonyl methane provide better oral absorption and less intolerance than regular corn-based vitamin C. Tocotrienols, the other half of the vitamin E family, have proven their utility in lowering cholesterol levels along with Policosanol, derived from the wax of sugar cane. Significant positive data exists to indicate that the introduction of ribose, the central five-carbon sugar in the ATP molecule and the backbone of DNA and RNA, helps patients undergoing bypass surgery to recover from the stunning and hibernation due to poor energy metabolism in the heart muscle. Ribose is also effective in treating congestive heart failure and improving performance in elite athletes.

The greater bioavailability of CoQ10 suspensions helps all the body’s mitochondria, but especially the mitochondria-rich myocardium. Vitamins K1 and K2 not only help normalize clotting, but also move calcium in the body out of arterial plaque and joints into the bones and blood where it is needed. Magnesium malate seems to improve magnesium absorption and give greater anti-spasmodic protection for the vascular system, as well as provide a calming effect on the nervous system to help prevent sympathetic dominance.

Oral EDTA chelation has always been a helpful adjunct to intravenous chelation. Now oral EDTA chelation is available in a phosphatidylcholine, liposomal matrix that increases its oral absorption. This product is especially recommended for our patients who don’t have good veins. Rectal suppositories of EDTA are also a cost-effective and practical alternative to IV EDTA.

Bringing to light the homocysteine problem and its relationship to vascular disease and sticky blood is another milestone for cardiovascular health. This is a particular genetic “SNIP” – actually “SNP,” for single nucleotide polymorphism — that causes abnormal amounts of homocysteine to be made from cysteine in about 28% of patients and can be treated by adequate supplementation of folic acid, lysine, B6, and trimethylglycine. New glutathione preparations available for oral use, as well as the intravenous preparations, are of great help in removing toxic metals in vascular disease and in many neurological conditions. Elucidation of the role of nitric oxide (NO) in vascular endothelial health and as a vasodilator coupled with the importance of arginine, time-release arginine, and citruline and EDTA in boosting NO levels is another great advance. Vitamin D deficiency is also rampant in the population and is related to vascular disease as well as osteoporosis and joint disease. Don’t forget green tea, which has many uses in CVD. A nice review, providing many references for many of the above cardiovascular related nutrients, may be found in Sherry Rogers’ book, The High Blood Pressure Hoax.26

Bioidentical Hormone Replacement Therapy
Of the many advances in cardiovascular health in the last 30 years, perhaps none is more important as bioidentical hormone replacement therapy. Our hormones are important controllers of our vascular system. Hypothyroidism abounds, especially with borderline low blood levels. Hypothroidism is related to high cholesterol levels, low blood pressure, fatigue, and poor absorption of important heart nutrients like magnesium and chromium. Natural desiccated thyroid replacement therapy also helps with weight loss, mood, and constipation. Adrenal support with DHEA, 7-keto DHEA, pregnenelone, and adrenal cortex preparations keeps blood sugar steady, helps keep the body out of sympathetic dominance, and provides mild anabolic support to the heart. Progesterone is greatly protective for women in estrogen dominance, not only to avoid cancer but to prevent heart disease as well. Too much estrogen reduces oxygen utilization and creates hypoglycemia and weight gain. Testosterone is a big heart helper in both sexes. A greater relationship to cardiac events exists in patients over 70 who have low testosterone levels than with those who have high cholesterol levels. In this regard, I find it troubling to recall that none of the statin drugs have been studied longer than 12 weeks and that greatly inhibiting cholesterol synthesis also may cause a reduction in testosterone and other steroid hormone levels when taken over the long term.

A Case That Makes It All Worthwhile
This year we have had many greatly improved cardiovascular patients, but the progress of one in particular, whom we shall call Rocky, has been very heart-warming. Rocky is a 67-year-old retired Pan Am employee from Belgium. He was working as a security officer in a local casino when he collapsed in late July 2004. He was rushed to the hospital with shortness of breath. His electrocardiogram showed an old posterior wall infarct and rapid atrial fibrillation. A dual isotope myocardial perfusion study revealed a severe inferior wall defect from apex to base; a severe lateral wall defect from apex to base; a severe apical defect; and a moderate anterior wall defect. The mid-lateral wall was infracted. The left ventricle was massively dilated. There was akinesis of the inferior wall and significant hypokinesis of the anterolateral wall. Contraction was asynchronous. Ejection fraction was less than 10%. Angiography showed severe three vessel disease, a 70% occlusion of the left main, a subtotal occlusion of a large obtuse marginal artery, 70% stenosis of a diagonal, 50% stenosis of the left anterior descending and an occluded right with a posterior descending that filled by collaterals. He was hypertensive with kidney failure, liver failure, diabetes, hypercholesterolemia, ischemic cardiomyopathy, and congestive heart failure. With this presentation, the cardiovascular surgeon declined to do coronary bypass surgery and he was referred for medical management and cardioversion. He was discharged on enalapril, Coumadin, magnesium oxide, Sustane, Potassium chloride, Vistaril, Metoprolol, Aldactone, Lasix, amiodarone, Zocor, and testosterone gel.

In mid-September 2004, he appeared in my office, interested in chelation therapy and an integrative approach to his heart disease. After signing all the appropriate informed consent documents for each of the subsequent therapies, we began his treatment. His initial laboratory results showed a homocysteine of 27.4, C reactive protein 7.3, glucose 211, uric acid 10.9, creatinine 2.7, BUN 67, GGT 97, and triglycerides 330. He was on oxygen at night and was having weight fluctuations of several pounds per day from water retention related to his CHF. Rocky is a cheerful, highly motivated, and compliant person and began our program with enthusiasm. His physical exam was remarkable in that his heart sounds were very diminished to inaudible; he had mild ankle edema; and he had several mercury amalgam dental fillings. He gradually started far infrared saunas at 1000 for five minutes and worked up to 30 minutes at 1300 with no adverse effects. The saunas always made him feel better as he began to sweat out his toxic load of plastics, chemicals, and metals. On average, he went three to five times per week for nine months and then slowed down on the frequency of saunas as he felt better. After saunas, he took a detox cocktail of electrolytes, glutathione, vitamin C, and enzymes. He was able to sweat immediately, in contrast to some older patients who can’t sweat for months. He began a nutritional supplement program with multiple heart supportive nutrients with oral chelation, CoQ10 at 100 mg four times per day with vitamin E, mixed tocopherols, acetyl L carnitine, Cretaegus tincture (Hawthorne berry), desiccated thyroid, adrenal support, testosterone cream, B12, folic acid, Bucco herbal tonic for the kidneys, chromium, vanadium, Gemnemasilvestre for his blood sugar, peppermint oil drops for any shortness of breath, Nattokinase, vitamin K after Coumadin withdrawal, deodorized fish oil, primrose oil, B6, Lysine, time-release arginine, ribose with magnesium malate, proteolytic enzymes, and DMSA and chlorella for mercury detox after amalgam removal.

After several weeks of nutrient repletion, Rocky started chelation therapy with a low dose of disodium, magnesium EDTA to begin. His BUN and creatinine fell steadily to within normal limits during his therapy. He quickly was able to tolerate the full three grams of EDTA and completed 30 weekly chelation treatments and subsequently has had four more monthly treatments. Likewise, he completed 30 weekly intravenous infusions of phosphatidylcholine and four more monthly maintenance treatments. His diet counseling of a moderate protein, low simple carbohydrate, high-fiber diet paid off with a 35-pound weight loss from 225 to 190 lbs. Homocysteine is down to 16.1 (still working on this), C reactive protein is 1.68, glucose 91, uric acid 7.5, triglycerides 166, cholesterol 181, LDL 101, HDL 47, GGT 31, BUN 26, and creatinine 1.4.

In addition to the above treatments, we also used Laser Energetic Detoxification (LED), as taught by Lee Cowden, MD. LED is the application of low-power laser light modulated through homeopathic preparations of toxins, allergens, organs, hormones, and neurotransmitters to acupuncture points. Rocky was treated for sulfanilamide, Bactrim, and Septra (found in meats which putatively block sulfur metabolism in the whole body), 23 different mercury salts, cadmium Diazenon, DDT-DDE, insulin, pancreas, benzene, xylene, toluene, Dioxin, HGH, PCBs, Heptachlor, testosterone, formaldehyde-formic acid, petroleum, Atrazine, carbon tetrachloride, methyl ethyl ketone, glucagon, leptin, liver, and heart.

Repeat perfusion study in May 2005 showed an ejection fraction of 45% with good improvement in the left ventricular size. Many of the hypokinetic areas remained, but the study was of poor quality. Rocky has been working out with a personal trainer, rowing and lifting weights. He can walk several flights of stairs with no dyspnea and works ten hours per day, seven days per week as a checker in a large grocery chain (against medical advice) as a favor to a relative who manages the store. He has no chest pain or other vascular symptoms and is very happy with his newly found energy and endurance. He tires a little at the end of the day but, in general, says that he has never felt better in his life. He is off all medication except metoprolol and metformin, his nutrients, and hormones. His blood pressure is normal, and now you can actually hear his heart in normal sinus rhythm with a stethoscope and, as Rocky would say, “That’s a good thing.”

Moving Forward
Over the past 30 years, we have witnessed a huge burst of knowledge and treatments that have revolutionized our understanding of CVD. These treatments and scientific understanding of the basis of vascular disease are a great blessing for our patients and for us. The times are changing, and the safe harbors for integrative doctors are increasing. The Homeopathic Medical Boards in Nevada and Arizona have been in existence for over twenty years and have regulated homeopathic and integrative therapies successfully. An Investigational Review Board (IRB), created by the legislature in the State of Nevada to study and document alternative therapies, provides a great opportunity to gather the much-needed data to help support the safety and importance of integrative therapies. The California Business and Professions Code sec 2500 acknowledges the significant interest of physicians and patients alike in integrative approaches and holistic-based alternatives within the practice of medicine and charges the boards to establish specific policies, review statutes, and recommend modifications of law, to assure California consumers that the quality of medicine is the most advanced and innovative it can be, both in terms of preserving the health of California residents and providing effective diagnosis and treatment of illness for the residents of that state. With this in mind, it is time to expand our research and teach these advances to the next generation of physicians and healers.

Correspondence
Michael Gerber, MD, HMD, MD(H)
President, Nevada Homeopathic and Integrative Medical Association
Gerber Medical Clinic, Inc.
3670 Grant Drive
Reno, Nevada, 89509
Drmichael@gerbermedical.com
www.GerberMedical.com

References
1. Clarke NE, Clarke CN, Mosher RE. The “in vivo” dissolution of metastatic calcium: an approach to atherosclerosis. Am J Med Sci. 1955; 220: 142-149.
2. Clarke NE. Arteriosclerosis, occlusive vascular disease and EDTA. Am J Cardiology. 1960; 2: 233-236.
3. Clarke NE. Treatment of occlusive vascular disease with disodium ethylene diaminetetraacetic acid (EDTA). Am J Med Sci. 1960; Jun: 732-744.
4. Chappell TL, Stahl JP. The correlation between EDTA chelation therapy and improvement in cardiovascular function: a meta-analysis. Journal of Advancement in Medicine. Fall 1993; Vol. 6, Number 3.
5. Edwards DA, Carazon II, Essad LM. EDTA chelation therapy in myocardial stunning and hibernation. Journal of Advancement in Medicine. Winter 1997; Vol 10, Number 4.
6. Ali M, Ale O, Fayemi A, Juco J, Grieder-Brandenburger C. Improved myocardial perfusion in patients with advance ischemic heart disease with an integrative management program including EDTA chelation therapy. Townsend Letter for Doctors and Patients. January 1999.
7. Rudolph CJ, McKnight EW, Barber RK. A nonsurgical approach to obstructive carotid stenosis using EDTA chelation. Journal of Advancement in Medicine. Fall 1991; Vol 4, Number 3.
8. Rudolph CJ, McKonagh EW, Barber RK. Effect of EDTA chelation and supportive multivitamin/trace mineral supplementation of chronic lung disorders: a study of FVC and FEV. Journal of Advancement in Medicine. Winter 1989; Vol 2, Number 4.
9. Riiordan HD, Cheraskin E, Dirks M, Schultz M, Brizendine P. Another look at renal function and the EDTA treatment process. Journal of Orthomolecular Medicine. 1987; Vol. 2. No.3.
10. Rudolph CJ, Samuels RT, McDonagh EW. Visual field evidence of macular degeneration reversal using a combination of EDTA chelation and multiple vitamin and trace mineral therapy. Journal of Advancement in Medicine Winter. 1994; Vol. 7, Number 4.
11. Hancke C, Flytlie K. Benefits of EDTA chelation therapy in arteriosclerosis: a retrospective study of 470 patients. Journal of Advancement in Medicine. Vol 6, Number 3.
12. Olszewer E, Carter JP. EDTA chelation therapy in chronic degenerative disease. Medical Hypotheses. 1988; 27 41-49.
13. Casdorph HR, Farr CH. EDTA chelation therapy iii: treatment of peripheral arterial occlusion, an alternative to amputation. Journal of Holistic Medicine. Spring/Summer 1983; Vol 5. No. 1.
14. Kindness G, Frackelton JP. Effect of ethylene diaminetetracetic acid (EDTA) on platelet aggregation in human blood. Journal of Advancement in Medicine. Winter 1989; Vol 2. Number 4.
15. Casdorph HR. EDTA chelation therapy ii, efficacy in arteriosclerotic heart disease. Journal of Holistic Medicine. Spring/Summer 1981; Vol. 3. No 1.
16. Chappell LT. Randomized double-blind studies on sodium-magnesium EDTA. Journal of Advancement in Medicine. Summer 1995; Vol. 8. Number 2.
17. Casdorph HR. EDTA chelation therapy ii, efficacy in brain disorders. Journal of Holistic Medicine. Fall/Winter 1981; Vol.3. No.2.
18. Chappell LT. Point/counterpoint – effectiveness of EDTA chelation therapy. Alternative Therapies. May 1995; Vol.1. No. 2.
19. Letters to the Editor: Chelation Therapy Circulation. September 1, 1995; Vol. 92, No 5,
20. Escobar GA, Escobar SC. Chelation in Peripheral – Arterial Insufficiency. 1990.
21. McDonagh EW, Rucolph CJ. Noninvasive treatment for sequellae of failed coronary blood circulation: 100% occlusion of left anterior descending coronary artery, 30% stenosis right coronary artery, and left ventricular contractility deficit. Journal of Neurological and Orthopedic Medicine and Surgery, 1993; Vol.14. No. 3.
22. Olszewer D, Sabbag FC, Carter JP. A pilot double-blind study on sodium-magnesium EDTA in peripheral vascular disease. Journal of the National Medical Association. Vol. 82. No.3.
23. Rudolph CJ, McDonagh EW. Effect of EDTA chelation and supportive multivitamin trace mineral supplementation on carotid circulation: case report. Journal of Advancement in Medicine. Spring 1990; Vol.3. Number 1.
24. McDonagh EW, Rudolph CJ, Cheraskin E. An oculocerebrovasculometric analysis of the improvement in arterial stenosis following EDTA chelation therapy. Journal of Holistic Medicine. Spring/Summer 1982; Vol. 4 No.1.
25. Rudolph CJ, McDonagh EW, Barber RK. A nonsurgical approach to obstructive carotid stenosis using EDTA chelation. Journal of Advancement in Medicine. Fall 1991; Vol. 4. No. 3.
26. Rogers SA. The High Blood Pressure Hoax. The Sand Key Company, Inc.;2005. 1-800-846-6687 www.prestigepublishing.com
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Dayton: Chelation Therapy: Yesterday, Today, and Tomorrow

88_dr_dayton_computerby Martin Dayton, DO, MD, MD(h)
Reprinted from the February/March 2006 Townsend Letter with permission

Chelation (pronounced ke’lat’shun) therapy in medicine is generally regarded to be the use of chelating agents to remove toxic heavy metals from the body. Toxic heavy metals include – but are not limited to – arsenic, cadmium, lead, and mercury. All metals, however, can be toxic when present in large enough concentrations.

The first widely used medical chelating agent, British Anti-Lewisite (BAL), also known as dimercaprol, was developed in the 1940s. Lewisite is an arsenic-based compound used in gas warfare. The chelating agent Ethylene Diamine Tetra Acetic Acid (EDTA) was also first used clinically in the 1940s. EDTA comes in two injectable forms that have been approved by the U.S. Food and Drug Administration (FDA): Calcium disodium EDTA, to treat lead toxicity; and Disodium EDTA, to treat elevated blood concentrations of calcium. EDTA is effective in removing calcium while BAL is not. BAL is effective in removing mercury, but not calcium. Both remove lead. These and other medical chelating agents such as 2, 3 dimercapto-propane sulfonate (DMPS), dimercaptosuccinic acid (DMSA), 3-mercapto-D-valine (penicilliamine), and desferrioxamine (DFO), all have distinctive characteristics governing circumstance-dependent usefulness.

Magnesium disodium EDTA is created by the addition of magnesium to commercially available disodium EDTA. This is the form of ETDA complex that has been popularly used to intravenously treat cardiovascular, autoimmune, and other degenerative diseases. Despite five decades of use in the treatment of cardiovascular disease, intravenous EDTA is not embraced by mainstream medicine nor approved by the FDA for treatment of cardiovascular conditions.

Studies favoring the use of intravenous EDTA in treatment of cardiovascular disease and other degenerative diseases have appeared in the medical literature since the 1950s. In 1956, N.E. Clarke published a study in the American Journal of Science, in which results showed that 19 of the 20 patients with angina studied received unusual relief, with some patients experiencing a normalization of electrocardiograms. Other benefits reported during this period, still being reported today, include improved memory; better sight; hearing and smell; and an increase in energy. Heavy metal toxicity interferes with normal physiologic function and repair, leading to numerous symptoms and contributing to many diseases. Multiple conditions may be alleviated simultaneously in the same person through reduction of heavy metal toxicity.

Various studies, both pro and con, have been performed to test the benefits of chelation therapy. However, studies performed thus far have been unable to gain universal acceptance because they were either too small (in number of subjects), not of acceptable design, scientifically biased, or otherwise flawed. In a 1993 study by L.T. Chappell. et al. in the Journal of Advancement in Medicine, the authors examined the overall effects of chelation therapy on 22,765 patients. Of those patients, 87% demonstrated objective benefit. Since then, the popularity of chelation therapy has continued to grow with ever-increasing numbers of success stories. Battles have raged, as they continue to rage today, between physicians promoting chelation, based upon best available evidence, and mainstream conservative clinicians who wish to restrict chelation usage unless a universally accepted study is performed that definitively proves efficacy. Approximately a decade after the study mentioned above, the National Institutes of Health gave the nod and, more importantly, $30,000,000 in funding, to perform a definitive study with 2,372 patients, 50 years of age or older, who have a history of a previous heart attack. The study is taking place at over 100 private medical offices, clinics, and centers across the USA, including prestigious institutions such as Mount Sinai Hospital, Miami Beach; the Mayo Clinic; and the University of Missouri .

The study, Trial to Assess Chelation Therapy (TACT), is led by cardiologist GervasioA.Lamas, MD, director of cardiovascular research and academic affairs at Mount Sinai Medical Center, Miami Beach. The study was carefully designed with input and agreement from both mainstream physicians and experts experienced in chelation therapy.

TACT follows a randomized double-blind format. Participating patients are placed into four different groups via a randomization process to help assure homogeneity.

One-half of the patients are given intravenous infusions of magnesium EDTA, while the other half receives infusions of a liquid placebo. All patients receive oral vitamin and mineral supplements to take home. To distinguish the contribution of the vitamin and mineral supplements from that of the intravenous infusions to clinical outcome, the two groups are subdivided into equal numbers of participants, each receiving either high-dose or low-dose vitamin and mineral supplements. The actual compositions of the infusions administered and supplements dispensed are not disclosed to the patients or to the administering /dispensing personnel, hence, the phrase, double-blind. All treatment records are coded for later evaluation.

Patients receive three-hour infusions weekly for 30 weeks, followed by ten more bi-weekly infusions for a total of 40 infusions. Throughout the study, routine medical care otherwise continues as before under the care of the patients’ own physicians. All patients participating are followed until the end of the study, up to five years, to determine presence or absence of clinical benefits, such as reduced incidence of heart attack, stroke, hospitalization for angina, coronary revascularization, and death. Effects on quality of life and cost of health care savings will also be assessed. In addition to potentially gaining personal health benefits at no cost, patients participating in the study are also rewarded in knowing that their participation will contribute to the future well being of others who have or are at risk of developing coronary artery disease. If TACT proves chelation to be effective and cost-effective, mainstream medicine will be forever changed for the better. There is no charge to patients for participating.

For information in regard to TACT or participating in TACT call or visit the following:888-644-6226

Web sites:
http://nccam.nci.nih.gov/chelation/studysite.htm
http://www.clinicaltrials.gov/show/NCT00044213

EDTA may be used preventively as well as therapeutically. W.Blumer and E.M.Cranton published a study in the Journal of Advancement of Medicine, which followed 231 subjects over the course of 18 years and reported a 90% reduction in cancer mortality in patients who had received ten or more Calcium EDTA infusions compared to those who did not.

Oral EDTA is used today preventively and therapeutically. Despite a five-percent EDTA absorption per the oral route, studies have validated benefit. EDTA may also enhance detoxification in form of rectal suppositories and as an additive to bath water.

Transdermal use of DMPS, a sulfur-containing chelator, provides benefit where other routes of DMPS administration are less desirous. Sulfur-containing foods such as eggs, garlic, and broccoli contribute to reducing the body burden of susceptible toxic metals. The common herb/spice cilantro has gained much recognition for its ability to reduce toxic metal burden. Nutritional supplements such as ascorbic acid, lipoic acid, malic acid, and DL methionine may be used to address metal toxicity as circumstances dictate. Various non-prescription preparations synergistically combining substances to enhance chelating properties are constantly being introduced into the marketplace. An innovative product based on zeolite has recently been introduced. Infrared heat saunas, magnetic mattresses, galvanic current, mineral baths, and sweat-inducing exercise also have proven to benefit metal toxicity.

Metabolic and genomic testing offers information regarding our individual abilities to detoxify. With such information in hand, physicians can target inherited and acquired weaknesses nutritionally, medically, and via lifestyle modification to aid heavy metal detoxification.

Drs. A. Yasko and G. Gordon are researching the viral influences that affect heavy metal retention. The use of virus-specific, RNA-based oral supplementation has demonstrated impressive clinical results in detoxification of heavy metals recalcitrant to previous attempts of removal with chelating agents alone. This futuristic technology is available for use today.

For more information, visit the following web sites: www.autismanswer.com; www.holistichealth.com; www.gordonresearch.com

The American Board of Chelation Therapy, which certifies physicians with toxic metal expertise, inclusive of chelation therapy, has recently changed its name to the American Board of Clinical Metal Toxicology. This was done in part to better reflect the need to address the bigger picture of heavy metal toxicity. We need to be environmentally proactive, to clean up contaminated areas, to control industrial and agricultural wastes, to remove toxic metals from vaccines and dentistry, and to educate the public in regard to the presence of toxic metals in products we use, including the foods we consume.

Organizations sponsoring chelation training for physicians include the following: American College for Advancement in Medicine (ACAM)
800-532-3688
Web site: http://www.acam.org

International College of Integrative Medicine (ICIM)
866-464-5226
Web site: http://www.icimed.com

Chelation: Technical Sidebar
Chemically, chelation is the process of binding an electrically charged metal atom with another molecule, the chelating agent (chelator), to form heterocyclic ring molecular structures. A heterocyclic ring contains dissimilar atoms. Chelating agents are molecules that have the capacity to form such structures when binding with metals. The electrical charge of the metal is neutralized by the sharing of electrons in chemical bonds between the metal and chelating agent. The resultant metal complex is a chelate. Such chemical bonds have been metaphorically depicted as grasping pincers of a claw. The word chelation is derived from the Greek language, chele, meaning claw.

EDTA Metal Metal – EDTA
The metal is generically depicted by the letter M. Metals that bind to EDTA include metals essential to life, such as magnesium and calcium, as well as toxic metals, such as cadmium and lead. Any metal can be toxic when present in too great a quantity. Nitrogen (N), oxygen (O) and carbon (C) atoms compose the basic ring elements of EDTA. The letter H depicts a hydrogen atom bonded with oxygen (O) to form OH. H2 depicts two hydrogen atoms, which are bound to ring forming carbon (C) atoms. The single solid lines ( / ) between EDTA ring forming atoms represent single chemical bonds. The parallel lines (=) reflect double chemical bonds. The broken lines (—) depict “claw-like” bonds between non-metallic elements of EDTA and the chelated metal (M). Although Sulfur (S) atoms are not found in EDTA, they may be found in other chelating agents. The distinct chemical makeup of various chelating agents provide them with unique abilities to bind different metals under differing circumstances. Chelating agents are selected for therapeutic use based on their respective properties.

Chelation may be used to deliver metals into and remove metals from the body. Magnesium ascorbate (vitamin C) is a chelate found in orange juice and in nutritional supplements. Chelation involves reversible binding of metals. Thus, ascorbate may release the essential metal magnesium in the body and complex with the toxic metal lead to form lead chelate. The lead exits the body complexed as lead chelate, reducing the body burden of lead. Chelates generally exit the body through the kidneys, via urine or through the bile via the stool. However, chelates may not necessarily eliminate toxic metals, but rather redistribute them in the body. Since many orange juice drinkers and daily vitamin and mineral-tablet users have excess mineral toxicity and related diseases, the medical field of clinical metal toxicology has much to offer. Clinical metal toxicology, which includes chelation therapy, deals with various issues in regard to preventing and reducing metal toxicity.

Chelating agents are prevalently found in industry, including textile dyeing, water softening, enzyme deactivation, and food preservation. Besides being useful in medicine, chelation is essential for life. Chlorophyll is a chelate of the metal magnesium. Vitamin B12 is a chelate of cobalt. Heme, a component of hemoglobin, is a chelate of iron.

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