- Implausibility of EDTA Chelation Therapy
- The Original Claim
- Pathology of Atherosclerotic Plaque
- EDTA Chelation Therapy Protocol
- Quantitative Considerations of EDTA
- Chelation Therapy – Fad Treatment with Real Risks
- Edta: Health Benefits, Uses, Side Effects, Dosage & Interactions
- Learn Everything You Need to Know About Chelation Therapy
- Chelation Therapy: Confused by claims of benefits? Oral chelation is not created equal!
Implausibility of EDTA Chelation Therapy
Planned clinical trials of ethylene-diamine-tetra-acetic acid (EDTA) chelation therapy by the National Center for Complementary and Alternative Medicine and others call for investigation of chelation’s biochemistry and pharmacology, its toxicity, and the history of claims made for it.
EDTA, known to reduce serum levels of polyvalent metals by chelation, was proposed in the late 1950s for removal of calcium from atherosclerotic plaques. Proponents now claim that EDTA can remove toxic heavy-metal ions and that it can neutralize or reduce oxygen free radicals.
A review of atherosclerosis pathophysiology and EDTA chemistry reveals that (1) EDTA chelation effectiveness is implausible; (2) the preponderance of evidence shows ineffectiveness; and (3) EDTA augments oxidative reactions involving iron instead of inhibiting them, resulting in increased lihood of production of oxygen free radicals rather than neutralization of them, as claimed.
Further investigation of this therapy for atherosclerosis and degenerative diseases may be ethically questioned.
The Original Claim
The initial claim for EDTA chelation (1950s) was an assumption that the structure of arterial plaque depended on its calcium content.
Calcium was compared to rivets in a steel structure, the removal of which would cause the arterial plaque to disintegrate, thus enlarging the lumen’s diameter and increasing blood flow.
This mechanism was ned to that of a drain cleaner cleaning a water pipe [1-4].
By the mid-1970s the mechanism of calcium removal had been challenged, as no proof had been presented.
Advocates invoked parathormone (PTH) to explain perceived benefits, theorizing that when ionic calcium was removed from serum by EDTA chelation it was replaced by calcium from bone, the loss of which was said to stimulate PTH secretion, which promoted remineralization of bone.
The calcium for bone remineralization was said to be supplied through “gradual transfer” of calcium from hardened arterial tissue and plaque. This was said to soften the arteries and cause the plaque to disintegrate [1,5].
By the early 1980s, basing theory on more recent knowledge of free-radical effects on tissue, proponents posited a new and current theory of free-radical neutralization.
The proposed mechanism was that toxic metals such as iron and copper, released by clot lysis at arterial injury sites, generate free radicals that oxidize fatty acids to lipid peroxides, which then would generate new free radicals.
This chain of oxidation reactions would cause arterial cell membrane damage and plaque formation. This mechanism was more in line with then-current thinking on the pathophysiology of atherosclerosis.
Advocates then claimed that through EDTA binding, iron would become chemically nonreactive, cease catalyzing free-radical production, and thus curb the pathological processes that cause atheromas .
A more recent chelation advocate theory states that atheromas are benign tumors that arise when artery cells mutate as a result of free-radical damage to their DNA .
Pathology of Atherosclerotic Plaque
The modern consensus of the genesis and pathology of atherosclerosis differs from both older and recent chelation theories. In brief, arterial atheromas begin as low-density lipoproteins (LDL), cross the endothelial cell layer of the artery at a point of local injury or oxidant damage, and are deposited in the subendothelial layer.
Monocytes, attracted to the injured area and subendothelial layers, engulf LDL and become foam cells, collectively forming a fatty streak on the arterial wall. The accumulation of foam cells ruptures the arterial endothelial cell layer, and platelets aggregate at the site and release growth factors, stimulating smooth-muscle cells to proliferate.
During repair, cells produce collagen and form a fibrous, collagen-rich cap over the site (plaque). This plaque contains cholesterol, lipid particles, fibrous protein, and debris. The plaque enlarges as the process repeats. Calcium deposition inside the atheroma is a late event, and is not intrinsic to the genesis or maintenance of the atheroma’s structure.
Calcium rarely occupies more than a small fraction of the plaque’s volume .
EDTA Chelation Therapy Protocol
The American College of Advancement in Medicine (ACAM), an organization of physicians advocating use of EDTA chelation, developed the following protocol for EDTA administration .
An intravenous infusate of 500 to 1000 ml of Ringer lactate or 10% fructose solution contains 50 mg EDTA per kilogram body weight, heparin, magnesium chloride, lidocaine, pyridoxamine, B-complex vitamins (including vitamin B12), and gram (usually 5 gm) amounts of vitamin C (ascorbate). The solution is infused slowly over 3.5 to 4 hours, 1 to 3 times a week.
The initial series is about 30 infusions, with the possibility of additional treatments later. Minor changes have occurred over the past 20 years, including use of magnesium-containing EDTA, but no pharmacologically significant change has occurred.
Adjunctive therapy consists of gram doses of oral ascorbate; vitamin E; mineral supplements of magnesium, calcium, potassium, copper, iron, chromium; and vitamins at doses ranging 3 to 5 times the recommended daily intake (RDI). Optional oral supplements include pancreatic enzymes, thyroid extract, estrogen, fiber, dimethylglycine, and iodine.
Lifestyle modifications include exercise program, stress reduction, caffeine and tobacco avoidance, alcohol limitation, and nutritional counseling.
Current charges are in the range of $100 per infusion, with an average of 30 treatments. There are about 200 physician practitioners in the United States practicing EDTA chelation for degenerative disease.
Quantitative Considerations of EDTA
EDTA was first synthesized and patented in 1938 . It is a highly negatively charged ring compound with 4 negative charges that hold polyvalent metal ions in a highly stable, water-soluble form.
The strength with which each metal is held varies; in order of decreasing strength as follows: iron+++, mercury++, copper++, aluminum++, nickel++, lead++, cobalt++, iron++, zinc++, cadmium++, manganese++, magnesium++, and calcium++.
The relative amount of each ion held by EDTA depends on each element’s relative affinity, the strength of its bonding to tissue and transport proteins, and its concentration in plasma.
In general, a preparation of EDTA containing an ion with lesser affinity will exchange that ion for one with greater affinity. For instance, EDTA has a lesser affinity for sodium than for calcium.
Thus, disodium EDTA will exchange its sodium ions for a calcium ion, and reduces hypercalcemia of malignancy in emergency situations [7,8].
Calcium-sodium EDTA, another commercial form, will exchange its calcium for a metal higher on the affinity scale and is approved for use in heavy-metal poisoning such as lead poisoning.
The postulated reason for lead binding to EDTA in preference to mercury, for which EDTA has a greater affinity, is that mercury is more tightly bound to tissue ligands by -SH bonds, or that it exists in compartments not available to EDTA.
Copper and iron, also held more powerfully to EDTA are also more strongly bonded to tissue and transport proteins — ferritin and transferrin for iron, ceruloplasmin for copper .
Therefore, although EDTA binds some copper and iron, it is not useful for reducing overload states.
EDTA-metal complexes are excreted by the kidney with a biological half-life of 20 to 60 minutes, Rapid infusion of disodium EDTA may cause acute hypocalcemia and tetany, weakening of cardiac muscle contraction, and arrhythmias. However, slower infusion (
Chelation Therapy – Fad Treatment with Real Risks
Pseudoscience is sexy and it sells – big time. Fraudsters, hucksters, and snake oil salesmen will always be a plague to our society as long as there is a susceptible public.
Let's be honest.
In the age of information (and misinformation) it can be very difficult to determine what is real and what is not, allowing potentially dangerous medical products and procedures to become fads.
When it comes to making a buck, the utter lack of supportive data has not hampered charlatans. While there is a legitimate medical use for chelation therapy – a treatment for toxic acute metal poisonings from mercury, iron, arsenic, lead, uranium, and plutonium, to name a few. But some people are misusing this therapy claiming that it treats problems other than toxic metal poisoning.
Luckily for the public, there are organizations ours. We exist to shoot down pseudoscientific nonsense and provide the public with actual facts actual scientific evidence. We may not be the winner of a popularity contest but that's because the truth is boring. Okay, enough about us, let us discuss chelation.
Chelation therapy has gained notoriety in junk science circles as a treatment for a variety of ailments, ranging from atherosclerosis to aging and autism.
It has been touted as the “roto-rooter” of arteries, essentially eliminating the need for statins – a dangerously false claim. There is no evidence that chelation therapy works any better than placebo in the treatment of coronary artery plaques.
So, the benefits of chelation therapy, in this instance, are imaginary while in reality, the risks associated with it are real and significant.
Some of the common side effects of chelating agents include:
- Burning sensation when injected into a vein
- Fever and chills
- Nausea and vomiting
- Convulsions or seizures
- Fall in blood pressure
- Breathlessness or tightness in the chest
- Respiratory failure
- Low blood calcium
- Irregular heartbeats or cardiac arrhythmias
- Severe allergic reactions may occur with the use of some chelators and lead to skin rash, eczema, exacerbation of asthma or asthma attacks.
- Severe hypersensitivity reactions may lead to anaphylactic shock and even death.
- Depression of the bone marrow leading to low counts of red blood cells, white blood cells and platelets. This can lead to anemia, infections and an increased bleeding tendency.
- Kidney damage and failure leading to end stage renal disease requiring dialysis.
- Liver damage may be seen with some chelating agents and some patients may develop liver failure.
- Damage to the brain leading to a decline in cognitive function
- Vitamins and vital nutrients may leave the body along with the heavy metal. This can be a particular problem among children who require adequate levels of nutrients for normal growth and development. In addition, vitamin supplements may not always replenish the loss of vital nutrients caused by long term chelation therapy.
Dr. Gary Gordon, MD, DO, is a co-founder of the American College of Advancement in Medicine (ACAM) – an organization created solely for the promotion of chelation therapy – is unrecognized by the scientific community. Gordon feels all humanity is suffering from lead poisoning, but we are not.
“Everybody on Earth now has a minimum of about a thousand times more lead in their bones than can be found in any human bones from over two hundred years. So we’re reaching the point of maximum tolerance… [e]very time we turn on a power plant we create more cases of autism.”
(Insert eye roll). This will be a topic for a different conversation. Click here for full text of his blathering.
The treatment for lead poisoning, first and foremost, has always been prevention – to identify and remove potential sources of lead from the environment. Community-wide preventive actions are recommended when children are found to have blood lead levels (BLLs) of 10 µg/dL or higher.
With BLLs of 15-19 µg/dL, nutritional and educational interventions are recommended. With BLLs of 20 µg/dL or higher, medical evaluations and environmental interventions are recommended. Chelation therapy provides transient benefit in the patient in whom the source has not been identified.
Even then, treatment should be performed in a pediatric intensive care unit at a legitimate medical center that is familiar with this treatment.
Patients' cardiovascular, neurologic, renal and hepatic functions must be closely followed, and the treatment itself can precipitate kidney injury.
Quacks and others who seem to have a financial stake in promoting chelation therapy argue that this treatment should be provided not just for those in whom BLLs are 45 µg/dL (absolute indication for medical treatment) but for any child with BLL above five µg/dL. These recommendations are unnecessary, reckless and irresponsible. There is a large push for chelation therapy in places Flint, Michigan, even though the actual harm from lead in the water was greatly overstated.
A study, which was conducted between 1994 and 2003 by Kim Dietrich, an epidemiologist at University of Cincinnati College of Medicine, focused on one and two-year-old with BLLs between 20 and 44 µg/dL. Some children received a placebo and others chelation therapy.
Dietrich and his team followed up with the kids when they were five, and again at age seven.
Although chelation therapy was successful in reducing the BLLs of the treatment group at the time, “the active drug group was no better in terms of their neurobehavioral development or neurological development, or in any other areas of health that we examined than the group that received placebo,” Dietrich stated. Children treated with chelation therapy were equally as ly to have developmental delays and cognitive problems as the kids who got the placebo.
Another concern about the use of chelating agents is that they carry the risk of redistributing lead from bone (its main depot in the body) to soft tissues such as brain and liver – definitely not good – or it could simply redeposit the lead into bone. This risk can be mitigated by choice of chelating agent used.
Utilizing chelation therapy requires some understanding of pharmacokinetics as well as an understanding of body's metal ion homeostasis – meaning when essential minerals in the body are lost through chelation, bad things can happen such as abnormal heart rhythms. Caution is required as there are real risks involved.
It is doubtful that pop-up infusion centers catering to the latest fad will be adequately equipped to monitor patients appropriately.
Alarmism and sensationalism are akin to cults – that proponents of “alternative medicine” or what I refer to as “prophets of fear,” parasitize society by promoting junk science on their walk to the bank. Dr. Gary Gordon is just one stinky fish in a whole sea of liars.
When you are the co-founder of the sham accreditation body for chelation therapy training, charging folks $1,745 for an advanced chelation workshop for the Certified Chelation Therapist (CCT) designation with renewal every seven years seems motivation enough to legitimize your existence.
Profiting off fear and subjecting people (especially children) to unnecessary and dangerous treatments seems not only unconscionable but criminal, in my humble opinion.
Edta: Health Benefits, Uses, Side Effects, Dosage & Interactions
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Learn Everything You Need to Know About Chelation Therapy
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Chelation therapy is a treatment used in alternative medicine. It's the process of chelation, in which chemicals are used to remove heavy metals and other substances from the body. Although chelation was originally used to treat conditions lead poisoning, chelation therapy is now claimed to protect against heart disease and other major health problems.
In chelation therapy, a chemical substance is introduced into the body through an intravenous (IV) drip.
Once it enters the bloodstream, the chemical substance binds to certain molecules (such as metals or minerals) and then removes those molecules from the body.
According to proponents of chelation therapy, eliminating excess or toxic metals or minerals from the body can enhance health and fight disease.
The most common form of chelation therapy uses a synthetic amino acid called ethylene diamine tetra-acetic acid (EDTA). EDTA is known to remove substances such as lead, iron, copper, and calcium from the blood.
It should be noted that the only FDA-approved chelating agents are available solely by prescription. These agents are approved for use only in specific circumstances, such as in the case of lead poisoning or iron overload.
Chelation therapy is said to aid in the treatment of atherosclerosis (i.e., hardening of the arteries). Since calcium deposits are found in artery-clogging plaques, it's thought that using chelation therapy to remove calcium deposits can restore healthy blood flow in the arteries.
Some proponents suggest that EDTA can act as an antioxidant and protect against the damaging effects of chronic inflammation. To that end, chelation therapy is also used to treat osteoarthritis and other inflammation-related conditions.
In addition, chelation therapy is sometimes used to treat the following health issues:
- Alzheimer's disease
- High blood pressure
- High cholesterol
- Multiple sclerosis
- Peripheral artery disease
- Rheumatoid arthritis
- Band Keratopathy
Chelation therapy is also claimed to improve memory, treat diabetes-related complications, and promote recovery from stroke.
Although chelation is known to be effective in the treatment of heavy metal poisoning, scientific support for chelation therapy's effects against other health conditions is very limited.
For a report published in the Cochrane Database of Systematic Reviews in 2002, researchers analyzed five previously published studies testing the effects of EDTA-based chelation therapy in patients with atherosclerosis-related cardiovascular disease. Their analysis found insufficient evidence for chelation therapy's effectiveness in improving clinical outcomes for such patients.
In a research review published in BMC Cardiovascular Disorders in 2005, scientists looked at seven previously published studies that focused on the use of EDTA-based chelation therapy in the treatment of cardiovascular disease.
They determined that use of chelation therapy in the treatment of cardiovascular disease isn't supported by the best available scientific evidence and that using this therapy as a substitute for standard care “may result in causing indirect harm to the patient.”
Furthermore, a report published in the American Heart Journal in 2000 concluded that chelation therapy “should now be considered obsolete” as a treatment for heart disease, given its potential to cause severe adverse effects.
However, there's some evidence that chelation therapy may be beneficial to people who have suffered a heart attack. In a National Institutes of Health-funded study published in Current Opinion in Cardiology in 2014, for instance, researchers evaluated the effectiveness and safety of EDTA-based chelation therapy in 1,708 people who had experienced a heart attack.
Results of this study revealed that chelation therapy was associated with a significant reduction in the risk of issues such as stroke and hospitalization for angina. Chelation therapy appeared to have an even greater benefit in people with diabetes, the study's authors point out.
They also note that chelation therapy may improve health in heart attack patients by reducing oxidative stress. However, there were several problems with this study that make its results somewhat questionable.
Further randomized trials will be necessary to really assess whether chelation therapy may be helpful in people with heart disease.
Side effects commonly associated with chelation therapy include diarrhea, headache, high blood pressure, loose stools, low blood sugar, nausea, poor appetite, skin rash, and vomiting. In some cases, chelation therapy may trigger serious side effects such as kidney damage and abnormally low blood levels of calcium.
There's also some concern that chelation therapy could remove calcium from healthy bones and other tissues. Children, pregnant women, and people with heart or kidney failure should not receive chelation therapy.
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Chelation Therapy: Confused by claims of benefits? Oral chelation is not created equal!
Although oral chelation is promoted as “safe, fast and cost effective” by its manufacturers, it cannot produce the results of intravenous treatments given under the supervision of trained doctors who carefully monitor your progress with sophisticated diagnostics. And you may not want to guess when it comes to preventing or treating the main reason people have circulatory and heart disease, or other degenerative problems.
Conventional medicine has been using various intravenous chelation approaches since deployed troops were poisoned with the heavy metal arsenic during the First World War.
Coined from the Greek chelè, meaning claw — to reflect their capacity to bind metals within a “claw-” molecular structure, which is then excreted without further interaction with the body — the first medically-used chelating agent was developed at the start of WWII as an antidote to anticipated use of arsenic gas by the Germans.
Today, chelation therapy is the recognized, U.S. Food and Drug Administration approved, medical treatment for heavy metal intoxication by lead, cadmium, aluminum, mercury, arsenic, and even iron.
Despite decades of medical use in response to large-scale heavy metal exposures along with overwhelming scientific rationale and evidence, chelation therapy is often overlooked as a solution to the adverse health effects caused by more gradual build-up of toxic metals. Why? you ask. There are a number of reasons:
1. The controversy between newer oral chelation supplements and the intravenous treatments used for decades is confusing. Because oral chelation is regulated as a supplement, it does not come under the same scrutiny as physicians offering intravenous chelation therapy in their clinics.
2. Well-done scientific research that supports use of intravenous chelation treatment is used to justify claims made by manufacturers of untested oral supplements.
3. Because most exposures are not large-scale, occuring gradually at low levels from living in industrialized nations, for most of us the exact cause of our symptoms is hard to pin-point, or our symptoms are subtle, or we may not have symptoms but are trying to prevent disease from occurring.
4. Subtle symptoms, or worse, diseases one is trying to prevent, are very, very difficult to study. This makes FDA approval for use with chronic degenerative diseases difficult (and very costly) as supporting research must show cause and effect. Keep in mind that chelation therapy is approved for use when someone has a known heavy metal exposure.
The fatigue, discomfort, and moodiness of low-level exposures
Ever-increasing use and accumulation of pollutants in general, and persistent organic pollutants in particular, have received recent attention for their long-lasting adverse health effects.
Gradual exposure to hazardous toxins is becoming more prevalent especially in overpopulated and industrialized parts of the world. Such exposure contributes to increased health risks .
Unfortunately, there is no easy fix to protect or intervene against diseases associated with exposure to these insidious environmental pollutants.
Many pollutants, including heavy metals and persistent organics, bioaccumulate (pass up the food chain to humans) and build up in our bodies where they cause damage both locally to the tissues where they accumulate, including contributing to the formation of cancer, vascular disease, accelerated aging as well as altering the normal patterns of hormones — patterns that effect everything from energy level to fertility to mood.
Exposure to heavy metals can occur via many common sources: house paint (lead), dental fillings (mercury), vaccines (mercury), cigarettes (cadmium), food, drinking water and hazardous waste sites.
Over 4000 articles in the medical literature connect small amounts of lead in the body and high blood pressure.
Elevated mercury and antimony have been found in hearts of heart disease patients at autopsy .
Un many chemicals that can now be detected in the human body, the toxic effects of heavy metal exposures are well understood and many sources of exposure are regulated. Despite this, millions of Americans suffer from chronic, low-level, exposures to heavy metals, including lead, mercury, arsenic, antimony and cadmium.
A Center for Disease Control report states that 10% of American women of childbearing age (7 million women each year) have mercury in their blood at levels that are potentially unsafe for the developing fetus .
Clear evidence now links exposure to toxins such as mercury, lead, pesticides, and in utero smoking exposure to higher levels of autism and/or ADHD .
Despite the clear benefit to health of eating fish as a source fatty acids, many of us avoid fish because of its high mercury content — knowing that mercury is linked with cardiac disease [5;6].
Getting rid of unwanted contaminants
Many doctors argue — have argued for decades — that chelation therapy can address low level metal exposures and consequent degenerative diseases.
Recent understanding of how pollution contributes to the formation of blocked heart arteries, by contributing contaminants — inflammation-causing molecules known as “free radicals” — many of which are heavy metals, has lead to investment in large-scale clinical trials to gather more data on the effectiveness of chelation therapy to treat our number one killer, heart disease.
The National Institutes of Health's alternative medicine center recently funded a large experiment — 2,372 heart-attack survivors. Led by Dr. Gervasio Lamas of the Mount Sinai Medical Center-Miami Heart Institute, the five-year study began enrolling participants at about 100 sites around the country in 2003.
Lamas said he decided to design the study when one of his own patients asked about chelation.
“While my answer, as a very conventional cardiologist, was initially, 'No, that's silly,' as I looked into it I realized I didn't really have the evidence base to say that,” Lamas said.
With hundreds of thousands of people seeking chelation therapy annually, “now we'll see what the real truth is.”
The efficacy of chelation therapy has been clinically demonstrated with positive results in hundreds of thousands of cases where this treatment was utilized . In one smaller study, the results with intravenous chelation were so pronounced that the control group was taken off placebo and given chelation therapy so as to not withhold beneficial care .
The safety of this therapy, when properly administered, is also well known.
It is estimated that over 500,000 patients nationally have been safely treated with this therapy by physicians utilizing the protocol developed by the American College for Advancement in Medicine without a single fatality attributed to I.V. EDTA. Surgical procedures or even taking aspirin have a much greater fatality rate.
Effective chelation therapy is administered in I.V. form over the course of several hours. Although thousands of websites promote oral chelation agents — it is important to understand why this approach does not work:
1. Effective chelation therapy depends on whether the chelating agents are able to remove heavy metals that are circulating in the blood or deposited in cells in the body — the chelator must get into the blood and cells.
2. Only about 5% of the oral chelation agent, EDTA, gets into the bloodstream.
3. Further, oral chelation may prevent absorption of certain nutrient metals that are required at low levels for proper nutritional health.
4. Oral chelation agents do not effect the build-up of calcium, iron, or copper within the cells – a build-up that can lead to stiffening and hardening of tissues and other degenerative diseases.
The ABC’s of Chelation Therapy
Maulfair Medical Center gets you started on your chelation program with a thorough medical examination and a series of key tests.
The necessary laboratory tests vary from patient to patient, but there are a few tests everyone will need.
These tests include: toxic metal and mineral status, comprehensive metabolic panel and a complete blood count.
Other tests may include a pre and post-provocative challenge for heavy metals. Some tests will be repeated periodically, to monitor your kidneys efficiency in removing metals.
Maulfair relies on thirty years experience utilizing chelation therapy to treat chronic, degenerative diseases including hardening of the arteries, coronary heart disease, carotid artery disease, peripheral artery disease, diabetes, arthritis. Clients of Maulfair Medical Center’s comprehensive chelation program have gained back their quality of life with improved circulation, restored energy, motivation and overall sense of well being.
Maulfair Medical Center, Topton PA
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