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Chelation
Therapy
What
is chelation therapy?
Chelation therapy
involves the use of chemical compounds injected into the blood stream
, muscle or taken by mouth to bind metals that are present in toxic
concentrations so they can be excreted (usually in urine) from the body.
What
are legitimate uses for chelation therapy?
Chelation therapy
is medically indicated when toxic levels of heavy metals such as iron,
arsenic, lead, and mercury are present. While iron is a vital metal
the other metals (arsenic, lead, and mercury) are not required by the
body.
- Lead toxicity
most commonly occurs with young children exposed to old houses with
lead paint dust or chips. Occupational exposure (soldering, welders,
smelters, battery reclamation) is also a risk. Lead screening for
children has now become a standard part of a doctor's visit for children
in may states.
- Mercury toxicity
almost always occurs with high risk occupational exposures including
dental workers, manufacturers of batteries/ thermometers, tannery
work/taxidermy, and contaminated seafood.
- Arsenic poisoning
usually occurs from exposure to insecticides, herbicides, rodent poisons,
veterinary parasitic medications, or intentional poisoning.
Other heavy metals,
mentioned only in passing because toxic exposure is extremely uncommon,
include: cadmium, manganese, aluminum, cobalt, zinc, nickel, copper
and magnesium.
Heavy metal toxicity
can cause a wide range of problems including severe injury to the body
organs and the brain.
Common chelating
agents include:
- Desfuroxamine
Mesylate:
used for iron toxicity, intravenous preferred route of administration.
- Dimercaprol
(BAL):
lead, preferred agent for arsenic & mercury toxicity, given intramuscularly
- DMSA:
an analogue of Dimercaprol that can be given orally for lead and arsenic
poisoning
- D-penicillamine:
an oral chelating agent used for lead, arsenic, or mercury poisoning.
Much less expensive but not as effective as DMSA.
- Calcium
Disodium Versante (CaNa2-EDTA):
can be used in conjunction with BAL in lead toxicity. Never used alone
in treating lead toxicity because chelates only extracellular, not
intracellular lead.
Diagnosis of heavy
metal toxicity is serious and must be made by a physician based on clinical
symptoms in conjunction with laboratory testing. Chelating agents are
potentially toxic and should not be used unless absolutely indicated.
Chelation therapy is heavy duty stuff!
Can
chelation therapy be dangerous?
Absolutely! All
chelating agents have both minor and potentially life threatening side
effects. They must be used under the supervision of a physician in a
hospital setting.
Side effects of
CaNa2-EDTA include: 2
- Kidney
damage (especially if dehydrated)
- Chelation
of essential minerals (iron, copper, zinc). Calcium also chelated
but to much lesser extent than these other essential metals.
- Skin
peeling and blisters
- Minor
(headache, chills, fever, fatigue, muscle aches
We focus on CaNa2-EDTA
because it is by far the most commonly used chelating agent promoted
by quack practitioners for uses other than proven heavy metal poisoning.
It must be remembered that although CaNa2-EDTA was one of the first
agents available, it is no longer the treatment of choice for any heavy
metal toxicity.
What
are quack claims for chelation therapy? 1
After EDTA was found
effective in chelating and removing toxic metals from the blood, some
scientists postulated that hardened arteries could be softened if the
calcium in their walls was removed. The first indication that EDTA treatment
might benefit patients with atherosclerosis came from Clarke, Clarke,
and Mosher, who, in 1956, reported that patients with occlusive peripheral
vascular disease said they felt better after treatment with EDTA.
In 1960, Meltzer
et al., who had studied ten patients with angina pectoris, reported
that there was no objective evidence of improvement in any of them that
could be ascribed to the course of EDTA chelation treatment. However,
during the next two months, most of the patients began reporting unusual
improvement in their symptoms. Prompted by these results, Kitchell et
al. studied the effects of chelation on 28 additional patients and reappraised
the course of the ten patients used in the original trial [2]. They
found that although 25 of the 38 patients had exhibited improved anginal
patterns and half had shown improvement in electrocardiographic patterns
several months after the treatment had begun, these effects were not
lasting. At the time of the report, 12 of the 38 had died and only 15
reported feeling better. (This "improvement" was not significant,
however, because it was no better than would be expected with proven
methods and because there was no control group for comparison.) Kitchell
et al. concluded that EDTA chelation, as used in this study, was "not
a useful clinical tool in the treatment of coronary disease."
Unproven Claims
Proponents claim
that chelation therapy is effective against atherosclerosis, coronary
heart disease, and peripheral vascular disease. Its supposed benefits
are multiple and include increased collateral blood circulation; decreased
blood thickness; improved cell membrane function; improved intracellular
organelle function; decreased arterial vasospasm; decreased free radical
formation; inhibition of the aging process; reversal of atherosclerosis;
decrease in angina; reversal of gangrene; improvement of skin color,
healing of diabetic ulcers. 1
Proponents also
claim that chelation is effective against arthritis; multiple sclerosis;
Parkinson's disease; psoriasis; Alzheimer's disease; and problems with
vision, hearing, smell, muscle coordination, and sexual potency. 1
The primary claim
currently in vogue is that chelation dissolves calcium deposits present
in plaques that clog and plug up arteries. There is absolutely no known
agent that can "dissolve" atherosclerotic plaques and reverse
"hardening of the arteries. These plaques are very complex and
consist of thickening of the muscular wall of the artery in addition
to calcium and cholesterol deposits. If there was a magic potion it
would be a sure bet that pharmaceutical companies and legitimate doctors
would be using it!
Furthermore, CaNa2-EDTA
is only effective in chelating extracellular heavy metals ( that found
dissolved in blood and other body fluids outside of cells).
Various studies
have been cited by supporters of chelation therapy for atherosclerosis;
however, none of these claimed benefits has been demonstrated by well-designed
clinical trials.
The "Approved"
Protocol- NOT 1
The primary organization
promoting chelation therapy is the American College for Advancement in Medicine (ACAM),
which was founded in 1973 as the American Academy for Medical Preventics.
Since its inception, ACAM's focus has been the promotion of chelation
therapy. The group conducts courses, sponsors the American Journal
of Advancement of Medicine, and administers a "board certification"
program that is not recognized by the scientific community. The 1998
edition of Encyclopedia of Medical Organizations and Agencies
states that ACAM had 535 members.
In 1989, an ACAM
protocol for "the safe and effective administration of EDTA chelation
therapy" was included in Cranton's "textbook," a 420-page
special issue of the journal that contains 28 articles and a foreword
by Linus Pauling. The protocol calls for intravenous infusion of 500
to 1,000 ml of a solution containing 50 mg EDTA per kilogram of body
weight, plus heparin, magnesium chloride, a local anesthetic (to prevent
pain at the infusion site), several B-vitamins, and 4 to 20 grams of
vitamin C. This solution is infused slowly over 3.5 to 4 hours, one
to three times a week. The initial recommendation is about 30 such treatments,
with the possibility of additional ones later. Additional vitamins,
minerals, and other substances-prescribed orally-"vary according
to preferences of both patients and physicians." Lifestyle modification,
which includes stress reduction, caffeine avoidance, alcohol limitation,
smoking cessation, exercise, and nutritional counseling, is encouraged
as part of the complete therapeutic program. The number of treatments
to achieve "optimal therapeutic benefit" for patients with
symptomatic disease is said to range from 20 ("minimum"),
30 (usually needed), or 40 ("not uncommon" before benefit
is reported") to as many as 100 or more over a period of several
years. "Full benefit does not normally occur for up to 3 months
after a series is completed," the protocol states -- and "follow-up
treatments may be given once or twice monthly for long-term maintenance,
to sustain improvement and to prevent recurrence of symptoms."
The cost, typically $75 to $125 per treatment, is not covered by most
insurance companies. Some chelationists, in an attempt to secure coverage
for their patients, misstate on their insurance claims that they are
treating heavy-metal poisoning.
In 1997, ACAM issued
a revised protocol describing the same procedures but adding circumstances
(contraindications) under which chelation should not be performed. As
in 1989, the document gives no criteria for determining: (1) who should
be treated, (2) how much treatment should be given, or (3) how to tell
whether the treatment is working.
Conclusion
Chelation therapy
should only be used for heavy metal toxicity that has been diagnosed
by a reputable physician. It has no place in reversal or prevention
of atherosclerosis, angina, high blood pressure, poor circulation or
other cardiovascular (heart diseases).
CaNa2-EDTA
can leach out other
essential metals such as iron, zinc, copper and magnesium from the blood
causing adverse
health effects while having no effect on calcified atherosclerotic plaques.
Although we do not
wish to minimize problems caused by heavy metal toxicity it generally
is quite rare and normally requires specific exposure or risk factors.
A vast majority of people do not come into significant contact with
toxic heavy metals.
If any person solicits
your business claiming that heavy metal toxicity might be a problem
for you and wants to do testing and treatment our advice is to turn
away and run. If you are concerned you might have risk factors or exposure
to toxic heavy metals visit a reputable physician.
Top
Resources
1.
"Chelation Therapy- Unproven Claims and Unsound Theories"
by Saul Green, Ph.D. @: http://www.quackwatch.com
provides
a comprehensive
review of chelation therapy well worth reviewing for those interested
in learning more)
2.
"Heavy
Metals" by Marsha D. Ford in: Emergency Medicine- A Comprehensive
Review, 4th ed., Tintinalli, JE., Ruiz, E., and RL. Krome editors, 1996,
pp.833-841
Doctors
Corner INternet Group, Inc. 1997-2004
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