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Chelation Therapy

The word “Chelation” comes from the Greek word “chele” which means a claw of a crab or lobster and implies a strong, pincer-like grasping. In the case of Chelation Therapy, the grasping is done by a chelating agent and the object grasped is a metal atom. This chelating agent forms a very stable chemical complex with a mineral or metal ion known as a “heterocyclic ring structure.” There are many examples of chelates in nature such as magnesium in the chlorophyll molecule in plants, iron in the hemoglobin of blood cells in man and other higher organisms and the incorporation of cobalt in the vitamin B-12 molecule. There are many “Chelating Agents” in nature such as vitamin C, sulphur-containing amino acids and many enzymes. Unless some of the enzymes contain a firmly bound metal atom they will not be active or have a decrease in their activity. Even the usual drugs used in medical practice in the treatment of disease are often dependent upon Chelation processes for their action. A new science has emerged which deals with the subject of Chelation and is know as Complexion or Bioinorganic Chemistry.2 The basis of this field is the inorganic chemical principles contained in and well explained by Ligand Field Theory. This theory deals with the mechanisms by which organic chemicals form three-dimensionally stable structures with metal ions through sharing of electrons. The resultant compounds are very stable and will only break apart with difficulty. A review of the science underlying Chelation Therapy may be found in a treatise by Bruce W. Halstead, M.D.3 The principles, which are the basis of Complexion Chemistry or Ligand Field Theory, are among the most fundamental in nature. In view of the array of nature’s applications the exploitation of these principles and concepts in the treatment of human disease is not only logical but also predictable. In short, Chelation is a process whereby the metals are held and positioned by body chemicals so as to facilitate chemical reactions, which are essential to life. Chelation Therapy is the introduction of naturally occurring or synthetic organic chemicals into the human body in order to facilitate chemical reactions, which lead to the discharge of poisonous metals from the body and the rearrangement of essential metals in the body for the promotion of life’s chemical reactions.

History of Development of E.D.T.A. and its Medical Usage

In the 1930s German chemists were searching for a compound which would bind calcium and other metals in order to prevent staining of printed-pattern linens with calcium from hard waters. This basic research was being carried on independently in the United States by Frederick Bersworth who after much trial and error with different compounds finally patented E.D.T.A. In the late 1950s Dr. Clarke at Providence Hospital in Detroit in collaboration with Martin Rubin, PhD., Emeritus Professor of Chemistry at Georgetown University, began using E.D.T.A. intravenously to remove lead from people who had been poisoned in the automotive and other industries. He noted that indeed people with high lead levels in the circulation and their tissues began to excrete large amounts of lead in the urine after the administration of E.D.T.A. and began to feel better when the lead burden was removed. Coincidentally, the older patients who had arteriosclerosis involving the brain, heart, and peripheral vessels began to experience an improvement of their symptoms related to arteriosclerosis. There was an improvement in their angina, exercise tolerance and in their symptoms of Cerebrovascular insufficiency.4-7 A number of American physicians who had been given no hope by their own M.D.s for various circulatory conditions began to undergo Chelation Therapy in Dr. Clarke’s office. They usually improved and then went back to their own towns and began giving this treatment to their own patients.

What is Chelation Therapy Used For?

Chelation Therapy is used as the primary treatment for heavy metal intoxication by lead, cadmium, aluminum, mercury, arsenic, and even iron.8-10 At this time, it is also used to treat occlusive vascular diseases in conjunction with diet, nutritional supplements, and lifestyle changes. Because Chelation Therapy appears to improve circulation and reduce toxic chemical reactions in the body, it has also been used successfully for arthritis, diabetes, high blood pressure, and eye diseases such as macular degeneration.11-18

Can Chelation Be Used as a Preventive Measure?

It is often a good idea to undergo a series of Chelation treatments and maintenance therapy to prevent or delay the onset of vascular disease and the aging process. This is especially important if there is a strong family history of these types of problems. Dr. Steven Davies of London, England has shown that heavy metals accumulate in human tissues throughout life and we can assume these poisons have deleterious effects on our health. Evidence from a Swiss study indicated a reduced cancer incidence in patients who were chelated preventively.19

How Does Chelation Work?

Numerous theories have been erected to explain the obvious benefits of Chelation Therapy. The following is a list of possible mechanisms, all of which have been partially proven by research studies. 1) Heavy metals such as Lead, Mercury, Cadmium, Arsenic, Nickel, and Antimony have been shown to relentlessly accumulate in human tissue over a lifetime. Aluminum has been implicated as a possible factor in the causation of Alzheimer’s disease. These poisonous metals disrupt the normal biochemical processes. They insinuate themselves into the active sites of enzymes thereby altering such enzymes’ activities, and they initiate “free radical reactions,” which produce noxious chemicals that damage cellular structures such as proteins, cell membranes and DNA. The results at the level of the whole organism are the development of degenerative diseases-arteriosclerosis, arthritis and cancers. The removal of these poison metals with Chelation Therapy is probably a major mechanism by which Chelation normalizes biochemical activity thereby improving circulation and energy. 2) Essential metals such as iron, copper, manganese, and zinc are rearranged in the various body compartments resulting in improved enzyme activity at the cellular level. 3) Calcium deposits are removed from vessels and intracellular membranes leading to increased blood flow and better functioning of the enzyme systems imbedded in those membranes. The result is, again, improved organ function, vitality and energy level. 4) The blood clotting elements known as platelets are made less sticky, reducing clots in the vessels and leading to improved circulation and reduction in the thromboses that occur during heart attacks and strokes. 5) E.D.T.A. binds trace elements like iron, which are known initiators of “free radical reactions”. These free radical reactions are thought to be the chemical origin of arteriosclerosis, cancer, and inflammations. In general, they are thought to be the cause of aging and its concomitant degenerative processes. With respect to #3 above, realize that a slight increase in the internal diameter of an occluded vessel results in a large increase in blood flow through that artery. In fact, doubling the vessel’s diameter results in a 16 to 32–fold increase in blood flow. If even a 10% increase in diameter occurs, there is still 1 l/2 to 3 times the blood flow. Therefore, a vessel doesn’t need to be completely unclogged in order for the patient to experience a reduction in his symptoms.

Figure 2
A small increase in the diameter of an obstructed artery
results in a large increase in blood flow throught that artery.
The positive effects of E.D.T.A. Chelation Therapy are probably dependent both on decreasing the blood vessel occlusion and on the cellular and subcellular level effects of this agent. There are also probably many other unknown mechanisms.

Have Scientific Studies Shown That Chelation Therapy Is Effective?

If you call the American Medical Association or ask your cardiologist if Chelation Therapy can help arteriosclerosis chances are they will report that no studies have been done to document effectiveness of this treatment. In fact, studies proving effectiveness of E.D.T.A. in removing calcium deposits from tissues and reducing chest pain in heart patients date back to the 1960s.22-40 Unfortunately, in the early years excessive doses of E.D.T.A. were used and adverse reactions followed. No nutritional support was given during therapy at that time and treatments were given on a daily basis, five or six days per week. As a result of the publication of a very few reports of poor results with Chelation the interest in treatment waned for a time. However, because of the dramatic improvement in so many patients, doctors continued to give the Therapy. By the beginning of the 1970s, a professional organization of Chelation therapists was founded known today as The American College for Advancement in Medicine. Doctors from that group began to publish their findings. H. Richard Casdorph, M.D., PhD. Published two articles in 1981. The first one documented an increase in left heart function immediately after a Chelation treatment using a radionuclide scan. The second study, again using a nuclear scan for measurements, revealed a highly significant increase in blood flow to the brain in a group of 15 patients after an average of 20 Chelation treatments.23 All 15 patients also had improvement in their symptoms. A study done by Drs. McDonagh, Rudolph and Cheraskin in 1982 revealed a definite increase in blood flow to the brain using measurements of blood flow to the eyes.25 This study helps us to understand why Chelation Therapy often improves vision. These authors did two more studies in 198226 and 198327 showing improvement in kidney function using Chelation Therapy. This is contrary to the often-repeated claim by opponents of Chelation Therapy, that E.D.T.A. is dangerous to the kidneys. As long as the treatment is given slowly and in the recommended dosage even patients with moderate kidney dysfunction can be helped. Drs. Casdorph and Farr published a report in 1983 of four patients with gangrene of the lower extremities who were treated with Chelation Therapy, nutritional supplements and hyperbaric oxygen.28 All four patients had been told to undergo amputations by other doctors and sought an alternative in E.D.T.A. Chelation. All four patients were successful in avoiding amputation and follow up more than a year later revealed all patients to be doing well and free of pain in their legs. McDonagh et al published another study in 198529 on 77 elderly patients with documented occlusive vascular disease of the lower extremities. After 60 days of treatment, Doppler Ultrasound blood pressure measurements revealed a highly significant improvement in blood flow to the feet. Studies by Dr. Van der Schaar in Holland and Dr. Kindness here in the U.S. were reported at the third International Chelation Conference at Georgetown University in Washington D.C. in July 1989.30 Both studies revealed that E.D.T.A. infusion changes the “stickiness” of clotting factors in the blood known as platelets. This then results in a decrease in clot formation. Clot formation is thought to be the mechanism of various inflammatory disorders as well as heart attacks and strokes. Dr. Van der Schaar was a busy cardiovascular surgeon until 1985 when he began to experiment with Chelation Therapy. He has Chelated thousands of patients and only rarely does bypass surgery anymore. Brazilian doctor, G.P. Deucher, published an article in 1987 documenting increased discharge of heavy metals such as iron in the urine after infusion of E.D.T.A. This finding correlated with a decrease in cardiovascular symptoms. In 1985, I published a study done with Drs. John Bederka and Simca Brudno revealing large increases in aluminum output in the urine after infusion of E.D.T.A.31 Many researchers believe that accumulation of aluminum in the brain may be at least partially responsible for premature senility (Alzheimer’s disease). In 1989, Efrain Olszewer, M.D. and James P. Carter, M.D., DrPh published a retrospective study of 2,870 patients who had undergone Chelation Therapy in Brazil. Patient response was evaluated by Doppler blood flow studies, EEG, motor and sensory tests, cognitive evaluation and memory tests. Overall, 68.8% of the patients had a “marked improvement”, while 20.4% had a “good improvement” as defined in the study. This represented an overall improvement of 91.2%. Patients with heart or peripheral vessel disease fared better than those with carotid or cerebro-vascular obstruction.34 Drs. Rudolph and McDonagh treated 31 patients with Chelation Therapy for arteriosclerosis of the carotid arteries and published their results in 1991. Evaluation of the degree of obstruction in the subjects’ carotid vessels was performed before and after 30 infusions of E.D.T.A. using a Doppler ultrasound scanner. Overall intra-arterial obstruction decreased an average of 21%. This was highly statistically significant at p35
A study of 470 patients in Denmark was published in 1993 by Drs. C. Hancke and K. Flytlie. In this study 80 to 91% improvement was documented depending on the measurement used. Of special interest: 92 of these patients had been initially referred for surgery (27 for leg amputations and 65 for coronary bypass) but after undergoing Chelation Therapy only 10 of this group had to undergo surgery. (Only 3 had amputations and 7 went to bypass surgery.) This saved 24 legs, 58 open-chest surgeries and $3,000,000 of insurance money in Denmark.36 In 1994, Drs. Rudolph, Samuels, and McDonagh reported a dramatic improvement in a 59-year-old woman’s visual fields after 30 Chelation treatments. This patient had been diagnosed with Map-Dot-Fingerprint dystrophy, a form of macular degeneration. Concomitantly her visual acuity was restored to normal after the treatments and 1-year follow-up revealed no relapse.37 Even studies that purport to prove that Chelation Therapy isn’t effective, when carefully analyzed, reveal the efficacy of E.D.T.A. The study of Van Rij showed that 60% of patients with very severe peripheral vascular disease in fact improved after 20 infusions of E.D.T.A. And, in this study, the E.D.T.A. group was compared to a “placebo” group that in fact received thiamine, vitamin C and magnesium. This was not in fact a placebo and only serves to prove that the vitamins and minerals we routinely add to the Chelation solution in fact are also efficacious in improving circulation!38 Dr. H.J. Holliday, a vascular surgeon, published a case study in 1996 of a patient with recurrent carotid stenosis after an endarterectomy operation that he then chelated with E.D.T.A. This patient presented with an 80-85% stenosis of the right internal carotid artery and underwent an operation to remove the plaque. However, 2 years later the obstruction recurred to 65-70% and in 6 more months it had progressed to 70-75% again. The patient elected to undergo chelation therapy instead of another operation and after 20 chelation treatments the stenosis was reduced to 60-65% with a concomitant decrease in peak velocities with Doppler indicating an improvement in the hemodynamics at the site of obstruction. Dr. Holliday concluded that “E.D.T.A. chelation provides an exciting approach … that reduces the degree of blockage”.39 Dr. Majid Ali and his associates published a study in which 26 consecutive patients with ischemic heart disease who had failed to respond to various combinations of by-pass surgery, angioplasty and multiple drug therapies were treated with 20 or more infusions of E.D.T.A. Some of these patients were assessed with Thallium Myocardial Perfusion Scans before and after their treatments. Of the 6 patients who underwent these scans 5 showed definite improvement in myocardial perfusion (more blood flowing to the heart muscle in areas previously lacking such flow). Overall clinical improvement as judged by relief of symptoms was as follows: 61% excellent, 17% good, 13% moderate and 9% poor. This is obviously far better results than can be expected from a placebo effect and there was no mortality (death) during the course of the study.40 The question is always raised by patients and doctors alike: will Chelation Therapy unblock obstructed arteries? While there is no definitive proof at this time that is acceptable to the FDA, there are studies, which are highly suggestive that Chelation can do this. Drs. Rudolph and McDonagh treated a man with severe hypertension with a blockage to his left renal (kidney) artery. The patient underwent Chelation Therapy as an alternative to surgery. After 70 treatments there was a dramatic reduction of obstruction in the artery from 60-70% down to about 20% and his blood pressure normalized.45 The American College for Advancement in Medicine is working with doctors and hospitals worldwide to sponsor studies to document E.D.T.A. Chelation therapy as a viable treatment for arteriosclerosis and other diseases of aging. In time we believe E.D.T.A. Chelation Therapy will become an accepted, “standard” procedure in the practice of medicine. NOTE: Individuals wishing to obtain a compendium of scientific articles on E.D.T.A. Chelation therapy may obtain the following volume from the publisher. A Textbook on E.D.T.A. Chelation edited by E.M. Cranton. Forward by Linus Pauling, Ph.D. Journal of Advancement in Medicine, Volume 2: l/2, Spring/Summer 1989. Published by Human Sciences Press, Inc., 233 Spring Street, New York, New York, 10013–1578.   1-212-620-8473. One can also access more information about and literature related to E.D.T.A. Chelation Therapy via the website of ACAM at http://www.acam.org

How is Chelation Therapy Given?

The Chelation agent, E.D.T.A. is administered intravenously in a solution of dilute salt water or in sterile water. Besides the E.D.T.A., the following substances are added to the bottle: Vitamin C — This vitamin acts as an antioxidant and is needed to activate enzymes and assist in connective tissue synthesis and turnover. Magnesium Sulfate — This mineral is added to counteract the effects of low calcium induced by E.D.T.A. and to replace magnesium, which is almost always deficient in the diet and in total body stores. Magnesium is needed to operate most enzyme systems and in particular, to improve heart function. B-Complex Vitamins — These vitamins act as cofactors in all energy transformations in the body. Pyridoxine (Vitamin B6) — This vitamin is needed for most biochemical steps in amino acid metabolism, especially in the processing of the cardiotoxic substance known as homocysteine. Some theories of atherosclerosis hold that abnormal elevations of homocysteine initiate vascular disorders. Hydroxycobalamin (Vitamin B12 — Cyanocobalamin) — This vitamin is needed for brain function, blood formation and in the synthesis of genetic material. Procaine — This substance is added to inhibit burning at the site of infusion. Heparin — This substance is added to prevent vein inflammation. In addition, other materials such as trace minerals may be added in individual cases. The I.V. needle is placed in a hand or arm vein and the solution is infused over a 2–4 hour period depending on how it is tolerated. The patient will sit in a recliner chair during the treatment and may read, watch television, or just relax.

Are There Any Side Effects?

Side effects may be divided into “short term” and “long term”. The “short term” effects occur during and within a day or two after the treatments. They may be divided into the five categories listed below: 1) Because E.D.T.A. is an acid, burning may occur at the site of the infusion. This can be alleviated by slowing down the infusion rate or adding more magnesium or procaine. 2) Dizziness, muscle spasm, and numbness of the hands, feet, or around the face may occur due to lowering of calcium. These are normal effects of lowering the blood calcium in some patients. These symptoms are easily corrected by slowing the infusion rate, adding extra magnesium, potassium, or calcium to the I.V. and are not in any way dangerous. 3) Some patients report symptoms of fatigue, dizziness, and slight nausea caused by the lowering of their blood sugar level. These symptoms can be avoided by eating a good meal before treatment. Patients are encouraged to bring snacks with them. Diabetic patients are most susceptible to this glucose imbalance and will often have to lower their insulin dosage during a course of treatment. 4) As with all detoxification treatments, symptoms such as joint pain, headaches, fatigue, and flu-like feeling may occur or become worse initially. In almost all cases, these side effects disappear after a few treatments. 5) Rarely a true allergy may occur to E.D.T.A. or one of the other components of the infusion leading to sneezing, nasal congestions, dizziness, or skin rash. By removing one or more of the ingredients from the bottle, we are able to eliminate these reactions in most cases. Allergy to the actual chelation agent E.D.T.A. is almost unknown. Long term “side effects” or reactions to Chelation Therapy include the following: 1) The most serious complication of Chelation Therapy is kidney damage. We evaluate kidney function before and periodically during the treatments. If any diminished function is found before treatment, we use smaller doses of E.D.T.A. or treat less frequently. Rarely, kidney function will be so poor that we have to recommend no Chelation. If kidney function appears to deteriorate during a course of treatment we also reduce the dose or frequency. Occasionally, it is necessary to interrupt the treatment for a while. Despite the risks to kidney function, the fact is, almost no patients experience damage to their kidneys as a result of Chelation and in fact, most patients with mild reduction of kidney function will improve during their Chelation Therapy. In thousands of infusions we have given, we have never seen permanent kidney damage result from Chelation Therapy. On the contrary, we have seen improvements in kidney function when the Chelation was administered prudently. 2) Like every drug, some of the E.D.T.A. is cleared through the liver. We measure liver function before and during treatment. We have never had a case of liver damage during therapy. If a patient comes in with cirrhosis or chronic hepatitis we may have to treat very slowly or not at all. 3) The most common long term adverse reaction to E.D. T.A. is the depletion of the essential metallic elements such as zinc, iron and manganese. This can result in fatigue, anemia, rashes, and allergic tendencies. These effects rarely occur because you will be prescribed mineral replacement therapy both to correct deficiencies and keep up with losses due to Chelation. In 1999, Dr. Richard Anderson of the Nutrient Requirements and Functions Laboratory at the U.S. Department of Agriculture published an article based on research he did with me on patients treated at Waters Preventive Medical Center. We found that E.D.T.A. does not result in any net loss of copper or chromium. Prior to our study, because of in vitro (in test tubes and not in a biological system) experiments it was thought that the removal of copper and chromium would be effected by E.D.T.A. Chelation. We still usually ask patients to supplement with these essential elements because there is much evidence that they are deficient in a large segment of the adult population. In 2001, Dr. Anderson and I published a follow-up study on some of my Chelation Therapy patients. In this study we documented that the average patient excreted seven (7) times the cadmium and forty (40) times the lead after as compared to before a chelation treatment. At the same time, the average patient retained over 80% of the magnesium added to the EDTA solution. The removal of poisonous metals such as return true”>lead as well as the increased cardiovascular functioning produced a substantial increase in general health. Finally, as this booklet goes to the printer, we are happy to report that the National Institutes of Health has announced the funding of a $29 million study on the treatment of coronary heart disease with EDTA Chelation Therapy. This study will be centered at the Miami Heart Institute and will be supervised by Cardiologist Gervasio Lamas, M.D. It will involve EDTA treatment of 2300 heart patients comparing EDTA to placebo. After 40 years of trying, we will finally get a U.S. Government sponsored study of Chelation Therapy that could lead to general acceptance of this treatment.47 NOTE:   IT IS IMPORTANT NOT TO TAKE MINERALS THE DAY OF YOUR CHELATION TREATMENT. Both short term and long term side effects can be evaluated by ongoing laboratory follow-up testing.

“Good” Side Effects

Improvements in metabolism and circulation often result in changes, which can appear to be “reactions” or “side effects”. These include improvement in vision, which results in the current optical prescription needing a change, as well as, the need to decrease insulin requirements in diabetics.

How Many Treatments Are Needed?

This varies from case to case. Some medical doctors who began practicing Chelation medicine 15 years ago have themselves undergone as many as 500 treatments over the years. We recommend an initial course of 30 treatments at no more than twice weekly. Most of our patients take one treatment per week. After the initial course of 30 treatments, maintenance therapy is usually recommended. Recent studies in Holland have shown that the positive side effects on blood platelets lasts for about three weeks after an E.D.T.A. infusion. We generally recommend a treatment every three or four weeks after the initial series. In severe cases the initial series may extend far beyond 30 treatments and appropriate maintenance may be one treatment every two weeks.
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