In all the hype, chelation has its place, and its risks
If you were to believe everything you heard about chelation therapy, you might think it’s something of a cure-all. Satisfied patients describe miraculous improvements in conditions such as asthma and Alzheimer’s, and some doctors contend that it can clear blocked arteries and prevent cancer.
In cases of severe poisoning, chelation therapy can be highly effective. Chemicals are used to speed the elimination of metals from the body by attaching -- or “chelating” -- to them. (The bound metal then passes rapidly out of the body in the urine.)
Among the other uses of chelation therapy, the most promising is for the treatment of atherosclerosis, particularly coronary artery disease. (Speculation that chelating drugs could help dissolve plaques in the arteries by binding to and removing calcium contained in them led to their initial use for this purpose.) The therapy is widely touted as a way of reversing hardening of the arteries and is said to restore blood flow through blocked arteries without surgery.
Treatment consists of intravenous infusions several times weekly for a month or more, typically with a drug called ethylenediamine tetra-acetic acid, or EDTA. “Many patients continue with lifelong therapy,” says Dr. Allan Magaziner, president of the American College for Advancement in Medicine, a nonprofit organization that promotes alternative and complementary medicine. Costs often run in the thousands of dollars; patients generally pay the bill because the therapy is not covered by insurance.
Proponents of the therapy point to a handful of studies that they say demonstrate the safety and effectiveness of chelation therapy. Most of these studies, however, involved only small numbers of patients.
Critics -- of which there are many -- simply charge that the therapy hasn’t been proven effective in the treatment of coronary artery disease. Based on a review of available research, the American Heart Assn. concluded in 2002 that no scientific evidence demonstrates any benefit from this form of therapy; other major health organizations have expressed similar concerns.
They also point out that, although chelation is considered relatively safe, it is not entirely without risks. EDTA can cause kidney damage and, when administered too rapidly, can trigger abnormal heart rhythms, or arrhythmias.
To help determine if chelation therapy offers any benefits to people with coronary artery disease, the National Institutes of Health has launched a nationwide study that will involve more than 2,300 patients. Half will be treated with EDTA, the other half with a placebo.
The study’s principal investigator, Gervasio Lamas, a cardiologist at Mount Sinai Medical Center in Miami Beach, is optimistic. “There are thousands of patients who have presumably had very positive -- even miraculous -- results with EDTA therapy,” he says.
More controversial is the use of chelation therapy for “low-level” heavy metal toxicity. Although most physicians test for heavy metals only when there is reason to believe that exposure to a specific metal has occurred, or when a patient is experiencing specific symptoms of toxicity, some doctors use these tests to evaluate nonspecific symptoms such as headache, chronic fatigue, bone pain and “brain fog.”
When levels of heavy metals are found to be elevated, chelation therapy -- usually with EDTA -- may be recommended to treat what is deemed to be low-level poisoning or to help “detoxify” the body.
There is, however, no scientific evidence to support this type of treatment. “Although there are a lot of doctors out there that will offer chelation for presumed low-level heavy metal toxicity, it’s bad medicine based on poor science,” says Cyrus Rangan, a board-certified medical toxicologist in Los Angeles.
Of course, the absence of good science doesn’t always stop people from choosing to pursue treatment, and use of chelation therapy for questionable purposes will undoubtedly continue.
But people who take a “why not” attitude toward the therapy need to know that there may be good reasons not to try it. Just as potential benefits of chelation therapy are largely unknown, so too are its potential risks.
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Dr. Valerie Ulene is a board- certified specialist in preventive medicine practicing in Los Angeles. She can be reached at themd@att.net.
