Chelation Therapy
Chester J. Zelasko, Ph.D. | January 26, 2007

In the past several months, we’ve gotten a number of questions about the effectiveness of chelation therapy to reduce the risk of heart disease. The claims for chelation therapy run from removing plaque from arteries to lowering cholesterol to detoxifying the body.

What is chelation therapy and what does the science say? This Newsletter answers those questions.

What is chelation therapy?
Chelation therapy involves the use of a chemical agent that will bind with some noxious substance in the body; the purpose is to eliminate the substance from the body. This process has been used to remove lead and other heavy metals and is still used to some degree for that purpose. However, in the 1960s, physicians treated heart attack patients with a specific chelating agent and claimed to have reversed the symptoms. Over the past 40 years, chelation therapy has been the object of numerous research trials, some well-designed and some not. The results have been less than positive.

The chelating agent used was ethylene diamine tetraacetic acid (EDTA), and it’s still used today. The typical course of chelation therapy for cardiovascular disease was a three- to four-hour infusion of EDTA, usually mixed with antioxidants. Treatments took place weekly for 20 weeks or more.

In a randomized clinical trial of subjects who had been diagnosed with cardiovascular disease for over 21 years, twice-weekly chelation sessions for 15 weeks and then monthly for another three months resulted in no change in any measures of cardiovascular disease when compared with controls (1).

Another study tested the ability of chelation therapy to improve blood flow by allowing blood vessels to dilate (2). In a double-blind, placebo-controlled trial, researchers used 33 sessions of chelation therapy to examine changes in blood flow between the control and experimental groups. There were none.

In a recent review article, researchers attempted to perform a meta-analysis of all published clinical trials of chelation therapy (3). Out of 388 articles found by examining at least seven medical data bases, only 14 studies could be found that met acceptable scientific standards. Of those, only seven were pooled for analysis due to duplication. The analyses could find no support for improvement in cardiovascular disease after chelation therapy.

Given the lack of evidence, one would think that would end the story. It does not. The Trial to Assess Chelation Therapy is now underway through the National Center for Complementary and Alternative Medicine of the National Institute of Health. The TACT study will include over 2,300 patients and is currently recruiting patients over 50 who have had heart attacks. In a published interview, study director Dr. Gervasio Lamas, states that, "What we're trying to figure out is if chelation therapy--as it's been practiced now for many years in the community--is really beneficial. And by ‘beneficial’ what I mean is does it prevent heart attacks? Does it prevent having procedures to open coronary arteries? Does it prevent strokes? Does it keep patients healthier? That's really what we need to figure out." (4)

Chelation in a Pill
Many products sold as dietary supplements contain EDTA as well as other antioxidants that claim to work the same as EDTA infusion. A thorough review of the science results in not a single study demonstrating efficacy of using oral chelation for reducing cardiovascular disease.

Using EDTA as a supplement assumes that it will pass through the gut whole and be absorbed whole. Because EDTA is a protein, that’s unlikely. The assumptions continue--that the quantity of the active ingredients will be sufficient to actually chelate the arteries. Again, there’s no evidence that it will.

The Risks of Chelation Therapy
While rare, deaths can occur from chelation therapy due to the alterations of electrolyte balance. When noxious metals such as mercury and lead are not present, the EDTA will attract other positively charged ions such as calcium. In fact, one theory is that it’s the removal of calcium from arterial walls that reduces the plaque from arteries. Altering the calcium balance can result in kidney damage and death. The Mortality and Morbidity Weekly Report in 2006 reported three deaths in three states as a result of chelation therapy (5). In one case, a woman with cardiovascular disease had undergone the treatment before. In another, a young child with autism was undergoing chelation therapy to remove toxins.

Chelation Therapy--Yes or No?
Based on the scientific evidence, the answer is "not yet" and certainly there’s no benefit to chelation via supplement. When the TACT study is complete, it will give more insight into whether the treatment is effective for heart disease.

It’s easy to just say "Don’t do that," but many people have found they feel better after chelation therapy. Feeling better doesn’t mean you have really reduced your risk of disease. Should you do it anyway? That’s for you to answer for yourself. Before I let anyone infuse my body with chemicals repeatedly for weeks at a time, I’d have to be very sure they knew what they were doing and would guarantee an improvement in some cardiovascular measurement.

Until then, reducing heart disease will just have to be done the old fashioned way: eat better, lose weight, exercise regularly, and don’t smoke. Period.

References:
  1. Knudtson ML, et al. Chelation therapy for ischemic heart disease: a randomized controlled trial. JAMA. 2002; 287(4):481-6.

  2. Anderson TJ et al. Effect of chelation therapy on endothelial function in patients with coronary artery disease: PATCH substudy. J Am Coll Cardiol. 2003;41(3):420-5.

  3. Dugald MR et al. EDTA chelation therapy for cardiovascular disease: a systematic review. BMC Cardiovascular Disorders 2005, 5:32.

  4. http://nccam.nih.gov/health/chelation/

  5. MMWR March 3, 2006. Deaths Associated with Hypocalcemia from Chelation Therapy --- Texas, Pennsylvania, and Oregon, 2003--2005. MMWR 55(08);204-207.
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