Questions and Answers: The NIH Trial of EDTA Chelation Therapy for Coronary Heart Disease

Preliminary results from the Trial to Assess Chelation Therapy were presented November 4, 2012, at the American Heart Association Scientific Sessions. Key results will be added to this document following publication of the study in a scientific journal; however, at this time we must respect the embargo of the journal in which the study may appear. The questions and answers below provide information on the purpose of the study, what EDTA chelation is, and about coronary heart disease in general.

About the Study

What is the Trial to Assess Chelation Therapy (TACT)?

TACT is the first large-scale, multicenter study designed to determine the safety and efficacy of EDTA chelation therapy for individuals with prior heart attacks. The National Institutes of Healths National Heart, Lung, and Blood Institute (NHLBI) and National Center for Complementary and Alternative Medicine (NCCAM) co-sponsored TACT. This study is over 20 times larger than any previous study of chelation therapy. It was designed to be large enough to detect if there are any moderate benefits or risks associated with the therapy.

Why did NCCAM and NHLBI decide to study this therapy?

In addition to effective standard therapies, such as lifestyle modifications, medications, and surgical procedures, some patients with CHD seek out EDTA chelation therapy as a treatment option based on anecdotal reports of improved symptoms in patients with heart disease. Prior to TACT, the evidence cited in the support of using EDTA chelation therapy was in the form of case reports and case series.

Therefore, NCCAM and NHLBI saw a public health need to conduct a large-scale, well-designed clinical trial that could determine whether EDTA chelation therapy is safe and might be effective for treating CHD.

How commonly is EDTA chelation therapy used?

The 2007 National Health Interview Survey, conducted by the Centers for Disease Control and Prevention, found that 111,000 adults 18 years of age and older used chelation therapy as a form of complementary medicine in the previous 12 months.

What was the purpose of the study?

The purpose of the study was to determine the safety and efficacy of EDTA chelation therapy for treating CHD. TACT was designed to see whether EDTA chelation therapy and/or high-dose vitamin/mineral supplements are safe and effective in treating individuals with prior heartattacks. Specifically, they sought to determine if EDTA chelation and/or high-dose vitamin supplements improved event-free survival (length of time without a cardiovascular event, such as a heart attack).

The investigators looked at several markers of improvement, or endpoints, to make these determinations. The primary endpoint in the trial was a composite of:

 All causes of death
 Heart attack
 Stroke
 Hospitalization for angina
 Coronary revascularization.

Secondary endpoints included:

 Cardiac death, or nonfatal heart attack, or nonfatal stroke
 The individual components of the primary endpoint
 The safety of the therapy
 Health-related quality of life
 Cost effectiveness.

What was the basic design of the study?
The study was a placebo-controlled, double-blind design that included 1,708 participants aged 50 years and older with a prior heart attack. Its purpose was to test whether EDTA chelation therapy and/or high-dose vitamin therapy is effective for the treatment of CHD.

EDTA chelation therapy, as practiced in the community, often includes administration of high doses of antioxidant vitamin and mineral supplements. In order to test whether some of the therapys effect may be attributable to vitamin/mineral supplements or to the EDTA solution itself, the investigators randomly assigned participants to receive either EDTA chelation solution or placebo. Then, the patients in the two groups were again randomly selected to receive either low-dose or high-dose vitamin/mineral supplements.

The EDTA chelation therapy or placebo solution was delivered through 40 intravenous infusions that were administered over a 28-month course of treatment. The first 30 infusions were delivered on a weekly basis and the last 10 were delivered every two to eight weeks. Following the infusion phase, participants had contact with study staff at 3-month intervals until the study was complete.

What did TACT cost?

TACT cost approximately $31.6 million over the course of the 10 years it took to conduct and complete it.

Study Background

What is coronary heart disease?

Coronary heart disease (CHD) is the most common form of heart disease, which is the leading cause of death among American men and women. Each year nearly 380,000 Americans die from CHD. In CHD the coronary arteries, the vessels that provide oxygen-rich blood to the tissues of the heart, become blocked by deposits of a waxy substance called plaque. As plaque builds, the arteries become narrower and less oxygen and nutrients are transported to the heart. CHD can lead to serious problems, such as angina (pain caused by not enough oxygen-carrying blood reaching the heart) and heart attack. A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle is cut off. If blood flow is not restored quickly, the affected section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious health problems or death.

Factors that can increase the risk of developing CHD include

 High blood pressure
 High blood cholesterol levels
 Smoking
 Overweight or obesity
 Physical inactivity
 Diabetes
 Insulin resistance
 Metabolic syndrome
 Unhealthy diet
 Family history of CHD
 Older age

Symptoms of CHD can include chest pain, shortness of breath, lightheadedness, cold sweats, or nausea, but not everyone with CHD has symptoms.

How is CHD diagnosed and treated?

Diagnosis of CHD is based on personal medical and family histories, risk factors for CHD, a physical exam, and the results from tests and procedures. Doctors who suspect CHD may recommend one or more tests, such as those that check levels of fats, cholesterol, and sugar, electrocardiograms (EKG) to check the hearts electrical activity, stress tests to record the heartbeat during exercise, nuclear scanning to check for damaged areas of the heart, and angiography to see if there are blockages or narrowings in the blood vessels that feed the heart. Treatment of CHD includes lifestyle changesstopping smoking for patients who smoke, reducing fat in the diet, and engaging in a prescribed exercise program. Medications may also be prescribed, such as aspirin to prevent heart attacks, medications that decrease the workload on the heart, or medicines that reduce blood cholesterol levels or blood pressure. If these efforts are not effective, a patient may need to have the narrowed or blocked arteries re-opened through a procedure called percutaneous coronary intervention (PCI), or bypassed through surgery. PCI involves threading a thin tube into an artery and expanding a balloon-like apparatus as a way to increase the size of the artery so more blood can flow. Bypass surgery is used to treat severeblockages by using veins or arteries from other areas of the body to divert blood flow around the blocked coronary arteries.

To learn more about CHD and its diagnosis and treatment visit: http://www.nhlbi.nih.gov/health/health-topics/topics/cad/.

What is EDTA chelation therapy?

Chelation is a chemical process in which a substance is used to bind molecules, such as metals or minerals, and hold them tightly so that they can be removed from a system, such as the body. In medicine, chelation has been scientifically proven to rid the body of excess or toxic metals. For example, a person who has lead poisoning may be given chelation therapy in order to bind and remove lead from the body before it can cause damage.

In the case of EDTA chelation therapy, the substance that binds and removes metals and minerals are the salts of EDTA (ethylene diamine tetra-acetic acid), a synthetic, or man-made, amino acid that is delivered intravenously (through the veins). EDTA was first used in the 1950s for the treatment of heavy metal poisoning. Calcium disodium EDTA chelation removes heavy metals and minerals from the blood, such as lead, iron, copper, and calcium, and is approved by the U.S. Food and Drug Administration (FDA) for use in treating lead poisoning and toxicity from other heavy metals. Rather than testing calcium disodium EDTA, TACT used another salt, disodium EDTA, under an FDA license as an investigational new drug (IND). Although disodium EDTA is not approved by the FDA to treat CHD, some physicians and alternative medicine practitioners have recommended its use in chelation as a way to treat CHD.

What are the possible side effects of EDTA chelation therapy?

The most common side effect is a burning sensation at the site where EDTA is delivered into a vein. Rare side effects can include fever, headache, nausea, and vomiting. Even more rare are serious and potentially fatal side effects that can include heart failure, a sudden drop in blood pressure, abnormally low calcium levels in the blood (hypocalcemia), permanent kidney damage, and bone marrow depression (meaning that blood cell counts fall). Hypocalcemia and death may occur particularly if disodium EDTA is infused too rapidly. Reversible injury to the kidneys, although infrequent, has been reported with EDTA chelation therapy. Other serious side effects can occur if EDTA is not administered by a trained health professional.

What did the chelation infusions contain?

For TACT, the active, 10-component, chelation solution was selected to match most closely the standard solution used by chelation practitioners. The solution contained up to 3 grams disodium EDTA, 7 grams of ascorbic acid, 2 grams of magnesium chloride, 100 mg of procaine hydrochloride, 2500 U of unfractionated heparin, 2 mEq potassium chloride, 840 mg sodium bicarbonate, 250 mg pantothenic acid, 100 mg thiamine, 100 mg pyridoxine, 100 mg procaine, and sterile water to make up 500 mL of solution. The placebo solution consisted of 500 mL of normal saline and 1.2% dextrose.

The infusions were prepared at a central pharmacy for the study and then shipped to the study sites in refrigerated containers.

Where did the study take place?

The study was conducted at 134 research sites located across the U.S. and Canada. The research sites represented a mix of clinical settingsuniversity or teaching hospitals, clinical practices or cardiology research centers, and chelation practices. Per standard clinical trial procedure, the sites were selected based on a thorough review of qualifications by the study team and required approval of the study by their local institutional (ethical) review boards.

Who participated in TACT?

Over the course of the study 1,708 patients were randomized after signing informed consent839 patients to chelation and 869 patients to placebo. The study recruited participants who were at least 50 years of age or older, had had a heart attack at least 6 weeks prior to evaluation, and had not had chelation therapy within the past 5 years. The participants also could not have:

 History of allergic reactions to EDTA or any of the therapys components
 Coronary or carotid revascularization procedures within the past 6 months or a scheduled revascularization
 History of cigarette smoking within the last 3 months
 Childbearing potential
 History of liver disease
 Diagnoses of additional medical conditions that could otherwise limit patient survival, such as cancer.

On average, TACT participants were 65 years old. Eighteen percent of participants were women and 9 percent were minorities. Participants heart attacks had, on average, occurred 4.6 years before enrollment. The study population had a high rate of diabetes (31%), prior coronary revascularizations (83%), and use of medications, such as aspirin (84%), beta-blocker (72%), and statins (73%).

How was patient safety monitored?
A number of safety mechanisms were in place, including a rigorous protocol with standard rates of infusions and doses of disodium EDTA based on kidney function. Oversight by a Clinical Coordinating Center ensured that the sites did not give infusions to patients for whom they might pose a risk because of their medical conditions. An NIH-appointed Data and Safety Monitoring Board monitored the trial throughout its entirety, providing ongoing oversight and review of patient safety. In addition, the FDA provided oversight as is required for all drugs used under an Investigational New Drug Application (IND).

When will the study results be published?

Preliminary results from TACT were presented November 4, 2012, at the American Heart Association Scientific Sessions. A manuscript has been submitted for publication in a peer-reviewed scientific journal. Even though preliminary results were shared at the meeting, we must respect the embargo of the journal in which the study may appear and refrain from sharing results until they are published in the literature. When the study is published, we will update this information with the key results.

For More Information

NHLBI Health Information Center

The NHLBI Health Information Center provides information to health professionals, patients, and the public about the treatment, diagnosis, and prevention of heart, lung, and blood diseases and sleep disorders.

P.O. Box 30105
Bethesda, MD 208240105
Phone: 3015928573 (or dial 711 for access to free Telecommunications Relay Services (TRS)
Fax: 3015928563
Website: nhlbi.nih.gov
Email: nhlbiinfo@nhlbi.nih.gov (link sends e-mail)

NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on NCCAM and complementary health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226
TTY (for deaf and hard-of-hearing callers): 1-866-464-3615
Website: nccam.nih.gov
Email: info@nccam.nih.gov (link sends e-mail)

THE DYSOX MODEL OF RENAL INSUFFICIENCYAND IMPROVED RENAL FUNCTION WITH OXYSTATIC THERAPIES

Majid Ali, M.D.

With Alfred O. Fayemi, M.D., Judy Juco, M.D., and Shara Fischer, B.S.

In this column, we cite a large body of our previously published histopathologic and biochemical findings1-14 concerning renal insufficieny to provide a framework of reference for presenting the dysox model of renal insufficieny, including: (1) histopathologic and biochemical studies of renal diseases; (2) autopsy findings of tissues in subjects on chronic hemodialysis; (3) microscopic and biochemical observations concerning oxygen homeostasis and dysoxygenosis (dysox) that led to the development of the dysox models of atherogenesis in general and of renal vascular pathology specifically; and (4) limited data concerning improved renal function with oxystatic therapies. We follow that up with: (1) a brief review of the efficacy of EDTA chelation therapies for renal insufficiency by others; (2) profiles of recovery from chronic renal failure of several of our patients; (3) brief comments about the enormous potential of oxystatic therapies for obviating the need for chronic dialysis and renal transplants; and (4) financial data showing potential for enormous savings with oxystatic and chelation therapies of empirically established efficacy.

Histopathologic Studies in Chronic Renal Failure

In 1982, in The Pathology of Maintenance Hemodialysis,1 two of the authors (MA & AOF) summarized a large body of their biochemical and pathologic observations on patients receiving chronic hemodialysis. Of great significance to the subject of this column among those studies were the histopathologic abnormalities observed in the vasculature, especially arterionephrosclerosis and arteriolonephrosclerosis.5 In addition to the renal consequences of those vascular changes, we also delineated patterns of cellular injury in other sites, including: (1) cardiac myocytolysis at autopsy (the degree of which correlated well with reduction in the ventricular ejection fraction before the death of patients)6; (2) cerebral arteriosclerosis associated with cerebral and cerebellar cortical atrophy7; (3) pulmonary interstitial changes associated with interstitial edema and fibrosis8; (4) hepatosplenic and adrenal siderosis9; (5) systemic oxalosis10; (6) parathyroid hyperplasia11; malignant neoplasms12; and (7) structural abnormalities in other tissues.13 Our main conclusion drawn from those studies was that progressive renal perfusion deficit caused by accelerated arterionephrosclerosis and arteriolonephrosclerosis was the primary pathologic mechanism responsible for perpetuation and progression of renal insufficiency. Furthermore, all biochemical and histopathologic abnormalities encountered in patients on dialysis during life and at autopsy could be explained on the basis of perfusion deficits in the kidneys and other tissues.

The Dysox Model of Atherogenesis

During the last two decades, the focus at the Institute of Integrative Medicine has been on the clinical aspects of derangements of oxygen homeostasis, redox equilibrium, and acid-base balance. Derangements of those primary homeostatic mechanisms set the stage for abnormalities of the autonomic, inflammatory and autoimmune responses in patients with chronic disorders, including neoplastic disorders.15-24 Specifically, morphologic changes of oxidative coagulopathy,15 patterns of oxidative regression to primordial cellular ecology,20 and biochemical profiles of dysoxygenosis (dysox)21including respiratory-to-fermentative shiftswere described. That body of work led to the putting forth of the hypothesis of the oxidative-dysoxygenative model of coronary artery disease (ODCAD)25 and later the dysox model of atherosclerosis,26 which has the following three core tenets:

The first essential energetic-molecular lesion in atherogenesis is oxidative dysautonomia, primarily related to issues of spiritual dysequilibrium (unrelenting anger and a persistent sense of being a victim);

The second essential molecular lesion in atherogenesis is oxidative coagulopathy involving oxidative injury to all plasma and cellular components of the circulating blood, primarily related to issues of nutrition and environment; and

The secondary lesions are intimal, medial, and thrombotic-occlusive phenomena that are the consequences of those two primarry lesions, and essentially represent disturbed oxygen homeostasis with mitochondrial uncoupling of respiration and oxidative phosphorylation in those tissues.

The dysox model of atherogenesis in generaland the dysox model of vascular pathology specifically in the present context reach far beyond the prevailing cholesterol and inflammatory theories of arteriosclerosis. In 1997, one of the authors (MA), with his colleague Omar Ali, described the morphologic features of oxidative coagulopathy and marshaled thirteen lines of evidence for our view that cholesterol is not a major factor in the pathogenesis of atherosclerosis.15 In that article, we asserted that the inflammatory response in atheromathe basis of the inflammatory theory of arteriosclerosisoccurs as a consequence of oxidosis in the circulating blood, with subsequent regional intimal and medial injury. Since then, several lines of direct and incontrovertible experimental evidence for the dysox model of atherogenesisand of arterionephrosclerosis and arteriolonephrosclerosis in the current contexthave been developed. For instance, in mice most atherosclerosis loci recognized so far have not been associated with systemic risk factors associated with atherosclerosis.27 For those reasons, in the clinical application of the dysox model of arteriosclerosis, we have emphasized the need for focusing on oxygen homeostasis in the vascular wall in the reversal of cardiovascular disease.

The Dysox Model of Renal Vaasular Pathology and Renal Insufficiency

Seen in light of the morphologic observations in patients with renal failure and evidence of the pathogenetic role of dysoxygenosis in atherogenesis cited above, perpetuation and progression of chronic renal insufficiency can be seen essentially as renal dysoxygenosis. The primary strength of the dysox model of progressive renal insufficiency is twofold: (1) It brings into sharp focus the significance of pathophysiologic disruptions in body organs other than the kidneys especially in the bowel, blood, and liver ecosystems that profoundly affect renal functional status; and (2) It requires that all elements that threaten oxygen homeostasis anywhere in the body, as well as those related to lifestyle stresses, be considered in designing integrative management plans for reversing renal failure. In order to underscore the crucial importance of those two considerations, below we present some aspects of cellular energetics that are fundamental for understanding the dysox model of renal vasular pathology.

The vascular wall regularly undergoes regional disturbances of molecular energetics27-30 including the uncoupling of respiration and oxidative phosphorylation as components of physiologic inflammatory response discussed in a previous (May 2005) column. It has been shown that such uncoupling occurs to some extent in all cells, and to a greater degree in blood vessels that are predisposed to the development of atherosclerosis.27-30 Those earlier findings have been fully validated by recent studies with mice generated to exhibit doxycycline-inducible expression of uncoupling protein 1 (UCP1) in the artery wall.27 In such mice, UCP1 expression in aortic smooth muscle cells causes hypertension and increases dietary atherosclerosis without affecting cholesterol levels. Furthermore, UCP1 expression regionally increases superoxide production and decreases the availability of nitric oxide the two clear markers of local oxidosis. Some recent advances in the understanding of mitochondrial pathophysiology provide further evidence for the dysox model of renal insufficiency. For readers with special interest in the subject, additional comments on this crucial subject are included in a later section.

The dysox model of renal insufficiency is of crucial importance, both for understanding the nature of the processes that perpetuate renal failure and for designing scientifically sound strategies for reversal of renal failure. In that light, the dysox model of chronic renal insufficiency is seen as a unifying model with a strong explanatory power for therapies that have been empirically shown to be effective for restoring renal function.

EDTA Nephrotoxicity

Much has been written and spoken about nephrotoxic effects of ethylenediaminetetraacetic acid (EDTA). In our view, following are the important aspects of this subject:

. Under experimental conditions, EDTA is known to cause acute tubular necrosis and glomerular filtration dysfunction. 31-34

. During the early years of EDTA chelation therapy, EDTA nephrotoxicityrising serum creatinine levels, in most caseswas seen when large doses were administered rapidly. 35-37

. EDTA does not cause renal dysfunction in individuals without pre-existing renal damage when infused slowly in doses of 1 to 1.5 grams over a period of ninety minutes or more. 38

. EDTA chelation therapy can be administered safely with concurrent use of most commonly prescribed agents for cardiovascular disorders (unpublished observations made at the Institute).

. Safety and efficacy of EDTA infusions for improving renal function have been recognized by many groups of clinicians. 39-47

. Nearly all patients with renal insufficiency can tolerate modest doses of EDTA (100 to 250 mg) when administered slowly (90 to 120 minutes) to well-hydrated individuals after an initial period of restoration of bowel, blood, and liver ecologies.

For safe EDTA chelation therapy, the last consideration is the most crucial. It is our practice not to initiate EDTA chelation therapy for our patients with renal insufficiency until the bowel, blood, and liver issues have been effectively addressed and some direct oxystatic therapiesintravenous hydrogen peroxide and ozone infusions, singlet oxygen therapy, and othershave been administered. The theoretical and clinical aspects of EDTA and hydrogen peroxide have been described in detail in Dysoxygenosis and Oxystatic Therapies, the third volume of The Principles and Practice of Integrative Medicine 48

Integrated EDTA/H2O2 Regimens

In our experience, a weekly combination of EDTA and hydrogen peroxide infusions proved more effective than EDTA infusions alone for patients with serum creatinine levels between 1.2 to 2.5 mg/dL. For individuals with creatinine levels above that range, we generally prefer hydrogen peroxide infusions to EDTA infusions. Initially, we use modest doses of EDTA ranging from 100 to 250 mg. EDTA infusion therapy requires close monitoring with serum creatinine measurements, usually before each infusion during the first five to six periods of therapy. Needless to say, such infusions are administered as components of an integrated treatment plan with robust nutrient and herbal therapies. (See Integrative Nutritional Medicine, the fifth volume of The Principles and Practice of Integrative Medicine 49 for details.)

Brief Review of EDTA ChelationTherapy for Improving Renal Function

The names of Sidbury,31 Meltzer,43,44 Soffer,32 Schwartz,33-35 Stamp,36 and Stankovic37 stand out among the earlier investigators of EDTA chelation therapies. In 1975, Morgan reviewed the subject of EDTA chelation for lead nephropathy, with focus on issues of safe dosage and clinical efficacy of EDTA therapy, and presented his experience with seventeen patients.39 (The term ‘lead nephropathy’ may be reassuring for some, but clearly the mere coexistence of nephropathy and increased body lead burden are not sufficient to exclude the presence of other factors of importance in the dysox model of renal insufficiency.) McDonagh, Rudolph, and Cheraskin stand out among those who documented the efficacy of EDTA for improving renal functions during the 1980s. 40-42

Although chelation treatment for childhood lead poisoning and for industrial lead exposure has been well defined, the issue of renal insufficiency associated with heavy metal body burden has not been addressed effectively. Nephrologists generally recommend ‘watchful waiting’ for patients with renal insufficiency (except for prescribing ACE inhibitors) until the time comes for dialysis or kidney transplant. In that context, we were elated to see a 2003 report in The New England Journal of Medicine including the following in the conclusion section of the abstract: “Low-level environmental lead exposure may accelerate progressive renal insufficiency in patients without diabetes who have chronic renal disease. Repeated chelation therapy may improve renal function and slow the progression of renal insufficiency.” 550

It seemed to us then that the day of EDTA chelation for reversing renal insufficiency, at least in persons with documented increased body lead burden, had arrived. Alas! That did not turn out to be the case. Individuals with renal insufficiency continue to be neglected with the regrettable ‘watchful waiting’ strategy. Indeed, an editorial accompanying that article was entitled “Increased Body Lead BurdenCause or Consequence of Chronic Renal Insufficiency?”51 It is needless to point out the subliminal message of doubt in the choice of words for the title.

Toxic Metal Nephropathy and Its Reversal

Two hundred two patients with chronic renal insufficiency (indicated by a serum creatinine level between 1.5 mg per deciliter and 3.9 mg per deciliter) who had a normal total-body lead burden and no history of exposure to lead were observed for 24 months.

The New England Journal of Medicine 50

Who had a normal total-body lead burden! A normal total body lead burden? What might that be? This is a crucial point. Any and all amounts of toxic metalswithout any known physiologic roles and with well-established toxicity to oxygen homeostasis and redox equilibriummust be deemed a health hazard and a target for safe chelation therapies. Lead toxicity in children is a more compelling problem than in adults with equivalent body lead burden by weight. Thus, the recommendation that lead poisoning should be accepted only when the blood lead level is higher than 10 g per deciliter is simply not acceptable. Fortunately, it is being recognized that there is no threshold blood level at which lead has no adverse effect on health. 52-55

As for the renal function, it has been estimated that each increase of 100 g (0.5 mol) in the body lead burden is associated with a decrease in the glomerular filtration rate of 0.3 ml per minute per 1.73 m2 of body-surface area, after adjustment for other factors (P<0.001).50 However, the blood lead level, in general, is a poor measure of the long-term exposure to lead and the actual total body lead burden. It is now widely recognized that the red cell level of lead reflects only recent exposure. It has also been estimated that approximately 90 to 95 percent of the lead is stored in calcium-dependent skeletal pools with slow turnover. The best measure of body lead burden, in our view, is with measurements of 24-hour urinary elimination of heavy metals after a combined EDTA and DMSA challenge (see Heavy Metal Load and Toxicity, the seventh volume of The Principles and Practice of Integrative Medicine, www.majidali.com).

Oxystatic Integrative Protocols for Improving Renal Function

The sun-soil model for restoring oxygen homeostasis, redox equilibrium, and acid-base balance has been described at length in Integrative Nutritional Medicine.49 In that model, the pathogenetic mechanisms causing acquired chronic disorders are related to spiritual disequilibrium symbolized by sun issues of unremitting anger, sense of being a victim, forgiveness issues, and othersand altered states of bowel, blood, and liver ecosystems that are metaphorically equated with the soil-roots unit of the plant. Thus, the protocols employed at the Institute for improving renal function are heavily focused on those two aspects of the sun-soil model. Among direct oxystatic therapies found to be of critical value, as mentioned earlier, are hydrogen peroxide, ozone, and EDTA chelation infusions. The theoretical and practical aspects of those therapies have been presented in detail in Dysoxygenosis and Oxystatic Therapies. 48

Case Studies of Improved Renal Function

The reversal of chronic renal failure with integrative treatment plans, including EDTA chelation therapy, has been documented in several reports.31-37,39-44 As for the deteriorating renal function in patients with arteriosclerosis, autoimmune disorders, and heavy metal toxicity, during the last two decades we had also clinically validated the observations of those earlier works. Some of our limited observations were included in Oxygen and Aging (www.Canary21.com.) In this column, we include several case studies that illustrate patterns of improved renal function, as assessed with serial measurements of of serum creatinine levels, over periods of several months (Figure 1). It is important to point out that results shown were acheived with integrated management protocols that included robust nutrient, herbal, and self-regulatory mesaures. Underscoring the inter-relationships between inflammation, renal perfusion, and renal sufficiency, Table 1 presents data correlating changes in the serum creatinine levels with those in the blood levels of C-reactive protein, and blood pressure observed in a 75-year-old man with atrial fibrillation.

Improved Renal Function WithoutEDTA Chelation

Following the dysox model of renal insufficiency presented above, improvement of renal function should be achievable without chelation therapies if other issues can be vigorously addressed. That, indeed, is the case. The following illustrative case study documents an example. In April 2005, we saw a 49-year-old engineer with hypertension, inhalant allergy, and renal insufficiency with a serum creatinine level of 1.6 mg/dL. His creatinine level was 1.5 mg/dL in April of 2001. He had worked in the World Trade Center area in New York City and was heavily affected by the events related to the collapse of the Towers. His health steadily deteriorated during the following months, with rising blood pressure and worsening of allergic symptoms.

Table 1. Correlation of Serum Creatinine Levels with Blood Pressure, CRP, and Fatigue in a 75-Year-Old Man with Atrial Fibrillation*

Date Creatinine CRP BP Fatigue/leg edema

9/ 2003 1.4 _ 145/78 mild/mild
3/2005 1.4 67.9 174/94 severe/ severe
Early 5/2005 1.6 61.4 155/90 moderate/moderate
Late 5/2005 1.7 _ 124/68 moderate/moderate
6/2005 1.4 53.6 126/60 none/none

* The patient was not seen at the Institute between September 2003 and March 2005, and complied poorly between March and June 2005.

Some months later, his serum creatinine level was found to be 1.6 mg/dL. However, he was not offered any treatment plan to reverse renal failure. The creatinine levels stayed at about 1.6 during the next three years. We gave him detailed explanation of the nature of his kidney disorder and its relationship with hypertension and renal insufficiency. As a part of our integrative oxystatic management plan, we prescribed self-regulatory breathing methods, exercise, nutrient and herbal protocols, and hydrogen peroxide infusions and EDTA chelation with a dose of 250 mg. (See Dysoxygenosis and Oxystatic Therapies48 for details.) He received only one EDTA infusion and could not continue infusion therapies for reasons of cost. Four weeks later, his creatinine level was 1.2, a value lower than 1.6, for the first time in four years. It was our clinical sense that what contributed most to the drop in creatinine level was the time spent on giving him a clear view of the problem and our plan of corrective action, as well as his self-regulatory work (generalized vasodilatation with consequent improved renal perfusion), since we have never seen such rapid improvement in that short a period of time with nutrient and herbal programs alone in any of our other cases.

Cost Savings of Integrated Oxystatic Plans Including EDTA Chelation

The dialysis and kidney transplant industry has mushroomed during the last three decadeswith no sign of letup. To give some sense of the financial scale, Medicare’s portion of the End Stage Renal Disease (ESRD) program grew from $5.8 billion in 1991 to $17.0 billion in 2002, representing 6.7% of the total Medicare budget.56 That is only the Medicare side of the dialysis industry picture, and essentially represents the cost of dialysis for those over 65 years of age. To that must be added another $5 billion or so for the Americans under the age of 65.

The yearly cost of dialysis per patient is approximately $65,000 for Medicare and $100,000 for non-Medicare patients. For Medicare beneficiaries, this breaks down as follows: The Medicare cost per member per year (PMPY) is about $53,000. It is estimated that coinsurers add another $10,000 to the bill, raising the total to approximately $65,000 per year. To make matters worse, the annual increases in the dialysis costs are estimated to continue to grow by about 10%, as has been the case for recent years. The annual cost of an integrative plan (including oxystatic infusions and EDTA therapy) at the Institute is less than $8,000 for the first year and $5-6,000 a year after that. We need not belabor the point. Those numbers speak eloquently. What those numbers are silent about is the enormous biologic cost of receiving dialysis therapy for years and decades or the broad range of nonrenal benefits that accrue from successful reversal of chronic renal insufficiency.

Mitochondrial Energetics of Significance to the Dysox Model of Renal Insufficiency

In this section, we present some information about cellular energetics to shed more light on the dysox model of renal insufficiency. In human biology, mitochondrial respiration energetics generate ATP from ADP phosphorylation, and the electron transport in that process accounts for most reactive oxygen species (ROS) production.57 ROS generation begins with molecular oxygen picking up electrons to produce superoxide at complex I and III.58 Located at the inner mitochondrial membrane are anion transporters called uncoupling proteins (UCP1, UCP2, and UCP3), which permit proton leakage back into the mitochondrial matrix, two consequences of which are a decrease in the potential energy available for ADP phosphorylation and a reduction in ROS generation. UCPs also increase respiration, which accelerates superoxide production in the setting of low proton motive force.59 Superoxide, in turn, activates uncoupling protein.60,61 Thus a valuable contrariety in free radical homeostasis at one of the most fundamental levels of molecular energetics of human biology is established.

In the vascular wall, smooth muscle cells are the principal source of ROS.57 In order to study the effects of uncoupling respiration and oxidative phosphorylation, mice with doxycycline-inducible expression of UCP1 restricted to aortic smooth muscle cells were generated. In such mice given doxycycline (2 mg/ ml in sucrose-containing drinking water), aortic UCP1 messenger RNA expression was induced by nearly 12-fold compared with the control wild-type mice drinking sucrose-containing water alone.27 Transgenic mice carrying the reverse tetracycline transactivator driven by the -441 SM22 promoter were mated with mice transgenic for a tetracycline responsive element (TRE)-UCP1 minigene yielding UCP1 mice. There was no doxycycline-dependent induction of UCP1 gene expression in the aorta of SM22-rtTA mice (lacking a TRE target) or TRE-UCP1 mice (lacking an antibiotic-inducible transactivator).

Doxycycline induction of aortic UCP1 expression significantly increases both systolic and diastolic blood pressure. That hypertensive effect was abrogated ten days after removing doxycycline from the drinking water. Plasma renin activity also increases significantlyup to three-foldin doxycycline-treated mice. Concomitantly, urinary sodium excretion decreases in the presence of doxycycline, suggesting activation of the renin-angiotensin-aldosterone system. By contrast, urinary excretion of norepinephrine, a marker of sympathetic activation, is not altered by UCP1 induction.

The relevance of oxygen-driven and redox-related events in the matrix to the oxidative-dysoxygenative model of tissue injury has been underscored.62 While the electron transfer events in human cellular energetics have been well delineated, the subject of electron transfer in matrix has received little attention so far. Among microbial species, organisms that can transfer electrons to extracellular electron acceptors Fe(iii) oxides and othersare of crucial importance to microbial organic matter degradation and nutrient cycling. Recent studies with a pilus-deficient mutant of Geobacter sulfurreducens revealed that the microbial species was unable to reduce Fe(iii) oxides, but wasable to attach to them.63 Work with conducting-probe atomic force microscopy showed that the pili were highly conductive of electrons. It appeared that the pili of G. sulfurreducens served as biological nanowires, transferring electrons from the cell surface to the surface of Fe(iii) oxides. Such electron transfer through pili indicated that there might exist yet other unique cell-surface and cell-cell interactions. It seems likely that similar electron transfer nanowires might also exist in the matrix of human tissues. What might be the clinical significance of derangements involving these nanowires in human illness and renal insufficiency in the present context remains to be elucidated.

The Core Message

The single most important message of this column is this: In the vast majority of patients, renal insufficiency can be successfully managed, renal failure reversed, and dialysis avoided with well-considered and well-executed integrated oxystatic protocols that correct the cellular energetic dysfunction in renal microvasculature and nephrons. None of the patients seen at the Institute with the initial serum creatinine levels of less than 4 mg/dL, who were able to follow the program for more than six months, went on to receive dialysis treatment or kidney transplants during the periods of ongoing treatment. In Figure 1, the data for falling serum creatinine levels in several patients with renal insufficiency managed with oxystatic protocols, including EDTA and hydrogen peroxide infusions, are displayed. We end this column with the following quote from the 1982 preface written for The Pathology of Maintenance Hemodialysis1:

Notwithstanding the success achieved in the man-machine interaction, and the assumption of renal excretory function by the dialysis process, the fundamental derangements in chronic renal failure have come into sharper focus with growing experience with MHD [maintenance hemodialysis]; the dialytic therapy, as we know it today, is unable to reverse the uremic milieu.

We believe that statement is as true today as it was in 1982. However, our understanding of the disruptions in oxygen homeostasis, redox equilibrium, and acid-base balance in renal failure has vastly improved. And so have the opportunities for the integrative physician to improve renal function and obviate the need for chronic dialysis and renal transplantation.

Figure1. Profiles of Improved Renal Function as Measured by Falling Serum Creatinine Values Over Several Months of Management of Seven Patients With Chronic Renal Insufficiency Are Displayed.

References:

1. Ali M, Fayemi AO. Pathology of Maintenance Hemodialysis. 1982. Springfield, CC Thomas.

2. Ali M, Rigolosi R, Fayemi AO, Braun EV, Frascino J, Singer R. Failure of serum ferritin levels to predict bone marrow iron content after intravenous iron-dextran therapy. Lancet 1982;i:651-655.

3. Ali M, Fayemi AO, Rigolosi R, Frascino J, Marsden T, Malcolm D: Hemosiderosis in hemodialysis patients: an autopsy study of 50 cases. JAMA 1980;244:343-345.

4. Fayemi AO, Ali M. The pathology of end-stage renal disease in hemodialysis patients. Israel J Med Sci 1979;15:901-909.

5. Fayemi AO, Ali M. Intrarenal vascular alterations in hemodialysis patients: a semiquantitative light microscopic study. Human Pathology 1979;10:685-693.

6. Ali M, Prasad PV, Rigolosi R, Braun EV, Frascino J, Singer R, Fayemi AO, Angeli R, Haft J. Cardiac myocytolysis: pathologic basis of cardiomyopathy in dialysis patients (abstract). Kidney Int 1982;21:161.

7. Ali M, Fayemi AO. Pathology of Maintenance Hemodialysis. 1982. Springfield, CC Thomas, pp 84-91. pp 302-5.

8. Ali M, Fayemi AO. Pathology of Maintenance Hemodialysis. 1982. Springfield, CC Thomas, pp 84-91. pp 238-250.

9. Fayemi AO, Ali M, Braun EV. Oxalosis in hemodialysis patients: a pathologic study of 80 cases. Arch Pathol Lab Med 1979;103:58-62.

10. Ali M, Fayemi AO. Pathology of Maintenance Hemodialysis. 1982. Springfield, CC Thomas, pp 84-91..

11. Fayemi AO, Ali M. Malignant neoplasms in long-term hemodialysis patients. J Med Soc NJ 1979;76:497-500.

12. Fayemi AO, Ali M. Acquired renal cysts and tumor superimposed on chronic primary kidney diseases: an autopsy study of 24 patients. Path Res Pract 1980;168:73-83.

13. Ali M, Rigolosi R, Frascino J, Fayemi AO. Iron overload in hemodialysis patients (abstract). Kidney Int 1979;16:880,.

14. Ali M, Rigolosi R, Frascino J, Singer R, Fayemi AO. Discordance between serum ferritin and bone marrow iron in dialysis siderosis (abstract). Kidney Int 1981;19:141.

15. Ali M, Ali O: AA oxidopathy: the core pathogenic mechanism of ischemic heart disease. J Integrative Medicine 1997;1:6-112.

16. Ali M: Oxidative menopausal dysfunction (OMD-II):hormone replacement therapy (HRT) or receptor restoration therapy (RRT)? J Integrative Medicine 1998;2:125-139.

17. Ali M. Ali A. Oxidative coagulopathy in fibromyalgia and chronic fatigue syndrome. Am J Clin Pathol 1999; 112:566-7.

18. Ali M: Darwin, oxidosis, dysoxygenosis, and integration. J Integrative Medicine 1999;3:11-16.

19. Ali M: Fibromyalgia: an oxidative- dysoxygenative disorder (ODD). J Integrative Medicine 1999; 3:17-37.

20. Ali M: Oxidative regression to primordial cellular ecology. J Integrative Medicine 1998; 2:4-55.

21. Ali Recent advances in integrative allergy care. Current Opinion in Otolaryngology & Head and Neck Surgery 2000;8:260-266.

22. Ali M. Oxidative coagulopathy in environmental illness. Environmental Management and Health. 2000;11:175-191.

23. Ali M. Dysoxygenosis. J Integrative Medicine. 2002;6:1-34

24. Ali M. Hypothesis: obesity is adipomyocytic dysoxygenosis. J Integrative Medicine. 2004;9:19-38.

25. Ali M. Beyond the cholesterol and inflammatory theories of coronary artery disease: The oxidative-dysoxygenative coronary disease (ODCAD) model. J Integrative Medicine. 2002; 7:1-19.

26. Ali M. The Dysox model of atherogenesis. J Integrative Medicine. 2004; 9:33-40.

27. Allayee H, Gharalpour A, Lusis AJ. Using mice to dissect genetic factors in atherosclerosis. Arterioscler Thromb Vasc Biol 2003;23:1501-1509.

28 Heuper WC. General reviews. Arch Pathol 1944;38:162-181.

29. Santerre RF, Nicolosi RJ & Smith SC. Respiratory control in preatherosclerotic susceptible and resistant pigeon aortas. Exp Mol Pathol 1974;20:397-406.

30. Bernal-Mizrachi, Gates, Weng, et al. Vascular respiratory uncoupling increases blood pressure and atherosclerosis. Nature 2005;435:502-506.

31. Sidbury JB Jr, Bynum JC, & Fetz LL. Effect of chelating agent on urinary lead excretion. Comparison of oral and intravenous administration. Proceedings of the Society of Experimental Biology and Medicine 1953;82: 266.

32. Soffer A. Chelation Therapy. Charles C. Thomas, Springfield, IL 1964.

33. Schwartz SL, Hayes JR, Ide RS, Johnson CB & Doolan PD. The nephrotoxicity of ethylenediaminetetraacetic acid. Biochem Pharmacol 1966;15:377.

34. Schwartz SL, Johnson CB & Coolan PD. Study of the mechanism of renal vacuologenesis induced in the rat by ethylenediaminetetraacetate. Mol Pharm 1970;6:54.

35. Schwartz SL, Johnson CB, Hayes JR & Doolan PD. Subcellular localization of ethylenediaminetetraacetate in the proximal tubular cell by the rat kidney. Biochem Pharmacol 1967;16:2413.

36. Stamp TCB, Stacey TE & Rose GA. Comparison of glomerular filtration rate measurements using inulin, 51Cr-EDTA, and a phosphate infusion technique. Clin Chim Acta 1970;30:351.

37. Stankovic D & Keser-Stankovi M. Effects of EDTA on liver and kidneys and protective effects of EDTA on these organs in animals treated with lead. Folia Med 1979;14:101.

38. Ali M, Ali O, Fayemi A, et al: Efficacy of an integrative program including intravenous and intramuscular nutrient therapies for arrested growth. J Integrative Medicine 1998; 2:56-69.

39. Morgan JM. Chelation therapy in lead nephropathy. Southern Medical Journal 1975;68:1001, 1003.

40. McDonagh EW & Rudolph CJ. A collection of published papers showing the efficacy of EDTA chelation therapy. Gladstone, MO, McDonagh Medical Center 1991.

41. McDonagh EW, Rudolph CJ, Cheraskin E. The effect of EDTA chelation therapy plus supportive multivitamin-trace mineral supplementation upon renal function: a study in serum creatinine. J Holistic Medicine 1982;4:146.

42. McDonagh EW, Rudolph CS, Cheraskin E. The effect of EDTA chelation therapy plus supportive multivitamin-trace mineral supplementation upon renal function: a study in blood urea nitrogen (BUN). J Holistic Medicine 1983;5(2):163.

43. Meltzer LE. Chelation Therapy. In Seven MJ and Johnson LA (eds): Metal Binding in Medicine. Philadelphia, JB Lippincott 1960.

44. Meltzer LE, Kitchell JR, & Palmon FJ. The long term use, side effects, and toxicity of disodium ethylenediamine tetraacetic acid (EDTA). Am J Med Sci 1961;242:11.

45. Khalil-Manesh F, Gonick HC, Cohen A, Bergamaschi E, Mutti A. Experimental model of lead nephropathy. II. Effect of removal from lead exposure and chelation treatment with dimercaptosuccinic acid (DMSA). Environ Res 1992;58:35-54.

46. Wedeen RP, Batuman V, Landy E. Safety of the EDTA lead-mobilization test. Environ Res 1983;30:58-62.

47. Belknap EL. EDTA in the treatment of lead poisoning. Indust Med & Surg 1952;(21):305.

48. Ali M. The Principles and Practice of Integrative Medicine Volume III: Dysoxygenosis and Oxystatic Therapies. 2003. Washington, D.C. Capital University Press (in collaboration with Canary 21 Press, New York, www.cuim.edu & www.Canary21press.com).

49. Ali M. The Principles and Practice of Integrative Medicine Volume V: Integrative Nutritional Medicine. 2003. Washington, D.C. Capital University Press (in collaboration with Canary 21 Press, New York, www.cuim.edu & www.Canary21press.com).

50. Lin J-L, Lin-Tan D-T, Hsu K-H, et al. Environmental lead exposure and progression of chronic renal diseases in patients without diabetes. N Eng J Med 2003;348:277-286.

51. Marsden PA. Increased body lead burdencause or consequence of chronic renal insufficiency? N Eng J Med. 2003;348:345-347.

52. Canfield RL, Henderson CR Jr, Cory-Slechta DA, Cox C, Jusko TA, Lanphear BP. Intellectual impairment in children with blood lead concentrations below 10 {micro}g per deciliter. N Engl J Med 2003;348: 1517-1526.

53. Hollenberg NK. Lead exposure and chronic renal failure. Arch Intern Med 2004;164: 2507-2507.

54. Yu CC, Lin JL, Lin-Tan DT. Environmental exposure to lead and progression of chronic renal diseases: a four-year prospective longitudinal study. J Am Soc Nephrol (abstract) 2004;15:1016-1022.

55. Selander S. Treatment of lead poisoning. A comparison between the effects of sodium calcium edetate and penicillamine administered orally and intravenously. Brit J Indust Med 1967; 24:272.

56. USRDS Annual Report. 2004. Washington, D.C.. page 204. And www.aksys.com/therapy/esrd.asp, as of July 13, 2005.

57. Drge W. Free radicals in the physiological control of cell function. Physiol Rev 2002;82:47-95.

58. Nohl H. Generation of superoxide radicals as byproduct of cellular respiration. Ann Biol Clin (Paris) 1994;52:199-204.

59. Skulachev VP. Uncoupling: new approaches to an old problem of bioenergetics. Biochem Biophys Acta 1998;1363:100-124.

60. Echtay KS, Roussel D, St-Pierre J, et al. Superoxide activates mitochondrial uncoupling proteins. Nature 2002;415:96-9.

61. Nisikawa T, Edelstein D, Du XL, et al. Normalizing mitochondrial superoxide production blocks three pathways of hyperglycaemic damage. Nature 2000;404:787-790.

63. Reguera G, McCarthy KD, Teena Mehta T, et al. Extracellular electron transfer via microbial nanowires. Nature 2005;435:1098-1101.

ABSTRACT: Twenty-four years have elapsed since my first article on EDTA, co-authored with Dr. Robert C. Vance[1] first appeared. In the past 50 years, it is estimated that over one million patients have received intravenous chelation therapy with one widely used chelator, EDTA. Unfortunately, I believe we may have still failed to discover the primary mechanism(s) of action responsible for the frequently dramatic clinical improvements seen in numerous apparently unrelated conditions treated with EDTA and/or other chelators, unless it is simply that the binding and/or removal of toxic metals permits improved metabolic functioning in a variety of conditions. With science documenting the adverse effects of commonly encountered low levels of heavy metals on health, it is possible that chelation therapy is being vastly underutilized in standard medicine and that combinations of new and existing Chelating agents may need to be employed to deal with the broader spectrum of toxic metals now being identified as contributors to many if not most diseases, including aging.

INTRODUCTION

I am currently a medical consultant to two companies that are involved in food supplement sales and both of these companies sell oral EDTA containing products. Since my initial review of the available literature1 many more references to EDTA are now available[2],[3]. Unfortunately, today’s excessive focus on the potential benefits to patients suffering symptomatic cardiovascular disease has significantly, stifled the utilization of EDTA and other chelators in other conditions where I believe it should be routinely utilized, at least as an adjunct to other therapies. These indications include many common and difficult to treat conditions from acute rheumatoid arthritis and psoriasis, to cirrhosis of the liver and cancer, where clinical benefits have been described. I hope to refocus attention to the metal binding activity of chelating agents in general, so that this treatment may soon achieve its proper recognition as an adjunctive therapy in the management of many common health problems.

A BROAD VIEW OF CHELATION IN MEDICAL PRACTICE

Brain[4] and renal function[5],[6] diseases, macular degeneration[7], arthritis[8] and arteriosclerosis[9],[10], are all conditions that have been reported to show benefits from IV EDTA chelation. Over thirty documented mechanisms of action associated with the use of thisform of chelation therapy have been published. Newer developments in molecular medicine and cell signaling suggest, however, that there may be other, far more important basic mechanisms waiting to be discovered. One of these might be regulation of transcription factor NFKappa activity, which plays a pivotal role in immune dysregulation. The dramatic responses in some cases of rheumatoid arthritis in the literature may be explained with inhibition of Nfkappa by EDTA[11],[12],[13],[14]. This opens up many interesting possibilities for future chelation research in several seemingly unrelated conditions. Recent research in Alzheimer’s disease involves the cortical deposition of Abeta. This has been found to be completely reversible with zinc and copper chelation[15].

I believe that Chelation therapy for subclinical metal toxicity could soon become far more widely employed by many health care practitioners, many of whom probably will never become trained by either one of the organizations providing advanced training, or become fully certified by the American and/or the International Board of Chelation Therapy. There are many natural substances, including all weak organic acids, that are chelating agents and the public will undoubtedly soon begin self-treating with these various chelators as the health benefits of lowered levels of toxic metals becomes more widely appreciated. Accurate medical advice concerning oral chelating agents is essential. For example, research strongly suggests that cysteine-based oral chelators may, for example, re-deposit tissue-extracted mercury in the brain[16]. Neither Chlorella, nor PCA (Peptidyl Clathrating Agent) significantly chelate mercury out of the body in spite of the claims[17]. Garlic, on the other hand, appears to be generally beneficial and is documented to lower the level of lead in tissues[18], as well as to decrease platelet aggregability[19] and demonstrate significant cardiovascular and anti-atherosclerotic benefits[20],[21],[22].

Chelators may also provide beneficial effects through their influences on other substances. For example, Morrison[23] documented as much as 90% reduction[24] in incidence of acute heart attacks, using his polysaccharide-based formula[25]. By adding EDTA to his orally administered formula, we found that blood coagulability was reduced using the Chandler Loop test[26],[27] (Gordon, GF, unpublished observation).

BYPASS VERSUS NEW IMPROVED COMPREHENSIVE CHELATION THERAPY

New developments focusing on the role of inflammation in cardiovascular disease[28],[29],[30],[31],[32],[33], clearly suggest that intravenous EDTA chelation therapy can no longer reasonably be considered as a primary or single complete therapy for the long-term management of cardiovascular disease[34].

Administration of IV EDTA offers many dramatic benefits including improved blood flow, and it deserves far greater recognition as a part of any comprehensive cardiovascular supportprogram. With the recent recognition that some heart conditions have as much as a twenty thousand times increase in the level of some toxic heavy metals, chelation therapy, should be far more routinely employed. Some chelators believe that there is a worthwhile distinction between arteriosclerosis and atherosclerosis, which might improve treatment outcomes. They believe there is a higher content of calcium in the arteriosclerosis and a higher lipid content of the plaque seen in atherosclerosis. One of ACAM’s co-founders, David J. Edwards (written communication, October 14, 2000), has indicated that he is observing significantly enhanced benefits from IV chelation in the atherosclerotic patient by his addition of three lipolytic agents (choline, inositol, and methionine) to the IV treatment with the EDTA. Dr Edwards believes this treatment might be thought of as “lipid stripping” enhanced chelation. He feels that the primary benefits of EDTA is related to its primary metal-binding activity, and thus arteriosclerosis with its higher calcium content should be expected to have better results than atherosclerosis where the lipid problem must be separately addressed. He tries to distinguish between atherosclerosis and arteriosclerosis by the use of either rapid CT scan or soft tissue extremity x-rays.

I believe that IV EDTA Chelation therapy for cardiovascular disease should never be employed without concurrent aggressive effective pharmacological and/or nutritional/natural product based therapy for all the newly recognized applicable cardiovascular risk factors. These include replenishment of deficient minerals that become relatively even more deficient in the face of the serious excesses of toxic metals in heart muscle cells. Furthermore it has now become essential to deal effectively with the infectious[35] and resulting hypercoagulability[36] aspects reflected in the newer cardiovascular risk panels[37].

It is now established that about 85% of sudden cardio- and cerebro-vascular deaths are due to rupture of vulnerable, non-calcified arterial plaque and subsequent clot formation.28 This form of plaque, invisible by conventional angiography, initiates a terminal thrombo-embolic event superimposed on chronic vascular inflammation, hypercoagulation and metabolic derangement as in acquired homocysteinemia. Patients who choose I.V. chelation instead of by-pass surgery hope for more than symptomatic improvement, and when some learn that they still have seriously calcified coronary vessels on ultra high-speed cat scans, they are very disappointed. Some mistakenly opt for surgery at that time, even if they find they can easily sustain a far higher level of physical activity following their “unsuccessful” chelation therapy. Unfortunately most patients are unaware of the new information about Vulnerable Plaque, the kind that is actually now believed to be involved in heart attacks, and they are not told that this truly life-threatening plaque is not readily seen on any currently widely available vascular tests, including angiograms. This failure has led me to consider the standard vascular tests relied on to sell by-pass and other invasive procedures to patients, as, at the very least, unreliable and misleading. Improved oxygenation of ischemic tissues is a reasonable goal of therapy and simple improvement in exercise tolerance testing is very useful in evaluating this.

I believe that most patients seldom are adequately informed regarding the severe limitations of all surgical approaches in the management of their vascular disease. In fact, since the vulnerable plaque involved in 85% of heart attacks and strokes cannot be seen with modern technology, their heart surgery is generally attacking the wrong plaque and thus is providing little, if any, long term benefit at great expense and risk. It is now widely believed that the underlying cause of death in heart attacks and strokes is from a blood clot related to vulnerable soft plaque due to anactive infection in the arterial wall, often caused by herpes related cytomegalic virus or chlamydia pneumonia. Current research calls for treating the blood to prevent these life-threatening clots, not the blood vessel.24

I hope that wider dissemination of this new information will help lead to the end of the largely useless surgical attack on coronary vessels so rampant today. In fact, some believe that operating on infected tissue is poor medical practice, which happens frequently with unstable angina as shown by elevated C-reactive protein levels that standard medicine has such difficulty managing. In fact, Dr Terry Haws has informed me that using the cardioCRP test offered by Quest Labs, that the majority of his new patients are coming back reported as “at risk” (verbal communication). It appears that just as “safe” levels of cholesterol and homocysteine tests, over time, were moved lower and lower, the same can be anticipated with c-reactive protein testing as more data regarding “ideal” values is accumulated. The infection that apparently we all have in our vascular tissues causes hypercoagulability, resulting in local ischemia that is far better treated medically[38]. Of course, intravenous chelation always has a place in the management of any ischemic process. We all routinely expect to see improved circulation in 85% or more of our chelation patients[39] and there are over thirty potential beneficial actions of EDTA to help explain this improved blood flow.

I believe that with our improved understanding regarding the need for effective control of hypercoagulability in virtually all ill patients[40], it may be beneficial to routinely add a more therapeutic level of intravenous or subcutaneous Heparin[41], along with more aggressive therapeutic levels of intravenous Vitamin C, in our efforts to manage this newly identified epidemic of hypercoaguability/infection related problems. 4,000 to 6,000 units of Heparin, based on weight, administered subcutaneously b.i.d. are safe, for a therapeutic trial of several weeks, without doing specialized coagulation studies in patients without a history of serious bleeding disorder (personal communication with David Berg, May 3, 2000). Longer term use of oral enzymes[42] or daily heparin injections to decrease fibrinogen concentrations and soluble fibrin monomers appear to greatly facilitate the treatment of any chronic infectious process36.

Appropriate enteric-coated oral enzymes containing bromalain and/or heparin injections decrease fibrinogen concentrations and soluble fibrin monomers to facilitate the treatment of any infectious process. A safe approach in helping to combat infection can be with colostrum and colostrum-based transfer factor[43],[44],[45],[46] and other immune enhancing and cardiovascular supporting nutritional supplements[47],[48],[49],[50],[51]. All are now better supported with a new, non-acidic, neutral pH, well-tolerated form of oral Vitamin C, and/or Vitamin C infusions. The already high efficacy of combinations of these natural approaches in dealing with any infectious process has recently been significantly enhanced by an effective extract of gram-positive bacteria known as muramyl polysaccharide glycan complex. This has been found to enhance immunity against all infections, and even shows anti-tumor activity[52].

We no longer have to rely on the long-term use of largely ineffective antibiotics alone for the control of chronic and often resistant infections now recognized in the hypercoagulability problem. Antibiotics alone have been shown to be inadequate for long-term control of chlamydia, although currently some experts are recommending a full year of azithromycin,35 or the other chronic hidden infections found in the vascular wall that is now clearly implicated in
deaths from vascular disease[53].

I believe that the optimal use of EDTA in clinical practice needs to be totally repositioned, probably as an adjunct to most other therapies, providing improved management of most chronic diseases, since its primary function is eliminating excessive levels of metals. I fear negative outcomes from currently proposed and/or ongoing chelation cardiovascular studies where removal of the wrong plaque is the focus and the ethical dilemma in blinding any study may seriously jeopardize any studies[54]. If, on the other hand, trace element studies are done to document the significant detoxification benefits seen with chelating agents, and long-term outcomes and quality of life data are compared to standard therapies, the combination of this data should offset any detected failure to simply remove plaque. Combined with safe, effective, natural treatment of all the newly recognized risk factors, such a comprehensive chelation protocol, I believe, would produce exceptional results. Since we have now entered the age of Einsteinian, molecular-based cardiology, nothing but the elimination of most by-pass surgery, a Newtonian concept, should be the goal.

Generally, the toxic metals removed by intravenous EDTA chelation simply start to re-accumulate once the treatment is discontinued. Thus, a number of oral chelators, including ascorbic, malic and lactic acids[55], may help maintain chelation benefits more cost effectively over a lifetime. Another approach is to reduce the biologic availability of heavy metals. For example, selenium binds mercury, markedly diminishing its potential for biologic harm, and many naturally occurring substances such as rutin and lactoferrin have been shown to have chelating properties. There is however, no single chelator available today that can effectively deal with the wide spectrum of potentially toxic metals that have been implicated in the degenerative diseases associated with aging. Thus, I believe that a broad spectrum of natural and/or pharmacological agents with chelating ability would be predictably more effective. My experience is that a comprehensive preventive approach can be effective even in high-risk patients, i.e. those with documented hi-grade involvement of two or three vessels.

For example, eicosapentaenoic acid supplementation[56],[57] augmented with garlic[58], ginkgo, EDTA activated polysaccharides, bromelain and rutin can all be effectively employed synergistically in such a comprehensive broadly based protection program.

There is no critical need for monitoring with bleeding or clotting tests patients maintained on such a program since there is no significant risk of pathologic bleeding. It is, however, important to emphasize to the patient that this protection must be continuously maintained. Aspirin and NSAID’s reportedly contribute to over 16,000 deaths each year[59], largely as a result of induced G.I. bleeding. The benefits from aspirin and Coumadin are seriously limited24. The use of modern platelet aggregation and fibrinogen studies can show patients just how incomplete their standard drug protection is. By later repeating these tests after initiating a comprehensive natural product based anticoagulant program, patients can generally see the remarkably improved level of protection they now enjoy with little or no side effects.

The Homeopathic Medical Board of Arizona Chelation Peer review committee that I chair has currently advised physicians in Arizona that all chelation informed consent procedures for cardiovascular disease should specifically spell out the important caution that, even thoughpatients may enjoy tremendous symptomatic improvement, actual (regular or visible) plaque reversal as measured and relied on today for prescribing life-threatening vascular surgery, may not be occurring.

BLOOD CLOTTING

Berg38 has shown that a coagulation panel that is more sensitive than hitherto available is capable of distinguishing healthy from unhealthy subjects with over 95% accuracy. In fact, hypercoagulability is associated with a large number of chronic diseases.39

Since EDTA prevents clotting in blood collection tubes used daily, I believe more sensitive tests may show some subtle reduction of hypercoagulability. Possibly lowering the number of adhesion molecules, or soluble fibrin monomers, may be one of its subtler, but life saving benefits. The combination of a polluted environment, stressful life style and chronic low-grade infection leading to hypercoagulability, initially called the AntiPhospholipid antibody syndrome, has now more recently been renamed “immune system activation of coagulation” (ISAC). It appears to be surprisingly common and those at risk need long-term effective but safe lifelong anticoagulation treatment. Aspirin alone is too weak and too dangerous to handle this epidemic of hypercoagulability. It has also recently been reported to be too dangerous for men with hypertension to take on a regular basis[60]. Effective aspirin substitutes include pancreatic enzymes (Wobenzym)[61] and properly stabilized bromelain supplements, preferably used in combination with garlic, Ginkgo, and salmon oil. A polysaccharide/ chelation based product, containing EDTA, also acts as an effective aspirin substitute and affordably helps to meet this nearly universal need[62].

ORAL EDTA

Chelating agents are routinely added to our food supply so that EDTA, for example, is added to foods for its ability to bind with the transition metals, particularly iron and copper[63]. These agents inhibit rancidity in substances such as oils[64],[65]. This has led me to consider the potential benefits from the non-absorbed fraction of orally ingested EDTA, which, I believe, may help prevent oxidative degradation within the intestinal tract, just as phytic acid has been reported useful in chelating iron, which acts as a catalyst in the development of colorectal cancer[66]. Many oral-chelating agents, including EDTA, might provide long-term protection, including helping to prevent potential intravascular coagulation[67],[68],[69],[70]. Remarkable responses have been attributed to various chelating agents, including DMPS, Penicillamine, Desferoxamine, as utilized by Paul Cutler (personal conversation, October 7, 2000) in the treatment of diabetes, infections and cancer and EDTA[71],[72] in an extremely diverse number of conditions[73],[74],[75].

There are, in fact, over 300 references to the use of oral EDTA3. Nonetheless, there are many knowledgeable clinicians who are very negative about the oral ingestion of EDTA and who raise
questions about its long-term safety. Recently published research has more than adequately rebutted those concerns63, 64,[76]. I believe that the benefits of lowered levels of toxic metals and diminished availability of transition metals more than offsets any theoretical concerns about potential essential trace mineral depletion, about which I believe we have adequate knowledge to monitor and treat[77],[78], and some research suggests that minerals become more bioavailable[79]. Since only 5% of orally ingested EDTA is absorbed, taking 1200 mg for a year would provide at least some of the benefits seen from receiving 10 intravenous therapies of 3gm each a year[80],[81].

I am totally convinced that there are significant benefits from oral chelation for patients unable to undergo a more complete program of intravenous therapy, and further that oral EDTA helps provide for an effective maintenance program even for those who are concurrently undergoing a series of intravenous chelation treatments[82]. Oral EDTA for the treatment of asymptomatic lead toxicity was FDA approved for the indication “to increase the excretion of lead.” This is described in the Physicians’ Desk Reference (PDR) through 1976, with obvious supporting references in the FDA files, complete copies of which we are still attempting to obtain. We, as licensed physicians, specializing in Chelation Therapy, I believe are fully responsible and probably legally liable to become adequately informed about the pro and con of all forms of chelation therapy, if we are to adequately discuss all of the available choices with our prospective chelation patients. This would seem essential if we hope to obtain a totally informed consent before prescribing chelation therapy for any reason, to our patients.

Oral EDTA probably exerts some anticoagulant and antiplatelet effects partially by the effect of chelating calcium ions[83],[84]. It has also been shown to prolong prothrombin time[85],[86] and has effects on platelets[87],[88] and other blood components[89],[90] cell membranes[91] and has cholesterol-lowering potential[92]. EDTA has also has been the subject of a US patent[93] because some therapeutic substances, especially sulfated polysaccharides, like heparin, which previously were only effective when given parenterally, became orally effective in the presence of EDTA.61 Oral EDTA therapy was discussed in the Waukegan News-Sun, because a soap manufacturer, Neil Purdy, was supplying EDTA powder to anyone who contacted him[94]. A physician, Dr. James Mercer of Lenexa, Kansas, was favorably disposed to recommend this treatment to his cardiovascular patients. Dr. Mercer received a letter because of the improvement seen in a shared patient, from Dr. Sawyer, Professor of Surgery, State University of New York (written communication November 9, 1971) as well as a letter of support from Loren Parks, Director of Parks Electronics Laboratory, Cardiovascular Instrumentation of Beaverton, Oregon (written communication June 13, 2000). The oral EDTA therapy program recommended to those patients involved taking 3gm of sodium EDTA given in 6 ounces of preferably grapefruit juice or a Vitamin C drink. Additional mineral supplementation was advised for the patients. Dr. Mercer also reported a consistent lowering of cholesterol and triglycerides in the over 100 patients he treated with this regimen.

Studies have been published measuring urinary and fecal lead excretion induced by oral EDTA[95]. However, the use of EDTA in the treatment of lead-poisoned workers fell into disfavor because of abuse by industrial-based physicians, who ignored the basic axiom of good medical practice, which is to remove as much as possible the source of exposure, rather than concentrating on the less expensive prescribing of oral EDTA tablets to lead workers[96]. Inspite of this, the PDR through 1976 under Riker continued to list calcium disodium Versenate tablets with the only approved indication, to increase the excretion of lead[97].

The body has many metal binding substances, including albumin, metalothioneins, ferritin, ceruloplasmin, transferin, and others. A reasonable hypothesis may be that additional chelators further support our health by enhancing our body’s ability to handle free metal catalyzed reactions. The reason that EDTA is routinely added to the food supply today is to help prevent the oxidative degradation of nutrients by chelating the transition metals. Our individual consumption of EDTA from food sources is estimated to average between 15mg-50mg per day. There has been concern raised that the widespread use of EDTA in our food may have an adverse effect on the environment because EDTA was non-biodegradable and may have increased the solubilization of heavy metals, particularly cadmium[98]. Increasing low levels of EDTA in the environment may lead to the enhanced uptake of heavy metals, particularly cadmium, in living tissues. Fortunately, I believe we can neutralize this concern because cadmium had been shown to respond to adequate therapeutic administration of oral EDTA[99],[100],[101]. EDTA has a 40-year history of oral use in asymptomatic patients with laboratory evidence of lead accumulation and can safely be given continuously in doses of up to 1gm a day to adults. Concomitant administration of essential trace elements, especially zinc, is obligatory. Its safety seems to be firmly established, and the potential of mineral depletion seems to be minimal.63,[102].

In fact, at the NIH/ODS Bioavailability Conference the ENVIRON International Corporation report on mineral absorption listed EDTA as a dietary factor enhancing absorption and bioavailability of zinc along with protein, cysteine, citrate and methionine[103].

In a recent recorded and published interview by ACAM member and Diplomate of ABCT, Ron Kennedy, MD, of Santa Rosa, California, on the subject of oral chelation[104], I provided more of the historical background to further assist others in understanding some of the potential clinical applications of oral chelation.

The central role of iron in catalyzing free radical pathology, and consequently upon health span and longevity, belies the common clinical perception that iron saturation is preferable to the risk of deficiency. Epidemiological studies show that iron stores, as measured by serum ferritin, accumulate four times faster in males than pre-menopausal females and that cardiovascular disease is also four times more likely in age-matched men. Monthly menstrual iron losses may thus mitigate cardiovascular risks in a manner analogous with the chelation of excess free iron, inasmuch as hysterectomy, even with intact ovarian function, abolishes the protective effect[105]. Similarly, regular blood donors show decreased incidence of myocardial infarction and cancer, recalling the Swiss experience with regular EDTA rapid IV injections of Calcium Disodium EDTA in carefully monitored patients over almost two decades. For example, the level of lead has now been shown to relate directly to IQ[106]. This suggests that it would be prudent to offer some form of oral chelation to every student, recognizing the cost and importance of education in our society.

CHELATION AND HEAVY METALS

Chelation therapy benefits may still however be primarily the result of the obvious heavy metal detoxification. Blumer[107] showed dramatic long-term benefits from parenterally administered calcium disodium edetate that clearly support the concept that we all may live far longer and healthier lives by simply decreasing our body burdens of lead. Occult lead intoxication has been documented to be a cause of hypertension and renal failure[108], and the disappearance of immune deposits in a patient with renal impairment due to low-level lead toxicity has now been demonstrated by renal biopsy before and after EDTA chelation[109]. It has also been reported in one study that 4 out of 6 patients being treated for renal failure who developed gout de novo had underlying plumbism[110].

The future of combined chelation agents appears promising and largely understudied. The combined use of EDTA and DMSA shows clear advantages if the primary focus of therapy is identified- namely to reduce body burden of heavy metals such as lead[111]. With lead toxicity still being an epidemic in the US, there is still no standardization in its therapy. Less than one-third of responding lead clinics report utilizing oral chelation as the agents of choice even though the 1984 consensus statements fully describe the use of penicillamine. Oral DMSA also appears to be safe and effective for the treatment of childhood lead poisoning. There is still no consensus regarding the use of provocative testing or protocols for treatment[112].

Olwin[113] was one of the earliest investigators to recognize that blood flow improvement in vascular disease patients from EDTA chelation was very probably due to removal of lead. At that time, over twenty years ago, most experts were unwilling to accept this all too obvious explanation. This was partly due to our lack of understanding regarding the subtle adverse effects we are all suffering from as a result of the over 1000-fold increase in lead levels in average bone tissues today over pre-industrial levels. Since then, we have become much more knowledgeable about the magnitude of these increases in average lead levels and the adverse health effects associated with them[114],[115],[116],[117],[118]. Research to document whether or not most chelation benefits are primarily from deleading effects alone, however, is complex and expensive. Furthermore, we cannot readily find a “control group” that is not significantly lead-burdened anywhere on our planet today. Experts now generally agree that there is no safe level of lead[119],[120],[121],[122]. This may make proving what chelation really does as complicated as that involved in documenting the adverse effects of second-hand smoke, from which virtually no one was truly escaping. Since everyone had some of the adverse exposure it was not simple to prove the long-term benefits of a smoke free, or in this case, a low lead internal environment[123].

Over the past twenty years, the so-called “safe levels” of all potentially toxic metals have gradually been lowered to the point that I believe that no one is escaping at least some of their adverse effects[124],[125],[126],[127]. This would suggest that everyone would have better health and respond better to the management of any disease process if we could safely and cost effectively assist them in controlling some of these toxic metals now seen in all living tissues. Therapeutic assistance might be either through simply increasing the capacity of the body to bind free metals safely, or by effectively removing them through some form of chelation therapy. We need to establish some standards for the responsible use of chelating agents. There are millions of children in the world suffering from sub-optimal health because of toxic metal overload[128].

Upon finding at least a doubling of the excretion of a known toxic metal in a provoked urine specimen, compared to baseline tests, it would be reasonable to suggest some form of chelation, preferably oral.

We know that there are numerous published papers describing adverse effects with cadmium[129],[130],[131],[132], aluminum[133],[134],[135],[136],[137], mercury[138],[139],[140],[141],[142], iron and copper[143]. Crapper-McLachlan[144],[145],[146],[147] has done extensive studies relating aluminum to the aging process. The mercury issue, thanks primarily to dental fillings, continues to wreak havoc on our health[148],[149],[150]. With the public’s interest in anti-aging and detoxification, it appears reasonable that many will choose to detoxify themselves with whatever non-prescription chelators with which they become aware. We should be able to augment their efforts with knowledge and therapies they cannot self-administer.

Whenever possible, it makes good sense to remove the patient from a lead or other metal contaminated environment, but this is frequently not possible. Abuse of this principle by physicians working for the lead industry resulted in subsequent confusion regarding the benefits from the use of oral EDTA[151]. They failed to follow the simple and basic principles of ethical medicine since nothing was done to clean up the workers’ environment. They chose instead to administer the inexpensive tablets of oral EDTA to the workers in order to maintain their blood lead levels in acceptable ranges, so they could continue working. Therefore, workers remained at risk on the job. This led to the American Medical Association condemning the use of oral EDTA in lead poisoned workers, although the tablets were FDA approved for treating asymptomatic lead poisoning, with the recommended dose of 1000 mg per 35 pounds body weight.

With increasing research documenting the danger of elevated iron levels, and the life-prolonging benefits associated with regular donation of blood, it is beginning to become quite clear that it may become malpractice to prescribe iron to patients without documenting their need. Many believe that it is the lower levels of iron that is primarily responsible for the increased life span of women over men. Research on a new oral iron-chelating agent under study shows dramatic benefits including protection against skin cancers, skin aging, ultraviolet protection and significant neural protection in trauma.

The initial observation of symptomatic improvement in chest pain in patients receiving EDTA for lead poisoning was coincidental[152],[153],[154]. This led to many years of research on the effect of various chelating agents, whether administered orally or intravenously.

The many potential benefits from the chelating effects of toxic and transition metals have already been mentioned and we may come to realize that we have seriously under-utilized all forms of chelating agents in medical practice today due to our lack of appreciation of the tremendous increases in total metal burden we all face as a part of today’s environmental degradation[155]. Current research regarding the adverse effects from our increased lead burden and the more recently recognized iron overload problem[156],[157],[158],[159],[160] warrants every physician becoming knowledgeable in the appropriate use of oral and parenteral chelators and/or metal binding substances. It may not be necessary to completely remove a toxic or transition metal to obtain significant clinical benefits, as simply binding it, thus making it less available,
may markedly diminish its potential for harm.

Experts in chelation chemistry (bio-inorganic chemists) such as David R. Williams[161] have suggested that most health problem can be shown to involve a deficiency or excess of trace minerals at some level. The fact that Dimethylpropanyl sulfate (DMPS) was used by Russian investigators[162] in the treatment of atherosclerosis and they reported and measured improved circulation I believe further suggests that the primary beneficial action from chelating agents is from reduction of our ubiquitous toxic metal burden, although life-extension benefits may be more directly related to the associated reduction in free radical pathology.

CALCIUM AND CHELATION

One of the paradoxes of aging is the occurrence of osteopenia in conjunction with vascular and soft tissue calcification, the precise cause of which is unknown. A deficiency of Vitamin K is an integral part of this undesirable pathologic calcification process[163],[164]. This is a complex process since coronary calcification is markedly increased in hostile young adults[165].

Nearly 90 percent of young dialysis patients have coronary calcification 2.5 to 5 times more than normal, raising serious questions about the current practice of aggressive calcium supplementation to offset the disturbed phosphorus metabolism in these patients. Those consuming the highest intakes of calcium revealed the most calcified vessels. Some of the worst levels were seen with associated elevations of c-terminal parathyroid hormone and this was also related to lower bone density[166],[167],[168].

Until effective prevention of this process becomes more widely available, the anti-aging benefits of chelation to reduce calcium content in vascular tissues remains highly desirable. However, it is clearly not a routinely predictable outcome. It should always be employed in association with the therapeutic modalities already discussed. After reviewing hundreds of radiograms before and after IV EDTA chelation, it is clear that grossly visible pathologic calcification is generally reduced[169], as I have seen on hundreds of before and after radiograms from the practice of Dr. Ray Evers (Gordon GF. Unpublished observation) even in nephrocalcinosis, calcinosis universalis[170],[171] and Mnckeberg’s sclerosis[172]. Extensive calcification of arteries was seen in radiographs of the 5,000-year-old “Ice Man” and in Egyptian mummies. Therefore, calcification of arteries is not a new disease. Sudden death from heart attack I believe is a modern, separate new, problem. The current research on hypercoagulation due to chronic inflammation may be a plausible explanation for how this is superimposed on arteriosclerosis.

Aging, Lead and other heavy metals

Davies[173] showed that aging was associated with a gradual decrease in the levels of essential trace elements and a gradual increase in the levels of potentially toxic metals. Thus, chelation of heavy metals[174], together with replacement of essential elements is a logical step in the control
of aging[175].

In considering the phenomena associated with aging, Tyler found that EDTA increased the life span of sea urchin sperm cells significantly by adding it to the seawater medium. The same kinds of results were observed in cells from roosters and steers[176]. The decline of hormone levels with aging has been the subject of considerable interest, and much attention has focused on exogenous replacement strategies or attempts to re-stimulate endogenous secretion and release. Another potential benefit is suggested by the finding that lead lowers brain energy levels[177]. Energy is essential for optimal health and the achievement of our maximum useful lifespan. Furthermore, Low-level lead exposure has recently been shown to speed up brain aging[178]. Also the immune system has been shown to be more vulnerable to low levels of lead than other organ systems, leading to increased incidence of infectious disease and neoplasia[179]. The ability of EDTA to remove low levels of lead and other toxic metals, which we might then expect to favorably influence immune, metabolic and endocrine function, appears to be worthy of further study. Oral DMSA has been found to chelate mercuric residues, and urinary recovery of mercury was shown to correlate with increased human growth hormone levels[180]. The role of EDTA in the reversal of cross-linkages as a potential mechanism for the correction of biological aging was carefully reviewed by Carpenter[181]. The dramatic life-span prolongation following EDTA exposure in prokaryotes and eukaryotic germ cells deserves further study[182],[183],[184] as is the apparent improvement of general health commonly observed in humans from exposure to intravenous EDTA that may be partially explained by preventing or reversing the pathologic calcium accumulation seen in the aging of all mammalian cells[185].

Research indicates that a combination of several chelating agents offers significant anti-aging potential and EDTA may still find a major role in longevity medicine.

CONCLUSION

The potential contribution of chelating agents such as EDTA to the health of mankind can be greatly augmented as we begin to appreciate the wider implications of their basic detoxifying activity[186]. We now have the unparalleled history of over 40 years of extensive and safe use of EDTA, with studies showing increasing life span in research models. Oral EDTA in our toxic world may become as essential for health as an essential nutrient, and it appears to offer potential benefits as diverse as those seen with some essential nutrients, suggesting we all carry a greater burden of toxic metals than is in our best interest for achieving either optimal health or our maximum intended useful lifespan. The completed human genome project will help us better appreciate human biochemical individuality so someday we may even know in advance which patients will have the more dramatic clinical improvements and apparent age-reversal that we have all seen in some of our patients with EDTA.

It is my belief that virtually everyone could benefit from the continuous lifetime ingestion of EDTA, and/or other chelators, to help offset the increasing burden of toxic and free metals coming from our degraded environment. By contrast, it has been proposed that 50 percent of theAmerican public should be on lipid lowering drugs[187] and the Pharmaceutical industry is seriously proposing that such medications become available over-the-counter[188] so that the public can self prescribe these clearly not innocuous lipid lowering drugs. We must move toward evidence-based medicine. The skyrocketing costs of largely ineffective and soon unaffordable orthodox cardiovascular health care have been outlined in detail[189]. I suggest that over-all health benefits from lowering toxic metals in everyone would far exceed those from administering statins to one-half of our population, with less risk, and less cost, since oral EDTA costs little more than vitamin C, and when combined with garlic[190] would provide a broader spectrum of affordable chelation activity.22

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HICC Corporate Rapid Test Package will get your workplace ready as you reopen during this pandemic

The outbreak of the novel corona virus (Covid-19) and the ongoing incidences of infected cases have prompted worldwide concern. Companies, organizations, and all business sectors, realizing the impact of this global pandemic, need to adapt secure practices and preventive measures before resuming operations.

That said, as you reopen your business, it is utmost important to bring back your employees safe. Similarly, you have to ensure your workplace remains Covid-19-free because this virus causes severe infection with no specific cure and known vaccines to date.

The best way to protect your staff is to invest in their healthcare and get them tested for Covid-19 so they can take appropriate actions to safeguard their health.

While test kit shortage still leaves a ton of workers unable to be tested, especially in areas with high Covid-19 cases, the Food and Drug Administration (FDA) has approved the use of Rapid Test Kits to address the crisis. These Rapid Test Kits are not intended for personal use and can only be administered, evaluated, and interpreted by licensed medical professionals.

We at Holistic Integrative Care Center (HICC) are happy to share that we have made these tests accessible and affordable for employers like you.

 

Corporate Rapid Test Package

Our Corporate Rapid Test Package uses a one-step Covid-19 (SARS-CoV-2 Antibody) Test that yields instant result in 15 minutes. The test is accurate with high sensitivity and specificity; it’s very easy to use; it is approved by the FDA, the World Health Organization and the Foundation for Innovative New Diagnostics; and it’s CE marked—which means it complies with the essential requirements of the relevant European health, safety and environmental protection legislation.

Furthermore, our Corporate Rapid Test Package offers several service provisions you can choose from based on your business needs:

(1) Rapid Test Kit + Nurse
(2) Rapid Test Kit + Diagnostic Center Professionals
(3) Rapid Test Kit + Medical Professionals with Orientation and Assessment

To complete the process of the rapid testing, we also discuss the next step following the interpretation and assessment. We have laid out appropriate therapies and treatments pertinent to the test results. All this, because we at the HICC, being a prominent internationally-accredited Integrative Medicine healthcare provider, are committed to providing our clients with the best possible care and valued support.

With our Corporate Rapid Test Package, we will help you prevent the spread of Covid-19 and at the same time uphold your strong duty to ensure the safety of your employees who are the backbone of your company’s success. We will help you prioritize their health and wellbeing during this pandemic and beyond. Both you and your employees ultimately benefit in this situation.

If you want to learn more about our Corporate Rapid Test Package or if you want to schedule corporate testing, you may contact us at:

Mobile nos.: 09089443363 | 09176224565
Telephone no.: 02 7744 5355

Our medical facility is located at 5th Floor Bernnman Centre, 28 Quezon Avenue, Quezon City, Philippines

You may also check our website to know more about our products and services, https://www.hiccph.com/

Follow us at our Facebook page www.facebook.com/hiccph/ for promotions and live updates.

By Jyren Imperial

The number of Cancer cases in the Philippines in 2018 was at 141,021 with 86,337 total deaths according to the World Health Organization. The highest incidence rate at 24,798 is Breast Cancer affecting all female patients while Lung Cancer has the highest incidence rate at 12,086 for male patients.

In 2019, more than 1.7 million people in America will be diagnosed with Cancer. Cancer is a major public threat worldwide. If not detected early, it will not only cause a burden on the patient but it will be a difficult experience that will change the lives of the whole family. Aside from the physical challenges and emotional pain because of Cancer, the financial cost of Cancer treatments is also a burden to the patients and their families.

Cancer is not a single disease but a group of similar diseases. Cancers don’t develop overnight. Our genes, lifestyle, the environment around us, and eating habits can develop our risk of acquiring Cancer. Reduce your Cancer risk with these cancer-fighting steps to naturally prevent Cancer before it starts.

1. Give Up Sugary Drinks ​ — Sweetened beverages can speed up the growth of endometrial cancer, a type of cancer that begins in the uterus. Cancer Council Victoria found out that one soft drink a day could increase your risk of cancer. Sugar is the key contributor to Cancer tumor and may also increase the risk of obesity and diabetes. So drop that another round of sweet drink and switch to water.
2. Avoid tobacco ​ — smoking has been linked to many types of Cancer — such as cancer of the oral cavity, larynx, esophagus, and lung. Also, regular smokers are at higher risk of developing heart disease and other lung diseases. It is also important to note that even exposure to secondhand smoke will also increase your risk of lung cancer. Staying away from tobacco — is an essential phase of preventing Cancer. Be motivated to quit and avoid tobacco rather than live with chronic heart disease and Cancer. Ask your doctor for strategies and alternatives to help you in quitting tobacco.
3. Stand more and sit less ​ — The American Cancer Society discovered that women who spend 6 hours or more time sitting per day have a 10% greater risk of getting cancer than women who spend less than 3 hours of free time sitting. According to Reader’s Digest, people who consume most of their day sitting are at a 24 percent advance risk for getting colon and endometrial cancer than people who spend less time in a chair.
4. Eat Steamed Broccoli ​ — A Cancer-preventing superfood that you should eat often. Italian researchers found that steamed broccoli has more glucosinolate ( the healthy component of the vegetable) compared to boiled or fried broccoli. The nutrients of this power veggie seep into the cooking water when boiled instead of staying in the vegetable according to the Harvard Family Health Guide.
5. Drink Green Tea ​ — Scientific studies show that green tea extracts can stop cancer cells from spreading. The healing capability of green tea has been respected in Asia for many years. Scientists believe that a chemical compound with antioxidant properties found in green tea has an anti-tumor (anti-cancer) effect.
6. Visit your Doctor Regularly ​ — Regular health exams and tests can help you find health concerns before they start. By getting the proper healthcare screenings and treatments, you are taking actions that will help your chances of living a fulfilling and healthier life. It is important to always check with your doctor with any health concerns to address it right away. Dr. Imelda S. Edodollon is an Integrative medical doctor which identifies the root cause and prescribed necessary supplements and treatments that will improve or advance in the reversal of the disease.
7. Look For Holistic Medicine ​ — In the quest for optimal health and wellness, Ozone therapy is one of the most versatile forms of therapy available today at Holistic Integrative Care Center (HICC). Their internationally certified medical doctor, Dr. Imelda Edodollon uses the ​highest specifications and international procedure. ​Ozone therapy fights and prevents Cancer, it is beneficial for Cancer patients as part of a holistic approach to treat Cancer alongside chemotherapy and radiation. This will also boost the immune system to fight and prevent cancer naturally.
   

Holistic Integrative Care Center (HICC) is located at UG 11 Cityland Pasong Tamo Condominium, 6264 Calle Estacion, Brgy. Pio Del Pilar, Makati City.
Take charge of your overall health and set an appointment with them at (02) 744-5355 | 0917-622-4565 | 0905-457-4458 and 0943-292-3910.

By Jyren Imperial

Being a SuperMom is the coolest, hardest and most noble job in the world. As amazing as it is, becoming a mother has its exciting and demanding shifts in life. Moms make a variety of sacrifices to ensure the well-being and comfort of their children. Campbell Soup Company conducted a study and found that 53% of moms don’t get enough sleep; 47% miss out date nights and 47% neglect hobbies or time with friends. Their nutrition is also suffering because 62% don’t always have time to sit down and eat a decent meal causing 53% to struggle in eating healthy food because of dedicating an unbelievable amount of time to their children every day.

New research has found that moms spend 97 hours a week parenting. Can you imagine that all the jobs are done by moms? From nurse, teacher, chef and many more. Therefore, moms are left less than an hour of ‘me time’ per day. Joint pains, back pain and general body pain can be tough for SuperMoms that always support and care for their children.

While arthritis can happen in any joint in the body, doctors say that the ones we used the most are more affected such as hands, feet and the weight-bearing joints like the back, hips, knees, and ankles. The symptoms can vary from Pain, Stiffness, Swelling, Tightness in the joint or cracking and Decreased range of motion. Most SuperMoms experience these symptoms while doing some type of physical activity.

There are more than 100 types of arthritis. Osteoarthritis is the common one that develops in joints with overuse. Rheumatoid arthritis is another type that is an autoimmune disease in which your immune system attacks your joints. While the diagnosis is common doctors say treatment varies depending on the cause.

Here are the 7 Proven Ways SuperMoms Can Manage Arthritis Pain

1. Start an arthritis exercise program – First, you have to understand what type of activity is within your limits and level of exercise is appropriate to your type of arthritis. A mild to moderate exercise can help ease arthritis pain and stiffness such as stretching, walking, water aerobics and flowing movements, such as tai chi and yoga.
2. Achieve to lose some weight – dropping one pound of weight will result in four pounds of pressure being eliminated from the knees based on a 2005 study of the Arthritis Foundation. A 2010 study from the University of Paris published in the Annals of Rheumatic Disease indicated that weight loss can lessen pain, improve function and lower inflammation levels in the body.
3. Change your eating habits – Eat at least 3 to 4 ounces of fatty fish twice a week because they’re highest in anti-inflammatory omega-3 fatty acids and vitamin D, which are both beneficial for minimizing the inflammation and symptoms of arthritis. Adding garlic, ginger, broccoli, walnuts, berries, spinach, grapes, and olive oil to your daily meal will bring powerful components that may bring relief from inflammation and arthritis. This food will be beneficial for your overall health because of its disease-fighting powers.
4. Drink lots of water – Adequate water consumption can lessen joint pain and other arthritis symptoms. Drinking 8 to 10 glasses of water everyday helps flush out uric acid from your body. Enough water intake can help keep your joints well lubricated and can help prevent gout attacks.
5. Choose to use a mobility aid – Having a device designed to help people who are having difficulty moving around is additional support for people with Arthritis. It will improve and assist in balance when walking and it will decrease the risk of falling.
6. Keep yourself warm at night – A lot of people with arthritis say that their arthritis symptoms get worse when the weather is cold and drizzly. Get started with heat treatments like using heating pads, taking warm baths or soaking yourself in heated water to soothe stiff joints and relax the muscle. Heat strengthens circulation, providing nutrients to your joints.
7. Talk to your doctor – If you are a SuperMom and have been enduring years of joint pain and inflammation it is best to consult with an Integrative doctor to know more about a safe, natural way to experience immediate pain relief called Prolozone Therapy. Prolozone treatment uses ozone gases to treat a variety of ailments, from chronic pain and carpal tunnel syndrome to sprains and strains. It is a form of non-surgical ligament reconstruction and is a permanent treatment for chronic pain.

Find out more about the life-changing benefits of Prolozone therapy at Holistic Integrative Care Center (HICC) located at UG-11 Cityland Pasong Tamo Condominium, 6264 Calle Estacion, Pasong Tamo Makati City.

You may reach them at (02) 744 – 53355 | 0917-622-4565 | 0905-457-4458 | 0943-292-3910. Visit their website at hiccph.com and Facebook and Instagram page @hiccph.

By Jyren Imperial

Being a SuperDad is never easy. ​To be a real dad, a hero to your kids is ​definitely ​ ​the most exciting and demanding job in the world. ​Every father can be a Superdad and it’s surely rewarding but it isn’t always simple. ​ As amazing as it is, becoming a father has its shifts in life which requires daily effort and enthusiasm.

Study shows that even though ​a lot of dads know their long-established roles as providers and disciplinarians, they believe that they can do more. They view themselves as their kids’ play companion, tutor, and travel buddy.

Dads face many challenges to ensure the well-being and comfort of their children. Based on the top advertising firm ​McCann Worldgroup Philippines (MWG) a report called ” ​The Truth About Filipino Dads” 47% of dads doesn’t have enough time, 18% enforcing discipline and 17% doesn’t have enough money. They truly have that super dad cape, however, d ​ads are still only given a week of paternity leave as to at least three months that moms have.

Joint pains, back pain and general body pain can be tough for SuperDads that always support and care for their children. While arthritis can happen in any joint in the body, doctors say that the ones we used the most are more affected such as hands, feet and the weight-bearing joints like the back, hips, knees, and ankles. The symptoms can vary from Pain, Stiffness, Swelling, Tightness in the joint or cracking and Decreased range of motion. Most superdads experience these symptoms while doing some type of physical activity.

There are more than 100 types of arthritis. Osteoarthritis is the common one that develops in joints with overuse. Rheumatoid arthritis is another type that is an autoimmune disease in which your immune system attacks your joints. While the diagnosis is common doctors say treatment varies depending on the cause.

Here are the 7 Proven Ways superdads Can Manage Arthritis Pain

1. Start an arthritis exercise program – First, you have to understand what type of activity is within your limits and level of exercise is appropriate to your type of arthritis. A mild to moderate exercise can help ease arthritis pain and stiffness such as stretching, walking, water aerobics and flowing movements, such as tai chi and yoga.
2. Achieve to lose some weight – dropping one pound of weight will result in four pounds of pressure being eliminated from the knees based on a 2005 study of the Arthritis Foundation. A 2010 study from the University of Paris published in the Annals of Rheumatic Disease indicated that weight loss can lessen pain, improve function and lower inflammation levels in the body.
3. Change your eating habits – Eat at least 3 to 4 ounces of fatty fish twice a week because they’re highest in anti inflammatory omega-3 fatty acids and vitamin D, which are both beneficial for minimizing the inflammation and symptoms of arthritis. Adding garlic, ginger, broccoli, walnuts, berries, spinach, grapes, and olive oil to your daily meal will bring powerful components that may bring relief from inflammation and arthritis. This food will be beneficial for your overall health because of its disease-fighting powers.
4. Drink lots of water – Adequate water consumption can lessen joint pain and other arthritis symptoms. Drinking 8 to 10 glasses of water everyday helps flush out uric acid from your body. Enough water intake can help keep your joints well lubricated and can help prevent gout attacks.
5. Choose to use a mobility aid – Having a device designed to help people who are having difficulty moving around is additional support for people with Arthritis. It will improve and assist in balance when walking and it will decrease the risk of falling.
6. Keep yourself warm at night – A lot of people with arthritis say that their arthritis symptoms get worse when the weather is cold and drizzly. Get started with heat treatments like using heating pads, taking warm baths or soaking yourself in heated water to soothe stiff joints and relax the muscle. Heat strengthens circulation, providing nutrients to your joints.
7. Talk to your doctor – If you are a SuperDad and have been enduring years of joint pain and inflammation it is best to consult with an Integrative doctor to know more about a safe, natural way to experience immediate pain relief called Prolozone Therapy. Prolozone treatment uses ozone gases to treat a variety of ailments, from chronic pain and carpal tunnel syndrome to sprains and strains. It is a form of non-surgical ligament reconstruction and is a permanent treatment for chronic pain.

Find out more about the life-changing benefits of Prolozone therapy at Holistic Integrative Care Center (HICC) located at UG-11 Cityland Pasong Tamo Condominium, 6264 Calle Estacion, Pasong Tamo Makati City.

You may reach them at (02) 744 – 53355 | 0917-622-4565 | 0905-457-4458 | 0943-292-3910. Visit their website at hiccph.com and Facebook and Instagram page @hiccp

Fact: Heart disease is still the leading cause of death in the Philippines. You can prevent heart disease and heart attacks with the latest medical innovations.

Heart specialists have pointed out the necessary lifestyle changes to reduce the risk of heart ailments. It requires removing the factors that lead to clogged arteries, which may cut off blood flow to the heart. If not examined, conditions such as Heart disease will start to show.

Lower the risk of getting heart disease by taking action to improve your overall health.
Start your healthy heart journey with these 8 ways to get on track.

1. Stop smoking – We know it’s hard, but it’s harder to recover from a heart attack or stroke in a hospital bed. People who smoke are more than twice as likely to suffer from a heart attack as nonsmokers. If you smoke, better start quitting. If you know someone in your household that smokes, encourage them to quit as well. Be motivated to quit rather than live with chronic heart disease.
2. Get physically active every day – Exercise at least 30 minutes a day, at least five days a week. Get that heart-pumping aerobic exercise that is good for your cardiovascular health. Being physically active is a major step towards good heart health, and it’s one of the most powerful tasks to have stronger heart muscle.
3. Aim to get and stay at a healthy weight – Losing extra weight is good for your heart. Keeping a healthy weight is vital for your overall health. It can also help you lower high blood pressure, manage diabetes and control many diseases.
4. Control your blood pressure – According to NYU Center for the study of Asian American Health 3 out of 5 Filipinos have hypertension or High Blood Pressure. When your blood pressure is high it makes the heart pump harder that can cause artery walls to swell or burst. Regularly check your blood pressure readings at home, and try to stay in your normal range.
5. Manage stress – Studies have shown a connection between coronary heart disease risk and stress in a person’s life that may increase the risk factors for heart disease and stroke. Stress increases cholesterol levels and blood pressure which will leave a bad impact on your heart health.
6. Limit alcohol intake – Regular alcohol consumption can damage your heart which can cause cardiomyopathy, diseases of the heart muscle. The high use of alcohol can also raise your blood pressure.
7. Follow a heart-healthy diet – You may be eating lots of food, but your body may not be getting enough nutrients it needs to stay healthy. Choose foods low in saturated fat, ​trans fat ​, and sodium. Include fruits and vegetables to your diet with fiber-rich whole grains, fish, nuts, etc. The good news is that there is a tasty, nutrient-rich food meal plan by NutriChef that is carefully calculated and professionally made by well- trained ​certified ​Holistic Chefs​ that fit to what your body needs. Include Nutrichef’s Keto friendly meal plan in your diet to ward off high cholesterol & heart diseases. It is guaranteed that each meal is healthy and appetizing. Try the delicious Keto friendly meal plan that comes with a free dessert.
8. Regular Check-ups are important – One out of every three deaths results from cardiovascular disease and every year heart disease is the most serious health problem in the country. However, many people who had a suspicion of related heart conditions don’t rush to their doctor’s office to address the symptoms. The good news is that we now know a form of complementary therapy that is offered at Holistic Integrative Care Center (HICC) to avoid heart problems and is used by Internationally certified Integrative Medicine doctors as an alternative to angioplasty and bypass surgery over the years.

For more details about HICC, Keto-friendly products, and services, follow them on Facebook, ​https://www.facebook.com/hiccph/ ​ or call (02) 744-5355. HICC is located at ​Cityland Pasong Tamo Condominium, 6264 CALLE ESTACION, Pio del Pilar, Makati, 1235 Metro Manila. They are open, Monday to Saturday, from 9:00 am to 6:00 pm.

For over 5,000 years, many different cultures have used these healing plant oils for a variety of health conditions. Essential oils that time were known as “materia medica” or system of healing. In 1928, French chemist, René-Maurice Gattefossé used lavender oil to heal a burn on his hand. He further studied its’ benefits that made him the father of “Aromatherapy”. Essential oils affect not only our biochemical, cellular, physical level but also our emotional, intellectual, spiritual and aesthetic areas of our lives.

Essential oils are extracted directly from the bark, flower, fruit, leaf, seed or root of a plant or tree, and just one drop can have powerful health benefits. EO’s are volatile, lipophilic, hydrophobic and do not contain allergens. They are produced through steam distillation which is the most common way of extracting oils, Cold pressing  which is used to extract oils from citrus fruits and fruit peels and the Solvent extraction or known as liquid-liquid extraction.

Fruits, flowers, leaves, seeds that are used in making essential oils are very delicate. They are carefully planted, trimmed, picked at the right time and extracted using high quality extractors. Organic essential oils have so many health benefits such as it fights cold and flu symptoms, relax your body and soothe sore muscles, heal skin conditions, alleviate pain, balance hormones, improve digestion, reduce cellulite and wrinkles, clean your home. They can be used topically, inhalation, oral ingestion and suppository. Common essential oils to start with are lavender, lemon and peppermint.

For topical use, put 2 drops to your hand then rub on beneficial areas such as; neck, forehead, temples, chest, abdomen, arms, legs, bottom of feet. Avoid skin around eyes, inner ear and broken or damaged skin. Essential oils are composed of very small molecules that can penetrate your cells, and some compounds in essential oils can even cross the blood-brain barrier.

For a better sleep, proper breathing and clean air, put 2-4 drops of oil to your diffuser and inhale the relaxing scent of it. It improves your respiratory system, and calms your body and mind. Overnight diffusion of essential oils can help you overcome insomnia, anxiety, depression and nightmares.

Oral ingestion of essential oils is highly beneficial because it will enter to your system directly, from the gastrointestinal tract, to your organs and to your cells. They are said to be lipid or fat soluble allowing them to be easily transported to all of your organs including the brain. Put 1 drop of lemon essential oil in a glass of water to prevent you from having cough and colds. You may also place 1-2 drops in a supplement capsule. A drop under your tongue is also beneficial for instant absorption. Proper dosage is 1-5 drops every 4-6 hours. To avoid essential oils toxicity daily dose is no more than 20 drops for 24 hours. There are essential oil that needs to be diluted before taking it orally like cassia, cinnamon, clove, cumin, geranium, lemongrass, oregano and thyme. Combine these oils with 3 drops of carrier oils like almond, avocado, castor, coconut and olive oil for proper absorption. Essential oil can be mixed with your cooked and raw dishes too. Make sure to put just 1-2 drops only because these oils are highly concentrated.

Essential oils can be part of your first aid kit. It is said to be essential because whenever you experience stress, headache, indigestion, allergy, wound, sting, muscle pain or injury, It’s always good to have essential oils that can subside pain and discomfort in just a few minutes.

Healing that cares inspired Dr. Imelda “Meddie” Edodollon, MT, MD, NMD in going into integrative medicine – a medical approach different from the conventional one that Filipinos are used to.

Dra. Meddie, who has been a medical practitioner for the past eight years, believes that integrative medicine is best approach in healing the whole person not just the body, but the person’s mind and soul as well. Her strong desire to make a difference made her establish the Holistic Integrative Care Center (HICC), which combines the best practices of both conventional and alternative medicine on top of her compassionate approach in handling patients.

“In the field of medicine, being healthy does not mean the absence of disease. Being healthy means that one achieved a balance of everything,” she said.

According to Dra. Meddie, integrative medicine takes a holistic approach which means that everything about a patient is being treated their mind, body and soul. It is so encompassing diagnosing a patient can take at least an hour. This field of medical science combines the use of conventional medicine, traditional medicine, herbal medicine, proper and monitored diet, lifestyle modification, psychological analysis and many other approaches depending on the condition of a patient. It establishes that sickness may be brought about by many factors such as medical background, emotional problems, improper diet, constant stress, mental conditions and even environmental conditions.

Dra. Meddie started practicing integrative medicine in 2012 and established HICC in 2015 to cater to the needs of clients or patients who have had long-standing, seemingly incurable illnesses which remained unresolved by standard medical practice and procedures. She spent time in studying many treatment methods and various medical institutions abroad offering alternative medical studies.

She opted to focus on HICC after personally witnessing how integrative medicine saved her father’s life after he suffered from multiple organ failure (lungs, heart and kidney failure). Like many who refuse to give up on their loved ones, Dra. Meddie searched for a cure for her father’s apparently hopeless situation. Her search led her to integrative medicine, which in turn resulted in her father’s survival. He not only survived, but his condition improved and is still improving as of this time.

Since then, Dra. Meddie practiced integrative medicine which is governed by several international protocols. In fact, she is the only Filipino doctor who is recognized by the Gerson Institute in San Diego, California – an institution that introduces a kind of alternative therapy that cures cancer and other chronic diseases. She is also among one of the few medical integrative medicine practitioners in the Philippines, who offer patients a better quality of and a disease-free life.

For more details about HICC and how integrative medicine can change patient’s lives, please contact:

Jasper “Jay Mante” Maguiguad
HICC PR and Communications Head
0916-9175054 / 0918-4641137
dustin.jdmp@gmail.com
Holistic Integrative Care Center
UG 11, CPT Condominiun, Calle Estacion, Brgy Pio Del Pilar, Makati City

EDTA Chelation
The Real “Miracle” Therapy for Vascular Disease

The story of EDTA chelation therapy is as much political as it is medical. Consider these facts:

 EDTA chelation may be one of the most effective, least expensive, and safest treatments for heart disease ever developed, yet it is practiced by perhaps only 2,000 physicians in the United States.
 EDTA chelation is not typically covered by medical insurance, even though insurance companies would save billions of dollars each year if they did.
 Although they save far more lives than conventional treatments for heart disease and other chronic degenerative diseases at a fraction of the cost, physicians who practice and promote EDTA chelation for these uses have been harassed, vilified, smeared, and, in some cases, driven from their profession by powerful medical societies and government agencies that practice and promote conventional medical treatments.

What Is EDTA Chelation?
EDTA chelation is a therapy by which repeated administrations of a weak synthetic amino acid (EDTA, ethylenediamine tetra-acetic acid) gradually reduce atherosclerotic plaque and other mineral deposits throughout the cardiovascular system by literally dissolving them away.

EDTA chelation has frequently been compared to a “Roto-Rooter” in the cardiovascular system, because it removes plaque and returns the arterial system to a smooth, healthy, pre-atherosclerotic state. A better metaphor might be “Liquid-Plumr,” because, where Roto-Rooter violently scrapes deposits off the interior surfaces of your plumbing with a rapidly rotating blade, Liquid-Plumr simply dissolves them away.

Roto-Rooter is a far better metaphor for conventional medical treatments for heart disease, all of which are closely tied to the concept of the cardiovascular system as plumbing. When a pipe/artery gets clogged, simply ream it out or flatten the deposits (angioplasty). If that doesn’t work, just cut away the bad section(s) and replace it (them) with a new piece of pipe (coronary artery bypass graft, or CABG). It’s the same basic strategy older cities use for replacing their century-old water mains. And we know how successful that is!

“Because EDTA is so effective at removing unwanted minerals and metals from the blood, it has been the standard ‘FDA -approved’ treatment for lead, mercury, aluminum and cadmium poisoning for more than 50 years.”

CABG, known affectionately in the medical profession as “cabbage,” is the most frequently performed surgery in the United States. At up to $50,000 per procedure, that indeed amounts to a lot of “cabbage,” not only for cardiac surgeons but also for hospitals. As we shall see, these figures provide a powerful incentive for physicians to reject an effective, but inexpensive and unpatentable treatment like EDTA chelation.

It is commonplace for physicians who regularly prescribe EDTA chelation to encounter heart disease patients who have failed all the standard treatments but who make remarkable – even unbelievable – recoveries once given EDTA. Other patients, on waiting lists for CABG surgery, found they did not need the surgery following a series of EDTA chelation treatments.

EDTA exerts its beneficial effects on the body because this molecule is extremely proficient at chemically bonding with mineral and metal ions. This bonding process, known as chelation, is a natural and essential physiologic process that goes on constantly in the body. EDTA’s chelating abilities make it ideal for many tasks:

 Because EDTA is so effective at removing unwanted minerals and metals from the blood, it has been the standard “FDA-approved” treatment for lead, mercury, aluminum and cadmium poisoning for more than 50 years. EDTA normalizes the distribution of most metallic elements in the body.
 Because it is so safe and effective, EDTA is also used widely as a stabilizer for packaged food. Minute amounts of EDTA (33-800 PPM) added to food help to preserve flavor and color and to retard spoilage and rancidity. (Read your food labels.)
 Because EDTA inhibits blood clotting so well, it is routinely added to blood samples that are drawn for testing purposes.*
 EDTA improves calcium and cholesterol metabolism by eliminating metallic catalysts that can damage cell membranes by producing oxygen free radicals.

Thanks to these and probably other effects of EDTA, it has been reported to have a wide variety of benefits.

*If you followed the O.J. Simpson trial, you probably know that EDTA was featured prominently. The defense contended that EDTA, supposedly found in certain of “The Juice’s” blood drops at the murder scene, indicated that that blood had spent some time in a collection tube before being “planted” by the LAPD. If there was EDTA in Simpson’s blood, though, it may well have come from the meal he ate on the plane ride from Chicago to LA.

EDTA Chelation vs. Conventional Therapy for Vascular Disease
Researchers first started to notice EDTA in the days during and after World War II when men who worked in battery factories or painted ships with lead-based paint began coming down with lead poisoning from their high exposure in these jobs. EDTA was found to be extremely effective for removing the lead from the men’s bodies, but what really made people sit up and take notice was an apparent reduction in symptoms of heart disease in many of these men.

The first systematic study of EDTA in people with atherosclerosis was published in 1956.1 When the researchers gave 20 patients with confirmed heart disease a series of 30 I.V. EDTA treatments, 19 of the patients experienced improvement, as measured by an increase in physical activity. Another study 4 years later in a similar population found that 3 months of EDTA infusions resulted in decreases in the severity and frequency of anginal episodes, reduced use of nitroglycerin (a common anti-angina drug), increased work capacity and improved ECG (electrocardiogram) findings.2

It soon became clear from these and later studies that EDTA treatments result in progressive and widespread improvement and stabilization of cardiovascular function. This is in contrast to standard treatments, such as angioplasty or CABG, which instantaneously restore normal function in the few treated arteries, but leave the rest of the body completely untreated (there’s every reason to believe that if arteries are clogged in the heart, they’re also clogged in other vital organs, like the kidneys and brain). High-tech treatments for heart disease, such as angioplasty and CABG, long hailed as medical breakthroughs, are in fact, oversold, overpriced, and ineffective, especially when compared with EDTA chelation. The truth of this assertion has been demonstrated on numerous occasions over the last 2 decades:

 The average mortality for CABG surgery is 4% to 10%.3,4 In fact, CABG has no overall effect on improving survival. According to one study published in the New England Journal of Medicine, “As compared with medical therapy, coronary artery bypass surgery appears neither to prolong life nor to prevent myocardial infarction in patients who have mild angina or who are asymptomatic after infarction in the five-year period after coronary angiography.”5 By contrast, mortality rates for EDTA chelation, when carried out according to accepted protocols, approaches 0%.6
 Grafted coronary arteries are more than 10 times as likely to close up again within 3 years compared with coronary arteries that are not replaced with a graft.7 Improved blood flow following EDTA chelation therapy is permanent as long as regular EDTA therapy (either oral or I.V.) is maintained.
 Significant cerebral dysfunction, especially in older patients, is commonly seen following CABG.8 Because EDTA chelation restores blood flow to the brain, it often results in improved cognition and memory.9
 Atherosclerosis is typically a body-wide disease. If your coronary arteries are occluded, it’s a safe bet that arteries in your brain, kidneys, lungs, and other vital organs are also occluded. Angioplasty or CABG can clean out only a few arteries supplying the heart. Another surgical procedure, endarterectomy, is commonly used to clear out the carotid arteries that supply the brain. When patients who have undergone carotid endarterectomy are treated with EDTA afterwards, the degree of subsequent restenosis (re-occlusion) drops by 10%.10
 Despite the danger and costs associated with these procedures, they are often only temporary fixes. Restenosis of treated coronary arteries occurs within 6 months in as many as one in three cases.11 By contrast, EDTA chelation permanently removes blood vessel obstructions throughout the body without dangerous and expensive surgery. How well does EDTA chelation work? Virtually every study that has looked at the efficacy of EDTA chelation in vascular disease has demonstrated significant improvements. Here is a brief sampling of a few of the major results:
 A 1993 meta-analysis of 19 studies of 22,765 patients receiving EDTA chelation therapy for vascular disease found measurable improvement in 87%.12
 In a study of 2,870 patients with various degrees of degenerative diseases, especially vascular disease, almost 90% of the patients showed excellent improvement, as measured by walking distance, ECG, and Doppler changes.13
 A small, blinded, crossover study of patients with peripheral vascular disease found significant improvements in walking distance and ankle/brachial blood flow.14
 In 30 patients with carotid artery stenosis, there was a 30% improvement in blood flow after EDTA treatment.15
 Using retinal photographs in patients with macular degeneration, one researcher demonstrated significant improvement following EDTA treatment.16
 EDTA chelation treatment was evaluated in patients with carotid and coronary disease using technetium 99 isotope techniques. Significant improvement in arterial blood flow and ejection fraction (a measure of heart pumping ability) was reported.17,18
 When 65 patients on the waiting list for CABG surgery for a mean of 6 months were treated with EDTA chelation therapy, the symptoms in 89% (58) improved so much they were able to cancel their surgery. In the same study, of 27 patients recommended for limb amputation due to poor peripheral circulation, EDTA chelation resulted in saving 24 limbs.19

Negative Results?

Of course there have been a few studies that did not (at first) seem to support the efficacy of EDTA chelation therapy. The most prominent apparently well-controlled studies have been two Danish trials 20,21 and a New Zealand trial,22 all of which reported no apparent benefits. A close analysis of these studies, however, revealed problems with both the controls and the interpretation of the data.

“Because EDTA chelation restores blood flow to the brain, it often results in improved cognition and memory.”

As noted by Chappell and Janson,6 the standard EDTA chelation treatment protocol was not followed in these trials. They all included primarily smokers (notoriously poor responders) with severe vascular disease who received only 20 I.V. treatments. With such patients, 30 to 40 treatments are normally required before a significant effect is typically seen. Although the New Zealand trial was supposedly placebo-controlled, the “placebo” used actually had chelating properties of its own. Thus, the fact that the differences from “placebo” were small is meaningless.

When the raw data from the New Zealand study were examined, it was found that 26% of the EDTA-treated patients compared with only 12% of the “placebo” controls achieved an improvement of greater than 100% in walking distance; among nonsmokers or smokers who had quit, 66% of the EDTA-treated group increased their walking distance an average of 86% compared with 45% of the controls, who improved by just 56%. Reduced blood flow, as measured by the ankle/brachial index, was found in 6% of the EDTA-treated patients and 35% ofthe controls. Although the authors of these studies reached negative conclusions, in fact, their data actually supported the use of EDTA chelation.

How Safe Is EDTA Chelation?
EDTA, is a safe, nontoxic substance. The LD50 (so called when the dose will kill 50% of experimental animals) for EDTA is 2000 mg/kg body weight, which makes it about 3.5 times less toxic than aspirin. Although the FDA refuses to approve it for treating vascular disease, EDTA chelation has been the approved treatment for lead or other heavy metal poisoning for 50 years. When administered according to the treatment protocol developed by the American College for Advancement in Medicine (ACAM), I.V. chelation is more than 300 times safer than CABG surgery. Most side effects of treatment involve minor discomfort (eg, nausea, dizziness, headache) that resolves quickly.

The greatest risks occur when an infusion is given too rapidly or in too large a dose. These risks virtually vanish when EDTA is administered by a properly trained physician who follows the ACAM protocol. To the extent that oral EDTA is a completely noninvasive therapy, it is even safer than I.V. EDTA.

I.V. or Oral EDTA?
Most chelation therapy carried out today involves I.V. administration of EDTA, however, oral EDTA, which has a history at least as long as its I.V. cousin, is an option that is only now starting to be appreciated. Clinical experience suggests that oral chelation provides some, but not all, of the benefits of I.V. therapy. Overall, the difference in benefits is more one of degree and speed than of quality.

I.V. therapy has a direct and powerful effect on the body almost instantaneously. An I.V. session usually lasts about 3 to 4 hours, during which about 1500 mg to 3000 mg of EDTA (plus vitamin C and other nutrients) are administered. The number of treatments necessary (generally about 20-50 sessions) depends on the individual’s condition. Candidates for I.V. chelation are people that have been diagnosed with serious atherosclerosis, heavy metal poisoning, or symptoms of vascular occlusion or significant calcification of tissues. Only about 3% to 8% of an oral dose of EDTA is absorbed, compared with 100% of an I.V. dose. Therefore, the time and dosage required to achieve the same benefits with the oral form are quite different. What can be achieved in only a few hours with I.V. EDTA chelation may take several weeks or months with oral EDTA chelation. However, oral EDTA may be appropriate for people whose condition does not demand rapid action. For example, oral chelation can be used to:

 avoid complications and diseases that result from heavy metals and calcification
 prevent the formation of blood clots, thus reducing your chance of a heart attack or stroke
 lower the level of blood cholesterol
 help thin the blood
 aid in reducing lipid peroxidation, a major cause of atherosclerosis
 protect the body against certain carcinogens, pathogens and other toxins that can reduce the quality of health

Oral EDTA is not meant to replace I.V. therapy for those people who have serious vascular disease. It is very useful, though, for people who have completed an I.V. course and want to stay on a maintenance program, for people who “for whatever reason” are unable or unwilling to undergo I.V. chelation, and for those whose I.V. treatments may have been interrupted.

The Politics of EDTA Chelation
Organizations like the American Heart Association and the American Medical Association, which condemn EDTA chelation as ineffective for treating vascular disease, often quote the Danish and New Zealand studies, mentioned earlier, to support their position.20-22 What they fail to mention is that the Danish studies were criticized by the Danish Committee for Investigation into Scientific Dishonesty because of improper randomization and double-blinding, as well as premature breaking of the blinding code, which amounted to a deliberate bias. When the results of the New Zealand study were examined by two independent statisticians, it was concluded that the trial actually supported the efficacy of EDTA.23

“Virtually every study that has looked at the efficacy of EDTA chelation in vascular disease has demonstrated significant improvements.”

It is unlikely that any other issue in modern medicine has been more highly politicized than that of EDTA chelation therapy, and it is clear that most of the opposition to EDTA is due to the threat this therapy represents, not to patients’ health but to the bank balances of orthodox physicians, pharmaceutical companies, and hospitals. Treating cardiovascular diseases is big business in the United States (and the rest of the Western world), bringing in tens of billions of dollars each year.

As Garry Gordon, MD, DO, the “Father of Chelation Therapy” has pointed out, “Every time a surgeon does a heart bypass, he takes home a luxury sports car.” Each CABG procedure costs between $25,000 and $50,000; each angioplasty costs about $15,000; drugs for reducing cholesterol, lowering high blood pressure, and normalizing heart rhythm bring the pharmaceutical industry hundreds of millions of dollars each year. And these are just the most common examples. What happens when you add EDTA chelation therapy to this mix?

A course of I.V. EDTA chelation therapy costs between $2000 and $4000; oral EDTA is even less costly. To the degree that these therapies reduce the need for the more expensive conventional therapies – a large degree, indeed – they threaten to diminish the income of a significant portion of the medical establishment. Consider this one example: As noted earlier, in a study of 65 patients who were treated with I.V. EDTA while they were waiting for CABG surgery, 58 (89%) no longer required the procedure.19 At $50,000 per procedure not done, that means that surgeons and hospitals gave up nearly $3 million just for these few patients. Now remember, that CABG is the most common surgical procedure performed in the US (368,000 in 1989).24

Given these figures, it’s not hard to understand why the medical profession is so in love with CABG and related procedures. As one physician noted, “It pays the bills.” So enamored are they of these procedures that they perform them even when they are not necessary. In an article published in no less prestigious a publication than the Journal of the American Medical Association, the authors concluded that only 56% of the surgeries performed were for appropriate reasons, 30% for equivocal reasons, and 14% for inappropriate reasons. The percentage of appropriate surgeries varied from 37% in some hospitals to 78% in others.25 When you consider that even when it is “appropriate,” CABG surgery is no better than conventional medical treatments for improving survival,5 you have to wonder whether the real “miracle” of heart surgery does not entail bringing people back from death’s door, as much as turning a common chronic degenerative disease into a source of outrageous fortune. If you needed one example of why the cost of health care has gone into earth orbit, you need look no further than the conventional treatment of heart disease.

“If you needed one example of why the cost of health care has gone into earth orbit, you need look no further than the conventional treatment of heart disease.”

Given these figures, it’s also not very hard to understand why the medical profession has reacted so violently against physicians who practice chelation therapy, often attempting, in the words of that great seeker of medical truth (that’s a joke folks), Dr. Victor Herbert, “to put them out of business.” Because EDTA has long been approved for treating heavy metal poisoning, and because physicians are free to use any “approved” medication for any use they see fit, as long it does not endanger the patient, EDTA chelation therapy is perfectly legal. This has not stopped medical boards in a number of states from bringing charges against physicians who prescribe EDTA chelation for vascular disease, smearing them as “quacks,” and attempting to restrict the use of this therapy. Fortunately, most of these attempts have failed.23

You can be certain that if EDTA had a large pharmaceutical company advocating its use, these problems wou quickly evaporate. But since the patent for EDTA ran out nearly 30 years ago, there are no huge profits to be made from marketing it. With no pot of gold at the end of theEDTA rainbow, no one is going to put up the hundreds of millions of dollars required to do the randomized, double-blind, placebo-controlled clinical trials required to get the FDA to approve EDTA for vascular disease. And with few large, randomized, double-blind, placebo-controlled clinical trials to refer to, the conventional medical establishment feels justified in condemning EDTA therapy as “unproven.” It’s a familiar “Catch 22” that faces all natural or unpatentable therapies.

Conclusion
While most American physicians choose to remain blind to the benefits of EDTA, those who prescribe it are free to witness its life-enhancing benefits on a daily basis. One of those physicians is Dr. Garry Gordon, whose own life was saved by EDTA and who has been a leader in chelation therapy since the early 1960s. “I have taken on patients who were inoperable, who had already had every known form of bypass surgery, who had no more veins in their legs to strip out and put into their heart, and who were sent home to die, and I could get those people back to full functioning,” says Dr. Gordon.

For an interview with Dr. Garry Gordon, see Exclusive Interview with Garry Gordon, M.D., D.O.: Oral Chelation for Improved Heart Function – Apr. 1997

References:
1. Clarke NE, Clarke CN, Mosher RE. Treatment of angina pectoris with disodium ethylene diamine tetraacetic acid. Am J Med Sci. 1956;December:654-666.
2. Meltzer LE, Ural E, Kitchell JR. The treatment of coronary artery heart disease with disodium EDTA. In: Seven M, ed. Metal-Binding in Medicine. Philadelphia: JB Lippincott; 1960.
3. Edmunds LH, Stephenson LW, Edie RN, Ratcliffe MB. Open-heart surgery in octogenarians. N Engl J Med. 1988;319:131-136.
4. CASS Principal Investigators and the Associates. Coronary artery surgery study (CASS): a randomized trial of coronary artery bypass surgery: Survival data. Circulation. 1983;68:939-950.
5. CASS Principal Investigators and the Associates. Myocardial infarction and mortality in the Coronary Artery Surgery Study randomized trial. N Engl J Med. 1984;310:750-758.
6. Chappell LT, Janson M. EDTA chelation therapy in the treatment of vascular disease. J Cardiovasc Nurs. 1996;10:78-86.
7. Cashin WL, Sanmarco ME, Nessim SA, Blankenhorn DH. Accelerated progression of atherosclerosis in coronary vessels with minimal lesions that are bypassed. N Engl J Med. 1984;311:824-828.
8. Arom KV, Cohen DE, Strobl FT. Effect of intraoperative intervention on neurological outcome based on electroencephalographic monitoring during cardiopulmonary bypass. Ann Thorac Surg. 1988;48:476-483.
9. Olszewer E, Carter JP. EDTA chelation therapy in chronic degenerative disease. Med Hypotheses. 1988;27:41-49.
10. Holliday HJ. Carotid restenosis: A case for EDTA chelation. J Adv Med. 1996;9.
11. Parisi AF, Folland ED, Hartigan PA. Comparison of angioplasty with medical therapy in the treatment of single-vessel coronary artery disease. N Engl J Med. 1992;326:10-16.
12. Chappell LT, Stahl JP. The correlation between EDTA chelation therapy and improvement in cardiovascular function: a meta-analysis. J Adv Med. 1993;6:139-160.
13. Olszewer E, Carter JP. EDTA chelation therapy in chronic degenerative disease. Med Hypotheses. 1988;27:41-49.
14. Olszewer E, Sabbag FC, Carter JP. A pilot double-blind study of sodium-magnesium EDTA in peripheral vascular disease. J Natl Med Assoc. 1990;82:173-174.
15. Rudolph CJ, McDonagh EW, Barber RK. A non-surgical approach to obstructive carotid stenosis using EDTA chelation. J Adv Med. 1991;4:157-166.
16. Rudolph CJ, Samuels RT, McDonagh EW. Visual field evidence of macular degeneration reversal using a combination of EDTA chelation and multiple vitamin and trace mineral therapy. J Adv Med. 1994;7:203-212.
17. Casdorph HR. EDTA chelation therapy, II: efficacy in brain disorders. J Holist Med. 1981;3:101-117.
18. Casdorph HR. EDTA chelation therapy: efficacy in arteriosclerotic heart disease. J Holist Med. 1981;3:53-59.
19. Hancke C, Flytie K. Benefits of EDTA chelation therapy on arteriosclerosis. J Adv Med. 1993;6:161-172.
20. Sloth-Nielsen J, Guldager B, Mouritzen C, et al. Arteriographic findings in EDTA chelation therapy on peripheral arteriosclerosis. Am J Surg. 1991;162:122-125.
21. Guldager B, Jelnes R, Jorgensen SJ, et al. EDTA treatment of intermittent claudication – a double-blind, placebo-controlled study. J Intern Med. 1992;231:261-267.
22. van Rij AM, Solomon C, Packer SGK, Hopkins WG. Chelation therapy for intermittent claudication: a double-blind, randomized, controlled trial. Circulation. 1994;90:1194-1199.
23. Schachter MB. Overview, historical background and current status of EDTA chelation therapy for atherosclerosis. J Adv Med. 1996;9:159-177.
24. Gundy P. Cardiovascular diseases remain nation’s leading cause of death. JAMA. 1992;267:335-336.
25. Winslow CM, Kosecoff JB, Chassin M, Kanouse DE, Brook RH. The appropriateness of performing coronary artery bypass surgery. JAMA. 1988;260:505-509.

*These statements have not been evaluated by the Food and Drug administration. These products are not intended to diagnose, treat, cure, or prevent any desease.

Chelation Therapy Reduces Cardiovascular Events for Older Patientswith Diabetes

For Immediate Release:
Tuesday, November 19, 2013

Chelation treatments reduced cardiovascular events, such as heart attacks, and death in patientswith diabetes but not in those who did not have diabetes, according to analyses of data from theNational Institutes of Health (NIH)-funded Trial to Assess Chelation Therapy (TACT).However, researchers say more studies are needed before its known whether this promisingfinding leads to a treatment option.

Chelation is a chemical process in which a substance is delivered intravenously (through theveins) to bind atoms of metals or minerals, and hold them tightly so that they can be removedfrom the body. Chelation is conventionally used as a treatment for heavy metal (like lead)poisoning, although some people use chelation as an unapproved and unproven treatment forconditions like heart disease.

Chelation therapy is not approved by the U.S. Food and Drug Administration to treat heartdisease. However, use of chelation therapy to treat heart disease and other health problems grewin the United States between 2002 and 2007 by nearly 68 percent to 111,000 people, according tothe 2008 National Health Statistics Report.

The diabetes subgroup analysis of TACT was published today in Circulation: CardiovascularQuality and Outcomes and presented at the American Heart Associations Scientific Sessions2013. TACT is a study supported by NIHs National Center for Complementary and AlternativeMedicine (NCCAM) and National Heart, Lung, and Blood Institute (NHLBI).

TACTs initial report was published in the March 27, 2013, issue of The Journal of the AmericanMedical Association. This previous report showed that infusions of a form of chelation therapyusing disodium ethylene diamine tetra-acetic acid (EDTA) produced a modest but statisticallysignificant reduction in cardiovascular events in all EDTA-treated participants. However, furtherexamination of the data showed that patients with diabetes were significantly impacted bychelation therapy while patients without diabetes were not.

The patients with diabetes, which made up approximately one third of 1,708 participants,demonstrated a 41 percent overall reduction in the risk of any cardiovascular event; a 40 percentreduction in the risk of death from heart disease nonfatal stroke, or nonfatal heart attack; a 52percent reduction in recurrent heart attacks; and a 43 percent reduction in death from any cause. In contrast, there was no significant benefit of EDTA treatment in the subgroup of 1,045 participants who did not have diabetes.

These are striking results that, if supported by future research, could point the way towards new treatments to prevent complications of diabetes, said Gervasio A. Lamas, M.D., the studys principal investigator and chairman of medicine and chief of the Columbia University Division of Cardiology at Mount Sinai Medical Center in Miami Beach.

From 2003 to 2010, 1,708 adults aged 50 and older were enrolled in TACT, of whom 633 had diabetes. Study participants had suffered a heart attack 6 weeks or more before enrollment (on average, the heart attack occurred about 4.5 years earlier). The participants were assigned randomly to receive 40 infusions of disodium EDTA chelation solution or a placebo solution. Patients also were randomly assigned to receive high doses of oral vitamins and minerals or an identical oral placebo. Most participants also took standard medicines for heart attack survivors, such as aspirin, beta blockers, and statins. They were followed for a minimum of 1 year and up to 5 years, with followup ending in October 2011.

TACT was not designed to discover how or why chelation might benefit patients with diabetes.

Although subgroup analyses of clinical trials do not provide definitive answers, they are very useful in identifying future research questions, said Josephine Briggs, M.D., Director of NCCAM. The effects seen in this population are large and very intriguing. This analysis suggests strongly that more research is needed to examine possible benefits of chelation in diabetics and the potential mechanisms.

We share Dr. Briggss interest in these compelling findings, said Michael Lauer, M.D., Director of the NHLBIs Division of Cardiovascular Sciences. Additional studies are needed before we can determine the potential place of EDTA chelation therapy, if any, in the treatment of patients with coronary artery disease and diabetes.

TACT was supported by grants from the NIHs NCCAM (U01AT001156) and NHLBI (U01HL092607).

For more information or to arrange an interview with an NIH spokesperson, please contact the NCCIH Communications Office at 301-496-7790 or nccihpress@mail.nih.gov. To schedule an interview with Dr. Lamas, contact Robert Alonso at 305-674-2600 or Robert.Alonso@msmc.com. Follow Dr. Lamas on Twitter.

About the National Center for Complementary and Integrative Health (NCCIH): NCCIHs mission is to define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health approaches and their roles in improving health and health care. For additional information, call NCCIHs Clearinghouse toll free at 1-888-644-6226. Follow us on Twitter, Facebook, and YouTube.

Part of the National Institutes of Health, the National Heart, Lung, and Blood Institute (NHLBI) plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics. NHLBI press releases and other materials are available online at www.nhlbi.nih.gov.

About the National Institutes of Health (NIH): NIH, the nations medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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Medscape Medical News

EDTA Chelation Therapy May Prevent Progression of Renal Disease

Laurie Barclay, MD

January 22, 2003

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Jan. 22, 2003 — Ethylenedinitrilo tetraacetic acid (EDTA) chelation therapy presumably reduces the progression of renal disease in patients with high normal lead levels and without diabetes, according to the results of a randomized trial reported in the Jan. 23 issue of the New England Journal of Medicine.

“Low-level environmental lead exposure may accelerate progressive renal insufficiency in patients without diabetes who have chronic renal disease,” write Ja-Liang Lin, MD, and colleagues from Chang Gung University in Taipei, Taiwan. “Repeated chelation therapy may improve renal function and slow the progression of renal insufficiency.”

For 24 months, the investigators observed 202 patients with chronic renal insufficiency (serum creatinine 1.5 – 3.9 mg/dL), normal total-body lead burden, and no history of exposure to lead. After this observation period, 64 subjects with an elevated body lead burden were randomized to lead-chelation therapy with calcium disodium EDTA, or to placebo, for three months. For the next 24 months, 32 patients with high-normal body lead burdens (80 – 599 μg) received weekly chelation therapy; this was discontinued if body lead burden fell below 60 μg. The remaining 32 patients received weekly placebo infusions for five weeks every six months.

During the observation period, 24 patients reached the primary end point of increased serum creatinine to 1.5 times baseline value. Predictors of reaching this endpoint were serum creatinine level and body lead burden at baseline.

After the 27-month intervention period, glomerular filtration rate (GFR) improved significantly in the chelation group but declined in the controls (change in GFR, 2.1 5.7 mL/min/1.73 m 2 body-surface area vs. -6.0 5.8 mL/min/1.73 m 2; P < .001). During the 24-month period of repeated chelation therapy or placebo, the rate of decline in GFR was also lower in the chelation group than in the controls.

In an accompanying editorial, Philip A. Marsden, MD, from St. Michael’s Hospital at the University of Toronto in Canada, commends the investigators, but wonders if the findings are generalizable to Europe or North America. Environmental lead contamination, genetic susceptibility to lead accumulation, and lack of treatment with angiotensin-converting enzyme inhibitors in the absence of hypertension could all be different in the Taiwanese population. Another caveat is that EDTA therapy can exacerbate cognitive dysfunction and other adverse effects of lead exposure.

Finally, he notes that EDTA “has protean biochemical and cellular effects both in vitro and in vivo…. Some may rightfully argue that the results do not demonstrate that lead-chelation therapy improves short-term renal function in humans. Rather, they show that EDTA-chelation therapy does.”

N Engl J Med. 2003;348:277-286, 345-347

Reviewed by Gary D. Vogin, MD