EDTA Chelation - Anaturalhealingcenter.com

Applications Of EDTA Chelation TherapyL. Terry Chappell, M.D.AbstractEthylenediamine tetraacetic acid, or EDTA, is a synthetic amino acid approvedby the FDA for the removal of toxic metal ions such as lead. EDTA is used in isolationfor heavy metal poisoning; however, the vast majority of practitioners who offerintravenous EDTA treatments utilize it as a part of a comprehensive therapy programfor treating atherosclerosis and other chronic degenerative diseases. Treatment is aimedat removing accumulations in the body of harmful levels of aluminum, iron, copper, andtoxic heavy metals, all of which enhance free radical damage. Treatment objectivesalso include the removal of metastatic calcium from soft tissues, enhancement of thelevels of ionic magnesium intracellularly, and reduction of pathologically enhancedclotting mechanisms, especially platelet adhesiveness. Because of its mechanism ofaction, EDTA chelation therapy might be useful to prevent or treat rapid oxidation ofLDL cholesterol, ischemia-reperfusion injuries, arrythmias, hypertension in the presenceof low-level lead accumulation, and congestive cardiomyopathy due to iron overload.Reports also indicate autoimmune diseases such as rheumatoid arthritis, Wegener’sgranulomatosis, and scleroderma respond to EDTA chelation therapy.(Alt Med Rev 1997;2(6):426-432)Chelating Actions of EDTAEthylenediamine tetraacetic acid, or EDTA, is a synthetic amino acid that is approvedby the FDA for removal of toxic metal ions such as lead. EDTA chelation therapy for treatingatherosclerosis and other chronic degenerative diseases is an off-label use, consisting of a seriesof intravenous infusions with EDTA, accompanied by vitamins, minerals, and other supplements.“Chelation” derives from the Greek chele, which refers to the claws of a crab. It describeshow certain molecules surround and bind metal ions. Many therapeutic agents act aschelators, including aspirin, ascorbic acid, tetracycline, and other antibiotics. 1 Naturally occuringexamples of chelates include magnesium in chlorophyll, and iron in hemoglobin.At physiologic pH, EDTA readily binds with calcium and promotes its excretion. It alsobinds and removes other metals in the body such as zinc, iron, copper, lead, arsenic, cadmium,and aluminum. The binding of these metals results in a variety of clinically relevant actions byEDTA. 2 The lowering of serum calcium during and immediately after a treatment stimulates therelease of parathyroid hormone, resulting in the partial removal of metastatic calcium deposits,including those from atherosclerotic plaque. The removal of heavy metals and excessive ironand copper results in the reduction of free radical production and a decrease in lipid peroxidation.Terry Chappell, MD is certified by the American Board of Family Practice and the American Board of Chelation Therapy with addedqualifications in Geriatricts. He serves as an associate professor of family practice at Wright State School of Medicine and is the immediatepast president of ACAM.Correspondence address: Celebration of Health Center, 122 Thurman St., Bluffton, OH 45817Page 426 Alternative Medicine Review ◆ Volume 2, Number 6 ◆ 1997Copyright©1997 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission

ChelationImproved calcium/magnesium balance leadsto reduced platelet aggregation and improvedblood flow characteristics.HistoryIn 1955, Norman Clarke observed thatpatients treated for lead toxicity, who had coexistingatherosclerosis, not only excreted leadeffectively, but also experienced major improvementsin their arterial disease. 3 Clarkesubsequently reported on the successful treatmentof angina pectoris 4 and occlusive vasculardisease 5 with EDTA. Meltzer, Kitchell andassociates confirmed the work of Clarke. 6,7 Favorablearticles appeared in mainstream medicaljournals with EDTA chelation featured inthe American Medical Association’s MedicalWorld News. A brief but intensive interest inEDTA by researchers in such fields as rheumatology,cardiology and endocrinology followed.However, although Meltzer, Kitchelland associates’ final article on the subject in1963 reported rather impressive improvementsin a group of patients with severe coronaryartery disease, the authors concluded thetherapy “did not benefit patients more thancommonly used therapeutic methods” and wasnot a useful tool in the treatment of coronaryartery disease. 8 Subsequent to this publication,interest in EDTA moved into the realm of alternativemedicine and faded from mainstreamacademia.A re-emergence of interest in EDTAoccurred in the 1980’s, with a number of reportsin the medical literature documenting improvementof vascular disease with objectivetesting measurements following treatment withchelation therapy. Casdorph published twoarticles showing improvement in blood flowto the brain 9 and increased cardiac output. 10Casdorph and Farr described chelation as analternative to amputation in peripheral vasculardisease. 11 McDonagh, Rudolph andCheraskin collaborated on numerous studiesand showed various benefits fromchelation. 12-16Olszewer and associaties publishedtwo reports suggesting a beneficial effect fromchelation; a retrospective analysis of 2870patients with vascular and other chronic degenerativediseases 17 and a single-blind, crossoverstudy of a small group of patients withperipheral vascular disease. 18 In the formerstudy, objective testing measures indicatedmarked or good improvement in 87 percent ofpatients. The results for vascular disease patientswere even more impressive. All ten subjectsreceiving chelation therapy improved.Half of these individuals showed no changewhile they were receiving placebo.In the 1990s, Hancke and Flytlie publishedan outcome study with an interestingsubset of patients who were on the waiting listin Denmark for surgery. After electing to receiveEDTA chelation therapy, 58 of 65 patientsawaiting cardiac bypass surgery nolonger required this procedure. Twenty-fourof 27 patients being prepared for amputationbecause of critical limb ischemia were alsotreated successfully and did not require amputation.19Rudolph, McDonagh and Barber reportedgood results in 30 patients treated withEDTA for carotid artery stenosis. Doppler ultrasoundshowed improvement in all patientswith an average reduction in intra-arterial obstructionof 20.9 percent (p

a total of 24,006 patients. In order to ensurethe few large studies did not skew the results,a comparison was made between the large andsmall studies. Once again, the results were almostidentical.Two prospective trials conducted bygroups of vascular surgeons in Denmark 23,24and New Zealand 25 reached negative conclusionsregarding the use of EDTA in peripheralvascular disease. Both studies consisted primarilyof subjects who continued to smokethroughout the trial. These studies have alsobeen severely criticized for protocol discrepancies.26-31 Although it was not mentioned inthe article, 25 the latter study contained an outlierin the control group who had improvedfar more than any other subject in the study.The study group was so small (15 treated patients)the outlier severely distorted the results.If the outlier were excluded, the study wouldhave shown an improvement in the grouptreated with EDTA.The American College for Advancementin Medicine has spent a great deal ofmoney and effort during the last 15 years tohave unbiased academic researchers performprospective, randomized studies utilizing chelationtherapy for coronary artery disease andperipheral vascular disease. One major clinicaltrial was aborted before it was completed.Another was cancelled the day it was to besent to government funding sources. Effortsto accomplish the research required to changethe package insert to include an FDA-approvedindication for vascular disease are continuing.Recently, Messerli’s standard cardiologytextbook devoted an entire chapter writtenby Rubin to the appropriate use of EDTAchelation therapy in vascular disease. 32 EDTAshould be treated like many other cardiovasculardrugs which are utilized for off-label indicationsbut have not yet been subjected torigorous, large-scale, double-blind, clinicaltrials for those purposes. Surgical therapiessuch as bypass, angioplasty and stents havebeen broadly accepted and widely utilizedwithout such trials to prove their efficacy.Clinical experience and the limited scientificstudies suggest EDTA chelation therapy mightbe safer, more cost effective, and potentiallymore efficacious than these options.Current Use of Chelation TherapyEDTA is rarely used in isolation, exceptperhaps for heavy metal poisoning. Thevast majority of practitioners who offer intravenousEDTA treatments utilize it as a part ofa comprehensive therapy program. They rejectthe prevailing opinion that a systemic diseaselike atherosclerosis can be effectivelytreated with isolated surgical interventions.Likewise, these practitioners prefer to minimizethe use of pharmaceutical agents that canboth interfere with biochemical pathways andenzyme systems, and often result in unwantedside-effects. While EDTA is certainly a medicationwith potential side-effects, it is extremelysafe if used according to accepted protocol.33 Large amounts of oral and intravenousantioxidants are given with chelation therapy,especially vitamins E and C. Treatment isaimed at removing accumulations in the bodyof harmful levels of aluminum, iron, copper,and toxic heavy metals, all of which enhancefree radical damage. Treatment objectives alsoinclude the removal of metastatic calcium fromsoft tissues, enhancement of the levels of ionicmagnesium intracellularly, and reduction ofpathologically enhanced clotting mechanisms,especially platelet adhesiveness. These mechanismsof action were described in the extensivereview article by Cranton andFrackelton. 34 Additional information about thecomplex mechanisms initiated by EDTA arelisted in the book Questions from the Heartby Chappell. 35A treatment course usually consists ofa series of 30-40 intravenous infusions ofdisodium magnesium EDTA in a mineralPage 428 Alternative Medicine Review ◆ Volume 2, Number 6 ◆ 1997Copyright©1997 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission

it is probably prudent to treat the above-listedconditions with EDTA only if coexistingvascular disease is present.Because chelation therapy removestoxic metals through the kidneys, its use couldtheoretically promote damage. Because of this,EDTA chelation therapy is contraindicated forindividuals with advanced kidney disease. 59Although the incidence is extremely rare, allergicreactions to EDTA have been reported.Physicians must be careful with patients whohave significant congestive heart failure, dueto the potential for fluid overload subsequentto frequent IV administration.EDTA is a powerful drug that shouldbe used only by knowledgeable physicians.Training programs are available through theAmerican College for Advancement in Medicine(ACAM) and the Great Lakes College ofClinical Medicine. Certification of specialistsin chelation therapy is provided by the AmericanBoard of Chelation Therapy (ABCT), followingsuccessful completion of oral and writtenexaminations and a review of patientcharts. Recertification is required every fiveyears. ACAM and ABCT have also helped toestablish certification organizations in severalother countries.ConclusionEDTA chelation therapy is used by asmall group of specially trained physicians inthe treatment of a wide variety of chronic degenerativediseases associated with vascularproblems. Chelation therapy protocol combinesintravenous EDTA, nutrition therapies,and lifestyle changes. It is used as an adjunctto or as an alternative to bypass surgery and/or angioplasty. Frequently, cardiovascular andother medications can be reduced and qualityof life improved by EDTA chelation therapy.Continued research is needed to fully assessits role in a comprehensive integrated approachto these difficult problems.References1. Halstead BM. The Scientific Basis of EDTAChelation Therapy. Colton, CA: Golden QuillPublishers; 1979:5-15.2. Chappell LT, Janson MJ. EDTA chelationtherapy in the treatment of vascular disease. JCardiovasc Nurs 1996;10:78-86.3. Clarke NE, Clarke CN, Mosher RE. The “invivo” dissolution of metastatic calcium: anapproach to atherosclerosis. Am J Med Sci1955;229:142-149.4. Clarke NE. Treatment of angina pectoris withdisodium EDTA. AM J Med Sci 1956;232:654-666.5. Clarke NE. Atherosclerosis, occlusive vasculardisease and EDTA. Am J of Cardiol1960;6:233.6. Kitchell JR, Meltzer LE, Seven MJ. Potentialuses of chelation methods in the treatment ofcardiovascular diseases. Prog Cardio Dis1961;3:338-349.7. Meltzer LE, Kitchell JR, Palmon F Jr. Thelong term use, side effects and toxicity ofdisodium ethylenediamine tetraacetic acid(EDTA). Am J Med Sci 1961;242:51-57.8. Kitchell JR, Palmon F, Aytan N, Meltzer L.The treatment of coronary artery disease withdisodium EDTA: a reappraisal. Am J Cardiol1963;11:501-506.9. Casdorph HR. EDTA chelation therapy II,efficacy in brain disorders. J Hol Med1981;3:101-117.10. Casdorph HR. EDTA chelation therapy,efficacy in arteriosclerotic heart disease. J HolMed 1981;3:53-59.11. Casdorph HR, Farr C. EDTA chelation therapyIII: treatment of peripheral arterial occlusion,an alternative to amputation. J Hol Med1983;5:3-15.12. McDonagh EW, Rudolph CJ. A collection ofpublished papers showing the efficacy ofEDTA chelation therapy. Gladstone, MO:McDonagh Medical Center; 1989.13. Rudolph CJ, McDonagh EW. Effect of EDTAchelation and supportive multivitamin/tracemineral supplementation on carotid circulation:case report. J Adv Med 1990;3:5-12.14. McDonagh EW, Rudolph CJ, Cheraskin E. Anoculocerebrovasculometric analysis of theimprovement in arterial stenosis followingEDTA chelation therapy. J Hol Med1982;4:21-23.Page 430 Alternative Medicine Review ◆ Volume 2, Number 6 ◆ 1997Copyright©1997 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission

Chelation15. McDonagh EW, Rudolph CJ, Cheraskin E. Theeffect of EDTA chelation therapy plus multivitamin/tracemineral supplementation uponvascular dynamics (ankle/brachial systolicblood pressure). J Hol Med 1985;7:16-22.16. McDonagh EW, Rudolph W, Cheraskin E.The influence of EDTA salts plus multivitamin-tracemineral therapy upon total serumcholesterol/high density lipoprotein cholesterol.Med Hypoth 1982;9:643-647.17. Olszewer E, Carter JP. EDTA chelation therapyin chronic degenerative disease. Med Hypoth1988;27:41-49.18. Olszewer E, Sabbag FC, Carter JP. A pilotdouble-blind study of sodium-magnesiumEDTA in peripheral vascular disease. J NatMed Ass 1990;82:173-177.19. Hancke C, Flytlie K. Benefits of EDTAchelation therapy on arteriosclerosis. J AdvMed 1993;6:161-172.20. Rudolph CJ, McDonagh EW, Barber RK. Anon-surgical approach to obstructive carotidatheromatous stenosis: an independent study. JAdv Med 1991;4:157-166.21. Chappell LT, Stahl JP. The correlation betweenEDTA chelation therapy and improvement incardiovascular function: a meta-analysis. J AdvMed 1993;6:139-160.22. Chappell LT, Stahl JP, Evans R. EDTAchelation treatment for vascular disease: ameta-analysis using unpublished data. J AdvMed 1994;7:131-142.23. Sloth-Nielson J, Guldager B, Mouritzen C, etal. Arteriographic findings in EDTA chelationtherapy on peripheral arteriosclerosis. Am JSurg 1991;162:122-125.24. Guldager B, Jelnes R, Jorgensen SJ, et al.EDTA treatment of intermittent claudication -a double-blind, placebo controlled study. J IntMed 1992;231:261-267.25. Van Rij AM, Solomon C, Packer SGK,Hopkins WG. Chelation therapy for intermittentclaudication: a double-blind, randomized,controlled trial. Circulation 1994;90:1194-1199.26. Editorial. EDTA chelation: a rebuttal. J AdvMed 1992;5:3-5.27. Cranton EM, Frackelton JP. Negative Danishstudy of EDTA chelation biased. TownsendLetter for Doctors 1992:604-605.28. Hancke C, Flytlie K. Manipulation withEDTA. Ugeskar Laeger 1992;154:2213-2215.29. Lonsdale D. EDTA chelation therapy. Am JSurg 1993;166:316.30. Committee on Scientific Dishonesty (UVVU).Conclusion concerning complaints in connectionwith trial of EDTA versus placebo in thetreatment of arteriosclerosis. Copenhagen,Denmark: Danish Research Councils; 1994.31. Chappell LT, Miranda R, Hancke C, et al.EDTA chelation treatment for peripheralvascular disease. J Int Med 1995;237:429-434.32. Rubin M. Other drugs for the treatment ofcardiovascular disease. In: Messerli, ed.Cardiovascular Drug Therapy. Philadelphia,PA: WB Saunders Co; 1996.33. Rozema TC. The protocol for the safe andeffective administration of EDTA and otherchelating agents for vascular disease, degenerativedisease, and metal toxicity. J Adv Med1997;10:5-100.34. Cranton EM, Frackelton. Free radical pathologyin age-associated diseases; treatment withEDTA chelation, nutrition and antioxidants. JHol Med 1984;6:6-37.35. Chappell LT. Questions from the Heart.Charlottesville, VA: Hampton Roads;1995:124-134.36. Escobar GA, Escobar SC, Ordonez I, GonzalezM. Chelation in peripheral arterial insufficiency.Cirugia y Cirujanos (Surgery andSurgeons) 1995;61:58-62.37. Rudolph CJ, Samuels RT, McDonagh EW.Visual field evidence of macular degenerationreversal using a combination of EDTAchelation and multiple vitamin and tracemineral therapy. J Adv Med 1994;7:203-212.38. Lamb DJ, Leake DS. The effect of EDTA onthe oxidation of low density lipoprotein.Atheroscelerosis 1992;94:35-42.39. DeBoer DA, Clark RE. Iron chelation inmyocardial preservation after ischemiareperfusioninjury: The importance of pretreatmentand toxicity. Ann Thorac Surg1989;47:939-945.40. Zylke J. Studying oxygen’s life-and-deathroles if taken from or reintroduced into tissue.JAMA 1988;259:960-965.41. Choi D. Ischemia-induced neuronal apoptosis.Curr Opin Neurob 1996;5:667-672.42. Solti F, Juhasz-Nagy S, Kecshemeti V, et al.Effect of the Ca2+ chelators EDTA and EGTAon sinoatrial-node activity and heart irritability.Acta Physiol Acad Sci Hung 1982:60:155-164.Alternative Medicine Review ◆ Volume 2, Number 6 ◆ 1997 Page 431Copyright©1997 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission

43. Jick S, Karsh R. The effect of calcium chelationon cardiac arrhythmias and conductiondisturbances. Am J Card 1959:287-293.44. Harlan WR, Landis JR, Schmouder RL, etal. Blood lead and blood pressure. JAMA1985;253:530-534.45. Rahko PS, Salerni R, Uretsky BF. Successfulreversal by chelation therapy of congestivecardiomyopathy due to iron overload. J AmColl Card 1986;8:436-440.46. Freeman AP, Giles RW, Berdoukas VA, et al.Early left ventricular dysfunction and chelationtherapy in thalassemia major. Ann Intern Med1983;99:450-454.47. Leipzig LJ, Boyle AJ, McCann DS. Casehistories of rheumatoid arthritis treated withsodium or magnesium EDTA. J Chron Dis1970;22:553-563.48. Hansotia P, Peters H, Bennett M, Brown R.Chelation therapy in Wegener’s granulomatosis,treatment with EDTA. Ann Otol RinolLaryng 1969;77:388-402.49. Bark RE. Treatment of systemic sclerosis. ModTreat 1966;3:1287-1301.50. McDonagh EW, Rudolph CJ, Cheraskin E. The“clinical change” in patients treated withEDTA chelation plus multivitamin/tracemineral supplementation upon reportedfatigue. J Orthomol Psych 1985;14:1-5.51. McDonagh EW, Rudolph CJ, Cheraskin E. Thepsychotherapeutic potential of EDTA chelation.J Orthomol Psych 1984;14:214-217.52. McDonagh EW, Rudolph CJ, Cheraskin E. Theeffect of EDTA chelation therapy with multivitamin/tracemineral supplementation uponreported fatigue. J Orthomol Psych 1983;13:1-3.53. McDonagh EW, Rudolph CJ, Cheraskin E. Theglycohemoglobin (HbA1C) distribution inEDTA eligible patients. J Orthomol Psych1984;12:1-3.54. McDonagh EW, Rudolph CJ, Wussow DG.The effect of intravenous disodium ethylenediamine tetraacetic acid (EDTA) upon bonedensity levels. J Adv Med 1988;1:79-85.55. McDonagh EW, Rudolph CJ, Barber RK.Effect of EDTA chelation and supportivemultivitamin mineral supplementation onchronic lung disorders: A study of FVC andFEV1. J Adv Med 1989;2:553-561.56. Blumer W, Reich T. Drug dependence causedby toxic metals, Metal Compounds in Environmentand Life 1992;4:231-236.57. Bjorksten J. Possibilities and limitations ofchelation as a means for life extension. J AdvMed 1989;2:77-78.58. Blumer W, Cranton EM. Ninety percentreduction in cancer mortality after chelationtherapy with EDTA. J Adv Med 1989;2:183-188.59. Cranton EM. Kidney effects of ethylenediamine tetra acetic acid (EDTA): a literaturereview. J Adv Med 1989;2:227-234.Page 432 Alternative Medicine Review ◆ Volume 2, Number 6 ◆ 1997Copyright©1997 Thorne Research, Inc. All Rights Reserved. No Reprint Without Written Permission