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Chelation therapy for heart disease

Heart disease is the leading cause of death in the United States. Many people are looking for ways to prevent a heart attack or stroke. Some of them are using a treatment called chelation therapy. The National Institutes of Health (NIH), a federal government agency, says that more than 800,000 medical visits for chelation were made in the United States in 1997.¹ A study in Canada found that nearly 8% of patients with heart disease have tried chelation treatments.² Americans may be spending as much as $3 billion a year on this treatment.³ Chelation is not one of the standard treatments for heart disease.

What is chelation? Chelation involves the use of agents such as EDTA. EDTA stands for ethylene diamine tetra-acetic acid. EDTA has been used since the 1940s to help the body get rid of heavy metals and minerals in the bloodstream. EDTA is given to treat heavy metal toxicity such as lead poisoning.¹

For heart disease, chelation treatments are given by IV. This means the medicine is given through a needle into a vein. The schedule of treatments can vary. A patient might be treated one or two times a week for a total of at least 30 treatments. Each treatment may last up to 3 hours.⁴ The treatment includes vitamins and minerals. These are given to replace nutrients that are lost during the therapy.⁵

What are the side effects? Side effects are rare. Some people may have a burning feeling where the needle goes into the skin. Others may have fever, low blood pressure, headache, upset stomach, vomiting, low blood counts, and kidney failure.¹ Other problems can be loss of appetite, joint pain, gout, numbness or weakness in the hands and feet, inflammation of a vein, and trembling.⁶

Why is EDTA being used for heart disease? In 1955, a doctor found that some people with heart disease who received EDTA for lead poisoning had less chest pain.⁷ Since then, other experts have shown that chelation therapy may improve symptoms of heart disease.⁸

How does chelation therapy work? No one knows for sure, but EDTA may be an antioxidant.^1,3,9 Antioxidants may help reduce swelling in arteries that are partly blocked. This swelling can lead to a heart attack or stroke. The NIH says that chelation could “reduce inflammation in the arteries and improve blood vessel function.”¹

Why is chelation an alternative treatment? Some studies have shown that chelation works. Other studies have not. In one famous study, people with heart disease could do more exercise whether they had chelation or not. Because of this, the authors said there was not enough proof that chelation therapy worked.⁴

Most experts agree with these authors. Larger studies must be done before chelation can be a standard treatment. Many medical groups and government agencies have said that people should not have chelation treatments.¹⁰ Some are afraid that IV EDTA is not safe for people with heart disease. Many years ago, a few people died after they had the treatments.⁸Recently, though, there have been no deaths. There have also been very few problems.

Will more studies be done? The NIH is paying for a big study of IV EDTA treatment for heart disease.¹¹This study is called TACT. TACT stands for Trial to Assess Chelation Therapy. This study will take place at about 100 sites across the country. It will include 2,372 patients. It is 20 times larger than any study done before. It will take place over 5 years.¹

What are the facts about chelation therapy? Chelation is being used more and more. The treatment may have some risks. Some small studies have not shown that chelation helps. A large study is now being done to see if chelation works and is safe. Until this study is done, your doctor and PA can give you only their opinion about chelation. It is a good idea to be cautious about treatments that have not been well studied.

What about oral chelation? Some herbal products sold online and in health food stores are said to work as chelation therapy. Many of them claim to be a low-cost treatment for heart disease. The ingredients can vary and some products do not even list their ingredients. People should ask their doctor before buying these products.

REFERENCES

1.    National Institute of Health. Questions & answers: the NIH trial of EDTA chelation therapy for coronary artery disease. Available at: http://nccam.nih.gov/news/2002/
chelation/q-and-a.htm. Accessed December 8, 2004.
2.    Quan H, Ghali WA, Verhoef MJ, et al. Use of chelation therapy after coronary angiography. Am J Med. 2001;111:686-691.
3.    Lamas GA, Ackermann A. Clinical evaluation of chelation therapy: is there any wheat amidst the chaff? Am Heart J. 2000;140:4-5.
4.    Knudtson ML, Wyse DG, Galbraith PD, et al. Chelation therapy for ischemic heart disease: a randomized controlled trial. JAMA. 2002;287:481-486.
5.    Shelton B. Homotoxicology and calcium EDTA chelation. Explore. 2002;11(6). Available at: http://www.explorepub.com/articles/shelton2_11_6.html. Accessed December 8, 2004.
6.    Access Medicine. Calcium EDTA. Available at: http://www.accessmedicine.com. Accessed December 8, 2004.
7.    Ernst E. Chelation therapy for peripheral arterial occlusive disease. Circulation. 1997;96:1031-1033.
8.    Ernst E. Chelation therapy for coronary heart disease: an overview of all clinical investigations. Am Heart J. 2000;140:139-141.
9.    Frishman WH. Chelation therapy for coronary artery disease: panacea or quackery? Am J Med. 2001;111:729-730.
10. American Heart Association. Chelation therapy: AHA recommendation. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4493. Accessed December 8, 2004.
11.    National Institute of Health. NIH launches large clinical trial on EDTA chelation therapy for coronary artery disease. Available at: http://nccam.nih.gov/news/2002/chelation/pressrelease.htm. Accessed December 8, 2004.