Health Studies 301 Complementary and Alternative Therapies

Study Guide: Unit 16

Chelation Therapy

Chemical structure of EDTA chelate. Yikrazuul, 2010, (adapted from Shaddack, 2005), public domain.

Unit 16 examines chelation therapy, which aims to bind and remove calcium from the blood and thereby treat atherosclerosis.

Learning Objectives

Upon completion of Unit 16, you should be able to

• explain the concept of chelation therapy.
• discuss the scientifically proven and non-proven uses of chelation therapy.

Learning Activities

Study Questions

As you complete the activities for Unit 16, keep the following questions in mind. You may want to use the Personal Learning Space wiki on the course home page, and answer these questions as a way of keeping notes to focus your learning.

1. What claims are made for chelation therapy?
2. What are the proposed mechanisms for this therapy?
3. How does evidence-based medicine deal with chelation therapy?
4. What problems might be associated with its use?

Unit 16 Discussion Forum

When you have completed the other activities for this unit, answer at least one of the questions in the Unit 16 Discussion Forum, and respond to at least one post by a fellow learner.

The more questions you answer, the better prepared you will be for the final exam!

Read

In addition to the notes provided here, read

Lamas, G.A. & Hussein, S.J. (2006). EDTA chelation therapy meets evidence-based medicine. Complementary Therapies in Clinical Practice, 12, 213–215.

The Practice of Chelation Therapy

Ethylenediaminetetraacetic acid (EDTA) is a chemical with a high affinity for bi- and trivalent cations such as calcium, magnesium, lead, and zinc. The EDTA, with attached substances, is then excreted through the kidneys. EDTA is commonly used in conventional medicine as treatment for heavy metal poisoning, particularly lead. It is usually administered orally.

This treatment has been turned into a CAM therapy. Chelation therapy is practised by repeatedly injecting a chemical solution of EDTA into a vein, often in combination with mega-vitamin therapy. A typical course of treatment includes 20 to 30 treatments at a cost of $100 each.

Since the 1950s, alternative medicine practitioners have been recommending the use of chelation therapy in the treatment of atherosclerotic cardiovascular disease. Suggested mechanisms are as follows:

• EDTA may decalcify or remove calcium from the atherosclerotic plaque, reversing plaque formation in the arterial wall. Investigators feel this theory is flawed because the major constituents of plaque are scar tissue, cholesterol, blood cells and fibrin, not calcium. Since EDTA cannot pass through the artery cell membranes, it cannot chelate the calcium there. Even if EDTA could remove calcium from the walls of the narrowed blood vessels, cholesterol and fibrous tissue would remain to obstruct blood flow.
• EDTA may inhibit the free-radical oxidization of low-density lipoprotein (LDL) cholesterol and other lipids by removing metal ions necessary for this reaction. There is little supporting evidence for this mechanism.

Chelation has also been recommended by unconventional practitioners for the treatment of Alzheimer’s disease, complications of diabetes, and a number of degenerative disorders.

Proponents of chelation therapy argue that the usual treatments for vascular disease are expensive and have some associated morbidity and mortality. By comparison, chelation therapy using EDTA is less costly than traditional treatments and appears to be safe.

Proponents of chelation therapy have suggested reasons why chelation therapy is not supported by mainstream medicine. One argument has been that heart and bypass surgery is a lucrative business. They also argue that as there is no patent on EDTA, its manufacturers have no incentive to carry out further studies or to promote its use. In other words, the real reason why mainstream medicine has failed to adopt chelation therapy is not because the therapy lacks solid supporting evidence of effectiveness but because of its lack of profitability. Similar arguments are often made for several other types of CAM therapies.

Potential Hazards

What is really happening during chelation? Rather than removing calcium from atherosclerotic plaque, it is much more likely that EDTA is simply binding to calcium in the blood and removing it from the body. The body maintains the blood level of calcium by taking it from the bones. The net result is that chelation causes the loss of bone calcium—not a desirable outcome.

The most frequent adverse effect of EDTA is a burning sensation at the infusion site, which diminishes with lower infusion rates. As stated in the reading for this unit, there have also been reports of renal toxicity resulting from EDTA (Lamas & Hussein, 2006).

Research

Most of the published studies on EDTA chelation therapy have come in the form of testimonials and inadequately documented single case reports, published in books and pamphlets by physicians using the therapy. The reading for this unit presents a good summary of the research that has been conducted on the therapy (Lamas & Hussein, 2006). However, a more recent study gave very different results (Lamas et al., 2014). This large randomized study was carried out on patients who had suffered a heart attack. The results suggest that chelation therapy was effective, especially when the patient was also treated with large doses of vitamin/mineral supplements. The combination of the two treatments resulted in a 26% reduction in the risk of a new cardiac event over the course of five years. These surprising results mean that we cannot dismiss chelation therapy. Clearly, further investigation is required.

Summary

Chelation therapy is associated with significant risks and costs. Until recently there was a lack of credible evidence showing that the therapy is effective. However, a large study published in 2014 indicates that the therapy may be of value in the treatment of patients with clinical heart disease.

Learning Activity

Self-test Quiz

Do the self-test quiz for Unit 16 as many times as you wish to check your recall of the unit’s main points. You will get a slightly different version of the quiz each time you try it. (This quiz does not count toward your final grade).

If you have trouble understanding the material, please contact your Academic Expert.

References