Several years ago, one of my columns discussed chelation therapy. At that time I stated that the evidence for the benefits of chelation therapy was weak, but that the National Institutes of Health was planning a large, placebo-controlled study to really see if chelation therapy is beneficial for heart disease.
Although not yet published, the results of this clinical trial (TACT -- Trial to Assess Chelation Therapy), were presented at the recent meeting of the American Heart Association. What this study showed is that there is benefit to chelation therapy for the prevention of heart attack, stroke and death in those patients with existing coronary artery disease.
There is robust medical evidence to indicate that specific metals in our environment can make their way into our bodies. Lead, mercury, cadmium and other metals that are commonly found in our environment can result in an increased risk of heart disease, diabetes, asthma and other medical illnesses.
There is debate however as to what constitutes a clinically important exposure. The "safe" levels of exposure recommended by the Environmental Protection Agency do not always coincide with current research. This may be because the EPA looks primarily at acute exposure.
There is good medical research to indicate that chronic, low-level exposure can increase the risk for a number of serious medical conditions. One could easily postulate that if you could remove these toxic metals from the body that this would reduce the risk of heart disease, diabetes asthma, etc. This is the basis of chelation therapy.
The word chelation comes from the Latin word meaning claw. In essence chelating agents grab onto toxic metals and allow your body to excrete them in the urine. In traditional medicine, chelation is used for high levels of metal toxicity. However, chelation for chronic medical conditions has been an area of intense debate for decades.
The process of chelation involves introducing chelating agents into the body either through the vein, orally or even as a rectal suppository. As of yet there is no good data that indicates which route is more efficacious. Chelation therapy is done over time and can be quite expensive if done intravenously. Using better chelating agents, the therapy is quite safe. The question has always been is it effective.
In the TACT study, there was a statistically significant improvement in death, heart attack and stroke among those patients who were getting chelation therapy. The benefit increased in those patients who also had diabetes. The conclusions from the study however need to be somewhat cautiously interpreted since this is only the first good study that has been done and results have only been presented and not yet published.
I am surprised this study was actually done because the push back from some in medicine was quite strong. Although the results are promising, I do not feel that chelation therapy is a stand-alone therapy for the treatment of heart disease but, especially among diabetics, chelation should be seriously considered.
• Patrick B. Massey, M.D., Ph.D is medical director for complementary and alternative medicine for the Alexian Brothers Health System. His website is www.alt-med.org.