Chelation with EDTA
Chelation (pronounced ke-LA’shun) literally means “to chemically bind to.” I sought additional training and certification in chelation therapy after finding that many patients had heavy metal overload. I was trained through the American Academy for the Advancement of Medicine and have been administering this treatment for many years. EDTA (ethylenediaminetetraacetic acid) is a synthetic amino acid that can be given intravenously. EDTA was first used in the 1940s for the treatment of heavy metal poisoning, especially lead poisoning. Although it is not approved by the FDA to treat heart disease, some physicians and alternative medicine practitioners use EDTA chelation as a way to treat this disorder. At least twenty books have been authored on the subject of chelation, but more large clinical trails need to be conducted before a firm conclusion can be made about the role chelation may play in lowering the risk of a heart attack. Using chelation therapy for the treatment of heart disease is still considered to be an experimental treatment. EDTA chelation therapy is approved by the FDA only for toxic metal poisoning and hypercalcemia (a condition of too much calcium).
Does EDTA Chelation Work?
In some cases it may help, but this depends on many factors. The efficacy and mechanism of action are still being studied. I have noticed that it is most effective when elevated levels of toxic metals are present. Several theories have been proposed for how this treatment may work. One theory suggests that EDTA chelation might work by directly removing calcium found in fatty plaques that block the arteries, causing the plaque to decrease in volume.
Another is that the process of chelation may stimulate the release of a hormone (calcitonin) that in turn causes calcium to be removed from the plaques and redistributed. A third theory is that EDTA chelation therapy may work by reducing the damaging effects of oxygen ions and reactive transition metals (oxidative stress) on the walls of the blood vessels. Reducing oxidative stress could reduce inflammation in the arteries and improve blood vessel function. This is why EDTA is used to prevent the spoiling of food. It blocks oxidative reactions.
The ability of EDTA to neutralize oxidative reactions caused by transition metals has many beneficial anti-aging effects on the body (Lamb, Mitchinson, and Leake 1995; Stadler, Lindner, and Davies 2004). Transition metals are those in the middle of the periodic table. Transition metals/minerals can form negatively charged complexes that are reactive. Most toxic metals (minerals) are transition metals as well as the nutritionally essential metals iron and copper.
LDL oxidation can only take place in the presence of transition metal ions, such as iron and copper, and human plaque biopsies contain significant amounts of reactive copper and iron (Lamb, Mitchinson, and Leake 1995; Stadler, Lindner, and Davies 2004) whereas the blood usually does not contain these highly reactive species of iron and copper (Lamb, Mitchinson, and Leake 1995).
Giving more credibility to the notion that chelation is a valid treatment is published data indicating that heavy metals, particularly mercury, may contribute to atherosclerosis (Landmark and Aursnes 2004). The negative cardiovascular effects of mercury stem from its ability to induce oxidative stress, inflammation, thrombosis, vascular smooth muscle dysfunction, endothelial dysfunction, dyslipidemia, immune dysfunction, and mitochondrial dysfunction (Houston 2007).
Lead is very bad for the cardiovascular system as well. The main sources of lead exposure are lead-based paint, leaded gasoline, lead-soldered plumbing fixtures, pipes, and canned foods, contaminated alcoholic beverages, lead-glazed kitchen/dining utensils, and mining and industrial contamination, as well as occupational exposure. Since the banning of lead-based gasoline, paint, and solder, as well as passage and enforcement of environmental regulations, exposure to lead in the United States has declined. Ground contamination continues to be a current source of lead exposure in the industrial societies. Heavy exposure also continues in countries where environmental regulations are lax or poorly enforced (such as India and China) (Vaziri 2008). Keep in mind the United States had no regulations either prior to 1960.
Lead can be absorbed via the respiratory and gastrointestinal tracts and even through the skin. Over 95 percent of the total body lead content resides in the bone, where it can persist for decades. As we age, gradual release of lead from the bone serves as a source of toxicity long after initial exposure. Conditions, such as osteoporosis, accelerate the release of lead from bone. Measurement of blood lead concentration primarily reflects recent/current lead exposure and does not reveal past exposure. Measurement of urinary lead excretion after EDTA provocation provides the best estimation of total body lead burden (Vaziri 2008).
The negative effects of lead on the cardiovascular system are really quite impressive. Chronic lead exposure causes high blood pressure, thrombosis, and cardiovascular disease by (Vaziri 2008):
- promoting oxidative stress.
- limiting nitric oxide availability.
- impairing nitric oxide signaling.
- augmenting adrenergic activity.
- increasing endothelin production.
- altering the renin-angiotensin system.
- raising vasoconstrictor prostaglandins.
- lowering vasodilator prostaglandins.
- promoting inflammation.
- disturbing vascular smooth muscle Ca2+ signaling.
- diminishing endothelium-dependent vasorelaxation.
- causing endothelial injury and limiting endothelial and blood vessel repair.
- inhibiting angiogenesis.
- reducing endothelial cell growth.
- reducing tissue plasminogen activator and raising plasminogen activator inhibitor-1 production.
The fact that heavy metals cause oxidative stress and cardiovascular disease is undisputed in the literature (Valko, Morris, and Cronin 2005; Wolf and Baynes 2007). Critics of chelation conveniently fail to mention or look at this data. Because of the connection between heavy metals in atherosclerosis, I will often screen patients for toxic metal overload and only recommend chelation for the treatment of heavy metal toxicity. Anyone who has high blood pressure and atherosclerosis should be screened for toxic metals with a urinary provocation test. In my clinic I use DMPS and EDTA.
The side benefit is less oxidative stress and better endothelial function. Since EDTA is also an anticoagulant it may work by preventing platelets from sticking together, which could prevent the formation of blood clots on the walls of blood vessels. Often chelation treatments contain heparin, which is anti-inflammatory and anticoagulant.
Additionally, intravenous treatments often include high doses of magnesium and B vitamins, which have their own beneficial effects. Magnesium, in particular, is an effective treatment for high blood pressure, coronary spasm, and congestive heart failure. Magnesium reduces inflammation, endothelial dysfunction, oxidative stress, and platelet clumping. Magnesium also acts as a mild calcium blocker and as a vasodilator. Chelation therapy may actually work to prevent heart attacks, thanks to the sum of all the biochemical and physiologic effects that it has.
The net effect of undergoing chelation therapy may be a reversal of many age-related changes. Because toxic transition metals accelerate aging through damage to DNA and oxidative stress, chelation treatment may play a larger role in anti-aging medicine than we had once believed. It may be effective in reversing atherosclerosis because it reduces oxidative stress, is anticoagulant (decreases clotting), lowers serum calcium, and lowers blood pressure.
When used as approved by the FDA for treatment of heavy metal poisoning, EDTA has a low occurrence of side effects. The most common side effect is a burning sensation experienced at the site where the EDTA is delivered into the veins. Rare side effects can include fever, hypotension (a sudden drop in blood pressure), hypocalcemia (abnormally low calcium levels in the blood), headache, nausea, vomiting, and bone marrow depression (meaning that blood cell counts fall). Injury to the kidneys has been reported with EDTA chelation therapy, but it is very rare. Other serious side effects, including death, can occur if EDTA is not administered by a trained health professional certified in chelation treatment.