What Is It?
Intravenous chelation (pronounced key-LAY-shun) therapy has been a respected and widely used medical treatment for heavy-metal poisoning--especially lead poisoning--for more than 50 years. However, some physicians also promote the therapy as an alternative treatment for arteriosclerosis (hardening of the arteries), including coronary artery disease, peripheral vascular disease (blockage or narrowing of blood vessels in the legs), and the mental deterioration caused by small strokes.

Over the years, suggesting chelation therapy for anything other than heavy-metal poisoning has been met with considerable controversy. And there have been few trials conducted in a manner satisfactory to all the physicians involved. Doctors who believe that chelation therapy is ineffective (the majority) routinely cite studies that are unacceptable to those physicians (the minority) who believe chelation is helpful. Conversely, studies either conducted or quoted by "believers" suggesting that chelation is effective are routinely disparaged by the "nonbelievers." This, of course, leaves patients quite confused.

What neither side disagrees about, however, is that the chemical EDTA (ethylenediaminetetraacetic acid) does remove toxic metals from the body. During treatment, EDTA is administered intravenously and the drug travels throughout the body gathering up such toxic metals as lead, arsenic, and aluminum from various organs. The term "chelation" is derived from the Greek word chele, which means "to claw." Like a claw, a molecule of EDTA grabs or binds onto a molecule of metal and carries it through the bloodstream to be excreted in the urine.

The origins of chelation therapy. EDTA was first used medically in the 1940s to treat workers from battery factories who had developed lead poisoning. In the early 1950s, Dr. Norman Clarke, Sr., director of research at Providence Hospital in Detroit, Michigan, was using EDTA for lead poisoning and found that his patients also reported less pain from angina (chest pain due to blocked arteries). In addition, they noted improved memory; better sight, hearing, and smell; and an increase in energy.

At the time Clarke and other doctors postulated that it was EDTA's effect on calcium within the body that might account for these results. They theorized that, during chelation, the EDTA could be grabbing onto the calcium within the arterial plaque lining blood vessels and removing it, the way it removed lead in poisoning cases.

With the calcium gone, they felt, the plaque dissolved, circulation improved (not only to the heart, but also to the brain, eyes, and other organs) and patients reported feeling better. One writer at the time even dubbed chelation therapy "a Roto-Rooter for the arteries." Unfortunately, X-rays and biopsies later showed that chelation had no effect at all on calcium within the arteries, and this early theory was discounted.

A second, more widely accepted theory--and one that continues to be popular--suggests that, by removing toxic metals, the EDTA also removed a significant source of destructive oxygen molecules known as free radicals. With free-radical production slowed, the arteries could then heal, shedding their plaque and lessening the symptoms of heart disease. Today antioxidant vitamins are thought to play a key roll in "mopping up" free radicals throughout the body and, for this reason, large doses of antioxidants are typically administered along with the EDTA.

The controversy continues. While many chelation studies have been done over the years, very few rigorous studies have ever been performed on humans. Critics of the therapy note that most studies showing its effectiveness have been done by physicians with a financial interest in the therapy. Proponents respond by saying that studies disproving chelation have typically been performed under the supervision of physicians with a financial interest in costly surgical procedures.

Despite the disagreements, interest in chelation as an alternative treatment for heart and vascular problems has continued to grow, with thousands of people seeking out the therapy annually as an option to coronary bypass surgery and balloon angioplasty.

How Does It Work?
Once the intravenous solution of EDTA enters the bloodstream, it is believed to attach itself to metal molecules. It then takes about 48 hours for the body to excrete these substances through the urine. Because the therapy can also remove small amounts of zinc, copper, calcium, manganese, and other essential minerals from the body, supplemental vitamins and minerals are often added to the EDTA infusion. This is a complicated process that should only be performed by a trained professional.

What You Can Expect
At your first visit the physician will take a thorough medical history, review your previous medical records, and do a full physical examination. An electrocardiogram, blood flow studies to the legs, a CT scan of the vessels surrounding the heart, and tests for levels of toxic metals in the body may be ordered to confirm a diagnosis that would benefit from chelation therapy.

Since chelation will alter some blood chemistries, the doctor will also order certain tests as baseline studies--usually a blood count, chemistry profile, and urinalysis. During your first visit, an actual chelation treatment won't be performed. You'll receive treatment once the preliminary tests have been evaluated by the practitioner.

Chelation is painless and usually takes two to three hours per session. You recline comfortably while the EDTA is infused, usually through a vein in the arm or the back of the hand. The attending physician--an M.D. or D.O. (osteopathic doctor) trained in its use--monitors your blood pressure, blood sugar, and kidney function prior to and throughout the treatment.

The number of treatments needed depends on your initial condition and how well you tolerate the infusions. Usually one or two visits each week are prescribed, with a total of 40 sessions required if chelation is prescribed for a heart or vascular condition. The total cost could run as high as $4,000. (Treatment for metal poisoning usually involves 20 to 50 sessions.)

Health Benefits
Although chelation therapy has long been an FDA-approved and widely accepted treatment for heavy-metal poisoning, most conventional physicians believe that current research in humans does not support its use for any other illnesses, including heart and vascular disease. Indeed, mainstream doctors suggest that EDTA cannot pass through cell membranes to reach calcium deposits, and even if it could, the amount of calcium it could "bind" with is negligible.

Proponents of chelation point out that other factors affecting heart and vascular problems are at work too, including the positive effect of the beneficial anitioxidant vitamins and minerals given as part of the therapy. In addition, many heart patients receiving chelation therapy are often advised to stop smoking, adopt a low-fat diet, get more exercise, and reduce stress--all of which have proven heart benefits.

In 1993, a comprehensive review of all the studies done on chelation therapy over the preceding 37 years found that few studies, either "pro" or "con," had been rigorously controlled. Although some of the trials showed a temporary improvement of angina, reductions in death rates were not convincingly demonstrated.

Today, the American College of Advancement in Medicine (ACAM) in Laguna Hills, California, and the American Board of Chelation Therapy in Chicago, Illinois, the two key certifying organizations in the field, are working with the FDA on studies to establish the safety of EDTA for arteriosclerotic diseases.

How To Choose a Practitioner
The use of EDTA chelation therapy for any purpose requires a trained, certified practitioner with at least several years of experience in the field, and many states require licensure--M.D., D.O. (doctor of osteopathy, or N.D. (naturopathic doctor)--for the use of the chelating agents. Chelation therapy can also be given by a nurse practitioner or a physician's assistant as long as a doctor supervises.

The American Board of Chelation Therapy and the American College of Advancement in Medicine both train and certify physicians in the use of chelation therapy. You can contact these organizations to obtain a list of specially trained physicians in your area.

Cautions
Chelation should be administered only by a physician experienced in its safe use. Always check the practitioner's credentials.

For anything other than emergency heavy-metal poisoning, do not use chelation therapy if you have kidney disease or damage, liver disease, or a brain tumor, or if you have an underactive thyroid (hypothyroidism).

Do not use chelation therapy if you are pregnant or trying to conceive.

Never substitute chelation therapy for conventional heart-disease treatment.

If you develop any serious side effects, including anemia, blood clots, irregular heartbeat, joint pain, or severe inflammation at the area where the needle was inserted, seek traditional medical treatment immediately.