CAUTIONARY TALE #101: THIS TIME IT’S CHELATION

(January 2003)

For more than four decades, one of the treatments advocated for those with coronary heart disease has been chelation - giving injections of a drug (EDTA) that complexes with metal ions such as calcium and iron and excretes them from the body in the urine. The idea is that EDTA by lowering body content of those metals, or by other mechanisms, improves heart muscle function resulting in greater functional ability (greater ability to exercise), less chest pain (angina) caused by reduced coronary blood vessel flow, and an improved quality of life. Estimates of chelation use in the United States range from 100,000 persons a year to 500,000 persons at a cost of hundreds of millions of dollars. A recent review by an acknowledged authority on alternative and complementary medicines called the use of chelation with EDTA "obsolete". A report in the Journal of the American Medical Association, by a well-respected group called the PATCH Investigators outlines the results of a careful study of 78 persons with known coronary heart disease who suffered from persistent heart pain (angina). Half were given 33 intravenous injections of EDTA over a six-month period; the other half (the controls) agreed to dummy injections (placebos) over the same time period. Participants did not know whether they were getting active drug or placebo. Both groups received oral vitamins, a standard procedure during chelation therapy.

At the end of the study, exercise capacity, a treadmill test (exercise cardiogram) and a quality of life survey were carried out. No benefits were found in any of the tests leading the authors to conclude: "there is no evidence to support a beneficial effect of chelation therapy in patients with ischemic heart disease or stable angina".

Commentary: There are still a lot of practitioners who urge or carry out chelation. The evidence is now quite clear: It does not work - and there are well known complications and risks from injecting EDTA. Unless equally careful studies of chelation for ischemic heart disease show clear benefit (a very unlikely possibility), anyone now advocating or administering chelation for ischemic heart disease can be considered as practicing hokum and can risk being labeled a charlatan. As Dr Ernst noted in his review, "these reports collectively provide no reliable evidence to suggest chelation therapy is of benefit in coronary heart disease...chelation therapy for coronary heart disease should be discarded".

Chelation as a treatment for symptoms from coronary heart disease does not work.

Despite the overwhelming negative evidence, a federally-supported multi-center study is getting underway in the United States to provide a definitive answer; it would be very surprising if the conclusions differ from those of Dr Ernst.

Knudtson, M.L., et al. Chelation therapy for ischemic heart disease. Journal of the American Medical Association. Vol 287 (January 23/30) Pgs 481-486. 2002.

Ernst E. Chelation therapy for coronary heart disease. American Heart Journal. Vol 140 (January) Pgs 139-141. 2000.