Archives

Chelation therapy - a bypass option

In this article three Sri Lankan doctors - Dr. Mrs. M. Vamadevan MBBS (Cey) FFARCS (Lond), Dr. Mrs. T. Saravanapavanathan MBBS (Cey) DA (Lond) FFARCS (Lond) and Dr. Mrs. N. Nadarasa MBBS (Cey) explain what Chelation Therapy is which is a cost effective option for by-pass surgery.

They are responding to a request made by the Health Watch, to the Management of the Poorna Health Care Trust in Piliyandala, which is conducting a Chelation Therapy clinic in Colombo for a detailed article on this as several Health Watch readers have been writing to us for details on this therapy.

Chelation Therapy is a form of treatment used in the clinical management of atherosclerosis, (clogging and hardening of the arteries) and has been practiced since the 1960s.

Dr. Norman Clarke pioneered the initial treatment of heart disease by Chelation Therapy as part of a research experiment carried out in the 1950s in the USA. He noticed that patients treated for lead poisoning by chelation showed improvement in ischaemic heart disease. As a result, chelation therapy was introduced to treat patients with coronary vascular disease and is now an accepted alternative treatment for patients suffering from vascular diseases such as angina, diabetic neuropathy and gangrene, peripheral arterial disease, cerebral vessel disease including stroke etc.

There are chelation clinics in more than 46 countries including America, England, New Zealand and Australia.

Chelation Therapy is a safe, effective and relatively inexpensive treatment to restore blood flow in victims of atherosclerosis without surgery.

Chelation Therapy involves the intravenous infusion of Ethylene Diamine Tetra Acetic Acid (EDTA) along with magnesium sulphate plus vitamins and minerals at therapeutic doses in 500 mls of normal saline or 5% dextrose.

How does the therapy work?

* The EDTA infusion chelates (or attaches to) toxic metals in the body, making them water-soluble and then discharging them through the kidneys.

* In diseased blood vessels calcium is deposited in the smooth muscle layer of the arteries and makes the vessels hard and non-pliable resulting in decreased blood flow. Chelation removes this calcium so that the vessels become soft and pliable.

With every heart contraction the arteries can expand and receive more blood and expel this blood to the tissues by effective elastic recoil of the vessel wall. Therefore, the blood flow is increased.

* Plaques that block the arteries are the result of calcium being laid over the fat deposits in the vessel wall. When calcium ions are removed by this treatment the plaque looses its firm and rigid base and becomes soft and the vessels become pliable. This results in more blood supply to the tissues.

* Chelation prevents the damage caused to the blood vessels by oxygen free radicals and heals the lining of the blood vessels. (Ref. Scientific Basis for Chelation Therapy by Halsted and Rozema 1997).

Note: EDTA removes calcium deposits in abnormal sites only. The normal calcium in bones and blood is not removed.

Conditions improved by Chelation therapy?

* Angina

* Peripheral arterial diseases

* Diabetic gangrene

* Hypertension

* Peripheral neuritis

* Macular degeneration of the eye

* Gallstone and kidney stones

* Senility

* Alzheimer's disease

* Parkinson's disease

* Osteo arthritis

What is the evidence that Chelation Therapy works?

Although scientific studies have been done in various countries and published in journals, a large-scale double blind trial has not been done mainly because conducting trials would be very costly and no pharmaceutical company will fund such a study as it will not be able to recoup this expenditure later in sales.

Studies have shown that chelation therapy increases the blood supply to the heart and limbs. In fact circulation to all parts of the body is improved when blood vessels become more resilient as a result of ionic calcium being removed from the arterial walls.

Clinical results

In our experience most angina patients have obtained relief and some have been stopped using vasodilator drugs. In addition some have reduced their medication for high blood pressure and diabetes. Patients who had been incapable of carrying out their normal work obtained relief with a few treatments.

1. A 40-year old driver suffering from peripheral arterial disease was referred to us by a vascular surgeon. He had ulcers on his leg that were not healing due to decreased blood supply.

With chelation therapy the ulcers healed, the pain during walking gradually decreased and finally left him completely.

He was even able to climb Adam's Peak (Sri Pada) without any problems.

2. A 64-year old patient who suffered from severe angina and was very depressed came for treatment. After 3 treatments of chelation the severity and frequency of his angina decreased and he reduced his intake of glyceryl trinitrate.

Treatments

He stopped the tablets after 7 treatments. He was able to resume his usual work, visit his estate and supervise work and became a very cheerful and changed personality.

3. A lady, 63 years old, who was unable to carry out her normal household duties because of angina got relief with 5 treatments and has now given up all her medication and is leading a healthy life.

4. A lady aged 67 years who suffered from insufficient blood supply to the carotid artery was referred by a vascular surgeon. She had frequent fainting spells and when she came to the clinic could hardlly walk. After receiving chelation therapy she walks regularly to church, which is a quarter mile away from her home and is able to help in the housework.

Patients are happy to share their experience of chelation therapy with fellow patients.

However it must be emphasized that this is not a magic remedy for vascular diseases.

Active patient cooperation is essential. Patients must be committed to the treatment and be willing to make changes in their inner attitude and lifestyle, diet and eliminate risk factors such as smoking, obesity and stress - if they wish to see good results. It is very important that plenty of water is drunk both during and after treatment as the EDTA,

along with the toxins present in the blood, are discharged via the kidneys and water is necessary to flush these out.

The usual course of treatment is a minimum of 30 drips but this varies according to the response of the patients, once or twice a week, as directed by the doctor. Once the course is completed booster infusions are recommended, initially once a month and later at two or three monthly intervals.

Contraindications

There are no contraindications for this treatment. Patients with kidney disease too can have treatment, with adequate precautions and under the specialized supervision of the doctors. Kidney function is monitored at regular intervals.

There are no serious side effects reported with this therapy. However, on the day of the treatment patients may develop aches and pains of the body, dizziness or headache and may pass urine more often. These symptoms may be experienced but are harmless.

Diet

Opinions vary about what constitutes a healthy diet. However, there is convincing evidence that a vegetarian diet is the most favourable for reducing cholesterol and improving all-round health.

The recommended diet for those receiving chelation therapy here is a vegetarian diet consisting of plenty of fresh fruit and fresh vegetables, pulses and wholegrain cereals, all of which contain fibre and antioxidants that act by mopping up free radicals which damage the blood vessels and tissues.

'White Coat' effect on blood pressure

Dr. Dennis J. Aloysius Family Physician has picked this interesting item from the BMJ of August 2002.

GPs should not make decisions about treating patients with hypertension based on high readings of blood pressure they have taken, finds a study in this week's BMJ. Instead, researchers recommend the use of home measurements by the patient or repeated measurements by a nurse, to counter the 'white coat' effect.

The aim of the research was to assess various methods of measuring blood pressure. Eight doctors and three practice nurses participated in the research involving 200 patients.

The patients had either been newly diagnosed with high blood pressure or were already receiving treatment for their high blood pressure. They were all being considered for treatment changes based on clinical readings.

Blood pressure readings were repeatedly made by either a nurse, home measurement, ambulatory monitoring or by a doctor. The researchers found readings made by the doctors were high in comparison to those visited by the nurse or measured by the patients at home.

The authors conclude: "The 'white coat' effect is important in diagnosing and assessing control of hypertension in primary care and is not a research artefact.

If ambulatory or home measurements are not available, repeated measurements by a nurse or the patient should result in considerable less unnecessary monitoring, initiation and changing of treatment.

It is time to stop using high blood pressure readings by general practitioners to make decisions about treatment."

Overall the home measurement system performed significantly better than all other methods and was also preferred best by patients, they conclude.

Another centenarian passes away

Mrs. Marian Agnes Wijesinghe another centenarian in the Health Watch collaborated Prof. Colvin Gooneratne Centenarian Study Project, passed away last week at her residence at Nawala.

She was the 6th Centenarian in the study, and was going on her 105th year when she died, peacefully last Saturday.She is the fourth Centenarian in the study list of 27 Centenarians to have passed away, since the study began in May 2001.

Health Watch together with the Study Team wish to convey our deepest condolences to the members of Mrs. Wijesinghe on her death.

SLMC decides to set up local guidelines for test-tube (IVF) baby procedure

Health Watch Medical Advisory Panel has been informed that the SLMC (Sri Lanka Medical Council) its last meeting had decided to appoint a Committee to draft a set of guidelines to be followed in carrying out the Test-tube baby procedure in Sri Lanka.

This Committee is to be appointed shortly by the Medical Council.

This followed an article carried by the Health Watch following the media publicity given to the last test-tube baby born in Colombo, with pictures of the baby and the mother carried in the press.

A Health Watch Reader raised the query whether it was in keeping with medical ethics to give pictorial publicity to every personal medical procedure like that.

Following our article the Vice-President of the SLMC Dr. Ananda Samarasekera wrote a lengthy article to the Health Watch, which we carried last month, commending the Health Watch for raising the issue, which was very appropriate. He also traced in the article the history of the IVF procedure and the guidelines laid for it in other countries.

The oldest living centenarian: She is rich in health

Dr. Viraj Peramuna on the oldest living centenarian in Sri Lanka

I did the medical study on the oldest living centenarian in Sri Lanka:- O. T. Engonona who is to be honoured by the OPA next week for her achievement in living.

As a member of the Centenarian Study Team, I feel honoured myself to have been able to carryout the medical study on this poor Centenarian who is 114 years old and living in a hut in Galle.

It will be interesting for Health Watch readers to know that she can still walk with minor help. Her hearing and vision is impaired, but remains satisfactory.

Her past memory is still satisfactory as she can well recall her childhood and adulthood incidents. She recalls, having an argument with her class teacher in Grade I over an incident for which she was not responsible, and when the teacher hit her for something she had not done, she had got so annoyed that she had thrown the books at her, and returned home.

and never went back to school again. She regrets the incident now, that put an end to her school carrier, but consoles herself saying "that is my fate, and I have to accept it."

She recalls how she travelled in a horse driven cart on her wedding day, and gave her age as 24, when actually she was 22, because the marriageable age at that time was 24 years.

She says she had married one of her cousins, who was very dark, for love, compared to her complexion which was very fair, her friends and relatives had compared the match to "a crew on a thambili flower". Her day to day memory at present is a bit impaired.

She doesn't have any major medical problems other than generalised body aches and pains, and weakness, which is common in old age.

Her lung and heart sounds are normal. Her blood pressure at (130/80) is normal. Cataract surgery had been done in the right eye 3 years ago.

Her diet

Breakfast - Prefers gram, cowpea, green grams.

Lunch - Rice & curry with vegetables and fish. She has never eaten meat.

Dinner - Breed or rice.

Family details

She has been the youngest in a 6 membered family. Her father and mother had both died in their 80's. Her grandfather had lived up to 102 years.

Her family

Her husband had died at 61 years. They had produced 9 children three of them had died in early childhood. Out of 6 children 2 sons and one daughter are married. She says they rarely come to see her. The other 3 daughters who are unmarried are looking after her. The eldest of them is 78 years, and the youngest 55 years.

Question Box

Question sent by K. D. Dharmapriya, Pannipitiya.

Is there any convincing evidence that chelation therapy helps patients suffering from angina?

Are there enough double blind clinical trials carried out regarding chelation therapy?

Reply: As I mentioned in my reply to a "Health Watch" reader on 16-08-2002, chelation therapy is a recognized procedure of treating patients suffering from severe coronary artery disease (C.A.D.) all over the world and there is evidence that chelation therapy helps patients with severe angina.

I have no particular interest in this therapy and I have to-date not visited the chelation therapy clinic in Colombo. But I have met a number of C.A.D. patients whose cardiac symptoms have improved following chelation therapy.

Majority of patients who received chelation therapy are angiographically proved C.A.D. patients who had been advised to undergo "urgent bypass Surgery" by their cardiologists but were frightened to undergo the surgery. Some of them were in their 80's.

As far as I am aware there have been no deaths due to chelation therapy during the last 20 years unlike coronary artery bypass surgery which carriers a mortality rate of about 5 to one per cent.

Randomized trials

Coronary bypass surgery as a planned approach for patients with angiographically proved C.A.D. was begun by Sones and Favalro in 1967 at Cleveland Clinic Foundation without any randomized trials.

Nobody questioned about medical ethics (1967-1983)

In UK in 1971 mortality of bypass surgery in most of the cardiac centres was 25 per cent. Results of randomized trials about bypass surgery was published in medical literature only after 1983 and by that time more than 100,000 patients with C.A.D. have been subjected to bypass surgery and from 1967 to 1983 nobody questioned about the medical ethics of doing by-pass surgery without performing any randomized controlled trials.

Digitalis (Foxglove)

William Withering published his famous book on Foxglove (digitals) in 1785 and this life saving drug was used for treatment of heart failure and atrial fibrillation by the physicians all over the world although there were no randomized controlled clinical trials. Only in early 20th century were randomized clinical trials done using digitalis.

Penicillin

Same is true of penicillin which was discovered by Fleming in 1941 and this very useful antibiotic was used to treat patients without any controlled trials. In 1943, two hundred patients were successfully treated with penicillin and Surgeon of the US Army authorized the use of this drug in military hospitals and was later used for army forces without subjecting this drug to any clinical trials.

Salicylates

This drug was isolated in 1829 and was used for treatment of rheumatic fever in 1875. This drug was introduced into medicine by Hoffmann, a chemist at Bayer who named this drug as aspirin in 1899 without subjecting aspirin to any double blind clinical trials. As far as I know double blind controlled trials were performed only after 1950 by millions of patients had been treated with aspirin although there were no double blind controlled trials.

There have been so many other drugs, medical and surgical procedures which have been used without double blind controlled trials.

Chelation therapy had been started as a recognised procedure in treatment of patients in 1944 and EDTA chelation therapy has been successfully used to treat angina from 1955 to date.

News | Business | Features | Editorial | Security
Politics | World | Letters | Sports | Obituaries |

Produced by Lake House
Copyright 2001 The Associated Newspapers of Ceylon Ltd.
Comments and suggestions to :Web Manager