Sunday, April 15, 2012

Drano for your heart?

There is a growing number of people around the world who believe they have found an alternative treatment for clogged arteries. The idea is to use a kind of molecular Drano and slowly remove the plaques that line the artery walls. It is called chelation therapy.

Is there any evidence that shows this treatment is good or bad?

Almost...

The National Institutes of Health (NIH) has completed data collection on a large-scale double-blind clinical trial to assess the efficacy of chelation therapy to treat coronary artery disease (CAD). This study is called the Trial to Assess Chelation Therapy or TACT. Though the trial itself has had its own trials and tribulations the study is now complete and the results are being mulled-over by the primary researchers at the Mount Sinai School of Medicine with the intention of publishing results within this calendar year - 2012.

UPDATE: Publication of results now postponed until February 2013!

Why am I interested in this? Doesn't this study pang of "alternative medicine" aka - quackery? 

I await the results with extreme anticipation because of my father. 

My decision to go into science and complete a PhD in biochemistry was made in direct response to my father and his seemingly unreasonable evangelism of chelation therapy as treatment for clogged coronary arteries. My father is a firm believer that chelation therapy saved his life. I think he perhaps got lucky somewhere amid the myriad "alternative" treatments he underwent with no scientific way to assess whether the chelation therapy helped or harmed him. The reality is that until this point there has not been a sufficient study to make a scientifically sound assessment of this treatment.   

While I was in high school in the late 1990s my father (now 80 years old) had heart problems - namely congestive heart failure and arrhythmia. He was a lawyer-turned-vitamin salesman and had it in his head that he did not want to end up dead like many of his contemporaries. I watched as many of his life-long buddies had open-heart surgery only to die weeks or months later from pneumonia, MRSA or other illnesses brought on by their chest cavities having been cracked open. 

After having a spiral CAT-scan of his heart at age 65 my father was told he had up to 80% blockage in some of his coronary arteries. His cardiologist suggested bypass surgery but my father did not want his chest opened up. He had heard through friends in Erie, PA that he could try an alternative treatment with no surgery. He signed up and against the advice of his cardiologist began to receive weekly doses of intravenous EDTA and tetracycline in order to remove the plaque from his arteries. He repeated this every week for many months. After the initial intravenous treatment he switched to a maintenance program of monthly EDTA suppository that he has been on ever since. 

The idea that EDTA or ethylene diamine tetraacidic acid injected in a person's blood could wrestle away calcium deposits (aka apatite) from the walls of hardened arteries seemed to-good-to-be true to me. This was until I went to the dentist's office in graduate school.  I had and still have a orthodontic retainer behind my lower front teeth (I am now 29 years old).  Every 6 months I have to have the accumulated plaque removed from the back of my lower front teeth which builds up due to higher concentration of dead and dying bacteria there due to the retainer.  While I was in graduate school visiting the school dentist the dental hygienist told me that keeping plaque cleared from a person's gums helps fight heart disease by keeping plaque in their coronary arteries low. I was flabbergasted. Here I had a direct link between  bacterial plaque and coronary artery disease.  I could understand that calcium deposits on the tooth enamel were similar to calcium deposits in hardened arteries.  I saw that injecting high concentrations of EDTA would impose Le Chatelier's principle on the calcium ions present in a clogged coronary arteries and thus reduce the size of the atherosclerotic deposits. Despite this theoretical comprehension I was and still am highly skeptical of EDTA chelation therapy. I see my father's success with the treatment as anecdotal. Perhaps he was not as likely to have a heart attack as his vital statistics would have him believe.  My skepticism remains.

Beyond the chelation therapy, my father has for as long as I can remember advocated "preventive medicine" like vitamins and various concoctions sold by his former company - Rexall Showcase International (Now called Unicity).  My father  had unfortunately fell into a pyramid scheme run by a bunch of crooks in the early 90s. I could see right through this bullshit when I was 12 years old! A company named "Sundown" acquired the brand-name "Rexall" in 1985 and used it to lure in "sales associates." Think AMWAY for vitamins. Rexall Drugstores had a shining reputation with old-timers like my father who remembered the good-old-days when Rexall Drugstores were synonymous with root-beer floats and grandpa's heart-burn remedies. Sundown bought the company and used the brand-name (with no connection to the remaining chain of Rexall drugstores) to sell vitamins and weight loss products in big package deals to "sales associates" who could then sell the product to whomever they could convince. I recall the most touted of the panacea powders my father peddled was called BiosLife 2. A disgusting chalky version of what we know as "Emergen-C." But, as Rexall Showcase International's stock tanked, my father's enthusiasm for the brand waned.

In addition to Rexall my father has also evangelized the writing of Julian Whitaker MD. Dr Whitaker as Dad so fondly calls him, writes a weekly newsletter lauding the new advances in "alternative medicine" and telling all subscribers exactly where they can purchase all the new supplements - FROM HIM. 

As much as all this bothered me as an adolescent what really bothered me was that I could not have a rational conversation with my father - a very reasonable man. I love my father and I could not understand how he was so sucked in to to all this crap. I have a hypothesis that he so desperately wanted to be healthy and live a long time so he could be with us into old-age, that he would believe anything. I can't say that he was wrong as he has survived several bouts of congestive heart failure and a mini-stroke. But the fact that he was so manipulated by executives at Sundown/Rexall Showcase International fills me with an uncontrollable animosity towards these snake-oil salesmen. 

I am admittedly skeptical of most of my father's self-prescribed therapies. But as for TACT I have my mind open as "THERE WILL BE DATA!" The pricipal investegator in this study is Gervasio A Lamas, M.D. of Mount Sinai School of Medicine. I have heard that the results will be published and made publicly available around June 2012. Please join me in the assessment of said data! Finally I can have a rational discussion with my father grounded in data on a subject quite literally near and dear to his heart. 


Lamas, G., Goertz, C., Boineau, R., Mark, D., Rozema, T., Nahin, R., Drisko, J., & Lee, K. (2012). Design of the Trial to Assess Chelation Therapy (TACT) American Heart Journal, 163 (1), 7-12 DOI: 10.1016/j.ahj.2011.10.002

Ernst, E. (2000). Chelation therapy for coronary heart disease: An overview of all clinical investigations American Heart Journal, 140 (1), 139-141 DOI: 10.1067/mhj.2000.107548
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