Question: I recently heard about something called chelation therapy to clean out clogged arteries.  Wouldn't that be better than a bypass to prevent heart attacks?  What is chelation therapy and how does it work?

Answer: Chelation therapy was developed in the mid-1900s for the treatment of heavy metal poisoning.  It involves injecting  chemical binding agents into the bloodstream.  These chemicals will bind themselves to lead, as well as to certain other metals, including iron, mercury, copper and zinc.  Once this binding has taken place, the chemicals and the metals can be excreted from the body through the kidneys and stools.  Another legitimate use of chelation therapy is to treat people who have a disorder called hemochromatosis that can lead to an unsafe buildup of iron in their bodies.

      Two chemicals have been approved by the U.S. Food and Drug
Administration (FDA) for chelation of lead and mercury poisoning.  They are
dimercaptosuccinic acid (DMSA) and ethylenediaminetetraacetic acid (EDTA).
There are also other drugs -- some of which can be taken orally -- that have
been used as chelating agents.

      Anecdotally, some people who have received chelation treatments for
lead poisoning said they felt much better overall after the procedure.
There have also been reports that chelation therapy might improve
circulation, as well.  But, the claims don't stop there.  You can find
proponents advocating what they call "the miracles of chelation therapy" for
improving a wide variety of conditions such as leg cramps, arthritis,
multiple sclerosis, Parkinson's disease, vision problems, psoriasis and even
sexual dysfunction.

      Most of these claims are totally bogus.  However, the high level of
interest -- and the anecdotal information I mentioned earlier -- have led
the National Institutes of Health (NIH) to launch a large scale
investigation of chelation therapy for the treatment of coronary artery
disease.  Their goal is to enroll over 30,000 patients to see if there is
any truth to the claims of chelation therapy clearing out arteries and
improving cardiovascular health.  This study has been ongoing since about
2003 and they hope to have it completed by 2010.

      It may be worth waiting for the findings.  If, indeed, chelation
works to clear arteries, then we will hear about it.  If not, we will hear
that too.  So, the jury is still out on the question of using chelation
therapy to treat coronary artery disease.  And, while chelation therapy is
safe, there are possible side effects to both DMSA and EDTA, so the
medications should not be used unless you really need them.

      I would urge you not to seek chelation therapy for "clogged arteries"
until the NIH jury returns it verdict.  In the meantime, discuss your
concerns with your family physician or a cardiologist.  If you want to know
more about the NIH study, go to their Web site at
www.ccam.nih.gov/chelation.

Family MedicineR is a weekly column. To submit questions, write to Martha A.
Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O.
Box 110, Athens, Ohio 45701, or via e-mail to
readerquestions@familymedicinenews.org. Medical information in this column
is provided as an educational service only.  It does not replace the
judgment of your personal physician, who should be relied on to diagnose and
recommend treatment for any medical conditions. Past columns are available
online at www.familymedicinenews.org.