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John Trowbridge: What are we trying to accomplish with chelation treatments? If a patient is substantially "loaded" with toxic metals, treatment goals will be different than those for one with high-grade blockage disease in critical arteries. Patients suffering with crippling inflammatory and/or autoimmune diseases might require a another approach.
Injectable and oral medication alternatives to EDTA should be considered, depending on a variety of factors. However, 60 years of beneficial and safe reports regarding EDTA would argue for that to be the basic IV chelator. Others could be added in ways that maximize their safety considerations as well, such as oral DMPS, DMSA, and d-penicillamine, as well as IM DFO.
With different stability constants and side effects, using two or more chelating agents at the same time poses potential risks to the patient. The simplest way to avoid such unpredictable interactions is to administer one chelating drug at a time. In 1993 I developed the idea of administering different chelating drugs on an intermittent, pulsatile schedule. This protocol avoids the potential of interaction of two or more chelation drugs but still allows for exploiting the "preferences" of each drug for different toxic metals. Extra physiologic minerals would, of course, be needed to handle the additional chelator load.
To minimize side effects, I have patients take 1 250 mg tablet each evening during the week. For example, a patient might be advised to take d-pen 250 mg each bedtime on days 1-7 of the month, then DMSA 250 mg each bedtime on days 8-14, then d-pen again on days 15-21 and DMSA again on days 22-28, with a "break" until day 1 of the next month. I do not mix IV EDTA with DFO, nor do I give d-penicillamine or DMSA within 4 to 6 hours of EDTA IV.
With the changing urinary elements test reports, a patient might be told to take just d-pen or DMSA every day of the month. Now that oral DMPS is readily available, it might be inserted into the "weekly" protocol as well, especially when mercury levels are substantially elevated on the test report.
By 1997, I had confirmed that our reduction of toxic heavy metal body burden - as measured by the d-Pen challenge urinary elements test - was proceeding at a rate at least one-third faster than with IV EDTA alone.
Two serious mistakes that beginning doctors often make when giving chelation therapy are insufficient attention to mineral depletion and too rapid reduction of cardiovascular medications. Ample minerals must be supplied, either orally or IV, and gradual reductions of meds are required in order for the body to "relearn" more normal functions.
Conrad Maulfair: With calcium being an important factor in the aging process and in the atherosclerotic disease process, we want to have the maximum benefit from its removal that is possible. I personally am a strong advocate of the 3-4 hour chelation treatment simply based on clinical experience.
Patients suffering from end-stage chronic degenerative diseases are misled when they read or are told that oral application of chelating agents and in particular EDTA can be an alternative to a comprehensive chelation therapy program including the parenteral administration of EDTA. A patient having significant end-stage disease opting to take an oral chelation product because it is cheaper and does not require a personal commitment of time and involvement is most assuredly going to experience a poor outcome. A practitioner who encourages a patient with significant disease to think that using oral chelation is better than doing nothing is being as irresponsible as allowing a patient uncontested to continue to smoke one pack of cigarettes a day because it is better than the two packs a day that he/she had previously smoked.
Garry Gordon: There are many articles and studies that support the use of calcium EDTA. A great number are listed on my website. I have listed 507 abstracts that document the usefulness of oral calcium EDTA to protect lead workers from toxic exposures. Patients who have leaky gut might benefit more from oral EDTA due to enhanced absorption. Blumer and Cranton's classic article that was included in Cranton's textbook showed a 90% reduction in the incidence of cancer for patients with high levels of lead who were treated with intravenous calcium EDTA.
The reported results with IV calcium EDTA for patients with kidney failure and/or diabetes are impressive. This alone should stimulate a flood of research to examine the benefits of calcium EDTA.
Neither author has any conflicts of interest to report.
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L. Terry Chappell, MD, is in private family practice in Bluffton, Ohio. He has served as president of ACAM and ICIM and was an investigator for TACT.
Jeanne A. Drisko, MD, CNS, is the Hugh D. Riordan Endowed Professor of Orthomolecular Medicine and director, KU Integrative Medicine at the University of Kansas Medical Center. Dr. Drisko started KU Integrative Medicine at the request of the dean of the School of Medicine in 1998. KU Integrative Medicine has flourished and includes the four pillars of the academic institution to include patient care, research, teaching, and service. She also served as president of ACAM and as an investigator for TACT.
Dr. Jeanne Drisko
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