As of Tuesday, June 18, 2013
DEAR DOCTOR K: I have heart disease. Will chelation therapy help reduce my risk of a heart attack?
DEAR READER: That’s a timely question, because a recent study of chelation therapy has generated a lot of interest and debate.
Chelation therapy is used to eliminate metals or other toxins from your body. During the procedure, chemicals are infused into your bloodstream. When these chemicals find unwanted substances as they travel through your blood, they attach themselves to them and carry them out of the body in your urine. For people with toxic levels of lead or mercury, chelation therapy is an FDA-approved method to help with their removal from the body.
Its use for heart disease is more controversial. Here’s the idea: Heart disease results when your blood vessels are narrowed by atherosclerotic plaques that limit blood flow. These plaques are largely made up of fat, cholesterol and calcium. Chelation with a chemical called EDTA pulls calcium out of atherosclerotic plaques — or so the thinking goes. This is supposed to shrink plaques and make artery walls healthier. Thus, the risk of heart attack, stroke and other problems related to blood vessel diseases should decrease.
For decades, chelation practitioners have claimed that the procedure works. But results of a recently published study didn’t support the positive claims.
The study included 1,708 adults age 50 and older who had a previous heart attack. Half of the patients got 40 infusions of EDTA solution along with high doses of vitamin and mineral supplements. Half got a placebo (saltwater) solution. People were chosen for the chelation therapy group and the placebo group by a random process.
The researchers followed the patients for about 4.5 years. Twenty-six percent of people in the chelation group had heart attack, stroke or hospitalization for chest pain or heart bypass surgery. That was compared with 30 percent of patients in the placebo group. Statistical testing showed that the slightly lower rate of heart problems in the chelation group could have occurred by chance.
More troubling was the fact that many people who were assigned to have chelation therapy never actually received the therapy. Nearly 20 percent dropped out of the study before completing the therapy. So drawing conclusions about the value of chelation therapy from this study is difficult.
There are more established ways to prevent heart attacks, stroke and premature death. For example:
— Get active
— Eat better
— Don’t smoke — Control cholesterol
— Manage blood pressure
— Lose weight
— Reduce blood sugar
If you already have atherosclerosis, you should be taking a statin drug and a daily aspirin.
If you take these steps, I think the current evidence says that you’re unlikely to get any extra benefit from chelation therapy. In contrast to that inconclusive evidence, the evidence on each of these lifestyle changes and medications is conclusive: They all definitely protect you from heart disease, strokes and premature death.
Dr. Anthony L. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.