Cardiovascular Chelation

MAY 2010Cardiovascular Chelation

Personal Pollution and Matters of the Heart

“This can’t be happening” is often the first thought. Gripping, gnawing chest pains give way to a heavier, crushing feeling that generates fear. The idea of “indigestion” soon gives way to “impending doom.” In this setting, 9-1-1 is sometimes a reluctant last resort, after antacids and resting produce only a pitiful response.

The arrival of paramedics brings reassurances from technicians who methodically start oxygen, apply EKG leads, and prepare for transport. Nurses and doctors in the emergency room go about their duties calmly and with dispatch – starting IVs, administering medications that relieve the urgent worry. Transfer to the coronary care unit is swift and easy, and monitors beep with the soothing monotony of a metronome.

From A to Z, everything about the medical team responses engenders trust and dependence in the patient: “These folks really know what they????re doing. Thank God I got here in time.” Trusting eyes gaze into the cardiologist????s face, searching for any clues that the situation is worse than it might appear. Again, reassurance: “You’re here, you’re safe – we need to do some tests to figure out how best to fix you now.”

Slippery slope? Conveyor belt? One-way road to a “dead” end? Many terms have been applied to the “work-up” and “treatments” offered in modern cardiology and cardiovascular surgery. In point of fact, major studies 30 years ago showed that one in six bypass operations are life-saving, when high-grade blockage is worsening in the left main artery or early in the left anterior descending (LAD) artery (the “widow-maker” or “artery of sudden death”)1.

Then what of the other five in every six patients? Therein lies the rub.

‘Treating’ with Tests

Everyone knows about the routine resting heart tracing: 12-lead EKG, often with a “rhythm strip” of several seconds. The predictive value is minimal in the absence of symptoms or an irregular pulse2. A 24-hour (or longer) Holter monitor gives valuable insights into rhythm disturbances but has little use in confirming “ischemic” disease, where blood flow to regions of the heart muscle is becoming compromised. Worthy of comment is that ischemic patterns can be documented in patients without blockage in the heart arteries but with magnesium deficiency or other conditions creating episodes of heart artery spasm. Vasospasticity can constrict blood flow transiently, and chest pains, shortness of breath, weakness, pale complexion, and sweating can mimic heart “angina pains” or even “myocardial infarction (MI).”

Angina simply means reversible chest pain events, often responding to nitroglycerin-type medications. The success of these drugs produces further patient trust that the cardiologist “knows how to treat me.” Myocardial infarction results from sudden blockage of blood flow to a (small or large) portion of the heart muscle. A heart artery already narrowing from deposits of plaque is more easily blocked completely by sudden formation of a platelet plug, also called a “thrombosis” (ACS or “acute coronary syndrome”). More recent studies show that the gunk in plaque is more likely to break off if a smooth hardened surface has not formed (so-called vulnerable plaque). Such free-floating chunks will always find a smaller arteriole and lodge there, blocking blood flow beyond … a heart attack3.

Vasospastic episodes can occur in patients who have artery blockage disease and in those who do not. When tests show minimal blockage that should not be causing angina episodes, cardiologists are sometimes stumped and nevertheless recommend “revascularization” procedures: balloon angioplasty, stents, even heart artery bypass. Each of these operations is based upon a “Roto- Rooter” plumbing concept of heart disease: open the plugged pipes or simply route around them.

This “conventional cardiology concept” comes from the tests upon which they rely in figuring out how to fix heart disease4. Simply stated, “If the only tool you have is a hammer, then all the problems you see look like nails.” Since many cardiology tests look at the “plumbing,” the treatments advised are designed to address flow blockages that can be seen. That viewpoint creates the fundamental restriction – blinders, if you will – preventing well-trained cardiologists from being able to see the value of treatments other than those in their “plumber’s toolkit.”

One of the most widely known heart tests is the “stress EKG.” A blood pressure cuff is applied, patches with electrical leads are placed on your body, you begin to walk on a treadmill, and the workout is gradually increased to a jog5. If your legs become fatigued, if you become short of breath, or if the heart tracing shows certain changes – “flags” that indicate problems – then the test is concluded; otherwise, you race along to a calculated heart rate. Comparing your blood pressure changes to the exercise heart tracing gives a hint of how well your heart muscle is working; in other words, how well your blood is flowing to your heart and other muscles.

Even a “negative” (“normal”) stress test is often followed by a “nuclear stress test,” simply because your cardiologist “wants to be sure.” This examination starts with a stress test followed immediately by a radioactive “tracer” injected just as a fancy Geiger counter is placed over your heart. About four hours later, you are placed under the Geiger counter again. Images “after exercise stress” and “at rest” are compared – if the tracer pictures after exercise show “holes” that later “fill,” you have blockage disease restricting the blood flow. If the “holes” don’t “fill” later at rest, then you have had one or more heart attacks where muscle tissue has been replaced by thickened scar. No “holes” after exercise? Then you appear to have adequate blood flow to your heart muscle.

Even a “negative” (“normal”) nuclear stress EKG is often followed by a “coronary angiogram” (heart artery “pictures” – also called an “arteriogram” or “catheterization”), simply because your cardiologist is “being complete” in your evaluation after being admitted for chest pains. Trusting your doctor – and reassured by your test reports so far – you naïvely consent to this much more invasive test. A catheter (tube) is placed into a large artery (as in your groin) and advanced to your heart, where X-ray dye can be injected to outline the pattern of your heart arteries. One tiny technicality: the severity of diameter narrowing is commonly overestimated by 30% to 60%6.

Bingo! Narrowing is likely to be identified, since you did come in with chest pains. Now your cardiologist has a reason to recommend “balloon angioplasty” (another tube, this one with a blow-up tip that crushes 65, according to the National Center for Health Statistics. During 2006, some 2,192 heart transplantations were performed7.

But What If You’re ‘One of Those Five’?

If only one in six patients has a heart bypass operation8that is life- saving or life-extending, what is the blockage against the wall of the artery), often with placement of a “stent” (sort of a Chinese finger-trap in reverse, where it is inserted stretched out then “springs open” to press against the wall of the blood vessel). Modern stents are “radioactive” or coated with “chemotherapy,” to reduce your body’s attempt to cover over this strange device, thereby narrowing the artery again.

Balloons? Chemotherapy? Radio- activity? You might have a few questions, but your cardiologist is reassuring that you’ll probably be able to avoid “open heart surgery” (a bypass operation). Now that’s appealing! Once again, you innocently consent to another procedure, hoping that your future will be bright and comfortable. But the results from surgery can’t ever be guaranteed.

Speaking of surgery – what happens if your cardiologist invites a cardiovascular surgeon to discuss a bypass operation with you? For the vast majority of patients, the answer is simple: your lack of knowledge about options will mean that you trustingly agree to have the surgery. Americans are suffering in droves, like lemmings to the sea: in the US in 2005, 469,000 coronary artery bypass procedures were performed on 261,000 patients. An estimated 1,265,000 “stent” procedures were performed; approximately 69% of these were performed on men and approximately 50% on people aged situation for those other five patients who also often undergo the surgery? Most survive, some do not, many feel better … but their improvements might well have been possible with modern medications and lifestyle changes alone9. Virtually every “open-heart” patient will suffer some slight or significant degree of “pump syndrome,” neurological or mental changes associated with the heart- lung pump10. About 1 in 20 bypass patients will die during or soon after surgery. Of those who survive, over half can be expected to suffer fairly dire concerns over the next 12 months: heart attack, stroke, heart rhythm disturbance, congestive heart failure, or rising blood pressure. And each of these events will force these patients back into the trusted arms of their cardiologists and consulting medical specialists.

Perhaps one of the best reviews of the limitations, side-effects, and outright hazards of angioplasty, stents, and bypass surgery can be found in several chapters of the book, Is Heart Surgery Necessary? What Your Doctor Won’t Tell You, by Julian Whitaker, MD.1 Before undergoing any of these procedures, every patient owes his family – and him- or herself – the time to read and understand these risks, in order to question his doctors appropriately and be able to give an actual informed consent, should he so choose.

What About Treating the Patient?

Wait! Can you actually afford to wait, do you have the time – the luxury – to read this and other books, to get the true details for yourself? While doctors sometimes give the impression that “you’re a ticking time bomb, we’ve got to move quickly,” published studies have shown quite the opposite conclusion. Harvard cardiologist Peter Graboys showed, 20 years ago, that patients who chose to wait before having bypass surgery suffered no deaths from heart disease over the next 21⁄2 years11. A second study showed only a 1.1% annual death rate from heart disease over the following five years for those who politely (or not so!) declined to have an angiogram, likely concluding that this was just “a map for surgery” that they were reluctant to undergo12. This rate is far below an estimated up to 5% death rate for bypass surgery. Balloon angioplasty surgery offers an estimated 1% deaths, but recurrent procedures are quite likely. Recognize that Harvard’s cardiology staff used only routine medications available at that time, along with “usual” lifestyle changes – diet, exercise, and so on. As conventional physicians, they had little interest (or faith) in integrative technologies such as nutritional supplements or chelation therapy. The combined use of (even more modern) medications now, along with specific “orthomolecular nutrition” and chelation, would be predicted to enhance further the startling results that they obtained with minimal effort, and clinical experience supports that expectation.

Rather than progressing rapidly to invasive and potentially risky tests, an integrative physician sometimes will order a set of echocardiograms, basically “sonar” ultrasound pictures of heart muscle performance. When valves and heart muscle function appear reasonably normal and the “ejection fraction” (percentage of blood pumped from the heart with each beat) is normal or almost so, then performance has been preserved even though blockage disease might be present. Activity or exercise might display reduced capacity, consistent with blood flow reduction. A patient with frequent angina, and especially with chest pains at rest, is more likely to have blockage changes best treated first by surgery unless he or she refuses and an aggressive nonsurgical treatment program is pursued13.

The recent availability of “heart scanners” (EBT, or electron beam tomography) has helped to quantify the degree of blockage present as well as its location. This 10-minute test uses minimal radiation and gives reasonably reliable pictures, from which a heart artery diagram of calcium-hardened blockage can be constructed. Again, “high-grade” (severe) blockages early in the left- side heart arteries can move a patient toward the “surgical option” for best survival, with follow-up chelation to treat the underlying cause.

An integrative physician offering chelation therapy will, of course, review and consider cardiology tests available from other specialists in order to best plan a treatment program. Angiogram pictures, though, will rarely be required.

Nonsurgical Treatment of Heart Disease?

Can blockage disease be effectively and safely treated without surgery? The answer, as demonstrated by dozens of clinical studies and case reports over the past 50 years, is an unreserved “Yes!”

However, reduction of blockage should be considered only a possible and desirable side effect and not the goal of a chelation treatment program. An early thought in the late 1950s was that chelation “worked” by removing artery blockage. This seemed a logical way to explain observed improvements in heart function, EKG patterns, congestive heart failure, chest X-ray images, angina chest pains, shortness of breath, and activity levels14. Without question, some patients do show reduced blockage, as demonstrated by before-and-after-treatment heart scan images in two patients reported to the American Chemical Society in 199415. Of interest is that virtually 9 out of 10 patients show improved heart performance – but not all of those show reduced blockage disease by any test performed16.

Another factor to recognize is that our tests are less than precise in quantifying the degree of blockage present, whether improving or worsening patterns. Several assumptions are made in each test setting (heart, carotid neck arteries, abdominal aorta, legs, and so on). The presumed “gold standard” – such as heart angiograms – are difficult to interpret at best … and the same test can be read differently on different days … by the same cardiologist. If blockage doesn’t disappear with chelation, then what could explain the obvious and dramatic clinical improvements in the vast majority of patients? In actual fact, blockage probably is reduced in many arteries: a 10% to 15% increase in “cross- sectional diameter” (the area through which blood can flow, where larger diameters have less resistance to flow) produces double (or more) blood volume delivered to tissues downstream17. Current tests fail to reliably detect such small reductions in blockage with increases in blood vessel diameter – but the patients can clearly feel and enjoy the improvements, as overwhelmingly noted with chelation therapy. The use of artery bypasses and stents is based upon increasing the diameter of a “feeding” vessel, but such operations involve many risks and the duration of improvements can be limited. Indeed, the diameter increases of bypasses and stents are noted only at the operation site and not generalized throughout the arterial system as with chelation therapy.

Studies documenting patient improvements with chelation are well summarized elsewhere18–20. What has received very little attention is how much these improvements can be attributed to decreased toxic metal burdens – coincidentally reducing inflammation – and other mechanisms. When platelets have less free radical inflammatory injury, they become less “sticky,” less likely to form sudden “clots” or “plugs” and completely block ailing arteries. When magnesium is provided in large doses, blood vessels more readily dilate to increase flow volume and have less spastic tendency to restrict flow. Vitamins B6 and C, amino acids lysine and proline, essential fatty acids, zinc – these and other nutritional supports that are provided during a series of chelation treatments clearly help to stimulate improved clinical function, detoxification, and tissue repair. Even nattokinase (or lumbrokinase), which lowers blood flow “viscosity” by reducing free-floating monomer fibrin strands, might help explain some of the benefits seen in advanced chelation programs.

What About ‘Personal Pollution’?

All chelating medications share in common one key property: forming a particular chemical bond with certain positively charged ions (metal atoms)21. This drug–metal complex allows for easier removal of the metals through the kidneys. In many cases, the chelating drug prefers to bond with so-called heavy metals that are toxic to the body. Reducing the presence of toxic metals allows for usual “physiologic” chemical reactions to proceed more normally.

Toxic metals insert themselves in place of appropriate metals (such as magnesium or zinc), “sitting” on active sites in enzymes and blocking needed chemical reactions. In addition, they stimulate a tremendous increase in the rate of production of “free radicals” (also described as “oxidants” or “ROTS,” “reactive oxygen toxic species”) that inflict lasting damage to body cell structures, especially those involved in the mitochondria, the tiny “energy-factories” that produce the ATP that powers all cell processes in all cells. (Antioxidant vitamins – such as vitamins C and E and beta-carotene – glutathione, and other molecules help to protect vital molecules from free radical injury22). Another concept to describe free radical production is inflammation, the destructive and powerful process that creates the pain of arthritis, of heat and chemical burns, and basically all departures from normal function and physiology. Blockage within blood vessels, of course, is one of these “departures.”

A better understanding of how toxic metals lead to suffering and death is found in several observations over the past 40 years, almost from the time humans began in earnest to poison the planet. Animal studies have shown that heavy metals are uniformly neurotoxic, immunotoxic, carcinogenic, and directly harmful to all vital organ systems. The onset and severity of suffering depends, of course, on the dose and exposure patterns as well as cellular compartmentalization and tissue equilibration. Death follows slowly or rapidly based on the same criteria. Toxic heavy metals are throughout the environment (air, food, water, objects) and there is no way to avoid them entirely. Since they come into your body easily but leave much more slowly, all of them accumulate over time and increasingly interfere with body metabolism.

Every person will suffer some (slight or increasingly significant) degree of impairment among his or her many organ systems, based upon his or her exposures, nutritional status, biochemistry, physiology, and so on. Basically, the “weakest link” in each individual will begin to show toxic damage first. In a more global holistic view, virtually all human ailments (including expression of genetic aberrations) can be aggravated by – or even directly attributed to – increasing burdens of toxic heavy metals23. Since bioaccumulation from the environment cannot be avoided, attention must be directed to minimizing exposure and removing those that have gained entry. The medical procedure of removing them, of course, is called “chelation therapy.”

A general idea of the magnitude of “toxicity” can be gleaned from providing tainted cage water to rodents, where their only liquid source is laced with a heavy metal. Daily water intake is based on animal weight. Thus, calculations can be made regarding how much of a particular toxic metal was required to kill any individual animal. The lowest dose that killed the first one is noted. Amounts are recorded all the way up to the highest dose, the one that finally killed the last remaining animal in a group of 100. These name for this group of concentrations is lethal dose (LD), and a number is appended, to indicate the population percentage that has succumbed to that amount of toxic metal. For example, the LD1 is the concentration to kill the first animal; LD50 is enough dosage to kill half of the subjects (50 out of the 100). The LD100 dose is the amount that will kill all of the animals.

Of greater concern to people who think they have only minimal exposure to toxics is that small amounts of different toxic heavy metals can combine to create ever more destructive changes. The overwhelming majority of people are lulled into a false sense of security that they “don’t have too much toxics on board, their levels are really ????low.’” One rodent study showed that combining the LD1 level of mercury with 1/20th the LD1 level of lead in the cage water did not kill just 2 animals (addition), it did not kill 4 or even 8 animals (multiplication) – this seemingly inconsequential combination killed all 100 of the rodents (amplification)24. Extending the implications to human beings is sobering, particularly when we are making our environment increasingly toxic. Modern medicine has no other method to remove toxic metals (as or after they enter) than the chemical process of chelation. Indeed, this is the only FDA-approved method of detoxifying from this heavy-metal toxic body burden.

Treating the ‘Personal Pollution’

The question, does chelation work? was well answered in the very earliest studies, in the 1950s, by Norman E. Clark Sr., MD, the “father of chelation therapy in America” 25. Subsequent studies have confirmed his early observations, with rare exception (and those often criticized as having faulty scientific design or controls). But two questions arise: first, will chelation help all blood vessel problems? And second, what about over-the-counter oral products that might work just as well as the intravenous treatments?

The range of occlusive (blockage) blood vessel disorders – in the heart, neck, brain, central core (including kidneys), and legs – has been widely studied. The results are uniformly positive, though the percentages of those areas that improve rise with increasing distance from the brain. As a clinical rule-of-thumb, “brain” and “eye” problems improve significantly about 75% of the time, heart problems about 88%, and leg problems about 92%. (Some studies have suggested even better results26,27). The differences deserve further investigation, but suffice it to say that they probably relate in some degree to different forms of calcium deposition (“hardening”) in the different artery walls.

The most common diseases causing significant blood vessel blockages are diabetes (both types, especially when poorly controlled) and high blood pressure (“hypertension”). In both conditions – as in most others – the improvements with chelation can be startling. Legs scheduled for amputation – a frequent conclusion for diabetics – have been largely saved by chelation treatments28,29. Clinical experience confirms that blood sugar control is often improved, sometimes dramatically, and dosages of insulin or oral hypoglycemics can be reduced for many patients … reducing side effects, of course.

The sugar-control implications for “metabolic syndrome” (an inaccurate title for “insulin resistance syndrome”) are overwhelming. Also misnamed “cardiometabolic syndrome,” this pattern shows elevating blood pressure, blood sugar, and triglycerides, lowered HDL (“heart protective”) cholesterol, along with enlarging waistline. This cluster of disease findings is associated with higher incidences of heart attacks and strokes, two of the top three leading killers in the US. Chelation therapy produces impressive results in these patients. Results in other disease conditions (such as Raynaud’s phenomenon, scleroderma, systemic lupus, rheumatoid arthritis, Parkinson’s, and so on) are similarly encouraging30.

So the second question – “over- the-counter” items that might help – raises some interesting concerns. For example, when people order the latest hyped-up bottle from a newsletter or other brochure, are they really worsening inside while they delay seeking actual, scientific, evidence- based chelation therapy? Younger people, with lesser exposures to toxics and fewer degenerative issues, might “buy some time” with such readily obtained “nutritionals.” Older folks – especially those with degenerative diseases or (even unknown) history of prolonged or extraordinary exposures – are walking straight into the lions???? den. While any one individual might live a long and fruitful life without actual chelation, the vast majority are likely to succumb to the common killers, usually at the common ages. Even sequential “negative” (“normal”) test reports showing minimal blockage changes in arteries are no protection against sudden blockage from “sticky” platelets or other results of localized inflammation.

The longer-lived European (especially Mediterranean and Baltic) societies, particularly those whose citizens remain vital and active late in life, can offer some hints as to useful dietary counsel. Sulfur – found in onions, garlic, many grains, legumes, red meats, eggs, nuts and seeds, broccoli, cabbages, even milk and asparagus – readily binds with toxic heavy metals, but only weakly. Selenium – found in Brazil nuts and a variety of meats – also can bind to heavy metals. When foods are grown (or animals are raised) in sulfur- or selenium-deficient soils, they have minimal amounts of these valuable minerals. Their use as significant “chelators” – even in the form of alpha-lipoic acid or methyl-sulfonyl methane (“MSM”) or N-acetyl-cysteine (“NAC”) – has not been adequately studied.

Some publicly promoted products have cilantro, chlorella or other algae, and other botanical nostrums and are widely touted as helping to remove toxic metals. Again, their use as significant “chelators” has not been persuasively studied. Claims are made for EDTA in various products administered orally, but none of these have been subjected to rigorous scientific studies in any ways that successful intravenous EDTA chelation has been evaluated. Indeed, a number of formulas also have the nutritional element chromium listed as an ingredient in the same capsule or tablet. Once EDTA “finds” the included chromium, it binds more strongly than with almost anything else and is only slowly released. So, you get virtually no benefit from the chromium or chelation value from the oral EDTA.

If neither foods nor over-the- counter “oral chelators” offer much prospect of demonstrable lasting improvement, then what options exist other than intravenous chelation therapy? Here we are treading on “unstudied ground” once again. Heavy toxic metals interfere in so many ways – blocking enzyme and other metabolism reactions, creating inflammation, making “sticky” platelets, “rusting” the inner linings of blood vessels and thereby encouraging blockage, damaging brain and nerve functions, impairing immune defenses, encouraging the development of cancer, and so on. Theoretically the reduction of the total body burden, by any means, should aid the restoration of more normal functions.

Several chelation medications – such as D-penicillamine and DMSA – have been given orally, safely, for many years. Perhaps the detoxification of heavy metals cannot work nearly as successfully as intravenous EDTA. However, speculation can be offered: carefully prescribed use of various oral chelation medications might, over long periods of time, offer important benefits to people unable or unwilling to take in-the-vein treatments; however, they might forego some (possibly critical) improvements with artery blockage disease. In the near future, this would be a fruitful area for study by the National Center for Complementary and Alternative Medicine (in the US National Institutes of Health).

When Hot Dogs Are Banned …

Based on the studies available over the past 60 years, should we be optimistic regarding chelation therapy – whether intravenous EDTA or various oral chelator medications – finally becoming available for the majority of Americans? Absolutely not.

At a recent trial, where I was serving as an expert witness for the defense, the state medical board attorney noted: “Since EDTA and other chelation medications are approved by the FDA for removal of toxic metals, then really their use is “conventional” medicine practice, not “alternative” or “integrative,” right?” My reply: “Well, yes, except for one teeny-tiny technicality.” “What’s that?” asked the prosecutor. “The state medical boards.” “Why do you say that?” he asked, surprised. “Isn’t that why we’re in this trial? All of the medical boards ignore approval by the FDA, ignore the clear evidence found in the medical literature, and ignore the overwhelming reports of patient benefits from chelation – and they prosecute the doctors offering the treatment, just as you are today.”

A recent pediatrics study claims that 10,000 emergency-room visits are made each year for children who are choking on hot dogs. Some six dozen reportedly die. Each year. If that many patients suffered death as a result of chelation therapy properly administered, the treatment would have been banned several dozen years ago. In sharp contrast to the “wiener losers,” whenever any single patient complains of “side effects” or – as happens every few years, when a patient ill enough to finally seek chelation treatments dies anytime during the therapy program – the state launches a full-scale investigation, usually seeking to remove the “offending” doctor????s license to practice medicine31. As a society, we tolerate dozens of deaths from the lowly hot dog – at the same time we tolerate dozens of millions of preventable deaths and untold suffering from heart attacks, strokes, high blood pressure, kidney failure, macular degeneration, and amputations for gangrene, among the many disease conditions that could have been helped by chelation. When will the public demand a change of policy that we can believe in?

Chelation drugs have long been approved as safe and effective by the US Food and Drug Administration (FDA). In fact, the Evers case (1978) was a hallmark advance in guaranteeing that doctors may use drugs approved for one purpose for any other condition; a chelator was the subject of dispute with the government.

Commonly Used Chelators

  • Calcium-EDTA (Sodium-EDTA was recently withdrawn from the market but is available by special compounding)
  • D-penicillamine
  • DMSA
  • desferrioximine
  • DMPS (widely approved around the world, available in the US by special compounding)
  • BAL (the very first, less commonly used)
  • Various formulations are available, including intravenous, oral, rectal, intramuscular, and transdermal.

Toxic metals have no purpose inside the body. Whenever present, they interfere with normal, necessary biochemical reactions, often by displacing and “substituting for” the usual physiologic metals in enzyme molecules. Impaired enzymes cease their conversions of “Substance A” to “Substance B,” eventually bringing cell metabolism, repair, and reproduction to a standstill. Apoptosis (dissolution) of such poisoned cells is the common result. Unfortunately, the toxic metal is still present in the body and can affect other cells as well. One unexpected result of osteoporosis is due to the body’s attempt to sequester (“hide”) lead in the bones, keeping it farther away from more essential cells and tissues. As bone dissipates in older age, lead is released and can cause increasing damage even though it might have been present for dozens of years. These and other observations might explain many of the wonderful results claimed by most patients, as their heavy toxic metal body burden is reduced through chelation therapy.

Common Toxic Metals
lead | mercury | arsenic | cadmium | nickel | tin | aluminum | antimony … among others group of concentrations is lethal dose (LD), and a number is appended, to indicate the population percentage that has succumbed to that amount of toxic metal. For example, the LD1 is the concentration to kill the first animal; LD50 is enough dosage to kill half of the subjects (50 out of the 100). The LD100 dose is the amount that will kill all of the animals.

  1. Coronary Artery Surgery Study, Veterans Administration Study, and the National Institutes of Health Study, each well summarized by Whitaker J. Is Heart Surgery Necessary? What Your Doctor Won’t Tell You. Washington, DC: Regnery Publishing; 1995.
  2. Reliance on a standard EKG can be foolhardy: despite a “normal” tracing at 2 p.m., I admitted an elderly gentlemen to a monitored bed because his story wasn????t quite right; at midnight, he was rushed to the CCU within minutes of the start of his heart attack. Had he been home, he likely would have died.
  3. Corti R, Farkouh ME, Badmon JJ. The vulnerable plaque and acute coronary syndromes. Am J Med 113(8):668-680, 2002.
  4. Each of the ideas presented here applies to other blood vessel problems as well – such as “peripheral artery disease (PAD, or “abdominal aortic aneurysm )” or “carotid artery disease” – but this commentary is focused on heart disease issues.
  5.  If arthritis, weakness, or other conditions prevent you from walking or running, medications can be injected that will race or work (“stress”) your heart, in order to perform this test.
  6. Lim MC-L. Advanced CT imaging: effective diagnosis of coronary disease. Asian Hosp Healthc Manag. diagnostics/ct_imaging.htm. Accessed February 18, 2010.
  7. Heart disease and stroke statistics – 2008 update. A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. Epub 2008;117:e25–e146.
  8. Also called “coronary artery bypass graft” operation, or “CABG” (pronounced “cabbage”)
  9. These statistics were derived in studies some 30 years ago, long before many of the advanced heart and blood pressure and rhythm-controlling medications were available to cardiologists.
  10. Butler J, Rocker GM, Westaby S. Inflammatory response to cardiopulmonary bypass. Ann Thorac Surg. 1993 February;55(2):552–559.
  11. Graboys TB, Biegelson B, et al. Results of a second-opinion program for coronary artery bypass grafting surgery. J Am Med Assoc. 1987;258:611–614.
  12. Graboys TB, Biegelson B, et al. Results of a second-opinion trial among patients recommended for coronary angiography. J Am Med Assoc. 1992;258(2):537–540.
  13. Patients often expect to receive the treatments that they have self-selected as “appropriate” – surgery is sometimes the best choice, since other treatments can be done only on live patients.
  14. Clarke NE, Clarke CN, Mosher RE. The “in vivo” dissolution of metastatic calcium, an approach to atherosclerosis. Am J Med Sci. 1955;229:142–149.
  15. Rubin M, Rozema TC, Casdorph HR, Scarchilli A. Cardiac decalcification by Na2MgEDTA. Presented at: American Chemical Society, 208th meeting. Washington DC, 1994; as reported in Messerli FH, ed. Cardiovascular Drug Therapy. 2nd ed. New York: WB Saunders Company; 1996:1613–1617.
  16. In my clinical experience, not unusual is the patient showing clinical improvement while the follow-up heart scans show reduced calcium scores (correlating to blockage) in some arteries and increased scores in others. Further, I have had one patient whose ultrasound showed
    moderately severe carotid neck artery blockage; one side showed dramatic reduction of blockage while the other clearly intensified, leading to referral for carotid endarterectomy surgery on just the worsening side (“CEA”).
  17. As described by the Hagen-Poiseulle equation in fluid dynamics, ignoring that the flow of noncompressible blood across an irregular lining might show marked reduction of turbulent disruptions as the luminal diameter is increased and the plaque surface becomes smoother, leading to even greater gains in blood volume delivered distally.
  18. Research sponsored by Hoekstra III PP, Gedye JL, Hoekstra Jr P, et al. Serial infusions of magnesium disodium ethyleneamine tetraacetic acid enhance perfusion in human extremities. Prepublication draft: Therma-Scan Inc., 26711 Woodward Ave., Huntington Woods, MI 48070.
  19. Chappell LT, Stahl JP, Evans R. EDTA chelation therapy for vascular disease: a meta- analysis using unpublished data. J Adv Med. 1994;7:131–142.
  20. A complete listing of the dozens of persuasive articles by McDonagh E, Rudolph C, et al. is available online at http://www.mcdonaghmed. com/abstracts.htm.
  21. Alfred Werner won the 1913 Nobel Prize for inorganic chemistry with his delineation of “complexion” (chelation) chemistry.
  22. Interestingly, two glutathione molecules might be useful for intracellular detoxification but they only weakly bind to one atom of a toxic metal. However, the GSH molecule cannot be taken by mouth and is “expensive” to produce. Glutathione is essential to be present in high enough concentrations to recycle vitamins C and E, for enhanced antioxidant protection.
  23. As an example, low levels of environmental lead have shown a direct relationship with elevated blood pressure without the classic presentation of lead toxicity: Batuman V, Landy E, Maesaka JK, Wedeen RP. Contribution of lead to hypertension with renal impairment. NEJM. July 7, 1983;309(1):17–21.
  24. Schubert J. Combined effects in toxicology-a rapid systematic testing procedure Cadmium, Mercury and lead. J Toxic Environ Health. 1978;4:763–776.
  25. Clarke NE, Clarke CN, Mosher RE. Treatment of angina pectoris with disodium ethylene diamine tetraacetic acid. Am J Med Sci. 1956;232:654– 666.
  26. Olszewer E, Sabbag FC, Carter JP. A pilot double-blind study of sodium-magnesium EDTA in peripheral vascular disease. J Natl Med Assoc. 1990;82(3):173–177.
  27. Olszewer E and Carter JP. EDTA chelation therapy: a retrospective study of 2,870 patients. Medical Hypoth. 1988;27:41–49.
  28. Lamar CP. Chelation therapy of occlusive arteriosclerosis in diabetic patients. Angiology. 1964;15:379–394.
  29. Casdorph HR, Farr CH. EDTA chelation therapy, III: treatment of peripheral arterial occlusion, an alternative to amputation. J Holistic Med. 1983;5(1):3–15.
  30. Boyle AJ, Clarke NE, Mosher RE, et al. Chelation therapy in circulatory and other sclerosing diseases, such as scleroderma and rheumatoid arthritis. Fed Proc 20 (Part II supp). 1961;10:243–251.
  31. Carter JP. Racketeering in Medicine: The Suppression of Alternatives. Norfolk, VA: Hampton Roads; 1992.

Chelation Therapy: Stepping Into the Next 60 Years A Historical Commentary

Chelation Therapy:
Stepping Into the Next 60 Years

A Historical Commentary

Going to the Dogs–and Nowhere Else?

What we now unquestioningly call “modern medicine” was largely invented since the late 1940s. Houston cardiovascular surgeon Denton Cooley, MD, studied pediatric procedures in postwar Europe, and his research efforts have saved countless children. Coronary endarterectomy was tried for occlusive disease, but most patients had diffuse involvement and were poorly qualified. Other partners of Houston cardiovascular surgeon Michael Debakey, MD, were Ed Garrett Sr., MD, and Jimmy Howell, MD. In the early 1960s, they were in the forefront of perfecting a technique of removing a peripheral vein and inserting it as an aortocoronary bypass on the heart … of dogs. Endless hours spent in the dog lab led to skills and procedures hitherto unknown. Other complementary technologies were arising at the same time, including selective coronary angiography (to identify and locate high-grade occlusion), the cardiopulmonary bypass “pump” (“heart/lung” machine), and startling advances in anesthesia and antibiosis. Still, the dogs were their only bypass “patients,” and their survival was not the object of the research.

Despite sharing with their cardiology colleagues the potential for success of their new surgical approach, no patients were forthcoming. Finally, cardiologist Ed Dennis, MD, endorsed a last-ditch effort to salvage patients moribund after their infarction. In 1964, Garrett led the team to perform the first successful coronary artery bypass procedure, at Baylor University. The early patients, already preterminal, failed to survive. With the prospect of revascularization too tantalizing to resist, stable patients with severe angina were then referred for surgery. The first two died. The third survived. And a new era of surgical success emerged.

But… Banished Forever to the Pound?

Intravenous EDTA chelation therapy was welcomed directly into patient practice in a most unusual way: in the emergency room. A child presented to the Georgetown University Hospital in 1952, clearly suffering with lead poisoning (from chewing paint off a window sill?). Pediatrician S. P. Bessman, MD, recalled a recent conference wherein neurology researcher Martin Rubin, PhD, described exchanging lead for calcium by a new “chelating” compound … in the test tube. “Can I use it in this kid? How do I dose it?” Serendipity led to clinical success and the child recovered. The case was reported in the Medical Annals, District of Columbia, later read by Norman E. Clarke Sr., MD, a cardiologist in Detroit. He was seeing plumbism (lead intoxication) in battery-factory workers, and thought to try this new chelation treatment. Soon, his patients were reporting less use of nitroglycerin, fewer angina pains, and increased activity without dyspnea. Why not, he thought, try this on “heart patients” who were not suffering with lead toxicity. They, too, dramatically improved with chelation. And a new era of medical success emerged … and was soon to be banished like an old dog.

The NIH TACT Results

Almost 60 years after the first discovery that EDTA chelation therapy could be effective in the treatment of heart and blood vessel diseases, results of the first large randomized double-blind trial were reported at the American Heart Association meeting in November 2012. A number of commentaries have identified “problems” with the 7-year- long National Institutes of Health (NIH) study, under the direction of cardiologist Gervasio Lamas, MD, of the Mt. Sinai Medical Center, Miami Beach, Florida. An 18% reduction of cardiovascular events in the entire treated group suggests a beneficial effect. However, one cadre accounted for substantial improvements: diabetic patients enjoyed a 39% decrease in adverse events compared with placebo (usual medical treatment) controls.

Given the increase in diabetes in the American population – including the younger age of onset for many victims – any treatment offering significant benefit should, in the best of possible worlds, be readily embraced.

Diabetic Complications

Research at the NIH in diabetics during the 1970s showed that normalization of blood sugars preserves endovascular and end-organ tissues, approaching the baseline health seen in normoglycemic populations. Over the past 30 years, there has been an alarming increase of obesity. Enlarging girth is often accompanied by the ominous signs of cardiometabolic syndrome, emphasizing the critical need for early and aggressive control of blood sugar. Nevertheless, ingrained societal patterns – including nutritional debasement in daily food selections – complicate efforts to achieve the lifestyle changes essential for nondrug hyperglycemic control. Drugs, of course, impose the risk of side effects and even hypoglycemic episodes, so many physicians are comfortable allowing patients to float with higher- than-normal fasting and postprandial patterns … and thus tolerating the commensurate development of occlusive changes affecting end organs.

Chronic renal dialysis is one of the most expensive repetitive procedures in modern medicine, and diabetics claim an inordinate volume of these resources. The NIH TACT trial excluded renal failure patterns in order to simplify data analysis. A seminal 2003 study by Lin and Lin- Tan, published in the New England Journal of Medicine, matched patients developing nondiabetic renal failure and carefully treated the intervention group with intravenous EDTA chelation. While the untreated observation group devolved toward dialysis, the treated patients improved toward normal kidney function, presumably due to reduction of lead in the kidneys. Many experienced chelation physicians have seen serum creatinine levels reduce over time in both their diabetic and nondiabetic patients, but a conclusive study remains to be done – and is sorely needed and could be done easily with pooled data.

Beyond Diabetes

Reports of chelation improvements in diabetics have been peppered throughout the medical literature over the past 50 years. In 1964, Carlos P. Lamar, MD, offered his diabetic patients a real chance at a more normal life, saving limbs scheduled for amputation, saving vision in those going blind, and lowering insulin dosages. Kansas City, Missouri, chelation specialists Ed W. McDonagh, DO, and Charles J. Rudolph, DO, PhD, were joined by research professional Emanuel Cheraskin, MD, DMD, to publish 31 papers documenting their clinical practice experience over the 1980s and 1990s. Topics included significant improvements of vital importance to diabetics and nondiabetics alike: blood sugar, cholesterol, HDL cholesterol, triglycerides, kidney function and serum creatinine levels, artery blockage disease (even of the aorta), severe heart artery blockage, blockage of neck carotid arteries, hardening of the arteries, platelet clotting functions, fatigue, pulse rate and blood pressure, serum calcium and iron levels, trace element patterns in degenerative diseases, psychological status, and general “clinical change” (improvements) observed in chelation patients. Perhaps of more interest to many readers is the demonstrated reversal of macular degeneration (commonly seen in diabetics) reported by McDonagh and Rudolph’s group in 1994. Their evidence included retina photographs, documenting improvement consistent with increased circulation to the eyes. Pooled objective data from practicing ophthalmologists could easily document a pattern of improvement, offering hope where there is no other treatment.

Coronary Occlusive Disease

The “end organ” of most concern for diabetics and nondiabetics alike is the cardiac muscle. Heart disease “statistics” 60 years ago were generally reported as reduction in symptoms, in angina and infarction, and improvement in EKG patterns. For the past 20 years, we’ve had benefit of the ultrafast CT “heart scan,” helping outline the anatomy of calcified plaque in coronary vessels and allowing for earlier identification of those at risk. For over 50 years, selective coronary angiography has provided “a map for surgery” – but its extensive use in postoperative bypass patients has created an industry ripe for challenge as generally unnecessary and sometimes fallible. For almost 50 years, coronary artery bypass grafting (CABG) has been shown to provide a life-saving alternative for those with significant diffuse disease or “left main” or “left anterior descending” artery occlusion. The 50-year-old technologies of coronary “ballooning” and “stenting” – now impregnated for drug elution – remain popular despite the frequency of restenosis or other complications. The question of whether ultrafast CT is suitable for documenting improvements with chelation remains elusive, since some symptomatically successful patients continue to show advancing calcium scores. Collateral channels are not readily seen in these pictures or even in angiograms, so perfusion studies with stress-and-rest thallium scans can be more revealing.

Salvage of cardiac muscle is the sine qua non of all interventions. Indeed, kinase infusions within the early hours of acute infarction have preserved countless organs with minimal or no damage. Various drugs have found popularity in the conventional cardiology community as possibly reducing or delaying development of coronary occlusions. These include, of course, the “statin” drugs and antithrombotics such as clopidogrel. A number of concerns have been raised regarding their extensive side effects, including interruption of physiologic biochemistry (such as with statins, impaired synthesis of vitamin D, bile acids, coenzyme Q10, and so on). Chelation avoids these challenges to normal functions. Further, chelation has greatest success when occlusion has not progressed to tight stenosis or to the point where unstable plaque threatens to block distal flow. Coronary angiography is still risky, especially with regard to vulnerable plaque. Additionally, it is limited in not being able to discern plaque reduction that yields very slight increases in cross-sectional vessel caliber, a situation wherein fluid dynamics produces a much greater increase in flow volumes. Once again, clinical improvement is one of the best measures of success.

So the question remains: besides lifestyle changes to minimize risks, what actual treatments could enhance myocardial salvage? The almost 60-year history of consistent reports suggests that EDTA chelation has already established itself as an unrecognized but viable alternative, with patient satisfaction and clinical improvements routinely in the 90% range in published studies.

EDTA Chelation and Cardiac Disease

Beginning with Clarke’s initial reports in 1955, anecdotal papers have repeatedly documented that “heart patients” improve with a wide variety of symptoms. Angina episodes, dyspnea on exertion, blood pressure elevations, rhythm disturbances, electrocardiogram patterns – all these were shown to improve in reports over the first 10 years. Other small group reports over the past 50 years have continued to confirm these early findings. The usual critique is that they involve a small number of patients or that double-blinding is absent. These criticisms, of course, ignore that proposed CABG surgery was canceled in the majority as no longer needed, and that people are still walking on limbs scheduled for amputation.

The importance of a nonsurgical alternative for coronary disease is highlighted by a recent report on war fighter deaths over 10 years in the Middle East. Autopsies on 3832 service members, killed at an average age of 26, showed that almost 9% had some blockage forming in their heart arteries. About a quarter of these had severe blockage, yet they were asymptomatic and deployed into combat. As more sensitive diagnostic modalities are developed and widely employed, an increasing percentage of the population will “qualify” for treatment of their clinically silent diseases. In such cases, early and consistent use of chelation might dramatically lower medical care costs while improving overall health outcomes.

Anatomy vs. Microphysiology

Perhaps of greatest interest is the effort to understand why – or how – EDTA chelation is responsible for such dramatic cardiac (and other) benefits. Borrowing from the engineering concept of “opening the pipes,” such as with bypass or stenting, early explanations focused on a “Roto-Rooter” effect of “dissolving” the atherosclerotic blockage. While this effect has been observed and documented in some chelation patients over the years, such a view is probably severely limited.

Much more likely is that chelation acts in just exactly the way that it is “approved” by the Food and Drug Administration: it reduces the body burden of toxic heavy metals such as lead, arsenic, cadmium, mercury, and so on. Sadly, the conventional medical community sets the standards and those lab parameters are for acute intoxication (as reflected in blood levels) rather than for total body burden (as reflected in hair or nail clippings or by collecting urine after challenging with a chelating drug). Since the “acute exposure” tests fail to “show toxicity,” insurance carriers decline claims for reimbursement.

The significance of reducing toxic metals cannot be overstated. But the mechanisms by which this result could produce dramatic improvements remain open to rampant speculation.

An early explanation suggested that, in states of impaired antioxidant levels, cholesterol serves as an electron sponge to help protect the endothelium. Oxidized cholesterol, being a “sticky” molecule, then deposits along the vessel margin, especially at sites of branching or disrupted flow. Having a weak activity similar to that of vitamin D, oxidized cholesterol invites calcium to be deposited in a noncovalent binding. Over time, accretion of more cholesterol, calcium, and cellular detritus results in a discrete volume of occlusive plaque, subintimal and medial. Pathologist Rudolph Virchow, MD, called this metastatic calcium, since it was out of the bones and teeth but not bonded in place. Accordingly, EDTA was thought to “pinch” these available calcium atoms and thereby initiate dismantling and dissolution of the plaque. A more sophisticated view might relate to lowering of ionized calcium in circulation, stimulating release of parathyroid hormone, leading indirectly to mobilization of “releasable” calcium in hardened plaque and body tissues.

One fascinating result of such speculation is the inclusion of calcium as a toxic element when it is abnormally deposited in organs through a variety of aging and degeneration mechanisms. While babies are “soft and rubbery,” aging individuals are increasingly hardened and brittle. This one feature – reduction of metastatic calcium depositions, peppered throughout organelles and cells and interstitium as well as in plaque – might be “the key” to results with intravenous EDTA chelation. This speculation receives support from the realization that “sick mitochondria” accumulate excessive calcium and swell (especially in magnesium deficiency), disrupting the stereochemical alignment of the electron transport chain on the cristae shelves, markedly reducing the efficiency of oxidative phosphorylation and, hence, the health of the cell. One way that mitochondria “get sick” is through the selective deposition of lead and other heavy metals, disrupting mitochondrial DNA expression as well as energy production. Reversal of these mitochondrial modifications could explain many (if not most) of the clinical improvements demonstrated with EDTA treatments.

Chelation patients often report significant symptom improvement within the first half-dozen or dozen treatments, long before a major improvement in blood flow “through the pipes” is likely. When reviewing organ failings – as seen with liver, kidneys, and brain in addition to heart – such mitochondrial inefficiency might be a primary mechanism. Similarly, removal of toxic heavy metals by chelation is much more biologically cost effective than the body’s detoxification effort that leads to depletion of intracellular glutathione. Thus, chelation can help to preserve cellular antioxidant status and a more robust ability to regenerate vitamins C and E as electron donors.

Recall also that all other toxic metals are accumulating throughout the tissues as well – mercury, lead, cadmium, arsenic, and so on – with their separate contributions to free radical production and functional impairment. Iron is an essential element that can be present in excess (iron “storage” disorders, even polycythemia), where it also stimulates the generation of free radicals, which are especially toxic in metabolically active tissues such as liver and heart. Jukka T. Salonen, MD,

PhD, MScPH, of Finland, reported in 1992 a large prospective study of men with no symptoms of heart disease. Over the next 3 years, the lifetime total of cigarettes smoked was the primary risk factor in those suffering myocardial infarction. The second factor was an elevated blood ferritin level (possibly correlated with a shift toward tissue acidosis). This provides an easy laboratory test to discover those at higher risk – levels rising higher above 100 ng/ml are directly associated with an increasing incidence of coronary events. The iron story is, however, complicated, and ferritin only slowly declines over dozens of EDTA chelation treatments.

A side issue is coming to the forefront: the expanding use of injectable diagnostic imaging contrast agents, such as gadolinium, iron (Feridex), and manganese (Teslascan). Urinary challenge tests with D-penicillamine in some patients have shown very high excretion levels of gadolinium. The clinical significance of these findings is unclear, but the use of chelation treatments in patients who have had repeated contrast studies might prove valuable. Gadolinium use has been linked to onset of nephrogenic systemic fibrosis.

Another factor deserving study is the effect that chelation might have on the improvement of tissue perfusion by reducing constriction of the tiniest arterioles, which serve as a large bed of peripheral resistance vessels. Where increased arteriolar resistance opposes the systolic pressure, relaxation of these “flow- limiter” muscles can raise tissue perfusion volume considerably. Increasingly sensitive vascular lab studies and digital thermography are two inexpensive and noninvasive methods that can be used to document improved perfusion.

McDonagh and Rudolph, among others, have shown that chelation produces a more normal reduced platelet volume and increased pliability. Ease of flow through capillary beds provides increased perfusion and oxygenation help to maintain normal tissue alkalinization. Reduction of acidotic microenvironments slows the production of free-floating single fibrin fibrils from fibrinogen, further lowering viscosity in the narrow capillaries. Any combination of these microphysiologic changes could explain improved tissue viability and marked improvement in clinical symptoms and organ function.

Peripheral Vascular Disease

Being listed as a “labeled indication” by the Food and Drug Administration usually allows for insurance approval and reimbursement of treatment for a particular condition. Few people know that EDTA was listed in late- 1950s editions of the Physician’s Desk Reference (PDR) as “indicated” for the treatment of peripheral vascular disease. A study with about half a dozen patients showing marked improvement had led to labeling approval. Then came the 1962 Kefauver-Harris Amendment to the Federal Food, Drug, and Cosmetic Act, requiring a review of both safety and efficacy in the approval process. When studies were considered insufficient to conform to the new standards, the indication was dropped from the label.

While early studies concentrated on cardiac improvements, concurrent benefits for occluding leg arteries attracted attention. Carlos P. Lamar, MD, in 1964 reported on legs saved from amputation. H. Richard Casdorph, MD, and Charles H. Farr, MD, PhD, confirmed these improvements in a small series in 1983, as did James P. Carter, MD, DrPH, and Efrain Olszewer, MD, in a double-blinded study published in the Journal of the National Medical Association in 1990. McDonagh and Rudolph in the 1980s documented marked enhancement of the ankle/ brachial index in 117 patients with occlusive disease. Carter and Olszewer reported in 1988 on a 28-month retrospective analysis of 2870 patients treated with intravenous EDTA: peripheral arterial disease patients showed marked improvement in 91% and good improvement in another 8%. Given that surgical success is lessened with smaller vessels and when near or crossing joints, chelation as a nonsurgical alternative offers hope to thousands.

Thermography specialist Philip P. Hoekstra III, PhD, reported privately to me in 2009 the results of his 13- year study of 19,147 patients with peripheral (leg and arm) artery stenosis, not yet severe enough to require amputation. Arterial perfusion of all extremities demonstrated significant “warming” in 86% of chelated patients.

Carotid Arteries

Carotid arteries act as a special case of the peripheral vascular bed – and their improvements with chelation have been documented repeatedly. Rudolph and McDonagh described in 1991 the striking and highly significant reversal of atherosclerotic stenosis of both internal carotid arteries in 30 patients treated with only 30 EDTA infusions over a 10-month period. Ultrasound imaging showed that overall obstruction was decreased by 21% – and those who showed more severe stenosis had even greater reduction of blockage. Their study had been planned after their 1990 case report of one patient having an original 98% occlusion reduced to only 33% after just 30 chelation therapy treatments. Given that strokes can occur as a complication of otherwise successful carotid endarterectomy, chelation can reduce such misadventures for many. Where surgical intervention is warranted, pretreatment with chelation theoretically can improve the postoperative result. Again, more sophisticated equipment can allow easy, inexpensive, and noninvasive documentation of improvement.

Intracranial circulation responds less well. Casdorph in 1981 documented marked improvement in brain arterial flow in a small series of patients. Carter and Olszewer’s 1988 retrospective review showed marked improvement in 24% and good improvement in 30% of patients with cerebrovascular and other degenerative brain diseases. Surprising results are possible. One patient presented to me 18 months poststroke, still severely limited despite constant physical therapy. After 8 chelation treatments, he proudly showed that he could walk down the hall with an assistant holding his belt in the back, and he described having gotten into and out of the tub (with assist) for the first time since his CVA. “Small-vessel ischemic disease,” with or without dementia changes, generally shows stabilization or some improvement. Alzheimer’s dementia, especially when associated with significant toxic heavy metal patterns, can show encouraging benefits when treated early with chelation.

A Potpourri of Problems

Macular degeneration is a special case of vascular supply directly to a central nerve. Direct ophthalmic observation can show gradual deterioration … and gradual improvements. The most rewarding part, though, is having a patient resume reading or once again being able to thread a needle. I asked one patient, who received several dozen chelation treatments, to read this note on a chart cover: “PATIENT IS LEGALLY BLIND.” I then asked him to read whose chart … “Why, that’s mine!” Without glasses.

Atrial fibrillation is the most common arrhythmia, and its frequency elevates with advancing age. The risk of stroke increases considerably, so rhythm control has benefits beyond rising perfusion efficiency. Alfred Soffer, MD, reported on chelation for various heart rhythm disturbances in his 1964 monograph; results were variable but promising. Long- experienced chelation physicians have their anecdotal stories of patients reverting to and maintaining sinus rhythm.

Cardiac valvular sclerosis, sometimes proceeding to calcific stenosis restricting flow and allowing regurgitation, is a troubling problem. Although new percutaneous operations (using technology similar to angiography) are growing in popularity, their risks and success rates are still being evaluated. Theoretically, the decalcifying effect of EDTA chelation therapy should slow (perhaps even reverse?) sclerotic-to-stenotic change. At the very least, chelation should be expected to aid the intended surgical result by increasing the pliability of tissues. Neither angiography nor echocardiography is yet sensitive enough to detect slight reductions in calcium deposits.

Scleroderma is another special case, where distinctive arteriolar changes (in all organs but especially the skin) are associated with autoimmune patterns. Raynaud’s phenomenon appears to be prodromal in many patients. Conventional medications are often frustrating, and the addition of EDTA chelation therapy has been quite successful for many patients. Similarly, other autoimmune patterns – rheumatoid arthritis and systemic lupus erythematosus – have shown promising improvements with chelation. Benefits with “fibromyalgia” have routinely been reported by patients. These observations raise speculation that EDTA might be affecting membrane pathology, possibly related to or amplified by toxic heavy metals – induced through the mechanism of free radical attack? D-penicillamine, loosely called a “chelator” but acting by means of paired thiol groups, has long been used in conventional medicine to help with scleroderma and rheumatoid patterns.

Mitochondrial pathology has been recognized in many forms over the past decade, but the contribution of toxic heavy metals has been poorly appreciated. In the 1990s, laboratory studies by the Environmental Protection Agency showed startling changes in mitochondrial protein production seen in isolated organelles after exposure to “physiologic” levels of lead. Research into toxic heavy metal effects on mitochondria, endoplasmic reticulum, nuclear membranes, and cell-limiting membranes might offer the most fruitful future explanations for pathology and chelation benefits – but the laboratory funding required would be substantial.

Along Came A Spider …

A little-known effect of chelation is to neutralize biological venoms from snakes, spiders, scorpions, and the like. These poisons are a mixture of metalloenzymes, and inactivation occurs with displacement or removal of the critical metal cation. Appropriate research could lead to treatment protocols (intravenous, oral, topical) far more effective – and dramatically less expensive – than current antivenom preparations, which can cost thousands of dollars.

Venoms, as metalloenzymes, bring up a whole realm of possible treatments aimed at specific induction and function of enzymes throughout the body. In perhaps a third of instances, physiologic cations (magnesium, zinc, iron, manganese, molybdenum, copper, others) are positioned in the active site and help establish the functional conformation of the protein. As research shows which enzyme clusters are more sensitive to inhibition by toxic heavy metals displacing the expected cation, the prospect of targeted chelation could become a reality. One factor complicating targeted treatment is that chelators need to penetrate through the interstitial space into the cytoplasm and into mitochondria and even into the nuclear space. Similar concerns arise with penetrating the blood–brain barrier. Nanoparticle delivery systems, being developed for targeted chemotherapy, might be designed to enhance chelation efficiency at the “end-organelle” level rather than merely the “end- organ.” Again, laboratory and clinical expenses could be a major barrier.

Nutritional physiology is still poorly understood, and studies might reveal new ways to increase the benefits of chelation treatments. Mildred S. Seelig, MD, MPH, confirmed in the 1980s that higher blood levels of magnesium are correlated with reduced complications of myocardial infarction. Chelation therapists have long added extra magnesium to intravenous EDTA in order to amplify many of the cardiovascular benefits of treatment. Realizing that lower magnesium levels are common in diabetes, hypertension, atherosclerosis, cardiomyopathy, and a panoply of other pathologies opens an interesting door: what minerals (and vitamins), when supplemented specifically, might enhance the effectiveness of chelation treatments in particular clinical settings? Incidentally, in patients who appear to have an “allergic” reaction to a chelating drug, supplementation with molybdenum might blunt that response for the future.

Stem cell implants offer special considerations here – could they be more effective when combined with certain minerals … or after bathing in selective chelation solutions? Rotifers are primitive multicellular microscopic waterborne “animals” that accumulate calcium over their lifespan. Alfred M. Sincock, PhD, reported in 1975 on almost doubling the lifespan by bathing the organisms in various calcium- binding chelators. Similarly, the length of DNA telomeres – hence, the potential number of cell replications before genetic losses – might also be preserved by chelation treatments. The possible interactions of hormones and EDTA or other chelators is a field ripe for investigation. These cell physiology studies are technical and expensive, but the benefits might be unexpectedly rewarding.

Cost/Benefit Comparisons

Given the socioeconomic impact of medical and health choices, no discussion is complete without highlighting the “competing therapies” for cardiovascular and other diseases. Chelation treatments reasonably cost about $5 to $10,000 to produce outstanding benefit for about 90% of patients with coronary, carotid, or peripheral vascular disease. Or all three at the same time. While surgery addresses only a few inches of “blockage” with each operation, chelation works throughout the body – a real bargain for the majority of patients, who have diffuse disease. Charges for CABG range about $75 to $150,000 – for each operation – assuming no serious complications requiring extended hospitalization. A small but certain percentage of bypass patients (perhaps 2% to 3% or more, depending on many factors, especially comorbidities or more profound blockage) never return home. Many patients suffer with postoperative morbidity, including myocardial infarction, stroke, rhythm disturbances, worsening high blood pressure, and neurocognitive changes (“pump syndrome”). Repeat operations are frustratingly common, often within 10 years. (If it worked so well the first time, why is another operation needed?) Aorta and peripheral vascular operations usually cost one-third to one-half of heart bypass procedures. Balloon angioplasty and stenting are increasingly popular (with a failure rate of about 5%), reducing the need for open surgery of the chest or limbs except for those with critical ischemia. Perhaps 20% of patients require repeated angioplasty procedures, dramatically changing the cost profiles with each session ranging from about $30 to $50,000. L. Terry Chappell, MD, and John P. Stahl, MD, in 1993 published a meta- analysis of 19 carefully qualifying studies, concluding that almost 90% of cardiovascular patients showed objective clinical improvements. The savings possible with the early choice of chelation rather than the later choice of repeated operations will become increasingly important for an aging population.

Intracranial small vessel ischemic disease is virtually untreatable by conventional means, so even slight improvements with chelation therapy are a bargain at any price. Similarly, degenerative patterns such as scleroderma, rheumatoid arthritis, macular degeneration, distal peripheral arterial occlusion, and nondiabetic chronic renal failure are poorly treated with traditional approaches, making chelation appealing and very cost effective. Perhaps the “greatest value” is seen in vague or poorly diagnosable medical conditions – including fatigue, asthenia, delayed healing, a sense of “unwellness,” multiple sclerosis – wherein chelation can provide benefits not seen with aggressive drug treatments or even surgery. Stubborn infectious diseases, such as Lyme disease or even MRSA, can show improvement with chelation. While the mechanisms of action often remain obscure, the clinical benefits can be quite obvious in patients’ lives. A “chelation registry” might document improvements across a broad range of pathologies, but the effort would be expensive and likely of little value in convincing skeptics.

One other factor should be addressed: cancer prevention. Walter Blumer, MD, in Switzerland reported his experience in 1980 with calcium EDTA intravenous treatments administered over 10 years, showing a 90% reduction in cancer incidence in the 59 patients. His follow-up report showed a 90% reduction in cancer deaths over 18 years, compared with the untreated controls similarly exposed to lead from automobile exhaust, industrial pollution, and other carcinogens. When treating heart and vascular disease, magnesium EDTA is preferred, in order to “mobilize calcium and reduce blockage.” In a private communication related to me by Garry Gordon, DO, MD(H), Blumer noted that his patients “didn’t suffer with heart attacks.” These delightful results are most likely related to removal of toxic heavy metals, since calcium EDTA does not perturb ionized calcium levels, but unknown effects of EDTA might contribute as well. Considering that cancers of all cell types are the third leading cause of death in the US, what could be the true prevention benefit when the cost of chelation treatment is compared with that of traditional oncology care?

Any review of environmental toxic metal exposures shows the alarming explosion of pollution concentrating up the food chains in the biosphere. One area where unexpected progress is coming is with mercury exposure from dental amalgams. The just- completed World Mercury Treaty, a three-year project of the World Health Organization, proposes that countries completely phase out their reliance on mercury restorations in both children and adults. Controversial studies have related mercury to autism and Alzheimer’s dementia, among other problems. The startling fact is that many adults are unknowingly carrying around their primary source of the world’s most potent neurotoxin, in their “fillings” or root canals. This raises the specter of worsening environmental pollution through the water effluent from dental offices as these restorations are replaced, because mercury scavenging units – to be disposed of as biohazard waste – are not yet in widespread use. Boyd Haley, PhD, emeritus chair of chemistry at the University of Kentucky, assures us that newer chelating compounds are in development and that they could be used not only orally in humans but also to remediate mercury- contaminated rivers and bodies of water.

Blumer’s study, among others, provokes a critical question: If removal of toxic heavy metals is the most important factor in producing clinical results, how much can be accomplished by using oral “chelating” drugs, alone or in combination with intravenous chelation? Oral administration is much easier, has fewer risks, and can be applied across broad populations, especially in a preventive context or to address early pathophysiology. Since 1995, I’ve used customized combined programs of oral chelators along with intravenous EDTA. Our early studies suggested more rapid reductions in the body burden of toxic heavy metals. Further research into dithiol compounds as well as classical chelators might be very cost effective and exceptionally fruitful. If taste-enhancing technology can mask the noxious sulfur aroma of oral chelators, the potential exists for design of prescription “chelator foods,” vastly expanding the access for this treatment approach. These would be “drug-supplemented” foods, not merely sulfur-rich onions and garlic.

Some Final Thoughts

The great majority of our “medical” problems are directly related to “personal health choices,” known as lifestyle issues: tobacco use, alcohol excess, caloric surplus, nutritionally bereft foods, poor choice of food variety, sedentary habits, dental deterioration, limited sleep, unlimited stress, and so on. Unsuspected toxic heavy metal and chemical exposures challenge our organ performance at a rapidly expanding pace. Where personal responsibility fails to minimize our survival threats, what should be the societal commitment of resources to restore function and comfort?

The future face of medical care is difficult to predict. An enlarging patient base in the US poses increasing financial demands on already stressed budgets. Technological advances can be expected in virtually every arena, from diagnostic testing through treatment planning. CT scans, MRIs, and PET scans have sharpened our accuracy and understanding to allow earlier diagnosis and treatment, for better outcomes and longer survival. Same-day surgicenters and endoscopic procedures dramatically reduced the costs associated with many common procedures, such as cholecystectomy and most knee repairs. Will the changes still to come bring similar cost savings or will they, like organ transplant procedures, impose greater economic strains on a nation unprepared to ration “high- tech” care?

Victor Fuchs, PhD, in his seminal book Who Shall Live?, claimed in 1974 that we must deliver the very best care to the president because of his critical position in the society – but he cautioned that we simply cannot afford to deliver “presidential medicine” to the people. Just because we can do it – CABG surgery, angioplasty, total joint replacement, organ transplants – challenges us with the ethical question of whether we should do it. Or do it for some but not for others. Or do it for younger adults but not for “the elderly.” The reasonable cost and minimal resources required to offer chelation therapy “to the masses” suggest that this largely ignored treatment might soon evolve to play central roles in both preventive and therapeutic spheres in our emerging care system.

Mind-body medicine, a term well known in medicine, has major roots in observations made in the 1960s by one of my lab directors at Stanford, George Solomon, MD. Intensive study of the “relaxation response,” “healing touch,” “acupuncture,” and similar “soft science” technologies has led to widespread acceptance in the medical and lay communities. At about the same time, startling observations were being made of reversals of increasingly prevalent coronary and peripheral vascular maladies by chelation therapy with intravenous EDTA. Despite “hard science” showing that these beneficial discoveries have been replicated time and again, chelation remains largely unknown or, at worst, vigorously defiled. Paul Dudley White, MD, President Eisenhower’s cardiologist, encountered similar resistance for over two decades to his introduction of the EKG. René Laënnec was more fortunate in securing wide acceptance of the scientific results available with his new “stethoscope” within a decade in the early 1800s. Given a world increasingly aware of pollution with toxic heavy metals, and given a population with younger onset of serious degenerative diseases, and given 60 years of overwhelmingly successful results, why have conventional medicine and regulatory government tossed chelation aside, onto the trash heap of so-called fraudulent diversions?

Look to the Youth to Look to the Future

Look to the Youth to Look to the Future

There is no question that all of us want the best for total patent care. A great number of professionals now accept the team concept as the only way to satisfactorily meet patient needs. Podiatry is still suffering from a lack of visibility in the health care scene, and this diminishes its opportunity for full participation on the team.

Consider, as an example, the crowd around a movie theater snack bar during intermission. There is no defined line, and people are pressing up against the long counter trying to get the attention of the two or three people manning the snack bar. Often, how aggressive you are determines how soon you will eat. By analogy, a patient is like the person behind the snack bar counter—numbers of physicians and other health personnel are available to offer their services to the patient. Since there are comparatively few podiatrists, most patients have an overwhelmingly greater chance of contacting health care professionals other than podiatrists. In addition, the few podiatrists can get lost in the shuffle of misunderstanding—podiatrics isn’t pediatrics, and chiropody isn’t chiropractic.

Now is the time to establish the high visibility that is needed and to correct misconceptions by the patient public and practicing physicians. If you can intensify efforts to reach the critical mass, the ensuing reaction will firmly establish podiatry as a co-responsible branch of medical practice in the total care of the patient.

Why do I say that now is the time?

  • Podiatric education has blossomed in the past ten years
  • The new SAMA liaison has provided access to the major groups in medical affairs
  • HMO’s and prepaid group practices are coming into prominence
  • PSRO holds innumerable unanswered questions for the new future
  • Licensure and certification procedures are being actively debated in allopathic circles

These are converging on the medical scene and now is the time for podiatry to impress fully upon the minds of physicians and the patient public that foot problems are the specialty of the podiatrist.

I see three issues as important in assembling this critical mass: organize, humanize and educate.

By organize, I mean develop long range goals and immediate actions. By humanize, I mean that the essence of medical practice is people sense—a response to the needs of human beings. You can direct podiatry into the forefront of this revolution in medicine. By educate, I mean that what podiatry is and what it can do must be emphasized both to others and to your own students.

If you will indulge me the opportunity to offer some personal perspectives, then let me share some ideas that might speak to the excitement you too are feeling for the future of podiatry.


My first topic is to organize. 

We must integrate podiatry into the mainstream American medicine. In our current system, the only way podiatry can fully participate in total patient care is by its acceptance as a functional, separate professional field of medical practice.

The thing that literally distinguishes “foot specialists” from “eye specialists” is that the former train for and receive a D.P.M., while the latter train for and receive an M.D. Certain elements and emphasis of their training and advanced experience admittedly are different, but the basic problem with acceptance of D.P.M.’s is that they are not in “The Club.” To enlarge “The Club” beyond the limitations of a single membership card, you will have to negotiate with the AMA, AOA, American Hospital Association, Joint Commission on Accreditation of Hospitals, and of course, the orthopedists.

I urge you to continue your efforts to adopt comprehensive, long-range, sweeping strategies—to determine short-range, immediate actions—and to utilize to fullest advantage the APSA-SAMA channels.

SAMA has liaisons to major AMA councils and commissions, to the American Academy of Family Physicians, and other major organizations. Our liaisons are charged with presenting SAM’s concerns for agenda consideration at these various meetings. All that remains now is for the APA to work closely with the APSA and SAMA National Liaisons to see what new ways podiatrists can bring their concerns to the somber halls of the AMA and other organizations. SAMA, as the largest independent organization representing American’s allopathic medical students, has given fullest blessings to enhancing the professional relationship between allopathy and podiatry. Since we can introduce items to committee consideration, the leaders of American medicine must listen to our views.

When formulating the long-range goals, give due consideration to the possibility that podiatry might introduce a wholly novel and exciting dimension to medical education. With your efforts, in 20 or 30 years your schools might combine basic and specialty training into one continuum, whereby your students could receive an M.D. degree with certification as a specialist in foot care. It gives me a “heady” feeling to realize that senior podiatrists could be training a new kind of practitioner, one who would graduate form school with training that M.D.’s now wait to acquire in their residencies. These professionals could be the elite in a dramatically changing g medical educational system—and you hold the potential for those changes right here. You are the foot specialists of today who train those of tomorrow.

Organize as you see fit, then turn to your student channels to see in what ways the contacts that they have formed and nurtured can help right now to advance the profession.


My second topic is to humanize.

Perhaps this seems a strange item at first thought, but not so much so when you consider that we all are together in the business of helping people. And helping and people are very human words. The new breed of practitioners and students are wrenching the superstructure of health care training and practice—and with good reason. All of us are familiar with how the phenomenal upsurge of technology has led to what some term the “dehumanization” of the patient. I prefer to think of it as treating the disease but not the illness, of focusing on the pathology but not the person.

 In podiatry you have a distinct opportunity to demonstrate human compassion in the practice of medicine. Some jestingly say, “Let the podiatrist take care of the corns, calluses, and ingrown nails.” Let us put aside for a moment even the elegant surgical procedures of podiatry, Instead, just concentrate on the “trivial” problems that can be of paramount concern for the patient as a person. Reflect on your patients who were in otherwise good health but who could not easily move from bed to toilet or who could not easily move about in the kitchen. Each was as seriously ill as is someone with dramatic muscular or metabolic disease.

Podiatric research and practice has given us today the ability to take aggressive action to restore function, to relieve discomfort, and thereby to reinstill some of the vitality of living as an independent human being.

As physicians, we all see so much horrifying pathology that we drift into forgetting how debilitating seemingly trivial conditions can be. The technology is so complex for major restoration that we often focus our attention entirely there. Let us remember to pause with each person, to consider his needs, to reflect on how we have helped him, to suggest how he can best help himself. So when I say “humanize,” you can see that we are all into medicine—and living—are really about.


My final topic is to educate.

Let me remind you that I am a student. Educational issues are a daily part of my life. I am one of the practitioners of the future—so my thoughts today are some indication of how physicians will think tomorrow. Again, please indulge me some personal observations.

The idea of education is three-fold—you need to address: (1) the patient public, (2) the allopathic practitioners, and (3) your younger colleagues and students.

In educating the patient public, the major issue is visibility. We must share with others what podiatry is and what it can do. Each of you can personally, actively bring the message to people in their everyday activities—in the schools, at PTA meetings, in factories, at bowling leagues. As an organization, you must continue to develop media presentations of a public service nature for television, radio and magazines.

In your daily practice, continue to subscribe to standards of care that emphasize patient education. Every patient should become well aware not only of his particular foot problems, but also of how you as a podiatrist contribute to his total health are.

In education allopathic practioners, again the issue is visibility. A basic tenet is that no one seeks learning that he does not realize he needs. Your responsibility is to demonstrate where and how podiatry fits into the team concept of total patient care.

Liaison with local medical societies and groups will help take the “the unknown” dimensions out of podiatry. You will become familiar as a person and as a podiatric medical practioner. This familiarity is a critical part of medicine. Physicians and patients alike are much more comfortable in referrals made to colleagues who are personally known and respected as individuals. Likewise, your referrals can become more firmly based on personal knowledge of which allopathic physicians give special care to people with diabetes or with joint disease, as well as recognizing which physicians are good persons.

Your participation in HMO’s group clinics, and hospital services will go far to establish these professional bonds. Practitioners who respect the quality of your work-ups in referral to them will be more inclined to send other patients to you. Physicians who appreciate a well evaluated referral will encourage the patient to return to you for continued management of his foot problems.

Many other points could be made about integration with the mainstream of medicine, but the issue of quality medical work-ups leads directly to my last topic.

In education your students and younger colleagues, the emphasis must be toward the future. As with all else, the basic guideline is to do what is required for patient care. Let me share some personal observations.

“Just a foot doctor” and “doesn’t practice medicine” have been jestingly used with reference to podiatrists. It is important to remember as practitioners that the feet are indeed attached to myriad systems above the malleoli. A podiatrist is responsible for assessing how these other systems relate not only to problems with the feet but also to a patient’s total health as well.

If I were a student of podiatric medicine today, I would very much want my educational programs to be tailored so that:

…every podiatrist would use a blood pressure cuff routinely to assess circulatory function; allopathic physicians predominately feel that “blood pressure should be required reading for all doctors”

…every podiatrist would use an opthalmoscope routinely to assess peripheral Bessel status and to detect unrealized changes in refraction.

…every podiatrist would use a stethoscope routinely to assess total body sensory function and to detect unrecognized deterioration of hearing.

…every podiatrist would use urine test-sticks routinely to screen for potentially devastating renal and metabolic diseases

These are but a few of the practices required by the philosophy of contributing to total patient care.

When you refer a person to further diagnosis and treatment, the notation of a complete work-up can contribute substantially to patient welfare. This will assist the recognition of podiatry as a responsible professional branch of medicine. Additionally, it will favor your continuing participation in the management of foot problems as they relate to a patient’s overall physical status.

How a student or younger colleague learns is as important as what he learns. Residency training is virtually essential in the medicine of today. The art of medicine is a certain style of practice. That style is embodied in the application of basic knowledge in ways that are best transmitted through repeated observation and practice under experience tutelage.

Continue your efforts to provide fro your youth expanded opportunities—both externships and residencies, HMO’s and prepaid group practice situations might offer immediate solutions to this need.

The lessons to be learned from senior practioners—lessons of both medical and business practices—cannot readily be grasped in any other way. I urge you, in realization of this, to give formal specialty recognition to further you, in realization of this, to give formal specialty recognition to further training. In allopathic medicine, the classifications “board-eligible” and “board-certified” have become fundamental indications of demonstrated competence.

Continuing education should be a habit you pass on early to your younger colleagues, so that all podiatrist remain abreast of the technology that is required for delivery of the finest health care. Where possible, joint seminars with dermatologists, ophthalmologists, physiatrists, orthopedist, and others—including students of allopathic and osteopathic medicine—will serve best the educational interests of the groups involved.

Free-standing schools of allopathic medicine some years ago found that association with major universities strengthened both their academic and economic situations. Consider, in your long range goals, whether you can afford private unaffiliated schools.

Many more schools are needed when you consider that four hundred million feet are wandering around and only 8000 podiatrists are available. In the push for more schools of podiatric medicine, strive to maintain and improve on the quality to which your schools have risen in the past ten years. Continue your efforts to recruit the brightest and best among you to serve as professors for your students. Again, how a student learns is critical, and much of that is through example. Fine teachers can inspire the idealism of youth to seek practical ways to maintain enthusiasm and zest through many years of service to their fellowmen. Only you can realistically impart this unique feeling, and thus it is a major responsibility you bear.

Always be mindful that the decisions you make today will dramatically affect your students in their practices of tomorrow. Many senior physicians have told me that they want major student input on the issues they are debating. Final decisions will have little impact on their practices. Rather, they point out their efforts are aimed at protecting for future physicians a legacy of medical practice that is satisfying, productive, and beneficial to the doctor-patient relationship.

As I close, let me emphasize how critical the decisions are that you will make regard in the training and practice of podiatry. Continue to give your students and young colleagues a growing voice in their own future. Their future is the fruit of your life’s labors.

The time is right for students of podiatry to actively work with you in assembling that critical mass that I referred to at the beginning .The opportunities are there, the interest is there, and they need your support. They need your trust, your encouragement, your advice, your efforts, and very much so they need your financial backing. Please work with them. Share with them their enthusiasm and vision for the changes for the future. Give them your time and the benefits of your experience.

If you will permit me to paraphrase—put your money where your youth is.

Managing Cardiovascular Diseases: Ramblings of a Maniacal Frenetic: Pragmatic Reflections on Helping Patients Understand Their Illnesses and Treatments

Managing Cardiovascular Diseases:

Ramblings of a Maniacal Frenetic: Pragmatic Reflections on Helping Patients Understand Their Illnesses and Treatments

Pump, Pipes, and Performance Cardiovascular diseases (CVD), in order to be adequately evaluated and treated, need to be classified according to the likely etiology or explanation. Simply stated, CVD are associated with the pump (the heart), the pipes (arteries of whatever size and location), and performance (impaired function despite adequate anatomy). One last classification – pediatric – will be ignored for this article, since congenital heart diseases, as genetic or developmental irregularities, have their own unique considerations. When the “pipes” involve the venous system, such as with thrombophlebitis, this is treated as a special case of inflammation. Cardiovascular diseases (CVD), in order to be adequately evaluated and treated, need to be classified according to the likely etiology or explanation. Simply stated, CVD are associated with the pump (the heart), the pipes (arteries of whatever size and location), and performance (impaired function despite adequate anatomy). One last classification – pediatric – will be ignored for this article, since congenital heart diseases, as genetic or developmental irregularities, have their own unique considerations. When the “pipes” involve the venous system, such as with thrombophlebitis, this is treated as a special case of inflammation. Hey, Buddy, Can You Really Treat That? If we have incomplete or missing diagnoses, should you proceed with treatment? In fact, that complaint has been leveled at chelation therapists for years, that we fail to do “enough” diagnostic workup. If you want the details of your problem delineated down to the molecular level, go to your local university cardiologist. But if you want to feel better now and get on with your life, why not consider a treatment that works for most heart and blood vessel problems (and those of many other systems) that plague most people? Problems that don’t improve can continue to be evaluated. The only heart problems that don’t reliably show desired improvement are pediatric, because of their distorted anatomic features. The only peripheral (or central) blood vessel problems that don’t show expected improvement are ….. sorry, can’t recall any. What Do People Really Need to Know?

For the most part, medical explanations use technical terms that confuse or oversimplifications that mislead. Using the framework presented here, concepts can easily be offered that lead patients into a fair understanding of the treatments proposed and what to expect. (Much of “doctoring” is teaching, which improves compliance dramatically.)

When discussing “heart” disease, many practitioners fail to clarify the distinctions between problems with “pipes” and those with the “pump.” The vast majority of heart conditions treated with surgery involve the pipes, namely “blockage disease” in the coronary (heart) arteries. In discussing “vascular diseases,” other small arteries include those in “end organs” (where blood is finally delivered to the tissues, including inside the brain). Larger arteries are those coming off the heart, going “out” to the organs, up to the head, and down the arms and legs, and these are often more amenable to surgical intervention. In a distressingly large proportion of operations at any level, surgeons often imply that “your problem has been fixed; you’re as good as new,” simply because larger or medium-sized pipes have been popped open (ballooned, often with a bracing stent as well), bypassed (skipped over), or reamed out (endarterectomy) and sometimes “repaired” (patched). In actual fact, operations can be performed on just a few dozen inches of arteries but the underlying problems are widespread, affecting a distressing portion of the 60,000-plus miles of blood vessels sustaining your body organs.

When patients understand the need to restore better blood flow, distinctions can be made between surgical reduction or removal of blockage compared with nonsurgical ways to improve flow. Blockage is a “plumbing” concept, easily grasped. What is harder for many patients to grasp is that better “flow” dramatically relates to incremental reduction of blockage. Increasing the central channel diameter by merely 1/6th (just 16% widening of the vessel diameter) will just about double the flow through that vessel. (This tiny difference is difficult blockage be gently removed? “Cardio” exercise sometimes helps. But what about reducing obstructions naturally … through biological changes induced by IV chelation therapy? Overly simplified, EDTA chelation appears to dissolve the “mortar” that holds together the gunk that accumulates in the pipes, interfering with flow through the arteries. As the “glue” is removed, the body can safely, easily, and naturally reduce the blockage the same way that ice melts in your water glass without shattering into pieces. In fairness, sometimes very little reduction of blockage itself occurs, but gradual improvements to the nutritional status of cells can markedly improve their function and reduce symptoms earlier attributed to blockage.

When heart disease involves the “pump” portion of your heart, we’re looking at three distinct sets of pathologies. First, where blood flow has been completely interrupted to a small area of muscle, that tissue actually dies (heart attack, or “infarct”) and forms a scar. The scar, incidentally, might later stretch and thin out (ballooning out as an aneurysm), with a greater risk for chamber rupture … so surgery can be advisable. Second, the cells in an area can become “sick” from reduced blood flow (“ischemia”) or from nutritional deficiencies (magnesium, B-complex, even calcium), toxic accumulations (lead, mercury, arsenic, other toxic heavy metals), or other adverse changes (such as from organic toxins, pesticides, and so on). Affected muscle cells function less and less well, leading to alterations of normal contraction/relaxation patterns and pumping efficiency. Third, heart valve problems (especially for the aortic and mitral valves on the high- pressure left side) and enlargement of the aortic root or thoracic (chest) aorta are distinct anatomical problems often best treated by surgery. Recent advances are unbelievable, where certain heart valve operations (and even some large artery aneurysms) are being performed without “cracking the chest.” One exception is where calcification of valve leaflets might be improved by extensive IV EDTA chelation therapy, delaying the need for urgent surgical intervention … and even improving later operative survival.

Finally, when heart disease affects the pumping efficiency of your heart, these are “performance” issues. While this category might “blur over” into the second pathological pattern described above, it is distinct in a number of ways. Foremost is where electrical conduction pathway “defects,” for whatever reason, can lead to rhythm disruptions (atrial fibrillation, others) where the pump muscle – although otherwise functionally capable – beats erratically or less efficiently. “Cardiomyopathies” (heart muscle impairments) can result not only from rhythm malfunctions but also from viral (even bacterial, fungal, and parasitic) infections, nutritional deficiencies, toxic heavy metals such as mercury, decreased oxygen saturations, and even hormonal imbalances (hypothyroidism, perhaps deficiencies of testosterone or progesterone or others).

The Fire Within

Inflammation is a chemical reaction, whether in organic or inorganic systems. What causes fire damage to the “outside” – to any structures, from cell organelles all the way up to observable tissues – also wreaks havoc at submicroscopic levels inside biological systems. At the tiniest level, we’re looking at the shifting around (actually, “stealing”) of electrons, with resulting conformational changes of the molecules. The concept is one of “free radicals,” electron-seeking molecules, first proposed by Denham Harman, MD, in 1955. Other concepts have been advanced, many of which rely upon a basic appreciation of the central role of free radicals. For example, in 1942 Johann Björksten proposed the cross- linkage theory to explain the “hardening” of tissues as we grow older or sicker (recall the stiff and brittle rubber band found at the back of your desk drawer). Again, electron changes are involved.

The greatest problem with free radicals is that they damage normal molecules in an accelerating pattern, somewhat like a ping-pong ball (the “initiating” radical) being thrown into a room full of mousetraps, each “loaded” with another ping pong ball. The resulting “fire” is akin to a nuclear reaction, wherein it tends to amplify and continue until it is exhausted or quenched. In the body, “antioxidants” are essential to interrupt (“quench”) electron free radical damage, known as “oxidation” or inflammation. Virtually all degenerative diseases – including cardiovascular – are directly related to free radicals in their initiation and propagation, unrelentingly through cell injury, organ dysfunction, and finally body death. These rampant oxidative changes are the common denominator, and the damages to various intracellular organelles or metabolic pathways advance in their interruption to normal function to where they are finally identified as different disease “diagnoses.” Remember: all involve effectively the same inflammation chemistry.

Since the disease promulgation process is similar in widely variant tissues, this biochemical understanding opens the door to treatment programs that can have a generalized effectiveness without being specifically targeted toward any particular diagnosis. Enter chelation therapy. Clearly chelation is a dominant answer to most cardiovascular diseases. Surgical and drug interventions might still be needed, especially for more advanced disease patterns. But chelation remains the mainstay of treatment.

The Missing Cardiovascular Diagnosis

Repeated (even annual for many “heart patients”) treadmill EKG testing has minimal preventive value … but pays very well. My closest contact with diagnostic limitations of a resting EKG was an older gentlemen who presented with uncharacteristic discomforts at 2 in the afternoon … a regular cardiogram was normal, but I was still suspicious. Hospitalized at my insistence to a continuously monitored bed, he suffered his heart attack at midnight. “Instant” coronary care unit response meant a dramatic reduction of otherwise likely heart muscle damage. Repeated testing of cholesterol and triglycerides has minimal preventive value … but pays very well. Evolving metabolic syndrome changes, once suspected by clinical presentation and slightly elevating fasting or random blood sugars, are best evaluated merely by clinical monitoring and only periodic testing of blood sugars with concurrent insulin levels. Genetic hyperlipidemias are more ominous and pose substantial survival risks, far more significant than the trivial implication of “your cholesterol is high at 230 and you need statins!” Even repeated coronary (heart) or aortic and peripheral (belly and legs) angiographic X-ray dye pictures (merely “maps” for surgery) in symptomatically stable patients have minimal preventive value and attendant appreciable risks. These invasive tests serve primarily a mapping function, to document progression of blockage advanced to the point where surgery is now desirable. And again, the angiograms pay well … and should be reserved for deteriorating conditions where salvage surgery is imminent.

(A critical side comment on cholesterol: the “bad rap” that it has suffered over the past 65 years is simply undeserved. The normal response of your body to various situations is to raise cholesterol as a proper defense or adaptation. If you want to be sure that eating eggs and butter and meats does not increase heart disease, trust the observations of a scientist who spent 70 years of his life studying these issues: Cholesterol is Not the Culprit: A Guide to Preventing Heart Disease (2014), by Fred Kummerow, PhD – this is mandatory reading! More on cholesterol, high blood pressure, and nine other frauds in medicine: Malignant Medical Myths: Why Medical Treatment Causes 200,000 Deaths in the USA Each Year and How to Protect Yourself (2006), by chemistry professor Joel Kaufman, PhD.)

Coronary calcium scans (“heart scans,” coronary artery CT calcium scoring, also called EBCT for “electron beam”) are noninvasive and useful predictive monitors for coronary events. Their value is enhanced when a sequentially rising calcium count is documented, particularly in a patient who has been asymptomatic. An exciting development is the markedly improved sensitivity of coronary MRA, magnetic resonance angiogram (imaging of heart blood vessels) without (or especially with) use of peripheral intravenous contrast. Among the most accurate “predictive” clinical tests are the carotid neck artery and abdominal aorta ultrasounds (or even CT scans), along with the noninvasive vascular lab tests for leg (peripheral) artery disease. These usually allow tracking of credible blockage and flow patterns, but they don’t reflect the entire range of pathologies hidden inside the vessel walls.

The ideal predictive tests would be those that disclose unsuspected “tendencies” to develop more aggressive diseases. When a particular patient has a number of such genetic or epigenetic (variable gene expression, depending on environment and other factors) proclivities, he or she warrants more attention. Here is your “likely candidate” for more extensive and earlier blockage disease to progress. Since “pipe” problems can be imaged and measured, tests should be proposed as indicated by history, clinical exam findings, and abnormal laboratory patterns. (A simple example serves well: history of visual changes, ophthalmic exam showing blood vessel or retinal changes, with elevated blood sugars – clearly carotid artery studies are appropriate, perhaps even a brain SPECT scan, maybe others.) Unfortunately, the data are unclear regarding how best to predict the development of non-“pipe” pathologies – those of the pump or its performance. Cardiac muscle biopsy is not something to consider!

One predictive parameter that is grossly underemphasized is that of oxygen saturations. Numbers of studies have shown that decreasing nocturnal saturations – which reflect lowering oxygen tension in the blood and, hence, in the tissues and especially inside the mitochondria energy factories of the cells – are directly related to impaired pump function and performance issues. The critical continuous generation of ATP to power cellular processes is absolutely dependent on sufficient oxygen to receive and remove electrons stripped during oxidative phosphorylation in the mitochondria. Energy production is perilously degraded when the anaerobic fermentation pathway is employed. When oxygen saturations are raised toward normal, improvements in tissue functions in all organs can be expected, including retarding of “aging” degeneration and even deferred initiation/promotion of neoplastic patterns. Otto Heinrich Warburg, MD, nominated 47 times for the Nobel prize, finally received the unshared award in physiology in 1931 for discovery of the “nature and mode of action of the respiratory enzyme.” Concluding that cancer (and other deterioration diseases) should be interpreted as a mitochondrial dysfunction, Warburg proclaimed that “the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar.” As noted in Wikipedia, “When frustrated by the lack of acceptance of his ideas, Warburg was known to quote an aphorism he attributed to Max Planck: “Science progresses not because scientists change their minds, but rather because scientists attached to erroneous views die, and are replaced.” Sound familiar?

Though autoimmune issues are not the main topic for this review, practitioners should remain alert to the prospect that they might be aggravating heart and blood vessel problems. The defense system, just like all others, works optimally when oxygen tensions are sufficient, nutritional status is replete, and toxic metal and chemical exposures are minimal. When conditions are not ideal, aberrated responses are more likely and any tissue can be targeted. Since endothelial blood vessel linings are present throughout the circulatory system, any immune attack on their components can alter function – and subsequent changes can be induced in end-organ tissues anywhere. Autoimmune heart problems occur classically after untreated streptococcal infections (“strep throat”), wherein any heart tissue or the surrounding sac can suffer severe damage. Recent reports have documented antiendothelial cell antibodies as associated with accelerated artery disease in patients with rheumatoid arthritis (RA), systemic lupus (SLE), and “spondyloarthropathies” (systemic sclerosis found with inflammatory joint diseases of the vertebral column – which can include psoriatic arthritis, inflammatory bowel disease, and so on). More autoimmune interactions will be identified in the future.

Unnoticed or misdiagnosed parasitic infections might be at the root of many diseases appearing to be autoimmune. While most people think of “worms” or “flukes,” since they are most commonly diagnosed in humans, the vast majority of parasites are single-cell organisms, extremely easy to “get,” astonishingly difficult to document or diagnose, and particularly difficult to treat. And, of course, most physicians disregard or dismiss the idea that parasites contribute that much to degenerative diseases – this oversight might be fatal to thousands of patients each year. Parasitic infections are no longer classifiable as just “diseases of the third world.” “Montezuma’s Revenge,” traveler’s diarrhea sometimes acquired in Mexico, is due to a single- cell amoeba, which (like almost all tiny parasites) is readily shared through water exposure. How many other cases of diarrhea or digestive disorders are related to unsuspected organisms? Malaria is the classic case to document endothelial blood vessel damage associated with infection. Virtually all of the world’s oceans, lakes, and rivers are teeming with parasites of some sort, found mostly in the first 9 feet below the surface. Genomic testing might become the ideal way to document some of these unwelcome residents, but many of them reside deep in tissues, where they wreak havoc. Their “stealth mode” keeps them from being “seen” until damage is profound, such as abscesses in the brain and even multiple sclerosis.

Recent discoveries of biofilms – aggregates of microorganisms within a secreted slime or protective matrix and present on virtually all moist surfaces “outside and inside” human beings (such as plaque on the teeth) – suggest that all infectious agents can be shielded from access to the immune system or antibiotics and thus could persist for years, repeatedly seeding infection that could provoke or amplify inflammation, degenerative diseases, and autoimmune responses. Complex infection patterns linked to biofilms could be more than a passing fancy, and might indeed hold critical clues on prevention and treatment of most cardiovascular diseases. Bacterial biofilms have been found within fatty deposits of damaged arteries. Perturbations of the gut microflora are clearly related to inflammation and dysfunction of the intestinal lining. Periodontal disease (progressive gingivitis, gum inflammation) has long been associated with heart attacks and strokes. Effective dental hygiene can reduce these risks, especially important in compromised patients such as diabetics. An excellent review of how oral disease correlates with systemic health is presented in Mouth Matters; How Your Mouth Ages Your Body and What YOU Can Do About It (2013), by Carol Vander Stoep, RDH. Keep in mind that all these departures from normal structure and function are associated with inflammation … and that this poses special challenges to maintenance of all cell activities.

Incidentally, as mitochondria become “sick” – such as having their chemical pathways poisoned by toxic metals – they swell with increasing calcium concentration, disrupting their shelflike cristae fold structures, dramatically interrupting the electron transport chain. Chelation therapy has been shown to repair such injured organelles, restoring more normal energy generation. So here arises the charge that chelation can be criticized for claiming that it “fixes everythin’, jus’ like some kinda snake- oil!” But … patients claim (and dozens of studies by Edward McDonagh, DO, and Charles J Rudolph, DO, PhD, as well as others have documented) that chelation does “fix mos’ everythin’!”

All toxic metals are, to some extent, accumulating in endothelial linings and throughout heart and blood vessel cells as well – mercury, lead, cadmium, arsenic, and so on. Each has a separate contribution to amplify free radical production leading to functional impairment. Rodent studies suggest a marked intensification of damage when two or more heavy metals are present, even in trivial concentrations. But toxic heavy metals are not the only culprits. Iron is an essential element that can be present in excess (iron “storage” disorders, even mild polycythemia?), where it also stimulates the generation of free radicals that are especially toxic in metabolically active tissues such as liver and heart, even more so in compromised patients such as diabetics. Neurodegenerative disorders such as Alzheimer’s and Parkinson’s have been conclusively linked to excess iron accumulation in brain tissues. Elevated cancer rates are seen in patients with iron overload. These clinical observations confirm Warburg’s contention that mitochondrial decay, mediated through amplified free radical attacks, is the root of disparate and disastrous disease patterns that steal our comfort and, ultimately, our life.

Jukka T. Salonen, MD, PhD, MPH, of Finland, reported in 1992 a prospective study of 1931 men with no symptoms of heart disease. Over the next three years from entry, the lifetime total of cigarettes smoked was determined to be the primary risk factor in those 51 patients who experienced acute myocardial infarction (heart attack). The second factor was (not cholesterol or blood sugar or blood pressure or obesity!) an elevated blood ferritin level (possibly correlated with a shift toward tissue acidosis). Beyond an accurate smoking history, this realization provides an easy laboratory test to identify those at higher risk. Ferritin levels rising ever higher above 100 ng/ml are directly associated with an alarming increasing incidence of coronary events. The iron story is, however, complicated because adequate pools of iron are essential for life. Ferritin only slowly declines after dozens of EDTA chelation treatments – correction of other metabolic perturbations is essential. Even mild iron-excess patterns might be clinically more significant than earlier appreciated.

A toxic metal side issue is now coming to the forefront: the expanding use of injectable MRI diagnostic imaging contrast agents, such as gadolinium, iron (Feridex), and manganese (Teslascan). Urinary challenge tests with D-penicillamine in some patients have shown very high excretion levels of gadolinium. The clinical significance of these findings is variable, but chelation in patients who have had repeated contrast studies might prove very valuable.

Gadolinium use has been linked to onset of rare but often crippling nephrogenic systemic fibrosis, especially in patients with reduced kidney function.

Oversaturated with Facts?

So-called sleep apnea is associated with magnified rates and more injurious cardiac events. Sadly, most physicians have only a passing exposure at best to the parameters of at-rest oxygenation. (The awake-in-the-exam-room-chair saturation level obtained in some offices is almost useless for prediction, unless the patient is in clinical distress.) “Obstructive” events are routinely blamed for desaturation events, but my experience shows that accusation is misplaced in the vast majority. Thus, patients are subjected to “scuba-torture” (CPAP pressure mask worn during the night), usually disrupting sleep patterns for many. Further, CPAP is notorious as a failing therapy within a year of two of starting, due to minimal results (of simply blowing room air) and frustrating discomfort.

Pause to consider: if you use an “obstructive” treatment (CPAP) for a “central” problem (as interpreted from “low sats”), how likely is it to succeed? Obstructive sleep apnea is routinely “diagnosed” by sleep labs – but my observations and clinical results over the past 22 years clearly show that central apnea is far more common … and easily controlled by nasal cannula oxygen from a home concentrator during sleep. Medicare and insurance companies concede that saturations below 89 qualify for “lifetime” oxygen support. In sharp contrast, patients with “sats” from the mid-90s on down show improvements with virtually all heart and circulation problems, mentation, arthritis, digestive disorders, strength and vitality, and so on. Recall that robust oxygen availability is essential for mitochondria to meet the metabolic demand for ATP. My testing of nocturnal oxygen saturations over the past 22-plus years has proved that the vast majority of desaturation patterns can be related to central causes. This central “respiratory disconnect” appears associated with past head injuries of any kind and/or toxic insults (heavy metals, organic and inorganic chemicals). Presumably hypoxic/anoxic shock and severe infections (especially meningitis and encephalitis patterns) would qualify, but my experience is too limited to offer those conclusions.

These desaturation issues present a glaring example of “the Missing Diagnosis.” When “modern” medicine doesn’t have (or doesn’t accept) a specific treatment program, then its regimented practitioners routinely miss the accurate diagnosis for one very simple reason … they don’t look for or don’t actually see the problem.

Another worthwhile topic to explore would be EECP (enhanced external counterpulsation), compression therapy wherein air pressure cuffs squeeze on the legs during the relaxation phase of the heart beat (diastole). In a surprising number of cases, augmented boluses of recently oxygenated blood surging through the coronary arteries and vital organs appear to produce a significant improvement in underlying pathology. At present, the cost and complexity of such strategies are prohibitive for many – and, again, the added benefit of supplemental oxygen during EECP treatments is likely overlooked by conventional practitioners.


A major change in our food processing has occurred in just the past 40-some years: the introduction of HFCS, high-fructose corn syrup, as a flavoring. Actually, more as a “sweetener.” But it’s not really “all natural,” as we think of foods (such as glucose or sucrose ). And it doesn’t taste just exactly like sugar – but it is close enough to substitute in an astonishing number of “sweet” foods and drinks … and even in ketchup, mayonnaise, hamburger and hotdog buns, and the like. The worst part is that it acts more like a drug than the historical sweeteners such as cane or beet sugar or honey, encouraging you to “seek more” of the HFCS-supplemented foods. You probably avoid such foods … certainly you would recognize the chemical name. But would you tag as the same … “corn syrup solids”? “Natural sweeteners”? “Fructose” (fruit sugar) or “fructose syrup”? “Crystalline fructose”? HFCS intake (often quickly, in soda pop, candies, cookies, “treats,” cereals and baked goods, and junk foods) spikes insulin release and triggers production of triglycerides and cholesterol, let alone aggravating or actually causing intestinal permeability syndrome (“leaky gut”). Elevated insulin levels contribute to all the pathologic damage of metabolic syndrome, the preliminary to adult-onset diabetes, now epidemic in America. 

Recent years have shown a 600% increase in daily consumption of HFCS, often unknowingly. Of concern are not merely obesity but also the discovery of interruption of hippocampal function (memory, orientation, even behavioral regulation) and creation of neuroinflammation. HFCS-induced inflammation has also been documented throughout sensitive endothelial tissues lining the heart and blood vessels and in joints. An association with cancer has been shown as well, supporting Warburg’s insistence on mitochondrial deterioration as a primary event. The staggering number of HFCS foods are dangerous not only because of their empty-calorie content (lots of calories, devoid of real food value) leading to nutritional deficiencies, and not only because they encourage increasing intake of sugary/starchy foods, but also because these very foods sponsor the development and worsening of tooth decay, obesity, cardiovascular diseases, diabetes, and the “Yeast Syndrome.”

Here’s a provocative observation: HFCS foods entered the food chain in about 1971, and the first book describing the Yeast Syndrome appeared in 1978, The Missing Diagnosis, by Orion Truss, MD. “Syndrome X,” cardiometabolic (or just metabolic) syndrome, was first described in the 1987 Banning Lecture to the American Diabetes Association by Stanford endocrinology professor Gerald Reaven, MD. This clinical pattern clearly is the developmental step toward induced diabetes and preventable cardiovascular diseases. Key pathognomonic features of metabolic (or “insulin-resistance”) syndrome are the curse of our suffering survival as we age: obesity (increasing girth, elevated body mass index), higher blood pressure, elevating blood sugar (with increasing insulin production), elevating triglycerides, and decreasing HDL cholesterol. Oh – and don’t even get me started on the toxic cellular effects of “other” sweeteners such as aspartame, acesulfame potassium, sucralose, and saccharine. These were approved for limited use in foods for diabetics. Now they are widely scattered through the food chain, needlessly exposing millions to chemicals with demonstrated toxicity. (You should also be careful of Sapporo Diet Water – yes, I’ve seen it! – and Bernard Dehydrated Water … an empty tin!) Incidentally, the overwhelming percentage of corn, as used in production of HFCS, is a GMO – genetically modified for more robust growth. Some have declared these genetic manipulations by chemical giant Monsanto are the inevitable end of healthful foods. Gives you that warm, fuzzy feeling again, right?

GMO crops are engineered to resist herbicides, so higher concentrations can be applied to increase the commercial yield per acre. Are you ready for more and more hidden sources of glyphosate residues (broad-spectrum weed-killer Roundup) – now the world’s largest- selling herbicide and another demon- invention from Monsanto? Glyphosate has been connected to, among a growing list of other health challenges, an increased rate of miscarriage, reduction in sex hormone production, and disruptions to endocrine system development. What about autoimmune inflammatory celiac enteropathy – classically described as “gluten intolerance”? Celiac patients experience a twofold increased risk for coronary artery disease, along with arrhythmias and heart failure. Glyphosate residues on grains might be the real culprit in the recent rise in apparent clinical patterns, since they create the setting for destructive inflammation throughout body tissues … in not just the intestinal linings but also mitochondria.

Recent reports suggest that glyphosate interruption of cytochrome P450 detoxification enzymes, disruption of aromatic amino acid synthesis by the gut microbiome, and impaired sulfate metabolism could amplify inflammatory pathways, resulting in many degenerative diseases … including those of the heart and blood vessels. Oddly, glyphosate “cages” (chelates?) aluminum in the gut and enhances absorption of this toxic metal. The (controversial! and challenged) speculation of glyphosate- induction of diseases has been suggested by consulting chemist Anthony Samsel and MIT computer science senior research scientist Stephanie Seneff, PhD, as the “textbook example” of “exogenous semiotic entropy”: the disruption of homeostasis by environmental toxins.1 But you can rest assured: the Council on Science and Public Health of the American Medical Association has concluded that “it appears unlikely that HFCS contributes more to obesity or other conditions than sucrose.” Keep in mind also that the common high-fat/ high-sugar diet creates hyperinsulinemia (part of the metabolic syndrome), a key factor in promoting prostate cancer. Could enhanced inflammation (promoted by glyphosate?) along with the yeast proliferation induced by such a diet be a major feature in cancer promotion? For years, I have treated elevated prostate specific antigen (PSA) patients aggressively for the Yeast Syndrome … with uniformly encouraging results. For a provocative review of the crucial interrelationship of fungus (yeast) and cancer, consider this internet video by the television host of Know The Cause and my dear friend for over 30 years, Doug Kaufmann: http://www.knowthecause. com/index.php/cancer.

Getting on with the Drugs and Stuff

You might think that I’m spending too much time and space discussing the “food issues” – and you’d be wrong. Master teacher of the American College of Cardiology, Demetrio Sodi-Pallares, MD, practicing clinical and electro-cardiology for 60 years with impoverished Mexican citizens, has long treated dramatic degenerative heart diseases with little more than radical changes in the diet. His “nontoxic therapy” evolved from low-sodium/high-potassium diet plus infusions of “polarizing” (GIK = glucose- insulin-potassium) solutions to later include a strong electromagnetic field of 200 gauss and even later use of beta blockers, thyroglobulin, and exercise.

In case you haven’t yet grasped the significance of diet in development of disease, refer to the classical findings of Weston A. Price, DDS, research director for the American Dental Association, who documented the deleterious effects of “foods of commerce” (Nutrition and Physical Degeneration: A Comparison of Primitive and Modern Diets and Their Effects; 1939), and those of Francis M. Pottenger Jr., MD, regarding uncooked foods (reviewed in Pottenger’s Cats: A Study in Nutrition; 1995. The Price- Pottenger Nutrition Foundation offers tremendous resources at As the science of nutritional biochemistry advanced during the mid-1900s, our understanding of health and disease dramatically expanded.

Recall that our populations were told since the 1960s to avoid salty foods, to lower the tendency to develop high blood pressure, a major risk factor for heart disease. Sure, we have made serious efforts to avoid “salting at the table.” But we still eat salted peanuts, salted pretzels, salted chips, salty pickles, salty deli meats, and so on. And these salted sources don’t have added iodine. Why is this an issue? Over 100 years ago, public health authorities adopted the addition of iodine to table salt, a product that virtually everyone used, in order to reduce the incidence of thyroid disease (goiter). So now we have three generations of patients who have received a steady salt intake but minimal iodine. Bingo! Broda Barnes, MD, showed some 40 years ago that low thyroid levels (associated with low iodine intake) are directly associated with a rising risk of heart attack (Hypothyroidism: The Unsuspected Illness; 1976). Denis Wilson MD, has shown that raising thyroid hormone levels (especially free-T3) and raising basal body temperatures closer to “normal” can lower heart disease risk, and blood tests are rarely reflective of adequate support levels (Evidence-Based Approach to Restoring Thyroid Health; 2014). As you might predict (note: tongue-in- cheek!), these observations continue to be challenged by the American Thyroid Association.

Magnesium holds a special place for cardiovascular diseases. Lowered intracellular levels of magnesium are difficult to detect but clearly important. When serum levels are normal, intracellular magnesium may have been scavenged to maintain that measurement. Low serum levels are, therefore, beyond critical and must be addressed, since they contribute not only to high blood pressure but also both pump (CHF, congestive heart failure) and performance (contractility and rhythm disturbances) failures, as thoroughly documented by Seelig.2 Complementing magnesium certainly are manganese, copper, and zinc – adequate levels of all are essential for the formation of SOD, superoxide dismutases, thought to be the fifth most prevalent enzyme set in the human body, since they serve critical antioxidant functions in mitochondria, intracellular cytoplasm, and in extracellular fluids. SOD enzymes outcompete the essential tissue production of superoxide, used to defend against invading bacteria, protecting body cells from internally generated oxidant injury. Back to mitochondria and that inflammation idea, right? Recently developed laboratory tests can be invaluable in helping practitioners identify patterns of nutritional deficiency that can aggravate inflammation; especially helpful are micronutrient testing to evaluate their function within leukocytes (white blood cells), urinary amino acid patterns wherein abnormalities suggest the setting for disease development or progression, and chelation challenge urinary excretion to provoke underlying essential element deficiencies, sometimes supplemented by the old standard of tissue mineral analysis by hair sampling.

Another aspect of cardiovascular disease that might relate to nutritional status and the quality of food intake involves the hypercoagulability (clotting) and rheological (flow) properties of blood. People with underlying biochemical conditions – such as diabetes, alcohol abuse, tobacco use, and even hypertension, to name a few – are more at risk for triggering abnormal clot formation. Those with “vulnerable plaque” – artery blockage that is “unstable” (inflamed and irregular in composition and shape) and more likely to have pieces “break off” and slam into tinier vessels further downstream, causing sudden vascular disasters – often suffer with a dangerous accentuation of their clotting patterns. Sometimes referred to as “sticky blood,” underlying changes relate to an increased tendency to activate the clotting cascade to form a “plug” (clot or thrombus) in a blood vessel that leads to a sudden severe (even complete) interruption to flow. This ischemia pattern must be corrected as quickly as possible (infusion of a kinase “clot-buster” within 4 hours) or tissue death ensues – infarction is death of the tissue, whether heart attack, brain stroke, gangrene, retinal occlusion blindness, kidney necrosis, and so on. When a blood clot forms in deeper veins in the legs, the situation is far more ominous than painful discomfort: if dislodged, the plug can zip into the lungs, and such a pulmonary embolism can literally cause sudden death. Risks for these events are reduced by all the treatment strategies discussed along with the addition of oral “fibrinolytic” clot-buster enzymes such as nattokinase (from soy), lumbrokinase (from earthworms), or serrapeptase (from bacteria within silkworms). “Thick blood” (excessive numbers of red cells) is a different but also aggravating condition that can create similar blockage. Platelets (tiny circulating cells responsible for starting the formation of a clot) can become “irritable” when inflammatory conditions are present (including low oxygen saturations, toxic heavy metals, toxic organic chemicals, elevated blood sugars), and their undesirable activation can amplify “sticky blood” tendencies.

A couple of last points on foods. Bioflavonoids (polyphenols), cell- signaling sugars, and a wide range of other goodies are essential for well- being. Colorful vegetables are the source of bioflavonoids (and other “live” factors) on the planet. These are critical in biological functions (believe it or stop reading the basic science journals!) and virtually all of them are now being also shown to have powerful antifungal (and even anticancer) activities. Other goodies include items such as intracellular glutathione (difficult to absorb unless enhanced by liposomal packaging, synthesis rate limited by scarce availability of L-cysteine, essential for antioxidant activity and detoxification), CoQ10, and (induced production of) nitric oxide. These latter two are critical for control of cardiovascular efficiency – pump and performance issues – while the last aids in dilatation (widening … or reduced constriction) of the pipes. While these and other factors are not readily “replenished” by direct supplementation, their synthesis and incorporation can be encouraged by specific nutritional support beyond merely the regular “multivitamin/-mineral formulas.”

Mitochondrion Basics

Likely derived from prokaryotic ancient “bacterial” invaders into eukaryotic cells, these tiny “power plants” produce the ATP-based (adenosine triphosphate) energy used by virtually every cellular process. Cell life and division – even cell death – relate to mitochondrial status. Think of a “mito” as a “Dagwood sandwich” from the comic strip Blondie, with outer bread slices encasing a pile of layers of meats and cheeses. The “bread” in this illustration serves as a limiting outer membrane, through which sugars and fats can enter and ATP compounds can exit. The layers of meats and cheeses are equivalent to “shelves” (called cristae) inside the mito, stacked one upon another and separated by an insulating matrix. Enzymes and substrates involved oxidative phosphorylation (processing of sugars through to the end products of the electron-transport system) are aligned along these shelves in specific order, much like you would search for the volume of an encyclopedia from A to Z, not randomly. When all is working well, an innocent “sugar” molecule tumbles its way along, much like a Slinky toy trips its way down stairs, going quickly from one to the next chemical reaction, in order.

Lead and other toxic heavy metals (and even iron, in excess) disrupt the inner shelf arrangements (apparently by inflammatory changes) and diminish enzyme efficiencies, reducing the rate of energy production. Further, as the mito becomes sickened and less able to perform, it can accumulate calcium ions and swell, distorting the shelf arrangements even more. While specific studies have not been done, EDTA chelation therapy appears a likely prospect to reduce internalized calcium and to restore more normal mito shape and function. Whether lead and other toxic metals are actually removed from within the mito is unclear, but in vitro laboratory studies demonstrate increased energy production in heart muscle as a result of chelation. As an interesting side note, Denham Harman, PhD, MD, who proposed the free-radical theory of aging, was frustrated by observing no increase in lifespan of research animals with the addition of antioxidant supplementation. He concluded that such nutrients did not routinely make their way into the mitochondria, which are concurrently producing as well as being damaged by free radicals. He therefore proposed the mitochondrial theory of aging in 1972, where the health of these organelles is the primary determinant of maximum lifespan.

Before settling into the comfort of “modern diagnostics and medications,” be sure that exposures in the patient’s setting are well understood. Especially be wary that we have less and less understanding about more and more complexities. For example, when tetraethyllead was removed from vehicle gasoline in 1976 – a good idea to reduce environmental pollution, to lower blood pressure and heart attack risk, to minimize kidney damage, to improve brain function, and so on – the replacement mineral chosen was manganese. The health hazards associated with manganese combustion products have now been debated for decades. Might we later find that our replacement is almost as challenging to human health as the original lead that aided octane performance in the gasoline?

Another provocative speculation is that the modern practice of “polypharmacy,” wherein several drugs are prescribed concurrently, might induce or amplify inflammatory processes. Medications are approved for use by the Food and Drug Administration based upon limited clinical testing, where most variables are tightly controlled. The general public, though, offers nothing but variables! The dubious interactions of multiple drugs simply haven’t been studied, and their role in unwittingly aggravating disease processes – or even in inducing new ones, such as through interference with mitochondrial functions – raise disturbing questions about the bases for “modern” medical practice.

Mitochondrial dysfunctions are at the root of all degenerative disease progression. Understanding that optimal cellular and tissue function requires a robust supply of ATP energy leads to the obvious realization that all body activities are impaired whenever this vital component is limited. Any reduced antioxidant capability allows for unbridled inflammatory chemistry to wantonly damage cell structures and enzymes. Impairment of energy- dependent production of immune molecules leaves an undefended body increasingly prone to opportunistic attack by uncommon organisms, including those generally considered as nonpathogenic commensals or symbiotes on body surfaces, especially in the intestinal and respiratory tracts. Reduced digestive functions lead to a plethora of chemical and biological insults to gut tissues (and, subsequently, to fragile endothelial cells lining heart and blood vessels), not to mention amplification of nutritional deficiencies.

With rising challenges and diminished circulatory capacity, the physiologic strain on heart performance advances like falling dominos, inevitably resulting in degrees of kidney failure, deterioration of liver functions, accelerating diminution of gastric and pancreatic and hepatic secretions with progressive digestive impairments, peripheral circulatory embarrassment, and even organic brain syndrome. Obviously past lifestyle habits – tobacco and alcohol use, poor food choices, limited sleep, compromised stress adaptation patterns, licit and illicit drugs – create a setting (Claude

Bernard’s “internal milieu”) in which all of these results from mitochondrial dysfunction can accelerate more rapidly than in others with more moderate health routines. Clearly the description offered can be observed over a matter of days or weeks in preterminal patients – or can be discerned by an astute practitioner some years (even decades) before the debilitations become obvious to others.

Putting Together the Bigger Map

While these ramblings might seem to have little to do with “cardiovascular diseases,” ask yourself: “Should I be treating the damage from degenerative diseases while ignoring the environmental factors that persist and aggravate the condition?” That’s rather like allowing the patient to wear the shoe causing the blister perhaps merely an hour or two a day. How foolish! Note that I do not ask whether the problem is with pipes, pump, or performance. The “diagnosis,” in a classical sense, is almost irrelevant. The key is to establish the link between the condition and associated lifestyle choices and exposures so that a more comprehensive (holistic!) approach can be used.

In effect, I am proposing that virtually all treatment for cardiovascular diseases should be aimed at the “utility” level. This example highlights this point: Whoever lives in a house, it matters not … the house has the “same” utilities as found with all other houses. Whether a baker, a banker, a teacher, a postman, you depend upon electricity coming in and light and heat going out, depend upon water coming in and drainage and sewage going out, depend upon food and supplies coming in and trash going out. Even a driveway coming in and roads going out!

Consider each “house” to be a single “cell” of the body. Thus, a neighborhood of similar houses would constitute an “organ” and a large cluster of assembled neighborhoods would comprise a “body.” Our current medical paradigm aims at treating problems within specific neighborhoods. I propose that most of our treatments should be aimed at houses, at the utilities provided to and functioning within the individual cells. Regardless of which utilities or cells are suffering, those are the levels at which treatments shouldbe aimed. This viewpoint encompasses a broader explanation of the symptoms and signs seen in illnesses, correlating the expression of disease in other organ systems (neighborhoods) that are likewise being affected by the impairment of their similar utilities.

Changing the Slope–Oh, No! Not Calculus! As I propose this somewhat different approach to assessment and treatment, let me offer how I describe to patients our assessment and monitoring of their conditions. Our explanation induces patients to stay with treatment programs much longer than they did before. First, let me give homage to indices such as the SF-36 Health Survey. Consisting of 36 items, the SF-36 is a brief survey designed to assess functional health and well-being in a variety of age, disease, and control populations. … Each question relates to one of eight domains: physical functioning, role-physical, bodily pain, general health perceptions, vitality, social functioning, role-emotional, and mental health. Results from these subscales contribute to scores for overall physical and mental health.3

In order to better address our particular patient population, I designed a customized “symptom-rating” form of about 50 items, printed on the flip side of our office visit notes page. At every doctor-patient visit, the patient rates his discomforts (from 0 to 10) before being seen. The various “positives” serve as foci for discussion at that meeting. Further, by “flipping up” the chart pages to earlier encounters, the progress of symptom reduction can be easily seen over time, from first visit to present time.

I describe to “newbie” patients that the first thing we’re trying to do is to gain some understanding of what actually is affecting them. At this point, many patients usually will interrupt to share, once again, their various diagnoses (from other physicians), to be sure that I’m not overlooking their concerns. I acknowledge their statements and say that we understand that their various disease problems, as a whole, are worsening over time. They agree. I tell them that my first job is to identify the “pinch points,” where doing something simple and deliberate will slow the rate at which they’re worsening … then level them off, so that they’re no longer worsening … then raise the slope of the curve, so that they’re steadily improving … with the ultimate goal being to return them to more robust health, often better than that they’ve experienced in recent years.

This explanation encompasses a broader view of “health” more along the lines of Bircher, “a dynamic state of well-being characterized by a physical and mental potential, which satisfies the demands of life commensurate with age, culture, and personal responsibility.”4

For those who need a more visual presentation, perhaps this graph might illustrate the concepts easier, since I do draw it “out in space” for patients:

During the next phase, as noted by the solid line above the “D,” you are finally able to achieve some improvements and your patient clearly feels healthier. In the final phase, the solid line above the “E,” results from your treatment patterns have become obvious and your patient is benefiting greatly. When you’re able to establish a “maintenance program,” your job is to monitor the hallmark symptoms carefully – along with relevant labs and exam findings – to “stay ahead of the curve,” keeping most symptom severity scores at 3 or often less.

What about the dotted line on the graph? Some patients present to you as markedly more acute or chronically worse than anyone would like. “But doctor, I just found out about you. …” The steeper slope above the “A” shows that you have less time to evaluate and find successful treatments. Nevertheless, your job remains the same: slow the rate of worsening, find ways to hold everything “level” while you “buy time” for treatments to work (or to be identified), then work for gradual improvement and then much more aggressive changes.

Patients who are not themselves integrative medicine physicians can have only a brief, disjointed, and even mythical view of the roots of their problems, the diagnostic finesse often needed, and the treatment options available. What they clearly understand (or at least hope for) is that doing specific actions could lead to particular, desired results. Their motivation to continue their treatment programs comes only from successful responses. Since a patient has completed our same “SF-36-type” questions at each office visit, he or she can readily see the “march” of lower and lower “scores” away from “10” and toward “0” over the course of several office encounters.

The demonstrative graph is easy for patients to understand. Assume that the patient has symptom complaints, rated on our 0-to-10 scale as shown on the left side. These roughly correlate inversely to the feeling of health and wellbeing, as shown from 0 to 100 on the right side. The patient presents with declining health and worsening symptoms, as noted by the solid line above the “A.” During this first phase, your job is to define the underlying issues well enough to start improving the patient’s condition … which means slowing the rate of worsening, as noted by the solid line above the “B.” As you understand underlying causes better and work more with the patient, you work to hold most symptoms “level” or “unchanged,” as noted by the solid line above the “C.” This, in itself, is a major accomplishment … now you have the opportunity to make a real difference for this patient. What More is There to Learn?

Absolutely everything. The practitioner has three essential tasks. First, to learn what needs to be known about diagnosing and treating the conditions he/she holds himself out to treat. Second, to establish and oversee proper treatment programs. And third, to effectively explain to the patient and family “what it is and how we’re treating it,” as often as needed.

Reflecting on a lifetime career of treating “all comers,” including those with cardiovascular diseases of all kinds (including two patients who were removed from the heart transplant list, due to startling improvements), I find myself struggling to offer comments of value to other practitioners. Most everyone knows the first and second tasks quite well, at least well enough to achieve basic improvements for patients. What matters, then, might be efforts to learn just a little more about how to explain the situation to the patient and family. My methods have been successful on many levels, with patients from all backgrounds, with all conditions, and at all levels of presenting severity.

As we strive to learn better to take care of our patients, let us strive also to learn better how to make what we do make sense to those whose world depends on our “doing it right.”

If you doubt the relevance of these concepts I’ve presented … just try them! See whether patients are more receptive to your ideas of diagnosis and treatment. See whether they are more compliant – and whether they continue for maintenance programs moving them toward years of more robust health and longer, more rewarding, and vital independent and comfortable living. If you don’t try them in your practice but instead ignore that they have any value, may you be blessed by this wonderful quote from Founding Father Benjamin Franklin: “Any fool can criticize, condemn and complain – and most fools do.”

The Story of my Father My father told me, in early 1979, that he was going to see a doctor about doing chelation therapy. I went only slightly berserk, insisting that I would have heard about it in my
training or residency if it had any value for cardiovascular diseases. He “wisely” stayed away from that charlatan. Then my mother needed drastic surgery for a bleeding ulcer in
the fall of 1982. As I needed to fill my days while seeing her in San Francisco, I visited the office of Robert Haskell, MD. We discussed nutritional medicine and dietary programs … and then he asked, “Well, you do chelation therapy, of course?” I explained my reservation about doing any treatments that were exaggerated in their claims of helping … especially with a wide variety of illnesses. He said simply: “Come with me.” We climbed up one flight of stairs. “Here,” he said, “is my nurse. And my charts. And my patients. Have a good day.” And what a day it was! I could barely believe the documented results of patients who had barely been able to walk due to shortness of breath or chest pains or calf pains. And I got to hear their stunning stories, in person – and to lay my hands on their bodies. I was hooked. I spent the next five months studying everything that I could find
on chelation, so that I would “ace” the written exam. At the training, I met Warren Levin, MD, of New York City, clearly the best lecturer at the meeting. I spent two glorious learning days in his office; the same for Milan Packovich, MD, of Pittsburgh; also for Charles Farr, PhD, MD, of Oklahoma City; and for another eight doctors who generously offered to share their best ideas with me, so that I could strive from the start “to be the best.” H. Ray Evers, MD, of Dothan, Alabama, graciously hosted me for three days to see the best of the past. And thus began my saga, to “learn more and do better than anyone else.” At the very least, each of my parents and I myself benefited greatly. Trowbridge’s Idiot’s Guidelines to Diagnosing Cardiovascular (and Other) Diseases The following questions are essential!

  1. Who is affected? Environmental exposures, other illnesses/ operations?
  2. What is the change (deviation) from normal structure/function?
  3. When did these changes start? When have they progressed?
  4. Where is the site … of the ill organ/s? Of the patient (home/work/
    travel, present and past)?
  5. Why did the change/s occur (preceding or associated events)?
  6. How did the change/s develop and worsen? This is often the most
    critical question. …

The principal part of everything is the beginning. By answering these basic “reporter’s questions,” a good start can be made toward diagnosis and effective early treatment. Every patient starts here, no matter how complex or easy. Following this list reduces your likelihood of skipping an important factor and heading in the wrong direction. Trowbridge’s Diagnostic Testing for Dummies: Cardiovascular Diseases The following tests can be useful:

(Obviously physical exam with pulse and blood pressure and respiratory rate, CBC with differential and platelets, metabolic chemistry panel, and urinalysis, 12-lead and rhythm EKG, and CXR just to be sure that “basics” are covered) ….and

  • Ferritin
  • Homocysteine
  • Fructosamine
  • Glycohemoglobin
  • Vitamin D3
  • ESR
  • ANA (quantitative plus pattern)
  • RA (quantitative)
  • Fibrinogen
  • Uric acid
  • LDL low-density lipoprotein
  • Lp(a) lipoprotein cholesterol
  • Small dense LDL
  • Remnant lipoprotein (RLP) cholesterol
  • HDL or HDL2b cholesterol
  • Apolipoprotein B
  • Triglycerides.

These factors look largely at genetic or epigenetic issues, to focus treatment on those factors where free radicals matter most. Anatomic function testing, as described, is directed toward specific “problem” areas.

Trowbridge’s “12-Step Program” of Don’ts and Do’s


  1. Assume that the “other doctors” will
    appreciate your participation or any patient
  2. Assume that the condition has been
    correctly diagnosed or cannot be treated;
  3. Assume that the present medications are
    not contributing to or actually causing
    symptomatic complaints;
  4. Assume that a failing course is a likely
    outcome for this patient at this time;
  5. Assume that the treatments earlier
    prescribed by other doctors are correct or
    even required;
  6. Assume that nutritional support has little to
  7. Assume that any “diet” that has been earlier
    counseled is appropriate;
  8. Assume that oxygen saturation levels are
    sufficient, even when not grossly abnormal;
  9. Assume that an operation is the best next
  10. Assume that activity level seen is the best
    that can be obtained;
  11. Assume that your patient understands
    anything at all about his/her condition,
    treatment, improvement, or worsening;
  12. Assume that your patient is at peace in his/
    her soul.


  1. Expect to educate your patient about the medical and political community as well as about costs and coverages for whatever you do – in person, through books
    and brochures, with your staff actively
  2. Expect that effective treatment can be
    started, literally, immediately and then
    improved upon;
  3. Expect that a substantial improvement is
    within easy reach;
  4. Expect that the rate of worsening can be
    slowed then halted for many patients …
    and then “better” is “within reach”;
  5. Expect that your assessment will reveal alternatives that have been missed,
    disregarded, or ignored;
  6. Expect that proper supplements can be, in fact, life-saving;
  7. Expect that radical revision of food intake can be life-saving;
  8. Expect that supplemental oxygen can be life-saving;
  9. Expect that any patient can be better prepared to survive; any needed surgery … or to avoid it altogether;
  10. Expect that a gradual physical therapy program can be started immediately;
  11. Expect that you will need to explain
    the patient’s condition (pipes/pump/ performance, mito energy production, interrelated body functions, and so on) and basics of his/her treatment plans … often;
  12. Expect that crucial spiritual encounters can be lifesaving.

* These steps assume that appropriate medical treatment will be pursued concurrently, including detoxification of organic toxins or toxic heavy metals as needed.

  1. Samsel A, Seneff S. Glyphosate’s suppression
    of cytochrome p450 enzymes and amino acid biosynthesis by the gut microbiome: pathways to modern diseases. Entropy. 2013;15(4):1416–1463.
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    eds. STOP, THAT and One Hundred Other Sleep Scales. New York: Springer-Verlag; 2012:317–318.
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How long will we watch our children suffer from the water crisis?

How long will we watch our children suffer from the water crisis?

There’s a crisis in America and we all know it. The funny thing—but really not-so-funny thing—is that the government has taken minimal action. We sit here and watch the TV screens display images of the gruesome brown water that the government has okayed to drink. We see images of children getting blood drawn just because the government has ignored the problem for so long, that it’s now affecting our nation’s children.

Lead contamination is an awful thing. It’s a silent contamination. We can’t taste it, we can’t smell it, and often times, when someone is affected by it, it goes unnoticed. Lead has flu-like symptoms for adults, and even worse symptoms for children. These include growth problems and weight loss, a lower IQ, fatigue, hearing loss, irritability, and more.

How can we watch our government do nothing and literally ignore the lead problem that has now ravaged our nation? There are only 9 states that have “safe” lead levels in their water supply.

Safe isn’t even an accurate term, considering the Environmental Protection Agency has declared no amount of lead safe. However, by the EPA’s Lead and Copper Rule, “safe” is defined as less than 15 parts per billion.

The contradictions are also muddying the waters and preventing real change.

These safe states include Alabama, Arkansas, Hawaii, Kentucky, Mississippi, Nevada, North Dakota, South Dakota and Tennessee.

Our infrastructure has failed us. Our government has failed us. So, as citizens of the United States of America, what do we do? What do we have to ask ourselves now?

The issue in schools and daycares

In America, our children come first, but really, they’re being put last.

According the USA Today, the Federal government only requires lead testing in “about 10% of the nation’s schools and a tiny fraction of day cares (1).”

The Safe Drinking Water Act doesn’t cover nearly 90,000 public schools and 500,000 daycare facilities because testing is expected to be conducted by their city or community.

So, is this what happened in all of the schools that withheld vital information from hundreds and even thousands of students and parents?

That’s right. Schools across the country are hiding critical information. At Quakertown Christian School in Pennsylvania, lead levels were four times above the reasonable level in 2013, but it took two years for anything to be said.

In Ithaca, New York, two elementary schools excessively violated the Lead and Copper Rule. Caroline Elementary School had one test with results of 550 parts per billion. Remember, the actionable level is just 15 ppb. Enfield Elementary came back with one test of 280 ppb.

It’s said that tests were taken in September, but parents weren’t informed until February. If there is an actionable level of lead, it is required that a notification to the public should be sent out within 30 days.

Meanwhile, in Wisconsin, a large portion of schools don’t test at all. Their reasoning? They don’t know how.

Not only is this a sign of ignorance, but it’s a sign of negligence. As authority figures of public schools, teachers and superintendents have a responsibility to seek vital information and stay updated on crises across the nation.

Considering Michigan is their neighbor, Wisconsin should be aware of the water crisis’ birthplace: Flint, Michigan. Despite their awareness or lack of, Wisconsin’s teachers and school board members are now sitting in shame.

Such lack of initiative should be considered a crime. Wisconsin’s FOX6 asked the biggest school districts in southeastern Wisconsin if they test their drinking water, and out of those who replied, all answers were no.

In 2004, the Wisconsin Department of Natural Resources said that there are no special programs monitoring or controlling lead in school and daycare drinking water.

So, really, what is the real issue?

 Is it misinformation? Is it ignorance? Lack of initiative? Despite the reasoning, there really is no valid reason why teachers and school board members are turning their heads or not turning heads at all.

There needs to be a federal government initiative for every state government to issue appropriate regulation that all schools should individually test for lead in their water. There should be biannual lead testing in schools and daycare facilities.

There is no excuse as to why we are letting this happen and allowing our children to be affected. We are limiting their potential by our own obliviousness. How can we call ourselves the “Land of Opportunity” when we are reducing our children’s capabilities?

Fixing the crisis

Many schools are bringing in filters and sending in bottled water for kids—but filters are often inadequate and bottle water is not always lead-free.

This fix is only temporary. Do they expect to continue this way of life until the end of time?

Temporary fixes are irrelevant—we need change.

Change means changing the infrastructure that lies underneath our schools and daycares. Change means a hefty amount of money. Change means help.

However, the question is always the same. Where will this money come from?

There are plenty of options.

Maybe someone who wins the Powerball will donate a portion to the wondrous nation they live in. Perhaps schools across the nation will start a charity. Or, perhaps the federal government will hop in to assist the states in designing and implementing effective programs to support their country—their children. That would be the ideal option here.

Tell me how we are able to spend nearly 54% of our discretionary federal spending on military costs, while we spend 6.28% on education, 5.86% on veteran care, and 5.93% on medical/health care (2)?

By taking just a mere 5% of $598 billion spent on the military, we could aggregate nearly $30 billion into infrastructure costs. This still leaves military spending at $560 billion, which should be plenty.

The cost of replacing pipes in schools and daycares across America is unknown for now. Replacing pipes is expensive, but there’s no doubt that we can spare 5% of our funds for a start.

Now, to clarify, military spending is undoubtedly necessary. But is $598 billion necessary? We need to think about our logic here. If our children can’t grow up healthy and are unknowingly forced to experience behavioral and mental problems in turn, what portion of these children can’t continue their lives as normal? What portion of these children won’t pursue their dream of fighting for our country because they simply drank American water?


This entire situation is truly sad. Our government is turning heads and playing the silent game. They have held their tongues for too long, but so have we.

As Americans, we need to speak up and have a voice that our country has given us. Start a rally. Start a charity. Start a movement. Do something.

Not only are we not receiving the financial care we need for the water crisis, but Americans aren’t receiving the right education on this crisis either. The EPA holds responsibility for this. As a Federal Government agency, the EPA needs to reach out to every state to ensure that every single state, household, and school in America has this lifesaving information.

There must be pamphlets, presentations, and discussions. An informational movement needs to happen because too many people are unaware of the crisis across America—the silent infection. And if they are aware of the crisis, ignorance and negligence bewilder the rest of us, while authority figures lack initiative and fail to reach out to someone for such vital information.

We need to know how to test the water. We need to know when. We need to know what lead means for us and our children.

We really just need to know what to do.

This is a call for help to the federal government to provide leadership to the States, to help us overcome the problems of toxic water exposures that are affecting our own citizens. Too many of us are in the dark. Lead poisoning is a healthcare crisis. It’s time to act like it.

Children in schools and daycares across America are being severely affected by the water crisis.

Alabama, Arkansas, Hawaii, Kentucky, Mississippi, Nevada, North Dakota, South Dakota, Tennessee are all considered “safe.”

Only about 10% of public schools are tested under Federal government requirements.

Some schools across the U.S. have had exceedances over 36 times the legal limit.


Teachers lack the knowledge that is necessary to keep our children healthy and learning to their fullest extent.

Schools and daycares are offering bottled water as a solution. However, this does not fix the problem.

More donations need to be made from across the nation.

The government spends about $600 billion on military spending.

Our Federal Government holds responsibility for aid in our nation. We are in a crisis–we need education and funds now. 

Source 1:

Source 2:

Tragedy of the Flint Michigan Contamination

Tragedy of the Flint Michigan Contamination: Lead in The Water – Is It Time to Freak Out?

The simple answer is … it’s not so simple. But you must pay attention to what is happening to you and your family to be able to respond accordingly.

Over 27,000 innocent children in Flint, Michigan, have been exposed to startlingly high levels of lead in their city water supply – sometimes 13,000 times the concentration found in nearby localities – for many months, without any warning, even without early official acknowledgment when the problem was identified. The city emergency manager had changed its water supply but failed to comply with Federal and State standards, with dire consequences. They switched back after 18 months to the previous, safer water source, when the State of Emergency was declared in Flint. Now, city dwellers are left with corrosive toxics leaching from their pipes for who knows how long.

So, how can you really know “what is happening?” That is the hard part. So, let’s make it easier for you to see it right now.

Recent reports suggest that the major “toxic exposure” is to lead. Quite honestly, it is impossible for lead to be the only poison you’re being exposed during this event. Over time, scientists will determine and share their additional discoveries with the public, so that even better treatments can be offered.

Is it true that younger children can suffer more serious damage from lead exposure? The answer “yes” is simple for you to see: brain and nerves and other organs are rapidly developing… and lead strikes right in the middle of these. The results of such poisoning can be horrific.

Studies reported since the early 1980s have documented that higher lead levels in the body “led directly to” a falling IQ. Kids sometimes “act dumb” when they’re fooling around – but the tragedy of becoming a permanently “dumb adult” due to preventable brain damage is a life-destroying lifelong handicap.

How will you recognize more serious lead exposure problems? How about decreased bone and muscle growth and poor muscle coordination? Speech and language problems show up along with developmental delay, even seizures and damage to the nervous system and hearing, and even to kidneys. Lower but still toxic levels can be seen as irritability or behavioral issues, difficulty concentrating, headaches, loss of appetite with sluggishness or fatigue; belly pains can show with nausea, vomiting, and constipation.  Skin color can be pale due anemia. Some complain of muscle and joint weakness or pain, also a metallic taste.

Adults can show similar system problems, additionally developing as high blood pressure, heart disease, leg circulation diseases and gangrene, declining mental function, memory loss, headaches, mood disorders, changes in sperm counts and even miscarriage or premature birth. Other heavy metals or chemical toxins (even from yeast/mold) can worsen symptoms such as this or create even other discomforting issues.

Sadly, there’s no treatment available for this poisoning.  Wait! that’s not true! But that is exactly what many worried patients (and parents) will hear from their local doctors in Michigan or around the country – “everyone knows that lead poisoning is irreversible.”  Commonly used blood testing rarely confirms toxic metal levels, rendering it nearly useless. Accurate diagnosis and precise treatment of heavy metal poisoning – such as with lead, mercury, arsenic, nickel, cadmium, even aluminum and others – is a specialty in medical practice that has evolved over the past 60 years.

What are the TWO key factors that are critical to remove lead that is starting to damage body tissues? First, you need management by a physician who understands and offers a treatment called “chelation” (key-LAY’-shun). FDA-approved medications are available to remove toxic metals – and that is the only effective treatment, nothing else works, not drugs, not surgery, not anything else.

Second, you need chelation treatment that is started early enough and continued long enough. During this treatment program, your specialist will include nutritional supplements to replace “usual” minerals (such as magnesium, zinc, others) that are removed during the treatment for toxic metals, along with vitamins that help to reverse changes due to the poisoning.

The biggest problem that many patients and parents will face is … that doctors and others who have no experience with, or any understanding of, lead poisoning and chelation therapy can discourage you from seeking such treatments. Delay in starting treatment of sudden exposures can result in permanent limitations of brain functions – thinking, intelligence, learning, memory, reasoning, then school performance and later career choices – for a child who depends on his parents to rely on physicians who can find out quickly what is going on and can fix it right.

How successful is chelation therapy at reducing lead deposited in children, and even in adults? Medical studies for years have shown overall excellent results in children when proper treatment is continued as long as each particular patient needs. Each year, over 300.000 young children are found to have unsafe levels of lead in their blood; more definitive tests – urine “challenge” testing, hair analysis – would reveal even more. Adults have already had dozens more years to accumulate lead and other toxic heavy metals from so-called “acceptable” levels in the food, water, and air. Their program is longer because their body burden is much more than just from the recent exposure to poisoned water.

How critical is it for you to avoid further exposure right now? Absolutely required! So you must heed precautions offered by local public health officials. You might need to follow these preventive steps for quite a long time. Tainted water can seep into the underground water table, leading to longterm unexpected exposures, such as well water, foods from gardens or even farms, and public water, such as swimming pools or local ponds, rivers, lakes, or even city water supplies. What is worrisome is that poisons spread through the environment are much more difficult to remove and might linger for years, causing continuing health challenges long after any “cleanup” has been declared to be completed. The dangers are very real even though invisible.

Did you know that you can “see” and even “smell” lead-laden water, so you can easily avoid drinking it or using for cooking or bathing? That is a myth, pure bunk, a total lie. The only way to protect your children and yourself from continuing poisoning in Flint is to pay attention to recent local water testing that documents the level of toxic heavy metals found over time. Only in this way can you take needed steps to insure pure water and foods for your family – even if you need to make those changes for many months after the cleanup has been reported as concluded.

Is someone to blame for this serious event? Of course. Investigators will find someone who “did something wrong”–that’s obvious. But your usual environment has already been a dangerous place for the last 60 years or more. Lead paint’s so common in the past (toddlers chewing on window sills or toys), lead gasoline (still used for small airplanes), lead pipes and bootleg stills (lead solder) are easy examples, often explaining gradual toxic accumulations seen now in adults. The Flint water poisoning is a more acute event that suddenly changes everything for a large number of unsuspecting people – infants, children, and adults of all ages – adding further to their underlying body burden of lead and other toxic metals already accumulated over their lifetime.

Is there a bright spot in this disastrous event? Only this: many thousands more people will learn now of the tremendous healing powers of chelation therapy. A few hundred physicians around the country have been trained to deliver chelation therapy, and various approved drugs are available. Beyond rescuing exposed children from a lifetime of lower potential and performance, the reduction of toxic heavy metals by chelation has been documented to improve a wide variety of conditions in virtually every organ. Reducing the lead levels in exposed children is essential right now to minimize or delay later crises as adults suffering heart attacks, high blood pressure, leg artery diseases and gangrene, loss of vision, and much, much more.

Who will really care about your family and your situation in the future? The “news cycle” will soon move on to other headlines and you will be left stranded with the tattered remains of your life. Take advantage now of this opportunity to find a specialist who could help you with your poisoning problems. To consult with a specialist physician who has training in chelation therapy, contact the International College of Integrative Medicine ( or the American College for Advancement in Medicine ( Be diligent in your search and review the doctor’s credentials conscientiously. Remember: your toxic metal problem (from whatever source) is a serious health challenge and needs treating now … it’s urgent to get the lead out!


John Parks Trowbridge M. D., FACAM, has been recognized as a specialist in chelation therapy since 1985.  Acknowledged as an expert in various fields of integrative/“alternative” medicine, he has served as a leader of several professional organizations, he was awarded the Distinguished Lifetime Service Award by the International College of Integrative Medicine in 2014 and honored in 1990 as a Fellow of the American College for Advancement in Medicine.  His most popular book is Bantam Books’ The Yeast Syndrome and he has published over 50 hours of CDs and DVDs, along with lecturing across the country and around the world.  281-540-2329 – [email protected].

Flint, Michigan’s water originally came from Lake Huron; however, in order to save money, Flint switched their water source to the Flint River.

Children who have been affected by lead may develop more slowly, mentally and physically. IQ points may dwindle as well.

Adults will experience flu-like symptoms if affected by lead. However, high blood pressure is a common side effect too.

It’s critical to find a doctor who has prior experience with toxic metal poisoning, specifically in lead.

Common causes for lead contamination include lead-based paint. This was often used before the 1970s.

The water crisis has been across headlines for months now, yet many news sources fail to give a valid treatment plan for those who have been affected. Find alternative sources of information for chelation therapy.

The Lead Epidemic


Young, A., & Nichols, M. (2016, March 11). Beyond Flint: Excessive lead levels found in almost 2,000 water systems across all 50 states. Retrieved from

Centers for Disease Control and Prevention. Prevention Tips. (2009, June 25). Retrieved from

Lead Poisoning Prevention, Treatments, Effects. (2009, January 14). Retrieved from

Lead Contamination: What You Need to Know

Lead Contamination: What You Need to Know

How do I find out if my water contains lead?

There are a few ways you may find out if your water contains lead. The first option would be to look at your pipes. The easiest access would be under your kitchen sink. If this is a metal pipe, scratch the pipe with a knife. If the scratch is silver, it is possible it is made of lead. From here, grab a magnet and see if the magnet sticks to the pipe. If it does not stick to the pipe, it is lead.

These pipes may be anything from your faucet, to your actual pipes, fittings, or solder joints. Despite whatever pipe it is, lead is not okay for your home! We recommend that you replace your lead pipes using a safer alternative, such as copper or plastic or polyvinyl chloride (PVC).

Another way to find out if your water contains lead would be to contact your home’s water supplier and ask for a lead test. These should be free of charge. You may also ask for a copy of the Consumer Confidence Report. Often times, water suppliers have these online. You can find them here.

If you would like to test for lead yourself, you are able to do so, but it is not recommended. These tests may not have correct accuracy. Because this is such a serious issue, we recommend you to utilize your water supplier and get professional help.

However, if you do wish to use an at-home kit, buy one from a home store. Test your tap by using water that has been sitting overnight, meaning wait until water has not been turned on or used for several hours, and then turn on the faucet to use the water that has been aggregating. This water is best for testing because it has been in the pipes longer.

Reasoning for this is because the longer water sits inside a pipe, the higher chance it has to corrode. This happens if the water is highly acidic or has low minerals.

You may send this to a lab for analysis, or you may simply trust the kit you bought. Many times, the test will turn a designated color if there is lead in your water.

How do I find out if paint in my home contains lead?

Homes built before 1978 often contain lead-based paint. There are several ways you can test for lead.

The first is the most accurate and recommended test: the lead-based paint inspection. This is when an inspector comes in and checks out all painted (and wall-papered) areas of your home, inside and out. From here, it’s taken to a lab and tested.

A risk assessment test only takes samples of chipping paint, paint that looks as if a child has been biting or licking, and dust and soil from your home. This assessment does not test all of your home, like the lead-based paint inspection. Only certain areas are tested, meaning there is still room for error.

A hazard screen is even less extensive than the risk assessment test. Samples of paint are taken from chipping areas and a dust sample is taken as well. No soil is tested unless there is reason to believe there may be lead contamination.

Again, at home lead tests are not strongly recommended. However, they work just the same as a water lead test (meaning the strip will change a designated color depending on lead levels).

Soil may be collected from your home because lead-based paint chips may have have fallen into the soil and contaminated it. Soil may also be contaminated through smelting, leaded gasoline, or other industrial causes.

Dust from your home is tested because it collects on certain areas that may have lead-based paint. This is just another way to test for lead.

Check out this link to find an inspector around you.

What else do I need to know about lead?

Lead is everywhere. It’s a scary thought, but it’s unfortunately true.

Often times, toys contain lead-based paint. Be mindful when purchasing toys for children and stay on top of news regarding lead in toys. Make sure children are not biting, licking, or putting toys in the mouth. If the toy contains lead, this is not beneficial for children.

There have been several recalls over the past decade in regard to lead-based toys. In 2007, popular toy company Fisher-Price recalled nearly 1 million toys. Again, be mindful of such toys and make sure to find out what these toys are made of.

There are several other ways lead can come into your home and affect you and your loved ones. Once again, working with lead-based paint is a risk. This includes renovation, battery recycling, refurnishing furniture, and automobile work.

Hobbies such as hunting, fishing, staining glass, painting and making pottery, and collecting or painting stock cars may be dangerous as well.

Reduce Your Risk

If you do not have the money to get rid of your lead plumbing system, you may take these alternative precautions instead.

These precautions include using cold water for cooking and drinking. Know that you cannot boil lead out of water. Conversely, it is okay to shower in contaminated water, as long as you do not swallow the water. Thankfully, skin cannot absorb lead. However, we do recommend that you run cold water for at least five minutes before showering.

To reduce the risk of being affected by lead-based paint, we recommend that shoes are taken off once entering a home to reduce the risk of being affected by contaminated soil. Keep your home clean and free of dust, vacuum often (and do not beat rugs!), mop floors weekly, and rid any paint chips around your home.

If you or a loved one works with lead-based paint, pack an extra bag of clothes to change into after work and before coming home.

Make sure to wash hands often, as many surfaces in your home may contain lead-based paint. Children need to have proper nutrition high in vitamin C, calcium, and iron.

Cilantro and garlic are also helpful in reducing lead from the body. These foods are high in sulfur, and sulfur oxidizes lead. Other high-sulfur foods are brussell sprouts, cabbage, cauliflower, chives, onions, eggs, poultry, and nuts.

Cilantro can be added your cooking, but you may also add it into your water. Cilantro has the amazing ability to reach heavy metals that have been absorbed into the bone. This herb also aids in liver health, anemia, and nausea.

Please take all precautions provided and do your best to keep your home a safe and livable area! If you have any further questions, please contact Dr. Trowbridge and 1-800-FIX-PAIN (1-800-349-7246).

The easiest way to check your pipes is under a sink.

There are various types of pipe, however, lead is a no-go.

If you own an older home, be aware if your home has lead paint.

Getting an inspector to look at your home is your safest and best bet.

Toys often contain lead-based paint, especially those imported from outside the U.S.

Leaving shoes at the door helps track less soil, which may contain lead.

Is the Lead Water Crisis Impacting Your Community?

Is the Lead Water Crisis Impacting Your Community?

It’s hard to believe that the Flint water crisis started over two years ago. The media has taken hold of this predicament, informing the people of the United States that Flint, Michigan is actually quite a small problem in perspective to other states.

Some say it all began when Erin Brockovich ousted water suppliers of Flint, Michigan on her Facebook page. And soon, attention was brought to the city’s water issue and the people of Flint claimed Brockovich a hero. Brockovich’s Facebook page is still full of articles and call-outs to companies who have failed to fix their community’s water systems.

So, how did this happen? Most water companies are either failing to tell homeowners or placing the notice on the bottom of monthly water bills. Let’s be honest here—how many of you completely read through your water bill? Half of us look at the price and make a payment, while many of us simply pay online.

Wouldn’t you think that water companies would find it extremely important to notify homeowners that lead was poisoning their water? Shouldn’t owners be called or alerted with a door notice, or something that won’t be passed by? Perhaps if this idea were in motion, such outrageous “mistakes” like the following wouldn’t have happened.

Flint, Michigan was the first well-known affected lead area.

Out of 2,000 water systems in the U.S., 180 failed to notify their consumers of the high lead levels. How does a water company just forget to tell someone about the poison they’re indeed consuming? The worst part is that so many of these were school systems or daycares.

But the water companies want to share a different side of the story, straying blame away from their mistake. Lead actually does not come directly from the water plant. In fact, the majority of homes built before 1980 actually have some lead within the plumbing system.  It’s stated that over 7 million homes in the US have lead plumbing lines or solder joints that cause lead to leak through.

Corrosive water also causes lead to leak through. Water treatment plants add anti-corrosion chemicals to help the situation, but by then, it’s already too late. Lead has already leaked through, and anti-corrosion chemicals cannot dissipate the lead entirely. Lead levels are only reduced. In many cases, treatment plants are unable to feed anti-corrosion chemicals to all water lines because it is too expensive.

About 70 of the water systems that failed to notify their consumers served at least 10,000 people. That’s each water system serving at least 10,000 people! That’s 700,000 people at the very least. But facts show you that many more have been affected.

An engineer checks the quality of water at a treatment plant.

To put into perspective, in New Bedford, Massachusetts, 315,000 individuals were served; Passaic Valley in New Jersey: 315,000; Bangor Water District, Maine: 28,000.

The saddest part is that some of these water companies have known for years that certain lines contain lead. A Navajo Reservation church wasn’t aware of lead-contaminated faucet until 3 years later after the discovery.

Erin Brockovich has received numerous letters from individuals across the U.S., claiming water issues in their community. After receiving all of these letters about contaminated water lines, Brockovich started pin-pointing these locations out on a map, leaving a devastating picture. There are over 10,000 communities out there with contaminated water supplies… and think—these contaminated water supplies are only the ones Erin Brockovich has heard of directly.

There are more affect communities than just the one’s we’ve heard about.

Water towers store and often supply water to towns across the U.S.

The scary part is that it could be your community.

We urge you to test your water supply. If you live in a home built before the 1980s, it’s extremely important to check your area of residence for lead-based paint or plumbing systems. There’s a great risk involved with lead, and if you don’t take action, these effects can worsen beyond infection. These risks may impact your entire way of life, limiting your daily activities.

Call the National Lead Information Center at 1-800-424-LEAD (1-800-424-5323) for any questions.

If you or a loved one has become affected by lead, please call Dr. John Trowbridge’s office for a free consultation. Dr. Trowbridge is an expert in chelation therapy, a non-surgical treatment that dramatically reduces your body’s harmful toxins and chemicals—including LEAD!

Please take all precautions provided and do your best to keep your home a safe and livable area! If you have any further questions, please contact Dr. Trowbridge and dial1-800-FIX-PAIN (1-800-349-7246).

Check your water supply and if your home has lead-based pipes.