Mark Bittman: What’s wrong with what we eat, Ted Talk

In this fiery and funny talk, New York Times food writer Mark Bittman weighs in on what’s wrong with the way we eat now (too much meat, too few plants; too much fast food, too little home cooking), and why it’s putting the entire planet at risk.

Mark Bittman is a bestselling cookbook author, journalist and television personality. His friendly, informal approach to home cooking has shown millions that fancy execution is no substitute for flavor and soul.

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Dyslexia – ‘The Hundred Year Old Hidden Handicap’

By John B. Dunphy, published in Healing Power, Official Journal of the Irish College for the Advancement of Medicine, Issue 1, Vol. 1
ONE of the most frustrating and, in many cases, debilitating
conditions (academically, emotionally and socially) which presents
in clinical practice is a condition known as dyslexia. Dyslexia is
the best known terminology for a group of conditions whose core
problem is an inability to properly process language, be it written,
spoken or symbolic (e.g. numbers). lt is not a problem exclusive
to school children, but affects many aspects of life both in childhood
and adulthood.
The word’dyslexia’ comes from the Greek, meaning’difficulty
with words or language’. On one website, dyslexia was described
as a kind of mind often gifted, but physiologically different’ This
brain difference is not a defect, but it makes learning language
excessively hard.
The child with a dyslexic mind will have trouble from the very
beginning learning to understand speech and making themselves
understood; they may have difficulty with word recall; with sequencing,
so that words will get twisted – e.g. ‘baggetti, mellow, aminals’.
They may have difficulty distinguishing a’p’, ‘d’ and ‘b’; ‘was’ becomes
‘saw’, ‘Pat’ becomes ‘bet’; ‘nuclear’ becomes’unclear’, etc
What makes dyslexia difficult to recognise in the surgery setting
is that many of its characteristics can be a normal part of the maturing
process of young children. But in a child with dyslexia, these persist
longer than expected so that the child will appear slow in these
specific areas and normal in others.
This can easily be mislabelled by teachers and parents aslazy,
or they may take the view that the child will grow out of it in time’
These children are usually not lazy. ln reality, they are working
harder to fill in the gaps between what they actually see, hear
and feel and how they think about these things in their head and
try to put them into words.
The first recorded description of dyslexia was by a General
Practitioner in the BMJ of November, 1896 – over a hundred years
ago. lt was an event marked by an excellent Ieading article by
Professor Margaret J Snowling in the Journal of November 2nd,
1996 (Vol. 313), entitled: ‘Dyslexia: A Hundred Years on – a Verbal
Not a Visual Disorder which responds to Early lntervention’. lt is
a piece from which I will quote liberally throughout this afticle.
ln 1917, Opthalmologist J. Hinshellwood speculated that
these difficulties with reading and writing were due to a’congenital
word blindness’. Ever since then, the popular view was that dyslexia
was caused exclusively by a visual processing problem.
My involvement in the treatment of dyslexia was by chance’
While attending a workshop in the US on head injury and back
problems 12 years ago, I came across an unusual physical therapy
that had evolved into a treatment for dyslexia.
It can be very frusirating to research this subject, as definitions
differ in the US and Europe. However, most now agree that dyslexia
is a language processing problem, be it written, spoken or symbolic,
resultant from a difficulty in ‘phonological (speech) processing’
which makes it difficult to learn how to match printed letters with
the correct sounds.
The child with dyslexia may have normal, or very high lQ (e.g.
Einstein, Leonardo da Vinci, etc.), be very gifted, be an Olympic
athlete, or Formula One racing driver, be a film star, or artist with
great imagination. Many are very musical, with ability to sing and
play instruments at an early age. However, school can be a
frustrating nightmare for them, as it relies mostly on language skills,
ignoring all the other skills these children have in abundance.
Dyslexic children have difficulty learning to read by traditional
methods; have difficulty organising their desks, homework or holding
pencils correctly. They see their less bright classmates succeeding,
while they are failing. They may realise something is wrong, but
may cover it up both from parents and teachers. Their school days
are spent as if swimming against a strong current. Hard working,
they can appear lazy.

What To Watch Out For
1. Avoiding difficult tasks, especially involving reading, writing,
spelling or maths;
2. Spending too much time at, or not finishing homework;
3. Propping head up when writing;
4. Vocabulary exceeding reading ability;
5. lnappropriate or attention-seeking behaviour;
6. Difficulty understanding words in normal conversation;
7. Poor sense of direction;
B. Poor idea of time;
9. Poor motor co-ordination;
10. Stuttering, hesitant speech; poor word recall;
11. Difficulty remembering names;
12. Difficulty following sequential instructions or events;
13. Difficulty following motion or moving things (e.g. balls, people,
traffic);
14. Difficulty making decisions:
15. Feeling of inferiority, stupidity or clumsiness;
16. Difficulty organising daily activities and allotting time;
17. Doing the opposite of what is said;
18. Difficulty differentiating ‘left’ and ‘right’;
19. Difficulty tying shoelaces or buttoning jackets’

Dyslexia tends to run in families and cousins often exhibit other
language problems. lt is more common in boys than girls and may
affect 15% or more of the population. There is strong evidence
that it is heritable – the probability of a boy developing dyslexia if
his father is dyslexic can be as high as 50%.
Gene markers on chromosomes 1 and 15 have been identified
in families with dyslexia. Linkage on chromosome 6, in the region
of the human leucocyte complex, may explain the association with
auto-immune disease.
Dyslexia is a developmental disorder that affects people of all
ages, but its symptom profile changes with age. Studies of children
at genetic risk of dyslexia have reported difficulties in speech
production and gramatical expression at 30 months, followed by
slower vocabulary acquisition during the pre-school years,
culminating in deficits in phonological awareness and alphabet
knowledge in young schoolchildren. Parental reports of delayed
speech and language among children with reading difficulties have
been common in epidemiological studies.
The most comprehensive picture of dyslexia available is in
children of school age. Although, in most cases speech perceptual
abilities are intact, dyslexic children have difficutiy in reflecting on
the sound siructure of spoken words. Such phonological problems
make it difficult to learn how the letters and sounds of printed words
are related.
Most dyslexic children have difficulty using a phonic approach
to reading and their spelling often fails to represent the sound
structure of target words. Although dyslexic children overcome
many of their difficulties, in adulthood they experience subtle
problems with phonological awareness and reading and writing
skills. Functional brain imaging is beginning to elucidate why this
is so; it has been shown that, when dyslexic adults perform rhyme
judgement and verbal short-term memory tasks, they activate only
a subset of the brain regions usually involved. Plausibly, their
phonological difficulties may be due to weak connectivity between
anterior and posterior language areas of the left hemisphere.
Knowledge of the predictors of reading achievement and of
dyslexia has led to innovations in methods of intervention. A
pioneering study in Oxford showed that children who performed
poorly on a phonological processing task before they went to school,
benefited significantly from a training programme in sound
categorisation using rhyme and alliteration activities, particularly
when it was combined with teaching of letter sounds.
Subsequently, it has been shown that training in phonological
awareness, combined with a structured reading intervention, is
an effective form of treatment for poor readers and produces greater
gains than training in either reading or phonological awareness
alone.
A detailed case and family history may uncover dyslexic
difficulties and the routine assessment of pre-school children can
usefully incorporate a test of knowledge of nursery rhymes and
letters. Clinical experience shows that, with regard to dyslexia, it
is a fallacy to ‘wait and see how the child develops’. A delay at
the start of learning to read can quickly develop into a considerable
reading disorder if unattended.
Treating Children With Dyslexia

THESE children are basically frustrated by the world around them.
They have difficulty with right and left. They have little or no sense
of time. They have problems with basic co-ordination.

It is perplexing for the dyslexic child of normal lQ to see less
bright classmates acquire, with relative ease, skills in reading, writing,
spelling and arithmetic, which they themselves may find very difficult,
or impossible. Such children may react with temper tantrums,
psychosomatic symptoms, e.g. headaches, abdominal pains, wetting
or soiling, much to the alarm of parents, teachers and family doctors.
Parents are puzzled that a child that appears bright at home
can do so badly in school. Teachers generally find these children
baffling, as again they appear verbally bright and yet do not respond
to traditional teaching methods that work well for the rest of the
class. They may end up blaming the child or the parents, which
causes great disharmony both at home and at school.

By the time children present to me at our Carrigaline clinic,
they have usually been to a number of psychologists, councillors,
etc. The majority will be boys and often left-handed (not
necessarily). They will have co-ordination problems; will have a
history of early walking rather than crawling; will often have been
frustrated by team sports and are thrilled when the first test I do
is of their muscle strength and can guarantee them improved
sporting performance within a few weeks of their visit to me (i.e.
by correcting their inco-ordination). Once they see this improvement,
they pester their parents to bring them back for the full course of
treatment, not for the academic improvement, but for further
improvement of their sporting prowess.

Left-handedness can be familial. The family name of ‘Kerr’
apparently has a high percentage of left-handed members; so
much so, that their castle stronghold in Scotland was built
entirely for left-handed people, e.g. the railings, stairs, armour,
etc.

“ln our modern world, literacy is a minimum requirement
 in a society run largely via the written word.
Parents worry greatly about the future careers of
their dyslexic children. All careers are possible,
However, jobs requiring good special ability, such as
computer programming are particularly suitable.”

‘BlC’ have developed a rapid drying ink delivery pen, which is
ideal for left-handers as it solves the problem of smudging as the
child’s arm crosses the page.
Some children with dyslexia may have additional problems such
as allergies, ADD (Attention Deficit Disorder) or ADHD (Attention
Deficit Hyperactive Disorder).
As I mentioned already, the treatment protocol that I have used
over the past 1 2 years evolved f rom an osteopathic/kinesiological
background and began as a treatment for head injury and back
pain. Dr Carl Ferreri, a Kinesiologist/Chiropractor in New York had
observed that, follwing head injuries, he could demonstrate a
disturbance of the normal ocular-labyrinthine reflexes which are
necessary for efficient control of the skull in static and in motion.
He had developed a method of normalising this situation by digital
stimulation of these reflex zones, thus restoring normal function.
Some time later, he came across a research paper describing
similar problems in the skulls of dyslexic children. However, in
these cases, the problem was confined to the right side of the
skull (presumably affecting left brain activity). So he decided to
try this technique and, to his delight, it worked very well. He then
proceeded to expand his protocol to include an interesting eye
tracking technique together with some simple exercises (cross
pattern or cross crawl type). The protocol is completed in
approximately six visits, followed by a further three over 12 months.
As soon as the protocol is completed, the child begins to have
more self-confidence, becomes more competent at sports and
in social circumstances, and can then benefit in an observable
fashion from remedial teaching which, prior to treatment, had made
very little impact.
Exercise regimes have been popular in the US for some years,
e.g. marching-type exercises which apparently gave good initial
results, but sadly disimprove once the marching stopped. lnterest
in exercise programmes has been rekindled by the recent ITV
programme on dyslexia.
Another pleasant exercise programme is called ‘Brain Gym’
and can be done to music. lt improves co-ordination and is fun
for all the family.
ACLD Nationwide offers special reading classes and other
support programmes (see phone directories). Many websites are
worth exploring for information on tinted colour lenses, osteopathic
protocols, diet and food allergies and a host of practical tips on
parenting children with dyslexia, ADD and ADHD.
Therapies using light and colour have existed for many years.
Recently a new therapeutic device has been developed in
Belgium, a Photon Wave Light Stimulator. This allows the patient
exposure to a large number of colours individually and in
combination, at a range of frequencies and wave formations.
The chosen colour and frequency is transmitted via light
stimulation of the eyes and optic nerve, which transmits
‘photocurrent’not only to the visual cortex, but also to other areas
of the brain, including the hypothalamus, influencing sensory
integration and behaviour. This results in improved right brain/left
brain communication, concentration, memory, attention span, Iiteracy,
memory, etc. We have acquired one of these units for our practice in Carrigaline.

Adults
Dyslexia is an underestimated problem in the adult population,
as the main focus is on the school-going children. ln my practice,
I see primary, secondary and third-level students. Adults often ask
for treatment after they see their children diagnosed and treated.
Others present indirectly with back pain or past head injury and
the diagnosis presents itself in the course of testing. They are
invariably relieved to discover an explanation for aspects of their
lives which were previously inexplicable.
ln the UK, over 6% of the population have reading ages of
less than nine years. Over a million are known to be totally illiterate.
ln the US, over 23 million are known to be illiterate (e.g. a quarter
of men entering the US Navy are unable to read simple safety
instructions).
ln the US prisons, most behavioural problems occur when the
TV is turned off, as the vast majority of inmates are unable to
read or write and get bored and irritable. How many of our prison
population are dyslexic is not known. I personally have a high
degree of suspicion that dyslexia ls a major player in this
population group.
Dyslexia in adults can be difficult to spot as it can range from
very vague features in a high lQ, highly successful professional
with lots of drive, to the illiterate, unemployed inmate. The
embarrassment and frustration of an inability to read and write
can lead to persistent anxiety and depression. I have seen peoples
lives turned around by gaining this basic facility.
ln our modern world, literacy is a minimum requirement in a
society run largely via the written word. Parents worry greatly about
the future careers of their dyslexic children. All careers are possible.
However, jobs requiring good special ability, such as computer
programming, or those requiring good verbal ability, are particularly
suitable.
A US study by Prof Margaret Rawson (Sociologist) some 25
years ago into the career outcomes of dyslexic boys showed that
l4% became Research Scientists, 13% Business Executives. .11%
College Professors, 7% School Teachers, 7% Lawyers and 7%
owned or managed a business.
Even though this was a study of middle class students of
professional parents, it demonstrates that investment in the
treatment of dyslexia pays off spectacularly.
References on request.

 

Doctors – A Paradigm Shift

By Dr. J. B. Dunphy, published in Irish Doctors Environmental Association (IDEA, Issue 1, Vol. 1)

 Now that the 20th Century has drawn to a close, many of its paradigms have also run out
of steam. We see this in industry, commerce, social living and, now, in medical practice.
The word ‘paradigm’ comes from the Greek word ‘paradigma’, meaning model, pattern, example. So, a paradigm represents the dominant perception at a given time which sets 
rules by which you can anticipate success in problem solving. When a more desirable solution evolves, a paradigm shift occurs, making the old paradigm and those rigidly attached to it redundant.
It wasn’t that long ago that to run the four-minute mile, the so called ‘perfect mile’, was considered impossible. No one was able to do this ‘impossible’ feat. Why? Because the paradigm up until then, in relation to this accomplishment was wrong. Instead of attempting to run ‘the perfect mile’, an English medical student reasoned that he could run a sixty-second quarter mile with ease; he could even run two sixty-second quarters. If
he could string together four sixty-second quarter miles, he could run a four-minute mile! He did and the rest is history.
That same year, 18 other runners broke the four-minute barrier, because there was a NEW PARADIGM.
In his book, ‘Paradigms – the Business of Discovering the Future’, business writer Joel Arthur Barber claims there are three keys to success in the 21st Century: 1. Anticipation; 2.Innovation; 3. Excellence. He emphasises that all three are absolutely necessary and
describes a fascinating example of how a failure in one of these can undermine success in the other two. The example was Switzerland. Hard-working and innovative, the Swiss had dominated the world of watch-making for 60 years. They made the best watches in the world. They had constantly improved their watch technology. They had invented the
minute hand and the second hand. They led research in waterproofing. In 1968, they dominated the world market with 65% of world sales and close to 90% of the profits. They were so far ahead of the rest of the world that they had no real competitor. Even though the Japanese had greatly improved their watch technology and were by 1968 almost as good as the Swiss, they enjoyed only 1% of the world market. Yet, in only 10 years, the Swiss market share dropped to less than 10% and their worldwide profits from 90%, to less than 20%. What happened? A paradigm shift! The fundamental rules of watch-making had changed from mechanical to electric. Everything the Swiss had perfected…gears, mainsprings and bearings, were obsolete. In just three years, 50,000 
watch-makers in this small country lost their jobs – a catastrophe for Switzerland. 

The irony of this story is that it was avoidable had the Swiss been able to anticipate their own future…had they spotted that a paradigm shift was underway. In fact, it had been Swiss research that invented the electronic quartz movement. When this revolutionary discovery was presented to the Swiss watch-makers in 1967, it was rejected. They were certain that it had no future and allowed the technology to be displayed at the World Watch Congress that year. Seiko of Japan took one look…and went on to capture 33% of the world market.

The shift in my own thinking was helped by two events which occurred simrultaneously. On the evening of the birth of my first child – a baby girl – media reports said that Margaret Thatcher’s government had sent nuclear weapons to the Falklands war. At that moment, I determined to do all I could to make the planet a safer place for my new baby.
As many of you will know, I founded the Irish Medical Campaign for the Prevention of Nuclear War and represented Ireland on the International Council of International
Physicians tor the Prevention of Nuclear War – IPPNW, which was awarded the Nobel Peace Prize in 1985. I believe that doctors around the world, through IPPNW played a pivotal role in bringing the cold war to an end. It was only a matter of time before I realised that while the nuclear threat was the most urgent, other environmental problems
also needed to be addressed. Large pharmaceutical giants were polluting our air and water in Cork harbour. This eventually forced me to look at how I practiced medicine. The
drugs I was prescribing, what their manufacture was doing both to the planet and people for whom they were prescribed.
It was time to look to other modalities of therapy and, to my surprise, a vast and ever
expanding array of therapies existed. Many had been discovered and developed by mainstream doctors who, having presented their findings, were invariably rejected and ostracised by the medical establishment. 

For example, Dr Samuel Hehmann, working in Germany 200 years ago, was so horrified by the practice of the day decided to research and develop a safer and more humane form of therapy. Re-discovering the basics of hypocratic medicine, he developed what we now know as Homeopathy, which continues to be derided by the establishment, much to the advantage of non-medical practitioners who, like the Japanese in the Swiss watch story are going to reap the advantage in the coming decades as patients begin to vote with their feet.
Another case in point is that of Dr Edward Bach, a Harley Street consultant who, in the 1930s, made what to most of us was a crazy discovery…that the essence of flowers and trees were therapeutic for various emotional problems. Our current medical paradigm says this is impossible. Lay practitioners, not knowing that it is impossible, prescribe the Bach Flower remedies and often achieve the impossible, to our great surprise and anger. In the words of Edward Bach: “let not the simplicity of this method deter you from its use, for you will find the further your research advances, the greater you will realise the simplicity of all creation.’

In the early 1960s, Kendal and Kendal, working in the US, observed behaviour in muscles not previously described. A Chiropractor, George Goodheart, spotted their research and
went on to develop Applied Kinesiology. From this has evolved therapies such as Touch for Health; Edukinesiology; and Neural Organisation Therapy, used with great success in
Dyslexia and learning disorders as well as other problem areas not adequately addressed by the current paradigms.
A lovely quotation from Marcel Proust states: “The real act of discovery consists not in finding new lands, but in seeing with new eyes”. 

It was only in the past few years that I discovered a therapy developed here in Ireland which I believe represents a paradigm shift in the treatment of arthritis. It was discovered by Dr Patrick Collins in Lucan, Dublin in the early 1950s while researching immune response in allergy. He discovered that by diluting Procaine Hydrochloride and injecting it intradermally he could influence the course of rheumatoid and osteoarthritis. He published his results in the Irish Medical Journal of the day and internationally in Nature magazine.
He further discovered that by modifying his solution, he could apply it directly to the skin, which most colleagues – working from their paradigm – found incredible. Of course, in
recent years, many therapeutic agents are applied via the skin in patches, etc., which no longer seems so incredible. The clinic, established by Dr Collins in the grounds of the Spa Hotel in Lucan, continues to this day to treat patients with arthritis from all over Ireland and, indeed, overseas. It is now under the medical care of Dr Maurice Collins, a son of the founder of the clinic, who has continued to research this remarkable therapy.
Finally, let me share one last story with you. It tells of an affluent Galway doctors who had a little holiday home in a remote spot in Connemara and a large Merc to get there. Every
Sunday he headed off at speed along the windy roads which he knew like the back of his hand. On one of these lovely Sundays, while approaching a particularly nasty bend in the
road, around came a car out of control. The driver had only just pulled the car from going over the ditch, before swerving back into the doctor’s lane. He was sure he would be hit. He slowed to a stop. Again, at the last moment, the driver pulled the car back to its own side of the road, just missing the terrified medic. As it sped past, the pretty lady driver stuck her head out the window and at the top of her voice shouted: ‘Pig!’ Our Galway doctor was furious. How dare she. It was she who was all over the road. He immediately roared after her: ‘Sow!’ He reckoned that put her in her box. He then revved up his Merc and sped around the corner and ran smack bang into the pig!
The moral of this story is that over the next decade many people will be coming around blind bends yeling things at you. They may be too busy to stop and expiain. If you have
Paradigm Paralysis, you will be hearing only threats and insults. If you have Paradigm Pliancy, you will hear great opportunities.

OMEGA 3 AND PROSTATE CANCER STUDY (SELECT TRIAL)

 

 By  Dr. Neville Wilson, courtesy of drnevillewilson.com

The recent widespread media reports, implicating dietary omega-3 as a risk factor for prostate cancer in males, is likely to generate public concerns about the purported health and safety benefits of dietary oily fish or fish oil supplements.

Understandably, health conscious consumers of omega-3 supplements will be confused by these recent sensationalist media reports, and may be prompted to question, or even abandon, their long held beliefs and practices regarding the protective nature of supplemental fish oils.

A disturbing link between omega-3 polyunsaturated fats (N-3 PUFAS) and increased prostate cancer risk was proposed by researchers in a review of data from a previously conducted trial ( SELECT ), designed to evaluate the protective role of vitamin E and selenium in cancer risk.

The study was commenced in July 2001 and was discontinued in September 2008, on the grounds that no protective effects for selenium and vitamin E were demonstrated for the development of prostate cancer.

(The study in question is a review of data from the previous  SELECT study, known as a case-cohort design nested within the Select study ).

Despite the failure of this study to achieve its endpoint goal, and the acknowledgement of it’s authors that “neither of these findings proves an increased risk from the supplements and may be due to chance”, the SELECT trial was promoted as proof that antioxidant nutrients do not have proven benefits of cancer protection. (1)

The concluding remarks by the lead author of the study may be viewed as a hidden bias  against the use of anti-oxidant supplements, given his advice that dietary supplements be    used with caution.

According to the senior author, Dr. Alan Kristal, “we’ve shown once again that the use of nutritional supplements may be harmful”.

To their credit, the trial authors concede that a limitation of the study was the reporting of fatty acids as weight proportions, “because an increase in the percentage of one type of fatty acid requires a decrease in others”.

THE DATA :

In Table 2 of the study report the distribution of the several plasma phospholipid fatty acids among the SELECT participants is not given as a specific measurement, but rather as a percentage of the total distribution of fatty acids.

Since the percentage of EPA and DHA represents a very small percentage of the total distribution of fatty acids, we are left without answers as to which fats comprised the major proportion of the total distribution, and what their potential impact might have been on the end result.

A curious observation was the correlation between high trans-fat levels and an increased level of protection against the risk of high-grade cancer, a finding which is not supported by the wider body of scientific research.

Data from this study was collected and analysed to further investigate whether high consumption of omega-3 fatty acids could contribute to prostate cancer risk, and the authors reported that “these findings contradict the expectation that high consumption of long – chain omega-3 fatty acids and low consumption of omega-6 fatty acids would reduce the risk of prostate cancer”

The authors report that these findings are not novel, and have been reported in 2 previous studies, with the current findings replicating previous outcomes, but concede that “it is unclear why high levels of  long chain omega-3 PUFA would increase cancer risk, and further study will be needed to understand the mechanisms underlying the findings reported here”

The authors have thus conceded that the study outcome is not evidence of a cause and effect relationship between omega -3 and high grade prostate cancer, and that the correlation observed needs to be further assessed in a study specifically designed for that purpose.

The sensationalist reporting by the media did not include these cautionary remarks by the study authors, and they are thus guilty of  misleading the public through such false representations of the facts.

HOW RELIABLE ARE THESE CONCLUSIONS ?

The hypothesis of risk, as speculated by the authors of the SELECT study, which gave rise to the media reports, is not supported by hard evidence from within the study, and the researchers concede only a correlation, but not a cause and effect relationship, between omega 3 consumption and prostate cancer.

They also omit valuable information about the possible use of prescription drugs (like statins) by the participants, anti-oxidant supplement intake, the type, frequency, dosages and duration of dietary fat intake, level of physical activity, and the presence or absence of  stress, each of these being important factors which inevitably impact on risks to health.

They also provide no details as to whether or not oily fish or fish oil supplements was taken on a regular basis over the duration of the study.

It is not known whether any of the participants were taking statin drugs, widely prescribed for lowering cholesterol levels, or any other pharmacological agents.

Recent findings on the health effects of omega-3 fatty acids and statins, and their interactions, suggest that statins may inhibit the protective benefits of dietary omega-3 fatty acids. ( 2)

OTHER STUDIES :

The outcomes from several reputable studies contradict the speculative conclusions by the SELECT authors, showing “fish oil consumption may be protective against progression of prostate cancer in elderly males” (3) and these findings are supported by population based studies involving Japanese, Swedish and Eskimo males, who have a low incidence of prostate cancer and who consume liberal portions of oily fish regularly.

Swedish study of 6272 males, over a period of 30 years, showed reduced rates of prostate cancer by oily fish consumption. (4)

Japanese males consuming omega-3 fatty acids reduced their risks for prostate cancer (5)

New Zealand males with high levels of DHA ( a long chain omega-3 fatty acid) reduced their prostate cancer risk by 38 %. (6)

Researchers at the University of California looked for a link between omega-3 intake and prostate cancer in 2009. In a case controlled study of 466 males diagnosed with aggressive prostate cancer they found that an increasing intake of long chain n-3 (omega – 3 ) fatty acid was strongly associated with decreased risk of aggressive prostate cancer.  (7)

ABSENT DATA.

The absence of hard data from the SELECT study about the duration of fish oil consumption, and the source for the fish, or supplemental products, (if consumed) is one of several weaknesses which characterises this study, rendering it less than an authoritative guide to healthy dietary practice involving supplemental or dietary oily fish consumption.

We are not told what the nature and  source was of any ingested omega-3 fats by the participants, prior to their initial blood sampling, and although we do know that they were requested not to use nutritional supplements during the period of the trial, there is no evidence that some may have done upon discovery of raised PSA levels.

The source of dietary oily fish, or fish oil supplements, may impact significantly on the level of health hazard attributed to trial participants, given the high levels of environmental contaminants (PCBs, mercury) that may be present in certain areas of farmed  salmon, or inadequately purified omega-3 supplemental products. (8)

Exposure to persistent organic pollutants results in mitochondrial dysfunction in both animal and humans ( 9 )  and may inhibit the protective effects of n-3 fatty acids by an alteration of mitochondrial function.

STUDY DESIGN:

The study in question did not compare the outcome of fish oil or fish oil supplement  by consumption by one group of men, compared to that for another similar group of men who took a placebo instead of supplements.

A randomized placebo controlled study would be required to properly test the hypothesis of risk for prostate cancer.

According to the reported study method, serum was collected from participants in the previous Prostate Cancer Prevention Trial and, in this study, tested for phospholipid long chain omega- 3 fatty acids, together with several other fatty acids, and the distribution (percentages of omega-3 of the total fatty acids) was correlated with prostate cancer incidence, looking at  4 groups of men, graded for (a) no cancer, (b) total cancer (c) low grade cancer and (d) high grade cancer.

OMEGA 3 INDEX:

 

It is important to note that in this study omega-3 percentages were calculated as a proportion of total phospholipids in the plasma, taken at the commencement of the study, and not repeated at its conclusion.

Omega-3 fatty acids exert their protective functions at the level of cellular membranes,  and the study does not reflect cellular membrane omega-3 levels.

The measurement of omega-3 in red cell blood membranes can be obtained by use of a special test known as the HS-OMEGA 3 test,  formulated by Drs William Harris and C Von Schacky. (10) A low Index ( <4 ) is associated with an increased risk for morbidity and mortality, while a high Index ( >4 ) is associated with improved survival rates, the target range for a healthy HS-OMEGA-3 is 8-11%.

According to Dr. William Harris, the lowest quartile of omega-3 in the SELECT participants would correlate to an HS-OMEGA 3 Index < 3.16 % and the highest quartile to an HS-OMEGA 3 Index of > 4.77%, suggesting that men in the highest quartile of the study ( Table 3 of the study ) still had low levels of membrane omega – 3, and they were the ones who were at greater risk for high – grade prostate cancer.

Since blood samples to evaluate the levels of EPA and DHA (omega-3 fatty acids) were not repeated during the duration of the study it is not possible to evaluate a pattern of dietary oily fish or supplemental intake, or dosages consumed.

In the final analysis, only DHA proportions (and not EPA) correlated with high grade prostate cancer, and interestingly, ( and surprisingly ) higher proportions of trans fatty acids, known for their harmful effects, correlated with  a lower incidence of prostate cancer.

(The study might well have served to show that an increase of dietary trans-fats correlates with a decreased risk for prostate cancer, but no scientific evidence exists to support such a proposal !)

The wide range of fatty acids isolated in this study included EPA, DHA, trans fats 18:1, trans-fats 18:2, trans-fats 16, ALA, LA (18.2 omega 6), arachidonic acid, and mystery fats, which comprised the largest proportion of the total phospholipid count.

Any one of these unknown fatty acids could have been implicated in the prostate cancers observed.

ELEVATED DHA REPORTED:

 

The elevated DHA levels that were documented may have resulted from a previously ingested oily fish, but may also reflect a low fat diet, since low fat diets have been shown to raise DHA levels. (11 )

In a study by Raattz et al a low fat diet comprised of 20% fat (n-6 / n-3 ratio 11.1) was compared with a high fat diet of 45 % (n-6 / n-3 ratio 12.3 ) and resulted in a 28% higher membrane DHA level

Conventional dietary advice continues to promote low fat diets as nutritionally preferable to high fat diets, despite the evidence that low fat diets are usually higher in carbohydrate content, and more likely to precipitate insulin resistance, triglyceride increases, weight gain and attendant pathologies which are more likely than with high fat intake.

It is not known whether some of the study participants had been following a conventional low fat diet prior to, and throughout the duration of the study.

OMEGA- 3  TOXICITY ? :

 

Since Omega-3 fatty acids are long chain carbon bonds they are potentially unstable, and thus susceptible to oxidation, given an unfavourable  pro-oxidant environment.

EPA ( eicosapentaenoic acid) is an omega-3 (n-3) polyunsaturated fatty acid with 20 carbons and 5 double bonds.

DHA ( docosahexaenoic acid ) is an omega-3 ( n-3 ) polyunsaturated fatty acid with 22 carbons and 6 double bonds.

The longer the chain, and the greater the number of double bonds, the greater the risk for oxidative damage to these fatty acid chains, and this should be taken into account if large quantities of omega-3 are consumed, particularly in the absence of protective anti-oxidants.

These long chains are formed from their parent fatty acid (ALA) by a series of desaturation  (oxidation) and elongation, and while they are conditionally essential to health, they are relatively unstable and can be readily denatured if exposed to further oxidation.

Anti-oxidants are usually added to omega-3 supplements in order to protect them against oxidation.

Thus, too little, or too much, omega-3 in an unpurified or unprotected form, may be potentially harmful, and this effect has been demonstrated in experiments with mice. (12 ).

In conjunction with alcohol and sugar, excessive doses of omega-3 produced harmful outcomes for pregnant rats. ( 13 ).

High levels of omega-6, which characterise the western diet, will reduce levels of omega-3 through competition for the delta -5 and delta -6 desaturase  enzymes, and tilt the omega-6 / omega-3 balance in favour of inflammatory mechanisms in the body.

An excess of dietary omega-6 will stimulate the formation of prostaglandin E2, via the cyclo-oxygenase (COX) enzyme pathway, thereby enhancing new tumour growth through angiogenesis (new vessel growth). (14).

The potential for cancer development is therefore present when the ratio of omega-6 / omega- 3 is increased, the ideal ratio being 2:1 or even 1:1.

We have no data on the nutritional status of the participants in this study, and are thus incapable of assessing the underlying reasons for the increased incidence of prostate cancer.

OXIDATION OF DHA :

 

It has been shown that the oxidation of the longer chain deoxyhexaenoic acid (DHA) can produce a protein called carboxyethylpyrrole (CEP ), which is not produced by the oxidation of other poly-unsaturated fats, and which may be implicated in new vessel formation (angiogenesis ) within the retina of the eye, with subsequent risk for new vessel growth, retinal damage, and blindness, or even tumour progression. (15)

The anti-oxidants glutathione peroxidase and superoxide dismutase are present in the retina, and because of the high intensity of photogenerated radicles within the eye, these anti-oxidants are replaced every 12 days.

In the absence of protective dietary anti-oxidants such as glutathione peroxidase, superoxide dismutase, selenium, astaxanthin,  vitamin E – gamma tocopheral, and vitamin C, the risks for tumour progression may be increased, and we are not told whether the SELECT participants had taken anti-oxidant supplements or not, despite having been requested not to do so.

INTERACTIONS OF OMEGA-3  WITH STATINS :

 

In accordance with conventional dietary advice, large sections of the population are likely to observe a low fat dietary regimen, and many are also taking statin drugs, falsely believing that such practice is health protective.

The protective efficacy of omega-3 has recently been called into question after several recent randomized controlled studies, since 2005, failed to show a reduction in mortality rates from coronary heart disease for persons taking omega-3 supplements.

These recent “negative” findings of  omega-3 benefit contrast sharply with earlier (before 2005) “positive” findings, where significant reductions in cardiovascular mortality were reported in those participants taking omega – 3 fatty acids.

The well known DART (16), GISSI- Prevenzione (17), and MEDITERRANEAN alpha-linolenic (18) demonstrated significant cardio-protective properties for omega-3 fats, confirmed by a large meta-analysis, including prospective, as well as randomized controlled studies, by Mozaffarian et al, in 1999. (19)

Several recent studies have not supported these earlier findings, suggesting that other factors may have inhibited the previously demonstrated protective properties of omega-3 fatty acids.

A reasonable explanation for this discrepancy, as suggested by Michel de Lorgeril, is the fact that statins were not in use during the earlier trials, and their use in the more recent trials may have inhibited the protective potential of omega-3 used in those trials. (20 )

In a meta-analysis of randomized, double- blind, placebo controlled trials, researchers Kwak et al found that participants taking EPA and DHA  decreased their risk of cardiovascular events when they were NOT receiving statins, but increased their risk when they were taking statins. (21), suggestive of a strong interaction between omega-3 fatty acids and statin drugs.

In the GISSI-HF trial the effects of n-3 EPA/DHA was evaluated in patients with chronic heart failure, and in a combined study, the effects of a powerful statin (rosuvastatin / CRESTOR) were also evaluated, and neither the omega-3 nor the statin, were shown to be protective for patients with chronic heart failure. ( 22)

Again, a possible interaction between the statin and omega-3 fatty acid resulted in this reciprocal inhibition of the one by the other, as proposed by Michel de Lorgeril (20 )

OTHER STATIN EFFECTS:

However, the failure of rosuvastatin (CRESTOR) to provide protection against heart failure patients  in the absence of omega-3 in a trial by Kjekshus J et al, (23) must be explained by another mechanism, such as Co-Enzyme Q10 depletion, for which statins are notorious.

Statins deplete Co-enzyme Q10, a vital respiratory factor essential  for effective mitochondrial function in the cells of heart muscle, and are toxic for the mitochondria in a dose-dependent manner. (24)

Disturbances in mitochondrial functioning may lead to a wide range of pathological states, including infectious diseases, myocardial infarction, heart failure and cancer. (25)

Other statin effects which may inhibit the protective properties of omega-3, are raised omega-6 levels as a result of statin induced arachidonic acid increases.

Omega-3 is more effective when levels of omega-6 are low, and less effective when omega-6 levels are high.

If statins had been used by any of the participants in this study, their hidden potential for inhibiting the protective properties of omega-3 would have gone unnoticed and not reported.

CONCLUSION :

The failure of this study to take account of several confounding factors, as mentioned above, the absence of data regarding the actual dietary intake of omega-3 fatty acids by the participants, and plasma measurements which do not reflect cellular membrane levels, as obtained from the HS-OMEGA 3 Index, renders the reported outcome of this study inconclusive for a causal relationship between omega -3 and prostate cancer.

While association studies are useful in that they identify an area for further research, they do not prove causality, and cannot be interpreted as such. A specifically designed interventive study with a clearly defined clinical endpoint is required to corroborate the conclusions of this study.

Dr. Neville Wilson.

The Leinster Clinic.

IRELAND.

July, 2013.

REFERENCES:

 

  1. The Journal of the National Cancer Institute. July 10, 2013.
  2. BMC Medicine 2013, 11:5 Michel de Lorgeril et al.
  3. PLoS 8(4): Oct 11,2012
  4. Lancet 2001, June 2; 357 (9270): 1746-6
  5. Cancer Science vol 90, issue 9, p914-921,Sept 1999
  6. Br J Cancer 1999, Dec; 81 (7): 1238-1242
  7. Clin Cancer Research 2009 April 1; 15(7): 2559-66 Fradet et al
  8. Urol Oncol 2012, March-April; 30(2) 216-9
  9. PLoS ONE 2011, be5170
  10.  www.omegamatrix eu
  11. The Journal of Nutrition, Feb 1, 2001, vol 131, no 2, 231-234. Raatz S K et al
  12. Gastroenterology, 1995 Aug; 109 (2): 547-54
  13. Neurotoxicol Teratol 2010 Mar-Apr; 32(2):171-181
  14. J Biol Chem 2003 Oct 24;28 (43): 42027-35
  15. Lipid Research Lab- Robert G Salomon
  16. Lancet, 1989,2:757-761
  17. Lancet 1999, 354:447-455
  18. Lancet 1994, 343:1454-1459
  19. JAMA 2006, 296: 1885-1899
  20. BMC Med 2013, 11:5
  21. Arch Intern Med 201§2, 172: 686-694
  22. GISSI-HF Lancet 2008, 372; 1223-1230/1231-1239
  23. NEJM 2007, 357: 2248-2261
  24. Cell Mol Life Sc 2006, 63: 2415-2425
  25. NEJM 2011, 364: 829-841

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‘I believe the link between dairy and breast cancer is as strong as the link between smoking and lung cancer’ Cancer sufferer Jane Plant believes that diet can help you deal with the disease

I’m a survivor: Jane Plant has battled cancer for 26 years

AILIN QUINLAN – 26 AUGUST 2013

Having cancer, Jane Plant once wrote, is a “miserable business.” Coming from a woman who’s had a mastectomy, 12 sessions of chemotherapy, 35 radiotherapy treatments and has been battling the disease for more than 26 years, this has to be the under-statement of the year.

One of the world’s leading geochemists, Professor Jane Plant CBE, Professor of Geochemistry at Imperial College, London, has held a string of prestigious posts throughout her career, including a stint as chief scientist of the British Geological Survey from 2000 to 2005.

She’s also an internationally best-selling author – her latest book, containing the wisdom distilled from over a quarter of a century spent at the cancer frontline – ‘Beat Cancer: How to Regain Control of your Health and Your Life‘ – was written in collaboration with cancer expert Professor Mustafa Djamgoz.

Now 68, she believes diet and lifestyle play a crucial role in beating the disease.

It all started for Plant back in 1987, when she was attending a conference on gold exploration inCanada. Following a trip down a goldmine she had returned to her hotel room for a shower when she suddenly noticed a lump in her left breast.

“I phoned my GP in England and he told me to go to Princess Mary Hospital inToronto,” recalls Plant, who has no family history of cancer.

“They carried out tests and confirmed that it was cancer.”

Then aged 42, Plant attended the rest of the conference at which she was a speaker, and, on her return to England went to hospital and ended up having a left radical mastectomy:

“I was told not to worry, that it had not spread and that my lymph nodes were unaffected. They said to forget about it, but being a scientist, I couldn’t.”

She followed a recommended cancer diet – the Bristol Diet, as part of which, she had a daily organic low-fat yoghurt.

Five years later she found another lump, this time under her left arm. “I persuaded the doctor that it was growing and they took it out and gave me a thorough examination.”

Not long afterwards, another lump appeared close to the site of the first.

“They took that out. They gave me 35 radiology treatments. My ovaries were irradiated to induce menopause.”

Plant, now aged 47, was again given the all-clear.

“Six weeks later I found another lump behind my collarbone. That was taken out and proved to be cancerous.

“Within a few weeks another huge lump grew on the same site; it was also cancer – it was about the size of a boiled egg. I was having chemotherapy but it was not really working.”

In August 1993 – just over 20 years ago – the mother-of-three was informed that she had only two months to live “if we’re lucky”.

Her husband Peter, a mineralogist and gemologist had just returned from a trip to China and she and Peter were discussing possible reasons why so few Chinese women had breast cancer when realisation struck:

“He said that they didn’t have a dairy industry and they didn’t have any dairy at all at that time.”

Plant immediately eliminated dairy from her diet:

“I gave up the low-fat yoghurt I was having every day and in six weeks the huge lump had gone.”

And that was it.

Until 2011 when she got another warning in the shape of a very large lump which suddenly appeared beneath her collarbone:

“I had a huge lump which came up beneath my collarbone.

“It was like the top of a large mug, and the cancer had also gone into the lining of my right lung.

“I had little tumours all through my right lung.”

When she thought about it, she realised she had become a bit lax about my diet:

“I wasn’t checking ingredients, and, when I looked, I found that milk powder was contained in some of the food I was eating.”

Her son Tom, who is a doctor, advised her to go back on the strict, non-dairy diet and she said she would:

“He said promise me – and I said ‘I promise’.” Plant stuck to both promise and diet, and within 30 weeks the lump had reduced to about the size of a 50p piece.

“A few weeks later it had completely vanished.

“I’m still free, my last check-up was in June and I was told everything is now completely back to normal.”

She believes that there is a link between

consumption of dairy products Plant outlines her thesis:

“Basically dairy has now got a lot of oestrogen in it because it’s commonpractise to milk pregnant cows, which has driven up the oestrogen content of milk. It also contains tiny proteins called growth factors, and these growth factors directly promote cancer.

“We now know that cancer is epigenetic, which means cancer genes can be switched on but also off. Some of the key factors are diet and lifestyle and you need to use these to complete your orthodox treatment.”

She strongly believes the link between dairy and breast cancer is similar to that between smoking and lung cancer.

Dr. Catherine Logan, Nutrition Manager, National Dairy Council, disagrees.

“Many factors are thought to potentially influence the development of breast cancer including genetics and various lifestyle choices. “Recommendations to universally eliminate dairy foods, without suitably qualified and individually tailored medical advice and basis, are very concerning.

“The milk, yogurt and cheese food group offers a range of essential nutrients, and are an important feature of the Irish diet.

“Cutting them out of the diet is likely to impact the overall nutritional quality of the diet.

“If anyone has concerns regarding their diet and health – including breast cancer, they should speak to their GP or a qualified dietitian.”

Plant believes cancer patients should take the conventional treatment but should complement it by switching to the diet and exercise regime she recommends.

One of her diets, for those with active cancer, is essentially almost entirely vegan using proper living food.

The second diet is for prevention, for people who are in remission.

“You’re allowed small amounts of animal protein but no dairy – you eat masses of vegetables and fruit and any vegetable milk you like, eg soya almond, oat and rice and use good sources of protein such as lentils, chickpeas, beans etc.”

Enjoy plenty of protein but take as much as possible from vegetable sources such as lentils and keep salt and sugar to a minimum in favour of seasonings with anti-cancer action, such as the curcumin in turmeric.

Wholegrain cereals are also good for the body, says Plant, because they contain detoxing enzymes and substances which help suppress the growth of tumours.

Drink lots of water, she says, but avoid bottled – she believes harmful plasticising chemicals can migrate from the plastic container into the water.

Cancer, believes Plant, is a clever disease, so evasive that you must attack it on every possible front.

Professor Jane Plant is one of the keynote speakers at the Your Health Show, which takes place next month at the RDS Dublin.

Visit http://www.yourhealthshow.ie for more information.

Irish Independent

Report on the Proceedings of a Summit on New Directions for Chelation Therapy, published in Townsend Letter

From March 13 to 15, 2013, the International College of Integrative Medicine (ICIM) held a summit meeting about what should be accomplished next, now that EDTA chelation therapy has been supported as a useful treatment for vascular disease by the Trial to Assess Chelation Therapy (TACT). Experts from around the world were invited. This article is a summary of the conclusions and recommendations of this gathering. Key presentations were given by Drs. John Trowbridge, Efrain Olszewer, and Eleonore Blaurock-Busch. Representatives from the US, Canada, Indonesia, Brazil, Denmark, the Netherlands, Germany, Ecuador, and New Zealand participated, as well as the attendees for the Advanced Metals Workshop that was part of the spring meeting of ICIM. Recordings of the lectures are available from icimed.com.

Background
EDTA has been used as a treatment for vascular disease since Norman Clarke Jr.’s work in 1952. For a time line of the many studies that have supported its effectiveness, see chelation.me. In 1981, the American Medical Association (AMA) challenged the proponents of chelation therapy to produce a large-scale, randomized, controlled, clinical trial to prove its safety and effectiveness. The members of the American College of Advancement in Medicine (ACAM), led by president Ross Gordon, collaborated with Walter Reed Hospital to begin such a study for treatment of peripheral vascular disease in 1987. Unfortunately, the first Gulf War took the investigators away from the study, and it was not completed. In 1999, Congressman Dan Burton, chair of the Committee on Oversight, held a hearing bringing together the head of the Heart, Lung, and Blood section of the National Institutes of Health and several physicians who testified about their experiences with chelation. NIH subsequently called for proposals, and eventually TACT was funded, with Gervasio Lamas, MD, as chief investigator.

TACT was unique in that it combined university research cardiologists and experienced chelation specialists with private offices. 134 sites from the US and Canada participated in the randomized, placebo-controlled, double-blind, clinical trial. TACT continued for 7 years and included 1708 patients with documented previous heart attacks who continued to receive evidence-based therapy. The primary end point was a composite of new cardiac events to include death, heart attack, stroke, hospitalization for unstable angina, and need for revascularization surgery. TACT showed that the therapy was unquestionably safe, and the group treated with chelation therapy had fewer cardiac events, which was statistically significant. The results were announced by Lamas at the American Heart Association meeting on November 4, 2012, in Los Angeles. (Publication of the results occurred after the summit in JAMA. March 27, 2013;309([12]):1241–1250). The authors called for further studies to confirm the results and explore the mechanisms of action.

Where We Stand Now, According to the Summit
1.  TACT conclusively showed that chelation therapy used according to the recommended protocol is safe.

2.  TACT and the many other studies that preceded it support the use of chelation therapy as an option for patients with vascular disease, especially for those who also have diabetes and those with a history of anterior wall myocardial infarction.

3.  There is not yet enough evidence to state that chelation therapy should be given to all cardiac patients. More studies need to be done. A duplication of TACT would be ideal, as long as it included heavy metal testing. However, another $30 million to repeat the study might be difficult to find.

4.  Strong consideration should be given to doing a challenge test for heavy metals (especially lead) for all patients with vascular disease. If high levels are found, the patients should be treated with chelating agents.

5.  Regulatory agencies, such as medical boards, should immediately stop harassing physicians who offer chelation therapy to their patients who give appropriate informed consent. Physicians who offer chelation therapy have accomplished exactly what the AMA asked them to do in 1981 to justify its use.

6.  Most physicians who offer chelation therapy are happy to serve as consultants for placebo-controlled RCTs, but are uncomfortable with the ethics of giving placebos to patients who have come to them for help. Certainly, patients should not be asked to pay to receive placebos, especially for a potentially life-threatening illness. Physicians who provide chelation are almost always convinced that in their experience the therapy is very effective.

7.  Most chelation doctors believe that their primary goals of showing efficacy and safety with a RCT have been accomplished with TACT. Gaining FDA approval of EDTA for use in vascular disease is secondary, and they encourage qualified investigators to move in that direction.

Recommendations of the Summit
1.  More research should indeed be done on metal toxicity, free radical pathology, and various diseases that have been linked to free radical pathology, especially vascular disease.

2.  Chelation doctors do not have the resources to fund or carry out clinical trials, but they do have the expertise to help plan them.

3.  The conditions that are most likely to show benefit with chelation treatment and thus should have the greatest research priority are as follows:
a.   patients waiting to have limbs amputated due to noninfected vascular disease. For end points, all that is needed is to count the remaining limbs. Claus Hancke’s work is most impressive in this regard;
b.   walking distance and A/B index in patients with peripheral vascular disease. In our experience, a very high percentage of patients improve. Olszewer and Jim Carter documented this. There have been a couple of negative studies published on this subject in prominent journals, but they have been seriously flawed. Stephen Olmstead has written a good research protocol to evaluate chelation treatment for peripheral artery disease that is almost ready to go. He is willing to share his work with others. Attendees at the summit expressed significant concern that opponents of the therapy might proceed with new studies that are designed to fail, which has happened in the past;
c.   brachial artery stiffness and other measurements of vulnerable plaque. Peter van der Schaar is beginning a study on arterial stiffness;
d.   diabetic patients who have evidence of vascular disease;
e.   patients who have suffered an anterior wall MI;
f.    patients who have angina that is difficult to control with drugs;
g.   macular degeneration;
h.   patients who have been told that revascularization surgery is an option;
i.    Quality of Life measurements should be included in all research projects. Chelating physicians insist that their patients feel considerably better with treatment, even though that was not found to be present in TACT.

4.  Other areas that are important to study and are likely to show successful outcomes:
a.   patients with hypertension and elevated lead levels;
b.   arterial intimal thickness and high resolution ultrasound of the carotid arteries (see the work of Robert Bard);
c.   osteoporosis;
d.   mild to moderate Alzheimer’s disease associated with heavy metal toxicity;
e.   autoimmune diseases, especially scleroderma;
f.    fibromyalgia with high levels of toxic metals detected with a challenge test.

5.  There are many biomarkers in the laboratory that can help examine the mechanisms of action of chelation therapy. Expert biochemists (Blaurock-Busch, Jaffe, Quig) are happy to consult with investigators as to which ones are most appropriate to utilize in this assessment.

6.  Various combinations of chelating agents, and different doses of such entities as EDTA and vitamin C are important to study.

7.  Chelation therapy is useful to study at all stages, to include:
a.   preventive
b.   preemptive (early signs of disease)
c.   treatment of established disease
d.   treatment following revascularization procedures
e.   maintenance treatments: very important

8.  Use of NBMI, a compound being studied by Boyd Haley, might turn out to be a powerful therapeutic modality.

9.  Such international lecturers as van der Schaar, Olszewer, Ted Rozema, Hancke, Bruce Dooley, and Gene Godfrey continue to teach physicians on how to use chelation therapy safely and effectively. Organizations such as ACAM, ICIM, and A4M hold workshops in the US. Excellent recent textbooks have been published by van der Schaar and Blaurock-Busch (both are available through the International Board of Clinical Metal Toxicology).

Conclusion
Raising public, political, and media awareness is now essential. Experienced chelating physicians can help provide solid data to support general understanding of efficacy, mechanisms, and positive outcomes in the treatment of vascular diseases. Registries might be the best way for clinicians to collect data without the constraints of a RCT. Self-insured corporations, such as Parker-Hannifin are now paying for chelation therapy. Cooperation among organizations with similar interests, such as ICIM, ACAM, AAEM A4M, ABCMT, IBCMT, and specialized laboratories is strongly encouraged to standardize protocols and set up registries. This can be done quickly and with minimal expense. Physicians from around the world should be included. Experienced chelating physicians can serve as consultants for researchers who are qualified to perform RCTs. NIH and various foundations are encouraged to fund projects discussed in this article. Pollution with heavy metals continues to get worse, and evidence is mounting that their toxicity is an important factor in the development of chronic degenerative diseases.

Cardiovascular Chelation by John Parks Trowbridge, MD, Published in Townsend Letter, May 2010

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 pulse.2 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 attack.3

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 disease.4 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 jog.5 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 [As the “gold standard” for coronary artery disease, angiograms have several limitations. Recently developed computerized coronary angiography instruments (not yet widely available) will help to work around some of these errors of interpretation.]

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 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? Radio­activity? 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 65, according to the National Center for Health Statistics. During 2006, some 2,192 heart transplantations were performed.7

But What If You’re ‘One of Those Five’?
If only one in six patients has a heart bypass operation8 that is life-saving or life-extending, what is the 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 alone.9 Virtually every “open-heart” patient will suffer some slight or significant degree of “pump syndrome,” neurological or mental changes associated with the heart-lung pump.10 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 2½ years.11 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 undergo.12 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 pursued.13

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 levels.14Without 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 1994.15 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 performed.16

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 downstream.17 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 elsewhere.18-20 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 injury.22) 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 wholistic view, virtually all human ailments (including expression of genetic aberrations) can be aggravated by – or even directly attributed to – increasing burdens of toxic heavy metals.23 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.”25Subsequent 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 results.26,27) 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 treatments.28,29 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 encouraging.30

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 medicine.31 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?

©2010 John Parks Trowbridge

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

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.

John TrowbridgeJohn Parks Trowbridge, MD, has been certified since 1985 as a chelation specialist by the American Board of Clinical Metal Toxicology, for which he now serves as secretary. A Fellow of the American College for Advancement in Medicine, he has served as director, officer, or president of a number of professional and public associations. Popular as a professional and public speaker, he co-authored Bantam’s bestselling The Yeast Syndrome among several other books, CDs, and DVDs. His upcoming book, Life Long Health, presents chelation perspectives gathered from 27 years of offering this treatment. He provides a broad array of integrative medical therapies at his solo practice, Life Celebrating Health in Humble (Houston), Texas: jptlch@earthlink.net, 800-FIX-PAIN.

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 [AAA])” 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. http://www.asianhhm.com/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.

 

 

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May 26, 2010

A Timeline for EDTA Chelation Therapy as a Treatment for Vascular Disease by Terry Chappell, John Trowbridge, and Michael Schachter, published in Townsend Letter

Definition of Chelation:  Chelation, from the Greek word “chele” meaning claw, implies that an organic molecule binds a cation (charged mineral) in a pincer-like fashion, forming a heterocyclic ring structure. The most widely accepted (and FDA approved) use of chelation therapy is for the removal of toxic minerals such as lead from the body. A more controversial indication, discovered serendipitously during treatment of patients suffering with lead toxicity, involving the use of the chelating agent disodium ethylene diamine tetraacetic acid (EDTA), is in the treatment of all forms of atherosclerotic cardiovascular disease.

1893
Alfred Werner proposed the theory of metal-ligand binding (“the pincer-like fashion”), which provided the foundation for modern chelation chemistry and development of treatment.

1930s
The textile industry required a chelating agent to remove calcium during textile processing and this led to the synthesis of polyamino-carboxylic acids, one of which was EDTA. A patent was filed for EDTA in Germany in 1935.

1940s
Martin Rubin, PhD, professor at Georgetown University, who was involved in getting a patent for EDTA (along with chemist Frederick Bersworth), discovered its biological effects on calcium homeostasis. This led to its laboratory use as an anticoagulant, for which it is still used today (“purple-top tubes”).  Dr. Rubin helped to achieve approval by the FDA  for the treatment of lead poisoning (CaEDTA) and hypercalcemia (disodiumEDTA), and later collected the world literature on chelation.

1950s
Norman E. Clarke, Sr. and Albert Boyle separately published several articles showing improvement in patients with heart disease who were being treated for lead poisoning.

Foreman reported that high doses of disodium EDTA over a short period of time can cause kidney damage, leading to the development of safe treatment protocols.

1960s
In 1960, Dr. Marvin Seven and other authors edited a book entitled “Metal Binding in Medicine”, which contained papers on chelation that had been presented at two major symposia. Dr. Seven, who was associated with the National Institutes of Health, was killed in auto accident in 1961. This was considered by many to be a major blow to the development of EDTA chelation therapy, because he was a leading advocate of the therapy.

Kitchell and Meltzer wrote several articles reporting on positive effects of EDTA treatment for heart disease but their last article had a negative conclusion(not supported by their reported data), which discouraged further research by conventional doctors. A 1980’s re-examination and critique pointing out glaring errors in this negative article, by Cranton and Frackelton, was ignored by mainstream medicine.

Ray Evers and Carlos Lamar each collected huge volumes of anecdotal data showing vascular improvements with chelation therapy.  Lamar published his experiences in a series of articles, particularly documenting the salvage of legs with diabetic peripheral vascular disease.  Evers won a precedent-setting court case establishing that once a drug is approved for any purpose, it can be used for other indications at the discretion of a physician, which allowed the use of EDTA for vascular disease as well as for the use of dozens of other drugs by all American specialists.

In 1969, Abbott’s patent for EDTA expired, which resulted in decreased motivation to promote EDTA as a treatment for cardiovascular disease.

1970s
The American Institute of Medical Preventics, later called the American College for the Advancement in Medicine (ACAM), was formed in 1973 by Harold Harper, Ross and Garry Gordon and others to promote and teach chelation therapy. Since that time, ACAM has sponsored conferences and workshops on cutting edge subjects involving nutritional medicine and chelation therapy twice a year. Many physicians were trained in the safe administration of EDTA chelation therapy.

Garry Gordon and Robert Vance wrote an article about the mechanisms of action of EDTA chelation therapy.

Bruce Halstead wrote the book Scientific Basis of Chelation Therapy, This book was later updated by Ted Rozema.

1980s
Richard Casdorph, a practicing cardiologist, showed improvements in ejection fractions of the heart and in cerebral blood flow with chelation therapy in several articles.

McDonagh, Rudolph, and Cheraskin published about 30 articles documenting various positive effects with chelation therapy, including improvement in lipids, carotid blood flow, and lung function and no adverse effect on bone density.  This group and Cranton each wrote articles showing no problems with kidney function in patients treated with EDTA according to the published protocol.

The American Medical Association called for studies to see if chelation worked.  At the same time, conventional cardiologists wrote several editorials against the therapy.

The American Board of Chelation Therapy in 1983 was formed to certify doctors who give the therapy. It was later called the American Board of Clinical Metal Toxicology. ACAM also certified doctors who took its workshop on chelation therapy and passed its written and oral examinations.

The Great Lakes College of Clinical Medicine, later called the International College of Integrative Medicine (ICIM) was formed in 1983 to teach and do research on chelation and other integrative therapies.

After complex negotiations, in the late 1980’sWalter Reed Army Hospital agreed to do a randomized clinical trial on EDTA chelation therapy, but part way through the study it was discontinued, allegedly because the investigators were called to serve in the Gulf war and did not return to complete the study.

Frackelton and Cranton published a landmark study about free radical control as the primary mechanism for chelation therapy in 1984.

Olszewer and Carter published a study in in 1988 in Medical Hypothesis documenting 87% of vascular patients showing improvement with chelation therapy.  They later published a small cross-over clinical trial in 1990, documenting significant results in peripheral vascular disease, in the Journal of the National Medical Association.

Arlene Brecher lectured throughout the country and wrote a popular book (Forty Something Forever) promoting chelation therapy from the patient’s point of view.

Blumer and Cranton raised the possibility that EDTA therapy might prevent cancer in a population exposed to environmental lead exposure in a study with an 18-year follow-up.

1990s
Three groups of cardiovascular surgeons published small clinical trials on chelation therapy.  None had enough subjects to come close to clinical significance.  All were severely criticized in letters to the editor because of procedural errors.  All came to negative conclusions.  One even admitted that their purpose was to disprove the therapy.  At the initiative of Claus Hancke, the Guldager study was criticized for its shortcomings by the Danish supreme court.  Hancke and Flytlie published an article showing that 58/65 patients on the waiting list for cardiac bypass and 24/27 peripheral vascular patients also on a surgical waiting list were able to cancel their surgeries after receiving EDTA chelation therapy.

Peter van der Schaar, a Dutch cardiovascular surgeon, published several favorable studies and wrote a massive textbook on the therapy, recently in its 10th edition.

Michael Schachter had an article published titled: “Overview, Historical Background and Current Status of EDTA Chelation Therapy for Atherosclerosis” in 1996.

Elmer Cranton published a Textbook on Chelation Therapy, into its 2nd edition in 2001.

Terry Chappell published two meta-analyses summarizing the literature to date and coming to the conclusion that treatment with EDTA chelation therapy was very closely correlated to measurable improvement in vascular function

Opponents of chelation therapy, as well as almost all alternative therapies, call themselves “quackbusters”.  This small group of doctors has infiltrated the Federation of State Medical Boards and travels around the country making formal complaints about doctors who provide the therapy.

They tried to outlaw the therapy in California.  ACAM testified in defense of chelation and the California Medical Board voted down the proposal.

The Federal Trade Commission filed a complaint against ACAM for making a claim in a brochure that chelation was effective for vascular disease.  ACAM submitted almost 100 articles in support of the claim, but the FTC insisted that a large randomized trial was required to make that claim.  ACAM finally gave up after spending a million dollars in legal fees and signed a consent order saying they would not make such a claim any more, based on the evidence at that time.

Articles began appearing in the conventional medical literature that too much heart surgery was being done in the United States.  The outcomes from medical therapy were just as good for many patients, if not better.

Steve Olmstead, a research cardiologist from the University of Washington Medical School, wrote a 100 page monograph discussing in detail the mechanisms, chemistry, and scientific evidence on chelation therapy.  One of his conclusions was that the preponderance of the evidence was in favor of the therapy for peripheral vascular disease.  This document was distributed to every medical school library in the United States.

2000s
Representative Daniel Burton, chairman of the Congressional Oversight Committee held a hearing with testimony from the NIH and from experienced chelation physicians.  The conclusion was that a large study was clearly indicated.  Subsequently, the NIH sent out a call for proposals.  A review panel turned down the first proposal, but approved the second one, called the Trial to Assess Chelation Therapy (TACT).  The chief investigator is Gervasio A. Lamas, who is a world-renowned researcher.  Several prominent medical schools (Miami, Duke, Harvard) and experienced chelation physicians agreed to participate.

Several articles appeared in major journals showing that even small amounts of lead can increase the risk for hypertension and vascular disease.

Lin and Lin Tan published a leading article in the New England Journal of Medicinethat chelation can improve moderate non-diabetic kidney failure, presumably by removing lead and improving circulation to the kidneys.

Terry Chappell and seven colleagues published a study showing that patients with known vascular disease treated with chelation therapy had a much lower incidence of subsequent cardiac events, such as heart attacks and the need for surgery, than a comparable group of patients treated with conventional cardiac care.  These were the same end points as TACT, but the study was much smaller and was not a randomized, double-blind study.

2010s
It was reported by the Center for Disease Control (CDC) that a child died after receiving the wrong medication, disodium EDTA, in a short intravenous push.  It is very important to know that calcium EDTA, which is approved to treat lead toxicity can be given as a short IV push, but that disodium EDTA, which has been described in this timeline as a potential treatment for vascular disease, must always be given by a slow intravenous drip, at a rate no more than 1 gram per hour. Otherwise, the calcium blood level can drop dangerously fast.  The unfortunate child was given the wrong preparation, and that is the reason for the death.

Because many cardiologists discouraged patients from participating in TACT, enrollment proceeded slowly.  For several months, the study was delayed because a complaint by the “quackbusters” saying that it should be stopped immediately. The same group convinced a reporter from the Chicago Tribune to write a negative article about the study, even though no data had yet been released.  However, after seven years the study was finally completed on October 31, 2011.  The findings of the study are to be presented at the American Heart Association meeting in Los Angeles on November 4, 2012.  All we know at this point is that over 1700 patients enrolled nationwide, and the safety committee, which was active throughout the study, found no concerns for safety, using the study protocol.

Virtually all of the studies noted in the timeline used intravenous disodium EDTA with various vitamins and minerals.  The protocol for the safe administration of intravenous EDTA chelation therapy has been published by ACAM and ICIM in their training courses, and is used in certifications by ACAM and ABCMT.  Despite numerous claims, that oral EDTA might be similarly effective, there is no published evidence that oral EDTA might be helpful for treating vascular disease. Oral EDTA is only about 5% absorbed, which might make it useful for prevention for those exposed to high levels of lead on an ongoing basis, but most doctors who utilize intravenous disodium EDTA for vascular disease do not recommend oral EDTA for primary treatment.

The references for the articles cited in this timeline are available in Schachter’s historical article, in Chappell’s meta-analysis, and from L. Terry Chappell at P.O. Box 248, Bluffton, Ohio 45817 or at lterryc@wcoil.com.  A good number of additional articles and events were not included in the timeline for lack of space.

 

 

Consult your doctor before using any of the treatments found within this site.

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Natural Cure for Depression, Bipolar, ADHD, Schizophrenia..

Abram Hoffer PhD, RNCP, President Orthomolecular Vitamin Information Centre speaks about treating mental health concerns with nutrients. This alternative therapy employs vitamins, minerals, and amino acids to create optimum nutritional content for the body, as well as the right environment and equilibrium. Like most alternative medicine techniques, orthomolecular medicine targets a wide range of conditions. [depression, bipolar, adhd, schizophrenia, add, addiction, alcoholism, drug addiction…]

Orthomolecular medicine was developed by Linus Pauling, Ph.D., winner of two Nobel prizes, in 1968. It is designed to enable individuals to reach the apex of health and the peak of their performance by utilizing only naturally occurring substances (e.g. vitamins, minerals, enzymes, trace elements, co-enzymes). The proper balance of these substances in the body is the key to reaching physical, mental, and emotional health and stability. Orthomolecular medicine can be used therapeutically to treat diseases such as cancer and AIDS, or preventatively to impede the progress of degenerative disease and aging. When all is said and done, however, the main objective of orthomolecular medicine is to help the patient reach an optimal level of health; his or her self-esteem will probably improve in the process.

Although orthomolecular medicine did not fully develop into a therapy until the late 1960’s when Pauling coined the term “orthomolecular,” the premise behind this practice originated in the 1920’s, when vitamins and minerals were first used to treat illnesses unrelated to nutrient deficiency. It was discovered that vitamin A could prevent childhood deaths from infectious illness, and that heart arrhythmia (irregular heartbeat) could be stopped by dosages of magnesium. Hard scientific evidence supporting nutritional therapy did not emerge, however, until the 1950’s, when Abram Hoffer, M.D., and Humphrey Osmond, M.D., began treating schizophrenics with high doses of vitamin B3 (niacin). As a consequence of their studies, it was revealed that niacin, in combination with other medical treatments, could double the number of recoveries in a one-year period.

Eventually, it was determined that malnutrition and consumption of refined, empty-calorie foods such as white bread and pastries and overconsumption of sugar could yield disease and psychiatric disorders. It became apparent that a person’s diet was an overwhelmingly integral part of his or her health and well-being. Further studies showed that decreased intake of dietary fiber, bran, minerals, and complex carbohydrates was prevalent in patients with certain forms of mental illness, accompanied by a loss of vitamins and an increase in dietary fat.

Biochemical individual is a main principle of orthomolecular medicine. This principle was elucidated by Roger J. Williams, Ph.D. This principle is quite simple: every living organism is unique! Furthermore, each individual requires different relative amounts of nutrients for his or her satisfaction and optimal level of health. The government sets a minimum recommended daily allowance (RDA) which is supposed to be adequate for all individuals. However, many may need to exceed the RDA as well as the recommended 2,000 calorie diet in order to prevent severe deficiency disease. Thus, RDA values are not perfect guidelines for everyone. Several studies have proven the existence of biochemical individuality. For example, studies of guinea pigs showed a twentyfold variation in their requirement for vitamin C. A study conducted with human subjects revealed that children have varying needs for vitamin B6.

http://www.orthomolecularvitamincentr&#8230;
http://www.encognitive.com
http://www.youtube.com/EncognitiveVids
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