I thank Dr. Stephen Ely for his letter [“Research Doesn’t Support Chelation Therapy’s Effectiveness,” March 25, Xpress], as it provides insight into the forces keeping our conventional medical care focused exclusively upon expensive procedures and pharmaceuticals, without proper risk/benefit consideration given to nonprescription options.
The first force is “cognitive dissonance,” the mental discomfort we experience when confronted with new information that conflicts with existing beliefs or ideas. The discomfort increases relative to the investment [people have] in their current belief systems. So, after 14-15 years in higher education to become a cardiologist, it is almost impossible to accept that there may actually be a very useful therapy that they were originally taught was useless.
Indeed, their cognitive dissonance may blind them to the more recent $31 million National Institute of Health study known as TACT (Trial to Assess Chelation Therapy), which did show positive results, especially for diabetic patients. In fact, one recent analyses of this study (Circ Cardiovasc Qual Outcomes. 2014 7: 15-24) reports: “Post-myocardial infarction patients with diabetes mellitus aged >50 showed a marked reduction in cardiovascular events with EDTA chelation,” with “a 41 percent relative reduction in risk of a combined cardiovascular end point; … a 52 percent reduction in recurrent MI; and a reduction in death from any cause of 43 percent.”
Forbes magazine on Nov. 19, 2013, pointed out that the NNT (number needed to treat) with chelation therapy to prevent an event is about the same as with statin drugs (6.5 patients would need to be treated for five years to prevent one event). However, while statins carry significant risk for adverse events, the TACT study showed chelation therapy had zero significant risk.
The second force at play is “conflict of interest,” which we all understand. While Dr. Ely is correct that an entire series of EDTA runs about $4,000 and is not covered by insurance, that chelation client is seen 40 times over 20-40 weeks for that cost, at about $100 per IV. Dr. Ely neglects to compare that to the price of bypass surgery (which the Healthcare Bluebook puts at $39,572) or a coronary artery stent (ranging from $11,000-$30,000). The math is compelling.
In integrative medicine, we integrate whatever works and make decisions in partnership with fully informed clients. That is why I sent Bill Sites for his bypass surgery, because together he and I decided that it was finally time for it. I am so glad that it is available as an option and that he got a great result. However, while Dr. Ely asserts that “the medical consumer does need to be well-informed,” I doubt cardiologists are educating their patients about all of their true options, including chelation therapy and its enviable risk/benefit ratio, especially for their diabetic patients.
— James Biddle, MD
Asheville Integrative Medicine