School of Advanced Nutritional and Medical Research

Intravenous Versus Oral Chelation

December 9, 2001

Dear Editor:

As one of the original founders of AAMP (ACAM) I wish to take issue with several comments in the Intravenous Vs. Oral chelation letter from Dr Maulfair published in the Vol. 2 Number 3 Fall 2001 issue of CPAM. (Clinical Practice of Alternative Medicine.) I also believe that anyone wanting to understand the rationale for my comments herein will benefit greatly from a careful reading of all of the chelation related material in the last 2 informative issues you have edited.

There are good reasons for the disagreement we are having over the ideal ways to chelate, but I am not optimistic that we will ever prove that we are getting a roto-rooter like effect from the standard chelation protocol that I initially wrote for the first chelation protocol now almost 30 years ago. However, in the interests of providing a fully informed consent to all chelation patients I hope that we can all agree that patients are entitled to receive accurate information about any and all published ways to provide EDTA to help our patients. If you should learn that simple NITRIC OXIDE induction, which seems to occur if we merely remove toxic metals, and since this clearly provides a solid and defensible explanation for many of the circulation benefits we have come to associate with chelation therapy, then patients must be provided truthful information regarding every option for detoxification of heavy metals.

I am concerned that since some ultra-high speed cat scans are proving that plaque reversal is apparently not predictable, that we may me wasting our patients valuable time unless they are also candidates for the marvelous anti-aging benefits that I believe we are providing with our standard IV therapy. We cannot afford to risk losing chelation as a therapy for vascular disease and I fear that many patients may have unrealistic expectations that years of unhealthy lifestyle are all going to be forgiven with 30 IV chelations. We all know that many chelation patients at autopsy are still found to have extensive arteriosclerosis. My brother, Dr Ross Gordon, received well over 200 IV chelations, yet his autopsy revealed widespread active severe arteriosclerosis. Yet, we all know that he received substantial benefits from those infusions. I know believe that a substantial portion of those chelation benefits are primarily mediated through lowering the burden of toxic metals, allowing enhanced production of Nitric Oxide (NO) by endothelial tissues, and other tissues. If we focus on the effective removal of toxic metals, I think some of us may want to consider the use of 5-10 minute pushes of 1 to 3 Gm of Calcium EDTA, aided by the oral administration of at least 800 mg of EDTA on a daily basis for life. This is one of the alternatives that I believe patients are entitled to receive accurate information about.

I hope, therefore, to provide some balance and perhaps add fuel for the ongoing debate in this journal. I hope to elicit comments from other chelating physicians in this forum. Enhanced NO production following administration of IV EDTA is now a documented and published fact. (Ref.# 1).

I believe that toxic metal overload today is ubiquitous, and therefore I believe that any safe and inexpensive method that helps the body eliminate toxic metals should be a standard part of all medical practice, whether it is oral, rectal, transdermal, or parenteral, and not just for cardiovascular disease.

The published literature of over 32, 000 papers and now with the application by Duke university for over 50 patents over the past 18 month involving NO and heart disease, cancer, etc suggests all chelating physicians may want to focus on NO as a cost effective molecule which we can induce in our patients when we remove toxic metals, with great potential to help many patients.

Lead and other toxic metals in endothelial and other tissues are impairing enzyme function so you do not optimally produce prostacyclin, heparin or NO. Correcting this can provide your patients with many if not all of what we consider to be the chelation therapy benefits. I am sure that plaque removal is also possible, but I find it not probable with chelation alone, and it is difficult to prove in chelation research, particularly since I believe that it requires a multi-modality approach. I find that we must effectively address all of the many factors involved in plaque formation, including infection and the resulting hypercoagulability, if a high percentage of patients receiving chelation in any form, are to also enjoy plaque reversal. This research is simply too expensive for us to hope to accomplish, whereas NO research is already far along, with an initial positive study.

Meanwhile, I believe that the tremendous subjective improvements possible by increasing endogenous production of NO, warrants considering some form of affordable daily chelation. We all know that have ACAM members who have had over 2000 and 3000 IV chelations in their lifetimes, with obvious substantial benefits. These observations and the literature supports my belief that it is unlikely that anyone can get too much chelation over a life time, particularly with higher doses, if some monitoring is done.

Thus, if removal of any heavy metal such as lead is a benefit, then I believe Dr Maulfair's conclusion that oral EDTA is largely useless, is irresponsible. I am interested however that he has concluded that the rectal form of EDTA is effective, but I am interested to see what evidence he relies on to enable him to conclude that rectal administration is effective, since the experts I have consulted doubt there is any significant difference in absorption of EDTA between the two routes of administration, and the oral is a fraction of the cost and far more convenient.

I have adequate documentation that I believe will permit be to prove in any debate, if given the opportunity to show the published documentation, that his continued attack on oral EDTA shows a complete disregard for the published literature. I believe that any scientific audience looking at my documentation will laugh at his unsupportable conclusion that (EDTA) "cannot be absorbed orally in an amount sufficient to be of therapeutic value". This statement is simply untrue, as documented by my references published in Vol. 2, Number 1, this Spring. Furthermore, in that issue, your editorial stated, "There is agreement that EDTA removes lead when administered orally or parenterally". Therefore, it is surprising that we find this unsupportable statement published even in a letter to the editor. It would seem clear that Dr. Maulfair totally ignores any information published in our Journal in his effort to discredit the use of oral EDTA, a safe and effective metal binding agent costing as little as $20 a month.

Dr Maulfair claims that only 1/3 of the use of EDTA today is related to its ability to chelate lead and other heavy metals. I believe this is incorrect but in any event when doctors become aware of the NO research, I suspect there will be little clinical use of EDTA for anything but toxic metal removal. This should be obvious, since with this as the focus, physicians are using the drug for what it is approved for, and the fighting and argument about the use of chelating agents in medical practice should die down as it becomes obvious that it is an important PART of the approach to many diseases. We also use EDTA in this country by the railroad tank car for its FDA approved use as a food additive, to maintain nutritional value of food through its metal binding action. The official FDA explanation for this use is that EDTA helps prevent the oxidative destruction of nutrients by its metal binding actions. I believe it probably also provides similar benefits in our body.

I hope that our members read the excellent article in the same journal (Fall CPAM) by Poul Moller MSc. This article explains the true dimension of the toxic metal problem we all face today. But, just from the standpoint of mercury, I believe it is obvious that the concept is explains here applies just as well to all of the toxic metals. He has established that the average number of atoms of just mercury alone that he calculates to be present in every cell of the body is 40 million atoms of Hg per cell. When you try to extrapolate this number to lead and other toxins in the body, you would soon realize that whatever hope we have of really making a substantial dent with even 30 or 40 or 100 IV chelations, given over an entire lifetime, is obviously a case of too little chelation and that it is generally being given too late, if your goal is optimal health.

It seems clear to me, that if you understand the dimension of the toxic metal load, knocking out the optimal functioning of virtually every enzyme in our body, not just the NO pathways, we should all be on some highly effective oral chelation products everyday of our life, or we should not eat fish or other food, or breath the air, or drink the water. Thus, I believe we need to employ many modalities to continuously help pull these metal and other toxins out, hopefully before they become too firmly entrenched.

The explanation on p 209 of that same issue of CPAM by Dr Cranton further helps me make my case for daily chelation. He explains what really happens with chelation, namely it first removes unbound and loosely bound metals in plasma and extra cellular fluid, then later the intracellular metals become available as a diffusion gradient is established, etc. I conclude from this that it would be in our best interest to never stop chelating, as you want that diffusion gradient to continuously help you download toxins from cells in to extracellular fluid, but we can not afford to be tied to an IV bottle for our whole lifetime. Dr Cranton however was explaining that you should stop all chelation for several weeks in order to get an accurate provocative challenge test result. This ay be true for helping to prove degree of toxic metal overload for medical legal issues, but I believe he has made the diagnosis of heavy metal toxicity far too complex and set the levels far too high. His thinking may protect the polluters but I do not find his thinking to be in the best interest of the patient, particularly if you understand enzyme inactivation by toxic metals, as in NO synthesis.

I prefer to chelate orally with EDTA and Garlic etc., everyday of my life, and have, for over 16 years, thus keeping this chelation established gradient working to my advantage. It should be obvious that for optimal health, we must pull out more toxic metals everyday than we ingest. However, since I did not do this early enough in my life, whenever possible, I hope to take many intermittent rapid 5-10 minute parenteral chelation pushes to further help remove toxic metals that low levels of chelators would not touch, and thus increase the overall beneficial chelation effects.

In the final analysis, there will be different benefits from each form of chelation. For optimal benefits, knowing the primary goal of your chelation therapy is essential. I believe that it is advantageous to focus on eliminating all toxic metals, I believe I can support the concept that daily oral chelation is better, and when feasible support this with parenterally administered chelation. Here, I prefer the 5-minute push to the short bottle or the standard 3-hour chelation. I recommend however that to settle this issue in your own mind that every chelation physician measure the urine and fecal toxic metals seen on provocation, with different approaches and I believe you will find the best overall results are better with the 5-15 minute push of EDTA supported with regular use of oral chelators, including EDTA. Even mercury excretion is enhanced with this approach far better than with slow IV administration.

This is simply the law of mass action at work and clearly the higher concentration of EDTA, assisted with other chelators such as garlic, is better able to sequester more toxic metals and starts to get those that are more tightly bound to proteins. I believe you will find this approach particularly useful in any condition where toxic metals are the primary targets, as perhaps in dilated cardiomyopathy.

If on the other hand, anti-aging effects and/or removal of pathologic accumulation of calcium from major vascular or other tissues (calcinosis) are the primary goal of therapy for your patient, then you may favor the slower standard chelation approach. In fact, for same cases, you might even consider the longest and slowest chelation possible, perhaps even doing what one of the real pioneers in chelation therapy, Dr Carlos Lamar used to do, when he chelated his patients, around the clock, continuously for 2+ days.

As a co-founder and a current advisor to ABCT and as a member of ACAM and ISIM and as a member of the board examiners for the AZ Board of Homeopathic Medical Examiners, and as the head of the AZ mandated Chelation Peer Review Committee, I hope that we can start looking at the entire field of chelation again with new eyes, and not close any doors.

Oral EDTA combined with sulfated polysaccharides has been an integral part of my program to replace coumadin and aspirin for my patients since 1985 when I first incorporated EDTA into Dr Morrison's Formula with dramatic, documented clot prevention benefits. I am concerned that some patient might discontinue what I have found to be a safe, and far more effective alternative to aspirin and or coumadin, on his advice, and that they might subsequently suffer what I now find are usually an entirely preventable heart attack or stroke. Blood clots are now believed to be directly involved in the deaths of 85% of heart attack and stroke victims, and aspirin and coumadin are well documented to be very inadequate forms of anti-clot protection. Thus, I employ safe substances synergistically that really work together, for example, garlic, Ginkgo and sulfated polysaccharide, d, l methionine, malic acid, etc, all enhanced with oral EDTA, for all of my patients. I use this instead of using the common anticoagulant drugs used by others, which I find have such a poor therapeutic index.

As someone involved in blood coagulation studies for years, I have effectively relied on this clot prevention technique with oral EDTA containing products for over 15 years. Without this safe anti-coagulation strategy, I would be afraid to cancel over 95% of all previously recommended invasive cardiovascular approaches for my patients. It is the EDTA, that we see in the lavender tubes we draw blood into to prevent clotting, that I have documented is the key to this success. I will gladly hold my record up to anyone else to compare rates of heart attack and strokes versus any other program.

I do not see evidence that Dr. Maulfair has performed any independent published research that he must have if he is to legitimately attempt to refute the existing extensive literature on oral EDTA and lead. Please see documentation on my website www.gordonresearch.com. Even the FDA's approved ORAL EDTA years ago as an effective treatment for asymptomatic increased levels of lead by lab evaluation. It is clear that Dr. Maulfair has not reviewed the extensive published literature regarding oral EDTA. In fact, for an example, he uses his ref # 12 (Foreman, H et. al.) to make a point about the poor absorption of at most 5% of oral EDTA (other studies find up to 18%) but he failed to read the rest of that article that clearly supports my use of oral EDTA. That article states the following: The low absorption after oral administration is very surprising in view of the finding that the material is effective by that route in accelerating the excretion of yttrium2 and lead.1 There is no satisfactory readily apparent explanation of this at present. [Emphasis added.] Note- I believe that enhanced no production explains this!

Simply go to my homepage and click on the words "you want proof oral EDTA works". Some of the other references he uses also directly refute his conclusion, for example the Halstead book (ref # 1) specifically endorses the benefits of oral EDTA chelation therapy.

I hope the readers of this will actually decide for themselves who is right after they read at least 3 or 4 articles on my website, including those from JAMA. There are over 20 other supporting documents on oral EDTA there, and I believe these will convince any unbiased reader that Dr Maulfairs' conclusion about oral EDTA is wrong. It seems clear that Dr. Maulfair has also ignored all the other important references in my Review article published in The Spring 2001 Journal. These show that oral EDTA enhances uptake of some trace minerals, while also lowering total body burden of lead. The World Health Organization and advisors to the Nat'l Academy of Science recommend that EDTA should be added to the diet of poor countries to enhance mineral absorption for poor children, particularly of Iron and Zinc. Thus they do not see this terrible danger of mineral depletion.

I fear that there is a good possibility that another study by chelation opponents will again conclude that EDTA, as used in our protocol does not reverse arteriosclerosis. It seems prudent for us therefore to explore a scientifically safe and fully supportable concept like toxic metals causing endothelial dysfunction and chelation enhancing nitric oxide production, where we simply cannot be proven wrong! Of course, no one needs to stop using our safe 3-hour, therapy that we have used now for over 30 years. However, we can do that and use oral and 5-10 minute therapy if we use this NO concept. This makes many more new Doctors interested in joining us. They want to explore these other forms of administering chelation agents, combining oral and parenteral. I see Dr. Maulfair's letter to the editor, unless challenged, as a potential threat to those doctors that now want to learn about new methods of chelating.

WE simply need to acknowledge the obvious fact; that all forms of chelation, oral, rectal and parenteral enhance excretion of toxic heavy metals. We also can agree that we live on a polluted planet and therefore we are all far higher in lead and other toxic metal levels than our body can handle for optimal functioning. The overwhelming majority of published studies, only a few of which are on my web page, show that oral chelation clearly increases lead excretion virtually without fail. This excretion is often 5- 10 times above pretreatment levels, and oral EDTA costs about the same as Vitamin C, and many authorities believe it is equally safe.

Many chelating physicians have already read the articles on my website and many are starting to recommend oral EDTA everyday along with their multivitamin-mineral program. The dosage used is basically up to 1000 mg per 35# body weight. Oral EDTA probably cannot do all the things that parenteral EDTA does but it is inaccurate to say that is does nothing. I believe it should always be taken concurrently when anyone is taking it intravenously to augment the benefits. For those that want higher absorption, liposome EDTA has now appeared in the market place, however the increased costs for the liposome may partially offset the benefits of increased absorption. Many are now using Dr Blumer's approach and giving 1 Gm of Calcium EDTA, as a push. This rapid administration requires careful monitoring to be sure that adequate kidney function permits this approach, although the ½ life is still 3 hours, and Dr. Blumer's 20 plus year experience, although not on patients with advanced or serious illness, provides tremendous proof of long term safety, and proof of reasonable benefits, recognizing for the relatively low cost of this approach.

DR. Blumer has spoken about the benefits at ACAM, and Dr Cranton and DR Rubin have criticized his work in 1992 in Townsend Letter. They of course were still assuming that magnesium EDTA would reverse CAD. Actually, most of us are not administering fully reacted Mg EDTA, even if we add MG to the EDTA. Dr. Blumer is an honorary ACAM member in Switzerland, and he has reported an almost unbelievable 90% long-term reduction in CANCER incidence and an over 80% reduction in acute CV disease in his now 20+ years follow up study. He routinely uses a 5-10 minute entirely painless push of 1 Gm of calcium EDTA. This form of EDTA has finally become affordable in the United States. This rapid approach however clearly no longer can hope to make any claim of plaque decalcification mediated through parathyroid. In return, however, you offer your patients a more affordable and convenient form of chelation with useful, long-term, documentation regarding safety and potential long-term benefits. I believe that patients are legally entitled to hear all of this information regarding oral and rapid forms of chelation. Since all of this is still officially seen as non-standard care, we must provide adequate information for our patients to be fully informed and the misleading information contained in Dr. Maulfair's article suggests that he may not be providing a balanced or fully informed consent for patients at this time.

If you read about NO and heart disease circulation, cancer, and immunity I believe you may conclude that you may want to offer inducible NO therapy to your patients, if it is convenient and affordable. It seems firmly established that removal of toxic metals improves NO production. The literature clearly documents significantly enhanced lead excretion with oral EDTA. I believe that enhancing NO production to treat endothelial dysfunction due to toxic metals can well be a safe and sustainable ground from which our long foundering chelation movement can again move forward, while we all work to find even newer and better ways to safely detoxify our patients.

If you agree, then I am quite certain that someday, you will be chelating patients with many other new chelators and for many other indications that the early EDTA literature, in retrospect, clearly supports. With the NO concept, we now have a rationale to offer the benefits of chelation as a part of the program to patients for most health problems. I believe that these new approaches to chelation may save our patients enough time and expense. That we may then be able to empower our patients to also consider the often-dramatic benefits of various forms of intravenous oxidative therapies, which I believe are now essential to help control the serious chronic and stealth infections now implicated in most degenerative diseases. I believe that we need both therapies to deal with today serious chronic illnesses.

Reference

Green DJ, O'Driscoll JG, Maiorana A, Scrimgeour NB, Weerasooriya R, Taylor RR.
      Effects of chelation with EDTA and vitamin B therapy on nitric oxide-related
      endothelial vasodilator function. Clin Exp Pharmacol Physiol. 1999 Nov;26(11):853-6.
      PMID: 10561804 [PubMed - indexed for MEDLINE]