Great Smokies Medical Center of Asheville

Archive for the ‘ Heart and Vascular Disease’ Category

What is Chelation Therapy?

Thursday, January 5th, 2006

What Is Chelation?
History
The word Chelation is derived from the Greek work “chelos” which translates as “claw” and refers to the ability of Ethylenediamine Tetraacetic Acid (EDTA) to grab unto heavy metals and toxic chemicals for transportation out of the body.
A half-century of research in structural chemistry focusing on the ability of some amino acids to form constant stable bonds with metal ions preceded the rapid development in the 1930’s and 1940’s of a new range of compounds initially applied to industrial and then to medical uses. One of the industrial uses was preventing calcium in hard water from causing staining or other problems in textile printing. EDTA was developed and patented for this purpose.
In the early 1940’s it was discovered through research that EDTA was a highly effective antidote to heavy metal toxicity, especially lead poisoning. Further studies at Georgetown University by Dr. Martin Rubin revealed that EDTA had an effect of lowering of serum calcium levels in humans.
In the 1950’s, the use of EDTA for lead toxicity in clinical trials had surprisingly effective results. To this day, the Food and Drug Administration (FDA) still recommends EDTA as the ideal treatment for lead toxicity and for hypercalcemia (excess calcium). It was a coincidental finding in the 1950’s when it was observed that persons who had lead toxicity and blockages in their arteries often not only experienced marked improvement in their symptoms of lead poisoning, but also in their circulation.
Since these pioneering days, the protocols for the use of EDTA for both hardening of the arteries and heavy metal toxicity have improved. In the clinical experience of GSMC physicians, benefits including improved functioning have been observed for angina, stroke, high blood pressure, arthritis, intermittent claudication, diabetes, gangrene, digitalis (Lanoxin) toxicity, abnormal clotting tendencies, and scleroderma.

Modern Day Use of EDTA
EDTA Chelation Therapy today consists of the intravenous infusion of EDTA with other nutritional additives including Vitamin B6, magnesium, potassium etc., administered under the supervision of a trained physician over a three-hour period of time.
A course of Chelation Therapy could range from twenty treatments for prevention to in excess of forty treatments for severe and complex disease. Your physician will recommend a course of treatment customized for one’s individual circumstances. Remember it takes years to develop artery disease, and it is a serious medical condition. To reverse, stop or even slow down this disease process within the span of 30-40 Chelation Therapy treatments is an remarkable goal.

EDTA Chelation Therapy is considered by informed physicians who utilize it to be an effective first step alternative to surgical treatment for atherosclerotic vascular disease in individuals who have been deemed to be appropriate candidates. The physicians at GSMC readily refer patients for Coronary Artery Bypass, stent placement, and angioplasty if indicated, always weighing respective risks and benefits and the appropriateness of each potential therapy for each particular situation.

BENEFITS
One of the benefits of EDTA Chelation Therapy is its ability to simultaneously treat all the arteries in the body, unlike surgical bypass that may remedy just a few inches of blockage that exists in a circulatory system that contains 40,000 miles of blood vessels. Vascular disease is a systemic illness, and as all physicians recognize, a complex illness with varied contributors and causes.
Virtually everyone in our post-industrial society carries some toxic metals such as mercury, lead, arsenic and aluminum. The important causative roles these toxins have in human health have become better understood in recent years. Some of those best-known roles are: lead toxicity in neurological disorders and learning disabilities of children, excess iron (known as hemachromatosis) and vascular disease, and the suspected relationship between Alzheimer’s and aluminum.
In our experience, Chelation Therapy lowers heart disease risk by addressing the toxic effects of iron stores in the body, and helps prevent excessive clotting tendencies, thereby increasing longevity through prevention of heart attacks and strokes.
In our experience, when Chelation Therapy is used as part of a comprehensive program including nutritional supplementation, diet, exercise, stress reduction, lifestyle modification and smoking cessation, most of our patients experience a significant return of function and an overall improved sense of well-being. One should not expect to simply sit for a three hour IV each week and not change any risk factors that contributed to their health problems in the first place and still experience benefits. The person being treated has an active role to play in determining outcome of treatment.

Safety
Since its inception in 1979, the physicians at Great Smokies Medical Center (GSMC) have administered over 100,000 Chelation Therapy treatments. All GSMC physicians follow the American Board of Chelation Therapy (ABCT) protocol for the safe administration of EDTA. All GSMC physicians either are Board Certified in Chelation Therapy by the ABCT or are pursuing Board Certification, and are members of the American College for Advancement in Medicine (ACAM), a not-for-profit organization of physicians who explore scientifically based innovative therapies.
There has never been a fatality reported from the use of EDTA when the prescribing physician follows the ABCT protocol. By comparison, for every 10,000 cardiac bypass patients, approximately 300 will die from the operation and approximately 1,000 other patients will suffer serious consequences such as a heart attack or stroke.
Our extensive experience with EDTA Chelation Therapy has made it routine for GSMC physicians to identify two health problems that need to be addressed prior to the start of treatment.
* Kidney disease: EDTA is excreted from the body via the kidneys, so your GSMC physician will assess your kidney function both before and periodically during your course of chelation therapy. In our experience, patients with mild to moderately impaired kidney function often experience improved kidney function resulting from improved circulation to the kidneys.
* Congestive Heart Failure: If you have congestive heart failure, your GSMC physician will adjust your program accordingly, by simply using less IV fluid to deliver your dose of EDTA. Most people with congestive heart failure can take chelation therapy without any difficulty.
While the beauty of EDTA is its relative safety and simple chemistry, it does have some side effects that our trained staff can prevent or identify early:
* While usually a comfortable therapy to receive, occasionally mild to moderate discomfort at the site of infusion in the arm may occur and be remedied by minor adjustments including using a heating pad or repositioning the IV.
* Since it is possible for anyone to have an adverse reaction to any substance, it may happen that one or more of the additives in the Chelation IV bottle may cause an adverse reaction. Omitting suspect additives from subsequent IV’s remedies this situation.
* Lowering of blood sugar (a benefit for diabetics) is a side effect of Chelation Therapy that is easily remedied by eating before and during a chelation treatment.
Who can benefit from chelation therapy:
In our experience, the following medical problems have been shown to benefit from Chelation Therapy
* Angina, history of a heart attack, or coronary artery disease
* A history of bypass surgery or angioplasty
* Stroke, TIAs, carotid artery disease
* Diabetes and its circulatory complications of ulcers and gangrene
* Intermittent claudication
* Scleroderma
* Lead toxicity
* High blood pressure
* Arthritis
Recommended reading:
Bypassing Bypass:
The New Technique of Chelation Therapy, Elmer Cranton, M.D., Hampton Roads Publishing Company, Inc., April 1994.
Forty Something Forever:
A Consumer’s Guide to Chelation Therapy, Harold and Arline Brecher, Virginia, Health Savers Press, Herndon, 1992.
Professional Organizations:
American College for the Advancement of Medicine
23121 Verdugo Drive, Suite 204
Laguna Hills, CA 92653
Phone: 800-532-3688
www.acam.org

The Cholesterol Hypothesis of Heart Disease and Statin Drugs

Monday, September 12th, 2005

The guys in white coats are in your television set, and they’re advertising cholesterol-lowering drugs (statins) 24/7. They know if they throw enough spaghetti on the wall, some of it will stick. Americans spend $12.6 billion/year on statins, proving the cholesterol hypothesis has stuck.
The theory that cholesterol causes heart disease is called the cholesterol hypothesis. Its general acceptance as fact has resulted in cholesterol, a critically important molecule in health, being wrongly singled out, tried, and convicted of causing heart disease. This popular hypothesis falls short of explaining why people with low cholesterol have heart attacks, why people with high cholesterol can be free of heart disease, and why cultures such as the Inuit, who have fat-rich diets, have low heart disease incidence.
What has cholesterol done for you lately? For starters, feeling good is a symptom of adequate cholesterol levels. Cholesterol is required for the body to make reproductive hormones and the body’s anti-stress hormone, cortisol. Eighty percent of the cholesterol in the blood is made by a healthy liver that makes, every single day, as much cholesterol as is in six to eight chicken egg yolks. Cholesterol is part of the protective coating, the myelin sheath, that insulates nerves. Cholesterol "waterproofs" the protective cell membrane in each of the body’s cells. Cancer rates increase when cholesterol levels decrease. Cholesterol is required for the body to make Vitamin D. Stroke risk increases as cholesterol levels drop. High cholesterol levels in older people are related to longevity.
The cholesterol-lowering drugs of concern are statin drugs: Lipitor, Zocor, Pravachol, Lescol, Mevacor, and the new kid on the block, Crestor. (The 80 mg dose of Crestor was removed from the market shortly after it was introduced because of reports of kidney failure.)
The adverse side effects of statin drugs are well known and include rhabdomyolysis, muscle deterioration that can be detected by a routine blood test. Less well-known are partially reversible muscle disorders that cannot be detected by blood tests. If the affected muscles are involved in breathing, shortness of breath may result. If the affected muscle happens to be the heart, heart failure may result. Statin drugs inhibit the production of Co-enzyme Q10, an enzyme that drives energy production in every cell, notably in the liver and heart. Many animal studies show an increase (cont. p.2) (cont.) in the incidence of cancer with exposure to statin drugs. In fact, some researchers consider statin drugs to be carcinogenic. Peripheral neuropathy results in pain and lack of sensation in the feet and legs. This, as well as depression, irritability, and memory and cognitive problems are known side effects.
Many physicians and researchers question not only the safety of taking cholesterol lowering drugs, but they also challenge the validity of the hypothesis that cholesterol causes heart disease.
Well-established causes of heart disease include poor nutrition, a sedentary lifestyle, low copper, excess iron, poor antioxidant status, low HDL cholesterol, infection, inflammation, smoking, and various toxins (notably mercury).
In a drug-based healthcare system, what were once thought to be scientific "facts" are routinely replaced by new, updated "facts of convenience." For years, the acceptable level of LDL cholesterol was less than 130 mg/dl. The bar was recently lowered again, so statin treatment is now recommended to attain LDL levels at 70 to 100 mg/dl, resulting in 36 million Americans being targeted as potential users of statins. Six of nine physician panelists serving on the National Cholesterol Education Program (NCEP) that made the latest recommendations have been exposed as having received funding from drug companies that manufacture and market statin drugs.
If circulating LDL cholesterol were inherently dangerous, all arteries would have equal exposure to it and would be equally diseased. But LDL only penetrates the lining of an artery (epithelium) where the lining is damaged. As a result, vascular blockage occurs in already compromised sections of arteries.
When is "bad" LDL cholesterol good? LDL cholesterol has several important functions, including a starring role in the synthesis of cortisol, estrogen, testosterone, and progesterone. Elevated LDL levels are nature’s defense against viral infections. Once viruses are bound to LDL, the ability of the virus to release cytokines (chemicals that cause inflammation, pain, and clotting) is impaired.
Oxidized LDL, not LDL, is associated with arterial damage. Addressing causes of oxidation (excess iron, smoking, poor quality diets, etc.) and glycosolation (diets high in sugar) are two natural approaches that address underlying causes of damage to arteries.
Responsible recommendations for prescription drug use are made on a one-to-one basis between a physician and patient, not to 36 million people. People taking statin drugs need at least 50 mg of CoQ10 daily and are advised to report to their physicians any of the aforementioned side effects. Lifestyle modifications that can address known risk factors for heart disease include minimizing sugar intake, exercising, stopping smoking, and taking antioxidant supplements.

Angioplasty with Stent Placement vs. Exercise Training

Monday, September 12th, 2005

Research results reported in the March 2004 issue of Circulation may be the best news for heart patients since, well, the bicycle was invented.
The benefits of stent angioplasty as rescue intervention in acute coronary problems is well established. But its benefits are less clear in a patient with stable exercise-induced angina.
Cardiologists in Leipzig, Germany, studied 101 men with exercised-induced angina who had received routine coronary angiography. Participants were randomly divided into two groups: those who received 12 months of exercise training (20 minutes of bicycle ergometry daily and one 60-minute session of group aerobic exercise training per week) and those who had stent angioplasty.
The study rated clinical symptoms (the ability to exercise without angina), the level of oxygenation of the heart muscle, the necessity of further interventions (coronary artery bypass surgery and angioplasty), as well as adverse clinical outcomes (death from cardiac cause or stroke, and increasing angina resulting in hospitalization).
After one year, men in the exercise training group had an 88 percent event-free survival rate compared with 70 percent in the stent angioplasty group. The exercise training group had a 16 percent greater maximal oxygen uptake than the angioplasty group.
This study did not use drug-coated stents. Statistical adjustment for drug-coated stents puts their event-free survival rate at 72 percent.
The study results make sense when considering three facts. First, the heart is a muscle, albeit a very specialized one, and it can be conditioned by exercise. Second, the blockage of a coronary artery is not just a simple mechanical problem, but is the result of a complex series of events including inflammation, clotting, and immune responses. Third, stenting addresses one short segment of the coronary blood vessels, while exercise impacts the function of all the blood vessels.
Note that this study was performed in men with stable angina. Stable angina is pain of cardiac origin that occurs with exertion or intense emotion at a predictable level, decreases with rest, and does not progress to a heart attack. Crescendo or unstable angina is sudden or increasing pain of cardiac origin that occurs either at rest or with exertion and is associated with unstable plaque that is threatening to advance to a heart attack.
GSMC physicians recommend individualized risk assessment, a customized program of heart-friendly nutrients, and chelation therapy in addition to exercise.
People with heart disease should consult their physician for exercise recommendations.

Prehypertension?

Sunday, September 11th, 2005

In May 2003, the Journal of the American Medical Association (JAMA) reported new guidelines issued by the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC) to further decrease cardiovascular complications. A new category, prehypertension, is now defined as a BP of 120/80 to 139/89. Hypertension is defined as 140/90 or greater. The effect of doctors and patients acting on this narrowly defined category of prehypertension would likely be millions more prescriptions for drugs being written. The side effects of these drugs are much more likely to adversely affect health than a BP of 120/80. GSMC doctors think this new definition is enough to, well, give anyone high blood pressure. Get regular BP checks and get your healthcare from a physician who treats people and not numbers.

Risk vs. Benefit of Cholesterol-Lowering Drugs

Monday, August 22nd, 2005

by John L. Wilson, Jr., M.D.

The German drug company Bayer AG withdrew its cholesterol-lowering drug Baycol from the market in August, 2001 after it was linked to 31 (now 52 and counting) deaths. An estimated 700,000 people in America were taking Baycol. Many more whose doctors prescribed other closely related drugs in the “statin” family of drugs (including Lipitor, Lescol, Mevacor, Pravachol, and Zocor) are left wondering if they are at risk. 48 million prescriptions were written last year in the US for Lipitor alone. Our television sets are abuzz with marketing of statin drugs, appealing to a huge market of potential customers.

All statin drugs are linked to a rare muscle inflammation condition called “myositis” which occurs in about one in a thousand patients, especially if taken with another drug, Lopid (gemfibrizol). Rarely, “rhabdomyolysis” can result, where muscle cells break down to the extent that kidney failure and death can ensue. People taking statin drugs who experience muscle pain and weakness should consult their doctor. The elderly and women seem to be more at risk, and the adverse effects are dose related, meaning the higher the dose, the greater the chance of adverse effects. An elevated blood test, Creatine Phosphokinase (CPK), is an indicator of this muscle damage. A CPK test should be done on all patients who are taking statin drugs.

Statin drugs are “HMG Co-A Reductase Inhibitors”, meaning they block a liver enzyme required for making cholesterol. This same enzyme is also necessary to make Coenzyme Q-10, a very important nutrient essential for energy production in our body, and especially for heart function. Doctors seldom address this other common downside of statin drugs that can be remedied by supplementing Coenzyme Q-10.

For years doctors focused on cholesterol as having a major causative role in heart disease. Because cholesterol is found in arterial plaque, scientists thought that reducing cholesterol levels through low fat diets and drugs would result in less plaque in arteries. The presence of cholesterol in coronary artery plaque no more proves that cholesterol causes heart disease than the presence of a fireman at a fire proves firemen cause fires. In fact, firemen and cholesterol are both on the scene putting out different “fires”. Recent analysis of the Framingham Heart Study data suggests that the “fires” of oxidation, infection, and inflammation, likely due to a resulting increased clotting risk, are better predictors of a future heart attack than are cholesterol levels. Every doctor has seen heart attacks in patients with low or normal cholesterol levels. In fact, too low cholesterol levels pose risks, a fact seldom recognized, much less mentioned to patients. The liver makes 80% of one’s total cholesterol; only 20% is from dietary sources. Cholesterol is the raw material needed by the body to make hormones, including cortisol, estrogen, progesterone, and testosterone. Increased risk of cancer occurrence, mood disorders including depression, suicide, and numerous and varied symptoms of hormone depletion are associated with too low cholesterol.

A balanced cholesterol ratio in the body is the optimal goal. Most people are familiar with “good” (HDL) and “bad” (LDL) cholesterol. Doctors generally agree that having a low ratio of total cholesterol to HDL cholesterol is highly beneficial for cardiovascular health.

I find excellent overall results in cholesterol and triglyceride reduction in my practice from strict reduction of carbohydrates (sugar and starchy foods). Exercise also remains one of the better prescriptions for overall heart health. And, both are very unlikely to be recalled by a pharmaceutical company anytime soon. Unfortunately, lifestyle solutions to health problems are somewhat unpopular in a population desiring quick fixes. There are no drugs that provide a quick fix without risk. It is almost always good advice to not look to drugs as a first line defense for health problems.

Risk of Clot Formation Can be Measured

Monday, August 22nd, 2005

by Eileen M. Wright, M.D.

The ability to form a clot can be life saving, such as after an injury when a person might otherwise bleed to death. Several problems can happen, however, with the complex sequence of events that contribute to clot formation that leave a person at risk for unwanted clots.

Many people know someone who has had a heart attack “out of the blue”. This unfortunate new heart disease victim may have had no identifiable significant risk factors for heart disease, leaving the patient and his or her family wondering why. You may recall the recently publicized warning of the single greatest risk of potentially fatal health complications of air travel: pulmonary embolism, a clot in the lung. And we now have two potentially fatal medical conditions from clot formation in seemingly healthy people.

An increased chance of clot formation can occur after surgery, trauma, stress, toxin exposure, fractures, or infectious illnesses including viral, bacterial, or fungal infections. It is less well known that any chronic infection such as Epstein Barr virus, herpes, and gingivitis can similarly result in the blood flow being chronically more sluggish than desired. Circulation in small vessels can then become obstructed with fibrin, a strand-like substance in the blood involved in clotting, resulting in sluggish blood flow. Since blood cells transport oxygen and waste products, sluggish blood flow in small vessels results in poor oxygenation of tissues and accumulation of waste products. This often leaves tissues unable to heal and leaves a person feeling chronically unwell.

Physicians routinely address clotting abnormalities daily in emergency situations such as heart attacks, strokes, and pulmonary embolisms. Because clues to increased risk for clotting exist prior to actual clot formation, identifying and treating those at risk is now possible before a clot develops. Those wondering if they have this risk must have special blood testing done to assess inherited defects in coagulation. Fortunately, much can be done to treat this condition, and an ounce of prevention is certainly worth a pound of cure. Treatments for increased clot formation risk include taking Vitamin E and EFA (fish oil) supplementation to make platelets less “sticky”, exercise, stress reduction, avoidance of sugar and alcohol in the diet, daily water intake of one ounce for every two pounds of body weight, and taking garlic, which has been shown to be as effective as aspirin in reducing platelet stickiness. The prescription drugs Coumadin or Heparin may be prescribed. Both require periodic monitoring. Diagnosing and treating any underlying condition, such as an infection, that stimulates increased clot formation is also important for long-term treatment success.

If traveling either by air or car, and in particular following a recent infection, sitting with legs bent for an extended period of time can set one up for clot formation, as blood can be trapped and pool in the leg veins. Clots formed in the leg can be fatal when they travel to the lung. Reduce the risk of clot formation by drinking water and taking Vitamin E and fish oil prior to traveling. During travel, do ankle rotations, calf and leg stretches and isometrics frequently. Walk around the aisles of the plane if able, or if traveling by car, stop and get out of the car to walk hourly to increase circulation.

Assessing The Risk of Heart Disease

Monday, August 22nd, 2005

By John L. Wilson, M.D.

According to the American Heart Association, more than 2,600 Americans died of Cardiovascular (Heart) Disease each day in 1998. That is one death every 33 seconds. Considering that Cardiovascular Disease (CVD) has been the leading cause of death in the US since 1900 (except in 1918 when more deaths occurred from an influenza epidemic), it is becoming obvious that the prevention and treatment strategies have fallen short.

Factors that have long been thought to put an individual at risk for CVD include smoking tobacco products, sedentary lifestyle, obesity, high blood pressure, stress, abnormal blood fats including cholesterol and triglycerides, and a family history of heart disease. One’s inherited predisposition to heart disease does not mean that one is fated to get heart disease, as the expression of that genetic predisposition is strongly influenced by lifestyle. Lifestyle modification is critical to successful prevention and intervention of CVD.

For years, elevated cholesterol was the focus of thinking about the cause of CVD, and this decades long oversimplified and largely incorrect belief has been the basis of many ineffective recommendations. The British Medical Journal on March 31, 2001 analyzed 27 separate studies of dietary restriction of cholesterol and fats in reducing CVD risk and found it has no proven effect on total mortality rates.

So if heart disease isn’t a simple plumbing problem, what is it? New research reveals it to be the result of many complex chemical events in the body, that can include clotting, oxidation, inflammation, excess insulin levels, and inborn errors in metabolism that are aggravated by nutritional deficiencies. This more current information on the causes of heart disease has resulted in the development of blood testing that can more accurately identify individuals at risk for heart disease earlier in life, and, importantly, result in very specific interventions to reduce risk. Some of the most important tests are:

1. Lipoprotein (a) [Lp(a)] – Lp(a), a genetic risk factor thought to be the most dangerous of the “bad fats” in the blood stream, does not correlate with cholesterol or triglycerides, so it stands alone as a separate risk factor. Initially defined by Nobel Prize recipient Dr. Linus Pauling, N-acetyl cysteine is the treatment of choice for reducing elevated Lp(a) levels.

2. Fibrinogen – Elevated fibrinogen, involved in the formation of clots and plaque, can detect those at risk for abnormal clot formation. Increasing certain types of dietary fat, eating oily fish, taking Vitamin E, and taking anti-inflammatory natural enzymes may reduce elevated fibrinogen levels.

3. Homocysteine – When elevated, this sulfur-containing amino acid can be toxic to the body, including coronary arteries. High levels can be addressed with increased intake of vitamins B6, B12, and folic acid.

4. Antioxidant Status – Oxidation can damage the lining of arteries, and one’s ability to offset this damage can be measured in the laboratory. Treatment is lifestyle changes (specifically stopping smoking) and antioxidant nutrients.

5. High Sensitivity C-Reactive Protein (HSCRP) – This inflammatory marker can reveal if there is inflammation occurring in the lining of the coronary arteries, addressing the most recent theories on the origin of CVD that point to an infectious/inflammatory contributing cause.

6. Lipids – Recent research from Harvard suggests the Coronary Risk Ratio (Total cholesterol divided by the “good” cholesterol HDL), combined with HSCRP are the best early predictors of vascular disease.

7. 4-Hour Glucose-Insulin Tolerance Test (GITT) – Excess insulin causes a thickening of the lining of the arteries, setting the stage for CVD. It is also the definitive screen for early detection of diabetes that increases risk for CVD.

8. Ferritin – Hemochromotosis is the medical term for an elevated ferritin, a protein that stores iron. Just as iron can oxidize or rust when left exposed to the elements outside, excess iron is a major source of oxidation inside the body, notably to the blood vessels. We don’t age, we rust! Doctor-supervised blood donation or phlebotomy can often return ferritin levels to normal range.

9. Mineral Adequacy – Imbalances and deficiencies in mineral levels in the body can accelerate the damaging process of hardening of the arteries. Customized supplementation of minerals addresses this contributing cause of heart disease.

A comprehensive CVD risk assessment provides very specific information of exactly where one’s risk is, and provides opportunities for particularly effective prevention and customized early intervention to decrease that risk.

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