Evidence-Based Clinical Chelation E-Book

Dr. Eleonore Blaurock-Busch PhD

• Herausgeber: Books on Demand
• Kategorie: Fachliteratur
• Sprache: Englisch
• Veröffentlichungsjahr: 2020

Seitenzahl: 167

Beschreibung

This is an easy-to-read manual about chelation therapy. It contains specific protocols for the treatment of chronic metal overexposure, all of which are evidence-based, aiding the inexperienced and the experienced therapist in selecting the optimal chelating agent for the metal(s) in question. Expert chemists and chelation therapists have contributed invaluable knowledge and experience to this book. Most importantly, this is not a book promoting personal views or preferences. In fact, the information presents and explains different approaches, and allows the reader to draw his own conclusion. All the protocols listed have been modified for the treatment of chronic metal intoxication, included are oral and intravenous treatment plans. The authors explain in simple terms how a chelating agent´s bioavailability affects metal binding and how various protocols such as the Cutler Protocol affect the detoxification process, why DMPS binds mercury and which chelators are useful for the detoxification of certain organ system. Also discussed is the importance and effect of treatment pauses. Diagnostic tests are discussed, and which are useful under certain conditions. Shown are tables comparing the average metal binding ability of the various EDTAs, DMPS, DMSA and other chelating agents. Detailed information explains which chelator binds which metal and why, all of which aids the therapist in finding optimal treatment schedules. Novel chelating agents are presented such as MIADMSA, a new oral chelator specifically designed for arsenic intoxication, or how natural Pectin may be used an alternative for gadolinium intoxication, which metals are bound by lipoic acid and why a slightly alkaline environment supports metal binding, even preventing the often-feared metal redistribution. All in all, this evidence-based chelation "cookbook" should be in medical libraries and on the bookshelf of every physician treating environmental disease.

Leseprobe

Table of Contents

Preface

Introductions

Prof. Abdulkareem Almomen MD

Prof. Ulf Lindh

Dr. Ebrahim Sulaiman

Chapter 1

Short History of Antidotes and chelating agents

History of approved chelating agents in metal toxicology

List of Antidotes in Metal Toxicology

About Combination Treatments

Chapter 2

Preparing for chelation

Patient Consent Form

Parenteral chelation: Which renal function test?

Purpose of the Renal Function Tests

Special Concerns

The Renal Function Tests

Creatinine, General Information

Serum Creatinine

Cystatin C

Urine Creatinine

Creatinine Clearance

Glomerular Filtration Rate (GFR)

Estimated Glomerular Filtration Rate (eGFR)

Blood Urea Nitrogen (BUN)

Oral Chelation - What to do prior to Treatment

Fecal Metal Test

Pre-Sampling Suggestions

Sampling of Fecal Samples

Urine Tests to Evaluate Metal Chelation

Urine Collection Protocols

Urine Comparison Report

Treatment Cycles and Pauses

References

Chapter 3

EDTA - Ethylenediaminetetraacetic acid

Na2EDTA - Edetate disodium or Disodium EDTA

EDTA’s Safety Record

EDTA Therapy Guidelines and Protocols

Na2MgEDTA - Disodium Magnesium EDTA, also MgEDTA

Diabetes and Vascular Disease

Calcium and Cardiovascular Disease

MgEDTA Protocols

Dr. Sulaiman’s Protocol for Preparing MgEDTA

Drs. J. Carter and E. Olszewer’s Protocol

Dr. Strey’s Protocol

Combination Treatment MgEDTA iv and DMSA oral

CaEDTA (DiSodium Calcium EDTA)

Which EDTA?

Calcium and the EDTAs

Urine Challenge Test

Non-parenteral applications of EDTA

EDTA oral

EDTA Suppositories

References

Chapter 4

DMSA or Meso-2,3-dimercaptosuccinic acid

General Information

Which Metals?

DMSA Bioavailability

Preparing the digestive tract

PDR recommended treatment for acute lead intoxication

Oral dosage for Acutely Intoxicated Adults and Children

Andrew Cutler’s Protocol

IBCMT Protocol

MTM Protocol for the chronically exposed

Important information

Option A

Option B

Case 1: DMSA Comparison Report

Challenge Tests - how often?

DMSA Research Abstracts

Metal Exposure in the Children of Punjab, India

Safety and efficacy of oral DMSA

References

Chapter 5

DMPS - Sodium 2,3 Dimercaptopropane-l-Sulphonate

General Information

DMPS Bioavailability

Scope of Application

Side Effects

Oral vs intravenous use

DMPS Protocol for intravenous administration

The Challenge or Provocation Test

Material for urine metal testing

DMPS – Protocol for oral use

The Challenge or Provocation Test

Transdermal DMPS (TD-DMPS)

References

Chapter 6

Sodium Thiosulfate or Sodium Thiosulphate

General Information:

Medical Uses

Pharmacokinetics

Toxicity and Side Effects

Contraindications

Scope of Application

References

Chapter 7

DTPA – di-ethylene-triamine-pentaacetic acid

General Information

Clinical Pharmacology

Emergency Treatment after Radioactive Exposure

Emergency Treatment Protocol

ZnDTPA for the Chronically Overexposed

Route and method of administration

Side Effects and Safety

Contraindications

Overdose

Warnings and Precautions

References

Chapter 8

Prussian Blue

General Information

Indication

Side effects and contraindication

Treatment

References

Chapter 9

Copper Chelators

D-Penicillamine (DPA) and Copper

Pharmacology

Indications

Contraindication

Administration and Dosage

Precautions

Interactions

Hepatotoxicity

References

Tetramolybdate (TM)

References

Chapter 10

Iron chelator

Deferoxamin (Desferal®)

General Information

Clinical Pharmacology

Indications and Usage for Desferal

Acute Iron Intoxication

Chronic Iron Overload

Contraindications and Warnings

Drug Interactions

References

Chapter 11

Novel Approaches

Miadmsa: A novel chelation agent for Arsenic Metal Intoxication

General Information

:

Route of Administration and Bioavailability:

Scope of Application:

The Pre-Clinical Trials

Toxicity Profile of MiADMSA

Therapeutic Application

References

Lipoic Acid, another alternative?

Pectin as an alternative to synthetic chelators

Pectin and Toxic Metals

Study Protocol (Excerpt as listed by Eliaz and researchers)

The Use of Pectins in the Treatment of Metal Overexposure

Rare Earth Metals (Cerium, Gadolinium etc.)

References

Periodic Table

Preface

This book does not replace previously published books on chelation therapy by this or other authors. It is a brief and updated ‘cookbook of chelation therapy’, listing chelating agents with the potential to alleviate chronic metal intoxication. The information provided is based on present evidence.

Antidote treatments of chronic overexposure are relatively new. The treatment methods described in this book are the outcome of antidote usage that focused on acute intoxications only. Due to the increasing awareness of environmental problems, a modulated treatment approach became necessary, one that is considerably less aggressive, yet still effective. Such protocols as listed here are aimed specifically at chronic overexposures rather than acute intoxications.

There is one main difference between an acute intoxication and a chronic overexposure. An acute intoxication often is a life-threatening event that necessitates an aggressive medical approach; a chronically overexposed patient rarely requests such measures. Generally, an acute intoxication happens suddenly; a chronic overexposure happens over time. This also means that an acute poisoning immediately overwhelms the body’s defense mechanism, but in the case of a chronic intoxication the body has had time to adjust. Symptoms developed over time.

Another, most distinct difference is that symptoms of acute intoxications are usually easily identified, whereas chronic overexposure symptoms are mostly vague and thus are difficult to identify. Furthermore, chronic ailments are often multicausal. Today’s environmentally challenged patient shows multiply burden. The diagnosis may identify insignificant exposures to numerous toxins and this accumulation of minor amounts to multiple toxins results in a respectable burden, which overwhelms enzyme systems and other vital bodily functions. Chronic disease follows in time.

By reducing a chronic burden, we reduce or eliminate related symptoms. Another difference in the treatment approach of acute poisonings vs chronic overexposures is the element of time. When treating an acute case of poisoning, we are rushed to prevent acute damages, even death; when treating overexposures, we have time to dismantle the hill of toxic garbage that has piled up over time. When we improve the bodily environment, we improve health.

Since 1984, I have actively worked in metal toxicology, commonly referred to as chelation. Throughout this book, I refer to detoxification therapies as ‘chelation’ as this is the name widely used and recognized for metal detoxification procedures.

How did chelation therapy develop? In the Seventies and Eighties, a group of medical physicians, many of them cardiologists, were determined to set new standards and guidelines for the treatment of atherosclerotic and vascular disease. These dedicated minds set out to change medicine’s surgical approach in cardiology and eventually branched out into what is now called chelation therapy. Despite opposition from conventional cardiologists, these ‘chelation doctors’ founded organizations and achieved recognition for a treatment method they deeply believed in.

I have met prominent pioneers of chelation therapy, spoke and corresponded with notable doctors and initiators of ‘alternative medicine’. I like to mention Dr. James Frackelton of Ohio, Illinois, Dr. James Puckette Carter of Lousiana (both deceased), and Dr. Peter van der Schaar of Leende, Netherlands, all founders of organizations that stood up for chelation and other ‘alternative’ medical practices. Their teachings remain, but an increase in knowledge due to research necessitates updates. Hence this book.

In Germany, chelation has long been part of medicine. Due to chemical warfare threats of WWI and WWII, antidotes like BAL and DMPS were developed in England and Russia. Na2EDTA has a history of being used in German industries for its calcium-binding ability, which explains why the term ‘chelation’ has long been familiar to European and Russian industries and in medicine, long before ‘chelation therapy’ was propagated in the US and other countries.

Yet American physicians like Dr. Elmer Cranton MD who had served as Chief-of-Staff at a U.S. Public Health Service Hospital in Oklahoma, turned EDTA-Chelation into an alternative treatment method for cardiac disease. Other pioneers such as Michael B Schachter MD of New York and Terry Chappel MD of Ohio are still active notables along with Dr. Ephraim Olszewer of Sao Paulo, Brazil, and the study he conducted and published 1990 in cooperation with FC Sabbaq and JP Carter was one of the first important research papers published. This widely recognized study, a pilot double-blind study of sodium-magnesium EDTA in peripheral vascular disease, was one of the first providing evidence to the usefulness of MgEDTA. (Olszewer 1990)

During that time, the ACAM movement focused on NaMgEDTA chelation. Calcium i.e. plaque removal was its aim. In Germany, environmental physicians focused on mercury and the amalgam movement, thus relying on DMPS, and from 2000 on chelation groups organized in various countries around the world. Established chelation protocols were adjusted for the treatment of chronic overexposures. Articles and books were written, and a growing number of physicians became interested in chelation therapy.

In the years since, official protocols involving antidotes such as DMSA, DMPS, the EDTAs, DTPAs and others were repeatedly modified for the treatment of chronic metal exposure. New research information created awareness.

The main aim of this book is to help physicians understand why and how chronic and acute intoxications require different approaches, and to provide appropriate protocols for patient safety.

It has not been pointed out enough that treatment approaches concerning metal overexposure vary from country to country. The access to antidotes or chelating agents varies from country to country. Antidotes or chelating agents are pharmaceuticals. These prescription items are often sold over the internet. Web pages provide user information, but are not necessarily appropriate or accurate.

For instance, the difference between NaMgEDTA and NaCaEDTA is not sufficiently known and if an inexperienced therapist follows certain webpages recommendations, fatal accidents can, and have happened. This evidence-based book aims to aid patient and doctor in selecting the appropriate treatment.

Furthermore, a growing number of well-intended, but not fully informed physicians use one chelation agent and protocol for detoxing one and all metals, a rather simplified approach to chelation therapy. For a patient with multiple exposures (and these are more common in today’s polluted environment), a general detox program will bring improvement. A more individualized approach provides relief much quicker. For example, if a patient suffers from a high mercury burden, DMPS or DMSA will be the chelators of choice. If the patient shows a high cadmium burden, NaCaEDTA or NaMgEDTA should be selected instead. The well-informed chelation therapist will, after the appropriate diagnosis, start to detoxify the main toxin first by selecting the most appropriate chelator.

I compare chelation to the peeling of an onion. The more layers of toxins we peel, the better. Health will improve. Any chelator will remove some layer, but if we aim to remove the most critical toxin first, treatment success will come sooner.

I like to point out another issue of concern. It is common today to spend less time with patients. Questionnaires are used to evaluate patient histories; few physicians have enough time to sit down and talk with patients.

Dr. Ebrahim Sulaiman of Kuala Lumpur, Malaysia does take time. I met him in 2006, during IBCMT’s Malaysian conference. He impressed with medical knowledge, kindness, integrity and fondness of family, people and work. He proudly showed me his clinic. We kept in contact. When he invited me to be part of the 2nd Malaysian Conference of Metal Toxicology and Antidotes in 2019, I accepted (albeit a long travel time).

During this February 2019 conference, it became clear that Dr. Sulaiman had many followers, in Malaysia and neighboring countries. New and experienced doctors interested in chelation therapy asked for an updated, comprehensive version of existing textbooks. Dr. Sulaiman had published his short book Chelation Therapy in 2001: I had published a more comprehensive version in 2016, The Chelation Therapy Handbook: Toxic Metals and Antidote. Since then, evidence-based knowledge accumulated, and thus this book was planned. Because few doctors have time to read thick volumes, we promised a ‘cookbook approach’.

Over the years, MTM Laboratory of Germany accumulated and sorted through a considerable mass of data. Statistical evidence as provided in the following chapters should make physicians help select the chelator of choice. Presented here are synthetic chelators. Administering these chemicals is, in fact, a type of chemotherapy and requires knowledge and care. We must be selective in administering chelating agents. This book aims to aid physicians to provide safe and effective chelation treatments.

Another issue concerns diagnostics. As chelation therapy became popular, all sorts of diagnostics devices appeared, some useful, many are not. Clever marketing of simple ‘spectrophotometric’ devices promise ‘intracellular metal results within seconds’. Cleverly designed software provides ‘test results’ that appear reasonable, however fraudulent they are. Well-meaning doctors and their trusting patients are cheated by the distributors of such deceiving devices.

The term ‘evidence based’ has been overused. It is a fact, however that during the past twenty years and more, chelation has been administered to millions of people around the world with few problems. Evidence to its safety and effectiveness accumulated.

All data presented here has been researched and evaluated. This book provides evidence-based updates of chelation therapy in the hope to aid doctors, patients and critics alike.

Eleonore Blaurock-Busch MSc PhD

Introductions

Prof. Abdulkareem Almomen MD

This textbook is a precious companion for physicians, nurses, pharmacists, laboratories and students who are practicing or interested in metal toxicology and chelation therapy. The author Dr. Eleonore Blaurock-Busch who is well-known throughout the globe with comprehensive experience in diagnosis, treatment and innovative research in clinical metal toxicology has put together this book, which is easy to read and to understand; it is most practical.

This textbook puts at your hand knowledge of approved agents and protocols that date back to 1935 but have been updated with at-hand information and access to leaders and centers of excellence in metal toxicology and chelation therapy worldwide.

This textbook contains fundamental information on proper diagnosis of metals from various samples including hair, blood, urine, saliva, tissue and stool. It also includes proper patient assessment and evaluation, allowing appropriate selection of patients for the right chelation therapy protocol, and as such helps to avoid or minimize adverse effects.

Abdulkareem Almomen, MD, FRCPC, ABIM-Hem,

Professor and Consultant of Medicine, Hematology, and Metal Toxicology

King Saud University and National Blood and Cancer Center,

Riyadh-Saudi Arabia

[email protected]

[email protected]

Prof. Ulf Lindh

Metal intoxication may be encountered in several situations. Occupational exposure is, perhaps, the most intensively studied situation. There are, however, many other ways in which metal exposure can occur. One such example is the metal exposure from dental restauration materials such as dental amalgam. This material is in many situations called “silver amalgam” although the main component is mercury. The reason for the use of this name may be to cover the mercury. There have been a series of controversies almost since the first introduction of amalgam to Europe in the mid-19th century. At least three or four “amalgam wars” have been fought since then. The use of mercury amalgam was banned in the Nordic countries during the early 2000s.

Having been intensively involved in research and development of diagnostic methods for treatment of patients with ill health associated with metal exposure from dental restauration materials since the 1980s, I have realized the need for assisted metal detoxification. The Department of Clinical Metal Biology was established at the University Hospital in Uppsala, Sweden, for improving care and treatment of these patients. One important conclusion, apart from the fact that most patients recovered and experience significant improvement in quality of life, was that some patients had difficulties with the detoxification process and this showed a definite need for assisted detoxification methods.

The first international metal detoxification conference was held in Berlin, Germany, in June 2019. The conference attracted both academics and clinicians with experience from chelation therapy and detoxification. A lot of information was disseminated and built the ground for serious and rewarding discussions. Again, this event showed the need for assisted detoxification other than the bodies’ own.

A strong need for establishing ground for evidence-based detoxification was realized at the conference. The book by Dr. Eleonore Blaurock-Busch summarizes protocols for metal detoxification; it is a very good base for improving scientific knowledge. I sincerely recommend this book for everyone involved in detoxification as well as interested researchers and clinicians. Another advantage of the book is that it could facilitate approving chelation therapy in countries where it is hitherto not acknowledged by the authorities.

Ulf Lindh, PhD; Professor of bioinorganic chemistry, Biology Education Centre, Uppsala University, Sweden

[email protected]

Dr. Ebrahim Sulaiman

My journey into chelation therapy started in 1996, when my wife was not recommended to undergo a high risk second bypass operation. I was looking for an alternative and found it in chelation therapy which is also known as an approach to cardiovascular diseases using antioxidants. As a result of my research into complementary therapies such as chelation therapy, hyperbaric oxygen medicine, nutritional supplements, and external counter pulsation machine (ECP) therapy, my wife was successfully treated. I subsequently underwent a few diplomas and certification courses in these fields including Advanced Proficiency in Chelation Therapy from the American College for Advancement in Medicine (ACAM), and Clinical Metal Toxicology (CMT) from the International Board of Clinical Metal Toxicology (IBCMT) in 2001. I also wrote a 85 pages book on Chelation therapy in 2001.

I met Dr. E. Blaurock Busch of Micro Trace Mineral Laboratories (MTM), Germany who kindly and honorably paid a visit to my medical center in Kuala Lumpur, Malaysia in 2006. Since then I learned a lot from MTM lab by referring hair samples for heavy metal analysis and research.

Again Dr. E. Blaurock Busch was very kind to fly 17 hours from Germany to Kuala Lumpur to attend our Second Malaysia Conference and workshop on Clinical Metal Toxicology and antidotes on 22nd – 24th February 2019 where she gave important lectures on her research.

She was impressed by our workshop and teachings and honored me to contribute to this book.

This textbook provides safe and affordable treatment protocols, all evidence based. If done properly, chelation therapy offers many benefits. The information in this book may save life or limbs -literally! Again, our intention is to teach the candidates who attend our workshop in Malaysia to the best of our ability, all based on updated, present knowledge. The first step in our training is to encourage reading of this textbook, followed by hands on training. To be well versed and properly trained creates confidence of new and already experienced doctors of chelation therapy, all of which is for the benefit of patients.

Dr. Ebrahim Sulaiman MD

Klinik Ebrahim dan Surgeri Sdn Bhd

3.15 -3.17 The Ampwalk, 218 Jalan Ampang

50450 Kuala Lumpur Malaysia.

[email protected]

Chapter 1

Short History of Antidotes and chelating agents

An antidote is a remedy to counteract the effects of a poison or toxin, or something that prevents or counteracts injurious or unwanted effects.

The antidotes listed here are by no means all the chelating agents available in metal toxicology. We listed only those that have been approved by governmental agencies such as the FDA (Food and Drug Administration) of America, the German BfArM (Bundesinstitut für Arzneimittel und Medizinprodukte), or the Europäische Arzneimittel-Agentur (EMA). For a product to receive approval, the manufacturer or distributor has to prove the drug’s quality, its safety and effectiveness.

A drug becomes approved after the appropriate federal agency ensures that it is safe and effective. Such an agency does not test drugs, but requires documentation in the area of drug quality, safety and effectiveness. Any company applying for government approval must supply appropriate documentation. A drug may be approved for a limited time, after which a renewal process needs to be followed.

The antidotes listed here are useful in the treatment of a chronic metal overexposure.

History of approved chelating agents in metal toxicology

1935

EDTA was synthesized and patented by the German scientist F. Munz of the Hoechst Chemical Company in Germany.

1945

First synthesis and patent of EDTA in the USA.

1940