Respectful Insolence

Chelation therapy, in my somewhat Insolent opinion, is pure quackery. Unfortunately, it’s also one of the most common quackeries out there, used by a wide variety of practitioners for a wide variety of ailments blamed on “heavy metal toxicity.” Chelation therapy involves using chemicals that can bind to the metal ions and allow them to be excreted by the kidneys is standard therapy for certain types of acute heavy metal poisoning, such as iron overload due to transfusion, aluminum overload due to hemodialysis, copper toxicity due to Wilson’s disease, acute heavy metal toxicity, and a handful of other indications.

My personal interest in chelation therapy developed out of its use by quacks who blamed autism on the mercury-containing thimerosal preservative that used to be in many childhood vaccines until 2001 but has since all but disappeared from such vaccines except for one vaccine (the flu vaccine, for which a thimerosal-free alternative is available) and in trace amounts in some other vaccines. Mercury became a convenient bogeyman to add to the list of “toxins” antivaccinationists hype in vaccines. In fact, I’ve been writing about the pseudoscience behind the claim that mercury in vaccines is a cause of autism since nearly the very beginning of this blog, and I’ve periodically written about such things ever since, in particular the bad science of Mark and David Geier, whose idea that chemical castration of children with Lupron “works” against “mercury-induced” autism is based on a chemically ridiculous idea that somehow testosterone binds mercury and makes it harder to chelate. Unfortunately, this particular autism quackery has real consequences and has been responsible for the death of a child.

Chelation isn’t just for autism, though. It’s the quackery that quacks love for almost anything. Despite many practitioners advertising it for autism, cancer, Alzheimer’s disease (which Hugh Fudenberg has blamed on the flu vaccine, a claim parroted with Bill Maher, of course!), and just about every ailment under the sun, it’s easy to forget that the original use for chelation therapy promoted by “alternative medicine” practitioners was for cardiovascular disease. When it is used for coronary artery disease or autism, on a strictly stoichiometric and pharmacological basis, it is extremely implausible.Moreover, it is not without potential complications, including renal damage and cardiac arrhythmias due to sudden drops in calcium levels. Such arrhythmias can and have led to death in children, and in adults complications such as renal failure and death.

Despite this extreme implausibility, randomized controlled studies showing that chelation is no better than placebo for cardiovascular disease, a veritable cottage industry of chelation therapy for cardiovascular disease has sprung up, fueled by extravagant claims likening chelation to a “Roto-Rooter for your arteries” and an alternative to angioplasty and coronary artery bypass surgery and portraying the hostility of SBM to it as not based on medicine but rather on the “need” to protect the “billion dollar industry of angioplasty and CABG.” With most regimens costing $100 to $150 a treatment and “requiring” 30 to 40 doses, it’s a tidy little profit center for “alternative” physicians.

The belief that chelating toxic metals out of people can treat cardiovascular disease has no basis in physiology, biology, or pharmacology, but it’s a major treatment modality favored by naturopaths and many other “alternative” practitioners. Given the infiltration of quackademic medicine into medical academia, it should not be surprising that its advocates promoted clinical trials of this disproven modality. In the early 2000s, they succeeded in the form of the National Institutes of Health (NIH) Trial to Assess Chelation Therapy (TACT), a five year phase 3 trial begun in 2003 to test office-based, intravenous disodium ethylene-diamine-tetra-acetic acid (Na2EDTA) as a treatment for coronary artery disease (CAD). A while back, I learned that the results of this trial would finally be revealed on Sunday (i.e., yesterday) at the American Heart Association’s annual meeting in a session on late-breaking clinical trials in the form of two abstracts:

  • Results of the Trial to Assess Chelation Therapy
  • Quality of Life Outcomes in the Trial to Assess Chelation Therapy (TACT)

The story was embargoed until last night, but now the embargo is lifted and we can write about it freely, thanks to press releases and reported results of the trial. I expect that the results are—shall we say?—disappointing to chelationists. Certainly if this were a conventional medical therapy it would not be viewed as a particularly favorable trial. However, there are enough equivocal findings that the alt-med websites will soon be touting this study as ironclad evidence that chelation therapy works as well as bypass surgery. I guarantee it. In fact, I wouldn’t be surprised if such articles appear at the same time as this post. Chelationists have access to press information too and tend not to be as fastidious as us in honoring press embargoes.

The story of how this $30 million trial is long and depressing and was documented ably and in extreme detail in 2008 by my good bud Kimball Atwood, along with Wally Sampson, Elizabeth Woeckner and Robert Baratz, in an article for the Medscape Journal of Medicine entitled Why the NIH Trial to Assess Chelation Therapy (TACT) Should Be Abandoned. In it, Atwood et al documented the long and dubious history of TACT, how it came about through the political influence far more than scientific merit (of which it has virtually none), and how the investigators are utterly unqualified to carry out such a large multicenter trial, concluding that the TACT is “pointless, dangerous, unethical, and wasteful.” It’s worth reading the article in full detail, as well as other posts by Kimball Atwood, not to mention a post or two by yours truly. In addition, you should check out R. W. Donnell’s Magical Mystery Tour of NCCAM Chelation Study Sites, Part I, Part II, Part III, Part IV, Part V, Part VI, and Part VII. Seriously. As Dr. Donnell points out, only 12 of the 110 TACT study sites were academic medical centers. Many of the study sites were highly dubious clinics touting highly dubious therapies, including heavy metal analysis for chronic fatigue, intravenous infusions of vitamins and minerals (I could never figure out how infusing minerals could be reconciled with chelation therapy to remove minerals, but that’s just me), antiaging therapies, assessment of hormone status by saliva testing, and much more. Dr. Donnell also points out that the blinding of the study groups to local investigators was likely to have been faulty. So right off the bat, this study was dubious for so many reasons, not the least of which was that some of its site investigators were felons, a problem blithely dismissed by the NIH as being in essence irrelevant to whether the study could be done safely.

Efficacy? It’s a part of my science-based medicine fantasy.

Let’s take a look at the results of TACT, starting with the main outcome measures first, and then we’ll move on to the presentation describing quality of life (QOL) measures. The first presentation is by Gervasio Lamas, MD, a professor of clinical medicine at the Columbia University Division of Cardiology and now Chairman of Medicine at Mount Sinai Medical Center. and was entitled The Trial To Assess Chelation Therapy (TACT): Chelation-Placebo Comparison. One notes right away that the study was funded by the National Center for Complementary and Alternative Medicine (NCCAM, grant U01AT001156) and the National Heart, Lung and Blood Institute (NHLBI, U01HL092607). What’s interesting here is that the study was originally funded by NCCAM and then taken over by NHLBI later. NCCAM seems to be almost embarrassed by it, however. For example, the director of NCCAM, Dr. Josephine Briggs, has a tendency to be very quick to dismiss TACT as no longer within NCCAM’s purview. She is clearly embarrassed by our question and also dismissed it as having come into existence before she took over as director at NCCAM. The second thing I noticed was that this was funded under the NIH U01 mechanism. This mechanism is designed to fund multi-institution collaborations to “discrete, specified, circumscribed projects to be performed by investigator(s) in an area representing their specific interests and competencies.” In practice, what I gather from more senior investigators is that U01 grants are less like R01 grants and more like contracts (more specifically, they are cooperative agreements) to carry out specific projects. As such, they appear to be a bit more amenable to political pressures to be granted—or at least were.

The trial was a 2 x 2 factorial design that looked at:

  • Chelation plus high oral high dose vitamin and mineral supplement
  • Chelation placebo plus oral high dose vitamin and mineral supplement
  • Chelation plus oral high dose vitamin and mineral supplement placebo
  • Chelation placebo plus oral high dose vitamin and mineral supplement placebo

The regimen was also quite rigorous and is described in detail in a recent publication. One notes that the vitamin supplements included doses ranging from 25% to 6,667% of the RDA for these vitamins. For instance, the dose of vitamin C was 2,000% of the RDA; thiamin, 6,667%; and vitamin A, 500%. There were a total of 40 infusions that took three hours each. Thirty of these were administered weekly, followed by ten “maintenance” infusions administered two to eight weeks apart. Now let’s look at the nitty-gritty, followed by the results. First up, the inclusion criteria were:

  • Age 50 or older
  • MI > 6 months prior
  • Creatinine <2.0 mg/dL
  • No coronary or carotid revascularization within 6 months
  • No active heart failure or heart failure hospitalization within 6 months
  • Able to tolerate 500cc infusions weekly
  • No cigarette smoking within 3 months
  • Informed consent

The exclusion criteria were:

  • Chelation therapy within 5 years
  • Allergy to any study drug
  • Coronary or carotid revascularization within 6 months
  • Planned revascularization
  • Symptomatic or clinically evident heart failure
  • Heart failure hospitalization within 6 months
  • Blood pressure > 160/100
  • No venous access
  • Serum creatinine > 2.0 mg/dL
  • Platelet count <100000/mm3
  • Cigarette smoking within the last 3 months
  • Liver disease or ALT or AST >2.0 times the upper limit of normal
  • Diseases of copper, iron, or calcium metabolism
  • Inability to tolerate 500 mL of fluids weekly
  • Inability to keep to study schedules
  • Medical condition likely to affect patient survival within 4 years
  • Women of child-bearing potential

The placebo infusion consisted of 500 mL normal saline and 1.2% dextrose, while the chelation infusion consisted of:

  • disodium EDTA, 3 grams, adjusted downward based on eGFR,
  • ascorbic acid, 7 grams
  • magnesium chloride, 2 grams
  • potassium chloride, 2 mEq
  • sodium bicarbonate, 840 mg
  • pantothenic acid, thiamine, pyridoxine,
  • procaine, 100 mg
  • unfractionated heparin, 2500 U
  • sterile water to 500 mL

I find it very interesting that the investigators included procaine (a product of evil big pharma) in the chelation mixture. Yes, I know that disodium EDTA is also a product of the evil big pharma, but one can’t very well do chelation therapy without the chelating agent, can one? In any case, procaine is actually Novocaine and is a topical anesthetic. Its inclusion makes me wonder how much the chelation concoction being tested in TACT hurts as it is injected, as we usually don’t add local anesthetics to infusions unless the infusion causes significant pain at the injection site. Could this also contribute to the ability of patients to know if they’re getting the “real” drug (and, yes, disodium EDTA is a drug)? One wonders, one does.

One last piece needs to be put into place, and that’s to let you know the outcomes that were tested in TACT. The primary endpoint is a composite of death, myocardial infarction, stroke, coronary revascularization, and hospitalization for angina. In other words, investigators took all of these endpoints and added them together. The significance of this design will become clear in a moment, after I reveal the results. Another important point was that the original plan was to randomize 2,372 patients with a one year followup, a design that was estimated to have 85% power to detect a 25% difference. However, in 2009, due to low enrollment (more on that later), it was pointed out that “blinded investigators asked for a reduction of total sample size to 1,700, with a compensatory increase in follow-up to maintain same unconditional power.” I find it rather interesting that the word “blinded” is used, instead of just saying that the investigators asked for a decrease in number and a longer followup time in order to try to compensate for low accrual. The implication to me is that there were some investigators who were not blinded. Whether I’m reading too much into this or not, I don’t know, but it sounds odd. In any case, the request was approved.

So, on to the results. The result being touted by the investigators is described in the press release:

Heart attack patients given weekly infusions of chemicals used for chelation therapy had fewer cardiovascular events than those who received identical appearing placebo infusions, according to late-breaking clinical trial results presented at the American Heart Association’s Scientific Sessions 2012.

In the multicenter, double-blind efficacy trial, Trial to Assess Chelation Therapy (TACT),1,708 heart attack patients were randomized to receive 40 infusions of a 500 mL chelation solution or a placebo infusion, with a second randomization to an oral vitamin and mineral regimen or an oral placebo. The chelation solution contained three grams of the synthetic amino acid ethylene diamine tetra-acetic (EDTA), seven grams of vitamin C, B-vitamins, electrolytes, a local anesthetic and heparin, an anti-clotting drug. The placebo infusion was salt water and a small amount of sugar.

Researchers found that patients receiving the chelation solution had fewer serious cardiovascular events than the control group (26 percent vs. 30 percent). Cardiovascular events were defined as death, heart attack, stroke, coronary revascularization and hospitalization for angina.

Although participants with diabetes appeared to have a particular benefit from the infusions, the study team cautioned that subgroup analyses can be unreliable and need to be reproduced.

There’s the spin. Let’s look at the results. The primary endpoint (i.e., the aggregated serious cardiovascular events) did indeed show a modest difference, namely 30% of placebo subjects versus 26.5% of the EDTA chelation subjects (hazard ratio 0.82 for chelation). However, the result is just barely statistically significant, p = 0.035, with the 99% confidence interval for the hazard ratio ranging from 0.69 to 0.99. Note that the predetermined level for statistical significance for purposes of this study was 0.036. More importantly, if you look at the individual endpoints that make up that aggregate, there was no statistically significant difference in death, myocardial infarction, stroke, coronary revascularization, and hospitalization for angina. Subgroup analysis (always a questionable analysis that requires replication, even when preplanned, as in TACT) purported to show a much greater benefit for diabetics, with a hazard ratio of 0.61 (p=0.002), while patients without diabetes showed no statistically significant difference in any of the outcome measures, including the aggregated total bad outcomes (I like that term better).

There were some problems, as you might imagine. First off, only 65% of subjects finished all infusions, with only 76% finishing at least 30. That’s a high drop-out rate, and is likely largely due to just how grueling it is to have to undergo weekly three hour infusions for well over six months, followed by several more months of less frequent infusions. Moreover, 17% withdrew consent, resulting in missing data. I’m not sure how the investigators tried to correct for this (there are standard ways to do it), but these issues are serious. They might not be so serious if there had been a much more convincing treatment effect, but when you get equivocal results such as this such issues loom much larger. Indeed, critics have correctly pointed this out, as in this AP report:

Other experts questioned the results, especially because 60 more people in the group getting dummy infusions withdrew from the study than in the group getting chelation. Usually, more people in a treatment group drop out because of side effects, said Dr. Christie Ballantyne, a Baylor College of Medicine heart specialist. To find the opposite is “a red flag” that suggests those who got dummy treatments found that out and decided to drop out.

“There’s something funky going on here,” Ballantyne said. “It raises questions about study conduct,” especially since a difference of one or two people or complications could have nullified the small overall benefit researchers reported.

Dr. Clyde Yancy, a Northwestern University cardiologist and a former Heart Association president, agreed.

“It’s funny business,” he said. “I’ve never seen a study in which one in five people withdrew consent.”

Funny business is an understatement. A complete, unabashed fiasco would be a better description. Or maybe a total and complete waste of taxpayer money. Or perhaps an unethical sham of a trial, perhaps? Whatever you want to call TACT, this concern is quite consistent with worries expressed over six years ago by Dr. R. W. Donnell about the adequacy of the blinding of the trial. In light of such concerns, the differential drop-out rate between the two groups makes a lot more sense. Too bad that Dr. Lamias apparently didn’t see fit to include the relevant information in his press release or in his slide set.

Finally, no study would be complete without a consideration of adverse events. After all, in determining whether a therapy is worth pursuing, it is important to weigh its efficaciousness versus its safety. Overall, 79 adverse events were observed forcing discontinuation of infusions. Reasons included: reaching an endpoint; heart failure; other cardiac issues; GI problems; hematological problems; and a variety of other problems. Unfortunately, the presentation slides did not break down how many of these 79 adverse events occurred for patients in the treatment group versus patients from the placebo groups. In fact, given that there were four groups, these adverse events needed to be broken down into four groups but were not. There were a total of four unexpected severe adverse events possibly or definitely related to study therapy, two in the placebo group with one death and two in the treatment group, with one death. Kimball Atwood discussed some of the serious adverse events before in detail. It’s not entirely clear that these deaths didn’t have a lot to do with the incompetence of some of the investigators at the local sites where these patients were treated.

I will be awaiting the full publication, in which (hopefully) more will be revealed about these two deaths. In the meantime, it is clear to me that, even if these results are valid and there is a small benefit to chelation therapy, it’s a long run for a risky short slide.

Quality of life? We don’t need no steekin’ quality of life?

Still, even though the results are so unconvincing that the study investigators concluded that TACT “does not constitute evidence to recommend the clinical application of chelation therapy” and that (of course!) “additional research will be needed to confirm or refute our results and explore possible mechanisms of therapy” while also saying TACT showed “some evidence of a potentially important treatment signal in post-MI patients already on evidence-based therapy,” maybe the therapy does something for quality of life. It’s possible, albeit highly implausible. So in parallel, QOL outcomes were measured and presented as a second abstract at AHA presented by Daniel B. Mark, MD, MPH.

Several QOL tools were administered to participants in TACT. These included:

  • DASI: A cardiac-related functional status tool that ranges from 0-58 and reflects the ability of patients to do physical activities without difficulty or assistance in 12 domains
  • MHI-5: A tool that measures psychological well-being, including both
  • depression and anxiety. Investigators normalized scores to 50±10, with clinically significant difference being >2.5 points.
  • Other measures: SAQ (frequency, stability, QOL), SF-36, EQ-5D

In brief, 911 (53%) of the 1,708 main TACT subjects were randomly selected for the QOL substudy, with structured interviews at baseline, 6 months, 12 months, and 24 months. Let me tell you, though, that this study will be much easier to discuss than the main TACT trial for one very simple reason. There were no statistically significant differences in QOL outcomes measured for any of the assessment tools used at any of the time points examined.

So what do you do when your study is completely negative? Easy! You do subgroup analysis, and that’s what Mark et al did. Well, actually, these subgroup analyses were prespecified; so it’s basically legitimate. Even so, they couldn’t find much. All they could find is that patients with angina symptoms at baseline showed a modest treatment effect in favor of chelation therapy at one year, but at none of the other time points. A good rule of thumb is that for repeated measures, seeing an effect at only one time point is strongly suggestive that the difference for that time point is spurious and not real; so there isn’t much to say about this other than that this was about as close to a completely negative study as one might imagine, and even the press release had to acknowledge that:

“We didn’t see any effect on the quality of life of chelation therapy patients,” said Daniel B. Mark, M.D., M.P.H., lead author of the sub-study and professor of medicine, director of outcomes research at Duke University Medical Center and Duke Clinical Research Institute in Durham, N.C. “Patients weren’t any worse, but they weren’t any better.

One of the tools used to measure quality of life was the Duke Activity Status Index, DASI, to measure patients’ ability to complete daily tasks. The lowest score of 0 means the patient couldn’t do any chores associated with their own care such as feeding, toileting and dressing themselves. The highest score of 48 would be achieved by a professional athlete, Mark said.

At the beginning of the study, patients taking chelation therapy had a score of 24.6 and after two years it went up to 27.1. Those on placebo, dummy infusions that contained no medicine, had a baseline score of 23.5 that went up to 25.1. The small difference between chelation and placebo wasn’t significant enough to show a notable impact on how patients functioned in their daily lives.

The results were similar when researchers used the SF-36, the Short Form Health Survey, which assesses mental wellbeing or stress. After two years of chelation or placebo, patients reported similar scores.

“We thought it might make people feel better, but we didn’t see that consistently enough,” Mark said.

No, Dr. Mark didn’t see it at all, just as the trial investigators apparently didn’t see Edzard Ernst’s criticisms of their trial design when they cited his review article as a source. As Dr. Ernst put it:

The TACT has been criticized as being “unethical, dangerous, pointless and wasteful.” Yet, Lamas et al inform us that it went ahead with “reduced sample size” and that “TACT has finished enrolment.” From my perspective, the most puzzling part of the article of Lamas et al is the following sentence: “EDTA chelation of divalent and trivalent ions has been postulated to produce a favorable effect on atherosclerotic plaque, questionably leading to improvement in endothelial function, reductions in symptoms, and major vascular events.” To support this statement, Lamas et al cite my review that shows an “almost total lack of convincing evidence” and concludes that “given the potential of chelation therapy to cause severe adverse effects, this treatment should now be considered obsolete.”

Ernst was correct, and the now-revealed results of TACT only serve to confirm that.

The bottom line

When we criticize NCCAM and the infiltration of quackademic medicine into medical academia, we often point to the many pernicious effects that “integrating” pseudoscience with science- and evidence-based medicine has. One of these is the drive to test highly implausible therapies without adequate preclinical evidence, a practice at odds with the Helsinki Declaration’s requirement that clinical trials be based on firm basic science in preclinical models. This is problematic enough from an ethical standpoint when the treatment being tested is water (i.e., homeopathy), but when it’s an active treatment with real risks, it is completely unethical. That’s why I have said on multiple occasions that TACT is completely unethical. Worse, TACT was not funded based on a clinical need, scientific or clinical promise, or scientific merit due to its potential to reveal an important previously unsuspected mechanism of disease or target for treatment. Rather, it came into existence because a pro-quackery legislator, Rep. Dan Burton (R-IN) strong-armed the then-director of NCCAM to green light it. Later, it became such an albatross about NCCAM’s neck that NCCAM ceded control to NHBLI and downgraded its involvement to an advisory capacity. Indeed, Dr. Lamas himself seems to indicate that even he didn’t expect any positive results from TACT, although I suppose it’s possible that he means it was unexpected that this trial was, in essence, a negative trial:

“We have to look carefully at these unexpected results,” said Gervasio A. (Tony) Lamas, M.D., lead author of the study and chief of Columbia University Division of Cardiology at Mount Sinai Medical Center in Miami Beach, Fla. “Although not approved by the Food and Drug Administration for treating heart disease, chelation therapy has been used for over 50 years and has generally been believed by conventional medical practitioners and cardiologists to be without value. A definitive answer on chelation therapy will take much additional research. The most exciting part of this study is that there may be an unexpected signal of benefit. We need to understand whether the signal is true, or whether it occurred by chance.”

No, the “signal” only comes from having aggregated a bunch of outcomes into one large outcome, and even then this signal, in a study of over 1,700 patients, strained to reach statistical significance. On each and every individual outcome, the “signal” doesn’t exist!

Let’s step back a moment an look at this. In the case of TACT, the result of the “integration” of quackery with scientific medicine has been to spend $30 million on a trial conducted at highly dubious CAM and “integrative” medicine clinics whose practitioners were completely unqualified to carry it out. This expenditure of scarce research dollars has resulted in a primary finding that is at best equivocal and at worst completely negative, and a secondary finding that is completely negative. Even if this study’s results are taken at face value, we can say that chelation therapy for coronary artery disease does not increase survival, obviate the need for angioplasty or CABG surgery (a prime claim frequently made by chelationists), or even decrease the severity of patients’ angina symptoms or increase their tolerance for physical activity. It is worthless. Actually, it’s worse than worthless, because it’s expensive, arduous, and, even if we took TACT’s reported results at face value, promises minimal benefit.

I am not condemning this trial because it was negative. Sometimes—often, in fact—clinical trials fail to find a benefit from the experimental treatment. There’s nothing wrong with that. However, such clinical trials are based on a sound preclinical evidence base of basic science and animal experimentation that indicates scientific plausibility and a reasonable likelihood that the treatment would be efficacious in humans. TACT had none of these things. Indeed, there was an existing preclinical and clinical evidence base that gave every indication that chelation therapy shouldn’t work.

The acceptance of chelation among CAM practitioners is also as good an exapmle of the CAM double standard as I’ve ever seen. Imagine, if you will, if big pharma produced a treatment like chelation therapy that had no good preclinical evidence suggesting its efficacy and several existing clinical trials suggesting that it does no better than placebo for cardiovascular disease. Imagine that big pharma tried to get FDA approval to market its chelation therapy for cardiovascular disease. Imagine how CAM practitioners would react. Now look for how they react to this trial. I can predict it. (Not that it’s hard or anything.) They’ll make excuses. They’ll cherry pick the one seemingly promising result. They’ll claim that there was something wrong with the protocol or that the wrong chelating agent was used. They’ll demand more studies. In other words, they won’t simply admit that their therapy doesn’t work and move on.

In fact, I’m already thinking of things that quacks will say about this trial to try to excuse its failure and justify continuing to use chelation. One of them has already been used. In fact, it’s right there in the AP story:

The study’s leader, Dr. Gervasio Lamas of Mount Sinai Medical Center in Miami, said: “The trial needs to be taken for what it is — a step towards future investigation.”

Yes, it’s the “more study is needed” gambit. In these cases, unfortunately, the problem is that more study is always needed, regardless of how negative the study.

Comments

  1. #1 T.
    November 5, 2012

    What a waste of money =/

    Do the US have so many millions to throw away?

  2. #2 Lawrence
    November 5, 2012

    Regardless of who wins tomorrow, I’m going to start writing my Congresswoman to see if NCCAM can be put on the radar for Sequestration…..or better yet, the general budget axe.

  3. #3 qetzal
    November 5, 2012

    Why is there also heparin in the ‘chelation’ product? Wouldn’t that be a huge potential confounder?

    That’s another thing I hate about CAM. They just throw ingredients into their potions based on whatever seems like it might be good. What the hell was the justification for EDTA plus ascorbate, plus those salts, plus vitamins, plus procain, plus heparin?! And then a high-dose vitamin and mineral supplement on top of that? WTF?

    (I guess I could understand supplementing with Mg, in case too much is removed due to chelation by EDTA. But then why no Ca? Maybe that’s in the supplement, but then it would have gone to only half the subjects in chelation.)

  4. #4 bvg
    Mumbai, India
    November 5, 2012

    I am not a doctor but a B. Tech. and M. Tech. degree holder from world famous Indian Institute of Technology, Bombay. Seven years ago I suffered fatal heart attack but was successfully resuscitated. Later I was told to undergo triple vessel bypass but instead I underwent chelation therapy.
    After finding great benefit from it to me and many others I tried to know more about the therapy. Doctors did not tell me anything. I searched and researched. Learned most of the techniques, taught the therapy in all its details to doctors who later practiced it and found great benefit to treated patients.

    The mentality of many anti chelation doctors has been described in my book, “Angioplasty, Bypass Surgery Myths and Chelation Therapy Facts”

    The book describes the real nature and peril of the conventional methods.

    It also give rebuttal of all the anti chelation arguments made by many conventional medical practitioners.

    This book has been recommended by International Board for Clinical Metal Toxicology”

  5. #5 Eric Lund
    November 5, 2012

    The more money involved, the greater the potential for political pressure. Tens of millions of dollars is enough to get a Congresscritter to take notice, and I haven’t seen any evidence that Congresscritters are better informed about science-based vs. alternative medicine than the general public. It doesn’t have to get to Congress, either: a highly motivated bureaucrat could probably swing it, if everybody else in the paper trail were at best indifferent.

    That the head of NCCAM wants to wash her hands of this study says quite a bit: this trial is too absurd for somebody whose job it is to promote alternative medicine.

  6. #6 Eric Lund
    November 5, 2012

    After my earlier post, I went back and read Orac’s link about felons being involved, to find that Dan Burton (no less) was instrumental in getting funding for this study. So without the political pressure, this study would never have gotten off the ground.

  7. #7 Mark
    November 5, 2012

    2500 units of heparin? Really? How is this ok? How can you say the control for the chelation, which lacked heparin, is an adequate control? And who approved randomly loading people with heparin once a week? That’s not safe. I’m shocked they didn’t have more adverse outcomes.

    Whoever designed this trial should be drummed out of academia. Sorry but in science you should be testing a variable at a time, not 7. And shoving a grab bag of drugs into one mixture, and comparing it to saline is just shoddy, stupid science.

  8. #8 JohnV
    at my lab bench, not working
    November 5, 2012

    “Although participants with diabetes appeared to have a particular benefit from the infusions, the study team cautioned that subgroup analyses can be unreliable and need to be reproduced.”

    I’m not a physiologist so I have a question regarding people with diabetes and this study.

    The placebo infusion (500 ml) contained 1.2% glucose, isn’t that going to cause issues with a person’s diabetes?

    Since its not in the experimental infusion, would that not make it difficult for proper blinding?

  9. #9 Mu
    November 5, 2012

    I see one positive outcome, and that is that this specific protocol is not going to kill you. As potentially dangerous as EDTA is, that’s a good thing. Doesn’t do anything for you, but at least you’re not going to die from it. So that might not be true if compared vs. aggressive SBM treatment.

  10. #10 Denice Walter
    November 5, 2012

    A few notes about chelation:

    amongst those I survey, chelation is often recommended for other illnesses and conditions- for ASDs, cancer, hiv/aids, MS, Alzheimer’s, SMI… They find a way to justify the procedure which is arduous, expensive and possibly dangerous: it supposedly removes toxins, plaque and whatever else is detrimental to health ( as well as substances that AREN’T detrimental to health but are necessary- which they don’t talk about too much).

    So-called professionals who work in synch with woo-meisters ( see Metropolitan Wellness, for some examples) offer chelation as well as IV vitamins and nutritional counselling.

    Our old friend, Gary Null, elaborates upon this theme: not only is standard chelation efficacious but it may be supplemented or entirely replaced by eating/ drinking a particular type of diet and following a high dosage supplement regime.

    Green juices are advocated as ‘natural chelators’- a patient should ingest several concoctions daily that each include dark green vegetables, sea vegetables and algae-based products; these drinks are supplemented with added dried green vegetable powders/ and dried red/ purple fruit powders ( available at the website’s store) as well as a long list of supplements in capsule form ( available at the website’s store). These regimes are discussed in detail in video and book form ( also available).

    If you don’t relish undergoing a series of infusions, you can buy the products plus a juicer ( available as well) and chelate yourself without having to sit through hours and hours at an altie facility which you have to pay for.

    Chelation is also sold as a prevention measure: if you suspect that your life of wanton consumption has already done damage to that temple, your body, you can start cleaning house immediately. Prior to discussing these methods, the woo-in-charge usually instructs his audience about the gradual and subtle changes that occur in the CV system, internal organs and brain that will eventually reach a “tipping point” ( his words, not mine), i.e. a stroke, MI or cancer.

    -btw- ‘wanton consumption’ includes eating any type of meat or dairy products, non-organic fruits and vegetables, saturated fat, most cooking oils, food cooked over high heat or grilled, any food additives, any products with sugar, any alcohol whatsoever, wheat, GMO products, fluoridated/ chloridated water, pharmaceuticals etc, etc, etc.

    I am not making this up.

  11. #11 AdamG
    November 5, 2012

    Shorter bvg:

    “You’re all wrong, but I won’t tell you why…read my book to find out!”

    Nice try, but that won’t fly here. If you have a rebuttal to any specific claims made in the post above, feel free to share them.

  12. #12 Science Mom
    http://justthevax.blogspot.com/
    November 5, 2012

    After finding great benefit from it to me and many others I tried to know more about the therapy. Doctors did not tell me anything. I searched and researched. Learned most of the techniques, taught the therapy in all its details to doctors who later practiced it and found great benefit to treated patients.

    So? Anecdotes aren’t evidence; you didn’t conduct a proper study and you aren’t even a qualified toxicologist.

    The mentality of many anti chelation doctors has been described in my book, “Angioplasty, Bypass Surgery Myths and Chelation Therapy Facts”

    The book describes the real nature and peril of the conventional methods.

    I think you’ll find that pimping some shoddy book is going to be met with derision and scorn, particularly in light that this is a post discussing an actual study that failed to demonstrate any benefits for chelation and prevention of heart disease or improvement of survival rates.

    It also give rebuttal of all the anti chelation arguments made by many conventional medical practitioners.

    This book has been recommended by International Board for Clinical Metal Toxicology”

    Whoop-de-freakin-doo; from all appearances, IBCMT isn’t a recognised board certifying organisation and is a scam. They are also in denial about the efficacy of chelation therapy for alternative uses.

  13. #13 Militant Agnostic
    25 km west of a source of durian ice cream
    November 5, 2012

    @Denice Walter

    amongst those I survey, chelation is often recommended for other illnesses and conditions

    That chelation equipment is expensive – a capital asset like that has got to be put to work to pay for itself.

  14. #14 Denice Walter
    November 5, 2012

    @ Militant Agnostic:

    Actual equipment for chelation / IVs costs money unlike some of their other recommendations: hand-waving, medical hypnosis, NLP, EFT, flower essences, homeopathy, chakra balancing, meditation- which just involve verbalising and hand motions and take up very little shelf space.

    -btw- Can you smell the durian from 25 km away?
    I have been within 5-6 feet of them – but they were- fortunately- intact and I couldn’t smell anything. And I am rather good at sniffing out things.

  15. #15 JGC
    November 5, 2012

    Mr. Gokhale, despite Moneylife Foundation’s website describing you as an ‘expert on chelation therapy’ I can find no articles you’ve authored regarding chelation therapy published in any peer-reviewed journal. The minimal details given regarding your academic training (B Tech and M Tech degrees from IIT Mumbai) doesn’t support such a claim to expertise.

    Do you consider yourself an expert on chelation therapy, and if so on what basis? (Hopefully something other than having undergone chelation yourself, and time spent at Google U).

    Or is the Moneylife Foundation completely misrepresenting your qualifications?

  16. #16 lilady
    November 5, 2012

    @ bvg (BV Gokhale)

    Your *recommendation* for that book has been duly noted here…

    http://www.moneylife.in/article/angioplasty-bypass-surgery-myths-and-chelation-therapy-facts/22142.html

    “B V Gokhale 11 months ago

    To All,

    Please note that I am not a doctor.

    I have deeply studied alternative medicine. Since I find alternative medical treatments are very effective, safe and relatively inexpensive I take pleasure in promoting them.
    I do not expect any monitory gains through my efforts.”

    Yeah, we kinda figured that you are not a doctor.

  17. #17 lilady
    November 5, 2012

    Here’s another article about chelation and indications for its use for actual metal toxicities…

    http://www.poison.org/current/chelation%20therapy.htm

    “In 2007, the National Center for Health Statistics reported that 111,000 adults said they used chelation therapy, along with 72,000 children under the age of 18. [7] It is highly unlikely that 183,000 US residents required chelation therapy for the limited number of approved indications. It is much more likely that therapies were received for conditions attributed to heavy metals without scientific validation…..”

    “…..Chelation “therapy”: unapproved uses of chelation
    As noted above, chelation therapy is approved for a limited number of indications involving documented poisoning by heavy metals; it is carried out under medical supervision with prescription drugs. However, entering “chelation therapy” into an internet search engine yields more than 500,000 hits. Alongside entries relating to lead and iron poisoning are entries referring to “veggie caps”, chelation “without chemicals”, “dissolve artery blockages”, “chelation suppositories”, and “undesirable ionic material”, plus many ads for over-the-counter chelating substances. There is at least one entry offering chelation therapy while traveling overseas; this destination also offers cosmetic surgery.

    Chelation “therapy” is offered for a number of conditions: arteriosclerosis, angina, poor circulation to the legs and feet, autism, Parkinson’s disease, Alzheimer’s disease, cancer, diabetes, and many other conditions. Even when it is implausible or impossible for chelation to be effective, it has been made to sound rational to people unfamiliar with the causes of these conditions.

    To “diagnose” heavy metal poisoning as a cause of these conditions, and therefore appropriate for chelation therapy, practitioners will often administer a test or challenge dose of a chelator. In a day or two, a urine test is done to measure metals. Since some metals are found in all humans, these tests are always “positive”, though they are not measured against established or medically accepted standards. These results are then used to market chelation therapy to the individuals. The American College of Medical Toxicology warns that basing chelation therapy on these types of tests is without benefit to patients and may prove harmful. [15]“

  18. #18 AdamG
    November 5, 2012

    Mr Gokhale says that chelox therapy is an excellent method of detoxifying the human body. It can provide relief to non-diabetics too. Ailments treated by chelox therapy with at least partial success are: coronary artery disease, valvular disease, cardio-myopathy, migraine, hormonal imbalance, macular degeneration, rheumatoid arthritis, schizophrenia, fibromyalgia, Raynaud’s Disease, Scleroderma, multiple sclerosis, Lou Gehrig’s Disease, Alzheimer’s Disease and Parkinson’s Disease.

    Utter fraud. Maybe he defines “partial success” as “patient survived the ‘treatment’”

  19. #19 Militant Agnostic
    Upwind
    November 5, 2012

    @DW

    Can you smell the durian from 25 km away?

    I am upwind (prevailing) with a sour gas plant and a few herds of cattle and bison between me and the business (McKay’s Ice Cream) in question. For obvious reasons, the durian is not sold in cones – it is available only on a take out basis.

  20. #20 Autismum
    http://autismum.com/
    November 5, 2012

    Anyone else notice that when Mr Gokhale shows up on certain pages (generally ones with favourable reviews of his fantastical book) so does Sohan Modak? Strangely though, many of the latter’s comments seem to go missing and Mr B seems to be responding to questions that aren’t there. Funny that.

  21. #21 lilady
    November 5, 2012

    Forbes has posted an article about the TACT study…skewing the results as favorable.

    The first three comments are *very positive* about the study results. The fourth and last comment *isn’t* and the commenter links to Orac’s RI blog. :-)

    http://www.forbes.com/sites/larryhusten/2012/11/04/nih-trial-gives-surprising-boost-to-chelation-therapy/

  22. #22 Narad
    November 5, 2012

    The first three comments are *very positive* about the study results.

    Dooley indeed pops up in this 1999 item about the Florida chelation racket. In the context, one might wonder whether the change of direction from emergency medicine had something to do with his own disciplinary case.

  23. #23 Melissa G
    November 5, 2012

    My father had chelation therapy for his heart problems, back in the 1990s, I think it was. It cost his wife a lot of money, and in all likelihood it did him no good. I’m sure it was a great placebo. :P

    I didn’t know enough about the issue to recognize it as quackery. The brochure for the procedure sure sounded sciencey, though, and it fooled us enough not to try to talk him out of it. Sad waste of money on an unnecessary invasive procedure.

  24. #24 lilady
    November 5, 2012

    @ Narad: Dr. Bruce Dooley was the subject of disciplinary action, but I cannot locate the case or the final order. See if you can locate them:

    http://doh.state.fl.us/mqa/enforcement/discipline_reports/FO_07-19-01.pdf

  25. #25 Denice Walter
    November 5, 2012

    @ Melissa G:

    I sometimes wonder if placebos that cost** a great deal and/ or involve some hardship make the mar… excuse me, *patient* feel more comfodent of their efficacy because he or she has so much time, money and effort invested.
    This would predict that time-consuming, expensive diets/supplemental regimes should be valued more.

    ** I think that there’s some data on cost.

  26. #26 Militant Agnostic
    November 5, 2012

    @DW

    I sometimes wonder if placebos that cost** a great deal and/ or involve some hardship make the mar… excuse me, *patient* feel more comfodent of their efficacy because he or she has so much time, money and effort invested.

    It works for wine (at least the cost aspect).

  27. #27 Narad
    November 5, 2012

    See if you can locate them

    It’s not on-line, but you can write away for it if you’re really interested. This is a good one:

    “I’m not going to shut up!” yelled Dr. Bruce R. Dooley, a Naples physician who is president of the pro-chelation Alliance for Medical Freedom. “This is a kangaroo court!”

    Dooley left the meeting after board members called for a security guard, but he soon returned carrying a large, stuffed kangaroo.

  28. #28 Narad
    November 5, 2012

    It works for wine (at least the cost aspect).

    And is a pillar of the audiophile market.

  29. #29 anatman
    November 5, 2012

    question: how does the concoction tested compare to an actual chelation regime prescribed by actual doctors for actual metal toxicity?

  30. #30 AdamG
    November 5, 2012

    This Dooley individual seems like quite the character…his response to your comment, lilady, seems to be ‘the trial is correct because it was very sophisticated and Forbes said so’ as well as ‘orac is biased so I didn’t bother to read the post.’
    FAIL.

  31. #31 Eric Lund
    November 5, 2012

    I sometimes wonder if placebos that cost** a great deal and/ or involve some hardship make the mar… excuse me, *patient* feel more comfodent of their efficacy because he or she has so much time, money and effort invested.

    There is actual published evidence that this is the case:

    “Commercial Features of Placebo and Therapeutic Efficacy,” Rebecca L. Waber; Baba Shiv; Ziv Carmon; Dan Ariely, Journal of the American Medical Association, March 5, 2008; 299: 1016-1017.

    Waber et al. won the 2008 Ig Nobel Prize for Medicine for that study.

  32. #32 Denice Walter
    November 5, 2012

    @ Militant Agnostic:
    @ Narad:

    Not to mention apparel and accessories..

  33. #33 Narad
    November 5, 2012

    This Dooley individual seems like quite the character

    What really stood out for me was the line “In my opinion a legal challenge should immediately be lodged to force a retraction of this policy statement on three. (3) grounds at least.” The doubling down on the number is some serious pretend-lawyering.

  34. #34 Melissa G
    November 5, 2012

    Denise– I think there’s been some research suggesting that is the case!

  35. #35 lilady
    November 5, 2012

    @ Narad: Dooley posted back at me…I just re-posted back at him with other opinions from other cardiologists about the validity of the study…

    http://www.forbes.com/sites/larryhusten/2012/11/04/nih-trial-gives-surprising-boost-to-chelation-therapy/

    No way, no how, is a legal challenge EVER going to get insurance companies to pay for chelation for cardiac diseases…no less for “anti-aging” chelation therapy that Dooley offers to his patients.

  36. #36 Krebiozen
    November 5, 2012

    Weekly 3 hour infusions for such a small and clinically insignificant decrease in risk seems like a pretty poor deal to me, even if it wasn’t artefactual, which seems likely. I suspect walking for 3 hours a week would be much more beneficial, cheaper and more fun, depending on where you live, I suppose.

    I find it interesting that the chelation brew included procaine, as procaine was once hailed as a miracle drug in its own right, at a similar dose (100mg). It isn’t, I hasten to add, though it may have a mild antidepressant effect (PMID 12204).

  37. #37 herr doktor bimler
    November 5, 2012

    This book has been recommended by International Board for Clinical Metal Toxicology”

    A group of quacks — set up to promote chelation therapy for everything and to sell certificates qualifying one to administer chelation therapy* — are recommending a book all about the wonders of chelation therapy? No-one saw that coming.

    * The IBCMT is the source of Dr Dooley’s qualification for chelation.

  38. #38 Narad
    November 5, 2012

    No way, no how, is a legal challenge EVER going to get insurance companies to pay for chelation for cardiac diseases…

    Check out the “nanobacteria” guy who chimed in.

  39. #39 evilDoug
    altogether too close to durian icecream works (and downwind)
    November 5, 2012

    Anatman, I wondered the same thing. Here is one short doc I found on treating lead poisoning in kids (was, and may still be, a problem in areas, like NYC, with lots older houses with layer upon layer of lead-based paint):
    http://www.nyc.gov/html/doh/downloads/pdf/lead/lead-chelation.pdf

    in short – for CaNa2EDTA, 1 gram per day for 5 days

    Incidentally, ferric ammonium EDTA is the main component in “bleach” for color photographic processing – dissolves out the metallic silver after the color is developed.

  40. #40 Narad
    November 5, 2012

    Ah, yes, Gary Steven Mezo (who apparently has a habit of appending numbers and a plus sign to his name) has a Florida DUI record. Everything that rises must converge.

  41. #41 lilady
    November 5, 2012

    Another Forbes blogger has posted about this study….he’s quoting the same cardiologists (Dr. Steven Nissen-Cleveland Clinic, author of “Heart 411″), that I quoted…

    http://www.forbes.com/sites/matthewherper/2012/11/04/civil-war-a-study-says-chelation-might-help-heart-patients-but-doctors-dont-believe-it/

    I’ve also added my two cents on Herper’s blog and linked to Orac’s blog. :-)

  42. #42 Narad
    November 5, 2012

    I had totally missed out on “Nanobacterium sanguineum.” This pathogen from outer space apparently lacks DNA but is totes susceptible to tetracycline.

  43. #43 evilDoug
    November 5, 2012

    Perhaps it was done in the study, and Orac just hasn’t mentioned it, but it would seem to me that rigorous blood and urine chemical analysis would accompany a study of chelation. If I were trying to “improve” something by removing something, I would want to try to identify what I was removing that made the improvement. If isn’t as if anything actually chelated simply disappears or is transmogrified into water or something undetectable – it’s gotta go somewhere, and it’s gonna go when the patient has gotta go. Of course, this puts an even heavier burden on the test subjects – being bled at intervals for (I’m guessing) a day or two before AND after each infusion of soup. And lots of peeing in a cup.

    I remember years ago seeing something on TV about chelation for cardiovascular treatment, with some character holding up a vial of a very small amount of some dry material that had be obtained by evaporating his urine after a chelation treatment, and proclaiming how the treatment got that goop out of him. He seemed to have the notion that “regular” pee is just colored water, devoid of solutes.

  44. #44 Science Mom
    http://justthevax.blogspot.com/
    November 5, 2012

    Perhaps it was done in the study, and Orac just hasn’t mentioned it, but it would seem to me that rigorous blood and urine chemical analysis would accompany a study of chelation.

    That’s a very good point evilDoug and a very valid measurement given the hypothesis. I was just going to chime in to ask if blood-essential mineral levels were monitored as chelation isn’t all that specific about what is scavenged.

  45. #45 Kansas Practicioner
    November 5, 2012

    Chelation can be dangerous, but people have the freedom TO CHOOSE their own healthcare options. Chelation works to clean artieries out. The problem is sometimes it can cause plaque to break off and go to the heart and cause a heart attack. It does work though. Chelation can clean out artteries for a few hundred dollars or less rather than a more dangerous and more expensive open heart surgery.

    Of course Vitamin K2 does the same thing but at a slower pace. A combination of Vitamin D and K2 can over time clean out plaque from the arteries and is not as dangerous as helation or as expensive.

    K2 does even better. It removes the calcium buildup from the arteries and organs and moves it back into bone where it is supposed to be. It is also great in prevention of kidney stones by helping prevent calcium buildup in the kidneys.

    It is amazing how many people advocate healthcare “choice” of women when it comes to abortion but want swat teams to raid vitamin stores. It is rather silly that we have so many anti vitamin people in the world.

    Of course you can overdose on Iron and other vitamins as well as herbs, but overall more people have been harmed by prescription meds far more often than vitamins. If you watch tv all you see is lawyers trying to get money out of drug manufacturers becuase of damages or death cuased by said drugs. You never see lawsuits over damages by vitamins or herbs. That is saying alot right there.

  46. #46 Kansas Practitioner
    November 6, 2012

    Chelation can be dangerous, but people have the freedom TO CHOOSE their own healthcare options. Chelation works to clean artieries out. The problem is sometimes it can cause plaque to break off and go to the heart and cause a heart attack. It does work though. Chelation can clean out artteries for a few hundred dollars or less rather than a more dangerous and more expensive open heart surgery.

    Of course Vitamin K2 does the same thing but at a slower pace. A combination of Vitamin D and K2 can over time clean out plaque from the arteries and is not as dangerous as helation or as expensive.

    K2 does even better. It removes the calcium buildup from the arteries and organs and moves it back into bone where it is supposed to be. It is also great in prevention of kidney stones by helping prevent calcium buildup in the kidneys.

    It is amazing how many people advocate healthcare “choice” of women when it comes to abortion but want swat teams to raid vitamin stores. It is rather silly that we have so many anti vitamin people in the world.

    Of course you can overdose on Iron and other vitamins as well as herbs, but overall more people have been harmed by prescription meds far more often than vitamins. If you watch tv all you see is lawyers trying to get money out of drug manufacturers becuase of damages or death cuased by said drugs. You never see lawsuits over damages by vitamins or herbs. That is saying alot right there.

  47. #47 Narad
    November 6, 2012

    I see that the CNN item on TACT once again includes a chelation cheerleader, Kirti (Manelekas P.) Kalidas, from Florida. This is a digression, but for many years, Boca Raton was the spam center of the U.S. This devolves largely to Florida’s protection of real estate in the case of adverse legal judgments.

  48. #48 Narad
    November 6, 2012

    Link fixed, I hope.

  49. #49 Pareidolius
    November 6, 2012

    Did you see the testimonial on the NanobacTX site from Richard F. (minister, attorney & congressman)? I said that they clearly forgot to mention that he also saved nuns and kittens from a burning building while he was in astronaut training. Assholes.

  50. #50 Narad
    November 6, 2012

    The “serology” for Maniscalo & Taylor was performed by… Nanobac.

  51. #51 lilady
    November 6, 2012

    @ Narad: Buying a home in Florida does have its advantages…it worked for OJ Simpson, until he got himself into trouble, again:

    http://www.inquisitr.com/182096/oj-simpsons-florida-home-being-taken-away/

    Pareidolius, I can’t post that comment back at the Nanobac TX guy. :-)

  52. #52 David N. Brown
    November 6, 2012

    As I think I’ve mentioned here at RI before, the claim that chelation therapy can treat blood clots is one (probably the ONLY one) that makes sense. That’s because certain chelators are known to have the side effect of acting as an anticoagulant. Thus, the one plausible claim the chelationists have enjoys that distinction because of something completely unrelated to the heavy metal toxicity that chelators are supposed to cure. Of course, it seems unlikely that the chelators are particularly GOOD anticoagulants.

    David N. Brown
    Mesa, Arizona

  53. #53 Krebiozen
    November 6, 2012

    Kansas Practitioner,

    Chelation works to clean artieries out.

    No it doesn’t. Did you even read the article above?

    Of course Vitamin K2 does the same thing but at a slower pace. A combination of Vitamin D and K2 can over time clean out plaque from the arteries and is not as dangerous as helation or as expensive.

    Of course? Do you have any evidence that this is true? Or have you simply swallowed a lot of fantasies promoted by chelation therapists and supplement sellers? There is some evidence that vitamin K supplementation may slow coronary artery calcification but none that it will reverse it.

  54. #54 Orac
    November 6, 2012

    2500 units of heparin? Really? How is this ok? How can you say the control for the chelation, which lacked heparin, is an adequate control? And who approved randomly loading people with heparin once a week? That’s not safe. I’m shocked they didn’t have more adverse outcomes.

    From Kimball Atwood elsewhere:

    Here are explanations for the presence of heparin and procaine, quoted from Rozema, TC, “The Protocol for the Safe and Effective Administration of EDTA and Other Chelating Agents for Vascular Disease, Degenerative Disease, and Metal Toxicity.” (Journal of Advancement in Medicine Volume 10, Number 1, Spring 1997)

    4. Thrombophlebitis
    Local irritation at the infusion site may occasionally lead to superficial phlebitis. This uncommon complication can be minimized by adding from 1,000 to 5,000 units of heparin to each infusion. That small dose will act locally but will not generally cause significant systemic anticoagulation.

    e. Local anesthetic. Even with the use of magnesium and bicarbonate buffer, lidocaine or procaine may be needed to prevent pain at the infusion site for an occasional patient. This need occurs more commonly during the first few infusions

    Note that Rozema is one of Lamas’s co-authors for the TACT presentation at the AHA meeting. He’s also a convicted felon.

    Oy. That dose of heparin won’t cause significant systemic anticoagulation? What idiots. 5,000 U heparin is not a “small dose.” A typical loading dose of heparin these days ranges from 50-100 U/kg. 2,500 U, the amount of heparin in the infusion for the TACT protocol, is well within loading dose range for many women and lighter men. True, it’s given over 3 hours, and most loading doses of heparin are given over a much shorter period of time (say, 1 hour), but geez. These guys truly don’t know what they’re doing, do they?

  55. #55 Denice Walter
    November 6, 2012

    “These guys truly don’t know what they’re doing, do they?”

    Understatement of the year.

  56. #56 Orac
    November 6, 2012

    Or they do know what they are doing. I don’t know which possibility would be worse.

  57. #57 Kelly M Bray
    Looking for a cookie.
    November 6, 2012

    Lilady, what is the name of the Gadolinium lady at HuffPo?.She just posted on the Forbes article under the name “profitmedicine” . Guess what she is going on about?………

  58. #58 lilady
    Here's your cookie, Kelly :-)
    November 6, 2012

    You’ll find the Gadolinium lady (Sharon), here:

    http://www.huffingtonpost.com/margaret-i-cuomo-md/cancer-prevention_b_1609446.html

    I’ve posted on two Forbes articles…so I’m going back to them now.

  59. #59 lilady
    November 6, 2012

    @ Kelly M. Bray: Oh yeah, I posted back at “Gadolinium Sharon”…encouraging her to commence a lawsuit. I also linked to Dr. Kimball Atwood’s blog on the SBM website.

    http://www.forbes.com/sites/larryhusten/2012/11/04/nih-trial-gives-surprising-boost-to-chelation-therapy/

  60. #60 herr doktor bimler
    November 6, 2012

    If you watch tv all you see
    If the TV is Kansas Practitioner’s main information source, I think I see the problem.

  61. #61 Bryan Feir
    November 6, 2012

    I sometimes wonder if placebos that cost** a great deal and/ or involve some hardship make the mar… excuse me, *patient* feel more comfodent of their efficacy because he or she has so much time, money and effort invested.

    You know, of all things, this reminded me of one of the old Henry Reed books I read back when I was young. One of the the various things Henry comes up with to make money involved, I believe, turtles that had pictures painted on their shells. After planning on just selling them all at the same cost because all the pictures took the same amount of time to do, one of his partners suggests putting different prices on them so people who bought the more expensive ones think they were getting something special while the people who bought the cheaper ones think they were getting a bargain.

    Yeah, the trick of differential pricing to sell otherwise similar things was mentioned in a children’s book back in the 1960s.

  62. #62 Bronze Dog
    November 6, 2012

    It is amazing how many people advocate healthcare “choice” of women when it comes to abortion but want swat teams to raid vitamin stores. It is rather silly that we have so many anti vitamin people in the world.

    …Wut?

    Here’s a few hints:

    1. We’re not anti-vitamin. That’s your silly, possibly corporate, indoctrination talking. We’re against people telling lies about vitamins to make a profit while providing no benefit. I’m generally against the idea of selling something when the customer won’t benefit from it. Oh, and you don’t send SWAT teams after false advertisers. I’d be worried you’re projecting your own authoritarian enforcement preferences onto us. Personally, I want fewer SWAT teams in America.

    2. Vitamins supplements can be helpful for people with deficiencies in their diets or various physiological quirks that necessitate supplementation. Megadoses have some risk of harm, and that’s why I don’t think they should be marketed for the general public with vague buzz phrases, but instead focused specifically for people who have a real medical need. I wouldn’t go as far as requiring prescriptions, but warnings against overdosing and notes on who needs it on the container would probably be appropriate.

    3. A lot of vitamin supplements are manufactured by companies owned by “big pharma.” They’re cheap to produce and last I heard, there’s virtually no incentive for quality oversight thanks to DSHEA and similar corporate deregulation measures. That means they can cut a lot of corners and end up very profitable while the customers take on the risks of such cuts. The altie community is probably one of the best things that ever happened to “big pharma” for this reason, and I’m against anything that’d encourage further corruption and opportunism.

    4. We aren’t in favor of restricting choice, we’re in favor of informed choice. People should be able to make informed choices based on good, scientific evidence, not market-driven disinformation. Informed choice is inherently more free than misinformed choice. That’s why the altie community is so vehemently pro-censorship and when they can’t use a ban hammer on dissenters, they resort to SLAPPs and other forms of legal thuggery when some skeptic deigns to criticize them with evidence. They don’t want people to think about their choices, they want them to just trust the tribe’s propaganda. We, on the other hand, are blog people. We counter lies by using our freedom of speech. It’s about the only weapon I have right now.

    But, of course, you’re not interested in our real opinions. You just want to closedmindedly rehearse your prejudices, so if you come back, you’ll undoubtedly end up lying to my virtual face about what I believe because you’re obedient to your tribe.

  63. #63 Narad
    November 6, 2012

    Oh, and you don’t send SWAT teams after false advertisers.

    You mean you’re not hip to the FDA’s Gestapo tactics? (One gets the same trip from the raw-milk crowd.)

  64. #65 Kelly M Bray
    Eating the cookie.
    November 6, 2012

    That’s it, Sharon Hanson. I knew who it was from the particular whine.

  65. #66 Denice Walter
    November 6, 2012

    @ Bryan Feir:

    Sure, there is material along these lines in attribution research- that people place value on what they choose themselves, work for or pay more for. I can’t seem to find the specific reference about expensive woo ( not the one which Eric notes).

    -btw- do you pronounce your name *fire*, *fear* or *fair*?

  66. #67 lilady
    Have another cookie, Kelly :-)
    November 6, 2012

    Kelly, (hint) I just keyed in “Gandolinum toxicity” to find Sharon.

    @ Bryan Feir: Sometimes you get a *bonus* when you purchase pet turtles…painted…or…plain:

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5907a2.htm

  67. #68 Kelly M Bray
    Looking for a glass of milk
    November 6, 2012

    Lilady, her writing style and total self absorption are a dead give away.

  68. #69 Narad
    November 6, 2012

    Off topic, but in John Stone’s latest Jimmy Saville/Deer/Murdoch/etc. conspiracy rant at AoA, one finds that Tomljenovic thinks that the herd effect “does not rest on solid scientific evidence,” which I suppose isn’t particularly surprising, but I hadn’t seen it before.

  69. #70 Kansas Practitioner
    November 6, 2012

    I have no problem with raw milk myself. Poor farmers have to fear machine gun toting swat teams raiding their farms for selling real (raw) milk which man has partaken of for thousands of years.

    I suppose the DHS thinks that dairy farmers must be a larger threat than Islamic militant who wish death on America. Seems like we have more machine gun weilding masked agents raiding vitamin stores and dairy farms than Islamic terrorist organizations these days.

    Then again I can understand just how dangerous vitamin store clerks and dairy farmers can be. They might attack America with milk pails and Vitamin D samples. They must be stopped at all costs! They have become a more dangerous threat than Al Qaeda. I bet GNC and Ahmish farms oare higher on Obama’s terror watch list than Bin Laden was.

    Don;t get me started on the illegal raids on private vegetable gardens either. That is an offense worthy of a firefight. Citizens should hold their ground in such issues.

    Here we are $16 trillion in debt fighting Al Qaeda in multiple countries, warding off cocaine peddling coming from Mexico by way of illegal aliens entering on foot and yet the government’s highest military priorities are defending the nation against people who sell vitamins, milk, and vegetables. The 1950s look REAL good right now.

    Sorry, I do not understand this logic.

  70. #71 lilady
    November 6, 2012

    “I have no problem with raw milk myself. Poor farmers have to fear machine gun toting swat teams raiding their farms for selling real (raw) milk which man has partaken of for thousands of years.”

    Yeah, well I have a problem with raw (unpasteurized) milk and soft cheeses made with raw milk, Kansas Practitioner…

    http://www.cdc.gov/foodsafety/rawmilk/raw-milk-index.html

    “I bet GNC and Ahmish farms oare higher on Obama’s terror watch list than Bin Laden was.”

    Haven’t you heard Kansas Practitioner, that brave US Navy Seals, invaded Bin Laden’s compound in Pakistan and “eliminated” the POS terrorist, responsible for the deaths of 3,000 people?

    ” The 1950s look REAL good right now.”

    Yeah, bring back the 1950s when kids were dying from polio and before smallpox was eradicated from the face of the earth.

    “Sorry, I do not understand this logic.”

    Of course you don’t. You’re just plain ignorant, Kansas Practitioner. What time of medicine did you say you *practice*, Kansas Practitioner?

  71. #72 Kansas Practicioner
    November 6, 2012

    Raw milk is safe and individual sovereign men and women have the right to purchase raw milk from private farms if they so choose. Why all the crud about raw milk? Are we the only nation on earth who bans raw milk? Probably not, which is rather pathetic.

    Bin laden was killed in 2005. Navy seals raided a compound and killed one of his sons. If you remember correctly those same brave SEALs also conveniently died in a helicopter crash shortl thereafter. No pictures of Bin Laden’s body and no live survivors to come forward later with the truth. Real convenient.

    If you have a problem with raw milk my suggestion as a practitioner is to stay away from it. As a concerned sovereign indivudal I must persuade you to not restrict other sovereign individuals from purchasing raw milk from private sovereign farmers. I suppose we have to have a black market to sell milk now? What a disgrace this nation has become.

    Kids and grownups will always die of something. Unless Jesus comes today , eventually we will all die from something. The 1950s was a time when government had alot less regulatory power. Yeah, I know you will throw in the same old tired worn out argument about blacks and women and the draft and other such things, but economically, morally, and ethically we were a better nation back then.

  72. #73 Denice Walter
    November 6, 2012

    @ Narad:

    Oh, I’ve seen it: herd immunity is a “myth”. Of course, that’s common knowledge @ PRN and I’ve also encountered that courtesy of Janine Roberts.

  73. #74 Krebiozen
    November 6, 2012

    Isn’t Kansas Practicioner a sock puppet? He does seem very like Medicien Man and his various alter egos.

  74. #75 Denice Walter
    November 6, 2012

    Right, the use of ‘sovereign’ gave it away to me.

  75. #76 lilady
    November 6, 2012

    “Bin laden was killed in 2005. Navy seals raided a compound and killed one of his sons. If you remember correctly those same brave SEALs also conveniently died in a helicopter crash shortl thereafter. No pictures of Bin Laden’s body and no live survivors to come forward later with the truth. Real convenient.”

    Some of the RI Regulars were online when Orac posted this…

    http://scienceblogs.com/insolence/2011/05/02/osama-bin-ladendead-finally/

    You’re *off* by about five years, Kansas Practitioner. Your also *off* about everything you have posted.

    I’m beginning to think that your are a sockie, “practicioner” (sic).

  76. #77 Narad
    November 6, 2012

    Oh, I’ve seen it: herd immunity is a “myth”. Of course, that’s common knowledge @ PRN and I’ve also encountered that courtesy of Janine Roberts.

    I meant Tomljenovic in particular.

  77. #78 Kelly M Bray
    Drinking pasteurized milk thank you.
    November 6, 2012

    Kansas Practitioner sounds like he is a Naturopath, I also note he uses the word sovereign men and women. That’s a bit of a flag for a group of nuts that makes Ron Paul look normal.

    http://en.wikipedia.org/wiki/Sovereign_citizen_movement

    Also KP, I knew one of the families of the brave men who went down on the Chinook. You have no idea what you are talking about so don’t sully his name with your insults.

  78. #79 Politicalguineapig
    November 7, 2012

    KP: Uh, Bin Laden’s wives and children were living in the compound with him. They’re all still alive. Also, boy are you dumb. The 1950s had a higher crime rate then we ever do now; and sex crimes were hardly ever prosecuted. Murders of women and minorities were rarely prosecuted and the perp usually walked. I’m actually surprised that NASA ever got off the ground, considering how religious that era was.

  79. #80 Bronze Dog
    November 7, 2012

    Talk about persecution fantasies. KP, do you actually expect us to believe anyone is presenting a serious physical threat against vitamin pushers and raw milk producers? I’ve never heard anyone even advocate such an idea, and without good evidence to the contrary, I’d dismiss such an advocate as an unpopular fringe nut. That kind of rhetoric never reaches me except through the baseless assertions of crazed ranters like you, KP.

    For me, the marketing of vitamins to people who don’t need them is just a minor annoyance in the big picture, not some huge threat. The raw milk thing is in similar territory. Some people prefer the texture of non-homogenized milk and that’s fine with me. For non-pasteurized, I think I’m okay, so long as they’re well-informed of the possible risks, though I might be underestimating those risks. Of course, you seem interested in shutting down any such rational discussion about risk and benefit from the outset by flinging crazy, baseless accusations in an attempt to demonize us as The Other.

    The absolute worst I’d want to give the producers is a false advertising charge or something settled peacefully in a civil court, mostly about false health claims they’re likely to make. The only thing I really expect to happen is some skeptical blogging, followed by shrill alties claiming that our exercise of free speech to openly discuss an issue is exactly like police state terrorism because blog comments are exactly like armed forces bursting into homes and businesses.

    KP, why don’t you try surprising us by talking about the science?

    Kids and grownups will always die of something. Unless Jesus comes today , eventually we will all die from something. The 1950s was a time when government had alot less regulatory power. Yeah, I know you will throw in the same old tired worn out argument about blacks and women and the draft and other such things, but economically, morally, and ethically we were a better nation back then.

    So, except for all the grossly unethical and immoral stuff, things were more ethical?

    Frankly, I don’t buy your assertion that government had less regulatory power back then. The recent economic collapse was heavily tied in with the lack of regulation. I thought the 50s had more regulation in many areas. IIRC, some things were better economically because unions still had collective power back then and corporate taxes were higher. As I see it, the problem today is that as a nation we’ve given up everything we learned in the first half of the 20th century and gone back to crony capitalism.

  80. #81 JGC
    November 7, 2012

    Back then NASA was primarily about stealing a march on those godless commies and developing missile technology (the better to blow them up), later surveillance sattelites (the better to know where and when to blow them up), and ultimately arimed at winning the race to the moon (putting those godless commies in their place once and for all!)

    All things your true, god-fearing American could get behind.

  81. #82 JGC
    November 7, 2012

    Yeah, I know you will throw in the same old tired worn out argument about blacks and women and the draft and other such things, but economically, morally, and ethically we were a better nation back then.

    Because it’s obviously a much greater ethical and moral failing to mandate minimal food safety regualtions which restrict the sale of unpasteurized dairy products, than it ever was to violate the civil rights of women and minorities on a national scale. And if we can turn a profit by doing so, so much the better–right?

  82. #83 Politicalguineapig
    November 7, 2012

    KP: I also should add that there was a raw milk producer in my state that got shut down..by the state government. The feds had nothing to do with it. They were violating health standards; rats and chickens and mice everywhere, and yes, a kid died from E.coli after drinking raw milk from the dairy. I dare you to tell the family that their child was expendable.
    And ya know, I get that the world isn’t fair or safe, and that you can’t bubble-wrap it. But, there are a lot of deaths in the US that are preventable, and food safety regulations and workplace safety helps.

    I guess you like fingers and rat parts in your meat? Moldy cabbage? Hallucinogenic rye bread? Have fun with that, and good luck living past your fifties.

    JGC: I’m aware of the context of the moon race. I am just continually amazed that NASA could scare up enough US born scientists, since just about everyone went to Sunday School and church in the day.

  83. #84 Narad
    November 7, 2012

    I am just continually amazed that NASA could scare up enough US born scientists, since just about everyone went to Sunday School and church in the day.

    That’s because you labor with a very crude idée fixe.

  84. #85 JGC
    November 7, 2012

    As I recall, a large part of NASA’s success in the ’50′s was due to the 100 or so German scientists and engineers brought to the US courtesy of Operation paperclip, veterans of Germany’s V-1 and V-2 programs.

  85. #86 herr doktor bimler
    November 7, 2012

    KP: Uh, Bin Laden’s wives and children were living in the compound with him. They’re all still alive.

    KP believes in (or pretends to believe in) a conspiracy theory in which ObL was killed in 2005, but pretended to be alive for the next 5 years, so his execution / death in combat during the Obama administration was FAKED like the moon landings. For propaganda purposes that might fool the sheeple but not the likes of KP.

  86. #87 Demandabanana
    November 7, 2012

    FYI, the U01 is pretty much an R01 with hard milestones built in. It’s meant to make it very easy for the NIH to shut the project down or demand protocol changes, etc. I’m not sure how this project started, but R01s can be converted to U01s, or you can apply directly for a U01. Many (most?) ICs use U01s for their clinical portfolios.

  87. #88 Edith Prickly
    November 7, 2012

    Isn’t Kansas Practicioner a sock puppet? He does seem very like Medicien Man and his various alter egos.

    He hasn’t called anyone a “terd” yet – that’s usually the giveaway.

  88. #89 Edith Prickly
    November 7, 2012

    I am just continually amazed that NASA could scare up enough US born scientists, since just about everyone went to Sunday School and church in the day.

    Um, what??? are you seriously trying to lump in all churchgoers with the tiny but extremely noisy politicized current crop of fundamentalists who are demonstrably anti-science? The mainstream churches of the 1950s would not have been pushing any of those ideas on their congregations.

    In fact, if you actually know anything about the history of fundamentalist Christian engagement in American politics, they weren’t all that active in the 1950s – the first wave from the 20s and 30s had died down, and the current movement started up again in the ’60s (and got a big boost from being adopted by a certain political party…however, as of now they seem to have reached the limits of their usefulness.)

  89. #90 Calli Arcale
    November 7, 2012

    Edith,

    Yep. Also, NASA was more a fixture of the 60s than the 50s. They were started in 1958. They were lucky to inherit the folks at Redstone Arsenal, which included the German scientists, but it would be tarnishing a lot of good names to say that it was only them that got us to the moon. Also, NASA wasn’t about developing missiles or surveillance satellites, as someone suggested upthread. USAF and USN were working on those things, and were getting fairly territorial about it too. Part of the *reason* NASA got the Germans, actually, was because very few people in the military really trusted them, having spent much of the 1940s fighting them and trying not to be killed by the rockets they were building. NASA was rolled out of the former Army missile program at Redstone Arsenal, NACA (a civilian aviation research agency that was already decades old), and the Jet Propulsion Lab at Caltech — which was founded by a Chinese guy, actually, and there’s an interesting story there too. H. S. Tsien. During the Red Scare, McCarthyism cost him his illustrious Caltech career, and he eventually got shipped back to China in exchange for some downed US pilots captured in Korea. He went on to found the Chinese rocket program, which today is only the third manned space program in the world. There were many, many fine engineers and scientists involved besides him and the Germans, of course. Von Braun’s team did provide a sizeable advantage, and some real genius with respect to regenerative-loop cooling and some other innovations that made liquid-fueled rockets practical. But the Germans didn’t build our first ICBMs. The USAF did, very specifically not using any Germans, and that gave us the Atlas rocket, and then the Titan, which would be our primary ICBM for many years until solid-fueled ICBMs rendered it obsolete and it ended up working mainly as a satellite launch vehicle. The Germans, meanwhile, gave us Redstone (basically an uprated V-2, an IRBM), and the Saturn family. There were religious people involved in all of this, of course. But “religious” is not actually synonymous with “crazy fundamentalist loon”. A great many scientists go to church/temple/whatever regularly. They are seldom fundamentalists, however.

  90. #91 Shay
    November 7, 2012

    I am just continually amazed that NASA could scare up enough US born scientists, since just about everyone went to Sunday School and church in the day.

    Ever get tired of mouthing stereotypes, PGP?

  91. #92 Politicalguineapig
    November 8, 2012

    Shay: They aren’t stereotypes if real people live down to them. While the churchgoing population has drastically changed since the 1950s, religion and science will always be (and always have been) in conflict.

  92. #93 Shay
    November 8, 2012

    As Calli has pointed out, that’s bollocks.

    Tell me, do you ever stop “categorizing” entire groups of people and actually stop to think about them?

  93. #94 Krebiozen
    November 8, 2012

    I’m aware of the context of the moon race. I am just continually amazed that NASA could scare up enough US born scientists, since just about everyone went to Sunday School and church in the day.

    When you realize that the Vietnam War was going on at the time, and that the Apollo astronauts were talented pilots who would have been flying missions there if they were not being shot into space in a tin can, it makes a little more sense. I highly recommend Moondust by Andrew Smith, for an interesting look at the Apollo astronauts.

  94. #95 lilady
    November 8, 2012

    @ Krebiozen: How about this?

    http://atheism.about.com/od/aboutreligion/a/TechnologyReligion_4.htm

    “….An example of the first can be found in modern space exploration. The father of modern rocketry, Werner Von Braun, made use of Christian millennarianism to explain his desire to send humans into space. He wrote that the world was “turned upside down” when Jesus came to earth and that “the same thing can happen again today” by exploring space. Science did not conflict with his religion, but instead confirmed it: “In this reaching of the new millennium through faith in Jesus Christ, science can be a valuable tool rather than an impediment.” The “millennium” he spoke of was the End Times.

    This religious fervor was carried along by other leaders of America’s space program. Jerry Klumas, once a veteran systems engineer at NASA, wrote that explicit Christianity was normal at the Johnson space center and that the increase in knowledge brought by the space program was a fulfillment of the aforementioned prophecy in Daniel.

    All the first American astronauts were devout Protestants. It was common for them to engage in religious rituals or reveries when in space and they generally reported that the experience of space flight reaffirmed their religious faith. The first manned mission to the moon broadcast back a reading from Genesis. Even before astronauts stepped out onto the moon, Edwin Aldrin took communion in the capsule — this was the first liquid and first food eaten on the moon. He later recalled that he viewed the earth from a “physically transcendent” perspective and hoped that space exploration would cause people to be “awakened once again to the mythic dimensions of man.”

  95. #96 Krebiozen
    November 8, 2012

    lilady,

    How about this?

    Christianity in space! That reminded me of Richard C. Hoagland’s claims about NASA rituals, though he claims they were worshipping ancient Egyptian gods. Both Jesus and Osiris died and were resurrected so perhaps the confusion is understandable. Timothy Leary claimed that zero gravity turns on a dormant mystical circuit in the brain, so that may explain why a number of Apollo astronauts appear to have gone a bit odd ;-)

  96. #97 lilady
    November 8, 2012

    Hoagland is plain crackers, Krebiozen.

    I just filled out this short online political quiz from Pew Research…and in spite of my Christian beliefs…the results put me in the far-to-the-left Liberal Democrat category. :-)

    http://www.people-press.org/political-party-quiz/

  97. #98 Krebiozen
    November 8, 2012

    lilady,

    Hoagland is plain crackers, Krebiozen.

    Goes without saying, but I must admit I find him entertainingly bonkers – I particularly liked his robot head on the Moon. It’s another example of people seeing patterns in noise of course, but at least nothing he does puts people’s lives at risk (I can’t think of how it does anyway, apart from the general damage always pseudoscience causes), unlike nutters such as Burzyn$ki.

  98. #99 Denice Walter
    November 8, 2012

    @ Kreb:

    Although I don’t have a firm position on this yet, I do seriously wonder if belief in reasonably HARMLESS nonsense – including whimsy like astrology, aliens, vortices- allows unreality a foot in the door which will eventually allow alt med, woo and other harmful forms of un-science ( anti-AGW) in enter and take hold. I don’t know, I only wonder. I have to be careful how I say this because of the issue of religion..and I don’t really want to go there.

  99. #100 Krebiozen
    November 8, 2012

    Denice,

    That “foot in the door” is what I meant by “the general damage always pseudoscience causes”, though my syntax somehow a bit strange and Yodaesque came out.

    I’m not keen on slippery slope arguments, or on draconian curtailment of free speech, and I would be a little saddened if there were no Hoaglands to amuse me, but there is definitely a problem in this area. Science needs to improve its communication skills somehow, to hold back this black tide of occultism that threatens to engulf us (if I may indulge in a bit of Freudian hyperbole), but I’m not sure how.

    As for religion, I’m in (at least) two minds as well. It’s the fundamentalists, dogmatists and fanatics who are the real problem, but that’s true in any area of human belief, not just religion.

  100. #101 Narad
    November 8, 2012

    whimsy like astrology, aliens, vortices

    I always forget that its actually the lattice of coincidence.

  101. #102 Denice Walter
    November 8, 2012

    Not exactly slippery slope but rather that accepting ideas without thinking about how realistic they are sets up ( or exemplifies?) a habitual worldview that doesn’t question unlikely scenarios. Perhaps what I’m saying is that they may indicate the same underlying mindset- one being a slighter example.

    Freud always wrote about the conflict between the wish and external reality.. and reality testing. People who BELIEVE in these fancies – rather than using them as entertainment- may have the door open a bit wider than others.

  102. #103 Antaeus Feldspar
    November 8, 2012

    Shay: They aren’t stereotypes if real people live down to them.

    If 100% of real people in a category “lived down to” your prejudiced dismissals of them, then and only then could it be argued that those dismissals weren’t stereotypes.

    Since that has nothing in common with real life, you’re just a damn bigot.

  103. #104 herr doktor bimler
    November 8, 2012

    Freud always wrote about the conflict between the wish and external reality.. and reality testing. People who BELIEVE in these fancies – rather than using them as entertainment- may have the door open a bit wider than others.

    Freud being a case in point…

  104. #105 Denice Walter
    November 8, 2012

    @ herr doktor bimler:

    especially when he was speculating theoretically.

  105. #106 lilady
    November 8, 2012

    @ Denice Walter: Feel free to “go there”.

    Yes, I am a Christian and I rarely discuss my beliefs on the internet…choosing to do so, when I confront someone who indulges in categorizing/stereotyping people based on their religious beliefs, their race/ehtnicity, gender or socioeconomic status.

  106. #107 Denice Walter
    November 8, 2012

    @ lilady:

    I’ll refrain for the time being: it’s a subject, like poetry, that, for me at least, requires alcohol.

  107. #108 thenewme
    November 9, 2012

    Ack!! Yep… chelation and detox for cancer treatment. More heavily-promoted woo over at the breast cancer forum, marketed directly to cancer patients.

    Let the fact-twisting begin!

  108. [...] Insolence returnedherr doktor bimler on The results of the unethical and misbegotten Trial to Asess Chelation Therapy (TACT) are finally rev…Antaeus Feldspar on Stanislaw Burzynski: Slapped down by the FDA once againAntaeus Feldspar on The [...]

  109. #110 bvg
    November 14, 2012

    Dear JGC,

    Your post of NOv 5, 2012.

    Expertise is indicated by knowledge backed by rational thinking and not by degrees.

    Almost each of about 50 qualified and knowledgable doctors who has intgeracted with me for sometime has accepted my expetise in the domain of heart disease and chelation therapy.

    After being told that I will not live more than 6 months without triple vessel bypass I chose chelation therapy. Now nearly seven years have passed and my LVEF of 35 rose to 57. I did not have any heart attack and only one episode of hospitalization till morning chosen by me despite the fact that doctor had cleared me of any emergency.

    In seven years I must have spent nearly10000 hrs in studying chelarton therapy. I purchased every available book on Chelation Therapy and read it thoroughly.

    I have written many books on medical subjects in Marathi and English which have been greatly appreciated by highly qualified docrors and professors of medicines at universities.

    I did not want to rely only on book knowledge and see chelation therapy in action. Therefore,through a doctor trained by me five years ago, I have treated nearly 500 patients with different diseases.

    One and half year ago I conducted my first training training course meant to train doctors in gvining chelation therapy to patients. Later I have done seven more training courses. Totally I have trained 36 doctors including nearly 10 specialists (Pathologists, Radiologists and General Physicians).

    I have treated at least five specialists for their varied symptoms. Each one had at least 40 years experience in Gynac. Patho, Padaetrics, Heart Surgery etc. They were totally satisfied with my treatment.

    Finally, remember, I do not do all these things for earning money. I already have sufficient to live my life and my capab;e offsprings do not need anythi9ng from me. I have never charged any consultation fee to anybody who has approached me for medical advise.

  110. #111 AdamG
    November 14, 2012

    I have treated nearly 500 patients with different diseases.

    Why, then, have you not published your results in a medical journal? Shouldn’t the medical community be able to verify and evaluate your claims? It’s selfish to keep your allegedly miraculous treatment to yourself if it could indeed help many people.

    Finally, remember, I do not do all these things for earning money.

    If this were true, why did you publish your own book, for which you receive compensation, instead of writing and publishing in a medical journal?

    I’m not seeing a lot of this supposed ‘rational thinking’ that gives you expertise.

  111. #112 lilady
    November 14, 2012

    @ B.V. Gokhale:

    “One and half year ago I conducted my first training training course meant to train doctors in gvining chelation therapy to patients. Later I have done seven more training courses. Totally I have trained 36 doctors including nearly 10 specialists (Pathologists, Radiologists and General Physicians).”

    And,

    “Finally, remember, I do not do all these things for earning money. I already have sufficient to live my life and my capab;e offsprings do not need anythi9ng from me. I have never charged any consultation fee to anybody who has approached me for medical advise.”

    http://foundation.moneylife.in/promotion/gokhaleimages/Index.html

    What the hell is Moneylife TV, Mr. Gokhale?

    Why did you state in one of your Moneylife TV commercials that your *treatment* can detoxify aluminium and mercury from the brain?

    Here’s a free plug and a downloadable copy of B.V. Gokhale’s book on chelation therapy. Enjoy.

    http://www.bookganga.com/Preview/Preview.aspx?BookId=5148910396844029427&PreviewType=books

  112. #113 Krebiozen
    November 14, 2012

    bvg,

    Expertise is indicated by knowledge backed by rational thinking and not by degrees.

    How does rational thinking lead you to the conclusion that chelation is of any use in any conditions other than metal poisoning? There have been several clinical trials of chelation therapy in cardiovascular disease, as Orac describes above, and it doesn’t work. You appear to have deceived yourself.

  113. #114 JGC
    November 14, 2012

    Expertise is indicated by knowledge backed by rational thinking and not by degrees.>/blockquote>
    No, expertise is indicated by demonstrated understanding of a particular subject coupled with a a documented record of success at applying that understanding to achieve real-world objectives. With respect to expertise in chelation therapy, at minimum one would expect you can demonstrate you’ve received advanced training in the field from some accredited institution. Surely you’re not claiming to possess expertise based on independent research (i.e., ‘google U’) plus having received chelation therapy yourself?

    Almost each of about 50 qualified and knowledgable doctors who has intgeracted with me for sometime has accepted my expetise in the domain of heart disease and chelation therapy.

    Great for them—can you offer the rest of us evidence to support a claim to expertise, or are we expected to simply take your word for it that you’re not only an expert but lots of completely unidentified third parties have agreed you’re an expect?

    After being told that I will not live more than 6 months without triple vessel bypass I chose chelation therapy. Now nearly seven years have passed and my LVEF of 35 rose to 57. I did not have any heart attack and only one episode of hospitalization till morning chosen by me despite the fact that doctor had cleared me of any emergency.

    All of which may be true. The fact that you’ve lived for more than 6 months without bypass, or that you’ve had chelation therapy, etc., doesn’t argue that you’re an expert in chelation therapy, nor in fact that the chelation therapy you received is responsible for your continued survival without bypass.

    In seven years I must have spent nearly10000 hrs in studying chelarton therapy. I purchased every available book on Chelation Therapy and read it thoroughly.

    At what institution did you spend these 1000 hours studying chelation therapy, and how did you demonstrate that your study resulted in mster of the subject—did you sit for examinations, did you complete a masters or doctoral dissertation?

    I have written many books on medical subjects in Marathi and English which have been greatly appreciated by highly qualified docrors and professors of medicines at universities.

    Can you identify any accredited medical college which include your books as required or recommended reading for their students? Or am I expected to accept the mere fact you’ve written the books coupled again with a personal assurance that lots of completely unidentified but really smart people tell you they’re great as evidence you know what you’re talking about?

    I did not want to rely only on book knowledge and see chelation therapy in action. Therefore,through a doctor trained by me five years ago, I have treated nearly 500 patients with different diseases.

    Do you yourself have a medical degree? If so, from what college/university? If not, what are the laws governing the practice of medicine without a license in the countries where you’ve treated these 500 patients?

    One and half year ago I conducted my first training training course meant to train doctors in gvining chelation therapy to patients. Later I have done seven more training courses. Totally I have trained 36 doctors including nearly 10 specialists (Pathologists, Radiologists and General Physicians).

    I presume that if you’re training physicians to use a particular therapy that therapy has been shown to actually be safe and effective. Where can we find the clinical trials or comprehensive case history reports which establish this?

    If on the other hand you haven’t demonstrated safety and efficacy through clinical trial, how can you consider it ethical to train physicians to administer a treatment for which there’s no rational expectation it will work at all, let alone safely?

    I have treated at least five specialists for their varied symptoms. Each one had at least 40 years experience in Gynac. Patho, Padaetrics, Heart Surgery etc. They were totally satisfied with my treatment.

    Regardless of whether they were satisfied with your treatment (after all, they might be perfectly satisfied despite the treatment doing nothing at all) I trust you also evaluated biological or physiological endpoints which would indicate if the treatment was effective. What were they, and how did these values compare to the study’s control arm values? (You did include a control arm, right?)

    “Finally, remember, I do not do all these things for earning money. I already have sufficient to live my life and my capab;e offsprings do not need anythi9ng from me. I have never charged any consultation fee to anybody who has approached me for medical advise.

    The fact that it’s free doesn’t argue that it’s correct.

  114. #115 JGC
    November 14, 2012

    damn blockquote fail!

  115. #116 lilady
    November 14, 2012

    @ JGC:

    Mr. Gokhale is not a medical doctor. He states in his chelation book that he has a B.Tech and M.Tech, from IIT, Bombay India:

    http://en.wikipedia.org/wiki/Indian_Institute_of_Technology_Bombay

  116. #117 herr doktor bimler
    November 14, 2012

    “I’m not going to shut up!” yelled Dr. Bruce R. Dooley, a Naples physician who is president of the pro-chelation Alliance for Medical Freedom. “This is a kangaroo court!”

    Dooley left the meeting after board members called for a security guard, but he soon returned carrying a large, stuffed kangaroo.

    Dooley is based in New Zealand now and therefore a person of interest.

  117. #118 Krebiozen
    November 14, 2012

    JGC,

    damn blockquote fail!

    That’s why you need the handy Krebiozen RI comment previewer&#8482. Respectfully insolent comments without tears.

  118. #119 Krebiozen
    November 14, 2012

    Hmm. Maybe not ‘without tears’, but fewer tears. As long as you don’t try to get fancy with superscripts or ampersand HTML codes for ™ it works fine.

  119. #120 JGC
    November 15, 2012

    So basically he has no medical training, but when told he needed coronary bypass he instead underwent chealtion therapy, read books about chelation therapy, began advising patients about chelation therapy, began training doctors in how and when to perform chelation therapy, and has performed chelation therapy himself on 500 or so people.

    Good thing it wasn’t the other way around, where he was advised to get chelation therapy but instead choose to go with coronary bypass. He’d now be teaching surgeons how and when to perform coronary bypass and cracking people’s chests open to do bypasses himself…

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