The staff there performed a "challenge test" to see if Stemp's urine was positive for heavy metals. During his next visit Stemp consulted with clinic owner Kazuko Curtin. Though not a doctor or a nurse, she wore a white coat and told him that he was indeed suffering from lead and mercury poisoning. She also told Stemp, then 41, that he had Alzheimer's.
Her prescription: 18 months of chelation to remove the toxins. Two to four times a week, Stemp spent four hours hooked to an IV that transfused a chelating chemical. It made him confused and nauseated. He could no longer work. "I was withdrawn from life and family. I was lethargic and dizzy," he recalls. He was billed $180,000 over ten months before he quit a year ago in frustration. He's now suing Care Clinics and its staff for fraud. They deny the allegations.
Chelation is the unproven cure-all that will never die. Developed to remove arsenic from soldiers gassed during World War I, the method is used in mainstream medicine for rare cases of acute heavy metal poisoning. But a renegade group of doctors use it for a far broader range of ills--everything from heart disease to memory impairment--despite scant evidence it works and potentially dangerous side effects. They claim that removing small amounts of metal will resolve the symptoms.
Over the years chelation has been repackaged over and over again. The latest round of easy marks for chelation vendors are parents of children with autism. Some parents are convinced autism is caused by mercury in vaccines, despite many studies to the contrary. Several hundred doctors offer chelation in the autism market, many of them certified by a trade group called the American College for Advancement in Medicine. A 1998 consent decree the group signed with the Federal Trade Commission, in which it agreed to stop making claims about chelation's safety and effectiveness, evidently doesn't get in the doctors' way.
Chelation can be lucrative. A treatment might involve 40 sessions that cost $125 each, usually paid in cash. Various ancillary tests can push the tab above $10,000. Nationally, the chelation market "could be $100 million a year in total billings," estimates Stephen Barrett, a retired psychiatrist who operates QuackWatch.org.
Chelation, from the Greek for "claw," employs amino-acid-based chemicals that latch onto lead, mercury and other metals, allowing the body to more easily excrete them. Medical toxicologists use chelation for cases of serious heavy metal poisoning, such as from industrial accidents.
The American College of Medical Toxicology last summer put out a stern warning about the challenge tests that doctors use to justify chelation on people like Stemp. They test a patient's urine for metals, give a chelating agent, then test the urine again to see if it has more metal. Since everyone has some level of mercury in his blood, it's easy to show what looks like a dramatic problem. "Chelating agents have been found to mobilize metals in healthy individuals," said the statement. The test "has no demonstrated benefit."
Chelation's spread started in the 1950s, when some doctors thought it might be a way to remove the calcified plaque from the arteries of heart patients. But chelating arteries has never been shown to work in trials. In 1989 the Food & Drug Administration included chelation on its list of Top Ten Health Frauds. A 2002 study in the Journal of the American Medical Association compared heart patients who'd been given twice-a-week chelation infusions with those who'd been given a placebo. It found no difference on a treadmill test afterward. Chelation can cause liver and kidney problems; one of the 39 patients getting chelation dropped out after losing kidney function.
"If it worked we would have embraced it a long time ago," says George Todd, a vascular surgeon at St. Luke's-Roosevelt in New York, who says patients "waste time and money" with chelation. He learned the hard way. He once took his autistic son, now 30, to an alternative doctor who gave infusions of chelators. "I should have been suspicious when they said I had to pay $5,000 that day," he says.
In 2003 a study found that chelating agents caused 221 autistic children to expel mercury in their urine. Physicians, using protocols written by a patient group called Defeat Autism Now, soon began offering it. By 2005 an estimated 10,000 autistic children were being chelated.
That year, at the Advanced Integrative Medicine Center near Pittsburgh, a 5-year-old autistic boy from England died when the wrong chelating agent was used. A drop in blood calcium levels led to a heart attack. His doctor was indicted for involuntary manslaughter, but the charges were later dropped. A civil suit is under way. "We do not consider these treatments safe," says Eric Fombonne, a child psychiatrist at McGill University.
David Berger of Wholistic Pediatrics in Tampa chelates 60% of his autism patients and says the procedure is safe when done properly. He sells them a two-month supply of suppositories plus supplements to replace essential minerals. "I take the approach that all kids are heavy-metal-toxic until proven otherwise," Berger says, adding, "I'm open-minded."
The National Institutes of Health helped make chelation respectable in 2002 by starting a $30 million trial of chelation in heart patients as part of a congressional mandate to study alternative remedies; it is ongoing and expected to yield results in 2012. It also initially planned to study chelation for autistic kids but stopped that trial last year before enrolling patients, citing "no clear benefit" to children and "more than a minimal risk."
A 2008 article in the Medscape Journal of Medicine called the heart trial "unethical, dangerous, pointless and wasteful." It counted 30 deaths since the 1970s related to chelation. Retired Stanford professor Wallace Sampson, one of the authors, argues chelation may release metals tied up in tissue into the bloodstream and cause damage where there was none. It also can remove needed minerals.
Allan Magaziner, a family doctor in Cherry Hill, N.J., has chelated heart patients for 23 years and is part of the NIH trial. He says he's prepared to give it up if the trial shows it doesn't work. "That's life. We need to look at things scientifically," he says.
As evidence piles up against a vaccine-autism link, the rationale for giving chelation has shifted toward the notion that people with various diseases are prone to metal toxicity. Promotions for chelation are combined with warnings about lead-contaminated toys and mercury in coal-plant emissions, fish and dental fillings.
As for the plumber Stemp, it isn't clear what caused his original symptoms. But a trained toxicologist found no evidence of heavy metal poisoning. Stemp says he rarely met Care Clinics' Dr. Jesus Caquias, who signed off on all his treatments but who spent much of his time 350 miles away in Brownsville. The Texas Medical Board has twice disciplined Caquias for keeping bad records and making false claims about detoxification treatments. Last July FBI and IRS agents, with a search warrant, raided the Austin clinic and confiscated patient records.
Caquias did not respond to requests for comment. But in his response to Stemp's lawsuit, he said, "Patients have been helped by these treatments" and included letters written on his behalf by patients to the Texas Medical Board. Kazuko Curtin's lawyer, Michael Clark, says that he can't access her records but will vigorously defend her.
From: Forbes Magazine
Online by David WhelanReviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP
