Talk:Chelation therapy/Archive 2

Archive 1

Archive 2

Table Related Comments

The use of a table within this article is very welcome, and helps people sort through a large body of information about the relevant chelating agents in a methodical way. Below are some comments: 1) Blood-Brain barrier and Anatomical limitations of various Chelating agents. It is reported upon the Dimercaptosuccinic acid or DMSA page that DMSA cannot pass through the Blood-Brain barrier and therefore has limited use in that it cannot extract mercury within the brain. An extra column added to the table indicating medical limitations to the various Chelating Agents would be good. Also columns addressing, say, application method (say, via injection or ingested dose) and other relevant medical information about the agents would be informative for the purposes of this article.

AnInformedDude (talk) 18:35, 3 October 2012 (UTC)

Oregon Medical Board statement

A statement has been issued by the Oregon Medical Board:

• Chelation Therapy

This is a RS and can be used in the article. -- Brangifer (talk) 21:55, 6 October 2013 (UTC)

TACT Study Re-Analysis of Diabetic Subgroup

Further analysis of TACT Chelation Study, hot off the press, from the U.S. NIH (National Institutes of Health) website (Nov 2013):

"The patients with diabetes, which made up approximately one third of 1,708 participants, demonstrated a 41 percent overall reduction in the risk of any cardiovascular event; a 40 percent reduction in the risk of death from heart disease nonfatal stroke, or nonfatal heart attack; a 52 percent reduction in recurrent heart attacks; and a 43 percent reduction in death from any cause. In contrast, there was no significant benefit of EDTA treatment in the subgroup of 1,045 participants who did not have diabetes." http://www.nih.gov/news/health/nov2013/nccam-19.htm

To put this finding in perspective (if proven out with future studies), this reduction in risk is equal to or in excess of the benefit even statin drugs are capable of providing.

This Wikipedia page, as it exists now, is almost Orwellian in the upside-down manner it which it presents the latest findings regarding chelation therapy. For a more intelligent, open-minded, and balanced review of these latest findings, read the Nov 2013 AHA (American Heart Association) conference editorial, "Chelation Therapy: Promising for Diabetic Patients but Disruptive to the Medical Establishment." http://www.medscape.com/viewarticle/814723

Antidepressant were prescribed long before anyone had a clue as to how they worked (and we still don't really know). People are still debating the biochemical reasons as to why specifically statin drugs work so well for treating heart disease (as many high-quality studies have now demonstrated), whereas a number of other cholesterol lowering drugs/modalities have been resoundingly unimpressive by contrast. Wikipedia should not serve solely as a shrine for the establishment-minded, where people can only recite Vatican-issued dogma from various government and professional agencies. I trust someone will take the time to work on this Wikipedia page, not to turn it into some anti-science quackery page, but to properly reflect the shift from what has been, to date, largely anecdotal support of chelation therapy to what should now become evidence-based scientific interest and inquiry.

I have absolutely no idea what is going on, biologically, with chelation therapy, or even if these new findings will hold up with future research. But I now find it all very fascinating, and the knowledge base of medicine may be enriched by figuring it out if chelation therapy turns out to be substantive. The psychology of those who are presently turning over heaven and earth to tear down and dismiss the TACT study/findings (and make sure those stupid masses, as they are perceived, don't get the wrong idea in their misguided little heads) is also fascinating -- was someone under the false impression that the "official" and "proper" sources always have it all figured out?

Let's fix this Wikipedia article; in its current form it's an affront to thinking and open minded people.Bdmwiki (talk) 08:49, 26 November 2013 (UTC)

Chelation therapy has plenty of legitimate uses (that are detailed in the article). It also has a lot of illegitimate uses (also detailed). There seems to be a new line of enquiry wrt diabetes. I'm not quite sure what's being proposed. Alexbrn ^{talk|contribs|COI} 09:24, 26 November 2013 (UTC)

You're pulling my leg (incl wrt to how the article treats chelation for heart disease -- with its incredibly strong association with diabetes and metabolic syndrome -- and even the actual findings of the TACT study), right? I felt like a fugitive on the run from the Feds after reading the article, just for wondering if chelation might have potential for treating heart disease! I'm proposing a pretty significant overhaul of several portions of the article, in both content and the overall tone/bias, to bring it up to date wrt recent studies. Though chelation therapy for heart disease is certainly very far from proven, neither can it be viewed any longer in the same light as chiropractic adjustments, herbal cleansings, or colonic irrigation, esp. in light of the latest TACT study findings. Bdmwiki (talk) 10:18, 26 November 2013 (UTC)

We seem to have well-sourced content on the heart disease material. What specific things do you want to do? What's biased? What content needs to change? We can't really proceed with a general discussion about an "overhaul" ... Alexbrn ^{talk|contribs|COI} 10:27, 26 November 2013 (UTC)

Perhaps I'll take a stab at a partial rewrite, complete with proper sourcing. I disagree with you that the article is currently well-sourced, from a content and impression standpoint. For example, to refer to a study where the authors conclude there appears to be benefit, but then cite the exact opposite as being the case -- that is not a correct use of that source. Content matters. As I said, if no one else steps up to the plate shortly, I'll take a stab (in the time it will take to detail each instance of my grievances, I may as well draft a proposed rewrite.) — Preceding unsigned comment added by Bdmwiki (talk • contribs) 10:43, 26 November 2013 (UTC)

Definitely interesting results. We'll be allowed to report this in the article when it clears our WP:MEDRS rules, which will be when reviews of multiple studies are finished. These are preliminary and uncertain results: "...more studies are needed before it’s known whether this promising finding leads to a treatment option."[1] We don't use primary studies like this as sources, IOW we don't "present the latest findings regarding chelation therapy" (your statement above). We are not a news agency when it comes to medical matters. If you disagree, then go to the MEDRS talk page and try to get the rules changed. We can't do anything until that is done, so your dispute is not with us. -- Brangifer (talk) 04:41, 28 November 2013 (UTC)

As a service I'm going to post some links and comments about this study:

• Escolar E., et al. The Effect of an EDTA-based Chelation Regimen on Patients With Diabetes Mellitus and Prior Myocardial Infarction in the Trial to Assess Chelation Therapy (TACT), American Heart Association, Circulation, Published online before print November 19, 2013, doi: 10.1161/​CIRCOUTCOMES.113.000663

The full article can be downloaded free as a PDF document:

• http://circoutcomes.ahajournals.org/content/early/2013/11/19/CIRCOUTCOMES.113.000663.full.pdf+html

In the "Methods and Results" section of the abstract you'll find this: "However, after adjusting for multiple subgroups, those results were no longer significant." There was no effect on the group of patients without diabetes nor a mechanism of action to explain why it would work on diabetes patients, but not other patients. The difference was about 11 patients out of 300+ patients or about 3%. So, it is probably just chance rearing its ugly head and giving misleading results. As the study authors say: "These findings support efforts to replicate these findings and define the mechanisms of benefit. However, they do not constitute sufficient evidence to indicate the routine use of chelation therapy for all post–myocardial infarction patients with diabetes mellitus." -- Brangifer (talk) 17:32, 1 December 2013 (UTC)

RESPONSE: Actually, here is the unedited conclusion -- in its entirety -- from the abstract of the study you linked:

"Conclusions—Post–myocardial infarction patients with diabetes mellitus aged ≥50 demonstrated a marked reduction in cardiovascular events with EDTA chelation. These findings support efforts to replicate these findings and define the mechanisms of benefit. However, they do not constitute sufficient evidence to indicate the routine use of chelation therapy for all post–myocardial infarction patients with diabetes mellitus."

And of course it doesn't constitute sufficient evidence to now recommend putting all post–myocardial infarction patients with diabetes mellitus on chelation therapy -- it's the first such serious study. Had they said otherwise, they would have been unprofessional. But your opening quotation that "those results were no longer significant" was painfully misleading, since it referred only to the all-cause mortality / secondary end point and not to the primary endpoint (death, reinfarction, stroke, coronary revascularization, or hospitalization for angina) of the study as you made it appear. And the authors of the study absolutely did not in any way conclude or even imply that it was "probably just chance rearing its ugly head" as you suggested. The lack of an obvious mechanism of action is also not an argument against efficacy. As I pointed out, there are many highly effective drugs that have been used for decades without knowing the precise mechanism of action. I note that 100% of your extracted quotations were meant to appear negative when looked at out of context, whereas the conclusion of the study wrt diabetes was positive. No offense and nothing personal, but your above contorted portrayal of the study findings is precisely the kind of apparent bias that I would like to see remedied in the article.Bdmwiki (talk) 08:45, 4 December 2013 (UTC)

I think you'll find that the TACT data will not convince any scientifically sophisticated reader, and thus is unlikely to change expert opinion or clinical practice. Anyone with any experience in designing or interpreting clinical trials is going to recognize TACT as fatally flawed and essentially uninterpretable. The concerns have been outlined in detail elsewhere in the medical literature and are probably outside the scope of this talkpage. Unfortunately, the study is being promoted in a careless and misleading way which fails to account for its shortcomings. I think the expert community's view of this study is likely to be along the lines expressed by Steve Nissen: "We wasted $30 million and 10 years on an unreliable study... Public harm is going to come out of this. People are going to get bilked out of a lot of money. People are going to die." MastCell ^Talk 21:40, 4 December 2013 (UTC)

Yes, that Steve Nissen is an especially loud critic who now wants to speak to every newspaper because he predicted so vocally before the TACT results were in that there would be no benefit, and now he feels publicly humiliated. And yes, some cardiologists are threatened because it involves such a paradigm shift (i.e., "My mind's made up, don't confuse me with the facts."). But some cardiologists and many respected doctors and scientists are actually open to these new ideas:

Dr Gervasio A Lamas, Chairman of Medicine at Mount Sinai Medical Center and Chief of the Columbia University Division of Cardiology at Mount Sinai Medical, noted that some cardiologists have greeted the TACT results with skepticism and/or derision but argues that the results are actually intuitive for diabetologists and epidemiologists, who over years of researching diabetes complications have demonstrated that accumulation of advanced-glycation end products involves metal-catalyzed oxygen chemistry for their formation. As such, chelation of metal ions may be that much more important in diabetes patients, explaining the magnitude of benefit in this group. Indeed, note Lamas and colleagues in their paper, some common diabetes medications actually have chelating properties. "The reason this is exciting is—if this is borne out by additional experimentation—it is a way of treating the complications of diabetes that we have simply missed the boat on for decades, not knowing that metal chemistry was needed to form the advanced-glycation end products," Lamas stated. "If you look at these results depicted in these graphs, there is simply nothing like it. You show it to endocrinologists and they go bananas. Whether or not future studies show this to be true, the fact that it might be true is reason enough for there to be scientific interest in this." (Medscape) Dr. Eric Topol, a cardiologist with Scripps Health, said the medical community should pay attention. “Even with the warts of this trial, it does appear to signal a benefit,” he said. “That challenges the prevailing dogma.” (NY Times) — Preceding unsigned comment added by 108.224.165.120 (talk) 07:47, 5 December 2013 (UTC)

Well, like I said, I don't think any sophisticated reader is going to be convinced by these data, whether you're talking about endocrinologists or cardiologists. Between the 11 interim analyses, the mysteriously changing primary endpoint, the incredibly high (and imbalanced) dropout rate, the 10 pre-specified subgroup analyses, the effective un-blinding of the intervention, and the fact that a number of the site PI's had discplinary records or even felony convictions for fraud and, in some cases, data fabrication... well, I've found it useful as a case study in teaching the interpretation of published clinical trial results, so I guess maybe it was worth some of the $30 million, though. MastCell ^Talk 18:09, 5 December 2013 (UTC)

I think we're starting to miss the point. I retain a healthy skepticism, as we all should. But let's revisit the big picture. The U.S. National Institutes of Health and one of the nation's respected cardiology centers conducted a large study on chelation therapy for heart disease and found a compelling signal for marked reduction within the diabetic subgroup. Yes, many chelationists may be of questionable repute and the TACT study was necessarily associated with this group, but that is because chelation therapy has not been an accepted practice (and so pointing out this wart begs the question).

Try looking at it this way, instead. Blood letting (phlebotomy) has been looked back upon with ample derision for a century or more, but recently serious evidence started to emerge that significant cardiovascular disease reductions were associated with regular blood donation. That evidence does not mean: (i) that those same people who used to practice blood letting over a century ago would make quality physicians today or (ii) that the physiological reasons people once used to support blood letting should now be embraced -- i.e., one has to separate the potential legitimate science from the people/culture/history/basis. (And this analogy may be especially apt, because some of the actual benefit of phlebotomy may even be linked with reduction of excess iron, potentially akin to chelation effects). I would point out that of course the TACT study got a little dirty; it had to get in bed with a fringe element outside of mainstream medicine in order to do the study. So this all has to be put into proper perspective.

Also, let's not make the mistake of thinking pharmaceutical giants have pristine studies, either. As a fairly influential cardiologist, Dr. Harlan Krumholz (Professor of Medicine of Cardiology & Director of Clinical Scholars Program, Yale School of Medicine; Director, Yale-New Haven Hospital Center for Outcomes Research and Evaluation), writing in Forbes recently commented: "The irony is that if a drug manufacturer had gotten this result, they would have celebrated. We have billion-dollar drugs like fenofibrate and ezetimibe that have less evidence than chelation therapy has now." This quotation really captures the disconnect between the tone of the Wikipedia article overall (and specifically the section on heart disease) and the more legitimate spotlight that has emerged from the TACT study. Again, even with a Bonferroni correction for the multiple subgroups, the primary end point remained highly significant, and the National Institutes of Health openly supports the results. And let's keep in mind this is not a debate on whether or not chelation therapy works for diabetics with heart disease, but rather, what is the nature of scientific support and is this properly reflected in the article.

My big-picture point is that the tone and substance of this Wikipedia article are simply incongruous with the status of evidence and legitimacy of the organizations now inspecting it, and so the article needs to be revamped. Like it or not, chelation therapy has graduated a rung or two, for the time being at least, and this needs to be properly reflected.Bdmwiki (talk) 20:23, 5 December 2013 (UTC)

Which studies on blood donation and cardiac risk are you referring to? To my knowledge, the best available evidence (e.g. Aschiero et al., 2001) debunked the idea that blood donations ("bloodletting") reduced cardiac risk. Of course, I don't keep up with this literature, so please educate me.

I've never claimed that pharmaceutical-industry studies are "pristine". My actual view is quite the opposite, but regardless, the question has no bearing on the quality of the TACT trial other than as a diversionary tactic. But since you mention it, are you aware of any pharmaceutical-industry study where numerous investigators had pre-existing records of fraud, data fabrication, or substandard medical care? Where random FDA audits found that case report forms were being pre-filled before the patients were even seen ([2])? Would anyone attach any credence to such a study?

You also argue that the evidence for chelation is somehow comparable to the evidence for, say, statins. That's a fallacy. It's widely understood that the likelihood of a research finding being true depends, in part, on the prior probability of its being true. Statins were rationally developed based on an understanding of cholesterol metabolism, and proved their efficacy in a number of preclinical arenas before entering clinical trials. Their activity is biologically plausible. Chelation therapy for heart disease has no biological rationale (or rather, it has ever-shifting and largely debunked rationales). The prior probability that chelation therapy works is much, much lower than the prior probability that a statin works.

Therefore, it's entirely logical to demand a higher level of evidence to move the needle on chelation therapy. It's a serious logical error to apply the same standard of proof to a biologically plausible treatment with a high prior probability of efficacy (e.g. statins) as to an implausible approach with no biological plausibility (e.g. chelation). This is basic Bayesian probability, and underlies a lot of modern thinking about clinical evidence. MastCell ^Talk 23:25, 5 December 2013 (UTC)

Let's take your points one at a time, because I think this debate may be worthwhile for the Wikipedia article in the end:

(1) The actual efficacy of blood donation was immaterial to my point as I hope you realized -- but since you asked, here are some recent studies and article links supporting the cardiovascular benefits (and perhaps indirectly supporting some mechanism re chelation):

"Cardiovascular benefits of phlebotomy: relationship to changes in hemorheological variables", Perfusion, 2013 Sep 25

    http://www.ncbi.nlm.nih.gov/pubmed/24045034

"Effects of phlebotomy-induced reduction of body iron stores on metabolic syndrome", BMC Medicine, 30 May 2012

    http://www.biomedcentral.com/1741-7015/10/54[12/6/2013

"21st Century Bloodletting Reduces Cardiovascular Risk", Science Daily, 2012 29 May:

    http://www.sciencedaily.com/releases/2012/05/120529211645.htm

(2) Re fraud et al. One of my points was that lots of drug studies have dropouts, author conflicts of interest, prior negative trials, and other warts. But let me also try to make my point a different way. Imagine if you wanted to do a study to see if abortion was effective and safe during the time it was illegal. So the NIH funded a major hospital to oversee having lots of the back-alley abortionists do the surgeries. Amazingly, the results showed abortion was effective and safe. But then you came along and said, "Wait. Many of these so-called medical practitioners are liars, criminals, and incompetent doctors. Therefore, we cannot consider the possibility that abortion works or is safe." If that is your position, then you may want to pay to have the Cleveland Clinic perform the chelation therapy for the next study. Chelation therapy has not been illegal (though the Wikipedia article often suggests otherwise), but it has certainly been entirely displaced from mainstream medicine (perhaps for lack of scientific support, fairly or unfairly), and so we should not be surprised with these problems. But the reality of the biochemistry has nothing to do with the present-day subculture. The study managers probably did the very best they could given the state of the chelation field prior to their study results, they have been entirely transparent throughout the reporting process, and both the National Institutes of Health and Mount Sinai Medical Center support the results as published. That should be enough for Wikipedia to include the actual results, comments pro and con, and controversies surrounding the study.

(3) "You also argue that the evidence for chelation is somehow comparable to the evidence for, say, statins." Where did I argue that? If you are complaining about the quotation, "We have billion-dollar drugs like fenofibrate and ezetimibe that have less evidence than chelation therapy has now," you will need to take that up with the Yale Professor of Cardiology and Clinical Studies who said it (noting that neither of those drugs he mentioned is a statin).

(4) "Chelation therapy for heart disease has no biological rationale." Well, if it works, then by definition it does have a biological rationale, doesn't it? Or did you just mean to point out that we don't know everything... The real point of my argument was that objections having to do with not yet understanding the precise underlying mechanism do not prevent innumerable pharmaceutical drugs, established medical treatments, and serious surgeries from being utilized. No one really knows how the drug Provigil works, except that it does. People are still debating why antidepressants work. Gastric bypass surgery is incredibly effective and popular, but it was in use for a long time before its mechanisms even began to be uncovered (which is still ongoing). And as an aside, gastric bypass surgery usually resolves the underlying metabolic, blood pressure, and dyslipedia problems within 2-4 days of surgery -- and dramatically regresses carotid intima thickness within a year -- to an extent that any combination of statins, antihypertensives, & antidiabetic drugs would hold in envy, but scientists are just beginning to close in on the biological explanations for these surprising results. It was not until fairly recently that the true underlying mechanism for Metformin, one of the most successful drugs in medical history, was elucidated, after more than a half century of use (having to do with inhibition of mitochondrial respiratory complex I). Electroconvulsive therapy (ECT) is currently considered the gold standard in efficacy for treatment-resistant depression, but it is still anyone's guess as to how it works even after almost a century of use (and let's not forget some of the sordid medical history there). Each of these modalities has had "ever-shifting and largely debunked rationales", as you put it, leading up to some final correct explanation, so should these effective modalities now be rejected? (And can you look in the mirror and honestly say that you would give ECT fair consideration in a study if it had been practiced to date only by chelationists?) Even statins, whose efficacy you will note I strongly supported in my comments, have pleiotropic mechanism(s) that are considerable (and who knows, might in time even displace LDL-C reduction as the primary one, given the lackluster performance of other cholesterol lowering drugs). But if you must have some hook to temporarily hold your hat, I noted very generally that iron and metal-catalyzed chemistry may be central to the mechanisms surrounding reductions in diabetic complications if chelation therapy pans out, but I am certainly not wedded to this proposition.

(5) "The prior probability that chelation therapy works is much, much lower than the prior probability that a statin works. Therefore, it's entirely logical to demand a higher level of evidence to move the needle on chelation therapy" This one I definitely agree with (noting only philosophically that this 'prior probability' results from our inherent state of confusion), and I supported this sort of thinking previously. I explained that is precisely why the authors of the TACT study expressly recommended against now putting every diabetic on chelation therapy and in favor of more scientific research, to confirm or overturn their findings and to ascertain the precise mechanisms if the results hold.

I know your positions on chelation therapy and blood donation. And for all you know, I secretly agree with you. But what is your position on what should be included in the Wikipedia article, which is my real interest? Should it, as it currently does, state that the TACT study found no evidence for efficacy (opposite of the truth), that the NIH believes there is no scientific support for chelation therapy and heart disease (opposite of the truth), that no legitimate organization has ever found positive evidence (opposite of the truth), etc? I would like to see the article reorganized and rewritten to include the study findings, your criticisms and others, responses to those criticisms, the official NIH website position, quotations from prominent cardiologists, etc, to give a balanced view. What is wrong with that? Bdmwiki (talk) 12:02, 6 December 2013 (UTC)

We should probably move this discussion to my user talkpage, or yours, since it's drifting a bit. Thank you for the links regarding phlebotomy and blood pressure etc. As I said, it's not an area I keep up with, so I appreciate the chance to learn something.

Your abortion analogy is so far off-base that I'm not sure where to start. We're not talking about investigators who were disciplined for providing an unpopular medical therapy. The TACT investigators in question have records of financial fraud, falsifying medical records, conspiring to defraud Medicare, submitting false reimbursement claims, tax fraud, assault with intent to rape, felony extortion, practicing medicine without a license, lying on medical-licensing applications, falsifying research data, gross negligence, and engaging in patterns of unethical and unprofessional conduct. None of these have anything to do with the level of mainstream scientific acceptance for chelation. They have to do with basic honesty and integrity, and are directly relevant to the amount of faith one places in results generated by the study.

I just don't see this study as convincing in any way. If you look at its rationale, its design, the qualifications of its investigators, its conduct, or its results, you'll find plenty of grounds for skepticism. I didn't even get into the question of generalisability: most of the people enrolled in this study apparently get their medical care from chelationists and non-mainstream health-care providers. How many of them received (and adhered to) standard medical therapy for diabetes and secondary prevention of CVD? I suspect this patient population is substantially different, in many important ways, from the general population with diabetes and CVD. There's indirect evidence from the paper itself that the study population received substandard medical care at baseline: ~25% of them were not on a statin. ~25% of them were not on beta-blockers. ~35% were not on any form of ACE inhibition. ~15% of them were not on aspirin. All of those numbers should be pretty close to zero, right?

Anyhow... thanks for the phlebotomy links. MastCell ^Talk 22:34, 6 December 2013 (UTC)

I agree very much with points made by Bdmwiki. The way this article reads, with no direct references to the actual study and the positive outcome, is misleading. The study was done by professionals, of such a design and published in a quality journal so that at least the study's findings should be reported, making the tone of the whole article itself seem more fair and unbiased. — Preceding unsigned comment added by 89.162.102.177 (talk) 18:08, 10 December 2013 (UTC)

Well, I do agree that we should rewrite the current sentence on the TACT results to indicate the study's actual findings. At the same time, I think it's important to retain the context—for example, the fact no reputable body views the TACT results as sufficient to recommend chelation therapy to prevent heart disease. MastCell ^Talk 18:14, 10 December 2013 (UTC)

rampant bias

This article is clearly suffering from the same epidemic of psudo skeptisism that is plaguing many alternative health articles here on Wikipedia. Wiki folks should take note of the wayward editors indulging in manipulation of information that WILL AFFECT PEOPLE. The whole second paragraph is a fear smear written to bother the reader. In truth too much water can kill you. Pretty much anything can kill you. But the second paragraph would suggest that to dare engage in this therapy is near certain death risk. It is irresponsible writing . And who in their right mind would suggest chelation for cancer or autism? I had never even seen it suggested before reading the wiki entry... And since that is not the norm but rather a rare expetion ,to include the unethical notions as main talking points in the article over plays the rarity of an irresponsible person would make such irresponsible claims.

That is to say nothing of the content issue... Who is the father of chelation therapy? — Preceding unsigned comment added by 98.200.208.230 (talk) 14:23, 27 November 2013 (UTC)

128)

— Preceding unsigned comment added by 98.200.208.230 (talk) 14:38, 27 November 2013 (UTC) How is it the federal trade commission came to be in charge of evaluating the medical effectiveness of chelation for arterial plague? That doesn't make sense since the body of the FTC is not a scientific body but rather a body of commerce... Is chelation commonly used for horses or other animals? Just because chelation is used in alternative medicne to help with Lyme disease does not turn it into a fringe lunatic treatment option that normal kills people. Wiki articles on alternative medicin are suffering from psudo skeptics attempting to pass off opinions for facts. — Preceding unsigned comment added by 98.200.208.230 (talk) 14:36, 27 November 2013 (UTC)

You'll need to provide reliable sources to support the changes you imply need to be made to the article. Note that said sources need to be compliant with our guideline on reliable medical sources. If you have such sources, then we can talk; if not, you're just ranting and not helping. Qwyrxian (talk) 14:46, 27 November 2013 (UTC)

Condescending like the above is of no value. This talk here was to address a bias from this particular wiki page. The wiki entry itself IS the source. The changes I suggest are clear ,simple,understandable to all but those that want to protect misinformation or engage in conflict. Less bias. this is not a complicated suggestion. The intent of the article is clear and it is not to educate but to instill fear regarding chelation. God forbid someone with real metal poisoning be dissuaded from seeking treatment out of a fear of death propagated by an erroneous wiki entry...granted anyone relying on wiki for medical advice is a Darwin candidate. But I digress. This article is biased and written of negative slant to push an agenda. Who was the very first person to get chelation? How about some pictures of a person undergoing chelation. The article says some people died dng chelation... What happened to the practitioners? What happened to the parents? Where are the obit sources? Chelation saves lives too as I understand it, how about some numbers on how many lives are saved? I'm sure many jape axe have undergone chelation for radiation poison... Lots or radioactive particulate metal floating around over there.... Lots of material to improve this article and a great opportunity to remove the bias in this article in favor of a more journalist neutral — Preceding unsigned comment added by 98.200.208.230 (talk) 15:18, 27 November 2013 (UTC)

If you have sources for any of those things you think that should be added, please provide them. I personally do not have easy access to quality medical or medical history sources. Some of the details you ask for are beyond the scope of this article (like detailed biographical information about people who died during chelation), but some of the things you ask would be relevant.

Maybe the problem is that you're misunderstanding how Wikipedia works--there aren't a group of people tasked with control/improvement of specific articles. Rather, all people who look at a WP article and think that it could be improved are invited to help improve it. Yes, some of us, like myself, have more experience and are more familiar with our rules, so I can provide you with some guidance (for instance, if you find sources and present them here, I'd be happy to help analyze whether or not their meet our guidelines for sources on medical info). But the actual task of finding new information is up to the community at large.

I think you do make one overarching good point--I feel that the article does, relatively speaking, overemphasize the alternative/off-label use of chelation therapy, and could spend more time on the details of proper chelation use. So, will you help us find some good info to provide proper balance? Qwyrxian (talk) 21:31, 27 November 2013 (UTC)

Qwyrxian makes a good point. The article could use more information on the legitimate uses of chelation therapy. -- Brangifer (talk) 17:08, 1 December 2013 (UTC)

There is now evidence in the American Heart Journal that its use for diabetes (chelation for diabetes is an alternative medical therapy) is effective. Here is a link to a National Institutes of Health article citing it 2601:6:7180:73B:16B:63CD:2935:3764 (talk) 00:47, 20 January 2015 (UTC)

References

I have done some work formatting the references and adding links etc. Some refs need verification for page numbers and evaluation as reliable sources. I agree that more material on the legitimate use of chelation would be appropriate, references are needed. The appropriate medical use of chelation has been overshadowed by questionable practitioners (Barrett, Stephen (27 August 2012). "Be Wary of 'Board Certification' in Clinical Metal Toxicology". Quackwatch., or as the American Cancer Society puts it in their first sentences on the subject, "Chelation therapy is a mainstream treatment used to treat heavy metal poisoning. However, the term is also used to promote an alternative therapy that is supposed to treat heart disease, cancer, and other conditions." ACS 2008 ref 3) in general so I think the balance in the article is close to appropriate. I have also set up autoarchiving on this talk page. - - MrBill3 (talk) 19:46, 17 January 2014 (UTC)

lead

hello everyone. i edited the wording in the lead to provide what is in my opinion a more updated definition of the concept. if you disagree and would like to work with me on the edits, please let me know. thank you. GoGatorMeds (talk) 19:43, 27 June 2014 (UTC)

Remove prevalence information

I just removed this:

The American College for Advancement in Medicine estimates that 800,000 patient visits for chelation therapy were made in the United States in 1997.

My reasons are as follows:

1. This is a press release, and not under enough scrutiny per WP:RS
2. The information is not meaningful in its context. "Chelation therapy" seems to be defined in some non-standard way, including chelation therapy in the alternative medicine sense perhaps along with the same in the conventional medicine sense.
3. I do not know why the numbers for a certain county in a certain year can give insight to the practice as a whole.

Blue Rasberry (talk) 17:08, 10 July 2014 (UTC)

Archive review

I just looked through the archives to see if anything struck me as having been removed or changed in the article, and never having been resolved. There have been debates but on specific aspects of this article, and not the broad concept of chelation therapy generally. I am saying this to confirm that I feel the current version of this article is stable. Blue Rasberry (talk) 19:34, 10 July 2014 (UTC)

--- not really stable - While I've thought that Chelation was quack medicine - the other side of the story has changed:

See: TACT - https://www.sciencedirect.com/science/article/pii/S0735109716015989

For diabetic patients it appears to do long term good - will this be replicated? We don't know - (They are running TACT2) but the picture is not the open and closed story presented in this wiki-page. They were expecting to put Chelation to rest once and for all - but the results were surprising. To not be open to a possibility - no matter the history and origin - is not how we learn new things. If TACT2 shows the same thing - I think it would speak to just how much lead we are exposed to. See https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30025-2/fulltext — Preceding unsigned comment added by 108.243.106.82 (talk) 03:15, 6 October 2019 (UTC)