Chelation is a safe, and effective method of removing undesirable materials from the body. The term chelation is derived from the greek word: “Chela” meaning claw. i.e. the claw of a crab or a lobster. It means the incorporation of a mineral, ion, or cation into a ring by an organic molecule called a “chelating” agent. The chelating agent, an organic molecule such as an amino acid, grabs and claws into a ring, a mineral, ion, or cation (the chelate) such as iron or calcium.
Are you using detoxification products? Are they effective? Do you know exactly what elements they are detoxifying? Assess the effectiveness of your current detoxification program at Longevity Healthy Aging® Research Group (LHA®).
Chelation is a constant natural process- for example, amino acids chelate with minerals for transportation to their destination. Iron from meat and vegetables is released in the bowel during the digestive process, and combines with amino acids (is chelated) so that it can be effectively transferred through the intestinal wall into the bloodstream. Chelating compounds are present in nature for example, chlorophyll (the green matter of plants) is a chelate of magnesium, and hemoglobin is a chelate of iron. If you drink tea, a chemical called tannin, which is found in tea, chelates with iron (forming iron tannate), preventing its absorption.
Chelation therapy is an extension of the natural process to enable the removal from the body, by infusion, orally, or in the form of suppositories, of undesirable minerals and ions, by using a suitable chelating agent such as EDTA. EDTA is a preservative in much of the foods we eat, and is also found in small amounts in the infusions used by hospitals.
There are different types of therapeutic chelation. These include intravenous EDTA with trace minerals and vitamins which has been used in conjunction with lifestyle changes to treat vascular disease.
Mechanism of Action of EDTA: How chelation works:
A review of the chelation literature reveals its various mechanisms to be as follows:
- it reduces serum ionizable calcium with a secondary rise in parathyroid hormone and stimulation of bone formation
- removes metastatic calcium. It reduces calcium in the blood stream and subsequently in soft tissue by decreasing the hardening of the arteries and stiffening of the tissues
- removes ionic calcium from the cell with secondary improvement in mitochondrial function (mitochondria are the energy producing factories of the cell)
- it causes magnesium to move into the cell to replace calcium that has been removed
- increases excretion of metals from the body, both toxic heavy metals and transition metals (such as iron, copper, aluminum, lead, mercury, arsenic) which catalyze free radical pathology
- it serves as an antioxidant
improves endothelial function
- at the cell membrane it stabilizes lipid peroxidation (breakdown of fat) and inhibits low density lipoprotein oxidation
- decrease platelet aggregation-it serves as an anticoagulant
- it reduces blood pressure by reducing spasm of the vessels and by removing lead and other toxic metals
- it improves blood flow with a better supply of nutrients to the cells. It improves blood flow by making blood vessels softer and more flexible preventing-formation of vulnerable plaques and reducing at certain extent the stable plaques.
- Improve immunity
- Raises levels of hormones
FAQ’s (with answers) and More Information About Chelation:
A person with substantial blockages of the coronary artery was recommended to undergo a heart operation by the cardiologist- what should he choose, bypass surgery or chelation treatment?
I believe that in order for the person to be able to make a decision he requires sufficient and informed information from his cardiologist, heart surgeon, family physician, and chelation doctor.
They all have to be well informed on the benefits and complications of the treatment as well as the causes and progression of cardiovascular disease. I believe that only when he/she is well informed can the best decision be reached.
The information discussed with the patient should include:
- Risk factors for cardiovascular disease and methods of dealing with the various risk factors.
- Recognition of the fact that cardiovascular disease is a diffuse process affecting the majority of medium and large sized arteries in our bodies- treatment should therefore be targeted at the diffuse problem, rather than focus on isolated vessels.
- The risks and benefits of invasive treatments and of chelation treatments, including the fact that surgery only deals with a localized area of a diffuse problem (similar to the opening of a plugged pipe which may be only one of many that are plugging up). Chelation, on the other hand, provides a diffuse approach with widespread effects.
- The cost of the procedures ]CABG $58,889 US Angioplasty $56,225 US (Hlatky MA, Rogers WJ, Johnstone I, et al: Medical care costs and quality of life after randomization to coronary angioplasty or coronary bypass surgery. New England Journal of Medicine 1997; 336 (2): 92-99)].
- The mortality rate from the procedures: for example, the risk-adjusted mortality rate from angioplasty in New York State in 1994 was 0.87 (http://www.sjhsyr.org/perform/grph6.html) while the mortality rate from bypass grafting in New Jersey was found to be 2.60 (http://www.meridianhealth.com/mediarelations/archives/release71.shtml).
- Complications of the procedures, such as:
◊ memory changes
◊ changes in quality of life (such as in pain control, shortness of breath, energy)
◊ effects on life expectancy
◊ recurrence of symptoms (how long do benefits from the procedure last?)
I believe that only when the person is well informed can they make the best decision to choose between chelation, surgery, or a combination of both. In order for the person to be well informed, the health practitioner has to be knowledgeable in the various options available, or to be able to refer the client to the appropriate practitioner.
One of our patients, after three unsuccessful angioplasties, was recommended by the cardiac surgeon to undergo a bypass operation. He inquired about chelation, and was told by the surgeon that chelation will cause his blood vessels to “turn into cheese” (there is no evidence to support this assertion). He opted for chelation, nonetheless, with significant improvement in his condition and without the threatened “cheese transformation” of his blood vessels. The cardiac surgeon now tells my client: “I don’t care what you’re doing now, but whatever it is, continue to do the same!”
I believe that we have to care what our patients do for their health, and if there is any method of improving their well being with minimal side effects we have to learn about it, and then pass this information on to our patients.
One “small” thing to remember is that there are no magic bullets for good health- there is, however, a complex and integrated approach which is necessary.
Benefits and Side Effects of EDTA Chelation
There is increasing evidence that chelation therapy, if done appropriately, improves circulation in a large majority of patients and significantly improves quality of life.
What percentages of patients are improved after EDTA chelation therapy?
The result depends on many factors including the patients underlying medical condition, compliance, and the type of product used.
Dr. Terry Chappell and Dr. John Stahl collected information from 70 studies. It was found that 87 per cent of 22,765 patients had measurable improvements in their vascular disease after chelation treatment (Chappell LT, Stahl JP. The correlation between EDTA chelation therapy and improvement in cardiovascular function: a meta-analysis. J Adv Med. 1993;6:139-160).
A study by Dr. Carter and Olszewer on 2,500 patients who had heart disease, carotid artery disease, and peripheral vascular disease showed an 85 per cent improvement among patients undergoing chelation therapy (Olszewer E, Sabbag FC, Carter JP. A pilot double-blind study of sodium-magnesium EDTA in peripheral vascular disease. J Nat Med As. 1990; 82:173-177. Olszewer E, Carter JP. EDTA chelation therapy in chronic degenerative disease. Med Hypoth. 1988; 27:41-49).
In our center, all patients enrolled in advanced chelation program showed improvements in their subjective complaints. One patient underwent an angiogram and exercise stress test before starting the program. The angiogram was abnormal, and the stress test was positive after 2 minutes. He is now in our program for over 30 months, is free of chest pain, and is able to perform the stress test for 13 minutes (Click here for testimonials).
Is chelation therapy beneficial for different age groups?
Chelation therapy was found beneficial in patients of different age groups. Chelation is used to treat children with lead toxicity to remove the lead from their bodies as well as in adults of different ages in order to remove toxic materials from the body as well as to treat degenerative diseases of aging such as heart disease.
What are the most common side effects of EDTA chelation therapy?
Chelation therapy has very few side effects, if done appropriately. These include:
- mild discomfort at the site of the intravenous injection.
- occasional temporary lowering of the blood sugar or the blood calcium levels that can cause weakness or muscle cramping, but this is readily corrected.
- tiredness after the therapy.
- abnormal kidney test results have been described as a possible complication of chelation.
If the ACAM (American College of Advancement in Medicine) protocol is followed appropriately and the treatment is provided by a well-trained physician, then kidney damage is not reported, and in fact, kidney function may even improve. From our experience we have not seen kidney damage following chlelation in any of our patients. Not only this, but many patients actually show improvements in their kidney function tests. As a precaution, kidney function tests are performed regularly on all patients undergoing chelation treatment.
Are there any absolute contraindications to EDTA chelation?
There are probably no absolute contraindication to the use of EDTA other than the rare patient with severe allergy to EDTA, or acute lead encephalopathy. Renal dialysis may also be a relative contraindication. (Preventing lead poisoning in young children. A statement by the Centers for Disease Control, U.S. Department of Health and Human Services, Public Health Service. 1991; p.55. Mehbod H. Treatment of lead intoxication. Combined use of peritoneal dialysis and edetate calcium disodium. JAMA. 1967;201:972.)
Can I and should I use vitamin, mineral, and herb supplements in conjunction with chelation therapy?
Chelation therapy removes some food minerals from the body as well as the toxic ones- they have to be replaced with oral supplements and by adding the appropriate minerals to the intravenous solution.
How do we assess the effectiveness of chelation therapy?
Subjective changes such as decreased pain, improved energy, ability to walk longer distances.
Objective findings such as cure of skin ulcers, improvement in hypertension.
Tests such as:
- stress testing
- clotting studies
- lipid testing, monitoring changes in lipid levels such as lipoprotein a, HDL and LDL cholesterol
- toxic and essential material testing, tracking changes in the level of toxic materials.
- assessment of free radical damage and oxidative stress
We believe that assessment of level of function (using an exercise stress test, for example) and the patient’s well-being are among the most important factors in assessing the effectiveness of chelation treatment. Angiography may provide information about anatomy, but is unable to assess function. It is not a perfect test, and most importantly it is unable to identify unstable plaques.
There are studies that show that chelation treatment is not beneficial- explain?
Before making conclusions, it is very important to know all the facts.
There are studies that show that Vitamin C is beneficial and studies that show the opposite. There are studies that show that estrogen prevents heart disease and new studies that show that estrogen contributes to heart attacks.
Women in their 20’s and 30’s have higher levels of estrogen and generally do not suffer from heart attacks. After menopause some studies will suggest that women given estrogen have a higher risk of heart attack and stroke- other studies will say the exact opposite.
When studies contradict each other, what are health practitioners and patients supposed to believe to be true?
And the truth is that both are right (click here). It is not enough to simply offer a treatment. The treatment being offered may have the same name, but may be entirely different based on the products used, how they are used, and how they are combined into an effective treatment plan.
When somebody says “I underwent chelation therapy”, this is similar to stating “I ate bread” or “I met a woman” or “I use hormones.” These statements are vague and do not tell you anything. What kind of women, what kind of bread, which kind of hormones, what kind of chelation? There are different types of women, different types of bread, different types of hormones, and of course, different types of chelation.
Many studies should be reviewed with a lot of skepticism. Questions that need to be asked:
- Who performed the study?
- What is the training of the author in the subject (in this case, chelation)?
- What are the baseline characteristics of the groups treated (information about patient age, smoking status, history of heart disease or other medical conditions)?
- What type of chelation has been used and what tests have been done prior to starting the treatment?
- Has chelation therapy been performed on the basis of hair analysis testing? Is hair analysis of any value in deciding the type of chelation (See also detoxification)?
- What kind of material was used in the chelation? How are the materials mixed? From which pharmacy are the products derived? How does the pharmacy compound the products?
- Are all the products used in the chelation the same, since they may all have the same name? (ex. are all vitamin C the same since they are all called Vitamin C? Are all EDTA the same since they are all called EDTA? Is all DMPS the same?)
We found out that there are many variables influencing the treatment and each one may affect the results of the treatments. On this basis we have developed the Advanced Chelation Program which has produced excellent results.
What is your opinion of oral chelation?
I hear many statements about the effectiveness of chelation given orally or in the form of suppositories.
As previously stated, chelation is a natural process. Many foods have a chelating effect, such as tannic acid (found in tea), which chelates iron. EDTA is a food preservative added to some foods such as ketchup. Does this mean that by eating ketchup you are undergoing oral chelation? How much ketchup would one have to eat to have similar results as from intravenous chelation?
There are different types of medicinal oral chelation. They contain oral EDTA or DMPS or a combination of EDTA with vitamins and minerals. About 5 per cent of EDTA is absorbed when taken orally. Some believe that oral chelators remove beneficial minerals from the bowels.
My answer to the question of whether oral and suppository chelators are effective, is as follows. . In order to assess effectiveness, before and after using a chelator one has to test for toxic and essential elements in urine and if necessary also in blood and feces. One has to also check the level of toxic and essential elements before and during treatment. If the appropriate tests and appropriate lab was used (click here for our Longevity Lab Services), the results of the tests will provide clear answers as to the effectiveness of treatment.
What is the role of chelation as a preventative treatment for cardiovascular diseases?
The answers are simple – the decision is yours.
- It is a good idea to deposit a dollar in the bank every day starting in childhood.
- The initial damages to the blood vessels start in childhood and later progress to the development of atherosclerosis (see also Cardiovascular Disease).
- Studies have shown that by age twenty the atherosclerotic damage in our blood vessels is far advanced.
- Death is the first sign of heart disease in 25 to 30 per cent of us, so it is best to begin acting to prevent and treat before the warning signs appear.
- The etiology of cardiovascular disease is multi-factorial, and includes free radical damage, and the formation of unstable plaque in the blood vessels. Toxic metals and an excess of essential minerals (such as copper, manganese, and iron) activate damaging free radicals. Chelation works to remove toxic metals and an excess of essential minerals, thereby decreasing free radical damage. It also decreases platelet aggregation.
- Advanced Chelation, by targeting the risk factors for heart disease, offers a comprehensive program for the prevention and treatment of cardiovascular disease.
- The information is here – the decision is yours. It is best not to be like so many others who only seek help once they become unwell- remember, the best way to treat a disease is to prevent it.
Should I avoid vitamins on the day of chelation?
There is controversy about taking vitamins on the day of chelation. We suggests patients not to take minerals on the day of chelation but as already stated there is incomplete agreement on the topic.
What is your opinion of one and ten minute EDTA IV chelation?
In order to answer this question, one should assess the effectiveness of treatment, by performing appropriate testing both before and following the treatment. Such tests may include:
- the level of toxic elements in urine
- platelet aggregation
- free radical damage
- oxidative stress testing
If the tests are performed correctly, and show a consistent improvement following the treatment, it suggests that the treatments were effective, and that there is value in performing short duration chelation. If there is no objective improvement in lab results, then it suggests that this type of treatment is not effective for that individual
What is the proper administration time for a bottle of EDTA?
The standard protocol for use of EDTA is the administration of one EDTA treatment over a three to five hour period depending on the patient’s kidney function and cardiovascular status.
There are groups using a smaller bottle and a smaller amount of EDTA over a shortened period of time, but this is not the standard protocol adopted by ACAM (The American College of Advancement in Medicine).
What about maintenance treatment?
The maintenance treatment with EDTA chelation is performed every 3 to 4 weeks. Some groups suggest that for patients with diabetes mellitus and severe heart disease, maintenance treatment should be every two weeks. (Olszewer E, Sabbag FC, Carter JP. A pilot double-blind study of sodium-magnesium EDTA in peripheral vascular disease. J Nat Med As. 1990; 82:173-177. Olszewer E, Carter JP. EDTA chelation therapy in chronic degenerative disease. Med Hypoth. 1988; 27:41-49).
Conditions for which chelation was found beneficial:
Toxic materials and an excess of essential metals are considered potential risk factors for the development of conditions such as Alzheimer’s, Parkinson’s disease, osteoporosis, and cancer.
The methods by which chelation works include:
- a reduction of heavy metals and excessive essential metals such as iron or copper
- decreasing free radical damage
- improving immunity
- decreasing clotting
On the basis of these mechanisms, chelation, if done appropriately, is considered beneficial in delaying aging and in the treatment of the degenerative diseases of aging such as cardiovascular disease, osteoporosis, cataracts, Alzheimer’s disease, arthritis, cancer, and possibly macular degeneration (Olszewer E, Carter JP. EDTA chelation therapy in chronic degenerative disease. Med Hypoth. 1988; 27:41-49).
It is important to stress, however, that apart from cardiovascular disorders, there is very little in the scientific literature that links EDTA chelation with improvement in these conditions.
Advanced Chelation is a comprehensive program, offering a complex approach to health according to the person’s condition and results of tests we perform. EDTA chelation, nutrition, and nutrients are only a part of the program.
Dr. Bergman has developed the program of Advanced Chelation. He is a member of the American College of Advancement in Medicine (ACAM) and is a diplomat in chelation. Furthermore, he is the developer of the “Cell First Theory of Aging” based on cell damage, balance, and transportation.”
Why Advanced Chelation?
The advanced chelation program was developed over time. Chelation is only a type of treatment which can be beneficial if appropriately done, but can have complications if not. In addition, most of us will require a combination of different types of chelation, based on appropriate testing. We do not believe in magic bullets. We do not believe in a magic pill that makes us young and healthy (“we wish!”). Health is a complex process that requires complex care. Chelation treatment may be part of a health program, but good health requires a comprehensive approach which goes beyond simple chelation. The advanced chelation program was developed on the basis of the theories of aging, as our answer to the various causes of heart disease and other degenerative diseases of aging.
Advanced Chelation Questionaire
The Advanced Chelation program provides a complex approach to chelation, which includes education, and different types of chelation according to various diagnostic tests and regular assessments of treatment effectiveness. It is only one part of a comprehensive approach to health whose ultimate goal is the prevention, reversion, and treatment of the degenerative diseases of aging such as cardiovascular disease, osteoporosis, cognitive impairment and cancer.
Many people have undergone chelation or detoxification programs, either orally or by injections. Based on our center’s experience, many people who have undergone chelation have limited knowledge of this process except to state that it is “good to clean the body.”
Test your knowledge of chelation. We would appreciate if you may take a few moments from your time and answer the following questions:
Have you undergone chelation? (oral, IV or both) Yes No
Do you know how chelation works? Yes No
Do you know more than three mechanisms on how chelation works? Yes No
Do you know that there are different types of intravenous chelation? Yes No
Do you know what tests should be done before chelation starts? Yes No
Do you know how to diagnose the presence of toxic elements in your body? Yes No
If not, would you like to know? Yes No
If you have undergone chelation, were you tested for the presence of toxic elements before initiating chelation? Yes No
Have you ever had an assessment for the presence of toxic elements based on hair analysis? Yes No
Do you know if hair analysis is of any value for diagnosing the burden of toxic elements or an imbalance of essential elements? Yes No
Do you know what the best test is to diagnose the burden of toxic elements? Yes No
Have you undergone tests to assess the effectiveness of chelation treatment? Yes No
Do you want to know if your chelation treatment is effective? Yes No
Have you been told that you are “clean” of toxic elements on the basis of urine, blood or hair analysis testing? Yes No
In our program, we perform tests to identify the presence of toxic elements, and teach you about the value of various tests which are used in making such diagnoses. This is essential because the treatments offered, the effectiveness of the treatment, and the cost are affected by the initial assessment.
We consider provocative tests to be the best tests for diagnosing the burden of toxic elements. Hair analysis, on the other hand, has no value in the diagnosis of the burden of toxic elements, or in the assessment of the effectiveness of the detoxification process. This has been confirmed by a number of studies in recent years, such as a 1985 article published in the prestigious Journal of the American Medical Association, which concluded that hair mineral analysis was “unscientific, [and] economically wasteful” (Barrett S. Commercial hair analysis. Science or scam? JAMA. 1985 Aug 23-30;254(8):1041-5). More recently, in a 2001 study also published in the Journal of the American Medical Association, Seidel et al similarly concluded that hair mineral analysis was “unreliable, and we recommend that health care practitioners refrain from using such analyses to assess individual nutritional status or suspected environmental exposures” (Seidel S, Kreutzer R, Smith D, McNeel S, Gillis D. Asessment of Commercial Laboratories Performing Hair Mineral Analysis. JAMA. 2001;285:67-72).
Our program will show you how test results may be affected by the type of test used and by the type of products used. In addition, the same product can lead to different results and outcomes of treatment based on the compounding pharmacy which produced it. All these points are very important because they can affect you treatment results and cost.
The following are examples of patients who have undergone chelation using various chelating agents- they demonstrate that the results are dependent on both the type of agent used, and also the preparation (compounding) of the product itself. Mrs. V.S. underwent detoxification using one type of detoxification product. The level of mercury in her urine after using product A was read as zero. The apparent conclusion was that she did not have mercury in her body- this was the wrong conclusion. We suggested that she try another detoxification product (chelator), product B, and the results revealed that she had high amounts of mercury in her urine. What can we learn from this? She has mercury in her body but the first detoxification product used was not effective at removing the mercury so that none was detected in the urine. This underscores the importance of using the appropriate tests and products for treating and detecting toxic elements. Another example demonstrates the importance of using a well compounded product, as the type of compounding impacts on whether a treatment is effective or not: Mr. G. had his urine mercury level tested after being given a detoxification product (chelating agent) made at one compounding pharmacy. His level of mercury was 11. The same patient had a repeat test for urine mercury using the same type and amount of detoxification product, however this product was obtained from a different compounding pharmacy. His mercury level was found to be three times higher. What can we conclude from this? The second chelating agent used for detoxification is much more effective. This teaches us that it is not enough to use a certain product and say “I undergo chelation” or “I use detoxification products.” The key is using the right product, and finding out that it is in fact effective. At Longevity Healthy Aging™ Research Group, we will do our best to teach you about the various testing and treatment options, based on our own experience and from a review of the medical literature. This will help you in making an educated decision regarding your own care.
References and Further Reading:
Cranton EM, Frackelton JP. Free radical pathology in age-associated diseases: treatment with EDTA chelation, nutrition, and antioxidants. J Hol Med. 1984;6:6-37.
Gutteridge JMC. Ferrous-salt-promoted damage to deoxyribose and benzoate, the increased effectiveness of hydroxyl-radical scavengers in the presence of EDTA. Biochem J. 1987; 243: 709-714.
Deucher DP. EDTA Chelation Therapy: an antioxidant strategy. J Adv in Med. 1988;1:182-190.
Bjorksten J. Possibilities and limitations of chelation as a means for life extension. J Adv in Med. 1989;2:77-78.
Lamb DJ, Leake DS. The effect of EDTA on the oxidation of low density lipoprotein. Atherosclerosis. 1992; 94:35-42.
Rahko PS, Salerni R, Uretsky BF. Successful reversal by chelation therapy of congestive cardiomyopathy due to iron overload. J Am Coll Card. 1986;9:436-40.
Menasche P, Pinwica A. Free radicals and myocardial protection: a surgical viewpoint. Ann Thorac Surg. 1989;47:939-45.
Rudolph CJ, McDonagh EW, Barber RK. Effect of EDTA chelation on serum iron. J Adv in Med. 1991;4:39-45.
Gordon GB, Vance RB. EDTA chelation therapy for atherosclerosis: history and mechanism of action. Ost Ann. 1976;4:38-62.
Halstead BM. The scientific basis of EDTA chelation therapy. Colton, California, Golden Quill Publishers 1979.
Kaman RL, Rudolph CJ, McDonagh EW, Walker FM. Effect of EDTA chelation therapy on aortic calcium in rabbits on atherogenic diets: quantitative and histochemical studies. J Adv in Med. 1990;3:13-22.
Levy RJ, Howard SL, Oshry LJ. Carboxyglutamic acid (Gla) containing proteins of human calcified atherosclerotic plaque solubilized by EDTA: molecular weight distribution and relationship to osteocalcin. Atherosclerosis. 1986;59:155-60.
Walker FM, Wilson CW III, Kaman RL. The effects of EDTA chelation therapy on plaque calcium and plasma lipoproteins in atheroscelrotic rabbits. Fed Proc. 1979;38 (No. 4335).
Walker FM, Wilson CW III, Kaman RL. The effects of EDTA chelation therapy on plaque composition and serum lipoproteins in atherosclerotic rabbits. J Am Ost Assoc. 1978;78:144.
Kindness G, Frackelton JP. Effect of ethylene diamine tetraacetic acid (EDTA) on platelet aggregation in human blood. J Adv in Med. 1989;2:519-30.
Perizzolo KE, Sullivan S, Waugh DF. Effects of calcium binding nad of EDTA and CaEDTA on the clotting of bovine fibrinogen by thrombin. Arch Biochem Biophys. 1985;237:520-534.
Gordon GB, Vance RB. EDTA chelation therapy for atherosclerosis: history and mechanism of action. Ost Ann. 1976;4:38-62.
Altura BM, Altura BT. Magnesium withdrawal and contraction of arterial smooth muscle: effects of EDTA and EGTA, and divalent cations. Proc Soc Exp Biol Med. 1976;151:752-755.
Cranton EM, Frackelton JP. Current status of EDTA chelation therapy on occlusive arterial disease. J Adv in Med. 1989;2:107-119.
Cranton EM, Frackelton JP. Free oxygen radical pathology and EDTA chelation therapy: mechanisms of action. J Adv in Med. 1998;11(4):277-310.
Duffy SJ, Biegelsen ES, Holbrook M, Russell JD, Gokce N, Keaney JF Jr, Vita JA. Iron chelation improves endothelial function in patients with coronary artery disease. Circulation. 2001 Jun 12;103(23):2799-804.