Women: Don't Just Think Pink, Think Red

The public in general and women in particular associate the color pink with breast cancer and breast cancer awareness. The color red refers to cardiovascular disease. Increasing awareness of a health problem that can be lethal is obviously important. The more correct information you have about health the greater your potential to prevent bad outcomes or select treatment if needed. I offer the following correct and accurate data.

Cardiovascular disease (primarily heart attack and stroke) kill about twice as many American women as all cancers combined. Close to 50% of women will develop it during their lifetime and 1 out of 3 will die from it. The Agency for Healthcare Research and Quality in 2010 reported that 60% of hospitalizations were women, cardiovascular disease in women accounted for 2 million hospitalizations and is the number one cause of death in women. In the February 2005 issue of the medical journal "The Female Patient" we find reference to a study that showed "More than two-thirds of women who had sudden cardiac death had not previously been diagnosed with heart disease". Further "Deaths from sudden cardiac events increased by more than 20% in women 35-44 years of age, even as these events fell by more than 8% in the general population". Also "Women who have heart attacks are more likely to die, have another heart attack or be disabled by heart failure than men". From the August 8, 2001 issue of "Women's Health and Primary Care", "The 1-year myocardial infarction mortality rate in women was 44% compared to 27% in men, the 30-day myocardial infarction mortality rate in women was double that of men". From that same issue of "Women's Health", "More than one-third of women who had a myocardial infarction died within one year compared with only one-quarter of the men so affected."

Do I have your attention? Now the good news. The problem can be addressed and something can be done about it.

Contrary to popular opinion, having your cholesterol checked and taking a drug to lower it because high cholesterol causes heart attacks and strokes, is not founded in science. According to a study done at UCLA, the majority of people who have heart attacks have cholesterol levels considered to be within normal range. Finding real causes and correcting what is found has been clinically proven to be the road out; let us take a moment to briefly review the disease process of atherosclerosis and what can be done about it.

There was a study called the Rancho Bernardo study that "did not show a relationship between total cholesterol levels and fatal coronary heart disease in 983 older women during a three-year followup". It is true that plaque which blocks an artery is composed of, among other things, cholesterol. It is a particular kind of cholesterol, however, and not the kind that is evaluated in standard blood tests. It is a type of cholesterol that at one time in its life was normal (after all, our liver makes it because it is essential to health) but it became altered and as a result of that alteration, got stuck within the wall of the artery. Unaltered cholesterol (LDL cholesterol, the so-called bad one) will not stick in an artery wall irregardless of the amount in your blood or the amount that you eat, or the amount that you were born with. The major culprit in altering the cholesterol is free radical damage. Free radicals are reactive molecular substances which damage normal tissue and are the major factor in creation of all chronic degenerative diseases including the aging process. They cause generalized inflammation.

Where do these free radicals come from? We are exposed to thousands and thousands of free radical generating substances, including insecticides, pesticides, herbicides, fungicides, artificial food coloring, artificial food flavoring, food enhancers, flame retardants, industrial chemicals, and medical drugs. The list is extensive. Let us look at some specifics. We are exposed to toxic metals during our everyday living--lead, cadmium, mercury, arsenic, uranium, and others we find when properly tested in our patients of all ages, children to adults. Toxic metals can replace essential minerals in our cells; minerals such as magnesium, zinc, calcium and others which are essential for normal cellular function. When an essential mineral is replaced with a toxic metal, cellular function is reduced in its ability to create energy needed to protect itself and eventually chronic degenerative disease develops; after many years symptoms occur at which point people seek a diagnosis from a physician.

There are several minerals that I want to address particularly because in addition to being potentially toxic, they are also essential for life. Iron, for instance, is essential in hemoglobin which carries oxygen around through the blood to every cell in the body, which is necessary for cellular metabolism or energy production. Iron, however, can also accelerate free radical damage if it is in the vicinity where the free radical damage is occurring. Women statistically have a decreased risk of cardiovascular disease compared to men until they reach menopause and then it increases. When menopause occurs, menses stop and iron begins to get stored in the body and increased free radical damage can result because iron accelerates damage.

Calcium is essential for healthy bones, healthy teeth and muscle contraction, but when calcium suffers free radical damage it can be deposited in arteries causing heart disease and/or around tendons and ligaments contributing to arthritis, which are an unwanted effects.

The two conditions, breast cancer (or cancer in general) and cardiovascular disease have two things in common, the cause of their occurrence in the first place is free radical damage and the resultant inflammation, but there is a second. Radiation therapy is frequently recommended as part of the treatment protocol for breast cancer. Unappreciated is the potential for cardiovascular side effects due to radiation therapy. Irradiation can damage the heart arteries and even some heart cells contributing to the occurrence of heart disease. The main artery in the heart for most people, the left anterior descending coronary artery, lies on the surface of the heart close to the chest wall where it is particularly vulnerable to radiation damage.

It is common for the body when it cannot remove toxic metals it has ingested to deposit them in bone. Bone is relatively inactive metabolically until we age and our bone density decreases. When this occurs, the stored toxic metals can be released and deposited elsewhere; for instance, the arterial system contributing to atherosclerosis, aging and chronic degenerative diseases in general. The released calcium may also end up being deposited in places where it is not supposed to be, i.e., soft tissues such as tendons, ligaments and arteries.

An article in the "New England Journal of Medicine", February 1, 2007, speaks of exposures to air pollution and incidence of cardiovascular events in women. The conclusion of the study was that "long term exposure to fine particulate air pollution is associated with the incidence of cardiovascular disease and death among postmenopausal women". How does that work? The heavy metals and other things in air pollution are another source of free radicals. So, we have talked so far about the thousands of chemicals that we are exposed to, we have talked about the toxic metal exposure, we have exposure to fine particulate matter in the air and another study has shown evidence of increased vascular diseases, including heart attacks and strokes, in people who live in 28 cities over which the air was polluted with cadmium, another toxic metal.

So how can you tell if you have a problem?    There are two very informative studies. One evaluates the carotid arteries in your neck as a window into the vascular system to identify the first measurable evidence of vascular disease which precedes plaque build-up by decades. They also identify, if there is plaque found, what kind of the three potential kinds of plaque it is. With all of that data then, they can identify your arterial age as compared to your chronological age. This is not the common ultra-sound used by clinics but a patented, FDA approved study, that identifies very early changes in your arteries. The second study concerns toxic metal status. It has to be done properly. A standard blood test will not identify anything but an acute, in other words an immediate, exposure to toxic metals. Chronic exposures over time will not be reflected in the blood because the body recognizes metals as toxins and removes them from the blood to be deposited in body tissue. An appropriately done red blood cell and hair tissue evaluation is essential. There are a few other methods for evaluating toxic metal status. In other words, causes can be found out and treated.

One of the standard treatments for coronary artery disease is angioplasty in which a balloon attached to a catheter is inflated in an artery pressing the plaque into the wall of the artery. There are complications to this procedure, including the need for emergency coronary bypass surgery, the need for renal dialysis, stroke and death. The potential of these complications was 5.7% in men and 10% in women. Women also statistically have twice the risk of death after bypass surgery than men. You need to know the symptoms of coronary artery disease occur about 10-15 years later in women than in men. The symptoms of coronary artery disease in women can be different than in men and include excessive sweating, extreme fatigue, nausea, jaw pain, abdominal pain, headache, shortness of breath.

Antihypertensive or high blood pressure medication is a common treatment for vascular disease with associated high blood pressure. Enlargement of the heart is a common result of long-term high blood pressure. An article in the "Medical Journal of Hypertension" in 2008 reported a study showing women's benefit from high blood pressure medications was less than the benefit in men when it came to decreasing the potential of enlargement of the heart.

A February 2000 article in "Women's Health and Primary Care" referred to a statistic showing that the use of complementary and alternative medicine was rising dramatically; 58% of the demand for this medical philosophy comes from women. After all of that, how would you like some good news?

As I said earlier, something can be done about it and the earlier you address these problems the more effective any therapeutic approach will be. Learning about the presence of cardiovascular disease well before symptoms occur with a study like the CardiaRisk Scan that I spoke about earlier is an important diagnostic procedure. One of the things that they evaluate is the innermost lining of the artery thickening. It is called intima-media thickening, and it is a manifestation of inflammation in the arterial system. Inflammation in the body in other areas can contribute to that, including the intestinal tract, so evaluating the intestinal tract comprehensively is typically part of a diagnostic program utilized at the Maulfair Medical Center. While we are on the subject of inflammation, arthritis of course is a manifestation of inflammation in the joints and inflammation, wherever it occurs, has common denominators so that a lot of systems can improve when you address basic causes. Inflammation is also a manifestation of free radical damage. Identifying one's status as far as toxic metals is concerned will also be an important factor in not just vascular disease but chronic degenerative diseases in general and again menopause can enhance free radical damage potential as iron stores build up and with bone loss release of toxic metals building up as well. Hormone status can also be an important factor in chronic degenerative diseases, including the thyroid and the sex hormones. Comprehensive evaluation of those hormones is important but include evaluations beyond the standard blood tests.

A properly prescribed and monitored comprehensive chelation therapy program is a most effective way to treat vascular disease. That program individualized for each person has the potential of slowing down the disease process and even reversing it to varying degrees depending upon the degree of disease present at start of program, the patient's compliance with their part of the program. The earlier the program is started, the more effective it will be. The National Institutes of Health spent 30 million dollars in close to nine years studying the safety and efficacy of chelation therapy and the study was positive on both counts. This was especially true in patients who had vascular disease, more specifically coronary artery disease, and diabetes. The safety of chelation therapy was not even in question. The bottom line is something can be done about it. You just need to determine what it is first.

Chelation Therapy: Treatment Option for Chronic Degenerative Disease such as Atherosclerosis, Diabetes and Arthritis?

Chronic degenerative diseases such as atherosclerosis, diabetes and arthritis are called chronic degenerative diseases because they persist over a long period of time. Once the diagnosis of arthritis, diabetes or atherosclerosis is made it is generally accepted by patient and professional that the disease will be present for the rest of the patient’s life. What may escape notice is the disease process began long BEFORE symptoms were present and the diagnosis was made. A particularly salient example of this is atherosclerosis. Often the first “sign” or “symptom” of this disease is chest pain, if the disease is occurring in the arteries in the heart, or leg cramps, if it is occurring in the arteries in the legs. It could also be a stroke or strokelet if the disease is present in the carotid arteries. Subsequent to appropriate diagnostic procedures the patient is declared to have coronary artery disease, or peripheral vascular disease (blocked arteries in the legs) or carotid artery disease (blocked arteries in the neck). While the symptoms may seem to appear suddenly and the diagnosis made in a relatively short period of time, the arterial disease process, which resulted in the symptoms and the diagnosis, started 20, 30 or 40 years earlier.

Let us briefly examine the important parts of this chronic disease process. Our body is composed of approximately 10,000 billion individual cells. They are designed to perform specific functions. There are heart muscle cells, designed to contract and pump blood throughout the body. There are blood vessel cells present in numerous layers including cells that line the inside of the arteries, muscle cells and elastic fiber cells, designed to transport the blood, carrying nourishment to every cell. Keep in mind that the muscle and elastic fiber of the artery pumps blood along with the heart. These cells, fibers can become stiff, thus hardening of the artery. There are liver cells and kidney cells designed to clean the blood. The health of our individual cells is important then, is it not? If our cells are healthy, we are healthy, if they are not, we are not. When numerous cells and other substances in the body incur damage over a long period of time, a disease, for example, atherosclerosis, is diagnosed. Damaged cholesterol, for example, is deposited in artery walls and is an important part of the atherosclerotic disease process. This process is ongoing for years and years before it becomes a problem and before obvious symptoms occur. The result of this damage is the cell’s inability to function normally, a decreased ability to protect itself and perhaps even death and destruction.

Damaged cholesterol is the main ingredient in plaque, NOT undamaged, normal cholesterol. Medical science has been studying this damage and destruction for many years. It is known that a significant portion of this damage is caused by something called free radicals. Free radicals are reactive molecules that cause damage to cells and tissues by robbing them of electrons. This can happen to the lining of your arteries. It can happen to cholesterol. It can happen to the genetic material, the RNA and DNA within the cells. Virtually anywhere free radicals are present, damage to cells or tissue can result. Damage from free radicals left unchecked day after day, week after week, year after year results in the inability of cells and tissues to function normally. Eventually destruction, decreased function and death can result. The symptoms of disease processes then become obvious.

It is doubtful there is a person in the United States over 40 who does not believe, with certainty, that cholesterol is bad and that it causes blocked arteries. Most people regard high levels of cholesterol in the diet and in blood akin to a death sentence from atherosclerotic disease. People believe high levels of cholesterol result in an increased risk of heart attack and stroke when it is only true that a certain type of cholesterol makes up a significant part of the plaque that blocks arteries. This is the LDL type of cholesterol. It is not generally understood that it is not the amount of LDL cholesterol in the body that causes the plaque build up, but rather DAMAGED LDL cholesterol that makes up the majority of the plaque. In other words, when LDL cholesterol is damaged by free radicals, it is much more likely to stay in the artery wall. If the LDL cholesterol is not damaged, it is less likely to be deposited in the artery wall. One of the primary effects of a comprehensive chelation therapy program is the potential to reduce free radical damage thus protecting the cholesterol.

Calcium is an important mineral nutrient. As we all know it is an essential ingredient in healthy bones and teeth. It is also an important factor in properly functioning cells including muscle cells. It is well known that calcium becomes an important part of the plaque structure contributing to making it “hard”, hence “hardening of the arteries”. This form of calcium is called metastatic calcium. A study from 1944 in the Journal of Pathology discovered evidence of calcium in the walls of arteries, where it should not be, long before there was any plaque formation. Although calcium is one of the many nutrient substances is essential for a healthy body it can be destructive. Another important mode of action of a comprehensive chelation therapy program is lowering of minerals in the body including the metastatic calcium deposited in the body tissues where it does not belong.

Free radical damage can be accelerated significantly if the minerals iron and copper are present in the area where the damage is occurring. Toxic metals such as lead, cadmium, and arsenic can also contribute to accelerating the disease process and are also carcinogenic. Another mode of action of the comprehensive chelation therapy program is the removal of toxic metals and excessive iron and copper.

In summary, there are numerous damaging reactions that occur within the body at the cellular level resulting in the development of many chronic degenerative diseases including atherosclerosis. A comprehensive chelation therapy program is individually designed for each patient to treat or prevent the disease processes.

Let us explore the component parts of such a program. A properly prescribed, dispensed and monitored chelation therapy program is composed of three basic parts. The first part is the intravenous chelation treatment, which removes the metastatic calcium and the iron and copper which accelerate free radical damage. It also removes toxic metals such as lead and cadmium. The second part of the program includes specific nutrients, taken orally, that are essential for healthy cell function, and antioxidants as well as other substances to support and enhance the immune system. Mineral nutrients must be replaced. The third part of the program is diet and exercise. Educating oneself about the effects of free radicals and reducing free radical exposure is essential.

Numerous studies, evaluations, and medical papers have been written about chelation therapy over the past 40 years. Intravenous chelation treatments have been used for over 30 years with children to remove lead from the soft tissues of the body. It is extremely safe. Saunders medical textbook, Cardiovascular Drug Therapy, published in 1996, has a chapter dealing with chelation therapy and references 65 scientific articles. A recent study published in Evidence Based Integrative Medicine 2005; 2 (1), Insert footnote mark clearly shows evidence of the benefits of a comprehensive intravenous chelation program. People who had intravenous chelation therapy for vascular disease were followed for three years and experienced fewer cardiac events than people treated with bypass surgery, angioplasty or conventional medical therapy.

Studies have shown that millions of Americans are seeking alternative medical choices and relying less on the usual drugs and surgical medical modalities. It is encouraging to see that segments of the medical establishment are beginning to agree. A 1998 article in the American Journal of Medicine states “coronary arteriography (heart catheterization) is inadequate for assessing the severity of diffuse (many vessels) CAD (coronary artery disease)”. The authors also said that the adverse outcomes of invasive procedures such as bypass surgery and angioplasty outweigh the benefits when performed on patients who have good heart function. Their conclusion went on to say that this knowledge, which they gathered from 183 references, “… provides the basis for a shift in the management of CAD from an invasive procedure oriented viewpoint currently dominant in cardiology toward a non-invasive orientation.

Chelation therapy is a safe, non-invasive treatment for, and prevention of, chronic degenerative diseases.

Conrad G. Maulfair, Jr, DO

i. Navab, Mohamad, et al: The Ying and Yang of Oxidation in the Development of the Fatty Streak. Arteriosclerosis, Thrombosis, and Vascular Biology 16:7, 1994
ii. Blumenthal, HT, Lansing, AI, Wheeler, PA: Calcification of the Media of the Human Aorta and Its Relation to Intimal Arteriosclerosis, Aging and Disease. The American Journal of Pathology. 10:4, July, 1944
iii. Halstead & Rozema: The Scientific Basis of EDTA Chelation Therapy. Second Edition, 1997, Pages 87-91
iv. Messerli, FH: Cardiovascular Drug Therapy: Chapter 175, Magnesium EDTA Chelation, Second Edition, 1996, Pages 1613-1617
v. L. Terry Chappell et al, Original Research Article, Subsequent Cardiac and Stroke Events in Patients with Known Vascular Disease Treated with EDTA Chelation Therapy, a Retrospective Study. Evidence Based Integrative Medicine 2005: 2 (1)