RENEE MONTAGNE, host:
The National Institutes of Health now spends more than $120 million a year studying things like yoga and herbs. The Institute's National Center for Complementary and Alternative Medicine is applying rigorous scientific tests to alternative treatments. But the Center also has drawn criticism for studying therapies that are popular rather than those scientists believe have the best chance of working.
NPR's Jon Hamilton reports.
Unidentified Woman: I'm going to take your blood pressure anyway.
JON HAMILTON reporting:
Edward Coldich(ph) doesn't know much about alternative medicine, but he knows plenty about heart disease.
Mr. EDWARD COLDICH (NIH Study Volunteer): It was April 7th, 1994, when I had a major heart attack. I had a quadruple bypass, I had five stents put in, and (unintelligible) problems related to the heart.
HAMILTON: Coldich is a retired steelworker who lives near Baltimore. He's 67. Every Wednesday he comes to a clinic at the Johns Hopkins Bayview Medical Center. He'll spend several hours with an IV dripping fluid into his body. The fluid may be a placebo, or a powerful chelation drug called EDTA. Chelation drugs are typically used to reduce dangerous levels of lead and other metals, but in alternative medicine, EDTA is marketed as a way to clean out blocked arteries. So the NIH is spending $30 million to study chelation. Coldich is a volunteer in the study. He said the treatments are no big deal.
Mr. COLDICH: All you do is, you sit here and watch TV and (unintelligible) whatever you want, you know, have the people wait on you. And I don't feel a thing.
HAMILTON: Coldich's doctor is Pamela Ouyang. She's a cardiologist who says she never expected to use alternative medicines. But she agreed to participate in the NIH study because so many patients seem to believe that chelation works.
Dr. PAMELA OUYANG (Johns Hopkins Bayview Medical Center): I remember one young man who had severe coronary disease that I felt should go to bypass surgery, who decided he would go to chelation. And he came back and saw me a couple of times, really to tell me how well he was doing. And as far as I know, he never did go to bypass surgery.
HAMILTON: She doesn't know what happened to his heart. That was years ago.
At the time, chelation advocates believed EDTA cleared arteries by removing calcium. After all, calcium is a major component of plaques that build up inside blood vessels. Studies eventually showed that chelation had no effect on the calcium in these plaques, but Ouyang says the treatment remains popular.
Dr. OUYANG: People think, well, you know, I have all this build-up in my arteries, going to get something that sounds like Draino. It's a very sort of - it's appealing.
HAMILTON: These days advocates of EDTA say it may work by reducing free radicals in the body. But the drug still removes calcium, and that can be risky.
Dr. CECILIA DAVOLI (Kennedy Krieger Institute): Without adequate calcium, many of the body's functions will not work.
HAMILTON: Dr. Cecilia Davoli treats children with lead poisoning at the Kennedy Krieger Institute in Baltimore.
Dr. DAVOLI: So, for example, the muscles won't work. An important muscle is the heart, so the heart won't beat appropriately when the calcium level is too low.
HAMILTON: Or it won't beat at all. EDTA has been linked to several deaths.
Davoli uses a version of EDTA that doesn't remove calcium, but the NIH study uses a type that does, because it's what chelation practitioners use.
The study's principal investigator is Dr. Gervasio Lamas(ph), at Mount Sinai Medical Center in Miami Beach. Lamas says the EDTA study is a big departure for him. He usually tests conventional drugs developed in the lab.
Dr. GERVASIO LAMAS (Mount Sinai Medical Center): With alternative medicine, it's different. These are treatments that are out there. People are using them. Hypotheses have been proposed about them. Some studies have been done. But the scientific underpinning is less.
HAMILTON: Even so, Lamas thinks the chelation study is worthwhile. For one thing, thousands of people with heart disease are already using the approach. Lamas says if chelation works, cardiologists will have a new way to treat heart disease. And if it doesn't, consumers should know.
Dr. LAMAS: They need to know that they're going to be wasting their money. So practice habits and patient behavior, in terms of seeking alternative therapies, will certainly change based on this trial.
HAMILTON: Lamas says the NIH study was designed with help from the American College for Advancement in Medicine, or ACAM, a group that represents chelation practitioners. Lamas says that means these practitioners are likely to accept the results.
Dr. Allan Magaziner, a former president of ACAM, is less certain. He's treating patients in the NIH study at his clinic in New Jersey. He says he'll be skeptical if the results are negative.
Dr. ALLAN MAGAZINER (Former ACAM President): Sometimes statistics can be manipulated in certain ways, in certain studies, and so we have to make sure that that wasn't the case here.
HAMILTON: Is it possible that the results of this study would cause you to stop giving this therapy?
Dr. MAGAZINER: Sure. Sure. I mean, I'm a scientist. I'm a clinical physician. And so I don't know if I'd stop completely, because as I said we're still seeing great results with it, but it would have to perhaps change my criteria for which it's used.
HAMILTON: Pamela Ouyang, at Johns Hopkins, hopes practitioners won't dismiss a negative result. But she hopes the study will show some benefit from chelation.
Dr. OUYANG: You have to be willing to hope that it will work. I mean, clearly, if I felt that there was absolutely no way this thing could work, then it would be rather pointless to ask patients to participate in it.
HAMILTON: Ouyang says patients in the study are getting the best mainstream care along with their infusions.
Edward Coldich says that's certainly been true for him.
Mr. COLDICH: Every week I'm taken care of very good. So that's what I'm getting out of it right now. As far as what I'm feeling from this, I don't know.
HAMILTON: The NIH study of chelation is still enrolling patients. It should be completed sometime in 2008.
Jon Hamilton, NPR News.
RENEE MONTAGNE, host:
Last week we asked for your questions about stretching. You can find answers at npr.org/yourhealth. And while you're there, you can check out what the NIH says about the effectiveness of echinacea and acupuncture.
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