Heavy Metals And Chelation: Lifestyle diseases

Hi, good evening everybody, and thanks for joining us. Good evening, Dr. Vijay Mohan, great to have you here. Thank you very much. So the purpose of today's conversation is: 1, is chelation scientific and evidence-based? 2, should we do chelation on ourselves? 3, what are we losing if we are not chelating heavy metals from our body? And we have very, very experienced scientists and doctors here with me. We start with Dr. Praveen Saxena. Dr. Saxena is a medical graduate and an interventional radiologist, Hyderabad, working in the field of environmental medicine for many, many years, almost 3 decades now. He's a proud member of SOP, MED-US, Art Practitioner, Dr. Klinghart Academy, Storks, Insler, IMA, Ozone Forum of India, and many other renowned organizations. He works very passionately with autistic kids and is also the advisor to the Akhil Autism at LEADCON 2017 India. Welcome, Dr. Praveen, and I'm looking forward to hearing from you. Where do you think chelation came from? When was it first time that we heard the word chelation, and how did it evolve henceforth?

Uh, thanks a lot to Preeti. I must thank, uh, this IAFM for this initiative, and, uh, this is something which we thought, uh, I had during my medical college, we used to talk about something like penicillamine. And during our third or fourth year, maybe as I'm talking, going back to 1987 or '88, we had an acquaintance who had something like, there is a Keshav Fischer limb. And clinically, we thought he definitely, this guy has got Wilson's disease. And we were always looking into something, how we can work it out, looking at penicillamine and all that. So I think whatever our pharma books has given about D-penicillamine, BAL, lot of things were talked about initially. The thing which we are trying to now look into is what is this, how it is changing the whole perspective. And this is chronic metal toxicity was a big concern for all of us. As simple as that, I'll tell you, most of our patients are talking I don't smoke, I don't drink, why do you think I have got this problem? So this way we need to work it out, looking at retrospectively why our vitamin D levels are plummeted so down. At least in a tropical country like India, we don't see vitamin D levels sustainable. So this is one thing is called an elephant in the room, and I am very sure most of us are not have any idea about what are these vasculotoxic metals we are going to talk about, I'll just give a brief history from where this chelation therapy came and all that. It started usually with the— it started with the textile industry, and they were, they were in need to remove this calcium during dyeing process. So then started everything EDTA and all that, and this patent was granted in Germany way back in '35s. And in later 1940s, we, uh, we know about— now still we are using as an anticoagulant that purple bottle. Uh, we know that what are ACDs and all that. We keep using that. And the best part was FDA approval for the use in lead poisoning as well as hypercalcemia was a kind of thing which came into existence Lead toxicity was a big thing. I must tell you, I have one of the slides I think I'll be showing you subsequently. It was in 1897, this lead toxicity was seen more in patients who had gout, Saturnine gout it was called. And later on, this EDTA for lead poisoning was a big issue. We all know about what happens to the sailors and all that. Who had vitamin C deficiency and all that. The similar kind of thing happened to the people who were having this lead toxicity. And this is fantastic, particularly Norman Clark and these people, they have reported heart disease improvement. Norman Clark has got a big literature and he went on to give, produce a paper which was sodium, but is sodium EDTA chelation for coronary artery disease. Look into this work which was in 1956 base. It was in American Journal of Medical Sciences. This was the thing, Doc, I was trying to tell about, which was Saturn and gout. And the paper was 1886. It was— sorry, I quoted 1886. What they picked up was the conclusions, analysis of— there were about 100+ cases of gout and they just checked out on their arterial thickening and all that was— it's a purely, it's a plumbism case, what we call. And now I don't have to diagnose plumbism in a big way. It is when I see, when I see something. Yeah, yeah, please. So what happens is that I take an X-ray. My background with the radiology we used to see all vascular calcifications throughout. And we used to think, what is this? This is definitely some sort of plumbism where we have this arterial thickening with degeneration and it allows body tries to compensate with that. It tries to heal it at the first intention and this all calcium things deposition comes into picture. So during 1956 and 1960, this guy, Dr. Clark, who was a cardiologist. He reported his case studies and 20 patients, and out of that, 16 were having unstable angina. Everyone got a good relief. The best part was all of them, they were able to cancel their bypass or stenting and all. Not stenting that time, bypass was the major kind of thing. So this, on this basis, we started looking at, for me, How I came into this thing is just by a sheer— this one, I was working on something called autism, and I was thinking, I was very sure this is because of mercury, lead, and all the ADHD and all, and now aluminum. So I was purely working on that, and I happened to look at this work with Andy Cutler, what was doing. I was telling, this is way back in 2003. 2002. And Andy Holmes, uh, was the, uh, she was the very pioneer. She started picking up autistic kids' hair and nail analysis and started working out what is the kind of excretion and all that. Unless that paper I saw, uh, I was not aware. We used to think that the children who had higher, uh, hair and metals are the one which are suffering more It was like that kind of work, having met Bernie Rimland, trying to look into what is it and all that. Then I, then I tried working on that with— I was always practicing as a radiologist, so we used to do some interventions and all that a lot, and we did angioplasties also. Along with that, when we started looking at that, why this is so much problem with the distal ischemia, We went on to do some patients who had gangrene of the limb, and there was a paper which was presented, and look, based on that, we started doing EDTA chelation and all that. With that, it was a surprise for me when I saw most of the chronic diseases, let it be diabetes, let it be hypertension, everything has got the one common denominator, which is high oxidative stress. High oxidative stress, low vitamin D levels, proportional increase in homocysteine levels. And there are some other changes we used to look into, like fatty liver. We used to look into some hair and nail analysis and all that. So I started diving deeper and deeper. I was able to find out this book, Marvin Seven book, which was— it was again, this people have done really diligently, worked on some areas. And This, the other people, cardiologists specialists called Kitchell and Melzer, and they— I'm just trying to talk about what were the drawbacks, how things didn't go up, because whatever which was being done by the other physicians, this was not taken further because of some reasons. It was basically the whole of the association they were not supporting things and all that. And there are, there are good number of kind of results what they were getting in that very small cases. And I'm sure with the likes of what Dr. Hasnin has done, the numbers are thousands and more. When we cumulate in India, we have a big database and we have started working quite early and we can always, we have that. Going back to this again, Ray Evers, a chelating physician, so he used to use this EDTA for all the other degenerative diseases, especially in cardiovascular diseases. So what happened with this guy is he started giving EDTA in major doses, in the sense that time there was no 3 grams or 1 gram, that used to be around 9 grams or 10 grams used to be given, and it was given 5 days a week or something like that. And with that, there were some patients who went down the hill in the sense they get into some renal failure. And from there, it was like this was no touch-me-not therapy for everyone. Everyone said, areh, this is causing renal damage. And I can always tell you, having practicing for the last 20 years, we have never seen any patient. I think Dr. Asneer and other people Also can add to that, we never had any kind of renal insult. Most of the patients, because we have the protocols of IVCMT, ACAM, and it's a kind of very structured kind of thing. In the process, we started working on this. Gary Gordian is worth mentioning. Gary Gordian worth mentioning is this guy's— again, he was at ACAP president, and he was a radiologist basically, and he went on to produce a lot of things. And there were other people. Yeah, this again, Kasudov, Richard Kasudov needs a mention here. And he showed the improvement in ejection fraction of the heart with dilation. That time in '81 and all that, showing ejection fraction increase was a big thing. People used to use MUGA scan and all that. This 2D echo was not so available that time. But this was a clear mention. I felt this has to be shown. And there were other people who started working on— they had a large practice and most of them, they started publishing the results and all that. They were able to show lipid metabolism changes, carotid artery blood flow, lung function changes. And this were the kind of thing. Later on, there were some controversies with that. IBCMT and ABCMT came into picture. There are something still called ICIM. There is a thing called ACAM. There is a thing called American Academy of Environmental Medicine. I happen to be with one of the— in the panels where I saw this Elmer Cranton. All— most of you should know because he has got that book, what he has done, Bypassing a Bypass. It's a really good thing. Again, it's a 1984 book. I think it's a good referenced still. And there were other people. I would like to make, make a mention of a few people like Morton Walker. And there were some people like this. Yeah, one particular person who was instrumental was Dr. Peter van der Schaar. He is a cardiothoracic surgeon, and I must thank from the bottom of heart to Dr. Ascent Patel because he introduced us to this particular thing by introducing Dr. Peter van der Schaar. Amazing guy. He had done some fantastic work and he, he gave us a kind of roadmap how you go ahead. He has produced a kind of modules and we all went through that. And I'm really happy I'm a kind of, uh, this one, uh, fellow of clinical medical toxicology. I just want to show his picture here. Uh, I, I can always tell you he was something like 82 at that time, but he has full of energy. And he's a person who wrote the book Clinical Medical Toxicology. It is because of him I got in touch with in 2006 and 2007 and there was no looking back kind of cardiothoracic surgeon. Here I would like to maintain a very clear kind of thing. We are not here to replace any cardiothoracic surgeons or cardiologists. What are we trying to work out is when combined, if we are able to make some kind of vascular health proper by doing some— this is basically complementary. It is not alternate. Going along with that. And by that, your patient's outcome will be much better if you always use this modality also. And then came the most important thing because of a lot of controversies. There was a thing called NIS trial, which was trial to assess acclimation therapy. This was started. I, having seen the kind of enthusiasm what Gervasio Torri Lamas was having after doing this first trial and after the second trial. And now he says he wants to plan a TACT for PAD also, TACT for diabetics also. He has planned already TACT till 5. And the thing is, right now TACT 2 is running and there's a big kind of sponsor was done. NIH was a big sponsor. The main idea was trying to show what is the effectiveness of this therapy in a cardiovascular thing. So there were big hurdles came into when TACT started. Most of the cardiologists, they discouraged participation. They said, okay, this is some kind of snake venom. It's not very this one, but something which had people working on that. In 2012, TACD trial was completed. And November 2004, it showed EDTA treatment group showed statistically different significant benefits, and it was published in JAMA in 2013. So this design was— yeah, yeah.

Thanks for bringing the TAC trial here. And 2 more minutes.

Yes, yeah, yeah, yeah. So the treatment comprised was basically a kind of active infusion. There are two arms basically, and there was a placebo with oral vitamins, not using any other things. So this was quite significantly— 55,000 infusions were administered during the STAC-1 trial, and eligibility was above 50 of people having MI more than 6 weeks later. And all of them should have creatinine less than 2. This was the kind of things. And the primary event at endpoint— I do not, because of positive time, I just run through the thing. And what basically, 1,708 patients who had improved with this particular thing, we have got this separate data. Those who are diabetics, those who are female, the people who are using statin, the people who are on EDTA as well as placebo. So the thing was EDTA chelation was not a standalone therapy. People were using beta blocker, people were using aspirin, and we still, when we do in our practice, we don't discourage people not to have your other drugs like your aspirin and all that. So this was a complete kind of thing And I cannot— I need to emphasize here one thing. The total— what exactly was the endpoint things which have come? They were showing something 26%. There's a lot of statistics and calculations are here. And I can tell you, for a thing called statin, which was a cholesterol-reducing drug, that particular PI was something around 1% or 2%. And with this, it was 26%. I think, and the most of the efficacy came off with a lot of diabetics. People who are diabetics, they happen to get the best of the chelation therapy. They got immense benefit. And this is what we see here, because I think diabetes, we now understand what exactly is this microvascular disease and all that. So two things, perspective, keep it on the other side also, what, why the conflicts are there. There were people who objected to this trial, TSAD-1, and subsequently TSAD-2 trial is still going on. I think it should be over by 2024 April or something like that. And yeah, so this is people—

the data intact too is quite promising.

Yeah, yeah. So this retrospective analysis, I just want to bring in Terry Chappell's work also, very significant work. And this was done way back before this TSC trial, and you should know about this guy Terry Chappell. I think you know him personally. This is the thing, and he did 220 cases, and out of that age group and all that, previously people had surgeries and all that. So the outcome, the retrospective-based results outcome was better than the TACD group. And see, basically most of the TACD patients are more severe risk. So they had the people who were being registered in TACD were very severe. Everyone was having triple vessel and all that. Retrospective has has got good data. And I just— I have a minute, Preeti?

Yes, Dr. Praveen.

So the most important thing I just want to ask the people is, when you know you are not a smoker, when you know you don't have any predilection, your cholesterols are normal, okay, whatever you are doing, but what is happening at the thing at the practical level, the person who is more trying to maintain his weight, trying to maintain his kind of cholesterol, everything, he is going— he's getting into some problems. So it is high time people, all the people who are, uh, so-called educated and all that, should try to look into this thing called what are the environmental factors and what are the things which can— variables— what are the variables which are affecting this vascular health and lead. I have got scores of papers. We have Dr. Flora here. He has done, I think, more than 400 or 600 papers he has produced about that. There are big number of things. Only thing is there is a big— the scientists and the practicing physicians, they are not coming on the same page. I knew Dr. Flora's work for very long. I know Dr. Dinesh, what he has done in NIM showing lead levels in milk also was appalling. And we don't— we are now talking only about that, oh yeah, you— the cholesterol which is causing the things. This is a— this is a— should be a kind of, uh, yeah.

Thank you very much. And I think two messages I got from your conversation and talk. One, You are very, very passionate about this topic because I'm sure you've seen amazing results in your clients, children and adults both, with chelation. Because I saw you did not go through even one slide, but you spoke the full presentation bang on. So much of science, so much of data, so much of conviction. And thank you very much, Dr. Praveen, for sharing it that way because Despite the fact that we allopathy doctors have been studying this from 1852-56, you know, that's where chelation goes back to, where it's documented. But unfortunately, we are not speaking about it in chronic diseases. And second point, which I really liked in what you said, was— and I think which is very important for everybody— is This is one big missing link in our treatment protocols. Allopathy, it's not alternate, it's allopathy only. It's the main traditional medicine. So please, let's look at it. And, uh, for public, for patients, we all know our health is important. We are all learned people. Do listen to this full talk. We will also post some articles, studies, and references, their links in the description of this talk so that you can go in more detail and find ways to heal yourself better. Thank you, Dr. Praveen. And as you have multiple times mentioned in your talk, Dr. Hasnan Patel, we could actually see that Dr. Hasnan, you know, is also equally passionate about this. And I know he has a personal story which drives his passion in this. So, Dr. Hasnan, is going to talk about incidence and cause of metal toxicity. He is the consultant physician, clinical cardiologist, and clinical metal toxicologist. Dr. Hasnan, an internal medicine doc from Mumbai, has an experience of 42 years in this field. He practices at Dr. Patel's Clinic in Mumbai, completed his MBBS from Topiwala National Medical College worked in charitable hospital and did his fellowship in International Board of Clinical Metal Toxicology from International Board in 1991. He's a member of IMA, also an honorable physician in at Habib Hospital, clinical assistant Prince Ali Khan Hospital, medical superintendent Habib Hospital, and senior consultant at Wockhardt Hospital. He also holds house posts in general medicine, chest, and acute care at BYL, Nair Hospital, and many more. And over to you, Dr. Hasnan. I am personally very, very, very excited to hear your story today and also to inspire a lot of patients. And, uh, actually, Dr. Hasnan, you know why I took this topic today is also somewhere linked to you. I diagnosed myself with high mercury about 2 years back, and I had lots of symptoms. And then I've been working on that for last 2 years, and I think that's the reason I am equally passionate about this topic, and I really want this to become the mainstream medicine now. Thank you, Dr. Hasnan. Over to you.

Thank you very much for inviting me. I'm going to start with my own personal story. In 1996, I was jogging at the racecourse in Bombay and I developed some chest pain. So I stopped, waited for 2 minutes, took a few deep breaths, and started jogging again. And I managed to complete my exercise quota. 3 days after that, I had to stop and vomit. So I said, this is angina. So I rushed to the hospital, said, take my ECG. Absolutely normal. What do we do next? So let's do an echo. Echo absolutely normal. So I said, I want to do an angiogram. And they said, no, we'll do a thallium stress test. We did a thallium stress test, and the resident was telling me, sir, you're only wasting time. This is not required for you. And in those days, they used to do resting thallium first and exercise thallium after that. Resting thallium came normal, so he told me, don't do the exercise. I said, no, you just do it. Oh sir, you're only wasting. So it doesn't matter, do it. When he did the exercise thallium, it showed such a tremendous loss of flow that he was surprised. I could see his face going white, and he was punching the phone desperately to call my elder brother, who's also an MD consultant and a professor. Come quickly, we have to put him in hospital for a bypass. Anyway, everybody got together and they said, let's do the angiogram now and see. Lo and behold, the angiogram showed a long LAD block, nothing else. All the other vessels were clear. So that time there was only one doctor doing angioplasties in Bombay. Poor chap was hauled off from Madras, brought here, made to put two stents into my LAD, showed me an angiogram which was normal, and I said, 'Wow, modern medicine!' I was extremely thrilled that I could reverse the disease. Lo and behold, 15 days later, the chest pain started again. When it started again, I said, I'm getting chest pain. So they told me, don't be stupid, you got 2 stents in, you spent so much money, how could you say that you're getting the problem? I said, look, I'm getting the pain, I know. Anyway, they dragged me for 5 days. On the 6th day, I couldn't get out of bed. The minute I tried to get up from the bed, I'd get chest pain. So I said, I'm going into hospital. They did the angiogram the same day, and every single vessel was blocked. Every single vessel. The most famous cardiothoracic surgeon of Bombay was standing. He said, don't worry, I will operate on you.

I'm used to these vessels.

I said, don't worry, I won't charge you also. God bless him. Anyway, he did the 5-vessel bypass, and I was extremely thrilled. I got beautiful Y and Roux bypass going all over. I'm absolutely normal. I was normal for 1 year and 3 months. And then the angina came again. So back it was. They said, what shall we do now? I said, we do an angiogram. And the angiogram showed all the chunks were blocked. So I said, look, there's something wrong with me. I've had the best doctors. There's something wrong which you people cannot diagnose. And that's when I got in touch with Professor Vande Skani. He told me, you come here to Lindi, to my place, and I will treat you. And I will look after you and you can stay with me. I know that you have not made a lot of money in practice. So I joined him over there and I was there for nearly 3 to 4 weeks. And believe you me, in those 3 to 4 weeks, my entire attitude to life changed. Within the first 15 drips, I was walking at extremely fast paces, 4 to 6 kilometers a day without any chest pain. And I said, look, if all my vessels are blocked, why am I walking? And that's when it struck me that the interior of the left ventricle must be having millions of small channels. You don't really need those coronary arteries, it just conduits. And why cholesterol? That Praveen was saying, cholesterol is what is used by the body for repairing the interior of the cells. When that cholesterol is not utilized, has to collect. It collects, the blood doesn't want it, so it dumps it into the liver first. That's why 90% of Indians have got fatty liver. This is the first stage you're coming to. The liver cannot detox any further. You realize that point? I don't think many people have realized.

So, Dr. Hasnan, um, sorry, but I will want to add it here. In my practice now, I'm seeing it so often, every day. The moment you clean the liver, the response of the body changes.

Of course.

That's— that is the cleansing power of the body comes from the liver.

You can't even detox your gut till your liver is cleaned.

Precisely. Only then the rest of the stuff can be brought in for cleansing.

Exactly.

So this is what—

first pass, it's called first pass. Liver is the first pass.

Yeah, that's right. So this was my personal story, and now it's I'm 72 years old. I'm still taking chelation once in 7 days or once in 10 days. I won't say I don't get angina. I do get angina now because I'm 72 and I'm not willing to go for alternate day chelation anymore. I've tried all the therapies and 72 is a good age to go. Also, I'm quite happy.

No, no, 72 is just the beginning of—

you need to guide a lot of people.

Yes.

So I had a long presentation which I just want you to just put the slides on and go through them fast while I keep talking. I don't want you to even wait on the slide. Okay, your side. Basically, I want to show you what I did in the beginning when people said there's no such thing as chelation. I started doing the urine test post—

just a minute, have you uploaded it from your screen or you want me to upload it?

I want you to upload it.

Okay, so just give me a minute. Till then, you can please continue talking.

Okay, so basically I started doing the test to check how many people were metal toxic, and lo and behold, I found more than— more and more people are metal toxic, including those who are asymptomatic. So asymptomatic doesn't mean that you have no symptoms at all, but you have not recognized what is going on in your body, and it requires someone with common sense to see 'Hey guy, you know you left your car keys behind when you left the table.' The small things like a lapse of memory, or 'What is that guy's name? I'm only 42 and I can't remember his name.' These small things point you in the direction that your body is not responding the way that it should. So the doctor has to be vigilant about the patient. No, the wrong one.

Okay. No worries.

Yeah, so as I was saying, so I tabulated all these cases that I had done and I took them to Frankfurt and I showed it in the meeting over there. And you won't believe it, most of the doctors came to offer me donations to treat people in India when they realized India is so metal toxic. So at that time we coined the phrase that India is the trash can of the world. The whole world was dumping their old mercury batteries in India. They were dumping all their old computers and keyboards and monitors all in India. And here we used to heap them on the roadside, remove the chips, collect that whatever precious metals were there, and recycle them. So this is what was going on till today. We smelt gold using mercury. So when you are smelting gold with mercury, the poor people are inhaling the mercury vapor. Yeah, this is it.

Yes.

So this, as you can see, is done in June 2005. Can I have to keep going to the next slide?

Yes, just give me a minute. I'm going to put this on slideshow.

Yeah.

Yes, perfect.

So when I first saw heavy metals, I thought of the heavy metal bands until I realized This is what was happening in our country. I'm only going to talk about the first part, effect of industrialization in India. So you can see how manufacturing and environmental pollution increases all these substances, and they are directly proportional to the incidence increase in hypertension, stroke, IHD, Parkinson's, multiple sclerosis, Alzheimer's, and autism. Now this is 2005, and people never knew the word autism or multiple sclerosis. Case example, India. The link between obesity and diabetes has been there for long, and the Barker hypothesis— so thin people were never type 2 diabetics. We've got plenty of them now. Next slide, please. So India had 19.4 million diabetics in 1994. In 2005, I said we'll have 57.2, but the data now at 2022 shows that we got 79.4 million. So we were wrong in this prediction. We've got Nearly 50% more than what we were expecting. When are we going to wake up and realize that this is what has happened to the country and stop blaming our food only? Next slide. Next slide. WHO estimates 75% of the people have got diabetes. Of 300 million, that's what diabetes will live in India. We have passed that also. Again, here you'll see incidence of circulatory disease has gone up from between 1985 and 2015. And if I put 2025 out here, it will be even higher. So let's not go there. Next slide. Here again, next slide. This is all raw data showing you premature death from ISE for male manual workers is 58% higher than non-manual workers. Why? Because in the old days, this is the heart— never gets a heart attack, we were taught when we were in medical college. He's doing physical labor. And then we realized more of them were getting heart attacks, and we realized it was from the lead of the unleaded petrol that they were inhaling. So we never realized how bad that unleaded petrol was, but the government quietly got rid of it from the system, saying we got unleaded petrol now. But God is not going to change the air you're breathing. It's going to stay there. Cardiac surgery statistics, if you looked at also, it showed you that we were going higher and higher. Hypertension, we are going up. Cardiac surgery, we were going up. Go to the next. So on several population-based data also showed the same thing, that hypertension in developing countries was more than those in developed countries. 1.56 billion people worldwide in 2025. We have already crossed this, this barrier also. Developing versus developed, again, CVD accounts for 30 to 35% of deaths in women. Which never used to occur before. Women never had heart disease. They're protected by their periods. Here again, the same thing being shown to you with proof and, and the references as well. Next. So by 2020, chronic disease will account for 75% of all deaths, and this is true. And CVD is now more prevalent in India and China than anywhere else in the world. Next slide. So ask yourself, is the explosion of vascular disease in developing countries even through populations that are getting health conscious and obesity is not widespread as in the West? What is the answer to this? Next slide. Is this the answer? Chronic heavy metal toxicity, not yet recognized as a disease, but it's the revenge of the environment on us. So now I've given you enough food for thought about heavy metals. These are the diseases which you come where heavy metals are known to be responsible. Next slide. These are the other diseases, and metal allergy has clinical relevance. So there's a metal allergy and there's metal deposition. There are two types of this different metal diseases that you can get, and the body excretes in breath, in urine, stool, sweat, and through the skin. So you can get skin diseases like eczema and psoriasis. Which are a direct result of body trying to excrete metals. Next slide. Now this is from 2003 issue of Down to Earth. This is how they showed that mercury poisoning is hard to diagnose, that the symptoms are often similar to those of common ailments. So I've got migraine, but you will never say I've got it from lead or mercury. You've got migraine, that's it, what you tell the patient. You chelate these patients and they find the headaches go away. They don't even require the treatment anymore. And this is all going to be my last slide for today, which is India, the trash can of the world. Thanks to our Prime Minister, he has stopped this from happening.

Thank you, thank you, Dr. Hasnan. This is beautiful, and I really— I'm sure everybody listening here What a food for thought. Thank you, thank you.

Um, Dr.

Hasnan, you said that you still do chelation once a week. Yep. So what is your thought on frequency of chelations, and what is it that you want— you will want to tell people? Because generally what happens is when we start chelation, in the beginning they are quite you know, active and interested, but then over the time they start doing it only once a month, once in 2 months. So could you elaborate a little on—

Yes, I have done over, over 200,000 chelations totally till date. In that, I have patients who are treated totally free, concessionally, at cost, and with— and some at a very small profit.

All right.

So a patient can't afford it, I'll still treat him so that that constraint is removed. Most of the time doctors want to charge the patient, and this is why the patient says, I'm all right, why should I continue this treatment? So that is the time when you have to be a little more adjusting and say, forget about that, let's make certain that they remain free of metals and they remain healthy so they can look after their families. And of course, all the— all what you spend on them can be taken off your tax if you have a you have a trust like I do.

So Dr. Praveen, Dr. Flora, and Dr. Hasnan, generally, you know, when I started doing chelation, of course I studied it. Sometimes patients who have old history of tuberculosis, chances that it might exacerbate can happen. And in India, almost large number of patients, you know, a lot of us also might be having history of TB. What's your take on that, Dr. Praveen and Dr. Hasnan and Dr. Flora?

Yes, yeah, Dr. Preeti, this is one thing called calcifications and all that. When we do this EDTA and all that, we are, we are decalcifying some things. So what happens with most of the chronic pulmonary tuberculosis, they have calcific spots, they have infiltrates and all that. So once this decalcification occurs, some of the cavities can become open up and can cause problem, but We generally don't have much issues with that. We can take over with that when we start doing with vitamin Cs and all that. We work with in tandem. I think Astin has got some cases where he dealt with this.

Yeah, I have dealt with this. I've had 2 patients who reactivated their TB, but those are patients who have been on long-term chelation, and that's when you have to keep an eye on them. You keep an eye on their body weight to keep an eye on the ESR, and you always find they'll come to you with the first symptom, which is weight loss. Okay, now I've had more than 1,000 patients who've had TB and who've not reactivated. So that made me think back and say, why did these reactivate and not those? And two things came to mind. That probably when the calcium is removed from the blood vessel, it starts removing calcium from extracellular sites. That was one. And the second point that I thought of was, I've never seen a happy person with tuberculosis. There's always some sadness or something that reactivates it. So don't blame the metals or the chelation for it. Does it stand to reason?

Perfect, perfect. Excellent. Uh, Dr. Flora, we'd like to, uh, look into— because we had seen the kind of work what you have done— how we can translate into the clinical practice because you were the doyen, you started doing MID, MSA, and you had been on this particular stuff. Dr. Preeti, has Dr. Dinesh has came?

No, I think Dr. Dinesh is not able to join. I've sent him the link, but meanwhile I have a question here before we move to Dr. Flora. Dr. Patel, this question is from Mahesh. He wants to know, what is your opinion on the best way to diagnose heavy metal toxicity? Hair tissue or serum or urine or a Legoscan or any kind of other diagnosis?

Well, I always diagnose it clinically, so I really look at the nails and I can tell you immediately whether you've got it. I look at your skin, I look at your vasculature, I look at your blood pressure in both your arms, not in one arm.

Beautiful. So what do you look at, Dr. Hasnan?

All right, you can see the ridging of the nails, you can see the white marks on the nails. Immediately, you know, the nail is not forming. The nail is dead tissue.

It's excreting. It's an excretory product.

Nail is like urine. It shows you the metal. The skin shows it to you as well. Okay, now when you do a urine test, you do the urine test in two stages. One is before giving a chelator and one after giving a chelator. So you have the pre and the post, and then you see the difference between the two. So you know which are the metals coming out with the chelator and which your body is able to remove. and then you select the chelator. So choice of chelator is a separate topic altogether, which would take about an hour and a half for us to talk on. I don't want to go to that because I want to hear Dr. Flora talk about MIDMSA.

No, typically, Dr. Asneen, we call it as an EDTA mobilization test. I mean, this is what we normally use for diagnosing whether a person is suffering with the any— because as you rightly said, that pre-chelation and post-chelation, and if there is a difference, a significant difference between the excretion of a particular metal, particularly I'm talking about lead, then you can be able to diagnose. But in addition to what Dr. Hasnain has just said, Dr. Preeti, there are certain other markers which we have been using it for patients. Like for in case of lead poisoning, we have Delta-LAD is a very good marker. I mean, just you require a few microliters of— just 5 microliters of blood, then you can find it out whether a person— because this is a specific test for lead poisoning. And in addition to that, you can do also urinary ALA excretion. This ALA— delta-aminolevulinic acid dehydratase— this is a very sensitive enzyme. Even 5 micrograms increase in your body Uh, it will— at least the activity will be inhibited almost like 95%. So that's a very good test.

So, but it depends upon the difference, right? Now another question we have from Dr. Vijay Mohan Kohli is, what are the tests you are doing to check for the presence of heavy metal? This we have already answered. And, uh, how effective are oral chelators like zeolite, activated charcoal, etc.?

Okay, in oral chelators, I look at DMSA, DMPS. Those are what you call the real active chelators, not zeolite and all these things. These are very mild chelators, right? So, and I believe in using multiple chelators because each chelator will chelate separately according to the sensitivity of the metal. So very often when I have a patient with lead, like I've got one now with blood levels over 1,000 I have on DMSM with EDTA on twice a week schedules, and I check and see how does he feel tired the next day after the chelation, so I know that he's being over-chelated. You have to talk to the patient. You cannot go on blood levels. Each patient is an individual. Like, 5 fingers of the same size would not let you hold the microphone in your eye. So you have to look at each patient separately. Don't try and dump it in the— take this textbook says this, so this is Right.

So, Dr. Hasnan, any patients whom you will not kill it— do chelation on? So anything you are very particular in history that this patient I will not kill it?

Yes, I had a patient with creatinine of 11. He said, I want to be chelated. And I said no. And he said, no, I insist on it. So then I worked around it. I would send him to my clinic, do a chelation, and send it for dialysis immediately. And I would chelate him according to his body weight and his creatinine level. So you use that formula that we have made and you can kill it safely, but you have to keep a long gap between the chelations depending again on the patient. How easy— are you feeling better? I'll chelate you more often. No, I feel tired. You chelate him less often or reduce the dose. Watch the urine output, watch his weight, watch the protein in the urine. There are hundreds of ways that you can judge.

So that was my next question. If, you know, for some reason the patient says I cannot come twice a week, I cannot come once a week, I can come only once a fortnight, do you think chelation should still be done and it will still make some difference in the patient's health?

Well, I've got 8 patients in Yemen right now who are taking chelation over there in their own houses with their wives administering it to them on my say so. Okay, and these all 8 have had gangrene of the foot with partial amputation before they came to me, and they were advised below knee. All of them have got their feet saved. They've only lost one great toe, and they're all doing well. So it's not that you have to be in the presence of a doctor always. If it's not possible, find a way around it. A nurse can—

So, Dr. Hassan, let me phrase the question in a different way. Supposing the patient says, I don't want to get so many IVs, because IV is something not everybody is very comfortable with. What is the minimum frequency you will want to do?

Well, I just put them on DMSA, or I'd give you zinc DTPA, because zinc DTPA is an internationally recognized chelator for every single metal, and there you give it once in 15 days, is perfectly okay. You can use— that's the only chelator that we use daily as well. And I'm telling you, DMSA with zinc TTPA and DMPS is probably the finest combination you can use for all metals together, right?

So DMSA, of course, but DMSA I think takes a lot of time. And I agree, I— if I start chelating somebody with DMSA for mercury or lead, I tell them in the beginning itself that it's going to be a long journey.

All right, my dear, it's a way of life.

It's not exactly right.

You have to keep that in mind. Like you brush your teeth, you take your chelation.

Just wanted to add one more thing here. I think you need to keep all your channels of elimination open. One person comes to me after a week of constipation. He says, I have— we have not passed the poops and he wants to go for a chelation. That time we tell no ways we can work it out. So the idea here is try to see that all the channels of elimination are open and always you can always work it out. And yes, there is always some patients who need that base camp approach. They need that first 2 weeks are important for them. So we insist, then you can go for spacing and all that. So this is what And we are looking forward with Dr. Flora, something you can make, the zinc DTPA or something like that here, because it's not available here.

That was my next question, Dr. Praveen. So, but I think before that, we should give Dr. Flora this opportunity to now talk about treatment. Dr. Dinesh is finding it difficult to log in. I will help him while we listen to Dr. Flora. So Dr. Flora, ex-director, National Institute of Pharmaceutical Education and Research, Raibareli, Lucknow campus, and held an additional charge of Naipur Mohali for 1.5 years. Amazing institute, and thank you, Dr. Flora, for being here. He served for nearly 29 years at Defence Research and Development Organization, DRDO. In Gwalior, India, before taking up the present position. He is currently the Director and Dean of IRA Medical College, Lucknow. Dr. Flora got his PhD from CSIR Indian Institute of Toxicology Research, Lucknow, and was a postdoctoral research associate at Utah State University, U.S. Dr. Flora has contributed significantly in the area of clinical therapeutic measures for the treatment of arsenic poisoning. And this is another big thing when we do heavy metal testing. So nobody moves beyond the second consult if heavy metals have not been done in my practice. Now, I think in the last 2 years, what has evolved in my practice at least is gut health and heavy metal testing. And arsenic is huge. I'm seeing, you know, high levels of arsenic in a lot of patients, and arsenic is not being talked about too much. So, Dr. Flora, Some additional inputs on this we would be looking at when you, you know, speak. His most highlighted contribution includes the development of a new drug— wow— for treating cases of arsenic poisoning. The drug IND was approved by the DCGI in 2014 for human trials. Phase 1 human trial of the drug was completed by Cadila Pharma. Wow. Over to you, Dr. Flora. We are looking forward to hearing you.

Thank you, Dr. Preeti. And honestly speaking, I must make a confession that I am feeling an odd man out among these clinicians and physicians and medical practitioners. But yes, this is a typical, what you call it, a scientist perception about chelation therapy.

But Dr. Flora, without scientists and your inputs, we are useless.

Thank you.

And if we have to make India healthy, we have to actually work like this.

Thank you very much.

So thank you for being here.

Yes, thank you very much. Thanks a lot. Uh, well, uh, honestly speaking, uh, though I have been in DRDO and for almost like 20, 29, but this topic has been very close to me for almost like 35 years. I mean, and just about a 6 months back, we had a big conference in Berlin on the same topic, the chelation therapy. And honestly speaking, the topics which Dr. Hasnain and Dr. Praveen, my old friend, they have just talked about, there was a lot of debate on how useful is the chelation therapy. Well, I'm talking about, before I come jump over to my own topic, To be honest with you, when I chose this topic for my research work, I studied almost all the chelating agents which were available in the market. And it was another aspect that unfortunately there is very few chelating agents, because in my 30 or 40 years of my research career, finding a suitable chelating agent— Dr. Asneen talked about DMSA and DMPS, but Getting DMSA and DFPS in India is a very hard job. I mean, most of the time I used to get help from my colleagues from US in getting these chelating agents from abroad. Well, before I jumped over to finding new chelating agents, we thought that let me try— what, how about—

sorry, Dr. Flora, just a minute. I think Dr. Dinesh has joined us. Dr. Dinesh, welcome.

Welcome, sir.

Can I—

Yes, Dr. Flora, thank you. I'm sorry for it.

Sorry, sorry, I was listening to you all the way, but I have been put in a backstage. Thank you very much. This also happens in such type of meetings. Okay, welcome.

Thank you, Dr. Dinesh, and happy to have you.

All right, so can I continue?

Yes, Dr. Flora. Yes, Dr. Flora, I'm sorry for that.

No issue. Now what we have done it in last 30 or 40 years of my experience with the finding a new chelating agents, uh, most of the drugs, particularly calcium dihydrate, sodium EDTA, I know there are few clinicians who are very passionate about EDTA. And I started my own career with the EDTA because my PhD topic was on EDTA, that how useful is chelating agents. And I perhaps differ a little bit with Dr. Saxena because what we have found initially during my doctoral work, that this drug is have the wonderful effects in removing particularly metals from, uh, what you call it, uh, heart tissues. Because DMSA and DMPS both are the drugs which are soft tissue metal mobilizer, while EDTA is the heart tissue metal mobilizer. So you cannot use in chronic cases DMSA or DMPS, and you have no other option except to go for EDTA. In removing heart issues, particularly the femur, lead from the, uh, stores, uh, metal poisoning. Now in this particular case, what we have found, and during my 1 year's experience in Brisbane, it is a very old story. I think it was in '84 when I was a postdoctoral in Royal Brisbane Hospital. Dr. Hasnan said that in his experience, no patient has died because of renal insufficiency. But in that case, it is unfortunate that when I was in Royal Brisbane Hospital, 16 children died only because of— while we were being treated with calcium disodium EDTA. What happened? Perhaps a choice of a dose is very, very critical. What happened when the source the source of lead mobilization is through kidneys. And calcium disodium EDTA is mildly renotoxic. That is what we have found. And my thesis was entirely whether how useful is calcium disodium EDTA in cases of normal, normal kidney and the case of damaged kidney. And what we have found that in case of particularly young children's calcium disodium EDTA should not be used because it may lead to extra metal burden on kidneys. That was our research finding which we published in Journal of Pharmacology long back, this is some '88, '89. So that was our outcome. And then we found that calcium disodium EDTA is able— is not a specific chelating agent. It removes most of the other essential metals, and that's another big problem which we face. And the most highlighted work, which in the case of what we have reported, that calcium disodium EDTA redistributes metal from one organ to another organ. And this was proven beyond any doubt in animal studies that almost there was 2.5-fold increase in brain bed concentration after treatment with calcium disodium immediately. And this was published. And I, as expected, CDC reacted very indifferently to our report, which we published in American Society's journal. And I was asked to give a presentation in CDC Atlanta that you have to prove it with all your data, rare data. And then same studies were done in Rochester, and it was found out that yes, it does redistribute metal from one organ to another organ. And because of that, CDC has put a stop on the use of ethylcium disodium EDTA in children. And then what happened afterward, because you talked about arsenic cases, when I joined DRDO, arsenic came into picture. Particularly ICMR reported a number of cases from West Bengal, and as Currently, I think it has been reported by WHO, there are almost like 90 million patients— I won't say that subjects— who are already suffering with arsenic poisoning. So this topic was chosen, and we brought DMSA and DMPS from abroad and then did some clinical studies. And that trials were— clinical trials were done in West Bengal and even in Bangladesh. But unfortunately, both DMSA and DMPS failed in the clinical trials. And this work was reported by Dr. Muhammad Jumdar and many other groups. And beside, we also reported that both DMSA and DMPS, they are no good in cases of chronic arsenic poisoning. In both the drugs, they are wonderful drugs of choice as long as there is acute exposure to arsenic. But once there is chronic cases of poisoning, when there is a what you can call it, uh, skin cancer. There is gangrene and all these drugs have failed in providing any clinical, uh, and this was again reported in Clinical Toxicology long back, I think in '88 or '89. So both the drugs, they failed in the clinical trials and the challenge was in front of us and that what to do next. Can you put on the next slide, please? So anyway, I skip all this slide because I move over to my own work. Uh, just a minute, can you go back to earlier slide?

Yes.

This is a very typical characteristic of an ideal chelator, that it should have a greater affinity, low toxicity, ability to compete with natural chelators. Natural chelators are nothing but proteins and all. Ability to penetrate cell membrane, rapid elimination of toxic metal, have high water solubility, capacity to form non-toxic complex. So these are all the cases, but unfortunately there is none of the chelating agents which are available in the market, whether in the US or in any other part. This is a list of all the drugs which are there in the market for different metals. None of these chelating agents fulfill these requirements. Some few, I think, meet only 5 or 6. So these are the structures of some of the chelating agents. So this you can skip, Dr. Preeti. You can move on to the next one. Now, these are the drawbacks which I just have listed, and these are all published reports, and, uh, we have all done all the work in the animal studies. First was, was the first one, which is the most serious one, was reported by us, was the redistribution of arsenic, not only arsenic but also lead, from brain to brain. Then it's a heart tissue mobilizer. It has got some teratogenic effects. Particularly, it should not be used in pregnant ladies when administered between day 4, 1 to 14. Again, this is a— our animal study. Non-specificity is another big issue. So these are all the drawbacks of particularly calcium disodium EDTA. And as you rightly said, that DTPA also was used. And then we thought that why not, because the most of the teratogenic effects were because of huge amount of zinc mobilization after DTPA treatment. So we thought, let us make a complex of zinc and DTPA, and then zinc-DTPA complex was formed. And then when we injected in into the animals, what we found, that zinc-DTPA complex became so strong that why it never got ionized when it was administered into the animals. So keeping all this in view, that most of the drugs They are compromised, have some drawbacks, shortcomings. There were 2 or 3 strategies which were in front of us, and I worked specifically on these 2 strategies. One was the primary strategy which we adopted was synthesis of neoprolating drugs. It was easier said than done because it's not an easy job. But my experience in US when I worked with Professor M.M. Jones' lab for some time, when DMSA was approved, for by US FDA. So let us— I thought that let us see that if I can improve the efficacy of DMSA. And the second strategy which we adopted, particularly in case with lead poisoning, that we should use two chelating agents, EDTA, in combination with DMSA. I think this is the strategy which got most recognition from worldwide Because in, uh, particularly I'll talk about USA, where even this strategy combination treatment of EDTA with DMSA was tried in children, and it was published in Journal of Pediatrics, where 38 or 37 children were treated with combination treatment with success. Now, this is the strategy which we adopted. We all know about British antileucocytes, and this structure is on the left side. And then from British anthelucide, there are two analogs which we have prepared, DMSA and DMPS. DMSA, we all know, it's a US drug, Saxemer, which we call it, and DMPS, which Russians say that it's our product. So DMSA and DMPS both are the analogs of British anthelucide. And I adopted a very simple strategy, very simple chemistry. We thought that if we can make a lipophilic drug from DMSA, I think most of our problems will be solved. Because more with the lipophilicity, it will penetrate the cell membrane and go into the, uh, what you call it, heart tissues. Or it can cross the cell membrane and go into the intracellular sites and bring the arsenic out. Because in chronic cases, our major problem is bringing arsenic or lead from intracellular sites through extracellular sites and then bringing it out. So almost like 9 analogs were prepared. And we— what we did, there are 2 carboxylic groups in DMSA. You can see there are 2 carboxylic, and we made esters of this. Initially we made diesters, but when we prepared the diesters, what happened, that though they were very effective, but they become very toxic, uh, because of its high lipophilicity. And the drug itself became very toxic, and most of my 5, 6, 7, 8 years of work got in vain. And then we thought, let us make one carboxylic group and esterify it. This was the most toughest job. And of course, we made it esters of one carboxylic group, and we name it monoesters. Again, 9 analogs were prepared, and again we went back to the lab 9 esters were tested against all the animals, different animal models, starting from mice to rats to guinea pigs to hamsters, and lastly to monkeys. And then I think, uh, no need to go that fast, uh, let me catch up with you. Now, almost like 9 esters were prepared, and out of those 9 esters, we found that among the one ester monoisoamyl alcohol. And when we esterified it, it became the most effective one, and it solved most of my problems, starting from specificity, because it was more specific for arsenic. And even we tested against lead also, it was very effective. And except for Dr. Preeti, there was a huge loss of copper. There was no other metal which was lost. Only copper loss was significant, but otherwise it was specifically— it was binding with arsenic. Now we came to the conclusion, almost like 10-15 years of our preclinical studies, we found out among the three drugs, BAL, DMSA, and then lastly my own drug, it provides better therapeutic efficacy both in terms of clinical and biochemical recoveries, and it may be attributed to its lipophilicity. It's a low lipophilic because only monoesters was prepared, and its molecular size. And removal of toxic metal from both intra- and extracellular site may prevent redistribution of arsenic in brain. And this all was tested in animals, and we found there was no redistribution of metal from one organ, from liver to brain. That was, I think, after 15 years, we were, honestly speaking, we were jumping with joy that at least we have got some success. Can you move over to the—

Great job, Dr. Flora. And where can we get it?

Well, then came the most toughest job, then finding its safety profile, because before we go to Drug Controller General of India, they wanted a safety profile. So again, there was 4-5 years of work just to find it out, the safety of this. Compared to DMSA, I think you can see that this toxicity is bit high, on the higher side, because 1,000 milligram per kg compared to 13.2 grams of DMSA, that's the lethal dose, LD50. No major effects on liver, kidney, brain. As I've already said, that copper loss was the only matter of concern. But again, if you leave the patient for 2 weeks, uh, 1 week rest, copper come back to the normalcy. No redistribution. Acute and chronic It is safe, teratogenic profile safe, pharmacokinetic known in animal model, drug in. So then we went back to the Drug Controller General after 5 years, and of course they asked me, okay, you have to go to docs and you have to do pharmacokinetic studies and so many other things. Lastly, this is a very important part. I think, uh, I— this— we came very close to humans because we use human embryonic stem cells to test whether this drug is very close to, uh, what you call it, in human trials. And this was first time a drug was tested using human embryonic stem cells. This is a comment which we got from editor-in-chief, that this is the first reported studies where embryonic stem cells were used to test the efficacy of a drug in embryonic stem cell models. And you can see that in the both panels, there was hardly anything to choose between. Whatever we got in in vivo study, the same was repeated in in vitro studies. And although it was mildly toxic, in what you call in embryonic stem cell, but I think this is the most encouraging part of my work and the most highly, what you call, cited work about— I may say close to human trials. And then after this study, we went back to DCI, and then we got approval for human trials, I think in 2014. This was one part. And second part, I think I'll jump over to the combination treatment because this is again a very important part. Why we use this is for the reason that enhanced metal— because we are using a very low dose of agent. We do not have to use a very high dose of calcium disodium EDTA. We do not have to use what you call a potentially toxic dose of calcium disodium EDTA. And I think in my next slide we will show in a, in a better way that what, how this works, the combination treatment. And I think if you can show it in full slide, then only it will be better because it's an animated But anyway, if it is not possible, then leave it. What he— what he happens with— because DMSA is a lipophobic drug, it only— I think we have to go back.

Go back.

Yes, it removes metals only from the extracellular compartments. It doesn't go into the intracellular compartment. And what happened with our drug, which we have already completed Phase 1 clinical trials, it goes in both intracellular compartments and extracellular. What we did in case of lead poisoning was we used a low dose of calcium disodium EDTA in bringing lead from intracellular side to extracellular side. And then after 6 hours, we gave it again a small dose of DMSA. It took a lot of time to calibrate the doses because the calibration of doses is the most critical part Otherwise you may end up with some confusion. Now, and then EDTA and DMSA both were used in combination. I think, uh, CDC has already approved this protocol and they said that in case of lead poisoning, a combination of EDTA and DMSA will be ideal. In addition to that, I think, uh, in our Berlin conference it was clearly described that not only the combination treatment, but a use of an antioxidant along with EDTA or DMSA. It should be the best option for clinicians going for chelation therapy. And they went even to that extent that they said if you are not using an antioxidant during chelation therapy, it's a criminal offense. This is something they use very critical, a very harsh language in their discussion, and then this was approved. So two major— and we have already completed Phase 1 trial with the Apollo Hospital in Ahmedabad, and we have already completed Phase— the part of Phase 2. But unfortunately what happened, then I left DRDO and then came here, so this has got little standstill. But again, one American firm has come forward and they said we are going to complete complete the Phase 2 trial and Phase 3 trial.

I think we—

I do hope that this drug will be in market in next 2 years or 2 and a half years, because already we are almost done 75% of the work. And the drug perhaps will be the first drug which will be useful for treating chronic cases of metal poisoning. This is a short story of my 30 years or 35 years of a journey. Starting from scratch to coming over to a drug, IND drugs. Thank you very much.

Thank you, Dr. Flora, for sharing this and for all the effort you are putting in to find newer drugs. Because that's the another challenge. One challenge, of course, is that we are unaware. We have read it in medicine hundreds of years or even more than that before, but forgotten to use it. In chronic diseases today. Second challenge also is unavailability of these drugs.

That's true.

Right now they are available at a price which not everybody can afford.

Dr. Preeti, I mean, I just interrupt you for a moment. I think in last 1 year I might have got almost like 50-60 calls. Uh, I think the latest which I have— we have treated only about a week back from Mysore. They, they A lady called and her husband was suffering with chronic and all sorts of problems associated, clinical problems. He was almost like on the verge of dying. And we took a special permission from TCGI, and doctor said that if you can provide MiDMSA, that it will be good. So Kerala was very nice. I mean, that person has shown remarkable recovery, and now at least he's not dying.

That's, that's Definitely, Dr. Flora, and I'm going to come back to you off screen later tomorrow and see what more we can do and how we can do this fast. Great, thank you, Dr. Flora, for sharing this. Uh, a lot of questions in my mind which I will come back to, but now we have Dr. Dinesh Kumar, scientist, director, great, ICMR, National Institute of Nutrition, counselor, IUPHAR, PNPS, Director, Translational Science Research Services, Vice President, Nutritional Society of India, National Former President, Indian Pharmacological Society, National Secretary, National Former Secretary, Nutrition Society of India. Uh, with so many accolades and positions, Dr. Dinesh, I welcome you to speak on nutrient-heavy metal interactions. Dr. Dinesh, please unmute yourself.

You see my slides? They are getting— are you able to see my slides, madam?

Are you able to see a slideshow?

They're getting uploaded, no problem. Now I will start my information. My journey starts with lead pollution interactions. In fact, I am a non-clinical pharmacologist. I have joined the ICMR for doing this work on the mapping how the lead toxicity is existing among the various group of population. That was my basic work. And you will not believe me, after 37 years of service at ICMR, I have been given in my last 4 or 5 years the work of leaching, finding out the leaching of the lead from the tiles and a phthalate. So you will be asking why my topic nutrition pollution and interaction. And I am just to share with you this study which I have taken with the toys in ICMR. Everybody was asking us the question how ICMR and IAN is to the toys and late toxicity of AIDS. The issue is that a young mother, mother with a child of 3 days or 4 days in India, who is laborer, goes for employment and she gives a small tie to the child and this child keeps the tie in the mouth and from the mouth it leaches out the lead. This is what exactly the tie story and to their anemia. And that is where the heavy metal monitoring among the child, among the pregnant women, among other things has become a very vital If my slide gets open, I will be thankful. Otherwise, because I think it looks to be very slow, but separately put one word. Really speaking, when I am hearing to the news today also, our COVID baba is again appearing on Earth, and this is all we are not able to understand whether this will continue or not. Today's news is very bad Because this is 8,000 cases today they have been recorded. Now I am just giving you some 2 or 3 examples where you can understand why this poisoning cases have become important. First thing is that we have made an attempt to use the hyamine, which Dr. Flora has worked extensively. I thought that he would have shared his views on the thiamine. This thiamine is a weak chelator and having a potential to prevent, if not reduce, the lead toxicity in the body. What happened when I was just monitoring this study, as per the nutrition scientists, they think that we have to go for the natural source of using the substances. The thiamine is having the donation of electrons, so it used to donate the electron to the lead. And I have done this study in Indians of Bangalore where we found out that thiamine has a weak potential to bind it to lead, and that is how the lead gets chelated. This is one part of my studies. Now coming to the second part of my studies, that my interest was that the weak, weak, weakest— that means Heavy metal poisoning, which is a very serious issue, specifically with the nutrition. Wherever there is a nutritional deficiency, heavy metal poisoning is always going up. Many a times, Dr. Saxena is sitting here, we used to have a lot of discussion how to diagnose the person whether he is a heavy metal person or nutritionally abnormal. That is where if there is anemia, what is the issue? If there is a lead toxicity, what is the issue? There should be biomarkers for this. So we have developed biomarkers for detecting the heavy metal toxicity, ophthalmology, renal toxicity, and neurological parameters. And this is how we have actually worked out with the biomarkers to detect the lead toxicity. Then came the issue of heavy metals coming into the food chain cycle, how the food chain cycle is getting polluted because of the heavy metals. Because many of you are from Hyderabad, Dr. Flora is from Lucknow. In Hyderabad, you are able to see a lot of green leafy vegetables. The same case is in Bangalore, the same case is in Mumbai. Where you can see the frothing issue which is coming out very openly from the drain system. You can just see the Bangalore majority of the city at one season, the frothing comes, and this is all because of the intermediate drugs or pesticides or other these things which are leached into the drain system. And the palak and other these things, greeny leafy vegetables, they have a capacity to accumulate them. and we are consuming it, and we are building up our heavy metal. For this, I will give you one epidemiological study where we are directly involved. That is happened in Dadra Nagar, Haveli, Mumbai. I may not like to mention the name of a company because of my government compulsions, but the company is known to produce the heavy metal, lead metals, which used to be kept on the Dadra Nagar Haveli River. And this water, wherever it used to touch, it used to contract the lead, and this lead used to go into the vegetable that is called as a gongura in our place. It is a palak and other vegetable having a rich source of iron. Majority of the cattle Cow, when they graze on this specific vegetable, after the vegetable is consumed, this cow and cattle were actually walking, dragging their feet. The hip— the lead levels were 700 and 800, which is 60 to 700 times more than the normal limits. Then we found out the whole epidemiological incidence. The factory used to run in the night times. They used to collect the lead cells, small, what you call, fruity packets. And then there used to be tin and lead, and all this used to be melted. The furnace used to emit the heavy metal, and if you stay there for 25 minutes, you cannot even take a breath, and it used to be in a dangerous situation. Then we have done an epidemiological investigation. 0 km radius of the industry, 5 km of the radius of the industry, 1 km, and 5 km. You will not be believe— if the slides would have come, I would have happily shown the slide where you can just see higher the lead level, lower the hemoglobin level. Higher the lead level, lower the other heavy metal levels. And this has shown us that there is a direct relationship between the heavy metal poisoning and the pollutants. If you are healthier, your heavy metals will definitely be down. If you are not healthier, then all these things will happen. Many vitamins have been tried, many nutrient supplementations have been done, and we can just say that With the climate change, this situation is going to be worse. The heavy metals are going to accumulate more in the green leafy vegetables. Our fertile soil cannot be done. So we have to really think about some intervention, some solution for this. With these words, I mean, like to stop here. I am a last speaker. You are enjoying a meal. I have to take the meal. Thank you very much.

Thank you, Dr. Dinesh, for connecting the dots. This was the biggest link which was to be connected, and we could not end the session without that. And very rightly said, water— exposure of water to these heavy metals, to the vegetables which we are eating today, all of that, the full cycle, we are getting exposed to lots and lots of heavy metals. And this situation is going from bad to worse to worst. And high time we find some solution. And I think solution only comes when there is awareness in more and more people. And this is a small initiative from IFM to do that. Thank you all for your support. Dr. Flora and Dr. Hasnan, I have a question for you from Dr. Vijay Mohan Kohli. Have you found if iodine deficiency plays a role in accumulation of heavy metals?

Dr. Flora, you're muted. Dr. Flora is muted.

I'm sorry. Yeah, deficiency of iodine does affect lead poisoning. It increases the lead poisoning. This is what we have found in our experimental study, but High iodine, uh, contents do not have any effects on that, by the way. It means they don't interact with each other, but deficiency of iodine facilitates more absorption of that. This is what we have found. Dr.

Hasnim, perhaps this probably plays a large part in all the myxedema we are seeing now in young girls. Yes, we're giving L-throxine. We don't realize that what you have to do is a nutrient correction. And Dr. Bardwaj was quite right. Until we get the lead and metal out of the water that you're using for irrigation, you are never going to sort out the problem.

Exactly.

Scrubbers on the chimneys of these people that are emitting lead fumes.

You need to look into the—

especially into Bengal, West Bengal specifically— the arsenic content. The reason why they're so inflammatory all the time getting annoyed and creating all sorts of riots. One of the things is the lead in their brain and the arsenic. So that's why it should be a mainstream treatment for everybody.

Dr. Hasnain, I think it's a real puzzle for us, particularly in West Bengal, that from where this groundwater arsenic has come. I mean, there have been stories floating around. I mean, some funny stories also, that even during World War, Japanese have left some arsenicals. Arsenicals means arsenic weapons. And they are— but it's a puzzle which has never been able to solve it, because in Bangladesh, it's at some of the places, particularly in 24 Parganas, the arsenic level has been as high as 3,000 nanograms per liter.

Don't look at uranium. That's one thing that's being ignored, especially in Punjab. And, and I'm telling you, they need to check the water coming out of all these facilities with what's going in and what's coming out, so you know what's happening. It did the same thing with Coke. They said, oh, you're putting heavy metals in Coke and pesticides. So we took the water incoming to the plant and outgoing from the plant and showed them that we are removing more and you're putting in. So whenever you dig a tube well which is more than 40 meters, you are going to hit metals. Not for you to drink. He put it underground so you wouldn't touch it.

But yeah, so Dr. Patel, you have rightly said water is extremely important. And I think that's another debate to have some other day, that what— how means which water to take. Is RO good? Is Kangen water good? Is well water good? I don't know, right? And I think most of us are trying to find questions for that. But next time I think that should be our topic. I will want to thank everybody, everybody who joined us. I think this has been the most interactive session I've had in last 12 months. Thank you, Dr. Hasnan, Dr. Praveen, Dr. Flora, and Dr. Dinesh for being a part of such interesting discussion. I'm sure more people will come forward, learn more, use it on themselves. Because I was going through, you know, hearing Mark Hyman one day, and he said that anybody who's 50+ and has not done chelation on himself or herself, they have decided they don't want to live quality life.

True.

Right, so if any one of us here has not done chelation, I think time to do it tomorrow morning, right? Uh, thank you very much. It was a pleasure hosting all of you. I learned a lot, and I'm sure everybody learned a lot. Please share some articles. I will add in the description so that people can know more and more, and what can really spread. Thank you. Bye-bye and good night.

Thank you.

Good night.

Special thanks to Dr. Praveen. Dr. Praveen, thank you very much for creating this panel. Thank you.

Thank you.

Bye-bye.