Case Study from Book: Stiffness in Knee and Ankle Joints (John)

John was a 58-year-old retired, heavy equipment operator who had a 15-year history of stiffness in his knee and ankle joints, a sensation of tightness of the skin in his lower limbs, as well as decreased sensation in both feet. He experienced cramps in his lower leg muscles approximately twice per week at nightime. The only medication he was taking was Lipitor for high cholesterol. He also experienced occasional gout attacks in his feet if he consumed too much alcohol or protein. He noticed that during the previous few years he had developed an intolerance to cold, and for the previous three years he had noticed that his balance was not as it should be. He did not have much exposure to mercury from amalgams because he had complete extraction of his teeth at 18 years old, following an accident.

Several years before I met him, John had attended a naturopathic physician, who conducted a hair analysis which showed elevated levels of copper, selenium, mercury, and manganese. John had stopped smoking at 45 years old and had one or two drinks of alcohol per day. He had a very bad family history for heart attacks. His father, all of his paternal uncles, and his paternal grandfather had died in their 60s from this cause, consequently, John had recently undergone a treadmill test, which was normal. He told me that at work he had a lot of exposure to metals and chemicals. Also, he did all his own mechanical work, which exposed him to various greases containing lead and arsenic. He was also exposed to leaded gasoline. He had spent a lot of time working with pressure treated wood and furthermore, as a hobby, over several years, he made his own lead bullets in his garage for black powder guns.

When I examined John, he appeared well, and his pulse and blood pressure were excellent. He had a few non-specific changes in his fingernails, and he had vertical creases in his earlobes (these are often associated with coronary artery disease). He had a full set of dentures. His reflexes, however, were almost absent and he had decreased sensation in his feet. He had difficulty walking heel to toe (as if walking on a tightrope), and when I asked him to stand with one foot directly in front of the other with his eyes closed, he fell over.

I performed a number of laboratory tests including iron indices, homocysteine, highly sensitive C-reactive protein, thyroid indices, copper indices, kidney function tests, cholesterol indices, and the usual chemistry tests. These were all well within the normal ranges. I also suggested that we perform an EDTA chelation challenge test because of John’s previous exposure to metals. He declined to get this test done but wanted to proceed with a trial of EDTA chelation therapy. His cardiac treadmill test was negative, but because of his family history, I suggested that he consider getting an ultrafast CT scan of his coronary arteries (this is a reliable and noninvasive screening test for coronary artery disease).

Dietary instructions were reviewed, a nutritional supplement protocol was prescribed, and John began EDTA chelation treatments twice weekly. After 15 treatments, both he and his wife noticed a remarkable improvement in his mood. His energy had increased significantly, and he found that his joints were more flexible, less swollen, and markedly less painful. He also noticed that the numb spots on his lower legs and feet had resolved and that for the first time in years he was able to feel the floor with the soles of his feet.

At this point, John agreed to have an EDTA chelation challenge test. The results showed an extremely high level of arsenic (500 mcg with normal being less than 120). His cadmium level was also elevated (3.3, with normal being less than 2), as was his lead level (19, with normal being less than 5), and also his Nickel level (20, with normal being less than 10). John’s arsenic level was one of the highest that I have observed and when I questioned him further, I discovered that for many years he had consumed partially filtered well water and had a lot of exposure to pressure-treated wood.

John decided to get the ultrafast CT scan of his coronary arteries, but unfortunately there are no electron-beam computed tomography units in Canada. I referred him to a hospital in Seattle, Washington, and his results were once again disturbing. The ultrafast CT scan calculates the amount of calcium in the lining of coronary arteries. This measurement is significant because the calcium level correlates 100 percent with the amount of plaque. People who have mild plaque in their arteries would have a calcium score of 100 or less. John's score was 3,910, discovered in 22 different sites.

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