Thursday Shorts: Cannabis, Tirzepatide, and Chelation
August 29, 2024
(A) Chelation doesn’t lower risk of future heart attacks in those at high risk
Chelation therapy reduces the concentration of heavy metals like lead and is an important and effective treatment for lead poisoning. Alternative medicine practitioners have been using chelation therapy to try to reduce risk of heart attacks for decades, although there has not been good medical evidence that this works. Researchers randomized about a thousand people at exceptionally high risk of future heart attacks because they had both diabetes and previous heart disease. Half received 40 weekly chelation doses, while the other half received 40 weekly placebo shots. They found that about 36% of each group had a heart attack, stroke, revascularization (bypass or angioplasty), hospitalization for unstable angina, or death. The chelation made no difference whatsoever.
Employers are periodically asked to cover this therapy; this research shows that they should not.
A quick web search shows that there are five providers that offer chelation services within five miles of my home in metro Boston.
(B) Cannabis use associated with more head and neck cancers
Researchers queried medical records of about 116,000 patients from 64 provider organizations over 20 years and found that rates of all types of head and neck cancer were statistically significantly more common in those who also had cannabis use disorder. The researchers presented risk ratios after adjusting for tobacco and alcohol use, which are known risk factors for this group of cancers. Overall, the risk of head and neck was about three times higher for those with cannabis use disorder.
Cannabis smoking does not appear to have as high a risk of cancer as cigarette smoking, but inhalation of products of combustion clearly increases risk of this type of cancer. This study evaluated cannabis smoking only, and did not evaluate risk of oral ingestion (such as gummies).
(C) Tirzepatide decreases incidence of diabetes by 94%
Eli Lilly reported on Tuesday that in a 44-month follow-up of over 1,000 people with pre-diabetes, the likelihood of progressing to diabetes decreased by 94%. This is a press release, and a peer-reviewed paper will be published at some point in the future. Participants in this clinical trial lost an average of 23% of their body weight during the 44 months, although those who discontinued the medication began to regain weight. A previous study showed that semaglutide (Wegovy) decreased progression to diabetes by 73% in a similar population. This adds to the evidence that GLP-1 medications have substantial metabolic benefits beyond lowering weight.
(D) New COVID vaccination available
The Food and Drug Administration (FDA) approved the updated Moderna and Pfizer 2024 COVID-19 vaccines last week. Stay tuned… full note on this tomorrow.