braceletWith updates, from Kenneth J. Dillon, Intriguing Anomalies: An Introduction to Scientific Detective Work. Notes, bibliography, and images can be found in the original. For a brief overview, see Ten Key Points about Medicinal Bracelets.  For his novel of discovery science, see Rosemarie (Washington, D.C.:  Scientia Press, 2021).

 

 

Chapter 4

The Science of Medicinal Bracelets

The vision inspiring the study of medicinal bracelets is of an attractive, simple, easy-to-use, safe, naturally effective kind of medicine. Investigation of medicinal bracelets can also reveal fascinating deeper patterns of the body.

The case for medicinal bracelets seems self-evident. A medicinal bracelet that could, for instance, suppress pain in arthritis would convey highly attractive benefits. Instead of having repeatedly to purchase drugs with inevitable side effects and then dose them correctly, one could simply make a one-time acquisition of a bracelet and wear it with almost no further thought. Minimally invasive, the bracelet would possess the beauty of jewelry and eliminate the risk of children overdosing on their parents’ pills. For poor people in developing countries, a bracelet that provided iron and zinc could help solve major health problems. And bracelets can encourage better patient adherence than oral medications because they enjoy an image of a benign natural remedy.

Scientists, too, should be eager to study the effects of medicinal bracelets. Why do they work for some people and not for others? What are their mechanisms of action, indications, and side effects? What could be done to improve their design? What actually happens in the skin as it absorbs the substances from the bracelet, if indeed it does? Is there any physiological change connected with circumventing the gastrointestinal tract? What can medicinal bracelets tell us about deeper patterns of the body? What can they teach us about nutrition in general? Do magnets on bracelets provide any benefit, and how might that occur?

Alas! Negative factors have conspired to obscure this vision, so that medicinal bracelets exist in a limbo of neglect and disdain, even while tens of millions of people worldwide wear them and many wearers swear by them. These negative factors include:

  • the blinkered conservatism of some medical doctors, quick to rule out new approaches and even to stigmatize them;
  • the low-tech nature of medicinal bracelets, far removed from the cutting-edge, highly sophisticated work of most scientists. The reluctance of scientists to work on medicinal bracelets makes it difficult to put together strong grant proposals;
  • the egregiously unscientific claims of some vendors;
  • the generic, low-price nature of medicinal bracelets, which makes them of little interest to drug and device companies;
  • the lack of support from a major therapeutic discipline with thousands of practitioners like Traditional Chinese Medicine. Medicinal bracelets can be found in Ayurvedic medicine; but those traditionally contained known toxic metals like lead, so they have correctly been downplayed; and
  • the timidity and negligence of funding agencies.

Ideally, science should deal with such an intriguing, little-explored subject as medicinal bracelets with a series of well-designed experiments that can provide a factual basis for testing hypotheses and building up a body of evidence and theory. In reality, though, pathetically little funding is available. Still, several clinical trials give us some data to work with.

Fortunately, a theoretical approach can piece together a picture of how bracelets work, what they can and cannot do, how to optimize them, and what they tell us about the functioning of the human organism.

Transdermal Micronutrition

All methods of absorbing microminerals are not created equal. There is intriguing evidence that microminerals absorbed transdermally, ion by ion, have superior action and fewer side effects than microminerals taken by oral supplementation, via muscle injection, or intravenously.

Typically dispensed from a copper bracelet that forms the cathode, the most useful transdermal microminerals besides copper are iron and zinc. This Transdermal Micronutrition (TDM) has many potential applications:

  • iron supplementation, including in special indications such as boosting iron levels in iron-deficient malaria patients, where oral supplements are under suspicion of actually feeding the parasites, though there is contrary evidence. In a clinical trial of iron supplementation and malaria in Tanzanian infants, ordinary iron supplementation adequate to replenish stores did not increase susceptibility to clinical malaria in infants but lowered by a third the rate of severe anemia, a common cause of infant death, accounting for 27 percent of infant deaths in one hospital. Iron from a TDM bracelet might do even better;
  • in the case of treatment of an anemic cancer patient with TDM, one can hypothesize that the tiny trickle of iron and zinc (and inevitably copper) ions that crossed the skin would immediately be sequestered by the red blood cells and would serve to provide a steady stimulus to the immune system. So in theory the iron would not be available to feed the growth of tumor cells, unlike the situation with such interventions as oral iron supplements or Total Iron Dextran. TDM’s other fundamental effects on metabolism might also play important roles in making it a valuable adjuvant therapy in cancer with significant anemia and/or zinc deficiency;
  • in the treatment of zinc deficiency among poor children in developing countries and the elderly worldwide;
  • Transdermal Micromineral Immunostimulation (TMI) as an adjuvant therapy in many infectious diseases. It seems likely that TDM zinc would perform as an excellent immunostimulant in individuals with zinc deficiency, it is not clear whether using a zinc-containing TDM bracelet with zinc-replete patients would have a beneficial effect.  It is possible that supplying additional zinc via the transdermal route would provide effective immunostimulation even in zinc-replete individuals;
  • in environmental medicine, where the bracelet’s ion-substitution effect can help reduce the impact of many kinds of toxic substances; and
  • in certain neurological and psychiatric indications, where zinc can boost levels of serotonin and serve itself as a neurotransmitter in a natural way that has few or no side effects.

In theory, TDM exploits a capability that human beings have inherited from distant ancestors. Its action suggests that in certain circumstances human beings can exhibit behavior resembling medusa and polyp stages (see below); and that the transition between the two can convey a powerful tonic effect. TDM’s abilities to bypass the liver and to provide a steady supply of micronutrients differentiate it from gastrointestinal feeding and help explain some of its effects.

Iron-Deficiency Anemia

Iron-deficiency anemia (IDA) is the world’s leading micronutrient deficiency and, in the developing world, the second most serious nutritional problem after hunger itself. Iron deficiency is responsible for over 85 percent of the estimated 2.1 billion anemic people worldwide.

IDA can lead to fatigue, learning disabilities, mental retardation, stunted growth, physical debility, decreased body temperature regulation in adult females, increased incidence of low birthweight and premature infants, increased prevalence of maternal death at delivery, and reduced resistance to infection. Iron-deficiency status makes an individual much more vulnerable to environmental toxic substances, including heavy metals, pesticides, industrial chemicals, and radioactive materials. One can speak of Disease-Induced Susceptibility to Toxic Substances (DISTS) whereby an infected or otherwise diseased individual’s normal functioning and immunological defenses are undermined by environmental toxic substances that are of a completely different origin than the primary disorder.

Fortification of foods, supplementation, and emphasis on dietary intake of iron have had significant success in reducing the prevalence of IDA in rich and middle-income countries. In recent years, these programs have had some impact on IDA in poor countries as well. Still, hundreds of millions of people live beyond the reach of such programs, and many people remain vulnerable to iron deficiency and IDA even in rich countries.  Certain approaches (e.g., supplementation) encounter problems with adherence and risk the danger of abuse (poisoning of children who swallow their parents’ iron pills). Injections of iron can help in some cases; but they can have side effects and are relatively expensive and unappealing to many. Lastly, some sufferers from IDA simply cannot absorb iron via their gastrointestinal tracts at the requisite rate to attain and maintain iron-replete status.

Efforts to fortify food are very worthwhile; but there remains a need to investigate new treatment modalities that can correct this major, worldwide public health problem.

Zinc Deficiency and Zinc Therapy

Meanwhile, zinc deficiency (ZD) is associated with stunting of growth, metabolic disorders, behavioral disorders, slow wound healing, and poor immunity. ZD is hard to diagnose because no one laboratory test or combination of tests is decisive in every case. As a result, the prevalence of ZD is not known. However, many patients with chronic infectious diseases have ZD.

Given zinc’s presence in more than 80 enzymes, it is not surprising that zinc plays a critical role in immunity, though that role is not fully understood. Zinc’s ability to form strong, readily exchangeable, very flexible ligands with the side chains of organic molecules makes it uniquely effective at the catalytic site of these enzymes. Unlike iron, whose redox properties involving the shift between Fe (II) and Fe (III) can cause severe oxidant damage in oxygen-rich environments, zinc is not associated with oxidant damage and in fact can, in various enzymes, diminish it. Oral zinc supplementation can have a significant immunostimulatory effect and has proven value in the prevention and treatment of infectious diseases. However, little research has been done on the transdermal absorption of zinc, nor is there published information comparing various modes of delivering zinc in order to determine the optimal one.

The ratios of zinc to iron and copper have physiological significance and are clearly of concern in that the three minerals dynamically compete with each other and with calcium, manganese, and other microminerals for absorption from the gastrointestinal tract. It appears that a high copper:zinc ratio can have deleterious effects.

Copper Bracelets

Copper bracelets generally cause no side effects other than easily reversible discoloration of the skin and, in people with metal allergies, skin irritation. So their potential for conveying therapeutic effects is deserving of careful investigation.

Copper is an important human trace element. Some 75-150 mg are present in healthy adults, with a daily turnover of 2-3 mg. In humans, copper plays a role in some 30 enzymes, including the critical enzymes superoxide dismutase (SOD, a suppressor of the leading reactive oxygen species superoxide) and ceruloplasmin (an antioxidant that keeps copper and iron ions from creating oxygen radicals; ceruloplasmin is also important for the uptake of iron into hemoglobin). In the (blue) blood of some crustaceans, copper substitutes for iron to form cyanoglobin. Aside from the rare genetic disorder of copper overload (Wilson’s disease), humans can store and use a rather large amount of copper without any deleterious effects, though oral intake of some copper compounds can cause nausea and vomiting. However, significant overdoses can cause a range of damaging effects, including hepatomegaly and cirrhosis of the liver. Copper is abundant in a variety of foods, including legumes, nuts, seeds, and shellfish.

Available in two main isotopes and two states of oxidation (+ and +2), copper is absorbed in the gastrointestinal tract via the same mechanism as zinc, and it readily substitutes for zinc and iron in the body because of its similar location in the periodic table (i.e., the similar configuration of its electrons). In turn, silver (and perhaps gold) can substitute for copper in enzymes like ceruloplasmin. So ion substitution plays a significant and not fully understood role in copper metabolism, and thereby in its medicinal effects.

Copper in the History of Medicine

In ancient Egypt, various copper compounds were used to hasten wound healing, treat headaches and epilepsy, and sterilize water. Copper acetate €”known as verdigris €”became the antiinfective of choice in Greek medicine; and Roman medical treatises recommended a number of copper compounds for a range of skin, neurological, and inflammatory disorders. Copper was used in ancient India and Persia to treat lung disorders, while the Aztecs used it, perhaps in a gargle, for “heat of the throat”. In India copper found extensive use for treatment of skin and internal disorders. In ancient China a law prohibited the use of paper money in bars and prescribed that payment be made with copper coins, for hygienic reasons.

The renowned Renaissance physician Paracelsus treated inflammatory and autoimmune diseases with copper, and he held that copper was an effective treatment of parasitical disorders.

During the 1800s, certain French and German physicians used copper compounds extensively and conducted intriguing epidemiological studies. J.G. Rademacher found that copper hammerers were healthier than workers in other industries; but his treatments with oral copper compounds frequently led to nausea and even vomiting, so he had to mix them with cinnamon and wine. Rademacher treated with copper compounds neurological and rheumatic disorders as well as herpes and warts.

In his book Metallothérapie (1871), Victor Burq showed that workers in the copper industry had suffered far lower death rates during the cholera epidemics of 1865 and 1866 than workers in other industries. Burq used both oral copper and copper or copper/zinc (brass) bracelets to treat hysteric paralysis, migraines, and anemia. Italian physicians also determined that inhaled copper dust swiftly corrected the anemias of chlorotic girls who took jobs in the copper industry.

A copper-based potion of the Swiss physician Koechlin, based on a Chinese original, was widely used in Central Europe to treat a range of skin, neurological, and infectious diseases including tuberculosis. A. Luton conducted clinical studies in which he successfully used copper to treat pulmonary tuberculosis. Eventually, Bayer and other companies marketed copper-based intravenous and oral medicines for the treatment of tuberculosis, and Bayer’s Ebesal came into use as a treatment of arthritis.

In other words, over the course of thousands of years many medical practitioners have used copper to treat a wide range of human ailments.  However, the quality of much of the evidence does not meet modern standards, so more studies must be done. Also, almost all of the reporting refers to oral or, more recently, intravenous copper, which may or may not be relevant to transdermal copper.

Advantages of Transdermal Copper

Copper drugs have intriguing historical evidence and abundant testimony on their side, but their generic status means that few companies are attracted to develop and market them because of the difficulty of obtaining strong patent protection. In addition, many medical doctors and researchers are skeptical of such wide claims, while generally useful interventions like copper represent a threat to pharmaceutical corporations. Moreover, generics like copper are not espoused by any specific ethnic or philosophical group, and therefore lack the network and sustained support needed to overcome obstacles and eventually win their way into standard use. As a result, they tend to slip through the cracks, with the curious outcome that they may possess considerable unappreciated value.

Copper bracelets show more promise than dietary copper and oral copper compounds for several reasons:

      1. Gastrointestinal disorders disrupt copper absorption;
      2. Age-related physiological changes reduce absorption;
      3. Binding of gastric or dietary ligands, e.g., by grain-based phytates (high in soy products), can hinder uptake;
      4. Chronic inflammation reduces absorption;
      5. An inappropriate diet (e.g., high dairy content) can reduce copper intake;
      6. Regional dietary deficiencies can lead to low copper; and
      7. Various oral copper compounds can cause nausea and even vomiting.

A frequent objection to the notion that bracelets can provide copper in nutritional or medicinal (i.e., drug-like) amounts arises from the sense that the skin is not the normal, correct means for food absorption. But before the evolutionary development of the gastrointestinal system, the skin was the only means of obtaining food. So the transdermal feeding route is correctly considered as an alternative, more ancient system of nutrition. This perspective also can help overcome the assumption that the skin serves primarily as a barrier. In fact, the skin can serve as a barrier or as an entry way into the organism, depending on the circumstances.

A recent addition to understanding is the theoretical insight that the red blood cells constitute the dermal optic photoreceptor and photoanalyzer that with ultrahigh sensitivity identifies and analyzes potential food on or near the skin. In turn, this property makes much more believable the perception that microminerals on the skin can penetrate by both push factors (iontophoresis and chemical penetration enhancers) and by pull factors (hunger, Hidden Hunger for microminerals in deficiency, and €”self-medication in disease). The rate of absorption of copper from a bracelet depends on the condition of the body.  In cases of copper, zinc, or iron deficiency, the body will absorb copper at a higher rate. A similar pattern of higher absorption seems to hold for chronic disease states where the disease process itself, typically immunological/inflammatory or tumorous, requires a supply of energy. In healthy people, in contrast, absorption will be much slower or possibly will not occur.

Copper bracelets discolor the skin as the blue-green copper deposits there. However, this discoloration can be washed away with soap and water over the course of a day or two, and there is no evidence that it harms the skin, though in a people with metal allergies copper can cause contact dermatitis.

Over the past two billion years, the action of increasing amounts of dioxygen in dissolving copper’s sulfide bonds made copper initially into a very available poison, so eukaryotic cells and particularly those of mammals and algae had to evolve mechanisms to sequester, buffer, and eventually use copper in enzymes. As a result of this successful evolutionary development, copper replaced iron in several roles and became a key player in human physiology. This process made copper, in the right amount, an unusually safe metal compared with many others. However, both copper and zinc are counter-indicated in Alzheimer’s disease and metastatic cancer, though that might not apply to transdermal copper and zinc.

Mechanisms of Action

Many mechanisms of action have been proposed for the effects of copper bracelets:

      1. There is none:   all effects are imagined;
      2. Psychological: the placebo effect explains the results, and therefore believers are more likely to obtain favorable outcomes. Walker and Keats found that, in contrast to controls, previous users with rheumatic conditions felt significantly worse when not wearing their copper bracelets, while 14 refused to go without them during the trial. Even if copper bracelets are found to have a biochemical effect, it might still be accompanied by a psychological one. A psychological impact could be achieved in part via the specific action of copper in the brain as well as by a general placebo effect In addition, other psychological effects could clearly play a role;
      3. Biophysical:  The high electrical conductivity of copper; the addition of magnets, batteries, etc.; and the electrochemistry of the bracelet-skin interface make bracelets a form of energy medicine.  This occurs in their common C shape, while a complete ring may possess enhanced capacity for electromagnetic effects.  The bracelet can stimulate the red blood cells, which are ultrasensitive to electromagnetic fields, thereby adding energy to the blood and activating the immune system.  A Mayo Clinic study found that “ionized” copper/zinc bracelets were no more effective than standard ones for muscle and joint pain relief, but both were effective about three-quarters of the time. Ordinary elemental and molecular vibrations and other physical phenomena such as the corona effect of the ends of the C bracelet might convey some medicinal benefit.  Also, any electromagnetic aspects of the bracelet might be felt not only on the very sensitive surface of the skin but also in the center of the bracelet’s circle, i.e., in the middle of the wrist, as in an electrical motor arrangement. Such effects would relate to the many experimental findings that copper wires stimulate the growth of plants.  In general, the physics of copper bracelets requires more research, including on what weight to ascribe to it compared with the better-characterized chemistry of bracelets;
      4. Copper ions are components of enzymes (superoxide dismutase, ceruloplasmin, etc.) that reduce reactive oxygen species, provide iron for the formation of hemoglobin in erythrocytes, help form collagen for wound healing, and otherwise improve the body’s functioning;
      5. Medicinal amounts of copper are absorbed differentially by infectious microorganisms and thereby poison them (aside from mammals, algae, and Staphylococcus aureus bacteria, living organisms tend to be highly vulnerable to copper poisoning), while in inflammatory states the differential absorption of copper by activated immune cells tends to impede their metabolism and suppress their overactivity;
      6. The provision of copper may optimize the use of iron and zinc in the immune system and otherwise;
      7. Simply correcting hidden copper deficiency can help optimize the body’s resistance to disease;
      8. Copper can compete with toxic minerals for absorption and physiological use, thus reducing their harmful impact and making them more likely to be eliminated. These include cadmium and lead, and €”they may also include silver (and perhaps gold) from jewelry worn by anemic individuals, which can substitute for copper in ceruloplasmin and thereby disrupt delivery of iron for the formation of hemoglobin;
      9. In certain anemic and sick individuals, there is a transdermal feeding response that activates an ancient physiological system in the body and conveys a powerful tonic and immunoprotective effect. In other words, all copper is not created equal. Receiving it across the skin may provide extra benefit quite aside from direct entry into the blood that evades the obstacles associated with the gastrointestinal route. The body may hoard its stored and orally ingested copper while avidly absorbing copper from a bracelet for use in healing itself; and
      10. In certain hard-to-define categories of individuals, copper has a beneficial effect for reasons not understood at present. This would explain why some arthritis sufferers appear to benefit from copper bracelets while others do not.

Other explanations might exist; several explanations might pertain in any individual case.

Australian scientists found evidence suggesting that copper from bracelets does penetrate the skin and can have an ameliorative effect in rheumatoid arthritis. In particular, habitual wearers of copper bracelets strongly favored copper bracelets over look-alike anodized aluminum bracelets in a clinical trial. Indeed, copper and zinc dispensed by the bracelets may have more thoroughgoing effects on the destructive progress of rheumatoid arthritis than do non-steroid anti-rheumatic drugs (NSAIDs), which are only good for reducing pain. In effect, this means that copper/zinc bracelets may be a Disease-Modifying Anti-Rheumatic Drug (DMARD) like methotrexate.

Five Case Studies

1. A 39-year old woman with a history of anemia and fatigue put on a copper bracelet with iron (steel) inserts. Within one day of starting to wear the bracelet, she reported that the skin on the shoulder of the arm with the bracelet had become very dry and rough. She said she felt hungry yet did not want to eat. She was able to read for hours instead of being unable to concentrate. After two days of wearing the bracelet, she reported that she felt in an unusually elevated mood and contacted the researcher to ask whether the bracelet had some special ingredient in it. After the third day of wearing the bracelet, she removed it because she felt so euphoric that she feared doing something foolish in public (she said that she had developed an urge to procreate). With the bracelet off, her fatigue and inability to concentrate returned.  Soon thereafter, she was diagnosed with ovarian cancer.

2. A female medical researcher around 40 years old had complained that, after skipping lunch or fasting at midday during Lent, she regularly had hypoglycemic headaches in the late afternoon. When she wore the bracelet, however, she reported that there was no sign of headache. When she stopped wearing it, the headaches returned.

3. An elderly woman had longstanding, painful arthritis refractory to all medications; the arthritis had twisted and gnarled her fingers. She wore a copper/zinc bracelet for 18 days with no effects. On the 19th day, her pain disappeared and she could wiggle her fingers for the first time in years.

This third case suggests that there is a loading effect in which copper and especially zinc were taken across the skin and filled a deficiency—probably the common zinc deficiency of old age. The same bracelet proved less effective on other elderly persons, and a pure copper bracelet was completely ineffective in a dozen cases. Provisionally, it appears that the effective principle in “copper” bracelets for the treatment of arthritis might actually be zinc; that it works best in cases where the inflammation is restricted to a small area (in this case, the knuckles); and that it works by supplying zinc (and perhaps copper) in cases of deficiency, leading to the formation of antioxidant enzymes and otherwise modulating the immune system.

4. A 60-year old male with hepatitis C wore a copper/iron bracelet for 10 days. The iron caused skin irritation on his wrist. He reported no other effects. On the tenth day, he fell into a depression (a “blue funk”). So he took the bracelet off. Within 30 minutes his mood had improved to normal. One explanation is that, although his hemoglobin level was somewhat below normal, it was sufficiently high that the iron and copper absorbed through the skin entered his brain and crowded out the zinc, leading to depression. Once he removed the bracelet, the zinc level in the brain quickly rebounded.

5. A 70-year old semi-retired male engineer in good general health reported that he had had tremor in his hands, but nowhere else, for 25 years. His father had had the same tremor. A general practitioner had diagnosed this engineer’s case as familial tremor. He had also heard it termed “anticipatory tremor”—it occurred mainly when he moved his hands to undertake some action. Over time the tremor had gained in amplitude. When he held a piece of paper, he had a hard time reading because his hands would shake. When he lifted up a briefcase, his hand would “go wild”, with jerks of a full inch back and forth. However, the tremor was not so bad as significantly to disrupt his manual activities at work. He is right-handed. The tremor is worse in his left hand than in his right at a ratio that he estimated as 3:2.

Out of curiosity and without having any notion of treating his tremor, the engineer began to wear 24 hours a day on his left wrist a copper bracelet with two 1 mm diameter NdFeB magnets on the inside of each end (=4). One week later, his wife remarked, “Your hands aren’t shaking.” He did not know of any other reason for this than his wearing of the bracelet. He reported that the amplitude of the tremor had dropped by approximately 80% in typical situations. But when he became nervous or, for instance, was carrying his briefcase, the tremor was only reduced by approximately 33%. The reduction in tremor occurred in both hands. He did not observe any other effects except that he had to wash off the green copper that appeared on his skin.

Related Phenomena

In recent years dermal patches have been used to deliver vitamins, drugs, and other non-mineral substances on a sustained basis to the skin. However, it is not clear that anyone has successfully applied this approach to micromineral nutrition.

The Traditional Chinese Medicine practice of moxibustion (moxa), whereby a dried herb (Artemisia vulgaris) is crumbled, piled on the skin, and burned, runs parallel to the transdermal micronutrition process using a bracelet that operates on an electrochemical principle. No one has persuasively explained the mechanism of moxibustion; but telling evidence supports its effectiveness in, for example, turning fetuses in the womb in order to avoid breech delivery. One explanation of moxibustion is that neither the inhalation of the smoke nor the particular herb used is as important in conveying its results as are the iontophoretic effect of the warming of the skin, the provision of a source of nutrients (the herb), and the consequent entrainment of the physiological changes associated with transdermal feeding. This view assumes that moxibustion operates via a physical signaling effect that would occur regardless of the identity or chemical composition of the dried herb that is burned on the skin during the procedure, €”an assumption that would require careful investigation to prove or disprove.

If TDM and moxa share the same mechanism(s) of action, it means that TDM may have action in some or all of the unusual indications for moxa.

As a passive iontophoresis device, the TDM bracelet also could facilitate the transport of drugs across the skin. The same results could presumably be achieved by spreading iron and zinc (in oxide or carbon/calamine configuration) particles in a paste on the skin, then applying positive and negative electrodes (active iontophoresis) to induce the skin to open its lipid barrier. Iontophoresis has many benefits as a drug delivery system:

      1. It overcomes the barriers presented by the proteolipids of the stratum corneum, the skin’s natural biological membrane;
      2. The transdermal route bypasses gastrointestinal degradation and hepatic metabolism, thus preventing variation in the absorption and metabolism of the drug;
      3. It eliminates the need to remember to take the medication, thereby improving compliance;
      4. It avoids the trauma associated with subcutaneous or intravenous injection;
      5. It may decrease adverse side effects related to oral and parenteral administration; and
      6. It permits rapid termination of the medication.

The apparatus and procedure for active iontophoresis tend to be a bit cumbersome, while there is a minor risk of burns. Iontophoresis also generally requires a visit to a practitioner. The TDM bracelet’s simple, passive character overcomes these deficiencies.

How a Bracelet Works

In the treatment of IDA, a typical medicinal bracelet consists of a copper matrix that serves as the cathode and an iron component that becomes the anode. The redox interaction of these two elements in the bracelet creates an electrochemical cell that reaches into the skin. In keeping with the hierarchy of the electrochemical or galvanic series, the less reactive/more noble metal copper will be conserved in the bracelet while the less noble of the pair, the iron or zinc, will lose electrons to it in an oxidation reaction and be deposited in ionic form into the solution, i.e., into the sweat on the skin and the fluids beneath the skin. In effect, it is the application of the concept of a sacrificial anode to micronutrition, with the beneficial effect shifting from the conservation of the cathode to the dispensing of the anode. The same processes would occur with many other pairs of elements, e.g., silver and zinc.

Preliminary casual tests of the TDM bracelet suggest that it has no effect on persons with iron-replete status. On those with iron deficiency, however, the effect can be powerful. For instance, as mentioned above, the skin on the shoulder of the arm with the bracelet can become very dry and rough, suggesting a response that goes back to the time when human ancestors were swimming about in the primeval sea. Before there were such appendages as arms, any sensation at the wrist would be attributed to the shoulder or flipper area. Such a sea creature floating about might eventually land on a spot which, via its skin, could provide a continuous flow of nutrition and energy. In response, the creature would anchor itself to this location and undergo a transformation. This would involve shifting at least in part from a gastrointestinal to a transdermal source of nutrition. In other words, the Transdermal Micronutrition phenomenon suggests that in certain circumstances human beings retain a capacity for shifting from a medusa-like stage to a polyp-like one.

In effect, TDM can be termed the Original Feeding System (OFS) of human beings. Before the development of the gastrointestinal tract, the OFS was the only source of nutrition humankind’s distant ancestors had. What mechanisms controlled it and where they were located are not known. It is possible that in the brain a distinct center controls the OFS, or that different pathways link the skin and the gastrointestinal tract to the same brain center. Yet presumably the OFS existed long before there was a brain. An important goal of research in this area is to determine whether shifting from the gastrointestinal mode of eating to the transdermal one entrains other effects as well–for instance, neuro-psychological ones such as changes in appetite.

To trigger the TDM response, three factors seem essential:

      • A state of deficiency;
      • A source of energy, in this case the electrochemical reaction on the skin’s surface; and
      • The supply of a much-needed nutrient—€”iron.

When these factors are simultaneously present, a signal is sent to the skin to open up its lipid barrier and absorb the nutrient. Once the transdermal feeding is completed and the individual becomes iron-replete, the process will switch itself off. If this is true, then TDM for IDA does not run the danger of leading to excessive absorption and hemochromatosis. It is not yet proven that no significant amount of iron will penetrate the skin in cases when subjects have normal iron status.

TDM is typically continuous, in contrast to gastrointestinal feeding, which is intermittent. Continuous TDM may thus send a different signal to the body. During gastrointestinal feeding the body can never feel sure that it will have another meal soon. In contrast, the “anchoring” to the bracelet in TDM offers a continuous, secure flow of nutrition and energy, especially if it is worn 24 hours a day. It sends a signal to the body that the individual as well as a possible fetus will receive a reliable supply of the much-needed nutrient.

The iron and zinc in TDF move directly into the blood without first passing through the liver and undergoing sequestration there. In theory, the effect of this is different from, and conceivably more powerful than, the effect of iron and zinc obtained through the gastrointestinal route. Whether and how it might differ from injected or infused iron and zinc are not known. Plausibly, injected/infused iron and zinc have a stronger effect than oral iron and zinc because they are completely and immediately absorbed by the blood and tissue, while transdermal iron and zinc enjoy this advantage and in addition the advantage of triggering the primitive transdermal feeding response. Of special interest is the possibility that slow, steady transdermal absorption of iron and zinc might permit the body to distribute them with ideal precision, so that far lower doses would be required than via any other route, and the likelihood of side effects would be correspondingly low. However, such small amounts of iron and zinc, while perhaps fully protective, might not suffice to correct overall iron or zinc deficiency status. To avoid the danger that eventually iron and copper from the bracelet could block the supply of zinc to the body, it is advisable to include zinc in the bracelet or to provide oral zinc supplementation when the bracelet is worn for more than a few days.

The particular ratio of the copper and iron in the alloy, their deployment throughout the bracelet, and the shape of the bracelet all are variables that need to be experimented with in order to arrive at an optimal solution. Other variables such as temperature, the polarization behavior of the electrochemical couple, the conductivity of the environment, the composition and motion of the solution, protective skin surface films, the presence of microbes, the development of oxygen pockets leading to passivation, the thermal history of the alloy, and the relative surface areas of interacting elements further complicate the picture. In ongoing corrosion, the shift of half-cell potentials toward each other as a result of corrosion (polarization) ensures that the rate of corrosion changes over time. All these make it difficult to predict and control flow rates of iron across the skin. However, the apparently self-regulating nature of the process and the use of natural, essential micronutrients tend to reduce the need for the precision that is so important in the provision of drugs from dermal patches.

Whatever role various complicating factors might play, the electrochemical forces operating by themselves according to the simple model of an electrochemical cell appear adequate for explaining most of the dispensing and absorption phenomena.

The rate of the electrochemical reaction and hence of the deposition of iron by a TDM bracelet can presumably be enhanced by magnetizing it, by raising its temperature, or by running a tiny battery-operated current through it. But none of these is thought essential, and in fact they could detract from the clarity of understanding of the mechanisms of action.

The bracelet can treat micronutrient deficiencies, primarily iron and zinc.  It’s €”not an iron supplement for healthy, well-nourished, iron-replete people, for which purpose it is probably ineffective anyway. The TDM bracelet also has an application as a form of prophylaxis for children exposed to toxic substances in the environment. When the child is iron-replete, the bracelet may be inactive; but should the child’s iron and zinc status begin to decline, the device would tend to activate and correct the deficiency, thereby protecting the child against increased vulnerability to ambient toxic substances.

In this ion-substitution application, TDM can play a significant role in protecting hundreds of millions of children (and adults as well) in urban and industrial areas of developing countries who are exposed to lead, other heavy metals, chemicals, and radiation. Research has shown that ingestion of paint and house dust is a much smaller source of lead poisoning than the lead-laced dirt along heavily traveled roads where vehicles use leaded fuels. So TDM can become a shield against lead poisoning of children living in cities throughout the developing world, where leaded fuels will be used for decades to come.

Transdermal Micromineral Immunostimulation

A typical TDM bracelet is made of 100-percent food-grade copper. Into it can be inserted food-grade iron and zinc/carbon (calamine) disks on the inner surface of the bracelet. The disks are rounded on the top, which rises above the surface level of the copper matrix and thus presses itself slightly into the skin to ensure maximal contact. Each bracelet contains perhaps six iron disks and two zinc ones, and the ratio of inner surface area, €”at least initially, is 6:3:1 of copper:iron:zinc. The disks can be tapped into machined indentations slightly smaller at the aperture than the disks so that they fit snugly yet are removable. Many configurations of the bracelet are possible.

The “pull” factor of the Transdermal Feeding response acts in concert with the electrochemical “push” factor. Whether the skin also generates enzymes and acids to enhance the corrosion of the bracelet needs study.

A typical application of TMI would be as an adjuvant therapy in the treatment of HIV. For instance, TMI could be added to protease inhibitors to lower the dose of drugs required to suppress the disease.  It is conceivable, especially in initially iron- and/or zinc-deficient individuals, that TMI could be an effective monotherapy of a given infectious disorder.

Transdermal Micromineral Immunostimulation via the TDM bracelet appears to offer several advantages over other immunomodulatory technologies:

  • feeding such critical rate- and function-limiting ingredients as zinc and iron transdermally to a wide range of immunoenzymes and other proteins could in theory outperform treatment with one or several cytokines;
  • as mineral nutrients, zinc and iron are likely to convey more long-lasting effects; and
  • TMI could help solve the critical problem of distribution of immunomodulatory substances that has long plagued the biotechnology industry. This point can be formulated as the TMI Paradox: Using bracelets to dispense iron, zinc, and copper appears imprecise and even crude compared with advanced biotech immunomodulatory interventions, yet the Transdermal Feeding system precisely distributes transdermal microminerals ion by ion, while many high-tech immunomodulatory approaches encounter problems in distribution that reduce their efficacy and lead to side effects.

Other Potential Applications

As with adding magnets or an electric current, it is easy to imagine a multiplicity of embodiments for the electrochemical principle of TDM: necklaces, rings, earrings, armbands, anklets, dermal patches, etc. So, too, the TDM bracelet can be made to dispense many other minerals besides iron and zinc (for instance, Cr, Se, and I), as well as a wide range of natural substances and certain drugs embedded or attached to the anodic mineral. A bracelet on one arm can dispense one micromineral while a second on the other arm dispenses another. However, experience teaches several home truths:

  • few of these imaginative approaches come to fruition;
  • even if one were able to dispense selenium or vanadium or some other ultratrace element into the skin, getting the dose right would be exceedingly difficult and so the danger of overdose would be high;
  • competing ways of dispensing drugs through the skin are probably superior to the TDM bracelet; and
  • dispensing iron and zinc from a bracelet in an optimal manner promises to convey excellent medical benefits, so it makes sense to focus on getting this task right before considering more exotic ones.

Still, it is true that the TDM bracelet has other potentially beneficial applications.

TDM in Neurology and Psychiatry

While excessive iron has been found to do damage to neurons and all metals are counterindicated in Alzheimer’s disease and trauma, there are reasons to believe that proper dosing of iron, zinc, copper, and other minerals can have good effects in overcoming neurological deficits and in treating certain conditions. Generally, microminerals have been dispensed via oral supplements, muscle injections, or intravenous infusions. Judging by the possible advantages of transdermal microminerals in other indications, we may hypothesize that TDM will prove more effective than current methods of applying microminerals in neurology and psychiatry.

The most obvious initial target would be to test zinc dispensed from a TDM bracelet as a glutamate-like neurotransmitter and a means of boosting levels of serotonin, a zinc-based molecule, in the treatment of depression. In effect, TDM zinc would compete with serotonin reuptake inhibitors such as Prozac and Zoloft. Its potential advantages:

  • by entering the biochemical processes of serotonin formation at a fundamental level, TDM zinc would be equal or superior to SSRIs in terms of effectiveness;
  • if one would add iron to the bracelet, TDM zinc/iron might enhance the overall well-being of a given patient by correcting anemia that had tended to reduce the supply of oxygen to the brain;
  • a bracelet dispensing both zinc and iron might also activate the physiological change from a gastrointestinal to a transdermal feeding mode, with potential psychological benefits that go beyond the serotonin boosting factor;
  • by altering and optimizing the brain’s mix of chemical ingredients, TDM microminerals may be curative and thus avoid the burdens of long-term dosing;
  • properly dosed TDM zinc would presumably have fewer side effects; and
  • it would be much less expensive.

In addition, there may be ways of using the TDM bracelet in special indications such as to reduce craving in certain obese people, alcoholics, and drug abusers. In effect, the hypothesis would be that one component of craving may be a “Hidden Hunger” for micronutrients generated by certain brain cells; and that this demand would constitute an iron- or zinc-deficiency state.

Side Effects

Over time, an iron-dispensing TDM bracelet rusts and spreads some of this rust onto the skin. To enhance the effects of the treatment, any iron present on the surface of the skin can be rubbed into the skin on a daily basis before the residue is cleaned off. But the rust will also dirty blouses and shirts. It can detract from the beauty and appeal of the bracelet as a piece of jewelry. Still, weekly polishing with a steel brush can remove scale and rust. Correctly maintained (mainly by avoiding excessive bending), the bracelet will last for three years or more.

A TDM bracelet can employ a wide copper band and relatively small steel and/or zinc/carbon (calamine) disks to minimize the possibility that rust will leak out of the area underneath the bracelet in the course of daily use. Users should remove the bracelet when taking a bath or shower and wash off the accumulated rust. Experience in several casual tests of a prototype suggests that rust is a minor issue; but the wearer should avoid white, long-sleeved shirts and blouses that might be stained. To avoid staining sheets while wearing the bracelet at night, subjects may wish to wrap a piece of washable or disposable cloth around the outside of the bracelet.

Iron and rust from the bracelet may discolor light skin in a manner akin to that sometimes observed in subcutaneous iron injections. Zinc and copper from the bracelet may also stain the skin, as with standard copper bracelets. Zinc is hardly noticeable on various colors of skin. Again, daily washing should minimize any coloration effect, including the green of copper.

The wearer may also shift the bracelet from one arm to another and up and down the arm every few days to ensure that no single patch of skin becomes stained or irritated by excessive amounts of iron and copper. However, a minority of wearers, mostly women, will develop an allergic reaction to various metals on the skin; most of them will choose to stop wearing the bracelet. In some commercial bracelets nickel and other non-nutritive metals can exacerbate this effect.

Since iron overload is such a prevalent, harmful fellow-traveler in syndromes like hepatitis B and C, a copper-zinc version of the bracelet is recommended for iron-replete and iron-overload individuals. It is conceivable that the absorption of this zinc and accompanying copper could cut down on the absorption of oral iron and thereby reduce potential damage from iron overload.

A potentially significant side effect of the use of the bracelet could be in the interaction of the iron with other competing essential minerals in the body, which could lead to unintended deficiencies in them. This is thought to be unlikely for copper because some copper will inevitably corrode from the bracelet despite the sacrificial anode effect of the iron and zinc in preserving the copper intact. Competition with calcium can be counteracted by taking oral calcium when using the bracelet long-term.

Another potential problem is that iron supplementation can feed microbial infections.  In malarial regions, wearing a bracelet a few hours per day in combination with zinc can keep excess iron from accumulating in the pools of intra-erythrocyte iron used by Plasmodium falciparum or of the extracellular non-transferrin-bound iron that can be used by infectious agents in HIV and tuberculosis.  In laboratory and clinical studies, an oversupply of iron, whether in body stores or in ongoing absorption, seems to have been the culprit.

The Silver-IDA Corollary

A significant and perhaps decisive factor in the prevalence and severity of IDA in certain countries is the use of silver jewelry by individuals with a tendency toward low iron status. In India hundreds of millions of people suffer from iron deficiency to some degree or another. Most of these are adult females, but they include many children and some adult males as well. At the same time, hundreds of millions of people also wear silver jewelry, primarily in the form of anklets but also as belts, bracelets, rings, earrings, etc. In earlier times, many adult males wore silver anklets; but now this is considered effeminate.

In a country where there are many poor people who are vulnerable to malnutrition anyway and where many people are vegetarians by choice or by necessity, it is not surprising that many people are iron deficient (though well-nourished vegetarians have little risk of iron deficiency). What is remarkable is that such a high proportion of the population suffers from iron deficiency; that in many cases it is inordinately severe; and that it has proven stubbornly resistant to treatment by supplementation, food fortification, agricultural intervention, and nutrition education.

Two explanations have been offered: the prevalence of hookworm and the heavy use of milk and other cow products by a lactovegetarian population (calcium in milk being a kind of antagonist to iron). But hookworm seems too narrow an explanation, while consumption of cow products seems too broad: why do these women and children have iron deficiency and not others who drink milk?

As a close analogue of copper, silver can be dispensed by selective leaching from an anklet just as copper is from a copper bracelet. Within the body, silver has been demonstrated to occupy many of the same sites as copper. Thus the argument would be that, in the body of a malnourished person (or perhaps a pregnant one), a trickle of silver from anklets would be deposited on the skin and absorbed, enter into the bloodstream, and €”substitute for copper and thereby keep it from forming ceruloplasmin, which is essential to iron utilization.

Ceruloplasmin constitutes less than 3 percent of body stores of copper, which are small in the first place. Thus a few micrograms of silver daily might occupy enough sites in ceruloplasmin ordinarily occupied by copper to create or deepen iron-deficiency anemia. An assumption is that incoming copper (and hence presumably silver) is directed preferentially to the formation of ceruloplasmin rather than to storage locations because of ceruloplasmin’s vital role in iron metabolism.

Whether the stoichiometry of the trickle of silver would suffice to play this role; whether the silver might have other deleterious effects; and what the relative influences of such subclinical silver poisoning and malnutrition might be are subjects for investigation. Other possible explanations are that the silver reduces the body’s demand for iron that otherwise would be absorbed through the gastrointestinal tract; and that the body lumps silver into the same category as copper and thus responds to a “copper” overload that is actually largely silver by sequestering iron in the liver.

It is conceivable that silver plays such a role in the fetus as well. Subtle brain damage could also result from the concentration of high levels of silver, yet be ascribed to other causes. The wearing of silver jewelry by Indian babies could continue this pattern, so that in effect silver would be present throughout the life cycle in women, though not necessarily at levels generally considered toxic. Absorbed silver could also have long-lasting effects in males even after they stopped wearing silver jewelry because of the cumulative dose or because of susceptibilities to other toxic substances that their consequent iron-deficiency status may have induced in them.

Silver jewelry is also common among certain peoples in Africa and is worn widely throughout the entire world. In many cases, it can be presumed to be innocuous. An iron-replete person could presumably wear silver jewelry without any adverse effect. However, it is possible that silver from jewelry could play a role in IDA and other syndromes in rich and middle-income countries as well as in the developing world. Gold jewelry could likewise be implicated because gold is also an analogue of copper, though as a more noble metal gold is less subject to corrosion. Gold’s cost also makes its use in jewelry, especially by poor people with malnutrition, much less prevalent. Platinum fits this pattern, too.

Magnetic Bracelets

Often, magnets are placed near the ends of a copper bracelet so that they are in close contact with the veins on the inner side of the wrist. While many observers see a placebo effect at work, some try to explain the effects of the bracelets as caused by the magnets stimulating the red blood cells, with their high iron content. It is reasonable to expect that the magnets operate very much like light in Biophotonic Therapy (ultraviolet blood irradiation).

According to a recent review article, 13 out of 21 studies reported a significant analgesic effect from static magnets; 11 out of 15 (73.3%) of the better quality studies demonstrated a positive effect in neuropathic, inflammatory, musculoskeletal, fibromyalgic, rheumatic, and postsurgical pain. But in many of these cases, the magnets were applied directly to the painful area. Here we are more interested in action-at-a-distance from a bracelet. In a trial of magnetic bracelets in osteoarthritis of the hip and knee with 194 subjects aged 45-80, researchers found that wearing a standard strength (170-200 mTesla) static bipolar NdFeB magnetic bracelet reduced pain scores more (11.4% with a 95% confidence level) than with a non-magnetic (dummy) bracelet. They left open the question of whether it was a placebo effect or a specific physical one, and they proposed no mechanisms of action. But they noted that the strength of the magnetic field played a significant role because on a third group that wore bracelets with a weaker magnetic field (21-30 mTesla), they were no more effective than the dummy ones. It is possible that copper and other substances corroded from the bracelets, entered the skin, and had a medicinal effect; but the study did not examine this question.

One hypothesis would be that the transdermal micromineral and magnetic principles (and similar energized approaches such as ionic or battery-run bracelets) deliver approximately the same benefit, while combining the two would convey greater benefit.

A Call for Research

How could we develop a better scientific understanding of the effects of medicinal bracelets?

First, we need to conduct more clinical trials on a range of indications, including prophylaxis against environmental chemicals, toxic metals, and radioisotopes. Copper and copper-zinc bracelets should be tested against oxidative stress in atherosclerosis and other cardiovascular disorders. The disappointing results of clinical trials of antioxidant vitamins in cardiovascular disorders were predictable because no antioxidant vitamin acts inside arterial walls. Copper-based antioxidant enzymes do.

Second, stable isotope studies can help track copper, zinc, and iron throughout the human organism over time and provide a far finer sense of their interactions and effects.

Third, epidemiological studies of workers in copper industries compared to those in other metal industries could provide data regarding the potentially very important prophylactic effect of transdermal copper against both infectious and autoimmune disorders.  Inhaled copper’s effects need to be better characterized.

The bottom line:

  • all true scientists should support investigation of the mechanisms and actions of bracelets containing copper, zinc, and iron as well as magnetic ones;
  • individuals with conditions that may be treatable with a medicinal bracelet should consult their medical practitioners about the advisability of wearing one; and
  • people concerned with exposure to environmental pollutants or infectious diseases should consider wearing a copper bracelet for prophylaxis. This is particularly true for smokers and people with respiratory disorders. Copper-based superoxide dismutase in the lungs is a critical component of defense against oxidative damage.

A final note: thus far zinc has proven itself far more amenable to being dispensed from a bracelet than has iron. Even though one can achieve excellent effects with iron in certain circumstances, skin irritation and staining of skin and clothing represent formidable barriers to acceptance by many people.  However, substantial numbers of people will see that they could benefit from transdermal iron and will not be deterred by what they deem minor inconveniences. Nonetheless, the goal of treating iron deficiency anemia, which provided the original impetus for this investigation of medicinal bracelets, may remain elusive. Yet it still will have played an important role by leading us to understand and deploy copper, zinc, iron, and magnets in an optimal and scientifically based manner.

*****

See also:   Essential Tremor Treated with Copper Bracelet.

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Kenneth J. Dillon is an historian who writes on science, medicine, and history.   See the biosketch at About Us.  For detective work on ancient and modern history, see his The Knowable Past (2nd ed., Washington, D.C.:  Scientia Press, 2019).

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