We are very sad to share the news that Dr Neil Burman passed away on the 2nd June after a short illness. A loving father, grandfather, husband and doctor, he will be dearly missed by all.
We will leave this blog as an archive and memorial to him.
We are very sad to share the news that Dr Neil Burman passed away on the 2nd June after a short illness. A loving father, grandfather, husband and doctor, he will be dearly missed by all.
We will leave this blog as an archive and memorial to him.
Posted in Uncategorized
update 22 Mar 2019 at the equinox.. neil.burman@gmail.com
ONGOING WILFUL MISCONCEPTION, DENIAL OF HIGHDOSE VITAMIN D3 LOADING DOSE, NOT VIT D2: the 2017 trial https://www.atsjournals.org/doi/full/10.1164/rccm.201705-0936OC from Harvard, Mongolia and London centres by Ganmaa, Willette, Jolliffe ea High-Dose Vitamin D3 during Tuberculosis Treatment in Mongolia. A Randomized Controlled Trial in 390 pts, in fact was only apparently for 8 weeks, using ‘biweekly’ vit D3 140 000iu doses; their comment that the 8week serum ?25OHvit D was elevated from 6 to only 60ng/ml suggests that they were given a moderate dose of only 560 000iu over 8 weeks, without the crucial up front 640 000iu loading dose repeated after a month as in Salhuddin’s trial in Pakistan . so it is unsurprising that the Mongolian trial, unlike the Pakistan trial, showed no benefit after only 8 weeks. Biweekly is ambiguous, either fortnightly or every two weeks, but the mediocre response suggests 140 000iu Vit D every 2 weeks ie 70 000iu/wk, with a bld level of 60ng/ml comparable to what we see on 50 000iu/wk as standard minimal supplement dose in adults. I take 100 000iu vit D3/wk, running my bld level at around 100 to 120ng/ml, with normal calcium and PTH levels.
As studies have shown exhaustively below, unlike highdose vit C which has dramatic lifesaving benefit, oral vitamin D3 supplement works slowly over months unless, like antibiotics and vit C, given as a upfront loading dose of vit D3 around 10 000iu/kg. no toxicity has ever been reported from even eg 2million iu as oral loading dose, as happened in a nursing home in Netherlands to 2 nonagenarians.
Lately we have been eeing patients with poor blood 25OHlevel and PTH response on vit D3 50 000iu/wk. But in each case it turns out that this is due to fraud. Where D3 has been the gold standard for more than a decade, doctors and pharmacists are mostly still ignorant of the benefit of vigorous dose, and especialy that using the human, mammal ie lanolin-derived hormone Vitamin D3 cholecalciferol is crucial, not the plant xenohormone vit D2 ergocalciferol, which is only perhaps 1/16th of the benefit of vit D3. giving D2 actually lowers 25OHvitD3 level and 25OHvitD2 blocks vit D3 receptors, and thus a may actually worsen eg Rheumatoid arthritis. This error is perpetuated by the local supplier here, Aspen, fraudulently supplying vit D2 50 000iu tabs called “strong Calciferol” without indicating that it is D2, not D3. Most doctors, pharmacists and dispensing nurses are not taught this vast difference; but the fraud is perpetuated by the local Medical Schools and thus State Clinics dispensing the same fraudulent D2 Strong Calciferol instead of the needed vit D3- also without indicating on pillbags and scripts that it is D2 not D3. The original Lennon-Aspen Strong Calciferol data sheet from 1974 updated 2004 still on line http://home.intekom.com/pharm/lennon/calcifer.html does not indicate that it is vit D2 not D3.
and Naik, Hegde ea ea recently reported Effect of DOTS Treatment on Vitamin D Levels in Pulmonary Tuberculosis
The media have lately labelled calcium plus vitamin D supplements as useless because of the recent review December 2017 by a Chinese team Zhao ea showing “No significant associations were found in trials between supplements of calcium, vitamin D or their combination and incidence of fractures. eg https://www.medscape.com/viewarticle/890687/
The gold standard, the biggest longest costliest trial ever, the Womens Health Initiative, in many thousands of American women mean age ~63yrs for an average of 7years, ie about 55000 patient- years of vitamin D+ calcium supplement , independent of HRT reduced fractures by an astounding 35% with vit D3 only 400iu/d ie a paltry 1 million iu vit D3 – but crucially spread daily over 7 years, not a bolus annually or one-off dose. https://link.springer.com/article/10.1007/s00198-012-2224-2
Since natural ie avoidable all-cause medical mortality from middle age is overwhelmingly from vascular and cancer causes (apart from frailty fractures and infections in the old), the 12% LOWER mortality at higher epidemiological vit D3 intake and levels confirms that higher vit D3 also significantly reduces vascular and cancer disease; as shown in lower premature degenerative disease rates closer to equatorial than at darker latitudes.
But supplements with vit D2, or alphacalcidiol or calcitriol, gives no benefit in lower mortality, may worsen risks – as does avoidance of sun exposure.
The crucial benefit of supra physiological ie megavit D3 supplement eg >1000 iu/kg/d is born out by its proven curative benefit the past 15 years in multiple sclerosis, vitilligo, psoriasis, myasthenia gravis ( Coimbra Protocol 2016 https://www.coimbraprotocol.com/general-information)
So since people globally in all social classes are increasingly stressed sedentary urban dwellers and indoor workers, with the deteriorating global food chain, combating the tidal wave of common communicable ie infectious, and noncommunicable ie DEGENERATIVE (obesity-diabetes-vascular ,malignant, arthritic, fracturing, dementing) diseases , all – especially those with longer life expectation- increasingly require supplementation for both detox, and vigorous supplementation of the micronutrients listed.
While a few common deficiencies like coq10, vit K2, lutein /zeoxanthine, glucosamine-chondroitin and marine oil are scarce costly essentials, at least the majority of the major deficient essentials- (animal and coconut oils, trigycerides, vitamins D3, C and Bco, magnesium, lugols iodine, selenium, (and iron in children and younger women) are easily and cheaply supplemented.
COST: Vitamin D3 as Pharmacopoeia /USP standard powder is freely available wholesale through an importing pharmacist by the kg powder – @ 100 000iu/gm at about R600 ie US$50/kg =~ US$0.025 per 50 000iu per week… a flat 1ml measuring scoop hold just 1/2gm of such powder ie ~50 000iu vit D3. Tablets/capsules have to be assembled and are thus costly by comparison.
The increased social and economic burdens for osteoporosis-related fractures worldwide make the prevention of such injuries a major public health goal. Previous studies reached mixed conclusions regarding the association. Randomized trials from July, 2012, to July, 2017 were analyzed. Results:A total of 33 trials involving 51 145 participants fulfilled inclusion criteria. There was no significant association of calcium or vitamin D or the combination with risk of hip or nonvertebral or total fractures compared with placebo or no treatment (calcium: RR, 1.53 [95% CI, 0.97 to 2.42]; vitamin D: RR, 1.21 [ CI, 0.99 to 1.47]. There was no significant association of combined calcium and vitamin D with hip fracture compared with placebo or no treatment (RR, 1.09 [CI 0.85 to 1.39]. No significant associations were found between calcium, vitamin D, or combined calcium and vitamin D supplements and the incidence of nonvertebral, vertebral, or total fractures. Subgroup analyses showed that these results were generally consistent regardless of the calcium or vitamin D dose, sex, fracture history, dietary calcium intake, and baseline serum 25-hydroxyvitamin D concentration. These findings do not support the routine use of these supplements in community-dwelling older people.
Cochrane Database Syst Rev. 2014(1):CD007470. Vitamin D supplementation for prevention of mortality in 95,286 adults in 56 RCTs. Bjelakovic,Gluud ea University of Nis, Serbia,https://www.ncbi.nlm.nih.gov/pubmed/24414552 The present systematic review updates and reassesses the benefits and harms of vitamin D supplementation used in primary and secondary prophylaxis of mortality Vitamin D3 statistically significantly decreased cancer mortality (RR 0.88 (95% CI 0.78 to 0.98); P = 0.02; 44,492 participants; 4 trials). Vitamin D3 combined with calcium increased the risk of nephrolithiasis (RR 1.17 (95% CI 1.02 to 1.34); P 0.02; 42,876 participants; 4 trials). Alfacalcidol and calcitriol increased the risk of hypercalcaemia (RR 3.18 (95% CI 1.17 to 8.68); P = 0.02;; 710 participants; 3 trials). AUTHORS’ CONCLUSIONS: Vitamin D3 seemed to decrease mortality in elderly people living independently or in institutional care. Vitamin D2, alfacalcidol and calcitriol had no statistically significant beneficial effects on mortality. Vitamin D3 combined with calcium increased nephrolithiasis. Both alfacalcidol and calcitriol increased hypercalcaemia.
Osteoporos Int. 2013 Feb;24(2):567-80. Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study. Prentice ea , USA. https://link.springer.com/article/10.1007/s00198-012-2224-2 The Women’s Health Initiative (WHI) double-blind, placebo-controlled clinical trial randomly assigned 36,282 postmenopausal women in the U.S. to 1,000 mg elemental calcium carbonate plus 400 IU of vitamin D(3) daily or placebo, with average intervention period of 7.0 years. The trial was designed to test whether calcium plus vitamin D supplementation in a population in which the use of these supplements was widespread would reduce hip fracture, and secondarily, total fracture and colorectal cancer. RESULTS: Among women not taking personal calcium or vitamin D supplements at baseline, the hazard ratio [HR] for hip fracture occurrence in the CT following 5 or more years of calcium and vitamin D supplementation versus placebo was 0.62 (95 % confidence interval (CI), 0.38-1.00). In combined analyses of CT and OS data, the corresponding HR was 0.65 (95 % CI, 0.44-0.98).
Daily vitamin D supplementation is often inadequate in treating vitamin D deficiency due to poor compliance. A single, large dose of vitamin D given at timed intervals may be an alternative strategy. METHODS: We conducted a systematic literature review to investigate the efficacy of a single large bolus dose to treat vitamin D deficiency. We identified 2,243 articles in PubMed using the terms “high dose vitamin D,” “single dose vitamin D,” “bolus vitamin D,” or “annual dose vitamin D.” Manuscripts were also excluded if the study: (1) did not use oral cholecalciferol or ergocalciferol, (2) used vitamin D analogs, (3) enrolled participants under age 18 years, (4) administered doses <100,000 international units (IU) (2.5 mg), or (5) administered >1 dose per year. References of eligible manuscripts and the Cochrane databases were also searched. Large, single doses of vitamin D consistently increased serum/plasma 25-hydroxyvitamin D (25[OH]D) concentrations in several vitamin D-sufficient and -deficient populations. Vitamin D3 doses ≥300,000 IU provided optimal changes in serum/plasma 25(OH)D and parathyroid hormone (PTH) concentrations. Vitamin D supplementation also impacted bone health and extraskeletal endpoints. CONCLUSION: single vitamin D3 doses ≥300,000 IU are most effective at improving vitamin D status and suppressing PTH concentrations for up to 3 months. Lower doses, however, may be sufficient in certain populations. Vitamin D doses >500,000 IU should be used judiciously in order to minimize adverse events.
https://www.vitamindwiki.com/Vitamin+D+and+Sun+conference+%E2%80%93+Germany+June+2017 JOINT INTERNATIONAL SYMPOSIA “VITAMIN D IN PREVENTION AND THERAPY” AND “BIOLOGIC EFFECTS OF LIGHT” June, 2017, Schlossberg Hotel, Homburg/Saar, Germany
Click here to download all of the talks and posters from VitaminDWiki AVOIDANCE OF SUN EXPOSURE AS A RISK FACTOR FOR MAJOR CAUSES OF DEATH Pelle G. Lindqvist. Clintec, Karolinska Institut Sweden From an evolutionary perspective, there must be an evolutionary selection advantage in having adequately pigmented skin for the regional ultraviolet (UV) radiation. One possible mechanism might be differences in life expectancy; however, there is no such evidence. Based on the large prospective Melanoma in Southern Sweden (MISS) cohort (n=29,518), we assessed differences in life expectancy by sun exposure adjusted for age, income, education, marital status, smoking and comorbidity. Low sun exposure habits were found to be a major risk factor for all-cause mortality. This was caused by an increased risk of death due to cardiovascular disease (CVD) and non-cancer/non-CVD. Therefore, due to the increased life span among those with highest sun exposure, this exposure naturally results in an increased prevalence of cancer death. In addition, sun exposure increases the incidence, but is related to better prognosis of skin cancer. The findings indicate that there is a need for modification of guidelines regarding sun exposure.
THE IMPACT OF DOSE, BODY SURFACE AND OTHER FACTORS ON UVB-INDUCED VITAMIN D SYNTHESIS: A SYSTEMATIC REVIEW AND META-ANALYSIS Nadine Jager1 Jorg Reichrath ea Saarland University, Homburg, Germany; Background: Vitamin D deficiency is a worldwide health problem. Under most living conditions in Europe and North America, up to 90% of the body’s requirements of vitamin D have to be fulfilled by the ultraviolet B (UVB)-induced cutaneous synthesis of this prohormone. As a consequence, it is of high scientific interest to determine the impact of various factors on UVB-induced cutaneous vitamin D production, measured as serum 25(OH)D3 concentration. Aim: It was the aim of this systematic review and metaanalysis to investigate our present scientific knowledge on this topic. Additionally, the half-life of 25(OH)D3 was estimated. Materials and Methods: A systematic literature search was conducted using MEDLINE and cross-referenced studies to investigate the impact of exposure to artificial UV- sources on vitamin D status. Relevant parameters included 25(OH)D3 serum level before and after exposure, UV source and dose (in standard erythema dose (SED)) and time of exposure. Summary mean differences and 95% confidence intervals were derived from random-effects meta-analysis to account for possible heterogeneity across studies. Results and Conclusion: We found 15 papers published in the past 7 years. In summary, our study indicates that single doses between 0.75 and 3 SED result in the highest increase in serum 25(OH)D3 per dose unit (SED). Exposure with higher single doses of UVB resulted in less pronounced increases in serum 25(OH)D3 per dose unit. It can be concluded that UVB exposure with single doses between 0.75 and 3 SED are desirable in respect to cutaneous vitamin D synthesis. Interestingly, the increase in 25(OH)D3 serum concentration was not proportional to the amount of exposed body surface. Partial exposure of the body surface resulted in relatively higher increase of 25(OH)D3 serum concentration per SED (AH-25(OH)D/SED/% body surface) as compared to exposure of the whole body. For instance, exposure of face and hands resulted to an 8-fold higher increase in AH-25(OH)D/SED/% body surface as compared to whole body irradiation. Moreover, our results confirm the relevance of the baseline 25(OH)D3 level. The lower the baseline, the higher was the 25(OH)D3 increase after irradiation. In the studies included in this systematic review, the half-life of 25(OH)D3 can be estimated to be about two months.
update 16 May 2016. to our health: neil.burman@gmail.com HIGH TO MASSIVE DOSE VITAMIN D3 IMPORTANCE – TEN TIMES MORE THAN MAXIMUM SUNLIGHT CAN PROVIDE – IN REVERSING COMMON VIT D DEFICIENCY/RESISTANCE FOUND IN ALL MAJOR DISEASE eg ALL INFECTIONS, INSOMNIA, MULTIPLE SCLEROSIS MS, Myasthenia Gravis, SLE, RA, PARKINSON’S, DEPRESSION, VASCULAR DISEASE, CANCER, VITILLIGO, PSORIASIS, PERIPHERAL NEUROPATHIES, MENTAL ILLNESS.
Poor ill patients seem to accept neuroarthropathy- as a way of life since it usually has no visible signs (for anyone to see) till late– poor circulation, ulcers, falls, arthritis- , and malnourished diabesity patients have bigger worries with uncontrolled diabetes and often uncontrolled hypertension despite even insulin; and the HIV+-Tuberculosis patients have the multiple toxic burdens of antiretroviral and antituberculous therapy.
Because the burden of these diseases as well as stress from corruption and violence here is amongst the highest in a major city in the world, affecting especially the poorest and most illiterate labourers, state clinics rarely have budgets to cover the necessary vitamin and mineral supplements the poor also need on their poverty fast food diet.
Our patients accept that in return for life extension by designer antimicrobials and antidiabetic/ antihypertensives, all they will get for pain relief is the combination of physiotherapy, and designer synthetic palliative drugs- paracetamol, ibrufen /diclofenac, tramadol, amitryptiline, and if lucky some ung meth sal . These factory-synthesised drugs give little relief, and no improvement in prognosis since they do not address the proximate causes of the neuroarthropathy, associated depression and work incapacity (and later strokes, arthritis, dementia, ulcers, gangrene, chronic lung/heart/ liver/ kidney/visual disease)- respective causes including stress, infective, drug-induced, tissue glycogenation, the misguided fast-food high carbohydrate-low fat diet obesity; and manual labour/multiple trauma wear and tear, and nutritional deficiency including much-needed marine and saturated fats, vitamins and minerals..
The pioneer work discussed below in Pakistan(Salahuddin ea, Basit ea), Italy (Cipriani ea) and Brazil (Coimbra ea) in using respectively Vit D3 ~700 000iu loading dose and chronically up to 1000iu /kg/day ie average 70 000iu/day, up to 120000iu per day to reverse deadly acute and chronic disease, is comparable in its simplicity safety and low cost to :
*Semmelweis’ revolutionary discovery Vienna in the mid 19thC of hand disinfection to decimate childbirth sepsis deaths; and
*Pauling’s landmark lifesaving escalation of Vit C dose to a gm per kg per day for all severe disease; and
*the parallel discovery in UK and USA of the crucial role of not just the RDA preventative microdose but also the pharmacological anti-disease benefits of 10 to 100times bigger doses of all the vitamins B complex 1 to 12.
Cipriani ea 2010 seems to be the first report on Pubmed of deliberate oral dosing with megadose 600 000iu vit D3 ie 10 000iu/kg, albeit only in health to assess bloodlevel response and safety. Since then, as we previously noted, 2 million unit single overdose in nonagenarians in Netherlands has been shown to do no harm – ie about 40 000iu/kg. .
And as the Australians and others report below, there is no hint of vigorous vitamin or mineral supplements being stigmatized as performance enhancing for eg sport – despite vitamin D3 having the distinction of being truly an anabolic ie performance-enhancing (seco)steroid .
There is no point in giving vitamin D by injection (except in those in ICU on prolonged nil per mouth) since it is so well absorbed provided given with fat eg in fishoil/coconut/DMSO oil. And obviously the higher the dose given, the more important to avoid more than a traditional multisupplement pill a day with low calcium and vitamin A retinol; combined with a low calcium diet (ie low dairy low peanut) ; and supplementing plenty fresh green produce [providing magnesia a few hundred mgs a day, and vitamin K2 perhaps 35mcg/d].
Dr Mike Holick Prof of Medicine at Boston University interviewed by Dr Joe Mercola Dec 2015 details the rationale underpinning the (eg Coimbra) massive vit D3 dose regime for severe immune disease, “as opposed to plenty of sensible sun exposure for general good health and lower deathrate from all diseases and infections. Most melanoma occurs on the least sunexposed skin, with lower melanoma and all other deaths with high sun exposure. Dark days promote melatonin and thus daytime sleepiness and depression- which bright light in the morning for an hour reverses, and elevates b-endorphan, which has many times the painkilling effect of morphines ie opioids, and antidepressants. Vitamin D deficiency more than doubles the risk of all diseases; even 2000iu vit D3 a day in the 1st yr of life in Finland halved the risk of type 1 diabetes– with loss of protection if vit D dose dropped to 400iu/day. Vitamin D/ sunlight reverse leukemic cells. But maximum sunlight exposure nearer the tropics still only elevates 25OHvit D level to a maximum of about 50ng/ml- whereas increasing evidence proves that it may take more than 10 times that bloodlevel to prevent and treat deadly diseases- depending on your genetic vitamin D receptors.
Even 1000iu/d vit D with bld level about 30ng/ml halves risk of many cancers, with doubling benefit as 25OHvit D level is doubled serially eg by 10 000iu/d or 50 000iu/d. The kidneys however limit production of the hypercalcemic 1,25vit D, thus avoiding hypercalcemia provided calcium intake is not supplemented by calcium pills, nuts. vit A etc. The higher the vit D level above 30ng/ml (up to >? 500ng/ml), the more of our 2000 enzyme systems are activated to fight all disease without hypercalcemic risks. Hunter gatherers had levels twice as high as dressed housed people today, around 50ng/ml, with increasing anticancer and antiinfection/antiautoimmune benefit from vit D up to safe levels eg 100ng/ml and higher. .”
At Thisisms.com this is multiple sclerosis March 2016 seems to be the latest from neurologist Dr Cicero Coimbra via grassroots health. He stresses that to cure degenerative/ autoimmune disease eg MS, Parkinson’s, SLE, RA, vitiligo ie to overcome genetic Vit D resistance may require vit D titration up to 1000iu/kg/d ie up to even 40000iu/d to 200000iu/d,
And 25OHvitD blood level to 1000ng and even 4000ng / ml for a few years to produce cure, before reducing to maintenance vit D3 eg 100iu/kg/day ie ~ 50000iu/wk.
Hypercalcemia and thus calcinosis is avoided provided PTH level is maintained in the low normal range, not suppressed. Optimal support includes low calcium and high water diet and Vit B2, magnes selenium zinc phosphor supps.
COST IMPLICATION:
The spectrum of vitamin D3 adult dose thus extends from the
traditional prevention RDA 10iu/kg/ ie~700iu/d against rickets (infants start with 1000iu/d or 25000iu ie ½ scoop/month of standardized vit D3 100iu/mg powder)
to vigorous 100iu/kg/day (ie 50 000iu scoop /wk ) for common disease prevention/treatment (toddlers 2000iu/d/ ½ scoop/fortnight));
to massive 1000iu/kg/day eg 60 000iu/dy for severe autoimmune/immunodeficiency diseases – with mandatory monitoring of levels of calcium, creatinine, 25OHvitD3 and now PTH levels;
to mega 10 000iu/kg eg 650 000iu as a loading dose for eg TB or meningitis or severe trauma—which dose may maintain 25OHvit D3 blood levels in a “sufficiency” range above ~40ng/ml for a month or two, so obviously requires appropriate maintenance dosing.
Imported vitamin D3 100cwt concentrate powder (100iu/mg) per kg from an importing pharmacist costs about R500/kg ie R0.50/100 000iu- far lower than the cost of the highrisk plant xenocalciferol vitamin D2. Thus to the State (excluding packaging and dispensing cost) , the wholesale cost of vit D3 is about R0.15 per 50 000iu per week for maintenance dose; or for 50 000iu/day R10( US $0.6)/month ie retail abt R60pm ie US$5 for megadose therapy; compared to the quoted retail US$20/month in Brazil. .
THE NEUROPATHY OF DIABETES, DRUGS/TOXINS, POST-VIRAL,TRAUMA, SPONDYLOSIS, DEMENTIA:
PERIPHERAL NEUROPATHY: Already in 2006 Oh-Park ,Sheehan .ea, Lancet. Albert Einstein College of Medicine, New York wrote about AIDS-ARV neuropathy Charcot neuroarthropathy in the era of HAART.
Young, Dancho ea Tucson, Arizona, wrote 2012, ” Charcot arthropathy is a devastating joint condition that affects persons with neuropathy. With HIV/AIDS treatments prolonging the lives of these persons, it is likely that long-term sequelae of the disease will become more evident in the near future. Patients with this disease frequently develop peripheral neuropathy. A high index of suspicion must be raised in any patient with peripheral neuropathy of any cause and a red, hot, swollen, painful foot for Charcot neuroarthropathy to give these patients proper treatment to help prevent the devastating effects of Charcot neuropathy with its potential consequences including foot ulceration and amputation. We know only too well the same applies to diabesity, as it did in the days of heavy smoking.”
In 2013 Zubair ea in India showed that diabetics with foot ulcers had vitamin D levels 1/4 of that of matched diabetics without foot ulcers; and “factors which predict the risk of developing ulcer independent of 25(OH)D status were A1c (>6.9%) [OR 4.3), neuropathy [OR 6.9; retinopathy [OR 3.3; nephropathy [OR 3.1) and smoking [OR 4.5]. It is not clear whether the suppression of delayed wound healing seen during 25(OH)D deficiency is a secondary effect or is a direct action of vitamin D on certain components of the immune system.”
Tiwari, Singh, Swain ea at Hindu Universities Uttar Pradesh,India have shown elegantly in
*2012 Tiwari ea Vascular calcification in diabetic foot and its association with calcium homeostasis. Vascular calcification (VC), long thought to result from passive degeneration, involves a complex process of biomineralization, frequently observed in diabetes and an indicator of diabetic peripheral vascular disease.. ..In 74 patients with diabetic foot ulcer, Vascular calcification was present in 42% of patients. Significant difference in vitamin D, HbA1C, and eGFR levels was observed in VC +ve compared to VC -ve. Severe vitamin D deficiency was more common in VC +ve (51%) compared to in VC -ve (18%). Sub-group analysis showed that the risk of VC was significantly higher (RR = 2.4, P < 0.05) in patients with vitamin D < 10 ng/ml compared to others. .and
* Br J Nutr. 2013. Tiwari ea Prevalence and severity of vitamin D deficiency in patients with diabetic foot infection. In Diabetic Patients with and without infection (n289), 25(OH)D (nmol/l) was significantly lower (16) v. 20ng/ml P < 0·001) in cases than in controls. Risk of severe vitamin D deficiency (25(OH)D < 10ng/ml) was significantly higher in cases than in controls (OR 4·0, P < 0·0001). Age, duration of diabetes and HbA1c were significantly higher in cases than in controls and therefore adjusted to nullify the effect of these variables, if any, on study outcome. The study concluded that vitamin D deficiency was more prevalent and severe in patients with diabetic foot infection. ; and the need for vitamin D supplementation in such patients for a better clinical outcome
*.in Br J Nutr.. 2014 Tiwari ea show Vitamin D deficiency is associated with inflammatory cytokine concentrations in patients with diabetic foot infection . Vitamin D is a potent immunomodulator and a common deficiency in different population groups including patients with diabetic foot infection. in 112 diabetic foot infection cases and 109 diabetic controls , cases had significantly higher concentrations of IL-6 (P≤ 0.001), IL-1β and TNF-α (P≤ 0.006) than controls. Risk of severe vitamin D deficiency (25(OH)D <10ng/ml) was significantly higher in cases than in controls (OR 4·0, P < 0·0001). A significant negative correlation was also observed between 25-hydroxyvitamin D concentration and circulating concentrations of IL-1β (r -0.323; P≤ 0.001) and IL-6 but not between 25-hydroxyvitamin D and TNF-α and IFN-γ concentrations.
This year 2016 Wukich , Sadoskas ea. University of Pittsburgh & Georgetown USA in Diabetes Metab Res Rev. show that (Charcot) neuroarthropathy (CN) of the ankle and hindfoot is challenging to treat surgically or nonsurgically. Deformities associated with ankle/hindfoot CN are often multiplanar, resulting in malalignment; and shortening of the limb often occurs from collapse of the distal tibia, and ankle, with significant alterations in the biomechanics of the foot. eg predisposing the patient to lateral foot ulceration. Collapse of the talus, secondary to avascular necrosis or neuropathic fracture, further accentuates these deformities and contributes to a limb-length inequality CONCLUSION: Surgical reconstruction of ankle and hindfoot CN is associated with a high rate of infectious and noninfectious complications. Preoperative measures that can improve outcomes include assessment of vascular status, optimization of glycemic control, correction of vitamin D deficiency and cessation of tobacco use.
Now 2016 Basit A, Malik RA5 ea in Universities Karachi Pakistan & Manchester UK , show that A single intramuscular dose of 600 000 IU vitamin D in 143 participants with predominantly type 2 diabetes, aged ~ 52.3years, with high Douleur Neuropathique 4 (DN4) score by 20 weeks gave significant increase in 25(OH)D (from 31.7 to 46.2±10.2 ng/mL, p<0.0001) and significant reduction (p<0.0001) in positive symptoms on the DN4 , and total pain score (p<0.0001, The Basit – Malik Pakistan-Manchester paper showing great efficacy of 600 000iu vit D3 load dose in peripheral neuropathy diabetics matches the huge 40% improvement benefit of similar loading and monthly vit D3 dose against severe PTB shown by Salahuddin ea in Pakistan in 2013 http://www.ncbi.nlm.nih.gov/pubmed/23331510 that we have previously analyzed in this column
ie apart from smoking; the very low vitamin D levels common in most but especially ill people associate with about 5 fold risks of uncontrolled diabetes, infections, retinopathy , progressive leg ulcers, peripheral neuropathy and arthritis- Charcot arthroneuropathy- -and thus gangrene and amputation; and vigorous safe (supraphysiological) vit D boost reverses the risks. .
And a reminder that a 2015 study in Cape town from Coussens ea Universities in W Cape and Penn State confirm what we see daily in practice, that vitamin D deficiency is endemic in our population
while as we have pointed out repeatedly, the State here continues to dispense the inferior vitamin D2 (as the fraudulently labeled “strong calciferol”, not disclosing that it is ergocalciferol D2) despite this plant xenohormone vit D2 having been rejected by world authorities in favour of the much cheaper and effective human D3 cholecalciferol.
And now 2016 Cadegiani , Brasilia, Brazil another landmark massive-vit D dose report ; Remission of Severe Myasthenia Gravis After Massive-Dose Vitamin D Treatment.. Vitamin D has been shown to be related to autoimmune diseases, such as multiple sclerosis and psoriasis. Correlations have been reported between vitamin D levels and prevalence and severity of other autoimmune disorders, and also between vitamin D therapy and disease improvement and remission. This reports a patient with severe and refractory myasthenia gravis (MG) who followed a massive-dose treatment (80,000 to 120,000 IU/day) promoted by a medical center in Brazil (Coimbra ea) and she had her first complete remission after this type of treatment for at least 18 months (ie at least 50 million iu) with increased vitamin D serum levels (400 to 700 ng/mL) and major fall in her AChR antibodies – but acute relapse when vit D was inadvertently stopped and her vit D level halved; with again recovery when megadose vit D was resumed CONCLUSIONS: This case may reinforce the reported correlation between vitamin D level and disease severity and introduces a possible new use for vitamin D as a potential target for treating autoimmune diseases. We recommend large, double-blind, placebo-controlled, randomized studies using high-dose vitamin D treatment for refractory autoimmune diseases to reliably assess this pharmacotherapy target for these diseases.
The above case concurs with previous reported massive dose daily vitamin D3: Finamor , Coimbra ea , Universities of Brazil 2013 A pilot study assessing the effect of prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis. Autoimmunity has been associated with vitamin D deficiency and resistance, with gene polymorphisms related to vitamin D metabolism frequently described. High doses of vitamin D3 may conceivably compensate for inherited resistance to its biological effects. Nine patients with psoriasis and 16 patients with vitiligo received vitamin D3 35,000 IU once daily for six months ie ~7million iu in association with a low-calcium diet (avoiding dairy products and calcium-enriched foods like oat, rice or soya “milk”) and hydration (minimum 2.5 L daily).. After treatment 25(OH)D3 levels significantly increased (from ~15 to 106-132ng/mL. PTH and 25(OH)D3 serum concentrations correlated inversely. The PASI score significantly improved in all nine patients with psoriasis. Fourteen of 16 patients with vitiligo had 25-75% repigmentation. Serum urea, creatinine and calcium (total and ionized) did not change and urinary calcium excretion increased within the normal range. High-dose vitamin D3 therapy may be effective and safe for vitiligo and psoriasis patients.
neurologist Prof Dr Cicero Coimbra from Univ Sao Paulo presents their results since 2002 in over 4000 pts ( 1000 patients each with multiple sclerosis and Parkinson’s diseases), who have been well controlled without other therapies, provided the dose is high enough- 10 000iu/d up to about 1000iu/kg/d eg >70 000iu/d for the obese, on a low calcium ie low dairy/peanuts diet, high fluid intake and high exercise, to normalize blood calcium, and titrate PTH level to the low normal range. Dr Cicero Coimbra discusses high dose vitamin D toxicity: https://www.youtube.com/watch?v=Vxwk-YPrx7o&feature=youtu.be. PTH level should not be completely suppressed. In their clinic ( of 7 doctors) for Autoimmune chronic diseases incl MS, RA, SLE, psoriasis, vitiligo, type 1 diabetes , they have treated over 4500 pts on this high quality vit D3 high fluid low calcium diet protocol, with only 14 cases of reversible vitamin D toxicosis (hypercalcemia) so far detected ie 0.3%. Babies of mothers thus treated in pregnancy have high psychomotor development. (Vitamin C supplement should not be concurrently excessive to avoid oxalosis). They define success as being disease-free or non-progressive old fixed disabilities- 95% reach full cure. There vit D3 therapy costs only ~US $20/mo, to optimize the immune system against both infections and autoimmune disease let alone cancer. Optimal dose of vit D3 replacement becomes at least 10 000iu/day for adults especially with autoimmune diseases due to common vitamin D resistance. Ideally testing baseline blood and urine at baseline and after a few months on at least 10 000iu/d.
In Effect of a single oral dose of 600,000 IU of cholecalciferol on serum calciotropic hormones in young subjects with vitamin D deficiency:. 2010. Cipriani ,Minisola ea .University of Rome Italy tested 48 young subjects with vitamin D deficiency with a single oral dose of 600,000 IU of cholecalciferol. The 25(OH)D level was ~15.8ng/ml at baseline and became ~77ng/ml at 3 d (P < 0.001) and ~62 ng/ml at 30 d (P < 0.001). The trends were maintained in a subgroup followed up to 90 d (P < 0.001). Mean serum Ca and P significantly increased compared to baseline, whereas serum Mg decreased at 3 d. CONCLUSIONS: A single oral dose of 600,000 IU of cholecalciferol rapidly enhances 25(OH)D and reduces PTH in young people with vitamin D deficiency.
Moderate ie physiological increase in just vitamin D levels and intake (from average diet and sunshine and a traditional supplement) within the average population bloodlevel range understandably has modest benefit- reversing at least rickets- in an indoor living clothed population, even 1st world middleaged: from Wisconsin Univ, Karen Hansen ea’s recent RCT – JAMA 2015- Treatment of Vitamin D Insufficiency in Postmenopausal Women– confirmed this, showing little practical benefit shortterm (ie over 12mo) between placebo, and supplemented vit D3 5600iu/wk and 25000 iu a week, (~3600iu/d); the highest dose perhaps doubling the baseline 20ng/ml 25OH vit D level. ie into the low “adequate” range average around 40ng/ml.
Be aware again that the same university’s group published in 2014 An Evaluation of High-Dose Vitamin D 2 for Rheumatoid Arthritis Karen Hansen ea that vit D2 ~100 00iu/month for a year actually worsens patients and lowers vit D3 levels , so there is no longer excuse for using vitamin D2 supplement when it blocks D3 receptors and lowers blood vit D3.
The inferiority of vit D2 was confirmed in eg Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill Pediatric Burn Patients. Gottschlich, Kagan U Cincinnati Ohio 2015: 50 patients aged 1 to 18yrs with burns were enrolled. All participants received multivitamin supplementation , plus , 100 IU/kg D2, D3, or placebo daily RESULTS: There were no significant differences in serum vitamin D levels between groups, but >10% of patients had low 25OHD at discharge, and %deficiency worsened by the 1-year follow up for the placebo (75%), D2 (56%), and D3 (25%) groups. There were no statistical differences in clinical outcomes between treatment groups, although vitamin D supplementation demonstrated clinically relevant decreases in exogenous insulin requirements, sepsis, and scar formation. The high incidence of low serum 25OHvit D levels 1 year following serious thermal injury indicates prolonged compromise. Continued treatment with vitamin D3 beyond the acute phase postburn is recommended to counteract the trajectory of abnormal serum levels and associated morbidity.
The perception seems to be that up to 40 000iu vit D3 a day, a bld level below abt 150-350ng/ml is safe, ie unsafe above that. The evidence for such ceiling ie higher dose harm in fact is lacking since as we have previously discussed here, healthy people have taken up to 150 000iu a day for decades without evidence of harm… provided they took adequate fluids, and did not take supplements of calcium, or also take high vitamin A which notoriously causes acute hypercalcemic toxicity, or have rising calcium levels . .
But note that vit K2 improves absorption of vit D3 CHOLECALCIFEROL , and vit K2 and magnesia improve benefit of vit D3,while protecting against overdose effects ie calcification, stones and confusion. Problem in many toxicity reports is that they used either vit D2 ergocalcif (WHICH BLOCKS THE NEEDED D3) , or used accidental massive overdose (millions of units vit D ) daily for months- or massive INJECTIONS) or combined vit D WITH CALCIUM REPLACEMENT AND/ OR EXCESSIVE VITAMIN A – which combinations are dangerous; we need magnesium (not calcium or high vitamin A supplements).
SO I continue to take vit D3 ~70 000iu/wk ie ~10 000iu/d, with vit K2 supp ~700mcg a wk ie 100mcg/dy and a balanced multisupplement incl. magnesia in addition to a multisupplement A-Z, and fish oil and Lugols iodine 15% 2 drops a day; with if I do get a “flu” attack during bad weather, prompt abolition by a few antibiotic doses of topup Lugols iodine 15% a few tsp (ie ~1000mgs iodine), and vitamin D3 eg 300 000iu, and vitamin C a few tsp orally and by sniffing. .
The problem with many adverse effect reports of vit D3 overdose eg the Dominican Republic Soladek 2011 report Lowe ea below, and Prof Heaney’s response, is that they failed to even consider the massive associated overdose of the far more hypercalcemic vitamin A let alone calcium supp reported by most patients. It becomes apparent that NO calcium supplement should be encouraged on a prudent diet; but instead supplements of Vit D3, magnesia, vits K2 and C, CoQ10, and fish oil ; in addition to a balanced (A to Z) RDA-based multisupplement for seniors like eg Solal’s, Vital’s Multitime, Centrum etc.. with a low calcium diet if massive dose vitamin D3 is indicated as in autoimmune diseases (Coimbra ea).
Ndb
the Australian Govt Supplement Overview has an intriguing report on vit D in sports, with no hint of vit D supplement being a steroid abuse. .http://www.ausport.gov.au/data/assets/pdf_file/0003/594174/CORP_33413_SSF_Vitamin_D_FS.pdf Vitamin D is classified as a fat soluble vitamin which acts functionally as a steroid hormones. There are 2 different isoforms of Vitamin D: D3 (cholecalciferol) which is the important isomer formed in human skin and D2 (ergocalciferol) which is the plant-derived ie xeno-equivalent. D2 was the first isoform to be characterised and was first used in Vitamin D supplements and for food fortification. D3 is now considered preferable. D3 is biologically inert until converted in the liver to 25(OH)D and to 1,25(OH)D in the kidney. Vitamin D plays an important role in calcium and phosphorous homeostasis (bone health),but more so in gene expression and cell growth. The recent recognition of Vitamin D receptors in most body tissues indicates a role for Vitamin D in many aspects of health and function. Vitamin D is now known to be important for optimal muscle function.
The principal source of circulating vitamin D comes from exposure to ultraviolet B (UVB) radiation from sunlight. In 2010, the Institute of Medicine issued new Dietary Reference Intakes for Vitamin D, assuming no sunlight exposure: this included a Recommended Dietary Intake of 600 IU/d and an Upper Level intake of 4000 IU/d (www.iom.edu/vitamind). BUT no evidence has ever been published to support this ceiling intake.
Whereas Vitamin D deficiency can lead to several health issues including increased risk of bone injuries, chronic musculoskeletal pain and viral respiratory tract infections. There is also emerging evidence that supplementing Vitamin D in athletes with sub-optimal Vitamin D levels may have beneficial effects on athletic performance in particular strength, power, reaction time and balance.
There is no universally accepted definition of vitamin D deficiency however, the following definitions based on serum levels of 25(OH) Vitamin D are often cited:
Vitamin D deficiency: serum levels < 20 ng/ml (50 nmol/L); Vit D insufficiency: serum levels < 30 ng/ml
Vit D sufficiency: serum levels > 30 ng/ml Ideal Vit D range*: 30-50ng/ml
Toxicity: > 150ng/ml, when combined with raised serum calcium
(*Higher status may be preferred for athletes to allow a greater safety margin and to optimize performance; some agencies working with elite athletes often set their own thresholds for desired Vitamin D concentrations)
Ie they quote no evidence for the 25OH vit D ceiling of 50ng/ml.
Confirmed in
Owens DJ1, Close GL ea . UK Universities . 2015..A systems-based investigation into vitamin D and skeletal muscle repair, regeneration, and hypertrophy. Skeletal muscle is a direct target for vitamin D. Observational studies suggest that low 25[OH]D correlates with functional recovery of skeletal muscle following eccentric contractions in humans and crush injury in rats. However, a definitive association is yet to be established. To address this gap in knowledge in relation to damage repair, a randomised, placebo-controlled trial was performed in 20 males with insufficient concentrations of serum 25(OH)D (~18ng/ml). Prior to and following 6 wk of supplemental vitamin D3 (4,000 IU/day) or placebo (50 mg of cellulose), participants performed 20 × 10 damaging eccentric contractions of the knee extensors. Supplemental vitamin D3 increased serum 25(OH)D and improved recovery of peak torque at 48 h and 7 days postexercise. Together, these preliminary data are the first to characterize a role for vitamin D in human skeletal muscle regeneration and suggest that maintaining serum 25(OH)D may be beneficial for enhancing reparative processes and potentially for facilitating subsequent hypertrophy.
2016 Is there an optimal vitamin D status for immunity in athletes and military personnel? He CS1, Gleeson M ea .Vitamin D is mainly obtained through sunlight ultraviolet-B (UVB) exposure of the skin, with a small amount typically coming from the diet.It is now clear that vitamin D has important roles beyond its well-known effects on calcium and bone homeostasis. Immune cells express the vitamin D receptor, including antigen presenting cells, T cells and B cells, and these cells are all capable of synthesizing the biologically active vitamin D metabolite, 1, 25 hydroxy vitamin D.There has been growing interest in the benefits of supplementing vitamin D as studies report vitamin D insufficiency (circulating 25(OH)D < 50 nmol/L) in more than half of all athletes and military personnel tested during the winter, when skin sunlight UVB is negligible. The overwhelming evidence supports avoiding vitamin D deficiency (25(OH)D< 30 nmol/L)to maintain immunity and prevent upper respiratory illness (URI) in athletes and military personnel.Recent evidence supports an optimal circulating 25(OH)D of 75 nmol/L to prevent URI and enhance innate immunity and mucosal immunity and bring about anti-inflammatory actions through the induction of regulatory T cells and the inhibition of pro-inflammatory cytokine production. We provide practical recommendations for how vitamin D sufficiency can be achieved in most individuals by safe sunlight exposure in the summer and daily 1, 000 IU vitamin D3 supplementation in the winter.
Sarris J1, Ng CH1. Ea, Universities of Melbourne, & Deakin, Australia; & Harvard Boston; 2016 show in Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses. http://www.ncbi.nlm.nih.gov/pubmed/27113121 Adjunctive standardized pharmaceutical-grade nutrients, known as nutraceuticals, has the potential to modulate several neurochemical pathways implicated in depression. A systematic search up to 2015 for clinical trials using adjunctive nutrients for depression RESULTS: Primarily positive results were found for studies testing S-adenosylmethionine (SAMe), methylfolate, omega-3 (primarily EPA or ethyl-EPA), and vitamin D,. Mixed results were found for zinc, folic acid, vitamin C, and tryptophan. . No major adverse effects were noted in the studies adjunctive omega-3 versus placebo revealed a significant and moderate to strong effect in favor of omega-3. CONCLUSIONS: Current evidence supports adjunctive use of SAMe, methylfolate, omega-3, and vitamin D with antidepressants to reduce depressive symptoms.
Raina AH1, Bhat FA1 ea ., India.. 2016 Association of Low Levels of Vitamin D with Chronic Stable Angina: A Prospective Case-Control Study. http://www.ncbi.nlm.nih.gov/pubmed/27114971 Coronary artery disease (CAD) is a major cause of death and disability in developed countries. Chronic stable angina is the initial manifestation of CAD in approximately 50% of the patients. Recent evidence suggests that vitamin D is crucial for cardiovascular health. The prevalence of vitamin D deficiency in our region is 83%. METHODS: a prospective case-control study in 100 cases of chronic stable angina compared controls. Vitamin D deficiency was defined as <20 ng/mL, vitamin D insufficiency as 20-30 ng/mL and normal vitamin D level as 31-150 ng/mL.RESULTS: The prevalence of vitamin D deficiency among cases and controls was 75% and 10%, respectively. 13% had normal vitamin D levels (31-150 ng/mL). None had a toxic level of vitamin D. Among the controls, 10% were vitamin D-deficient, 57% had normal vitamin D levels. The mean vitamin level among cases and controls was 15.53 ng/mL and 40.95 ng/mL, respectively, statistically significant (P ≤ 0.0001). Among the cases, we found that an increasing age was inversely related to vitamin D levels (P = 0.027). Low levels may be an independent, potentially modifiable cardiovascular risk factor.
Jetty , Glueck Kumar ea . Jewish Hospital Cincinnati, Ohio, USA 2016 show 12mo Safety of 50,000-100,000 Units of Vitamin D3/Week in Hypercholesterolemic Vitamin D-Deficient, Patients with Reversible Statin Intolerance. : http://www.ncbi.nlm.nih.gov/pubmed/27114973 Such Vitamin D3 therapy (was safe and effective when given for 12 months to reverse statin intolerance in patients with vitamin D deficiency. Serum vitamin D rarely exceeded 100 ng/mL, never reached toxic levels, and there were no significant change in serum calcium or eGFR
https://riordanclinic.org/2013/10/vitamins-d3-and-k2-the-dynamic-duo/ As we explore the healing power of higher doses of vitamin D3 at the Riordan Clinic, we have found it prudent to partner the safety and effectiveness of this dynamic duo. For every 5,000–10,000 units of D3 being recommended and tested for, we are recommending 100 mcg of K2 mk7 to be sure and prevent the inappropriate calcification that higher doses of D3 alone could cause.
http://www.amazon.com/MIRACULOUS-RESULTS-EXTREMELY-SUNSHINE-EXPERIMENT-ebook/dp/B005FCKN2S#reader_B005FCKN2S is a recent book by Jeff T Bowles .
Newsletter: Gary Null and vitamin D toxicity 2010 by John Cannell, MD http://www.vitamindcouncil.org/newsletter/newsletter-gary-null-and-vitamin-d-toxicity/ “Warning: If you intend to take massive doses of vitamin D based on this newsletter, which I highly recommend you do not, read the entire newsletter. In addition, accurate determination of side effects of massive doses of vitamin D was not available in the early 1930s, nor was accurate determination of the true amount in each pill possible. Is 2,000,000 IU/day of vitamin D toxic? Ask Gary Null, alternative medicine guru and entrepreneur. He took his own supplement, Ultimate Power Meal, for a month and became extremely ill; one batch of Power Meal apparently contained 1,000 times more vitamin D than it should. That is, it contained 2,000,000 IU of vitamin D3 per serving instead of 2,000 IU per serving. Mr. Null became sicker and sicker as he gulped it down.
After suing his own supplier for permanent physical damage, Mr. Null then reported it took 3 months to get the extra vitamin D out of his system and that he is now alive and well. If Mr. Null took it for the full month that he claims, and if his Power Meal contained 2,000,000 IU per dose, Mr. Null consumed 60,000,000 IU in one month. Could he really be fine now with no lasting injuries? In an attempt to answer that question, I went back to the 1930s and 40s. Massive doses in the 1930s The earliest references I could find to enormous doses of vitamin D were in the 1930s. In 1935, Drs. Dreyer and Reed, of the University of Illinois School of Medicine, published their observations on 700 patients treated with “massive” doses of vitamin D for up to two years.1 ….” read on..http://www.vitamindcouncil.org/newsletter/newsletter-gary-null-and-vitamin-d-toxicity/ http://www.livescience.com/50765-vitamin-d-supplements-toxicity.html
Vitamin D Overdose Dr. Liji Thomas, MD 2016 http://www.news-medical.net/health/Vitamin-D-Overdose.aspx vitamin D toxicity can occur from high intakes of supplements containing vitamin D, but not from dietary intake. Prolonged sun exposure also does not result in vitamin D toxicity because the previtamin D3 is degraded as the skin heats up, and also because of the formation of various other non-functional forms of vitamin D from the thermally activated compound. Long term intakes of vitamin D above the upper limit recommended causes symptoms of toxicity. However, the intakes must be higher than about 40,000 IU/day, or the serum level of 25-hydroxy above 500-600 ng/mL, and the patient is usually also taking excessive amounts of calcium as well.
Dietary Supplement–Induced Vitamin D Intoxication Klontz KC, Acheson DW. To the Editor 2004: Vitamin D intoxication that is associated with the consumption of dietary supplements is reported rarely. In 2004, the Food and Drug Administration (FDA) learned of the following case. A 58-year-old woman with diabetes mellitus and rheumatoid arthritis began taking a dietary supplement called Solutions IE Ageless Formula II on January 12, 2004. Fatigue, constipation, back pain, forgetfulness, nausea, and vomiting soon developed. On March 15, 2004, she was hospitalized because her speech was slurred, and a blood glucose reading taken at home was 30 mg per deciliter. On admission, her serum levels were as follows: calcium, more than 3.75 mmol per liter; 25-hydroxyvitamin D, 460ng/ml (normal range, 9-5);; parathyroid hormone, 12 ng per liter (normal range, 10 to 65); and creatinine, 265 μmol per liter. The patient was treated with intravenous normal saline, furosemide, and pamidronate. On March 19, 2004, while still hospitalized, she was informed by the product distributor of an error in product formulation such that 188,640 IU of vitamin D3/d had been added to the daily serving size of six capsules instead of the intended 400 IU. IE SHE HAD TAKEN ~12.2MILLION IU OF VIT D3 IN 2 MONTHS. At discharge on March 24, the patient’s serum levels were as follows: calcium, 2.60 mmol per liter; blood urea nitrogen, 10.0 mmol per liter; and creatinine, 221 μmol per liter. The patient died from a cause unknown to us on January 8, 2005. Laboratory analysis of the product by the FDA, obtained from one of two lots reportedly overfortified with vitamin D3, revealed 186,906 IU of vitamin D3 in each serving size of six capsules, indicating that the patient had consumed roughly 90 times the recommended safe upper limit of 2000 IU per day. Long-term daily vitamin D consumption of more than 40,000 IU (1000 μg) is needed to cause hypercalcemia in healthy persons.2 In March 2004, the product distributor announced that during the previous month it had received three complaints from customers who had been hospitalized for hypercalcemia and vitamin D toxicity
2011 Vitamin D toxicity due to a commonly available “over the counter” remedy from the Dominican Republic. Lowe H1, Bilezikian JP. ea Columbia Univ, NY.. http://press.endocrine.org/doi/10.1210/jc.2010-1999?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed& Hypercalcemia in ambulatory patients is occasionally caused by vitamin D toxicity. We report nine patients presenting to Columbia University Medical Center with hypercalcemia due to a supplement from the Dominican Republic containing massive amounts of vitamin D. All reported recently taking Soladek readily available in the Dominican Republic and in Upper Manhattan. serum calcium values before the ingestion of Soladek were not elevated According to the manufacturer’s label, each 5-ml vial of Soladek contains vitamin D3 (600,000 IU), vitamin A (120,000 IU), and vitamin E (5 mg). Laboratory analysis by HPLC revealed that the supplement actually contained vitamin D(3) (864,000 IU) and vitamin A (predominantly retinyl palmitate 123,500 IU) per vial.IE 864000 IU VIT D /day FOR UNKNOWN DURATION. a similar case was reported earlier http://www.thecamreport.com/2009/11/soladek-toxicity-in-a-60-year-old-woman/
Comments by Prof Robert P. Heany Creighton University, Omaha, Nebraska on Lowe et al: Hypercalcemia in vitamin D intoxication JCEM http://press.endocrine.org/e-letters/10.1210/jc.2010-1999 The report by Lowe et al. on vitamin D intoxication from an OTC supplement (1) is instructive and useful. I comment on the authors’ suggested mechanism of hypercalcemia in such cases. The authors propose that the elevated concentration of serum 25- hydroxy-vitamin D [25(OH)D] is the responsible agent, through loose binding to the vitamin D receptor. While my colleagues and I have shown that 25(OH)D can improve calcium absorption (2), I believe there is a simpler explanation for hypercalcemia in vitamin D intoxication, particularly as the reported values of 25(OH)D were not uniformly high in these nine cases. [In fact the patient with the highest serum calcium had actually the lowest value for 25(OH)D.] Instead, as Vieth suggested several years ago in a paper actually referenced by Lowe et al. (3), elevation of free circulating 1,25(OH)2D (calcitriol) is the most parsimonious explanation. This level is not commonly measured, and was not reported in the cases described by Lowe et al. Vieth has estimated the binding capacity of the D-binding protein (DBP) at approximately 4700 nmol/liter, and it is generally recognized that fewer than 5% of its binding sites are occupied at typical cholecalciferol inputs. However, in the face of huge cholecalciferol doses, as in the nine cases described here, it can easily be calculated that most or all of the binding sites on the DBP would be occupied by cholecalciferol itself as well as by 25(OH)D and 24,25(OH)2D, all of which are bound to the DBP more avidly than is calcitriol. Lowe et al. did not measure serum cholecalciferol, but it is virtually certain that its concentration would have been elevated, if for no other reason than that the capacity of the hepatic 25-hydroxylase is limited, and serum cholecalciferol concentration rises steeply for cholecalciferol inputs in excess of the saturation level of the 25-hydroxylase [which typically occurs at serum cholecalciferol levels of about 10 nmol/L and serum 25(OH)D of about 80 nmol/liter (4)].Even if all of the binding sites of the DBP were not continuously occupied by less polar metabolites, high occupancy would shift the equilibrium between the free and the bound calcitriol, so that free calcitriol concentration would likely have been substantially above normal values continuously. The authors speculate as to the origin of the elevated total calcitriol concentrations, given the down-regulation of the renal 1-á- hydroxylase in such cases.
2016.Deficient serum 25-hydroxyvitamin D is associated with an atherogenic lipid profile: The Very Large Database of Lipids (VLDL-3) study. Lupton JR1Michos ea . Cross-sectional studies have found an association between deficiencies in serum vitamin D, as measured by 25-hydroxyvitamin D (25[OH]D), and an atherogenic lipid profile. These studies have focused on a limited panel of lipid values including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG).OBJECTIVE: Our study examines the relationship between serum 25(OH)D and an extended lipid panel (Vertical Auto Profile) while controlling for age, gender, glycemic status, and kidney function.METHODS: We used the Very Large Database of Lipids, which includes US adults clinically referred for analysis of their lipid profile from 2009 to 2011. Our study focused on 20,360 subjects who had data for lipids, 25(OH)D, age, gender, hemoglobin A1c, insulin, creatinine, and blood urea nitrogen. Subjects were split into groups based on serum 25(OH)D: deficient (<20 ng/mL), intermediate (≥20-30 ng/mL), and optimal (≥30 ng/mL). The deficient group was compared to the optimal group using multivariable linear regression.RESULTS: In multivariable-adjusted linear regression, deficient serum 25(OH)D was associated with significantly lower serum HDL-C (-5.1%) and higher total cholesterol (+9.4%), non-HDL-C (+15.4%), directly measured LDL-C (+13.5%), intermediate-density lipoprotein cholesterol (+23.7%), very low-density lipoprotein cholesterol (+19.0%), remnant lipoprotein cholesterol (+18.4%), and TG (+26.4%) when compared with the optimal group.CONCLUSION: Deficient serum 25(OH)D is associated with significantly lower HDL-C and higher directly measured LDL-C, intermediate-density lipoprotein cholesterol, very low-density lipoproteins cholesterol, remnant lipoprotein cholesterol, and TG
Vitam Horm. 2016;100:255-71. doi: 10.1016/bs.vh.2015.10.001. Epub 2015 Nov 30. Molecular Approaches for Optimizing Vitamin D Supplementation. Carlberg C1.Vitamin D can be synthesized endogenously within UV-B exposed human skin. However, avoidance of sufficient sun exposure via predominant indoor activities, textile coverage, dark skin at higher latitude, and seasonal variations makes the intake of vitamin D fortified food or direct vitamin D supplementation necessary. Vitamin D has via its biologically most active metabolite 1α,25-dihydroxyvitamin D and the transcription factor vitamin D receptor a direct effect on the epigenome and transcriptome of many human tissues and cell types. Different interpretation of results from observational studies with vitamin D led to some dispute in the field on the desired optimal vitamin D level and the recommended daily supplementation. This chapter will provide background on the epigenome- and transcriptome-wide functions of vitamin D and will outline how this insight may be used for determining of the optimal vitamin D status of human individuals. These reflections will lead to the concept of a personal vitamin D index that may be a better guideline for an optimized vitamin D supplementation than population-based recommendations.
the Ides of March 2016: Where have we been the past 5 years in ignoring the crucial role of K2 supplement with vit D3? against cancer, fractures, infections, vascular disease and diabetes ,
like the crucial role of Lugols iodine + selenium, and magnesium (not calcium), coQ10, and animal, marine and coconut ie saturated fat oil- supplement for all chronic disease prevention?
Considering that our western processed food staple diet, and the diet of the poor majority everywhere, is increasingly deficient especially in these nutrients, with by profit-motivated industrial design disease-promoting cholesterol-depletion, refined sugars, transfats, antibiotics, hormones, and noxious at-any-dose elements from fluorine and aluminium upwards.…
I see I was promoting K2 in my emails 4 years ago, and since 2009, on my Healthspanlife blog ie in my lectures and thus in my healthspanlife blends .
Unlike the Big Pharma-Disease-Industry- controlled denialists of conservative safe natural phamacological vitamin therapy like the Linus Pauling Institute and Wikipedia https://en.wikipedia.org/wiki/Vitamin_K2,
the vitamin K2 Polish scientist Dr Katarzyna Maresz PhD 2015 writes (see abstract below) Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health. Maresz K1. International Science and Health Foundation Krakow, Poland Inadequate calcium intake can lead to decreased bone mineral density, thus increase the risk of bone fractures. Recent scientific evidence, however, suggests that elevated consumption of calcium supplements may raise the risk for heart disease and can be connected with accelerated deposit of calcium in blood-vessel walls and soft tissues. In contrast, vitamin K2 is associated with the inhibition of arterial calcification and arterial stiffening. Dosing of K2 was supported by a population-based study with 16 000 healthy women aged 49 to 70 years drawn from EPIC’s cohort population. After 8 years ,it showed that a high intake of natural vitamin K2 (ie, not synthetic K2, but not of vitamin K1) was associated with protection against cardiovascular events. For every 10 mcg of dietary vitamin K2 consumed (in the forms of menaquinone 7 (MK-7), menaquinone 8 (MK-8), and menaquinone 9 (MK-9), the risk of coronary heart disease was reduced by 9%. … The researchers found that a daily dose of 180 mcg was enough to improve bone mineral density, bone strength, and cardiovascular health. They also showed that achieving a clinically relevant improvement required at least 2 years of supplementation.
While vit D3 cholecalciferol soltriol was the multiprevention megavitamin of the past decade, and CoQ10 the decade before that, catching up with the protean benefits of increasingly diet- deficient vitamins published (350 000 Pubmed citations) the past century, and of vitamin K since 1936, and K2 since 1946,
vit K2 is the most publicized ie advancing megavit of the current decade:
Adequate intake ie ~45 to ~150mcg/d is crucial with magnesium, boron etc to balance vigorous vit D3 supplement,
for both bone, immune/cancer, and cardiovascular health.
Thus even just ~55mcg/d K2 supplement HALVES the risk of cardiovascular disease – very important in overweight/stressed/ aging people.
BUT The authorities quoted have assessed safety and optimal longterm effective doses of vitamin K3 and vitamin D3 IN ISOLATION for major prevention. However, we know that optimal nutrition is balanced nutrition, not one or two nutrient is superdose with an average fastfood mediocre diet.
This finally convinces me to add vit K2 ~ 35 to 100mcg/day ie 200 to 700mcg/wk to my own vit D3 supplements. at a trivial bulk wholesale cost of ~10mg/d 1% K2 ie ~R0.1/day or R14 – ( US$1) bag per 40 weeks of vit D3 @ 50 000iu vit D3 twice a month.
Like Mercola 2010 http://articles.mercola.com/sites/articles/archive/2010/08/26/this-could-be-even-bigger-than-the-vitamin-d-discovery.aspx, Byron Richards already in 2010 wrote a major review promoting K2 multipurpose: http://www.wellnessresources.com/health/articles/vitamin_k2_bones_cardiovascular_health_blood_sugar_control_cancer_prev/
As a recent BBC review details, “Vitamin K1 has a relatively short half-life and is rapidly cleared from the blood by the liver within eight hours. In comparison vitamin K2 has a longer half-life of up to 72 hours, meaning it remains biologically active in the body for longer. Vitamin K2 is also absorbed better by the body, and is linked to cardiovascular health. It directs calcium to the bones, and prevents it from being deposited where it shouldn’t be, for example arteries and organs, where it can cause harm.
The Kansas Riordan Clinic promotes the Superhuman Duo of D3+K: they point out that ” Because an accurate LD50 for vit D in humans has never been determined (thank God!) most researchers use the LD50 for dogs as an estimate for humans, using a hypothetical human subject weighing 50kg, 110 pounds: in order to reach the LD50 dose, that subject would need to consume over 3,500 of the 50,000 IU D3 caps in a 24 hour period (146 capsules an hour, total 175million iu) in order to have a 50% chance of dying. By conscientiously using vitamin K2 in conjunction with D3, this issue of “metastatic calcium” is thoroughly avoided. Finally, like vitamin D3, strong evidence demonstrates vitamin K’s amazing ability to reduce cancer risk. For example, men taking vitamin K2 mk7 (a naturally occurring long acting form of K2) at 45 mcg a day can statistically reduce their risk of prostate cancer by 60%! That is just one of many cancer risks that are reduced significantly by regular K2 ingestion. As we explore the healing power of higher doses of vitamin D3 at the Riordan Clinic, we have found it prudent to partner the safety and effectiveness of this dynamic duo. For every 5,000–10,000 units of D3 being recommended and tested for, we are recommending 100 mcg of K2 mk7 to be sure and prevent the inappropriate calcification that higher doses of D3 alone could cause.
For the safety of vigorous dose of vitamin D3, the masses of D3 evidence we assembled by August 2015 is that 2million units as a single oral dose does no harm to nonagenarians, nor has over 100 000iu a day for 28 years ie over a billion iu in middle-aged women.
In 2015, Like *Joe Leech and *Hogne Vik , *Angela Pifer nutritionist notes the essensiality of balancing vit D3 with K2 “Vitamin D3 should never be taken alone. Always take a combination Vitamin D3/ Vitamin K2 liquid emulsion, at night for best absorption. This is because vitamin D3 improves calcium absorption across the GI tract and vitamin K2 is the cofactor needed to transfer calcium into your bones, and not your arteries. (Eur J Clin Nutr. 2016 Feb 24. doi: 10.1038/ejcn.2016.3. Steady-state vitamin K2 (menaquinone-7) plasma concentrations after intake of dairy products and soft gel capsules. Knapen, Vermeer ea . Maastricht University, Netherlands. In a previous human intervention study, we observed an improved vitamin K status after 8 weeks of intake of a yogurt fortified with vitamin K2 (as menaquinone-7, MK-7) and vitamins C and D3, magnesium and polyunsaturated fatty acids. It was hypothesized that the added nutrients contributed to this improvement. Here we report on a study in which we compared the fasting plasma concentrations of MK-7 from (a) yogurt enriched with MK-7, vitamins D3 and C, magnesium, n-3 poly unsaturated fatty acids (n-3 PUFA) and fish oil (yogurt Kplus), (b) yogurt fortified with MK-7 only (yogurt K) and (c) soft gel capsules containing only MK-7, For 42 days in healthy men and postmenopausal women between 45 and 65 years of age daily consumed either yogurt K, yogurt Kplus or capsules. RESULTS: The increase in plasma MK-7 with the yogurt Kplus product was more pronounced than the increase in MK-7 with the capsules, reflecting vitamin K status improvement. No significant differences in fasting plasma concentrations of various biomarkers between the yogurts were found. CONCLUSIONS: Dairy matrix and nutrient composition may affect MK-7 delivery and improvement of vitamin K status. Yogurt fortified with MK-7 is a suitable matrix to improve the nutritional status of the fat-soluble vitamins.)
Some recent of the other 5000 K2 refs on Pubmed, apart from the abundant reviews by Garry Gordon, Joe Mercola, Mike Howard, Jeff Dach, Townsend letter, ea , are
Integr Med (Encinitas). 2015;14; 34-9. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health. Maresz K1. International Science and Health Foundation Krakow, Poland Inadequate calcium intake can lead to decreased bone mineral density, thus increase the risk of bone fractures. Supplemental calcium promotes bone mineral density and strength and can prevent osteoporosis. Recent scientific evidence, however, suggests that elevated consumption of calcium supplements may raise the risk for heart disease and can be connected with accelerated deposit of calcium in blood-vessel walls and soft tissues. In contrast, vitamin K2 is associated with the inhibition of arterial calcification and arterial stiffening. An adequate intake of vitamin K2 has been shown to lower the risk of vascular damage because it activates matrix GLA protein (MGP), which inhibits the deposits of calcium on the walls. Vitamin K, particularly as vitamin K2, is nearly nonexistent in junk food, with little being consumed even in a healthy Western diet. Vitamin K deficiency results in inadequate activation of MGP, which greatly impairs the process of calcium removal and increases the risk of calcification of the blood vessels. An increased intake of vitamin K2 could be a means of lowering calcium-associated health risks. “ Calcium Concerns: If at least 32 mcg/d of vitamin K2 is present in the diet, then the risks for blood-vessel calcification and heart problems are significantly lowered, the elasticity of the vessel wall is increased. Moreover, the beneficial effects of vitamins D and K on the elastic properties of the vessel wall in postmenopausal women has been seen in clinical trials. If less vitamin K2 is present in the diet, then cardiovascular problems may arise. Dosing of K2 was supported by a population-based study with 16 000 healthy women aged 49 to 70 years drawn from EPIC’s cohort population. After 8 years ,it showed that a high intake of natural vitamin K2 (ie, not synthetic K2, but not of vitamin K1) was associated with protection against cardiovascular events. For every 10 mcg of dietary vitamin K2 consumed (in the forms of menaquinone 7 (MK-7), menaquinone 8 (MK-8), and menaquinone 9 (MK-9), the risk of coronary heart disease was reduced by 9%. A study on 564 postmenopausal women also revealed that intake of vitamin K2 was associated with decreased coronary calcification, whereas intake of vitamin K1 was not. ” A recent, double-blind, randomized clinical trial investigated the effects of supplemental MK-7, MenaQ7 (NattoPharma ASA, Hovik, Norway) for a 3-year period in a group of 244 postmenopausal Dutch women. The researchers found that a daily dose of 180 mcg was enough to improve bone mineral density, bone strength, and cardiovascular health. They also showed that achieving a clinically relevant improvement required at least 2 years of supplementation.It showed a significant improvement in cardiovascular health as measured by ultrasound and pulse-wave velocity, which are recognized as standard measurements for cardiovascular health. In that trial, carotid artery distensibility was significantly improved for a 3-year period as compared with that of a placebo group. Also, pulse-wave velocity showed a statistically significantly decrease after 3 years for the vitamin K2 (MK-7) group, but not for the placebo group, demonstrating an increase in the elasticity and reduction in age-related arterial stiffening.”
* Nutrients. 2015 Oct ;7;8905-15. Menaquinone-7 Supplementation to Reduce Vascular Calcification in Patients with Coronary Artery Disease: Rationale and Study Protocol (VitaK-CAC Trial).Vossen, Kroon ea Coronary artery calcification (CAC) develops early in the pathogenesis of atherosclerosis and is a strong and independent predictor of cardiovascular disease (CVD). Arterial calcification is caused by an imbalance in calcification regulatory mechanisms. An important inhibitor of calcification is vitamin K-dependent matrix Gla protein (MGP). Both preclinical and clinical studies have shown that inhibition of the vitamin K-cycle by vitamin K antagonists (VKA) results in elevated uncarboxylated MGP (ucMGP) and subsequently in extensive arterial calcification. This led us to hypothesize that vitamin K supplementation may slow down the progression of calcification. To test this, we designed the VitaK-CAC trial which analyses effects of menaquinone-7 (MK-7) supplementation on progression of CAC. The trial is a double-blind, randomized, placebo-controlled trial including patients with coronary artery disease (CAD). Patients with a baseline Agatston CAC-score between 50 and 400 will be randomized to an intervention-group (360 microgram MK-7) or a placebo group. Treatment duration will be 24 months. We hypothesize that treatment with MK-7 will slow down or arrest the progression of CAC and that this trial may lead to a treatment option for vascular calcification and subsequent CVD.
* Ugeskr Laeger. 2015 Aug;177:V12140700. Vitamin K2 influences several diseases]. Hey H1, Brasen CL. Lillebælt, Kabbeltoft, In this paper we discuss the evidence of vitamin K2 deficiency which is a factor in several chronic diseases like diabetes, osteoporosis, cancer, inflammatory and cardiovascular diseases. This deficiency is very common in the mentioned diseases although it is rarely treated by clinicians. Randomized clinical trials have shown that patients witr can benefit from vitamin K2 supplement. Further studies are needed to ascertain the effect of vitamin K2 supplement in patients with diabetes and inflammatory bowel diseases.
* Oman Med J. 2014;29;172-7. Vitamin k dependent proteins and the role of vitamin k2 in the modulation of vascular calcification: a review. El Asmar, Arbid ea, American University of Beirut, Lebanon. Vascular calcification, a cause of cardiovascular morbidity and mortality, is an actively regulated process involving vitamin K dependent proteins (VKDPs) among others. Vitamin K is an essential micronutrient, present in plants and animal fermented products that plays an important role as a cofactor for the post-translational γ-carboxylation of glutamic acid residues in a number of proteins. These VKDPs require carboxylation to become biologically active, and they have been identified as having an active role in vascular cell migration, angiogenesis and vascular calcification. calcification.
* Dermatoendocrinol. 2015 Jan;6e968490. Vitamin K: an old vitamin in a new perspective. Gröber U, Reichrath J, Holick MF, Kisters Essen, Germany.& Boston, MA USA. The topic of “Vitamin K” is currently booming on the health products market. Current research increasingly indicates that the antihaemorrhagic vitamin has a considerable benefit in the prevention and treatment of bone and vascular disease. Vitamin K1 (phylloquinone) is more abundant in foods but less bioactive than the vitamin K2 menaquinones (especially MK-7, menaquinone-7). Vitamin K compounds undergo oxidation-reduction cycling within the endoplasmic reticulum membrane, donating electrons to activate specific proteins via enzymatic gamma-carboxylation of glutamate groups before being enzymatically reduced. Along with coagulation factors (II, VII, IX, X, and prothrombin), protein C and protein S, osteocalcin (OC), matrix Gla protein (MGP), periostin, Gas6, and other vitamin K-dependent (VKD) proteins support calcium homeostasis, inhibit vessel wall calcification, support endothelial integrity, facilitate bone mineralization, are involved in tissue renewal and cell growth control, and have numerous other effects.
Posted in anti-aging, cancer, Food & Diet, Hypertension, Uncategorized, vitamins
Tagged cancer, Charcot, Coimbra, CVD, fracture, Heaney, Holick, Hypertension, massive dose vit D, MG myasthenia gravis, MS multip sclerosis, mythical vitamin D toxicity ceiling, osteoporosis, peripheral neuropathy joints, prevention, psoriasis, Salahuddin, sports anabolic steroid abuse, supplements, vit D toxic bloodlevel threshold, vit D toxic dose threshold, vitamin D, vitelligo
update 10 Dec 2016 remember that quotations from experts are in italics:
Note noteworthy timeous new reviews: in the latest 7 dec BMJ :
Advice on sugar and starch is urged in type 2 diabetes
advising on low sugar low starch to treat obesity diabetes,
and correction The scientific report guiding the US dietary guidelines: is it scientific?
of the extensive comment on bad new USA guidelines by Nina Teicholtz of 2015 ,
together with reviews of Gary Taubes new book Dec 2016 on The Case against Sugar http://articles.mercola.com/sites/articles/archive/2016/12/11/gary-taubes-the-case-against-sugar.aspx , being a bigger disaster than even smoking and other drugs..
These help to back up Tim Noakes, Zoe Harcomb, Richard Feinman, Peter Wise and at least two dozen other scientific teams around the world, and Integrative medicine, against the fastfood-pharma – hightech medicine – hospital industry trying to discredit Banting diet and needed proven supplements for deficiencies – of natural vits D+C+ iodine +magnes + multisupps , cannabinoids, fishoil + BID HRT (eg melatonin, cholecalciferol, progesterone etc), and other natural supps, and homeopathy,-
so as to keep people profitably sick by the sugary lowfat diet and smoking, vaccines , and patent Big Pharma-raincheck prescription antimicrobials, statins, fosamaxes and ranelates, antithrombotics, designer hormone substitutes,screening mammo and chemotherapy, bariatrics , nsaids, ACEIs and ARBs, antidementia, patented antidiabetics, analgesics, opiates,calcium, aluminium, mercury, and psycho-pharmaceuticals- none of which address the CAUSES of disease as do coaching on better diet, lifestyle and integrative medicine. …
Even more remarkable is the total ignoral of the 25 + scientific RCTs done http://smashthefat.com/science/ and published since 2000 that validate very low carbs high fat Banting (calorie distribution: 8.5% carbs, 62% fat, 30% protein) as much better than the current USA – RSA low fat (54% carbs, 29% fat, 17% protein) generous PUFA and carbs diet. See update review of the experts below at https://healthspanlife.wordpress.com/2015/08/29/adopting-low-carbs-high-fat-healthy-diet-for-most/
Harcombe and Noakes have now published Mistake or mischief: The universities of Stellenbosch/Cape Town low-carbohydrate diet review: debunking the Naude, Volmink ea critique. http://www.samj.org.za/index.php/samj/article/view/11605/7753 A major error of the US/UCT analysis was that it missed the point, did not even consider the very low carbs high fat (+- 8.5% vs 62% fat) intake of the ketogenic Banting regime. The Naude review classified low carbs as diet cals below 45% carbs, high fat as diet cals above 35% from fat. So they did not analyse at all the ketogenic +-8% very low carbs, 60%+ ie very high fat Banting diet.
The latest is Prof Richard David Feinman’s series of papers from the prestigious SUNY State Univ. NY https://feinmantheother.com/ . on the benefits of Warburg ketogenic ie low carbs diet for cancer, never mind obesity diabetes, and epilepsy ( which goes back to 1931 on Pubmed) , the latest eg Nel ea 2014 Jefferson Med College USA https://www.ncbi.nlm.nih.gov/pubmed/24675110and perhaps Autism Spectrum Disorder https ://www.ncbi.nlm.nih.govpubmed/27841033
. Now Prof Peter Wise emeritus oncologist from ImperiaL College London has thrown a cat among the pigeons http://www.bmj.com/content/355/bmj.i5792, in his November 2016 BMJ critique of Cancer drugs, survival, and ethics, pointing out how ‘Despite considerable investment and innovation, chemotherapy drugs have had little effect on survival in adults with metastatic cancer’. A meta-analysis 2004 explored the contribution of cytotoxic chemotherapy to five year survival in 250 000 adults with solid cancers from Australian and US trials.3-important effect was shown on five year survival only in testicular cancer (40%), Hodgkin’s disease (37%), cancer of the cervix (12%), lymphoma (10.5%), and ovarian cancer (8.8%). In the remaining patients—including those with the commonest tumours of the lung, prostate, colorectum, and breast—drug therapy increased five year survival by less than 2.5%—an overall survival benefit of 1 to 3 months., as in Europe. Drug treatment can therefore only partly explain the 20% improvement in five year survival mentioned above. The approval of drugs with such small survival benefits raises ethical questions, including whether recipients are aware of the drugs’ limited benefits, whether the high cost:benefit ratios are justified, and whether trials are providing the right information. In search of ethics : Many irregularities and competing interests—in pharma, in trials, in government approval, and in the clinical use of cancer drugs—impact ethically on the care and costs of patients with cancer. . Spending a six figure sum to prolong life by a few weeks or months is already unaffordable, and inappropriate for many of the 20% of the (Western) population who will almost inevitably die from solid tumour metastases. Ethical cancer care demands more prompt and radical treatment of localised and regional disease, together with highly skilled, earlier, supportive care are the important yet underfinanced priorities in cancer control. Finally, aggressively targeting the less than ethical actions of stakeholders in the heavily veiled medical-industrial complex may be the only way forward: current market driven rather than health driven priorities and practices do not benefit cancer patients.”
He provoked counterattack from vested interests: Twenty UK medical oncologists retort in BMJ: http://www.bmj.com/content/355/bmj.i6487.As UK health professionals specialising in the drug treatment of cancer, we think that Wise’s analysis strays into the territory of unbalanced opinion.
So we come back to addressing the causes of disease for both prevention and treatment, by integrative ie combining natural and hightech means.
updated 29 Aug 15
Six months later after the first World fat>carbs HFLC groundbreaking congress in Cape Town, Pubmed and Google search show no obvious new information on this life-and-death topic that the February Cape Town International Banting Congress highlighted. .
but the publication of Real Food Revolution II Raising Superheroes now provides much new evidence and impetus.
While carnivores ( mammals and pterodactyls-birds) from ~300million years ago survived the extinction of the carnivorous big dinosaurs sixty million years ago, so have current carnivorous primates- tarsiers– and us carnivorous humans nurtured from conception on animal protein and animal fats:
Top anthropologist Prof Gail Kennedy (of UCLA and much work at Olduvai Gorge) in her classic 2005 Journal of Human Evolution article “From the ape’s dilemma to the weanling’s dilemma: early weaning and its evolutionary context“ summed up >2million years of evolution of exclusive human breastmilk ie animal-protein-and-fat>carbs -based infant feeding: ” Although humans have a longer period of infant dependency than other hominoids, human infants, in natural fertility societies, are weaned far earlier than any of the great apes: chimps and orangutans wean, on average, at about 5 and 7.7 years, respectively, while humans wean, on average, at about 2.5 years. Assuming that living great apes demonstrate the ancestral weaning pattern, modern humans display a derived pattern that requires explanation, particularly since earlier weaning may result in significant hazards for a child. Clearly, if selection had favored the survival of the child, humans would wean later like other hominoids; selection, then, favored some trait other than the child’s survival. It is argued here that our unique pattern of prolonged, early brain growth and the neurological basis for human intellectual ability cannot be sustained much beyond one year by a human mother’s milk alone, and thus early weaning by one year, when accompanied by supplementation with more nutritious adult foods, is vital to the ontogeny of our larger brain, despite the associated dangers. Therefore, the child’s intellectual development, rather than its survival, is the primary focus of selection. Consumption of more nutritious foods derived from animal protein increased by ca. 2.6M yrs ago when a group of early hominins displayed two important behavioral shifts relative to ancestral forms: the recognition that a carcass represented a new and valuable food sourced potentially larger than the usual hunted prey; and the use of stone tools to improve access to that food source. The shift in the hominin ‘‘prey image’’ to the carcass and the use of tools for butchery increased the amount of protein and calories available, irrespective of the local landscape. However, this shift brought hominins into competition with carnivores, increasing mortality among young adults and necessitating a number of social responses, such as alloparenting. The increased acquisition of meat ca. 2.6 M yrs ago had significant effects on the later course of human evolution and may have initiated the origin of the genus Homo.”
The thesis of Raising Superheroes by Kennedy’s summation of human brain dietary evolution from babies nurtured on animal meat and fat is supported by serious studies: a 2010 critique in The Keto Diet for Health; in the textbook Guts and Brains ,2007 ed paleoarcheologist Wil Roebroeks at Univ Leiden .; and University Michigan anthropologist John Speth’s Springer Verlag 2010 The Paleoanthropology and Archaeology of Big-Game Hunting – Protein, Fat, or Politics?
Many sensible voices including locally like Kath Megaw encourage breastfeeding till at least a year in South Africa. Certainly http://www.nhs.uk/conditions/pregnancy-and-baby/pages/solid-foods-weaning.aspx doesnt say anything different from what sense and the authorities quoted below say- breast milk and then mushy whole food.
NICUS the Nutrition Info Centre of University Stellenbosch recommendations on line for 6-12mo infants certainly advocate increasing meats, fish, vegs, fruits & pulses. But the SA Guidelines on weaning 2012 Introducing solid foods from Stellenbosch University Dietetics says plainly “Complementary food is semi-solid porridges & milk that are given from six to eight months, then vegetables or fruit and then progressing to a mixed diet in mashed form small portions of solid food given until 12 months, when family foods are integrated”. ie NICUS advocates while weaning off breast, get baby (hooked) only on cereals for 2 months. where is the evidence to justify solely cereals as started diet? There is no good science published to justify this belief, marketeering; and no parallel in the non-primate infant world. .
NICUS say further: “Both early (< 4 months) and late (> 7 months) introduction of gluten should be avoided. Gluten should be gradually introduced while the infant is still being breastfed as this may reduce the risk of celiac disease, type 1 diabetes mellitus and wheat allergy.
“More than 14% of energy from proteins in the eight- to 24-month period may cause an early adiposity rebound and the development of overweight in young children. A dietary fat intake of 30-45% of total energy is recommended. The American Heart Association (AHA) has a limit of 40% fat of total energy with an emphasis on a more liberal intake of unsaturated fat and a focus onensuring adequate intakes of omega-3 fatty acids in infants and children.
In fact scientific evidence has never supported the obsession against eating (animal) saturated fat, triglycerides; nor human need for promoting the plant protein gluten. As we were and are taught in basic biology, only water, essential aminoacids- protein, essential fatty acids- fats- and the trace ~two dozen vitamins and minerals are, as eg all textbooks say, essential nutrients required for normal human body function that either cannot be synthesized by the body at all, or cannot be synthesized in amounts adequate for good health (e.g., niacin, choline), and thus must be obtained from a dietary source.[1] . So its marketing hype that gluten is any more of an essential macronutrient than sugar, carbohydrates .
Wiki succinctly lists essential ie indispensable macronutrients (like the trace ~two dozen micronutrient vitamins and minerals) as: Essential fatty acids (EFAs) and essential amino acid EAA nutrients
The Wiki entry on gluten has a major paragraph on the common problem of gluten intolerance (especially wheat) , but no claim that it is an essential nutrient- for the simple reason that the gluten-containing cereals eg wheat and related grains, (including barley and rye) are like carbs not essential foodstuffs, and commonly cause distant health problems.
But the alarming disinformation is in that RSA article Introducing solid foods table 1 and the NICUS table Nutrient requirements @ 6 to 12 mo. Their recommended figures are: “total fat RDA 30gm/d ie ~270kcals and protein 13.5gm ie 54kcals on a total average RDA calorie intake of 710kcals”. That leaves the majority ie the balance of the energy intake- 385kcals to be made up by carbohydrates – ie 385/4 = ~ 95gm carbs. That gives their recommended (non-protein) carbs:fat energy ratio as 385:270 ie >1.4– which they imply can come also from plant oils. This RDA contrasts with the long-known (see below) (white and black) mothers’ s breast milk carbs:(animal) fat energy ratio of almost half (of what NICUS recommends 1.4:1): 30:38 kcals/gm ie ratio~0.8.
And even more dangerously, that Univ Stellenbosch table gives the RDA of vitamin D as 5mg/d ie 40 000iu/d. Neither that gross overdose, nor 5mcg/d = 400iu/d, are near the modern proven necessity of perhaps 1000 iu/d in swaddled urban babies – the vast majority of whom in Africa are black and therefore make even less vit D3.
rice milk: as http://everythingbirthblog.com/2012/01/rice-milk-why-it-says-not-to-give-it-to-children-under-five/ rice / and Noakes’ team says, Rice/ricemilk – like the vast profitable fast food industry in baby purees and formulae- is ( like the killer Food mega-industry carbs and plantoil-based food pyramid of the past 40 years of Ancel Keyes ea ) a marketing (Gerber’s) legend, but not a necessity or good for babies- it lacks fat and protein; and may be contaminated with eg arsenic!
As the Real Food Revolution book II Raising Superheroes says, promoting natural real food is not about banning carbs or promoting high protein intake – thats impossible and unnecessary on mixed real food- but eating more fresh unprocessed energy, as mostly animal incl fish fat more than natural ie plant carbs, as in breast milk; with rarely if ever processed foods including synthetic transfats and refined carbs like sugars, “white” flours and starches, and the derived alcohols.
17 May 2015 ADAPTING AND ADOPTING BANTING FOR BABIES a la Canadian-WHO recommendations and age-old good practice. canada-guidelines-advise-meat-as-baby-first-food/ Health Canada clarifies stance on meat for babies
Prof Tim Noakes’ team asks for all to sign petitions supporting his argument. We can doubt he needs it since he knows better than most how strong the evidence is.
When us Seniors’ generation was born around WW2, as in ancient times we were from > 6 months age gradually weaned off breast onto and brought up on real fresh food- butter, cream, home-grown veggies, fresh fish and pasture-fed meat /hens (and thus eggs and whole cows’ milk); with a tsp of codliver oil a day as the quintessential brainfood for those of us not brought up on oily ie pelagic sea fish..
Food was produced (like us humans) – especially by us mostly poor – without antibiotics, GMO, pesticides; and packaged, dressed without plastic, let alone massive electromagnetic exposure (microwave, TV, computers, cellphones and then WiFi). Like most on the planet, we had no cars or TV, so we also got plenty of sunshine- vits cholecalciferol D3, and ascorbic acid C (from abundant organic sun-drenched fresh fruit) – and exercise walking/ cycling to transport/ school/ sport or outdoor work as herders, farm/ building labourers etc if not the minority of us in shops/ factories/ office. Basic education and care – literacy-numeracy and hygiene – was provided mostly by state schools competing widely with mission schools, staffed from dedicated teachers’ /nurses/theological training colleges with intensive community experience; and (if mostly from the bible) literate parents from church/ libraries and radio.
But in our >50 years in medicine, all those aeons-old social foundations have increasingly been wiped out , especially in Africa by the ever-more corrupt advertising (especially on TV) and Fast Food- GMO- Disease Industry in partnership with corrupt oligarchy government that closed teachers’ and nurses training colleges; and rural /farm depopulation with mass migration driven by government-led poverty to city ghettoes. .. .
Already by 1970, teaching hospitals- following USA -devised corrupt industry factory-farm-food marketeering (not science and nutritional evidence-based) – started (by the non-medical Ancel Keys) nagging us via our medical school cholesterol clinics to start cutting cholesterol ie meat- dairy- fat intake in exchange for increasing intake of factory mass-produced refined and then genetically modified and insecticide-laden carbohydrates (sugar, maize, soya) and unproven synthetic hydrogenated seed-oils; and cholesterol-busting drugs like clofibrate, the statins, and aspartame – none of which were ever scientifically validated, and have been increasingly incriminated like sugar, fructose and smoking the past 30 years as major health pollutants. .
The scientific evidence has never the past 50 years shown benefits even matching harms from the profit-driven junk marketing of cholesterol-busting drugs and diets – artificial low-animal -fat cholesterol high carbs diets , and synthetic omega6 hydrogenated plant oils like “margarines” and Cremora, and sunflower cooking oils – for any common disease let alone average lipidemias. But the American public was bludgeoned into obeyance/obeisance and then silence, and have suffered increasing obesity and disease ever since – to the joy of the profiteering Fast Food and Disease Industry and their lobbyists in and outside governments. Now the SA Dieticians’ Association attack Noakes (and thus pre-1960s healthy normal world practice, and still Canadian guideline) diet promotion of more animal fat calories than carbs calories for weaning infants;
but the milk comparison the Dieticians quote in their attack- like the figures in the breastmilk Wiki review – shows remarkable conformity between UK mothers’ breast milk and eg Bantu mothers (1950)- milk has about 26% more calories/100gm from animal fat ie +- 38cals than from milk carbs +- 30cals, with protein ~1.1g%.. Obviously, LCHF promoters do not preach no-carbs diets since there is no such real food free of carbs.
The message has always been to take more fat calories than carbs calories, especially not refined empty calories like sugar and commercial fructose-laden drinks and GMO maize. Laymen have difficulty grasping that these refined simple sugars are slow cumulative poisons like longterm smoking, aspartame (Canderel) , oral synthetic sexhormones, fluoride, aluminium, mercury, lead, excess iron, etc. And obviously with poverty and dependency increasing in RSA due to almost worst- in-the -world State schooling since 1994, infant mortality from joblessness and thus stress, violence , malnutrition are increasingly rife in the Born-Frees ie those born in the new South Africa since 1990.
The Diet Association fails to ask simply: where are the references for promoting protein-and fat-rich food for weanlings? They are listed abundantly in the social and medical literature of the past century, especially the current literature we seniors in health science practice have read weekly the past 50 years from the 1960s; and conveniently now analyzed in depth by medical journalist Nina Teicholz and her numerous experts of the past 50 years she interviewed, in chapters 5 and 6 of The Big Fat Surprise 2014 (Scribe Pubs, Australia & UK);
following in the footsteps of contrarian ie high-carbo-sceptic investigative nutritionists like the archetypal insulin-resistant William Banting 1869 (ironically a distant kinsman of Fred Banting the Nobel-winning discoverer of insulin 50 years later) and his physician Dr William Harvey; Vilhjalmur Stefansson from 1923; Arthur Pennington 1949; Robert Atkins since 1963, Gerald Reaven from 1965 (Syndrome X); WPU Jackson & George Campbell in Cape Town from 1968, Denis Burkitt and Tom Cleave in Africa from 1970, James le Fanu since 1984 (the Rise and Fall of Modern Medicine 2001); Gary Taubes since 2001 (Good Calories Bad Calories 2007); Rooseboom ea 2006 (The Dutch Winter Famine of 1944-45); and Sam Feltham Slimology 2014, the 25 RCTs so far from many universities reported between 2000 and 2014 that Feltham et al detail eg ( in his book Slimology) by numerous contrarian academic clinician experts; all these authorities show that for health and reversing obesity in adults, the LCHF diet is uniformly more successful than the HCLF diet.
Increasing adverse experience with antibiotics, multiple vaccines, factory foods eg formula milk powders, GMO crops, tap water, doctored dairy milk, aspartame, pesticides like DDT and Roundup glyphosphate, crops grown in heavily polluted but nutrient-exhausted soil, and grain/antibiotic/hormone grown foods partly explains why we should avoid as far as possible exposing (future and current) pregnant women and infants to antibiotics, sugar, concentrated fructose, commercial dairy and processed refined cereal products, and aluminium-mercury-tainted vaccines, as far as possible.
In conclusion: it is sad that ADSA the Association for Dietetics in SA, attacks evidence-based Banting proponents personally instead of rebutting in academic scientific robust debate – the scientific media- the best scientific references and policies as thoroughly assessed and promoted by real-world experts below. Clearly, ADSA cannot quote any good science to support its contrary destructive commerce-based policy (of the past ~40 years ) about diet providing the majority of energy as sugars and hydrogenated omega6 – (it and the local medical schools havent done so) instead of low carbs high animal-fat natural food- so now it hides behind the sub judice rule.
ndb
REFS:
Gwyneth Paltrow 2013 has provoked the wrath of the dietetic establishment by saying that she avoids feeding her children bread, rice and pasta, because she believes that these carbohydrate foods aren’t good for them. Paltrow was writing in her new low-carb, gluten-free cookbook, It’s All Good, which is out in April, and whose recipes are said by her publisher to “form the basis of the diet Gwyneth goes back to when she’s been overindulging, when she needs to rebuild, or lose weight.” Dieticians who subscribe uncritically to government nutritional guidelines have been wheeled out to testify to how ‘vital’ carbohydrate is in the diet, and warn in the bleakest terms of the dangers of restricting it. “Paltrow is putting her children, aged eight and six, “at risk of nutrient deficiencies”, warns one. Her children “won’t be able to think straight as their brain won’t be functioning”, says another. In the same Daily Mail piece, it is even observed that Paltrow’s children are thin – shock horror! – as if this was automatically cause for concern. So accustomed are we to the sight of overweight children, thin ones are beginning to look unusual …… read on
Dr Sheila Innis’ recent review Impact of maternal diet on human milk composition and neurological development of infants Am J Clin Nutr. 2014;99:734S-41S. http://www.ncbi.nlm.nih.gov/pubmed/24500153 from Univ British Columbia, Vancouver, Canada concludes unequivocally what vast evidence shows: that animal fat especially Omega3 marine DHA & EPA are crucial for neurodevelopment and all membranes – such natural saturated animal fats make up some 20% of adult brain. Maternal nutrition has little or no effect on many nutrients in human milk; for others, human milk may not be designed as a primary nutritional source for the infant; and for a few, maternal nutrition can lead to substantial variations in human milk quality. Human milk fatty acids are among the nutrients that show extreme sensitivity to maternal nutrition and are implicated in neurological development. Extensive development occurs in the infant brain, with growth from ∼ 350 g at birth to 925 g at 1 y, with this growth including extensive dendritic and axonal arborization. Transfer of n-6 (omega-6) and n-3 (omega-3) fatty acids from the maternal diet into human milk occurs with little interconversion of 18:2n-6 to 20:4n-6 or 18:3n-3 to docosahexaenoic acid (DHA) and little evidence of mammary gland regulation to maintain individual fatty acids constant with varying maternal fatty acid nutrition. DHA has gained attention because of its high concentrations and roles in the brain and retina. Studies addressing DHA intakes by lactating women or human milk amounts of DHA at levels above those typical in the United States and Canada on infant outcomes are inconsistent. However, separating effects of the fatty acid supply in gestation or in the weaning diet from effects on neurodevelopment solely due to human milk fatty acids is complex, particularly when neurodevelopment is assessed after the period of exclusive human milk feeding
. The Canada guidelines The Canadian statement 2013 reads unequivocally: POSITION STATEMENT Weaning from the breast: Barbara Grueger; Canadian Paediatric Society , Community Paediatrics Committee Paed Child Health 2013: updates the similar previous Canadian Paediatric Society position statement 2004.[3] ” – “North American parents have traditionally introduced rice cereal as a first food. There seems to be a movement away from this practice in the general mama community, especially white rice cereal. Baby-led weaning is a method of foods introduction wherein the baby is offered whole foods. The baby has complete control with this method. For example, you steam a whole artichoke, place it on baby’s tray and allow him to decide what to do with it. Infant cereal, pureed meats and fish are recommended as first foods by the American Academy of Pediatric AAP, Canadian Paediatric Society (CPS), Dieticians of Canada, Breastfeeding Committee for Canada, Public Health Agency of Canada, and Health Canada. CPS also identifies poultry, cooked egg yolk and well-cooked legumes (beans, lentils, chick peas) to be good sources of iron and suitable for first foods”.) Exclusive breastfeeding provides optimal nutrition for infants until they are six months old. After six months, infants require complementary foods to meet their nutritional needs. This is when weaning begins. Weaning is the gradual process of introducing complementary foods to an infant’s diet while continuing to breastfeed. The timing and process of weaning need to be individualized by mother and child. Weaning might be abrupt or gradual, take weeks or several months, be child-led or mother-led. Physicians need to guide and support mothers through the weaning process. “Breast milk is the optimal source of nutrition in infancy. Breastfeeding protects infants from a wide array of infectious and noninfectious diseases. With few exceptions,[1] healthy term infants require only breast milk (with vitamin D supplementation) [2] to meet all their nutritional requirements until they are about six months old. The Canadian Paediatric Society, Dietitians of Canada, Health Canada and the WHO recommend exclusive breastfeeding for the first six months of life and continued breastfeeding with complementary foods for up to two years and beyond (no upper limit has been defined). Iron from meat has the best bioavailability[4][17] and can be readily absorbed from the gastrointestinal tract. After six months of age, when breastmilk alone cannot provide enough, additional protein sources (such as meat, fish, egg yolk, tofu, lentils and cheese) are needed. Roughage should also be introduced to the diet, although it is not clear when adding fibre becomes necessary. There is no conclusive evidence that delaying the introduction of eggs, fish and nuts (including peanuts) beyond four to six months of age helps to avoid food allergies.[13][18][19] As a greater variety of solids and liquids are introduced to a baby’s diet, weaning will progress. “A review of the literature using MEDLINE (1966 to 2012), the Cochrane database and relevant websites, WHO, the Canadian Paediatric Society, Health Canada and the American Academy of Pediatrics, concluded: Given the limited nature of evidence on weaning, the recommendations in this statement are based largely on expert opinion and consensus. “Generally, infants were breastfed longer in ancient times[8] than in Western societies today. Mothers in Zulu societies have traditionally breastfed their infants until 12 to 18 months, at which point a new pregnancy would be anticipated. Ancient Hebrews completed weaning at about three years. Around the world it is not uncommon for children to be completely weaned at two to four years of age.[9] Anthropological studies have described final weaning at the following points: when the infant reaches four times his birth weight; when the infant’s age is six times the length of gestation (ie, 4.5 years); or when the first molar erupts.[9][10] “The early introduction of mixed feedings began in early 19th-century Western society. Prominent contemporary physicians such as American Pediatric Society founders Drs. Luther Emmett Holt and Job Lewis Smith recommended that weaning begin at around nine to 12 months of age or when the canine teeth appeared. Smith recommended against weaning during the summer months because of the risk of “weanling diarrhea”. As weaning was recommended earlier and earlier, infant mortality increased. Introduction of weaning foods was an important cause of infant mortality in the 19th century. In the early 20th century, mothers were encouraged by the medical community to raise their children scientifically or “by the book”. In the 1920s, the United States government published Infant Care, referred to at the time as the “good book” and read by women from all socioeconomic groups. It recommended cod liver oil, orange juice and artificial feeding.[8] “In 2008, according to the Public Health Agency of Canada, 87% of children were breastfed for some period of time while only 16.4% were exclusively breastfed for six months. Still, this figure represents a steady increase in breastfeeding rates over the previous five years. Breastfeeding duration varies depending on maternal age. Only 11% of infants of mothers aged 25 to 29 years continue to breastfeed exclusively for six months, compared with 20% of infants of mothers 35 years or older.[11] The most common reason mothers give for weaning is a perceived insufficiency in milk supply. Women who breastfeed for longer than three months most often cite return to work as their reason for weaning.[11] Canadian breastfeeding practices may continue to improve because many mothers receiving employment insurance can delay their return to work for 12 months postpartum. Nutritional and developmental issues : At around four to six months of age, most infants are developmentally ready to handle puréed foods. They are developing the oral motor coordination necessary to accept different food textures. However, they are at risk for choking on chunky food pieces such as nuts, whole grapes and hot dog wheels that require advanced oral motor coordination not achieved before three years of age. “Sucking and chewing are complex behaviours with reflex and learned components. The learned component is conditioned by oral stimulation. If a stimulus is not applied while neural development is occurring, an infant may become a poor eater. There is a relationship between prolonged sucking without solids and poor eating.[7] While it is ideal for infants to be exclusively breastfed for six months, it is also true that after a certain age, human milk alone cannot supply all of an infant’s nutritional requirements.[6][13] Individual circumstances may make it appropriate for some infants to start complementary feedings as early as four months of age.[13][14] “Age-appropriate intake of calories and micronutrients is important for growth, motor and mental development.[12][13] Delaying the introduction of nutritional solid foods much beyond six months of age puts an infant at risk for iron deficiency anemia and other micronutrient deficiencies.[15] Picciano et al followed older weaning infants (12 to 18 months of age) by collecting data on dietary intake and growth. Many of the study children were ingesting less than the recommended levels of fat (less than 30% of total calories), iron and zinc. Grains, whole milk, dairy products and meats were identified as important sources of iron, vitamin E and zinc.[16] By four to six months of age, iron stores from birth are diminishing, necessitating the introduction of iron-containing foods at six months of age for all infants.[4] Iron supplementation after the first weeks of life or at four months of age for the exclusively breastfed infant has been recommended by some groups.[14] When there is a delay in introduction of iron fortified foods, oral iron supplementation needs to be considered.[14] The process of weaning While the best method for transitioning from fully breastfeeding to complete nutritional independence is not known, the process should meet the needs of both baby and mother.[20] Physicians may refer mothers to the La Leche League’s website and the Canadian Paediatric Society’s Caring for Kids website (see Resources for parents, below). Weaning can be either natural (infant-led) or planned (mother-led). Gradual weaning (infant-led weaning) occurs as the infant begins to accept increasing amounts and types of complementary food while still breastfeeding on demand. With gradual weaning, the complete wean usually occurs between two and four years of age.[8] In Western cultures, there remains a relative intolerance to this type of weaning and many mothers who breastfeed their older baby or child become “closet nursers”. Closet nursing takes place privately, at home. This relative secrecy tends to compound erroneous beliefs about appropriate breastfeeding duration.[7]
2012: .http://www.cbc.ca/news/health/steak-and-tofu-recommended-for-babies-1.1199034 and
http://www.thestar.com/news/canada/2012/09/24/hold_the_pablum_’give_that_baby_some_meat’_new_canadian_guidelines_advise.html : Megan Ogilvie Health Reporter, 2012 Forget squash and sweet potatoes; steak is now recommended for baby’s first solid food. In a major departure, new Canadian guidelines say parents should be offering their six-month-old infants meat, fish, poultry or meat alternatives two or three times a day.. these iron-rich foods should be the first that babies consume when being introduced to solids. The recommendations, part of a joint statement quietly released last week by Health Canada, are sure to give some parents pause. Previously, it was recommended that babies start out eating infant cereals, followed by fruits and vegetables, as they transition to solid foods.
Healthy Pregnancy, Baby & Child by Sarah TheHealthyHomeEconomist One of most misguided and damaging pieces of advice coming from the vast majority of pediatricians, dieticians, and other “experts” is to give rice cereal as a baby first food around the age of 4-6 months. This advice is extremely harmful to the long term health of the child, contributing greatly to the epidemic of fat toddlers and the exploding problem of childhood obesity. Rice cereal is never a healthy baby first food. Not only is it an extremely high glycemic food when eaten alone (spikes the blood sugar) but it also contains ample amounts of double sugar (disaccharide) molecules, which are extremely hard for such an immature digestive system to digest. The small intestine of a baby mostly produces only one carbohydrate enzyme, lactase, for digestion of the lactose in milk. It produces little to no amylase, the enzyme needed for grain digestion until around age one.Now, at least one governmental body is waking up to the harmful notion of cereal grains as the “ideal” baby first food. Health Canada in collaboration with the Canadian Pediatric Society, Dietitians of Canada and Breastfeeding Committee for Canada has issued new guidelines for transitioning a baby to solid food and two of the first weaning foods recommended. Meat and eggs! While these guidelines are certain to rile vegetarian and vegan groups, the fact is that meat and eggs are indeed perfect weaning foods for a baby. Not only are these animal foods extremely easy to digest compared with cereal grains, but they also supply iron right at the time when a baby’s iron stores from birth start to run low. The inclusion of meat in these baby first food guidelines is in line with the wisdom of Ancestral Cultures which frequently utilized animal foods for weaning. A traditional first food in African cultures is actually raw liver which the mother would pre-chew in small amounts and then feed to her child. The guidelines specifically note the role that ancient wisdom played in the decision to no longer recommend cereal grains and instead suggest meat: “While meat and fish are traditional first foods for some Aboriginal groups, the common practice in North America has been to introduce infant cereal, vegetables, and fruit as first complementary foods.” Soft boiled egg yolks are also an ideal choice as a baby first food as they supply ample iron as well as choline and arachidonic acid which are both critical for optimal development of the baby’s brain which grows as its most rapid rate the first year of life. Unfortunately, while the suggestion of meat and eggs is a good one, the joint statement from Health Canada also inexplicably includes tofu and legumes which are both a terrible choice as a baby first food. The starch in legumes would cause the same digestive problems as rice cereal and the endocrine disrupting isoflavones in tofu would be a disaster for baby’s delicate and developing hormonal system. But, let’s give credit where credit is due. At least meat and eggs are appropriately included on the baby first food list. Good on you Health Canada! Perhaps your neighbor country to the South will wake up and get a clue about how to properly feed babies based on your lead. I’m not holding my breath. Sarah, The Healthy Home Economist
Int J Obes (Lond). 2005;29 Suppl 2:S8-13. How much protein is safe? Agostoni C1, Riva E. ea University of Milan, Italy Since breastfeeding and human milk seem to prevent, while high dietary proteins in the first 2 yr of life seem to promote later overweight, questions have been raised on the safe levels of proteins in the early years. How much protein (as a percentage of total calorie intake) is safe RESULTS: We should move from the figure of 7-8% in the 4-month exclusively breastfed infants up to the maximum acceptable levels of 14% in 12-24-month-old infants. When protein supply represents less than 6% and energy is limited, fully breastfed infants are likely to enter a status of negative nutrient balance. Over the limit of 14% energy from proteins in the 6-24 months period, some mechanisms may begin to operate, leading young children towards an early adiposity rebound and overweight development, beyond any genetic predisposition. Preliminary data seem to indicate a causal role for whole cow’s milk proteins. CONCLUSION: We suggest maintaining breastfeeding as long as possible, and, in case human milk is insufficient, to introduce infant formulas, appropriate for age, up to 18-24 months, in order to keep protein intakes in the safe range of 8-12% within a diet adequate in energy and balanced as far as macronutrients.
Health Canada clarifies stance on meat for babies By Global News with files from Jennifer Tryon Health September 25, 2012 Health Canada is clearing the air about what kind of solid foods babies should be introduced to. The clarification comes after some media outlets reported Tuesday that the agency changed its list of recommended first foods for Canadian babies to include meat and meat alternatives – like eggs, tofu and legumes – to help meet nutritional needs. For the record, Health Canada has not recently modified these guidelines. Since 2004, the agency has recommended iron-rich foods, such as meat and iron-fortified cereal, as a baby’s first solid foods, because iron is crucial to brain development. Most baby cereals now contain iron. There is no scientific evidence suggesting meat is harder on a baby’s digestive system, but parents are reminded to puree the meat with water or breast milk, so it’s easier for the child to swallow. Registered dietitian Cora Rosenbloom also tells Global National‘s Jennifer Tryon that there’s no reason to withhold eggs. “There’s really no evidence to say that food allergies are going to be more common if eggs are introduced earlier.” Link to Health Canada’s current recommendations. Follow Jennifer on Twitter: @JenTryon
Posted in DIET BANTING, Food & Diet, overweight prevention, PAEDIATRICS
Tagged Banting, breast feeding, Childers, Feltham, Gail Kennedy, Gail Kennedy UCLA, Guts and Brains, Harcombe, HCLF, Health Canada, John Speith, LCHF, Malhotra, Nicus, NICUS errors, Noakes, Phineas, Raising Superheroes, Real Food Revolution II, Roebroeks, Steffanson, The Keto Diet for Hralth, Westman
note that quotations are in italics.
update 14 Sept 2016 neil.burman@gmail.com having just received a sorrowful posting from Diana below, I now discover that there are a number of similar complaints that I had missed and not posted; so I have now posted them under comments. This condition is such a nightmare for sufferers that I post them as you submitted them, with your name and email if thats how you sent them. I can delete your contacts if you like, but the more you sufferers communicate and exchange ideas the better for sufferers.
Sufferers must surely have tried some nonirritating local anaesthetic cream, or eg virgin coconut oil, or simply massage for relief.
given the risk of even low strength estrogen cream being well absorbed from mucous membranes more than from skin, and thus (altho beneficial for brains, bones, skin, heart etc) potentially adverse for endometrium, breast, and many other target organs, we leave the vascular engorger estrogen as the last resort- first try anything but topical sex hormonesl then if still desperate, sparingly up to 3% progesterone cream; testosterone cream is also healing, but virilizing ie not to be used if arousal, clitoromegally, breast proliferation is not wanted.
Since my 2009 review, there are some 15 new abstracts in English on Pubmed from USA, Canada, Europe, Israel and Japanese groups. There dont seem to have been any major breakthroughs in management of this rare and distressing disorder. Antiepileptics may be promising- like cannabinoid oil , and the ketogenic diet are, in epilepsy.
Since the brain responds so well to more natural dietary fats (eg animal triglycerides, MCT- coconut oil, fish oil ie EPA, DHA) and withdrawal of excitogenic glucose loading that most people indulge in, and so many patients today are overweight with estrogenizing glucose insulin resistance, in general I encourage patients to think of epilepsy let alone memory loss (including Alzheimers) and mood disorders as brain diabetes, glucose toxicity with deprivation of good needed dietary fats; and thus to try Banting diet rather than the populist fast food industry-promoted disasterous high carbs low fat low cholesterol fad of the past 50 years. This simple dietary advice is at worst harmless distraction, and generally beneficial for the unhappy women with multifactorial PGAD,
Given their ubiquitous benefits in so many disorders, harmless trial is warranted with: vigorous vitamin D3 replacement to the commonly optimal level around 100ng/ml (which may require the average safe 10 000 iu vit D3.day, but perhaps 10 times that with unpredictable vitamin D resistance) seems worth considering for this rare but extremely distressing disorder ie PGAD;
antidepressants;
cannabinoid oil;
lowdose naltrexone LDN;
hypnotherapy has been reported helpful, but potentially hazardous.
If not obviously due to psychiatric, or tumour eg Tarlov cysts, or pelvic venous problems, PGAD may be likened to variant true epilepsy or the only somewhat less common PNES syndrome – psychogenic non-epileptic seizure syndrome – that like PGAD has been increasingly recognized only this millennium, and which is overall even more of a dis-ease and psychiatric problem that true epileptic diseases, .
abstracted English refs published since 2009 review:
J Sex Med. 2014 Jan;11(1):136-9. A periclitoral mass as a cause of persistent genital arousal disorder. Bedell S1, Goldstein AT, Burrows L.New York University describe a woman who developed PGAD in association with a periclitoral mass, a potential physical cause of the disorder that has not been previously described in the medical literature.A postmenopausal woman presented with 6 months of persistent, unrelenting genital arousal and clitoral pain that was unrelated to sexual stimuli. Careful examination revealed a tender, firm, mobile, left-sided mass that appeared to compress the dorsal nerve of the clitoris.Complete excision of the mass resulted in full resolution of her symptoms over several weeks. Localized causes of persistent genital arousal, though rare, should be included in the differential diagnosis PGAD as detection and treatment can lead to a complete recovery.
J Sex Med. 2013 Jun;10(6):1549-58. Cognitive and emotional determinants characterizing women with persistent genital arousal disorder. Carvalho J1, Veríssimo A, Nobre PJ. Porto, Porto, Portugal. joana.pereira.carvalho@gmail.com The aim of this study was to characterize the cognitive and emotional style of women reporting PGAD. More precisely, the content of sexual beliefs, thoughts, and emotions during sexual intercourse was explored.Forty-three women presenting PGAD and 42 controls responded to a web survey. This study was cross-cultural in nature and women worldwide (over 18 years old) were asked to participate. After controlling for sociodemographic characteristics and psychopathology, findings showed that women reporting PGAD symptoms presented significantly more dysfunctional sexual beliefs (e.g., sexual conservatism, sexual desire as a sin), as well as more negative thoughts (e.g., thoughts of sexual abuse and of lack of partner’s affection) and dysfunctional affective states (more negative and less positive affect) during sexual activity than non-PGAD women. Notwithstanding the impact of neurophysiological determinants in the etiology of this syndrome, results support the psychological conceptualization of PGAD and highlight the role of cognitive-behavioral therapy (CBT) for PGAD symptomatology. More specifically, cognitive and behavioral strategies would be aimed at targeting maladaptive sexual beliefs and thoughts, as well as regulating negative affective states resulting from a dysfunctional cognitive style regarding sexuality. In all, CBT in association with a medical/pharmacological approach, could be clinically relevant in the management of PGAD.\
J Sex Med. 2013 Feb;10(2):439-501 Persistent genital arousal disorder: characterization, etiology, and management. Facelle TM1, Sadeghi-Nejad H, Goldmeier D.New Jersey Medical School-Surgery-Urology, Newark, NJ 07103, USA.. Since its first description in 2001, many potential etiologies and management strategies have been suggested. To review the literature on PGAD, identify possible causes of the disorder, and provide approaches to the assessment and treatment of the disorder based on the authors’ experience and recent literature.PubMed searches through July 2012 were conducted to identify articles relevant to persistent sexual arousal syndrome and PGAD. PGAD is characterized by persistent sensations of genital arousal in the absence of sexual stimulation or emotion, which are considered unwanted and cause the patient at least moderate distress. The proposed etiologies of PGAD are plentiful and may involve a range of psychologic, pharmacologic, neurologic, and vascular causes. PGAD has been associated with other conditions including overactive bladder and restless leg syndrome. Assessment should include a through history and physical exam and tailored radiologic studies. Treatment should be aimed at reversible causes, whether physiologic or pharmacologic. All patients should be considered for cognitive therapy including mindfullness meditation and acceptance therapy.
posted 2009:
Restless Legs (Ekbom’s) Syndrome, common with iron deficiency, diabetes, kidney failure etc, is bad enough. But combination with restless genitals is an awful prospect. Normally it is men who famously have restless genitals that cannot be sated…
Sandra Leiblum first described persistent genital arousal disorder in women in 2001, and since then has reported on some 171 cases in New Jersey.
Marcel Waldinger now reports on some 23 cases in the Netherlands; with average age of onset around 50years ie menopause. His group has now characterized this disorder as having:
restless leg syndrome and/or an overactive bladder, urethral hypersensitivity; involuntary genital arousal with unprovoked orgasms, onset often during early menopause, as well as the 5 diagnostic criteria of persistent genital arousal disorder (PGAD) – :
Leiblum discriminates such disorder from Female Sexual Arousal Disorder on the basis that “FSAD women displayed the greatest problems in desire, arousal, lubrication, orgasm, and pain while women with PGAD reported somewhat more desire than the control group but did not meet the cutoff score for sexual dysfunction.
It is strange that no other gyne or sexual health clinics in the world have so far reported clusters of such patients as have these two clinics in New Jersey and Den Hage .
Leiblum ea could elicit only perhaps 1 such case (ie 1%) at a sexual health clinic in London UK. From an Internet survey she reported in 2007 that in the 50% of cases who had all 5 diagnostic criteria, “ they were significantly more likely to be depressed (55% vs. 38% who did not have all 5) and to report panic attacks (31.6% vs. 14.6%). They were more anxious and more likely to monitor their physical sensations. Both groups reported high rates of childhood and adult sexual abuse, although the PGA women reported a higher prevalence of sexual victimization. They were significantly more likely to endorse negative feelings about their genital sensations and also more likely to complain of chronic fatigue syndrome than women without the condition (10% vs. 0%). There were no significant relationships with pharmacologic agents and symptoms. It is hypothesized that for a subset of women, psychological factors, namely anxiety, reinforce exacerbate and maintain PGAD.”
But they have anything but nymphomania (origin 1775: Oxford English dictionary), although they may be so mislabeled ie pseudo-nymhomania (Fenichel 1933). Kinsey’s 1948 book on Female Sexual Responsiveness did not even mention, index nymphomania. Kuperman 1961 in his chapter on Sex Hormones unknowingly implies the difference between nymphomania and pseudonymphomania: “nymphomania may occasionally be treated successfully and paradoxically with androgens.. these patients who respond to androgens by a decrease in desire for frequent stimulation are probably those who have been unable to achieve satisfying orgasm, which androgen provides.. in other such patients, progesterone suppositories as an antiandrogen agent may diminish unwanted desire and erotic tendencies. ”
Stuckey ea describe a single case who was cured by coil embolization of pelvic varicose veins- a more realistic therapy than embolization of the clitoris to infarct it, or amputation as was practiced by eminent UK physicians in Victorian times.. .
MANAGEMENT:
Women with RGS/PGAS do not have either a central arousal disorder or craving for love/attention, but vascular- neuropathic clitoral engorgement; which topical progesterone or anaesthetic eg lignocaine cream may relieve by treating the endpoint, not the cause.
If varices are the strong associate, perhaps it is worth considering the pathophysiology of varices, which are apparently often associated with sensory neuropathy, presumably through swelling pressure on nerves – local varicose oedema. Vercellini ea note that pelvic varices are one common cause of pelvic pain in women.
Increased pressure and thrombosis aside, varicose veins are strongly associated with female gender, ie with testosterone:estrogen level about 1/200th of that in middle-aged men, and loss of collagen (ie ascorbic acid) in smooth muscle and extracellular matrix.
Higher female estrogen is associated with stronger bones, and oedema, stress incontinence and vascular relaxation; but it notoriously contributes nothing to muscle growth and strength except in the unique uterus itself – only estrogen grows the uterus. Only androgen grows body muscle mass and strength. From early menopause, testosterone falls gradually; but especially with fattening, estradiol falls gradually but fat-derived estrone increases, reversing the premenopausal estradiol>estrone dominance. Hence across midlife women mostly shrink their skeletons and lean mass but expand their fat mass steadily- ie couch potatoes develop increasing fatness frailty.
Hence (compression stockings for varicose legs aside), especially in women, apart from raising the legs, the foot of the bed at night, we commonly see varicose vein discomfort and distension in the legs and anus (piles) relieved by a few grams of bioflavinoid – ascorbic acid blend a day. A topical cream may augment this.
And as regards neuropathy of the legs, apart from GABA plus 5HTP for nonspecific relief, we often see significant improvement with a vigorous blend of nerve nutrients including vitamins BCo, zinc and alphalipoic acid.
It may add to understanding of this awful problem if other sufferers contribute their experience. Anonymity will obviously be preserved if their comments are published.
UPDATE 22 APRIL 2016: BREAST SCREENING OF WELL WOMEN BY SOUTH AFRICAN MEDICAL SCHEMES : a reminder:
DIAGNOSTIC xray mammography is an invasive DIAGNOSTIC procedure FOR A BREAST LUMP/BLEEDING that irradiates and crushes the breasts; and is therefore universally recommended by independent experts and trials ONLY for women ( with a breast lump) where cancer needs to be excluded; and provided as a free service by the state every 10 years, and by medial schemes as a prescribed medical benefit PMB on demand.
Prof Michael Baum University College London, London responded: “Catch it early, save a life and save a breast’: this misleading mantra of mammography: The one thing every layperson and politician knows with confidence with regard to breast cancer is that you’ve got to ‘catch it early,’ preferably before you can even feel it. It may come as a shock to some readers, but I disagree and there’s such a thing as ‘catching it too early’. Like Peter Gøtzsche in the current edition of the JRSM,1 the global breast cancer screening programme has to be considered a ‘failed experiment.’ I also agree that the screening service as now provided should be closed down. I would go on to suggest that all the human and technological resources released by the closure of the National Health Service Breast Screening Service (NHSBSP), be redeployed into more fruitful areas for enhancing women’s health. That aside we have much to learn from the fact that the experiment, set up in good faith, has indeed failed to live up to our expectations. The mantra, ‘Catch it early, save a life and save a breast’, turns out to be a false promise. Screening may have a borderline effect on reducing cause-specific mortality but does not save lives as judged by the outcome measure of all-cause mortality.2 As far as saving breasts is concerned, the opposite is the truth. Populations of women attending for screening have a greater chance of a mastectomy than any control group.2
The hypothesis being tested in the experiment originated in the last half of the 20th century and was based on the assumption of the log linear kinetics of cancer development with distant dissemination being determined by the size (a poor surrogate for ‘age’) of the cancer. This was considered so self-evident as to have been translated into an ideological expression of faith. Yet, the experiment failed. The national breast screening programmes around the world have provided us with a natural experiment of the greatest historical importance, first, because it failed to deliver and, second, because of the recognition that mammography in asymptomatic women leads to the over-diagnosis of ‘pseudo-cancers’.3
Cancer was defined by its microscopic appearance about 200 years ago. The 19th century saw the birth of scientific oncology with the discovery and use of the modern microscope. Rudolf Virchow, often called the founder of cellular pathology, provided the scientific basis for the modern pathologic study of cancer.4 As earlier generations had correlated the autopsy findings observed with the unaided eye with the clinical course of cancer 100 years earlier,5 so Virchow correlated the microscopic pathology of the disease. However, the material he was studying came from the autopsy of patients dying from cancer.
In the mid-19th century, pathological correlations were performed either on cadavers or on living subjects presenting with locally advanced or metastatic disease that almost always were pre-determined to die in the absence of effective therapy. Since then without pause for thought, the microscopic identification of cancer according to these classic criteria has been associated with the assumed prognosis of a fatal disease if left untreated. There is a syllogism at the heart of the diagnosis of cancer and therefore runs like this; people frequently die from malignant disease, under the microscope this malignant disease has many histological features we will call ‘cancer,’ ergo anything that looks like ‘cancer’ under the microscope, will kill you. I would therefore like to restate the argument, that some of these earliest stages of ‘cancer’ if left unperturbed, would not progress to a disease with lethal potential. These pathological entities might have microscopic similarity to true cancers, but these appearances alone are insufficient to predict a life-threatening disease. If we stand back and take a broader look at nature this shouldn’t be surprising.
Conventional mathematical models of cancer growth are linear or logarithmic, in other words completely predictable at the outset; predicting transition from in-situ phases to early invasive and from early invasive to late invasive over time. Most natural biological mechanisms are non-linear or better described according to chaos theory. The beauty of the tree in full leaf and the symmetry of a sprig of broccoli, reflect their fractal geometry that looks remarkably similar to the appearance of the mammary ducts and lobules under the microscope.6 The rate of growth and the development of the lung along with the fingers and toes in the fetus cannot be described in linear terms. Prolonged latency followed by catastrophe should not be all that surprising.7 We accept the case for prostate cancer, as we know that most elderly men will die with prostate cancer in situ and not die of prostate cancer. In fact, the UK national PSA screening trial (ProtecT) is predicated on that fact with two a priori outcome measures defined, deaths from prostate cancer versus the number of cancers over-detected and treated unnecessarily.8
Further support for this contention comes from other sources. For example, there has been an epidemic of bilateral mastectomies in the USA following the uncontrolled proliferation of MRI scans in the routine work-up of women presenting with a single focus of early breast cancer.9,10 The MRI scan is guilty of unveiling not only latent foci of pseudo-cancers outside the index quadrant but also latent foci harboured in the contra-lateral breast. This is heartbreaking when one considers all the work over three decades and all the patient volunteers in trials of breast conservation.11,12 We now know with the utmost confidence that breast-conserving surgery is a safe alternative to more radical surgery, yet that hard won knowledge is brutally ignored when the surgeon is induced to treat the MRI image rather than the patient. Next, it is worth noting that contrary to all common sense predictions, the increased rate of detection of duct carcinoma in situ has led to an increase in the mastectomy rate for the screened population.2,3 Up to 45% of screen detected cases of duct carcinoma in situ end up having mastectomy because of the multi-centricity of the disease.13 Yet, the paradox is that clinically detected multi-centric invasive breast cancer is relatively uncommon.14 In conclusion, therefore, we can state, with a great deal of conviction, that a large proportion (in the order of 50%3) of screen detected (pre-clinical) foci of breast cancer is not programmed to progress if left unperturbed. This observation is of seismic importance and could set the agenda for breast cancer research for the next decade. If we choose to ignore these observations, because they fail to support our ideological belief system, then we will have missed an opportunity of a lifetime and that would be unforgivable.
The superiority of even ultrasound screening over xray mammography has been shown in women with dense breasts (like most today in our obese society) in Br J Cancer. 2015 ; 112: 998–1004. A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women Shen ea, Chinese women tend to have small and dense breasts and ultrasound is a common method for breast cancer screening in China. However, its efficacy and cost comparing with mammography has not been evaluated in randomised trials. Methods: At 14 centres across China during 2008–2010, 13 339 high-risk women aged 30–65 years were randomised to be screened by mammography alone, ultrasound alone, or by both methods at enrolment and 1-year follow-up. Results: Among the 30 cancers (of which 15 were stage 0/I) detected, 5 (0.72/1000) were in the mammography group, 11 (1.51/1000) in the ultrasound group, and 14 (2.02/1000) in the combined group (P=0.12). In the combined group, ultrasound detected all the 14 cancers, whereas mammography detected 8, making ultrasound more sensitive (100 vs 57.1%, P=0.04) with a better diagnostic accuracy (0.999 vs 0.766, P=0.01). There was no difference between mammography and ultrasound in specificity (100 vs 99.9%, P=0.51) and positive predictive value (72.7 vs 70.0% P=0.87). To detect one cancer, the costs of ultrasound, mammography, and combined modality were $7876, $45 253, and $21 599, respectively.
update: 28 July 2015 Mammography’s $4-Billion Problem Millions of women receive false-positive results annually, and 20,000 are overtreated. by Shannon Firth WASHINGTON — For too many women, breast cancer screening does more harm than good, a researcher said here. Thermography is a non-invasive imaging procedure which uses a heat-sensitive camera to capture an image of the human body. Since we are pretty much symmetrical beings, seeing one breast significantly warmer than the other would be a red flag, suggesting the presence of a heat-generating lesion. The lesion could be an abscess, or increased blood vessels feeding an early tumor, or simply a recent hematoma from injury. In any case, no radiation is used to obtain the image, there is no compression of the breast, and the study can be repeated frequently with no risk of inducing neoplastic transformation. Studies show that thermography can diagnose significant inflammatory disease up to several years before a mammogram shows calcification. Insurance does not pay for this test. Thermography does not diagnose cancer. Nor does mammography. At least thermography is helpful and does no harm. And if a mass is palpated, then excisional biopsy is indicated no matter what the tests show. Common sense needs to prevail.
July 06, 2015 Mammograms Again Found to Have No Impact on Mortality JAMA Intern Med. . Breast Cancer Screening, Incidence, and Mortality Across US Counties Harding, Pompei; Burmistrov, Welch, Abebe, Wilson, Harvard University, Cambridge, Massachusetts Importance Screening mammography rates vary considerably by location in the United States, providing a natural opportunity to investigate the associations of screening with breast cancer incidence and mortality, which are subjects of debate. Objective To examine the associations between rates of modern screening mammography and the incidence of breast cancer, mortality from breast cancer, and tumor size. Design, Setting, and Participants An ecological study of 16 million women 40 years or older who resided in 547 counties reporting to the Surveillance, Epidemiology, and End Results cancer registries during the year 2000. Of these women, 53 207 were diagnosed with breast cancer that year and followed up for the next 10 years. The study covered the period January 1, 2000, to December 31, 2010, and the analysis was performed between April 2013 and March 2015. Exposures Extent of screening in each county, assessed as the percentage of included women who received a screening mammogram in the prior 2 years. Main Outcomes and Measures Breast cancer incidence in 2000 and incidence-based breast cancer mortality during the 10-year follow-up. Incidence and mortality were calculated for each county and age adjusted to the US population.Results Across US counties, there was a positive correlation between the extent of screening and breast cancer incidence (weighted r = 0.54; P < .001) but not with breast cancer mortality (weighted r = 0.00; P = .98). An absolute increase of 10 percentage points in the extent of screening was accompanied by 16% more breast cancer diagnoses (relative rate [RR], 1.16; 95% CI, 1.13-1.19) but no significant change in breast cancer deaths (RR, 1.01; 95% CI, 0.96-1.06). In an analysis stratified by tumor size, we found that more screening was strongly associated with an increased incidence of small breast cancers (≤2 cm) but not with a decreased incidence of larger breast cancers (>2 cm). An increase of 10 percentage points in screening was associated with a 25% increase in the incidence of small breast cancers (RR, 1.25; 95% CI, 1.18-1.32) and a 7% increase in the incidence of larger breast cancers (RR, 1.07; 95% CI, 1.02-1.12). Conclusions and Relevance When analyzed at the county level, the clearest result of mammography screening is the diagnosis of additional small cancers. Furthermore, there is no concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the overall rate of death from the disease. Together, these findings suggest widespread overdiagnosis.
Breast cancer is the second most common cancer among women in the United States.
BENEFITS OF SCREENING Screening for breast cancer means looking for signs of breast cancer in all women, even if they have no symptoms. The goal of screening is to catch cancers early. Early-stage cancers are easier to treat than later-stage cancers, and the chance of survival is higher. Routine screening for breast cancer lowers one’s risk of dying of breast cancer.
Screening for breast cancer is done by mammography. A mammogram is a special series of x-rays taken of the breast. A doctor looks for any abnormal signs or patterns on the mammogram that might be breast cancer. These signs usually show up on the mammogram before any lump can be felt in the breast. If there is anything unusual on the mammogram, more tests have to be done. These tests can include another mammogram, an ultrasound, or a biopsy. Studies have shown that women who have routine mammograms have 10% to 25% less chance of dying of breast cancer than women who do not have mammograms.
Another possible harm of screening is overdiagnosis. This means finding something on a mammogram that is breast cancer or has a chance of becoming breast cancer, but is such a low-risk type of tumor that it would never have caused any health problems if left alone. Instead, because it was found on mammogram, standard cancer treatment, such as surgery and radiation therapy, is recommended. In cases of overdiagnosis, these treatments are unnecessary and costly and can have both physical and psychological side effects. It is difficult to know exactly how often overdiagnosis happens, but some studies estimate that 1 in 5 breast cancers found on mammograms are overdiagnosed and lead to unnecessary treatment.
12 February 2015 Why I’m Opting out of Mammography Christie Aschwanden1 JAMA Intern Med. at a routine appointment a few days after my 40th birthday, my gynecologist gave me a prescription for a mammogram. There was no discussion, no explanation. Just a slip of paper, handed to me without a word as I left the examination room. When I asked the doctor what she’d just given me, she told me it was an order for a mammogram. I could call the number to schedule an appointment. “Wait—why should I get a mammogram?” I asked. “Because it could save your life.” Her voice conveyed a note of impatience… read on..
24 Jan 2015 early diagnosis ( by screening the well), and treatment of pre-cancer of eg breast and prostate is increasingly discredited as dangerous, especially for women at ~10years younger prime-of life ( and much higher risk than men) due to menopause. .
Commentary: Prof Peter Gøtzsche Nordic Cochrane, Denmark. Int. J. Epidemiol. Jan 2015: SCREENING- A SEDUCTIVE PARADIGM THAT HAS GENERALLY FAILED US: “Screening healthy people has face value and great public and political appeal. It looks so simple, and yet screening is fraught with difficulties. These start already with the terminology, and common slogans like, ‘Catch the disease early, before it has produced any symptoms!’ are misleading on two counts.
First, disease means lack of ease, which is not what we understand by being healthy; but people who work with screening tend to forget that they deal with healthy people. For example, women being invited to mammography screening are often called patients in scientific articles. The second error is the assumption that the disease is caught early. That is rarely the case, and breast cancer is again a good example. If we assume that the growth rate for a particular cancer is constant, then the women have harboured the cancer for 21 years on average before it is large enough to be detected by mammography screening.1 Finding precursors to cancer is of course an entirely different matter.
A third problem with screening is that it always causes harm. Sometimes it also leads to benefits, and sometimes the benefits are sufficiently large to outweigh the harms. The main focus in screening trials should therefore be to quantify the harms, but this has rarely been the case, if ever. Screening trials focus on disease-specific mortality, which may seem natural, but it is the wrong outcome. Screening leads to overdiagnosis, and interventions that are beneficial for real patients can be lethal for healthy overdiagnosed people. Radiotherapy of overdiagnosed women may kill at least as many as those who are spared dying from breast cancer by attending breast screening.2
Total mortality should therefore be the primary outcome in screening trials of mortality, and Saquib et al. report a systematic review in this issue of the journal that aimed at clarifying whether screening lowers total mortality for diseases that carry a high disease-specific mortality.3 They focused on cancer, cardiovascular diseases, type 2 diabetes and chronic obstructive pulmonary disease. They did not find any screening trials for hypertension or chronic obstructive pulmonary disease. Disease-specific mortality was reduced with ultrasound for abdominal aortic aneurysm in men, mammography for breast cancer and faecal occult blood test and flexible sigmoidoscopy for colorectal cancer, but the risk ratio point estimates for all-cause mortality were all very close to 1.00 (range 0.98–1.03).
Screening proponents often say that disease-specific mortality is the right outcome, arguing that in order to show an effect on total mortality, trials would become unrealistically large. I believe this argument is invalid, for both scientific and ethical reasons. We do randomized trials in order to avoid bias, and our primary outcome should therefore not be a biased one. Drug interventions are usually more common in a screened group, and they tend to increase mortality for a variety of non-disease related reasons.4
From an ethical perspective, it is problematic to screen the whole population in a certain age group without knowing whether this makes people live longer, while knowing almost certainly that it makes people less happy. It took 50 years after the first randomized trial of mammography started before we knew what the psychological consequences are of the many false-positive findings.5 A specially designed questionnaire was developed using focus groups and women who had attended screening were followed up for 3 years. Even after so long a time, those who had experienced a false-positive diagnosis had an anxiety level (and other psychological problems) that fell between that for women with breast cancer and women who had always been told they did not have cancer. This study showed for the first time that the psychological harms of breast screening are substantial and long-lasting, and they affect a huge number of healthy women, as the cumulative risk of a false-positive result after 10 mammograms ranges from about 20% to 60%.6 Added to this comes the psychological harm inflicted on all the overdiagnosed women who do not know that they are overdiagnosed but think that they suffer from a fatal disease. It is therefore pretty clear that any utility analysis that takes the psychological harms of breast screening into account will come out negative, as was recently reported by the Swiss Medical Board.7
It is worth noting that when screening does not work, it might be because beneficial effects are outweighed by harmful ones. Diabetes drugs, for example, are approved on the basis of their glucose-lowering effect without knowing what they do to patients. And the only large trial of tolbutamide ever performed was stopped prematurely because the drug increased cardiovascular mortality.4 Rosiglitazone was once the most-sold diabetes drug in the world, but it was taken off the market in Europe in 2010 as it causes myocardial infarction and cardiovascular death; and pioglitazone has been linked to heart failure and bladder cancer.4
Screening is popular, but we need to be much more careful in the future when we contemplate approaching healthy people with our screening tests, and should demand much stronger evidence than when we treat patients.”
September 16, 2014 — A U.K. clinical trial examining whether mammography screening should be offered to a broader range of women must be halted due to ethical and medical concerns, according to a letter published in BMJ by a group of longtime opponents to breast screening. But not everyone agrees, and the controversy looks set to continue. In a strongly worded letter published (BMJ) on 16 September, a group led by Dr. Susan Bewley raised concerns about the U.K. age-extension trial, which is examining whether the age range for screening should be extended to both younger and older women. They challenge the design of the trial as well as the qualifications of its chief investigator, calling the study an “out of control trial with ineffective oversight.”“Our concerns relate to the science and ethics of this trial. Women should always be told the full facts — here they are unwittingly participating in a research trial without fully realizing that the harm/benefit ratio is uncertain,” Bewley said. “There is no overall mortality benefit from breast screening at any age if you look at the Nordic Cochrane review — only a reduction in breast cancer mortality.”
Age, y | No. of Breast Cancer Deaths Averted With Mammography Screening Over Next 15 y | No. (95% CI) With ≥1 False-Positive Result During the 10 yc | No. (95% CI) With ≥1 False Positive Resulting in a Biopsy During the 10 yc | No. of Breast Cancers or DCIS Diagnosed During the 10 y That Would Never Become Clinically Important (Overdiagnosis)d |
40 | 1–16 | 6,130 (5,940–6,310) | 700 (610–780) | ?–104e |
50 | 3–32 | 6,130 (5,800–6,470) | 940 (740–1,150) | 30–137 |
60 | 5–49 | 4,970 (4,780–5,150) | 980 (840–1,130) | 64–194 |
Invisible Risks, Emotional Choices — Mammography and Medical Decision Making Lisa Rosenbaum, M.D. cardiologist & journalist N Engl J Med October 16, 2014: in 1993, frightened New York City parents agitated for asbestos removal from schools. As often occurs, public fear trumped expert risk assessment; the parents’ demands were met, the victory was celebrated, but then the celebration crashed. It turned out that removing the asbestos would mean closing the schools for weeks, disrupting parents’ lives. “As the costs of the removal came on-screen,” writes behavioral economist Cass Sunstein, “parents thought much more like experts, and the risks of asbestos seemed tolerable: Statistically small, and on balance worth incurring.”1
It is partly because our perceptions of risk are so influenced by our changeable emotions that we turn to experts to perform cost–benefit analyses. From environmental regulations to nuclear energy, such expert assessments inform policies meant to improve public health and welfare. We would not ask airline passengers to create standards for aviation safety or car owners to optimize fuel-emission standards, and in medicine, too, we still depend on expert-generated guidelines. Increasingly, however, in this era of patient-centered care and shared decision making, those guidelines emphasize the role that patient preference should play in the weighing of risk and benefit for any given evidence-based recommendation. This approach, with virtue on its side, is driven by the aspiration that we can, with the proper tools, empower patients to think like experts. But can we?
Many medical decisions involve considerable uncertainty and complex tradeoffs, but none seem to highlight the tension between emotions and risk assessment more than mammography screening. Although the U.S. Preventive Services Task Force (USPSTF) recommended in 2009 that women under 50 years of age not undergo routine mammography screening, and that those between 50 and 75 years of age be screened less frequently, screening rates have apparently held steady or perhaps even increased. There are many possible reasons for this trend: physicians’ habits, conflicting guidelines, medicolegal concerns, radiologists’ preference for the status quo, and the mandating of screening coverage for women of all ages in the Affordable Care Act. But I suspect that the trends also reflect the powerful role that emotions play in both reinforcing women’s commitment to screening and the challenge of communicating the potential harms of mammography.
Consider a discussion with a 45-year-old woman with no family history of breast cancer about the most likely harm of screening: a false positive result. Maybe you say, “For someone like you, there is around a 50% chance that if you have regular screening over the next 10 years, you will have a false positive result. That could lead to repeat testing, potentially including a biopsy, and lots of worry and anxiety.”2 But though doctors striving to reduce unnecessary testing tend to emphasize the psychological stress involved, this possibility does not seem to loom large for women facing this decision.
Perhaps these results reflect the likelihood that, when facing tough tradeoffs, we anticipate and try to avoid regret, rather than anxiety. Despite the demonstrable harms on the population level, cancer screening rarely begets regret for the individual. As Ransohoff and colleagues have written about the persistence of prostate-cancer screening, “the screening process is one without negative feedback. A negative test provides reassurance. A positive one is accompanied by gratitude that disease was caught early. And a false positive test, regardless of the distress it may cause, is nevertheless followed by relief that no cancer was ultimately found.”5 So women who have had false positive mammograms may spend the rest of their lives worrying that they are at heightened risk for breast cancer. But they are not left with regret about having had the test in the first place.
What about the risk of overdiagnosis — being diagnosed with and treated for a tumor that would never have become clinically significant? The potential toxic effects of treatments, ranging from chemotherapy and radiation to lumpectomy and mastectomy, make overdiagnosis the greatest potential harm of mammography screening. Though overdiagnosis has been notoriously difficult to quantify, a recent analysis of data on mammography screening over the past 30 years suggests that of all breast cancers diagnosed, 22 to 31% are overdiagnosed.6 Nevertheless, there are few risks of this magnitude that are more “off-screen” than overdiagnosis.
The first challenge in conveying this risk to women is that many are simply unaware that overdiagnosis occurs. One survey showed that only 7% of women believed that there could be tumors that grow so slowly that an affected woman would need no treatment; another study showed that women found the concept confusing even after a brief educational intervention. After being educated, women thought the information should be considered in decision making, but most believed it would not affect their own intent to be screened.3,7
This disconnect between awareness and intent speaks to the fundamental challenge of conveying the potential harms of mammography screening. That is: we do not think risk; we feel it. As research on risk perception has shown, we are often guided by intuition and affect.8 For example, when our general impressions of a technology are positive, we tend to assume that its benefits are high and its risks are low. We estimate our personal risks of disease not on the basis of algorithms and risk calculators, but rather according to how similar we are, in ways we can observe, to people we know who have the disease. And when we fear something, we are far more sensitive to the mere possibility of its occurrence than its actual probability.
That may be why overdiagnosis does not resonate emotionally. We do not see women walking around with “an overdiagnosis.” Instead, we see breast-cancer survivors. We do not hear people complaining about having endured radiation, chemotherapy, and a lumpectomy. What we hear instead is, “Thank goodness I had a mammogram and caught it early.” Our relatives do not eye us critically when we get a mammogram that reveals a nascent tumor. But people shake their heads and say, “I wish she had taken better care of herself,” when we are diagnosed after not having been screened. Thus, we can be educated about overdiagnosis. We can refine our estimates about its likelihood and incorporate them into our recommendations, as the USPSTF did in 2009. But it is hard to summon fear of a risk that remains invisible.
So how do we balance the goal of engaging women in decision making with the reality that emotions play a powerful role in shaping our understanding of benefit and risk? Some experts emphasize the need to address sources of misperception that inform beliefs far outside clinical encounters. Researchers at Dartmouth, for example, have described the misleading nature of various screening-advocacy campaigns. One advertisement by the Komen Foundation, for instance, features a photo of a beautiful young woman, with a caption reading, “The 5-year survival rate for breast cancer when caught early is 98%. When it’s not? 23%.”9 Though 5-year survival rates, because of lead-time bias and overdiagnosis, do not actually tell you whether the test saves lives, the visceral appeal of “catching something early” easily eclipses the difficult mental calculations one must undertake to figure out why early detection does not necessarily mean living longer.
The problem is that once impressions have formed, whatever their source, educational efforts to address misperceptions often fail and can even backfire. In a recent randomized trial evaluating approaches to vaccine education, for example, researchers found that, among parents least likely to vaccinate their children, exposure to information emphasizing that there is no link between vaccines and autism mitigated misperceptions but nevertheless further reduced their intention to vaccinate.10 Indeed, the fact that sound scientific information that challenges beliefs can simply intensify those beliefs has been recognized by cognitive psychologists for decades. What was more disappointing in this study was that more creative attempts to engage parents emotionally, such as using images or narratives of children dying of measles, not only failed to increase vaccination intent but also cemented some parents’ conviction that there is a link between vaccines and autism.
If there is tension between belief and sound medical information regarding vaccines, for which the benefits so clearly outweigh the risks, the tension is only heightened for decisions with more complex tradeoffs. The vaccine study thus raises two key challenges for the profession.
The first is empirical. As the locus of decision making shifts toward the patient, this study reminds us how little we know about how beliefs inform interpretation of medical evidence — or about how to negotiate those beliefs in pursuit of better health. Closing this empirical gap is daunting. Not only does each person have his or her own belief system, but the particular beliefs that are relevant for a decision regarding, say, elective percutaneous coronary intervention or palliative chemotherapy may be quite different from those relevant to childhood vaccination or mammography screening. Moreover, even though it is more practical and financially feasible to conduct a study that looks at how interventions affect knowledge and intent, what we really need are long-term studies of how new approaches to sharing information affect downstream behaviors and outcomes.
Which brings us to the second challenge, more ethical than empirical: How do we balance the need to honor preferences and values with the imperative to translate our evidence base into better population health? Our current default, particularly since medical recommendations are increasingly debated publicly, is to emphasize that decisions are “personal.” After the 2009 guidelines were published, the Obama administration and many physician leaders were all over the news reminding us of the importance of personal preferences. But even as more data accrue, including a recent review suggesting that the harms of mammography are greater than we once thought and the benefits fewer,11 the message we hear is not “Let’s do fewer mammograms.” Rather, it is “Let’s honor patients’ preferences.”
Though we certainly need to be sensitive to patients’ values, it is often hard to distinguish values from an emotional understanding of risk. Consider the decision to initiate statin therapy for primary prevention of cardiovascular disease. One patient, an avid tennis player, may recognize the potential for improved cardiovascular health but feel that the prospect of myalgias simply outweighs any potential benefit. That is a preference. Another patient hates drug companies and therefore believes that statins must lack cardiovascular benefit and be highly likely to cause myalgias and liver disease. That is an emotional understanding of risk. Both patients arrive at the same choice, but should we really celebrate them as equally informed decisions?
The tangled nature of emotions and values is particularly relevant to mammography screening, as evidenced in qualitative research done since the 2009 guidelines were released. One study explored the beliefs and attitudes of an ethnically diverse sample of women in their 40s. Though many were unaware of the guidelines, the researchers found that educating them about the new recommendations strengthened rather than diminished their commitment to screening. Women also expressed fears that the guidelines were an attempt by insurers to save money and keep them from getting the care they needed. Many women, expressing their abiding conviction that mammograms save lives, said they would have “no use” for a decision aid and viewed the weighing of benefits and harms as “irrelevant.” In fact, many said they wanted to be screened more than once a year and beginning before the age of 40 years. Finally, many believed that it was unjust that laywomen had been left out of the guideline-development process and the weighing of potential benefits and harms that it entailed.12
Such responses echo a broader debate among leading scholars of risk perception about whom we should rely on to evaluate risk. Some, such as Sunstein,1 recognizing our general difficulties in thinking about probabilities, argue that this task ought to be left to experts who can create policies to maximize public welfare. But the psychologist Paul Slovic has argued that the very concept of risk is subjective. Whereas experts tend to conceive of risk as “synonymous with expected annual mortality,” Slovic reminds us that riskiness means more to people than mortality rates.13
Undoubtedly, the recognition of the affective nature of risk perception is critical to the physician’s role in helping patients live longer, higher-quality lives. But even if we can, in some general way, address misleading statistics that drive inflated perceptions of the benefits of mammography, what do we do about the 38-year-old woman who insists on annual screening because she just lost her best friend to breast cancer? Or the 43-year-old with fibrocystic breasts who last year had a false positive mammogram and is now convinced her risk is even higher? Is there some hierarchy of emotional reasoning dictating that certain causes of heightened fears are more acceptable than others? Or because we know it is often impossible to tease out sources of belief, much less rank them, is a better approach the more paternalistic one: definitive guidelines on which physicians base their recommendations, with less emphasis on the role that patient preference ought to play?
One of the hallmarks of heuristic reasoning, as emphasized by Daniel Kahneman,14 is that faced with a hard question, we answer an easier one instead. In some sense, then, as a profession, we have fallen into a collective heuristic trap. Rather than confront these thorny ethical questions head on, we have answered an easier question: Should we respect patients’ values and preferences? The right answer will always be yes. The much harder question is how to balance that respect with our professional responsibility to use our expertise to translate clinical science into better population health.
Defaulting to patient preference in the face of uncertainty has become the moral high ground. But it is as much our job to figure out how to best help our patients lead healthier lives as it is to honor their preferences. No matter how well we can define the tradeoffs of a medical decision, the threshold at which we decide that benefits outweigh harms is as subjective as individual patients’ perceptions of those tradeoffs. But this recognition does not stop us from making rigorous attempts to quantify the tradeoffs, any more than it should stop us from trying to better understand how our patients’ feelings and beliefs inform their understanding of those numbers, consequent behaviors, and health outcomes. As Slovic has emphasized, experts’ efforts to communicate risk will fail in the absence of a structured two-way process. “Each side, expert and public, has something valid to contribute,” he notes. “Each side must respect the insights and intelligence of the other.”13
“Hello , What are you doing to detox your patients on a daily basis? We live in a crazy world where nutritional supplements with little or no clear risks to consumers are seized/ restricted, but Authorities drag feet on stopping the use of a proven toxin like BP-A found as a coating inside of most canned goods. Please understand that Randy Jirtle at Duke has shown that BP-A made healthy brown Agouti mice become obese, yellow and diabetic! That effect led to an epigenetic change, which will persist for generations and was shown to be an epigenetic change in methylation.Plan to protect yourself with lots of methylation support. I take my Beyond B12 sublingual product that provides Methyl Folate and Methyl B12. Please know virtually everyone tests positive for BP-A in urine much of the time, as we have great difficulty in avoiding this poison in our daily living. Yet authorities ignores the dangers although they finally are doing something to protect babies a little.How can anyone practice effective medicine today and ignore the toxin burden we all carry. Remember when I got out of training in 1958 normal sperm count was 140 million; today few have 40 million. I detox daily with my “Power Drink” and PEMF and I definitely show real benefits even at age 79.“BPA has been linked to possible health problems of the brain, breast and prostate. In 2008, the environmental group Natural Resources Defense Council asked the FDA to ban use of the chemical because of what it termed “serious adverse health effects.”In 2011, the American Medical Association deemed BPA an “endocrine-disrupting agent” and urged that “BPA-containing products with the potential for human exposure be clearly identified.” The FDA said it continues to evaluate the safety of BPA-containing products.”http://online.wsj.com/article/SB10001424127887323740804578600113164806902.html?mod=djemHL_t
Tying up Garry Gordon’s two themes above is obviously the fact that , as in eg the USA ARED (Centrum) trial, the Lemon-Rollo McMaster supermouse trials and the Scottish Highlands, and China supplement trials, multisupplements are longterm (especially with vigorous levels of vitamins C and D and magnesium) both antioxidant, insulin sensitizing, methylating, Nitric-oxide promoting and (heavy metal) detoxicants- ie promote healthspan and suppress degenerative diseases and infection. . .
UPDATE 18 OCT 2014: more arguments against screening mammography from UK and Canada:Curr Oncol. Oct 2014; 21(5): 210–214. Reflections on screening mammography and the early detection of breast cancer. A Countercurrents Seriesa S.A. Narod, MD *Women’s College Research Institute, Women’s College Hospital, Toronto, ON.A little learning is a dangerous thing.— Alexander Pope, An Essay on CriticismIn the stormy aftermath of the recent publication of results from the 25-year Canadian National Breast Screening Study (nbss)1, various opinions questioning the validity of the study’s results have been expressed2–7. I was a latecomer to the study. In 2005, I was charged with oversight of the final record linkage and the statistical analysis and interpretation of the final data set. Dr. Anthony Miller has been my mentor since 1987. Our first joint paper, on screening for cervical cancer, was published in 19918. I chose not to respond to individual criticisms, but instead to collect my thoughts and to try to explain why the study authors saw no benefit from screening.Most of the criticism from the radiology community focuses on issues of study design (which they claim was inadequate) and on the quality of the mammography (which they also claim was inadequate). Cancer survivors bolster those criticisms with testimonials and appeals to common sense. Supporters of the study are drawn from the public health community, and they tend to focus on overdiagnosis and health economics.The report at issue is not the first emerging from the nbss. Earlier reports9,10 were criticized for not having allowed adequate follow-up time. But the 25-year results resemble the early results, and the authors are no longer criticized for premature disclosure. None of the first-generation critics have acknowledged the consistency; instead, they look elsewhere and point out other weaknesses. They claim that high-risk women were assigned to the mammography arm in violation of the principle of randomization. In his bestseller The Emperor of All Maladies, Siddhartha Mukherjee says, as a matter of fact, that high-risk women were assigned surreptitiously to the mammography arm, which explains the lack of observed benefit11.The most recent nbss report1 tallied the breast cancers that occurred in each of the two study arms after the screening period ended (that is, between years 6 and 25), counting 2584 cancers in the screening arm and 2609 cancers in the control arm. If the screening arm had been enriched for women at “high risk,” that enrichment must have been performed in a peculiar fashion, using only risk factors that have a transient effect. Perhaps Dr. Mukherjee would care to explain what those factors were. It follows that the excess of cancers seen in the screening period (years 1–5: 666 vs. 524) was a result of early diagnosis and not from stacking the deck.In any case, compelling evidence against the criticism of assignment of high-risk women to the screening arm is provided in the most recent analysis1, and that criticism is no longer raised (although no one has retracted or apologized). Instead, critics now insist that many women with palpable lesions were sent directly to the screening arm by duplicitous research assistants. There is no reason to believe that such actions (which would involve a national conspiracy of dozens of coordinators who spoke two official languages) were taken, but even if they had been, the study and its conclusions would not necessarily be invalidated. Even if all the women with prevalent cancers had been shunted to the screening arm, the situation could still be remedied by ignoring all cancers found at the first screening round (prevalent cancers) and focusing instead on the incident cancers. Such a strategy is not uncommon in screening studies. In the nbss, no woman had the opportunity to “cross the floor” from one study arm to the other after initial assignment. Therefore, if we exclude all prevalent cases from the analysis and focus on women with no cancer at study entry, we can re-evaluate the benefit of mammography thereafter. The hazard ratio for death from breast cancers detected in screening rounds 2–5 was 0.90 (95% confidence interval: 0.69 to 1.16;p = 0.40).But what about crossover? It is claimed that a certain proportion of the women in the control arm—perhaps as high as 20%—opted for screening off-study, in particular after the screening period was over. That crossover will, some say, eclipse a benefit of screening that might otherwise have ensued. That is, the benefit of mammography (which might well have been substantial) was nullified by a subcohort of independently-minded women who went for mammography at the end of the 5 years. That speculation is fanciful, but if true, should be welcomed, because it can now be said to a patient who, at age 40, requests a mammogram, that there is no hurry; she can come back in 5 years for a mammogram and achieve the same net benefit. And when she comes back at age 45, she can be reprieved again until age 50.Crossover is a form of contamination that results in misclassification of the exposed and unexposed groups. In a trial, it will tend to bias the result toward the null. The best way to avoid misclassification is to randomize the patients after they agree to participate—as the nbss did. In contrast, in the Swedish two-county trial (discussed in more detail a little later in this article), the subjects were randomized by intention-to-treat—that is, by whether they received or did not receive an invitation to mammography12–15. Of the 78,085 women in Sweden who were offered screening, 69,645 accepted and 8440 declined. In effect, then, 8440 women in the Swedish study were de facto misclassified (versus an undisclosed number of hypothetical crossers-over in the Canadian study). The proponents of the Swedish study do not see that misclassification as a shortcoming, but instead use it to buoy their argument in favour of screening. They say that if everybody invited for screening came for screening, then the protective effect would have been more profound. In the Swedish study, all women in the control group were offered a screening test after the screening period ended (a reasonable thing to do); but those authors were not criticized for “contaminating” their study.
The second issue raised concerns the quality of the mammography. After all, the nbss tests were completed 30 years ago using 30-year-old technology. I still wonder how things might have been done differently. Mammography screening identified 212 women with breast cancer who would otherwise have been missed. They had cancers that were, on average, 1.4 cm in size, with 67% being node-negative. The survival of those women was very good. At the end of the study period, 170 women with a nonpalpable mammography-detected breast cancer were alive or had died of other causes. How many of those lives did screening save? Fifty? Twenty-five? Ten? Unfortunately, all we can say is that the number was too few to be noticed. If a significant number of those 170 lives had, in fact, been saved, surely the difference between study arms would have been noticeable. Breast cancer deaths numbered 180 in the mammography group and 171 in the control group. Perhaps some of the survivors believe that their lives were saved. They might perhaps have written a letter to the editor of their local newspaper extolling the virtues of mammography. But 42 women with a nonpalpable mammography-detected cancer died (none of whom has written a letter to the editor).
I am also among the authors of several publications on the benefits of screening by magnetic resonance imaging (mri) in high-risk women16–18. Those studies were greeted as successes, given that they demonstrated how, with the use of mri, breast cancers could be downstaged. Those studies were accepted by the radiology community as being supportive of screening. Whether mri reduces mortality has not yet been shown. I cannot predict whether mri screening will be effective in reducing mortality 10 years down the line, but I fully expect that if a mortality benefit fails to materialize, the studies will be criticized for using 30-year-old equipment and a poor study design.
Much of the criticism of the nbss has come from Drs. Daniel Kopans and László Tabár, and fellow travellers such as Siddhartha Mukherjee and Patrick Borgen2–7,11. They use the Swedish two-county trial as evidence of a good study that supports the use of mammography and quote a 30% reduction in mortality. Naturally, they do not criticize their canonical study, but it is time to take a closer look.
In the nbss, women were randomized on an individual basis after they had attended the study centre. The result was two groups of equal size and 100% compliance with the first screen. In Sweden, the two counties were divided into 19 geographic strata that were then divided into either 2 blocks (Östergötland) or 3 blocks (Kopparberg). The resulting 45 blocks were randomized, and women in more than half the blocks were sent a letter of invitation to screening. Of the 59% of women who received an invitation, 89% came for the first screen and 83% came for the second screen14.
The Canadian women were offered 5 mammograms 1 year apart. The Swedish women were offered mammograms every 2 years (ages 40–49) or every 3 years (ages 50–74) for up to 8 years. They underwent fewer screens (Table i). The cancers detected by mammography in Canada were similar in size to those detected in Sweden (Table i), but the size of the cancers occurring in the control group were very different. Those comparisons suggest that physical examinations or breast cancer awareness (or both) were important contributors to the size of cancers detected in Canada. A diminution of cancer mortality would not be expected to be associated with a 0.2 cm mean difference in tumour size, but might be expected with a net reduction of 0.7 cm in size19. Of the cancers detected in the screening arm of the Canadian trial, 68% were palpable. That fact has been a source of criticism. But a physical examination was not conducted as part of the screening protocol in Sweden, and the comparable number of palpable tumours was not given. Therefore, given the much longer mean time between screening visits in Sweden, and the high proportion of women in the screening arm that were never screened, I estimate that between 70% and 80% of the cancers in the mammography arm in Sweden would have been palpable and could have been detected by physical examination—had it been done. The fact that the relevant number is not given is a critical lapse. Suppose, for the sake of argument, that 100% of the cancers detected in the screening arm in Sweden were in fact palpable (not a gross exaggeration). What then would be the point of mammographic screening? And if that number (the palpable fraction) is not available, how can the results be judged? Neither the Swedish nor the Canadian trial can exclude the possibility that the benefit from invitation to mammography might have been restricted to women with palpable cancers.
A comparison of key parameters in the Canadian National Breast Screening Study (nbss) and the Swedish two-county trial
The Canadian study reports the number of cancers detected in the follow-up period after the end of the screening period and the number of subsequent deaths from breast cancer. From year 6 to year 25, 2584 incident cancers occurred in the screening group, resulting in 298 deaths (11.5%), and 2609 incident cancers occurred in the control group, resulting in 321 deaths (12.3%). Those data are important because they confirm that, in the absence of screening, the cancer incidence and mortality are equal in the study groups. Where are the comparable numbers for the Swedish study? Again, they are not given. But in looking at the extraordinary Figure 1 from the most recent report of the Swedish study12, the mortality curves are seen to continue to separate at 25 to 29 years after the initiation of screening, and long since screening had stopped.
Tabár and colleagues ask readers to believe that the benefits of mammography are everlasting (or at least for 20 years beyond the end of screening). They make that claim despite having no surety about whether the deaths from breast cancer in years 25–29 were the result of cancers diagnosed during the screening period or diagnosed after screening had stopped. They claim that most of the deaths from breast cancers diagnosed in the control arm occurred more than 10 years after diagnosis. Thus, the reader is asked to accept that a mean of 2.3 mammograms obtained in year 1–7 are more likely than a baseline imbalance in breast cancer risk to lead to a reduction in breast cancer mortality of 30% in years 25–29!
The incidence and mortality rates corresponding to cancers that were diagnosed after the screening trial was stopped are unavailable. Seeing the survival curves corresponding to cases detected in the screened and unscreened cohorts would be interesting. In the nbss, most cancer deaths occurred, as expected, within 10 years from diagnosis1. When the nbss was challenged as to having achieved an even balance in the study groups, the authors provided the relevant data. The Swedish authors should do the same. Patrick Borgen has stated that the nbss is the “worst clinical trial ever done”5—an extraordinary statement. Either he has devoted his life to poring over medical tracts with the zeal of a Talmudic scholar, or he is speaking nonsense. But refuting his claim is easy: it takes merely the time required to read the Swedish papers.
Once the facts are accepted (that screening mammography fails to do what it was intended to do, and that overdiagnosis is real and substantial), then the most interesting questions can begin to be addressed. Did the nbss fail because mammography is not a sufficiently sensitive imaging technique? Or has the screening community been working under false premises?
Consider sensitivity. Proponents of mammography say that the technique is currently better than it was in the 1980s, largely because it is more sensitive. (Specificity is also important, but is not at issue here.) They argue that “the more sensitive, the better.” The earlier a cancer can be identified and managed, the better. The smaller, the better. But those contentions generate an interesting paradox. Consider a woman with a small early-stage breast cancer. The recommendation is that this woman be followed with annual bilateral mammography for 5 or more years to identify recurrences and contralateral cancers20. That recommendation is based on the knowledge that the risk of contralateral cancer is between 0.5% and 0.8% annually21 and that a diagnosis of contralateral cancer is associated with an increase in mortality from breast cancer22. (It has not been shown that screening for contralateral cancer reduces mortality.) But mri is a much more sensitive screening tool than mammography, and by using mri in that setting, a small contralateral breast cancer can be identified in 4% of women with newly-diagnosed breast cancer23. And yet routine mri of the contralateral breast is not recommended, because it has not been shown to improve survival. Instead, the recommendation for follow-up with annual mammography continues. The paradox is this: If 8 years’ worth of incident breast cancers can be identified in one shot, why bother to pick them up in dribs and drabs? The mri-detected occult lesions are understood not to be clinically meaningful because they do not adversely affect mortality (overdiagnosis); however, if a similar lesion were to be found as a primary cancer in the ipsilateral breast, the radiologists insist that it is clinically meaningful. Once the paradigm that an increase in sensitivity increases overdiagnosis is accepted (that is, not all lesions are clinically meaningful), then it is the responsibility of clinicians to try to determine the ideal level of sensitivity.
The nbss has been berated for working with 30-year-old machinery, but I think that the greater problem is that clinicians are still working under 30-year-old assumptions. How much is really known about the relationship between size and survival? How confident is our community about early detection? It is universally accepted that tumour size and survival are inversely related for women diagnosed with palpable breast cancer24. That understanding is the rationale for early detection by mammography or other means. But it does not logically follow that a decrease in tumour size will necessarily lead to a decrease in mortality.
Consider two analogous situations. First, among women with breast cancer who experience a local recurrence, the strongest predictor of death is a short time from diagnosis to local recurrence25. However, that finding does not imply that a further shortening of the time from diagnosis to recurrence through intensive imaging would worsen survival. Second, studies of children with neuroblastoma noted that the children diagnosed in the first year of life experienced much better survival than those diagnosed thereafter26. That observation encouraged physicians to consider that screening for neuroblastoma by measuring urinary metabolites would increase the proportion of children diagnosed in the first year and thereby reduce mortality. The resulting clinical trial unfortunately found no benefit27. Neuroblastoma with a favorable prognosis is detectable by screening, but those cases are associated with a very high rate of spontaneous regression or maturation of the neuroblastoma into benign ganglioneuroma. Very few cases of neuroblastoma detected by screening have unfavourable biologic features such as N-Myc amplification28.
The relationship between breast cancer size and survival is not fixed, and the slope of the curve that defines the relationship varies according to the stage and pathologic features of the breast cancer24. The strongest relationship is seen with large cancers and node-positive cancers29. The relationship is attenuated among women with triple-negative cancers, with her2 (human epidermal growth factor receptor 2)–positive cancers, and with BRCA1-positive cancers19,30. Size does not predict mortality well for women with nonpalpable cancers29. Is it possible that there are additional categories wherein the size–survival relationship does not hold, and that eventually every woman with breast cancer will be able to be assigned to one of those categories? If more specific categorization were to be possible, then there would be no expectation of benefit from early detection—through mammography or any other means. In statistical terms, the question is “Are there variables n1, n2, n3, … nx, such that, after adjusting for n1, n2, n3, … nx in a follow-up study, size is no longer predictive of survival?” For example, in a study of 5423 women with cancers of less than 2.0 cm, tumour size was not predictive of survival after adjustment for grade, hormone receptor status, and her2 expression30. Those data suggest that, as the mean size of breast cancers in a population diminishes, further reductions in size can achieve only marginally less benefit. The lesson of mammography should be used to rethink the fundamentals of breast cancer and its natural history so that planning can commence for the experiments and clinical studies that will lead to better outcomes in the future.
Curr Oncol. Oct 2014; 21(5): 215–216. re: Reflections on screening mammography and the early detection of breast cancer Baum, MD ChM* *Professor Emeritus of Surgery & Medical Humanities, University College, London, U.K.
I welcome this opportunity to comment on the piece by Dr. Steven Narod in this issue of Current Oncology. His commentary systematically responds to, and rebuts, the near-hysterical reactions to the recent publication of the 25-year follow-up results of the Canadian National Breast Cancer Screening Study1. I admire his restraint in the face of criticisms that go way beyond the boundaries of polite scientific disputation.
Much of the criticism the authors of the trial have faced goes so far as to accuse them of being guilty of scientific misconduct and fraud. Those charges are libellous, but I’m sure that Narod et al. are wise enough not to resolve their differences in a court of law, but simply to open their books to scientific scrutiny, in a way that fair-minded clinicians can judge who are the real culprits. Narod has achieved precisely that end in his timely and measured response. My only criticism is minor … in that he doesn’t go far enough. For example, it could easily be pointed out that the results of the National Breast Cancer Screening Study sit comfortably within the confidence intervals of a Cochrane Collaboration overview of the screening trials, with no hint of heterogeneity2. If anything, the trial in that overview that is closest to being an outlier is the Swedish two-county trial, whose authors are the shrillest of all the critics3.
The debate is so polarized that, leaving aside possible conflicts of interest, the only assumption that can be made is that the clash is one of ideology rather than scientific discourse. In other words, the true believers in the screening dogma will never be persuaded of the error of their ways by data alone, and so when facts don’t fit their prejudice, they resort to ad hominem attacks.
I was one of those who established the first screening centre in London and South East England in 1988, but as an open-minded clinical scientist, I allowed the emerging new data to change my mind. With all due modesty, that is what is called an expression of scientific integrity. Of course, as Narod points out, the prolonged and futile debate merely inhibits real progress on the subject. The importance of breast screening programs lies not in their success, but in their failure. As Huxley put it, “The tragedy of science is the slaying of a beautiful hypothesis by an ugly fact.”
The national breast screening programs around the world have provided us with a natural experiment of the greatest historical importance, not because of their success in reducing breast cancer mortality, but because of the observations that have emerged concerning overdiagnosis of the disease4,5. About two hundred years ago, cancer was defined by its microscopic appearance. With the discovery and use of the modern microscope, the nineteenth century saw the birth of scientific oncology. Rudolf Virchow, often called the founder of cellular pathology, provided the scientific basis for the modern pathologic study of cancer6. As earlier generations had correlated autopsy findings observed with the unaided eye with the clinical course of cancer one hundred years earlier7, so Virchow correlated the microscopic pathology of the disease. However, the material he was studying came from the autopsies of patients dying from cancer. In the mid-nineteenth century, pathology correlations were performed either on cadavers or on living subjects presenting with locally advanced or metastatic disease who were almost always predetermined to die in the absence of effective therapy. Since then, and without pause for thought, the microscopic identification of cancer according to those classical criteria has been associated with the assumed prognosis of fatal disease in the absence of treatment.
A syllogism at the heart of the diagnosis of cancer therefore runs like this: People frequently die from malignant disease. Under the microscope, this malignant disease has many histologic features that we will call “cancer.” Ergo, anything that looks like “cancer” under the microscope will kill you. The screening debacle therefore suggests that some of the earliest stages of “cancer,” if left unperturbed, will not progress to a disease with lethal potential. Those pathologic entities might have microscopic similarity to true cancers, but their appearances alone are insufficient to predict a life-threatening disease.
Conventional mathematical models of cancer growth are linear or logarithmic—in other words, completely predictable at the outset. They predict transition from in situ phases to early invasive, and from early invasive to late invasive over time. Most natural biologic mechanisms are nonlinear or are better described by chaos theory8. Prolonged latency followed by catastrophe should not be all that surprising. We accept the case for prostate cancer, because we know that most elderly men will die with prostate cancer in situ and not of prostate cancer. In fact, the United Kingdom’s national prostate-specific antigen screening trial (protect) is predicated on that fact, with two a priori outcome measures defined: deaths from prostate cancer, and the number of cancers over-detected and treated unnecessarily9.
Next, it is worth noting that, contrary to all common-sense predictions, the increased detection rate of ductal carcinoma in situ has led to an increase in the mastectomy rate for the screened population4,5. Up to 45% of women with a screen-detected case of ductal carcinoma in situ end up undergoing mastectomy because of the multicentricity of the disease10. And yet the paradox is that clinically detected multicentric invasive breast cancer is relatively uncommon11. Surely that is proof enough that at least half the foci of ductal carcinoma in situ will regress if left alone; of course, determining which half remains the problem.
In conclusion, then, it can be stated with a great deal of conviction that a large proportion (on the order of 50%) of screen-detected (preclinical) foci of breast cancer are not programmed to progress if left unperturbed. That observation is of seismic importance and could set the agenda for breast cancer research into the next decade. The choice to ignore those observations, either because they do not support personal prejudice or because of some sleazy political agenda, will result in our community missing an opportunity of a life-time—and that would be unforgivable.
Narod is to be congratulated for his systematic and robust rebuttal of the unjustified attempts to destroy the credibility of the Canadian trial by a small group of vociferous critics who provide a background noise so loud that it nearly drowns out the true signal of the 25-year experiment of population screening for breast cancer.
“There’s non so blind as those that will not see.”— Jonathan Swift, Polite Conversation
Curr Oncol. Oct 2014; 21: 205–207. Screening mammography: the turning of the tide? W.D. Foulkes, MBBS PhD McGill University, Montreal, Quebec This issue of Current Oncology features a Counter-currents article by Dr. Steven Narod, “Reflections on screening mammography and the early detection of breast cancer”1, that is accompanied by a commentary from Professor Michael Baum2 supporting Narod’s thesis. Indeed, in Baum’s view, Narod’s only error was not to push home the point that the Canadian National Breast Cancer Screening Study (nbss) is not an outlier among mammography screening studies. He commends Narod for a measured response to the widespread criticism that followed publication of the 25-year follow-up results of the by now notorious nbss.
It seems as if almost everyone has an opinion on screening mammography. Everyone is entitled to an opinion, of course; but discussions about mammographic screening tend to take on a special, almost unique, quality—which perhaps speaks to the investments (financial, psychological, and career) made by many of the protagonists, which Professor Baum fleetingly mentions as potential conflicts of interest in his editorial. Baum prefers to see the ongoing debate—if that is what it is—as a clash of ideologies. But what are these ideologies that are so opposed?
Essentially, Baum’s argument is that the proponents of screening are not really scientists, in the sense that they do not accept refutation of data by data. He could be right, but I think the more parsimonious and psychologically more plausible explanation is that the aforementioned investments are simply too great: the stakes are too high. That the stakes are high is, in my view, very clear. Breast cancer is a common disease, and if population-based screening mammography is shown to have failed and is therefore no longer offered, billions of dollars would be saved every year in the United States alone3.
Narod contrasts the results of two large trials of mammography (one carried out in Sweden, the two-county study) with the nbss data. Having read these carefully laid out arguments, I think that most disinterested, but informed, readers will accept that many of the legion of criticisms that have been placed at the door of the nbss simply do not hold up to scrutiny. But mud sticks, and so many observers who do not like the results of the nbss point again and again to the same “flaws.”
One of Narod’s most telling points is that the survival curves for the two arms of the Swedish trial continue to remain separate up to 29 years after the trial was started. That observation is not consistent with any known effect of mammographic screening. It is much more likely that the populations were simply different to start with.
Further discussion of the pros and cons of these two trials is now fairly pointless. There are not much new data to be had, and I can’t see Drs. Kopans and Tabár, on reading Narod’s article, deciding that perhaps the benefits of mammography have, after all, been overestimated. Without new data, we can’t resolve this critical issue. So perhaps we need to stop the current process and actually do some new research to gather the required data.
A recent Perspective article in the New England Journal of Medicine4 noted the presence of a deep chasm separating women’s views of the likely benefit of mammographic screening and the actual data available. The nongovernmental Swiss Medical Board subsequently determined that women could not make informed decisions about screening without access to more nuanced information. Moreover, the Board felt that the benefits of mammographic screening were likely to be so small that no new screening programs should be introduced and existing programs should be allowed to run down. Their decision caused the expected uproar, but it is interesting to note that the results of a reader poll after a Clinical Decisions article 2 years earlier in the New England Journal of Medicine5 showed that a clear majority did not think that screening mammography should be started at age 40. Those results are contrary to the recommendation of many breast cancer organizations. But on the basis of these newer findings, it seems to me that the tide has turned, insofar as there are now enough interested parties prepared to question the benefits of mammography.
One of the points that Narod makes bears some discussion: He sees the problem not in terms of 30-year-old mammography machines in nbss study, but in 30-year-old thinking about the biology of breast cancer on the part of those who support screening. Logically, it can be seen that, as breast cancers enlarge, the number of cancer cells within them increases, which can provide opportunities for more malignant clones to emerge. Earlier detection will thus prevent those emerging clones from worsening outcomes. This quasi-Halstedian view, that a breast cancer makes a stately progression through biologically distinct and distinguishable stages and that the grade worsens as the tumour enlarges (assumptions that are at the heart of the original explanation of how mammography “works”6), are no longer part of mainstream thinking about breast cancer biology. Even ductal carcinoma in situ seems to possess many of the molecular changes found in invasive breast cancers, albeit at lower frequencies7,8. It seems as if the “die is cast” fairly early in the life of a breast cancer9. Intrinsic subtypes hold true as cancers grow and metastasize10, and the sojourn time varies from subtype to subtype11. Some breast cancers regress12. Others grow very rapidly13. These are not ideal biologic circumstances for the success of an “across the board” screening program. That conclusion is even borne out by a careful examination of the two-county study data14. The one group for whom screening mammography would be hoped to work—women between 40 and 49 years of age with a grade iii breast cancer (a group likely to contribute disproportionately to the observed mortality from breast cancer)—does not seem to achieve any mortality savings (see Figure 20 in Tabár et al.14). Survival at 16 years from randomization was identical in the invited and screened groups (relative risk: 0.95; 95% confidence interval: 0.55 to 1.64). One wonders if, in fact, the shoe is on the other foot. What has been learned about interpreting screening data from the current understanding of the natural history of breast cancer?
On the other side of the ledger, overdiagnosis has emerged in the past several years as a major issue in breast cancer screening. Quantifying the benefits and harms of mammography make for sobering reading by disinterested parties. If one starts with a sample of 1000 U.S. women 50 years of age, and if those women are screened annually for a decade, fewer than 4 women will avoid a breast cancer death; 3–14 women will suffer the consequences of over-diagnosis; and many hundreds will have at least 1 false alarm15. Work by Welch and Frankel suggests that women would think differently about mammographic screening for breast cancer if they were made aware of those figures at time of invitation for screening. Using best estimates, only 1 woman in 4 who develop a screen-detected breast cancer will avoid a breast cancer death16. The other 3 will do just as well, or just as poorly, without screening—or, of more concern, will have been diagnosed with a cancer that was not destined to ever present clinically. In the observational Norwegian study, only one third of the reduction in deaths from breast cancer could be attributed to mammographic screening per se17. Most women with a screen-detected breast cancer are therefore either diagnosed early (but with no effect on outcome) or are overdiagnosed.
We have been here before. Maureen Roberts, director of the Edinburgh breast screening project, died of breast cancer in 1989. While hopeful that mammographic screening would benefit women, she concluded from an analysis of the Edinburgh trial results that it did not. Before she died, she wrote “Breast screening: time for a rethink?” for the British Medical Journal18, concluding, “I feel sad to be writing this; sad because naturally after so many years I am sorry that breast screening may not be of benefit. I am also sad to seem to be critical of the many dear and valued colleagues I’ve worked with over the years, particularly those who have made such a magnificent contribution to the care and welfare of women with breast cancer. But they will recognise that I am telling the truth.”
It is time to work toward a trial of screening mammography that will incorporate variable thresholds, molecular markers, genetic testing, and psychological and physical measures of the effect of overdiagnosis. One of the two authors of the New England Journal of Medicine Perspective article discussed earlier, an ethics representative on the Swiss Medical Board, has argued that there is a moral requirement for a randomized controlled trial of mammography19 based on Welch’s idea of differing detection thresholds. I believe that women will be interested in such a study. But because almost every major U.S. medical organization focusing on breast cancer prevention, diagnosis, or treatment has stated that women should begin undergoing mammography annually from the age of 40 years, will any agency have the courage to fund it?
1. Mammograms May Offer Less Benefit Than You Think:
In one survey, most women said they believed mammography reduced the risk of breast cancer deaths by at least half and prevented at least 80 deaths per 1,000 women screened.5 In reality, mammography may, at best, offer a relative risk reduction of 20 percent and prevent in absolute terms only onebreast-cancer death per 10,000 women.
2. Mammography May Increase the Risk of Breast Cancer in Women with a BRCA 1/2 Mutation:
Results published in the British Medical Journal (BMJ) show that women carrying a specific gene mutation called BRCA1/2 (which is linked to breast cancer) are particularly vulnerable to radiation-induced cancer.6
Women carrying this mutation who were exposed to diagnostic radiation (which includes mammograms) before the age of 30 were twice as likely to develop breast cancer, compared to those who did not have the mutated gene. They also found that the radiation-induced cancer was dose-responsive, meaning the greater the dose, the higher the risk of cancer developing.
3. False Positives are Common (and Dangerous)
In the US, the risk of having a false-positive test over 10 mammograms is a concerning 58 percent to 77 percent!7, 8 When a woman is told she may have breast cancer, it causes considerable anxiety and psychological distress. Meanwhile, you will be subjected to more testing, such as biopsy or surgery, which carry their own set of risks, unnecessarily.
4. Mammograms May Not Work if You Have Dense Breasts
Up to 50 percent of women have dense breast tissue, which makes mammograms very difficult to decipher. Dense breast tissue and cancer both appear white on an X-ray, making it nearly impossible for a radiologist to detect cancer in these women. It’s like trying to find a snowflake in a blizzard.
Breast density laws have been passed in California, Connecticut, New York, Virginia, and Texas, making it mandatory for radiologists to inform their patients who have dense breast tissue that mammograms are basically useless for them. A law is now being considered at a federal level as well.
5. There are Other Screening Options
There are other screening options, each with their own strengths and weaknesses, and you have a right to utilize those options. Remember, only a biopsy can confirm cancer. Screening tools only aid in the process of showing concern.
Your Waist Size Is Linked to Your Breast Cancer Risk It’s important to remember that getting a mammogram, if you choose to, is not the same as prevention. In order to truly avoid breast cancer, you need to focus your attention on actual prevention and not just early detection, and one way to do this is by maintaining a healthy weight, and, particularly, a healthy waist size.
Researchers analyzed data from 93,000 mostly overweight post-menopausal women. This included data such as their general health, cancer status, and skirt size (which was used as a gauge of waist size). The latter – skirt size – was strongly linked to breast cancer risk.9 As TIME reported:10
“An increase in skirt size was the single most predictive measure of breast cancer risk, the study concluded. When women went up a single skirt size over a 10-year span between their mid-20s and mid-60s, they were shown to have a 33% greater risk of developing breast cancer after menopause. Buying two skirt sizes up during that same period was linked to a 77% increased risk.”
Clothing sizes can be quite ambiguous, of course, with a size 8 in one brand equal to another’s size 10. Yet, the premise that increasing waist size might increase cancer risk is sound. Breast cancer is the most common cancer in women, and obese women are thought to be up to 60 percent more likely to develop cancer than those of normal weight.
The reason for this increased risk is because many breast cancers are fueled by estrogen, a hormone produced in your fat tissue. So the more body fat you have, the more estrogen you’re likely to produce. However, excess fat around your mid-section may be particularly dangerous.
Why Your Waist-to-Hip Ratio Matters If you have a high waist-to-hip ratio, i.e. you carry more fat around your waist than on your hips, you may be at an increased risk for certain chronic conditions. Certain body compositions do tend to increase your risk of chronic disease, and carrying extra inches around your midsection has been repeatedly shown to increase cardiovascular health risks. Your waist size is also a powerful indicator of insulin sensitivity, as studies clearly show that measuring your waist size is one of the most powerful ways to predict your risk for diabetes, and this could also play a role in cancer as well.
To calculate your waist-to-hip ratio, measure the circumference of your hips at the widest part, across your buttocks, and your waist at the smallest circumference of your natural waist, just above your belly button. Then divide your waist measurement by your hip measurement to get the ratio. (The University of Maryland offers an online waist-to-hip ratio calculator11 you can use.) To determine your waist-to-hip ratio, get a tape measure and record your waist and hip circumference. Then divide your waist circumference by your hip circumference. For a more thorough demonstration, please review the video below.
Waist to Hip Ratio | Men | Women |
---|---|---|
Ideal | 0.8 | 0.7 |
Low Risk | <0.95 | <0.8 |
Moderate Risk | 0.96-0.99 | >0.81 – 0.84 |
High Risk | >1.0 | >0.85 |
The Sugar Connection Obesity, including abdominal obesity, is driving up rates of breast cancer in many developed countries. And what is driving up rates of obesity? Many factors, actually, but sugar certainly plays a primary role. There is no shortage of research linking excessive sugar consumption with obesity, and the intake of sugar-sweetened beverages appears to have a particularly strong link. It was more than five years ago when UCLA researchers found that adults who drank at least one sugar-sweetened beverage a day are 27 percent more likely to be overweight or obese.12 Even those who only drank soda occasionally had a 15 percent greater risk.
This is far more than simply an issue of consuming “empty calories,” as sugary drinks, soda, and even fresh-squeezed fruit juice contain fructose, which has been identified as one of the primary culprits in the meteoric rise of obesity and related health problems—in large part due to its ability to turn on your “fat switch.” Alarmingly, research presented at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions suggested sugary beverages are to blame for about 183,000 deaths worldwide each year, including 133,000 diabetes deaths, 44,000 heart disease deaths, and 6,000 cancer deaths.
About 77 percent of food items in US grocery stores contain added sugar. So it’s no wonder that, while the American Heart Association recommends a daily sugar limit of six teaspoons for women and nine for men, the average American consumes more like 22. If health agencies really wanted to make a dent in breast cancer, they would focus on sharing the truth about sugar (and grains), and their role in obesity and cancer. Unfortunately, breast cancer is big business, and mammography is one of its primary profit centers. This is why the industry is fighting tooth and nail to keep it, even if it means ignoring (or downplaying) the truth.
Avoiding Sugar and Other Top Breast Cancer Prevention Tips I believe the vast majority of all cancers, including breast cancer, could be prevented by strictly applying basic, commonsense healthy lifestyle strategies, such as the ones below. No available screening method, whether mammography or otherwise, is going to lower your risk of breast cancer… but the tips that follow will:
In addition to exercise, try to limit your sitting time to three hours a day while taking 10,000 daily steps during your non-exercise hours.
Breast screening: an obsessive compulsive disorder. in Cancer Causes Control. 2014 Jul 11. Prof Yunus Luqmani a British oncology biochemist, Kuwait University writes “Mammographic screening was founded on the premises that “it saves lives”, ‘early is better than late,’ which prevails in several countries but controversial since its inception. Findings and interpretation of clinical trials data vary considerably, with disagreement on the outcome and value of such procedure, not just about the benefits but about the potential harms of mass screening. Many are being screened for the benefit of the few. Even this might be acceptable but for concern for many women with screen detected cancers that will potentially not cause them harm, and who are very likely receiving unnecessary treatment. Many call for complete cessation of indiscriminate screening if not re-assessment of age and periodicity . Of great concern is that screening is being vigorously advocated by many healthcare workers, the media, and lay persons alike without proper awareness or appreciation of the consequences. Although some National leaflets now present a truer picture, there is distinct lack of transparency to allow women to distinguish perception from reality and to make informed choices. How many would elect to be screened if they knew that for every one woman who is notionally saved by early detection, anywhere from 2 to 10 otherwise healthy women are being turned into breast cancer patients?
Benefits of mammography |
|||||||||||||||||||
“the benefits of screening mammography are modest at best” (Elmore & Harris BMJ 2014;348:g3824). This is the conclusion after the latest research to come out of Norway where the introduction of screening has been gradually introduced over the last 2 decades (Weedon-Fekjaer et al BMJ 2014;348:g3701).The Norwegian authorities invited women between 50 and 70 years old to attend for screening every second year and looked at before and after death rates from breast cancer. They found RELATIVE risk reduction of 28% in those invited compared with those not invited to be screened. Without knowing the ACTUAL risk reduction or the harms of screening this sounds like a “good deal”. However it is an observational study not a randomised trial and therefore susceptible to various biases.For women to make up their own minds about screening, actual figures of benefits and harms need to be given because without accuracy perceived dangers and benefits are very far from reality. For example in the US or UK asking women about their estimates of breast cancer deaths – taking 1000 women aged 50 and following them for 20 years – gave the following results:
Women believe that breast cancer is a far greater threat than it really is. They also believe that screening halves such risk. If actual death reductions from breast cancer are taken into account, screening benefits are modest at best and if all cause deaths are taken into account the benefits all but disappear. |
Commentary The mammography debate is one of the facets of the Miami Breast Cancer Conference this year. It seems as though the field of breast cancer has always been controversial, going back half a century, and breast cancer is a disease that, more than most others, is very polarizing. This disease engenders great passion—and great debate, which has been ongoing about the role of screening mammography.
A few weeks ago, The New York Times covered an article that was published in the British Medical Journal 1 about the Canadian National Breast Screening Study. On the surface, this study failed to show any benefit from mammography. That was the story that the writer, Gina Kolata, picked up and ran with. Ms. Kolata had written about her own experience with breast cancer a number of years ago; her breast cancer had not been picked up on a mammogram, and so she is somewhat biased.
In short, the Canadian study evaluated mammograms from more than 90,000 women who had very primitive mammograms between 1980 and 1984, and that is really the first problem with this study: the technology and the equipment then was incredibly limited, such that the mammograms only showed 30% of breast cancers; whereas, today, mammography detects 70% to 80% of breast cancers. Thus, taking results generated by technology from 34 years ago and making a conclusion about them in today’s world is a stretch.
One of the fundamental flaws of the Canadian study, besides the dated technology on which the conclusions were based, was that it was not randomized. Nurses, and, in some provinces in Canada, doctors, did a clinical breast exam, and, if they felt a mass or a lump, they preferentially put the patient into the mammography arm. That is what I would have done in their place; if I felt a lump, I would not be willing to send someone home.
By the end of the study, there were more than 100 extra breast cancers in the mammography arm and more breast cancers that had spread to lymph nodes in the mammography arm. And, in fact, the chance of dying of breast cancer was higher in the mammography arm.
All of the authorities with whom I have ever spoken or read who have reviewed this study dismiss it as very flawed. A number of the doctors who were involved with the study resigned their positions in protest. Despite all of that, The New York Times ran an article headlined, “Vast Study Casts Doubts on Value of Mammograms” (February 11, 2014).
Well, it is a vastly flawed study, and, in fact, there are six other, much larger and much better controlled studies, all of which showed a reduction in breast cancer mortality from 20% up to 40% in women who have mammograms—and that is certainly what we observe clinically.
We felt that it was important to really highlight this at the Miami Breast Cancer Conference this year. My guess is that our audience already knows this; but, what we would like to give them is the science about why the Canadian study was flawed so that they can talk to their patients and talk to their colleagues who may not be in the breast cancer field. That is really what I think our mission is for part of this year’s conference.
We think that this is dangerous information. We think that women will unnecessarily lose their lives to breast cancer if they forego mammography, which this study frankly says one should. I have a busy practice in Brooklyn, New York, and, at least once or twice a week, I see someone, without any question, whose life was saved by a mammogram.
I think that we all agree we need something better than mammography. We all agree that mammography can lead to over-diagnosis of breast cancers, and over-diagnosis happens, of course, when we screen for diseases in other areas of the body. We all accept this limitation.
But, for a major media outlet to take a single study that was deeply flawed and not even mention the existence of other studies, even as a point–counterpoint, I think was a bit outrageous!
12 March 2014 this publication on the Huffington Post website today under screening mammography is as appropriate as when it was published in 2010:
The NBCAM has assured women that “early (mammography) detection results in a cure nearly 100 percent of the time.” More specifically, the NBCAM is directed to claims for reducing the incidence and mortality of breast cancer through early detection by annual mammography starting at age 40. Moreover, mammograms can miss cancers in premenopausal women due to the density of their breasts, and also fail to detect cancers smaller than half an inch.
Still denied by the ACS is clear evidence that premenopausal mammography poses significant risks of breast cancer. The routine practice of taking two films annually for each breast results in approximately 0.5 rad (radiation absorbed dose) exposure. This is about 500 times the dose from a single chest X-ray and is broadly focused on the entire chest rather than narrowly on the breast. This is also 25 times higher than is allowed by the Environmental Protection Agency for whole-body radiation from local nuclear industries (0.02 rad). Moreover, the breast is the most sensitive organ to ionizing radiation.
As warned by the prestigious National Academy of Sciences in 1972 but still ignored by the ACS, the premenopausal breast is highly sensitive to the risks of cancer from mammography, as each rad exposure increases the risks of breast cancer by 1 percent. This results in a cumulative 10 percent increased risk for each breast following a decade of routine screening. This can also accounts for the 19-percent increased incidence of breast cancer since 1975. Not surprisingly, the prestigious U.S. Preventive Task Force, supported by the National Breast Cancer Coalition, warned last year against routine premenopausal mammography. Also, not surprisingly, routine premenopausal mammography is practiced by no nation other than the U.S.
Risks of premenopausal mammography are some four-fold greater for the 2 percent of women who are carriers of the A-T gene (ataxia telangiectasia) and are highly sensitive to the carcinogenic effects of radiation. By some estimates, this accounts for up to 20 percent of all breast cancers diagnosed annually. Compounding these problems, missed cancers are common in premenopausal women due to the density of their breasts.
That most breast cancers are first recognized by women was admitted by the ACS in 1985. “We must keep in mind that at least 90 percent of the women who develop breast cancer discover the tumors themselves.” Furthermore, an analysis of several 1993 studies showed that women who regularly performed breast self-examination (BSE) detected their cancers much earlier than women failing to examine themselves. The effectiveness of BSE, however, depends on training by skilled professionals, enhanced by an annual clinical breast examination. Nevertheless, in spite of such evidence, the ACS dismisses BSE, and claims that “no studies have clearly shown [its] benefit.”
As reported in our 1999 publication in the International Journal of Health Services, an article in a leading Massachusetts newspaper featured a photograph of two women in their twenties. The article promised that early detection by mammography results in a cure “nearly 100 percent of the time.” Questioned by journalist Kate Dempsey, an ACS communications director responded: “The ad isn’t based on a study. When you make an advertisement, you just say what you can to get women in the door. You exaggerate a point — Mammography today is a lucrative [and] highly competitive business.”
If all 20 million U.S. premenopausal women submitted to annual mammograms, the minimal annual costs would be $2.5 billion. Such costs would be increased some fourfold if the industry, supported by radiologists, succeeds in its efforts to replace film machines, costing about $100,000, with high-tech digital machines, costing over $400,000, even in the absence of any evidence for their improved effectiveness.
With this background, it is hardly surprising that the National Breast Cancer Awareness Month neglects to inform women how they can reduce their risks of breast cancer. In fact, we know a great deal about its avoidable causes which remain ignored by the ACS. These include:
The enthusiastic and continuing support of premenopausal mammography by the ACS is hardly surprising in view of its major conflicts of interest that still remain unrecognized. Five radiologists have served as ACS presidents. In its every move, the ACS promotes the interests of the major manufacturers of mammogram machines and films, including Siemens, DuPont, General Electric, Eastman Kodak and Piker. The mammography industry also conducts research for the ACS, serves on its advisory boards, and donates considerable funds. DuPont is also a substantial backer of the ACS Breast Health Awareness Program. It sponsors television shows touting mammography; produces advertising, promotional materials and literature for hospitals and doctor; and lobbies Congress for legislation promoting the availability of mammography. The ACS has been and remains strongly linked with the mammography industry, while ignoring or criticizing the value of breast self-examination, even following training by a qualified nurse or clinician.
The ACS conflicts of interest extend well beyond the mammography industry. The ACS has received contributions in excess of $100,000 from a wide range of “Excalibur (industry) Donors,” who manufacture carcinogenic products. These include petrochemical companies (DuPont, BP and Pennzoil), Big Pharma (AstraZenceca, Bristol Myers Squibb, GlaxoSmithKline, Merck & Company and Novartis), and cosmetic companies (Christian Dior, Avon, Revlon and Elizabeth Arden).
Samuel S. Epstein, M.D. is professor emeritus of Environmental and Occupational Medicine at the University of Illinois at Chicago School of Public Health; Chairman of the Cancer Prevention Coalition; and a former President of the Rachel Carson Trust. His awards include the 1998 Right Livelihood Award and the 2005 Albert Schweitzer Golden Grand Medal for International Contributions to Cancer Prevention. Dr. Epstein has authored 270 scientific articles and 20 books on cancer prevention, including the groundbreaking “The Politics of Cancer” (1979), and most recently “Toxic Beauty” (2009, Benbella Books: http://www.benbellabooks.com) about carcinogens, besides other toxic ingredients, in cosmetics and personal care products. Email: epstein@uic.edu. Web: http://www.preventcancer.com.
update 6 March 2014 Switzerland debates dismantling its breast cancer screening programme BMJ 2014;348:g1625 “A row has erupted in Switzerland after the Swiss Medical Board recommended that the country’s mammography screening programme for breast cancer be suspended because it leads to too many unnecessary interventions.
In a report made public on 2 February, the board said that while systematic mammography screening for breast cancer saved 1-2 women’s lives for every 1000 screened, it led to unnecessary investigations and treatment for around 100 women in every 1000.1 “The desirable effect is offset by the undesirable effects,” said the report, which was based on study data from 1963 to 1991 comparing 1000 women who were screened with 1000 women who were not. The report also concluded that screening was not cost effective.…”
update 1 Mar 2014 Supporting informed decision making when clinical evidence and conventional wisdom, clash. The nub of the screening mammography war – and all hard-sell marketing hype- is elegantly analyzed by a USA multiUniversity Communications team in Against conventional wisdom: when the public, the media, and medical practice collide. Jakob Jensen ea argue that “the screening mammography controversy was driven by the systematic removal of uncertainty from science communication. To increase comprehension and adherence, health information communicators remove caveats, limitations, and hedging so science appears simple and more certain. This streamlining process is, in many instances, initiated by researchers as they engage in dissemination of their findings, and is facilitated by public relations professionals, journalists, public health practitioners, and others whose tasks involve using the results from research for specific purposes. Uncertainty is removed from public communication because many communicators believe that it is difficult for people to process and/or that it is something the audience wants to avoid. Uncertainty management theory posits that people can find meaning and value in uncertainty. CONCLUSIONS: Science is routinely simplified as it is prepared for public consumption. In line with the model of information overload, this practice may increase short-term adherence to recommendations at the expense of long-term message consistency and trust in science”.
We see the same collusion between corporate marketeers and government regulators in so many high-profit industries:
* on Pubmed, screening mammography features for 50 years, and continued to expand exponentially without hindrance until enough epidemiologists – led by the Cochrane Group- collectively rang enough alarm bells the past decade. The zealous huge-profit USA radiology-oncology industry simply shouted down the negative result of the massive Canadian Screening Mammography trial outcome 30 years ago in 90 000 women, and continue to do so with the 25year results now reported. The huge Breast Industry retaliates by threatening whistle blowers.
*and as a result, the past 30years,- against all rational food science and biology – Montsanto’s Government- approved rape of healthy food agriculture by genetically modified crops laced with toxic environmentally persistent glyphosate C3H8NO5P- Roundup.
It is no irony that one of the leading medical scientists of the 20th century Dr John Gofman took part in the Manhattan nuclear Project, was a pioneer of VLDL lipidology, and then an activist for protecting women against the accumulating harm of mammography – “there is no safe dose of radiation”.
at Exam. | Resulting Risk of Mammogram-Induced Breast Cancer. 1998 | |
Any age in | 1 exam: | 1 chance in about 1,100. |
30-34 range. | 5 exams: | 5 chances/1100, or 1 chance in 220. |
Any age in | 1 exam: | 1 chance in about 1,900. |
35-49 range. | 10 exams: | 10 chances/1900, or 1 chance in 190. |
Any age in | 1 exam: | 1 chance in about 2,000. |
50-64 range. | 15 exams: | 15 chances/2,000, or 1 chance in 133. |
Dr Emily Transue MD eloquently describes her personal disillusionment with screening mammography.
They fail to list other adverse effects: 7. Pain and bruising of crush mammography- sometimes prolonged; 8. spreading early and likely dormant cancer. 9. Increased incidence of breast cancer and thus more irradiation, mastectomy and all-cause mortality, and 10. complications of surgery, radiotherapy and chemotherapy. ………………………..
The Canadian study, launched in 1980, is the only trial to enroll participants in the modern era of routine adjuvant systemic treatment for breast cancer, and the women were educated in physical breast examination as advocated today.4 These important features may make this study more informative for a modern setting, compared with other randomised trials. The results of the study are strikingly similar—for both lack of efficacy and extent of overdiagnosis—to recent studies evaluating today’s screening programmes.5 6 7 The real amount of overdiagnosis in current screening programmes might be even higher than that reported in the Canadian study,4 because ductal carcinoma in situ, which accounts for one in four breast cancers detected in screening programmes,8 was not included in the analyses.
Other studies also indicate that improved treatment rather than screening is the reason for the decline in breast cancer mortality during the past four or five years.5 7 Even though different studies arrive at different reductions in breast cancer mortality (from 10% to 25%), these benefits translate to only marginal differences in absolute effects. Much larger variation is seen in the estimates of overdiagnosis.6 In studies based on statistical modelling, overdiagnosis was less than 5%.6 By contrast, most observational studies report higher estimates of overdiagnosis, ranging from 22% to 54%,6 depending on denominator used.9 When the number of breast cancers detected at screening is used as the denominator (as in the Canadian study), the amount of overdiagnosis observed in the previous randomised controlled trials is strikingly similar (22-24%).4 10
How do the data on mammography screening compare with data on prostate cancer screening by prostate specific antigen, which is currently not encouraged in the United Kingdom and other countries owing to its small effect on mortality and large risk of overdiagnosis (www.screening.nhs.uk/prostatecancer)? The figure on bmj.com shows that the absolute harms (overdiagnosis) and benefits (mortality reduction) are not very different between the screening types. The 20 year risk of breast cancer for a 50 year old woman is 6.1% with screening (including 22% overdiagnosis 4),11 and 5.0% without screening; and the corresponding numbers for prostate cancer in a 50 year old man are 3.9% with screening (including 45% overdiagnosis 12) and 2.7% without screening.11 The 20 year risk of death from cancer for a 55 year old woman is 1.5% with screening (assuming a 20% reduction in mortality2)11 and 1.9% without screening; and the corresponding numbers for prostate cancer in a 55 year old man are 1.0% with (assuming a 20% reduction in mortality12) and 1.3% without screening.11
Nevertheless, the UK National Screening Committee does recommend mammography screening for breast cancer but not prostate specific antigen screening for prostate cancer, stating that the “aim is to only implement programs that do more good than harm and that the informed choice is a guided principle of screening” (www.screening.nhs.uk/screening). Because the scientific rationale to recommend screening or not does not differ noticeably between breast and prostate cancer, political pressure and beliefs might have a role.
We agree with Miller and colleagues that “the rationale for screening by mammography be urgently reassessed by policy makers.” As time goes by we do indeed need more efficient mechanisms to reconsider priorities and recommendations for mammography screening and other medical interventions. This is not an easy task, because governments, research funders, scientists, and medical practitioners may have vested interests in continuing activities that are well established.
RESPONSES: 12 February 2014 BMJ 2014;348:g366 : 1. rebuttal by USA radiologists : Daniel B. Kopans, Professor of Radiology Harvard Medical School. Having been one of the experts called on in 1990 to review the quality of their mammograms I can personally attest to the fact that the quality was poor (1). To save money they used second hand mammography machines. The images were compromised by scatter since they did not employ grids for much of the trial. They failed to fully position the breasts in the machines so that cancers were missed because the technologists were not taught proper positioning, and their radiologists had no specific training in mammographic interpretation.
The CNBSS’s own reference physicist wrote:“..in my work as reference physicist to the NBSS, [I] identified many concerns regarding the quality of mammography carried out in some of the NBSS screening centers. That quality [in the NBSS] was far below state of the art, even for that time (early 1980’s). ” (2)
In this latest paper (3) the authors gloss over the fact that only 32% of the cancers were detected by mammography alone. This extremely low number is consistent with the poor quality of the mammography. At least two thirds of the cancers should be detected by mammography alone (4). In their accompanying editorial (5) Kalager and Adami admit that ” The lack of mortality benefit is also biologically plausible because the mean tumour size was 19 mm in the screening group and 21 mm in the control group….a 2 mm difference.” Poor quality mammography does not find breast cancers at a smaller size and earlier stage and would not be expected to reduce deaths.
The documented poor quality of the CNBSS mammography is sufficient to explain their results and all of the above disqualifies the CNBSS as a scientific study of mammography screening, but it was even worse than that. In order to be valid, randomized, controlled trials (RCT) require that assignment of the women to the screening group or the unscreened control group is totally random. A fundamental rule for an RCT is that nothing can be known about the participants until they have been randomly assigned so that there is no risk of compromising the random allocation. Furthermore, a system needs to be employed so that the assignment is truly random and cannot be compromised. The CNBSS violated these fundamental rules (6). Every woman first had a clinical breast examination by a trained nurse (or doctor) so that they knew the women who had breast lumps, many of which were cancers, and they knew the women who had large lymph nodes in their axillae indicating advanced cancer. Before assigning the women to be in the group offered screening or the control women they knew who had large incurable cancers. This was a major violation, but it went beyond that. Instead of a random system of assigning the women they used open lists. The study coordinators who were supposed to randomly assign the volunteers, probably with good, but misguided, intentions, could simply skip a line to be certain that the women with lumps and even advanced cancers got assigned to the screening arm to be sure they would get a mammogram. It is indisputable that this happened since there was a statistically significant excess of women with advanced breast cancers who were assigned to the screening arm compared to those assigned to the control arm (7). This guaranteed that there would be more early deaths among the screened women than the control women and this is what occurred in the NBSS. Shifting women from the control arm to the screening arm would increase the cancers in the screening arm and reduce the cancers in the control arm which would also account for what they claim is “overdiagnosis”. The analysis of the results from the CNBSS have been suspect from the beginning. The principle investigator ignored the allocation failure in his trial and blamed the early excess of cancer deaths among screened women on his, completely unsupportable, theory that cancer cells were being squeezed into the blood leading to early deaths. This had no scientific basis and was just another example of irresponsibility in the analysis of the data from this compromised trial and he finally retracted the nonsense after making front page headlines (6).
The compromise of the CNBSS trial is indisputable. The 5 year survival from breast cancer among women ages 40-49 in Canada in the 1980’s was only 75%, yet the control women in the CNBSS, who were supposed to represent the Canadian population at the time, had a greater than 90% five year survival. This could only happen if cancers were shifted from the control arm to the screening arm. The CNBSS is an excellent example of how to corrupt a randomized, controlled trial. Coupling the fundamental compromise of the allocation process with the documented poor quality of the mammography should, long ago, have disqualified the CNBSS as a legitimate trial of screening mammography. Anyone who suggests that it was properly done and its results are valid and should be used to reduce access to screening either does not understand the fundamentals, or has other motives for using its corrupted results.
2. confirmation: http://www.bmj.com/content/348/bmj.g366?tab=responses Per-Henrik Zahl, MD & statistician Norwegian Institute of Public Health. In this 30-year old study, the authors report no mortality reduction when screening with mammography and 22% overdiagnosis (1). The sensitivity of the mammography technique has improved tremendously in the last three decades. Ten years ago we got digital mammography and recently we have got tomosynthesis (2). The detection rate at mammography in the Canadian study was about 3 per 1000 in the second and later screening rounds (3). In digital mammography, the corresponding detection rate is 6 per 1000 screened woman and in tomosynthesis, the detection rate is 8 per 1000 (2). It could even have been higher if the pathologists had time to perform more biopsies (personal communications). In tomosynthesis a large number of stellate lesions appear, many more than in traditional mammography, and they are probably representing a reservoir of overdiagnosed breast cancers. In the last 15 years, the rate of interval cancer has been constant and is at the same level as in Canada 30 years ago (4). Thus, the level of overdiagnosis is far much bigger today than in Canada 30 years ago.
Hence Regulators in most countries have reduced recommendations for routine screening mammography to starting at age >50yrs and stopping by 70-75years (ie 10-12 times on average through midlife); whereas Radiology Associations ignore the risks and still advise screening annually from age 40 years, for life – ie at least THREE times as many times from age 40years. So women are doubly exposed to harmful pressure both in being bullied that they need screening xray mammography – the lie that ” screening mammography saves lives” when the benefit of this is unproven, and in being forced to undergo breast crushing repeatedly. A woman who recently attended for Sure Touch in Port Elizabeth objected to having her breasts snackwiched again by compression mammography. The flippant analogy is eerie when one considers how such women are expected to attend annually to have their breasts both flattened and irradiated – and more so with cumulative frying after therapeutic radiotherapy. No wonder some end up with a hard breast. . So while the young at heart may love nudging breasts-, and massage heals, (and Bissell and Fletcher at the Berkley lab show that gentle nudging with about 50 gm pressure knocks errant breast ductal cells back into healthy behaviour) – crushing force and coersion do women harm, not good; in contrast to men where forceful digital massage may (also with putative risk) relieve the infected painful prostate.. .
update 26 May 2013 Apart from the strident promotion of preventative mastectomy by a film star, reports the past week prompt review of : why and whether aggressive breast cancer may have doubled in young women 25-39years old; and it’s prevention by natural steps.
Lisa Willis, Karen Page, Trevor Graham, Tomás Alarcón, Malcolm Alison & Ian Tomlinson from Universities of London, Oxford, Cambridge, and Barcelona this month dissect “What Can Be Learnt about Disease Progression in Breast Cancer Dormancy from Relapse Data? why Breast cancer patients have an anomalously high rate of relapse up to 25 years after apparently curative surgery removed the primary tumour. Disease progression during the intervening years between resection and relapse is poorly understood. There is evidence that the disease persists as dangerous, tiny metastases that remain at a growth restricted, clinically undetectable size until a transforming event restarts growth. This suggests a natural question and a surprising answer: why are interesting trends in long-term relapse data not more commonly observed?” But they are observed: another recent 15 year followup study, from Denmark (Grantzau ea), furthermore shows that DXRT after early breast cancer almost doubles the risk of radiotherapy-associated second cancer to 1:200 of women so treated..
These reports raise yet further doubts about the wisdom of regular mass xrayscreening of well breasts from age 50 years let alone 40years, and worse- zealous major surgery and DXRT for preclinical disease, and then even worse, ongoing xray mammographic surveillance into old age.
They point in the opposite direction: that xray screening of well breasts should be avoided; DXRT avoided in localized early breast cancer; and surveillance for breast cancer limited to the many available non-xray methods;
and that women must be encouraged instead to maintain prevention with combination of safe natural (and multisystem-protecting) means as discussed repeatedly in this column – lifestyle, diet, exercise, and massage and oral use of safe natural preventative supplements. Anticancer antiangiogenesis factors from our diet are legion, include cannabis, mushrooms, resveratrol, green tea, black rasberry and Royal jelly. One would not recommend soya against breast cancr because of its phytoestrogen potential.
Xradiation has been known for decades eg 1978 1990 to be both an angiogenic and an antiangiogenic factor in tumour growth angiogenesis (Judah Folkman 1971) . so it is obviously a double-edged sword that should certainly not be used in the witchhunt for silent and usually irrelevant precancer in well breasts.
So we have the ludicrous situation reported today in JAMA that despite all the evidence for 20 years now to stop or at least halve mass xray screening and thus (over)treatment of silent early breast cancer, “Physicians, Patients Not Following Advice From USPSTF on Mammography Screening: In 2009, the US Preventive Services Task Force (USPSTF) recommended against routine screening mammography for women under 50 years and advised biennial rather than annual screening for women aged over 49yrs. But women and physicians ignored these recommendations. A new study from Harvard found that in 2005 to 2011, the percentage of women aged 40 to 49 years reporting that they had undergone mammography screening in the previous year was the same, about 47%. As for women aged 50 to 74 years, the percentage reporting mammography screening in the previous 12 months for each year analyzed also remained essentially the same, in the upper 50% range.”
Update 21 April 2013: FIFTEEN YEAR FOLLOWUP STUDIES OF BREAST CANCER AND ALLCAUSE MORTALITY FROM MENOPAUSE ONWARDS: Overall, long-term studies do not favour invasive breast screening or adjuvant therapy of early breast cancer, but actually argue against early diagnosis and treatment of both silent breast and prostate cancer. Rather, the focus must be on safe natural prevention to reduce the occurrence of all common degenerative diseases of aging.
Erbas ea at Univ Melbourne studied all sources for the prevalence of ductal carcinoma in situ. “The reported prevalence of undiagnosed DCIS in autopsy studies, of approximately 9%, has been used to suggest a larger reservoir of DCIS may exist in the population”.
Update 18 April 2013: a new study from Italy graphically illustrates the lower sensitivity of xray screening – U/S ie ultrasound picked up ‘significantly’ more tiny asymptomatic breast cancers missed in 22,131 women with negative mammography. “The overall U/S detection was 0.185%, but 0.55% with previous cancer vs 0.145% in women without cancer history (p = 0.0004), 0.22% in dense breasts (p = 0.17) vs .156% in fatty breasts. The U/S- generated invasive assessment was 0.19% The benign to malignant open surgical biopsy ratio was thus 0.17.” This is likely more overdiagnosis unless the women simply apply the preventative measures recommended below.
But while no screening method can diagnose cancer (only invasive biopsy can), and none can guarantee there arnt cancer cells busy germinating especially if stirred up by severe anxiety, radiation, crushing, biopsy etc, Sure Touch mapping is more accurate than even U/S for reassuring while reducing referral rate for U/S.
UPDATE 14 APRIL 2013: Because of the evidence the past score years set out below that xray screening actually does more harm than good, integrative medical clinics world wide do not promote xray screening mammography. But such clinics including in Cape Town generally offer regular safe and lower-cost anatomical eg Sure Touch mechanical tactile if not ultrasound or MRI, and physiological no-touch eg thermography ie bloodflow studies, – for those who need peace of mind. Some women choose to alternate Sure Touch and thermomammography.
While only 1 in 200 women have the familial gene risk, the majority of older women have the common multiple risk factors eg longevity, estrogenic and heavy metal pollution, stress, overweight density, smoking, alcohol; and there are many simple remedies described in these columns that can reverse most of the risk factors – not just of even genetic breast cancer and increasing overweight, but of all the major diseases of aging.
The problem remains the stubbornness of third party payers including governments to listen to both the evidence and to womens’ wishes, and pay for such safe, cheaper and arguably more accurate prscreening than crush xray mammography, if any is desired or desirable .
Dr Johnnie Ham MD MSc MBA Californian ObGyn discusses why xray screening mammography and aggressive medical assault on well breasts- the witchhunt for the pot of hidden gold, silent preclinical breast cancer – is a giant con by the for-profit high-tech medical goliath industry terrorizing and mutilating naive women.
Governments -WHO silence on harms of screening mammography : What is tragicomedy is that worldwide, government Regulators seem to be standing silently firm, not saying a word about the harm likely exceeding the medical benefit- the screening and cancer industry is far too profitable in jobs, taxes and votes. Search on the internet for Government warnings on harms of screening mammography does not yield a word of warning. Regulators and Medical Schemes piously promote quality screening, but say nothing about the harms versus benefits. The FDA still promotes annual screening mammography on line without a word about the risks and harms of mammography; others like the UK NHS promote it every 2 to 3 years. Yet the US Senate is actually considering a Republican Act to promote more xray breast imaging.
UPDATE 12 April 2013 The Wiki entry on breast cancer prognosis says now: “One result of media hype- breast cancer’s high visibility -(compared to other cancers in eg men, and other common major diseases) is that statistics may be misinterpreted, such as the claim that breast cancer will be diagnosed in one in eight women during their lives—a claim that depends on the unrealistic assumption that no woman will die of any other disease before the age of 95.[132] This obscures reality that about ten more women will die from heart disease or stroke than from breast cancer.[133]The emphasis on breast cancer screening may be harming women by subjecting them to unnecessary radiation, biopsies, and surgery. One-third of diagnosed breast cancers might recede on their own.[134] Screening mammography efficiently finds non-life-threatening, asymptomatic breast cancers and pre-cancers, even while overlooking serious cancers. According to Prof Gilbert Welch of Dartmouth Institute, research on screening mammography has taken the “brain-dead approach that says the best test is the one that finds the most cancers” rather than the one that finds dangerous cancers.[134]
The latest report Lancet 2011) on the Relevance of breast cancer hormone receptors and other factors to efficacy of Tamoxifen protection after breast cancer looked at 20 trials (n=21,457) in early breast cancer . In oestrogen receptor (ER)-positive disease, about 5 years of tamoxifen halved recurrence rates throughout the first 10 years but no further gain or loss after year 10; risk was approximately independent of progesterone receptor status (or level), age, nodal status, or use of chemotherapy. Breast cancer mortality was reduced by about a third throughout the first 15 years. Overall non-breast-cancer mortality was little affected, despite small absolute increases in thromboembolic and uterine cancer mortality (both only in women older than 55 years), so all-cause mortality was substantially reduced. In ER-negative disease, tamoxifen had little or no effect on breast cancer recurrence or mortality.
This is not surprising as tamoxifen like all synthetic sex hormones /blockers has a long list of adverse effects on bone, brain, cardiovascular, bladder, mood, immunity, body weight and metabolism, womb etc.
But the Oxford UK-led (Davies ea) landmark monumental ATLAS trial (2012) from 1996 -2010 in 36 countries and 180 000 women-years (mean presentation age mid 50s, ER+ breast cancer about 1 cm size, 2/3 had mastectomy – which is now known to increase mortality) showed that after 6846 women taking tamoxifen for up to 10 years, at about 15 years from diagnosis, tamoxifen in absolute terms was only marginal benefit- marginally reduced the risk for breast cancer recurrence, compared with stopping tamoxifen (617 vs 711; P = .002), reduced breast cancer mortality relatively by 8% (331 vs 397 deaths; P = .01) but that’s only about 1% in absolute terms, and reduced overall mortality by 10% (639 vs 722 deaths; P = .01). Over all, approximately 1/5 clinically relapsed, 1/7 deaths were from breast cancer; but of those who died, webfigures 4a and 4b of the supplementary appendix of the main ATLAS report showed that at autopsy almost half (43%) indeed had recurrent breast cancer. This gives the lie to early screening and treatment- 15 years later, even with tamoxifen for 10 years, early xray mammography detection and conventional surgical-radio-chemotherapy treatment does not cure much more than half of women with preclinical ER+ breast cancer that screening detects.The risk for recurrence by year 15 was 21.4% in the continuers group and 25.1% in the control group. ie only 3.7% absolute reduction. In addition, breast cancer mortality by year 15 was significantly reduced by nearly 3%; it was 12.2% in the continuers group and 15.0% in the control group. ie only 2.8% absolute reduction. Thus even in these women with early breast cancer, the cure rate even with tamoxifen was poor- slight reduction in the 25% recurrence and 15% breast cancer mortality rates. But almost half of the women who died had recurrence. Once again, the actual results published 4 months ago in the final Lancet report were much less impressive than the media release published 5 days later. Of these >6000 women allocated after initial surgery/ radio/chemotherapy to the tamoxifen or placebo trial, 85% did not die of breast cancer. But the cure rate was at best still only about 75%, and only half of those who died -by a mean of age 70 years – of any causes were free of breast cancer.
9 April 2013 Robert Stern at University of Arizona writes that “xray mammography alone is not a very good screening modality and has strikingly variable false positive, false negative, specificity, and efficacy rates, depending on what you read and who you believe.
8 April 2013: UPDATE: see vitamin D3 and Breast Cancer.
JAMA publishes on line from University Basel Switzerland, Shaw and Elger’s viewpoint on Evidence-Based Persuasion, often an ethical imperative to forcefully guide a hesitant patient into what seems to be the best decision, using arguments from Removal of Bias to Recommending Options and occasionally even Creating New Biases. The eternal problem remains, what is truly right? Is mass flu vaccine right? Is screening xray mammography truly lifesaving? especially if one quotes impressive but misleading relative risk reduction rather than in fact the crucial trivial absolute reduction? Is Directive Counselling however well-meant exercising undue influence? They conclude that it is an essential part of modern medical practice, without which it may be impossible to respect patients’ autonomy. Such necessary persuasion needs to meet 6 criteria.
A month ago BCAction held a webinar reported by Manie Clark
updating the risks and futility of screening xray mammography.
There are certainly many safe natural ways we reviewed recently of reversing the risks of breast proliferation and cancer, thus justifying periodic safe low cost breast screening – mammo-imaging – by independent eg digital, mechanical tactile ” Sure Touch ” , ultrasound and/ or thermo- means.26 Feb 2013. There is a flood of new progress against breast disease , breast cancer and xray screening mammography: Contrary to the for-profit Breast industry, like all independent authorities including the Cancer Association of South Africa CANSA , the National Cancer Institute of America in 2013 no longer recommends routine xray mammography screening- it rates the EVIDENCE on X-ray screening mammography as FAIR evidence for its sole and arguable benefit – Decrease in total and breast cancer mortality – -*Consistency of studies is only Fair. External Validity: Good. Internal Validity: Variable,. But as GOOD evidence for the FIVE major HARMS of xray screening -* both consistency, internal & external validity -are good –
Winifred Cutler’s Athena Institute team warns again that screening X-ray mammography on well women is dangerous , inflicts terror, it does not reduce but may worsen the occurrence of invasive breast cancer. The Berkeley Institute’s Dr Venugopalan under profs Mina Bissell and Daniel Fletcher show that simply gentle massage helps – Compressing Breast Cancer Cells Can Stop Out-of-Control Growth Shelley Hwang ea show that in California simple lumpectomy for early breast cancer reduced deaths (up to 2009) by 28% compared to mastectomy. Belinski & Boyages at the Westmead Centre in Australia show again that common very low vitamin D levels more than double the risk of breast cancer let alone colon and all other cancers. A Harvard team (Liu ea) has just shown that the carnage of legalized poisoning (smoking – lungcancer, vascular; alcohol -liver disease, violence; adulteration with refined sugar/fructose – diabetes, vascular disease, cancer) aside, breast cancer far outstrips the other common cancers (colon, prostate cancer) in preventible life years lost. Willaims ea show again the major benefit of metformin against lethal breast cancer. Amadou ea in France confirm again the strong link between abdominal obesity and breast cancer from childhood throughout life. This again highlights the criminal stupidity of delaying metformin use till obesity let alone infertility or diabetes are established. Metformin can safely be introduced at any stage of life provided it is started at very low dose eg below 250mg/day and cautiously titrated to the maximum well-tolerated dose to avoid nausea and diarrhoea- and temporarily halved or stopped in case of intercurrent gastrointestinal upset. . Grani et al from Rome, Italy and many others remind us that both thyroid and breast malfunction are common by middle age and need to be sought and managed together. We know that in most aging populations, deleterious deficiency of especially magnesium, iodine, selenium, sulphur, and vits B, C, D and K , and melatonin and sex hormones is very common along with crippling multitoxic carcinogenic overload. So it is logical to use multisupplements, and massage anti- inflammatory anti-cancer antioxidant chelating antiestrogenic deep – penetrating iodine, coconut oil and DMSO – into the breasts as multidisease prevention and part of treatment. Oz ea in Turkey show that DMSO is more effective against breast cancer than thalidomide. But more importantly, DMSO enhances transport of any anticancer agents into cancer cells. Already in 2008 Frederick ea showed that Lugol’s Iodine is an important antiestrogen adjuvant against breast cancer. Hence we advise the harmless combination of natural multisystem micronutrients- especially fish oil, coconut oil, DMSO, vitamin C, D, K, melatonin, metformin, selenium, Lugol’s iodine and appropriate progesterone/ testosterone/ DHEA – as nutrient supplements against all chronic aging diseases especially in women at risk of breast cancer. . At Univ Newcastle on Tyne, Dr Dorota Overbeck-Zubrzycka’s landmark PhD thesis just published on FOXP3 regulates metastatic spread of breast cancer via control of expression of CXCR4 chemokine receptor promises new gene therapy in future. and her parallel study with Harvey, A. Griffiths & C. Griffith, Randomised control trial of Breast Tactile Imaging as an assessment tool for diagnosis of breast lumps in 2009/10 is now being published in full in a leading UK journal, validating this ( Sure Touch) bedside and outpatient clinic procedure as an established no-risk screening procedure, objective breast mapping record for anxious women as shown in USA, Indian and Chinese studies. Thus increasingly Authorities are accepting that screening X-ray mammography harms far outweigh trivial if any improvement in survival. But screening – by eg regular clinical exam and mechanical tactile mapping – for early signs of breast degeneration allows gentle safe self – treatment of all multisystem diseases that reverses both the breast degeneration and multisystem risk factors.
BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f385 (Published 23 January 2013) Cite this as: BMJ 2013;346:f385
Thus they advise against screening people with an expected lifespan of below about 10 years. But who would undergo such bothersome risky screening even over 10 years for a proposed benefit (in death risk reduction) of 0.1% a decade ? They found the reasons against routine screening of those not at high risk ( ie no suspicious personal symptoms or familial history) are as usual those of the ensuing anxiety, the procedures – radiation and colonoscopy and biopsies – and overdiagnosis. The worst is of course the cumulative risk of breast irradiation, and perforation death from colonoscopy: “For cancer screening, about one in 10 patients who are screened (with xray mammography , or with fecal occult blood testing) will have a false positive result, leading to recall worry and likely biopsy/ colonoscopy. Serious complications (such as perforation, major bleeding, and death) occur in 3.1 colonoscopies per 1000 screened. One in 100 routinely mammography-screened women will be biopsied, and one in 1000 will be subject to overdiagnosis (that is, diagnosed with a breast cancer that was unlikely to have been clinically evident during their lifetime) and possibly unnecessary treatment.”
The same arguments apply strongly against routine screening of men for prostate cancer, or smokers for lung cancer, in the absence of symptoms. . It should be noted that even the Wikipedia Mammography review now strongly highlights the arguments against mass screening mammography. The introduction sums it up bluntly: “task force reports point out that in addition to unnecessary surgery and anxiety, the risks of more frequent mammograms include a small but significant increase in breast cancer induced by radiation.[3][4] The Cochrane Collaboration (2011) concluded that mammograms reduce mortality from breast cancer by an absolute amount of 0.05% or a relative amount of 15%, but also result in unnecessary surgery and anxiety, resulting in their view that it is not clear whether mammography screening does more good or harm.[5] They thus state that universal screening may not be reasonable.[6] Mammography has a false-negative (missed cancer) rate of at least 10 percent. This is partly due to dense tissues obscuring the cancer and the fact that the appearance of cancer on mammograms has a large overlap with the appearance of normal tissues. A meta-analysis review of programs in countries with organized screening found 52% over-diagnosis.[6]“
It can be argued that noninvasive screeing that finds suspicious premalignant signs can then motivate prevention by natural means- lifestyle diet and appropriate supplements. But since these preventative steps (including blood-pressure and waist/breast girth measurements and monthly self-exam for breast changes) hugely reduce the risks of all serious acute and chronic diseases, accidents and premature disability and death, routine mass screening for common ‘silent’ internal cancers eg breast, prostate colon lung womb and ovary , is irrelevant, risky and huge waste of resources for no benefit. Not applying sensible diet, lifestyle, blood-pressure checks and supplements is like failing to maintain your car, house, computers and electrical appliances etc , until these crucial assets break down. The evidence against hightech screening of the well of course does not stop the anxious well from worrying. As a heavy cigarette-smoking prof of lung medicine said 30 years ago, if an anxious patient demands a scope despite reassurance that the risk:benefit doesnt justify it, it is wise to do it. Or someone else will. At least in the context of the younger adult who will thereby be more motivated to apply prevention, non-xray non-invasive screening by eg Sure Touch breast mapping- from onset of menopause, or younger in eg diabetics and others more prone to cancer eg in AIDS, – and ultrasound quantitative bone-density risk measurement from toddlers upwards , in exercising ie sportspeople, and in any serious chronic disease especially with hormone overtones eg thyroid, diabetes, COPD/ asthma, cancer, arthritis, paralysis, AIDS,TB, cardiacs, renal, liver disease – are relatively low cost and safe compared to the traditional xray screening procedures. The brilliant new French movie The Intouchables is all about choices of lifestyle and the risks entailed. Thats what screening, and voluntary prevention, are about. No adult should be pressurized – by vested interests – into having hightech eg xray (breast, bone) or more invasive (eg scope, biopsy) screening without understandable explanation of the possible although infrequent immediate and distant risks, and remote if any benefits. Only the frequent incidental unexpected screening discovery of hypertension, increased breast lumpiness/density, and low bone density, and initiation of simple lifestyle diet changes and safe supplement therapy- the below- listed scores of supplements against all common degenerative diseases (and if needed the best primary antihypertensive – lowdose reserpine and co-amilozide – costs perhaps $1 a month to control most; and simple (breasts, arthritis, wound or elsewhere) antiinflammatory self massage if indicated with Lugol’s iodine, and analgesic antioxidant coconut oil and DMSO), gives huge early and permanent preventative pain and inflammatory benefits without risks. There are also promising studies on Pubmed between 1989 and 2011 of the benefits of DMSO in management of prostate problems in rats, and humans for transrectal procedures and intravenously as cancer adjuvant palliation. DMSO-MSM is cheaply and safely available . It comes back to basics that are anathema to politicians, Government, profiteers, Big Business Pharma and the Disease Industry. Motivating and enforcing better lifestyle and natural diet (minimizing sugar , aspartame, alcohol, processed food especially cornstarch) , and healthgiving realistic doses of supplements – vits (all – especially B, C, D3 and K), minerals (especially Mg, Zn, I2, Se, P, Bo,) and biological (plant and sealife – not land animal) extracts, (including fish oil, metformin, bioidentical human hormones, tryptophan, MSM, DMSO, chondroglucosamine, coconut oil, cinnamon, pepper, curcumin, arginine, carnitine, carnosine, ribose, coQ10, proline, rauwolfia) – reduces the occurrence of serious disease drastically with decades of health extension. This vastly reduces profit to the Disease Hospital-Drug and processed food- alcohol – tobacco industry in delayed disease till very old age, and thus loss of skilled workers’ jobs – that need to be taken up elsewhere. That’s called reinvention, recycling…
Posted in all-cause mortality, anti-aging, cancer, MAMMOGRAPHY, medicopolitical economics, prevention, SCREEENING IMAGING, supplements, war for profit and poverty
Tagged antioxidants, ATLAS trial, aTTom trial, Banting, behaviometrics, biometrics, Bissell, Breast Assault, breast cancer, breast cancer conspiracy, breast cancer in young women, breast compression force, BSCS, CANADIAN MAMMOGRAPHY SCREENING STUDY, cancer, CANCER SCREENING AN OBSESSIVE-COMPULSIVE DISORDER, coconut oil, colon, colon cancer, comparative table methods of breast imaging., DMSO, enza ferreri, Evidence-Based Persuasion, Fletcher, fmr Appfelstad interview on breast cancer, fracture, Gigerenzer, heuristics, Hidden Breast Cancewr Conspiracy, Hypertension, Lugol's iodine, magic oils, mammography alternatives, massage, mechanical tactile breast mapping, metformin, Misfearing, MULTIVITS LOWER BREAST CANCER MORTALITY BY 30%., Natural Medicine Clinics, NEVER SAY ITS HOPELESS, Noakes, overdiagnosis overtreatment, Peer perversepressure, peventative mastectomy, prostate cancer, psychological consequences of false positive reports, PTSD from Xray mammography, radiation dose, RETHINKING MAMMOGRAMS, screening, SCREENING COERSION, Screening mammography & Bambi, Shaw and Elger, snackwich breast, Sponsor Bias against nonsignificant trial results, Sure-Touch, SWISS DUTCH VIEWS, tamoxifen, thermomammography, Uncertainty management, vitamin C, vitamin D, WATCHFUL WAITING, What happened to evidence-based medicine?, wounds, xray dose
update 7 November 2015: comments & feedback please.
Orthoiodosupplementation in a Primary Care Practice Jorge D. Flechas, M.D. its undated but the latest ref is 2004..
but informative 2014 iodine update video by Dr Jorge Flechas:
some points: “why women have so many more thyroid problems eg estrogen blocks iodine; whereas ovary hot nodules may cause thyrotoxicosis from secreting T2. Iodine alerts the brain, so dont take at night! give no more than ~12mg/d ie 2 drops 15% in pregnancy, it stimulates the baby!
“Iodine ie I2 diffuses into cells whereas iodide need to be transported in; babies lack the symporter Iodide transporter, so babies need iodine not iodide.
ie thyroid, ovary and WBCs can make thyroxine- but preferably they mop up low iodine intake. Thyroid supplements doesnt provide enough iodine for needs elsewhere .
” Millions of women in Japan and Korea on their marine diet used to normally ingest ~13.5mg iodine a day, producing very low neonate problem rates in pregnancy and with IQ far higher than average.
“in the west, Iodine has been taken out of bread and milk, and salt intake cut – associated with increased rate of ADD in USA 500% and more cancer thyroid, breast, ovaries, endomet, cretinism, goitre .. – as iodine intake and output in USA has been halved by admin policy…
the kidneys excrete excess ingested iodine, so avoiding overdose from high iodine intake.
“ie if sufficiency, a 50mg iodine load will excrete >90% . so the spot test for low iodine excretion, and 24 hr high iodine excretion, reflect defective sodium symporter problem. This corrects with ongoing iodine supplement. 80% of vegans in USA are iodine deficient due to skipping seaweed for iodine! Asians eat seaweed in everything.. the body can hold 1.5gms iodine; 50mg in the thyroid, 20% in the skin, 30% in muscles…
– if depleted of iodine, we cant sweat or use our muscles (fibromyalgia), brains, or control the breasts or ovaries.. .. just add ATP cofactor ie incl vits B2 & B3 to iodine…
“Bread & esp cooldrink’ iodine (eg Mountain Dew) has been replaced by bromine, which causes schizoid behaviour… .. Iodine reverses the immortality of cancer cells.
” 3000mg/d ester C , and highdose iodine, and B2+B3 , reverse the iodine symporter block, & abolish the fibromyalgia in 80% of sufferers. .
This Flechas review is encouraging for repletion with Lugol’s 50 to 100mg iodine /day ie 6 to 12 drops 15%; after perhaps a precautionary skin test dose for allergy.
especially for protecting breasts, cancer, diabetics, obesity, heart disease, immune, memory and stroke problems.. .
It does seem that as with vits C and D3, iodine has a minimal RDA as far as basic prevention goes ie ~0.15mg – 1mg/d for avoiding cretinism (cf scurvy with >10mg/d vit C, or frank rickets with 400iu/d vit D3) ; and at the other end of the spectrum ie treating severe disease, grams a day of iodine and vit C, and vit D3 >50 000iu ie >1mg/day..
Then longterm maintenance with eg ~12 mg iodine a day ie 2drops/d 15% Lugols, cf 1 to 3 gm a day vit C, vit D3 ~7000iu ~ 0.2mg/day… .
perhaps the corollary may be that , (as with vit D3 eg 2million ie ~ 50mg), a massive accidental load dose eg 2gms iodine- 20ml 15% Lugols- (which apparently bypasses the detox reaction at lower ie buildup dose, and incidentally provides 1gm potassium) may be both harmless and will reload for who knows how many years- presumably provided one takes a good magnesium and selenium ie realfood Banting diet .
To test tolerance, and try to reverse my familial irreversible atrial fibrillation, I have built up my Lugols’ dose so far to 15% 1 to 2 tsp a day ie 4 to 8ml, ~800mg combined (I + I2) iodine with 400mg potassium K a day;
whereas a load dose vit D3 eg 0.6 to a million units (6-10gms of standard max strength 100 cwt powder – with a good magnesium and vit K2 diet as in realfood Banting) will replete safely and harmlessly for less than a year.
Its a pity the simple IODINE urine test is- unlike the skin patch test duration- so tediously long and costly (and both can occasionally mislead),
whereas the blood vit D calcium-creat levels are quick to take but costly tests.. .
But in those who can afford them , the tests are essential to validate the clinical results we get with iodine and vit D3 .
see prev Healthspanlife.wordpress.com ie May 2014 update.
quotes from authorities are in italics: please feed back on errors and experience
Massive iodine deficiency is as universal worldwide (compared to 50 years ago) as are
*deficiencies of: ..vitamin C (except those who live on fresh fruit and veg);
..vitamin D (except those who work outdoors in sunny climes);
..magnesium; and
..natural saturated fats in all except keen carnivores;
..and increasing deficiency of other vitamins in the food chain, forced on the public by government-sponsored industries and “health authorities” for 50 years now;
*and unnecessary dangerous food-chain toxins ( refined carbohydrates; calcium/bromine/ fluorine/salt, aluminium, mercury supplements, synthetics eg transfats, pesticides eg glyphos Roundup, GMO foodstuffs, antibiotics ; and steroids). .
But with seafood almost wiped out by greed and pollution, and increasing global nuclear pollution, and failure by food producers to supplement iodine never mind vit D and magnesium in the depleted food chain,
iodine repletion with vigorous Lugols iodine (with its consort selenium) is even more of a priority than concomitant vitamin D (with its consort vit K2) and magnesium supplementation, and vitamin C, plus a broad balanced other score A to Z multisupplement ..
So the dangerous scaremongering myths need to be debunked about the “dangers” of iodine at over a mg a day – when the safe general therapeutic dose is not just ~12mg/d but up to 100mg/d for longterm prevention, and over a gm/d for major diseases; ie >10 000 x the RDA. The US recommended adult dose of iodine for nuclear exposure is about 120mg, without any mention of remotest risk of toxicity.
This 1000 x order of magnitude with iodine is like
*the almost 10 000x margin between minimalistic vitamin C 10mg/d dose (RDA now 60mg/d) to avoid scurvy, up to >3v-7gm a day to treat infections, and >30 gm/day (intravenously, or buffered orally) to treat cancer;
*and vitamin D3 (RDA now up to ~800iu/d) up to 250 x more eg from 200iu /d to prevent rickets vs 50 000iu/d to treat some serious diseases, vs 2million iu single doses and 150 000iu/d for decades that have no documentable toxic effects in adults.
Infants obviously need proportionate dosing of all, not left to depend on mother’s milk when she has received no more than the usual prenatal supp folate and iron.. . .
The heaviest essential metal iodine is perhaps the most rare essential mineral – Wiki: “Iodine is rare in the Solar System and Earth’s crust (47th/60th in abundance):”- hence iodine deficiency is universal – especially now it has become fashionable in our lifetime to stop adding iodine to foodstuffs; and instead food manufacturers pump in toxic halides like bromine and fluoride (like dangerous mercury and aluminium in vaccines, aluminium in antacids) that (unlike chlorine, iodine and refined sugars) have no essential biological need and benefit , only risks;
and recognition that commercial pure white runny salt NaCl – overdosing chlorine- is adverse because of worsening hypertension with aging and fast foods, instead of encouraging seasalt. .
The myths have been debunked that
*(unlike our essential blood chlorine in moderation), either fluorine or bromine are essential trace element halogens, any more than commercial cane sugar or fructose are biologically essential in our diet;
*and the Wolff-Chaikoff Effect myths (that iodine is toxic at much more than a mg a day) debunked by Abraham & Brownstein’s review of scientific evidence the past century including Wartofsky, et al 1970 that we overdose with iodine at only 20 x the RDA (0.15mg/d) ie over a mg/ day,
*and the myth that only potass KI /sodium NaI iodides should be supplemented. The most proven iodine is in Lugols iodide providing the balance between KI and free I2.
*Another commercially driven myth is that blood thyroid hormone levels are adequate to diagnose biologically significant iodine sufficiency, and commercial thyroxine to treat patients– the commercial hormones dont address, may worsen the serious iodine deficiency throughout the body that contributes hugely to acute and chronic, common and rare diseases
Studies of traditional Japanese after WW2 showed that their far better cancer-, cardiovascular,- thyroid health (before they emigrated to America, or took up Western diet) was attributable especially to the kelp ie iodine intake in their then-safe seafood diet, giving them an average iodine intake of about 12 mg/day- at least 100 times the current American imposed RDA of 0.15mg/d. But who can trust kelp, seafood from the poisoned oceans and rivers any more?
I recently took for a day each approx 20drops Lugols 2% pd in water ie iodine ~9mg a day; then 15% 4 drops ie 30mg/d …then up to , then 10drops ~70mg/d to test for detox reaction. I carry on with ~50mg/d, as many patients take it . I suppose my lack of detox reaction is not surprising since I have been detoxing for years on about 6 gm a day of a 50 -supp -multiblend( half vit C).- but no more than a mg/d of potass iodide. I find physical and mental stamina better, no longer have angina from stress or walking fast- which I could not do a fortnight before due to angina and fatigue. . .
One shudders to think of the billions of people – especially kids- who are dull, not achieving their full potential for lack of iodine, either because health professionals dont think we need more, or because patients are dismissed as euthyroid based on the usual thyroid lab hormone tests (which ignore iodine deficiency/excess in the majority who dont fall clearly in the over-or underactive blood hormone range).
Conventional western medicine apparently no longer considers or measures iodine deficiency, forgetting that iodine is the primary essential deficient mineral (along with magnesium, selenium, sulphur, phosphate; and iron in kids and reproductive women) for all systems in the body, not just for thyroid hormone levels- which dont reflect iodine security anywhere outside thyroid hormone production by the thyroid. .
IODINE OVERDOSE?
Iodine is needed in microgram mcg amounts for the thyroid, milligram mg amounts for breast and other tissues, and therapeutically as anticancer in gram amounts.[2]- Dr. David Miller
The theoretical iodine lethal LD50 for humans ie 1/10th of rodent dose is about 2 gm / kg, eg 6gm for a newborn baby, 140gm for an adult… a bottle of 20ml 2% Lugols in water contains 400mg, a 100ml bottle of 15% in water contains 15gm iodine(ie a 20ml bottle 3g) ie a harmless dose except corrosive if swallowed neat,.
Hence retailers if at all dispense Lugols 2%; we dont lightly prescribe/dispense 15% Lugols except for topical massage. And for cancer and we stick to 20ml dropper bottles.
not even Dischem and Clicks at Cavendish stock Lugols- only 2% iodine tinct IN ALCOHOL ie strictly for burning scratches… so no retailer should sell 100ml of any Lugols prep, only 20ml 2% Lugols, as is enforced in USA. It is indeed apparently regulated in the same way here., ‘tho’ the SA Medicines formulary doesnt mention that (recommends it only preop for eg thyroid storm), nor the multidisease benefits of Lugols including on the brain, wounds, infections, cardiac, vascular, cancer lungs etc;
nor the usual DETOXIFICATION REACTIONS as heavy metals are mobilized, for which (like eg metformin) the Lugol’s dose must be started low and titrated to tolerance with lots of fluids including magnesium, seasalt, selenium , vits B. eg Brief symptoms from heavy metal detox include “headaches, agitation, palpitations, nervousness, the jitters or irritated thyroid symptoms; pimples; skin rashes; fatigue, muscle aches, fever, diarrhea, worsen sinus/asthma, and brain fog. “. http://nourishingplot.com/2014/08/30/detoxing-fluoride-bromine-and-chlorine-naturally/ , http://www.iodine-resource.com/lugols-iodine.html , http://www.tiredthyroid.com/blog/2013/07/15/iodine-protocol-asthma-hives-sulfite-sensitivities/ and http://drsircus.com/medicine/iodine/iodine-and-detoxification. If these heavy metal detox reactions occur, stop the Lugols a few days, increase the detox remedies, then resume Lugols at a lower dose that you dont react to.
Threads indicate that detox problems go away once iodine dose exceeds 50mg/d- especially if taken with a multisupp incl vit C, magnes , BCo, & selenium; and plenty of seasalt in water. (the only one of these not in a multisupplement AntiAging blend is salt).
In perspective, the thyroid holds 50 milligrams of iodine, the breasts hold 200 milligrams, the skin holds 400 milligrams of iodine, and the whole body holds 2,000 milligrams, and possibly much more. Iodine is found and used in every hormonal receptor in the body. in 1911, 900 milligrams 0.9gm/day!) were considered usual and safe dosage. At 6 grams 6,000 milligrams/day!), iodine has been used to cure syphilis, skin lesions, and chronic lung disease. Iodine makes us smarter, helps with mental functioning. Low iodine is associated with low IQ’s with a difference of up to 13.5 points in children; but iodine deficiency is also associated with mental functioning in adults, because iodine not only chelates lead, but, according to Dr. Jorge Flechas, iodine prevents lead from lodging in the body in the first place. Low thyroid function decreases brain circulation, which slows intellectual function. low thyroid function is associated with cognitive impairment, memory loss, depression, slowness of mind, anxiety, suicidal tendencies, and a variety of psychiatric disorders. Bleichrod’s meta-analysis of 17 studies showed iodine sufficiency increases IQ by 13.5 points in children. Iodine prevents heart disease. Iodine is needed with the use of cordless phones, cell phones and now smart meters to prevent hypothyroidism. Iodine decreases insulin needs in diabetics.
IODINE ALLERGY? The risk of iodine allergy is quite low – Drs. Abraham and Brownstein were only able to identify 3 of 4,000 people who had a negative response to the iodine. People do not become allergic to iodine per se, but people react to the displacement of bound heavy metals; and can become allergic to protein-bound iodine as is found in shellfish or to the binding agents, excipients, fillers, preservatives and/or synthetics (rather than the bioavailable form of iodine itself) commonly found in tablets, capsules, and even liquids. Actually, iodine can help eliminate food allergies according to Dr. Derry.
But dont take Lugols at the same time as vit C, which neutralizes the antimicrobial effects of Lugols. so take them at opposite ends of the day.
and because iodine attacks only pathogens and abnormal cells, not our good probiotic biome or healthy cells, it has none of the risks of pesticides , antibiotics, antivirals, radiotherapy, chemotherapy etc.
RESEARCH ON LUGOL’S IODINE?
despite Dr Jean Lugol having published his landmark 1829 work on his iodine complex ie ~185 years ago, there is predictably little research on it published on Pubmed, for the obvious reason that Big Pharma and the Disease Industry and governments wont fund research on such a cheap cure, which would greatly increase survival, but in the short term reduce illness and thus need for health industry workers, hospital beds, pharmacies and new drugs.
There are apparently only three clinically relevant LUGOL’s papers listed on Pubmed ie in the past 50 years:-
from India 2012 Consul ea – confirming that painting the cervix with Lugols (the Schiller test ) and vinegar is as effective as Pap smear for screening; thus combined, the two simple cancer diagnostic paints make up for Lugols iodine for cervix cancer being only about 85% sensitive and specific ie not as reliable alone as a costly lab Pap smear…
Greece 2007 Theodoropoulou ea confirming that preoperative Lugol’s iodine 80mg/d for 15 days in euthyroid people was accompanied by increased intrathyroid total iodine but no changes in intrathyroid hormone HI or demonstrable increases of serum T4 and T3 were observed. It is hypothesized that the maintenance of normal intrathyroidal HI is the result of the combined inhibitory effect of iodine on thyroid hormone synthesis and on the release of T4 and T3 from the thyroid.
and
Italy 1986 Marani ea –Iodine is therapeutic in various pathologies where immunity plays a dominant role, eg it facilitates cure in tuberculosis, lepromatous, syphilitic and mycotic incl sporotrichosis lesions . This effect does not depend on iodine’s action on the micro-organism responsible, but on host immune boosting. . Iodine may also be used in Panniculitis, in erythema nodosum, in nodular vasculitis, erythema multiforme etc. . To establish relationship between dietary iodine and immune response, 607 infants in an area of endemic goitre were studied: 215 were given Lugol solution (2 drops- presumably 20mg? a week for about 8 months ; and 392 not. Immune response was assessed by the skin test tetanus toxoid (in the U.S. 80% of paediatric cases aged 2-10 years old were positive). A significant difference was noted in the average diameter of the infiltrations after the tetanus toxoid skin test in the two groups considered (P less than 0.001). The results indicate that an adequate iodine intake is necessary for normal retarded immune response – a fact that the disease industry and Big Pharma blatantly ignore. . . (Iodine does not have the adverse effect of antibiotics on our gut biome, or causing antibiotic-resistant pathogens)
But there are dozens of scientific Lugol’s studies not referenced by Pubmed:
The End of Antibiotics and the Rise of Iodine as an Effective Alternative 2008 Mark Sircus
Iodine and viral infection?
David Derry, MD, PhD Thyroid Science 2009 Iodine: the Forgotten Weapon Against Influenza Viruses
Mamo & Naissides International Journal of Infectious Diseases (2005) from Australia show Iodine Could be effective in the treatment of human immunodeficiency virus and AIDS-associated opportunistic infections. as it is in rodents and cats .
Inactivation of human immunodeficiency virus by iodine-releasing products Harbison & Hammer Boston, Massachusetts 1989 showed that “povidine-iodine completely inactivated HIV at concentrations of greater than or equal to 0.5% ie is highly effective at killing HIV.
Betadine is simply “a stable complex of povidone and elemental iodine, contains 9.0% to 12.0% available iodine ie 90-120mg/ml .. Free iodine slowly liberated from the povidone-iodine PVPI solution kills microbe (but not healthy mammalian) cells through iodination of lipids and oxidation of cytoplasmic and membrane compounds, thus exhibits a broad range of microbicidal activity against bacteria fungi protozoa and viruses. Slow release of iodine from the PVPI complex in solution minimizes iodine toxicity towards mammal cells.” This compares exactly with a similar iodine complex 15% Lugols which contains about 10% ie 100mg iodine /ml water .. at far lower cost than but identical safety and efficacy to the patented Betadine – a modern designer marketable patented crib of Lugol’s .. …
and
Lugols for animal thyrotoxicosis
and IODINE, A CRITICAL NUTRIENT 2014 http://drlwilson.com/Articles/IODINE.htm
and
Iodine: Its Role In Health and Disease: New Exciting Concepts Michael B. Schachter, M.D. 2007: Guy Abraham MD, former professor of obsts gyne & endocrinology at UCLA School of Medicine, has written papers about iodine that drastically changed my thinking about its role in health and the prevention and treatment of disease. I had been impressed by Dr. Abraham’s previous work, which showed that vitamin B6 and magnesium could be very helpful to women with premenstrual syndrome (PMS) and was eager to learn what he had to say about iodine. Through a series of articles termed “The Iodine Project,” Dr. Abraham proposed that the optimal daily dose of iodine for a WELL person is approximately 12.5 mg, which is 100 times the RDA of 0.125 mg, ie that the current prevailing medical opinion that more than 2 mg a day of iodine is toxic is wrong. He traces the source of this major blunder to a scientific experiment on rats that was published in 1948 by Drs. Wolff and Chaikoff, which erroneously concluded that iodine inhibits the thyroid gland at doses of about 20 times the recommended daily allowance (RDA) for iodine. This conclusion was later generalized to humans and can be found in medical textbooks, including endocrinology and nutrition textbooks. Guy Abraham wrote in 2005: In hypertension, iodine sufficiency resulted in normalization of blood pressure without medications; as reported by other physicians using this program. Best results were achieved when orthoiodosupplementation was combined with a complete nutritional program emphasizing magnesium instead of calcium. Obesity increases the requirement for iodine and up to 100 mg elemental iodine/day may be required to achieve and maintain sufficiency. Increased demand for iodine occurs with excessive amounts of goitrogens from the diet and lifestyle. eg, smoking increases serum thiocyanate levels, interfering with the sodium/iodide supporter function. Low thyroid iodine is associated with thyroid hyperplasia and cancer. Could thyroid hormones cause the same iodine depletion in breast tissue? The prevalence of breast cancer is higher in women on thyroid hormones. Medical iodophobia resulted in removal of iodate from bread 20 years ago, replacing it with the goitrogen bromate- which associated with increased obesity, diabetes, and hypertension, thyroid and breast cancer. Recent reports show association between low iodine intake in women during pregnancy and attention deficit and hyperactivity disorder (ADHD) in their offspring. The most plausible explanation is a decreased sensitivity of the nuclear thyroid hormone receptor to thyroid hormones. We previously reported evidence for improved receptor response to thyroid hormones following iodosupplementation. Therefore, iodine is not only necessary for the synthesis of thyroid hormones but also for their effect on target cells. This effect is probably due to iodination of the thyroid hormone receptor. The essential element iodine, which is the inorganic, non-radioactive forms, deserves more attention from researchers and clinicians. It maybe the missing link in patients currently resistant to conventional hormonal therapy.
and see
http://www.earthclinic.com/remedies/lugols-iodine-supplements2.html
re adding enough selenium, chromium, vit C, Magnesium, Vitamin B2/3
and
Until 2007, in the United States, Lugol’s solution was unregulated and available over the counter as a general reagent, an antiseptic, a preservative,[11] or as a medicament for human or veterinary application .
However, effective August 1, 2007, the DEA now regulates Lugol’s solution (and, in fact, all iodine solutions containing greater than 2.2% iodine) as a List I precursor because it may potentially be used in the illicit production of methamphetamine.[12] However, transactions of up to one fluid ounce (30 ml) of Lugol’s solution are exempt from this regulation. When buying Lugol’s Solution on places like Amazon, most sellers fail to indicate the DEA tracking requirement. On the other hand Lugol’s Iodine solution is available over the counter in Canada and Mexico.
Toxicity Because it contains free iodine, Lugol’s solution at 2% or 5% concentration without dilution is irritating and destructive to mucosa, such as the lining of the esophagus and stomach.
Doses of 10 mL of 5% solution have been reported to cause gastric lesions when used in endoscopy.[13] The LD50 for Iodine is 14,000 mg/kg [Rat] and 22,000 mg/kg [Mouse].[14]
Most guidelines accept that anything with an LD50 >2 g/kg (-5 g/kg in some countries) can be classed as having a low acute toxicity[citation needed] which classifies Iodine as having low toxicity. Potassium Iodide is not considered hazardous.[15
http://jeffreydachmd.com/breast-cancer-prevention-with-iodine/
Iodine Dosages
Treatment of Influenza and other Diseases iodine-dosages 2009 “After testing over 500 patients, I found that 94.7% of my patients are deficient in inorganic iodine. Dr. David Brownstein In this chapter I will present different views and practices from present as well as from the long past when iodine was vastly more popular as a medicine than it is today. For whatever irrational reason, doctors and patients fear iodine thus en mass do not use to its fullest potential.
Humans tolerate large doses of iodine but the ultra high doses that were used many decades ago are not required to get the most out of iodine therapy. Just a little goes a long way, as the governmental iodized salt programs showed but this dosage level was only effective for Goiter and its avoidance. It actually takes very little iodine to prevent this disease but no one ever said that was the only purpose and need for iodine in the body. Today people are more deficient then ever before because our need for iodine has increased in direct proportion to our toxic burdens especially of other competing halogens. Read on at http://drsircus.com/medicine/iodine/iodine-dosages
Pps
see lugols_dosage_chart. . But for obvious reasons stick to 2% till you know you tolerate and need much stronger drops.
Posted in AIDS, all-cause mortality, anti-aging, arthritis
Tagged Abraham, AIDS HIV, Alzheimer's, antioxidants, Brownstein, cancer, CVD, depression, diabetes, estrogen, fish oil, fracture, heart attack, Hypertension, infection, influenza, insulin resistance, iodine deficiency, lipidemia, Lugol's iodine, metformin, mortality, obesity, orthoiodosupplement, osteoporosis, overweight, selenium, supplements, vitamin D
neil.burman@gmail.com Cape Town, South Africa
CONSPIRACY OF SILENCE, DENIALISM? THE FLARE AND CURE OF MERS?- MIDDLE-EAST SEVERE ACUTE RESPIRATORY- RENAL SYNDROME SARRS CORONAVIRUS OUTBREAK; AND EBOLA? : An Inconvenient truth? human (sunshine-) vitamins C+D DEFICIENCY syndrome facilitating a benign virus spread from eg camels (or mosquitos) to middlemen eg camelmen to human vit C/D deficient contacts- in whom the infection becomes lethal ?. Copyright reserved. A narrative diary journal since August 2013
5 September 2015: with the Hajj only a fortnight away, the fresh MERS outbreak in KSA continues its upsurge, with the past week 34 cases and 11 deaths ie still rising weekly rates. Compared to 16 cases and 7 deaths there in July, August had eight times more– 127 cases; and 42 deaths ie 33% mortality. Worse, the human outbreak has spread from Riyadh all over the country except on the coast. .
What is even more puzzling is that the KSA now plans to pay out over a $billion ie $133 300 compensation for each of the >1200 people who have died there of MERS . This is despite the fact that, as reported repeatedly on links below, their own scientists keep publicizing that residents there have severe vitamin D deficiency owing to the KSA culturally enforced sun exclusion ie coverup code especially for older adults. And that it costs no more than ~$5 a year for vitamin D3 for each person to take a harmless multidisease protective dose eg adults 50 000 iu every fortnight if not weekly ( as with any microbial after a loading therapeutic dose of eg 200 000 to 500 000iu if indicated ), with which we get excellent protection everywhere. Unlike their excellent doctors, KSA authorities dont publish a word of warning and prevention on their English websites about the deficiency of vits C & D well shown in their urban population.
26 August 2015 : while the MERS outbreak in S Korea terminated weeks ago at 184 cases and 29 deaths- ie 16% mortality, with no cases reported anywhere else outside Saudi Arabia in the world, where there were only 129 cases and 32deaths; the latest score from Riyadh KSA is 1171 cases and 502 deaths ie 43 cases and 15 deaths the past week.
Yet a new statement from the KSA MOH this week makes no mention of the apparent chief risk factor for MERS in KSA – their observant citizens’ profound deficiency of the sunshine vitamin D3 that their sharia sun-excluding apparel promotes, and that their health professionals have stressed for years, and that is so easily corrected by lifesaving vitamin D3 supplement at negligible cost. Only prisoners denied any sunshine and supplements have as bad vitamin D deficiency.
25 Aug 2015just a month before the 2015 Hajj, Saudi Arabia has announced a fresh MERS epidemic this month – based exclusively in Riyadh: in July there were only 16 new cases with 7deaths (compared to June‘s 27/14) ie the rate fell to about 4 cases a week. But this August the rate has mushroomed twelve-fold since July, from 4 to 22/wk, to now ~48 cases alone the past week @ ~7/day – 72% men; ie already this month 105 cases, 31 deaths; ie the recent death-rate has strayed to 29%. . One of today’s 6 deaths was among the 8 new cases reported today. Almost all the cases lately have apparently been reported from one Riyadh hospital the King AbdulAziz center. so the reported totals from KSA are now 1165 cases and 498 deaths ie 43% deathrate; with critical cases/ deaths mostly in the elderly. .
So is more incidental MERS contamination being detected by wider surveillance of well contacts? One can speculate whether the recent spurt, and deathrate, in KSA are because of wider MERS surveillance of asymptomatic people; and the very old dying of usual causes? when finding of the virus may be coincidental, not pathogenic? Does symptomatic stable indicate anything more than a common febrile URTI? The figures on the KSA Govt website are radically different from those on the FluTrackers.com site.
And VITAMIN D DEFICIENCY THERE? a new paper in Med Hypotheses. 2015 Aug from KSA again highlights the Saudi scientific community plea not to ignore the disaster of epidemic and so easily and cheaply remediable vitamin deficiency there- at least 63% are moderate to severely vitamin D deficient: Nabi, Hobani ea Jazan University, KSA ask: Can we hypothesize a link? High prevalence of vitamin D deficiency and cancer in KSA populations: In spite of so much sunshine, about 83.6% of Saudis are deficient in the ‘sunshine vitamin’ D – 31.9% have severe, 32% have moderate and 19.7% have mild vitamin D deficiency (VDD). Females are more severely vitamin D deficient. Apart from the genetic anti-vitamin D factor- darker skin color – various manmade factors contributing to skin sunlight deficiency and thus likely to epidemic viruses (and also significantly shorter adult life expectancy compared to other opulent countries) include housing designs, religious practices, lifestyle choices- which in ultra-conservative-run KSA seem to be uniquely sun-exclusive, and rigorously enforced.
As especially in Muslim countries, and China, and South Africa, and all darkskinned people who shun the sun- as do all who use sunblockers, prefer avoiding tanned wrinkled or darker skin or skin cancer- or those who work and live mostly indoors and with covered bodies, limbs and often faces- Low vitamin D in yet another sunny country- Thailand ; Jnl Clin Translat Endocr March 2015 Siwamogsatham ea. Vitamin D deficiency and insufficiency is also common in Thailand ( latitude between 5°30′ N and 20°30′ N) where adequate UVB exposure is available all year round. Chailurkit et al. [12] conducted the largest-scale examination of vitamin D status in Thai population,reported a 50% prevalence rate of vitamin D insufficiency & deficiency , defined as serum 25(OH)D level < 30 ng/mL . Life style and environmental factors are the major factors that determine vitamin D status.. Thai women are at risk likely due to sunscreen usage and sun avoidant behavior to maintain a fair complexion. Living in urban areas and with less leisure time in the sunlight., ncreases the risk of vitamin D insufficiency due to increased pollution, which decreases the amount of UVB available for cutaneous vitamin D synthesis. Furthermore, in Thailand dairy products are not fortified with vitamin D and very few vitamin D-rich foods are part of the Thai diet. Thus, dietary intake of vitamin D in Thai people is generally low.
17June 2015 update: while a German who contracted MERS in the Middle East in February has now died of lung complications in Germany, KSA Saudi Arabia reported 17 cases and 8 deaths in the past two weeks, similar to the rates in May; totals now 1035 with 458 deaths. Wiki puts the world totals (26 countries including the Korean who visited China) at 1340 cases with ~530 ie 39% deaths .
But originating from a single visitor to KSA, South Korea has now recorded 162MERS cases- 6 cases a day since 20 May- and 20deaths ie 12%. There a survey- Hong ea in Int J Tuberc Lung Dis 2014 – reported “Association between vitamin D deficiency and tuberculosis in S Korea, with healthy controls having frank vit D deficiency ( mean 25OHvitD level 16 ng/ml) but 60% higher than in TB patients (mean 9.86ng/ml). The prevalence of severe vitamin D deficiency was higher in patients with TB (51.1%) than in controls ( P = 0.001). The median 25(OH)D level increased from 11.40 ng/ml (IQR 7.85-15.73) to 13.18 ng/ml after treatment completion (P = 0.037). Presence of TB and history of TB were independently associated with severe vitamin D deficiency.”
Yet as is not available in local South African RSA TB-HIV clinics with prevalent vitamin D deficiency, there is still no reported policy of vitamin D supplementation apparently reported from S Korea (or KSA, or RSA) , despite (as in KSA and RSA) a study there 2 years ago (from Jeong of Dept Paediatrics at CHA University, Seongnam SKorea 2013) “Factors affecting the vitamin D status in South Korean children” finding ” prevalence of vitamin D deficiency (
(15-20 ng/mL) was 19.5%. Overall, the mean serum 25(OH)D levels was 22.9±9.9 ng/mL. They were the highest in them preschoolers (2-5 years, 24.4 ng/mL) and the lowest in the adolescents (11-16 years,15.9 ng/mL). In addition, they were significantly higher in summer as compared with winter. The prevalence of vitamin D insufficiency and deficiency was relatively higher in our series of children. It is imperative that the public policies be established to provide vitamin D supplementation for South Korean children.”
ONGOING GLOBAL DENIAL OF NEED FOR MICRONUTRIENT SUPPLEMENTS: It seems that national authorities from the Americas to Europe to Africa to the middle east to Asia, including the medical industry, continue to refuse to heed overwhelming evidence that vigorous micronutrient supplements are needed, available, lowcost, highly effective and safe to prevent and treat epidemics like HIV-TB, flu, MERS and Ebola – especially when vaccines and antiviral drugs are without benefit, and when vitamin D deficiency is universal in clothed indoor-studying- and -working peoples, especially the poor who cannot buy supplements by choice. . .
6 June 2015 update: After a quiet April, KSA is now suffering fresh jeopardy from acute midsummer flareup of MERS. But so is the world with outbreak of MERS in Korea and China, while thousands of refugees from tribal wars in the middle east and North and even South Africa cause more concern for spread of such plagues.
As the Middle East girds itself against mounting Islamic warfare in the region, after only a handful of MERS cases in April- 8 cases and 6 deaths- KSA has in May seen 33 cases with >50% fatality – 18 deaths; and already in June the case rate has doubled from April’s 1 a day to May – June’s 2 cases a day, giving cumulative totals there to 6 June of 1026 MERS cases and 450 deaths..
By contrast, in South Korea only 5 deaths (8% mortality) have been reported in 84 cases so far the past 16 days – including a Korean who got to China. That chillingly brings the outbreak firmly onto the Asian mainland. South Korea now passes the UAE as the second biggest outbreak country after the KSA- but like the UAE and elsewhere, a far lower deathrate, perhaps simply because of initial contact tracking, since the outbreak has been totally in hospitals.
It seems that Vitamin D deficiency may be as much the cause of MERS susceptibility in South Korea as in KSA? A 2008 Korean University survey shows that despite its temperate latitude of ~35degrees, and humidity, South Korea had widespread vitamin D deficiency even in its young people: Serum 25-hydroxyvitamin D [25(OH)D] levels and the prevalence of vitamin D insufficiency defined as serum 25(OH)D level of less than 20 ng/ml. Vitamin D insufficiency was found in 47.3% of males and 64.5% of females, whereas only 13.2% of male and 6.7% of female population had a serum 25(OH)D level of greater than 30 ng/ml. Vitamin D insufficiency was most prevalent in the age of 20-29, with a rate of 65.0% in males and 79.9% in females, and least prevalent in the age of 60-69 in males and 50-59 in females. Those who work usually indoors were more predisposed to vitamin D insufficiency. In the adult population, predictors for vitamin D insufficiency included young age groups, spring and winter seasons, living in an urban area, and indoor occupations. CONCLUSIONS:Vitamin D insufficiency is very common, and it is now a greater threat to the younger generation in Korea. Current recommendations for vitamin D intakes for Koreans are inadequate, especially for the youth. In 2012 they reported “We found that vitamin D insufficiency or deficiency is a very common health problem in Korean adolescents, particularly in girls, and that serum 25(OH)D levels are inversely associated with insulin resistance and lipid profiles. These results suggest that more time spent in outdoor activity for sunlight exposure and higher vitamin D intake may be needed in younger adolescents in South Korea”
“Vitamin D Deficiency Around the World 2015 Even the Indian Medical Association recently organized continuing medical education to address the rise of vitamin D deficiency in their sun-soaked nation. Endocrinologist Dr. Sanjay Badada told Times of India:1 “Vitamin D deficiency is rapidly gaining epidemic proportions yet it is the most under-diagnosed and under-treated nutritional deficiency in the world. In our experience, 40 percent to 50 percent patients get diagnosed with Vitamin D deficiency as a part of their normal routine tests with no apparent symptoms. On the other hand, 80 percent to 90 percent of patients who come in with musculoskeletal complaints such as back pains, unexplained muscle pains, or general fatigue suffer from Vitamin D deficiency. Vitamin D was also discussed at the 2015 European Congress of Endocrinology. One talk2 addressed the “Mediterranean paradox,” as researchers have tried to understand why as many as 90 percent of pregnant mothers (and their newborns) in the sunny Mediterranean region are deficient in vitamin D. A systematic review looking at 15 studies concluded that predictors of low maternal vitamin D concentration included dark skin and sartorial habits—meaning the manner in which they dress, or in this case, being too covered up, preventing sun exposure on bare skin. Moreover, vitamin D supplementation was very low, and few pregnant women met the recommended daily intake (RDI) of calcium and vitamin D.”
12 April 2015 update: KSA has now reported 977 cases with 426 deaths ie 43% deathrate. Ignoring the past 12 days (2 cases, 4 deaths), the March rate was 1.9 cases per day with 49% deathrate; in Feb it was 3/day with only 42% deathrate. so while the reported caserate is down by a third, the fatality ie deathrate is up almost 20%. The Wiki MERS report is now a month out of date, with climbing deathrate.
Perhaps the lull in new MERS case detection/reporting is merely a result of that region (like the war-torn Central Africa – never mind the ebola epidemic-) being in the middle of an ethnic Muslim religious war – genocide- by fanatical jihadists on both more “liberal” Islamists and other religions. This increasingly threatens to overthrow the 20thC-European-created hereditary tribal governments of the desert/camel/oilfield region- KSA, Yemen, Jordan, the Gulf States etc, as happened in Egypt; not to speak of the power vacuum instability created in Iraq and Libya by more recent Western elimination of virtual dictators without ability to ensure democratic succession there any more than in Egypt, Afghanistan or Pakistan; and the oppressive dictatorships that prevail in Iran and Syria..
24 March 2015 KSA reports 964 cases and 419 deaths ie only 6cases and 3 deaths the past week. The Ebola outbreak meanwhile simmers down in W Africa in its anniversary week. . New reports from North America again highlight the importance of optimizing vigorous vitamin D3 dose and blood levels.
15 March 2015 MERS so far this March, in KSA already 37 cases , ie 17 a week, 21 deaths. This brings the reported case KSA total to 957 cases, 416 deaths; but deathrate the past 4 weeks to ~57% (the KSA website) . With the timelag in KSA reporting to international registries, Wiki reports that to 12 Mar there were only 402deaths /938 cases in KSA ie 43% deaths; but 1082 cases worldwide with 439 ie 37% deathrate in 24 countries- 118 cases with 28 deaths in the 8 middle east nations surrounding the KSA, giving a deathrate around but not in KSA of only 24%, and 3 deaths in 7 cases in their 3 African neighbouring countries; and 8 deaths in 22 cases in 12 distant countries ie 36% deathrate.
so while there have apparently been no new MERS cases outside KSA in their summer for months, the ongoing reported caserate in KSA is alarming with the deathrate having climbed to 55%. Obviously, to explain the apparent rising deathrate, detection and reporting of new MERS cases in KSA will likely be increasingly of only serious respiratory cases and their immediate contacts; and otherwise unexplained deaths; but the fact is that 10 MERS- associated deaths were again detected there the past week..
So while camels rather than bats are teeming with MERS virus and believed to be the main vactor to their human compatriots, it is instructive to to see a number of recent studies (1, 2, 3) in north African camels showing that they have vitamin D levels 10 to 40 times higher than Arabian citizens who import them en masse, farm, nuture, milk and eat them. MERS is if at all a trivial coronavirus corrhyza in such camels, like the common cold coronaviruses cause in humans. This contrasts with the scarcity of MERS cases reported from N Africa- where camel farmers presumably do not cover up as religious law makes the Saudi citizens do.
And it correlates with the epidemic of Ebola in central West Africa- Guinea, Sierra Leone and Liberia , where the chief vector of Ebola seems to be ebola-resistant fruit bats, who live in the dark and have very low vitamin D levels- presumably like their very dark-skinned human compatriots, who presumably also still live largely in the forests or in cities and thus have equally low vitamin D levels; and thus far reported about 25000 suspected cases and 10000 deaths ie 40%; with no antiviral cure in sight; with ?4 deaths in ?18 cases so far reported outside Africa.
These are more reasons to pour safe lowcost effective antivirals vits C and D3 (with balancing vits A, Zinc etc) into such patients and their compatriots at risk. (vit K2 supplement matters only long term against arterial calcification, osteoporosis and cancer in longevity.)
7 March 2015. EPIDEMIC BY power-crazy RELIGIOUS & ECONOMIC EDICT?: MERS: globally ~1040 cases of MERS have been reported. But apparently none outside Saudi Arabia in recent months: So March opens in KSA with 7 day MERS caseload 19 new cases (mean age ~56yrs), and 8 deaths ie total now 939 and deaths 403. . Thats ~20 cases reported the past 7 days there, with 10 deaths ie 50%… in a country in which 18 months and more ago endemic vitamin D deficiency was reported in the Saudi Gazette by their scientists; widely attributed to the obvious cause, that in a land of such abundant sunshine, more so than in any other country in the world, women are obliged by draconian religious law to cover up almost totally outside their houses, and elderly observant men almost as much.
European Journal of Clinical Nutrition , (18 February 2015) Determinants of vitamin D deficiency among undergraduate medical students in Saudi Arabian. , A cross-sectional study was performed among 255 first- to fifth-year male undergraduate medical students of a major universities in Saudi Arabia. Results: Majority of Saudi medical students (75.2%) had 25(OH)D levels <30 nmol/l = <12ng/ml,. Multivariate analysis showed that the odds of having 25(OH)D serum levels of 30 nmol/l were seven times higher both in students who took vitamin D (odds ratio (OR)=7.2, 95% confidence interval (CI)=1.8–29.9, P=0.006) or multivitamin supplements (OR=6.9, 95% CI=1.7–27.3, P=0.006) within 1 year.. There was no significant association between 25(OH)D serum levels and average time spent outdoors per day (P=0.369) and type of clothing (long-sleeved vs short-sleeved; P=0.800). Conclusions: Vitamin D deficiency was highly prevalent in Saudi medical students. Modifiable factors such as vitamin D intake and PA could be targeted for intervention.
Wiki says (and Medscape echoes) that “Immune system: “While it is known that melatonin interacts with the immune system,[53][54] the details of those interactions are unclear. Antiinflammatory effect seems to be the most relevant and most documented in the literature.[55] There have been few trials designed to judge the effectiveness of melatonin in disease treatment. Most existing data are based on small, incomplete clinical trials. Any positive immunological effect is thought to be the result of melatonin acting on high-affinity receptors (MT1 and MT2) expressed in immunocompetent cells. In preclinical studies, melatonin may enhance cytokine production,[56] and by doing this counteract acquired immunodeficiences. Some studies also suggest that melatonin might be useful fighting infectious disease[57] including viral and bacterial infections, and potentially in the treatment of cancer.”
on Pubmed melatonin as an immunomodulator goes back to 1980.
As Wiebke Arlt and Hewison wrote in 2004, “Aging is associated with a decline in immunity described as immunosenescence; paralleled by a decline in the production of several hormones, as typically illustrated by the menopausal loss of ovarian oestrogen production. However, other hormonal changes that occur with aging and that potentially impact on immune function include the release of the pineal gland hormone melatonin and pituitary growth hormone, adrenal production of dehydroepiandrosterone and tissue-specific availability of active vitamin D. It remains to be established whether hormonal changes with aging actually contribute to immunosenescence and this area is at the interface of fact and fiction, clearly inviting systematic research efforts. “
But Observant- aging- Muslims are forbidden the prime cicardian rhythm of outdoor sunshine stimulation of their skin, and in women even their retinae with total veiling. Thus although women are the tougher gender, observant Islam condemns them to be increasingly more compromised goods and chattels than even camels…
There is still no word that the KSA has recently bothered to promote vigorous dose vitamins D3 and C, ( with vit A, zinc, selenium and iodine), as simple safe potential antidotes to their heavily enforced overdressing blockading sunshine-vitamin D3 , that their own medical scientists have repeatedly warned about..
A new report says “Ebola virus is among the most deadly pathogens, with case fatality rates of up to 90%.1 Ebola virus is categorized as a tier 1 pathogen by the US government because of its potential for deliberate misuse with significant potential for mass casualties. The current outbreak of Ebola virus in West Africa with more than 23 000 cases and 9000 deaths2 also demonstrates the long-underestimated public health threat that Ebola virus poses as a natural human pathogen. There are no licensed vaccines or postexposure treatments for combating Ebola virus.
But as with pollution, insecticides, road carnage, influenza, TB, HIV-AIDS, malaria, cholera, smoking, sugar, aspartame, alcoholism, it doesnt suit the Big Pharma & Disease Corporates, their paid marketing professors/researchers at universities, and government and hospital/ health industry, to promote avoidance, prevention, cure, natural cheap available remedies like vitamins, minerals and other natural remedies, when disease requiring hospital admission, a patented synthetic vaccine or other drug is far more profitable. . Only Disease Pays.
28 Feb 2015 after a quiet KSA 2014/15 year-end with declining MERS case reports- 11 in December, 20 in January, the past week has seen 18 new cases but 9 deaths in KSA, the KSA totals SINCE 2012 UP to 920 CASES AND 395 DEATHS (43%) ie for February 75cases and 31 deaths. . As always, until the KSA MOH Command clarifies, how many of these are current, versus catchup reports from previous weeks/months, remains to be seen. But as the winter recedes there, the death rate this month remains 41%%….
And in UAE one new (expat) case died this month; and a new case in a nurse returning to the Philippines from KSA is the first case in that country, .. combining KSA with Wiki stats, bringing apparent world totals to perhaps about 1029 cases and 420 deaths.. The deathrate from MERS has widened starkly from 42% in to 30% outside KSA.
8 Dec 2014: HEALTH ADVISORY FOR VISITORS TO OR FROM MIDDLE & FAR EAST, EUROPE, AFRICA, the AMERICAS: The MERS infection outbreak slacks off: – down from the recent 2 cases a day to 25 cases in November with 12 deaths; 4 cases so far this month with 3 deaths- ie the deathrate is picking up. . No more exports reported from KSA since one returned home to Qatar last month. the quadrupled case rate since October has fallen back from 39 cases & 15 deaths a month ; – and deathrate (9 deaths) in October in KSA that doubled to 0.6/day is back to the 55% rate, still awesome for such a rich and sophisticated country.
though MERS is well below that of the ebola epidemic – some 5000 ie almost 40% deaths among 15000 cases so far- that is ravishing central west Africans impoverished by genocidal warlords; not to mention flu, cholera, HIV, TB, polio-and dengue-like illnesses . Two ebola- infected people from W Africa have died in USA, but 8 have recovered in USA from Ebola .
Latest evidence is that the current ebola epidemic is due to bats- human overpopulation causing massive deforestation, displacing ecologically vital bats (never mind vital bees, birds and butterflies) from their natural habitat. Liberian workers who flew to USA and Germany with Ebola died; but 8 of 9 infected cases have recovered there; as have infected European health workers. .. . .
But West Africans are reportedly trying to flee to South Africa to escape the epidemic. and 9 out of 16 Medicine sans Frontiers staff who contracted ebola died. .Is ebola falling there? or are patients simply hiding, dying outside hospitals?
SO OPTIMIZE YOUR DIET, VITAMINS D3 & C DOSES, SUNSHINE, AND AVOID SELFSABOTAGE- SMOKING, SUGARS, ALCOHOLISM, AND RASH HYGIENE.
25 Nov 2014 the MERS toll mounts in KSA- the past week only 4 new cases but 5 deaths. so this month its 21 cases, 11 deaths.
20 Nov 2014 Now 808 cases ie 18 this month, only 5 the past running week; with 9 deaths this month; so 12 cases under management.
13 November 2014 The rates pick up again- KSA declares 16 cases under treatment, 447cases recovered, 804 cases, 342 deaths; ie this month 15 cases and 5 deaths .
4 November 2014: KSA declares 15 Cases Under Treatment, 440 Cases Recovered, 793 Cases, 338 deaths, ie in the past week 13 new (9 Saudis, 4 expats) and 5 deceased cases of MERS.
22 Oct 2014: now the KSA declares 12 Cases Under Treatment, 431 Cases Recovered, 772 Cases, 329 deaths; ie 9 more cases in KSA past week ie 1.3/day. So thats 18 cases in 22days ie the case rate up to >0.8/day, with 10 deaths – all with previous chronic illhealth – this month ie mortality lately 55% (8 Saudi males age 51-69, a Saudi woman age 55 and an expat male age 40)….
14 Oct 2014 The first MERS case outside KSA was reported yesterday in Qatar, in a returnee from KSA, ie thats 5 cases this week contracted in KSA, reportedly bringing world total to 892 cases and 356 deaths. Croft says Over the past 30 days Saudi Arabia has reported 17 MERS infections, 9 of which were from the Taif region; which concurs with the KSA stats excluding the backlog of old cases reported last month… Four Saudi males this week with MERS in Jubail, Taif and now Riyadh , and deaths each in Riyadh and Taif.. so Saudi MERS cases there now 10 Cases Under Treatment, 429 Cases Recovered, 763 Total; and 324 deaths ie 43% death rate . In 14 days this month that’s 9 new cases in KSA, 5 deaths, 3 cases recovered; compared to September’s net ?12 new cases. The stats for September (incl 19 deaths) are blurred by the adjustments announced on 19 Sept (with previously unreported cases up to 3 June, with net 16 new cases after other corrections); so the new cases and deaths reported in August may be correct-4 new pts, 4 deaths; and July 9 new cases, 6 deaths; and June 28 new cases? .. .
So the MERS case rate in KSA so far this month has mushroomed from the 0.3/day in July, the nadir of 0.13/d in August, ? 0.4 in Sept, to 0.64/d this month; and the deathrate from 0.2/d in July to the nadir of 0.13/d in Aug to >0.6/d this month.
BUT 6/9 OF THE NEW CASES THIS MONTH HAVE BEEN IN THE GARDEN RESORT CITY OF TAIF 100 KM SOUTH OF MAKKAH- mostly in Saudi men with camel contact. perhaps this may be because of a resevoire of MERS in camels there. The climate may be favourable for humans BUT ALSO FOR MERS- October temps of 15 to 30c, humidity of 40%, 11 mm rainfall.’
MORE ON OPTIMAL VITAMIN D3 DOSE, AND THE DIFFICULTY OF ACHIEVING CLINICAL OVERDOSE: Four new reports highlight how difficult, and important it is to achieve adequate optimal bloodlevels of vitamin D with vigorous vitamin D3 supplements, let alone overdose with any significant adversity: note three used the recommended vitamin D3, not the long-condemned mislabeled Lennons/Aspen vitamin D2 (which is misleadingly labelled “caciferol” without disclosing that it is D2 not D3). Even a single 2 million iu overdose of vit D3 in nonagenarians had no adverse effect-since the bloodlevel was back to zero by 3 weeks, thats above 100 000iu/day on average…....continue..
8 Oct 2014 1st Ebola case diagnosed in Dallas USA in a Liberian visitor, who died today (one of > 4000 deaths in W Africa estimated so far); and a new case in Spain, the first infection outside Africa. Ebola anxiety spreads.. It is alarming that the MERS deathrate is not falling but rising there-5 new MERS cases already this month, vs 12 in Sept, 5 cases in August; and now 8 deaths in past 38 days..
VITAMIN D3 DOSE: We get excellent results in outpatient adults with loading oral dose of vit D3 of about 200 000 to 400 000iu depending on illness severity and body mass; then pro rata about 50 000iu per week till better, tapering to fortnightly when well; pro rata in kids...continue..
30 Sept 2014 another new Mers case in KSA, a 70yr old Saudi man in AlMadinah.
“The last report issued December 2013 for the previous 3 months by the USA Department of Justice (Vaccine Court), for compensation made by the USA Services for people injured or killed by vaccines – available as a Power Point presentation – 139 claims settled , with 70 of them being compensated. So, just over 50% of the claims filed for vaccine damages were compensated during this period. Once again, the greatest percentage of damages compensated were for the influenza vaccine, and most of those were for Guillain-Barré Syndrome (GBS). Yet these facts, in a Department of Health website, are never reported in the mainstream media. Read the report yourself in the Power Point file here. Of the 70 cases compensated, 42 ie 60% were for the flu vaccine. The combined total of the other 40% of cases settled included the following vaccines: Hep B, Tetanus, HPV, DTaP, MMR, IPV, PCV, Hib, Meningococcal, Varicella, TD.
29 Sept 2014 MAJOR SAUDI UPDATE: FRESH MERS FLAREUP WORSENS: There have lately been 3 new cases, (2 Saudis and an expat), near Mecca; 2 in Riyadh- and now death of a 38yr old previously well Saudi woman in Riyadh.
Thats 3 MERS deaths; and 4 new cases – Saudis- in central KSA the past 10days, 11 this month; contradicting the puzzlingly optimistic comment this week from KSA health ministry’s Fakeih that “MERS is not an issue in Saudi anymore. We are doing all we can to have a safe Hajj for all our guests.” If MERS is not an issue, why is the new caserate there picking up, and the deathrate not falling?
the KSA Ministry‘s recent audit found some 19 previously unlisted MERS cases in the 10 week April -May 2014 surge – all but three of the cases were in Jeddah- plus some false positives , and changes of status..
The totals there now are 8 Cases Under Treatment, 426 Cases Recovered,753 Total; and 319 deaths ie 42% death rate .
But outside KSA there have been no further MERS cases or deaths reported for months, so thats apparently worldwide 885 cases , deaths 353 = 40%. But the deathrate outside KSA remains only 26%. and outside Arabia the deathrate remains 10/30 ie 33%.
Despite the surge in KSA in the ~10 weeks mid-March till early June, before the peak summer season in the Northern Hemisphere, the ongoing outbreak in KSA (14 cases there since the month’s lull till mid-August) contrasts with the last MERS cases reported outside KSA in early-mid-July about 10 weeks ago – 2 cases in Abu Dhabi ie the UAE, & 5 in Iran. .
So thats a total in KSA of 20 more new cases and 13 more deaths than was reported before the audit on 12 Sept. Of the KSA 749 total, 27% were healthcare workers; 65% were Saudis- the vast majority this season in Jeddah and Riyadh; 61% male; 4% under 16yrs, 45% between 16-45, 27% 45-60. and 24% 60+ years. ie approx 15% of all cases in every 15year age bracket from 16yrs up, but only 4% in the first 15 years. Deathrate was “only” ~18% in EACH OF the three 15year agebrackets up to 45 years, but 45% in the 46-60yr olds; and quadrupled to 80% over age 60years.Thus unlike eg flu, only in the KSA elderly is MERS par excellence a highly risky infection .
MERS IN KIDS: the likely number in KSA extrapolated from 4% of 749 cases is about 30 kids under 16yrs; but the new KSA bargraphs show ~18% deaths in kids ie about 5-6 died. so the child deathrate has doubled from 9% 1/11. In Dr Memish’s April paper there were only 11 pediatric cases positive by screening and confirmatory PCR for MERS-CoV reported from Saudi Arabia. Two patients were symptomatic and the other 9 cases were asymptomatic. The median age of patients was 13 (range 2-16) years. There were eight females and three males (2.7:1 ratio). One symptomatic patient died (1/11 = 9%) and the other symptomatic patient recovered. The diagnosis of patients was based on positive nasopharyngeal swabs on the majority of the patients. Most cases of childhood MERS-CoV infection was asymptomatic and tested positive during contact investigation of older patients. Severe disease can occur in children with underlying conditions.
So in KSA with a mean population age close to 20 years, the age distribution of MERS is roughly spread across adult lifespan, sparing (with both low incidence and low mortality) children who make up almost half the population. This is the opposite of the claimed swine flu severity in kids in the “pandemic” of 2009. Perhaps in KSA this is as expected since generally schoolchildren take more dairy products, get more exercise, sunlight, fresh produce and supplements, and wear less sun-exclusive clothing- supporting vit D+C deficiency evidence as the proximate cause of MERS-CoV susceptibility in KSA adults..
So despite repeated published warning from the top KSA scientists that their conservative (ie covered) dress and diet code puts Saudis at very high risk of known vitamins C & D & Zinc deficiency, the blackout on acknowledging this and promoting vigorous vits C and D3 & Zinc supplements continues, with 80% death risk for the elderly and 20% for every child who contracts MERS in KSA. Until proved otherwise by simple trial of vigorous supplements, this denial, omission in fact may be culpable homicide on the part of KSA authorities- especially as the KSA, with a mean annual income per head similar to UK and western Europe and with similar Caucasian origin population, notoriously has life expectancy 5 years lower than that of UK and much of the North Atlantic lands. .
16 Sept 2014 one new case today 31yr old expat male, prev chronic, in ICU Riyadh; yesterday 76yr Saudi male in the far south, prev chronic, in ICU. total thus 730, 29 active,… already 5 in 2wks this month.. as the Hajj picks up…
12 Sept 2014 Bad news strikes KSA with the Hajj in full swing- after 3 clear days, 2 new MERS cases but not in the eastern provinces like the last cluster, this time one each in Riyadh and the Mekkah region, both Saudis, both in ICU; but not the usual seniors- a 38yr old male with previous health issues; and 28yr old female, neither of them healthcare workers. So now the KSA numbers are 28 under care; 399 recovered; 729 total; 302 died.
8 SEPT 2014 after 9 case-free days, the 727th new case, 60y old male expat, in Jubail, in ICU…
31 August 2014 THE KSA MERS CASE RATE PICKS UP: 42% death- rate: another new case 29 Aug, a 34 yr old expat health worker in Jubail, ie 3 cases in past 7 days. another MERS-related death- a 69yr old Saudi man in Dammam- as usual, with preexisting disease. . So KSA has now 25 Cases Under Treatment; 399 Cases Recovered ; 302 cases died; total 726 Cases ie 42% died. 45% dead or impaired. 5 new cases past month. and apparently 4 deaths. KSA reporting does not allow analysis of duration of illness to assess the current mortality rate.
Yet Drosten, Memish ea from the international Corona Virus Study Group write in the NEJM this week: “Transmission of MERS-coronavirus in household contacts is only 5% in 26 MERS index patients and their 280 household contacts. Strategies to contain the MERS-CoV depend on knowledge of the rate of human-to-human transmission, including subclinical infections. The median time from the onset of symptoms in index patients to the latest blood sampling in contacts was 17.5 days (range, 5 to 216; mean 34.4d“.
This again confirms the obvious, that the virus, like the common cold, is low virulence and transmissibility EXCEPT in the frail and elderly – who (perhaps like many overworked hospital workers) in KSA who as reported there apparently get little sunshine, little vitamin D3, and likely little vitamin C. The rate of MERS in students, kids, farm workers, labourers remains very low, presumably because they get plenty of sunshine. And no article/report on MERS from KSA – where all adults are forced to cover up their skin outdoors- says that anyone is encouraged to vigorously top up their vits C and D3 levels.
OUTCOMES: triangulating cases scantily reported on the KSA MERS website with 30 new cases since mid-June, 5F (28-55yrs, 4 Saudis) and 25 men; there have been 8 deaths all in men between 38 and 80yrs old. The high deathrate in the men may be because their average age was about 59yr vs 41yr in the women.
August: 5 new cases (1 Saudi female; 1 male an expat HCW; 2 of the men- 69 and 72yrs, Saudis, chronics, died within 3 and 6 days respectively ),
July: 10 cases; 2 Saudi female; of the 8 men, 2 are HCW , 2 expats- one of whom died the same day aet 73yrs.
June: 24 cases. Reporting was upgraded 1 June, so stats before July- with the ~100 case undated backlog reported- are problematic. from mid June there were 15 cases reported, 3 females; 5 deaths (2 expats aet 38 & 42) in the 12 men; the Saudi deaths were aet 45-80yrs.
27 August 2014 2 new cases past 3 days, Saudi man and woman in Dammam.(one subsequently proven false +ve) 25 Cases Under Treatment, 399 Cases Recovered ; 725 Cases Total; 301 cases passed away .
24 August 2014: 12 days free of new MERS cases in KSA. but on 22 Aug the death of another male, a 66yr old expat, was reported in Riyadh, this totals 23 Cases Under Treatment, 399 Cases Recovered; 301 cases passed away, (May Allah have mercy upon them). * Total 723 Cases. 44.8% dead or impaired.
But Alghamdi ea from the KSA Govt & Universities, and Lincoln University UK have this week published The pattern of Middle East respiratory syndrome coronavirus in Saudi Arabia: from June 2013-May 2014 ie some 425 cases (before the recent June “discovery” of another 100+ cases there). This study deduces that the outbreak thrived especially in Riyadh and Jeddah with high temperature and low humidity ie summer desert conditions; older men being at much higher risk than their kinswomen. . But once again, the paper studiously avoids the obvious reasons why KSA is at the hub of the MERS storm. The authors like the KSA authorities totally ignore the repeatedly published studies by their own academics the past decade, and even by USA authorities like Prof Mike Holick, that Saudis have markedly low vitamin C and D and even zinc levels. And their increasingly orthodox overdress as they age and have more leisure time drastically increases their vitamin D deficiency.
This comes back to usual Media and Governmental Semmelweis denialism , persisting with the myth that good diet and prescription medicines are enough. In fact balanced nutrition with fresh natural produce is becoming a rarity even in stable progressive urban cities, and the resultant epidemics of infections let alone degenerative diseases are in most cases due, (apart from deliberate pollution especially with plastics, estrogenics , pesticides, endocrine disruptors eg phthalates, heavy metals including fluorides, bromates; dioxin etc, radioactivity, and high refined carbs, and inadequate fish oil and medium chain triglycerides and water intake), to micronutrient deficiencies especially of vitamins C, D3, K2, and crucial minerals like magnesium, zinc, iodine, selenium, chromium etc.
Modern infectious outbreaks like the resurgence of influenza, polio, TB, HIV and MERS, and hemorrhagic fevers like Ebola and Marburg, are arguably as others have proposed deficency diseases – eg scurvy, since all the severe infections listed, never mind acute bacterial infections, have been shown for almost a century to respond dramatically to highdose vit C, vit D3 and some zinc, and multivite (A,B), without antibiotics or much benefit from eg ARVs or tuberculostatics. .
As of 12 pm August 20, 2014: “now only 25 Cases Under Treatment; 398 Cases Recovered Total 723 Cases; 300 cases passed away”
19 August 2014 : KSA updated figures no new MERS cases past 7 days. BUT another death– a 72yr old Saudi man with previous chronic disease, in Riyadh on 17 Aug. so “As of 12 pm Aug 19, 2014: 723 Cases, 26 Cases Under Treatment; 397 Cases Recovered; 300 cases passed away (May Allah have mercy upon them).”. ie the death + impaired rate 326/723 has risen to 46.4%, deathrate 41.6%. ?? 855 cases, 334 deaths worldwide?
So thats 326 patients in KSA who died or are still impaired by MERS, who might have been spared by simple highdose vits (D3 + C) supplement-at trivial cost, no major adverse effects, but massive evidence of protection and cure against all serious diseases; in a population at long-known high vits C+D3 deficiency risks. .
The Zeitgeist occupation analysis of MERS cases to 4 June shows unchanged pattern: 164 Health workers, 150 retired persons, 23 children, 11 pilgrims, 3 tourists, 2 construction labourers, 1 butcher, 1 camelbreeder, 1 shepherd… (out of 838 cases reported till then- ie occupation was disclosed in only 44% ie 380 pts) . The reason for the majority nondisclosure is not given.
The question remains: why are (inter)national authorities ignoring all the published evidence linked below, that vigorous dose vitamin D3 supplement eg 5000iu/kg loading dose then 1500iu/kg/fortnight eg 100 000iu every two weeks , plus a few grams of buffered vitamin C a day, drastically reduces all diseases including virus infections?
12 August 2012 KSA reports (after a month free of new cases) despite peak summer there, two new previously chronically ill Saudi cases in two days: a 72year Riyadh man; a 59 year old man far south of Riyadh; and death of a previously reported apparently formerly well 74 year Riyadh Saudi man. But they dont say when these recent elderly Saudis took ill or died. Total in KSA now 723 cases, 41% deaths. 28 cases under treatment ie 45.2% dead or impaired. ..
To put MERS in perspective, Ebola in Central Africa this year has infected over 2000 cases, 50% deaths, probably worsening the >100 000 malaria deathrate per year in the region, globally >200 million cases a year with a million ie 0.5% deaths.. .. Mosquito-spread Chikungunya virus spreads from Africa/Asia to over 570 000 people across the central Americas .. … .
9 Aug 2014 still not over: NOT THE END OF THE ARABIAN MERS CoV OUT- BREAK- STILL MORE QUESTIONS THAN ANSWERS, : its now 30 days since the last reported MERS case – BUT the fact is that the KSA Bulletin chillingly reports “As of 12 pm 9 Aug, 2014: 1.” still 27 Cases Under Treatment 2. 396 Cases Recovered. 3. 298 cases passed away (May Allah have mercy upon them). total 721 case. so 30 days after the last recorded new case, 27 patients there are still suffering from MERS sequelae – for at least four weeks duration now, likely now permanent?. .
27 cases out of 721 total reported in KSA is only about 4%. But since these 27 cases remain under care a month after the last reported new case, they must now be at best approaching chronically impaired, if not on renal or respiratory assistance. ie the total of dead and impaired rises to 325/721 = about 45%. More important, KSA has apparently not yet released an analysis of the demography and primary and secondary causes of death of these cases- presumably by MERS definition, respiratory and renal . This analysis is urgently needed. All we know for certain is that there was a MERS outbreak apparently in one of their Dialysis units; and that the outbreak was especially bad in health workers especially hospital staff.
COMBINED SEVERE ACUTE RENAL AND RESPIRATORY FAILURE: Forty years ago we (Burman ND, Austin M, Thatcher GN ea) delivered a review of Groote Schuur Hospital experience at a local South African renal congress on the high mortality of combined acute renal and respiratory failure in the age of hemodialysis and ventilators, respiratory intensive care, antibiotics and immunosuppression. . Apart from the common major sepsis, trauma and allergic eg antibiotic causes, the obvious “primary” cause – which any virus eg MERS-CoV may mimic- , is the “autoimmune” hypersensitivity Goodpastures Syndrome GPS – which untreated has a mortality of ~80% but with modern treatment perhaps 20%. This is half the deathrate reported in KSA from MERS. There is no shortage of respiratory and renal ICU and dialysis, advanced medical specialists in KSA centres. So from GPS perspective, much better salvage might be expected.
“GPS is rare affecting about 1ppm (0.5-1.8 per million people) per year in Europe and Asia.[5] The peak age ranges for the onset of the disease are 20-30 and 60-70 years.[5] It is also unusual among autoimmune diseases in that it is more common in males , less common in blacks than whites. This may partly explain why the inhabitants of the dromedary-exporting Horn of Africa have been spared MERS outbreaks.
A recent review from Germany gives the mean time from onset of MERS to acute renal failure of only 11 +-2 days (c0mpared to 20 days in SARS). It is well reported that those contracting acute MERS are already sufferers from major chronic illnesses eg diabetic- cardiorenal-respiratory ie heavily predisposed to immune failure if not already in renal failure.
Humans have some four primary excretory/detox systems: hepato-gastrointestinal; skin; renal; and lung. In Arabia, water is scarce, the desert climate is hot and dry, and the obligatory dress for the observant almost total body cover by robes. So MERS SARRS is high risk especially as it knocks out the two main excretory systems- renal, respiratory, and in very high ambient temperatures also the skin; except for the affluent minority who have aircooled spacious private homes and offices; with often a reported element of viral gastroenteritis, akin to influenza. .
The mystery remains: why is the UAE reporting 73 cases/9.2million ie 8 per million, but only 12% mortality, compared to the adjoining KSA 721 cases/30 million ie 24 per million? with 93% of world MERS cases recorded from KSA and UAE, and all cases anywhere traceable back to the Arabian Peninsula. The KSA and UAE urgently need to publish an analysis of the demography and pathophysiology of their MERS cases. Is it mostly indigenous Arabs who are contracting and especially dying from MERS in these countries, or also many foreign workers, mainly malnourished labourers?
A major factor is likely demographic: Wiki says In KSA “There are 20 million Saudi citizens and 5 million foreigners living in Saudi Arabia.[14] Most Saudis are Sunni Muslims, approximately 23 percent are Wahhabis, With the world’s second largest oil reserves , the Kingdom is categorized as a high income economy with the 19th highest GDP in the world. Saudi Arabia is an absolute monarchy.[70] However, according to the Basic Law of Saudi Arabia adopted by royal decree in 1992, the king must comply with Sharia (Islamic law) and the Quran, while the Quran and the Sunnah (the traditions of Muhammad) are declared to be the country’s constitution.[71] According to The Economist‘s 2010 Democracy Index, the Saudi government is the seventh most authoritarian from among the 167 countries rated.[72]. The ethnic composition of Saudi citizens is 90% Arab and 10% Afro-Asian.[212] Saudi Arabian dress strictly follows the principles of hijab (the Islamic principle of modesty, especially in dress).
In the UAE ie Emirates, Wiki says in 2013 UAE’s total population was 9.2 million; 1.4 million Emirati citizens and 7.8 million expatriate ie 16.6% Emirati (citizenry), 23% other Arabs, 54.4% Asians, and 6.0% other expatriates. Thus the relatively democratic & liberal UAE has only 40% Arab ie (majority also Wahhabi) Muslim population, compared to some 90% in the KSA. . in 2005, 76% of the total UAE population was Muslim, 9% Christian, and 15% other (mainly Hindu). Census figures do not take into account the many “temporary” visitors and workers while also counting Baha’is and Druze as Muslim.[65] Among Emirati citizens, 85% are Sunni Muslim, while Shi’a Muslims are 15%.
The comparable life expectancy in the bigger but relatively poor mostly caucasian countries of Europe is 80 yrs (Portugal), 81 (UK) to 83yrs , and 84.6 in Japan. Why the richer KSA has so much lower life expectancy can only be due to combination of culture (overdress?) and perhaps genetics- but Israel, also a predominantly eastern mediterranean semitic people, like Europe has life expectancy of 82.1 years. on that tabulation, UAE expectancy is 79.2yrs, USA 79.8, but KSA only 74.3.
Comparison of Gross domestic product and per capita income for 2014 fail to explain the differences in life expectancy ie survival between the highest earning countries, with KSA, UAE, Israel and much of the middle east countries falling in the $30 to $40 000 per capita income bracket.
NO NEW CASES WORLDWIDE: 4 suspected MERS cases investigated in Hong Kong after arriving there via Dubai have proved negative for MERS.
while Ebola, AIDS, cholera, polio and bubonic plague spread despite major efforts at containment… with at least USA and UK preparing for ebola outbreak, and China for the bubonic plague.
8 August 2014 Ebola virus disease EVD update – West Africa Disease outbreak news Between 5 and 6 August 2014, a total of 68 new cases of Ebola virus disease (laboratory-confirmed, probable, and suspect cases) as well as 29 deaths were reported from Guinea, Liberia, Nigeria, and Sierra Leone. On Wednesday, 6 August and Thursday, 7 August, an Emergency Committee determined that the current outbreak constitutes a Public Health Emergency of International Concern. and advised that: it constitutes an ‘extraordinary event’ and a public health risk to other States; the possible consequences of further international spread are particularly serious in view of the virulence of the virus, the intensive community and health facility transmission patterns, and the weak health systems in the currently affected and most at-risk countries.
It was the unanimous view of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have been met. New cases and deaths attributable to EVD continue to be reported by the Ministries of Health in Guinea, Liberia, Nigeria, and Sierra Leone. Between 5 and 6 August 2014, 68 new cases (laboratory-confirmed, probable, and suspect cases) of EVD and 29 deaths were reported from the four countries as follows: Guinea, 0 new cases and 4 deaths; Liberia, 38 new cases and 12 deaths; Nigeria, 4 new cases and 1 death; and Sierra Leone, 26 new cases and 12 deaths.
As of 6 August 2014, the cumulative number of cases attributed to EVD in the four countries stands at 1 779, including 961 deaths. The distribution and classification of the cases are as follows: Guinea, 495 cases (355 confirmed, 133 probable, and 7 suspected), including 367 deaths; Liberia, 554 cases (148 confirmed, 274 probable, and 132 suspected), including 294 deaths; Nigeria, 13 cases (0 confirmed, 7 probable, and 6 suspected), including 2 deaths; and Sierra Leone, 717 cases (631 confirmed, 38 probable, and 48 suspected), including 298 deaths.– mortality rate so far 55%.
For a viral hemorrhagic illness, as for acute MERS and flu, Ebola treatment and prevention remains supportive, including plenty of fluids and salts, multivites incl K1, highdose vitamin C eg a few grams hourly to tolerance, vitamin D3 perhaps 300 000iu orally to start then 100 000iu weekly, iodine, zinc, selenium, garlic, ginger, ecchinacea and colloidal silver till out of the woods.. .
29 July 2014 the first Wiki update in weeks indeed shows no reported increase in KSA cases with 41% fatalities; but total Arabian Peninsula cases up to 825 with 321deaths ie 39% fatalities, and 96.3% of global – 855 cases and 331 deaths ie 39%.
28 July 2014 THE END OF THE ARABIAN MERS CoV OUTBREAK? its now apparently 18 days without new MERS cases reported from KSA , compared to 6 cases in the previous week… . so the Wiki figure of WHO-reported cases in the Arabian Peninsula (plus the 2 recent cases in UAE) totals 814/(835 globally ie 97.5% of reported world cases), with 315 Peninsula deaths ie 38.7% fatality rate- but only 13% in the far less coverup- restrictive UAE with its huge foreign worker population. . . supporting the studies of KSA scientists of more severe vit D deficiency in the most covered-up observant people, citizens of Saudi Arabia and its fellow ultra-observant Wahhabi bordering neighbour states (except the UAE) to the south and east. .
and now Ebola epidemic outbreaks kill hundreds in central Africa. The nocturnal fruit bat (that locals eat) is apparently the vector. There is strong reasoning that these could be prevented, successfully treated (humans if not bats) with safe highdose vits C and D3. Like humans, all tested families of bats, including major insect- and fruit-eating bat families, cannot synthesize vitamin C,. and have very low vit D levels, make vitamin D only if they roost in sunlight.
and Central Africans are very darkskinned, and the masses malnourished from rampant genocidal wars, so they will have the lowest levels of vitamins C and D3.
20 July 2014 MAYBE.. JUST LACK OF REPORTING? NO COMPLACENCY YET: Giuseppe Michieli‘s A Time’s Memory to 17 July shows 17 more reported MERS cases (all outside the KSA -still 721 cases, 297 deaths): globally 852 with 329 deaths; Arabia 829 with 319 deaths; ie rest of world 23 cases and 10 deaths- similar mortality 41% in Arabia compared to 43% in the 23 infected cases who returned to their own countries (middle east, north Africa, Europe, USA, Malaysia, Philippines) not on the Arabian peninsula- from their visit/working there or, rarely, contact with returnees. . So has the outbreak stopped in the past 10 day
ps the USAEBN radio website reports startlingly different case numbers in far fewer nations, especially tenfold more cases in Qatar and half the number in UAE. Time will tell. . this high occurrence in Qatar is not reported anywhere else? on 24 July it reports for KSA alone 834 Cases (897 in the Arabian Peninsula); 288 Fatalities. globally 873 cases with death rate only 35%. still the massive discrepancies with startlingly far more cases in Qatar and Philippines and far less in the UAE. This website claims, perhaps not implausibly, that “Government Organizations Do not want to publish total numbers of cases for fear of panic, USAEBN will be trying to track it.”
Virologist Dr Ian MacKay IN MID JULY puts the world total of cases at 846 in his informative analysis of age and gender demography.
But with neighbouring Iraq in civil war breakdown and even polio flareup, who knows how many there are suffering and dying from unmonitored MERS CoV.
14 July 2014 The UAE reports 2 new cases of MERS CoV – the first in a long time-, bringing their total to about 73 cases, 9 deaths ie 12% fatality. . KSA reported one new case 10 July ie 4 past week, and 5 in each of the the previous few weeks; with no deaths, tally now 721 cases, 295 deaths ie 41%. The UK Gov travel warning is about terrorism in the region, not MERS.
The vexed question of the method of spread of MERS CoV between animals- dromedary camels- and humans continues to be hotly debated between expert virologists and camelmen. The KSA has still not issued [ any restriction on camel imports from the suspected source of the MERSCoV- the Horn of Africa.
But the argument is irrelevant for practical purposes. Tradition, belief dies hard, like the strictly enforced hijab overdress, and camelkeeping: “Riyadh’s camel market stretches several miles along a highway out of the city. It’s not true. Camels occupy a special place in Saudi society, We live, sleep, eat and spend our whole lives with camels, we drink their milk, its a medicine.. There’s no disease,” said a trader at the market”. Its the story of 160 years ago, the cholera-spreading London’s Broad St water pump until Dr John Snow recognized and stopped the source of the cholera diarrhoea epidemic. This far more lethal KSA lung-kidney epidemic is simpler- encourage people worldwide to get plenty of free natural sunshine , or if living at far north darker latitude or practicing hijab and unable to sunbathe- especially over Ramadan- take at negligible cost vigorous supplement of vitamin D3 to a high safe bloodlevel .
8 July 2014 Spread of MERS CoV- Down but not out: from 15 cases a day in early May, now KSA has reported 8 new cases past 7 days; ie 720 total, 294 deaths- 4 new cases past 3 days, with 1 new death. 18 new cases in 24 days since 13 June. So the rate of new cases is not dropping there the past month – or simply more cases being tested and reported. Only sick cases who see doctors, and their contacts, and city health workers, are likely being screened.
The death rate in KSA since the outbreak 2 years ago remains 40%. why should this be? other than that Saudis do not benefit from the midsummer as do other populations- they remain shrouded in overdress and thus severely vitamine D deficient? and the virus seems to spread not airborne but by direct contact – human to human, or camel-(milk?)-human? and the KSA has not yet been reported to have stopped mass camel importation from the Horn of Africa for butchers to supply meat.
MERS CASES BY OCCUPATION: Shane Granger has tabulated more recent reported MERS cases by occupation where data is available – >375 cases:. Health Care Workers (HCW) the largest group – 161: includes all types of unidentified Health workers (i.e. Nurses, Doctors, hospital and clinic staff). Retired: also 161 (incl Pilgrims 11). Schoolkids 18 -third. Farmers 12 – fourth. . tourist 3; construction 2; Camelbreeder, butcher , shepherd one each.
The retirees are the elderly, generally frailer, probably more at leisure, more orthodox ie more ritually overdressed? and circulating /concentrated more through/in the cities especially Mekkah, Riyadh, Jeddah, and visiting the more frail and sick worldwide; thus more susceptible.
Healthworkers are obviously the most stressed and hardworking, exposed to concentration of symptomatic MERS cases and thus ingestion and surface (if not droplet) contamination .
The major surprise is the low occurrence in schoolkids, pilgrims, and non-health industry workers, teachers, clergy, armed forces, shop and office staff, non-healthcare govt workers, etc.
This also favours nutritional ( sunlight/vit D/C/zinc) deficiency as a significant factor in susceptibility of retirees and healthworkers to MERS. The general population (unless seriously ill with other disease) is largely immune to MERS, like flu and common colds, in them the MERS CoVirus seemingly causes nothing more.
4 July 2014 frail pilgrims should postpone the Hajj this year. the European Centre reports KSA 716 cases, 293 deaths; worldwide 843 cases (817 in Arabia incl now 4 in Iran), 322 deaths. in 21 countries, ie 21 cases outside the Middle East (ie outside the camel contagion area south-east across the Arab states that have had 791 cases so far) . So thats about 10 new cases over the mid summer in KSA the past 15 days so far. Only 1 new death. Case reporting from the rest of the world lags behind.
So the Philippines has advised its citizens to postpone Hajj to Mecca this year.
Certainly frail pilgrims – especially with diabetic and cardiorenal/respiratory diseases -all over the world will be wise to postpone. And the KSA is at last considering stopping import of camels (4.7 million a year mostly for human consumption, – mostly from Somalia, which has never reported a MERS case) – from the Horn of Africa- their main meat supply. This appears to be the source of the outbreak- simply camel colds that kill only sickly humans who unlike camels avoid sunshine by edict… . Up to April 2014, it was predominantly a disease of older men; (it appears that camels are men’s work); but by midMay the male dominance in human MERS cases was fading.
But is the core problem the well-camel MERS-Covirus carriers? It is in fact more likely that the prime cause is that the entire KSA population is at extreme risk – both because those who can afford it overdress by religious edict, especially upperclass Muslim women in total coverup and thus badly vitamin D deficient; and because the KSA imports vast numbers of mostly poor unskilled foreigners to do mostly manual work. Such poor labourers are usually undernourished, living in poor conditions, and with poor access to medicines and medical care until they collapse; and unless outdoor labourers, living and working long hours indoors, and hence also badly vitamin-D and C deficient. . The Wiki review Saudi Arabia “Foreign workers estimated them to number 1/3 of KSA residents recently. Saudi Arabia has become increasingly dependent on foreign labour, and although foreign workers remain present in technical positions, most are now employed in the agriculture, cleaning and domestic service industries. The hierarchy of foreign workers is often dependent on their country of origin; workers from Arab and Western countries generally hold the highest positions not held by Saudis, and the lower positions are occupied by persons from Africa, the Indian subcontinent, and Southeast Asia. the situation has persisted because of a reluctance by Saudis to take on menial work and a shortage of Saudi candidates for skilled jobs.[.. The Saudi economy has, therefore, remained dependent on importees for expertise in specialized industries, and on the Asian workforce for the construction industry, menial and unskilled tasks.[8] Saudization is generally considered to have been a failure.[10]
THE MERS-CoV CAMELTRAIN FROM AFRICA: This again begs the huge question: if camels carrying asymptomatic airways MERS CoV are indeed the virus vector from Africa – almost 5000 a year from Somalia alone- imported into KSA through Jeddah port, WHY ARE THE EXPORTING CAMEL- TRADERS and camel- breeders IN NORTH AFRICA NOT SUFFERING vastly from MERS respiratory-renal syndrome? They are likely Muslim if not black Africans; oil-rich Arabia employs vast numbers of overseas expats as labourers, and outside the KSA, Arabia especially the UAE hosts hundreds of thousands of non-Muslim professionals. But unlike say Indians and other Asians, Pinoys and Malaysians are mostly Muslim, so are more likely to observe cover-up dress code, and thus be more vulnerable to MERS. . This again supports the evidence that the current symptomatic serious MERS-CoV SARRS – Severe Acute Respiratory Renal Syndrome – that occurs in and kills almost exclusively vit D deficient frail observant Muslims – is due to conditioned sunlight deficiency. The north African camel breeders and traders, and the camel herders and camel men in Arabia ( like cowboys on the prairies and herders worldwide in hot climates), are unlikely devout well -berobed Bedouin of Arabia. Camelmen like cowboys get plenty of sunshine vit D, if only via bare faces and arms; and thus can with probable impunity, immunity against MERS, drink raw camel milk and travel with vast camel herds.
27 June 2014 update: (compared to 13 June 2014 KSA 702 cases, 292 death, worldwide 826 cases, 326 deaths): there are now reported in KSA 710 or 718 cases ie 8 -16 in 2 weeks, no more deaths; and globally 833 cases & 322 deaths. . Australian virologist Dr Ian Mckay postulates why vast camel imports (from Africa, via Jeddah port) for eating is likely the source of MERS in Saudi Arabia. He omits the obvious link in the chain, that the deathrate from MERS CoV is far lower outside Saudi Arabia because this sunny country is the strictest in the world for enforcing Wahhabi hijab total overdress code and thus profound acquired vitamin D deficiency even in men, and worse in females who in public – unlike men- must have even their heads and faces veiled by a niqab- and in pilgrims from other lands who as part of their holy pilgrimage undertake to follow permanently the strict hijab dresscode. Their simple option is to take effective permanent vitamin D3 orally eg 50 000 iu weekly.
IT IS COMMON CAUSE THAT ONE DOESNT, CANNOT PREVENT OR TREAT INFECTION BY POOR NUTRITION OR LOWDOSE ANTI- MICROBIALS- such policy is futile if not dangerous for breeding resistance as well as disease extension. The studies below confirm the obvious, (as Klenner, Pauling, Cameron ea showed the past 50 years with highdose vit C injection), that vitamin D3 orally also works as a multiantimicrobial agent if given as early as possible in safe very high dose and bloodlevel eg 600 000iu monthly (in the first month, – in Salahuddin’s Pakistan PTB patients (presumably also Sunni muslim) initially mean wt 45kg, thats vit D3 ~440iu/kg/d) for two doses ie a mean of 300iu/kg/day over 90days; not the current preventative recommendation of 80iu/kg /day to a safe blood level of around 50-60ng/ml. As Holick has said, with adequate water intake even 50 000iu vit D3 a day ie 1.5million iu/month for months causes no toxicity. Given the 40% mortality rate in the frail Saudi MERS patients, and in acute severe influenza and other serious viral infections, it can be expected that such highdose immediate vitamin D3 therapy orally with eg 600 000iu, combined with highdose vitamin C, zinc and some multivite, (never mind appropriate antibiotics in acute bacterial infection) will similarly virtually eliminate mortality.
But no KSA Govt website mentions this- except the Saudi Gazette a year ago which strongly urged vitamin D supplement in the KSA as even daily sun exposure does not bring most Saudi women above the vitamin D deficiency threshold. It says Since Muslim women can only reveal the hands and face, they may need to be out in the sun for longer than 30 minutes. But the review conspicuously fails to mention that in public outdoors in KSA, women must have even the head and face covered. It also propagates surprising dangerous nonsense that “severe deficiency needs monthly vitamin D injection – “Mom, have you taken your vitamin D injection this month?, when all it requires is an oral daily, weekly or fortnightly dose vitamin D3 at trivial cost.” It does stress “One of the main reasons why vitamin D deficiency is so common in the Kingdom is because there are very few food sources of vitamin D. Foods which have fairly good amounts of vitamin D are fish liver oil, sweet potatoes, egg yolks, vegetable oils, butter, and fatty fish such as salmon, sardines, and tuna,” said Dr. Rasha Jameel, a consultant in family medicine at a local hospital. In the United States, all milk and dairy products are fortified with vitamins A and D, but no such measures are in place in the Kingdom“.
This correlates with a new metaanalysis (in the BMJ this month) of observational studies from Europe and USA, that all-mortality hazard ratio over a mean of 10 years increases by 57% as vit D level falls from the highest to the lowest level. The KSA apparently chooses to ignore that, as this column reported recently from WHO data, despite apparently being the wealthiest country per capita of bigger populations in the world, KSA’s population life expectation is about 5 years lower than eg far less sunny Britain’s; ie KSA all-cause mortality rate is avoidably materially higher. Despite KSA medical professors having reported in studies that most of the KSA population is deficient in vits D and C, the KSA Govt website chooses to ignore this on official websites; unlike other even Middle-Eastern governments promoting vit D fortification or meaningful safe supplements costing trivial amounts.
Even a new study last year from KSA universities confirmed that ” Most commonly consumed food products by Saudi population which are supposed to be fortified by vitamin D are either not fortified or contain an amount less than (apparently from their table 2 ~ half of) recommended by guidelines set for US marketplace”. Even a UAE authority recently stressed “Can fortified milk fight Vitamin D deficiency? Shockingly low levels of D3 among UAE population cannot be rectified by milk alone.” As Holick ea, including a Turkish University 2010 trial report, oral vitamin D3 is far more effective , and safer than, either vitamin D2, or vitamin D injection -never mind much cheaper. This current ostrich-head-in-the-sand denialism by the KSA government is like that of the RSA govt under Presidents Mbeki and Zuma 10-15 years ago about preventing and treating HIV-AIDS – considering that the safe and beneficial daily intake of vitamin D3 is now universally recognized as 4000 if not 10 000iu/day (ie about 80iu/kg/day or pro rata up to perhaps fortnightly) , to a mean blood vit D level of about 60 to 80ng/ml. .
As Prof Mike Holick pointed out a few years ago, “Even in Saudi Arabia, Qatar and South Africa, more than 50% of the population is deficient in vitamin D, all because of their avoidance of sun. Based on some of the literature, it seems that we could probably decrease health care costs across the board by 25% if everybody had optimal vitamin D status.” As Al Faraj ea reported in Riyadh in 2003, Prof Zahid Naeem from a KSA university wrote in 2010, “Vitamin D deficiency is an ignored epidemic in KSA and globally“; confirmed by a KSA study by Ali ea in 2012: “Even in a sunny country like Saudi Arabia the prevalence of vitamin D deficiency in young female is high“.. One does not need to speculate why the KSA and all governments globally choose to ignore this inconvenient truth, downplay effective vigorous vitamin C and D3 (sunshine) supplements- such widespread vitamin D and C deficiencies, like cigarette smoking and alcohol abuse, suit governments and Big Pharma- the Disease Industry- in reducing populations growths and creating jobs for the highly profitable Disease Industry and it’s shareholders- for whom Only Disease Pays. Cheap safe natural Prevention Does not Pay since it at least halves sickness never mind disease industry jobs, taxes and profiteering in the global $multitrillion Disease and Diet and Vaccine and Invasive Screening Industry scams.
And Karen Hansen ea at Univ Wisconsin 2014 have just shown that giving vitamin D2 (not D3) 50 000iu fortnightly for a year is actually adverse – as Holick and others have show – IT DEPRESSES – perhaps halves – THE BIOLOGICALLY ACTIVE blood 25OHVIT D3 while boosting perhaps 5 fold the far less active blood 25OHvit D2 levels , and actually worsens rheumatoid arthritis clinically and serologically . One can speculate whether vit D2 actually blocks optimal function of VDRs vitamin D receptors. Trials published 2012 from Japan and Netherlands showed that vitamin D3 – blood 1,25(OH)2D3 (but not TNFalpha blockers) blocked inflammation (ie TNF tumour necrosis factor alpha activation of vascular calcification).
Salahudfin ea’s new randomized controlled trial from Pakistan Vitamin D3 injection accelerates clinical recovery from tuberculosis shows “impressive clinical (weight gain, chest xray and sputum clearing) improvement over 3 months on outpatient TB therapy (Directly Observed Therapy (DOTS) with 2months of 4 antituberculous drugs [Isoniazid, Rifampicin, Ethambutol and Pyrazinamide] followed by 6months Isoniazid and Ethambutol) with two doses 600 000iu vit D3 imi (vs placebo inj) a month apart- ie equivalent to about 7 000iu/day over the 3 months treatment period . This dose of vitamin D is as recommended for vitamin D supplement by the Pakistan Endocrine Society. Trough 25OH vit D levels increased from about 20 to 90ng/ml. After 12weeks, the vitamin D supplemented pts (mean 28 yrs, BMI 17.2kg, 85% moderate to far advanced lung disease) had significantly greater mean weight gain (kg)+3.75, (3.16 – 4.34) versus+2.61, p 0.009; lesser residual disease by chest xxray- 30% fewer zones involved 1.35 v/s 1.82 p 0.004, and 50% or greater reduction in cavity size 106 (89.8%) v/s 111 (94.8%), p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g secretion in patients with baseline ‘Deficient’ vitamin D serum levels (p 0.021). Patients in the vitamin D arm and serum < 30 ng/mL (‘Insufficient’ and ‘Deficient’ groups) at enrollment had significantly greater improvements in TB severity scores compared to patients with normal baseline vitamin D levels; p 0.014. This corresponds with the earliest reports of the benefits of vitamin D in TB patients published in 1848 [21] that describes disease arrest, weight gain and reduction in mortality in patients with TB treated with cod liver oil compared to standard therapy alone. More recently, Martineau et al [7] demonstrated that a single oral dose of 2.5mg (100,000IU) of vit D2 significantly reduced growth of mycobacteria . A randomized, placebo controlled study on 67 Indonesian patients, by Nursyam et al , Jakarta [22] reported that pulmonary TB patients given 420,000IU of vitamin D over 6weeks ie 10 000iu/day had significantly higher sputum conversion rates as compared to placebo (p 0.002). Martineau et al. [8] showed that 100,000 IUs of 25-hydroxyvitamin D3 supplementation significantly improved sputum conversion rates in patients with the Taq1 25-hydroxyvitamin D receptor polymorphism of the tt genotype. .
As Salahuddin ea note, the good results in Pakistan in only 3 months with vigorous INITIAL dose vit D3 contrasts with Two recently published large randomised, controlled trials of conservative vitamin D3 over months that achieved far lower blood vitamin D levels found no difference in clinical outcomes or mortality: after 400,000iu of 25-hydroxyvitamin D3 or placebo were given by Martineau ea in London, UK to 146 pulmonary TB patients – where mean (trough or midpoint) vit D level (after 100 000iu vitamin D(3) or placebo at baseline and 14, 28, and 42 days after starting standard tuberculosis treatment) – was surprisingly only 40ng/ml at 56days – ie after a mean of 7000iu/d by 56 days, vs 10ng/ml on placebo)- less than half of the bloodlevel achieved on vit D3 in the Pakistan trial ;
and by Wejse et al 2009 in Guinea-Bissau to 365TB patients – who received 300,000 IUs of vit D3 ie only 100,000 IU or placebo at inclusion and again 5 and 8 months after the start of treatment, ie below 1000iu vit D3 per day over the 12 month trial period “. The Guinea-Bisseau pts thus might have achieved a mean blood vit D level boost of only 10ng/ml.. and now Havers ea (Baltimore) show Low 25(OH)D is common in diverse HIV-infected populations and is an independent risk factor for clinical and virologic failure; Low 25(OH)D was associated with high body mass index (BMI), winter/spring season, country-race group, and lower viral load. Baseline low 25(OH)D was associated with increased risk of human immunodeficiency virus (HIV) progression and death (adjusted hazard ratio (aHR) 2.13; 95% confidence interval [CI], 1.09–4.18) and virologic failure (aHR 2.42; 95% CI, 1.33–4.41). and Shepherd ea (Eurocoord) Low Vitamin D predicts short term mortality in HIV-positive persons Odds of death decreased by 46.0%( P = .04) for a 2-fold increase in latest 25(OH)D level.. In patients with current 25(OH)D
19 June 2014 update no new cases reported from anywhere the past few days, may be because the KSA is not reporting regularly. so the great news is that more than 2 years after the onset of the MERS CoV outbreak in Arabia, no ongoing transmission has been reported from any of the 22 countries so far affected.
THE POLIO SPREADING GLOBAL EPIDEMIC This decline of the MERS outbreak with the heat of summer contrasts sadly with the now-declared global epidemic of wild natural poliomyelitis– which was hoped to be extinct by now, with Hindu- run India being declared polio-free; but now spreading out with mass refugees from wherever war and chaos are successfully ignited by profiteers and fanatics to neighbouring countries. Eg an expanding militant Islamic Wahhabi arc – ie ultraorthodox overdress code – predisposing to vitamin D deficiency? from Asia– Pakistan, Afghanistan, to middle east – Syria, Palestine, Iraq, Israel; to East/West Central Africa eg Somalia, Cameroon, Ethiopia, Kenya, Nigeria, Guinea-Bissau, – with 365 cases reported in 2013. Perhaps more important is zero natural virus cases in Niger and Chad but cases caused by the circulating vaccine derived virus. The wartorn DRCongo and Sudan are likely next polio outbreaks, while Angola has banned Islam because of its perceived militancy. …
And in February, never mind an outbreak of polio-like paralysis in northern California, a new case was reported in a South African neighbour- in Botswana – for the first time there in 20 years –; “Polio virus is endemic in five countries besides Nigeria: Afghanistan, Egypt, India, Niger and Pakistan. Scientists confirmed that the virus isolated from the boy in Botswana came from Nigeria by laboratory tests that showed it was genetically similar to the strain that has been infecting children in Nigeria . In the past 18 months, polio viruses genetically linked to northern Nigeria have caused new cases of polio in nine previously polio-free countries. Besides Botswana, they are Benin, Burkina Faso, Cameroon, the Central African Republic, Chad, Ghana, Ivory Coast and Togo.” So polio is likely to break out in RSA not because of Islamic overdress but because of the masses of war refugees absorbed by democratic dispensation from the polio-afflicted African states to the north, and poor water supplies, sanitation and nutrition, in so many areas in the northern provinces, despite mass polio vaccination. . In Cape Town’s poorer areas’ clinics, we see almost as many foreign pan-African refugees as we do local black Africans.
15 June 2014 new case reported in the 23nd country – Bangladesh, arrived from USA via Abu Dhabi airport. But now disproven. CRUCIAL EFFECTIVE VITAMIN D3 DOSING: TRIALS USING SUBOPTIMAL VIT D DOSES AND LEVELS ARE MISLEADING: A major new metaanalysis of the benefit of Vitamin D and Respiratory Tract Infections VIDARIS in PLOS 2013 by Sweden’s Karolinska Institute Bergman ea showed that in the 11 relevant trials (published between 2007 and 2012 ie done through the first decade of this century) using vit D3, “Overall, vitamin D showed a protective effect against RTI (OR, 0.64; 95% CI, 0.49 to 0.84). And the average vit D level at baseline was only 24ng/ml, but with the mediocre vit D3 doses used then of average 2000iu/d (300 – 4000iu/day) given for between 7wks and 3 yrs, the average bloodlevel achieved on replacement was only 50% higher at 36ng/ml”. This confirms more direct experience with higher doses that blood level increment, and benefit, is proportionate to vit D3 dose, at least up to the proven speculative safe upper dose of at least 10 000iu/day (whereas the proven safe longterm daily dose is> 50 000iu/day). “More important, the protective effect was larger in studies using once-daily dosing compared to eg monthly bolus doses (OR=0.51 vs OR=0.86, p=0.01)”. This concurs with our experience of major benefit against respiratory infection that is based on published studies giving a loading month’s dose of about 80-100 iu/kg/day ie ~3000iu/kg; then that monthly dose split conservatively eg 50 000iu every week or two depending on mass, and severity of ill-health; to a more successful blood-level of 60 to 100ng/ml. Similarly, the 2014 VIDA trial across USA- Effect of Vitamin D3 on Asthma Treatment Failures in Adults With Symptomatic Asthma and Lower Vitamin D Level, Castro ea, showed “Vitamin D3 for 28 weeks did not reduce the rate of first treatment failure or exacerbation in adults with persistent asthma and vitamin D insufficiency. These findings do not support a strategy of therapeutic vitamin D3 supplementation in patients with symptomatic asthma“. But this trial had the same severe limitation as the Swedish metanalysis of vit D3 benefit- it also used only 4000iu/d. “While all were vitamin D insufficient ie below 30 ng/ ml before the trial and half were deficient with levels below 20 ng/mL, supplementation brought levels above the 30 ng/mL threshold for 82% in that group – mean levels were 41.8 ng/mL at week 28 in the supplement group, while the mean stayed in the deficient range for those who got placebo. ” So 4000iu/day merely doubled the bloodlevel to only about 40ng/ml – only about half of the putative optimal dose. These recent studies force us to conclude that bad weather, and bad prevalent respiratory viruses, and especially with major acute, or chronic illness as in those with or at risk of serious infections eg major trauma or sepsis, MERS-CoV, Ebola, malaria, cholera, cancer, diabetics, smokers, asthmatics, bronchitics, AIDS-TB., pneumonia and old age sufferers, and especially hospital, laboratory and clinic- health workers- we should for an average 70kg adult give a loading dose of about 4000iu/kg, ie 300 000iu, then 10 000 iu/d, or 50 000iu every 5 days, or more simply 75 000iu (about 1.5ml of 100cws vit D3 powder) weekly; or at a stretch, 300000 if not 400 000iu monthly. . As the common imported vit D3 powder concentrate is 100 oooiu / Gm ie per 2 ml, it is simple to take the slightly sweetish powder up to 2 or more 4 ml teaspoons ie 200 000 -400 000 iu on the tongue. The majority of residents of developed countries now live urbanised with mechanized transport, and – especially in Muslim or cold countries- dont live and work / walk all day stripped in the sun. The poor malnourished peasants live crowded in ghettoes , and the poorest are generally the darker skinned and therefore make the least vitamin D3. So with rare exceptions, everyone needs the vigorous vitamin D 3 doses discussed above. But at the prevalent bulk vit D3 powder price of at most about US$0,o2 per 100 ooo iu, at a mean population age of around 20 to 25 yrs -outside Europe- it would cost a country of eg 50 million people perhaps $o.5 per head per year ie conservatively $25 million a year to prevent > 90% of common illnesses including drugging and violence consequences. Of course no government can tolerate such massive loss of jobs and taxes in a decimated disease industry that now turns over $ trillions annually – up to 18 % of national budgets. So it’s up to individual adults, especially householders, educators and employees , to see that the cheapest cure-all after clean water – vitamin D3 – at $2/citizen per year- is recommended and freely available.
13 June 2014 KSA now has apparently reported 702 cases, 292 deaths ie 14 more cases, 12 more deaths in past 11 days.. worldwide 826 cases, 326 deaths. And a new multinational vitamin D study confirms why vitamin D3 not D2 must be given. TIME TO SWOP FROM MISNAMED “STRONG CALCIFEROL” VIT D2 TO THE REAL VIT D3. 6 June 2014 on the 10th anniversary of the SARS epidemic , a new 2013 review (by Japanese epidemiologists) Remembering SARS-CoV: A Deadly Puzzle and the Efforts to Solve It brings home the lessons, the similarities between the two recent killer coronavirus outbreaks, in both outbreaks affecting only residents of closed communities (Arabia and China respectively), with carriage of the virus by travelers into their closed kin communities elsewhere. . Especially the problems of hospital confinement, and superspreaders. Sun-blocking culture among the Chinese whereever they live in their ethnic communities is also stressed in modern literature. Lu et al 2012 show very high levels of vitamin D deficiency in Shanghai. The obvious lesson of the past decades was not noted then or now- prevention is better than cure, as in AIDS and pneumonia and all other infections, simply by superboosting the immune boosters within sensible limits – sunshine/vitamin D3 and C, zinc, iodine, selenium; and for the likely deficient, appropriate iron .. 4 June 2014. Saudi Arabia reports confirm they have indeed uncovered many more cases, as tabulated by the Wiki report yesterday- 689 cases, 283 deaths. Shane Granger in his Random Analytics concurs. The graph by the KSA authorities shows that most of the unreported cases reputedly occurred from March through to the first week of May, and that that outbreak is almost over, down from a peak of over 100 cases a week ie at the end of their winter- when vitamin D levels are at their lowest- to about 25 cases a week. .They do not say when the excess MERS-related deaths occurred. Who knows how many more cases and deaths are underreported from the KSA, when the annual Hajj is imminent, and religious tourism is a vast industry for the KSA. This MERS outbreak is in contrast to the 8200 recorded case SARS (coronavirus) outbreak of 2002/3 in China, S.E.Asia, (Canada and USA) and sparsely across Europe – but only 1/4 of the MERS’ ie 9.6% mortality . Just one case was recorded in the middle east and Africa- in Kuwait. Although the SARS and MERS viruses were traced through mammals to bats, the affected populations were genetically different- Chinese versus Arabic ie Caucasian. But a decade after the SARS outbreak, Chinese in Shanghai also had 85% below the vit D insufficiency threshold (30ng/ml) at the end of winter. An International Osteoporosis Foundation study of 2009 showed very high prevalence of vit D insufficiency throughout Asia including China- but worse in Malays. Thus the susceptibility to and mortality from SARS and MERS in the respective races- like Swine flu susceptibility in the frail in USA and Mexico in 2009 and anywhere since- is likely due like any disease to the combination of both socioeconomic burden, genes and sunshine vitamin deficiency. But whereas socioeconomics; genes; and ethnic taboo on sun exposure as in strict Muslims, are not easily correctable, traditional micronutrient deficiency is- especially vigorous vitamin and mineral supplements, without offending cultural taboos.
3 June 2014 update : In the past 5 days, Google websites reported 2 new cases/d in KSA. BUT Wikipedia this evening reports the latest collation: in KSA, 688 cases with 282 deaths ie 41% mortality; this is far higher than in its close 7 Arab neighbours including Iran, with a total of only 89 cases but only 26% mortality. If these figures are accurate, there have apparently been 125 cases in KSA since 29 May ie 25 new cases/day there; but 96 deaths ie 19 per day. But this gross epidemic has not been reported on Google, so hopefully the Wiki MERS tabulation will be corrected- unless it because the KSA was not announcing cases. . Apart from the 8 Middle East nations counted above, the Wiki figures for the outside 16 countries in the rest of the world – 25 cases, 7 deaths ie 28% mortality, are more consistent with reports to date outside KSA, and moderately lower than the fatality rate reported in KSA . All MERS- confirmed cases were contracted in the Arabian peninsula (or from travelers from there). All adults in the KSA including visitors would by edict be almost totally robed when outdoors, the women also with hijab. On the other hand, observant pilgrims from non Arab countries are more likely both older- having chronic degenerative diseases ie more vulnerable- , but likely get more sunshine skin exposure at home, and taking protective supplements before and after; thus possibly explaining the lower mortality and low prevalence of carriage of MERS outside Arabia. The average Saudi Arabian is aged around 20years, but the young there presumably face the same policy against skin sun exposure, and apparently against protective micronutrient supplements. 31 May 2014 Mers update the past 2 days just one new case in Saudi Arabia, but 2 cases in Algeria back from KSA – the 21st country ; and now a total of 6 cases in Iran with 1 death.
29 May 2014: The 26 May Cape Town suspect’s deep nasopharyngeal swab screens have proved negative for Influenza A eg swine flu, and MERSCoV, and she is recovering. . The NICD says they have perhaps 5 requests for screening in returnees from KSA, all negative for MERS CoV. KSA reports 3 new cases past 48hrs , while of recent screened cases there, 4 more have recovered and gone negative. ie 565 cases , but 6 more deaths ie 186 died – 33%; Worldwide thus at least 680 cases / 215 died. But apart from KSA and Jordan (5/10 died= 55%) the fatality rate in the other 19 countries reported is thus also 22.6%, as low as 13% mortality in UAE if their figures are to be believed. The problem is we dont know how many subjects were screened in each country to get the perspective.. Perhaps UAE simply screened many more ‘well’ people with “flu’. of recent cases reported from countries outside Arabia, virtually all presented clinically with serious URTI. Only 2 MERS-COV cases have been finally confirmed in USA, both travelers back from KSA. Thus it is apparent from all the screening patchily reported the past 2 years that: 1. air/physical contact crossinfection between humans (as between camels and humans) is common; 2. but resultant actual colonization (ie the asymptomatic MERS CoV carrier- akin to say the common staph nasal carrier) is reassuringly low- likely in mildly immunocompetent people with suboptimal vigorous eg vit D3 levels and intake of vits C, zinc etc; and cleared naturally within days; 3. BUT of those colonized with invasive MERS CoV who actually present sick enough-ie with MERS– (generally those with comorbidities) to consult doctors, mortality may be > 50% (as eg in KSA, Jordan, Qatar, UK) – likely because they have poorly controlled diabetes, HIV, heart/lung/kidney disease; or very low vit D3 levels and very low intake of vit C, zinc etc. 4. So far survivors of MERS apparently do not stay carriers of the virus. These observations will be simple to affirm/ refute by storing, or immediately testing, all carriers’ and cases’ blood for 25OH vit D3 (albeit expensive) as well as the other obvious markers . But it is harmless and virtually cost-free to treat all such people anyway with vigorous vits D3, C and zinc against all latent/patent diseases. Parallel experience with seasonal flu/ common colds is that while the URTI may have been protracted till the patients consult, virtually all cases quickly resolve with vigorous supplements (vits C, D3, iodine, multivite, appropriate iron, and appropriate decongestants/ “vix” steaming. And of course it is simple and appropriate to deep-sniff pure vit C + D3 powder- as easy as using a nasal sprayer. . 27 May 2014 Jordan reports a fresh (10th) case; KSA now 562 cases –no new cases, but one more death; national school exams start there irrespective.. so global total now may be 650..now 2 in Iran. – – the 21st country?. Its not to say that >650 people have caught the illness, since apart from 30% who died of MERS , at least 20% were well, found only on viral swabs of contacts, ie by definition did not have the MERSyndrome that has killed 30%.. The global authorities have not revealed how many of the balance of 50% of those who screened positive actually developed any flu-like symptoms, as opposed to those who survived pneumonia & renal failure. Vigilance is necessary everywhere since both seasonal (H1N1) flu is spreading in the southern hemisphere, and MERS from Arabia with the recent peak there, and business, social and umrah travelers pouring through the Middle East hubs- especially to and from the worldwide Muslim diaspora , and trade hubs, . . “If you get sick within 14 days of being in the Arabian Peninsula, call a doctor and tell the doctor where you traveled.” said an NBC report earlier this month. 26 May 2041 Our first ‘ground zero’ MERS suspect returnee from Riyadh today screened in Cape Town?: after a weekend with my own flu attending a 3day medical congress here, and bad family news last night, I was caught flatfooted this morning at a walk-in local family practice clinic full of people with sudden flu/gastro gripes: the first lady in (robust, no chronic illness) with usual sudden overnight flu had after two weeks visiting her family in KSA, jetted back from there just two weeks ago, having sat behind a man coughing and spluttering. Before starting highdose supplements etc, she was deep nasopharyngeal swabbed for flu and MERS exam by our South African National Institute for Communicable Disease. Then we will, if she/her family prove positive, contact the airline to start tracing all passengers and contacts here. She is hardly in the risk category that has rocked the KSA. We dont know yet about her flight fellows..
25 May 2014: HOPEFULLY THE MERS SURGE IN KSA IS OVER? latest cumulative Saudi reports are of ~558 MERS cases in KSA, 179 deaths ie ~7 new cases detected a day (none elsewhere) . Thus in the 3 weeks since 3 May, unverified reports mainly from middle east websites are of about 101 new cases ie about 5 new cases a day, and 42 deaths in KSA ie 2/day– ~40% mortality. The rate of new cases presenting and being detected is down, but with the incubation time-lag (5 to 14 days till illness if any), assuming that all sick citizens are promptly tested, the mortality rate will fall next week from its peak a week ago. Tightening protective measures in the KSA and no doubt in all global air-hubs outside KSA are hopefully working- there has apparently not been another reported cases outside KSA the past week. 96% of all cases detected have been in KSA & UAE, with 90% of deaths from MERS being in detected cases there. The lack of new cases reported elsewhere suggests that the global figures are now about 641 cases and 208 deaths ie about 32% mortality. .
22 May 2014 update: in KSA 544 cases, 176 deaths ie so far 18 cases/million, 32% mortality; UAE 7/million; worldwide 661 cases, 207 deaths ie 32% globally. But excluding KSA and UAE, the occurrence of MERS in the rest of the world – including most of the >billion Muslims- has been 50 cases ie Ian Mackay points out, the trend in new cases in KSA is downwards the past month. The common denominator in KSA appears to be that especially city Muslim women there must be virtually totally covered when outdoors in public view.. But as noted earlier in this column, repeated university studies there by their own specialists have shown that their people are especially vulnerable to vitamins D and C deficiency, so easily correctable , a testable hypothesis at trivial cost? This perhaps easily controllable plague is surely an unintended consequence for one of the most highly learned and religiously devout peoples in the world? Is the epidemic growing solely in the KSA because by strict custom, Saudi Arabian residents (and their pilgrim visitors-who also are likely ultraobservant) have to cover up maximally, Dress to Kill? In the rest of the Arabian peninsula the MERS incidence rate is only a fraction? although the deathrate is similar.
19 May 2014 update: KSA toll now 537 cases / 173 deaths ie 31% mortality. The total there was inflated by 19 patients in the Jeddah dialysis unit contracting MERS some time recently. It remains to be disclosed how many of these cases were diabetic, were on vigorous vits C/D supplements, and died? The global figures are now 620 cases tested positive and 202 deaths.
17 May 2014 including a 3rd case (by direct contagion from a newly arrived traveler) in USA, there are now about 650 MERS cases reported worldwide, 200 deaths ie 32% fatalities; 14 new cases daily globally the past 3 days; KSA 529 cases 168 deaths (ie 11 new cases a day; and 16 deaths the past 3 days). But 96% of all cases worldwide to date presented in the Arabian peninsula’s 80 million Arab population, and apparently all 27 outside cases were exports from KSA or their immediate contacts. .. The Wiki entry Tourism in KSA states plainly : “In December 2013, Saudi Arabia announced its intention to begin issuing tourist visas for the first time in its history. Restrictions and security : Visas are only issued for business, relatives of Saudis, transit to a third country, and Muslim pilgrims; general tourism is not allowed.” So effectively in KSA cities there are in public only heavily-garbed Muslims. Apparently now “non-muslim tourists can visit the KSA in a group organized by an accredited agency”, obviously provided they conform to local religious norms. But “A limited tourist visa programme was cancelled in March 2014.[5] Saudi Arabia does not currently issue a visa for tourist travel. Hence apparently the KSA population especially in the cities is overwhelmingly Muslims conforming to orthodox Wahhabi Sunni outdoor attire- although there are apparently some 1 million christians (ie 1:30 of the population -presumably mostly professional/technician experts- in the big cities) in the KSA. Apparently there are over a million camels in the KSA, (apparently nearly 25million worldwide) with a lifespan akin to humans. “Camels come from neighboring Middle Eastern countries, in part, but also from countries in eastern Africa, including such already beleaguered places as Sudan and Somalia, Nigeria, Tunisia, Ethiopia. Just now online, not scheduled for formal publishing until this summer, is a brand-new CDC report finding widespread evidence of MERS-CoV in African dromedary camels too.” With the dromedary numbers (at least 1 per 30 Saudi citizens), camels’ huge stamina ie resistance to disease, including apparently the MERS virus they carry, their cherished role including as pets, meat, transport, racingstock, and supply of fresh warm milk in KSA society; and the reported low human vitamin D (and perhaps C) levels in the heavily-garbed city citizens, no wonder camels are an ongoing source of the hitherto unknown MERS coronavirus illness for immunodepleted citizens in KSA? whereas the camels themselves apparently suffer no more than a mild cold. A respiratory virus infection in a temperate climate is usually easily thrown off with symptomatic Rx, supplements and plenty of fluids; but on the other hand, in middle east desert temperatures and in all-over robes, hyperthermia and dehydration from MERS may more obvious cause of pneumonia and (pre)renal failure- especially in a population with high rate of sickle cell, diabetic, overweight, cardiovascular and hypertensive disease. Average temperature are about 29-330C ie mean peaks of 40C; with humidity 17% in Riyadh & Medina, but much higher in Jeddah; intermediate in Mecca..
And “Middle Eastern countries import tens of thousands of camels from eastern Africa annually. Many Saudi camels are imported. Scientists don’t yet know where the MERS virus originated or how camels got it, but it has been found in African countries and as far away as Spain’s Canary Islands, where a tiny population of camels lives for the past 400 years . ” Camels in the kingdom are like dairy cows, beef cows, racehorses, pulling horses, beloved Labradors, and living daily reminders of holy scripture, all in one. (Camels appear, honorably, in the Quran.)” As the latest report from Pulitzer Centre Prof Cynthia Gorney’s Nat Geographic account of MERS ends, “Fresh warm camels milk straight from the udder is “Very heavy, very sweet, very therapeutic” Ameer said, after I stopped shouting at him over the phone. If I were still in Saudi Arabia at this moment, I told him, I would be smacking him upside the head.” What likely gave Ameer his claimed immunity? that he had been years in USA?, and like Arabian desert camel-keepers probably lightly clothed and much in the sun- thus with good vitamin D levels?
A new report today from WHO chillingly details a party of at least 9 Umrah pilgrims since April 2014 who from Jeddah visited Mecca and Medina and then back via Jeddah to Amsterdam, Greece and USA with developing MERS – from the Jeddah sub-clade which has been identified in at least 30 cases there.. These linkages do not explain why the MERS outbreak has mushroomed solely in KSA residents – not in Muslim communities outside Arabia into which travelers flying home via Jeddah have imported the virus. The co-factor may be that, having inhaled/ingested the virus from human carriers in the KSA, these foreign travelers, often with co-morbidities, were also more vulnerable to the MERS virus because of their adherence to the same all-over dress orthodoxy, and dietary vitamins D & C and perhaps zinc depletion (with or without sickle cell trait) as has been reported prevalent in the KSA; and detailed with references below. A study is awaited of comparative skin shade, diet and skin sunshine exposure (ie degree of conformance to strict Sharia covering) between Saudi Arabians of longterm Arab descent, and their relatives and similarly conforming co-religionists in the distant diaspora Muslim overseas communities that send Umrah and Hajj pilgrims through Jeddah to Mecca and the other shrines. A current wiki-islam website stresses the serious health hazards (both skeletal- rickets and osteoporosis – and across all system diseases including immune-infection- protection) of full-cover Islamic ie hijab dress through sunlight vitamin D deficiency, unless vigorous vitamin D supplement is taken. It is no surprise that this is as much of a danger for hijab Muslims in high-sunshine desert latitudes as in bleak low-sunshine cities far north.. This might explain why the latest WHO population statistics (perhaps 2011 ie before the MERS outbreak) show that – despite being perhaps the richest per-capita nation (from oil reserves) in the world,- the KSA has expected survival age 5 years below that of UK, especially from combined (hypertension-diabetes-coronary heart- kidney ) disease rate of 375 in KSA vs eg 80 in UK. But even then, a different WHO website showed flu and pneumonia deathrate (before the MERS outbreak) 37 in hot, dry KSA ie 50% higher vs 23.7 in UK. and in about 2011, KSA had a mean population age of 20 years, with annual (agri-and seafood) imports ie dependence of US$17billion, due to its desert-limited agripotential; with predicted rapidly increasing urbanization . It will cost pennies, and a few weeks’ followup of supplement dispensing to KSA citydwellers, (and incoming pilgrims before they leave their diaspora homes for the KSA), of vigorous dose vitamins D3 + C and a multisupplement including the other vitamins , magnesium, zinc, iodine; and fish oil and virgin coconut oil (ie a blanket antioxidant, antiinfection, antihypertensive insulin-sensitizing umbrella supplement) to confirm if the emerging epidemic of MERS (let alone hypertension-heart-diabetes-kidney disease) in KSA is significantly slowed, as common infective and degenerative diseases are here in Cape Town, by such supplements. This simple prospective clinical monitoring of those receiving or not receiving the swine flu vaccine in 2009 was universally recommended, but Authorities refused to enforce such simple monitoring, so there is no clinical evidence that the swine flu vaccine significantly reduced morbidity from the outbreak, which was globally statistically trivial except in the Mexican source outbreak. Similarly, there is no evidence that the spread of MERS-CoV in KSA is epidemic considering that even in the four most densely populated cities – in the three abutting midwest provinces – containing almost half the national population, – the detected spread of MERS illness is still so low (except in the incubator hospitals). Even though camels are so widespread. it is intuitive that rural/desert citizens may take both more fresh (desert) crops (ie vit C) and more vit D- from both camel milk and more sun exposure from outdoor work with more skin exposure in such labourers. Some pictures of camel attendants apparently in the KSA on the internet show bareheaded men in vests. 16 May 2014 the latest KSA stats reported are 515 cases, 160 deaths ie 30% mortality. Globally 621, deaths 189 14 May 2014 now ~592 cases reported in 20 countries – the latest in the Netherlands, and a 3rd case in USA; with ~31% mortality (KSA 495 cases, 152 deaths ie 31%; with 20% asymptomatic). 12 May 2014: USA reports a 2nd case arrives there. a 5th death with MERS has been reported in Jordan. Saudi Arabia reports 8 new cases since yesterday, and 2 more deaths. But as expected, in the KSA eye of the storm , it appears that only contacts of patients are being screened- at least 20% of patients who screen positive for the virus have remained well. So the morbidity and mortality% are in fact very skewed, they are apparently not screening the local population for carriers. The ~28% death rate refers only to deaths in the cohort that were afflicted with MERS and their contacts.
11 May 2014 A new Reuters report today highlights the widespread intimate contact with camels in KSA. “Does the KSA want to control the uncontrollable“? “So far, the reported cases have all originated in Saudi Arabia or in the southeastern part of the Empty Quarter, in the UAE. There are no reports of those outside Saudi Arabia having transmitted the disease to others.“ the past week has seen another ~116cases ~15 cases a day- reported in the Middle East, and another 34 deaths there ie the total has reached ~578 cases (483 in KSA- Kingdom of Saudi Arabia) and ~163 deaths (142 in KSA). So the death rate has fallen to <28% overall. Lebanon and USA become the 18th/19th countries to report a case of a returning traveler. But virtually all identified cases originated in the KSA neighbourhood. The latest figures show that MERS originated and breeds exclusively in the Middle East- (cases per million ppm the past 2 years) in 16 ppm in KSA(483 cases total), 6ppm in UAE (53 total), 3.5 ppm in Qatar(7 total) and 1ppm or less in Jordan (9 total- the first reported cases, in April 2012)) or elsewhere. Apart from the frequency of camels, and the high prevalence of deficiency of vitamin D and possibly vitamin C reported below, ethnic culture may play a major role: In KSA, Qatar and UAE the great majority of citizens are Wahhabi Sunni muslims. By contrast, Yemen is only 65% Sunni, but Oman is distinctly different Sharia culture. Iraq and Iran are predominantly Shia culture.
Jordan on the other hand is a unique Hashemite culture although also 70% Sunni; so contrary to the Wahhabi countries, “ Jordan is one of the most liberal countries in the Middle East, with a secular government“. So the increasing prevalence of MERS in the Wahhabi Arabian peninsula peoples relates perhaps to the likely cluster of predisposing factors: well-covered male and especially female orthodox attire, if not also higher prevalence of sickle cell trait, and diet, which is associated with deficiency of vits D, C, A and E as referenced below. Feminist Muslim websites may correctly argue that Hijab does not cause vitamin D deficiency; but it likely contributes significantly to it’s spread via lowered vitamin D production in skin – with orthodox Muslim women arguing that such women can arrange private sunlight skin exposure. This trend to vitamin D deficiency from low oral and sunlight-mediated vitamin D is incidentally mirrored in new studies:. : from USA – The Vitamin D status of Prison Inmates– which confirmed that, on a ‘sufficient’ diet including vitamin D intake, the higher the security isolation of inmates (and therefore least sun-exposed), the lower the vitamin D status- especially in the darkest-skinned inmates; from Israel Effect of different dress style on vitamin D level in healthy young Orthodox and ultra–Orthodox students in Israel; and in southern Italian nuns.
So vit D deficiency in MERS may be like in AIDS: Vitamin D Deficiency in HIV: A Shadow on Long-Term Management)? (2014, London UK). But vigorous vitamin D charge – by sunshine and especially vit D3 supplement- as an immune and anabolic booster is one of the safest and cheapest preventions of all disease that there is. With the Ramadan Hajj to the KSA this year only 6 weeks away, intended pilgrims need to top up their vitamin D3 levels and multivites vigorously now, to boost both their infection resistance and improve control of all major diseases they have; and take plenty of vitamin C with them. So should their communities, contacts here as pilgrims return from the Hajj. SUNSHINE AND ORANGES: ANTIBIOTICs VITAMINS C AND D: like vitamin C, Vitamin D is hardly a new anti-infective agent as an Israeli study (Borella ea 2014) now confirms, since sunshine sanatoria were the only effective treatment of tuberculosis in the pre-antibiotic era even after WW2; and ” An association has been established between low levels of vitamin D and upper respiratory and enteric infections, pneumonia, otitis media, Clostridium infections, vaginosis, urinary tract infections, sepsis, influenza, dengue, hepatitis B, hepatitis C, and HIV infections“. Especially in this post-antibiotic age of rampant antibiotic resistance. Sunshine and Oranges – Empty Cradles- is ironically, the account of Britain’s infamous ruthless export- banishment to the Colonies -from the early to post WW2 20th C of thousands of surplus children of poor or orphaned families. Shades of the forced transport of ‘felons’ to Devil’s Island and the British outposts of previous centuries. Usually clad in scanty rags, in Australia they certainly had plenty of sunshine ie vitamin D , and the abundant local oranges (vitamin C); but like their surviving mothers, much grief and poverty – while from lack of these same nutrients, their kith and kin back in UK were ailing with infections and rickets . .
3 May 2014 four months later: MERS RESURGENCE: NOT A PANDEMIC BUT A DEFICIENCY SYNDROME? more precautions needed: With the recent flareup of MERS Middle Eastern Respiratory Syndrome in the Gulf States, the number of reported cases since New year has more than doubled to 457 ie to >24 cases a week there, but still only in residents/ travelers from/through the Middle East hub, and their contacts; in 17 countries including Europe, Egypt, Malaysia, Philippines and now a traveler from Riyadh to USA. The death toll has reached 133/457 ie the death rate has fallen steeply from 42% last December to 29% overall, understandably as more cases are detected by screening in the source, the Kingdom of Saudi Arabia KSA. Wiki and Reuters seem to give the most update (if not WHO-confirmed) stats. So the evidence so far is that, while camels are endemic carriers there, most recent sick cases have apparently been been traceable human to human transmission – apparently all among Muslims, and in the malnourished or chronically ill older, and health workers as in the case just reported in USA. So there is no apparent spread by other vectors eg bird and farmyard swine as in the case of influenza. Since the reports available indicate that the MERS virus is dangerous only in those already malnourished or with serious other systemic disease, it is like flu- pretty harmless in the well adequately nourished and housed. While frequent flyers are generally well off and well nourished, the same cannot be said for those in virtual ghetto slavery all over the world, eg migrant labourers working on contract in the Gulf States, who have apparently been among the latest victims . So as with the overblown Swine Flu non-pandemic of 2009, there is no good evidence to label MERS a deadly epidemic, it in fact seems to have low cross-infectivity compared to say influenza which spreads like wildfire- but with no more morbidity (except in Muslims?) than the common cold corona viruses.
WHY IS MERS LIMITED OVERWHELMINGLY TO AND SPREADING ONLY IN THE KSA and UAE? is it a unique genetic trait of Saudis? or is it micromalnutrition unique to this ultra-orthodox Muslim nation with unique almost total skin coverup outdoors? why was there no outbreak of MERS in the millions of pilgrims who did the Hadj to the KSA last year? the KSA is 100% muslim, whereas the UAE only 76%, with far more foreigners working and living there. It is common cause that peoples who keep well covered during daylight hours – as ultraobservant Muslim (and ultra-orthodox Jewish) women and men do, have much lower vitamin D levels. Those on restricted diets are also more prone to malnutrition including vit D deficiency, especially if low in dairy products. Common sense perhaps explains why Saudis – in the heart of Islam (Mecca, Riyadh, Jeddah, Tobuk) have low vitamin D and likely also low vitamin C and zinc levels, and thus more infections. Moderate to severe vitamin D deficiency was reported prevalent last year in Saudis by Al-Daghri, Sabico ea from King Saud University Riyadh- where Hasanato in 2006 reported low vitamins A, C and E and zinc levels in severe sickle cell disease. El-Hazmi ea from the Saudi College of Medicine also in 2011 reported that Saudi Arabia and Bahrain have the highest prevalence of sickle cell genes in the Middle East, at up to 18%. Bahrain has just opened a sickle cell hospital, but Bahrain has the tiniest population (1.3million) of the Gulf States although the highest population density, compared to the 38million of the KSA plus the UAE which have had over 90% of MERS cases. Most if not all the camels in Bahrain are in a zoo; whereas in the KSA camels are a favourite if not sacred possession and listed first as the domestic animal. So the absence of MERS in Bahrain is unsurprising.
The UAE on the other hand also has many camels as entertainment if not also for travel – with 5000 camels entered in a beauty contest there alone.. So, despite long days ie much sunshine exposure in Arabia, low fresh water availability likely reduces hygiene (washing and oral hydration) capacity for the masses let alone camels. And the well-covered dress code, and low availability of private sun-exposed balconies and courtyards (unlike apparently more liberal Muslim countries) mean that the Saudi masses do not have the opportunity to get much-needed sun exposure to even the face, neck and limbs let alone the torso.
Hence Saudis have as obvious major risk factors for MERS -not just the teeming MERS reservoir in their valued camels (also a staple milk supply), but more importantly endemic deficiency of vitamins C, D (and perhaps E, zinc) and water compared to relatively less clothed populations in other hot but also better water-supplied countries that also do not carry much sickle cell disease.
Camel meat is apparently no longer a staple in the KSA where staples now include Bread, hummus, rice, and Tabbouleh– a “salad” generally made of parsley, bulgur, tomatoes, garlic, and lemon; Kapsa: the national dish is chicken and rice with vegetables; and Kebab: a base of roasted lamb or chicken and vegetables in pita bread. There seems little vitamin D in that varied diet, especially not pita bread or rice.
The only good unfortified and unprocessed food sources of vitamin D are apparently oily fish, liver, mushrooms, and (if fortified), egg yolk and dairy products ; or else vitamin D3 supplements. ..
Finally, it is common cause from published studies and our local experience that infections eg HI, TB, influenza, herpes and the common (Corona virus) cold are easily treated and prevented by vigorous safe intake of vits C & D combined with the other multivites, zinc, iodine, iron and selenium. In advanced infection cases of eg HIV and TB (in trials from Central Africa and Canada), combining even modest doses of just 2 or 3 of these supplements with appropriate antivirals and antibiotics reduced dreadful morbidity and mortality by two-thirds. NATURAL PREVENTION/TREATMENT: with the theoretical double peril of influenza and MERS- (ie as with the looming Influenza A gastro-/respiratory season in the southern hemisphere), with no proven vaccines or antivirals reported or likely, those in contact with Middle East travelers- or any infection eg flu outbreak- are again reminded to boost their immunity and global health with safe effective lowcost NUTRITIONAL ANTIINFECTIVE supplements: 1.VITAMIN D3 CHOLECALCIFEROL 2500-4000iu/kg/month (not the weak vit D2 ergocalciferol falsely labelled “Strong” Calciferol tabs) most simply taken as a few scoops ie 50 000 to 250 000iu of vit D3 powder/MONTH at all ages (AND IDEALLY target BLOOD- LEVEL 80-100ng/ml depending on overall illhealth state. IT IS VIT D3 THAT IS STRONG CALCIFEROL, NOT VIT D2, since experts report that vit D3 is apparently four times more potent than D2. 2. MULTIVITES with zinc selenium and iodine (and iron for likely deficient eg kids, young women), but especially 3. buffered VITAMIN C ASCORBATE at least 3gm/d orally ( if not with bad infection symptoms – 10 or >30gms / day if not ivi) at trivial cost as powder; to tolerance; 4. with eg ecchinacea, melatonin, garlic, colloidal silver, sutherlandia and whatever other antiviral available locally. Since flu and colds disrupt both sleep and outdoor activity, nothing makes as much sense as co-supplementing both of the day and night hormones melatonin and vitamin D; as well as the other sunshine vitamin- ascorbic acid (solar-produced in abundance in eg fruit) – to improve both sleep, rest and immunity. For small kids/infants the vitamins and minerals can simply be taken as powder in liquid ie in feeding bottle or a glass. It is increasingly notorious how depleted modern breastfeeding mothers (on the industrial polluted fructose-sucrose- aspartame PUFA-antibiotic-hormone-glyophos- GMO laden food chain now prevalent) and baby formulae (unlike colostrum from pasture-fed eg New Zealand dairies) are in such lifesaving immune and anabolic anticancer boosters.
Ironically, recently Prof Zahid Naeem ea from the KSA Qassim University publicised in their university International Jnl of Health Science Vitamin D Deficiency- An Ignored Epidemic in 2010 and 2012 , with prevalence there of up to 80% in the KSA despite the abundant sunshine, thus urging vitamin D supplementation. . But such simple prevention – of all disease but especially wished-for megaprofit pandemics like flu and HIV- is anathema to the multinational Big Pharma and their lobbyists in the global Disease Industry, which employs millions worldwide and generates trillions in income for government and corporates. Prevention does not pay. Simple prevention suits no-one working in the disease and drug and hospital industry since it makes most health workers especially doctors and administrators and hospital largely redundant. It seems that public health officials choose to go on ignoring the deficiency epidemic even in the KSA- unlike Dubai, there is no website of the KSA Govt promoting vitamin D supplementation. The solution is too cheap – and embarrassingly simple. An anonymous blogger details the numerous reasons for endemic vitamin D deficiency in especially the Gulf States.. at least the Dubai Govt publicises the deficiency, and supplementation. Is it irony, or an indictment of the prevailing world-wide largely male-dominated -subservient female culture, that already back in 2001, there were strong warnings about Niqabs and Burqas as Impediments to Health? already in 2012, dairies in the UAE were fortifying milk with vitamin D; and in 2001 academics published a study showing the many reasons for prevalent vitamin D deficiency in the KSA. and Prof Mike Holick in 2010 published an authoritative review The Vitamin D Deficiency Pandemic: a Forgotten Hormone Important for Health urging vigorous vitamin D supplementation universally. As detailed elsewhere in this column last year, the prophet of vitamin D and melatonin the late Prof Walter Stumpf must be shaking his head repeatedly along with the late Prof Linus Pauling, about the neglect of authorities to promote and distribute vigorous supplements of vitamin C and D3 to the afflicted Arabian peoples let alone worldwide. But then we need to be reminded of the infamous Vitamin Murders, how Prof Sir Jack Drummond was mysteriously murdered with his family on holiday in France in 1952, when he and Linus Pauling were the leading vitamin discoverers and promoters of the 20th century (as Walter Stumpf was of melatonin and vitamin D). The Big Pharma Disease Industry combined with the might of the FBI and the FD could never shut Pauling up; but by whom and why the Drummonds were murdered remains unsolved, thus fertile conspiracy theory. Reading Drummond’s papers on the internet, one can understand why the burgeoning patent drug industry then as now hated natural lowcost unpatentable remedies, unbeatable natural safe antiinfective agents like vits C and D and iodine – each almost universal panaceas. . .
This universal truth about industry suppressing natural remedies is the Semmelweis Paradox, that had the leading obstetrician of his day murdered in his prime by his jealous rivals.
27 Dec 2013 the outbreak not over: 9 new cases; ie overall deathrate 42%, but past 2 weeks 4.5 cases a week just from the KSA.. : Since April 2012, the European Centre reports 175 laboratory-confirmed cases, including 73 deaths, of acute respiratory disease caused by Middle East respiratory syndrome coronavirus (MERS-CoV), have been reported by national health authorities. 27 December, Saudi Arabia confirmed nine cases (five asymptomatic healthcare workers and four patients suffering from chronic disease, two of whom had died). 24 Dec 2013 the score now stands at 166 (163 at 16 Dec) cases and 71 fatalities- 42% – in 18 months since the first identified case in June 2012; ie per week – 2 new cases and 1 fatality . No pandemic. No outbreak. Considering the duration of the awareness of the new virus in humans- apparently from bats/camels/swine, even after 18 months of millions of pilgrims visiting the Middle East, and far more foreign travelers flying through those hubs, and intensive surveillance on those routes east and west, the morbidity and mortality have been negligible with only a handful of perhaps related deaths in frail patients. Whether as with seasonal avian ie H1N1 flu from China to the West and south there will be a flareup of MERS-CoV cases in the pending winter from now on in the Middle East, remains to be seen..
12 November 2013 Considering that the Hajj has just ended with millions of pilgrims returning home, and vast numbers of multinational passengers transit through the Middle East hubs, its reassuring that (depending on which reports are duplicates and delayed) only 3 or 5 tested positive cases and 1 or 2 deaths have been reported the past week: especially since only serious flu-like cases are likely to be tested- but more so in the affluent who can afford to fly. So far no reports of MERS-CoV case are apparent in South Africa, although flu-like illness remains common here. Perhaps more people are heeding warnings to take multivites plus zinc plus vigorous vits C and D. The ECDC and OSAP and NowNews and GlobalAlert report As of 11 November 2013, there have been at least 154 laboratory confirmed cases of MERS CoV worldwide, including 65 deaths ie 42% in TESTED cases. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East. Saudi Arabia has reported at least 125 symptomatic and asymptomatic cases including 53 deaths Jordan two cases both of whom died United Arab Emirates five cases, including one fatality Qatar five cases, including two deaths and Oman one case who has just died. Thirteen cases have been reported from outside the Middle East: inthe UK (4), France (2), Tunisia (3), Germany(2), Italy (1) and Spain (1). 31 Oct 2013 with the Hajj over, the latest score is 149 cases and 63 deaths ie 42%. http://www.who.int/csr/don/2013_10_31/en/index.html ie 5 new cases a week from the region, 30% deaths. http://gmggranger.wordpress.com/2013/10/29/quikstats-mers-cov-in-the-arabian-peninsula-nov-2013/ 17 Oct 2013 with the Hajj in full swing, the latest tally is apparently 139 cases and 60 deaths. So thats only 1 case reported a week the past 4 weeks, and no deaths in that time. Promising news, although we continue to see bad viral-like respiratory-gastro infections in adults locally with the volatile weather.
20 Sept 2013 with below a month to go to the Hajj, the latest Quickstats are 135 cases confirmed, and 60 deaths ie 44% mortality- all new cases and deaths apparently in KSA and the Gulf States. Thus in the past 7 weeks, 41 new cases have been reported ie 6 a week, all in the Gulf States; with unaltered mortality (44%) apparently restricted to the chronically frail. This as the drastically variable Cape Town weather alternates sunshine joy and freezing wet snow or hail, with high prevalence of both respiratory and gastroenteritis attacks, sometimes with protracted debilitating bronchitis; how much of this is local seasonal colds- coronavirus– or flu, orMERS-CoV, or the explosive Norwalk virus, is speculative and academic. Basically So What since management is symptomatic, and vigilant prevention crucially effective with hygiene, home rest and multivites but especially highdose vits D3 up to 10 000 (100iu/kg) iu/day or weekly equivalent plus buffered vit C up to tolerance >100mg/kg/day, zinc, selenium and for the malnourished, iron; perhaps safe plant immune boosters like sutherlandia, garlic etc; and avoidance of smoking, sugar and the likes- boozing and sweetened soft drinks (fructose, aspartame,sucralose).
11 August 2013 OUT OF AFRICA? no new cases of MERS-CoV have been reported the past week; but while camels (in Oman) are now also suspect hosts/ transmitters in the M E, there is some evidence that the MERS virus has the closest virus match yet found to bat CoV in South Africa. As a precaution, with upgrading of shrines in Mecca, KSA is actively reducing overcrowding by Hajj visitors by 20%, and warning the frail and elderly not to go this year. With the prevalent bad winter respiratory and gastroenteritis infections at least around densely populated and polluted Gauteng and KZ-Natal, and especially the floral mountain kingdom of greater Cape Town- all are encouraged to take vigorous doses of vitamins D3 and Superenhanced vitamin C with a broad multimineral-multivite – extra vits A, E, B & coQ10; the minerals zinc, selenium, iodine, colloidal silver, (and iron in the young commonly at risk of deficiency); probiotics ; rooibos or buchu or green honey and lemon tea, sutherlandia; licorice, St John’s wort, garlic, echinacea, olive leaf etc; including sniffing vitamin C ; and if snotty rhinitis/sinus/bronchitis symptoms, steaming with eucalyptus etc.. And during acute attacks especially of respiratory and gastro attacks, avoid sugar, fat, dairy and wheat intake.
2 August 2013 The Hajj to Mecca this year is in the third week of October. While over 15 million (of the world’s ~1.5billion) Muslims visit Mecca – Umrah- annually, some 3 million pilgrims worldwide make the seasonal Hajj visit trip, with pro rata from South Africa only 2000 (of our ~2.5million) apparently the quota of pilgrims allowed this year by Saudi Arabia . But increasing numbers of frequent flyers of all nationalities and races to and from South Africa – Europe fly via the Gulf States Emirates airline, if not commuting to work and visit family there – including professional sports teams for tournaments… So this week’s flood of warning bulletins on the Gulf State respiratory infection outbreak are cause for urgent caution and prevention, perhaps grim news for those who fly that ME route, and their families and close associates and neighbourhoods. The 49% deathrate reported in the now 94 cases- 3 more reported 1 August from KSA- so far from the MERS-CoV Corona Virus MiddleEast Respiratory Syndrome outbreak is alarming, that has spread the past 10 months from the Kingdom of Saudi Arabia KSA and the Gulf States to Tunisia, Europe – France, Germany, Italy- and UK . It is now being recognized as distinct not just from the common cold coronavirus but also from the Chinese Severe Acute SARS-CoV virus outbreak since 2003, of which over 8000 cases have been recognized , but the latter virus having a fatality rate of only <10%; and the current violent but selflimited Norwalk virus gastroenteritis (explosive vomiting and diarrhoea for 1 -3days; (fatality rate <0.1%) raging in UK, it recently is the commonest cause of foodborne infection in USA .
No clinically effective vaccine or synthetic drug treatment has yet been found for these coronaviruses . The same lack of specific antiviral therapy applies against gastroenteritis viruses and influenza, but the mythical 2009 swine flu ‘pandemic’ was even milder (than some seasonal flu outbreaks) with a proven mortality rate far below 1% considering how rapidly far and widely it spread. The reservoir if any of MERS-CoV may be cave bats, (and, ominously, perhaps swine – c/f the 2009 swine flu ‘pandemic’ that wasnt; shades of the deadly Nipah virus outbreak of 1999 – from bats to pigs to man).. But the fact that MERS-Co is spread human to human, and mainly men , has been attributed perhaps to women in strict sharia society being well veiled and thus shielded from inhaling (and transmitting) the air-born virus, never mind womens’ generally stronger immune systems and hygiene, self-care. So beware all those in close contact with recent air-travelers through the ME states and surrounding subcontinent airports – never mind the S-E-Asia airhubs of Hong Kong and Singapore: it maybe only a matter of weeks before cases occur on the other continents especially in city dwellers, public transport commuters, factory and office workers; and who knows, perhaps where bats and swine cohabit close to cities, as around South Africa.. .. Its cold comfort that the latest report yesterday and today, note that this stage is perhaps like SARS in 2002 and swine flu in 2009, the ‘bottom of the iceberg’, with only severe cases being admitted, tested, reported, in already chronically ill frail patients; especially diabetics and renal failure – to which older Muslims are particularly prone; while the virus spreads silently, mildly if not harmlessly in the well majority, as in two young well women health workers in contact with a chronically ill elderly female case in Riyadh, KSA … ANTI-INFECTIVE PROTECTANTS and advice are available from the Natural Remedies Centre, 15 Grove Bldg, Grove Ave, Claremont, Cape Town ph 002721-6831465 or -6717415: Fortunately all Health Shops are well stocked with the many almost 100% protectants against serious infections including fungi bacteria and viruses – colds (ie corona-) and flu’-virus (let alone against all others) afforded by the basket of locally available (although mostly imported) natural lowcost evidence-based nutritionals – supplements the past decades: safe hefty combinations of a number of immune-boosting vitamins, minerals and foods, herbs. This septuagenarian author has, touch wood, on this combination- increased at occasional times of suspected colds-fever- , despite great stress, and flu ‘pandemics’, and avoiding vaccinations, not had a bad infection lasting a day in the past 5 years despite working in the highest risk poor townships and acute hospital clinics with rampant HIV – multiresistant TB cases .
Posted in INFECTIONS, prevention, supplements, vitamins
Tagged antiviral, arabia vitamin D deficiency MERS, Austria, BATS, camel colds, camel vector, Chikungunya, corona, CURE FOR MERS, Deficiency syndrome, Ebola virus, FLU PREVENTION, GLOBAL DENIAL OF NEED FOR MICRONUTRIENT SUPPLEMENTS, hajj, HAJJ SEPTEMBER 2015, highdose vitamin D therapy, HIJAB AND MERS, Inconvenient Truth, infection, influenza, melatonin deficiency, MERS DIARY, MERS NOT A PANDEMIC THREAT, MERS PREVENTION, MERS SOUTH AFRICA, MERS-CoV, Middle-East Respiratory Syndrome, muslims, Nab Hobani Jazan University, Norwalk, Pakistan, POLIO EPIDEMIC, RENAL AND RESPIRATORY FAILURE, Salhuddin, SARRS, SARS, SAUDI SARS, South Korea, TB, the cure of Mers, THE MERS CURE, TRAVEL ADVISORY CENTRAL WEST AFRICA, TRAVEL ADVISORY SAUDI ARABIA, virus, vitamin C deficiency, vitamin D, VITAMIN D DEFICIENCY, vitamin D overdose, vitamin D predictive equation, VITAMIN D REPLACEMENT, VITDal-ICU RCT
for appointments for consultations, or non-xray procedures by registered practitioners : Sure Touch breast prescreening on Saturday mornings next on 7 February 2015 by Sister Zeneath Ismail – cash R650 (then R450 if followup scan desired within 3 months); -QUS ultrasound quantitative bone density cash R450 -tariff item 3612- anytime; Unlike radiologists’ and thermography reports (which describe only the imaging finding), the rates quoted include relevant breast or bone consultation and management planning by specialist nurse & physician.
IF BOOKED TOGETHER, (not necessarily the same morning) then combined breast and bone screening is R1000.
OTHER SERIOUS health problems ARE DEALT WITH BY CONSULTATION DURING THE WEEK (OR ON A DIFFERENT SATURDAY MORN) : heart- ECG, fatigue, HRT, sexual health, hypertension, depression, memory/dementia, lung & lungfunction, anaemia-haematology; kidney/bladder/pelvic, hormone-endocrine, depression, osteoporosis, sleep, diabetes, thyroid, adrenal; cramp; skin, infection including STDs & HIV/AIDs, stroke, epilepsy-neurology, dizziness, heartburn/digestive/liver, neuropathy, sexual health, menopause, HRT, genitourinary; immune problems, or arthritis relief;
Thermography no-touch infrared screening for suspicious cancer /inflammatory changes: by Radiographer Melinda-next 23 March 2015. R900 breasts; R1100 head and upper; or lower body & pelvis; R1300 whole body.
Bookings/queries contact Evelyn/ Reyhana / Val at the Natural Medicine Clinic, 1st Floor no 15, Grove Medical Bldg, opp ABSA (parking ABSA Parkade ) near Warwick/Cavendish Square Claremont Cape Town RSA, ph +27216831465 or a/h +2783 4385248 or reyhanadaya@yahoo.com .
For the disabled – by arrangement drive up the ramp to the Clinic door on the Grove Bldg 1st floor parking deck.
Under CMS Council for Med Schemes Reg 10(6), open Medical schemes eg hospital plans have to pay from their own funds (not members’ savings) for appropriate outpatient consultation (tariff item 0191) for PMBs ie major conditions eg cancer, depression, neck/spinal problems, serious heart, lung, other disease., etc. Breast and osteoporosis concerns are generally part of menopause consultations N95.9 (if not already eg breast cancer code C50) and thus are often billable med scheme benefits. The menopause billable item only applies if you are 45yrs upwards, unless you have had total hysterectomy.
On patients’ requests, appropriate invoice can be prepared and submitted to your scheme for refund of your due benefits. Some schemes eg hospital plans falsely deny due benefits until reported to their regulator CMS. For medical plans where the billable tariff benefit rate is higher than the breast screening fee paid, the med plan rate 0191 will be charged eg R790 by the contracted specialist, and refundable by Discovery to the member. some basic schemes eg Keycare, Bonitas require preauthorization, or referral by their contracted GP .
Posted in anti-aging, cancer, MAMMOGRAPHY, menopause, osteoarthritis, osteoporosis, prevention, SCREEENING IMAGING
Tagged antioxidants, breast cancer, cancer, carnitine, cholesterol, coQ10, dementia, depression, diabetes, estrogen, fish oil, fracture, heart attack, HRT, Hypertension, infection, influenza, insulin resistance, insulin sensitizers, lipidemia, memory, menopause, metformin, mortality, NATURAL MEDICINE CLINIC, NMC, NRC, obesity, osteoporosis, overweight, prevention, PROGESTERONE, reserpine, rimonabant, sex, statin, supplements, Sure Touch Prescreening, tamiflu, testosterone, vitamin D, vitamins, WHI
CAPE PENINSULA HYPERTENSION & HEADACHE CENTRE (50 years of experience) at The Natural Medicine Clinic NMC , 1st Floor, 15 Grove Bldg, Grove Claremont, Cape Town- between ABSA Parkade on Grove Ave, and Warwick Sq opp Cavendish. ph 0216831465/ 071202574 or email doctor@healthspanlife.com.
As the commonest silent killer of aging people in the world, pain, obesity and often-resultant systemic hypertension HBP deserve the best and cheapest treatment. Headache is rarely caused by hypertension, but unlike hypertension, is usually easily controlled if not cured.
But precisely because HBP is so common- in half of us by old age, especially at night- it is a huge moneyspinner for Big Pharma and the Disease Industry.
so the last thing the HBP Industry wants is too successful too cheap treatment. Hence they (eg the WHO, the SA Hypertension Society and medical schools- state clinics)- blacklist the best baseline treatment- lowdose amilozide and lowdose reserpine, to promote sales of ever-newer unproven drugs with multiple risks. .
But 60 years of experience (5 centuries in India) confirms that Rauwolfia and its extract reserpine remain the best and sufficient treatment for most patients provided it is combined with a mild diuretic eg magnesium-potassium; or natural herbs eg Green tea, cranberry juice, Apple cider vinegar , Dandelion, Nettle, Fennel, buchu, horsetail;
or a magnesium-potassium conserving equivalent- the recent proven designer ie synthetic lowdose safe diuretic amilozide eg Amiloretic 55mg 1/4 to 1/2 tab, combined with natural lowdose reserpine 0.25mg tab 1/4 to 1/2 tab, both initially daily, eventually perhaps only 3 days a week. . These lower HBP and associated anxiety/depression gently but surely to avoid complications.
The NMC is open office hours from 9 am 6 days a week, and offers objective electronic arm and leg bloodpressure measurement and if required urine and heart testing for causes and effects of hypertension etc. If desired, appointment can be made with a hypertension-metabolic specialist physician.
see https://healthspanlife.wordpress.com/category/reserpine/ for further details to fight dementia, stroke, heart/kidney failure, heartattack, blindness, diabetes, gangrene, etc. The last thing the Disease Industry and hospitals, medical schools want us to do is wipe out these common diseases with safe lowcost treatment..
The Nonscience Witch Hunt Against Hormone Replacement Therapies for Deficiency Syndromes Must End
An A4M Position Paper on Physician-Prescribed HRT |
|||
Introduction “Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an undercover dictatorship to restrict the art of healing to one class of Men and deny equal privileges to others; the Constitution of the Republic should make a Special privilege for medical freedoms as well as religious freedom.”~Benjamin Rush (1745–1813), physician, writer, educator, Since the inception of the anti-aging medical movement in 1991, various establishment parties have ruthlessly leveraged their positions of power in academic, political, and regulatory arenas for the purpose of attempting to limit the use of hormone replacement therapies (HRT) in adults with documented clinical deficiencies. For over 15 years, a prolonged and calculated campaign of deceit, fraud, and suppression has threatened physician licensures and liberties to treat and prescribe life-improving therapies, leading potentially to the direct compromise of patients’ health and longevity. Dozens of physicians have been sanctioned and punished with loss of license and academic standing. This pernicious abuse of position and power is particularly prevalent with regard to recent challenges made against human growth hormone (HGH), testosterone (TRT), and DHEA replacement therapies that are trumpeted by the mainstream media. Biased reporters frequently – and inappropriately – demonize legitimate physicians and clinical compounding pharmacies that are reluctantly positioned on the frontline of a decades-old agenda to limit freedom of choice and information, and the physicians’ most essential responsibility to select the best course of therapy and medication for their patients. This conflict is being played out of late in the arena of anti-aging medicine, a clinical specialty that has flourished in its 22 year long history, garnering the support of more than 100,000 physicians and scientists worldwide who practice or research life-enhancing, life-extending interventions today. Prof. Dr. Imre Zs.-Nagy, of the University of Debrecen Medical and Health Science Center (Hungary), and founder of the Archives of Gerontology and Geriatrics (published by Elsevier), observes: “In my role as a basic and clinical scientist, I have had an opportunity to witness more than four decades of advances and declines in the arena of preventive medical care … there has been little else as dramatic, important, beneficial, and significant as the anti-aging medical movement.”1 A4M Position The Anti-Aging Medical Movement The Official Definition of Anti-Aging Medicine Anti-aging medicine utilizes diagnostic protocols that are supported by scientific evidence to arrive at an objective assessment upon which effective treatment is assigned. Physicians who dispense anti-aging medical care are concerned with the restoration of optimal functioning of the human body’s systems, organs, tissues, and cells. Attempting to rebrand what they cannot deny, those in positions of power in academic, political, and regulatory arenas are inventing new catchphrases including longevity medicine, successful aging, healthy aging, and the like, in an effort to dilute and absorb the A4M’s original definition of anti-aging medicine. To implement this campaign, we suspect that these individuals have pejoratively solicited major media outlets to denigrate the A4M, its officers, and its members. Critics with A Dark Agenda (Political Elites) There are TWO main “skeptic” organizations – the James Randi Educational Foundation (JREF) and the Center For Inquiry (CFI). Both are well funded from secret sources. JREF reported, in 2010, a total income of $999,971.00 and a Total Asset claim of $1,736,101. The Center For Inquiry, Inc (CFI), based in Amherst, New York shows on their Form 990 that they took in $5,242,304 in Total 2009 Income, and they had, that year, Total Assets of $3,017,144. Their Schedule B ANONYMOUS contributions totaled $2,318,652. More, CFI claimed that they received, in 2009, in addition to their anonymous contributions, a so-called “Management Fee Income” of $2,458,156. What do you suppose they managed? And who paid them to manage it? Maybe they manage Wikipedia health care articles? How about Search Engine Optimization (SEO) bringing skeptic, including Stephen Barrett’s (Quackwatch), articles to the first page of Google? Much more – This cabal minimizes and delays innovative medical advancements by lodging anonymous complaints to state licensing boards against cutting-edge practitioners. Their insidious campaign also controls grant monies and research funding, somewhat silencing the voices of innovative medicine in favor of mainstream views. By leveraging control of the media in direct jeopardy of journalistic integrity, this control group seeks to suppress all in medicine that is not fully controlled by the establishment. To permit this level of manipulation and disinformation is wrong and ethically corrupt. The fate of a valuable avenue of medical innovation for the public interest – anti-aging medicine – stands at-risk.3 A JAMA commentary purported to address the legality of human growth hormone (HGH, GH) treatment by physicians for growth–hormone deficient (GHD) patients.4 It is the view of A4M that the commentary contained a number of incorrect, misplaced references and studies, and multiple basic scientific errors, in an apparent attempt to damage the anti-aging medical profession and the physicians practicing solid, evidence-based medical health care focused on improving and maintaining patients’ quality of life. It is A4M’s further opinion that the authors selected self-serving studies, in which they failed to qualify the conclusions in an effort to bolster what A4M believes is a disinformation campaign. It is A4M’s opinion, for example, that they incorrectly intermingled Internet sales of homeopathic pseudo-“GH” sprays, amino acids, and sports nutritional over-the-counter products in order to inflate their incorrect claims suggesting an illegal diversion of HGH by physicians and pharmacies, implying a black market in FDA-approved prescription injectable HGH for hormone replacement treatments by anti-aging physicians where none exists. Misrepresentation in Competitive Sports Page 1, 2, 3, 4, Appendix/Notes |
neil.burman@gmail.com
20 July 2014 HIGH CARBS OR LOW CARBS? THE BIG FAT SURPRISE – which is best for weight loss? a collaborative literature metanalysis study July 2014 by Naude ea the universities of Stellenbosch, Cape Town and Liverpool (UK) claimed to compare the effects of low CHO and isoenergetic balanced weight loss diets in overweight and obese adults, stratified by outcomes at 3-6 months and 1-2 years. Of nineteen trials (n = 3209), 3 had adequate allocation concealment. In non-diabetic participants, analysis showed little or no difference in mean weight loss in the two groups at 3-6 months (MD 0.74 kg) or for blood pressure, LDL, HDL and total cholesterol, triglycerides and fasting blood glucose. In diabetic participants, findings showed a similar pattern. CONCLUSIONS: Trials show weight loss in the short-term irrespective of whether the diet is low CHO or balanced. There is probably little or no difference in weight loss and changes in cardiovascular risk factors up to two years of follow-up when overweight and obese adults, with or without type 2 diabetes, are randomised to low CHO diets and isoenergetic balanced weight loss diets.
‘But Noakes points out, Low-fat, high-carb, high-sugar diet a likely cause of obesity/diabetes “I refer to the report in the Cape Times of July 10, “Noakes’s popular low-carb diet is not healthier, better for weight loss – study “. Since the authors of that study (Naude ea) do not understand either what constitutes a low-carbohydrate diet or the unique biological effects of such diets, they were predisposed to produce a biased report that comes to exactly the wrong conclusion.
‘First, the conclusion of their study was predictable since the authors chose to review only studies in which subjects ate the same number of calories on both diets. It is not clear how the authors conceived that diets that provided exactly the same number of calories would produce different outcomes. Indeed, a core teaching of these nutritional scientists is that the degree of weight loss is determined by the reduction in calorie consumption. Thus the authors knew the outcome of their study even before they undertook it. This is not good science.
‘Second, the studies included in their meta-analysis are not of the low-carbohydrate diet described by either Dr Robert Atkins or ourselves in Real Meal Revolution. Dr Atkins realised in the 1970s that the majority of overweight/obese persons can only reduce their weights successfully, and keep that weight off in the long term, if they eat less than 60g carbohydrate/day for the rest of their lives. Higher intakes are increasingly less effective. In Real Meal Revolution we stress that those with insulin resistance/ type 2 diabetes need to keep their carbohydrate intakes even lower, ideally to about 25g/day. The “low-carbohydrate ” diets included in the meta-analysis provided a minimum of 200g carbohydrate/day (or 4-8 times higher than the carbohydrate content that is known to be effective). As a result this is a meta-analysis of studies providing a high, not a low-carbohydrate load for those with obesity/insulin resistance/type 2 diabetes.
‘Third, the extent of weight loss in the studies included in he meta-analysis is small, the greatest values being about 10kg. For most people with significant weight problems, such small weight losses are probably relatively meaningless and should be classified a diet failure, not a success. But freeliving persons who follow individually prescribed carbohydrate diets providing about 25g carbohydrate/day report quite remarkable degrees of weight loss, not infrequently up to 40-80kg, usually achieved effortlessly if the low-carbohydrate rules are followed.
‘Fourth, the unique biological effects of the properly-defined low-carbohydrate is that (i) It reduces hunger, allowing subjects to eat fewer calories without experiencing continual hunger. The point, as stressed by Dr Atkins, is that the low-carbohydrate diet is a low-calorie, no-hunger diet. (ii) The diet lowers blood insulin concentrations. In those with obesity/insulin resistance/metabolic syndrome, it is continually elevated blood insulin concentrations that cause ill-health (as clearly established by the work of Dr Gerald Reaven of Stanford University over the past 50 years).
‘The authors found that health benefits were no different on either diet. A number of properly designed, peer-reviewed meta-analyses of the real low-carbohydrate diets show that weight loss and health benefits are superior compared with higher-carbohydrate diets. Unfortunately, the authors appear to be ignorant of those studies since neither they nor your reporter refers to them. This implies the presence of bias, questioning the true intent of the report.
‘The report also includes the statement of the Heart Foundation of South Africa (HFSA) to the effect that a diet high in saturated fat causes heart disease. Unfortunately, the HFSA spokesperson appears unaware of Nina Teicholz’s recentbook, The Big Fat Surprise: Why Butter, Meat, Cheese Belong in Healthy Diet, and the June 23 Time Magazine Ending the War on Fat, which show that this dogma is false and is not based on any credible science. It is time the HFSA updated its understanding of what actually causes heart disease. They might also want to consider whether their promotion of their unproven low-fat, high-carbohydrate, high sugar diet for the past 37 years is the most likely direct cause of the obesity/diabetes epidemic that has since engulfed South Africans.
‘Indeed on a practical side, I wonder if the authors have ever considered studying the dietary intakes of the obese diabetic patients they treat at Tygerberg and Groote Schuur hospitals. Do patients with these diseases eat either high- or low-carbohydrate diets? Why is is that these twin diseases, which are crippling the health services of the Western Cape, began to increase exponentially only after the 1977 Dietary Guidelines that institutionalised the low-fat, high-carbohydrate diets? Surely these are the critical questions that should really be exercising the minds of the Western Cape’s nutritional scientists? The best conclusion that can be drawn from this study is that diets providing more than 10 percent of daily calories in the form of carbohydrate are equally ineffective in producing meaningful degrees of weight loss in those with obesity/insulin resistance/type 2 diabetes.”
15 June 2014 DIET RISKS FOR BREAST CANCER, INFECTION & ALL ELSE: Sugar? Fats? Vitamins?
IT IS COMMON CAUSE THAT ONE DOESNT, CANNOT PREVENT OR TREAT INFECTION BY POOR NUTRITION OR LOWDOSE ANTI- MICROBIALS- such policy is futile if not dangerous for breeding resistance as well as disease extension. The studies below confirm the obvious, (as Klenner, Pauling, Cameron ea showed the past 50 years with highdose vit C injection), that vitamin D3 orally also works as a multiantimicrobial agent if given as early as possible in safe very high dose and bloodlevel eg 600 000iu monthly (in the first month, – in Salhuddin’s Pakistan PTB patients (presumably also Sunni muslim) initially mean wt 45kg, thats vit D3 ~440iu/kg/d) for two doses ie a mean of 300iu/kg/day over 90days; not the current preventative recommendation of 80iu/kg /day to a safe blood level of around 50-60ng/ml. As Holick has said, with adequate water intake even 50 000iu vit D3 a day ie 1.5million iu/month for months causes no toxicity. Given the 40% mortality rate in the frail Saudi MERS patients, and in acute severe influenza and other serious viral infections, it can be expected that such highdose immediate vitamin D3 therapy orally with eg 600 000iu, combined with highdose vitamin C, zinc and some multivite, (never mind appropriate antibiotics in acute bacterial infection) will similarly virtually eliminate mortality.
But no KSA Govt website mentions this- except the Saudi Gazette a year ago which strongly urged vitamin D supplement in the KSA as even daily sun exposure does not bring most Saudi women above the vitamin D deficiency threshold. It says Since Muslim women can only reveal the hands and face, they may need to be out in the sun for longer than 30 minutes. But the review conspicuously fails to mention that in public outdoors in KSA, women must have even the head and face covered. It also propagates surprising dangerous nonsense that “severe deficiency needs monthly vitamin D injection – “Mom, have you taken your vitamin D injection this month?, when all it requires is an oral daily, weekly or fortnightly dose vitamin D3 at trivial cost.” It does stress “One of the main reasons why vitamin D deficiency is so common in the Kingdom is because there are very few food sources of vitamin D. Foods which have fairly good amounts of vitamin D are fish liver oil, sweet potatoes, egg yolks, vegetable oils, butter, and fatty fish such as salmon, sardines, and tuna,” said Dr. Rasha Jameel, a consultant in family medicine at a local hospital. In the United States, all milk and dairy products are fortified with vitamins A and D, but no such measures are in place in the Kingdom“.
This correlates with a new metaanalysis (in the BMJ this month) of observational studies from Europe and USA, that all-mortality hazard ratio over a mean of 10 years increases by 57% as vit D level falls from the highest to the lowest level. The KSA apparently chooses to ignore that, as this column reported recently from WHO data, despite apparently being the wealthiest country per capita of bigger populations in the world, KSA’s population life expectation is about 5 years lower than eg far less sunny Britain’s; ie KSA all-cause mortality rate is avoidably materially higher. Despite KSA medical professors having reported in studies that most of the KSA population is deficient in vits D and C, the KSA Govt website chooses to ignore this on official websites; unlike other even Middle-Eastern governments promoting vit D fortification or meaningful safe supplements costing trivial amounts.
Even a new study last year from KSA universities confirmed that ” Most commonly consumed food products by Saudi population which are supposed to be fortified by vitamin D are either not fortified or contain an amount less than (apparently from their table 2 ~ half of) recommended by guidelines set for US marketplace”. Even a UAE authority recently stressed “Can fortified milk fight Vitamin D deficiency? Shockingly low levels of D3 among UAE population cannot be rectified by milk alone.” As Holick ea, including a Turkish University 2010 trial report, oral vitamin D3 is far more effective , and safer than, either vitamin D2, or vitamin D injection -never mind much cheaper. This current ostrich-head-in-the-sand denialism by the KSA government is like that of the RSA govt under Presidents Mbeki and Zuma 10-15 years ago about preventing and treating HIV-AIDS – considering that the safe and beneficial daily intake of vitamin D3 is now universally recognized as 4000 if not 10 000iu/day (ie about 80iu/kg/day or pro rata up to perhaps fortnightly) , to a mean blood vit D level of about 60 to 80ng/ml. .
As Prof Mike Holick pointed out a few years ago, “Even in Saudi Arabia, Qatar and South Africa, more than 50% of the population is deficient in vitamin D, all because of their avoidance of sun. Based on some of the literature, it seems that we could probably decrease health care costs across the board by 25% if everybody had optimal vitamin D status.” As Al Faraj ea reported in Riyadh in 2003, Prof Zahid Naeem from a KSA university wrote in 2010, “Vitamin D deficiency is an ignored epidemic in KSA and globally“; confirmed by a KSA study by Ali ea in 2012: “Even in a sunny country like Saudi Arabia the prevalence of vitamin D deficiency in young female is high“.. One does not need to speculate why the KSA and all governments globally choose to ignore this inconvenient truth, downplay effective vigorous vitamin C and D3 (sunshine) supplements- such widespread vitamin D and C deficiencies, like cigarette smoking and alcohol abuse, suit governments and Big Pharma- the Disease Industry- in reducing populations growths and creating jobs for the highly profitable Disease Industry and it’s shareholders- for whom Only Disease Pays. Cheap safe natural Prevention Does not Pay since it at least halves sickness never mind disease industry jobs, taxes and profiteering in the global $multitrillion Disease and Diet and Vaccine and Invasive Screening Industry scams.
And Karen Hansen ea at Univ Wisconsin 2014 have just shown that giving vitamin D2 (not D3) 50 000iu fortnightly for a year is actually adverse – as Holick and others have show – IT DEPRESSES – perhaps halves – THE BIOLOGICALLY ACTIVE blood 25OHVIT D3 while boosting perhaps 5 fold the far less active blood 25OHvit D2 levels , and actually worsens rheumatoid arthritis clinically and serologically . One can speculate whether vit D2 actually blocks optimal function of VDRs vitamin D receptors. Trials published 2012 from Japan and Netherlands showed that vitamin D3 – blood 1,25(OH)2D3 (but not TNFalpha blockers) blocked inflammation (ie TNF tumour necrosis factor alpha activation of vascular calcification).
Salahudfin ea’s new randomized controlled trial from Pakistan Vitamin D3 injection accelerates clinical recovery from tuberculosis shows “impressive clinical (weight gain, chest xray and sputum clearing) improvement over 3 months on outpatient TB therapy (Directly Observed Therapy (DOTS) with 2months of 4 antituberculous drugs [Isoniazid, Rifampicin, Ethambutol and Pyrazinamide] followed by 6months Isoniazid and Ethambutol) with two doses 600 000iu vit D3 imi (vs placebo inj) a month apart- ie equivalent to about 7 000iu/day over the 3 months treatment period . This dose of vitamin D is as recommended for vitamin D supplement by the Pakistan Endocrine Society. Trough 25OH vit D levels increased from about 20 to 90ng/ml. After 12weeks, the vitamin D supplemented pts (mean 28 yrs, BMI 17.2kg, 85% moderate to far advanced lung disease) had significantly greater mean weight gain (kg)+3.75, (3.16 – 4.34) versus+2.61, p 0.009; lesser residual disease by chest xxray- 30% fewer zones involved 1.35 v/s 1.82 p 0.004, and 50% or greater reduction in cavity size 106 (89.8%) v/s 111 (94.8%), p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g secretion in patients with baseline ‘Deficient’ vitamin D serum levels (p 0.021). Patients in the vitamin D arm and serum < 30 ng/mL (‘Insufficient’ and ‘Deficient’ groups) at enrollment had significantly greater improvements in TB severity scores compared to patients with normal baseline vitamin D levels; p 0.014. This corresponds with the earliest reports of the benefits of vitamin D in TB patients published in 1848 [21] that describes disease arrest, weight gain and reduction in mortality in patients with TB treated with cod liver oil compared to standard therapy alone. More recently, Martineau et al [7] demonstrated that a single oral dose of 2.5mg (100,000IU) of vit D2 significantly reduced growth of mycobacteria . A randomized, placebo controlled study on 67 Indonesian patients, by Nursyam et al , Jakarta [22] reported that pulmonary TB patients given 420,000IU of vitamin D over 6weeks ie 10 000iu/day had significantly higher sputum conversion rates as compared to placebo (p 0.002). Martineau et al. [8] showed that 100,000 IUs of 25-hydroxyvitamin D3 supplementation significantly improved sputum conversion rates in patients with the Taq1 25-hydroxyvitamin D receptor polymorphism of the tt genotype. .
As Salahuddin ea note, the good results in Pakistan in only 3 months with vigorous INITIAL dose vit D3 contrasts with Two recently published large randomised, controlled trials of conservative vitamin D3 over months that achieved far lower blood vitamin D levels found no difference in clinical outcomes or mortality after 400,000IU of 25-hydroxyvitamin D3 or placebo were given by Martineau ea in London, UK to 146 pulmonary TB patients – where mean (trough or midpoint) vit D level (after 100 000iu vitamin D(3) or placebo at baseline and 14, 28, and 42 days after starting standard tuberculosis treatment) – was surprisingly only 40ng/ml at 56days – ie after a mean of 7000iu/d by 56 days, vs 10ng/ml on placebo)- less than half of the bloodlevel achieved on vit D3 in the Pakistan trial ;
and by Wejse et al 2009 in Guinea-Bissau to 365TB patients – who received 300,000 IUs of vit D3 ie only 100,000 IU or placebo at inclusion and again 5 and 8 months after the start of treatment, ie below 1000iu vit D3 per day over the 12 month trial period “. The Guinea-Bisseau pts thus might have achieved a mean blood vit D level boost of only 10ng/ml.. and now Havers ea (Baltimore) show Low 25(OH)D is common in diverse HIV-infected populations and is an independent risk factor for clinical and virologic failure; Low 25(OH)D was associated with high body mass index (BMI), winter/spring season, country-race group, and lower viral load. Baseline low 25(OH)D was associated with increased risk of human immunodeficiency virus (HIV) progression and death (adjusted hazard ratio (aHR) 2.13; 95% confidence interval [CI], 1.09–4.18) and virologic failure (aHR 2.42; 95% CI, 1.33–4.41). and Shepherd ea (Eurocoord) Low Vitamin D predicts short term mortality in HIV-positive persons Odds of death decreased by 46.0%( P = .04) for a 2-fold increase in latest 25(OH)D level.. In patients with current 25(OH)D <10 ng/mL, hsIL-6 concentration increased by 4.7%(95% CI, .2,9.4, P = .04) annually after adjustment for immunological/inflammatory markers, and no change in hsCRP rate was observed (P = .76)
Posted in all-cause mortality, anti-aging, cancer, menopause, prevention, supplements
Tagged Banting, breast cancer, Burkitt, Campbell, Cleave, Diet Delusion, HCLF, HFLC, Noakes, Paynter, Saccharine disease, sugar, vitamin C, vitamin D
UPDATE: 2 Mar 2014: PARACETAMOL ACETAMINOPHEN, DIGOXIN AND SPIRACTIN are ESTROGENIC: even the most popular and perhaps safest synthetic designer painkiller paracetamol acetaminophen (Tylenol, Panado) discovered in 1877 has again been shown (Harvard University 2014- the Nurses’ Health Study from 20 years ago) to be ( like the 250year old biological human hormone digitalis/digoxin, and the 50year old synthetic antihormone spironolactone), a weak estrogenic ie they proliferate the breasts and thus cancer potential. Acetaminophen use was positively associated with total Estrogen Metabolites (2+ days/week vs. non-use: 236 vs. 198 pmol/mg creatinine; p difference = 0.02, p trend = 0.11), Thus like its cousin phenacetin (never mind alcohol and smoking) after decades of fraudulent promotion as safe, paracetamol’s harms outweigh its utility
Thus while it is fairly safe in adults in moderation, like all designer synthetic drugs eg NSAIDs and synthetic/xenohormones, like even lowdose aspirin, paracetamol has many risks (even for the eyes) and doesnt cure anything- whereas digoxin and spiractin may have lifesaving benefits in serious heart/ hypertensive disease. .
As always, for pain best stick to physical cure by eg manipulation, massage, rest and exercise, heat or cold, acupuncture; or some natural safe biological analgesic/antipyretic combination– massage with arnica/menthol/coconut oil/ DMSO/cayenne/Lugol’s iodine/magnesium oil; or these orally with eg fish oil; vitamins C (eg citrus), D3 (sunshine) and B esp B5 (meat, whole grain, avocado, brassica); magnesium, manganese, copper, iodine, selenium; GABA (but not gabapentin and pregabalin – Bad Medicine); plant extracts eg boswelia, bromelain, buchu, catsclaw, curcumin, dandelion, MSM, nettle, ginger, caffeine, ecchinacea, sage, cherries, Oregano, rosemary, thyme, mint, cannabis, angelica, valerian; and cartilage eg glucosamine-chondroitin .
Oct 2013: BREAST PAIN, CHEST PAIN AND HORMONE CONTRACEPTION.
CHEST/BREAST PAIN: In men and women, nontraumatic pain in the front , back and sides of the chest (and abdomen) is mostly neuromusculoskeletal, and easily diagnosed by the history (absence of cough, central deep pain radiating especially to the jaw , back or left shoulder, breathlessness, fever, heartburn), and physical examination –absence of systemic signs or significant changes in pulse and bloodpressure);
and appropriate assessment of the neck and thoracic spine since these are so often where root pain (around the shoulder girdle, trunk and limbs) originates and can be simply relieved ie cured and thus diagnosed.
This is crucial in daily busy primary care ie general practice where patients –especially the younger fitter ones without the common high risks – want a quick opinion and fix so they can move on, not have to undergo xrays, heart- and blood-tests that specialists and hospitals, medical schemes, politicians and civil servants thrive on..
Older women of course usually have the major extra anterior chest organs – pendulous breasts – to consider. But the same history and physical exam as in men quickly mostly sorts out the source and thus the cause of the pain: a mammary cause eg hormonal congestion diffuse tenderness, discharge, or tender lump or gland, or root cause, is quickly apparent.
CASE REPORTS: at yesterday’s breast clinic we saw the usual spread of middle-age issues in the eight (mean age 45yrs, 32 to 65yrs) who booked for breast prescreening imaging :
HORMONE CONTRACEPTION vs NECESSARY (PRO)HORMONE SUPPLEMENTS:
TWO IN THEIR FORTIES ON DEPOT PROGESTINS:
CHEST PAIN: clerk Ms booked herself for screening with almost constant discomfort in her left breast for about 10weeks.. Like her and her doctors’ examinations, mammography a month earlier found nothing abnormal.. She had no history of trauma or pain elsewhere, just slight neck discomfort. Her last period was years earlier, still on contraception progestin injections. Examination and mechanical tactile breast imaging confirmed tender full breasts; with maximal palpation tenderness midthorax laterally at the site of her complaint. Pressure and rotation elicited no discomfort elsewhere. Gentle traction manipulation of her neck halved the ‘breast’ discomfort, which disappeared with a final satisfying click with gentle prone rotational pressure on her appropriate upper thoracic vertebra – confirming the root source of her pain had been cured; and obviated further concern , tests and analgesia.
Manageress also on longterm depot hormone contraception (Mirena), with growing breasts, rising weight despite careful diet, and concern about hip osteoporosis on DXA screening that was not improving but worsening the past 3 years on some routine vitamins C, D3 2000iu/day. K2 and calcium supplements. Her husband (not she) observed that she had severe night sweats.
Both of the ladies on synthetic progestin contraception were reminded that such depot synthetics suppress the ovaries ie cause artificial menopause with all its longterm subtle adverse effects, and that such hormones are known to slightly increase the risk of breast cancer, fattening and osteoporosis. Both were recommended progesterone cream, vitamin D and metformin as well as the other almost 20 bone supplements, for (pro)hormone balance and to assist with body fat and thus all-risk reduction
Ms mid-60s with no complaints except stress vertebral fracture from osteoporosis now on opioid patch! mother died of breast cancer at 78yrs; she has had 10 mammograms; just dense lumpy breasts;; advised vigorous vit D, Super C, K2; Triple Bone-Pain – antiarthritic blend; metformin; DHEA and melatonin 20mg/d;
Ms early 50s with menopausal symptoms, hypertension ( on perindopril) and lumpy breasts, now off Nuristerate, , was advised to take appropriate supplements including progesterone cream. There is a new report from Holmes ea Canada http://www.ncbi.nlm.nih.gov/pubmed/24075077 that ACEi/ARBs use eg perindopril was associated with significant 22% increased deaths from breast cancer (95% CI: 1.04-1.44), let alone the risk with such drugs of recurrent persistent cough and insidious nephropathy; so is advised to swop over to the safest best and cheapest 1st-line antihypertensive regime of lowdose reserpine with low dose amilozide,
Ms mid-30s with a child despite endometriosis and PCOS , 4 years after removal of Mirena (7 years) , had lumpy breasts. Advised metformin, vits D and Supervit C, minerals and vitamins.
Ms early 30s with PCOS , two aunts in their 50s with breast cancer, her granny from the other parent having died of breast cancer at 76years.. with lumpy breasts; she was advised the supplements including progesterone cream, melatonin, and metformin.
TWO IN THEIR 30S HAD KNOWN BREAST CANCER:
Ms mastectomy and DXRT 2011, now off Nuristerate , given weeks to live 18 mo ago with brain metastases that have shrunk with chemoradiotherapy and her zealous work as a cancer counselor; lumpy other breast; now advised metformin, sutherlandia, melatonin 20mg/d, vigorous vit K2, D and Supervit C, DIM, mushroom, astragulus, selenium, minerals and vitamins within her means.
Ms had lumpectomy and 3 positive glands/12 removed in 2011, refused further oncology/ radiochemotherapy. Lumpy breasts confirmed . Advised metformin, sutherlandia, melatonin 20mg/d, vigorous vits K2, D and Supervit C, DIM- I3C, mushroom, astragulus , selenium, minerals and vitamins; if not Iscador, cesium, TCM, and pancreas/gene therapy within her means.
BREAST PREVENTION REGIME: apart from optimizing diet and lifestyle with appropriate obesity-reducing diet and avoidance of estrogenic foods and drugs,
Based on published evidence and our experience from patients of analgesics and anticancer benefit, all were advised to try triple breast massage daily with coconut oil, Lugols iodine then DMSO for a few weeks, and if they want reassurance, return in a month or two for followup breast imaging to show the shrinkage in all lumps that most show. Those with higher risks are advised to take the oils by mouth as well, and if iodine depleted, oral iodine , for their global benefits.
However, short of avoiding sex, or use condoms and barrier creams, or ill-advised sterilization or dependence on coitus interruptus, their contraceptive method is hard to improve, short of relying on the oldfashioned intrauterine device without any contraceptive hormone. The oldest naturally occurring pregnancy we have seen was at 55 years, so women have to take care past this age…Natural human contraception with depot human progesterone and estrogen was developed decades ago, but naturally not made available commercially because only synthetics are patentable and thus commercially viable raincheck drugs that profit Big Pharma, health professionals and politicians. .
Instead, women are advised simply to protect the breasts, womb, brain, heart, skeleton, face etc, and stop menopause symptoms, by adding just enough human progesterone cream daily to their face makeup (+- vaginally); (testosterone cream sparingly if indicated for frailty, depression and poor sex) , and take a sensible daily blend of the twenty other natural bone and multisystem antioxidant anabolics (as this website www.healthspanlife.wordpress.com details under osteoporosis) including vitamin D about 2500iu/kg/month ie about 150 000 to 200 000 iu/month for an average size adult.
In people rapidly fattening due to lifestyle, stress and the bad marketed adverse food chain, wiser choices have to be promoted-which does not suit most politicians, Big Business or the Disease Industry for whom Only Disease Pays- Prevention Doesn’t Pay.. So to protect against fattening and insulin resistance perils, metformin to sensible tolerance is also an inevitable recommended natural albeit prescription supplement until healthy robust lean weight can be maintained without it.
The supplements listed above – (fish oil, appropriate parenteral human sexhormone replacement and the other antioxidants/anabolic vitamins, minerals and natural biologicals including the prohormones metformin and vitamin D) also mostly obviate the deplorable high-risk use (for commercial profiteering) of risky synthetics eg statins, bisphosphonates, psychotropes, analgesics, NSAIDS, patented xenohormones and chemotherapy etc – none of which address the underlying stress, deficiency and pollution ie primary causes of disease.
UPDATE: FIGHTING THE TIDE OF BREAST CANCER, DISEASE in YOUNGER WOMEN:
16 June 2013 A new review by Carolanne Wright reviews how to combat estrogen overload – How environment and lifestyle contribute to hormonal imbalance while devastating the health of both men and women.
27 May 2013 Wikipedia reports that in 2008, about half a million women died from breast cancers (out of some billion older women worldwide ie 0.5 per 1000 women, an annual deathrate of 0.05% pa), 23% of cancer deaths in women; with cancer overall accounting for about 13% of deaths -the commonest being stomach-colon-liver 2.8%; lung cancer 1.4%, then breast 0.46% of deaths. So breast cancer – mostly undetected globally by the luxury of mammography till it presents clinically- kills only perhaps 1:2000 older women per year, ie perhaps <25% of the perhaps 1:500 older women who develop clinical breast cancer- 995/1000 of older women’s deaths being from other causes than breast cancer.
These figures dispel the dangerously fraudulent fearmongering lie of the USA Radiological and Breast Cancer Associations and Curves International that “(screening) mammography saves lives”. Its good to see in the current Curves South Africa website that in this Celebrating Mothers’ Week at Curves, they have dropped the Mammography saving lives myth of 3 years ago that started this particular theme column. That hasnt stopped USA doctors from continuing to propogate the lie.
But some there eg Dr Lissa Rankin MD – daughter of a mammography radiologist- are still brave enough to refute the lie. And even the American Cancer Society chief medical officer doesnt make such ludicrous claims but points out how complex the issue of prescreening detection is. .
Johnson and Bleyer reported Feb 2013 from the SEER study that advanced breast cancer in young USA women 25-39yrs has doubled between 1976 and 2010.
South Africa (religion mostly African Christian) has the distinction of being one of Earth’s most corrupt and illiterate countries, with strange bedfellows – Latin America (mostly Catholic), Egypt Lebanon & Pakistan(Islamic), and South Korea(mixed religions)- that follow the USA in defying evidence – in this case of danger to cows and humans – and allow the use of rBGH recombinant Bovine Growth Hormone ; and sex hormones in dairy and meat production. The evidence of harm, eg carcinogenicity and feminization is so strong that such use has been banned in many countries for decades .
MORTALITY TREND AND CANCER IN RSA AND GLOBALLY: Breast cancer is usually a disease of postmenopausal women-who till a centry ago on average barely lived to that age. In South Africa at the peak of the untreated AIDS epidemic around 2000, with average lifespan drastically fallen, of all deaths, overall infections (HIV TB, pneumonias etc) caused about 39%, external causes 12%, cardio/vascular disease 11%, cervix cancer 1.4% and breast cancer 1.3%. But Statistics SA report last month that by 2010, with antiretrovirals, life expectancy had risen about 5years, and that of all deaths, HIV+TB deaths had at least halved to 15% (17% in Africans, 9% in coloureds, 2.4% in Indians), cardio/vascular deaths were 12% in blacks but 27.8% in whites; external causes down to 9%, cancers 9% (mostly digestive and respiratory); with only 20 breast cancer deaths ie 0.00% reported in RSA.
Breast cancer is still rare in a mostly young population with mean age of survival of women still half of that of the first world, with virtually a generation gap due to the carnage of the untreated AIDS era and institutionalized male violence especially against women, children and minorities- xenophobia.
But meat and dairy milk (in South Africa widely containing added rBGH and sex hormones) are among widely used foodstuffs likely contributing, as Joe Mercola notes, to the increasing occurrence of breast cancer in younger women. Never mind deadly sugars, smoking and alcohol consumption on the rise here in RSA.
AVOIDING CANCER AND MASTECTOMY:
To improve immunity, insulin receptor sensitivity, lessen obesity and excessive estrogenization (from both outside your body, and your own fat production):
Just this month, a major trial from UCLA (Smith, Kurzer ea) confirmed that in healthy sedentary young women, moderate exercise 2.5 hour a week significantly beneficially lowered the risky estrone level and raised the 2OH:16OH estrone ratio.
These preventative steps may remove justification for therapeutic mastectomy (which is known to reduce survival) for localized breast cancer , let alone preventative bilateral mastectomy even in women with high penetration BRCA genes, as publicized this month by filmstar Angela Jolie .
Posted in cancer, Feminization of Nature, hormones, HRT, MAMMOGRAPHY, prevention, supplements, vitamins
Tagged acetaminophen, aromatase inhibitors, breast cancer, breast cancer mortality, cancer, coQ10, estrogen, estrogen inhibitors, fish oil, HRT, hydroxyestrone, insulin sensitizers, mastectomy, obesity, OH estrone ratio, paracetamol, rBGH, vitamin D, xray
update 22/3/2014: the March equinox:Vaccines and antivirals for preventing and treating influenza in healthy adults have very modest benefit. as the seasonal flu epidemic wanes in the northern hemisphere and approaches in the south, Authorities eg the US CDC continue relentlessly to promote mass flu vaccination. The South African Authority NICD recommends vaccination for anyone at high risk ie the elderly, infants or the sick, and carers. It also recommends antivirals eg Tamiflu for infection- but the BMJ recently publishes Study claiming Tamiflu saved lives was based on “flawed” analysis. a 2012 BMJ report by the samemedical journalist Zosia Kmietowicz notes Cochrane group rejects Roche’s offer of “advisory board” to discuss analysis of oseltamivir data. The 2011 Cochrane question remains unresolved: Does Oseltamivir Tamiflu Really Reduce Complications of Influenza?
But current Cochrane review of controlled trial publications to 2013 confirms “Vaccination of pregnant women is recommended internationally, while healthy adults are targeted in North America. The overall efficacy of inactivated vaccines in preventing confirmed influenza has a NNV of 71 (95% CI 64 to 80). . Live aerosol vaccines have an overall effectiveness corresponding to a NNV 46 (95% CI 29 to 115). Vaccination had a modest effect on time off work and had no effect on hospital admissions or complication rates. Inactivated vaccines caused local harms. CONCLUSIONS: Influenza vaccines have a very modest effect in reducing influenza symptoms and working days lost in the general population, including pregnant women. This review includes 90 studies, 24 of which (26.7%) were funded totally or partially by industry. Out of the 48 RCTs, 17 were industry-funded (35.4%).
A current German review Methodological quality of systematic reviews on influenza vaccination. Fourty-six systematic reviews fulfilled the inclusion criteria. Average methodological quality was high but variability was large (AMSTAR range: 0-11). Quality did not differ significantly according to vaccination target group. Cochrane reviews had higher methodological quality than non-Cochrane reviews (p=0.001). this was due to better study selection and data extraction, inclusion of unpublished studies, and better reporting of study characteristics (all p<0.05).
Abstract: The Semmelweis Reflex is about rejecting, deriding important new scientific discoveries or any serious sincere statement/action. I didnt fully appreciate the importance of that age-old human (mostly male) evil – mocking, martyrdom and murder by denialism- until I started this review of the current flu season threat and the role of supplements, and researched pioneer medical martyrs Drs Ignaz Semmelweis, Jack Drummond and Linus Pauling as paradigms of the scourge of modern vested-interest denialism and falsehoods, in medicine as much as politics, religion etc..
In fact, just as it is negligence to deny (as Semmelweis’s persecutors did) gloving up or properly washing hands between examining patients , or ensure that every adult has bloodpressure checked occasionally, it is clearly bad practice not to ensure that everyone – especially the young and old, takes a multinutrient plus extra vigorous dose vitamins D3 and C, plus some protective herbs- garlic, cinnamon, ginger, origanum; and fish oil and/or coconut oil if not both; and drastically cut down sweetness intake- especially fructose, sucrose and aspartame that now pervade all mass- produced food and drinks..
update 21 January 2014 : URGENT: THE 2014 FLU EPIDEMIC: “High H1N1 prevalence and mortality rates a concern: Type A (H1N1) influenza, the commonest flu virus in Canada this year, has a higher than anticipated mortality rate causing some to wonder if it’s virulence has increased. The worrisome factor “is the reported mortality rate,” says McGill University. As of Jan. 13, there were twenty confirmed deaths in Canada attributed to H1N1. “There are more deaths than what we expect for the regular H1N1 influenza, The strain this year could be more virulent . 96% of this year’s lab -confirmed influenza is H1N1. The virus is unusual in that it appears to affect younger people more than other strains of seasonal influenza. People 20 to 65 are being hit harder than usual, comprising 52% of flu cases. However, if you look at Europe, it’s still H3N2. Its an example of how you never know what the flu is going to do.” Alberta confirmed a death on Jan. 8, due to the virus H5N1, an avian virus. The deceased woman had recently returned from China. The mortality rate is higher with H5N1 than H1N1, “but fortunately, it’s not an easy virus to transmit”. So far, it seems that there are no cases of H5N1 transmission from human-to-human. It seems like the cases of H5N1 are few and far between and related to contact with birds in China. Patrick Janukavicius, Montréal, Quebec. In the same period, at least 20 children have reportedly died of the same strain in USA.
update 12 Jan 2014 THE ANTIFLU VACCINE DECEPTION: this review by Doc Joe Mercola stresses the disease-mongering myths, futility and risks in real life of flu vaccination and antiflu drugs eg Tamiflu ; and the overwhelming importance of natural immune boosters like Vit D3 & C, zinc, selenium, herbs, and hygienic prevention.
1 Jan 2014 CURRENT INFLUENZA STATUS: The 22 December solstice is the sun at its southern nadir seen from planet Earth, the onset respectively of real winter in the Northern hemisphere, and real summer in South Africa. Last year the Gregorian New Year heralded a fierce flu season in the northern hemisphere, and as usual feathered- and jet-propelled air travel brought the corresponding surge at the bottom of Africa.
And ominously, the Plagues & Pandemics (Howard Phillips 2012) of temperate climates that did so much historically to mould global demography not least the past 360 years in South Africa ( –STDS- pox, bubonic, polio, cholera, influenza, and now tuberculosis, Mad Cow disease, and HIV-AIDS). and especially antibiotic-resistant germs – are all on the increase despite (or because of) the increasingly futile $trillion armamentarium of 20th century designer vaccines and other antimicrobials..
Pneumonia is a welcome friend of the old, often rapidly relieving prolonged degenerative incapacity; such ending mostly by virus respiratory infection the gateway for the final bacterial infection.
Unlike the selflimited coronavirus common cold, breath-and hand-borne type A influenza, although usually mild in the well, is the commonest trigger in the frail. Many of us in our (grand)parents’ time lost relatives in the 1918/1919 “Spanish” H1N1 flu pandemic. But that was a unique global catastrophe because it killed mostly armies of healthy men, and then young working adults, apparently from cytokine storm, with 30 % of the workforce out for up to3 weeks if not 20% mortality. This is harrowingly described in the recently published Letters ( to his Mother) of Dr Arthur Conan Doyle, who lost – apart from his first wife to TB- more young relatives to the flu than to warfare.
The recent spring months here – apart from seasonal allergies -have seen declining viral respiratory illness in Cape Town, with the upper respiratory accent often shifted down to more gastritis-enteritis .
But New Year 2014 UK and northern North America forecast and are having a wet if not white New Year. ‘Flu rates are reported already high and rising in USA and Canada– mostly influenza A H1N1(swine-avian flu-the main 1918/19 killer); including already 6 deaths in USA and 3 in Canada.
but not in Europe, where the influenza (A > B) prevalence is still low and slightly more H3N2 than H1N1; in UK there has rather been been increase in RSV respiratory syncytial virus bronchitis in infants. . .
In fact by 28 December the exploding H1N1 deathtoll had hit 13 in Texas alone; especially in youths; with increasing Tamiflu resistance reported eg in Missisippi.. On 24 Dec the USA CDC mailed an emergency Advisory Notice to Clinicians: Early Reports of pH1N1-Associated Illnesses for the 2013-14 Influenza Season: From November through December 2013, CDC has received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with influenza A pH1N1 pdm09 virus. Multiple pH1N1-associated hospitalizations, including many requiring intensive care unit (ICU) admission, and some fatalities have been reported. While it is not possible to predict which influenza viruses will predominate during the entire 2013-14 influenza season, pH1N1 has been the predominant circulating virus so far. For the 2013-14 season, if pH1N1 virus continues to circulate widely, illness that disproportionately affects young and middle-aged adults may occur.
Our regional South African Communicable Diseases Institute says , “H1N1 was documented here from April to September. But of 2566 pts with severe respiratory illness for January to October 2013 enrolled and tested at the five sentinel sites, only 6% were positive for influenza – mostly virus -H1N1. A pneumonia case in Cape Town was found to be due to Leigionnaire’s.
Now from China 147 human cases of avian influenza H7N9 have been confirmed including 48 deaths. – especially from poultry contact. No vaccine is currently available for avian influenza (H7N9) virus.
SAPA–AFP, 10 December 2013: Resistant flu virus keeps contagiousness. A mutant form of the H7N9 flu virus that is resistant to frontline drugs is just as contagious as its non-resistant counterpart, according to a study, published inthe journal Nature Communications. The virus has claimed dozens of lives since its outbreak in February. H7N9 is believed to have spread to humans from poultry, where it circulates naturally. The World Health Organisation (WHO) said on its website that “so far”, no evidence has emerged of “sustained” transmission of H7N9 among people.
And H7N1 and H7N7 has broken out in ostriches in South Africa,
So never mind the common cold coronaviruses and many other prevalent infections, increased caution is due against all common diseases at this season- both the USA H1N1 swine flu circulating the past few years, and now the Chinese H7N9 flu. . And the MERS-Co Virus Middle-East SARS-type outbreak has not gone away… 9 new cases reported the past week or two from the KSA alone .–the-deadly-middle-east-coronavirus-outbreak/
A current NEJM has a new report of a trial of quadrivalent Vaccine for Prevention of Mild and Moderate-to-Severe Influenza in Children by vaccine manufacturers GSK. The vaccine reduced severity by perhaps 70%- but at a cost of 1.5% serious adverse events, 50% more than the control group (hepatitis A vaccine only). The question remains- why risk flu vaccine’s ~1.5% serious adverse events when a single high dose of vitamin D3 300 000iu even just annually, and regular vitamin C with a multivite including zinc and selenium (at trivial cost ) largely cover one against a multitude of infections including AIDS and TB, and all degenerative health problems?
PRECAUTIONS:
Is it coincidence, or divine evolution, that we have had available at low cost for about 60 year (never mind zinc, selenium, iron, iodine, vitamins A and vitamin E) two safe natural major antimicrobials in vigorous safe dose – vitamins C and D3? Medico-Pharma Big Business and governments have been heavily discrediting and ruthlessly suppressing these for their own profiteering vested interest even as plagues of HIV, TB, influenza rage, and Big Business determinedly profits hugely from killer smoking and alcohol sales despite increasing marketing restriction? South Africa- a major producer of alcohol and tobacco-smoke, and fossil-fuel-burning power stations, factories and motorvehicles – continues to lead the world with the highest road and respiratory death rates despite zealous attempts to reduce their lethal use.
Apart from optimal hygiene including avoiding livestock and poultry contact, smoking, alcoholism and pollution including swimming and sick buildings- air-conditioning- what can we take to minimize avoidable influenza ie immune depletion risk? apart from enough sunshine, exercise, rest, sleep, walking barefoot, not carrying a cellphone, and good mixed fresh organic diet? The clinical benefit of influenza vaccines is anything but proven, and the adverse risks appreciable.
Big Business and thus governments and the media profit from illness, so they keep publishing articles promoting Big Business: new antibiotics, vaccines and other synthetic drugs that do not prevent or cure but if anything perpetuate chronic degenerative obesity-diabetes-vascular-respiratory,- digestive-arthritic-cancer diseases; – and GMO-genetically modified preserved food and bottled drinks stuffed with slow poisons like refined cornstarch – fructose; salt; sucrose and cereals, soya, Roundup, antibiotics, preservatives, estrogenics, aspartame, and especially boiled and baked omega6 and sugars; instead of marine omega3 and MCT- medium chain triglyceride virgin coconut oil, and unrefined cereals eg oats, wholewheat bread etc..
Big Business and it’s cash-cow Disease Industry decries the natural healthgiving lowsugar Asian/ Mediterranean diet-organically pastured and grown livestock meat and dairy products, lightly cooked if not raw (oily) fish, fruit and nuts, coloured veggies, and plenty of oils in their natural plant form. These were the norm till food processing became Big Business in our lifetime post WW2, and the developed world was bluffed by Organized Medicine, the Food Barons and Big Pharma with the masterly fiction of Ancel Keyes, into jettisoning the natural longevity “sea and farm” diet of the east eg Japan, and West eg Mediterranean (fresh produce & cholesterol-rich dairyproducts, meat and fish) for the Diet Deception (Gary Taubes, Tim Noakes) and Bad Pharma ( James le Fanu, Ben Goldacre) of Ancel Keyes‘ low-fat high-refined cereals, margarine; and the cholesterol -busting and psychotropes/ painkillers /antidementia/antivascular/ antidiabetic disease Designer Drugs-for-all myths.
It spends multimillions promoting alcohol, smoking and ever-newer designer prescription drugs and vaccine, and disinformation on old well-proven cheap drugs like reserpine, amilozide, metformin, natural physiological human hormone replacement, natural antioxidants and anti-inflammatories , and decrying ineffective but deliberately lowdose and isolated or imbalanced vitamins and minerals .
The ATBC vits A+E trial (isolated highdose vits A and E) was one such farce in very high risk smokers in an icy climate. . Others have been the recent Norwegian trial using only up to 1000iu vit D supplement a day,
and the current Annals Int Medicine editorial review of three new articles condemning multisupplements: , on which Mike Howard publishes a scathing critique –
*a commercial multisupplement in the TACT post-heart attack trial – but the composition of the multisupplement included only deficiency-disease prevention microdoses of micronutrients including 100iu vitamin D3/d and equally negligible vitamin K- not pharmacological doses of key vitamins eg vits B, C, D & K2 that are well proven to greatly reduce infections and chronic degenerative diseases ;
* the Physicians’ Health Study randomized elderly professional men to placebo or combinations of vitamin C (500 mg synthetic ascorbic acid), vitamin E (400 IU of synthetic alpha-tocopherol), beta-carotene (50 mg Lurotin), and a multivitamin (Centrum Silver – this included anti-deficiency disease low dose of all common vits and minerals BUT only 400iu Vit D3), .
* The third study- on lowdose (traditional anti-deficiency disease) Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer was simply a literature review of 26 best-quality published trials of microdoses – not pharmacological safe macrodoses.
ie these three trials published in this Annals Internal Medicine issue to please Big Pharma advertisors to discredit supplements shared the usual problem of now well-known futile lowdose supplement doses at least of vitamins D3 and K, if not also vitamin C in the multigram dose scientifically promoted by the Drs Stone- Klenner-Pauling followers.
Sir Jack Cecil Drummond (1891-1952) was one of the world’s pioneer 20th century biochemists and nutritionists in UK, from 1916- 1952 discovering or defining and promoting under his world-famous biochemist professors Rosenheim, Halliburton and Funk the role especially of vits A, B, C and E. Thanks to his and Churchill’s forceful vision and foresight, he oversaw food supply and diet and thus keeping Britons healthy through and after WW2. He was so successful in promoting healthy cheap and unpatentable micronutrients and natural fresh food (in the face of the mushrooming megaprofit processed food and designer drug industry) that it speculatively led to his and his family’s 1952 assassination by competing interests in France –The Vitamin Murders, Fergusson 2007. .
MURDER BY DENIALISM: It is incontrovertible common cause that irrational and often jealous medical denialism costs endless lives:
* Scurvy prevention: Dr James Lind (who did the first ever recorded clinical trial) showed by 1750 that sailors’ scurvy on long sea voyages was preventable; but despite his pioneer discovery, the British navy cost the lives of thousands more seamen from scurvy when the Admirals neglected for 50years until the Napoleonic Wars to supply the fresh produce- eg limes – that rapidly cured and prevented the lethal scourge.
This despite the fact that another UK navy surgeon Dr John Woodall had already over 130 years earlier- by 1617 – published in UK The Surgeon’s Mate stating We have in our owne country here many excellent remedies generally knowne,- Scurvy-grasse, Horse-Reddish roots, Nasturtia Aquatica, Wormwood, Sorrell, and many other good meanes… to the cure of those at home…and Sea-men returned from farre who by the only natural disposition of the fresh aire and amendment of diet, nature herselfe in effect doth the Cure (of scurvy- for which antiscorbutic citrus had been known since antiquity) without other helps. the Lemmons, Limes, Tamarinds, Oranges, and other choice of good helps in the Indies… do farre exceed any that can be carried tither from England.
* Childbed fever prevention: in 1865 Dr Ignaz Semmelweis (1818 -’65) an AustroHungarian Roman Catholic ob-gyne in Vienna, was locked up, and beaten to death within weeks, because he showed – to the outrage of his peers- that handwashing with chlorinated lime eradicated the epidmic puerperal fever (three times that in the midwives’ ward) in the doctors’ labour wards; 70years before Thir Reich terrorists took charge, his senior colleagues reacted violently to his progressive promotion of (what was already more advanced British and French) hygiene and science, and his urging them to wash their hands after examining corpses before examining women in labour.. . Tragically for Semmelweis and new mothers in the Hapsburg empire then, Pasteur (b 1822) and Lister (b 1827) ‘s germ antiseptic discoveries were already being implemented further west, but had not yet been publicized.
*metformin after centuries of use as an antidiabetic herb galega officinalis, and its extraction as an antidiabetic in 1922, came into increasing use globally from the 1950s as the best treatment for type 2 diabetes, but the USA- to protect their own new patent antidiabetic drugs – ruthlessly suppressed its use there (like that of the natural salt lithium for manic depression) for 40years till the mid-1990s.
*AIDS and ART denialism: until 5 years ago in South Africa the overwhelming-majority “people’s” government (with the country’s vast resources), and its successive “health” ministers, cost the lives of an estimated 300 000 AIDS victims through sufferers – indigent state dependents- being denied antiretroviral ART drugs, (never mind still till now denied quality education and civil security, and thus adequate basic nutrition, and meaningful housing, jobs and thus hope.) Genocidal AIDS denialism about which the still-ruling (since 1994) leadership cadre did nothing until under intense international pressure and repeated Constitutional Court orders, combined with political rival factioneering in the ruling party, they ousted the denialist president and his denialist Disease Minister in 2008.
DENIALISM TARGETS IN NUTRITION:
VIGOROUS VITAMIN C ASCORBIC ACID PHARMACOTHERAPY : Much effort and Big Pharma money has been spent to denigrate the irrefutable science-based work (between their advocacy years shown) of Drs Irvine Stone (1934-1984), Fred Klenner(1948-74) and Linus Pauling (1970-1991) of antibiotic dose >50 to 1000 mg/kg/d pure vitamin C (not the antiscurvy 10mg/d) – as a universally needed essential in primates. We primats, like guineapigs and a few birds and fish species, are among the few that do not make their own since we lost the needed gene and thus enzyme in our evolution..
It took about 150 years after Lind’s publication for the antiscorbutic factor to be named as vitamin C by Dr Jack Drummond, another 10 years for it to be assayed and its structure proven- but despite the pioneering clinical work of Dr Fred Klenner in the 1950s proving the lifesaving benefit of tens of grams a day intravenously, it took another 20 years before Dr Linus Pauling took up Dr Irvine Stone’s conviction and put highdose vitamin C on the world Nobel prize map; just on Pubmed, vitamin C has >51 000 citations since 1921, and intravenously in 763 entries since 1946, with Dr Fred Klenner reporting it intravenously asmajor antibiotic in the Southern Medical journal from 1948..
The 2009 book Injectable Vitamin C and the Treatment of Viral and Other Diseases collection of medical journal papers from the 1930s to 2006 details the exhaustive scientific evidence proving the uniform benefit of even 1gm a day vit C both as an antimicrobial antiinflammatory antioxidant and immunomodulator against major crippling / lethal diseases from polio to tuberculosis, pneumonia, hepatitis, rabies, encephalitis, neuritis, poisoning, cancer, and pancreatitis;
and the persistent resistance of the FDA and other multinational Regulators to recognize (so as to protect their domestic patent drug manufacturers- Big Pharma and their politician and civil service lobbyists )- such uniquely safe and effective natural drug therapy. The final chapters of that 2009 book pose the crucial questions of overwhelming vested interest by the organized medical – hospital –pharmaceutical mega-industry and governments in not eradicating preventable disease, the Big Pharma banning of natural effective remedies- The Origin of the 42-Year Stonewall of Vitamin C, and Medical Resistance to Innovation,
The University of Oregon, the Riordan-Gonzalez group and more recently Hemila and Chaker‘ and Ullah et al’ s 2012 reviews have published much validating what Drs Goodall, Lind, Drummond, Stone, Klenner, Pauling and Cameron started.
VIGOROUS VITAMIN D3 CHOLECALCIFEROLPHARMACOTHERAPY costing wholesale ~ <US$0.5/month for ~200 000iu /month in South Africa) reduces serious infection by perhaps 90% ie 9fold: . eg 80iu/kg/d – 500iu/d (15000u/month) for an infant, 50 000iu/wk or 200 000iu/mo for an adult; who if obese, may need two to three times the average dose, to achieve the (?) optimal 25OH vit D level of around 70ng/ml for health, higher for any acute or chronic chronic illness.The modern prophets of vitamin D3 have been the three pre-WW2 doyens :
Prof Chris E Nordin (MB ChB 1950) working in bone physiology for 60 years now; 84 papers on vitamin D on Pubmed
Prof Walter Stumpf (1927-2012; MD 1952) the recently deceased professor at North Carolina University, neuropsychiatrist and radiobiologist in his 60year medical career with over 500 publications (76 on Vit D on Pubmed) including early discovering that vitamin D targets all systems and diseases; professor-walter-e-stumpf-ahead-of-his-time/ and https://healthspanlife.wordpress.com/tag/stumpf-dr-walter/
paralled by Prof Robert Heaney (MD 1951) at Creighton University, osteoporosis and nutrition authority with 119 vitamin D papers on Pubmed since 1982, over 400 publications to date;
succeeded by Prof Mike Holick (PhD 1971, MD 1976) with 391 publications on vitamin D since 1970 on Pubmed, who has done more than most to show that the maximum daily body production of vitamin D3 with plenty of sunlight is enough to prevent rickets and reduce all disease, but nowhere near the pharmacologically therapeutic 80iu/kg/d needed to maintain a vigorous all-disease protective bloodlevel of 60-100ng/ml.
and Dr John Cannell (MD 1976, registered psychiatrist from 1993, nutritionalist), a legendary whistleblower . who successively campaigned against #cigarette smoking; and uncovered: # the cigarette-smoking (Black Lung) compensationitis fraud of miners’ pneumoconiosis; #the fictitious inflated “above national average” school results (Lake Woebegone) that all states were inventing and reporting (as is still happening – mass government deception- in South Africa) ; then the
# recovered memory therapy (RMT) scandal – a form of psychotherapy in which patients recovered memories of abuse that they had no previous memory of. Such therapy resulted in false memory syndrome (FMS) of events that never occurred as well as an epidemic of multiple personality disorder (MPD), a rare disorder historically conceived of as being a hysterical disorder. Unfortunately, many MPD patients believed the psychiatrist conducting the RMT and went home to falsely accuse their parents and others of horrendous acts that never occurred. Cannell teamed up with two Harvard professors to write a peer reviewed paper on RMT, debunking the witch-hunt; then since the 1990s researching and promoting # vitamin D deficiency as major cause of much psychopathology including autism, and vigorous vitamin D therapy to correct multiple diseases, through the Vitamin D Council. He has (co)authored some 13 papers, and published a book. .
Now a major longterm German Cancer Research screening program has just publishd the 2002-2013 ESTHER study (Perna ea) of 10 000 citizens followed with serial 25OH vit D levels; to assess the association of apparently unsupplemented vit D levels with fatal and nonfatal CVD in the same study population. Follow-up data, including survival status, up to over 9 years. Comparing subjects with 25(OH)D levels below 12ng/ml and above 20ng/ml resulted in the lower vitamin D level cohort showing a higher hazard ratio of 1.27 (95% confidence interval = 1.05-1.54) for total CVD and 1.62 (1.07-2.48) for fatal CVD in a model adjusted for important potential confounders. No significant association for nonfatal CVD was observed. In dose-response analysis, we observed an increased cardiovascular risk at 25(OH)D levels below 30ng/ml. Results for CHD and stroke were comparable to the results obtained for the composite outcome CVD. Our results support evidence that low 25(OH)D levels are associated with moderately increased risk of CVD, BUT the observed association is much stronger for fatal than for nonfatal events.
But the benefit of sunlight in healing tuberculosis has been used for well over a century; while the Google antibiotic benefit of calciferol on Pubmed goes back at least to 1950.
In a prospective 16 mo trial in press from Australia, vit D3 even just 60 000iu/month (ie 2000iu/day) halved antibiotic use in seniors. (Tran, Neale ea 2014) Effect of vitamin D supplementation on antibiotic use: a randomized controlled trial.
Since the toxic dose of vitamin D long term reportedly may be as high as 600 000iu/day or a blood level well >150ng/l , imagine how much better the antimicrobial benefit of vitamin D3 at 80 to 100iu/kg/day or pro rata – even higher eg 10 000+iu/day for obese people who sequester more vit D in fat. .
Dr Robert F Cathcart wrote 30 to 20 years ago in Med Hypotheses. 1981 Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy The amount of oral ascorbic acid tolerated by a patient without producing diarrhea increase somewhat proportionately to the stress or toxicity of his disease. Bowel tolerance doses of ascorbic acid ameliorate the acute symptoms of many diseases. Lesser doses often have little effect on acute symptoms but assist the body in handling the stress of disease and may reduce the morbidity of the disease. However, if doses of ascorbate are not provided to satisfy this potential draw on the nutrient, first local tissues involved in the disease, then the blood, and then the body in general becomes deplete of ascorbate (Anascorbinemia and Acute Induced Scurvy). The patient is thereby put at risk for complications of metabolic processes known to be dependent upon ascorbate. 1984 Vitamin C in the treatment of acquired immune deficiency syndrome (AIDS). evidence is that massive doses of ascorbate (50-200 grams per 24 hours) suppress the symptoms of the disease and can markedly reduce secondary infections. In combination with usual treatments for the secondary infections, large doses of ascorbate will often produce a clinical remission which shows every evidence of being prolonged if treatment is continued. .. despite continuing laboratory evidence of helper T-cell suppression. There may be a complete or partial destruction of the helper T-cells during an initial infection that does not necessitate a continuing toxicity from some source to maintain a permanent or prolonged helper T-cell suppression. However, it is possible ascorbate may prevent that destruction if used adequately during that prodrome period. Emphasis is put on the recognition and treatment of the frequent intestinal parasites. Food and chemical sensitivities occur frequently in the AID syndrome and may aggravate symptoms considered to be part of the AID syndrome. A topical C-paste has been found very effective in the treatment of herpes simplex and, to a lesser extent, in the treatment of some Kaposi’s lesions. Increasingly, clinical research on other methods of treating AIDS is being “contaminated” by patients taking ascorbate. 1991 A unique function for Vitamin C is as reducing substance, electron donor. When vitamin C donates its two high-energy electrons to scavenge free radicals, much of the resulting dehydroascorbate is re-reduced to vitamin C and therefore used repeatedly. Conventional wisdom is correct in that only small amounts of vitamin C are necessary for this function because of its repeated use. The point missed is that the limiting part in nonenzymatic free radical scavenging is the rate at which extra high-energy electrons are provided through NADH to re-reduce the vitamin C and other free radical scavengers. When ill, free radicals are formed at a rate faster than the high-energy electrons are made available. Doses of vitamin C as large as 1-10 g per 24 h do only limited good. However, when ascorbate is used in massive amounts, such as 30-200+ g per 24 h, these amounts directly provide the electrons necessary to quench the free radicals of almost any inflammation, and reduces NAD(P)H and therefore provide the high-energy electrons necessary to reduce the molecular oxygen used in the respiratory burst of phagocytes. In these functions, the ascorbate part is mostly wasted but the necessary high-energy electrons are provided in large amounts.
A recent review from Atlanta Kearns ea found 30 papers which aggregate to show that annual vitamin D3 dose (not D2) of optimally 300 000 to 500 000iu (wholesale cost ~R5 in South Africa) for deficient adults is best for avoiding poor patient compliance with minimal risk and major benefit.
THE INFERIORITY OF VITAMIN D2 SUPPLEMENT: It should be noted that the long-used Lennon’s Strong Calciferol datasheet (1974 updated 2004) does not indicate that this 50 000iu tablet labelled ‘calciferol’ is in fact vitamin D2 (ergocalciferol), not the fourfold more potent cholecalciferol D3 formed by sunlight in the skin. This is disclosed only on the Lennons website.. and in the South African Medicines Formulary. So ‘Strong Calciferol’ in South Africa (actually the D2 not D3 form of calciferol) is convenient but seriously deceptive mislabeling- much weaker than the ideal vitamin D3, and therefore its effect unpredictable compared to D3- in fact Dierkes ea Norway show that giving D2 may actually lower 25OH vit D level in the blood.. Sadly, despite this being reported to the local manufacturers and authorities, no correction of the clinically serious misperception created by the Strong Calciferol label and insert has been issued to health practitioners by the Medicines Control Council and the manufacturer Aspen-Lennons.
A recent 8yr study in Cape Town blacks Reciprocal seasonal variation in vitamin D status and tuberculosis notifications in South Africa Martineau, Nhamoyebonde ,Wilkinson ea confirmed that vitamin D deficiency (serum 25(OH)D <20 mg/L) is associated with susceptibility to tuberculosis (TB) in HIV-uninfected people in Cape Town as it is Europe. Vitamin D deficiency was present in 62.7% of 370 participants and was associated (OR ~5.4) with active TB in both HIV-uninfected and HIV-infected -(P < 0.001) people. Vitamin D status varied according to season: 25(OH)D concentration was double in summer-January- March compared to winter (23 vs 12ng/l; P < 0.001). Reciprocal seasonal variation in TB notifications was observed:lowest in autumn and highest in spring October through December (4,2 vs. 5; P < 0.001). Vitamin D deficiency is highly prevalent among black Africans in Cape Town and is associated with susceptibility to active TB both in the presence and absence of HIV infection.
Antimicrobial implications of vitamin D is detailed by Youssef, Peiris ea (USA Dermato-Endocrinol 2011) against all microorganisms – viruses, fungi, bacteria, protozoa (except perhaps leishmaniasis) as both profound prevention and therapy; in many cases without commercially invented marketed antimicrobials to which there is growing and deadly microbial resistance, let alone toxicity.. There is evidence that seasonal vitamin D deficiency status contributed greatly to the 1918/19 flu-pneumonia pandemic (Grant & Giovannucci 2009).
and finally, a month ago JAMA published from Effect of Micronutrient Supplementation on Disease Progression in Asymptomatic Antiretroviral-Naive HIV-Infected Adults in Botswana A Randomized Clinical Trial, that Micronutrient deficiencies occur early in human immunodeficiency virus (HIV) infection, and supplementation with micronutrients may be beneficial; however, its effectiveness has not been investigated early in HIV disease among adults who are antiretroviral therapy (ART) naive. 2 year supplementation with either daily vitamins BCo, C and E, selenium alone, or B,C,E with selenium vs placebo: study conducted in 878 patients infected with HIV subtype C with a CD4 cell count greater than 350/μL who were not receiving ART between 2005 and July 2009. Results participants receiving the combined supplement of vitamins plus selenium vs placebo had half the risk of reaching CD4 cell count 250/μL or less (adjusted hazard ratio [HR], 0.46); and secondary events of combined outcomes for disease progression or AIDS-related death, whichever occurred earlier [adjusted HR, 0.56); . There was no effect of supplementation on HIV viral load. Multivitamins alone and selenium supplementation alone were not statistically different from placebo for any end point. Reported adverse events were adjudicated unlikely related to the intervention, and there were no notable differences in incidence of HIV-related and health-related events among study groups.Conclusions and Relevance In ART-naive HIV-infected adults, 24-month supplementation with a single supplement containing vitamins BCo,C,E and selenium was safe and significantly reduced the risk of immune decline and morbidity. Micronutrient supplementation may be effective when started in the early stages of HIV disease.
the universities of Miami, Harvard and FloridaTHE PARADOX OF THE GLUCOSE- ASCORBIC ACID- CHOLESTEROL- STEROID CASCADE: Is it coincidence, or evolution, that the basic animal fast-energy circulating anabolic substrates are glucose, fatty acids and aminoacids? from which basic glucose C6H12O6 ( from ingested fructose C6H12O6 and sucrose C12H22O11, or fats or protein) the liver manufactures the basic cardinal steroid cholesterol C27H46O. Then from cholesterol we metabolize by adding or splitting off carbon molecules the crucial anabolic and regulating human hormones- 1. ouabain C29H44O12 the adrenal hormone made also in the hypothalamus and heart ; adrenal), 2. active calciferol C27H44O the strengthening and reproductive secosteroid; 3 the prime sex/ reproductive steroids pregnenolone C21H32o2, and thence progesterone C21H30O2, testosterone C19H28O2, DHEA C19H24O2. and thence estradiol C18H24O2. and 4 the prime adrenal mineralo/glucocorticoid steroids cortisol C21H30O5, aldosterone C21H28O5.
But we primates and a few other species lost the ability to synthetise on demand in quantities of grams a day the crucial vitamin C ascorbic acid C6H8O6 that is key to all the above. And vested interests in the Disease Industry want us to believe the biological nonsense heresy that we must ingest minimal unprocessed foods- cholesterol, fats (especially dairy, marine oil Omega3 and medium-chain triglyceride- coconut oil) and abundant vitamins C and D3, but eat abundant processed foods- refined plant Omega6, refined carbs- fructose, sucrose, fruit juice, cooldrinks, cereals, confections- which overload causes insulin resistance and thus lipidemia, obesity- metabolic syndrome -diabetes, cancer and cardiovascular disease.
The Semmelweis reflex: A current Wiki essay sums up the current genocidal problems of deliberate deceptions/denialism in Diet, Vitamins and causality – for ruthless profit and possibly cynical eugenics: “The Semmelweis effect is a metaphor for the reflex-like tendency to reject new evidence or new knowledge because it contradicts established norms, beliefs or paradigms.The term originated from the saga of Dr Ignaz Semmelweis, who discovered that childbed fever mortality rates reduced ten-fold when doctors washed their hands with a chlorine solution before examining patients. His hand-washing suggestions were rejected by his contemporaries, often for non-medical reasons. For instance, some doctors refused to believe that a gentleman’s hands could transmit disease (see Contemporary reaction to Ignaz Semmelweis). In his book The Game of Life, Timothy Leary provided the following polemical definition of the Semmelweis reflex: “Mob behavior found among primates and larval hominids on undeveloped planets, in which a discovery of important scientific fact is punished”. The expression has found way into philosophy and religious studies as “unmitigated Humean skepticism concerning causality“.[2]”
Idealism, ethics may evolve; but the problem of human bigotry, self-interest and subjective ie personal bias do not diminish, they spread. It is classic that Semmelweis (1818-1865) the observant innovative Catholic medical scientist of his time (before microbes and antiseptics were known) was fatuously condemned not just by his jealous competing Vienna colleagues, but even by his progressive and reformist Copenhagen contemporary obgyn Prof Carl Levy (1808-1865)- who outlived him by only 4 months;
ironically at the same time that their Copenhagen contemporary Dr Soren Kierkegaard (1813-1855) was increasingly isolating himself on the lonely ethical journey against the convenience lazzez- faire tide, writing for ethical life and religion against the hypocrisy of the Church and becoming the father of both reformist theology and psychology. But unlike Semmelweis who was way ahead of the bioscience and humanity of his time, Kierkegaard stuck to and isolated himself in promoting the incompatible ie blind-faith-based religion – the dilemma of Abraham’s conviction (or delusion) to sacrifice his son- and ethical morality;
and closely followed by Rudolph Steiner (1861-1925) another more profound European thinker who bridged science, spirituality, progressive education, architecture, agriculture, natural medicine, nutrition, and social reform;
contrary to the rationalists of the 19th Century “Age of Enlightenment” and since, like British historian-philosopher -ethicist Winwood Reade (1838 – 1875) who published the enduring secularist’s bible The Martyrdom of Man (1872), of which Churchill wrote 25 years later “he was right but wrong to say it” on the book’s critique of the wrongs of war and religion, of mankind’s selfishness, corruption and destructiveness (by the greedy aggressive acquisitive minority) against the weak masses and the environment) that carries on worse in the 21st century than even the 20th century; and 150 years later bioscientist and philosopher Stephen Jay Gould (1941-2002) rationalized sadly the non-overlapping Magisteria of Science and Faith, objective “provable” science – which in fact is seldom immutably constant as is mathematics- and purely faith-based “unprovable” religious belief.
It was only a year ago that Richard Conniff published his column on Strange Behaviours, The Medical Martyrs. And the medical hero martyrs in this review- Semmelweis, Margaret Sanger, Drummond and Pauling – never made it onto his list.
But then nor did the modern medical freedom fighters Steve Biko, Agostinho Neto, Che Guevera. Jonas Savimbi, Neil Aggett, and the living spouse of Steve Biko, Dr Mamphele Ramphele….
Women of the Century apart (like Margaret Sanger, Marie Curie, Eleanor Roosevelt, Golda Meir, Indira Gandhi, Helen Keller, Benazir Bhutto, Mother Theresa, Aung San Suu Kyi -many of whom have been martyred), it is a philosophical debate whether among the men the medical martyr Semmelweis (1818-1865) ranks with his 19thC contemporaries- Lincoln (1809-1865), Kierkegaard(1813-1855), Pasteur (1822-95), Lister (1827-1912) ; and his successors (and 20th C leading achievers): Koch(1843-1910), Edison(1847-1931), Steiner (1861-1925), Gandhi(1869-1948), Weizmann(1874-1952), Churchill (1874-1965), Einstein (1875-1955), Jung (1875-1961), FD Roosevelt(1882-1945), JK Galbraith(1908-2006), Martin Luther King (1929-68), Pauling and Mandela as arguably giant enduring male leaders -innovators- teachers and achievers of the past two centuries.
Unlike eg Socrates, Hippocrates and Jesus of Nazareth, one of the five greatest polymath medical and ethical sages of all time Rabbi Dr Moses Maimonides (RamBam) avoided martyrdom by burying himself in practicing selfless medical service for sultan and peasants alike, and jurisprudence for his GreekoRoman based Islamic-Sephardic times and philosophy, like his guru predecessor Avicenna and his contemporary savant Averroes. .
CONCLUSION: Today it can be argued that the denial of effective phamacotherapeutic doses of especially vitamins C and D3, let alone supportive doses of balancing vits (A, B1,3,5,6,9 & 12, E and K2); the often-crucially deficient minerals (eg magnesium, sulphur, phosphate, iodine, zinc and selenium), and biologicals like human transdermal balanced HRT, coenzyme Q10, alphalipoic acid, milk thistle, cinnamon, fish oil, chondroglucosamine, DMSO, coconut oil, is a repetition of denialism of the germ theory, and of optimal physiological human micronutrition as well as macronutrition. .
– especially when patients are poor and thus malnourished, and plagued by diarrhoea and stress, TB, lipidemic vascular disease and cancer; and when antiretroviral ART- although life-saving- is even more diabetogenic and neurotoxic than untreated AIDs.
Even transdermal administration is better than nothing, perhaps better (for the frail and noncompliant eg oldies) than oral or injection eg of vitamins D3 & C and progesterone , metformin, (in addition to the usual magnesium chloride, vits A, BCo & E) may be beneficial whether by patch or cream for both healing, infection, calming, heart, circulation, infection, arthritis, osteoporosis, and neuritis, applied under coconut oil, codliver oil and DMSO as further analgesic, anti-inflammatory, memory and absorption enhancers.
REFERENCES: New reviews bear out the major benefits of micronutrient supplements selenium, zinc, silver, vits A, B, C, D, E; and DMSO, sutherlandia and aloe against HIV-AIDs. and co-infection;
Micronutrient supplementation for children with HIV infection. Irlam JH, Rollins NC ea . Cochrane Database Syst Rev. 2013 Oct 11;10:CD010666.
Effect of micronutrient supplementation on disease progression in asymptomatic, antiretroviral-naive, HIV-infected adults in Botswana: a randomized clinical trial.Baum MK, Marlink R ea .JAMA. 2013 Nov 27;310(20):2154-63. .
Preliminary trial of aloe vera gruel on HIV infection.Olatunya OS, Oyelami OA. ea, J Altern Complement Med. 2012 Sep;18(9):850-3. doi: 10.1089/acm.2010.0735.
In vitro effects of Sutherlandia frutescens water extracts on cell numbers, morphology, cell cycle progression and cell death in a tumorigenic and a non-tumorigenic epithelial breast cell line.Stander A, Joubert AM. ea, J Ethnopharmacol. 2009 Jul 6;124(1):45-60
Sulfur in human nutrition and applications in medicine.Parcell S.Altern Med Rev. 2002 ;7(1):22-44.
Coconut (Cocos nucifera L.: Arecaceae): in health promotion and disease prevention.DebMandal M, Mandal S.Asian Pac J Trop Med. 2011 Mar;4(3):241-7
below are some of the most recent 94 studies of vitamin D and human infectionin published just in 2013:
New insights on the role of vitamin D in the progression of renal damage: Kidney Blood Press Res. 2013;37:667-78. . Lucisano S, Santoro D.ea Many studies indicate relationship between hypovitaminosis D and survival, vascular calcification, bone mineral metabolism, immune, cardiovascular and endocrine. Vitamin D analogs reduces proteinuria, in particular through suppression of the renin-angiotensin-aldosterone system (RAAS) and exerts anti-inflammatory and immunomodulatory effects. In particular vitamin D deficiency contribute to an inappropriately activated RAAS, as a mechanism for progression of chronic kidney disease (CKD) and/or cardiovascular disease. Human and experimental models of CKD showed that vitamin D may interact with B and T lymphocytes and influence the phenotype and function of the antigen presenting cells and dendritic cells, promoting properties that favor the induction of tolerogenic T regulators rather than T effectory. Interstitial fibrosis may be prevented through vitamin D supplementation. .
Should vitamin D supplementation be a regular part of asthma care? Gordon BR.Otolaryngol Clin North Am. 2014 Feb;47:97-108. .Vitamin D (vitD3) deficiency occurs frequently and has profound effects on health, especially asthma.
Vitamin D in asthma and future perspectives.Huang H, Zarogoulidis K. ea Drug Des Devel Ther. 2013 Sep 23;7:1003-13.
vitamin D deficiency associated with development of Acinetobacter baumannii infections in critically ill patients?; Türkoğlu M, Aygencel G et al.; Journal of Critical Care 28 (5), 735-40 (Oct 2013)
Association between vitamin D and hepatitis C virus infection: a meta-analysis. Villar LM, Romero-Gomez M. ea World J Gastroenterol. 2013 Sep 21;19(35):5917-24.
Association between prehospital vitamin D status and hospital-acquired bloodstream infections. Quraishi SA, Christopher KB. Ea, Am J Clin Nutr. 2013 Oct;98(4):952-9.
Human parvovirus B19 associated dilated cardiomyopathy. Jain P, Jain A, Khan DN, Kumar M. BMJ Case Rep. 2013 Aug 5;2013.
The role of vitamin D supplementation in the risk of developing pneumonia: three independent case-control studies. Remmelts HH, van de Garde EM ea .Thorax. 2013 Nov;68(11):990-6.
Correlation between serum vitamin D level and severity of community acquired pneumonia in young children Ren J, Sun B, Miao P, Feng X. Zhongguo Dang Dai Er Ke Za Zhi. 2013 Jul;15(7):519-21. Chinese. http://www.ncbi.nlm.nih.gov/pubmed/23866270
Role of vitamins D, E and C in immunity and inflammation. Shaik-Dasthagirisaheb YB, Pandolfi F. J ea Biol Regul [Correlation between serum vitamin D level and severity of community acquired pneumonia in young children].Homeost Agents. 2013 Apr-Jun;27(2):291-5.
Pre-hospital vitamin D concentration, mortality, and bloodstream infection in a hospitalized patient population.Lange N, Christopher KB ea. Am J Med. 2013 Jul;126(7):640.e19-27.
Vitamin D deficiency in HIV infection: an underestimated and undertreated epidemic. Pinzone MR, Nunnari G. eA Eur Rev Med Pharmacol Sci. 2013 May;17(9):1218-32.
Vitamin D deficiency and sudden unexpected death in infancy and childhood: a cohort study.Cohen MC, Offiah A, Sprigg A, Al-Adnani M. Pediatr Dev Pathol. 2013 Jul-Aug;16(4):292-300.
Serum 25-hydroxyvitamin D3 and the risk of pneumonia in an ageing general population.Aregbesola A, Tuomainen TP. ea J Epidemiol Community Health. 2013 ;67:533-6.
Treatment of pulmonary tuberculosis.Nunn A, Phillips PP, Abubakar I.Curr Opin Pulm Med. 2013 ;19(3):273-9.
Role of vitamin D in children with respiratory tract infection.Esposito S, Baggi E, Bianchini S, Marchisio P, Principi N. Int J Immunopathol Pharmacol. 2013 J26(1):1-13.
Tuberculosis incidence correlates with sunshine: an ecological 28-year time series study.Koh GC, Dedicoat M. PLoS One. 2013;8:e57752.
Improving outcomes in patients with psoriasis.Tidman MJ. Practitioner. 2013 ;257:27-30, 3.
vitamin C refs & infection:
Authors’ perspective: What is the optimum intake of vitamin C in humans? Frei B, Birlouez-Aragon I, Lykkesfeldt J. Crit Rev Food Sci Nutr. 2012;52(9):815-29.
Micronutrients at the interface between inflammation and infection—ascorbic acid and calciferol. Parts 1 & 2: .Ströhle A, Wolters M, Hahn A. Inflamm Allergy Drug Targets. 2011 ;10:54-74- FULL TEXT IS ON LINE. .
Vitamin C for preventing and treating tetanus Cochrane Database Syst Rev. 2008 Apr 16;(2):
Posted in AIDS, all-cause mortality, Alzheimer's, anti-aging, Big Pharma, cancer, depression, diabetes, diabetes prevention, flu, H1Ni swine flu, hormones, HRT, Hypertension, INFECTIONS, Lifespan, medicopolitical economics, prevention, supplements, Uncategorized
Tagged AIDS, antioxidants, ascorbate, cancer, Cathcart, Conan Doyle, corona, CVD, denialism, depression, diabetes, Drummond, fracture, H1N1, heart attack, Holick, infection, influenza, Klenner, lipidemia, Martyrdom of Man, memory, MERS, metformin, Nordin, obesity, pandemics, Pauling, plagues, pox, prevention, selenium, Semmelweis Reflex, statin, Stone, Stumpf, supplements, vitamin C, vitamin D, vitamins, Winwood Reade
Answer: none provided it is safely and economically measured and safely and economically corrected at all ages from small children to dotage. It is so cheap and easy to halve the fracture risk and rate in all, and thus save vast suffering, costs and especially deaths.
A spinal surgeon laments as we all do the poor correlation between dual xray bone density analysis DXA and fracture risk.
The simple answer is that bone density is not the top risk factor for fractures,
The chief risk for fractures in the aging is falls and fragility ie global health balance including agility-co-ordination, balance, and strength- muscle mass.
As this column has previously detailed, DXA is valuable for looking at risk areas in the hip or a vertebra;
but just as screening X-ray mammography overdiagnoses clinically relevant breast cancer, trunkal DXA measurement increasingly overreads bone density as we age because of false densification- vascular calcification overlying hips and spine, and progressive collapse wedging of vertebrae.
That’s why, as this column has previously referenced, QUS -quantified ultrasound – done mostly at the heelbone, has become the international gold standard for monitoring global fracture risk, since that bone measured in its long axis is generally free of overlying vascular calcification and collapse wedging. It is recommended by international bodies, many leading universities from Cape Town to Cambridge to Scotland, Japan and USA. .
There is generally good correlation between true DXA measurement at hip and spine, and heel QUS measurement.
And QUS lacks the cumulative radiation risks of DXA.
That’s why QUS bone density is increasingly recommended from childhood, for monitoring and thus simple prevention of frailty – thus avoiding the mushrooming fracture and frailty risk in later life
http://www.ncbi.nlm.nih.gov/pubmed/22878531 Osteoporos Int. 2012 Aug Quantitative ultrasound and fracture risk prediction in non-osteoporotic men and women as defined by WHO criteria.Chan ea Garvan Institute of Medical Research,Sydney, Australia.
http://www.ncbi.nlm.nih.gov/pubmed/22037972 Osteoporos Int. 2012 Jan:143-53.Quantitative ultrasound of heel and fracture risk. Moayyeri ea .University Cambridge UK. Metanalysis: 21 studies with 55,164 women and 13,742 men were included with a total follow-up of 279,124 person-years. All QUS parameters were associated with risk of different fracture: 1 SD decrease in BMD associated with almost doubling of hip fracture risk. (RR by BUA 1.69, SOS was 1.96). There was marked heterogeneity among studies on hip and any clinical fractures but no evidence of publication bias amongst them. Different validated devices predicted fracture risks with similar performance; with similar performance in men and women. This study confirms that heel QUS, using validated devices, predicts risk of different fracture outcomes in elderly men and women.
Oct 30, 2010.
FRAILTY FRACTURES- OSTEOPOROSIS- ARE ALSO COMMON- AND EASILY PREVENTED- IN AGING MEN
The just-published Champ study of osteoporosis in men over 70yrs in Australia shows the high risk for older men as well: 25% had vertebral fractures, but only 77% of the men with fractures had even osteopenia let alone osteoporosis on DXA screening. and this does not factor in the overreading by DXA at the spine and hip owing to the high prevalence of both calcinosis and vertebral collapse. And abysmally few of the men were taking realistic preventatives.
The study bears out:
that frailty, usually from aging – is the chief risk factor for non-violent fractures;
and the low sensitivity of especially DXA screening, never mind the folly of waiting for fractures or dementia or worse before doing safe lowcost (QUS bone risk) screening as one incentive to starting multipreventative supplements.
As the GIOS Project in Spain yet again confirms, simple diagnosis and safe treatment of those at risk of non-violent fractures is scandalously neglected.
And it does not require costly risky high technology – xray screening bisphosphonates or strontium ranelate..
Like doctors, men are far more resistant than even women to heeding warning to start screening and supplements early enough.
The CHAMP study again highlights the importance of asymptomatic middleaged men never mind women having periodic no-xray ultrasound quantitative bone strength scans routinely as the gold standard so as to prompt them to take the appropriate blend of the fewscore supplements effective against both frailty fractures as well as the associated lipid- diabetes- vascular -respiratory- dementia- cancer diseases.
Posted in Alzheimer's, anti-aging, cancer, diabetes, hormones, menopause, osteoporosis, prevention, supplements
Tagged Alzheimer's, antioxidants, BMD, cancer, CHAMP study, dementia, DEXA, diabetes, DXA, fracture, GIOS study, male osteoporosis, memory, osteoporosis, overweight, quantitative bone strength ultrasound
A: THERE IS NO PROBLEM PROVIDED THEY ARE APPROPRIATE.
update 20/12/12 Dr Giske Ursin of the Norwegian Cancer Registry has just published thoughts on collaboration – not anger for and against risky xray mammography – needed to move the field forward on avoiding breast cancer, to defend the integrity of women’s breasts. http://www.ncbi.nlm.nih.gov/pubmed/23234258
this column has previously reviewed mammography screening https://healthspanlife.wordpress.com/2011/11/06/negligent-promotion-of-screening-xray-mammography-as-saving-lives/
A new paper – from the USA National Cancer Institute no less- writes about the fraud of alarmist marketing of cancer screening/treatment. http://www.nejm.org/doi/full/10.1056/NEJMp1209407
Another new paper, from Wisconsin University, What Is the Optimal Threshold at Which to Recommend Breast Biopsy? notes that with an annual incidence of breast biopsy of 0.626% there (ie about 6 per 1000 women of the ~18 000 screened over 5 years ), 1 in 4 biopsied ie about 0.15% of those screened will be proven to have some degree of (pre)cancer.. They confirm the 2% risk threshold at which radiologists recommend biopsy. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492229/
Of well women, perhaps <1 in 20 justify screening breast imaging except in those women with relevant anxieties ie the worried well.
But screening xray mammography often uncovers clinically silent ie preclinical breast cancer which otherwise might never cause problems in lifetime; and such irradiation and crushing may activate and spread dormant precancer cells.
Just as cardiograms are electrical-, echo- or angio- images of the heart, mammograms MGMs are widely different technology images of the breasts.
But unlike heart disease, no living imaging technique diagnoses with certainty cancer that is not already clinically pretty obvious.
The breast carcinogenic radiation risks from X-rays have been known for a century and yet it’s heavy usage is often inappropriate, profit-driven.
When patient’s history and physical exam suffice to exclude significant risk of breast cancer with practical certainty, it is unnecessary to crush, irradiate, needle or cut. Low risk women expose themselves to a greater risk with lower-dose screening X-ray MGMs and more invasive costly tests. For the common “silent” cancers (e.g. prostate/breast), statistics do not support that routine invasive screening of the apparently healthy saves lives.
As with all technology, many ‘grams – imaging methods – have evolved for the breasts. Like the infants they are built to nourish, breasts are extremely sensitive to irradiation. The lower the X-ray dose, the worse the subtle genetic damage that may occur – even decades later. We know this from follow-up consultations with women with initially healthy breasts >15 years earlier who had repeated xray mammograms, versus their sisters who had xray mammograms only when suspicions arose; and from controlled laboratory experiments on rodents and human breast cells.
Objective statistical analyses since the Canadian breast X-ray screening trial more than 20 years ago, show no benefit, but show instead an increasing risk of more breast cancer, more breast surgery and more premature deaths in well women repeatedly xrayed. .
ALTERNATIVE BREAST SCANS available include no-touch photographic thermo-mammography, gentle ultrasound;
and gentle mechanical tactile imaging (MTI), which may be better than xray or ultrasound MGM show early warning signs such as thickening of tissue and lumps. These signs may be reversed with diet, supplements and lifestyle changes.
From international studies and local experience, MTI (e.g. Sure Touch Mammography) has become the best at outpatients, to document the physical exam findings with three-dimensional characteristics mapped.. With this simple process, perhaps < 1 in 30 healthy women may need referral for ultrasound, and perhaps < 1 in 100 cases justify biopsy, and as the Wisconsin study shows, <1 in 1000 found to have significant breast cancer. It has been validated as at least as effective as (if not better than) other breast imaging in studies in USA, England, China and India.
MTI is recommended by CANSA, which says that from 2005 data about 1:29 women will be diagnosed in their lifetime with breast cancer. .
Studies confirm the obvious, that the more experts with vested interests (in XRMGM and breast cancer management) who draw up Guidelines, the more likely that Panel is to encourage mass XRMGM and intervention. So instead of perhaps 1 in 30 woman justifying breast imaging, the Breast Disease Industry – including the USA Breast Cancer Association the Industry funds – wants every woman X-ray screened regularly ideally from age 40years for the rest of their lives. But despite rage from the $8billion a year USA breast screening industry, Authorities have steadily cut back the age of starting mass screening XRMGM from age 40 to 50 years and to every 2nd or 3rd years.
No preclinical imaging diagnoses cancer. The only sure diagnosis is lump excision histology – if not multiple biopsies with their risk of needle spread.
Talk about unsubtle seduction. This year – despite massive financial (including stock-market) and marketing pressure- even mammography wine and food parties at USA radiology centers to persuade women to submit http://online.wsj.com/article/SB126325763413725559.html -two books never mind a flood of scientific journal papers have just been published questioning routine xray mammography of the well:
Dr Peter Gotzsche and the Danish Cochrane epidemiology team have published the evidence from all over the world – from at least 14 countries- against universal XRMGM for all, against the myth of the benefits and safety of regular xray mammography.. http://www.dailymail.co.uk/health/article-2120750/The-expert-branded-woman-hater-saying-breast-cancer-screening-ruins-lives.html and
The Big Squeeze: A Social and Political History of the Controversial (XRAY) Mammogram (Culture and Politics of Health Care Work) by radiologist Dr Handel Reynolds 2012 http://handelreynoldsmd.com/the_big_squeeze_history_mammography.html
This blog is irregularly updated with the latest detailed pharmacological information on the ingredients of anti-aging preparations, the powder blend compositions, and mail-order/wholesale prices.
These are all detailed on the page Product Details and Pricelists. but of course all the ingredients, as food supplements, can be ordered individually to US or UK or Japanese pharmacopoea standard anywhere from any reliable importer or manufacturer.
The prices listed are not updated weekly, they are a guide; and dependent from day to day on imported costs which are mostly rising constantly .
For information email sales@healthspanlife.com (or contact 027836299160).
The public, as well as interested distributors/retailers, are invited to contact Healthspan Life!.
Posted in Alzheimer's, arthritis, cancer, depression, diabetes prevention, Hypertension, INFECTIONS, Lifespan, osteoporosis, overweight prevention, pain, prevention, senses, sex, sexual health, supplements
Tagged Alzheimer's, antioxidants, autism, carnitine, coQ10, depression, diabetes, fracture, heart attack, Hypertension, infection, insulin resistance, lipidemia, memory, obesity, osteoporosis, overweight, prevention, supplements, vitamin D
MANAGED ANTIAGING CLINIC CONSULTATIONS
PRODUCT DETAILS AND PRICE LISTS; SUPPLEMENTS AGAINST DISEASE, AGING
SWINE FLU UPDATE; Tamiflu protection?- evidence please? A windfall for USA?
NEGLECTED ESSENTIALS: CoQ10.. VITAMIN D... B12 ; STEVIA; FISH OIL; FAT-SOLUBLE SUPPLEMENTS;
OPIOIDS NOT NSAIDS IF PANADO DOESNT SUFFICE ..ACETAMINOPHEN/ PARACETAMOL RISKS .. WHY USE OTHER THAN PARACETAMOL FOR MILD PAIN?
VESTED INTERESTS IN RISING COSTS
THE MOST IMPORTANT DRUG THERAPY OF HYPERTENSION.. DRUG LISTS .. WHY IGNORE RESERPINE?..
DIABETES, METFORMIN: THE FIRST DIABETES PREVENTION PROGRAM: CHINA… PREVENTION OF OBESITY, DIABETES; PREGNANCY & METFORMIN .. METFORMIN FIRST… INSULIN TRIPLES DEATHS ; THE 30 year UKPDS… PREDIABETES TIME BOMB;
DEMENTIA ETANERCEPT;. FUTILE MODERN DRUGS;
DANGER, BIAS OF RANDOMIZED CONTROLLED TRIALS;
THE WOMENS’ HEALTH INITIATIVE WHI: MISPLANNED, MISREPORTED & MANIPULATED;
ESTROGEN+INSULIN vs TESTOSTERONE+METFORMIN ..APPROPRIATE HRT SEX HORMONE REPLACEMENT. ANDROGENS GIVE HEART STRENGTH AND HEALTH. NON-ORAL HRT; DVT AFTER ORAL HT;
SCAMS & SNARES: STATINS; BISPHOSPHONATES; …SCREENING MAMMOGRAPHY; BLACK COHOSH; RIMONABANT; GLITAZONES; FORTEO ; TIBOLONE;
ARTHRITIS: MULTIPLE EFFECTIVE NATURAL REMEDIES;
CANCER: PROGESTINS; HRT; PROSTATE ; HYPOCHOLESTEROLEMIA ;
update Dec 2016: Psychiatrist neuroplastician Dr Norman Doidge in his books on How the Brain Changes(prev. 2008); and then How it Heals Itself (2015), expands on the brain’s unique capacity to neuroplastically adapt and recover functions either by neuronal regrowth or by finding new pathways. https://www.theguardian.com/books/2015/jan/23/the-brains-way-healing-stories-remarkable-recoveries-norman-doidge-review. He details numerous landmark discoveries the past century about how diverse integrative noninvasive methods can help the brain heal, including cognitive, nutritional, physical, laser and electro/magnetic innovations- ideally early but even years later, in conditions ranging from cerebral palsy and autism, to stroke, multiple sclerosis, traumatic brain injury and blindness, to Huntingdons chorea, Parkinsons and dementias. ..
Dr EL Tobinick has since 2003 continued to report progressive improvement in neurological results with peripheral invasive ie perispinal etanercept injection, as his latest paper references.
Over the same ~15year period, Dr CG Coimbra neurologist at Sao Paulo University Brazil has proven increasingly the value of a nutritional regime including megadose vitamin D3 in reversing multiple sclerosis and other serious autoimmune diseases. http://www.vitamindandms.org/researchers/coimbra/ and https://healthspanlife.wordpress.com/2016/05/17/vitamins-k2-with-d3-the-vitamins-of-the-next-decade/
As Dr Doidge stresses, such landmark innovations take decades to be confirmed, especially if there are no new devices or drugs that can be marketed to generate massive profits (and jobs) for (the Disease) Industry, and governments and politicians via more jobs and taxes. And drug companies and the Disease and Hospital Industry will not fund the necessary major studies without medium-term major profit incentive- especially if the innovations are major prevention and cure, reducing the profitable disease burden. Thus the USA delayed recognizing the major role of metformin and lithium carbonate for some 25 years, and medicinal cannabis for almost 50 years., to protect their moneyspinning Big Pharma new synthetic drug inventions- none of which have proved enduringly safe and effective as have the old natural discoveries.
CNS Drugs.2016 Jun;30:469-80. Perispinal Delivery of CNS Drugs. Tobinick EL Institute of Neurological Recovery. Florida. Perispinal injection is a novel emerging method of drug delivery to the central nervous system (CNS). Physiological barriers prevent macromolecules from efficiently penetrating into the CNS after systemic administration. Perispinal injection is designed to use the cerebrospinal venous system (CSVS) to enhance delivery of drugs to the CNS. It delivers a substance into the anatomic area posterior to the ligamentum flavum, an anatomic region drained by the external vertebral venous plexus (EVVP), a division of the CSVS. Blood within the EVVP communicates with the deeper venous plexuses of the CSVS. The anatomical basis for this method originates in the detailed studies of the CSVS published in 1819 by the French anatomist Gilbert Breschet; then rediscovered by American anatomist Oscar Batson in 1940; with additional supporting evidence discovered in the publications of American neurologist Corning. Analysis suggests that Corning’s famous first use of cocaine for spinal anesthesia in 1885 was in fact based on Breschet’s anatomical findings, and accomplished by perispinal injection. The therapeutic potential of perispinal injection for CNS disorders is highlighted by the rapid neurological improvement in patients with otherwise intractable neuroinflammatory disorders that may ensue following perispinal etanercept administration. full paper and published peerreviewed references at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920856/
upodate 2009: Regrettably, there is as yet apparently no objective group clinical follow-up from Dr Tobinick or other clinicians since this column’s first report of February 2008 of instantaneous and sustained improvement in Alzheimer’s disease after etanercept (Enebrel) perispinal injection.
Search under this heading on Pubmed and Google yields material clinical papers only by the originator of this therapy Dr Tobinick.
The videos on line of February 2009 giving up to 4 year followup of a few individual recovered patients are exciting but anecdotal.
Professor Tobinick’s February 2009 paper describes elegant imaging of localization of labeled etanercept in the brain in a rat model.
Search of Pubmed for etanercept adverse effect in other uses yields a report of two cases of sarcoidosis after etanercept; almost doubling of the risk of cancer; and increased occurrence of psoriasis.
But in a relentless deadly disease like Alzheimers, these adverse events pale into significance if etanercept reverses dementia’s progression for even a few months, when no modern designer drugs in common use show any significant benefit as opposed to adverse effects.
So further report on durability of improvement from etanercept in Dr Tobinick’s group of patients, and confirmation of this application by other clinicians, is keenly awaited by many.
How many success stories have there been with etanercept in AD, against how many AD patients treated with etancercept in total? and what has been the average duration of remission compared to those not treated with the magic injection?
There is one report giving more recent detail, apparently a newspaper interview dated 12 April 2008 that says Dr Tobinick’s group has “treated around 50 patients at a private clinic by injecting etanercept, into the spinal column in the neck. .They claim 90 per cent respond to the treatment, usually within minutes.”
This response rate and speed bears out the promise of their report of a year ago; but there is no mention of such results on their website or anywhere else. Hence the skepticism of the British Alzheimer Society’s website .