UPDATES: HEALTHY LIVING

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@helathspanlife.com (or contact 027836299160).

The public, as well as interested distributors/retailers, are invited to contact Healthspan Life!.

MANAGED AGING / ANTIAGING CLINIC

In Claremont Cape Town except  Tuesday mornings at Hove To Medical Centre, Fish Hoek

A Specialist Internist Clinic offers consultations by appointment especially for managing (and ideally preventing)  the major chronic degenerative diseases of aging  and  maintaining physical, mental (and why not sexual?) vigour to a ripe and healthy old age.

INDEX OF RECENT MAIN TOPICS

MANAGED ANTIAGING CLINIC CONSULTATIONS

PRODUCT DETAILS AND PRICE LISTS;     SUPPLEMENTS AGAINST DISEASE, AGING

UPDATES

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;

HOMEOPATHY..

SOUTHERN  AFRICAN APOCALYPSE

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 ;

SEX: persistent female genital arousal syndrome.

METFORMIN THE MASTER DRUG:

neil.burman@gmail.com

It’s just a month since this column reviewed the only “drug” that is (like fish oil)  a universal panacea: A STUDY OF THE CENTURY: METFORMIN PREVENTION OF THE TIMEBOMB  DIABETES.

Now a  new study from Univ. N Carolina (Cantrell ea) shows that metformin is not just major benefit against breast cancer but also against endometrial (womb) cancer.

Emory Univ Atlanta (Narayan and Williamson 2009) claim in a new review that “trials show that lifestyle intervention reduces diabetes incidence by over 50% and is more efficacious than metformin. But neither experience nor realistic long term  trials show this.

Now a  followup report from the landmark Diabetes Prevention Program DPP in the USA ( first reported in 2002) in  middleaged overweight laizzez- faire volunteers (not patients) gives the longest ever controlled observation study (the DPPOS) – a mean of 8.5 years- of the benefits of strenuous lifestyle+ diet (LSD) alone for 8.5yrs, or with metformin  for 8.5yrs plus  strenuous LSD added for 5.7yrs,   or just adding LSD  for 5.7yrs  to the initial placebo laizze faire group.

The outcomes are impressive:

The original placebo group (on average attempted diet + exercise) had a diabetes incidence in the first 2.8years of 11.0 (9.8-12.3)% ie per 100 patient years (ie an enormous 5.5% a year, or perhaps 55% over 10 years); with LSD for the next 5.7 yrs their incident  diabetes halved to 5.6 (4.8-6.5)% ie perhaps 1% a year- a reduction of about 82% .

The original LSD group after 2.8yrs had had a new diabetes rate of 4.8%; continuing this regime for 3 times as long saw their new diabetes rate climb to 5.9%;

but the just metformin group- who had new diabetes rate of 7.8% – with added LSD for 5.7yrs saw their new diabetes rate fall further to 4.9% (compared to 11% on placebo and routine counseling) – and unlike the LSD-alone group, they maintained their original weight loss, in fact those over 60years maintained a further 2kg weight loss. Compared to the original placebo group diabetes incidence of 55% over 10years, metformin plus sustained exercise lowered new diabetes to about 8,9% over 10years ie 84% reduction in risk.

Thus this unique 10year study confirms that adding even lowdose metformin to LSD more than halves the incidence rate compared to  the average laizzez- faire patient on feeble diet-exercise alone, and maintains better fatloss than either mild or strenuous LSD alone. We know from clinical experience that titrating metformin to tolerance can maintain weight loss of 8% -provided it is not combined with psychotropes that hugely increase weight gain..

Thus there is every reason to always add metformin cautiously from the beginning to diet-exercise counseling in every overweight patient battling to lose fat and regain fitness, to abolish the lethal risks of metabolic syndrome and its diverse consequences- diabetes, cancer, cardiovascular disease, arthritis, dementia  etc.

It is common knowledge that less than 10% of patients maintain significant weight loss on any diet and exercise regime- it goes against human nature. The DPPOS confirms that preventative metformin to tolerance plus sensible diet and exercis is  the only regime that maintains weight loss and thus improves all health- drastically lowers all-cause premature disease and mortality.

No heavily marketed  designer “appetite/weight suppressant” drugs remotely achieves all the benefits of metformin, a unique  anti-glycation antioxidant,  appetite and weight suppressant, and anti-cancer, -stroke, -vascular , -infection, -arthritis , -infertility, and -dementing- disease natural nutrient. Hence as previously described, Big Pharma and the Disease Industry do all they can to suppress it’s preventative use (including having Regulators threaten us) , since no modern designer drug can compete. A short-term study (3 months) like the new University California Davis trial (Banazewska ea) (of statin versus metformin in PCOS) says nothing about the longterm benefits that matter to patients- not the Drug Industry whose concern is shorterm profit at all cost.

SWINE FLU UPDATE 11 NOVEMBER:………………… ODDS OF DYING OF SWINE FLU 1 IN A MILLION? WHY REGIONAL DIFFERENCES IN MORTALITY? WHY KAFKAESQUE U.S.GOVT.RESPONSE?………… IF SWINE FLU IS RAMPANT IN N.AMERICA,………… WHY STILL NO CLINICAL VACCINE TRIAL RESULTS? WHY THE CONSPIRACY TO AVOID RCT OF CLINICAL EFFICACY OF S.F.VACCINE?

neil.burman@gmail.com Cape Town

This WW1 Armistice day 20091111: A new report quotes the CDC projection that “4000 rather than 1200 Americans have died of swine flu since April.. and that the  University of Minnesota Center for Infectious Disease Research thinks deaths are likely to be in the 30,000-to-40,000 range, and would have a long way to go to even get there… The vaccine should also cut the death rate.”.

Yesterday an appeal from the FDA Commissioner of Food and Drugs went out to all to promote the swine flu vaccine. But Dr Hamburg does not quote one iota of evidence that the vaccine does or will do more good than harm- especially in those at highest risk, the pregnant, the  old and ill and infants. She fails to address the cardinal issue: why have no trials so far assessed the benefit of the vaccine (on swine flu infectivity and morbidity)  against placebo on a background of well-known anti-infective natural safe supplements?

It is perfectly obvious that with an apparent infectivity rate of swine flu well above 1:1000, but an apparent linked mortality rate of  2 per million of population per month through September-October- the USA- the FDA CDC and the other interlinked countries at highest risk- Canada, Australia,  UK, Brazil, Argentine -  had a duty to see that the vaccines were immediately tested in double-blind RCTs against placebo injection in volunteers-  at least the apparently moderate risk ie the well young, but most of all  in the high-risk groups ie the age extremes, pregnancy and those with serious chronic diseases.

From the already established  spread-, fatality- and complication rate, it is obvious that, during the current upsurge reported by these countries, it would take no more than a few weeks – at a vaccination rate even in Sweden of 2million people in a few weeks, with spread rate of thousands of new  tested cases a month, to produce the crucial answers- how far does the vaccine cut the infection rate, and  the morbidity rate and degree.

Yet according to the NIH Clinical trials.gov registry, there is still no such trial listed. The FDA decided it doesnt require efficacy data on the vaccines.

So it appears that the Authorities in all pandemic  countries are guilty of gross deception- at best  that they know that the vaccine is pretty useless, or worse, that they dont know – and don’t want to know till the vaccine is all used up. Dastardly conspiracy theorizing, by sober scientists,  but that’s what the Authorities’ declared deliberate omission (evasion of such a basic obvious  efficacy trial)  creates.

At least there is a double-blind placebo-controlled  clinical trial of Tamiflu in progress in Hong Kong, in 300 patients with the swine flu, lasting a year. . The outcome is likely to be that, if tamiflu doesnt prove to be worse than the placebo, 300 i far too few subjects to show any significant benefit over placebo.

Bloombergs reports today that Norway has had 6300 confirmed cases by last week and 16 related deaths by Nov 9, but while Sweden had cases doubling weekly to the last week of October, there have still been only 3 related deaths reported . However on Nov 9^th perhaps the 4^th related death was reported in Sweden.  . But Sweden has banned media reporting on swine flu vaccine deaths, which stood at 5 after 2million vaccinations.

It looks like the cumulative swine-flu related deathrate in Europe has reached 0.8 per million population.

20091109  The past week: only one new case has been reported in Southern Africa (Namibia) and no linked deaths in Africa; in Canada between 3-5 Nov there were 14 new linked deaths (14% increase);   in Netherlands 7 people died in the week to 6 Nov, with the total there still only around 20 attributed to the swine flu.

The USA latest  CDC report shows that in the 2 months   to end October influenza-associated death rate was  2 per million of population per month; for comparison, in 2006 the monthly deathrate  was 770 per million, of which influenza and pneumonia  contributed only 2.3%, the 8th  leading cause  after cardiac-, stroke, malignant, lower respiratory, accident, diabetes and alzheimer causes.  Since – accidents aside- all of these commonest fatal  diseases are precisely the highrisk patients that die most of influenza anyway,  it is unclear whether the present increase in ILS ( influenza-like syndrome)  deaths has significantly increased overall mortality

SWINE FLU 1918: There is a graphic  interview on November  5th with a living survivor of the 1918  genuine flu epidemic, which killed some 2.5-3% ie 25 000 of  every million  people   (5% in India) by blue death- drowning-  in at least America, France and Germany, far more in India.  That  H1N1 plague lasted at least 2 years,  infecting perhaps 1/3 of the world population of 1.5billion,  with 50% cross-infection  rate and mortality rate of between 2% and 20% of those infected.

SWINE FLU 1976:  that outbreak never spread beyond Fort Dix, where one victim died. But in the ensuing government panic, 22% of the population were given a hastily prepared vaccine, followed by 1098 cases of Guillaine-Barre syndrome, at least half of which were attributed to the H1N1 vaccine, with at least 25 deaths. A recent review puts this risk (of GBS after H1N1 vaccination) at about 1 in a million- far  higher than  there is now of  healthy people dying of the current swine flu outside the Americas and Australia.

SWINE FLU 2009: it is cold comfort to see the current swine flu  global picture on Wiki at the end of October- a true deathrate of probably <1 per million after at least 6 months. The big question is, will there be more waves of it or, worse, a deadlier mutation caused by hasty vaccination?

The biggest  question, mystery, now is:  if swine flu is indeed pandemic  and spreading at least in America and Australia, why are there still no placebo-controlled trials published confirming that the vaccines and antiviral drugs reduce infectivity, severity and mortality of the 2009 H1N1 virus?

INCIDENCE: While bigger countries have stopped testing all but key or high-risk suspect cases for swine flu,   the smaller countries’ figures of confirmed cases relative to population size are instructive:

closed communities like the Cook Islands, Hong Kong and Macau respectively found incidence of 0.9% – 0.47%;

but only 0.07 -0.25% in other “ islands” world wide – Caymans, New Zealand, Jersey, Bahrain, Iceland, Marshall, Australia, Malta.

Mainland countries that apparently continue screening all who report in with flu symptoms – like Portugal and Belgium -found respectively 0.24% and 0.08% of suspects positive for  swine flu.

FATALITY: As regards death rates: Mexico and South Africa reported apparently related deaths among confirmed swine flu cases as approx 0.7%/1000 infections ; Australia & Japan approx 0.5%; Hong Kong 0.12%; and Germany and Portugal approx 0.02%.

Multiplying  the incidence rate by the case  fatality rate- or more simply dividing the number of deaths by the population- suggests that if you the reader  are generally well, the odds of  your  dying of swine flu are far below  1 in a million; whereas infants, or the elderly,  the chronically ill or  the obese are at far higher risk of dying anyway.  So far there have been some 1500 deaths in 308million Americans recorded in people testing positive for swine flu- that, is some 5 deaths per million- but by epidemiological  reasoning by an  international team, most of those deaths were already in pregnant or  other (chronically) high risk patients  and therefore not attributable primarily  to the swine flu itself- they were already, knowingly or not, at high background risk..

1500 deaths in 6 months  in America is ~0.8 deaths  per million per month, but the  background- all-cause  death rate there averages about 68 per million per month by last CDC count.

Japan and India with the highest population density in the world for  big  developed populations are remarkable – since the first case in their spring 6 months ago,  similar  population deathrates so far  of only 0.00004%  or  0.4 per million.

whereas in USA the official attributed  swine flu death rate so far is  12 fold higher ie  about 0.0005% ie  5 per million. North America’s epidemic  had only a month headstart on the rest of the world.

These fatality rates may be the maximum theoretically, since even in these first-world countries, the great majority of those who did have swine flu symptoms would not have reported in to be tested.

While most cases of swine flu would have been unrecorded- shrugged off-  in both developed and poor countries it is likely that many deaths at the time of maximum scare may have been wrongly ascribed to swine flu. This is what the naysayers about deaths after vaccination (whether against eg HPV- cervix cancer or against swine flu) are arguing strongly- that with mass vaccination superimposed on normal deathrates, the deaths within a few hours of vaccination or within days of  flu  are simply co-incidence, they are unrelated to the co-incidental  vaccination or the flu….

In Canada, “The majority of suspect swine flu patients— over 85%  (in intensive care)    — have some associated medical risk factors.”

The current NICD  stats for South Africa show that 77% of those who died with swine flu had  relevant co-morbidity  – 50% had HIV, 28% were peripartum women, 21% were obese,  11% diabetic, and 9 to 11% had active TB and/or serious cardiac disease. 91deaths is 1.8deaths per million – surprisingly low in the most unequal and reckless population in the world with massive overweight and ischemic heart disease;   the poor  great  majority having  been  increasingly deprived of jobs, education and quality health care, and suffering the  highest AIDs, tuberculosis,  infantile and maternal  mortality rates,  due to criminally negligent government since ‘independence’ 15years ago which has left the majority increasingly worse off.

So while the 2009 swine flu infectivity  the world over  is  probably far above 1%,  the fatality rates  causally related to the flu virus in those who contracted the swine flu in developed prosperous northern  countries (eg Europe, USA, Canada, Japan) was surely well below 0.03% ie <3:10 000;   and in poor countries like RSA and Mexico and India, probably similar since the virus would have spread far more densely in crowded poor communities with  higher malnutrition and underlying common diseases- but more protected by  having already survived poverty-related infections but also having less robust immune response.

It remains a mystery of rational reasoning as to how the wildfire spread of the 2009 H1N1 virus, and the low linked case fatality rates,  justify the promotion by first-world countries of ‘pandemic’ panic and mass treatment  with untested vaccines  and risky antivirals- especially when the vaccines contain  notoriously risky adjuvants like mercury, aluminium and squalene, let alone extracts (and possibly prions)  from species other than humans. These countries seem to have learned nothing from experience the past century with influenza, polio and HIV.

The reasons may be simply economic- Only Disease Pays, it’s a huge boost for healthcare providers, and manufacturers of  “antiviral” drugs, test kits, anti-swine flu vaccines, masks, disinfectants etc.

Why are there such differences in reported swine flu deathrates in similar countries?

Examining regions in the ~  6 months since the the pandemic hit them:

EUROPE: the biggest nation- Germany with 80million people has had  20 000 people test positive ie 1 in 40 000, with 9 deaths  ie about 0.1 in a million of population.

Alpine Switzerland with almost 8million people has tested all suspicious cases with only 1000 confirmed swine flu, and no suspected deaths – but it  has  banned the  Glaxo  vaccine Pandemrix from being used in  pregnant women, children or young adults (below 18 years of age) or elderly (above 60 years of age).

Scandanavia: In Sweden this Glaxo vaccine has already been associated with 5 deaths in the first 2 weeks  -  5 deaths per (2) million population vaccinated in a month   -with  only some 2000 flu cases documented. Yet   so far in 6 months  only 3 -4 deaths there – 0.3 -o.4 per million population-  have been associated with swine flu itself . If 5 deaths there  soon after the swine flu vaccine , out of (2) million people vaccinated in less than a month,  are co-incidental- a vaccine-related death rate of 1:200  000. – one can equally argue that 4 deaths with the swine flu in a month  in a population of 9.2 million is not a causal relationship but co-incidence of death from other causes and not from the passing mild swine flu.. Norway has had 15 deaths ie 3/million; but Finland only 0.4  and Denmark only 0.16 per million. These and Switzerland are all cold countries with some 33million total population, 22deaths representing a fatality rate of 0.66 per million- the same as the average for Europe. Can there be such significant difference in prosperity and social services accross the EU  to explain the vastly different death rates? Or is it just statistical vagary, or  the fault of sensationalist disease-mongering  media?

A warmer but still cool  country like Germany has a swine flu deathrate of only 0.1/million, whereas the warmer British Isles have a rate of 2.5/million. And the  four  Greko-Latin European nations vary from 0.5 in Portugal & Greece  to 1.1 in  Spain to 4/million in Italy. Why the 8 fold difference? they all  take plenty of wine, olive products and a Mediterranean diet; and many citizens travel widely between these old countries and their migrant kith and kin at  the fountainhead  of swine flu  in North America. .

The overall European swine flu deathrate is only 0.78/million, with France – stretching from the Alps to two warmer  major oceans – similar, and the Low Countries only  0.5..  Why deathrates in three prosperous countries  genetically so linked to the rest of Europe but climatically so  diverse as  Norway, Italy  and UK   are so much above the rest of Europe remains to be unraveled.

CONTINENTAL DIFFERENCES:  in poor  South America there are also wide differences with 1.5 / million in Argentine but 7 per million in Brazil and the whole continent,   compared to 3 per million in the colder  North America;  4/million in the warmer  Caribbean; and  9/million in Australasia.  Why should deathrates be the high  in the Americas and Australasia, but 90%  lower in Japan, India and most of Europe?

But presumably the bigger and poorer the population, the fewer swine flu deaths  get reported, tested and  attributed- this may apply equally in Southern Africa, as in India, China and Russia.

Despite the vastly different climate conditions under which the majority of their people lives, the American deathrate so far – 5/million- is 25% higher than in Canada and poor Mexico’s 4/million. But the USA admits that most cases of virus-like pneumonia are no longer being tested for H1N1, there are assumed to be due to it. Yet some sources say that this assumption grossly overestimates the  actual swine flu.

COMPARISON WITH AIDS: while the flu also  knows no social barriers- it merely spreads faster and bites faster  in denser and more vulnerable  poor populations- AIDS remains largely a scourge of ignorance, violence (male) and recklessness(male)- especially amongst politicians, who are  amongst the most promiscuous people globally, but eg  in South Africa also the cruelest in deliberately depriving the population until very recently  of both a semblance of social security and antiretrovirals, while spending the abundance of tax revenue on corrupt profligacy – in unneeded weaponry, and personal luxuries like mansions and (to this day) German limos.

Hence the prevalence rate of AIDS varies from above  15% in Southern Africa ( antenatal HIV prevalence of 30%)  to between o.1 and 1% in the rest of the world; with mortality varying from 50% within a year  of clinical presentation in the malnourished squatter millions  without treatment, to 50% survival after 20years with decent living standard and ARVs etc. In South Africa this year AIDS is said to kill a thousand a day ie 20 per million of population every day ie 7200 per million (7.2% of the population) per year- against a crude birthrate of 2% giving a nett population decrease of 5.2% a year, reducing life expectancy at birth to only 49years .

THE VACCINE  SAGA: MORE DECEPTION WITH MISLEADING TRIAL RESULTS :

HIV-AIDS  VACCINE:  after >30years  there is still no proven safe  relevant vaccine in sight against the HIV.  But if rape and male reckless promiscuity  were stopped, there would be no need for a vaccine since cross-infection is so easily avoided.

SWINE FLU VACCINE: Since there has been  no  trial published of the clinical benefit of the  flu vaccine, no objective  information whatsoever is available to judge it’s efficacy versus risk  in  swine flu prevention.   No significant double-blind  trial has been done offering the flu vaccine versus placebo injection.  The first uncontrolled apparently open trial  started  in Australia 22 July, with results  promised and delivered within 6 weeks ie 2 months ago. It is strange indeed that just 8 weeks after the start of that trial, the Australian govt approved the vaccination campaign. . A medical media report of 11 Sept says only 240 people were enrolled in the trial, age 18 to 64 years ie outside the peak risk agegroups at the extremes of life; and the only result released was that the subjects had a good antibody response.

Even the NEJM official trial report gives no clinical results as to protection- although  the New York Times got it wrong in reporting that the “convincing  trial showed robust  protection” . This conclusion is hysterical nonsense since  the only data reported was the antibody response, which does not mean there will  necessarily be any clinical protection against the swine flu.  There can be  no conclusion  as to whether the vaccine reduced the swine flu infection rate or severity because there was no placebo group, double blind or otherwise. Similarly, the Australian trial in children 10 to 17 years old,  the Spanish trial in toddlers, the USA trial  in pregnancy,   and the Chinese trial, showed good antibody response by 10 days – but gave no result about clinical protection.

So all we need is a simple 2 x 2 RCT of  flu vaccine versus placebo vaccine, with all cases independently covered by eg a supplement of zinc plus  highdose vitamin betacarotene + C + D + K plus fish oil as baseline safety net,  or placebo. The most important question remains: given the huge proven benefit of  safe vigorous doses of these cheap freely available supplements against both flu and AIDS, do people need anything more than a multisupplement to reduce risk of all diseases?  and does adding a costly hazardous H1N1 vaccine on top of that give worthwhile better protection against swine flu? The answer must be overwhelmingly NO, given the risk of at least GBS if not anaphylactic death after H1N1 vaccines. Why take a vaccine if it’s risk is  far worse than that of the swine flu itself, let alone  simple all-system multinutrient prevention that reduces all-cause mortality by at least a third?

But the last thing that vaccine manufacturers,  marketeers and governments  want is a negative answer, so they dont allow such a trial- is it because they lack courage, or that they already know the answer is negative, or worst of all,  that the vaccine is worse than useless?

Some may argue that it is unethical to offer nothing ie double placebo in such an RCT with rare but arguably serious virus-related complications. So all could be covered by at least a simple standard multivite a day at below RDA levels- which by all accounts gives marginal if any benefits except in the malnourished.

Obviously the difficulty with such a virus trial  is cost and invasiveness:  in  an RCT of the vaccine, one ideally needs to have  both serological and culture screening for this hybrid H1N1 virus at baseline – as well as placebo-controlled evidence of reduction in disease. Since the swine flu is so far milder than seasonal flu, there is no other way of defining whether a specific swine flu  vaccine is of significant overall benefit against this H1N1 virus.

Trumpeting “pandemic” and compulsory vaccination with an unproven vaccine  is a great distraction and profiteering  for governments-  presidents and the Big Business that controls them and their agencies,   beset with insoluble political and corruption scandals as are most. Recently an Australian anti-vaccination group published a damning cross-referenced  litany of evidence against  the trillion$ vaccination industry.

The current “pandemic” distraction with swine flu while they wage war on their peoples, effective martial law implemented or foreseen  in the USA, China,  and South Africa (predicted conversion of the police to a massive politicized  paramilitary, nationalization of all major industry and business and provincial governments), is beyond the imagination of most fiction writers except masters like Margaret Atwood – ‘The Handmaid’s Tale’;  Jose Saramago – ‘Blindness’ and ‘Seeing’;  Gabriel Garcia Marquez ; Franz Kafka.  .

We can only continue to pray, hope that sanity will prevail , that  RCTs  of  both the swine flu vaccine and antiviral drugs are  being done  to prove that they are both useful, necessary and safe. There is no evidence on the internet of this,   suggesting that conspiracy theory may  prove correct – that the whole vaccination and antiviral drugs if not the severity of the ‘pandemic’  are simply the result of disease-mongering for profit, like ever-popular  war-mongering on every continent..

UPDATE NOV 2009: WANNABE ALTERNATIVE HRT eg TIBOLONE LIVIFEM INFERIOR TO APPROPRIATE HORMONE REPLACEMENT.

neil.burman@gmail.com

SUMMARY: No published trials have yet shown any alternatives as good as appropriate HRT (ie estrogen -progesterone- testosterone) for overall long term benefits post menopause.

eg  with  the synthetic progestin tibolone – the 3 year LIFT trial had to be stopped early due to strokes, and in  the 3year LIBERATE trial breast cancer recurrence increased 44%. As the International Menopause Society IMS keeps stressing, all synthetic sex hormones are inferior to appropriate balanced sex hormone replacement for eg menopause symptom relief, and against osteoporosis fractures. Many different modalities relieve the short-term menopause symptoms, but these matter far less than the long term preventable degenerative effects of hormone deficiency- which are the primary concern of patients, carers, internists and geriatricians. The average gynecologist (surgeon) deals only with  menopause symptoms, which mostly subside well within 10 years ie by age 60years – but that’s when all aging medical not gynecological problems start,   increasing  incapacity problems – vascular, cancer, fracturing, mental, mood, fattening, frailty, sex, incontinence and thus loss of decades of quality life.

Analysis To August 18, 2008 ·

The LIFT trial report by Steve Cummings et al (NEJM   August 14, 2008  The Effects of Tibolone in over 4000 Older Postmenopausal Women -mean 68years)  is another nail in the coffin of tibolone.

The LIFT trial was stopped after a median of just 34 months because it doubled strokes – up from 0.34% to 0.66% per year. .

Tibolone,  unlike appropriate HRT, has no significant reported benefit on all-cause mortality, on cardiovascular disease (which increased by 37% – p0.28), on memory/ dementia and on depression , although  it almost halved fractures –  but  it doubled the risk of stroke, trebled rate of breast discomfort and vaginal bleeding- which  rose from 2.9% to 9.5%; even the incidence of cervical dysplasia rose from 3.2% to 7.6%. And it increased weight in this already overweight cohort by an excess of 0.6kg in 3years..

Breast and colon cancer rates were too low to draw conclusions about benefit. “The tibolone group also had a decreased risk of invasive breast cancer (relative hazard, 0.32; 95% CI, 0.13 to 0.80; P=0.02) and colon cancer (relative hazard, 0.31; 95% CI, 0.10 to 0.96; P=0.04)” – but the incidence of these and coronary artery disease were each only 2 – 3% pa on placebo..

So it finally  confirms tibolone as just another synthetic progestin looking for a disease to treat, much inferior to real supplements including  appropriate HRT (vitamin D and   lowdose parenteral human estradiol-testosterone-progesterone) for reduction of all the major diseases of aging. There are no contraindications to, only benefits from  such long term appropriate  steroid hormone replacement.

Update November 2009:

In a further LIFT trial report (Ettinger & Cummings Sept 2008), Tibolone treatment for 3 years minimally increased endometrial thickness, hyperplastic polyps, and endometrial carcinoma.

In a Danish trial , tibolone had no benefit on cartilage degeneration. whereas appropriate HRT has benefit (Forsblad Scandanavia 2004).

In the massive 31-country 2002-4 LIBERATE trial (Feb 2009 Kenemans ea ) in over 3000 women after breast cancer, recurrent breast cancer increased 44% with tibolone over a mean of 3.1yrs. Tibolone was not different from placebo with regard to other safety outcomes, such as mortality (respectively 72  vs 63 patients), cardiovascular events (14 vs 10), or gynaecological cancers (10 vs 10).

A report in September 2009 from Health and Human Services’ Agency for Healthcare Research and Quality suggests that tamoxifen, raloxifene, and tibolone used to treat breast cancer significantly reduce invasive breast cancer in midlife and older women, but also increase the risk of adverse side effects.

Regretfully, tibolone has not fulfilled early  hope that it might be the first designer drug since metformin to be another panacea, reduce all-cause morbidity and mortality even in postmenopausal  women.

It appears that despite 40years  use elsewhere, tibolone (not invented and marketed by a US corporate)  has still not been  and is unlikely to be licensed for use in USA – like SERMS (tamoxifen, raloxifene) its benefits are so limited that they are not  enough to balance it’s risks. .. doubling the risk of stroke and increasing the already high  general risk of breast cancer by 44% in only 3 years. Whereas  all (ie multisystem) risks and frailty are reversed by the safe threescore mix of natural supplements plus appropriate balanced physiological human hormone replacement as regularly set out in this column. .

TIME TO COMPEL LOWDOSE RESERPINE AND LOWDOSE AMILOZIDE AS FIRST LINE THERAPY OF AVERAGE HYPERTENSION.

neil.burman@gmail.com

2009 has been a landmark year of published studies on first-line  hypertension treatment.

IT IS COMMON CAUSE THAT:

i. hypertension is the commonest presenting, simply detectable, monitorable and controllable chronic lifestyle degenerative disease today;

ii. the bedrock prevention and therapy  of essential hypertension is  public- patient  education – exercise, stopping smoking,  and minimizing salt (since 1904) , sugar, alcohol and cooked fat intake so as to reduce overweight;

iii. genetics and the above risk factors aside, three  of the primary “endogenous” causes and easily correctable  of essential hypertension are water deficiency , marine omega3 (EPA eicosapentanoic and DHA docosahexanoic acid) deficiency, and insulin deficiency if not frank adiposity/overweight and diabetes.

So adequate water intake, and fish oil, and metformin/galega to tolerance, (in appropriate adipose/overweight  cases) are cornerstones of antihypertnsive therapy along with diet and lifestyle changes before any antihypertensive drugs are added.

Recently there have been contentious suggestion  (eg Law and Ward UK 2009)  that target bloodpressure should be that of youth- 120/70 down to 100/60 – as long as it does not fall so low that the patient gets dizzy on standing up. But the non-contentious gold standard remains  that no one should be left with bloodpressure above at most 140/90 sitting.

ANTIHYPERTENSIVE DRUGS: There are over 1751 RCTs (since 1965) on Pubmed in adults aged over 45years with the ABCD of antihypertensives- Alpha-and ABs angiotensin -blockers, betablocker,  CCB, and Diuretic.

Yet no trial has shown  lower cost, and better superiority and safety  of any modern-drug  or combination over the triple-combination  lowdose amilothiazide (thiazide since 1956, amiloride since 1967)  with  lowdose reserpine(rauwolfia-derived- used since 1949). Since the German Reserpine trials, and results of ALLHAT and SHEP showing that reserpine as add-ongave  by far the best clinical outcomes, no head-on trials against modern drugs dare be done by drug companies or the clinicians they employ.

Over a year ago this column   reviewed that fifty year old treatments of overweight -hypertension – diabetes are still best, echoing this author’s SAMJ analysis 24 years ago of New antihypertensive drugs–blessing or costly nemesis? .

In 1989 pharmacist Alan Taylor published his MPharm thesis (Rhodes University)  on Cost Effective Antihypertensive Therapy at A Day Hospital. – showing in a prospective randomized controlled trial for 4 months that stepped care (starting with a mean untreated BP of about 200/120) achieved the target BP (<165/95) in 73% compared to 11.5% on individualized treatment, and with a cost saving of 36%, with somewhat lower incidence of side effects. Hydrochlorothiazide HCT 12.5 to 25mg/d was the first step;  methyldopa 250-500mg/d or reserpine  0.1mg/d  as the 2nd; hydralazine 10-50mg/d  low dose as the 3rd, alternatively atenolol  100mg as the 3rd or 4th step. Individualized treatment reduced bloodpressure by a mean  32.6/19 whereas stepped-care did so by 51.6/29.5mm Hg.. The HCT-Reserpine-Hydralaz-atenol regime was the most frequently prescribed (in 61.6%),

And in 2007  Barzilay ea documented . Getting to goal blood pressure: why reserpine deserves a second look.

and  in 2007 Rayner, Blockman ea from the Hypertension Clinic    at Groote Schuur Hospital found that at two community  health clinics  in Cape Town, only 40% of patients achieved a bloodpressure belwo 140/90, on a mean of 2.4 drugs per patient  www.ncbi.nlm.nih.gov/pubmed/17446953 – clinics where reserpine and amilozide were removed from the available drug list years ago.

MODERN DRUGS?  But why should patients be subjected to the multiple and indisputable major risks of modern antihypertensive drugs compared to the gold standard lowdose reserpine and low dose amilozide? eg

ABs angiontensin blockers - ACEI agiotensin converting enyme inhibitors and ARBs angiotensin receptor blockers like enalapril, candesarten  - pervasive cough, rashes, but far worse, lifethreatening angiodema, asphyxiation, skin sloughing; and now well-recognized slowly progressive loss of kidney function- which doesnt always reverse on stoppong the drug (Onuigb ea  21008, 2009); Suissa ea at McGill University published the first major longterm – > 10year- followup of hypertensive patients, showing that compared to thiazide,  only  ACEI increased the risk of endstage kidney failure  4.2 fold.

betablockers like atenolol, metoprolol – too slow heart rate, cold extremities, more depression, impoence,  asthma, glucose intolerance/ diabetes, heart failure, deaths;

and even calcium channel blockers -the gold standard of which is amlodiopine- have a formidable list of potential adverse effects (that lowdose reserpine and amilozide lack), of which some may be major nuisance if not dangerous (from the Sandoz product sheet): “Often: dizziness; palpitations; muscle-, stomach- or headache; dyspepsia; nausea – in 1 in 100 users; Sometimes: blood disorders, gynecomastia, impotence, depression, insomnia, tachycardia – in 1 in 1,000 users;  erratic behavior, hepatitis, jaundice – in 1 in 10,000 users; Very rarely: hyperglycemia, tremor, Stevens-Johnson syndrome – in 1 in 100,000 users. “  From the trials and experience, lowdose amlodipine is certainly the modern drug of choice to add if counselling plus ceiling doses of reserpine and amilozide, plus metformin for underlying adiposity/insulin resistance,  do not adequately control hypertension.

Why use these modern drugs with their major potential hazards  except for special circumstances last ditch?; when lowdose reserpine plus lowdose amilozide titrated to best effect rarely need a 4th drug added for good BP control;  and practically – unlike methyldopa, guanethidine and more modern drugs-  never causes persisting symptoms.

THIAZIDE ADVERSE EFFECT possible in even very low dose: anaphylaxis: Goetschalckx ea in 2007 could find exactly 49 case reports of thiazide-induced pulmonary oedema in the literature after 50 years of use in millions. Thiazides are obviously sulphonamides, but fortunately serious- anaphylactic- reactions like lupus vascullitis and shock  are extremely rare. Wikipedia does not even mention these under thiazides, and no abstracts on Pubmed even guess at their rare  incidence.

RESERPINE:   In 2007 Jos Barzilay ea documented Getting to goal blood pressure: why reserpine deserves a second look.

We last year examined closely the trials on thiazides and reserpine 1, 2, 3.  

Last year  we published the only ever tabulation of all accessible trials  of thiazides and reserpine, showing

in the thiazide dozen trials between 1985 (the UK MRC trial)  and 2003 (the CONVINCE trial) that  in 115000 patients for a mean of 4 years,  thiazide is as good as or better than all more modern drugs;

and that reserpine in 13 trials between 1977 (the Veterans’ Admin trial) and 1997(the German reserpine research group trials)  in 7500 patients for 1 to 3 years is as good as or better than all more modern drugs. Of course  the 2003 ALLHAT  and CONVINCE papers were by far the biggest trials validating thiazide as the gold standard in 50 000 patients for  3 and 5 years respectively; and the VA trials of 1977, 1982 and  and 1990 in 1479 patients showing reserpine as equal or superior to betablockers,  and the German trials of 1997  in 400 patients validating reserpine as equivalent to thiazide or a CCB, and the combination of thiazide and reserpine superior to an ACEI.

Now in 2009:

Shamon ea’s Cochrane review last month confirms that reserpine  alone is at least equivalent  in antihypertensive effect to any  modern first line antihypertensive alone ;

Wald and Law’s metanalysis of single or combination antihypertensives confirms that  “The extra blood pressure reduction from combining drugs from 2 different classes is approximately 5 times greater than doubling the dose of 1 drug.”

Wright ea’s Cochrane review confirms that  “thiazides reduce all-cause mortality by 11%;   Low-dose thiazides (8 RCTs) reduced CHD  by 28%; Beta-blockers and CCB reduced stroke by 17% and 42%, but not CHD  or mortality . ACE inhibitors reduced mortality 17%; , stroke  35%.      No RCTs were found for ARBs or alpha-blockers.” However, the abstract does not enumerate the major adverse effects of betablockers and ABs.

Wright ea’s   ALLHAT reanalysis confirms that thiazide was superior to the ACEI, CCB, betablocker and especially the alphablocker doxazocin. “neither alpha-blockers, ACEI nor CCBs  surpass thiazide-type diuretics (at appropriate dosage) as initial therapy for reduction of cardiovascular or renal risk. Thiazides are superior in preventing HF, and new-onset DM associated with thiazides does not increase CVD outcomes.”

Costanzo ea’s Italian study confirms that CCBs reduce the risk of stroke by 14% compared to ACEI; reduce allcause mortality by a trivial 4%; increase heart failure by 17% compared with ‘active’ treatment;

Hoffman ea’s review from New York confirms that, in autopsies of Alzheimer cases, those on antihypertensives had far less plaques that those without hypertension.

Sozen ea confirms that  ”ABs- Drugs with blocking effects on the renin-angiotensin-aldosterone system -  do not improve endothelial dysfunction long-term in hypertensive patients”.

Mackenzie ea’s Comparison of the effects of antihypertensive agents on central blood pressure and arterial stiffness in isolated systolic hypertension shows that central Pulse Pressure was only reduced significantly by perindopril, lercanidipine, and bendrofluazide, whereas atenolol had no effect. Lercanidipine reduced the augmentation index, whereas atenolol increased it. Aortic pulse wave velocity was not changed by any of the drugs. In summary, despite similar reductions in peripheral systolic and PPs with the 4 classes of drug, changes in central pressure and augmentation index varied. Because central PP and increased wave reflections are considered important risk factors in patients with isolated systolic hypertension, the choice of therapy may be influenced by these findings in the future.” Nothing illustrates better why the triple combination of amilozide and reserpine is the best.

It has previously been pointed out that in the long term Cache County study, potassium-sparing diuretic was the only antihypertensive that lowered- in fact by 75% – the incidence of new Alzheimers disease;  and amilozide-like combinations are more effective than either component alone in safely and effectively lowering hypertension. – Patterson Dollery & Haslam in 1965; Rosenfeld in 1980; and the Multicenter Diuretic Cooperative Study Group in 1981.

CONCLUSION:  Reserpine has indisputable central and peripheral benefits in lowering central pressure via mild lowering of anxiety, cardiac rate and cardiac output; and  peripheral vasodilation;                 while thiazide and amiloride both lower both excessive body salt and water, while thiazide vasodilates and conserves calcium,  and amiloride  reverses the  potassium -magnesium depletion  seen in hypertension and with thiazide. .

Since the lowdose combination of reserpine and amilozide is superior to all other first-line drugs alone or in combination, and retail costs about   US$1 a month in South Africa, (with negligible adverse effects compared to all other antihypertensive drugs), this combination is the mandatory  firstline therapy for all  hypertensive patients, with rare exceptions. These start with amilozide 13.75mg (1/4 tab) and reserpine 0.0625mg (1/4tab) /d- and many patients can eventually be controlled with these doses just 3 days a week; with other antihypertensives added only if hypertension is not controlled with these increased to the ceiling tolerated eg of amilozide 27.5mg/d and reserpine 0.125 mg/d (maximum reserpine 0.25 mg 5/week ie 0.18mg/d if tolerated).

Since roleplayers are there to serve patients, not the Drug and Disease Industry, all roleplayers ( the national Hypertension society , the provincial and state health and medical school authorities, medical schemes and all health practitioners)  have no choice but to obey the gold-evidence-based medicine set out herein, and reinstate reserpine and amilozide as mandatory 1st-line therapy of essential hypertension, with motivation  for alternatives to be provided in the  exceptional cases.

Unlike the USA and the East  where reserpine is still in national recommendations,  Authorities, regulators, suppliers and prescribers  in South Africa, Australia, the UK and Europe can no longer continue to defraud the public and deny patients this best treatment, since the two tablets (cheap amilozide and reserpine) are freely and universally available for  at most the retail South African prices quoted (less in bulk buy).

There is no shortage of reserpine;  and the evidence for them over all modern antihypertensives  is binding under  rules of evidence and therefore medical ethics. The current evidence discussed shows that this  old lowdose combination is superior to all modern drugs and modern marketted combinations in both reduction of all-cause endpoints, adverse effects, and cost.

And if proof is wanted, we must agree on a simple multicentre trial of the lowdose reserpine-amiloretic regime versus modern marketed combinations.

SWINE FLU UPDATE 30 OCTOBER: WANING DEATHS EXCEPT IN THE POOREST, AND THOSE GIVEN THE GSK VACCINE, OR SEASONAL FLU VACCINE ! :

THE W.H.O. PROMOTES EARLY TAMIFLU AND RELENZA FOR SEVERE CASES:

The WHO briefing note 13 dated 16 OCTOBER 2009 is particularly relevant to Africa:

“ Clinical features of severe cases of pandemic influenza: Pandemic (H1N1) 2009 says On the positive side, a growing body of evidence indicates that prompt treatment with the antiviral drugs, oseltamivir or zanamivir, reduces the severity of illness and chances of dying. These findings strengthen previous WHO recommendations for early treatment with these drugs for patients who meet treatment criteria, even in the absence of a positive confirmatory test.

In addition to pneumonia directly caused by the virus, evidence shows that pneumonia caused by bacterial co-infection can also contribute to a severe rapidly progressive illness. Bacteria frequently reported include Streptococcus pneumoniae and Staphylococcus aureus, including methicillin-resistant strains in some cases. As these bacterial co-infections are more frequent than initially recognized, clinicians stressed the need to consider empiric antimicrobial therapy for community acquired pneumonia as an early treatment. .

Disadvantaged populations, such as minority groups and indigenous populations, are disproportionately affected by severe disease. Although the reasons for this heightened risk are not yet fully understood, theories being explored include the greater frequency of co-morbidities, such as diabetes and asthma, often seen in these groups, and lack of access to care.

Although the exact role of obesity is poorly understood at present, obesity and especially morbid obesity have been present in a large portion of severe and fatal cases. Obesity has not been recognized as a risk factor in either past pandemics or seasonal influenza.

Yet the great majority of the South African population, with amongst the highest rates of stress- violence – murder- joblessness- poverty, obesity-diabetes, squalor, malnutrition, AIDs and resistant tuberculosis in the world- ie immunodepletion- has not seen a progressive swine flu epidemic the past two wet weeks. There has not been a swine flu death or seriously ill case reported in South Africa for weeks. Is this surprising when thousands  are dying daily of rampant violence, AIDs, TB,  etc?

GSK VACCINE  RELATED TO MORE DEATHS THAN THE SWINE FLU ITSELF?

And from Sweden, it is reported that while THREE  patients have died there  so far with the swine flu, since vaccination started there a fortnight ago   FIVE patients aged 50 to 90 years have died there  within days of vaccination with the  Glaxo GSK (Pandemrix/Arepanrix- containing aluminium, mercury and squalene) vaccine-  that is also being given in Canada and UK.

Yet the WHO figure today for swine flu deaths in Sweden is still given as only 2.

If death within days of contracting swine flu is attributed to the swine flu virus, then surely unexpected death within days of swine flu vaccine must equally be attributed to that vaccine?

What could be the reason?

It may be that the young are more likely to die from the new H1Ni mutation because with their high immune reactivity  and  not previously exposed to it ie desensitized, so it may cause a cytokine storm that wipes out their lungs.

So why should the elderly be dying after the Glaxo vaccine? Perhaps paradoxically for the same reason as the virus itself is killing children- the Glaxo vaccine contains immune boosters to gear up the body’s antibody response, which response may overwhelm the previously naturally immunized person whose systems are no longer as tough as they were.

It is difficult to find out on the Internet what formulation of anti-swine flu vaccine is being given around the USA. Perhaps it does not contain as much immune booster as the GSK vaccine. It seems that neither suppliers nor the US Govt believe that the public has a right or need  to know what it is being forced to be inoculated with, and pay billions of dollars for. .

Based on the 1918 and 1976 fiascos, and the US license now given vaccine companies to sell whatever untested vaccines they like ie with whatever adjuvants they choose,  without fear of immunity in case of mishap, manufacturers now have a license to make $billions without any risk. The Swedish experience already points the way to carnage- at taxpayers expense since legislators and highranking officials (apart from a convenient chosen scapegoat) are never held accountable.

DEATHS AFTER SEASONAL FLU VACCINATION?

and now Korea reports 5 sudden deaths after seasonal flu vaccine- all in subjects over 80yrs but one at 51yrs – since the Govt began providing free vaccine shots to the elderly. .

but paradoxically,  parts of Canada have suspended vaccination against seasonal flu for those under 65yrs after evidence that this vaccine may increase the risk of swine flu. And some have suggested that seasonal flu vaccine may cross-protect against swine flu- hence there are some advising that kids under 2 yrs have their seasonal flu vaccine postponed!

IS THERE A VITAMIN (D3) CONSPIRACY OF SUPPRESSION?

neil.burman@gmail.com Cape Town.

This column regularly  reviews and refers  to  the contentious issue of Regulators and Big Pharma suppression and disparagement of natural micronutrient supplements - The Vitamin Wars in which Jack Drummond and Linus Pauling were so embroiled by persecution and assassination-  so as to promote sales of designer drugs and focus on treatment not primary prevention, on the obviously sound shortterm  economic principle that prevention does not pay, Only Disease Pays.

Recent key papers perhaps expose the falseness of the vitamin  conspiracy, the condemnation if not regulatory suppression of free choice  supplements in favour of risky designer drugs like antimicrobials on the FDA’s  (ie the New Drug Industry’s)  efforts to protect the Disease Industry with the self-serving but poor argument  that experience and observational and evolutionary evidence are not good enough, only randomized controlled trial evidence will do.

This despite the major studies that vitamin D in optimal  dose, like vitamin C, in  fact in optimal multinutrient combination, offers better protection – prevention and treatment- than any designer drugs against all diseases, from acute and chronic infections eg  flu, HIV and other  STDs,   and tuberculosis and other bacterial (and parasitemia) infections, to autoimmune, lipid- hypertensive-vascular disease, depression and cancer, prevention of frailty and fractures, even sexual-reproductive health, dementia and multiple sclerosis – as Dr John Cannell of the Vitamin D Council repeatedly details.

Earlier this year a  research centre in San Francisco estimates benefit of increased vitamin D status in reducing the economic burden of disease in western Europe. The reduction in direct plus indirect economic burden of disease was based on increasing the mean serum 25(OH)D level to 100nmol/L, which could be achieved by a daily intake of 2000-3000 IU of vitamin D.  For 2007, the reduction is estimated at euro187,000 million/year. The estimated cost of 2000-3000 IU of vitamin D3/day along with ancillary costs such as education and testing might be about euro10,000 million/year. Sources of vitamin D could include a combination of food fortification, supplements, and natural and artificial UVB irradiation, if properly acquired. Steps to increase serum 25(OH)D levels can be implemented now based on what is already known.

A University Toronto study last month on    How to optimize vitamin D supplementation to prevent cancer, based on cellular adaptation and hydroxylase enzymology by Prof Robert Vieth Univ Toronto, Canada  analyzes the question of “what makes an ‘optimal’ vitamin D intake” ie  ‘what serum 25-hydroxyvitamin D [25(OH)D] do we need to stay above to minimize risk of disease?’. This simplistic question ignores the evidence that fluctuating concentrations of 25(OH)D may in themselves be a problem, even if concentrations do exceed a minimum desirable level. It explains why higher 25(OH)D concentrations are not good if they fluctuate, and that desirable 25(OH)D concentrations are ones that are both high and stable.”

A new study last week from Finland probes the benefits of vitamin D in institutionalized adults with intellectual disability ID, who may eat poorly and seldom get any sunshine. . Those given 800iu vitamin D daily for 6 months did better than those given simply 150 000iu imi at the start, when all had a mean vit D bloodlevel of 40nmol/L, the oral dose group having a final level of 82 compared to 62 nmol/L in the other group. PTH fell in both groups, but target D3 level of 80 was attained in 42 % orally vs 12%  imi.

and now this week Pietras ea from Boston  detail how Vitamin D₂ Treatment  50 000iu fortnightly for up to 6 years for Vitamin D Deficiency and Insufficiency in Boston increased vitamin D levels from 67  to 117 nmol/L, without change in blood calcium, and no kidney stones- but with persistent vitamin D deficiency in perhaps 10%, for a variety of possible reasons. They agree that oral vitamin D3 is the best preparation. This is retailed in South Africa for as little as  R6 (($0.80)  per 50 000iu. In fact, unless the patient has shortterm absolute contraindication to oral-enteral  supplement, there is no better (ie parenteral)  route  for vitamin D3 if not all supplements than via the stomach.

The short answer is that, from local and international experience with such doses, there is indeed no evidence of harm, only benefit- ie nothing to lose. Prudence dictates query about history of hypercalcemia/ kidney stone problems, and baseline and followup check of at least serum calcium phosphate and creatinine if not also vitamin D  levels, to judge whether dose of 2000iu or 10 000iu/day (or 50 000iu every week or month)  is both enough to produce stable blood level in the range of 125 to 150nmol/L, and safe for the individual.

SWINE FLU UPDATE: TAMIFLU/RELENZA/VACCINE- TOO LITTLE TOO LATE, TOO LITTLE EVIDENCE IN MORTALITY DATA FROM CASE STUDIES. EVIDENCE FAVOURS NATURAL SUPPLEMENTS.

see waning-deaths-except-in-the-poorest-and-those-given-the-GSK-vaccine/

Apropos the current  Swine Flu Conspiracy debate:

N D Burman Cape Town.

As the first 4 sudden deaths within days of swine flu vaccine are reported from Sweden and one from Hungary, and 39 cases of Tamiflu-resistance swine flu isolates have been reported,

Roche the manufacturers of Tamiflu yesterday kindly supplied studies  published 12 October from Canada and Mexico which are most valuable,   most of the victims depressingly young.

Their breakdowns don’t give a global figure of how many of the 226 patients had serious relevant comorbidities ie immunosuppression, cardiopulmonary, diabetic or morbid obesity. One cannot derive the number of serious comorbidity patients from the Mexican paper – in the Canadian paper only 30.4% had ‘major’ comorbidity. .

In the bigger 17week Canadian narrative series of 168 critical hospitalized cases there from April to August, 81% required ventilation;  90% received antivirals, so they cannot judge if these drugs  had benefit or were adverse; mortality was only 17.3% by 90days – promising, but in  a healthier northern population? from more sophisticated costly care? antivirals? or what?.

The smaller 10week Mexican series – 58 critical cases in 899 hospitalized (confirmed or suspected, not necessarily critical) cases from April-June is more helpful: 97% required ventilation; mortality was 41.4% in these critical cases by 60 days; survival was an impressive 7.4 fold higher in the 78%  (45) who received Neuraminidase inhibitors who did not, p <0.006 – but the numbers were small (especially the 13 who were not given NAI), and  they give no table to judge how they arrived at these odds, or the criteria by which NAI were given or were not given.

Neither of these studies  are trials, so one cannot draw any objective conclusions about Neuraminidase Inhibitors NAI effect on serious morbidity or mortality. Considering that hyperacute patients die too fast, and the rest only receive NAI after 3-4 days if sick enough, only a prospective RCT randomized controlled trial with NAI  in all suspected flu cases- with retrospective viral typing  of samples -can show this, and truly assess cost/benefit. The cemetries are littered with acclaimed drugs that were widely used for years until enough deaths occurred for it to become clear that the drugs were actually killers. But legislation enacted by the last Bush Administration  imdemnifies manufacturers from any liability in cases of calamity from their drugs!

Fortunately, with the swine flu rapidly on the decline at least in the USA, manufacturers cannot supply the millions let alone billions of doses  of swine flu vaccine that they and the USA authorities targeted. As HealthNews says, how can they produce anything safe?

By contrast, increasing numbers of practitioners are reporting virtual abolition of swine flu outbreak in patients (both in private practice and in institutions) who take a modest vitamin D3 supplement of 4000-5000iu/day (with up to 1000iu/lb /day for 3 days in any acute infection) .  Obviously the prudent will balance this with the usual protection from at least 800mg marine omega3 oil (eg 3gms 30% or 1g 80% fish oil; and a good multimicronutrient supplement including betacarotene;  zinc; oral ACS colloidal silver;  sutherlandia;  sniffing vitamin C powder; and  a few grams a day of oral  vitamin C – just not enough to cause diarrhoea.

email from Roche: Sent: Wednesday, October 28, 2009 5:41 AM “You can imagine that with the sudden unexpected pandemic all they tried to do is to determine whether the traditional neuraminidase inhibitors like Tamiflu will be effective in treating and preventing the duration, severity and incidence of co-morbidities of the new strain of influenza. .  Fortunately the odds are still in favour of receiving early treatment. We know that Tamiflu is effective in the treatment and prevention in most seasonal and pandemic strains of influenza A and B with very little resistance reported so far. The CDC site is a very useful resource for new information….”

SWINE FLU (?CONSPIRACY) UPDATE- PANDEMIC THAT NEVER WAS: WHAT A WINDFALL FOR THE UNITED $TATES OF EURO-AMERICA.

n d burman cape town

News on the 2009  swine flu pours in daily- see this column’s   last report only 4 days ago.

Roche’s response arrived a few days later.

Conspiracy theory: Definition: “A  theory seeking to explain a disputed case or matter as a plot by a secret group or alliance”…

We all disdain  farfetched conspiracy theories, but some eventually prove true- especially in war, politics and Big Business.  The British Intelligence deception  of the Germans in WW2 over the Sicily landings with The Man Who Never Was was one of the cleverest successful conspiracies at least of WW2. Conspiracy was the downfall of Richard Nixon, but not of  Joseph’s murderous brothers in planning sell him off to slavers going down to Egypt and then telling Jacob that his favourite youngest son had been eaten by a lion; and not of George W Bush- the most successful rogue politician and ruthless warmonger of modern times despite his irrelevant defeat by Al Gore in 2000  in the democratic popular vote. The truth about the $multibillion Armsgate conspiracy (arms which South Africa never needed) between top ANC politicians and various European arms traders is still being suppressed, to protect present and past presidents, politicians and business moguls  in South Africa and Europe…

But since no evidence can be found on Google, Pubmed or the USA Government websites, it is a given  that neither the ”Authorities”  (the Government Health Agencies NIH-CDC-FDA,  the WHO and the European Union) can produce any evidence to justify the claimed pandemic state of 2009 swine flu or its major danger which justify a national state of emergency declaration- in effect, martial law. Truly following in George W Bush’s footsteps after 9/11. Why would Government conceal such public health evidence if there was any? ..

Nor can the same world  ”Authorities”  that regulate and recommend them nor the EuroAmerican  manufacturers  produce any randomized double-blind  controlled trial RCT evidence in humans to satisfy regulatory criteria  for registration and prescription  of  either the recommended (swine flu) antiviral drugs Tamoxifen or Relenza, or vaccines based on both the  hyperinflated but unproven imminent risk theory of this disease or the efficacy versus harm from these costly agents.

So as other sober voices ask, on what evidence  is the USA basing its claims of a dangerous pandemic,  and  its mandatory recommendations? – which are binding on those Authorities’ prudent health professionals as well as on its state employed patients.

The continuously updated USA surveillance report notes explicitly that “Several states have abandoned the counting of confirmed cases. This step is justified by the finding, that at this point of the year more than 98% of detected flu cases are caused by the novel flu. Other states have started to report the number of hospitalized cases instead of infected cases. The CDC discontinued reporting of individual confirmed and probable cases of novel H1N1 infection on July 24, 2009.”  So there are no statistics from the USA to show that morbidity and deaths from swine flu are increasing, let alone attributable primarily to the 2009 H1N1 virus.     In fact  evidence apparently  suggests the opposite since mid-October.

On October 9, 2009, Dr Gary Null & healthcare associates filed for a USA court injunction to stop the FDA distribution of   swine flu vaccines since these violate Federal Law “in its hasty approval of four swine flu vaccines by failing to scientifically determine either the safety or efficacy of the vaccines.”

Profit Driven Swine Flu Propaganda - Pump Up the Volume - is a series of Natural News articles since October 21 by Evelyn Pringle, health freedom writer exposing a conspiracy by rogue USA Government’s arms and Disease  Industry to extort the biggest profiteering in history from drugs and vaccines forced on  billions of people -who may (as in the  previous ‘emergency” 1976 pandemic that never happened) derive far more illness than benefit from these unproven drugs.

Authorities - the FDA itself, no less- have hastily on 15 October racked up up this brutal campaign – now against Dr Andrew Weil – to suppress natural nutrition approaches that both work and are safe so as to favour their Disease Industries’ snakeoil profiteering. Under the mantle of no less than a Presidential State of Emergency declared this day October 24  over the nonexistent swine flu pandemic, they impose a ban on  disseminating knowledge- the benefits of proven naturally beneficial nutritionals  eg vitamin C; or astragalus – despite decades of evidence supporting it-  while at the same time stating blatantly ” The Secretary of Health and Human Services, under section 319 of the Public Health Service Act… has determined that a public health emergency exists nationwide involving the H1N1 Flu Virus that affects or has the significant potential to affect national security. Following this determination and in response to requests from the U.S. Centers for Disease Control and Prevention, FDA issued letters authorizing the emergency use of certain unapproved and uncleared products or unapproved or uncleared uses of approved or cleared products...” ie vaccines designed and hastily manufactured only this year, with no  efficacy trials to show reduction in serious illness and deaths and no longterm human safety record, containing known dangerous ingredients.

As if millennia of genocidal suppression of free choice and rights – the Martyrdom of Man – by those in power since recorded history began  was not enough. The greedy and ruthless learn well to manipulate power progressively to subvert justice and security  for all, as Churchill, Ivan Illich, JK Galbraith, Margaret Attwood, Tom Bower, Joe Stiglitz, Naomi Klein, Al Gore so eloquently wrote, and Kissinger’s Kindergarten (Bush father and son, Cheney, Rumsfeld, Wolfowitz) have so profitably  done  the past 35 years for themselves but not the nations including the USA that they sabotaged..

And today Dr Joe Mercola   reports on the CBS expose of massive US  CDC disinformation on their website  about the swine flu “epidemic” in the USA – which is reportedly contradicted by the individual US state health spokespeople.  Finland and Russia at least deproclaimed the pandemic, since nothing has been seen of the disaster predicted for the Southern hemisphere’ past winter – today being the official first day of Spring- , nor for North America in this  October fall month.

Just count  the untold $billions in profits for the USA via the companies who control the FDA – and for governments  around  the world who conspire with the disinformation  and largesse promoted by the  Disease-Industry controlled FDA and EU and  WHO.

It should be noted that Tamiflu is distributed by the Swiss-USA-based  giant Hoffman La Roche; Relenza marketed by UK-USA  giant GSK; and swine flu vaccines are now being mass produced by archaic methods (in hens’ eggs, animal cell cultures)  by GSK , Baxter international (USA) and Novartis (Switzerland-USA)  - containing amongst others the feared neurotoxins mercury-thiomersal, squalene (and- who-knows-even aluminium?)  to be injected, not taken orally when they are likely harmlessly excreted.  Co-incidentally, it was a USA Baxter heparin batch that was found to be contaminated, and in early 2009 a Baxter seasonal flu vaccine  vaccine batch destined for the Czech Republic that was found there to have contamination by a deadly H5N1 strain. Not to mention the US Merck’s intended universal flu vaccine. ; and Merck’s and GSK’s notoriously controversial anti-cervix cancer vaccines which have   been associated with much death and illness in young girls after it too was made mandatory in many regions, despite lack of evidence of benefit in longterm RCTs.

Furthermore, wiki reports that “In January 2009 the  USA awarded Swiss-based Novartis a $486 million contract for construction of the first US plant to produce cell-based influenza vaccine - to be located in North Carolina, aiming to produce  150,000,000 doses of pandemic vaccine within six months of declaring a flu pandemic”.

How’s that for strategic prophetic planning, 2 months ahead of the California-Mexico swine flu outbreak? .Some call it disease-mongering.

What an ‘unexpected’  windfall  the coincidence  of the outbreak of the American-Mexican swine flu epidemic 6 months ago has been for USA –  UK - European-based Disease Industry mega-corporations – all of which have at least one foot in USA-  and thus governments.

Is the outbreak and ensuing $billiondollar industry a fortuitous windfall? As the saying goes, success is not built on luck but on wise  planning.

So the jury will inevitably favour conspiracy theory until the Authorities involved produce the scientific evidence to justify the swine flu “pandemic” proclamation and the multi $billion antiviral drug and mandatory vaccine campaign against the still-awaited swine flu holocaust.

Why does it take the mind  back  to the 2003 USA Bush gang’s  decision  (that made their allied corporations  $billions, and made USA  the world’s biggest aggressor and debtor) to occupy  and destroy Iraq based on USA- ‘Intelligence”-fabricated  evidence that Iraq was a nuclear threat? and the world’s worst Great Depression ever  the past year as a result of Bush- Blair regimes’ conspiracy with the criminal  banking and stockbroking industry?

GROWING TAMIFLU-RESISTANT SWINE FLU: WHERE IS THE EVIDENCE THAT TAMIFLU DOES MORE GOOD THAN HARM? – ROCHE CANNOT PRODUCE ANY. AND WHAT ABOUT THE LETHAL H5NI FLU?

ANTIVIRALS FOR SWINE FLU?                      neil.burman@gmail.com cape town.

Twenty eight patients with swine flu virus resistant to the only apparently available oral antiviral , Tamiflu, were reported world wide by the WHO by 25 September.  Given that no countries can afford to screen for  flu in  even 1% of the thousands in every town  who have some symptoms of flu every day, the specific H1H1 swine flu  causes serious complications in apparently below 1 in 1000 cases, with mortality probably below 1 in 10 000 of those who contract it, considering that the virus has spread faster than an Australian or Californian  bushfire.

But given the pandemic nature of the outbreak, and the stockpiling of multimillion Tamiflu tablets, at a cost in South Africa of some US$30 per course, it is increasingly strange that no report has yet appeared of a randomized controlled trial of Tamiflu to show that, for it’s cost and especially adverse effects in children, it gives any significant protection for the rare life-threatening case. Its use is therefore purely speculative.

All it needs is to randomize double blind say 100 000 young people who complain of early flu to Tamiflu or identical placebo capsules- which would cost Roche pennies. We could have had the answer about Tamiflu’s benefits versus risks within weeks given the rate of spread. At a rate of swine flu infection of say 1: 1000, it should be proven within weeks whether swine flu has a proven infection rate of even 1:100, and of those who do get serious, of even 1:1000 serious complications- and thus whether Tamiflu is relevant at all in any type of flu.

Why was this Tamiflu trial not initiated by the CDC or WHO already in eg June, when the extent of the outbreak became obvious? It  seems that Roche and the CDC know there is no evidence to depend on Tamiflu- but the USA makes $billions in its sales.

Roche undertook 4 days ago at a Tamiflu marketing promotion to let me have the evidence… still waiting.  in fact, by 23 Oct,  a week after their rep made the commitment, I cant get an answer from Roche on Tamiflu either by phone or by email. Please watch this site for further announcements.

World Press in Iran claims that Tamiflu lowers mortality of   seasonal flu by 37% . But the current Medscape report on this study shows that this figure was anecdotal- not from a randomized controlled  trial but from comparison of patients treated by different teams without standardized prospective criteria and protocols  in two different Hong Kong  hospitals.

Yet the USA CDC - without such hard evidence- blandly continues to advocate Tamiflu use in suspected serious cases despite it’s common complication especially in small children. . And when by all accounts Tamiflu has to be taken within the first day or two of infection, when it is rarely yet apparent how serious the case will be. Their hilariously  contradictory advice means that Tamiflu must  be taken within 48 hours of onset in EVERY flu-like illness

Most serious of all, because of the lack of such a simple RCT, there is no evidence that Tamiflu may not do more harm than good in those at high risk – the young, the old and those with serious underlying systemic disease.

And even more serious, mortality of 61% occurred in the 431 known cases of  encephalitic H5N1  avian flu recently reported. The antiviral efficacy but poor clinical response (2/4 patients died) to Tamiflu in patients with H5N1 encephalitis does not augur well for Tamiflu benefit in serious swine flu H1N1 infection. And the continuous mutations of H5N1 has rendered vaccines pretty useless- again ill omen for swine flu. David Nabarro has been criticised for comparing the risk of avian flu to that of the genocidal AIDS in Africa. But at least AIDs has been converted with adequate nutrition and multiple antiretrovirals  from a disease lethal in about 7years to a chronic degenerative disease (like eg Diabetes) with a potential working lifespan of decades.

And at least the 3year Thai trial of new AIDs vaccines shows 26-31% reduction in new AIDs cases, without serious adverse effects- altho “Vaccination did not affect the degree of viremia or the CD4+ T-cell count in subjects in whom HIV-1 infection was subsequently diagnosed“. Thus, so far it is doing a lot more  than tamiflu or the swine flu,  or HPV cervix cancers vaccine (already with dozens of deaths reported soon after vaccination in apparently well young girls) are doing.

By all accounts, it would be far more effective against all infection , and perfectly safe, to take vitamin D3 – 2000iu/kg/day- for a few days (cost perhaps a few $)  with any suspected infection,  and then longterm 1000iu/kg weekly, together with daily a vigorous few grams supplement of vitamin C powder   (short of diarrhoea) and as snuff  twice daily;  and  daily 10 000iu betacarotene with zinc 20mg, some multivite – multimineral, some eg sutherlandia (cancerbush) and or colloidal silver, and a tsp of codliver oil or a gram of 80% fish oil concentrate,  as immune boost against all infections let alone most acute and chronic diseases.

The only caution with vitamin D is obviously to take reasonable fluids, and be wary in cases with kidney stones;  silent hypercalcemia in which vigorous dose vitamin D might cause problems is fortunately so rare as to make routine testing of vitamin D and calcium levels unnecessary, except obviously in the rare at-risk case with eg cancer or stones.

But such effective holistic prevention of all diseases of premature aging and death is anathema to the Disease industry and thus governments and Regulators, for whom Only Disease Pays.

We can only hope that evidence can immediately be produced to refute such skepticism, since use of Tamiflu (not to mention the now-available but longterm safety- and efficacy-unknown swine flu vaccine) instead of multisystem-protection supplements may  potentially result in much suffering and deaths, as happened with the shotgun Ronald Reagan-era  flu vaccine  that was never needed, but caused many deaths and paralysis from Guillaine-Barre syndrome. .

The harsh reality is that it is AIDS, H5N1 avian flu and multiresistant tuberculosis that is the pandemic threat- not swine flu with it’s rare bad risk.

So promoting massively expensive  unproven Tamiflu and universal  (swine flu  or HPV cervix cancer) vaccination as the USA is doing is immoral.  What is needed  for all  is  secure law and order, education, jobs, housing, clean power  water and  air,  and food, and fish oil and the appropriate supplements listed.

24  Oct :  see  update of 21 October for more revelations.

NEGLIGENT DOUBLING OF RISK OF DEEP VEIN THROMBOSIS DVT RISK BY PRESCRIBING ORAL XENOHORMONE THERAPY HT POST MENOPAUSE.

We have all lost relatives, friends, patients by  pulmonary embolism, let alone seen the devastating longterm effects of deep vein thrombosis.

The recent landmark trials – in USA( Womens’ Health Initiative),  and Oulu Finland-   showed that  (like metformin therapy), non-human ie xenohormone therapy eg premarin and prempro reduce all major longterm degenerative diseases  by between a third and half when given appropriately soon after menopause for up to 10 years – breast and  colon cancer,  diabetes, ischemic heart and brain disease, fractures, memory and visual loss, and breast-cancer- and all-cause -mortality.

Two major shortterm adverse effects of oral sexhormone therapy OHT – deep vein thrombosis and  gallstones- were  relatively rare. But worse, it is well proven that such OHT doubles the rate of  measurable postmenopausal fat gain and usually associated muscle loss.

A new study in France (Canonico et al) of hormone replacement therapy HRT,   in 80 000 postmenopausal women PMW over 10 years, shows that oral estrogen therapy OET and commonly used progestins, eg premarin/ prempro,  doubles the risk of deep vein thrombosis compared to non-users.  The overall risk of deep vein thrombosis was only about 0.07% per year or 7cases per 1000 women over 10 years.  But there was no significant association with transdermal estrogen, progesterone, pregnanes, and nortestosterone.

As this column has regularly reviewed, this French study thus again confirms that it is negligent, immoral  to expose women even shortterm to the risks of hugely marketed OHT- especially with non-human ie xenohormones-  when  appropriate balanced physiological non-oral human hormones via the skin/mucosa, although more costly,  give only major benefit, adding years to health and life.