Tag Archives: cholesterol

CHRONIC ILLNESS- MANAGED ANTIAGING & GENERAL PRACTICE CLINIC SOUTH AFRICA

update 6 April 2015

In Claremont  Cape Town

A  Specialist Family 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; as well as preventing and managing acute disease at all ages.

The clinic (a specialist physician and a nutritionalist)  offers all-system evaluation and if available, natural  (as well as essential prescription orthrodox) prevention/treatment including metabolic – weight-endocrine-diabetes; heart-lung -kidney; hypertension; neurological-pain; joint & muscle; abdominal, immune system ie infection, cancer and auto-immune  support;  genito-urinary, & sexual problems;

and appropriate screening – ECG, non-xray ( no-touch thermography- eg thermomammogram;   SureTouch tactile) mammograms, non-xray (ie  ultrasound) BMD ie  bone fracture risk measurement, body composition, and appropriate hormone profiling/replacement.

Phone during office hours for appointment: for Claremont office  ph 021-6717415  or 6831465 (or 083-6299160) – at Grove Medical Bldg 1st floor no 15 (opp ABSA Bank Parkade c/o Grove Ave Pearce Rd)  , or neil.burman@gmail.com ;  or consultation by telephone/Skype or email .

by appointment only:        OFFICE HOURSby appt: ph office:  9am-5pm weekdays, 9am-1pm Saturdays.  AFTER  HOURS up to 9pm any day generally at office: –  email doctor   neil.burman@gmail.com  or ph 6am to 9pm  0836299160. EMERGENCIES  cannot be dealt with- acute emergencies and trauma, bleeding cases  must go to any  Emergency Unit .

Billing according to means ie specialist professional rates:  eg as a preferred provider for Discovery Health-  consultation procedure  0190; for needy patients, what the medical scheme pays  Detailed medical report and advice protocol provided at R300. Even Hospital Plans have to pay for outpatient consultation for scores of PMBs ie Prescribed Medical benefit conditions like Menopause.

 Needy patients desiring brief consultation can be seen by arrangement at GP rate.    Bone density scan  (covered by some medical schemes)  procedure 3612..  Non-xray mammograms are not yet covered by medical schemes codes: R650 for SureTouch including clinical consultation, R800 for thermomammogram.

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Update on institutionalized modern medicines fraud: REBUTTAL & COUNTERREBUTTAL: IMPACT OF ADVERSE NEWS MEDIA ON PRESCRIPTIONS FOR OSTEOPOROSIS: EFFECT ON FRACTURES AND MORTALITY

neil.burman@gmail.com  

REBUTTAL OF: IMPACT OF ADVERSE NEWS MEDIA ON PRESCRIPTIONS FOR OSTEOPOROSIS: EFFECT ON FRACTURES AND MORTALITY

18 months ago a warning was published about   the risk of Negligence  Damages for  Prescribing Bisphosphonates- Fosomaxes- for common osteoporosis. 

 A year later an updated review of the evidence rebutted    the attempt by an Australian group (Phillip Sambrook  MD, BS, LLB, FRACP  ea )  to promote routine use of bisphosphonates, blame the news media for wrongly sensationalizing these largely unnecessary drugs’ rare but lethal  adverse effects. 

 Now three other eminent Australian professors, of   Oral and Maxillofacial Surgery and  Endocrinology  (Paul Sambrook, Chris Nordin and Alastair Goss) publish a further rebuttal  of Phillip Sambrook ea for serious errors in underestimating by at least twentyfold both the incidence and the seriousness of bisphosphonate risks.

 In  a USA case for damages against Merck,  for irreversible  osteonecrosis- resulting in jaw amputation-  following Fosamax, a patient was last year awarded $1.5million . This American class action is about over 1500 Fosamax cases against Merck.  So far two related case against Merck  have been  dismissed. But all such cases are on appeal. The robust American tort system may yet hammer Merck. .

 As recently as october 2010 Merck staunchly defends Fosamax’s safety for osteoporosis.

The FDA has recently added a warning about Fosamax-related thigh fractures.

But no evidence has ever been published that the catastrophic risk of bisphosphonates- however rare-  is justified for routine osteoporosis when

1.In common osteoporosis, Bisphosphonates have no multisystemic benefits  except for halving fracture risk, and

2.Appropriate combination of natural supplements- as this column has repeatedly revewed -approximately halve all risks ie of both osteoporosis fractures and all other common major diseases of aging, and thus chronic disability and deaths, without any significant risks.

Curent Authority statements eg from the Mayo Clinic simply fail to say this- why risk bisphosphonates?  New reports  in November-December of dozens of osteonecrosis cases on bisphosphonates  have just appeared on Pubmed  from Italy, Germany, Romania and Spain.

In fact a major international study has just beeen published showing the obvious, that survival in the elderly is strongly linked to gait speed and mobility. It is common cause that such integrated function is dependent on optimal joint, neuromuscular and cardiovascular integration- to which (- unlike the score of natural human micronutrient supplements that deplete with age-) bisphosphonates and strontium contribute nothing except bone density.

Fosamax lobbyists studiously avoid the plain  truth that it is not osteoporosis; but frailty – falls –  that is the chief cause of major elderly fractures- and that bisphosphonates and strontium may make bones appear denser.

Its too early to judge strontium ranelate (which also has rare but catastrophic risk- the DRESS syndrome); but fosamaxes in some cases  make bones more brittle; without in the slightest combating senescence frailty ie muscle, mobility, vascular, cancerous, arthritic, immune, mood, cognitive and neurological deterioration (unlike the multinutrient microsupplements – vitamins, minerals and biologicals like fish oil, chondroglucosamine, sex hormones which together halve all chronic major degenerative diseases and premature mortality) ..

August 15, 2010 Regulators like the FDA  and WHO the world health organization and  their worldwide equivalents are notorious for bowing to their chief funders- Big Pharma- in registering new designer drugs on the flimsiest evidence, often despite vociferous objection from some honest assessor at the Regulator; then waiting till there is an uproar of complaints over the drug before they belatedly demand more evidence of cost-benefit from the manufacturer, and admit that key adverse data were  suppressed from the outset- as happenened and is still happening most notoriously  in the case of aspartamate Canderal.

And what was obvious from the word go,   that  in the case of last year’s swine flu vaccines and the spurious pandemic declaration, the Regulators/WHO expert committees were  heavily loaded with biased specialists paid by  vaccine  manufacturers.

But why are the fosamaxes and other  bisphosphonates  still allowed to be prescribed  for osteoporosis? When the first report of long bone fracture associated with them first appeared on Pubmed 16 years ago (Guanabens 1994) and they are unnecessary -indeed contra-indicated – for osteoporosis.   Not for nothing does a  recent ABC Good Morning America broadcast   ask: “Fosamax: Is Long Term Use of Bone Strengthening Drug Linked to Fractures”?  

This review is in fact an update on The Fraud of Modern Medicines.

 A recent review from Oxford    lists the myriad adverse effects of bisphosphonates. They say “All four  currently approved nitrogen-containing bisphosphonates have a favorable tolerability and safety profile.” But why don’t they discuss the reality which is that although all these adverse effects  may be infrequent, why risk such serious  complications  such as 30% incidence of oesophagogastric symptoms?; oesophageal stenosis and cancer?, toxiderma, atrial fibrillation, eye, muscle bone joint pain?; or incapacity from jaw and teeth loss or  longbone fracture related to bisphosphonates for osteopororis?,  when bisphosphonates  are clinically unnecessary and unjustified for osteoporosis.

 Why dont they state the truth, that there are no head to head trials against the basket of proven natural supplements, comparing fracture and global benefits versus risks of bisphosphonates ? Most reviews eg Wikipedia say bisphosphonates are “ the leading prescription for osteoporosis”; but this is simply for the same reasons that statins are for lipidemia, angiotensin blockers for hypertension and sulphonylureas/ glitazones are for type 2 diabetes, and aspartame is for artificial sweetening- because drug companies market such hoped-for $billion rainchecks overwhelmingly, and fund no comparative trials against the gold standard old supplement basket that makes most hazardous modern drugs like statins, glitazones and bisphosphonates mostly redundant.

Filleul ea from Univ Mona, Belgium have just reviewed the world literature from 2003-2009, finding 2400 cases of BIOJ bisphosphonate induced osteonecrosis of the jaw. of these about 215 were not cancer cases. Such cases very rarely occur without cancer. So why risk them?

 So why does an Australian team bewail decreased use of the fosamaxes? Impact of adverse news media on prescriptions for osteoporosis:effect on fractures and mortality. Their statistical modelling is perhaps no more than promotion of bisphosphonates since it ignores the high number of adverse effects that bisphosphonates cause long term; and the major reduction in allcause disability and premature mortality that balanced appropriate supplements ( instead of bisphosphonates ) produce. Why would the lead author of so many papers- Professor Phillip Sambrook – promote bisphosphonate as the prime pharmacological prevention, and only calcium and vitamin D as the supplementary prevention of osteoporosis fractures?  when the evidence so strongly favours safe multisupplements including appropriate lowdose hormone balance as preventative against all major chronic diseases? Can a new-drug proponent who sits on the medical advisory boards of and has received speaker fees from Amgen, Merck Sharp & Dohme, Novartis, Sanofi-Aventis and Servier. be considered objective ? Their critique of the media for publicizing the potential disaster from bisphosphonates is hollow when they fail to mention the numerous potential risks, and the numerous benefits instead from supplements.

Geusens, Sambrook ea in 2008 published  a major review on Drug Insight: choosing a drug treatment strategy for women with osteoporosis-an evidence–based clinical perspective.. ‘The most important clinical determinant in the clinical choice of drug therapy for fracture prevention is a woman’s fracture risk; second is the evidence for fracture prevention in terms of spectrum, size and speed of effect. Other determinants include the potential extraskeletal benefits and safety concerns of the drugs.” But they again studiously avoid considering supplements (vitamins plus minerals plus appropriate hormone combination) as one of the drug regimes, especially as osteoporosis is simply one of the co-morbidities of aging, and far less of a risk for premature death and disability than stroke, cardiovascular, cancer, diabetes, frailty, dementia, arthritic disease and premature death – all of which can along with fractures be avoided and mitigated by the basket of supplements. So their review is surely biased in excluding all but new designer patent drugs while excluding the best and safe anabolics. .

 It is well proven from observational studies that longterm use of appropriate natural supplements reduce all-cause mortality by at least a third:              In the Womens’ Health Initiative WHI, appropriate hormone replacement HRT reduced all-cause mortality i.e. deaths from vascular disease, cancer and  fractures by 1/3 as well.    In the UKPDS the plant extract metformin reduced all-cause mortality also by 1/3. Understandably, metformin halves the incidence of new diabetes by reducing insulin resistance,  hence it also reduces fracture risk let alone cancer and vascular disease risk .   

 Incontestable data shows that epidemic deficiency  of vitamin D ,  vitamin C, magnesium, vitamin B especially B6,   vitamin K,    fish oil,    and prime hormone dysregulation  (thyroid, insulin,  cortisol vs androgens and estrogens)   in first-world aging populations are associated with increased mortality from all degenerative diseases especially fracturing, cardiovascular and cancer. It also showed that  vigorous supplements of balanced vitamins,  minerals (especially B,C,D,K, and Ca, Mg, Zn, Bo, Mn, Se, Cr), fish oil,  and human sex (co)hormones (testosterone, progesterone, estradiol, metformin) drastically reduce all morbidity and especially fractures  even  (perhaps especially )  in the well-off over nourished..  

  In contrast to bisphosphonates- which are aimed solely at reducing fracture in the at-risk elderly and thus reduce all-cause mortality by perhaps 10%-  these supplements in appropriate doses and balanced combination  reduce all-cause aging disease and preventable premature mortality by at least 50%, without any adverse risks. .  

Neville-Webbe ea (2010)  note that bisphosphonates have anti-cancer potential. So use it for terminal cancer fracture pain. Why use it for anticancer potential in those with just osteoporosis when the basket of supplements (including approriate HRT, vigorous dose vitamin D and if approriate metformin) gives safe  global protection against all the major aging diseases?

 Just the reduction in excess diet omega6 oils will mean that only 10% of the current necessary omega3 daily allowance (3.5gm) will be essential.  

 In 2007 a leading team from the International menopause Society  Genazzani ea  warned that “Recent controversies with hormone replacement therapy (HRT) have caused much concern in women and their health-care providers. As a result, the number of HRT users in USA has fallen dramatically. Consequently, the potential HRT-induced reduction in fracture risk is lost so that, in the next few years, we can expect an excess of 43,008 fractures per year in women aged 65 – 69 years. In addition, the recent evidence on the merits of early initiation of HRT on cardiovascular disease risk and neurocognitive function and the effect of type and combination of hormones on breast cancer risk now require an urgent review by the regulatory authorities of their recommendations about HRT.”

 Now – 8 years after the  debacle the WHI caused – the Endocrine Society has at last come out with a Position Statement admitting the grave consequences from the hysterical misinterpretation of the early release of the Womens Health initiative results in 2002-2004, especially in rising fracture and colon cancer rates from avoidance of appropriate HRT in menopausal women across midlife. . Let alone, as Genazzani ea said above and we discussed at international, UK and European menopause meetings in 2003-2006, the potential loss of benefit against breast cancer, heart, stroke, depressive, diabetic and neurocognitive problems.

 In conclusion: A major intervention is required from governments, world authorities  to reduce all-cause morbidity and mortality : by drastically curtailing the marketing and prescription of rarely essential prescription designer drugs like bisphosphonates, and strontium ranelate for osteoporosis;  by insisting on increasing universal intake of proven natural multisupplements that are increasingly deficient in the food chain for the poor,  for infants, youngsters and the multiplying  aging- in the latter, including appropiate HRT;  and by forcing the processed food industry to stop stuffing foods and drinks with not just salt  and aspartame but also fructose, sucrose, various growh hormones, and omega6 oils.

But neither Big Pharma manufacturers, governments, so-called independent regulators, nor university and private practice leaders or retail pharmacists will do so, promote evidence-based supplements over risky new drugs- there is too much money at stake from lost taxes. research funding, lower under-patent snake-oil sales and far less major disease and hospital admissions.

So it is up to patients and honest healthcare providers to insist that evidence-based supplements – not trading practice based on huge marketting and snakeoil preaching for profiteering – be prescribed for prevention/ managing the major diseases of aging including osteoporosis.

SIMPLE SAFE LOWCOST RISK MEASUREMENT AND CORRECTION: THE SOCIOECONOMIC IMPACT OF OSTEOPOROSIS

  neil.burman@gmail.com

Already just since April 2010, Pubmed (the on-line catalogue of peer-reviewed medical journal papers)  reveals four reviews – from USA, Mexico, Ireland and Cambridge UK-  on the huge socioeconomic impact of neglect  of long-available safe cheap measurement  and prevention of osteoporosis in aging populations. Especially that osteoporosis is underdiagnosed, and hence the need for improved use of diagnosis screening and preventatives.

And another study  from France reviews the deadly potential cutaneous (let alone gastrointestinal and other) risks of bisphosphonate and strontium drugs  prescribed for osteoporosis . Their  risk of serious adverse effects  may be <1:10 000 – but no study has ever been done comparing such $billion raincheck designer drugs with simple balanced lowcost safe combination of the score of natural supplements (some 7 vitamins, about 8 minerals and 5 human biologicals- costing as little as about US$10 a month) that are proven to prevent and heal osteoporosis let alone have major benefit on most major chronic diseases. .

The analogy is so simple- one does not treat :

anything but major pain with opioids or risky non-steroidal drugs  (or a sore throat with antibiotics) when simple safe modest-dose non-addictive analgesics and local therapy suffice; or

overweight,  or type 2 diabetes , or common mild to moderate hypercholesterolemia with any designer drug but metformin until control (with diet, lifestyle, supplements including metformin and appropriate other hormone adjustments)  is no longer good enough; or

 mild to moderate  hypertension requiring drug therapy with anything but perfectly safe lowdose reserpine plus lowdose amilozide – which suffice in almost 90% of mild to moderate cases- when more modern designer drugs (eg betablockers, angiotensin-converting – enzyme inhibitors and even the older methyldopa and calcium channel blockers) and newer drugs  both have infrequent but serious adverse effects, and are   less effective (they do not have the long duration and safety record of reserpine plus amilozide that makes it so effective even with erratic use) .

The socioeconomic model that measures the impact of a therapy only on one disease eg osteoporosis obviously also by intent supports the global profiteering and job-creation interests of Big Pharma and their well-rewarded allies – Government, Regulators, Universities, Research, Corporations and private practice. For these big-money industries, the use of a safe shotgun of unpatented and nonprescription supplements that more than halves the incidence, premature disability and mortality of both fractures AND all the common major aging degenerative diseases is anathema, since it reduces the Aging Diseases Industry from a $trillion goldmine in the aging who still vote, travel and earn, to a $billion expense when it matters far less- in the very old.

Hence Big Pharma is fighting a global war to abolish free choice of foodstuffs and supplements, conspire with governments to dictate what sources of foodstuffs must be eaten, and put all micronutrient supplement under doctors’ prescription! and above all else, suppress comparisons of designer prescription drugs with the gold standard old drugs and highly effective safe combinations of supplements.

This column has regularly published the growing irrefutable proof that high technology appliances and drugs are simply not needed to measure, prevent and treat common fragility fracture risk or any of the associated linked common chronic degenerative aging diseases.

And Guglielmi ea from Italian and Singapore Universities recently published another landmark review  confirming the voluminous evidence,  recent reviews from UK, that quantitative ultrasound QUS scan has replaced Dual Xray DXA bone mass density BMD  scan as the goldstandard fracture risk measurement test in common practice . Portable lowcost and therefore far more widely available QUS avoids the irradiation risk of costly centralized DXA, and the increasing overreading of bone density and hence risk score with aging due to accumulating calcification over the lower spine and hips.

It is of course intuitively and logically obvious that QUS devices that fix the target bone at a standardized site between the QUS heads as with eg the heelbone in eg the Norland CUBA footbox will eliminate most performer technique variation with a manually moved contact as in eg the Sunlight Beammed system.

Southampton University UK has also just published a study showing good correlation between peripheral QUS measurement and direct bone density measurement of excised fractured femoral heads from elderly hip replacement patients. .  .

And a Madrid team has just published a survey showing good correlation in children between 5 and 12 years between QUS measurements  and calcium-vitamin D intake.

CONCLUSION:  Safe and lowcost QUS can and thus should be used for bone risk measurement at all ages and locations – including schools and even the bedside;  in contrast to DXA which must not be used in those who are pregnant or not  at least post reproductive if not post-middle-aged.

Even in    the chronically frail or mentally dependent, periodic QUS screening is as crucial as eg bloodpressure screening since eg hypertensive , elderly, dementing or stroke patients share so many risk factors, and are thus are even more prone to osteoporosis- and incidental osteoporotic fracture easily converts the walking wounded  from needing supervised care to being totally wheelchair- or- bed- dependent.

STATINS UNRAVEL: IN REAL LIFE CAUSE 50% MORE SERIOUS DISEASE THAN THEY RELIEVE:

14 June 2010: neil.burman@gmail.com:

 The statin scam unravels:

In Effects of statins in men and women in England and Wales,  and Individualising the risks of statins in men and women in England and Wales Profs  Julia Hippisley-Cox and Carol Coupland from Nottingham University UK report  a landmark  population based cohort study :      In 368 general practices some 10% of the 2million adults aged 30 years upwards were new users of statins.

 In real life patients, (not in highly selected subjects for double blind  RCT randomized controlled trials), the study  shows the comparative numbers for benefits and risks of statins:  compared to patients on no statins,  statins were associated with (per 10 000 subjects treated with statins) :

 *not significantly associated with Parkinson’s disease, rheumatoid arthritis, venous thromboembolism, dementia, osteoporotic fracture, melanoma or cancer of stomach, colon , lung , breast, kidney,or prostate.

*decreased risks of cardiovascular disease CVD:  271 cases prevented in women, 301 in men; and oesophageal cancer ;

*increased risks of moderate or serious: liver dysfunction 74 cases in women, 71 in men , acute renal failure 23cases in women, 29 in men, moderate or serious myopathy 39 cases in women, 110 in men; and cataract. 307 cases in women, 191 in men.

 thus they estimate that in total, in both sexes, CVD may be prevented in 286 but serious other disease caused in 50% more ie 422 cases.

But the study glaringly ignores, overlooks that statin use is not associated with two of the commonest risk factors for preventible major degenerative diseases of aging: no  reduction in increasing overweight- obesity, or diabetes .

Numerous analyses show that statins have justification  solely in patients with vascular disease, in whom they reduce all-cause mortality by some 16% and coronary heart mortality by up to 40% – but no reduction in non-vascular mortality. eg Wilt ea 2004 .

But in those without vascular disease and risk factors (smoking, obesity), vascular disease causes fewer than half of premature deaths; so statin use in such “primary prevention” population understandably has no significant benefit on reducing premature vascular mortality. Statins never significantly reduce non-vascular mortality – in fact Hippisley-Cox and Coupland show that non-vascular morbidity in creases by 50% more than the reduction in CVD.                                  So while there is  overall slight  reduction in all-cause  mortality,  there is highly significant increase in overall morbidity.

 So contrary to the UK professors  Wald and Law and the Statin industry who want statins to be available like aspirin over-the-counter, this major Nottingham University UK study contradicts  use of statins except with  severe resistant lipidemia- as occurs rarely due to genetic disease  in perhaps 1 in 70 South African Afrikaners.

Before focussing on mild to moderate hypercholesterolemia and prescribing statins – which in turn further reduce the vital antioxidant insulin sensitizer co-Q10 never mind essential cholesterol substrate  and thus precipitate all sorts of problems not least fatigue, myopathy and myolysis , doctors and society need to  address boldly the major risk factors, correction of which may reduce all-cause premature mortality by:

exercise – at least moderate and regular – by at least 25% ;

stopping smoking and alcoholism – each by perhaps half;

fish oil supplement perhaps 2gm omega3 a day – by almost half;

appropriate sex hormone replacement in deficient men and women by at least 1/3.

vigorous vitamins C,  D,  magnesium (with  broad other micronutrient  supplements) for widespread low intake- by perhaps 25 to 50% each;

avoiding obesity and diabetes including by using metformin to tolerance – by perhaps half.

Smoking, alcoholism and lack of exercise are cases  in point: they are  acquired addictions; so instead of being palliated with damaging statins, patients with vascular disease or major risk factors should  be compelled to undergo group therapy until exercising adequately and cured of  smoking, alcoholism  and the consequent weight gain and multisystem diseases  from bad food and bad  lifestyle choices.

UPDATE: THE FRAUD OF BIG PHARMA MODERN CHRONIC DRUGS

neil.burman@gmail.comUPDATE: see 14 June 2010. The Statin Scam Unravels. 

 

Update: 6 May  2010: this week’s recall of Johnson and Johnson’s Tylenol, Motrin, Zyrtec, and Benadryl due to negligent contamination , in particular of Tylenol for children, leapfrogs America’s household favourite Johnson and Johnson J&J to 2nd place (with at least 6 bad drugs) in the fraudsters mafia roll of dishonour behind the unreachable leaders Pfizer with about a dozen notorious fraud drugs. What is another $81million fine to J&J  that had sales of >$63billion in each of the last two years with profit of above 20%, and that despite the recall still maintained this turnover in quarterly sales for the 1st quarted this year? 

The major thing is that despite J & J’s gross negligence endangering the lives of children, the FDA has taken no other action against them. They terrorize  with armed marshalls  for trivia and shut down small firms making safe health supplements and physicians using them, but the Big Pharma mafia are the darlings of the FDA and Government since they pay such vast amounts in fees and taxes to Govt and lobbyists- politicians and academicians- trialists – that they are untouchable in every country.. 

14 April 2010: So we  can throw away the fraudulent  Pfizer’s fraudulent Neurontin gabapentin  we have been taking? when there never was  evidence that it is as good and safe as it’s parent (our chief brain neurotransmitter aminoacid )  GABA; while it’s younger twin sister  Lyrica – pregabalin– designed  for extension of patent benefits –  is worse  … just like we can throw away the chronic nonsteroidal anti-inflammatories eg Voltaren diclofenac , Vioxx and Celebrex  that are  such heart risks, poor painkillers,   and do  nothing for the underlying destructive chronic disease process. Drugs for massive profit for the beloved Big Pharma Industry that  politicians go to endless lengths to protect.- even Obama and George Brown as witnessed by the multibillion dollar swine flu scam, even now  in 2010 with Obama’s Pharmacare bill. 

 And now Harvard  University shows that even Neurontin and lamotrigine  increase the risk of suicide by42% and 81% respectively. So the long list of fraudulently overmarketed  or hazardous -improperly registered  or prescribed drugs  without adequate trials or obligatory definite  indications-  grows. 

And then there is the Disease Industry hypermarketing technique of Diseasemongering-  promoting previously ignored or unrecognized variable human traits like anxiety, insomnia, lowgrade depression, mild  hypercholesterolemia, female low sexual desire, erectile dysfunction, postural or stress backache- to diseases requiring permanent designer drug therapy eg benzos, viagras, prozacs, statins, NSAIDS nonsteroidal anti0inflammatories;  or “corrective surgery” for all. 

Pfizer,  Bayer, GSK  and  Roche  with the 100% support of their respective government regulators and politicians   continue to vie for top place as the biggest fraudsters of all time – competing with  the food, tobacco, booze, media, vehicle, financial, lawyer, minerals, fuel  and politics  industries..   

Why is this? Because the public – taxpayers and the poorer consumers- are at their most vulnerable, pawns if not cannonfodder and guineapigs  when it comes to trust in government regulators and the giant consumer product  industries – manufacturers and big distributors-  that Govts  regulate – especially the disease and drug industries.  

  And government regulators are controlled by elected politicians   who ( apart from a few altruistic successful honest folk who stand out and are nominated for  or called to office -but not Ralph Nader) –  as  mostly  lawyers or failed businessmen/ workers or carreer trade unionists,   rarely seek higher office  except to further their own financial interests and power lust.   

Winston Churchill and Frank Rooseveldt vie with Margaret Sanger, Mahatma Ghandi  and Nelson Mandela  for honour as the leading persistent (western)  fighter for justice, human rights of the 20th century if not all time, since they were skillful – brave  but above all tough enough (unlike many heroic martyrs) to survive to see it through. 

Hence there is enormous incentive for collusion between politician/ government officials who control the taxes and spending thereof,  and the big businesses that control the big money that escapes the tax officials – including Big Pharma. In South Africa there is no incentive whatsoever for the MCC Medicines Control Council Regulator to work efficiently as all income it generates is absorbed by the Fiscus/Dept Health, which blatantly refuse to produces annual financials for the MCC – effectively a parastatal supposedly under an independent CEO and Board. 

 Below is a list of costly modern disaster or dubious largely chronic drugs and their manufacturers that earn  the profound distrust of consumers: (where there are a proliferation of me-too analogues in a group eg benzos, statins, NSAIDS, bisphosphonates, only the original one or two are listed since they led/lead the pack): 

PFIZER -Wyeth -Searle – Upjohn:  Neurontin; Geodon,  Bextra,  Zyvox,  Lyrica; Lipitor;  Celebrex; PremPro; aspartame; Rezulin;  Viagra; and Ativan=lorazepam/ Xanor=alprazolam – two  of the most addictive   chronic  “anxiolytic” benzos – again, in Wiki and MIMS their  indications are far fewer than the pages of problems they  cause us since the 1970s , papering over and masking symptoms by numbing the mind (as with alcohol and smoking) instead of patients addressing the underlying cause of their anxieties with psychotherapy including learning self-hypnosis control.   

Collectively, Pfizer (the conglomerate of rash clones it has swallowed) has as many modern disaster/fraud  drugs as the next two combined of its  major league fraud competitors: 

Johnson & Johnson – Risperdal  ;   prepulsid;  Tylenol, Motrin, Zyrtec, and Benadryl 

Bayer – Trasyol; Yaz/min Baycol, Paxil, Flonase, Cipro; 

Astra-Zenca – I.C.I. – Seroquel, Nexium ; Crestor,Tenormin, Losec; and thalidomide.. 

Roche  – Xenical, Roaccutane, Tamiflu; Valium. . 

Glaxo-Smith-Kline  GSK -swineflu vaccine; Avandia, Paroxetine. 

Sanofi-Aventis (Hoechst-Rhone-Poulenc)  – Actonel  ; benzbromarone;  swine flu vaccine; Cosaldon -Trental [Cosaldon R was an excellent peripheral vasodilator oxypentifylline plus vitamin E; then Hoechst subtly started downplaying Cosaldon R as it’s patent expired, and introduced the slightly phonetically changed  and far more costly ‘new’   drug Trental pentoxyfylline.. Hoechst would naturally not explain (except obviously on grounds of profiteering from the new patent substitute)  why they substituted an inferior “new”  drug for the better  older version which included the safe dose of vitamin E.] 

 Merck – Vioxx; Zocor,   Fosamax; gardasil. 

Eli  Lilly – Prozac, Zyprexa; memantine ; and DES-diethylstilbestrol, perhaps the most infamous of all commercialized drugs in causing problems even in grandchildren of those so recklessly exposed to it without evidence of benefit. (Eli Lilly was the last company to stop manufacturing it – in 1997! despite evidence of it’s disasterous effects published in 1953, and of cancer from 1971 . ) 

Novartis -Ciba Geigy- Voltaren, swineflu vaccine. 

Abbott labsMeridia=Reductil   

Biogenesis labs – Acomplia; rimonabant  

Bristol-Myers Squibb -Pravastatin;   Plavix, warfarin; And the sustained  cover-up of the COSMIC  metformin  obligatory postmarketing trial  done at the insistence of the FDA on a huge 9000 subjects for 1 year in about 1996/7.   This trial was eventually submitted for publication only in 2004 and thus published in 2005- but for the previous year  BMS and their licensor  the original patent-holder  Merck  denied any knowledge of such a trial although the summary was presented and published a year earlier at a US diabetes congress by the authors, and we supplied the COSMIC abstract- written by BMS researchers who did the COSMIC trial- to BMS and Merck… .        why would BMS and Merck  delay publication of this trial  for so many years, and blatantly deny knowledge of it after the first report of the trial result at a USA diabetes congress ? 

The answer can only be the predicted- because it confirmed in the biggest metformn trial cohort ever- 8000 patient-years- that metformin in diabetics gave zero significant adverse drug effects, with the all-cause deathrate in fact 9% lower than in those on other conventional antidiabetic therapies; and  four major diabetes prevention  trials of metformin in four continents confirmed that it at least halves the incidence of new diabetes- with zero significant adverse effects; and in the intervening years between this trial and it’s result publication, both BMS and Merck developed and launched their respective combinations of metformin and a sulphonylurea (M + SU) . This despite the fact that it was clear since at least the 1970s that the addition of sulphonylurea to  metformin is a desperate last resort since it is fraught with risk of hypoglycemia and reversal of the reduction in fatness produced  by metformin alone.           

A new  retrospective study just published from the UK patient database confirms the  folly known all along  of combination of SU with metformin in that  that over a mean of 4 years on therapy, the metformin+SU therapy reduced all-cause mortality by 23% compared to SU alone; while metformin alone compared to SU alone reduced mortality 1/3 more ie  by 30% – with trivial risk of hypoglycemia. This was similar to the outcome in the 20year UKPDS RCT, where metformin reduced all-cause mortality by 36% over a mean of 13 years, making it the safest and most effective  drug ever patented for  chronic degenerative  disease. . 

And note the cynical folly of the many manufacturers of the grossly overpromoted and overprescribed  bisphosphonates and statins  – which  have numerous serious adverse effects and  should be last-ditch therapy in metastatic bone cancer and in rare  serious hyperlipidemia, not for osteoporosis, not for mild to moderate lipidemia and certainly not over-the-counter as profiteers crave. 

ENDURINGLY BENEFICIAL MODERN CHRONIC DRUGS: 

The above drugs contrast with vey  few modern chronic designer drugs that are still the leaders in their fields, whether as original or generic – although none of them has been shown to address all-cause mortality and pathogenesis. 

Pfizer’s Norvasc=amlodipine  is a rare modern designer exception – dating from the late 1980s,  it’s patent has only just run out-  proving it’s enduring worth for longterm hypertension therapy as the premier 4th-line drug to add when reserpine 0.125mg plus amiloretic 1/2 (ie HCT 25mg + amiloride 2.5mg)  daily are inadequate for optimal control; with very low risk of serious adverse effects. 

BMS’  Captopril & Merck‘s  Renitec – angiotensin converting enzyme inhibitors ACEI –  date from the mid-late ’70s, and while they were and are the first of the invaluable ACEI inhibitors, 5th line antihypertensive drugs for common use, they have formidable potential for lifethreatening adverse effects- but they are on essential drug lists. In the past dozen years big pharma has attempted to substitute angiotensin 11 receptor blockers ARBs, for the aging ACEI,   but a recent metanalysis shows that neither group of drugs significantly lowers fatal or nonfatal cardiovascular events- and they all (unlike reserpine + coamiloretic + amlodipine) have risk of life-threatening  adverse effects. 

DRUGS FROM THE GOLDEN AGE: 

Virtually all other current  designer drugs of enduring and safe worth for chronic longterm use originated from the golden era of innovative and enduring designer drugs mostly around WW2 up to the 1960s: 

The modern  birth control OC pill taken chronically  by millions of women for up to decades for either contraception or symptom control, certainly dates enduringly and endearingly  from the post war Golden Era  as     Estinyl (Schering 1930s)  , with  or alternatively just a  progestin. Modern preparations are relatively so safe that they are the preferred contaceptives for millions of young women.  But we have just seen two young women unwisely started on Bayer-Schering’s Yaz/Yasmin develop in one case hypertension and major weight gain, the other hives- so such innovations are not necessarily better than established brands of OC . 

MSD’s 40year old Sinemet still the firstline gold standard for Parkinsons; Moduretic- amiloretic/ amilozide- still the first drug and permanent baseline  (in low dose eg half tab3 x a week or 1/4 – 1/2 a day) for hypertension; Epilim valproic acid for epilepsy; Tryptanol; 

Sanofi-Aventis Hoecht’s Lasix furosemide still the leading diuretic for  chronic severe heart failure, cirrhosis, nephrosis. 

Merck’s 80yr old metformin- the only laboratory – originated drug (a teak of the galega plant’s biguanide) that reduces all-cause mortality – by no less than 36%, without a single serious adverse effect or mortality if sensibly used; 

Bayer’s Adalat; Aspirin (1899) ; prednisone; 

Novartis-Ciba-GeigyImipramine-Tofranil the first successful commercialise and still enduring major antidepressant. 

Roche’s                            Rivotril; 

Abbott-Knoll                Isoptin; 

GSK’s  Zyloprim;   Imuran;  Panado- still the lead patent mild-moderate painkiller, safe at prescribed dose. 

Pfizer -GDSearle’s  Aldactone; Sulfasalazine; and the 100year old phenytoin -Dilantin, still a longterm lifesaving antiepileptic despite occasional major adverse effects. 

Boot’s  Brufen-  the NSAID nonsteroidal anti-inflammatory drug on Essential Drug Lists,  altho there is no evidence that this group of drugs is essenntial since they do not alter the course of the underlying chronic inflammatory disease or reduce longterm mortality and morbidity, are little if at all better than Panado+- codeine as painkillers, and have formidable risks. http://en.wikipedia.org/wiki/Ibuprofen#History  

Astra-Zenca-ICIs   Inderal was the first of the major new cardiovascular protectant beta-blockers which  are essential drugs., altho all have formidable potential adversity ; as with ACEI, no special optimal favourite has yet emerged;  they have some special chronic indicatiions, including heart conditions and special cases of hypertension. . 

THE BIG PHARMA RAINCHECK  MONEYSPINNERS: 

The US drug industry is reputedly worth >$100billion a year and the biggest industry to >$200billion; and globally some $643 billion, of which the United States produces almost half.  The gross industrial output in USA was apparently about $26 thousand billion in 2008 ie the drug inductry alone approaches 8% of total gross manufacturing output there.   

 It is surely no co-incidence that virtually all  the above  common fraud-drug  pharmacy companies are among the dozen top money-spinners listed on 2009 financials.. But perhaps the biggest racketeering of modern times has yet to be quantified, perhaps  $100 billion  of wasted money on last year’s swine flu  “pandemic” that never happened, in futile mass screening lab tests and vaccines and Tamiflu – giving massive profits  (some companies claimed >$6billion) with total indemnity against litigation to Roche, GSK, Novartis,  Baxter,  Sanofi et al.. The USA-dominated WHO hastily changed the core definition of pandemic early in the North American outbreak so it could declare the nonsensical pandemic to suit the pockets of the profiteering American-European conglomerate and the political lobbyists they employ in Government and beaurocracy… 

 So do we wonder why we can’t trust Big Pharma prescription drugs and doctors’ judgment? Read the stats of a 5years study of the relevant risks,  of  deaths from prescription drugs in USA ( versus natural supplements)  exceeding  over 106 000 to 1.   Thats why Big Pharma and it’s “regulators” like the US Govt FDA, the UK MCC, European medicines Authority EMA, and organized doctors, are so desperate to stop the public buying the supplements people choose- when early and permanent use of balanced natural supplements at least halve serious disease and thus medical consultations, prescription drug use and hospitalization. For profit, only disease (not prevention) pays. 

Of the  103  drugs that achieved  $billion sales  in 2006,: considering the chronic  disease drugs, only valproate and J & J’s contraceptive dates back to the 1980s; Wyeth’s Premarin-Prempro dates back to 1995; and  (omiting duplicate entries) only 33 were oral drugs for chronic major common degenerative (as opposed to infective or malignant or autoimmune )  diseases.  And of the ~33 , only  10 (in descending order of sales value on that list)  even vaguesly justified their  ranking and sales- amlodipine, venlafaxine, bupropion, metoprolol, Viagra ,carvedilol, valproate, ramipril, paroxitine and premarin- 

Reuter’s forecast of the 10  >$5billion raincheques for 2010  include in descending rank for common chronic diseases only the tablets Lipitor, Plavix, Diovan and Crestor- none of which are  proven essential drugs for common average disease use. They are there solely because of heavy marketing by Big Pharma, despite their mediocre results and major potential risks, with far better results given by long-proven natural supplements or by lowdose reserpine-amiloretic combination, then amlodipine . 

Finally, landmark  drugs that were not invented by, or were laregly ignored by,  suppressed by drug companies as medicinals: 

EDTA ethilenediaminetetraacetate was invented 80 years ago but never patented by Big Pharma as a medicine. Yet as an oral nutritional supplement in modest dose it is perfectly safe, and removes toxic lead, mercury, iron and many other heavy metals  (now routinely polluting the environment -food and water- chain)  from the body,  as well as uric acid– being effective preventative against gout, and an antiatheroma agent. It is apparently not a scheduled medicine in either USA, UK or South Africa, being a routine ie harmless – beneficial- food  additive preservative. 

Yet despite the vast evidence favouring fish oil, metformin and EDTA as perfectly safe and effective chronic  anticoagulation, the Disease Industry persists in promoting rat poison- warfarin, dicoumarol– as the common chronic anticoagulant, despite its’ proven risks of promoting hemorrhage, fractures – already known since at least 1998vascular calcinosis already known since 1998 and most recently published last month; and even cancer .   

Metformin is unique, the widest multidisease panacea ever extracted (from a traditional antidiabetic plant)  and patented. Like EDTA it was eventually identified in 1922 by university researchers Werner and Bell in Ireland – but only patented  and produced for routine diabetic use since the 1950s- and deliberately obstructed for use in the USA for another 40 years by the FDA and Big Pharma, which were busy as bees designing and mass marketing far less safe and effective USA sulphonylureas although these were already discredited by the  UGDP  almost 50 years ago, when metformin was ‘rediscovered’ and came into its own. 

Reserpine  also a plant (rauwolfia) extract  remains (with coamiloretic, amilozide)  both in low dose the first-line drug treatment of all classes of hypertension– which since the prevalence of this disease now approachines 50 % in aging adults, makes these drugs amongst the most prevalent essential drugs needed. As even wiki says,  from many major studies over decades, “Reserpine is one of the few antihypertensive medications that have been shown in randomized controlled trials to reduce mortality” – in at least a score conclusive trials of the individual components reserpine, thiazide and amiloride, the triple combination is by far the best firstline therapy, at a cost in South africa of about  $US1 a month.. . But Big Pharma and its profiteer lobbyists continue to suppress the combination fraudulently based on decades-old overdosage data. 

By contrast well over 100 natural micronutrient substances – cinnamon, garlic, ginger, codeine, reserpine, digoxin, huperzine A, galega-metformin and many other plant extracts; vitamins especially B,C,D  in higher dose; , minerals especially calmag,  zinc, chromium, boron, iodine, iron  and even lithium; and human biologicals that deplete with aging like glucochondroitin, CoQ10, acetylcysteine, arginine, cartnitine , GABA, 5HTP  and almost 20  other hormones  replaced chronically – provide almost every chronic major degenerative  disease with the best prevention and treatment, without the almost invariable  risks of  the modern designer chronic drugs discussed above. 

 Since alcohol and tobacco, salt and sugar are still freely sold over the counter OTC  without any restrictions except some  to children , the commonest causes of chronic degenerative disease in more than slightest daily usage, it is obviously lowdose vitamin K,  vitamin C and D, lithium, magnesium, reserpine, metformin- galega  and EDTA that should be mandatorily supplemented in the food chain for the fattening aging 1st-world populations, and allowed OTC purchase;  while indications are severely limited  for prescription of sulphonylureas, statins, bisphosphonates and the dozens of other disaster or dubious  designer drugs listed above.

Forbidden Medicine? Vitamin C-lecithin-fish oil- bioflavonoid interactions in the prevention of atherosclerosis, cancer and gallstones.

neil.burman@gmail.com

IS THERE ANYTHING NEW UNDER THE SUN?

Fish oil use for medicinal as well as dietary purposes  dates back at least to Viking times; but the 1922  scientific study of fish oil by Jack Drummond & Sylvester Zilva is the first paper on it on Pubmed, as a source of vitamin A.

But  in this ‘scientific’ era it took till the 1930s for fish  (ie codliver) oil’s  wide medicinal benefits  to be recognized.

Since then fish oil has proven to be the most pluripotential ‘micro’nutrient – at a dose as little as perhaps 100mg/day- in prevention and treatment (via either it’s omega3 EPA+DHA content, or its vitamins A and D content) of all common major diseases from learning , behaviour and memory disorders from birth to dotage, to infections, inflammation, arthritis, vision, pregnancy,  growth and osteoporosis, mood, Parkinson’s, hypertensive, vascular, thrombotic, lipid, cancer and diabetic disorders – probably halving all-cause ‘natural’ aging mortality.

The recognition of citrus juice- vitamin C – as a medicinal dates back apparently only 250 years to Dr James Lind’s recognition of it’s reversal of lethal scurvy. But it was first identified and isolated only about 80 years ago .  Since then it has proven to be as pluripotential a preventative as fish oil and now vitamin D3, and balanced sex hormone replacement.

The 1940s give the first reference  on Pubmed to bioflavonoids-which are anti-allergic, anti-inflammatory, anti-microbial, anti-cardiovascular disease, anti-varicose veins, anti-piles  and anti-cancer- and promote the absorption of vitamin C.

In 1971 Borgman & Haselden described the  effects of cod liver oil on dissolution of gallstones.

from 1973 Cameron Pauling & Campbell published their landmark work on vitamin C to tolerance (not antiscurvy doses or below many grams a day) in the prevention and treatment of many human cancers.

In 1974 Krumdieck & Butterworth’s landmark  paper on cholesterol-lecithin interactions: factors of potential importance in the pathogenesis of atherosclerosis. summarized the evidence for combining supplements of vitamin C and soy lecethin (ie polyunsaturated fatty acid at position 2)  in the prevention of atherosclerosis- since once this disease is present, it can take months to reverse.

in 1976  Navarro & Guevara described the importance of vitamin C in prevention of gallstones.

and by  1989 Wechsler  ea described how omega-3-fatty acids  – fish oil–  just 1.5gm a day decreases biliary cholesterol and lithogenicity.

by 1997 Mizuguchi ea described prevention  by fish oil of cholesterol gallstone formation in hamsters.

and in 1999  Takenaga ea described how Lecithinized ascorbic acid (PC-AS) effectively inhibits murine pulmonary metastasis.

Lecitithin is derived from food – meat, liver, legumes, cereals, fish and eggs – but not from fish oil.   It – phosphatidylcholine- is a principal component of fat metabolism, cell membranes, brain, semen, and against gallstones, atherosclerosis (and thus heart – vascular-hypertensive -brain-), breast,  cirrhosis and other liver diseases.

The crucial DHA and EPA omega3 fatty acids are, practically, derived exclusively from marine algae and thence krill and fish oil .

Hence the paramount importance (in preventing all common diseases)  of promoting fish oil (by the teaspoon or capsule) together with lecithinized Vitamin C to tolerance eg  vitamin C 50% enhanced with perhaps 15% calcium carbonate,  5% mag oxide,  10% bioflavonoid and 20% lecithin. Up to a heaped  tsp 2 – 3 times  a day of such an Enhanced Vitamin C  mix – ie to bowel tolerance- will provide 5 – 7.5g vitamin C, 500-750mg calcium, 300 -450mg magnesium, 1-1.5g bioflavonoid and 2- 3g  lecithin, without diarrhoea.

This self-degassing self-emulsifying blend puts within reach orally the eg 1gm/kg vitamin C per day vitamin C to produce the high enough plasma levels of vitamin C that have  been shown to be lethal to cancer cells in vitro and in vivo. For the much higher doses of vitamin C for this purpose eg 30gm daily, some  of the calcium and magnesium obviously need to be replaced with sodium to avoid 3000mg/day calcium and 1800mg/day  overdose.

Adding say 1tsp cod liver oil to half a glass of water with eg 3tsp of the powder blend (ie 6gm vitamin C) and beating it produces a smoothie emulsion  that is easy to drink. Who needs fish oil capsules now?. And there is  virtually no limit to the  amount of lethicinized calmag ascorbate – bioflavonoid omega3 emulsion  that can be poured into the body to combat eg infection, atherosclerosis and cancer.

Obviously to this should be added a blend of all the other few-score safe proven potential preventative supplements to combat all the other chronic diseases of premature aging including even multiple sclerosis (especially highdose vitamin D3).

So while oil and water dont usually mix in a glass, ie vitamin C and bioflavonoids are soluble in water but  not in  oil, combining them by taking them  together with lecithin, fish oil and calmag (to lessen acid load with  better absorbed calmag ascorbate) a few times a day makes huge sense for all disease prevention let alone support..

And none of it is news.

But the farce from  “authorities”- ‘Regulators’ (who are paid big protection money by Drug Companies)  – is that labels, marketing materials are  not allowed to say that cheap harmless food supplements prevent let alone treat disease!..

And “Authorities” want to regulate (or put on doctors’ prescription only) safe medicinal  food supplements when they will not ban   the biggest killer  drugs-  like DDT, PCBs,  PVCs (and other estrogenics eg from the highdose xenoestrogens & -progestins consumed  orally by possibly a billion women and excreted into the water chain to pollute land and sealife) ie  throughout the environment and  food chain; and  stuffing sodas and  processed foods with cornstarch, aspartame and phosphates; and over-the-counter refined sugar and salt, smoking tobacco and alcohol which should at best be made  prescription- or permit-only .

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 EuropeThe 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.