ePublications and Online Content & Commentary
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Original Research The Concern About B-vitamins Affecting the Oxidant Effect of Intravenous Vitamin C for Malignancy Maiko Ochi, ND, James Hetherington, ND, Davis W. Lamson, MS, ND
Abstract
The use of intravenous ascorbate has a long history in complementary medicine. Its efficacy against malignant cells via a pro-oxidant mechanism has been previously demonstrated. In some quarters, B-vitamins have been included with intravenous ascorbate therapy. Because of the antioxidant effect of some B-vitamins, the question arose as to whether their presence could decrease the anti-malignant effect of ascorbate. The data regarding the direct ability of several B-vitamins to decrease the concentration of the active agent providing the anti-malignant effect are summarized. The individual case of cobalamin in this regard is more complex than other B-vitamins, in that cobalamin and ascorbate generate hydrogen peroxide and kill tumor cells in vitro. The implications of this result certainly warrant in vivo studies. The overall conclusion is that data do exist demonstrating that some B-vitamins do have the capacity to decrease the concentration of the anti-malignant agent from ascorbate at the tissue of concern. The authors recommend that B-vitamins or other antioxidant materials not be included with intravenous ascorbate intended for anti-cancer purposes.
(Altern Med Rev 2011;16(Supp):1S-5S)
Editorial The Sky is Falling, the Sky is Falling”* (maybe some of it is) Al Czap, Publisher
*attributed to C. Little, rooster, date unknown
On July 2, 2011, the U. S. Food and Drug Administration (FDA) published an 86 page draft document – Dietary Supplements: New Dietary Ingredient Notifications and Related Issues – for a ninety day comment period in the Federal Register. This document is specific to new dietary ingredients (NDI) (i.e., dietary ingredients that were not marketed in the United States before October 15, 1994) and is a “Draft Guidance for Industry," which means it contains recommendations that, when finalized, will represent the FDA's current thinking on this topic. This document potentially changes the regulatory status of thousands of ingredients used in dietary supplements, and could result in a large percentage of currently marketed products disappearing from the marketplace. The net health effect for patient consumers, as well as physician practices, may be profound, if the FDA were to finalize this guidance as currently proposed. READ MORE....
LETTER TO THE EDITOR & AUTHOR'S RESPONSE Conservative Management of Post-Surgical Urinary Incontinence Using Applied Kinesiology
Abstract
Dear Sir,
I read with interest the article “Conservative Management of Post-Surgical Urinary Incontinence in an Adolescent Using Applied Kinesiology: A Case Report” which was recently published in your journal. READ MORE...
ENVIRONMENTAL MEDICINE ABSTRACTS AND COMMENTARY Walter J. Crinnion, ND (www.crinnionmedical.com)
ABSTRACT
Polychlorinated biphenyls (PCBs) contamination and aryl hydrocarbon receptor (AhR) agonist activity of omega-3 polyunsaturated fatty acid supplements: Implications for daily intake of dioxins and PCBs.
Bourdon JA, Bazinet TA, Arnason TT, et al. Food and Chemical Toxicology 2010;48:3093-3097.
Omega-3 polyunsaturated fatty acid (n-3 PUFA) rich oils derived primarily from fish are frequently consumed as supplements. Due to the tendency of persistent organic pollutants (POPs) to accumulate in exposed organisms, n-3 PUFA supplements can contain sufficient POPs to present a risk to consumers. Here we investigated PCB concentrations and aryl hydrocarbon receptor (AhR) agonist activity in 17 n-3 PUFA supplements available in Canada. PCBs ranged from <0.8 to 793 ng/g oil, with salmon- and seal-derived products yielding the highest values. AhR agonist activity from a reporter gene assay ranged from 1.3 to 72.2 pg TEQ/g oil, with salmon and tuna yielding the highest values. When consumed at the recommended doses and as a supplement to the average Canadian diet, seal-derived oil can contribute to exceedance of the tolerable daily intake of 20 ng PCBs /kg-BW/day, and salmon-, tuna-, and sea herring-derived oils can contribute to exceedance of the tolerable daily intake limit of 2.3 pg TEQ/kg- BW/ day. The beneficial properties of fish and n-3 PUFA supplements, and the results of this study suggest that it is prudent to consume supplements derived from small, cold-water fatty fish. Further research will be necessary to draw firm conclusions.
COMMENTARY
Multiple studies have documented the contamination of fish with PCBs and other persistent pollutants. Studies have also indicated that regular consumption of Atlantic salmon, or other PCB-contaminated fish, results in multiple PCBs being detected in serum. This study indicates that these lipophilic toxicants can also be found in fish oil supplements. Because of the health problems associated with PCB exposure, it is imperative that clinicians recommending fish oil supplements be aware of the potential for PCB contamination. This issue is also pertinent to health-conscious consumers buying fish oil supplements, especially pregnant women (who often take such supplements in hopes of having smarter children), since PCB contamination during pregnancy has been associated with having children with lower IQs and increased incidence of ADHD. It would be wise to only purchase fish oil supplements from companies that provide bona fide testing for contaminants for each of their lots of fish-oil capsules.
Salmon and cod liver oil products consistently had high levels of PCBs present. This result is not surprising for salmon oil, since all commercially available salmon oil products are from farmed Atlantic salmon, and studies have indicated that farmed salmon is high in PCBs. The highest levels of PCBs detected were in a seal oil product tested. Seal oil products ranged from one of the lowest readings to the highest level of PCBs found, giving it a higher mean level of PCBs than salmon. This highlights the fact that levels of these toxicants can vary widely in non-farmed sea creatures, as would be expected by carnivores (e.g. seals in this case) that can eat a widely varying diet in terms of location of their food and the type of food consumed. While, the PCB contamination level in farmed fish would be expected to be more consistent, since their diet (i.e. what they are fed daily) is extremely consistent. “Mixed small fish” had the lowest average PCB content. This would also be expected because lipophilic contaminants, like PCBs, bioaccumulate as we move up the food chain. Compared to carnivorous fish like salmon, cod, and tuna, small fish are much lower on the food chain.
This study also investigated the in vitro agonist activity of aryl hydrocarbon receptors (AhR) produced from these supplements. AhR agonist activity is the one of main mechanism by which dioxins cause their toxic effects. Chemical toxicants, other than dioxins, also do damage via this mechanism. For these non-dioxin compounds their AhR agonist activity is measured so that their toxicity can be compared to dioxins. The researchers provided ratings for both the total PCB levels and the AhR agonist activity of each of the oils tested, including ratings for these oils based on the amount normally consumed on a daily basis. Salmon oil capsules had the highest level of AhR agonist activity (i.e. dioxin-like activity) followed closely by tuna and sea herring oils. “Mixed small fish” had the lowest AhR agonist activity.
Overall, the of the various fish oil supplements tested in this study, the “mixed small fish” rated best (i.e., lowest in PCBs and AhR agonist activity), leading the authors of the study to conclude that, should one choose to supplement with fish-derived oils, “…it is prudent to consume supplements derived from small, cold-water fatty fish.” The other clear winner for lowest toxicity in this study was flax oil. In this study, flax oil supplements were the only omega-3 products that were free of PCBs.
ABSTRACT
Fate and complex pathogenic effects of dioxins and polychlorinated biphenyls in obese subjects before and after drastic weight loss.
Kim MJ, PMarchand P, Henegar C, et al. Environ Health Perspect 2011;119:377-383.
BACKGROUND: In humans, persistent organic pollutants (POPs) are stored primarily in adipose tissue. Their total body burden and their contribution to obesity-associated diseases remain unclear. OBJECTIVES: We characterized POP total body burden and their redistribution in obese individuals before and after drastic weight loss and compared these values with a variety of molecular, biological, and clinical parameters. METHODS: Seventy-one obese subjects were enrolled and underwent bariatric surgery. Blood and adipose tissue samples were obtained at different times from these individuals as well as from 18 lean women. RESULTS: POP content (17 dioxins/furans and 18 polychlorinated biphenyl congeners) in different adipose tissue territories was similar, allowing us to assess total POP body burden from a single biopsy. Total POP body burden was 2 to 3 times higher in obese than in lean individuals. We also found increased expression of some POP target genes in obese adipose tissue. Drastic weight loss led to increased serum POPs and, within 6-12 months, to a significant 15% decrease in total polychlorinated biphenyl body burden. Importantly, serum POP levels were positively correlated with liver toxicity markers and lipid parameters, independently of age and body mass index. CONCLUSIONS: POP content in adipose tissue and serum correlate with biological markers of obesity-related dysfunctions. Drastic weight loss leads to a redistribution of POPs and to a moderate decrease of their total body burden.
COMMENTARY
Several previous studies have shown that, when persons undergo weight loss (through either diet or surgical means), circulating levels of polychlorinated biphenyls (PCBs) and other persistent lipophilic pollutants increase in the serum and remain elevated for quite a while after the weight is lost. Evidence indicates these toxicants might reduce thermogenesis, adversely affect thyroid function, and cause mitochondrial damage [Note: This evidence is reviewed in my book Clean, Green & Lean published by Wiley). Anecdotal accounts of increased feelings of illness and “unwellness” during these times of higher serum persistent organic pollutants (POPs) levels have been reported as well. This is the first study to look at (1) the amount of toxicant-driven gene activity and (2) circulating levels of POPs, before, and at one, three, six, and 12-month intervals after bariatric surgery. The researchers reported levels of “indicator PCBs” (i.e., those found most commonly in humans) and “dioxin-like PCBs” in subcutaneous fat stores, omental fat stores, and in serum. The indicator, or marker, PCBs were comprised of PCBs #28, 52, 101, 118, 138, 153, and 180. Of these, PCBs 118, 138, 153, and 180 can be measured in serum samples by specialty laboratories, and, consequently, can be assessed by physicians. In this study, serum and subcutaneous fat levels of PCBs and dioxins/furans increased steadily after the surgery, along with toxicant-gene activity, coinciding with bariatric surgery-induced rapid weight loss. While the subcutaneous fat levels of the POPs increased across the board, when the estimated total body fat levels were added to the equation, slight decreases– approximately 15% – in total-POP-adipose burden were estimated. The researchers also found that, as the levels of PCBs went up in the serum, liver function tests (AST, ALT and GGT) also increased, suggesting ongoing liver damage from the presence of these toxicants. This study ended at 12 months; it is unknown how long beyond one year levels of circulating POPs would remain elevated following weight loss produced by bariatric surgery. Although this study did measure POPs in serum and levels in subcutaneous and omental tissue, it did not measure redistribution to other tissues (e.g. brain, heart, etc). This is an important area for future research, since animal studies have shown redistribution of adipose tissue stored POPs to these tissues with weight loss. This study is a strong reminder to clinicians that weight loss increases POPs in the circulation (i.e., they are mobilized from adipose tissue). It is also a reminder of the need to take measures to improve the excretion of POPs from the body in all people who are losing or have recently lost weight, in order to lower body burden of mobilized POPs.
