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Letters to the Editor Issue 212

listed in letters to the editor, originally published in issue 212 - February 2014

Ask This Question Before Taking Statins

Commentary by W Todd Penberthy PhD

Before taking statins, ask yourself one question. Why is it, given two people with identical environmental backgrounds, that on average one of them dies early due to cardiovascular disease? Is it because that individual has taken less statin drugs? Of course not. It is likely due to something different in their genetics, which causes differences in enzymes and levels of other proteins. This leads to differing requirements for essential vitamins and minerals.

Cardiovascular disease is largely caused by deficiencies of essential nutrients. Thus adjusting the diet makes sense. When your car breaks down, do you have the repair shop install a gadget not in the car's parts list? Of course not. We clean, tighten, remanufacture, or replace the correct part. Similarly, the body needs maintenance and some tender loving care. Statins are not one of our parts. Essential nutrients are what we need.

The reason people die of cardiovascular disease usually begins with inflammation and progressive calcification, not cholesterol levels. The correlations between inflammation, calcification and death by cardiovascular disease (CVD) are much stronger than for correlations between cholesterol levels and death by CVD (Bolland et al, 2008).

Following the guidelines of the American Heart Association (AHA) may be useful for liability and good business, but is not always useful for maintaining optimal health. To understand what's going on inside of the body, just take a look at the images of vascular calcification. In response to inflammation in arteries, plaques form. At the centre of an arterial plaque sits a hard calcification that contains calcium carbonate. Around this calcified nucleus, the plaque develops with fat deposits and a fibrous cap. In many cases the plaque can be reversed with excellent nutrition.

Considering the media attention given to statins, it's quite remarkable to learn that they only reduce the risk of mortality from CVD by less than 1 percent. In contrast, in clinical trials involving over 8,000 patients over 6 years, high dose niacin (3,000 mg daily) reduced mortality by 11%. And this lowered risk was tabulated 15 years after the clinical trial ended! (Canner et al., 1986) That represents a huge improvement over treatment with statins. Recent advances in molecular biology explain how this works. Niacin's amazing sustained effect is likely due to its effect on regulating sirtuin [Sir2] proteins that cause long lasting epigenetic changes in the structure of DNA. This type of epigenetic modulation is known to have long-lasting effects. The nutrition you get in early childhood, or even that your parents got before you were born, can affect your genes over a long period. The data from this study implies that 3,000 mg of niacin is far superior to statins for preventing CVD death. And it only costs about 35 cents per day.

Anyone who has the risk factors for death from CVD would be well advised to consider taking up to three 1,000 mg daily doses (or, for less flushing, 12 doses of 250 mg) of regular ‘fast-release’ niacin (Hoffer et al, 2012). It would also be wise to add 100 mg of the MK7 form of vitamin K2 and 1,000 mg flax seed oil with every dose of niacin. These nutrients reduce flushing and provide anti-inflammatory benefits. For a healthy heart, include 3,000-10,000 mg of vitamin C (Roberts and Hickey, 2011), 400-1200 IU natural vitamin E, and five cups of kale mixed with colourful vegetables and a bit of grass fed butter every day. Further, to remove calcifications, it may help to daily take two 200-400 mg doses of magnesium (citrate, chelate, malate, or chloride). This can help to dissolve the calcium deposits in arteries (Dean, 2007). None of these essential nutrients requires any prescription, and together they have tremendous advantages for health compared to a statin pill.

References

Bolland, M.J., Barber, P.A., Doughty, R.N., Mason, B., Horne, A., Ames, R., Gamble, G.D., Grey, A., and Reid, I.R. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ 336(7638): 262-266. 2008.

Canner, P.L., Berge, K.G., Wenger, N.K., Stamler, J., Friedman, L., Prineas, R.J., and Friedewald, W. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol; 8(6): 1245-1255. 1986.

Dean, C. The Magnesium Miracle. New York, NY: Ballantine, 2007.

Hoffer A, Saul AW, Foster HD. Niacin: The Real Story. Basic Health Publications, 2012.

Roberts H, Hickey S. The Vitamin Cure for Heart Disease: How to Prevent and Treat Heart Disease Using Nutrition and Vitamin Supplementation. Basic Health Publications, 2011.

About the Author

Dr Todd Penberthy is a research consultant, medical writer and one of the world's prominent niacin researchers. A list of his recent papers is posted at www.cmescribe.com/resume/

Further Information

Andrew W Saul PhD - Editor and contact person. omns@orthomolecular.org

Nutritional Medicine is Orthomolecular Medicine

The peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource. Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: www.orthomolecular.org

http://orthomolecular.org/subscribe.html

http://orthomolecular.org/resources/omns/index.shtml

Find a Doctor

To locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml

Editorial Review Board

Ian Brighthope MD (Australia)

Ralph K. Campbell MD (USA)

Carolyn Dean MD ND (USA)

Damien Downing MD (United Kingdom)

Dean Elledge DDS MS (USA)

Michael Ellis MD (Australia)

Martin P. Gallagher MD DC (USA)

Michael Gonzalez DSc PhD (Puerto Rico)

William B. Grant PhD (USA)

Michael Janson MD (USA)

Robert E. Jenkins DC (USA)

Bo H. Jonsson MD PhD (Sweden)

Peter H Lauda MD (Austria)

Thomas Levy MD JD (USA)

Stuart Lindsey Pharm D (USA)

Jorge R. Miranda-Massari Pharm D (Puerto Rico)

Karin Munsterhjelm-Ahumada MD (Finland)

Erik Paterson MD (Canada)

W Todd Penberthy PhD (USA)

Gert E. Schuitemaker PhD (Netherlands)

Robert G. Smith PhD (USA)

Jagan Nathan Vamanan MD (India)

Ausuo Yanagisawa Md PhD (Japan)

Evolution of Pelvic Organ Prolapse (POP) Treatment - Pelvic Floor Disorder Registry (PFD) Registry

by Sherrie Palm

Women navigating pelvic organ prolapse treatment options must decide whether or not to utilize non-surgical or surgical treatment. There truly is no right or wrong decision with surgical or non-surgical treatment options; the preference for your personal scenario is the right choice if it's the right choice for you.

Use of mesh for pelvic organ prolapse surgery can reduce the risk of additional surgery down the road. For those who opt for surgical treatment, APOPS recommends seeking a specialist (urogynecologist or urologist who specializes in pelvic floor) for your procedure just as you would an oncologist for breast cancer or neurologist for multiple sclerosis (MS) or brain tumours; it reduces the risk of complications. A dialogue should be initiated between patient and urogynecologist whether or not to utilize mesh for your repair. Research your procedure choices, ask your physician ALL questions you have, discuss your options regarding transvaginal mesh repair (through the vagina) or abdominal mesh repair (abdominal incision).

Recently the FDA issued a warning relating to concerns about transvaginal mesh procedure complications. Urogynecologists and urologists with an additional 2-3 years of fellowship training are the most logical surgeon choice for these intricate procedures. Additionally, it is a good idea to check the records of your individual physician to make sure you have found the right physician for your specific needs. We all need to know our options; there are choices regarding surgical procedures just as there are options whether or not to utilize surgical procedures at all. Ask all questions you have; a physician who will not take the time to address your concerns with this intricate procedure is not the physician of choice.

Some urogynecologists and urologists refuse to utilize mesh procedures; it is a personal preference the specialists in the field make on a one-on-one basis based on their individual concerns. A significant percentage of urogynecologists and urologists who utilize mesh feel transvaginal mesh procedures are beneficial and should remain an option. I am a woman whose surgical procedure was transvaginal mesh placement. I have been very happy with the outcome; as a woman who is extremely active, I wanted my POP repair to be a onetime event rather than worrying about potential for additional POP surgical intervention down the road.

Women who have concerns related to mesh procedures can post their questions to the APOPS Facebook Chatroom; a link to the Chatroom is on the Home page of the APOPS website. Women with POP navigating treatment options, women post-surgery both with mesh and without, women who prefer to utilize non-surgical treatment options, and multiple healthcare professionals share insights with each other.

http://pelvicorganprolapsesupport.org/home

The American Urogynecologic Society (AUGS) has now posted an informed consent for mesh procedures toolkit on their website. Multiple layers of POP mesh agenda are attached, patient hand-outs, info from AUGS and the FDA, informed consent checklist.

www.augs.org/p/cm/ld/fid=174

Further Information

Please contact Sherrie Palm, APOPS Founder / Executive Director on <sjpalm@wi.rr.com>

http://pelvicorganprolapsesupport.org/library/mesh

Ohio Amish & the Concentration Camps of Oncology

by Dr Mark Sircus Ac OMD DM(P)

Sarah, a 10-year-old Amish girl with leukemia, and her parents have left the country to seek alternatives to chemotherapy. Her parents said the treatments have caused their daughter a great deal of pain, and they'd rather focus on herbal and natural remedies.

The parents skipped the country after the courts said that their Ohio hospital could force chemotherapy on their daughter. Sarah had tumours on her neck, chest and kidneys when her parents initially agreed to chemotherapy at Akron Children's Hospital earlier this year. Her parents said the side effects were terrible, and they wanted to treat Sarah's leukemia with alternative treatments.

“The hospital believes the girl will die without chemotherapy and is morally and legally obligated to make sure she receives proper care,” said Dr Robert McGregor, the hospital's chief medical officer. Morally this doctor is on par with the worst elements of medicine but legally he is standing as tall as an SS doctor who knew he had the law and government behind him.

That might sound harsh but if we dig just a little below the surface we can see either ignorance or the greatest arrogance imaginable from doctors like this who lie and manipulate and even force “chemo” on a person even if it leads up to their death! What is Dr McGregor ignorant about or lying about because he knows, but just will not say? Is he telling the world about the side effects from chemotherapy that will eventually lead to Sarah’s death? Is he telling the parents how chemotherapy will damage her DNA?

Scientists wrote in Nature Medicine in August of 2012 that healthy cells damaged by chemotherapy secreted more of a protein called WNT16B, which boosts cancer cell survival. The researchers observed up to 30-fold increases in WNT production. What these doctors said obviously went over most oncologists’ heads. Chemotherapy interacts with nearby tumour cells and cause them to grow, invade, and importantly, resist subsequent therapy damage responses in benign cells. This all contributes directly to enhanced tumour growth kinetics.

Hurt, Kill & Treat all at the same Time

Children who survive brutal oncology treatments face increased heart health risk and should take measures soon after life-saving therapy to reduce the risk of serious problems later in life. While earlier research had shown that childhood cancer survivors face heart disease and other potentially serious health problems decades after treatment, a new study found that chemotherapy takes a toll on artery health while survivors are still children, leaving them vulnerable to premature atherosclerosis and heart disease.

We do not have to harm patients to cure them. Chemotherapy in general is a wrong idea though we will discover that there are natural forms of chemotherapy, like medical marijuana, that are more effective without the often-crippling side effects. What sense is there in saving a life if you are going to also destroy it?

"We've seen how sick it makes her," Andy Hershberger, Sarah's father, told ABC News in August. "Our belief is the natural stuff will do just as much as that stuff if it's God's will." "If we do chemotherapy and she would happen to die, she would probably suffer more than if we would do it this way and she would happen to die," he said.

Sarah told a probate and juvenile judge that she didn't want chemotherapy because it made her feel ill, can damage her organs and make her infertile. Medina County Probate and Juvenile Judge John Lohn said he could only transfer guardianship if the parents were found unfit.

"The court cannot deprive these parents of their right to make medical decisions for their daughter, because there is not a scintilla of evidence showing the parents are unfit," Lohn wrote in a ruling issued on July 31. Since then a higher court has ruled against the parents and they have fled the country to escape the brutality of the doctors and their treatments.

“A large number of people are living long and normal lives,” said Dr Patricia Ganz, an oncologist at UCLA who is one of the nation’s first specialists in the side effects of treatment. “It’s no longer enough to cure them. We have to acknowledge the potential consequences and address them early on.” Chemotherapy is not the way to go in treating children’s or anyone else’s cancer unless the chemo agents are gathered from natural sources and cause little of these damaging effects.

The western medical industrial complex is enamoured with radiation, surgery and chemotherapy for the treatment of cancer but most doctors themselves run from orthodox oncology treatments, knowing the horror and dangers. Chemotherapy’s agents are blunt instruments—toxins that kill healthy cells just as effectively as they kill cancer cells.

The essence of chemotherapy is to use chemicals strong enough to kill cancer cells. This is a good idea as long as the chemo agents do not harm the host meaning they do not harm us. There are plenty of substances that scientists have studied which shrink tumours reducing a person’s chances of dying from cancer and most of them in fact do not come out of the drug chambers of the pharmaceutical industry.

They Miss the Point

Every doctor learned back in medical school all about Dr Otto Warburg’s discovery in the 1930s when he discovered the main biochemical cause of cancer, or what differentiates a cancer cell from a normal, healthy cell. So great was this discovery that Dr Warburg was awarded the Nobel Prize. Dr Warburg said, “Cancer, above all other diseases, has countless secondary causes. Almost anything can cause cancer. But, even for cancer, there is only one prime cause. The prime cause of cancer is the replacement of the respiration of oxygen (oxidation of sugar) in normal body cells by fermentation of sugar… In every case, during the cancer development, the oxygen respiration always falls, fermentation appears, and the highly differentiated cells are transformed into fermenting anaerobes, which have lost all their body functions and retain only the now useless property of growth and replication.”

When we do not address this key driver it does not matter what we do - cancer will come back and kill us.

Otto Warburg was telling us that the cellular metabolism of cancer cells matches closely those of yeast or mold or fungus - that is, the cells ferment sugar / glucose / dextrose rather than oxidize it via the cellular mitochondria. So it follows logically that the same medical approach that successfully targets cancer would do the same for these yeasts, moulds and fungus.

There are many anti-cancer agents and therapies that contribute to changing the entire physiological profile of the tissue in which cancer cells exist (paying attention to what’s going on with the healthy and semi healthy cells). Change the level of oxygen in the tissues and you change the outcome of cancer and other diseases. The obvious solutions to cancer have eluded us due to the fact that those solutions have never been presented together as part of an organized protocol.

Natural Chemotherapy

Sodium bicarbonate, simple plain-old baking soda, is one of the strongest anti-cancer medicinals out there and the same can be said for iodine, magnesium, selenium and cannabinoids. The best form of natural chemotherapy would include all of these substances and more, administered in an organized and systematic protocol. My Natural Allopathic protocol focuses on pH management, cell voltage, magnesium and iodine medicine, cannabinoid medicine, selenium medicine, carbon dioxide levels in the blood, re-mineralization of the body, antioxidant therapy, anti-inflammation therapy, increasing oxygen transport and oxygenation of the tissues, opening up of blood vessels, saturation and healing of cells with concentrated nutritionvia superfoods, breathing retraining, emotional transformation processing (contacting ones vulnerable feelings), detoxification and removal of heavy metals and radioactive particles.

This compendium (due out early next year) will have over 2,000 pages of information about Natural Oncology and the treatment of cancer as an inflammatory and infectious disease. Cancer is as smart as we are stupid, meaning it knows how to exploit every mistake we make in terms of treatment and prevention. Cancer reaches into every area of our existence meaning emotions and stress, even sexual stress matters. We are much more than our inflammations and infections. We are what we eat, for instance, and this translates into gross nutritional deficiencies that doctors do not like to talk about.

Most people sense that modern oncology is very dangerous. What is most terrible about it is that treatments are in no way intended to target the cause or causes of cancer so even though the cancer industry is constantly talking about finding the ‘cure’, that’s the last thing on their agenda. The only treatments oncologists have to offer are therapies that do not treat cancer but rather make the person sicker and ultimately die a more horrible death.

Dr Peter S Nelson, a member of the Hutchinson Cancer Center’s Human Biology Division, describes the normal methods of chemotherapy saying, “In the laboratory we can ‘cure’ most any cancer simply by giving very high doses of toxic therapies to cancer cells in a petri dish. However, in people, these high doses would not only kill the cancer cells but also normal cells and the host.” Therefore, treatments for common solid tumours are given in smaller doses and in cycles, or intervals, to allow the normal cells to recover. This approach may not eradicate all of the tumour cells, and those that survive can evolve to become resistant to subsequent rounds of anti-cancer therapy.

What mainstream researchers are failing to find is that we can approach cancer treatment from a completely different and opposite angle to chemotherapy. Instead of trying to kill the cancer and harm the surrounding cells we imprison the cancer in a solid wall of healthy cells, thus that area being strengthened as opposed to being weakened by treatments. We create the conditions where we first limit the ability to grow and then send in some cruise missiles that directly target the cancer cells, choking the life out of them with waves of increased alkalinity, oxygen and Co2; plus hordes of vital minerals, vitamins, healthy fats and amino acids, enzymes and slow breathing exercises as well as far infrared therapy.

Special Note: Say No to Chemotherapy

New research suggests chemotherapy has devastating effects on the brain. Many cancer patients who receive chemotherapy report ‘chemobrain’ - a range of symptoms including a loss of memory and the ability to concentrate, and other problems such as difficulty thinking. In the September 2009 Journal of Cancer Survivorship women described a variety of emotions, including fear, frustration and emotional exhaustion with some women fearing losing their independence because they wouldn’t be able to take care of themselves like before. At the workplace, the side effects of chemotherapy robbed their ability to focus. “These data underscore the very serious ways in which chemobrain can affect the life experiences of cancer survivors - emotionally, psychologically and economically,” the researchers concluded.

Dr Mark Sircus Ac OMD DM(P)

Director International Medical Veritas Association

Doctor of Oriental and Pastoral Medicine

http://drsircus.com/

Vitamins Help Prevent Alzheimer's Disease - News Media Ignores Supplement Benefits . . .Again

Nutritional supplementation with antioxidants and the B-complex vitamins has been shown to help prevent dementia. Half of all cases of Alzheimer's, the most common form of dementia, could be attributable to known dietary and lifestyle risk factors, and at least one fifth of current cases could be prevented right now.

But there's no money for prevention research, or sufficient political will to put prevention steps into action. To date, tens of billions of dollars have been spent on developing drugs, none of which have proven to stop or slow down the disease process. Yet already studies have shown that B vitamins have decreased the rate of brain shrinkage in the areas affected by Alzheimer's by almost nine times, as well as dramatically slowing down memory loss, in people with mild cognitive impairment, the precursor to Alzheimer's. Other promising preventive factors include exercise; controlling blood sugar and blood pressure; omega-3 fish oils; and getting involved in more social activities.

"Of the millions of pounds so far pledged for dementia research by the UK Government, none has been spent on prevention," says Professor David Smith from Oxford University. Dr Smith's research group first identified that almost half of people over 60 have insufficient vitamin B12 to stop accelerated brain shrinkage. He believes we need to wake up to the fact that Alzheimer's is unlikely to be prevented by drugs.

Preventing Alzheimer's disease-related grey matter atrophy by B-vitamin treatment: www.pnas.org/content/early/2013/05/16/1301816110.full.pdf+html

Vitamins B12, B6 and folic acid shown to slow Alzheimer's in study: www.healthcentral.com/alzheimers/c/62/160989/vitamins-b12-shown-alzheimer/

Low vitamin B-12 status in confirmed Alzheimer's disease: http://jnnp.bmj.com/content/74/7/959.full.pdf+html

Ways to Use Nutrition and Lifestyle to Prevent Alzheimer's

Eat fish - Eat fish three to four times a week, with at least two servings of oily fish (salmon, mackerel, herrings, kippers, sardines or tuna). Eat more nuts and seeds, preferably raw; Up the antioxidants - Eat at least six servings of brightly coloured vegetables and berries. Supplemental vitamin E (natural mixed tocopherols and tocotrienols) 400 IU and several thousand mg of vitamin C per day are both good ideas; Cut sugar and refined carbs - Follow a low glycaemic load, Mediterranean style diet, with slow-releasing ‘whole’ carbohydrates. Minimize sugar, sugary drinks and juices; Take B vitamins - Supplementing with vitamin B6 (20mg), B12 (500mcg), niacinamide (400 mg) and folic acid (400mcg) is a sensible precaution. People with raised homocysteine need higher supplemental vitamin intake to prevent brain shrinkage; Limit coffee and stop smoking - Choose herbal or green tea instead; Be active - Keep physically, socially and mentally active by learning new things.

Ray Hodgson tried this approach. He took B vitamins and has also improved his diet, eating more fish, vegetables, and whole foods, and cutting back on sugar. "The effect has been remarkable," he said. "Whereas I had been forgetting names and finding it hard to take on new skills, my memory and concentration are definitely better."

The world-wide costs of dementia in 2010 were estimated to be over $600 billion. Prevention of dementia would thus not only prevent a tremendous amount of human suffering but would also save huge sums of money.

Further Information

High doses of vitamins fight Alzheimer's disease: Why don't doctors recommend them now? http://orthomolecular.org/resources/omns/v04n25.shtml

Niacinamide restores cognition in Alzheimer's disease transgenic mice: www.jneurosci.org/content/28/45/11500.full.pdf+html (pdf download may take a few moments)

There is more on the internet about how niacinamide can help Alzheimer's, such as this article: www.alternative-medicine-digest.com/alzheimers-treatment.html

Vitamins E, C cut Alzheimer's risk, study says: www.cnn.com/2004/HEALTH/conditions/01/20/alzheimers.vitamins.reut/ www.theglobeandmail.com/life/vitamins-e-c-cut-alzheimers-risk-study-says/article992961/ People of retirement age who took supplements of both vitamin E and C daily saw their risk of Alzheimer's disease plummet by almost 80 per cent. Full text of original study: http://archneur.jamanetwork.com/article.aspx?articleid=785249

Grant WB. Trends in diet and Alzheimer's disease during the nutrition transition in Japan and developing countries. J Alzheimers Dis. 1;38(3):611-20. doi: 10.3233/JAD-130719. Jan 2014. www.ncbi.nlm.nih.gov/pubmed/24037034

Dean C. The Magnesium Miracle. Ballantine Press. ISBN-13: 9780345494580. 2007.

Further Information

Andrew W Saul PhD - Editor and contact person. omns@orthomolecular.org

Nutritional Medicine is Orthomolecular Medicine

http://orthomolecular.org/subscribe.html

http://orthomolecular.org/resources/omns/index.shtml

Find a Doctor

To locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml

Editorial Review Board

Ian Brighthope MD (Australia)

Ralph K. Campbell MD (USA)

Carolyn Dean MD ND (USA)

Damien Downing MD (United Kingdom)

Dean Elledge DDS MS (USA)

Michael Ellis MD (Australia)

Martin P. Gallagher MD DC (USA)

Michael Gonzalez DSc PhD (Puerto Rico)

William B. Grant PhD (USA)

Michael Janson MD (USA)

Robert E. Jenkins DC (USA)

Bo H. Jonsson MD PhD (Sweden)

Peter H Lauda MD (Austria)

Thomas Levy MD JD (USA)

Stuart Lindsey Pharm D (USA)

Jorge R. Miranda-Massari Pharm D (Puerto Rico)

Karin Munsterhjelm-Ahumada MD (Finland)

Erik Paterson MD (Canada)

W Todd Penberthy PhD (USA)

Gert E. Schuitemaker PhD (Netherlands)

Robert G. Smith PhD (USA)

Jagan Nathan Vamanan MD (India)

Ausuo Yanagisawa Md PhD (Japan)

Something’s Fishy About Macular Degeneration

by Bill Sardi

Just seven months ago National Eye Institute researchers claimed fish oil “doesn’t seem to help macular degeneration,”[1] a sight-robbing eye disease that plagues adults in their senior years.

So how could another newly published study produce exactly opposite results? In fact, fish oil didn’t just slow down the insidious progression of this eye disease, it restored vision to every patient placed on high-dose fish oil. It was therapeutic and curative, not just preventive.

The study I’m referring to is likely to be dismissed. The study group was small - only 25 patients. There was no inactive placebo pill given to another group of patients for comparison, a requirement for scientific validity. And it’s also possible (but not plausible) that all the patients in the study were abjectly deficient in omega-3 fish oils, producing an atypical effect. But the study group was based in the Mediterranean where fish consumption is high. And it’s not likely any placebo effect was involved.

The study is so convincing, especially when combined with all of the positive fish oil studies conducted over the last decade (see chart below), eye physicians would now be derelict in their duty not to recommend every long-living senior adult to consume more fish, or better yet - take concentrated fish oil capsules, if they want to maintain their sight throughout their retirement years.

Growing evidence

The study I’m referring to was just published in the PharmNutrition journal.[2] It raises many questions, particularly why has it taken so long to discover high-dose fish oil can restore lost sight to many Americans. The data pointing to fish oil as a dietary agent that can stave off vision loss with advancing age has been growing for over a decade.

Except for one ‘fishy’ study, all other human clinical fish oil studies published over the past 13 years indicate fish oil slows down or prevents macular degeneration, a sight-robbing condition that affects central vision used for reading, driving and face recognition. The latest published study was more momentous than prior studies as it didn’t just show fish oil slows down the progression of the disease; it actually began to restore vision to patients within days of starting a daily regimen of high-dose fish oil capsules.

Slowing macular degeneration down is one thing, but reversing it is another. There is no cure for the common form of the disease, called dry macular degeneration. Antioxidant dietary supplements recommended for this disease slow down its progression by maybe 10 percent at best. Macular degeneration patients began experiencing improvement in visual acuity from the get-go. After six months a third of the patients could see letters that were three lines smaller on the eye chart. Another third saw two lines better and the remaining third a single line of improvement.

100% of patients with macular degeneration experienced improved vision when the normal course of the disease is insidiously progressive loss of central vision.

High Dose

The dose of fish oil was the highest used in any study so far - 5000 milligrams (3400 mg EPA, 1600 mg DHA), or a bit less than two tablespoons a day. That much fish oil is likely to be costly for retirees on fixed incomes, around two dollars a day. A six-month course would certainly be worth the investment, especially when some seniors might be able to renew their driver’s license or resume activities that help them stay independent.

The one “fishy” negative study was reported in the Journal of the American Medical Association in May of this year.[3] National Eye Institute researchers said fish oil "doesn't seem to help age-related macular degeneration." That study compared a low dose of omega-3 fish oil with an antioxidant formula providing lutein, zeaxanthin, zinc and copper (no true placebo group or inactive pill was used). The dose of fish oils in the treatment group was much lower than prior studies.

Some sceptical researchers I have consulted express concerns over the fact this study was conducted largely among well-nourished subjects who likely eat a lot of fish in their diet. I’m informed that the comparison group consumed up to 720 milligrams of fish oil from their daily diet. Also some study subjects in the comparison group may have been supplementing with folic acid which raises blood levels of omega-3 oils.[4] Researchers concede that “study results may not be generalizable, because the study population is a highly selected group of highly educated and well-nourished people.” Was the study rigged to fail?

References

1. http://www.sciencedaily.com/releases/2013/05/130513152403.htm

2. Georgiou T, Neokleous A, Nicolaou D, Sears B. Pilot study for treating dry age-related macular degeneration (AMD) with high-dose omega-3 fatty acids. PharmaNutrition, Available online 18 October 2013. http://dx.doi.org/10.1016/j.phanu.2013.10.001

3. The Age-Related Eye Disease Study 2 (AREDS2) Research Group. Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration: The Age-Related Eye Disease Study 2 (AREDS2) Randomized Clinical Trial. JAMA. 2013;309(19):2005-2015. doi:10.1001/jama.2013.4997. http://jama.jamanetwork.com/article.aspx?articleid=1684847

4. Das UN. Folic acid and polyunsaturated fatty acids improve cognitive function and prevent depression, dementia, and Alzheimer's disease--but how and why? Prostaglandins Leukot Essent Fatty Acids. Jan 2008;78(1):11-9. Epub Nov 28 2007. http://www.ncbi.nlm.nih.gov/pubmed/18054217

About the Author

COMPILATION OF STUDIES Fish Oil/ Age-Related Dry Macular Degeneration Studies Limited to human studies involving fish oil alone AMD= age-related macular degeneration
Study published	Type of study	Length of time	# of subjects	Location	Dose of fish oil	Result
PharmNutrition Dec 2013	Controlled THERAPY	6 mos	25 (40 eyes) 50-85 yrs of age	Cyprus	3400 mg EPA/1600 mg DHA	100% improved at least 1 line visual acuity; avg. 2 lines vision improvement (10 letters¹)
Ophthalmology Aug 2013	Controlled PREVENTION	3 years	263 55-85 yrs of age	France	270 mg EPA/ 840 mg DHA	Highest EPA/DHA blood level = -68% risk reduction for new blood vessel formation. No visual acuity improvement. Note: placebo was olive oil².
Ophthalmology May 2013	Dietary intake PREVENTION	5 & 10 yrs	2531	Boston, Mass	Dietary intake	8.1% and 16.9% of healthy eyes progressed (geographic atrophy) over 5 & 10 years; highest intake of DHA = -32% relative reduced risk
J American Med Assn May 2013	Controlled TREATMENT	4.3-5.1 yrs	4203 73.1 yrs mean age	Multi-center study USA	650 mg EPA/ 350 mg DHA	Omega-3 levels rose in blood but visual improvements were not significant
J. Nutrition April 2013	Dietary PREVENTION	32 mos avg	963 Age 73+ yrs	France	Dietary intake	Highest blood levels of omega-3 = -38% reduced risk for advance AMD
Investigative Ophthalmology July 2011	Dietary intake PREVENTION	3 yrs	666	France	Dietary intake	Fish oil intake decreased risk for early AMD (-17%) and advanced AMD (-74%)
Archives Ophthalmology July 2011	Dietary intake PREVENTION	–	38022 women- mean age 54.6 yrs	Boston, MA	Dietary intake	1 serving fish/week compared to 1 serving/week reduced relative risk for AMD -42%
Amer J Clinical Nutrition Dec 2009	Dietary intake PREVENTION	13 yrs	1837	Multi-center study USA	Dietary intake	High intake fish oil 30% less likely to advanced AMD
British J Ophthalmology Sept 2009	Dietary Intake PREVENTION	8 yrs	2934	Multi-Center Study USA	Dietary intake	Highest intake (=64.0 mg/d for DHA/ =42.3 mg/d EPA) had a significant ~25% decreased relative risk for disease
Archives Ophthalmology May 2009	Dietary Intake PREVENTION	4 yrs	6734 58-69 yrs of age	Australia	Dietary intake	Highest intake fish oil reduced relative risk for advanced AMD by 15%
Euro J Ophthalmology Jan 2009	Controlled THERAPY	6 mos	22	France	720 mg EPA/ 480 mg DHA	Improved circulation (“blood enrichment”) observed
Archives Ophthalmology Jan 2009	Dietary Intake PREVENTION	12-yrs	1837	Multi-Center Study USA	Dietary intake	Highest intake fish oil 30% less likely to develop advanced AMD
Archives Ophthalmology Sept 2008	Dietary intake PREVENTION	6.3 yrs	2132 71+ yrs	Multi-Center Study USA	Dietary intake	Participants w/highest levels of DHA intake half as likely to experience progression (geographic atrophy)as lowest intake
Archives Ophthalmology May 2007	Dietary PREVENTION	–	4519 60-80 yrs of age	Multi-Center Study USA	Dietary intake	-46% relative risk reduction for advanced AMD with highest DHA intake
Archives Ophthalmology July 2006	Dietary PREVENTION	5 yrs	2335 49+ years	Australia	Dietary intake	Highest intake of fish oil reduced relative risk for early AMD 59%
Archives Ophthalmology Aug 2001	Dietary PREVENTION	–	349 55-80 yrs of age	Boston, MA	Dietary intake	Greater fish consumption reduced risk for AMD
Am J Clinical Nutrition Feb 2001	Dietary PREVENTION	–	72489 50+ yrs of age	Boston, MA	Dietary intake	Highest DHA intake reduced relative risk for AMD 30%; more than 4 servings of fish/week reduced AMD risk 35%
Archives Ophthalmology March 2000	Dietary PREVENTION	–	3654 49+ years of age	Australia	Dietary intake	Fish consumption associated with reduced risk for advanced AMD
¹ One line of letters on the visual acuity chart = 5 letters ² Olive oil shown to halve risk to develop advanced AMD in another study (Archives Ophthalmology 127: 674, May 2009), so not wise choice of placebo. Would have narrowed differences between fish oil and olive oil supplemented subjects.

Further Information

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Advertising Standards Association (ASA) and Authors of the Swiss Health Technology Assessment HTA on Homeopathy report write to ASA and Secretary of Health

ASA - documented evidence - a story of evasion and bias
Our readers will be interested to read some specifics on how the ASA acts arbitrarily and chooses evidence to suit their own agenda. Nothing could be more apparent than in the case of Homeopathy: Medicine for the Twenty-first Century (H:MC21), as can be seen from the following exchange of correspondence between the ASA and the authors of a Swiss report on homeopathy. Here follows some explanation of the background to the exchange.
One important piece of evidence on the workability of homeopathy submitted to the ASA by H:MC21 (whose advert had been challenged by the ASA) was a copy of the Swiss Health Technology Assessment (HTA) on homeopathy. This provides solid evidence that ‘homeopathy has a history of success in chronic disease’.

The Swiss HTA was founded in 1999 for the scientific evaluation of medical technologies on the basis of their effectiveness, appropriateness, and efficiency, as well as social and ethical aspects and implications. All government agencies, all University Institutes, several University Hospitals dealing with Technology Assessment and the Swiss Medical Association are members. It is also important to know that homeopathy is integrated into the Swiss National Health system.

The ASA rejected this HTA report outright and stated that ‘the robust evidence we are looking for’ is that of Randomised Control Trials (RCTs). The ASA’s report (which Sir Hayden Philips, the Independent Reviewer of ASA Adjudications, confirmed as having been written under his ‘personal supervision’) bizarrely stated that the HTA contained no such evidence. More bizarre still was the belief of Sir Hayden and his ‘expert’ that the HTA’s main conclusion that homeopathy is safe, effective and cost-effective, was based on a re-working of just one negative analysis (apparently that of Shang, another report on homeopathy which chose to selectively interpret in a negative way a small number of specific studies) - see http://www.asa.org.uk/Rulings/Adjudications/2013/7/Homeopathy-Medicine-for-the-21st-Century/SHP_ADJ_139800.aspx.

The authors of the HTA report (Prof. Dr. Peter F. Matthiessen and Dr. Gudrun Bornhöft) responded to the ASA by pointing out to Mr Guy Parker (Chief Executive of the ASA) that their work contained well over one hundred RCTs whilst, on the matter of their conclusions being based on the alleged rewriting of just one study, Sir Hayden had but to glance through the contents pages ‘to reveal the falseness of this absurd claim’.

The HTA authors further told Mr Parker:
“In conclusion, we state that your writing does not even begin to approach a professional standard. We take great exception to your untenable allegation that we researched this important subject with the superficiality that you suggest, an implication which we consider defamatory.

“It is customary that authors whose work is misrepresented should have the right of a reply to be published in the same location as the attack was published. We therefore demand that you please place our reply on your website, with equal prominence to your own text”.

The HTA authors sent two letters to Mr Parker who declined to answer either of them, delegating the task to a Rob Griggs. ‘Rob’ (as he affably signs himself) wrote:
‘We disagree (sic) with your interpretation of the wording of our adjudications. During our investigation processes, we recieved (sic) expert advice on the various studies submitted by the advertisers as evidence supporting their marketing claims. We stand by that advice and our use of it’.
‘Rob’ was unfortunately unable to shed any light on why, and in what way, the ASA ‘disagreed’ with Professor Matthiessen and Dr Bornhöft, or why it was that the ASA felt entitled to deny the undeniable. As for the ‘received expert advice’, Mr Griggs also omitted to mention that the ASA’s ‘advisor’ appears to have had no training, experience, qualifications or indeed knowledge or understanding whatsoever in homeopathy, in clear contradiction of the requirements of ASA’s own Code of Practice. The ‘expert in homeopathy’ has instead pursued a career in conventional medicine pharmacology (with financial interests clearly opposed to homeopathy).

In any normal process of justice, an expert witness is cross-examined by the defence. No such process exists within the ASA; the ‘expert witness’ - hand-picked by the ASA - is just automatically deemed to be correct.

The ASA’s whole process of ‘justice’ gives rise to massive concern. This organisation is a private company, acting not only as its own self-appointed judge, jury and executioner, but more worryingly still, acting also as Counsel for both prosecution and defence, able to censor out anything from the Defence that they don’t wish the judge and jury to see. Not even the show trials of Stalinist Russia or Maoist China went that far.

Returning to Mr Parker‘s refusal to reply in person: could that by any chance have been due to the HTA authors’ use of the word Misrepresentation, a word which can be interpreted either in a general context or in a legal framework (see section two of the Fraud Act 2006)? And should other junior members of the ASA be wary in future of allowing the buck to be passed to them in this way?

The correspondence in full

Letter from the authors of the HTA to CEO of the ASA Mr Guy Parker

Dear Mr Parker,

We have read your ‘analysis’ of our ‘Homeopathy in Healthcare’ Health Technology Assessment: we find your writing frankly disquieting.

In your ‘discussion’ of homeopathy’s success in treating chronic disease, you say, bizarrely, that our HTA contains no 'robust evidence' such as RCTs. In fact, pages 130 - 140 of the HTA, for example, discuss 17 homeopathic RCTs, all conveniently summarized on page 207. Pages 103 – 106 refer to homeopathic RCTs in the hundreds.

It is certainly correct that RCTs are generally accepted as a ‘gold standard’ in conducting clinical trials. This is however only a convention (i.e. an ‘agreement’) and, albeit science based, is not free from a considerable quantity of biases. Notwithstanding that, our HTA book in any event fully satisfies the requirements of RCT research conventions.

Additional to that, Chapter 5 of Homeopathy in Healthcare examines, within the scientific paradigm of Evidence-Based Medicine, the problems and likely inherent bias of RCT methodology. This is a chapter of central importance which we would expect you to take seriously. You are of course entitled to examine and debate the points that we make, provided you do so from a logically and scientifically evidenced rationale. But to sweep this whole debate under the carpet as if it doesn’t even exist is patently unacceptable: to furthermore airbrush out of existence, so it would appear, all the RCT research that Homeopathy in Healthcare contains is deeply disturbing.

Your ‘analysis’ of our work becomes still more extraordinary. You say our ‘main conclusion regarding efficacy was drawn from a reconsideration of a previous meta-analysis of qualifying trials which found no significant difference between placebo and homeopathic treatment’ (seemingly referring to Shang et al).
Even a glance at our contents page would reveal the falseness of your absurd claim: reading our book in any detail at all would verify that our conclusions are, on the contrary, based on an analysis of:

·                 Well over 100 homeopathic RCTs
·                 22 meta-analyses, involving the results of thousands of patients (20 of the 22 found at least a trend in favour of homeopathy - many of them strongly so – while the remaining two were of low validity).
·                 a detailed study of homeopathy’s success in treating upper respiratory tract infections. Six out of seven controlled studies showed at least an equivalence with conventional-medical interventions, whilst a further 8 (out of 16) RCT studies showed results from homeopathy treatment that were significantly the superior.
·                 studies into beneficial homeopathic effects on animals and plants.
·                 changes which homeopathy has been shown to produce on cells in test tubes. An explanation of any kind of how this can be effected by mere ‘placebo’ has to our knowledge never yet been postulated.

On the other hand, and as a fact, Shang did not examine over 100 trials, but only 8, and the reasons for exclusion of other trials were not explained, contrary to scientific protocol. Selection of any data other than the 8 chosen trials would have produced a marked result in favour of homeopathy, in line with the overwhelming majority of meta analyses [see http://www.dokterrutten.nl/collega/ShangIJHDR.pdf ].
Throughout our HTA 'Homeopathy in Healthcare', the Shang study is mentioned only briefly in the discussion section. Your claim that we based our result on a reworking of Shang is therefore as false as is your statement that Shang carried out ‘a substantial review of over 100 placebo controlled trials showed no convincing evidence that homeopathy was superior to placebo’.

In conclusion, we state that your writing does not even begin to approach a professional standard. We take great exception to your untenable allegation that we researched this important subject with the superficiality that you suggest, an implication that we consider defamatory. You accuse us of basing our conclusions largely on a reworking of one deeply flawed paper, the Shang study. Yet this is the one paper on which you appear to have based your own conclusions, which are flatly contradicted by swathes of contrary evidence of which you revealingly make no mention. We find this bizarre.
It is customary that authors whose work is misrepresented should have the right of a reply to be published in the same location as the attack was published. We therefore demand that you please place our reply on your website, with equal prominence to your own text.

Yours sincerely,

Prof. Dr. med. Peter F. Matthiessen                                            Dr. med. Gudrun Bornhöft
cc Jeremy Hunt, Secretary of State for Health.
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Letter to Mr Hunt, UK Minister of State for Health

Dear Mr Hunt,

We appreciate that you are not personally responsible for the actions of UK university professors, nor of the UK Advertising Standards Authority Ltd. But as Minister of State for Health, we wish to bring to your attention the continuation of falsehoods that have emanated from your country concerning our Health Technology Assessment Homeopathy in Healthcare, which examined and found homeopathy to be safe, effective and cost-effective.

We enclose a copy of our reply to the Advertising Standards Authority Ltd., also of our earlier published replies to Professors Ernst and Shaw, both of whose writing we considered to be defamatory. We expect ASA Ltd. to publish our reply, just as others have agreed so to do in the past.

We request that you will act in all ways that your power permits to persuade the ASA Ltd, on the subject of homeopathy and our work, to remain within the boundaries of scientific actuality, to correct factual errors already made, and to refrain from issuing defamatory texts on our work in the future.

Yours sincerely,
Prof. Dr. med. Peter F. Matthiessen                                                Dr. med. Gudrun Bornhöft

Attachments:  Reply to Mr Parker, Advertising Standards Authority (ASA) Ltd. (email from 24th July 2013) Familiarity, objectivity – and misconduct Counterstatement to Shaw DM. The Swiss Report on homoeopathy: a case study of research misconduct. Swiss Med Wkly. 2012;142:w13594

Letter from to the authors of the HTA report from “Rob” of the ASA

Dear Prof. Dr med. Peter F. Matthiessen & Dr med. Gudrun Bornhöft,

Thank you for contacting us.

You might be aware that the ASA is the UK’s independent advertising regulator, recognised by the Government, Courts and UK Trading Standards Services as the ‘established means’ for regulating misleading and comparative ads in non-broadcast media in the UK.

I’d first like to make clear that it is not the ASA’s role to question the validity of alternative or complementary therapies in and of themselves; nor do we seek to restrict the right of individuals to choose treatment.

We are, however, charged with protecting consumers from potentially misleading advertising. When advertisers make claims about their products or services, in any sector, they must hold robust evidence to back up those claims. If they do not, the ASA has no choice but to ensure those ads are amended or withdrawn.

Your work was considered by the ASA, having been submitted by an advertiser as evidence to substantiate claims made in their advertising about the efficacy of homeopathy in treating medical conditions. Having sought expert advice, we considered however that 'Homeopathy in Healthcare' did not move the case forward in favour of the efficacy of homeopathy, in light of conventional standards for efficacy.

I appreciate that you disagree with this assessment. It would, however, be irresponsible for the ASA, as an advertising regulator, to ignore mainstream scientific and medical opinion when considering claims about products that are used in a medical or therapeutic context. The ASA’s current position on the evidence-base for the efficacy of homeopathy is supported by the findings of the House of Commons Science and Technology Committee’s report ‘Evidence Check 2: Homeopathy’, published in 2010. That report included a thorough review of a wide range of evidence on the efficacy of homeopathy (much of it submitted by homeopaths themselves), but it concluded that “there is a lack of evidence supporting the efficacy of homeopathy”.

Ultimately, if practitioners are concerned that existing methods for considering the efficacy of treatments or therapies are not fit for the task, they should raise these issues with the relevant expert bodies – for example the National Institute for Clinical Excellence or the Department of Health here in the UK.

Whenever the ASA makes a ruling, advertisers have recourse both to an Independent Review process and to judicial review, the latter providing a means for advertisers to have our decisions tested in the courts. If through this process our ruling is found to have been flawed, it will be amended, and the new ruling published on our website.

Thank you for taking the time to contact us.

Regards,    Rob
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Letter from the authors of the HTA report to Chairman of the ASA, Mr Guy Parker

Dear Mr Parker,

We refer to the reply we received from Mr Griggs, which we found irrelevant to our Email of 24th July which we addressed personally to you.

We do not comment on other countries’ health policies unless specifically invited by that government to do so, and we said nothing about your ‘position’ on homeopathy. Neither have we made any statement on the Science and Technology (2010) committee report: others such as Lord Baldwin and David Tredinnick MP have done so already - http://www.homeopathyevidencecheck.org/MPs.htm

Our complaint, unaddressed by Mr Griggs, concerned exclusively your organization’s false statements about our work; not a matter of ‘opinion’ nor of ‘policy’, but of plain Misrepresentation of Facts.

You say, on the internet, that our book’s conclusion is based largely on a reworking of Shang: as a fact, this is totally false. You say our book contains no RCTs: as a fact, this is equally false.

Aside from a legal incumbency to present facts truthfully and to correct errors made, I hope we can agree as a question of basic morality that members of the public should not be subjected to false or misleading communications - including yours.

Yours sincerely,
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Email to authors of the HTA report from Rob of the ASA

Dear Prof. Dr. med. Peter F. Matthiessen & Dr. med. Gudrun Bornhöft,

Thank you for your further email. Mr Parker has asked me to respond on his behalf.
We disagree with your interpretation of the wording of our adjudications. During our investigation processes, we received expert advice on the various studies submitted by the advertisers as evidence supporting their marketing claims. We stand by that advice and our use of it. As you might know, advertisers and complainants involved in investigations have the right to request an Independent Review of our decisions. However, I’m afraid our published processes do not give other parties that right.
I‘m sorry that you remain unhappy with the wording of our adjudications, but we cannot assist you further at this time.

Best wishes,

Rob