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A second wave of Corona epidemic is coming

Claus Hancke

That is why we need to be prepared

May 20, 2020

The Corona virus will return. Of course it will.

When and how bad it will be, we do not know, but it will come.

Curiously enough, most people expect the second wave this fall – what we are not being told is that this is because the population’s vitamin D level again will be low at that time that we also call the “flu season”.

One of Europe’s experts capabilities on Covid-19, Professor Christian Drosten of the Charité Institute at the University of Berlin, even thinks that the second wave could be tougher than the current one.

But should we then sit with our hands in our laps and wait for a vaccine?’
No, no and again no.

We must, of course, do everything we can to boost every Dane’s immune system so that we are “armed to the teeth” and can prevent a severe epidemic.

Well, isn’t it precisely an overreaction of the immune system (a cytokine storm) that kills lung patients? Yes. If they are vitamin-depleted, then it will happen.

However, several of the vitamins and minerals I have mentioned will specifically inhibit this cytokine storm from the activation of the NLRP3 inflammasome, which releases the inflammatory cytokines. Here, vitamin D and magnesium, selenium and the antioxidant vitamins are particularly important as they inhibit this cytokine storm and the subsequent inflammatory microcoagulation seen in the pulmonary vessels. It was described a week ago thoroughly in the Lancet by Prof. Dennis McGonagle and colleagues. They describe how there is actually inflammatory coagulation in the pulmonary vessels, rather than a pneumonia. Of course, this causes oxygen deficiency and such coagulation cannot be treated with a respirator. McGonagle and colleagues call it a diffuse alveolar and pulmonary interstitial inflammation in COVID-19 resulting in a macrophage activation that triggers extensive immunothrombosis.

Thus, according to this article, it is an inflammation-triggered immune response that leads to microcoagulation in the lungs, and that is what Covid-19 patients die from. This is interesting because this reaction can be dampened by vitamin D, selenium, magnesium and vitamin C.

Some of these substances have direct antiviral properties. We see this confirmed in the few scientific studies that are already published, as mentioned in the previous newsletters. The higher the level of intake (within a safe limit), the lower the mortality rate. Therefore, it is important to have high enough vitamin / mineral content for the immune system to be so effective that it will not cause severe lung disease. The more effectively we can prevent disease, the less we need treatment. The previous three newsletters have dealt with Vitamin D, Selenium and Zinc. Now we come to one of the cornerstones of human survival, namely Vitamin C. It is also called “ascorbic acid” after “a-scorbut”, ie against scurvy.

In the past, just as with other vitamins, these were believed to only protect against a deficiency of that vitamin. Thus, it was believed that vitamin C merely protected against scurvy, ie vitamin C deficiency.

However, the past 60-70 years of research have shown that vitamins (and certain minerals) have completely different and quite potent therapeutic properties when dosed accordingly.

Vitamin C is essential for our immune system, which has been documented in over 1,000 scientific articles. Finding evidence is not difficult. Rather, one must know how to limit oneself when searching.

Some of these articles are listed in the literature list. I have included a few old ones for historical reasons. After all, it is interesting that Frederick Klenner with high-dose vitamin C cured children from active polio, while here in Denmark we put them in iron lungs (the respirator of that time), while letting the virus rage in the body. Klenner killed the virus.

Another classic is Nobel Laureate Linus Pauling’s classic “The common cold …”, which created a great debate for and against.
Since that time, the scientific evidence has been well established and unanimously shows that vitamin C is essential for a well-functioning immune system.

Vitamin C has many extraordinary properties in that it can not only prevent disease but also be used in disease treatment.

If we are to concentrate on the current Covid-19 pandemic, then several serious studies around the world are using ascorbic acid intravenously to treat severe Covid-19 disease.

Contrary to the often heard mantra, “we have no treatment to offer Covid-19 patients”.

Well, we have.

It is true, however, that there are no gold standard randomized, double-blind, placebo-controlled studies published in reputable, peer-reviewed, medical journals. But come-on.

This is a completely harmless treatment with an extremely cheap, natural vitamin for a potentially fatal disease.

If the seriously ill Covid-19 patients have to wait for the above publication, then they will be dead. Why not try it when it can never hurt them? If doctors are nervous about the legal aspect, use Article 37 of the Helsinki Declaration on compassionate care. Here, the doctor’s judgment applies.

The theoretical basis for the antiviral effect of vitamin C is present, along with a second-to-none safety track record. There is even more than 70 years of clinical experience from doctors who have used ascorbic acid for a variety of diseases, including severe viral infections. In addition, a large number of scientific studies, which more than indicate that Vitamin C has a place in the treatment of viral infections.

The least that could be done was to do a pilot study with 10 patients hospitalized with severe Covid-19 disease and compare with 10 who did not receive vitamin C. All 20 patients would receive the standard treatment available today.
Then you can compare mortality, hospitalization time, and recovery time.
The study can be completed in a month within a general medical department’s budget. It can hardly be more simple.

But that is perhaps the problem.

The first four newsletters have dealt with optimization of the immune system using vitamin D, Selenium, Magnesium, Zinc and Vitamin C.

The next newsletter will summarize our knowledge of the Covid-19 pandemic and conclude with a comprehensive overview of what you can take if you want to be highly equipped with an optimally functioning immune system as the next virus threat approaches.

Take care of yourself and others,

Claus Hancke, MD,
Specialist in general medicine

Refs.

  • Alberto Boretti, Bimal Krishna Banik (2020) Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome PharmaNutrition. 2020 Jun;12:100190.  Published online 2020 Apr 21.
  • Cannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza. Virol J. 2008;5:29.
  • Carr AC, Maggini S. Vitamin C and immune function. Nutrients 2017;9(11):1211.
  • Chambial S et al (2013) Vitamin C in Disease Prevention and Cure: An Overview. Indian J Clin Biochem. 2013 Oct; 28(4): 314–328.
  • Gerber, WF (1975) Effect of ascorbic acid, sodium salicylate and caffeine on the serum interferon level in response to viral infection. Pharmacology, 13: 228
  • Gonzalez MJ, Berdiel MJ, Duconge J (2018) High dose vitamin C and influenza: A case report.  J Orthomol Med. June, 2018, 33(3).
  • Gorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533
  • Hemilä H (2003) Vitamin C and SARS coronavirus Journal of Antimicrobial Chemotherapy, Volume 52, Issue 6, December 2003, Pages 1049–1050
  • Hunt C et al. The clinical effects of Vitamin C supplementation in elderly hospitalised patients with acute respiratory infections. Int J Vitam Nutr Res 1994;64:212-19.
  • Kennes B, Dumont I, Brohee D, Hubert C, Neve P (1983) Effect of vitamin C supplements on cell-mediated immunity in old people. Gerontology. 29:305-310.
  • Klenner F 1949, Southern Medicine & Surgery, Volume 111, Number 7, July, 1949, pp. 209-214
  • Li W1, Maeda N, Beck MA. (2006) Vitamin C deficiency increases the lung pathology of influenza virus-infected gulo-/- mice, J Nutr. 2006 Oct;136(10):2611-6.
  • McGonagle D et al, 2020, Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Lancet May 7, 2020:1-9
  • Pauling L (1971) Vitamin C and the common cold Can Med Assoc J. 1971 Sep 4; 105(5): 448, 450.
  • Wintergerst ES, Maggini S, Hornig DH (2006) Immune-enhancing role of vitamin C and zinc and effect on clinical conditions. Ann Nutr Metab. 50:85-94.
  • Yejin Kim, Hyemin Kim, Seyeon Bae et al. (2013) Vitamin C is an essential factor on the anti-viral immune responses through the production of interferon-α/β at the initial stage of influenza A virus (H3N2) infection. Immune Netw. 13:70-74.

Zinc is important for the immune system

Claus Hancke

– also for Covid-19 disease

May 18 2020

In continuation of the previous two newsletters on Vitamin D and Selenium, a little important information about Zinc and its importance to the immune system is now presented here.

In these corona times, it is especially necessary that we each optimize our immune system so that we are well prepared for a possible new wave in about half a year from now, when people’s deposits of vitamin D again are declining.

In the Western part of the world, about 25% of the population has some level of zinc deficiency, especially the elderly, people with high alcohol consumption, people with chronic infections, those who get certain types of medicine, and elite athletes, who use up their magnesium and zinc.

Zinc is part of more than 200 different enzyme systems and is a prerequisite for normal growth and cell formation and a well-functioning immune system.

There is solid evidence that zinc deficiency leads to increased susceptibility to infection. Since zinc supplementation has also been found to reduce the duration of a cold, various zinc lozenges have been tried, and a Cochrane study of 18 studies found that 75 mg of zinc a day could reduce the duration of cold symptoms in healthy people, provided the zinc tablets were given within the first 24 hours after symptom onset.

The effect lies, among other things, in the skin and mucous membranes, where zinc is necessary for the cell replication that the body initiates when an infection is to be fought. This is especially true regarding the growth, maturation and differentiation of circulating lymphocytes, T cells and the killer cells, NK cells that we need to fight viruses.

In 2010, an in vitro study showed that zinc inhibits another coronavirus, namely SARS-CoV, which caused an epidemic in 2002. Zinc has a direct antiviral effect by inhibiting SARS-CoV RNA polymerase, which is a prerequisite for virus replication.

There is no specific study yet on the effect of zinc on the current CoV-Sars-2, but natural connections are looked for and, for example, the current Covid-19 disease is characterized by many people’s losing the sense of taste and smell, which is also seen in the case of zinc deficiency.
But it could be coincidence.

We have to take zinc all the time, as it is not stored specifically. It is not difficult to get enough zinc here in Denmark, just by eating real food and not industrial synthetic ‘plastic’ food. Zinc is found in meat, seafood, organ meat, fish, eggs, legumes, cereals, dairy products, green vegetables, fruits and berries. An intake of 20-30 mg per day is enough.

If you take zinc as a supplement, remember that it can reduce the copper content of the body, as zinc will upregulate the metallothionein synthesis, which can cause copper loss. This is probably not of great importance here in Denmark, where a large pig production has given us all a solid copper supplement.

In any case, we need zinc to optimize our immune system, so we are ready to fight an virus infection.

Now you have read about vitamin D, selenium and zinc in relation to the immune system.
The next newsletter to arm your immune system against Covid-19 will be about Vitamin C.

Take care of yourself and others,

Claus Hancke, MD,
Specialist in general medicine

Refs:

  • Read Scott A, Obeid S et al. The role of Zinc in antiviral immunity.(2019) Adv Nutr 2019;10:696–710
  • Skalny et al: Zinc and respiratory tract infections: Perspectives for Covid-19. Int J Molecular Med. April 13, 2020
  • Mossad S, Macknin M, Mendendorp S, et al. Zinc Gluconate Lozenges for Treating the Common Cold: A Randomized, Double-Blind, Placebo-Controlled Study. Annals of Internal Medicine 15 July 1996
  • Velthuis AJW, van den Worm SHE, Sims AC, Baric RS, Snijder EJ, van Hemert MJ (2010). Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture. PLoS Pathog 6(11): e1001176.
  • Shankar AH, Prasad AS. Zinc and immune function: The biological basis of altered resistance to infection. Am J Clin Nutr. 1998 Aug;68 (2 Suppl): 447S-463S. doi: 10.1093/ajcn/68.2.447S.
  • Singh M, Das RR. Zinc for the common cold. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD001364. DOI: 10.1002/14651858.CD001364.pub4
  • Yoshimura A, Naka T, Kubo M. SOCS proteins, cytokine signalling and immune regulation. Nat Rev Immunol 2007;7(6):454–65.

Selenium attenuates Covid-19 disease

Claus Hancke

But we don’t hear about it

May 11, 2020

At this time, new research is emerging, newly published, especially about SARS-CoV-2, which has shut down the world with its follow-up Covid-19. This disease specifically affects the lungs, which is why people with lung disease are at special risk of serious illness.

One of the world’s most respected selenium researchers, Margaret Rayman, together with a team of researchers, has just published an important letter in the American Journal for Clinical Nutrition that shows a significantly (P <0.0001) higher cure rate for Covid-19 patients with higher selenium levels in the body.

An interesting study from 2004 (Beck) showed that if a virus like corona passes through a host animal with selenium deficiency, the viral virulence will increase. The host animal lacks selenium to produce glutathione peroxidase for its own protection, thus allowing the virus to mutate freely to a more virulent form. Such selenium-deficient host animals are found in large selenium-poor areas of China, and could, for example, be a bat, or more likely a civet, which is a Chinese cat-like animal resembling a mongoose a little bit. It is eminent for adapting to urban environments and can be a nuisance near human housing where the cats’ excrements make a mess and carry diseases – especially if the animals lack selenium.

Rayman mentions a number of diseases that are improved by optimizing selenium supplementation via the immunomodulatory effect of selenium, in particular selenium’s ability to attenuate the virus’s ability to mutate in a more virulent direction.

Along with the above zoological observation, this led Rayman and colleagues to assume that selenium status and Covid-19 disease had a relationship, and they wanted to find it.

In a retrospective population-based analysis, daily reports (from a credible, non-governmental source) were collected from each province, municipality and city on confirmed cases, cured and deceased Covid-19 patients.

From previous studies, data on selenium levels in individual small districts were reported as selenium concentration in hair. Hair selenium concentrations have shown strong correlation with selenium intake in the different Chinese districts.

By the term “cured” is meant more than three days of fever-free lung function and lung symptoms clearly improved pulmonary x-ray or scan normal, and negative immunological test for the lung pathogen in question in two subsequent tests at least one day apart.

The recovery was significantly lower in Hubei Province (13.2%) compared to all other provinces (40.6%), and mortality in Hubei Province higher (3% – sick) than in all other provinces (0.6 %). Both differences are highly significant (P <0.0001).

However, one of the cities of Hubei Province showed remarkably higher recovery rates than the rest of the cities of Hubei, and it was Enshi (36.4%), which is known for high selenium intake and high selenium status.
The reason China is so thoroughly researched for selenium, is because there are areas in China with both the world’s lowest – and the world’s highest occurrences of selenium in the soil and in the food.

An area of very low selenium status is Keshan in northeastern Heilongjiang Province. We know Keshan disease, which is a cardiomyopathy / heart failure due to selenium deficiency. In Keshan, the mortality rate was 2.4% compared to the other province’s 0.5%.

The Rayman study has significant weaknesses in confounding factors and the use of old selenium data. It was also published as a “facilitator” so that the news can come out as quickly as possible at a time when any whistleblow is welcome and every stone must be turned over.
The Vitality Council has emphasized that the research does come from a serious researcher, Margaret Rayman.

Furthermore, when we can link her new data with a large number of heavy scientific studies, all of which point to selenium as a key ingredient in our immune system, the Vitality Council will conclude that selenium is necessary to optimize our immune system, so we won’t get so sick from Covid-19.

Take care of yourself and others,

Claus Hancke; MD,
Specialist in general medicine

Refs:

  • Rayman Margaret et al, 2020, Association between regional selenium status and reported outcome of COVID-19 cases in China Am J Clin Nutr 2020; 00: 1–3
  • Beck MA, Handy J, Levander OA. Host nutritional status: The neglected virulence factor. Trends Microbiol 2004; 12: 417–23.
  • Rayman Margaret. Selenium and human health. Lancet 2012; 379: 1256–68.
  • Harthill M. 2011, Micronutrient selenium deficiency influences evolution of some viral infectious diseases. Biol Trace Elem Res. 2011 Dec; 143 (3): 1325-36.
  • Huang Z, Rose AH, Hoffmann PR. The role of selenium in inflammation and immunity: from molecular mechanisms to therapeutic opportunities.
    Antiox Redox Signal. 2012 Apr 1; 16 (7): 705-43.
  • Beck MA, Nelson HK, Shi Q, Van Dael P, Schiffrin EJ, Blum S, Barclay D, Levander OA. Selenium deficiency increases the pathology of an influenza virus infection. FASEB J. 2001 Jun; 15 (8): 1481-3.
  • Steinbrenner H et al. 2015, Dietary Selenium in Adjuvant Therapy of Viral and Bacterial Infections. Adv Nutr 2015; 6: 73–82.

Severe Covid-19 disease can be prevented

Claus Hancke

But we don’t hear about it.

May 6, 2020

“Immunity! Well, that comes naturally.”
Does it?

Now we are so far into the corona crisis that the first serious scientific results are beginning to emerge, and since no one else does, the Vitality Council will try to disseminate these results.
“Just throw people into the water. They will swim by themselves ”.
A foolish claim. It is well known that the chances of surviving a dive into the water increases if you have learned to swim.
But that is, in fact, what the (Danish) authorities are saying, now that they are opening up the country while coronavirus is still circulating.
They are throwing people into increased viral exposure because then it is thought that people automatically get built-up immunity.
Well, this may be true if people can defend themselves, that is, have a well-functioning immune system.
Without good immune defence, people have no chance.

The (Danish) authorities  know very well that there are large groups in the population that have a impaired immune system. And yet, they expect us all to sit with our hands in our lap without doing anything while we wait for a vaccine that stands as an angel of salvation on the horizon.
A vaccine may be excellent, but firstly, it takes at least a year before we have it, and secondly, a vaccine can never keep up with a virus in the many mutations that make its immune profile so varied that a vaccine quickly becomes obsolete as we have seen with the flu vaccine.
The only thing that can keep up with an adequate immune response against a virus’ mutations is a well-functioning immune system in the individual.
Despite the knowledge that many people have an impaired immune system, we have in the months that the corona crisis has lasted, not once heard the (Danish) authorities give the public advice on how to optimize the immune system.
If the population has a fundamentally strong immune system, then a virus will do less harm as the individual course of disease will be milder.
People still get infected and maybe sick too, but they don’t have to die from it.

Let’s start with the simple, Vitamin D3.

It is quite evident that the Covid-19 disease is massively over-represented in the northern hemisphere. Just like the annual flu epidemic, which ravages the northern hemisphere in precisely December to March, whereas it ravages the southern hemisphere from August to October – and why is that?
We can thank the Sun for that. It is high in the sky in the summer and charges our stores of vitamin D, so we have a strong immune system from June to November, and of course the other way around in the southern hemisphere. We never get the flu in July-August.

A second indication is that elderly people are at particular risk. Older people more often have a very low level of vitamin D in their blood, as they do not get much out in the sun.

A third indication is that obesity is at particular risk. Vitamin D accumulates in the adipose tissue, where it does not benefit the immune system. Overweight people must therefore have a significantly higher dose of vitamin D to achieve the same blood concentration as slim persons.

A fourth indication is that the disease is over-represented in immigrants, who often have severe vitamin D deficiency. On the one hand, most immigrants have dark skin, which allows less passage of sunlight, and on the other hand, many immigrant women are covered, even in the summer, when they need to get their annual vitamin D dose.

A fifth indication is that diabetics are also a special risk group. On the one hand, diabetics often have an impaired immune system, and, on the other, many diabetics receive cholesterol-lowering medication. If people lack cholesterol, you cannot produce vitamin D, even though the sun is shining sufficiently.

A sixth indication is approaching evidence in the case of a recently published observational study that compared mean vitamin D levels in 20 European countries with prevalence and mortality caused by Covid-19. There was significant negative correlation between vitamin D level and both prevalence and mortality. It was interesting to see that both morbidity and mortality approached 0 in those populations where the vitamin D level was above 75 nmol/L.
Vitamin D levels are seriously low in the aging population, especially in Spain, Italy and Switzerland. This is also the most vulnerable group of the population in relation to Covid-19.

A healthy diet with green vegetables is also important, as they contain magnesium, which is a prerequisite for activating vitamin D.
Magnesium is included four places in the synthesis as well as the activation and deactivation of vitamin D, so without magnesium, vitamin D is ineffective.

If you combine these indices with solid evidence that vitamin D3 is essential for a functioning immune system, it is not far off to propose a solid dose of vitamin D3 to optimize a suffering immune system in immigrants, diabetics, older and overweight people in particular.

In the past, people were nervous about overdosing on Vitamin D, but this has proved unfounded. Extremely high doses need to be taken over a long period of time before there is any risk. In the past, it was also thought that a vitamin D level of 50 nmol/L was sufficient in the blood, but this is too low.
If people want to be sure that the vitamin D level is sufficient for an optimal immune system, the level should be between 75 – 150 nmol/L.

This newsletter is the first about some of the factors in our environment, nature, surroundings and diet that can optimize our immune system and thus reduce the risk of serious Covid-19 disease.
The next will deal with the latest research on selenium and Covid-19 disease.

Take care of yourself and others,

Claus Hancke; MD,
Specialist in general medicine

Refs:

  • Hewison M. Vitamin D and innate and adaptive immunity. Vitam Horm, 2011; vol 86:23-62.
  • Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020 Jan 16;12(1).
  • Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011 Jan;55(1):96-108.
  • Dancer RC, Parekh D, Lax S, D’Souza V, Zheng S1, Bassford CR, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax. 2015 Jul;70(7):617-24.
  • Urashima M, Segawa T, Okazaki M, et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010 May;91(5):1255-60.
  • Sabetta JR, DePetrillo P, Cipriani RJ, Smardin J, Burns LA, Landry ML. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One. 2010 Jun 14;5(6):e11088.
  • Uwitonze AM, Razzaque MS. Role of Magnesium in Vitamin D Activation and Function. J Am Osteopath Assoc. 2018 Mar 1;118(3):181-189.
  • Valint S. Vitamin D and Obesity. Nutrients. 2013 Mar; 5(3): 949–956.
  • McCartney DM, Byrne DG. Optimisation of Vitamin D Status for Enhanced Immuno-protection Against Covid-19. Ir Med J. 2020 Apr 3;113(4):58.
  • Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, Bhattoa HP. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020 Apr 2;12(4). pii: E988.
  • Aldridge RA, Lewer D, Beale S, et al. Seasonality and immunity to laboratory-confirmed seasonal coronaviruses (HCoV-NL63, HCoV-0C43, and HCoV-229E): results from the Flu Watch cohort study 30 March 2020.
  • McCullough PJ, Lehrer DS, Amend J. Daily oral dosing of vitamin D3 using 5000 TO 50,000 international units a day in long-term hospitalized patients: Insights from a seven year experience. J Steroid Biochem Mol Biol. 2019 May;189:228-239.
  • Ilie PC, Stefanescu S, Smith L. The role of Vitamin D in the prevention of coronavirus disease 2019, infection and mortality. Aging Clinical and Experimental research (https://doi.org/10.1007/s40520-020-01570-8) Springer Switzerland. 2020 May 6.

Much ado about nothing

Claus Hancke

February 12, 2019

One could justifiably use the above-mentioned Shakespeare title about a newly published article (1) that supposedly shows that antioxidant supplements reduce the effectiveness of chemotherapy and radiation therapy in postmenopausal women.

Please note that this assertion is by no means proven; there is much research that points in both directions.

The above-mentioned journal article does not contribute to clarification of the issue, not least because of the weak design of the study.

The data in the study came from interviews of postmenopausal women in two regions in Germany. The researchers used data from the “Mamma Carcinoma Risk Factor Investigation,” a study that was first published more than 10 years ago to report on the risk factors associated with postmenopausal hormone therapy.

Despite the known weaknesses of the interview study, the Danish TV2 reported the results of the study as a great sensation and with a headline that announced:

“New research: Dietary supplements can spread breast cancer.
German researchers have learned that antioxidant supplements can worsen breast cancer in women. The Danish Cancer Society is concerned.
For many years, there have been discussions as to whether antioxidant supplements are good for human health or not. And now a German study makes it clear that they are definitely dangerous for women with breast cancer.”

No, no, and no again.

There is no evidence for the dramatic TV2 news statements.

The German study does not make anything clear.

And the journal article authors’ own conclusion is much more cautious than the TV2 news report.

The journal article authors write:

“Our data do not support an overall association of postdiagnosis supplement use with prognosis in postmenopausal breast cancer survivors. Our results, together with other clinical and experimental evidence, suggest that during breast cancer treatment, antioxidants should potentiall be used with caution.”

In their journal article, the authors do not even advise against the use of antioxidants during chemotherapy and radiation therapy. They just urge caution.

Normally, German research results are shrugged off in Denmark, and interview-format studies get the same treatment. But, this time, the German interview study could be used to advance specific points of view, and so it was.

There are many things in this German study that grab the attention of the alert reader, and a close reading of the study reveals that the authors are biased, not least in their selection of earlier research on the topic.

An interview study, with no blinding of at all, is certainly not the most valid form of research and cannot be compared with prospective randomized controlled trials (RCT’s).

In the German study, the researchers asked some 2000 breast cancer patients whether they took antioxidant supplements before and/or after the time of their diagnosis with breast cancer and/or during their chemotherapy and radiation therapy.

The women in the study were to answer yes if they had just taken one or another supplement three days a week for a year at a given point in time. A “current user” was any woman who used supplement postdiagnosis within the 6 months before the first follow-up interview.

The term “supplement” and the term “antioxidant” are used quite sloppily but with a noticeable consistency. Whenever the researchers discuss the study, the usage, or the statistics, they use the term “supplements.” Whenever they discuss the chemotherapy or the radiation therapy, however, they use the term “antioxidants” without specifying what the term “antioxidants” covers.

In other words, the researchers have had to extend the definition of antioxidants with other supplements in order to achieve sufficient statistical power and thereby just barely sneak over the line into statistical significance.

About this, the authors write in their article:

“The main exposures of interest included postdiagnosis use (no postdiagnosis use, postdiagnosis use, current use) of any type of supplement; specific supplements, such as magnesium and calcium; and supplement group, such as antioxidants, in which there was adequate statistical power to conduct analyses. Only a few women reported postdiagnosis use of multivitamins, vitamins A, C, E, zinc, and selenium, and therefore they were collectively evaluated together as antioxidants in all of our analyses.”

Above and beyond the fact that the researchers have jumbled everything together in a big group that they call “antioxidants,” there is also a total lack of information about daily dosages, single dosages, and preparation types.

This study has a weak design and has unclear results. Therefore, the authors are careful to settle for a cautious conclusion, which speaks for itself.

The misinformation occurs when the Danish media then trumpet the study conclusion as the definitive truth.

Any serious researcher would avoid making such bombastic statements.

Litt:

  1. Jung AY et al. Antioxidant supplementation and breast cancer prognosis in postmenopausal women undergoing chemotherapy and radiation therapy. Am J Clin Nutr 2019;109:69–78.
  2. Flesch-Janys D, Slanger T, Mutschelknauss E, Kropp S, Obi N, Vettorazzi E, Braendle W, Bastert G, Hentschel S, Berger J. Risk of different histological types of postmenopausal breast cancer by type and regimen of menopausal hormone therapy. Int J Cancer 2008;123(4):933–41.

Contradictions about vitamins

Claus Hancke

 April 26, 2012

One may wonder about the Danish newspapers’ poor interest in the latest vitamin report. First of all, the report predicts dead to those who take vitamin pills, secondly, the turn-over for vitamins is one and a half billion kroner a year. The subject must interest many.

Here the report itself will not be discussed. It is already commented. On the other hand, attention must be paid to a very serious issue concerning the marketing of the report: The contradictory statements that a prominent researcher has used the report to make.

The statements are from chief physician Christian Gluud from Rigshospitalet. He has previously said peculiar things. It’s hard to forget how he on television declared antioxidants (like vitamin E and vitamin C) to be carcinogenic, even when they occur in fruit and vegetables. However, in fruit and vegetables there was, he believed, “a lot of other substances that might either correct the potential damage caused by the antioxidants or that could completely neutralize them.”

You might consider this amusing statement the next time you eat broccoli. It is thus an antidote to vitamins, you are eating!

Currently, Gluud said on TV that his latest study, which combined the results of different trials, is based on trials with commonly recommended vitamin doses. And yet, in almost all trials, there were used from five to twenty times the recommended dose or more.

Gluud has further said (the news program Deadline 2.4.2012) that his group has revealed that, for example, the antioxidants Vitamin C and selenium are directly life threatening, as they increase mortality by 4%. And yet, his report frees both of the two antioxidants for this accusation.

In the TV2 news (22.3.2012) Gluud said that “it’s quite common vitamin pills in very common doses that give the increased mortality.” But in an interview with Medwatch.dk he said the opposite: He could not comment on that subject – that multivitamins increase mortality – because no one had studied it!

If you ask chief physician Gluud, you may obviously get the answer that his current state of mind indicates. One moment, common vitamin pills are dangerous poisons, the next, it is not known, and at one time, selenium and vitamin C are poisonous, but at another time and towards another audience – those who read the report – they are harmless.

The contradictions do not prevent Gluud from hoping that the report will have “a practical and industry related consequence,” as he says. What that means is easy to understand. Gluud is/has been chairman of a lobby group that has sought to influence the European Commission to prevent the free sale of vitamins. They must be made into drugs, which in practice will push small vitamin companies out of the lucrative market, which alone in Europe is more than $ 20 billion a year.

When a researcher is politicizing, he invariably throws a dubious light over his research, justly or not. Worse, however, is when the researcher is facing the public, on a topic of great importance, against better knowledge.

In doing so makes him disqualified.

By. Niels Hertz, M.D

Huge victory for freedom of speech in America

Claus Hancke

May 5, 2011

The U.S. Food and Drug Administration (FDA) has suffered a stinging defeat in a lawsuit in Washington DC, where their tyrannical censorship of serious health claims have been found unconstitutional.

In the beginning was the word
“First Amendment to the United States Constitution” refers to freedom of expression as fundamental to the nation and is also the foundation of any civilized legal community today.

Without freedom of expression – no freedom
However, in civil services in many countries a tendency has crept in to promote their own political objectives by intimidation and over-management rather than under-management.

This is well known in Europe’s vast civil service, where no case is too small to rule from Brussels. And here in Denmark we know it as a tendency of the civil sevice to administer dietary supplements regulations in a far more restrictive way than it has ever been thought or spoken in the EU Food Supplements Directive, although this is much more restrictive than the equivalent in the U.S.
In other European countries like the Netherlands and England the same EU
rules are administered far more in consistent with people’s interests than is the case here in Denmark.

In the U.S. in 1996 the civil rights group “Citizens for Health” succeeded in implementing that a dietary supplement can only be banned if it is harmful.
Here in Denmark it will be prohibited if it is beneficial!

Lawsuit against FDA
It was the straw that broke the camel’s back to the “Alliance for Natural Health (ANH), and the organization sued the FDA in this matter in the District Court for the District of Columbia,” which recently ruled in the case.

The Court ruled that the FDA’s censorship of documented claims are contrary to the U.S. Constitution very first words about freedom of speech. The Court even allowed explicitly the following claims, which however was not about dietary supplements, but vitamins: “Vitamin C may reduce the risk of gastric cancer” and “Vitamin E may reduce the risk of bladder cancer”.

Denmark
Unfortunately we can´t expect Danish politicians in a foreseeable future to be awakened by a population who is surprised that there are health-promoting information, it may not get, even if it so desires.

One day, people will make politicians aware that this is contrary to the Article 10 of the European Convention on Human Rights in which one may not prevent people from information that they wish to receive.

This means that the authorities are on thin ice when they prohibit Internet sites that contain documented product information about diet or dietary supplements. The citizen performs however a independent active action when he or she click their way to a website; – thus accessing information on their own hand. But this is not allowed. It is not good for him to see how he can improve his health.

It must strike one with wonder, who might have an interest in restricting the population from such information.

A cry for freedom
Allow us here at Denmark’s Independence Day, May 5th to make below pious desire to promote general health in a free Denmark:
The Danish Vital Council believes that people should have free access to information about dietary supplements and free access to buy safe dietary supplement. This is the best guarantee to prevent accidents and to ensure that the consumer gets the best possible product to suit his needs.
This implies that:

1) The consumer must have free access to information
The Vitality Council believes that misinformation must be penalized.
Today we penalize information in Denmark. Not even pharmacies and doctors must be informed about the available scientific evidence concerning dietary supplements.
This should be changed so that consumers can get free access to accurate information.
2) The consumer must have free access to dietary supplements
The Vitality Council does not believe that it is in the public interest to have curtailed ones right to buy the dietary supplements, one may wish, when these are otherwise safe to consume.
The Vitality Council must therefore urge that no authority administratively hinder people’s access to dietary supplements whose safety can not be doubted.

By: Vitality Council

www.anh-usa.org/free-speech

Vitamin D protects against colon cancer

Claus Hancke

January 26, 2010

A huge European study now confirms that vitamin D may lower the risk of colon cancer by 40%.

The Danish Vitality Council has in several previous newsletters refered to scientific studies showing that vitamin D may lower the risk of cancer, and we have even been urged by journalists to withdraw those statements. Fortunately we have not complied.

A few days ago British Medical Journal published the largest study ever of the link between diet and health, known as the EPIC study, and this is just one of many results, we will see in the near future from this huge study.
More than half a million mostly healthy people from ten European countries have been closely studied and followed over 10 years by researchers from across Europe.

Participants completed detailed dietary questionnaires, and they have been checked with blood tests to identify their nutritional status.

At the time of analysis 1,250 cases of colon cancer had occurred and after comparison with a healthy control group researchers found that those who were low in vitamin D in their blood had significantly higher risk for this type of cancer.

Unlike many other studies this is characterized by being a prospective study. Thus looking-forward from the start time, and based on a group of healthy people. The study also distinguishes itself by involving so many different countries, cultures and – not least – food cultures.

Vitamin D, we primarily get from the sun, and a little bit from the diet. Danes are not the most tenacious fish eaters and much of the fish we eat is farmed and therefore does not include the fatty acids and other substances, we think they contain.

So we’re back at sunlight as the main natural source of vitamin D.

However, some of our ancestors for inscrutable reasons have found reason to settle north of the Alps, and it leads to midday sun high enough in the sky to make enough vitamin D in the skin for only 3-4 months a year (providing we have enough cholesterol).

So we must therefore tend to sunbathing when the Sun is at its highest point, ie the middle of the day, without sunblock, and therefore only half an hour, so we do not risk burning.

If it gets too complicated, you can also just grab a vitamin D capsule as a supplement. It is perhaps a little easier, and it can be done the whole year.
The dosage is somewhat controversial and should ideally be measured in a blood sample, but most serious scientists recommend between 2,000 and 4,000 IU, equivalent to 50-100 micrograms daily.

It will take a long time before we again will see such a thorough, multi-national study including so many people over such a long period.

So it is not just any study. It has high validity and ought to push the critically low RDA-value we have today.

By: Vitality Council

 

Litterature:
Jenab, M. et al (2010). Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations: A nested case-control study BMJ, 340 (jan21 3)
Can be downloaded directly at: www.bmj.com/cgi/content/abstract/340/jan21_3/b5500

Latest news on selenium

Claus Hancke

January 12, 2010

Intensive research is going on in utilization of selenium against cancer.
The public in Denmark do not hear much of it, but here is a selection of recent news.

The lack of television and newspaper information may give the impression that there is quiet on the antioxidant front concerning disease control. This is not the case. The news shortage is chiefly due to the censorship that has been introduced. Regarding selenium alone, being one of the major antioxidants, there were in 2009 published more than 900 scientific articles. Here we will mention a selection of recent articles about selenium in the fight against cancer.

A famous attempt to demonstrate whether antioxidants protect against cancer were performed in the years 1985-91 in the Chinese Linxian province. Nearly 30.000 participated in the study, which showed a strong decrease in cancer risk among those who received a supplement of selenium (50 micrograms) and Vitamin E and Beta Carotene (respectively 30 and 15 mg). Now it has been determined, what had happened to the participants 10 years later (2001). Even after so long a time, there were relatively more survivors in this group than among those who received other supplements (eg. Vitamin A + zinc, was of no benefit). In particular, the group had reduced incidence of cancer of the stomach, but it was the participants under 55 years of age who experienced the greatest gain – you must avoid lacking vital nutrients already from the youth.

Apparently this result is contradicted by another famous study, the SELECT trial conducted in the U.S. Here it appeared that you could not prevent prostate cancer using selenium, vitamin E or a combination of both. This study was in large scale and the result a huge disappointment.

One of the world’s leading selenium specialists, Margaret Rayman, did point out however, a few months ago what really is obvious: Supplementation with selenium is of no benefit if you already get enough! As a general rule you get enough in the U.S., where you typically get 3-4 times as much selenium in the diet as in Denmark. Sufficient selenium is essential for the body to form enough of the enzymes which we presume protects against cancer. Amongst others Rayman refer to another U.S. cancer trial where you just saw a massive impact in those who received the least amount of selenium, but no effect in those who got the most.

Heavy metals neutralized
One of the veterans in selenium research is Gerhard Schrauzer from San Diego University of California. He has been involved more than 20 years. Now he points out that selenium is able to detoxify numerous toxic metals that somehow during our civilized environment ends up in our bodies. This applies to lead, mercury, copper, cadmium, arsenic, etc. Selenium inactivates these metals by forming insoluble compounds with them. But, says Schrauzer, one must remember that at the same time selenium is used up, so we for that reason are less protected against cancer. In Europe we already get too little selenium, but heavy metals etc. increases the demand.

Taylor and associates have written an article on new advances in selenium research. They write that the renewed interest in selenium is linked to the fact that the anti-cancer effect is now very well documented in animal studies. This is worth noticing.

And precisely on animals a research team from San Diego University have demonstrated that the effect of chemotherapy (cisplatin) against cancer of the colon is reinforced considerably by large supplements of antioxidants (A and vitamin E and selenium) combined with fish oil. The group believes their achievement justifies that research is made with people. The result is very exciting because cancer doctors in this country often discourages in strong terms their patients from combining antioxidants with chemotherapy. The reason for this warning has hitherto been unclear.

Selenium and chemotherapy
Researchers from The Karolinska Hospital in Stockholm state without hesitation that it is well documented that selenium prevents cancer. They describe several experiments which have shown that selenium has strong anti cancer effects – especially against cancer, which no longer responds to chemotherapy. Normal cells will not be harmed by the selenium doses needed for this!

Italian researchers, however, stresses that people can get too much selenium (but living in Denmark you have take approx. two selenium tablets a day in order to get the same amount as a typical American). They argue that high doses may increase the risk of diabetes, an assertion, however, that is controversial.

In the Netherlands, like in China there has been an interest in selenium and cancer of the esophagus. More than 120,000 persons who was 55-69 years old in 1968, delivered at that time, a portion nail clips from their big toes. 16 years later it was found who and how many have got cancer of the esophagus or stomach in the meantime. Then the selenium levels in their nails was measured and compared with the levels in healthy subjects. It was found that the risk of both cancers was significantly higher among those who only had small amounts of selenium in their nails, and hence their body.

A curious study has been conducted in Japan. Here researchers cultivated broccoli-sprouts in a selenium-rich environment, so the sprouts got an extra high content of selenium. In a laboratory study the sprouts was investigated for their impact on prostate cancer tissue. The enriched sprouts inhibited cancer growth clearly better than normal sprouts. Now the Japanese suggests, that men eat that kind of sprouts to prevent cancer of the prostate.

Finally other Japanese mention, that it is well known that selenium can kill cancer cells from humans, but but precisely how this happens is still unclear. They have reached the conclusion that at least part of the effect is due to selenium starts off a cancer cell death process using the same mechanism (apoptosis) as when normal cells must be replaced and die. Such a mechanism is of course necessary, since almost all normal cells divide continuously. There would soon be twice as many, and we would grow indefinitely, if not worn-out cells were put out.

As you can see, the research is really alive. Much of our understanding of selenium is achieved in very recent years. More will undoubtly follow.

By: Niels Hertz, M.D.

References
1. Qiao YL et al. Total and cancer mortality after supplementation with vitamins and minerals: follow-up of the Linxian General Population Nutrition Intervention Trial. J Natl Cancer Inst. 2009 Apr 1;101(7):507-18. Epub 2009 Mar 24.
2. Lippman SM et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2009 Jan 7;301(1):39-51. Epub 2008 Dec 9.
3. Rayman MP. Selenoproteins and human health: insights from epidemiological data.
Biochim Biophys Acta. 2009 Nov;1790(11):1533-40. Epub 2009 Mar 25.
4. Schrauzer GN Selenium and selenium-antagonistic elements in nutritional cancer prevention.
Crit Rev Biotechnol. 2009;29(1):10-7.
5. Taylor D. Recent developments in selenium research. Br J Biomed Sci. 2009;66(2):107-16; quiz 129.
6. Ma H. Bi Efficacy of dietary antioxidants combined with a chemotherapeutic agent on human colon cancer progression in a fluorescent orthotopic mouse model. Anticancer Res. 2009 Jul;29(7):2421-6.
7. Selenius M. Selenium and selenoproteins in the treatment and diagnostics of cancer.
Antioxid Redox Signal. 2009 Sep 21. [Epub ahead of print]
8. Vinceti M. Risk of chronic low-dose selenium overexposure in humans: insights from epidemiology and biochemistry Rev Environ Health. 2009 Jul-Sep;24(3):231-48.
9. Steevens J. Selenium status and the risk of esophageal and gastric cancer subtypes: the Netherlands cohort study. Gastroenterology.. [Epub ahead of print]
10. Abdulah R. Selenium enrichment of broccoli sprout extract increases chemosensitivity and apoptosis of LNCaP prostate cancer cells. BMC Cancer. 2009 Nov 30;9:414.

Fish oil reduces age-related blindness

Claus Hancke

October 14, 2009

New U.S. study shows that intake of fish oil may reduce the incidence of age-related blindness by 30%

There seems to be no end to blessings from fish oil.

Fish oil is the end stages in the development of omega-3 fatty acids which is transformed from alpha-linolenic acid in a number of processes to E.g. eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) which then are converted to prostaglandin E 3 with a wide range of health-promoting properties.

The fish oils EPA and DHA are some of the strongest anti-inflammatory nutrients, we can consume. This is probably one of the reasons why they reduce the risk of blood clots, but they also reduces blood triglycerides, reduces inflammation in rheumatic diseases, enhances children’s learning capacity, reduces the risk of pre-eclampsia (pregnancy–induced high blood pressure) and premature birth, and gives brighter children from pregnant women who took fish oil and much more.

It is indeed difficult to see the end of the health-promoting properties, we can get from fish oil, and new scientific findings seems to emerge all the time which support its use.

Thus, even last week when researchers from the National Eye Institute in Bethesda, MD, USA, 7 October published a study in the American Journal of Clinical Nutrition.
Scientists have over 12 years studied 1,837 people with moderate to severe risk of age-related central blindness in the form of central atrophy or macular degeneration.

For both types of blindness, it appeared that the incidence was 30% lower in the group that took the most fish oil (0.11% of total caloric intake) compared with the group that took the least.

Although previous studies have been uncertain in its conclusions, the authors believe that the figures can be generalized, this is both a cheap and readily available intervention opportunity against risk families with high incidence of these diseases.

In times when the collective consensus have shouted in our ears that we should eat less fat, it is important to use common sense, read the research properly and stand firm.

Fat is healthy, and fat is vital!

One should obviously not wallow in margarine, french fries and chips, but make sure to eat well from the healthy fats as olive oil and especially fish oil.

It can be ingested as a liquid, as capsules, or as very attractive food.

Fish is not only healthy but also tastes very good indeed. Many people are nevertheless troubled by the increasing presence of heavy metals in fish, but if you avoid the large predatory fish as swordfish and tuna, there is significantly less in for example salmon and trout, especially if they are caught in clean rivers and lakes.

There are however problems with farmed fish, which often contains pretty much omega-6 fat, due to the fish feed composition. And this we should avoid. We already get far too much omega-6, especially linoleic acid, found in the cheap cooking oils with corn and sunflower oil, so as to avoid further bias, we must select the oily fish that are caught in the wild and not farmed.

We must remind you that in a previous newsletter we described two studies that showed that even eggs contain substances that prevent the age-related central blindness, so it may be, we soon will see a Danish ban against bread with eggs and herring. In Denmark food is not allowed to prevent a disease!

Enjoy your meal.

By: Claus Hancke, MD 

References:

  • Sangiovanni JP, Agron E, et al. Omega-3 Long-chain polyunsaturated fatty acid intake and 12-y incidence of neovascular age-related macular degeneration and central geographic atrophy: a prospective cohort study from the Age-Related Eye Disease Study, Am J Clin Nutr, 2009 Oct 7 (E-pub. Ahead of print)
  • Mares JA, Larowe TL, et al. Predictors of optical density of lutein and zeaxanthin in retinas of older women in the Carotenoids in Age-Related Eye Disease Study, an ancillary study of the Women’s Health Initiative. Am J Clin Nutr., 2006, 84(5): 1107-1122.
  • Wenzel AJ, Gerweck C, et al. A 12-wk egg intervention increases serum zeaxanthin and macular pigment optical density in women. J Nutr., 2006; 136(10):2568-73.