Huge study finds no benefit of vitamins

[ofonorow]

http://apnews.myway.com/article/20090209/D968BGTG0.html

Same modus operandi - release the results before the paper is published, so no one can provide a critique. I'll eat my hat of this study has an validity.

[godsilove]

http://apnews.myway.com/article/20090209/D968BGTG0.html

Same modus operandi - release the results before the paper is published, so no one can provide a critique. I'll eat my hat of this study has an validity.

The study has been published. And even if the results were announced prior to publication (not something that I'm a fan of myself), peer review means that it would have already gone through critique. Furthermore, papers are not immune from critique once they are published - nothing is stopping anyone from making a valid criticism of this paper.

Absence of evidence is not evidence of absence. Nonetheless, given the magnitude of this study, it seems improbable that multivitamins have much of a benefit in terms of cancer, CVD, and mortality risk - at least in postmenopausal women. Could there be benefits of multivitamin use in other groups e.g. adolescents or elderly men? Perhaps. There might also be risk reductions for certain diseases not looked at in the study. In any case, this isn't good news for Centrum. Does the emperor really have no clothes?

[sjmusic2]

From Owen's link...
"Co-author Dr. JoAnn Manson said despite the disappointing results, the research doesn't mean multivitamins are useless.
For one thing, the data are observational, not the most rigorous kind of scientific research. And also, it's not clear if taking vitamins might help prevent cancers that take many years to develop, said Manson, chief of preventive medicine at Harvard's Brigham & Women's Hospital.
She said multivitamins may still be useful "as a form of insurance" for people with poor eating habits."

I would like to see the full study to understand the complete methodology and results, eg. what were the dosing levels, if for example, it were one multi-vitamin per day (at RDA levels) it is hardly surprising that no major benefits were observed.

godsilove, do you have the full text by any chance ?

[godsilove]

From Owen's link...
"Co-author Dr. JoAnn Manson said despite the disappointing results, the research doesn't mean multivitamins are useless.
For one thing, the data are observational, not the most rigorous kind of scientific research. And also, it's not clear if taking vitamins might help prevent cancers that take many years to develop, said Manson, chief of preventive medicine at Harvard's Brigham & Women's Hospital.
She said multivitamins may still be useful "as a form of insurance" for people with poor eating habits."

I would like to see the full study to understand the complete methodology and results, eg. what were the dosing levels, if for example, it were one multi-vitamin per day (at RDA levels) it is hardly surprising that no major benefits were observed.

godsilove, do you have the full text by any chance ?

I don't have the full text with me at the moment - I've only looked at the abstract so far.

We should keep an eye on the Physician's Health Study, as they have a more rigorous trial design. The point about dosing is a good one - I don't think they stratified the population in terms of dosing, although that's only going by the abstract. With multivitamin pills, there is a genuine concern with adverse effects - so I think most only contain enough of each vitamin / mineral to prevent deficiency diseases associated with them. This observational study might suggest that at these doses, there is no preventative effect.

We see this with trials of Vitamin D3. An RCT looking at 400 IU supplementation found no overall benefit in colorectal cancer risk, whereas another looking at a higher dose found a significant risk reduction. This could be due to other factors such as differences in trial design, so these results always need to be regarded as tentative.

[ofonorow]

Thanks for the link to the abstract, and from the abstract I infer that this is another paper that was put together not because the original research was intended to determine the outcome of "multivitamins" on CVD and cancer, but because they were doing another study, had this data "available," discovered it supported their agenga after running their analysis on it. This is the same "trick" the Harvard recently used.

It is an interesting clandestine way to pretend you have studied something, because if the data is positive for nutrients, you don't have to publish and no one would be the wiser. Contrast this propaganda technique with real research, i.e., if the study was designed from the start to study vitamin use w/r to CVD and Cancer, you can hardly not report the results. I infer from a cursory read of the abstract that this study (or should I say 3 studies) were looking at vitamin D. So there was no design to this research, no approval, no rigor, and I would personally be ashamed to be associated with this.

But I hope to find the time - soon to read this paper.

[godsilove]

Thanks for the link to the abstract, and from the abstract I infer that this is another paper that was put together not because the original research was intended to determine the outcome of "multivitamins" on CVD and cancer, but because they were doing another study, had this data "available," discovered it supported their agenga after running their analysis on it. This is the same "trick" the Harvard recently used.

It is an interesting clandestine way to pretend you have studied something, because if the data is positive for nutrients, you don't have to publish and no one would be the wiser. Contrast this propaganda technique with real research, i.e., if the study was designed from the start to study vitamin use w/r to CVD and Cancer, you can hardly not report the results. I infer from a cursory read of the abstract that this study (or should I say 3 studies) were looking at vitamin D. So there was no design to this research, no approval, no rigor, and I would personally be ashamed to be associated with this.

But I hope to find the time - soon to read this paper.

Owen, observational studies by definition do not not set out to determine the outcome of an intervention. There is nothing clandestine about it, and these kinds of studies are quite standard in epidemiology. Of course, observational studies are not as rigorous as other kinds of studies, e.g. double-blind, placebo-controlled randomized trials. However, they do offer key advantages over interventional studies. For instance, doing a controlled clinical trial in this magnitude of subjects would be very expensive and a logistical nightmare. If the data is available, why not use it? It still can offer valuable insights. And while not the most rigorous of designs, there is still some rigor and definitely a study design. The women in this trial all had an annual check up where they reported multivitamin use. They were asked to bring the bottles with them so that the components could be recorded and correctly classified. Frequency and duration was also recorded.

Ultimately, a randomized, controlled trial like the Physicians' Health Study II will be needed to clarify the role of multivitamins, but I would not dismiss the results of this study so easily. Observational studies have their place. For example, they have been crucial in identifying the increased risk of lung cancer and several diseases due to smoking. They are also important for determining any adverse events arising from drug use in the general population.

I still don't understand why you assume that if positive data were found, that it would be published. Given the amount of time it must have taken to analyze over 100,000 patient records and do the statistical tests, I cannot imagine any scientists not wanting to get published. It's a very curious assertion. There are positive studies of certain vitamins which have been published, so that runs counter to your claim.

[ofonorow]

Owen, observational studies by definition do not not set out to determine the outcome of an intervention. There is nothing clandestine about it, and these kinds of studies are quite standard in epidemiology.

Which is the primary reason why I think epidemiological studies are generally a waste, but you miss my point. This study was presented, at least in the media, as if it were designed to test multivitamins w/r to CVD and cancer. That was clearly not the intention when this study was begun. It is deceitful to claim, after the fact, that this study was designed to draw these conclusions.

I can tell you haven't yet read Pauling's book, or are unaware of how difficult it is to get any studies by alternative medicine published in regular journals. The crime is that these studies are published in peer-reviewed journals, such as the Journal of Othomolecular Medicine - but not indexed in MEDLINE. No ordinary research is going to uncover what is literally a mountain of work.

By the way, even if this study had been conducted in the right way, so to speak, designed from the beginning to investigate the intake of multivitamins with respect to CVD and Cancer endpoints, it would still NOT BE SCIENCE. I know medical researchers aren't scientists, although they like to play scientists on TV interviews, but the essence of the scientific method is repeatablity. Science 101. Unless the experiment can be repeated by other researchers, it should have no weight and no bearing to real scientists. Try to obtain any of the data from the large studies, and if you do, please share it with me!
What is practiced is pharmaceutical marketing, not science.

[godsilove]

Owen, observational studies by definition do not not set out to determine the outcome of an intervention. There is nothing clandestine about it, and these kinds of studies are quite standard in epidemiology.

Which is the primary reason why I think epidemiological studies are generally a waste, but you miss my point. This study was presented, at least in the media, as if it were designed to test multivitamins w/r to CVD and cancer. That was clearly not the intention when this study was begun. It is deceitful to claim, after the fact, that this study was designed to draw these conclusions.

You are insinuating that the authors of the study are somehow being deceitful and clandestine, because of how you perceive the newstories. It's an unfair accusation, in my opinion. Firstly, the authors have little control of how the media handles the story. Secondly, it is not entirely correct to say that this study was not setup to find such correlations. The study included data from a huge cohort of women in an observational study - which was set up precisely to identify any links between various factors and health outcomes.

I can tell you haven't yet read Pauling's book, or are unaware of how difficult it is to get any studies by alternative medicine published in regular journals.

I don't see the relevance in this context. Are you simply bringing up the word "alternative" because we're talking about multivitamins rather than pharmaceuticals? If so, then you're creating a false dichotomy between evidence-based studies and what passes for the bulk of "alternative" medicine (e.g. magic crystals, magnets, and other forms of quackery). In my view, there's no need for two kinds of medicine. There are treatments that are shown to work, and those that are unproven.

You have no evidence whatsoever that a positive result from this study would not have been published, especially since several papers showing the benefit of certain supplements for certain medical conditions are published in the mainstream literature.

The crime is that these studies are published in peer-reviewed journals, such as the Journal of Othomolecular Medicine - but not indexed in MEDLINE. No ordinary research is going to uncover what is literally a mountain of work.

Journals vary in terms of what passes for "peer-review". Even some of the journals indexed on MEDLINE probably have lax standards. In any case, good science speaks for itself. The Journal of Orthomolecular Medicine has archives available online. I assume you bring this up because you know of a study - a much more well-designed study - than the one being discussed which shows the benefit of multivitamins. If that's the case, then please do share.

By the way, even if this study had been conducted in the right way, so to speak, designed from the beginning to investigate the intake of multivitamins with respect to CVD and Cancer endpoints, it would still NOT BE SCIENCE. I know medical researchers aren't scientists, although they like to play scientists on TV interviews, but the essence of the scientific method is repeatablity. Science 101. Unless the experiment can be repeated by other researchers, it should have no weight and no bearing to real scientists.
Try to obtain any of the data from the large studies, and if you do, please share it with me!

The study is repeatable. A re-analysis of the study would be pointless, unless there are gross calculation errors in their analyses. Reproducibility doesn't mean going over the same data and doing the same calculations again. If a similar study in a comparable population (i.e. post-menopause women) with similar baseline characteristics found no benefit of multivitamin use, then the results would be reproduced.

But I'm curious - if in your view a study has to be repeated (and not just repeatable) to qualify as scientific (never mind whether or not the conclusions are valid or not), then where do all the studies of your vitamin c heroes stand?

What is practiced is pharmaceutical marketing, not science.

That's a bizarre - if not hackneyed - accusation, to say the least. Even if pharmaceutical companies stand to gain from this latest study (well, except the manufacturers of Centrum), that does not mean they have anything to do with the study itself or the subsequent dissemination in the media.

[ofonorow]

I must say this discussion is prompting me to something we have been meaning to do, but haven't found the time. Irwin Stone collected what he thought were the best vitamin C studies over the years, and has more then 700 full papers a file cabinet. These studies are old and are not accessible by any known medical database. We need to scan and post this work at the Foundation. (And that would only leave some 79,300 "old" vitamin C studies to post, if Cheraskin was correct in the 1980s that there were 80,000 such studies.) I said to read Pauling for various reasons, and you should, but not the least of which is the knowledge that vitamin C is one of the most studied substances in the history of science, just behind aspirin and the prostaglandins.

There are treatments that are shown to work, and those that are unproven.

This is what medical students and doctors are taught, however not being "proven" is the wrong way to think about this on several levels, not the least of which is there is nothing "proven" in real science. There is no such thing, I'd be prepared to debate you on this fine point, if you like, but again it requires an understanding of what science is, and what it isn't. It is a misuse of the word, and even in mathematics, a proof depends on the axioms. You can prove Euclidean geometry, based on the various axioms, which happen not to accurately represent the real world - we now think.

Anyway, your axiom seems to be that if something worked, medical science would have studied it.

And in a sense this is true, however, such work never makes news. It is a quick way to get discredited and not receive further press or grant funding. (And imagine trying to get faculty at a university to approve research of vitamin C for heart disease!) If you want to really analyze your statement, get at the truth, you would be very surprised to learn that most "heavily" studied pharmaceuticals don't work in a very large segment of the people, (perhaps antibiotics excluded,). This is from statements made by the heads of the large pharmaceutical companies.

The "unproven" Pauling therapy appears to CURE severe heart disease in about 10 days. Any cardiologist could monitor its effect in about 2 weeks. Yet, it has never been studied? Why? What in your fantasy world makes you think that anything that would compete with a hundred billion dollar "heart disease" industry would get fairly evaluated in medicine?

You have no evidence whatsoever that a positive result from this study would not have been published, especially since several papers showing the benefit of certain supplements for certain medical conditions are published in the mainstream literature.

The evidence is abundant, and if you want to ruin a budding research career in the future, just try to get an article favorable to vitamin C, or other nutrients in a recognized medical journal. The reason is apparent by looking at the pages of any major journal - count the pharmaceutical ads. Who is paying for, and thus who really controls the content of these journals?

As far as impugning the integrity of the researchers, we are building a list of those who deserve to be impugned. Any research that hides the research data after publishing the study makes the list. I can think of no valid reason not to make science public. There are obviously honest researchers at Yale, for example, who reanalyzed the Finish "beta carotene causes lung cancer" results a few years back that made all the news. A reevaluation of the same data produced a completely opposite result. Make the data public. Be prepared to defend it, and perhaps those in the alternative community, the real scientists and pioneers in my opinion, would put credence in it.

To let you know how open my mind really is, while I think the "Candle in the Ear" people are plants - phony to discredit Alt. Med, I would not dismiss any "unproven" technique a priori - even magnets - unless there was a legit studied that was repeatable and showed no effect. On the other hand without good science, I don't push any alternative medicine. I learned long ago that as a novice in medicine, I was wise to restrict myself to what Pauling wrote. In this way, I had a scientific genius looking over my shoulder

[godsilove]

I must say this discussion is prompting me to something we have been meaning to do, but haven't found the time. Irwin Stone collected what he thought were the best vitamin C studies over the years, and has more then 700 full papers a file cabinet. These studies are old and are not accessible by any known medical database. We need to scan and post this work at the Foundation. (And that would only leave some 79,300 "old" vitamin C studies to post, if Cheraskin was correct in the 1980s that there were 80,000 such studies.) I said to read Pauling for various reasons, and you should, but not the least of which is the knowledge that vitamin C is one of the most studied substances in the history of science, just behind aspirin and the prostaglandins.

That would be great. I keep hearing about various benefits of vitamin C especially for preventing heart disease, but it's hard to find any studies demonstrating this in human subjects.

There are treatments that are shown to work, and those that are unproven.

This is what medical students and doctors are taught, however not being "proven" is the wrong way to think about this on several levels, not the least of which is there is nothing "proven" in real science. There is no such thing, I'd be prepared to debate you on this fine point, if you like, but again it requires an understanding of what science is, and what it isn't. It is a misuse of the word, and even in mathematics, a proof depends on the axioms. You can prove Euclidean geometry, based on the various axioms, which happen not to accurately represent the real world - we now think.

I think we've had a similar conversation before. When I use the word "proven" and "true", I don't use it in any absolute sense, but rather in the context of all scientific knowledge. That is, they are evidence-based yet tentative and asymptotic to truth.

Anyway, your axiom seems to be that if something worked, medical science would have studied it.

Not quite - I'm merely arguing that much of what I consider "alternative medicine" is precisely so because it has not been studied. I'm not saying that they do or do not work - but that they are unproven.

Some people think that there are two kinds of medicine - allopathic medicine controlled by evil bureaucrats and Big Pharma that largely consists of toxic drug remedies and barbaric surgical procedures, and alternative medicine characterized by natural remedies that promote "holistic" health. I think that is a mischaracterization. To me, there is medicine and there's quackery. The use of vitamins and supplements - as far as they are supported by evidence - fall under medicine. If tomorrow it was shown in double-blind placebo-controlled trials that acupuncture is an effective treatment for arthritis, I would be forced to regard it as medicine. Likewise, since evidence indicates that blood transfusions are safer than ESAs in many cases, I would support the former.

And in a sense this is true, however, such work never makes news. It is a quick way to get discredited and not receive further press or grant funding. (And imagine trying to get faculty at a university to approve research of vitamin C for heart disease!)

I really don't know why the University of California professors turned you down - but I would also think that anyone would find it difficult to convince researchers to study something other than their own choosing, unless they were willing to provide funding for it. Perhaps those particular researchers had other research interests, were already accomplished in other areas of research, or simply were not convinced that it was something worth pursuing.

But to say that it discredits researchers is something that I don't agree with. For instance, I recall there was a studylinked to on this forum about an observed link between high ascorbic acid levels in the blood and low BP. This was also reported in the press. Of course, it probably didn't create as much of as an impact in the media as the study in this thread, but there are good reasons for it, e.g. (i) the results are not wholly unsurprising; most people perceive vitamins to be good for you - so this was hardly good fodder for sensationalist headlines (ii) the study was relatively small in size - only 242 women were studied, etc.

If you want to really analyze your statement, get at the truth, you would be very surprised to learn that most "heavily" studied pharmaceuticals don't work in a very large segment of the people, (perhaps antibiotics excluded,). This is from statements made by the heads of the large pharmaceutical companies.

I wouldn't be surprised if certain medications don't work in certain groups of people; in fact, there are number of studies that show this. For instance, the cancer drugs Erbitux and Vectibix have been shown to be completely ineffective in advanced colorectal cancer patients whose tumors express a mutated version of a protein, whereas those whose tumors express the wild-type protein do see a modest benefit.
So of course we can never say that a particular drug will always work for every patient type; I am glad we are moving towards an era of personalized medicine, as in the future we will hopefully be able to tailor treatments based on a patients genotype or specific markers. (and apart from the legalistic definition of the term, I don't regard "drugs" as substances that exclude vitamins, minerals and other dietary supplements that are known to have a physiological effect - so I think that any argument for tailored treatments may also apply to vitamins)

The "unproven" Pauling therapy appears to CURE severe heart disease in about 10 days. Any cardiologist could monitor its effect in about 2 weeks. Yet, it has never been studied? Why? What in your fantasy world makes you think that anything that would compete with a hundred billion dollar "heart disease" industry would get fairly evaluated in medicine?

What do you mean when you say it "appears" to cure heart disease? How does one know such a thing, and how does one surmise that it is applicable to a larger population?

I do not know why the Pauling therapy has never been studied - yet if this is the case, I have to wonder why some people promote it regardless. Perhaps they don't believe in a scientific approach to healthcare.

Anyway, as a resident of Canada perhaps my perspective of things is influenced by the fact that there is a strong incentive for healthcare professionals to find treatments that are cheaper and equally as effective as existing therapies. You seem to think that there is only one kind of stakeholder that controls all medical research, i.e. the pharmaceutical industry and hospitals and doctors who profit from people being sick. But the fact remains that a lot of medical research is publicly funded - and that includes research on non-patented/non-patentable and off-patent agents. Of course, it's not a bottomless pit.

There are ongoing randomized clinical trials funded by the NIH that are looking at things like niacin and omega-3 for the treatment or prevention of cardiovascular diseases, for instance. This is not my fantasy world - it is what goes on in the real world. Not all clinical trials are funded by industry, and not all of them are set up with the sole aim of increasing profits for pharmaceutical giants. There's no reason to throw the baby out with the bathwater.

You have no evidence whatsoever that a positive result from this study would not have been published, especially since several papers showing the benefit of certain supplements for certain medical conditions are published in the mainstream literature.

The evidence is abundant, and if you want to ruin a budding research career in the future, just try to get an article favorable to vitamin C, or other nutrients in a recognized medical journal.

Okay...let's take the New England Journal of Medicine as an example.

I did a search first for "omega-3" and found the following positive studies on the first page itself:
https://content.nejm.org/cgi/content/ab ... 31/18/1194
http://content.nejm.org/cgi/content/abs ... 12/19/1210
http://content.nejm.org/cgi/content/abs ... 12/19/1205

Next, a quick search for "cholecalciferol":
https://content.nejm.org/cgi/content/ab ... 337/10/670
http://content.nejm.org/cgi/content/abs ... 27/23/1637

I wonder if these authors ruined their careers by publishing positive results for dietary supplements in a high-impact journal.

The reason is apparent by looking at the pages of any major journal - count the pharmaceutical ads. Who is paying for, and thus who really controls the content of these journals?

It's not surprising that medical journals contain pharmaceutical ads, considering that the readers of the journal are the ones being targetted by these ads. But their presence does not imply that the pharmaceutical companies are the one that decides what content gets published.

How does the scenario play out in your mind - say if a large randomized trial showed that high-dose ascorbic acid use over five years showed fewer mortalities from cardiovascular disease, and the investigators submit their manuscript to a top medical journal. Which pharmaceutical company has to pay off the editors? Would it be Merck, Pfizer, AstraZeneca or a consortium of all three? What if a group of researchers submits a paper showing that Drug A from Company Y is superior to Drug B from Company Z - what happens then?

If I flip through Nature magazine, I may see ads from Invitrogen, Qiagen, Sigma-Aldrich, etc - precisely because their customers are more likely to read the journal. But I don't see any reason to think that these companies have any substantial control over what gets published.

As far as impugning the integrity of the researchers, we are building a list of those who deserve to be impugned. Any research that hides the research data after publishing the study makes the list. I can think of no valid reason not to make science public. There are obviously honest researchers at Yale, for example, who reanalyzed the Finish "beta carotene causes lung cancer" results a few years back that made all the news. A reevaluation of the same data produced a completely opposite result. Make the data public. Be prepared to defend it, and perhaps those in the alternative community, the real scientists and pioneers in my opinion, would put credence in it.

Have you contacted the investigators in this particular case?

I believe the results of all publicly funded research should be made freely available; but I don't see the utility of making the raw data itself available. Most laypeople wouldn't be able to make any sense of it.

On the other hand, if you know of any scientists in the "alternative community" who might want to do another analysis of the data, say for example, looking at women reporting a certain dose of vitamin C and comparing them to those taking no or low-doses of vitamin C - perhaps they might be open to that.

http://www.whiscience.org/collaborators/

To let you know how open my mind really is, while I think the "Candle in the Ear" people are plants - phony to discredit Alt. Med, I would not dismiss any "unproven" technique a priori - even magnets - unless there was a legit studied that was repeatable and showed no effect. On the other hand without good science, I don't push any alternative medicine. I learned long ago that as a novice in medicine, I was wise to restrict myself to what Pauling wrote. In this way, I had a scientific genius looking over my shoulder

I would not completely dismiss an "unproven" technique either. But at the same time I don't think all unproven therapies should be regarded as equal either. Given what we know about the human body, I think we can be more skeptical of certain proposed treatments.

[Dolev]

In this convoluted world, it's actually good that they proved there are no benefits from a multi. If there were health benefits, then it would be classified as a drug and need a prescription, and would only be marketed by drug companies, as per the vitamin B6 trip.

[ofonorow]

In this convoluted world, it's actually good that they proved there are no benefits from a multi. If there were health benefits, then it would be classified as a drug and need a prescription, and would only be marketed by drug companies, as per the vitamin B6 trip.

Very astute Dolev, I wish I had thought of this silver lining...

[ofonorow]

That would be great. I keep hearing about various benefits of vitamin C especially for preventing heart disease, but it's hard to find any studies demonstrating this in human subjects.

Its not hard, its impossible. (Actually, we have posted the studies that do exist, starting with Willis, and lately Rath, et. al)

I think we've had a similar conversation before. When I use the word "proven" and "true", I don't use it in any absolute sense, but rather in the context of all scientific knowledge. That is, they are evidence-based yet tentative and asymptotic to truth.

Sorry for repeating myself, but it is a misuse of the word. If the medical profession said the "evidence is overwhelming", or "there is substantial reason to believe based on the evidence", that would be one thing, but instead the profession (and its educators) always imply that their tools (prescription drugs and treatments) are "proven". It may seem like a subtle point, and I know that patients like to be told there is "proof." (Who wants to take a drug that only has "substantial evidence"?), but "proof" also serves as a barrier to exclude modalities which no one has spent the money to research. In the case of the Pauling-therapy, we have a completely non-toxic, inexpensive treatment that makes very ill patients feel much better in about a week.

As far as the difference between "quacks" and such, my opinion has turned 180 degrees the more I learn about alternative medicine. The alternative doctors I think of are M.Ds, who have been highly trained, but have risked their careers and reputations because they believe, as I do, that there are better, less toxic or "orthomolecular" approaches to disease that ought to be tried first. They have generally become my heroes and they generally have such strong practices that their counterparts are very jealous.

I would point you to drbrownstein.com - I think we posted some of his videos, but his story is that he wanted to be a doctor since he was a young child - to help people. After he graduated he joined a large practice and quickly became disillusioned, rather than helping patients, he was filling them full of toxic drugs. He finally turned to his wife, I've made the decision, I don't want to be a doctor anymore... Anyway, then he started reading Dr. Jonathan Wright's books (Harvard Educated Alt. MD) and that led him on the path I wish ALL doctors would start following. Really helping people feel better and getting better. Brownstein has not sworn off all drugs (he prescribes a specific IV antibiotic for arthritis for instance) but his paradigm seems to be the correct one in my opinion.

I wouldn't be surprised if certain medications don't work in certain groups of people..

http://news.bbc.co.uk/2/hi/health/3299945.stm

A senior executive at Europe's largest drug maker has admitted most prescription medicines don't work for most people, it is reported.

Allen Roses, of GlaxoSmithKline, is quoted in a national newspaper as saying more than 90% of drugs only work in 30-50% of people.

What do you mean when you say it "appears" to cure heart disease? How does one know such a thing, and how does one surmise that it is applicable to a larger population?

I do not know why the Pauling therapy has never been studied - yet if this is the case, I have to wonder why some people promote it regardless. Perhaps they don't believe in a scientific approach to healthcare.

It appears to be a cure because practically everyone who has tried it (at the proper dosage) based on Linus Pauling's recommendation since 1996 has for all intents and purposes recovered. To get the feeling, you can start reading the testimonials here:
http://practicingmedicinewithoutalicense.com/#TESTIMONY

How does the scenario play out in your mind - say if a large randomized trial showed that high-dose ascorbic acid use over five years showed fewer mortalities from cardiovascular disease, and the investigators submit their manuscript to a top medical journal.

First, thank you for the links, but vitamin D doesn't count! (Vitamin D didn't make the debunk list for reasons we have already speculated on - Pauling didn't recommend supplementing vitamin D). And the Omega-3 evidence is quite overwhelming, but terribly old news to everyone in the Alt. Med community. What I'd like to see are the links to studies on vitamin C, especially a favorable study! (Good luck!)

The American Journal of Clinical Nutrition has some, admittly, but not a journal commonly read by Medical Doctors.

As far as how it plays out, in the first place, who would pay for such a study?

Actually, there was just such a study done in the UK, the results were so spectacular that the author filed international patents on the vitamin C/lysine/vitamin E combination used in the study - this work was COMPLETED in 2003, 3-year clinical trial, 200+ males. 6000 mg Vitamin C, 6000 mg Lysine, 800 IU Vitamin E, 'First-Ever' Soon to be Published...(2003?), Plaque growth 800-1500 percent higher in placebo group.

Here is the letter the author sent me in 2003.

Subject: Re: Trial on Lp(a) - using high doses.

Date: Wed, 5 Mar 2003 17:53:32 -0000

Dear Owen,

>From 1997 to year 2000 ( 2-3 year study) we conducted a trial using 6g/day magnesium-ascorbate, 6g Lysine and 800 iu Vitamin E and in addition flavonoids. The formulation is very similar to your suggestion and Linus Paulings.

We now have a lot of data on 200+ male individuals including Lp(a) but also on atherosclerotic, plaque size progression, plod pressure, lipid profiles (cholesterol, triglyserides).

You may be interested in viewing some of this data (yet unpublished) soon to be published.

One main important observation was that the plaque growth progression was nearly halted to about 2-3% per year in comparison with natural progression of 15-30%.

We did not find a significant reduction in Lp(a) as such but a clear reduction in Apob.

There were also other benefits such as the hair started to re-grow in several individuals.

The frequency of common colds were also reduced.

Best regards
Dr. K. Kenton
London
United Kingdom

So how does it play out in your mind that this study has never been published? (We have tried to contact Dr. Kenton, his patent attempts have been verified, however he fails to respond and has been incommunicado)

I believe the results of all publicly funded research should be made freely available; but I don't see the utility of making the raw data itself available. Most laypeople wouldn't be able to make any sense of it.

If you don't make the data available, then how do you have any faith what-so-ever in the analysis? Trust? It is irrelevant that lay people would or would not understand it (but you would be surprised).
I became interested in this issue after reading about the Oxford Heart Protection Study. They had a placebo group, a vitamin group and a statin group, a statin/vitamin combined group, etc. if memory serves. The paper lauded "massive benefits" in the statin group, but from the paper it was impossible to determine if these results were in the statin only, or in the statin-vitamin group. This would be important to know, don't you think? So I did contact them and they refuse to release their raw data.

I also contacted the Harvard professor (sessor?) about his recent study, and again, since the study was "ongoing" he refused to release the data.

[godsilove]

I think we've had a similar conversation before. When I use the word "proven" and "true", I don't use it in any absolute sense, but rather in the context of all scientific knowledge. That is, they are evidence-based yet tentative and asymptotic to truth.

Sorry for repeating myself, but it is a misuse of the word. If the medical profession said the "evidence is overwhelming", or "there is substantial reason to believe based on the evidence", that would be one thing, but instead the profession (and its educators) always imply that their tools (prescription drugs and treatments) are "proven". It may seem like a subtle point, and I know that patients like to be told there is "proof." (Who wants to take a drug that only has "substantial evidence"?), but "proof" also serves as a barrier to exclude modalities which no one has spent the money to research. In the case of the Pauling-therapy, we have a completely non-toxic, inexpensive treatment that makes very ill patients feel much better in about a week.

I don't know of any scientist that uses the word "prove" in the same way that a mathematician does - it is generally understood that you don't have proofs in science, but rather evidence (and I would use a word other than "prove" if I knew what the verb form of evidence was ).

As far as the difference between "quacks" and such, my opinion has turned 180 degrees the more I learn about alternative medicine. The alternative doctors I think of are M.Ds, who have been highly trained, but have risked their careers and reputations because they believe, as I do, that there are better, less toxic or "orthomolecular" approaches to disease that ought to be tried first. They have generally become my heroes and they generally have such strong practices that their counterparts are very jealous.

I would point you to drbrownstein.com - I think we posted some of his videos, but his story is that he wanted to be a doctor since he was a young child - to help people. After he graduated he joined a large practice and quickly became disillusioned, rather than helping patients, he was filling them full of toxic drugs. He finally turned to his wife, I've made the decision, I don't want to be a doctor anymore... Anyway, then he started reading Dr. Jonathan Wright's books (Harvard Educated Alt. MD) and that led him on the path I wish ALL doctors would start following. Really helping people feel better and getting better. Brownstein has not sworn off all drugs (he prescribes a specific IV antibiotic for arthritis for instance) but his paradigm seems to be the correct one in my opinion.

Perhaps there are mainstream doctors who are just pill-pushers who don't really give a hoot about the quality of life for their patients. At the same time however, there are many mainstream MDs who are conscientous of this. At the same time, perhaps there are alternative medicine doctors who really couldn't care less if their patients are benefiting from a treatment so long as they are able to milk the patients.
Again, I don't see the advantage in creating more false distinctions. Helping people feel better and get better is not exclusive to the alternative medicine community (just out of curiosity, what are the "alternatives" for pain management in chronic care and palliative patients). I would wholeheartedly agree with you that if there there are safer and more effective alternatives, that they should be pursued. By I think that this ultimately needs to be explored in an evidence-based fashion.

I wouldn't be surprised if certain medications don't work in certain groups of people..

http://news.bbc.co.uk/2/hi/health/3299945.stm

A senior executive at Europe's largest drug maker has admitted most prescription medicines don't work for most people, it is reported.

Allen Roses, of GlaxoSmithKline, is quoted in a national newspaper as saying more than 90% of drugs only work in 30-50% of people.

Again, I'm not surprised. There is a lot of genetic variation in human beings and different patients will respond differently to medications. This is why we still have a long way to go in fully utilizing advances in genomics and molecular biology.

Given this information, the direction we should be taking is not scrapping the use of prescription medicines altogether, but using an evidence-based approach to identify the subpopulations that are most likely to respond to a drug as well as those that are more susceptible to certain toxicities.

What do you mean when you say it "appears" to cure heart disease? How does one know such a thing, and how does one surmise that it is applicable to a larger population?

I do not know why the Pauling therapy has never been studied - yet if this is the case, I have to wonder why some people promote it regardless. Perhaps they don't believe in a scientific approach to healthcare.

It appears to be a cure because practically everyone who has tried it (at the proper dosage) based on Linus Pauling's recommendation since 1996 has for all intents and purposes recovered. To get the feeling, you can start reading the testimonials here:
http://practicingmedicinewithoutalicense.com/#TESTIMONY

How should I interpret testimonies?

Is it fair to say that if someone had reported not benefiting from Pauling Therapy that you probably would not have included his or her experience in your book? I'm sure you're aware of things like sampling error and statistical biases that need to be taken into account.

How many people would you estimate have tried Pauling Therapy?

How does the scenario play out in your mind - say if a large randomized trial showed that high-dose ascorbic acid use over five years showed fewer mortalities from cardiovascular disease, and the investigators submit their manuscript to a top medical journal.

First, thank you for the links, but vitamin D doesn't count! (Vitamin D didn't make the debunk list for reasons we have already speculated on - Pauling didn't recommend supplementing vitamin D). And the Omega-3 evidence is quite overwhelming, but terribly old news to everyone in the Alt. Med community. What I'd like to see are the links to studies on vitamin C, especially a favorable study! (Good luck!)

That's a bizarre reason to dismiss Vitamin D. Sorry, but I'm simply not convinced that scientists have a personal vendetta against the late Linus Pauling. And whether or not Omega-3 has been touted by alt.med proponents is irrelevant here - you made the claim that the way to ruin a research career would be to publish favourable studies on nutritional supplements. A simple search on one of the most prestigious medical journals debunks this claim.

With respect to Vitamin C, I did a search for articles on The Lancet
http://www.thelancet.com/journals/lance ... 40-6736(00)04128-3/abstract (2001)
http://www.thelancet.com/journals/lance ... 40-6736(99)03059-7/fulltext (1999)

From JAMA (original contributions only):
http://jama.ama-assn.org/cgi/content/ab ... type=HWCIT

From the BMJ:
http://www.bmj.com/cgi/content/abstract ... type=HWCIT

There's more where that came from. I'm trying to understand why you think there's an inherent bias against vitamins, but I'm simply not seeing it based on the evidence available to me. The above are all high impact journals that are widely read by physicians.

The American Journal of Clinical Nutrition has some, admittly, but not a journal commonly read by Medical Doctors.

It probably isn't since it isn't as broad in scope as the likes of the NEJM and BMJ, just as the Journal of Clinical Oncology might not be commonly read by MDs who are not oncologists. Nonetheless, the American Journal of Clinical Nutrition is still a fairly widely read journal by researchers in that field. I also recall seeing articles from it being cited by others in the high impact medical journals.

As far as how it plays out, in the first place, who would pay for such a study?

For the most part, taxpayers.

Actually, there was just such a study done in the UK, the results were so spectacular that the author filed international patents on the vitamin C/lysine/vitamin E combination used in the study - this work was COMPLETED in 2003, 3-year clinical trial, 200+ males. 6000 mg Vitamin C, 6000 mg Lysine, 800 IU Vitamin E, 'First-Ever' Soon to be Published...(2003?), Plaque growth 800-1500 percent higher in placebo group.

Here is the letter the author sent me in 2003.

Subject: Re: Trial on Lp(a) - using high doses.

Date: Wed, 5 Mar 2003 17:53:32 -0000

Dear Owen,

>From 1997 to year 2000 ( 2-3 year study) we conducted a trial using 6g/day magnesium-ascorbate, 6g Lysine and 800 iu Vitamin E and in addition flavonoids. The formulation is very similar to your suggestion and Linus Paulings.

We now have a lot of data on 200+ male individuals including Lp(a) but also on atherosclerotic, plaque size progression, plod pressure, lipid profiles (cholesterol, triglyserides).

You may be interested in viewing some of this data (yet unpublished) soon to be published.

One main important observation was that the plaque growth progression was nearly halted to about 2-3% per year in comparison with natural progression of 15-30%.

We did not find a significant reduction in Lp(a) as such but a clear reduction in Apob.

There were also other benefits such as the hair started to re-grow in several individuals.

The frequency of common colds were also reduced.

Best regards
Dr. K. Kenton
London
United Kingdom

So how does it play out in your mind that this study has never been published? (We have tried to contact Dr. Kenton, his patent attempts have been verified, however he fails to respond and has been incommunicado)

I did a search on PubMed for Kenton-K, and I found several articles by a US-based researcher who appears to be a urologist or gynecologist. Didn't seem to be another K Kenton there, so if there was one who undertook a study of pauling therapy, he doesn't appear to have any prior publication record.

What institution was he associated with when he contacted you?

If he holds the patent to this formulation, and his trial had a positive result - don't you reckon he would want it published? There's hundreds of different medical journals out there - even if the manuscript was not accepted for publiclation in the top journals, he would have been able to publish it somewhere. Or he could've written a book.

Do you have anything to go by other than his word to determine whether the trial ever took place to begin with? Perhaps the name or identity of the trial, so that it could be looked up in a registry.

My perception is simply this: you got a letter from someone who claimed to have conducted a trial on a regimen that he holds a patent to. For some reason, he is now incognito. There is simply not enough information there - no objective evidence that the trial ever took place, no evidence that he attempted to submit a manuscript to any journals, nor any evidence that he is an actual researcher. If you could help me out with more information, that would be appreciated.

I believe the results of all publicly funded research should be made freely available; but I don't see the utility of making the raw data itself available. Most laypeople wouldn't be able to make any sense of it.

If you don't make the data available, then how do you have any faith what-so-ever in the analysis? Trust?

Don't you? Have you seen the raw data from all the studies conducted by your vitamin C heroes? Is the raw data - not just the results - freely available to the public?

Perhaps an argument could be made for have a repository where raw data and lab notes from all scientific studies funded by public money could be stored. But the fact is that this simply isn't how science is currently practiced. Yes, for the most part we have to rely on trust. Occasionally, scientists do engage in scientific fraud - but if you're found out, you've basically thrown out your reputation. I have not seen "raw data" from Watson and Crick's experiments that led to their uncovering of the double helix structure, nor the "raw data" from Eric Kandel's pioneering experiments in Aplysia. I see no reason not to trust that they presented their results in good faith.

Of course, there are times when one might be skeptical of whether a researcher has acted in good faith. For example, if that researcher had undisclosed conflicts of interest, that should set off a red flag.

But asking scientists to release their raw data is an unusual (and possible offensive) request. I'm sure there are political and legal issues that arise as well (i.e. ownership of the data, fear of having someone else to profit off the data without giving adequate credit, etc). Refusal to give out raw data does not mean that the data is fraudulent.

It is irrelevant that lay people would or would not understand it (but you would be surprised).
I became interested in this issue after reading about the Oxford Heart Protection Study. They had a placebo group, a vitamin group and a statin group, a statin/vitamin combined group, etc. if memory serves. The paper lauded "massive benefits" in the statin group, but from the paper it was impossible to determine if these results were in the statin only, or in the statin-vitamin group. This would be important to know, don't you think? So I did contact them and they refuse to release their raw data.

Why do you need to raw data to see the difference in benefits? It's available in the published results.

For instance, in slide 42:
http://www.ctsu.ox.ac.uk/~hps/slidesfin ... /frame.htm

The rate of major vascular events had a similar benefit amongst those on simvastatin, regardless of whether or not they were taking vitamins.

I also contacted the Harvard professor (sessor?) about his recent study, and again, since the study was "ongoing" he refused to release the data.

Sounds reasonable to me.

[ofonorow]

Stimulating as always. Too bad I have a few other commitments.. You obviously haven't read my book
(See the Steve From Florida testimony. I fear he is no longer of this world, but his testimony was taken verbatum from this forum. Steve reported no success with the Pauling-therapy after the Cleveland Clinic inserted a medical stent. We also discuss the reasons why we believe persons who initially recovered so quickly, reported relapses over time, (yes not all the news was good news) and of course there is Carol Smith - who anyone can talk to and you can listen to her radio interview from our main web site - hers is a 9 year case study of on the Pauling therapy, feeling fine, getting a normal EKG, stopping for economic reasons and relapsing almost to the point of death. This happened 3 times.)

I don't know of any scientist that uses the word "prove" in the same way that a mathematician does - it is generally understood that you don't have proofs in science, but rather evidence (and I would use a word other than "prove" if I knew what the verb form of evidence was ).

You and I are in violent agreement! Yes! Scientists don't, that is exactly my point, but doctors and medical educators use this word all the time - incorrectly - as if medical science is a certainty.

How many people would you estimate have tried Pauling Therapy?

This is a very hard question to answer. We have been trying since about 1996 to get a simple story in the media that Linus Pauling had made the claim - he may have been wrong and the protocol is nontoxic - but they wouldn't even touch that. If it had made the news, then almost every heart patient could have tried it, and the problem would be behind us. Now we did make minor breakthroughs in relatively minor alternative media, and every time there was a lot of interest, so I would say that by now, after 13 years on the Internet, we probably have about 500-1000 visitors per day, there are other companies and Rath, so perhaps 30,000 per month at the most visit. I don't know how many try, but there are probably hundreds of thousands by now on vitamin C and lysine, mostly form word-of-mouth. But of course every one who goes to their cardiologist to ask about it are pooh-poohed. I say of course, but it is a fact.

That's a bizarre reason to dismiss Vitamin D. Sorry, but I'm simply not convinced that scientists have a personal vendetta against the late Linus Pauling. And whether or not Omega-3 has been touted by alt.med proponents is irrelevant here - you made the claim that the way to ruin a research career would be to publish favourable studies on nutritional supplements. A simple search on one of the most prestigious medical journals debunks this claim.

I have never made a claim that scientists are biased against Linus Pauling! (Of course, I don't consider medically trained doctors running these trials to be scientists.) I can point you to several books that expose the debunking campaign, at that time, orchestrated by certain individuals then connected with the AMA. An author posed as a reporter, offering to help, and was given access to files, and he made copies. He found that they had actually studied which alternative modalites seemed to work, and which ones were the most popular, and used this information to aim the disinformation campaign against. It is notable that vitamin D did not make the list, that's all. (They must regret their mistake now.) This is big business, huge business, and these interests know exactly where the competition comes from.


In general, I find the UK has more integrity than the US in these matters. I'll study your links. thx.

update: I did look at the first abstract, http://jama.ama-assn.org/cgi/content/ab ... type=HWCIT

regarding ascorbic acid and lead levels, and while this 1999 study was nice, Pauling wrote about this known result in his 1970 book, in the section mentioning that children who consumed more vitamin C had higher IQs, and speculated that this effect was probably due to the then already known result of lower lead levels in people with higher vitamin C blood levels (paint was a larger problem in those days). He has the studies cited, I'll have to check, but they were probably done in the 1940s. If I get time, I will study the references in this 1999 JAMA study to see if they found the earlier work Pauling cited. If they did, I will be surprised, because most of this early work is "hidden" from modern researchers.

For the most part, taxpayers.

This is what I would have thought. Unfortunately, the $27 billion funded (now $40 billion funded after stimuls) NIH turned us down - twice. Why does the government have no interest in this? Maybe because the pharmaceutical interests - for all intents and purposes - control the NIH? (And if you appreciate irony, after sending my book to the few (2) vitamin C friendly folks at the NIH - they contacted us - the Vitamin C Foundation - asking for grant money to help THEM - the NIH - study vitamin C!?! Think about that?!)

As far as the data, medical science has a blatant self interest, and to the extent Universities are dependent on NIH or pharmaceutical grants, they lose their objectivity. You can chose to believe what you want, but because of the outright fraud in so-called medical science (again I can quote Author and former editor of the New England Journal of Medicine about how these medical "studies" are routinely doctored) I do not believe it is worth my time to read any studies run by medicine.

p.s.s. By the way, a pet research project on my plate is to apply Artificial Intelligence (neural network) technology to the problem of analyzing medical studies, to create a tool that can provide a confidence level for a given study. But for this I will need access to the raw data. It will be a very special form of meta analysis - necessary because these large studies are impossible to repeat. Should the results of various studies be consistent, for example the rate of CVD events in the placebo group, then we would give higher confidence to the studies that are consistent. The idea is to develop a filter that if nothing else, allows us to question studies that fall outside what other studies have found.