Hazardous homeopathy: ‘ingredients’ that ought to make you think twice

Would you take a medicine made with arsenic? Or deadly nightshade? Lead? Poison ivy?

You’d ask some serious questions first, at least, wouldn’t you? Is it definitely safe? Or, more accurately, are the odds better than even that it will make me better without causing horrible side-effects? Or, you know, killing me?

There ARE medicines that are legitimately made from highly toxic compounds. For example, the poison beloved of crime writers such as Agatha Christie, arsenic trioxide, is used to treat acute promyelocytic leukemia in patients who haven’t responded to other treatments. Unsurprisingly, it’s not without risks. Side-effects are unpleasant and common, affecting about a third of patients who take it. On the other hand, acute promyelocytic leukemia is fatal if untreated. A good doctor would talk this through with a patient, explain both sides, and leave the final choice in his or her properly-informed hands. As always in medicine, it’s a question of balancing risks and benefits.

Would you trust something with no proven benefit and a lot of potential risk? There are, it turns out, a swathe of entirely unregulated mixtures currently being sold in shops and online which clearly feature the substances I listed at the beginning. And more. Because they are all, supposedly, the starting materials in certain homeopathic remedies.

Homeopaths like to use unfamiliar, usually Latin-based, names which somewhat disguise the true nature of their ingredients. Here’s a short, but by no means comprehensive, list. (You might find remedies labelled differently but these are, as far as I can tell, the most common names given to these substances.)

If you haven’t heard of some of these, I do urge you to follow the links above, which will largely take you pages detailing their toxicology. Spoiler: the words “poison”, “deadly” and “fatal” feature heavily. These are nasty substances.

There are some big ironies here, and I’m not referring to the metal. For example, a common cry of anti-vaccinationists is that vaccines contain animal tissues – anything and everything from monkey DNA to dog livers. But many also seem to be keen to recommend homeopaths and courses of homeoprophylaxis – so-called “homeopathic vaccines” – which use bodily fluids such as pus and blood as starting materials.

Now, at this point I’m sure some of you are thinking, hang on a minute: aren’t you always telling us that “the dose makes the poison“? And aren’t homeopathic remedies diluted so much that none of the original substance remains, so they’re just placebos?

Yes, I am, and yes, they are.

Does anyone test homeopathic remedies to make sure there’s nothing in them….?

In THEORY. But here’s the problem: who’s testing these mixtures to make sure that the dilutions are done properly? And how exactly are they doing that (if they are)?

One technique that chemists use to identify tiny quantities of substance is gas chromatography (GC). This is essentially a high-tech version of that experiment you did at school, where you put some dots of different coloured ink on a piece of filter paper and watched them spread up the paper when you put it in some water.

GC analysis is brilliant at identifying tiny quantities of stuff. 10 parts per million is no problem for most detectors, and the most sensitive equipment can detect substances in the parts per billion range. Homeopathy dilutions are many orders of magnitude higher than this (30c, for example, means a dilution factor of 1060), but this doesn’t matter – once you get past 12c (a factor of 1024) you pass the Avogadro limit.

This is because Avogadro’s number, which describes the number of molecules in what chemists call a “mole” of a substance, is 6×1023. For example, if you had 18 ml of water in a glass, you’d have 6×1023 molecules of H2O. So you can see, if you’ve diluted a small sample by a factor of 1024 – more than the total number of molecules of water you had in the first place – the chances are very good that all you have is water. There will be none of the original substance left. (This, by the way, is of no concern to most homeopaths, who believe that larger dilutions magically produce a stronger healing effect.)

What if the sample ISN’T pure water after it’s been diluted?

If you carried out GC analysis of such a sample, you should find just pure water. Indeed, if you DIDN’T find pure water, it should be cause for concern. Potassium cyanide, for example, is toxic at very low levels. The lethal dose is is only 0.2-0.3 grams, and you’d suffer unpleasant symptoms long before you were exposed to that much.

So what if the dilutions somehow go wrong? What if some sample gets stuck in the bottle? Or on the pipette? Or a few dilution steps get skipped for some reason?

Are these largely unregulated companies rigorously quality-checking their remedies?

Well, maybe. It’s possible some producers are testing their raw materials for purity (ah yes, another question: they CLAIM they’re starting with, say, arsenic, but can we be certain?), and perhaps testing the “stability” of their products after certain periods of time (i.e. checking for bacterial growth), but are they running tests on the final product and checking that, well, there’s nothing in it?

And actually, isn’t this a bit of a conflict? If the water somehow “remembers” the chemical that was added and acquires some sort of “vibrational energy”, shouldn’t that show up somehow in GC analysis or other tests? If your tests prove it’s pure water, indistinguishable from any other sample of pure water, then… (at this point homeopaths will fall back on arguments such as “you can’t test homeopathy” and “it doesn’t work like that”. The name for this is special pleading.)

A warning was issued in the U.S. after several children became ill.

Am I scaremongering? Not really. There’s at least one published case study describing patients who suffered from arsenic poisoning after using homeopathic preparations. In January this year the U.S. Food and Drug Administration issued a warning about elevated levels of belladonna (aka deadly nightshade) in some homeopathic teething products. Yes, teething products. For babies. This warning was issued following several reports of children becoming ill after using the products. The FDA said that its “laboratory analysis found inconsistent amounts of belladonna, a toxic substance, in certain homeopathic teething tablets, sometimes far exceeding the amount claimed on the label.”

Now, admittedly, I’m based in the U.K. and these particular teething remedies were never readily available here. But let’s just type “homeopathy” into the Boots.com (the British high-street pharmacy) website and see what pops up… ah yes. Aconite Pillules, 30c, £6.25 for 84.

What happens if you search for “homeopathy” on the Boots.com website?

Have you been paying attention lovely readers? Aconite is…. yes! Monkshood! One of the most poisonous plants in the garden. Large doses cause instant death. Smaller doses cause nausea and diarrhea, followed by a burning and tingling sensation in the mouth and abdomen, possibly muscle weakness, low blood pressure and irregular heartbeat.

I must stress at this point that there is no suggestion, absolutely none whatsoever, that any of the products for sale at Boots.com has ever caused such symptoms. I’m sure the manufacturers check their preparations extremely carefully to ensure that there’s absolutely NO aconite left and that they really are just very small, very expensive, sugar pills.

Well, fairly sure.

In summary, we seem to be in a situation where people who proclaim that rigorously-tested and quality-controlled pharmaceuticals are “toxic” also seem to be happy to use unregulated homeopathic remedies made with ACTUALLY toxic starting materials.

I wonder if the new “documentary” about homeopathy, Just One Drop, which is being screened in London on the 6th of April will clarify this awkward little issue? Somehow, I doubt it. Having watched the trailer, I think it’s quite clear which way this particular piece of film is going to lean.

One last thing. Some homeopathic mixtures include large quantities of alcohol. For example, the Bach Original Flower Remedies are diluted with brandy and contain approximately 27% alcohol (in the interests of fairness, they do also make alcohol-free versions of some of their products and, as I’ve recently learned, they may not be technically homeopathic). Alcohol is a proven carcinogen. Yes, I know, lots of adults drink moderate quantities of alcohol regularly and are perfectly healthy, and the dose from a flower remedy is minuscule, but still, toxins and hypocrisy and all that.

There are cheaper ways to buy brandy than Bach Flower Remedies.

Amusingly, the alcohol in these remedies is described an “inactive” ingredient. It’s more likely to be the only ACTIVE ingredient. And since Flower Remedies retail for about £7 for 20 ml (a mighty £350 a litre, and they’re not even pure brandy) may I suggest that if you’re looking for that particular “medicine” you might more wisely spend your money on a decent bottle of Rémy Martin?


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The Chronicles of the Chronicle Flask: 2016

2016 is limping to its painful conclusion, still tossing out last-minute nasty surprises like upturned thumb tacks in the last few metres of a marathon. But the year hasn’t been ALL bad. Some fun, and certainly interesting, things happened too. No, really, they did, honestly.

So with that in mind, let’s have a look back at 2016 for the Chronicle Flask….

January kicked off with a particularly egregious news headline in a well-known broadsheet newspaper: Sugar found in ketchup and Coke linked to breast cancer. Turns out that the sugar in question was fructose. Yes, the sugar that’s in practically everything, and certainly everything that’s come from a plant. So why did the newspaper in question choose ketchup and Coke for their headline instead of, oh, say, fruit juice or honey? Surely not just in an effort to sell a few more newspapers after the overindulgent New Year celebrations. Surely.

octarineThere was something more lighthearted to follow when IUPAC  verified the discoveries of elements 113, 115, 117 and 118. This kicked off lots of speculation about the elements’ eventual names, and the Chronicle Flask suggested that one of them should be named Octarine in honour of the late Sir Terry Pratchett. Amazingly, this suggestion really caught everyone’s imagination. It was picked up in the national press, and the associated petition got over 51 thousand signatures!

In February I wrote a post about the science of statues, following the news that a statue to commemorate Sir Terry Pratchett and his work had been approved by Salisbury City Council. Did you know that there was science in statues? Well there is, lots. Fun fact: the God of metalworking was called Hephaestus, and the Greeks placed dwarf-like statues of him near their Hearths – could this be where the fantasy trope of dwarves as blacksmiths originates?

MCl and MI are common preservatives in cosmetic products

MCl and MI are common preservatives in cosmetic products

My skeptical side returned with a vengeance in March after I read some online reviews criticising a particular shampoo for containing a substance known as methylchloroisothiazolinone. So should you be scared of your shampoo? In short, no. Not unless you have a known allergy or particularly sensitive skin. Otherwise, feel free to the pick your shampoo based on the nicest bottle, the best smell, or the forlorn hope that it will actually thicken/straighten/brighten your hair as promised, even though they never, ever, ever do.

Nature Chemistry published Another Four Bricks in the Wall in April – a piece all about the potential names of new elements, partly written by yours truly. The month also brought a sinus infection. I made the most of this opportunity by writing about the cold cure that’s 5000 years old. See how I suffer for my lovely readers? You’re welcome.

In May I weighed in on all the nonsense out there about glyphosate (and, consequently, learned how to spell and pronounce glyphosate – turns out I’d been getting it wrong for ages). Is it dangerous? Nope, not really. The evidence suggests it’s pretty harmless and certainly a lot safer than most of its alternatives.

may-facebook-postSomething else happened in May: the Chronicle Flask’s Facebook page received this message in which one of my followers told me that my post on apricot kernels had deterred his mother from consuming them. This sort of thing makes it all worthwhile.

In June the names of the new elements were announced. Sadly, but not really very surprisingly, octarine was not among them. But element 118 was named oganesson and given the symbol Og. Now, officially, this was in recognition of the work of Professor Yuri Oganessian, but I for one couldn’t help but see a different reference. Mere coincidence? Surely not.

July brought another return to skepticism. This time, baby wipes, and in particular a brand that promise to be “chemical-free”. They’re not chemical-free. Nothing is chemical-free. This is a ridiculous label which shouldn’t be allowed (and yet, inexplicably, is still in use). It’s all made worse by the fact that Water Wipes contain a ‘natural preservative’ called grapefruit seed extract which, experiments have shown, only actually acts as a preservative when it’s contaminated with synthetic substances. Yep. Turns out some of Water Wipes claims are as stinky as the stuff they’re designed to clean up.

Maria Lenk Aquatic Enter, Tuesday, Aug. 9, 2016. (AP Photo/Matt Dunham)

Maria Lenk Aquatic Enter, Tuesday, Aug. 9, 2016. (AP Photo/Matt Dunham)

August brought the Olympics, and speculation was rife about what, exactly, was causing the swimming pools to turn such strange shades of green. Of course, the Chronicle Flask knew the correct solution…

August also saw MMS and CD reared their ugly heads on social media again. CD (chlorine dioxide) is, lest we forget, a type of bleach solution which certain individuals believe autistic children should be made to drink to ‘cure’ them. Worse, they believe such children should be forced to undergo daily enemas using CD solutions. I wrote a summary page on MMS (master mineral solution) and CD, as straight-up science companion to the commentary piece I wrote in 2015.

mugsSeptember took us back to pesticides, but this time with a more lighthearted feel. Did you know that 99.99% of all the pesticides you consume are naturally-occurring? Well, you do if you regularly read this blog. The Chronicle Flask, along with MugWow, also produced a lovely mug. It’s still for sale here, if you need a late Christmas present… (and if you use the code flask15 you’ll even get a discount!)

In October, fed up with endless arguments about the definition of the word ‘chemical’ I decided to settle the matter once and for all. Kind of. And following that theme I also wrote 8 Things Everyone Gets Wong About ‘Scary’ Chemicals for WhatCulture Science.

Just in case that wasn’t enough, I also wrote a chapter of a book on the missing science of superheroes in October. Hopefully we should see it in print in 2017.

Sparklers are most dangerous once they've gone out.

Sparklers are most dangerous once they’ve gone out.

I decided to mark Fireworks Night in November by writing about glow sticks and sparklers. Which is riskier? The question may not be as straightforward as you’d imagine. This was followed by another WhatCulture Science piece, featuring some genuinely frightening substances: 10 Chemicals You Really Should Be Scared Of.

And that brings us to December, and this little summary. I hope you’ve enjoyed the blog this year – do tell your friends about it! Remember to follow @ChronicleFlask on Twitter and like fb.com/chronicleflask on Facebook – both get updated more or less daily.

Here’s wishing all my lovely readers a very Happy New Year – enjoy a drop of bubbly ethanol solution and be careful with the Armstrong’s mixture…. 

See you on the other side!

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Words of woo: what does ‘alkalise’ mean?

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‘alkaline’ diets usually revolve around eating lots of fruit and vegetables – no bad thing, but it won’t change your body’s pH

If you hang around in the unscientific chunks of the internet for any length of time, as I find myself doing from time to time, you start to come across certain words that get used over and over. They are usually words that sound very sciency, and they’re being used to make things sound legitimate when, if we’re honest, they’re really not.

One such word is ‘alkalise’ (or ‘alkalize’). I’ve met it often ever since I wrote my post ‘Amazing alkaline lemons?‘. So, what does this word mean?

Good question. Google it, and at least the first three pages of links are about diets and how to ‘alkalise your body’ featuring such pithy lines as:

“It’s not really a diet… it’s a way of eating” (is there a difference?)
“Alkalise or live a life of misery” (gosh)
“Alkalise or die” (blimey)
“Alkaline water” (apparently this is a thing)
“Why it’s important to alkalise your water” (using our overpriced products)

In fact, I had to click through several pages of Google links before I even got to something that was simply a definition. (I’m aware that Google personalises its search results, so if you try this yourself you might have a different experience.) Certainly, there are no legitimate chemistry, biochemistry – or anything else like that – articles in sight.

Hunt specifically for a definition and you get turn basic and less acidic; “the solution alkalized”‘ (The Free Dictionary), to make or become alkaline. (Dictionary.com) and, simply, ‘to make alkaline’ (Collins).

Universal_indicator_paper

pH 7 is neutral, more than 7 is basic

The first of these is interesting, because it refers to ‘basic’. Now, as I’ve explained in another post, bases and alkalis are not quite the same thing. In chemistry a base is, in simple terms, anything that can neutralise an acid. Alkalis, on the other hand, are a small subset of this group of compounds: specifically the soluble, basic, ionic salts of alkali metals or alkaline earth metals.

Since there are only six alkali metals (only five that are stable) and only six alkaline earth metals (the last of which is radium – probably best you steer clear of radium compounds) there are a rather limited number of alkalis, namely: lithium hydroxide, sodium hydroxide, potassium hydroxide, rubidium hydroxide, caesium hydroxide, beryllium hydroxide, magnesium hydroxide, calcium hydroxide, strontium hydroxide, barium hydroxide and radium hydroxide. There you go. That’s it. That’s all of them. (Okay, yes, under the ‘soluble in water’ definition we could also include ammonium hydroxide, formed by dissolving the base, ammonia, in water – that opens up a few more.)

This, you see, is why real chemists tend not to use the term ‘alkalise’ very often. Because, unless the thing you’re starting with does actually form one of these hydroxides (there are some examples, mostly involving construction materials), it’s a little bit lead-into-gold-y, and chemists hate that. The whole not changing one element into another thing (barring nuclear reactions, obviously) is quite fundamental to chemistry. That’s why your chemistry teacher spent hours forcing you to balance equations at school.

No, the relevant chemistry word is ‘basify‘. This is such a little-known word that even my spell checker complains, but it’s just the opposite of the slightly better-known ‘acidify’ – in other words, basify means to raise the pH of something by adding something basic to it. Google ‘basify’ and you get a very different result to that from ‘alkalise’. The first several links are dictionary definitions and grammar references, and after that it quickly gets into proper chemistry (although I did spot one that said ‘how to basify your urine’ – sigh).

What does all this mean? Well, if you see someone using the word “alkalising” it should raise red flags. I’d suggest that unless they’re about to go on to discuss cement (calcium hydroxide is an important ingredient in construction materials) cocoa production or, possibly, certain paint pigments, then you can probably write off the next few things they say as total nonsense. If they’re not discussing one of the above topics, the chances are good that what they actually know about chemistry could safely fit on the back of a postage stamp, with space to spare, so nod, smile and make your escape.

For the record, you absolutely don’t need to alkalise your diet. Or your urine*. Really. You don’t.

And please don’t waste your money on alkaline water.

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Lemon

There’s no good evidence that drinking lemon juice has a significant impact on urine pH.

* In the event that you actually have problematically acidic urine, perhaps due to some medical condition, there are proven treatments that will neutralise it (i.e. take it to around pH 7, which is the pH urine ought to be, roughly). In particular, sodium citrate powder can be dissolved in water to form a drinkable solution. Of course, if this is due to an infection you should see a doctor: you might need antibiotics – urinary tract infections can turn nasty. Yes, I am aware that the salt of the (citric) acid in lemons is sodium citrate, however there is no good evidence that drinking lemon juice actually raises urine pH by a significant amount. And yes, I’m also aware that dietary intake of citrate is known to inhibit the formation of calcium oxalate and calcium phosphate kidney stones, but that’s a whole other thing. If you have kidney stones there are a number of dietary considerations to make, not least of which might be to cut down on your consumption of certain fruits and vegetables such as strawberries and spinach (and ironically, if you look at some of the – entirely unscientific – lists of acid-forming and alkali-forming foods these are almost always on the alkaline side).

How to win an argument about homeopathy

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Jeremy Corbyn appeared to support homeopathy, five years ago.

Homeopathy has been in the news (again) lately. Someone managed to dig up a 2010 tweet by Jeremy Corbyn where he appeared to express support for it (so far he doesn’t seem to have commented again so let’s be generous: maybe he’s re-evaluated in the last five years). A few days ago The Express newspaper printed an article pointing out that in these times of austerity, the NHS is spending £5 million a year on ineffective homeopathic remedies, and then, of course, there was that really weird incident earlier in the month where a number of delegates apparently fell ill with hallucinations and cramps during a homeopathy conference in Germany (if an ‘LSD-type drug’ was involved, we can be certain of one thing: it wasn’t homeopathic).

I’m not going to go into the ‘science’ of homeopathy again, because I’ve done that before (seriously, if you don’t know what it is, follow that link back there). And besides, I’m starting to think the science angle is a bit (haha) pointless. Not because it’s wrong, but because it boils down to an un-winnable argument that goes something like this:

“Homeopathy can’t work because…. dilutions…. molecules… there’s nothing in it…. (etc)”
“AHHH but there are things science doesn’t understand… water memory… quantum (etc)”
“Ok, but many, many controlled trials have shown it doesn’t work.
“Those trials are all carried out by the Big Pharma, I don’t trust them.”
“Well, actually, not all of them….
“You can’t test homeopathy in the lab. It doesn’t work like that.”
“But it should, shouldn’t it? If it works? Legitimate pharmaceuticals have to pass those tests.”
“The tests are flawed.The whole peer-review system is corrupt.”
“Well, it may have a few problems, yes, but it’s the best thing we have right now.”
“Anyway, homeopathy cured by my brother’s milkman’s aunt’s dog’s arthritis.”
“Anecdotes really aren’t evidence.”
“Look, it doesn’t matter, I believe it works.”

And there we have it. You can’t get past that, at least, not with science. People that believe (and some of them are, worryingly, scientists and doctors) just believe. You can show them with evidence all day: they’ll tell you the science is wrong, or lacking in some way. Adding more science to that doesn’t help, it’s just – from the believer’s point of view – more science which is still wrong, or still lacking.

So recently I’ve taken another tack. I say, look for the money.

James Randi first issued his challenge in 1964.

In 1964 a stage magician and skeptic called James Randi issued a challenge, and it was this: anyone successfully demonstrating a supernatural or paranormal ability under agreed-upon scientific testing criteria would be paid a $1000 prize. Later it went up to $10,000, then $100,000 and eventually $1 million.

Since the challenge was first created by Randi over half a century ago, about a thousand people have applied, but no one has been successful. No one.

What does this have to do with homeopathy? Well, quite a lot. Because Randi has stated that homeopathy qualifies. In other words, anyone who can prove it works – under testing criteria agreed between the James Randi Educational Foundation (JREF) and the claimant – would win the $1 million. It doesn’t have to be some sort of ‘Big Pharma’ approved trial, it just has to be a trial that both JREF and the claimant agree, between them, is valid.

Big Homeopathy (well, they do it, why not us?) is unquestionably a million dollar business, perhaps the prize has never been claimed because ‘they’ don’t care about a piddly million dollars? But what about all the small-time homeopaths practising around the country? What about academics who continue to maintain that it works? Surely not all of these people are millionaires? $1 million has got to be worth having, hasn’t it?

I repeat. The prize never been claimed (despite at least one high-profile attempt).

James Randi, who is, at time of writing, 87 years old, has now retired. But fear not, JREF have said that they will continue the million dollar challengeas a means for educating the public about paranormal claims”. 

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Boots.com are selling homeopathic ‘remedies’ right now.

So this is what I say: if you believe homeopathy works, if you think you have convincing evidence that it works, go and claim the money. Then come back to me and we’ll talk. I promise to listen.

If you find yourself talking to proponent of homeopathy, suggest this to them, see what they say. One million dollars has got to be worth a bit of effort, surely?

Call me an old cynic, but I suspect at least some of these people know it doesn’t work, but selling pills that are made of nothing more than sugar, water and fancy packaging for over £5 a pop, or consultations at £30-£125 an hour, is making plenty of money anyway. Why mess with a good thing?

Forget belief, or even science. Look for the money.

Follow The Chronicle Flask on Facebook for regular updates.

But no one wants to research that; they can’t make any money from it…

A couple of my recent posts have focused on potentially dangerous ‘alternative’ treatments for medical conditions. Invariably, such posts generate comments along the lines of “I’ve been using it for years and I’m FINE” and the other favourite “ahhh but They don’t want to research it because it’s cheap and They can’t make any money from it!” (‘They’ is usually the eponymous ‘Big Pharma’).

It’s hard to argue with the first one. The friend of a friend of your uncle’s dishwasher repair main who’s smoked 40 a day for years without ever even getting a case of the sniffles doesn’t believe all that stuff about smoking being bad for you either. No one ever believes the thing they’re doing will turn out to be bad for them. Until, that is, they start getting nasty shooting pains in their left arm.

olaparib

Olaparib costs £49,000 per patient.

The other one though, well, let’s have a look at that. It’s a really common argument, especially from Americans who tend to be much more aware of the cost of medication than Brits. We on this side of the pond are somewhat shielded from the realities of specific costs by the way the National Health Service works. However, some recent decisions by NICE (The National Institute for Health and Care Excellence) have raised the issue of the price of medication in the minds of people over here as well. For example, just a few days ago it was widely reported in the press that NICE had turned down a drug called olaparib (Lynparza) – a targeted treatment for ovarian cancer – because its price tag of more than £49,000 per patient per year was considerably higher than NICE’s upper limit of of £20,000 to £30,000.

£49,000 is a lot of money, no question about it. In some places you could buy a house for that kind of money. At the very least, you could buy a big chunk of a house. For the average household it’s almost double a year’s salary. How could a year’s worth of a drug possibly be worth so much money? Surely the pharmaceutical company (AstraZeneca in this case) are having a bit of a laugh with this price tag? All the way to the bank?

Why ARE medicines so expensive?

Why ARE medicines so expensive?

Well, how much does it cost to develop a drug? A study by the Centre for the Study of Drug Development at Tufts University in Massachusetts reported that the average cost for drugs developed between 1995 and 2007 was $2.6 billion (*see update below) which, based on 2007 exchange rates, is very roughly £1.3 billion. Of course, these figures are from a few years ago – it will be more in today’s market.

Why so much? Well, it takes on average about 12 years to get a drug from the laboratory to the market (and many potential drugs fall by the wayside during the various testing processes). There are a lot of people involved, from researchers in the lab to people running clinical trials to chemical engineers who have work out how to get a small-scale lab production up to something much larger to the people who design and produce the packaging. Even if you just start adding up 12 years worth of salaries (the average salary of a chemical engineer is something like £35,000, for example), you quickly get into big numbers, and that doesn’t take the cost of offices, factories, equipment, raw materials and so on into account.

Back to olaparib and its £49,000 a year price tag. There are about 7000 ovarian cancer diagnoses in the UK each year, but it’s a very specific treatment that would probably only apply to about 450 women each year and it’s estimated to extend life by about a year so, sadly, each patient would probably only be taking it for one year. It’s difficult to get specific figures about development costs, but let’s estimate it took about £1.5 billion to develop it (probably a conservative estimate), and let’s give it 20 years to break even, since after 20 years drugs go off-patent (which means other companies can produce them), and profits immediately drop).

Are pharmaceutical companies really ripping us off?

Are pharmaceutical companies really ripping us off?

Based on those rough numbers, each year the pharmaceutical company would need to make about £75 million. Divide by 450 patients and you get (rounding up a bit) £170 thousand per patient per year – more than three times the price tag NICE was working with. To stress: this is just to cover development costs. I’m not adding any profit on here. Even if you allow for the fact that AstraZeneca are selling the drug in other countries (in the US and Europe in particular), it’s hard to see how their profit margins can be anything more than pretty small.

You might say, so what? This is someone’s life we’re talking about here. Life is priceless. Yes, of course. But unless they can break even, and in fact make some kind of profit, no pharmaceutical company is ever going to invest time in drug development. No one runs a business to deliberately make a loss. Not for long, in any case.

turpentine

Don’t let anyone convince you to swallow this stuff.

There are plenty of people out there claiming that some cheap, every-day substance can cure cancer (could be anything from a type of bleach to turpentine to baking soda, depending on the day of the week), but that ‘Big Pharma’ deliberately suppress these treatments, and/or refuse to research them, because they can’t make thousands selling them, and they would rather push their expensive (but, you know, tested) drugs.

Well no, the pharmaceutical companies can’t sell these kinds of ‘alternative’ treatments, because they’re controlled by extremely strict regulations and they can’t claim something works without rock-solid evidence. But don’t be taken in by the argument that it’s impossible to make a lot of money from selling this kind of stuff. Of course it’s possible: buy it in huge bulk, put it in small bottles with expensive-looking packaging, and the markup can be comfortably generous. Hey, if it’s possible to make money selling ‘ghost turds‘, then it’s possible to make money out of anything. And if you don’t want to actually sell it (which might upset the regulatory authorities) there are book sales, public appearances and private consultation fees. Oh yes, don’t let anyone convince you there’s not plenty of money to be made.

Besides which, it’s simply not true that medical researchers aren’t interested in ‘cheap’ substances. To quote the comedian Dara Ó Briain:

“Oh, herbal medicine’s been around for thousands of years!” Indeed it has, and then we tested it all, and the stuff that worked became ‘medicine’.

Except we shouldn’t be using the past tense; scientists continue to research this kind of thing all the time. Despite what the conspiracists might say, the people who work in these fields are genuinely interested in making people better. If they really thought baking soda could somehow cure a particular cancer, they’d be on it like a shot. Even if you don’t believe they’d do it for ‘the public good’, it’d be worth it for the prestige alone. Someone who managed to prove something like that would almost certainly be up for a Nobel Prize. The company they worked for would be using it in their marketing material forever more. You can’t buy publicity that good. (For more about this, check out this excellent article by Steven Novella.)

beetroot juice

Recent research suggests that beetroot juice could help treat high blood pressure.

Just to prove that research into simple, inexpensive stuff truly does happen, here are some examples (public health warning: I’m not advocating you experiment with any of these, I’m merely listing them to make the point. Discuss it with your doctor before you try anything):

Believe it or not, doctors like medicines that work.

Believe it or not, doctors like medicines that work.

These are just five examples. I’m certain there are many more. Researchers do look at well-known, relatively inexpensive substances if they think they might have a genuine therapeutic effect. That’s the sort of thing scientists do. The difference is that real scientists don’t rely on testimonials – the word of people who’ve “been taking it for years and never been healthier!” – they design proper, rigorous trials.

Sometimes these trials are promising, sometimes they’re not, but the substances that do turn out to be promising invariably find their way into medicine sooner or later because, essentially, doctors like medicine that works.

* Update: June 2015
After I wrote this post I came across this article on theconversation.com. It casts some doubt on the US$2.6 billion figure from The Tufts Center for the Study of Drug Development, and makes some interesting points about its calculation. In particular, it points out that more than once source has suggested the figure may be over-inflated. This could well be the case, in which case my rough estimate calculations might be off by some margin, but it’s impossible to be more accurate because pharmaceutical companies are pretty cagy about their actual costs. It is certainly the case that a number of pharmaceutical companies have existing, profitable medicines which are reaching the end of their patent lifetime and, it appears, not enough to replace them, leading to some recent mergers and acquisitions activity. A few have run into trouble: Glaxo Smith Kline issued a profit warning last year, as did the French group Sanofi SA. On the other hand, others have been doing extremely well. So are they genuinely over-charging for drugs? It’s a very difficult question, but I think it’s still safe to say that drug development is a very expensive business

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A horrifying story: autism, miracle mineral solution and the CD protocol

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It looks lovely, but what IS it?

UPDATE: August 2016
I’ve written a summary of the key CD/MMS facts, which you will find if you follow this link. The numbers quoted are slightly different in places, as I revised my calculations based on new reading.


In my last blog post I wrote about people using apricot kernels, which contain amygdalin, as a cancer treatment. I explained how this chemical is toxic, and why eating apricot kernels could be extremely dangerous. For me, the scariest thing was that some groups were recommending that children eat them to ‘ward off cancer’. If an adult makes a bad decision about their health and treatment and consequently makes themselves more ill, or even dies as a result, it is of course a tragedy. People who prey on vulnerable individuals in this way should have the book thrown at them (and as I said in my last post, the owner and director of The Vitamin Service Ltd was given a six-month suspended prison sentence and his company was fined £10,000 for just this).

But when these dangerous treatments are given to children it’s worse. It’s much, much, MUCH worse, because children aren’t consenting. They haven’t read around the whole area and made a conscious decision, even if deeply flawed, to ignore the advice of medically-trained professionals in favour of following some other regime. They trust their parents. If their parents are somehow persuaded into giving them something dangerous and toxic, they don’t know any different.

This is why when I heard about miracle mineral solution (MMS, sometimes called ‘master mineral solution’, or ‘miracle mineral supplement’) and the CD Protocol I felt I had to write about it. Plenty of others have written about this and tried to warn people, but this is one of those times that I feel that the more people that talk rationally about this, the better. If someone is even a bit undecided and goes looking for more information, I want them to stand every chance of finding words like these rather than dangerous and inaccurate information. So here goes.

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This year’s controversial Autism One conference is in May.

MMS and CD have been around for a few years, but they’re in the public eye again at the moment because of the upcoming Autism One conference*. This is a conference that claims to provide education and support advocacy efforts for children and families ‘touched by’ an autism diagnosis. Which all sounds very worthy and positive, but the conference is deeply controversial for, amongst other things, its anti-vaccination stance, its support for highly questionable therapies, and the general assertion that we are currently suffering some kind of ‘autism epidemic’ caused by environmental factors (although it’s true that autism diagnoses have risen in the last few years, evidence suggests this has much more to do with better diagnostic techniques than anything else).

This year’s Autism One conference is at the end of May, and someone called Kerri Rivera is planning to speak there.

KerriRivera

Kerri Rivera

Rivera is one of the founders of CD Autism. Visit the CD Autism website, and you will see that their headline is “Autism: Avoidable. Treatable. Curable”, which ought to right a few alarm bells right there.

For those who might not be aware, autism is what’s called a neurodevelopmental disorder, which essentially means the brain doesn’t develop in the ‘normal’ way. In particular, children with autism struggle with social interactions and often engage in repetitive, compulsive behaviours such as flapping their hands or compulsively lining up objects. Autism symptoms usually appear gradually as the child gets older, but occasionally children get to one or two years old and then suddenly appear to go ‘backwards’ and lose their ability to communicate with the world around them. Exactly why this happens isn’t well understood. There is strong evidence that autism is primarily genetic, although it is possible that environmental factors (pollutants, certain drugs, etc) in the first 8 weeks of pregnancy might also trigger it. Either way, it looks like children are born with autism, even if their symptoms don’t appear until later.

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Children with autism often repetitively stack objects.

Autism has no cure, in the sense that there isn’t a medicine or a treatment plan you can follow which will make it go away (although Kerri Rivera would have everyone believe otherwise). Children, however, often improve as they get older. This is probably simply due to the fact that as children grow their brains develop, and the human brain is remarkably adaptable and flexible. Autism is a spectrum disorder, which means there’s a huge range in the level of impairments individuals suffer. Those at the more severe end of the spectrum will always need huge amount of support and will never achieve independence. On the other hand, you do very occasionally hear stories of children ‘recovering’ from autism and losing their diagnosis (although it’s more likely that they were misdiagnosed in the first place). Others are able to learn coping strategies as they get older and, while they will probably always find certain aspects of daily life difficult, are ultimately able to function quite successfully in society.

This is where it gets dangerous, because a condition that naturally tends to improve over time is an absolute gift to anyone pushing quackery. It means that no matter what you do (or don’t) do, you’ll always be able to find lots of positive testimonials from people who are happy to say “I tried this and it worked for us!”, “My son/daughter is so much better since we started this treatment!” They probably did see a genuine improvement. Thing is, they would have seen it anyway. The really worrying question is: might they have seen a bigger improvement without the treatment? 

And so briefly back to CD Autism’s tagline: “Autism: Avoidable. Treatable. Curable”. Scientific research suggests that autism probably isn’t avoidable; children are born with it. It’s not curable. There are strategies which can help children and their families to mange it (along the lines of speech therapy, social skills therapy, structured teaching and so on), but there’s no one, single proven ‘treatment’ for autism.

As a parent myself, I can empathise with parents who don’t want to believe these things. You gave birth to an apparently normal and healthy child, and then you’re told they have this condition which will affect them for the rest of their life. A condition which prevents them from interacting normally with you and the rest of your family, and one which other people will find very difficult to understand. People who don’t know them may very well think they’re rude and disruptive, and that you’re a weak parent who needs to start dishing out some discipline. Your child probably isn’t going get the education you hoped for them. They might not be able to live independently, or even ever communicate effectively. And there’s no cure for this, although some therapy might help. Your child might improve with time, but you’ll just have to wait and see how much. The uncertainty, and the stress of dealing with a child exhibiting such difficult behaviours, must be incredibly difficult to deal with.

So yes, I can understand why parents might not want to believe the science. The whole ‘big pharma has all the doctors on its payroll‘ thing must be very tempting. People like Kerri Rivera say they’re not making money from selling these treatments – they genuinely just want to spread the word – so that makes them trustworthy, right? There are many stories of other parents who’ve tried it, and they say their child improved. Surely doing something is better than doing nothing?

Well, no. No, it isn’t. Not in this case.

Have you been wondering what the CD in ‘CD Autism’ stands for? It stands for chlorine dioxide. The ‘CD protocol’ is the chlorine dioxide protocol and CDS (another common acronym) stands for ‘chlorine dioxide solution’.

CDS is made from MMS: ‘miracle’, or ‘master’ mineral solution. Minerals sound good for you, right? It’s important to eat your vitamins and minerals, isn’t it?

Let’s get down to the chemistry. Kerri Rivera has previously attacked her critics for not knowing any chemistry, and describing MMS and CDS inaccurately as a result. Well I know some chemistry. I have a BSc and a PhD in the subject, and I taught it for over ten years. So I reckon I know enough not to get this wrong.

On the CD Autism site Rivera quite openly states that this treatment is based around chlorine dioxide, ClO2, which is produced when two liquids – sodium chlorite and citric acid – are combined. I reiterate, this isn’t hidden in any way, they are quite open about it.

SodiumChlorite

Sodium chlorite, NaClO2

There is also an MMS Wiki, which explains in more detail exactly what is in this solution and how it’s ‘activated’. Here they are again quite open: MMS starts out as a 22.4% solution of sodium chlorite, NaClO2, along with some table salt (sodium chloride, NaCl) and other trace ‘neutral’ chemicals “such as sodium hydroxide, sodium carbonate and sodium bicarbonate”. I find it interesting that they use the term neutral, because sodium hydroxide certainly is not, and least not in the pH sense of neutral. Sodium hydroxide is a strong alkali with a pH of (depending on the concentration) somewhere between 11-14. Sodium bicarbonate and sodium carbonate are also alkaline, although not as strong as sodium hydroxide. That said, Wikipedia gives a pKa value for NaClO2 of 10-11, which I estimate ought, for a 22.4% solution, to produce a slightly acidic pH of about 5 (I was expecting it to be alkaline, so fellow chemists, please weigh in if you disagree – is the pKa value wrong?) I suspect that enough sodium hydroxide is added to keep the mixture slightly alkaline, since NaClO2 is stable in alkaline and neutral solutions.

To a chemist, this list of chemicals is not very surprising. Bleach solution, the stuff that you use to clean your bathroom, is made by mixing cold sodium hydroxide with chlorine gas to produce a mixture of sodium chloride, sodium chlorate(I) (NaClO, also sometimes called sodium hypochlorite), and water. Just to be absolutely crystal clear, bleach is not one single pure chemical, it’s a mixture. Household cleaning products have even more stuff added to them to make them more effective, so it’s probably not accurate to directly compare MMS to household bleach (this doesn’t mean they’re safe, please read on).

NaClO2, the stuff in MMS, is made slightly differently. But it still starts out with the reaction between chlorine and sodium hydroxide, except this time the solutions are hot. This produces yet another form of sodium chlorate, NaClO3, which can then be combined with a reducing agent to ClO2 and a mixture of other things.

NaClO and NaClO2 are not quite the same things, something which Rivera and other CD advocates have been keen to point out. MMS is not bleach, they say, no matter how the media reports it. They have similar formulas, yes, but ozone and oxygen (a favoured example) also differ by one oxygen atom, and it’s safe to breathe oxygen whereas it’s not safe to breathe ozone.

Well. Yes. The thing about ozone and oxygen is true. Yes. But does that imply that NaClO2 and chlorine dioxide are completely safe and inert? Er, no. NaClO2 is a strong oxidant and, although it may not technically be bleach, and isn’t as corrosive as the bleach solution in your bathroom cupboard, will still make you sick if you drink it. In particular, it could affect blood-oxygen transport and cause kidney failure, amongst other things. It has an LD50 of 350 mg/kg for rats. That means that if rats are fed 350 mg per kg of body weight, half of them will die. If we scale that up to a 20 kg child (very roughly 6-7 years old), that suggests that 7 grams is enough to kill. Remember that MMS is a 22.4% solution, which I assume means 22.4 g per 100 g of water.

That means that a 100 ml bottle of MMS might be enough to kill a young child three times over.

Perhaps this is disingenuous of me. CD Autism don’t advocate drinking whole bottles of MMS, they suggest using a few drops at a time. Perhaps it’s not fair to talk about toxicity in this way. After all you can, for example, perfectly safely take a small amount of paracetamol, but if you swallow a whole packet you’ll be in serious trouble.

Chlorine-dioxide-from-xtal-3D-balls

Chlorine dioxide, ClO2

But here’s the kicker, you don’t use MMS as it is. You ‘activate it’. Ah yes. This means mixing it with an acid solution, in particular citric acid, the acid found in citrus fruits such as oranges and lemons. When you do this, another chemical reaction happens, and ClO2 (chlorine dioxide), NaCl (sodium chloride) and water are formed, and the resulting pH ends up somewhere around the 2.5-3 mark (which is acidic). Now we have a chlorine dioxide solution, hence “CDS”.

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You really don’t want to swallow this stuff.

Let’s look at the safety data for chlorine dioxide. Chlorine dioxide IS a bleach. You see, they’re clever here. When denying the whole bleach thing, they say ‘MMS is not bleach’ (true), not ‘CDS is not bleach’ (which would be false). Chlorine dioxide is a strong oxidising agent and under EU classification it’s described as very toxic, corrosive and damaging to the environment. It’s LD50 is lower than NaClO2‘s (lower is bad, it means less of it will kill you). Under US classifications, it has an NFPA Health rating of 3, which means that “short exposure could cause serious temporary or moderate residual injury”. Compared to chlorine dioxide, NaClO2 is practically harmless.

Industrially chlorine dioxide is used to bleach wood pulp and in water purification, but because it’s toxic the US Environmental Protection Agency has set a maximum level of 0.8 mg/L for chlorine dioxide in drinking water. Now, it’s difficult to be sure exactly how much NaClO2 actually gets converted to ClO2 when it’s ‘activated’ by adding citric acid, but based on the only half-sensible balanced equation I could find and allowing for 70% conversion, I estimate conservatively that there would be about 9.5 grams of chlorine dioxide per 100 ml of activated master mineral solution (plus, don’t forget, there’s still some NaClO2 as well). That’s 95,000 mg/L, which is over one hundred thousand times the safe limit for drinking water. Even if the conversion is much less than I’ve estimated, I think we can be sure it’s well over safe limits.

And this, THIS, is the stuff that CD Autism are advocating that parents give to their children to swallow, and use in enemas.

Oh, but wait, I know what’s coming: you don’t use the whole solution in one go. You use a few drops at a time. Fine. How many drops? Well, there are different ‘protocols’ for different diseases, and for different stages of ‘treatment’, but to pick one fairly randomly I have seen someone mention 15 drops in 700 mls. Assuming a drop is 0.1 ml, I reckon that’s still about 200 mg/L. To reiterate, US safe limits are 0.8 mg/L. This is two thousand times safe limits. Even if some of my assumptions turn out to be over-generous, we are dangerously over safe limits. Do not listen when CD Autism tell you chlorine dioxide is safe because it’s used in drinking water, and because they’re only using small amounts. It is not. The amounts they’re suggesting are not, in fact, that small. This is highly dangerous and is highly likely to make your child seriously ill.

As the FDA warns, CDS can cause nausea, vomiting, diarrhoea, and symptoms of severe dehydration. There have also been reports of liver failure and severe kidney damage. CD Autism will say that the nausea and diarrhoea are symptoms of ‘detox’. It is just your body getting rid of ‘parasites’ and ‘toxins’ that have accumulated. It’s not. These are symptoms of acute toxicity. The chlorine dioxide is poisoning you, or worse, your child. These symptoms are a sign that you should stop before you do any more damage. If it’s not already too late.

The advocates CDS say that “the chlorine dioxide molecule has a chemical characteristic that changes and makes it selective for pathogens“. In other words, chlorine dioxide somehow ‘knows’ to only attack harmful microorganisms. It doesn’t – chemistry doesn’t work that way. Molecules aren’t capable of distinguishing one from another. Chlorine dioxide attacks and damages all the cells in its path, healthy and (possibly) harmful alike. And bear in mind that the bacteria in and on our bodies still aren’t that well understood. Our bodies contain a hundred bacterial cells for every single human one. Most of these bacteria are not harmful; in fact quite the opposite. They help us digest our food, bolster our immune system, and may be involved in all kinds of other processes (there was a even a paper recently suggesting that a change in gut bacteria had caused obesity in a patient). If you put something inside you, particularly straight into your gut in the form of an enema, which indiscriminately destroys pretty much everything in its path you could be literally be doing untold damage.

I mentioned parasites back there, and I just want to say a little more about this. CD Autism and their ilk are big on parasites. They believe that huge numbers of the population are infected with parasites, and that these are causing everything from cancer to autism. Their evidence for this mainly seems to come from enemas, where the ‘results’ of enema treatments (I’ll spare you pictures) show long, mucous-y strands. They say that these are worms, and sometimes call them ropeworms. Critics, on the other hand, say they are intestinal lining, removed by the harsh enema process.

Of course there are some real intestinal worms that actually exist. Roundworms and tapeworms for example. If you think you may have one of these, see a doctor – there are safe and effective treatments you can use to get rid of them without resorting to chlorine dioxide enemas. There is however no real evidence for the fictitious ‘ropeworm’. It was born out of the fevered imaginations of Nikolai Gubarev (who works, or possibly worked, in occupational safety in Russia) and Alex Volinsky (a mechanical engineer). The articles which describe their ‘discovery’ have never been published in any kind of peer-reviewed journal, although they are available online. And the very fact that they claim in one of their papers that people with “blood pH of 8-10” are more susceptible should immediately tell you everything you need to know about their (lack of) medical background. Someone with a blood pH in that range would be dead. Blood pH is strictly maintained by your body to be between 7.35 and 7.45. If it somehow gets out of that range you’re in serious trouble. A high blood pH is otherwise known as alkalosis, and results in muscle pain, muscle weakness and low blood calcium levels, and ultimately leads to seizures.

In short, don’t believe anyone that tells you that you’re infested with parasites, unless it’s a qualified medical doctor who’s had a sample of your stool properly analysed in a laboratory.

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Jim Humble, who started it all in 2006 with a self-published book on MMS.

Finally, I have focused mainly on autism in this piece, and that’s because I find the use of MMS and CDS in this area the most upsetting. These chemicals are being used on children, doing them terrible damage, and it’s completely out of their control. But I also want to point out that MMS and CDS are suggested for the ‘treatment’ of a whole raft of conditions. There are ‘protocols’ for everything from acne to cancer, and from mad cow disease (seriously) to yeast infections. This all seems to have started with a character called Jim Humble, who is in his own words “an inventor” (and not a scientist, and certainly not a doctor). There is an article all about him here, which I strongly recommend. Of particular note is the fact that more than one country has an arrest warrant out for him, regarding the poisoning and death of several people.

All of which means that there is a real danger that if you go looking for alternative treatments for pretty much anything, you might at some point run into someone selling MMS and CDS. And if you do, please, turn and run.

Update June 2015

On the 28th of May 2015 a man called Louis Daniel Smith was convicted, following a seven-day trial, of conspiracy, smuggling, selling misbranded drugs and defrauding the United States. Smith operated a business called “Project GreenLife” (PGL) from 2007 to 2011, which sold a product called “Miracle Mineral Supplement,” or MMS, over the Internet. The government presented evidence that Smith instructed consumers to combine MMS with citric acid to create chlorine dioxide, add water and drink the resulting mixture to cure numerous illnesses including cancer, AIDS, malaria, hepatitis, lyme disease, asthma and the common cold.

The jury convicted Smith of one count of conspiracy to commit multiple crimes, three counts of introducing misbranded drugs into interstate commerce with intent to defraud or mislead and one count of fraudulently smuggling merchandise into the United States.  The jury found Smith not guilty on one out of four of the misbranded drug counts. He faces a statutory maximum of 34 years in prison at his Sept. 9 sentencing.

For the full press release from the United States Department of Justice, just follow this link.

One down…

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* Here, and throughout this article where I have felt that I ought to link to websites associated with MMS proponents, I have used the Do Not Link service. This allows me to link to the relevant pages without giving them any kind of boost in search engine rankings. I urge anyone who writes anything of a skeptical nature to use Do Not Link. Let’s not help these guys out if we don’t have to.

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Please don’t eat apricot kernels

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Apricot kernels do not cure cancer.

I’ll admit, I’m no huge fan of ‘alternative medicine’, particularly the ones which have been thoroughly tested and shown over and over again to be entirely ineffective (yes homoeopathy, I’m looking at you).

At best these treatments don’t work, and at worst they delay or even stop people getting the effective treatment they need. In fact, there’s an even worse possibility: they stop people from people from giving their children the treatments they need.

Ok, if you’re old enough to make decisions for yourself, and you’ve tried conventional medicine and it hasn’t worked terribly well for your particular problem, and you’ve found that, say, acupuncture somehow does make your chronic back pain a bit better, even if it is just placebo effect, then hey, it’s your money (just please don’t recommend it to anyone else who hasn’t checked out all their other options first, ok?) Also, please, please read this fantastic article which explains clearly what cancer is and what, crucially, it isn’t.

But there has surely has to be a special corner of hell reserved for people who peddle so called ‘cancer-cures’.

Medicine has moved on a lot in the last few decades. Advanced screening techniques and treatments mean that many cancers are no longer the death sentence they once were. 50% of people (in England and Wales) now survive cancer for ten years or more, which is double the figure 40 years ago. But it’s easy for a well person to say ‘cancer treatments’. They are not always quite so easy to get through. Cancer treatments – namely surgery, radiotherapy and chemotherapy – can be brutal and frequently come with a raft of unpleasant side-effects, particularly chemotherapy.

There are some people who decide that the cure is worse than the disease and personally, I think that’s their choice to make. They should have the right to make that choice, so long as it’s well-informed.

So long as it’s well-informed.

But there are people out there who are making money from desperate cancer sufferers. They sell them ineffective treatments, discourage them (directly or indirectly) from seeking or accepting the treatment they really need, and sometimes even encourage those people to use toxic substances that are likely to actually cause even more harm.

People like Roger Shelley, owner and director of The Vitamin Service Ltd. Who has just been given a six-month suspended prison sentence and his company fined £10,000 for selling potentially toxic ‘vitamins’ he claimed could cure and prevent cancer.

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Amygdalin. It’s not a vitamin.

In particular, he was selling apricot kernels, which he claimed contained a ‘vitamin’ called B17. There is no such vitamin. The chemical in question is something called amygdalin (sometimes also referred to as laetrile, although they are not quite the same thing). See the picture of it? See that CN group down at the bottom? That’s a nitrile group. Potassium cyanide, the poison so beloved of crime writers, has the formula KCN, which is a compound made up of K+ and CN ions. It’s the cyanide ions, CN, that do the damage, by interfering catastrophically with the way the body uses oxygen. Now, nitriles (like amygdalin) don’t usually give up their cyanide ions easily and so aren’t, generally, anywhere near as toxic as compounds like potassium cyanide.

Unfortunately one of the enzymes in your small intestine helps to speed up the breakdown of amygdalin. Eating apricot kernels can cause severe toxicity and death due to cyanide poisoning. Yes, severe toxicity and death. Eating apricot kernels can kill you.

Before I cause mass panic I should probably point out that if you accidentally swallow one on a summer picnic, do not fear. It takes more than one to do any damage. The Food Standards Agency says it’s safe to eat one apricot kernel a day (they’re not saying you should, mind you).

The Vitamin Service was recommending that adults take 35 kernels every day. That IS enough to do damage. In fact, it’s above the dose that the FSA highlights as causing severe symptoms. In this statement, they site a case (point 15) of a woman who ate 30 apricot kernels and was later found comatose.

Worse, The Vitamin Service were also recommending that children take 10 kernels a day, “to ward off cancer”. For children, who have a smaller body mass than adults, even this smaller dose could be extremely dangerous.

Patients following The Vitamin Service’s regime reported symptoms of dizziness and cogitative problems. Classic symptoms of cyanide poisoning. When they reported these symptoms they were advised to reduce the amount for a few days before increasing it again, because the symptoms were due to ‘toxins’. Indeed they were, a toxic substance in the very products The Vitamin Service were selling.

To add insult to injury, they were charging in the region of £600 for these kernels along with a raft of other supplements they were recommending.

Shelly admitted to misleading customers and failing to warn them of the risks of B17. He has been given a six month suspended prison sentence, and his company is no longer selling apricot kernels as a cancer treatment. Which you’d think would be a good thing. Problem solved, no?

Just Google “B17 cancer” or “apricot kernels”. There are dozens of sites out there promoting it as a cancer treatment, and many still selling products. I won’t link to them here, I don’t want to give them the traffic. But it’s frightening. Please don’t believe these people. Please listen to your doctors, the real ones, the ones who have studied for years to learn everything they can about medicines and illnesses, and who have sworn an oath to “do no harm”.

There isn’t an easy, painless, magical cure for the cancer that the pharmaceutical industry is hiding from us for some reason. We all wish there was, but there isn’t. Cancer is horrible, but a lot of the time these days it’s beatable with the right treatments. And for those, you need a qualified doctor.

This story was covered in detail on The One Show on BBC One, on Monday 4th February 2015. You can watch the clip here: start at about 4:30 minutes.

There is also an excellent, very easy to follow, summary of the use of laetrile on the charity Cancer Research UK’s website. Read it here.

Finally, once again, if you’re in the unfortunate position of having been diagnosed with cancer, please, please read this excellent article. It really does help to understand the importance of targeted treatment.

Update 8th June 2015

When I wrote this post I focused on the eating of actual apricot kernels, and Roger Shelley’s conviction for selling them. It is worth pointing out that although apricot kernels definitely contain amygdalin, it’s impossible to be certain exactly how much any one kernel contains. This is always a risk with any natural product like this.

This means there is a big, huge, difference between eating apricot kernels – even a known number of them – and being exposed to a small amount of amygdalin in a controlled manner, say as part of a cancer treatment trial. In the first situation you have no idea how much of the chemical you’re being exposed to, and no one is monitoring you to check for ill effects (which you might, or might not, be aware of). It is true that otherwise toxic compounds are utilised in chemotherapy. Arsenic trioxide is used to treat a particular kind of leukaemia for example, but this doesn’t mean swallowing a teaspoon of it every day ‘just in case’ would be in any way sensible or safe.

In 2010 there was a Cochrane review of all the work previously done on amygdalin and laetrile. It reported that there was no clinical data to support the use of these substances to treat cancer, that the risk benefit of using these substances was unanimously negative (the risk of severe poisoning far outweighed any possible benefit), and recommended that no further clinical research into laetrile or amygdalin be conducted on ethical grounds.

However, since I wrote this post I have been made aware that some research is still ongoing. Well, science is about finding answers after all. For example, both of the following papers have been published since the Cochrane review:

Notice that these papers are about the specific chemical amygdalin, rather than apricot kernels. Note also that the second paper contains the words in vitro, which means outside of living organisms. In a test tube in a lab basically. This might be an interesting starting point, but it doesn’t necessarily mean that the same effect can be reproduced in living organisms which have inconvenient things like a digestive system to work around. Also, bear in mind that effective cancer treatments are highly targeted. Tossing unknown amounts of a substance into the general vicinity of a tumour and hoping it’ll have the effect you want is like throwing a bucket of paint at a piece of fine china and expecting to see pretty decorations appear.

Digestion is a particularly thorny problem with this substance: in the first paper I mentioned above (which is a review of the work done to date, rather than new research) the authors specifically point out that amygdalin is a lot more toxic when it’s taken orally than when it’s given intravenously (injected). The reason is that, as I mentioned in my original post, it’s broken down by enzymes in your small intestine. You’re going to have a hard time injecting apricot kernels; you pretty much have to eat them. Which is risky.

Also, while the authors do provide a lot of examples of the therapeutic benefits of amygdalin, they also point out that the (apparent) “antitumor mechanism of amygdalin is not completely clear”, that “clinical trials and large retrospective studies showed that [it] had no stable antitumor effect” and that adverse reactions have been reported, particularly following large doses.

So, while this compound might be a subject for further research, I stand by my original point. Don’t eat apricot kernels.

Further update, 20th August 2015

I’ve recently been made aware of a someone called Dr Philip Binzel and, what appears to be, a rather famous book called “Alive and Well“. In this book, Dr Binzel describes his treatment of cancer patients using dietary changes and supplements, including laetrile. I can find remarkably little information about Dr Binzel and his credentials beyond what’s described in this book. However, it is a matter of public record that he died on June 6, 2003. So take any source discussing his work in the present tense with a large pinch of salt.

Another recent post on this blog which may be of interest addresses this common complaint, “no one wants to research that; they can’t make any money from it!

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