Sunday, August 24, 2014

Drug Wars: Robin Williams

Robin Williams' suicide death was shocking and surprising, until his health problems were made public. He'd been diagnosed with depression and Parkinson's disease in addition to having had a history of alcoholism and recreational drug abuse. And he had surgery in 2009 for a heart condition.

Just a month before Williams' death, the health news was abuzz with condemnations of an essential nutrient in the human diet: niacin. The drug company Merck was testing its high-dose niacin to determine if it really was helpful to people with heart disease. In the project, Merck researchers gave older adults with advanced cardiovascular disease a drug “cocktail” that included a statin, another cholesterol-lowering drug that works in the intestine, a drug that was refused approval by the FDA – and threw niacin in on top. When the research project didn't go as planned, Merck halted it, saying that niacin was causing dangerous side-effects and that, in general, it was harmful.

Merck's conclusion, however, contradicts 60 years of research and clinical discovery that niacin is the most effective, safest, and cheapest substance in the treatment of cardiovascular disease. Canadian psychiatrist and biochemist Abram Hoffer discovered niacin's cholesterol-lowering, heart-health effects after he had been using it successfully in the treatment of schizophrenia, depression, and alcoholism.

Hoffer, with a few others, discovered a stress hormone that was associated with schizophrenic episodes and theorized that in many cases mental illness was a biochemical imbalance that could be corrected with high doses of niacin. His research confirmed his theory. At the time, Hoffer thought he would be praised for his discoveries. Instead, other shrinks, especially those representing the American Psychiatric Association, did their best to ignore, and even discredit, Hoffer's work.

Hoffer and Linus Pauling, Ph.D., collaborating with others, did research, wrote papers and books, and established what they called orthomolecular medicine. Pauling, after famous physiologist Albert Szent-Gyorgyi, the Nobel Prize winner who discovered vitamin C, and the less well-known bio-chemist Irwin Stone, Ph.D., promoted and popularized the use of high-dose ascorbic acid. Pauling, however, met with substantial resistance, which persists to this day, from the conventional nutrition and medical establishments. Recently, a pediatrician who developed a vaccine for a common “stomach flu” virus, called Pauling a “quack” for recommending vitamin C for colds. This pediatrician's vaccine is manufactured by Merck. Vitamin C is known to have potent anti-viral activity. Pauling, a two-time Nobel Prize winner, is generally regarded as one of the most important scientists in Western history.

Bill W., founder of Alcoholics Anonymous, was treated successfully by Abram Hoffer for depression and alcoholism. Hoffer treated 5000 schizophrenics with niacin. Many of his case studies are remarkable. When asked how could something simple like the vitamin niacin be so effective against so many disease conditions, he would point to its essential importance in hundreds of metabolic reactions in every moment in the human body.

Robin Williams' health history – alcoholism, addiction, depression, heart disease, Parkinson's – would have made him a perfect candidate for Hoffer's high-dose niacin therapy. It's doubtful that Hoffer's approach was made available to Williams, and there's no guarantee that it would have helped him. But it is known that he was prescribed a “cocktail” of drugs, probably the “best” drugs developed by the “best” drug companies, by the “best” doctors money can buy. And it's known that the prescription drugs Williams was taking can cause depression. Friend and fellow comedian Rob Schneider clearly stated his opinion in the days following Williams' death that the prescription drugs caused Williams' suicidal depression.

In a 1996 article in which he discussed the differences between the vitamins-as-prevention versus the vitamins-as-treatment paradigms, Hoffer said, “The American Psychiatric Association bears major responsibility for preventing the introduction of a treatment which would have saved millions of patients from the ravages of chronic schizophrenia.” He said that the American Psychiatic Association had been “...captured by tranquilizers.” Anti-psychotic drugs, prescribed for schizophrenia and bi-polar disorder, netted $9.6 billion in 2004 and increased to $18.5 billion by 2011.

“Do not let either the medical authorities or the politicians mislead you. Find out what the facts are, and make your own decisions about how to lead a happy life and how to work for a better world.” Linus Pauling

William Conder August 2014

Saturday, August 23, 2014

Drug Wars (short version)

A July 2014 article in the New England Journal of Medicine (NEJM) discussed research that found niacin, which for 60 years was the best option for lowering cholesterol and improving cardiovascular health, was ineffective and that it may be dangerous in large doses.

Soon thereafter, the media, following NEJM’s lead, was awash in warnings with headlines like “New study finds niacin harmful for health” (The Utah People’s Post), “Excessive niacin consumption is harmful, study says” (, San Francisco), and “The dangers of niacin” (NBC news).

Niacin, a B-complex vitamin, is an essential nutrient in the human diet. A niacin deficiency causes pellagra whose symptoms include dermatitis, diarrhea, dementia, and death - the “4 D’s”. Niacin has been used without prescription as a nutritional supplement for decades, and in large doses in the treatment of cardiovascular disease and schizophrenia. It is safe and, except for skin flushing when used in larger doses, has no adverse side effects.

What happened?

The research, funded by pharmaceutical company Merck, was designed to test the effects of its drug, Tredaptive, on test subjects’ cardiovascular parameters. Tredaptive contains 1000 milligrams of extended-release niacin in combination with the drug laropiprant.

Laropiprant is a drug that inhibits hormone-like substances in the body called prostaglandins, specifically the ones that mediate niacin’s flushing reaction. Since the harmless flushing reaction is uncomfortable for some, laropiprant was combined with high-dose niacin to improve test subject compliance.

However, laropiprant has not been approved by the FDA. FDA’s reasons for non-approval have not been published, but some speculate that FDA was concerned about laropiprant’s safety. The Merck project was carried out in Europe.

The prostaglandins inhibited by laropiprant have several functions including causing blood vessels to relax. In other words, laropiprant makes it harder for blood vessels to relax. It’s this function, dilation or relaxing of blood vessels that niacin causes, that laropiprant inhibits.

In the Merck study, test subjects - over 29,000 high-risk cardiovascular patients age 50 to 80 years whose cholesterol had been lowered as a preparatory measure by a statin drug or statin in combination with a drug called ezetimibe - were given Tredaptive, Merck’s extended-release, high-dose niacin with laropiprant.

Ezetimibe is a drug that prevents absorption from the intestine of cholesterol in the diet. Though ezetimibe is an FDA-approved drug it, too, is controversial. Ezetimibe is effective at lowering cholesterol, but it has no effect in reducing atherosclerotic plaque that accumulates in arteries, and it’s associated with an increase in cardiovascular disease parameters. In fact, in a different study, a “paradoxical increase” in carotid plaque was found in patients who had the greatest reduction in cholesterol using ezetimibe. Results of research supported by pharmaceutical company Abbott published in NEJM in November 2009, using Abbott’s mega-dose, extended-release niacin (without laropiprant) found “[M]ajor cardiovascular events occurred at a significantly higher incidence in the ezetimibe group…” They concluded that their study “...demonstrates the superiority of extended-release niacin over ezetimibe when combined with statin therapy.”

Statin drugs lower cholesterol by inhibiting an enzyme in an important metabolic pathway. Cholesterol is the precursor of critical stress and sex hormones and vitamin D. Though statins are considered safe they are known to have side effects, including muscle pain and weakness, diabetes, sexual dysfunction, cognitive loss, neuropathy, and others. Further, it’s recognized that statins’ side-effects can be potentiated when used in combination with other cholesterol lowering drugs - ezetimibe, for example.

Statins earn drug companies billions of dollars a year. Merck’s Vytorin, the combination simvastatin and ezetimibe, and its Zetia, which is its ezetimibe alone, earned $4.6 billion in 2008.

We must question the quality of the journalism that reported Merck’s study and the credibility of Merck’s interpretation of its own results. Test subjects were older people with serious cardiovascular disease. To lower cholesterol in preparation for the study, test subjects were administered a statin drug, which inhibits an important metabolic pathway and can cause complicating side-effects. In combination with the statin, some test subjects were given a drug that has been shown to contribute to cardiovascular events even though it lowers cholesterol. Finally, test subjects were administered another drug, the test drug Tredaptive, that is a combination of a substance - not approved by the FDA - that inhibits another important metabolic pathway and whose effect is to limit the ability of arteries to relax, and the essential nutrient niacin in an extended-release mega dose.

The conclusion reported by Merck and the media was that niacin is harmful. But as it goes with drug wars, because the stakes are so high it’s hard to know what the truth is.

William Conder, August 2014.