Patrick Holford has broken his (unaccountable) silence about pandemic fears around Mexico City flu (aka, swine flu). Take vitamin C. Jab more vitamin C into your veins. Take more supplements. Black elderberry makes it harder for viruses to enter your cells. Roll up. Learn about the Rath formulation that cures everything from cancer to HIV and flu. Roll up.
Patrick Holford is Head of Science and Education at Biocare and a busy man. However, he has a little time on his hands since becoming a former Visiting Professor at the University of Teesside so he started a blog on which only paying-subscribers were allowed to comment. Oddly, however, rather than broadening his research and improving his scholarship, or even providing some thoughtful analysis on critical issues, Holford is just opting to re-issue his same old, same old pronouncements with some phrase substitution. He has done this with bird flu and the panic du jour, swine flu (or, more accurately, Mexico City Flu).
Over the weekend, I found myself wondering why Holford had not as yet blogged about the wonderful powers of vitamin C and its charms against Mexico City flu. Holford has just obliged: Can Vitamin C Kill Swine Flu. Now, with the Case Fatality Ratio and virulence of Mexico City Flu still unknown, many readers might think that it would be premature to pose that question, far less, answer it positively, without a heavy dose of irony stimulants or sardonoscorbic supplements but Holford is unabashed. He is quite happy to dust off his previous pronouncements on bird flu and re-purpose it for ‘swine flu’ in a sort of multi-purpose, ‘immune-boosting, take-all-comers’ flying pig flu preparedness supplementation programme.
The ideal amount of vitamin C for any flu is up to ‘bowel tolerance’. Start with 3 grams immediately, then 1 gram an hour and if you get diarrhoea, then halve this dose. If you don’t, double it. There are some forms of vitamin C, notably sodium ascorbate with riboperine, and lipospheric vitamin C that allow even more to be absorbed without reaching bowel tolerance. They are marginally better than straight ascorbic acid. Some people find ascorbic acid too acidic, in which case an ascorbate, such as sodium ascorbate, can be taken. It might be useful to have a supply at hand if a flu epidemic does break out. There is no harm in having 100 grams a day short-term, stopping once all symptoms are gone. If even this didn’t stop the flu I’d find a doctor who could administer intravenous sodium ascorbate. The trick with any infection is not to get it in the first place by keeping your immune system strong. I take 2 grams of vitamin C every day. If swine flu breaks out I’m doubling that to 4 grams – one every 6 or so hours, as well as supplementing zinc and selenium on a daily basis. Black elderberry contains something that makes it harder for viruses to penetrate cells. So this is an added bonus.
Holford is choosing not to address the issue that it is so far unclear whether the impact of this flu is greater on young people (20-45) who are tyically those with a more robust immune system.
We would also point out that the current strains implicated in Mexico City flu are reported to be H1N1, not, as yet, the H5N1 of avian flu (however, as Dr Tara Smith of Aetiology highlights, the picture is very unclear and depends upon some coordinated lab work). Holford appears untroubled by such uncertainty and writes:
Antiviral drugs, such as Tamiflu, work by inhibiting something called neuraminidase, produced by viruses and essential for their ability to replicate. So too does vitamin C according to recent research. This study tested the effects of a combination of ascorbic acid, green tea extract, lysine, proline, N-acetyl cysteine, selenium among other micronutrients on cells infected with influenza. This combination was also tested in a study on cells infected with Asian flu, in many respects similar to swine flu. According to the authors the nutrient mixture “demonstrated high antiviral activity evident even at prolonged periods after infection. Antiviral properties were comparable to those of conventional drugs (amantadine and oseltamivir); however, the nutrient mixture had the advantage of affecting viral replication at the late stages of the infection process.“
You will note that the ‘vitamin C research’ is by familiar Holford reference, Dr Jariwalla of the Holfordised vitamin C and HIV fame, and member of the Rath Institute. As far as we can tell, although this new study is in cell lines infected with flu viruses, it may be very optimistic for Holford to be touting the benefits of an unavailable formulation for prophylaxis against Mexico City flu in humans and in the real world. Unless Holford is just trying to borrow one part of that paper (about the vitamin C) to make an unevidenced leap to support his recommendations? Similarly for the ‘study’ that also uses this Rath formulation, we must emphasise that i) the formulation is not available; ii) there is no clinical evidence to support its use in humans as yet despite the abundant claims made for its omnipotence in conditions ranging from flu to cancer and HIV.[a] It possibly also clears the drains and cures dandruff but those are obviously peripheral to the main point which is that of ensuring a revenue stream from the current distress that some people are experiencing in the face of all this uncertainty about Mexico City flu and a possible pandemic.
So, remember, Holford’s unevidenced advice is:
- take up to 100g of vitamin C a day although there is no indication that this can raise your plasma levels beyond a certain saturation point using oral supplementation
- find a doctor who will administer intravenous vitamin C – Jerome Burne in a Daily Mail item mentioned that this costs £100 per session – although there is no evidence that this would be useful or that you would be in any condition to travel to a doctor’s office (in the event of a pandemic, there might even be temporary travel advisories or bans)
- avoid infection by supplementation of vitamin C, zinc and selenium
- as some (surely unintended) light relief, we learn that “[b]lack elderberry contains something that makes it harder for viruses to penetrate cells”: no reference, of course (see update 30 April).[b]
So, there you have it. The implausible, impractical and unevidenced Holford plan for preparing for a pandemic of Mexico City flu.
If readers are interested in some evidence-based advice, then keep an eye on the Dept. of Health announcements and the posts from the public health scientists and epidemiologists at Effect Measure. The Health Protection Agency has some advice and the NHS Direct website and phone line (0845 4647) are available.
Basic measures involve practising sensible cold and flu hygiene. Cough or sneeze into your sleeve, not your hands if caught short. If you blow your nose, cough or sneeze into a handkerchief, throw it away (preferably in a bag) and wash your hands thoroughly or use an alcohol hand gel if washing is impractical. If you are symptomatic, then don’t go into public places or mingle with others. Avoid touching your eyes, nose or mouth: you reintroduce the virus into your system or transmit it from fomites from contaminated door handles and other surfaces.
A fomite is any inanimate object or substance capable of absorbing, retaining, and transporting contagious or infectious organisms (from germs to parasites) from one individual to another.
There are many practical measures that can be taken. Make contingency plans with family, friends and neighbours: these can be as basic as having designated contact members to pick up prescriptions for you if you need an anti-viral prescription but should not travel to a doctor’s surgery or pharmacy to pick it up. If the likelihood of a pandemic increases and this may have an impact on public services, you may want to consider filling a prescription for other conditions, so that you have adequate medication. E.g., if you are a home oxygen user then you might want to enquire about continuity of supply if your local organisers have not been in touch with you as yet.
The New York Times has a good Q and A on the topic of Mexico City flu and preparedness as well as practical measures.
Good coverage: H5N1 – News and resources about avian and swine flu
Public health scientists and epidemiologists at Effect Measure
Practical advice from DemFromCT in Daily Kos: What Does The Swine Flu Outbreak Mean?
April 30: We are nothing but fair-minded at HolfordWatch so must note that Patrick Holford has updated his post to include a reference to the elderberries and their unevidenced properties for Mexico City Flu.
Black elderberry contains something that makes it harder for viruses to penetrate cells. In a double-blind controlled trial it cut recovery time in those with influenza by four days. So this is an added bonus.
Congratulations for providing a reference but – really? A small trial with people where we know too little about the placebo and whether or not it was obvious that the control group knew that they weren’t having the intervention. We know nothing about the participants’ prior beliefs about elderberry syrup. The authors’ conclusion is:
Elderberry extract seems to offer an efficient, safe and cost-effective treatment for influenza. These findings need to be confirmed in a larger study.
And Holford is pushing this as an intervention for Mexico City flu? Update to this: thanks to the commenter who found the full paper – the participants all had confirmed flu. However, we still have some concerns about the selection of participants, randomisation etc. although we will say, again, that this is an interesting study albeit this is not about Mexico City flu and it relates to a specific product, Sambucol, with a specific formulation.
May 4. Holford’s blog post had yet more unacknowledged updates: it is gaining references like so many accretions but it is still not helping on the issues of taking 100g of vitamin C.
Viruses get into body cells by puncturing their walls with tiny spikes made of a substance called hemagglutinin. According to research by virologist Madeleine Mumcuoglu, working with Dr Jean Linderman, who discovered interferon, an extract of elderberry disarms these spikes by binding to them and preventing them from penetrating the cell membrane. ‘This was the first discovery,’ said Mumcuoglu. ‘Later I found evidence that elderberry also fights flu virus in other ways.’ In a double blind controlled trial she tested the effects of the elderberry extract, called Sambucol, in people diagnosed with any one of a number of strains of flu virus. Their results, published in 1995, showed a significant improvement in symptoms – fever, cough, muscle pain – in 20 per cent of patients within twenty-four hours, and in a further 73 per cent of patients within forty-eight hours. After three days 90 per cent had complete relief of their symptoms compared to another group on a placebo, who look at least six days to recover. In another double-blind controlled trial it cut recovery time in those with influenza by four days. So this is an added bonus.
Back to some evidence-based writing on Mexico City flu, Effect Measure has an update on the type of flu: Swine flu: humans, a dangerous species. We must give another shout-out to Crof’s H5N1 coverage and to DemFromCT for H1N1: Why Do Schools Close, And When Do They Open?
[a] Roomi MW, Ivanov V, Kalinovsky T, Niedzwiecki A, Rath M (2004). “Anti-tumor effect of ascorbic acid, lysine, proline, arginine, and epigallocatechin gallate on prostate cancer cell lines PC-3, LNCaP, and DU145”. Res. Commun. Mol. Pathol. Pharmacol. 115-116: 251–64. PMID 17564322.
Roomi MW, Ivanov V, Kalinovsky T, Niedzwiecki A, Rath M (April 2006). “Antitumor effect of ascorbic acid, lysine, proline, arginine, and green tea extract on bladder cancer cell line T-24”. Int. J. Urol. 13 (4): 415–9. doi:10.1111/j.1442-2042.2006.01309.x. PMID 16734861.
Roomi MW, Ivanov V, Kalinovsky T, Niedzwiecki A, Rath M (April 2006). “Inhibition of matrix metalloproteinase-2 secretion and invasion by human ovarian cancer cell line SK-OV-3 with lysine, proline, arginine, ascorbic acid and green tea extract”. J. Obstet. Gynaecol. Res. 32 (2): 148–54. doi:10.1111/j.1447-0756.2006.00389.x. PMID 16594917.
Roomi MW, Roomi N, Ivanov V, Kalinovsky T, Niedzwiecki A, Rath M (October 2005). “Inhibitory effect of a mixture containing ascorbic acid, lysine, proline and green tea extract on critical parameters in angiogenesis”. Oncol. Rep. 14 (4): 807–15. PMID 16142336.
Roomi MW, Ivanov V, Kalinovsky T, Niedzwiecki A, Rath M (2005). “In vitro and in vivo antitumorigenic activity of a mixture of lysine, proline, ascorbic acid, and green tea extract on human breast cancer lines MDA-MB-231 and MCF-7”. Med. Oncol. 22 (2): 129–38. doi:10.1385/MO:22:2:129. PMID 15965275.
Roomi MW, Ivanov V, Kalinovsky T, Niedzwiecki A, Rath M (2005). “Antitumor effect of a combination of lysine, proline, arginine, ascorbic acid, and green tea extract on pancreatic cancer cell line MIA PaCa-2”. Int J Gastrointest Cancer 35 (2): 97–102. doi:10.1385/IJGC:35:2:097. PMID 15879623.
[b] For those who are curious, Flu Wiki has some information about black elderberry.