Patent or not, that is the question

November 16, 2023

Is it really necessary to have a patent and billions of kroner before the media takes an interest in sensationally good results?

The other day in the newspaper Politiken, you could read an article (1) about Ozempic and Wegovy /Semaglutide, including an interview with Professor Jens Søndergaard, who stated that a recent study from the Cleveland Clinic had shown a 20% reduction in serious cardiovascular events after 4 years of treatment, which is such a great medical breakthrough that he had never seen anything like it, and compared it to the discovery of penicillin. -This is really great.

Semaglutide costs DKK 2,400 per month and has side effects in the form of upset stomach and nausea.

The result is quite impressive, even if it is a relative risk reduction rather than an absolute risk reduction. But there are now other scientific studies from this year that have shown far more impressive results.

What if there were a treatment that after 4 years showed a reduction in cardiovascular mortality of over 50% at a price of DKK 369. per month and completely without side effects? … What??
Yes, that is precisely the conclusion of the 10-year follow-up of the 2013 study (2) of Selenium and Coenzyme Q10 in combination.

The study (3) was previously described in the Vitality Council’s newsletter of 23 April 2023. However, that is not what I want to focus on here. It is rather the selection of news in the media that I want to discuss.

What really surprises me is that a risk reduction of 20% for cardiac events draws huge headlines and benevolent admiration whereas an equally valid study, which even shows a reduction in cardiovascular mortality of over 50%, is not even mentioned in the same newspapers -and you can’t deny the quality of this study.

Is it because it’s too good to be true that the media don’t want to bother writing about the scientific article, or does it absolutely have to be an expensive prescription drug with side effects before it’s interesting?

Actually, Professor Urban Alehagen also doubted his own results, which is why he analyzed them again and again from different sides but came to the same result.

And he is not the only one, as numerous previous studies have shown consistent increased survival with selenium and/or Q10.

Senior physician Svend Aage Mortensen at Rigshospitalet published several fine studies (4) of Q10 against heart failure but without their winning any resonance in the very orthodox medical profession.

Substances such as Coenzyme Q10 cannot be patented. Is that where the dog is buried? After all, a patent opens up possibilities for absolutely exorbitant earnings and the resulting marketing, press coverage, etc., just as there are funds for further research, publications, press, etc. -A self-reinforcing wheel that just goes faster and faster.

Substances that cannot be patented easily drown in the media stream because there is no great interest when there is no big money involved. But that is precisely why one should be even more interested in the serious research that takes place with these unpatented products. Professor Alehagen’s studies have clearly shown that an expensive, patented product is not necessary to halve the risk of dying of cardiovascular disease.

It is simply incredible that the selenium and Coenzyme Q10 study has not found a place on the front pages of the media.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine

Refs.

  1. Politiken 13/11-2023
  2. U Alehagen et al. Int J Cardiol 2013;167:1860-1866.
  3. U Alehagen et al. Antioxidants 2023, 12, 759
  4. https://iubmb.onlinelibrary.wiley.com/doi/abs/10.1002/biof.5520180210

Q10 and selenium protect the heart

April 23, 2023

Supplementation of Q10 and Selenium over a 4-year period
could halve cardiovascular mortality.

A  short  time ago a very important scientific article was published.

The article was an offshoot of the sensational article by researcher Dr. Urban Alehagen and colleagues from 2015, who showed massive cardiovascular protection with supplementation of Q10 in combination with selenium.
Alehagen and colleagues then carried out a follow-up of this study, but not only that. They have also sought to dig into the actual cause of this positive effect, which was a halving of cardiovascular mortality after 4 years of supplementation.

The logic is straight to the point. The vast majority of cardiovascular diseases are caused by atherosclerosis, and this is caused by a combination of inflammation, i.e. a local response to tissue damage and oxidation (here rancidity). Without these two factors, atherosclerosis does not occur.

Briefly, the mechanism is that oxidation turns LDL3 cholesterol rancid, which is thereby “eaten” by a type of white blood cells called monocytes via a structure on the cell surface called a “scavenger receptor”. This means that LDL cholesterol is directed around the usual LDL receptor, which could otherwise easily block intake. But the scavenger receptor cannot stop its intake of LDL cholesterol if it is oxidized, because LDL in this form acts as a free radical. And that is exactly what the scavenger receptor is designed to let into the monocyte. However, since the intake cannot stop, even though the monocyte is probably so crowded, it swells up and is seen under the microscope as a large white blob. And when there are many of these monocytes together, it looks like foam. Therefore, these “overfed” monocytes are called “foam cells”.
Oxidation is thus required for a monocyte to become a foam cell.
When the monocyte circulates in the bloodstream, it will react if it finds an area, e.g. the blood vessel wall, where there is inflammation, e.g. due to high blood pressure. The monocyte will search for the inflamed area, penetrate the vessel wall (into the subendothelial layer), where it will perish and leave behind a fatty layer of oxidized LDL3 cholesterol. This will increase inflammation and attract even more foam cells, which in turn perish, leaving behind more of the rancid fat, which is gradually consolidated by fibrin and finally stabilized by calcium, which is the last step in atherosclerosis.

The entire above process will not take place unless there is both increased inflammation and oxidation.
And precisely selenium and Q10 inhibit both inflammation and oxidation. Therefore, it is perhaps not so strange that they prevent cardiovascular disease and reduce the risk of dying from it.

Q10
The body’s cells produce energy in order to function, and this energy requires Q10 in the cells’ internal power plant, the mitochondria.
Unfortunately, there is a natural decline in the body’s production of Q10 as we age, and it is therefore natural to supplement this.
Q10 is a substance that the body produces in almost the same way as it produces cholesterol. Q10 and cholesterol are actually sister molecules that look very similar. So when you take a cholesterol-lowering medication, you also lower the production of Q10. You should therefore be aware that you often lack Q10 if you take cholesterol-lowering medication.

Selenium
Selenium is a substance that we absolutely must not lack, and numerous studies have confirmed over the years that selenium deficiency can lead to, among other things, heart failure, cancer, metabolic disorders, arthritis, childlessness, atherosclerosis, increased inflammation and a number of immunological failures, which were particularly relevant in the corona era.
There are thousands of articles that cement heavy research into selenium, such as a study of selenium deficiency related to cardiovascular disorders and inflammatory conditions. Since cardiovascular disorders are also initiated by inflammation, it is natural to investigate this together.
Previous studies have also shown that low selenium in the blood was the cause of increased inflammation, increased risk of cardiovascular disease and early death.

The current study mentioned above is also primarily aimed at finding the biochemical mechanism behind this effect.

As mentioned above, it is based on Alehagen and colleagues’ article from 2015, and it is evidence with a very high degree of reliability, as it was a double-blind, randomized, prospective study. The participants were healthy elderly with an average age of 76 years. 165 received 200µg Selenium + 200mg Q10 daily, and 161 received placebo. The treatment lasted 4 years, after which various parameters were measured.
They were particularly interested in measuring the change in Sirtuin1, an enzymatic protein (deacetylase), which is important for the survival of cells when they are exposed to oxidative stress, because Sirtuin1 increases the effect of certain antioxidants.
But not only that. Sirtuin1 also inhibits the so-called NFκB signal, which is a substance that otherwise produces a strong inflammatory response.
So if you can increase Sirtuin1, you will thereby be able to inhibit inflammation and oxidation, – in other words, the two factors, which are mainly responsible for, among other things, cardiovascular diseases.
After a 4-year intervention period, the SIRT1 concentration was found to be significantly increased (from 252 to 469 ng/ml) in the active group and decreased (from 269 to 190 ng/ml) in the placebo group.
In a 10-year follow-up period, 25 in the active group and 52 in the placebo group died of cardiovascular disease, and the 77 who died had significantly lower SIRT1 concentration than the rest.
A small wrinkle in the study is that the so-called microRNA is also affected in a direction that inhibits the aging of the cardiovascular system. Micro-RNA contributes to the regulation of the gene activity. This has very far-reaching consequences for epigenetics, that is different modifications of DNA, which can turn genes on or off, and will of course be explored intensively in the future.

In this scientific trial, Alehagen and colleagues have shown that just 4 years of Selenium and Q10 supplementation inhibits oxidation and inflammation, and halves cardiovascular mortality over a 10-year period.

Now that selenium and Q10 are effective in inhibiting oxidation and inflammation, it is not surprising that they can halve the risk of dying from cardiovascular disease.
It is more strange that this is not standard advice from the medical profession when the evidence is so solid.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine

Don’t forget selenium

March 8, 2021

With the headline, we are entering the vital minerals, and selenium is one of the most important, because it is the gateway to 25 different selenoproteins, which control a wide range of processes in the body.

Selenium is a substance that we prefer not to lack, and numerous studies have over the years confirmed that selenium deficiency can lead to, among other things. heart failure, cancer, metabolic disorders, arthritis, infertility, atherosclerosis, increased inflammation, and a variety of immunological failures that are particularly relevant in this corona age.

Did you know, for example, that a vaccine will not work as intended if the vaccinated person lacks selenium and vitamin D. These two nutrients are necessary to activate the T cells, which must be able to recognize the infection the next time you encounter it (1,2,3). And they are also needed to moderate any vaccine-triggered cytokine storm.

There are thousands of articles cementing heavy research into selenium, and most recently, two months ago, an interesting study of selenium deficiency related to cardiovascular disease and inflammatory conditions was published (4). Since cardiovascular disease is also initiated by inflammation, it is natural to examine this collectively.

Previous studies have also shown that low selenium in the blood was the cause of increased inflammation, increased risk of cardiovascular disease and premature death (5,6).

Selenium dampens cytokine storms

The study included 858 healthy elderly and 606 cardiovascular patients of the same age.
The researchers examined the degree of inflammation by measuring the ratio of white blood cells (neutrophil / lymphocyte ratio), CRP and a wide range of cytokines, interleukins and chemokines.

They found a clear link between the lack of selenium and the incidence of cardiovascular disease as well as, not surprisingly, increased chronic, inflammatory load on the body, especially in the cardiovascular disease.

Selenium deficiency was associated with elevated values of circulating inflammation markers such as cytokines, interleukins and chemokines that are precisely characteristic of the scourge of our time, namely the risk of a cytokine storm at Covid-19.

Selenium is included as a moderator on an equal term with vitamin D, so that the formation and control of cytokines is formed and controlled, but to avoid the violent production called a cytokine storm, which triggers the damage that makes Covid-19 dangerous for individuals, weak people.

The researchers concluded that people with plasma selenium below 60 µg / l had almost twice the risk of cardiovascular disease compared to those who had a normal selenium content in the blood.

The result was convincing and statistically significant and corresponds very well to previous studies showing that the selenium-dependent glutathione peroxidase achieves its maximum activity in the blood when the concentration of selenium in plasma is between 70 and 90 µg / l (7).

In previous newsletters from May 2020, there are several references related to infections updated by Covid-19, and back in 2005 we wrote newsletters about cancer risk due to selenium deficiency. So selenium has been on the light board for many years, i.a. because there are so few who are aware that it is something we must not lack.

Daily intake (in Europe) should be around 100µg, and naturally it is found in fish, meat and certain nuts.
So remember selenium every day.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine

References

  1. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Piroth L et al, Dec.2020, Lancet. https://www.sciencedirect.com/science/article/pii/S2213260020305270
  2. Geisler C, Ødum N et al. 2010, Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nature Immunology 2010;11:344-349.
    https://www.nature.com/articles/ni.1851
  3. https://www.webapoteket.dk/saar-og-sygepleje/selvtest/quicktest-d-vitamin-p-222465
  4. https://www.cerascreen.dk/products/test-for-d-vitamin
  5. Alberto Boretti, Bimal Krishna Banik (2020) Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome PharmaNutrition. 2020 Jun;12:100190.  Published online 2020 Apr 21. https://www.sciencedirect.com/science/article/abs/pii/S2213434420300153
  6. Caly L et al, 2020, Antiviral Research, 178, june 2020, 104787.
    https://www.sciencedirect.com/science/article/pii/S0166354220302011?via%3Dihub
  7. https://clinicaltrials.gov/ct2/show/NCT04747574

A stool with one leg

February 21, 2021

As previously quoted, they wrote in the Lancet (1) December 20th that in the future everything should be done to prevent and vaccinate and find methods for the treatment of Covid-19, and the Vitality Council can’t agree more that this stool should rest on three legs.

But the Danish government has not agreed to that. Since March 2020, it has focused on vaccines and only vaccines. – A one-legged stool.

Not only has the Government and the state media focused unilaterally on vaccines, but they have also actively censored information on both prevention and treatment. The government media has also been obediently accompanied by microphone holders from the major social and print media. It has been irrelevant to the censorship whether this information was sufficiently well documented.

Prevention

In the previous many newsletters, the Vitality Council has primarily advised on prevention in terms of keeping the immune system intact.

In our modern way of life with easy and fast industrial food of poor quality, improper preparation and overeating of carbohydrates, there is a great risk that our immune system will run out of essential nutrients. I have reviewed this topic again and again and will not bore you with this at this time.

But I will try to give a simple model for understanding the functioning of the immune system. This is because it is absolutely essential in prevention against Covid-19 and all sorts of other infections.

The immune system has a myriad of different cells to work with, and it’s pretty complicated, but let’s try a Pixie model; -a mousetrap:
There are two main systems, a so-called “innate” (non-specific) immune system, which works all the time, and an “adaptive” (specialized) immune system, which is adjusted by infection. The innate system attacks just about everything when, for example, a virus penetrates the body, but first the adaptive needs to get familiar with the new virus, adjust and activate the so-called T cells for attack, and teach the memory cells to remember for the next time how these virus are best attacked (antibodies).

Back to the mousetrap.

In the loft with all the mice (virus in the environment) we put a box (the body), with a small hole in the side (the innate immune system), and inside the box we put a couple of mousetraps (the adaptive immune system).

If we lack proper nutrition, vitamin D, selenium, vitamin C and magnesium, then the hole in the box is very large (the innate immune system fails). Then many mice can enter the box at once, and the traps (the adaptive immune system) do not have the capacity to snatch many mice. – Especially not if there is a lack of vitamin D, which is necessary to activate the T cells (2).

If, on the other hand, we get enough of the above nutrients, then we only have a small hole in the box (a good innate immune system), and then only a few mice enter the box (the body) at a time, and the adaptive immune system (the traps) can snatch them one by one.
Remember the Danish Minister of Health showing a graph with red and green curves some time ago.
If too many come too fast, then the hospital system would collapse.
The same way with our immune system.

If it is intact, the innate immune system will make sure to moderate the load so that the adaptive defense can have time to get to know the enemy and calibrate its cannons accordingly. Hereby we avoid the overload that results in the so-called cytokine storm, which is the start of all the accidents.

That is why it is so important to provide proper nutrition and supplement with vitamin D, vitamin C, selenium and magnesium.
And remember in the dark winter: Vitamin D in the blood should rise to 30-50 ng/ml (75-125 nmol /L.)
If you can’t get the blood sample taken locally, there are several excellent options for home testing i Denmark (3,4).

Treatment

Often you see pseudo-science, where vitamins and minerals are used as treatment after disease outbreaks, and even often in relatively small doses. It is pointless and only suitable to show that it does not work. These nutrients are for prevention.
An exception, however, is Vitamin C in high doses given intravenously under medical supervision.

There is only scant evidence here at the Covid-19 pandemic (5), but previously there is ample evidence of an effect on viral infections, as mentioned in the newsletter May 20th 2020.

There have been numerous experiments with hydroxychloroquine, which, however, have yielded quite varying results, and research into it is unfortunately largely discontinued.

Ivermectin is a remedy against scabies and certain parasites, and reportedly also has an effect on Covid-19 (6). The Indian health authorities have approved a treatment with Ivermectin, Doxycycline and zinc.
Ivermectin costs about 100 times as much as hydroxychloroquine, so it will probably never be the big success.
One week ago, Israeli researchers published (7) a preliminary result of treatment with inhalation of CD24 exosomes in 30 hospitalized moderately to severely ill Covid-19 patients. The 29 recovered in 3-5 days, the last one also recovered, but after more than 5 days. It should be a cheap method without side effects, so it sounds promising. CD24 exosomes are proteins that, like vitamin D, control T cell activation and can attenuate the cytokine storm.
We are anxiously awaiting news from the Israeli researchers.

What now?

After all, health authorities and the government are on thin ice right now, unless they manage to be saved by the globally declining infection rates and death rates.
You vaccinate and vaccinate, but to no avail on the closure of the society. The function of the vaccine is primarily to alleviate the disease in the vaccinated person.
Even though we have been vaccinated, we can still be infected and pass it on to others, because the virus is still there. Therefore, even the vaccinated must continue with face masks, despite the poor evidence of the effect of the hated face masks.
On top of this, there are still new mutations. Currently the English with increased infection of children, which we see in Kolding these days, but on the horizon lurks the South African and two different Brazilian varieties, which are even less sensitive to the antibodies we have received from previous infection and from vaccination.
Well, then the vaccine just has to be adjusted, and then the population just has to be vaccinated again.
Okay. -How many times? So far, in 2 months we have only vaccinated 3% of the population. So good luck with the task if it all has to start all over again.
It seems like a Sisyphean task if the Government will continue to focus only on the one-legged stool.
As a solution to this chaos, the Government is now proposing a wild testing strategy, where we will be tested twice a week next year. This will cost just as much as the overall healthcare system, and one does not have to be a nuclear physicist to figure out that this will massively affect all other diagnoses in the healthcare system.
And the virus will not disappear either due to this.
It’s a bit like setting up photo traps to detect an army of soldiers invading the country. No defense, just registration while the invasion rumbles towards the defenseless population.
When the hopelessness of this strategy eventually dawns on the Government, there is hope that the one-legged stool will be given two more legs, namely prevention and treatment.
Then every single person can be informed about the possibility of defending themselves against Covid-19.
Only then will the disease become so mild that it resembles a common flu, by which we can drop the hated face masks and the lockdown of society.

May we ask for the three-stringed strategy as soon as possible thank you.

A stool with one leg is doomed to tip over.
A stool with three legs does not tip over.
No matter how uneven the surface is, it will not even tilt.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine

References

  1. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Piroth L et al, Dec.2020, Lancet. https://www.sciencedirect.com/science/article/pii/S2213260020305270
  2. Geisler C, Ødum N et al. 2010, Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nature Immunology 2010;11:344-349.
    https://www.nature.com/articles/ni.1851
  3. https://www.webapoteket.dk/saar-og-sygepleje/selvtest/quicktest-d-vitamin-p-222465
  4. https://www.cerascreen.dk/products/test-for-d-vitamin
  5. Alberto Boretti, Bimal Krishna Banik (2020) Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome PharmaNutrition. 2020 Jun;12:100190.  Published online 2020 Apr 21. https://www.sciencedirect.com/science/article/abs/pii/S2213434420300153
  6. Caly L et al, 2020, Antiviral Research, 178, june 2020, 104787.
    https://www.sciencedirect.com/science/article/pii/S0166354220302011?via%3Dihub
  7. https://clinicaltrials.gov/ct2/show/NCT04747574

Neglected opportunities

January 15, 2021

“The world is groping blindly for defences against the new virus variants” – according to a headline in the Danish newspaper Berlingske January 12th. The article then deals with gene sequencing and rapid diagnostics for infection control. But it is clear that panic spreads every time a new variant appears.

The fumbling in the dark began with clusters 1-5 found in Danish mink, which led to politician panic and the most drastic coercive intervention so far against any business in Denmark and the total closure of the region Vendsyssel.

The next time the panic screw was increased is now that the English variant B 1.1.7 is spreading. It is not more dangerous, but more contagious.

When the panic and anxiety from this variant begin to subside, then it’s time to introduce the South African variant and gravely tell us that this variant can now hit children, and then shut the country down. It is so deeply predictable that we absolutely must be pressed down into a state of chronic anxiety so that we conform to what is expected, and all of us line up for vaccination.

However, it is a good thing that the vaccines have arrived. The first vaccine was received by the media and politicians like a Messiah, and it was very nearly close to rose petals being sprinkled on the road in front of the trucks.

It is excellent that the health authorities quickly have launched vaccinating the elderly and seriously ill at risk. So far so good.

But my goodness, how they could have done so much good in the 10 months that have passed if they had listened to science.

When you consider that in order to shop in the supermarket Netto you have to look like a bank robber and wear a face mask whose effect is extremely poorly documented; -then it is striking that for months the authorities have turned a blind eye to well-documented opportunities that could have saved many lives and much suffering.

A study recently published in the Lancet (1) reviewed 89,000 hospitalizations with Covid-19 in March-April 2020 and Influenza Dec-Jan 2017-18.

It was found that Covid-19 caused significantly longer length of stay and greater mortality than the flu and it was concluded that in the future every effort should be made to prevent and vaccinate as well as find methods for treating Covid-19.

The Vital Council can only agree on this 3-string strategy: prevent, vaccinate, find ways to treat.

Unfortunately, this is not the strategy the government has chosen. Instead, they have chosen to put all their eggs in one basket.
Ever since the start of the pandemic, there has been hope and talk about the upcoming vaccine.
The authorities have been going all in, bone-hard, on the vaccine and only the vaccine and have not even wanted to squint at the other options in the three-stringed strategy mentioned above.

You can therefore understand the panic of the politicians until they were reassured that the mink variant was probably also sensitive to the upcoming vaccine. The same has now happened with B 1.1.7 from England, while we are still unsure of the South African variant.
That is to say the vaccines may in the future have difficulty keeping up with the constant changes in the highly mutated RNA virus, and one day they will fall short.

Yet all measures other than vaccines have been swept off the table despite massive documentation.
It is as if the authorities have overlooked that we humans actually have an immune system that is itself capable of adapting a new virus mutant.
Unlike a vaccine, a well-functioning immune system will be able to keep up every time a virus mutates.

Of course, it is necessary for the immune system to function optimally, and it ris necessary that we humans get a diet with the nutrients that the immune system needs.

This is so obvious that it hurts to say over and over again (see 5 previous newsletters from May 2020):
Decades of scientific evidence show that deficiency of especially vitamins A, C, D and K as well as deficiency of selenium, magnesium and zinc weakens the immune response and increases the incidence of infections, especially lung diseases. (2-10)

Specifically, in recent years there has been extensive writing about vitamin D, and the University of Copenhagen wrote almost prophetically on March 7, 2020, on its website in the News section: “Vitamin D is absolutely crucial for the immune system.”

Since then, several studies have been performed on vitamin D against Covid-19, which show significantly less infectivity, shorter hospital stays, milder illness, and lower mortality. (11-17) This documentation is further strengthened by the fact that the groups that are low in Vitamin D are those most affected by Covid-19, especially overweight persons, nursing home residents, immigrants, the chronically ill, and the elderly.

Traditionally, here in Denmark we have considered it sufficient, as long as the serum vitamin D (25-hydroxyvitamin D) level was 50 nmol/L (20 ng/ml) or more. This is not enough. All studies point to the need to have at least 75 nmol/L (30 ng/ml) in the blood and preferably 150 nmol/L (60 ng/ml.)
Far less than half of the Danish population are within these figures.
You cannot reach this preferred level, even if you then eat fatty fish every single day; you have to take supplements.
In turn, there is a major health benefit in eliminating the population’s deficiency of vitamin D. -Not only in the face of several of the major lifestyle diseases, but also of Covid-19.

Research shows, as mentioned, that sufficient vitamin D will shorten the duration of the disease, avoid hospitalizations, and reduce mortality from covid-19 disease. Those who become ill will simply have a mild course of the disease but will still build up immunological defenses until the next time they encounter it. If you also make sure that there is no shortage of the other above-mentioned vitamins and minerals, then the disease picture will look completely different in this country, and it could put a damper on the all-consuming anxiety and worry in the population.

Note: There is no talk of these vitamins and minerals being used to “treat” anything. They are used to correct deficiencies.

But it requires the authorities to think outside the box and show openness to the well-documented possibilities that exist here. Especially when these options are safe.
It is fine to think of collective infection control, but it does not preclude that one also thinks of the individual’s immune system and its well-being.

There has been an unfortunate streak of overlooked possibilities throughout the 10-month-long corona course. Opportunities that could have saved many lives and saved many sufferings.
-And these are, mind you, options that are significantly better documented than face masks.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine

References

1. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Piroth L et al, Dec.2020, Lancet. https://doi.org/10.1016/S2213-2600(20)30527-0

2. Arvinte C, Singh M, Marik PE (2020) Serum Levels of Vitamin C and Vitamin D in a Cohort of Critically Ill COVID-19 Patients of a North American Community Hospital Intensive Care Unit in May 2020: A Pilot Study. Med Drug Discov. 8:100064. https://pubmed.ncbi.nlm.nih.gov/32964205

3. Hewison M. Vitamin D and innate and adaptive immunity. Vitam Horm, 2011; vol 86:23-62.

4. Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020 Jan 16;12(1).

5. Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011 Jan;55(1):96-108.

6. Dancer RC, Parekh D, Lax S, D’Souza V, Zheng S1, Bassford CR, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax. 2015 Jul;70(7):617-24.

7. Urashima M, Segawa T, Okazaki M, et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010 May;91(5):1255-60.

8. Sabetta JR, DePetrillo P, Cipriani RJ, Smardin J, Burns LA, Landry ML. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One. 2010 Jun 14;5(6):e11088.

9. Uwitonze AM, Razzaque MS. Role of Magnesium in Vitamin D Activation and Function. J Am Osteopath Assoc. 2018 Mar 1;118(3):181-189.

10. Dofferhoff A et al, Reduced Vitamin K Status as a Potentially Modifiable Risk Factor of Severe Coronavirus Disease 2019, Clin Infect Diseases, 2021, https://doi.org/10.1093/cid/ciaa1258

11. Kohlmeier M. Avoidance of vitamin D deficiency to slow the COVID-19 pandemic. BMJ Nutrition, Prevention & Health. 2020;3.

12. Grant WB, Lahore H, McDonnell SL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020; 12(4):988.

13. McCartney DM, Byrne DG. Optimisation of Vitamin D Status for Enhanced Immuno-protection Against Covid-19. Ir Med J. 2020 Apr 3;113(4):58.

14. Aldridge RA, Lewer D, Beale S, et al. Seasonality and immunity to laboratory-confirmed seasonal coronaviruses (HCoV-NL63, HCoV-0C43, and HCoV-229E): results from the Flu Watch cohort study 30 March 2020.

15. Ilie PC, Stefanescu S, Smith L. The role of Vitamin D in the prevention of coronavirus disease 2019, infection and mortality. Aging Clinical and Experimental research (https://doi.org/10.1007/s40520-020-01570-8) Springer Switzerland. 2020 May 6.

16. McCullough PJ, Lehrer DS, Amend J. Daily oral dosing of vitamin D3 using 5000 TO 50,000 international units a day in long-term hospitalized patients: Insights from a seven year experience. J Steroid Biochem Mol Biol. 2019 May;189:228-239.

17. Kaufman H et al, SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels PLOS ONE, sept.17,2020

Update on Corona virus

August 26, 2020

Since the last newsletter from May 28, things have gone well here in Denmark.
On the other hand, viruses have become widespread, especially in those countries that have not taken the spreading of infection seriously.
In the past month, however, localized infection clusters have emerged in various places here in Denmark as well, especially in immigrant communities.
The reasons for this have been mentioned in the previous newsletters, whose advice is still valid, so I will not repeat it here, but instead focus on what has happened in the last 3 months.

Studies
In a literature study(1) from Norwegian, Russian and Swedish public health institutes six researchers have concluded that early intervention with Zinc, Selenium and Vitamin-D can alleviate the course of the disease, and virtually prevent the cytokine storm, which is the process responsible for the destruction of tissues, microthromboses, inflammation, etc. -the whole cascade that can take the life of the Covid-19 sick persons.

An almost simultaneous study(2) from Germany analyzed Serum-Selenium and Serum-Selenoprotein P, and both values were significantly lower in those who did not survive Covid-19.
(Selenium: 53.3 ± 16.2 vs. 40.8 ± 8.1 μg / l, Selenoprotein-P: 3.3 ± 1.3 vs. 2.1 ± 0.9 mg / L p<0.001). These results must be said to be highly relevant in our country, where we consume so little selenium. This study falls nicely in line with the former study.

On August 3, an article was published in the Lancet(3) which strongly calls for increased intake of vitamin D based on solid literature reviews.
This also falls in line with the first study mentioned above.

And, finally, there is a meta-analysis(4) of the role of vitamin D in the development of acute respiratory infection. It includes 30,000 people in controlled trials (RCTs), and has shown significantly reduced risk of acute respiratory infection already at 10-25 µg of vitamin D daily.
This confirms a previous meta-analysis(5), which also found a significant inverse correlation between the risk of acute respiratory infection and the vitamin D content in the blood.
All of the above studies are nicely in line with the advice mentioned in the five newsletters from May.

Authorities distribute vitamins
Azerbaijan has registered 35,000 Covid-19 cases in a population of 10 million. Of these, 1,800 were hospitalized and 508 died.
Here, the Ministry of Health has provided more than 3,500 Covid-19 patients with a free “medicine package” containing: Vitamin C, Vitamin D, Magnesium, Selenium, Zinc and Paracetamol.
The idea is then that the patients stay at home and treat themselves there.
Every day they are then contacted by the local hospital clinic and have to answer a series of questions, just as the doctor checks that they are taking their pills.
So far, a significant reduction in the number of hospitalizations in this group has been observed(6).

You can only shout cheers when you see authorities who can think outside the box and dare to start such a project. My guess is that the trend will continue and that home treatment will continue to reduce hospital admissions in Azerbaijan.

The idea is not bad because you initiate a completely harmless treatment of a, for some people, -dangerous disease.
But why wait until they get sick?

With timely care, one can improve the immune system of the entire population if one simply provides information about these supplements and their significance.

What could be done here in Denmark is to provide subsidies to the vulnerable groups, especially residents of the country’s nursing homes, who are completely dependent on the public perception of vitamins and minerals. If their own doctor does not prescribe a vitamin supplement, then residents are often denied help to get the supplements, despite their own desire. They are completely dependent upon the doctor’s knowledge or lack thereof. I think Danish authorities and medical staff would be shocked if we measured the level of vitamin D in the country’s nursing home residents.
If you do not want to use public funds to donate these subsidies to the residents, then you can at least make sure that both residents and their relatives are informed.

These newsletters on Covid-19 are unfortunately necessary as this knowledge and the scientific back-up are neglected in the public advice to the Danish population.

Take care of yourself and others

Claus Hancke MD
Specialist in general medicine

References

  1. Alexander J, Alehagen U et al. (2020) Early Nutritional Interventions with Zinc, Selenium and Vitamin D for Raising Anti-Viral Resistance Against Progressive COVID-19. Nutrients 2020, 12, 2358.
  2. Moghaddam A, Heller R et al. (2020) Selenium Deficiency Is Associated with Mortality Risk from COVID-19. Nutrients 2020, 12, 2098.
  3. Martineau A, Forouhi N (2020) Vitamin-D for Covid-19: a case to answer. Lancet 2020;8:735-6.
  4. Joliffe D, Martineau A, Damsgaard Camilla et al. (2020) Vitamin D supplementation to prevent acute respiratory infections: Systematic review and meta-analysis of aggregate data from randomised controlled trials. medRxiv BMJ (endnu ikke peer reviewed) 17.juli 2020.
  5. Martineau A et al. (2017) Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data.
    BMJ 2017;356:i6585.
  6. lmahamad A, (2020) 3.500 covid-19 patients provided with free medication. Azernews 18.august 2020. https://www.azernews.az/healthcare/168099.html

Be prepared for the next Corona epidemic

The population is not

May 29, 2020

The Corona is spreading more slowly now, and, here in Denmark, Covid-19 is gradually infecting fewer and fewer people and we are more aware of protecting ourselves against it.

There have been good effects from keeping our distance and from maintaining good hygiene in which we have all been well instructed.

Much to the surprise of the Danish Serum Institute, less than 2% of the Danish population has had the disease, and only a few of these individuals may have obtained immunity to SARS-CoV-2, which the virus is called.
This means that more than 98% have not been infected and are completely without immunity. So forget about herd immunity.

The Danish population is just as vulnerable it was were in March when it all started.

Let’s try to summarize what we know and what we can do about it.

What do we know now?
SARS-CoV-2, which is the virus responsible for the current Covid-19 pandemic, is characterized in that it – like the influenza virus – triggers a reaction with the release of a number of signaling molecules such as interleukins, interferons, and lymphokines.

When this release is powerful, it is called a “cytokine storm”, and with Covid-19, it is so powerful that immune cells begin to damage the tissues where the process is taking place, and, in this case, it is primarily the lung tissue that is damaged.

During the cytokine storm, a violent inflammatory response and increased release of free oxygen radicals are created, which further damages the lung tissue due to the subsequent inflammatory microcoagulation seen in the pulmonary vessels. Adding too much oxygen at this stage will only aggravate the situation, which several anesthesiologists have experienced when Covid-19 patients’ conditions worsen when they are put on a respirator.

What can we do about it
Thus, it is primarily about attenuating the fatal cytokine storm.
Here vitamin D, magnesium, selenium, and vitamin C are particularly important as they specifically inhibit this cytokine storm and the subsequent inflammatory microcoagulation in the pulmonary vessels.
If the level of these essential substances in the body is high enough then you will have a subdued cytokine storm and thus attenuated symptoms, as seen during influenza infection. Fresh extract of Coneflower (Echinacea) has also been documented in several scientific studies to effectively inhibit this cytokine storm.

It should be obvious to protect ourselves by promoting such harmless and inexpensive remedies, but unfortunately in the medical and pharmaceutical world, one tends to stare blindly at the most expensive solutions.
Medical professionals were first intrigued by the antiviral drug Remdesivir, which could shorten the disease period of Covid-19 from 15 to 11 days. This fascination has now been replaced by a new one, another drug, an experimental cancer drug, Bemcentinib that may prevent viruses from entering the cells. A phase II trial is underway for 120 people, and we hope we will be able to get the result in a few months.

Well, it is excellent that medical professionals try to find a medicine that can help in this situation, but is it absolutely necessary to find a new, expensive medicine with side effects, when there are other far cheaper options without side effects?

The long awaited vaccine
While all this is going on, the pharmaceutical industry is working full speed on a vaccine. A vaccine against an RNA virus is very difficult to make, and using a vaccine is especially problematic because viruses constantly mutate and thereby often change the immune response.

No vaccine has ever been safety-tested, in the same way that medicine is tested, and this is a bit problematic because in recent years, the industry has started to add substances whose purpose is to stimulate the immune system for effective antibody formation. And stimulating antibody formation is good enough, too, but the safety of these substances has never been investigated. In Denmark, the use of mercury (thimerosal or thiomersal) in childhood vaccines was stopped from 1992 and in influenza vaccines from 2004, with the exception of the vaccine in 2009, which was an embarrassing exception. The toxic mercury should never be used again for human use – neither in the teeth, for that matter.

But in recent years aluminum has been added in the form of nanoparticles as well as squalene emulsions. These adjuvants have not been safety tested. It has just been noted (WHO has noted) that the number of side effects is not greater than is usually seen with vaccination. Aluminum is a neurotoxin, but it has been used in vaccines in the form of various aluminum salts since 1930, so in that form it probably isn’t particularly harmful. The problem is that nanoparticles are now being used that cannot be stopped by a cell membrane. They can penetrate all tissues.
It cannot be ruled out that it is safe to use these additives. It’s just never been investigated.

It should be a simple task to make a study with each of these ingredients against a real placebo such as brine.
We have many excellent vaccines, so let’s not be vaccine deniers. Let’s welcome a SARS-CoV-2 vaccine when it arrives, and then just hope it is properly safety tested. Of course, this hope becomes a requirement if we are to be mandatory vaccinated.

Of course, the Coronavirus will return
When and how bad we do not know, but it will come.
As mentioned in the Vitamin C newsletter, one of Europe’s experts in Covid-19, Professor Christian Drosten from the University of Berlin, has stated that the second wave could be tougher than the current one.
And since more than 98% of the Danish population is without immunity against it, we should not sit with our hands in our laps and wait for a vaccine.

We need to be proactive.
We need to make sure that we have enough of the nutrients that can reduce the risk of our getting sick, and especially the nutrients that can dampen the cytokine storms, so that we get a mild course of illness if we get sick anyway.

Especially old people and people who eat only very little, who may also be weakened by chronic disease, will do well by supplementing the diet in order to be well equipped with an optimally functioning immune system as the next virus threat approaches.

An appropriate daily dose for a normal-weight adult will typically be:

  • Vitamin A: 1-2 mg
  • Vitamin B6: 4-5 mg
  • Vitamin C: 2-3,000 mg
  • Vitamin D3: 75-100 µg
  • Selenium: 100-200 µg
  • Zinc: 20-30 mg
  • Magnesium: 200-300 mg

Note: The low dose is for those weighing less than 70 kg (155 pounds / 11 stones).

If you start now, you will be prepared in the fall. This is an obvious strategy for the country’s nursing homes.

This is the fifth and final Covid-19 newsletter.

Unfortunately, the five newsletters are necessary as this knowledge and scientific back-up are neglected in the public counseling of the population.

Take care of yourself and others,

Claus Hancke, MD,
Specialist in general medicine

Refs:

  • McGonagle D et al. (2020) Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Lancet May 7, 2020:1-9
  • Zhang Y, Leung D, Richers B, et al. (2012) Vitamin D Inhibits Monocyte/Macrophage Proinflammatory Cytokine Production by Targeting MAPK Phosphatase-1. Journal of Immunology. 2012;188(5):2127-2135.
  • Alberto Boretti, Bimal Krishna Banik (2020) Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome PharmaNutrition.
    2020 Jun;12:100190. Published online 2020 Apr 21.
  • Sharma M, Anderson A et al.(2009) Induction of multiple pro-inflammatory cytokines by respiratory viruses and reversal by standardized Echinacea, a potent antiviral herbal extract. Antiviral Research, 2009;83(2):165-170.
  • Cannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza.
    Virol J. 2008;5:29.
  • Gorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533
  • Hemilä H (2003) Vitamin C and SARS coronavirus Journal of Antimicrobial Chemotherapy, Volume 52, Issue 6, December 2003, Pages 1049–1050
  • WHO Global advisory committee on vaccine safety 2020 (ikke ændret siden 2006). https://www.who.int/vaccine_safety/committee/topics/adjuvants/squalene/Jun_2006/en/

Selenium attenuates Covid-19 disease

But we don’t hear about it

May 11, 2020

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

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

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

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

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

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

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

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

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

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

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

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

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

Take care of yourself and others,

Claus Hancke; MD,
Specialist in general medicine

Refs:

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

Latest news on selenium

January 12, 2010

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

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

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

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

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

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

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

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

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

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

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

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

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

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

By: Niels Hertz, M.D.

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

New slander against antioxidants

March 13, 2007

A new article maintains that antioxidants cause death, but the article is based on a comparison of results from incomparable studies.

Once again a scientific article has created a commotion regarding antioxidants. It claims that they cause death. This has been heard, and disproved, before. Because of the common uncertainty regarding this subject, we are nonetheless forced to take a stand regarding this claim.

The man behind this claim is a Serbian professor from a university located in the town of Nis. One of the co-authors is a Danish physician who has, among other things, declared antioxidants to be poisonous and cancer causing on Danish TV. He even suggested that they are poisonous in the amounts found in vegetables.

The study is a so called Meta analysis. It combines as many old studies on antioxidants as possible and extracts a kind of average from their results. Small four week studies are blended up with larger studies which have gone on for up to 12 years. Studies where very small doses were used are blended up with studies on mega doses, studies using one antioxidant are blended up with studies on combinations of antioxidants (e.g. vitamin E, vitamin C, and selenium), and so on. Among the studies used, there are at least eight different combination treatments using vitamin E. This enormous mess alone causes the study to be somewhat questionable. One cannot calculate an average between apples and oranges.

This is not even the worst part. In an attempt to prove that vitamin E increases risk of death (the articles primary claim), the ignored studies where selenium was used together with vitamin E. The selenium studies often showed reduced mortality and lowered cancer risk. This was not good for the Meta analysis authors, it disturbed their theory. They eliminated 11 essential studies on vitamin E and selenium from the analysis.

Selenium was ignored, but that wasn’t enough. The still couldn’t prove that vitamin E is harmful. The numbers wouldn’t work. To solve this, the article uses the fact that the antioxidant beta-carotene, the yellow colouring in carrots, increases death rates in smokers. This is commonly accepted (although not completely certain). In two of the largest studies conducted on antioxidants, a very slightly increased death rate was found due to a combination of beta-carotene and vitamin E.

More peculiarities
Common sense lends to the conclusion that beta-carotene is the villain in these studies. This was known in advance. Combinations of vitamin E with e.g. vitamin C and/or selenium do not increase mortality. More likely the opposite is true. In the large and very thorough French SU.VI.MAX study, death rates in men fell by over a third when they received vitamin E and vitamin C as well as selenium (besides zinc and beta-carotene!). This introduced a new era because this was the first time in our part of the world that a large array of antioxidants was used in study; which is what most people recommend. The antioxidants in our food are an orchestra, not solo instruments. They must play together to work. In a Chinese study from Linxian the same thing was found: lower mortality after supplements of vitamins E and C, selenium, beta-carotene, and vitamin A.

But the article in question maintains that vitamin E causes death. The claim is built, along with the discussed “manoeuvres,” on the two aforementioned studies, because the other vitamin E studies are insignificantly small in comparison. In these studies vitamin E was used with beta-carotene, and vitamin E was blamed in the Meta analysis for the poor results.

This is like claiming that mineral water is deadly if someone dies after drinking water mixed with arsenic. This conclusion is insane. The arsenic is deadly, not the water. Even though A+B is dangerous, it can naturally not be claimed that both A and B are dangerous alone.

There are other peculiarities in the article. Among other things, in at least two of the studies used, mortality was calculated many years after the end of the study. This is comparable to blaming a traffic accident for back pain when the pain became apparent eight years after the traffic accident. This type of measure was apparently necessary to get the desired results.

It is very easy to make these arguments in a scientific journal. If not for the press, it would be ignored. The article is based on a comparison of a number of incomparable articles, and this makes it hardly worth the effort it takes to make it better. It has also been exposed to sharp criticism. It has been clearly dismissed by two unrelated statisticians and by a professor of nutrition at Harvard University, Meir Stampfer. Stampfer is world renown and among the leading figures in nutrition studies encompassing over 300,000 people. He says that he will continue taking his vitamin supplements, unfazed by the article. But he adds that the article can lead to misinterpretation of the information that we have.

This is unfortunately an all too real possibility. Not in the least because the analysis’s authors insistently do the same.

By: Niels Hertz MD

 

References
1. Bjelakovic G, Nikolova D, Gluud LL et al. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention trials. JAMA 2007;297:842-857.
2. Virtamo J et al. ATBC Study Group. Incidence of cancer and mortality following alpha-tocoferol and beta carotene supplementation: A postintervention follow up. JAMA 2003;290:476-485.
3. Lee IM et al. Vitamin E in the primary prevention of cardiovascular disease and cancer. The Women’s Health Study. A randomized, controlled trial. JAMA 2005;294:56-65.

jama.ama-assn.org