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Whoa!  Lay Off the Vitamins!
Posted: 04 February 2014 08:10 PM   [ Ignore ]   [ # 346 ]
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asanta - 04 February 2014 07:54 PM
Mriana - 01 February 2014 04:46 PM

  You don’t hear very often that babies are born with cancer though, that’s why I was thinking that maybe I misunderstood more than I think. 

Yes, it does happen. I have cared with perhaps a half dozen cases in my career. One fairly recently. It is always very tragic.

That is sad.  They haven’t had a chance to live.

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Posted: 05 February 2014 06:31 AM   [ Ignore ]   [ # 347 ]
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mckenzievmd - 04 February 2014 04:07 PM

You haven’t really heard from me?  grin I think I have said everything I needed to.

I think what he means is that you haven’t responded to my attempt to break down the disagreement into smaller, more narrowly defined pieces to try and iron out what the real disagreement is. You have said repeated “We don’t all have cancer,” but again it isn’t entirely clear where exactly the hangup is between your understanding and macgyver’s.

Why is it not clear? Malignant tumours, that is tumours that can spread by invasion and metastasis are what we refer to as cancer. Neoplastic cells are not cancer. I am sure neither you nor macgyver would refer to benign tumours as cancer, would you? I really have nothing more to say here. It is now up to macgyver to accept he misspoke when he said that we all have cancer.

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Posted: 05 February 2014 10:59 AM   [ Ignore ]   [ # 348 ]
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George - 05 February 2014 06:31 AM

Why is it not clear? Malignant tumours, that is tumours that can spread by invasion and metastasis are what we refer to as cancer. Neoplastic cells are not cancer. I am sure neither you nor macgyver would refer to benign tumours as cancer, would you? I really have nothing more to say here. It is now up to macgyver to accept he misspoke when he said that we all have cancer.

I think we are going to have to call this one a draw. I decided to research the origin of this claim. Having heard it many times and doing the math in my head it always seemed such a plausible claim that I never questioned it. There are nearly 6 trillion cells in the body and the odds that NONE of them would have the requisite defects to meet the criteria for a true cancer cell capable of metastasis at any given moment seemed ( and still seems) highly unlikely.

I assumed these claims were most likely based on some post-mortum studies and a statistical analysis of the probability of a cell having these defects multiplied by the huge number of cells in the body. Unfortunately while I can find some vague references to such studies in my search I could not find the actual studies or anything worth quoting here. Its amazing the amount of complete crap I came across on the internet when searching for this though. I pity the poor cancer patient who wanders onto the internet looking for help without a professional guide.

That being said I still think the premise is accurate. I would moderate the claim to say that most people probably have some cancer cells in them at any given moment. I think the biology and the mathematics support that claim. On what grounds would you dispute that claim George?

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Posted: 05 February 2014 12:10 PM   [ Ignore ]   [ # 349 ]
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Yeah, I think I read there are something like 4 million instances of cell division every second. That’s a huge number. But don’t forget that in most cases before the cell gets to the stage of being malignant, it’s killed by the immune system. Our immune system has to be very good at this, otherwise we wouldn’t be here. But eventually it starts to lose, which is why most cancer happens at old age. The same goes for the rest of animals. Domesticated animals are more likely to get cancer than wild animals because they live longer. And humans get cancer more often than other mammals because we live longer, mammals get more cancer than birds and reptiles because they live longer, and birds and reptiles get more cancer than amphibians because they live longer.

[ Edited: 05 February 2014 12:12 PM by George ]
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Posted: 05 February 2014 12:14 PM   [ Ignore ]   [ # 350 ]
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Look George, I tend to agree that it is more accurate to say “there is a high probability that through his or her life every individual often develops neoplastic cells which, in the absence of normal immune function, would go on to become cancer” than to say “we all have cancer all the time.” That said, I don’t see why you have been so reluctant to make an effort to clear up the misunderstanding. Your posts are, frankly, surly, and it doesn’t make the discussion enjoyable or productive. Is there any reason the tone of your comments has to be so irritated all the time?

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Posted: 05 February 2014 12:17 PM   [ Ignore ]   [ # 351 ]
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mckenzievmd - 05 February 2014 12:14 PM

Look George, I tend to agree that it is more accurate to say “there is a high probability that through his or her life every individual often develops neoplastic cells which, in the absence of normal immune function, would go on to become cancer” than to say “we all have cancer all the time.” That said, I don’t see why you have been so reluctant to make an effort to clear up the misunderstanding. Your posts are, frankly, surly, and it doesn’t make the discussion enjoyable or productive. Is there any reason the tone of your comments has to be so irritated all the time?

question

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Posted: 05 February 2014 04:53 PM   [ Ignore ]   [ # 352 ]
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Really? “I’ve said all I have to say, now it’s up to him to admit he’s wrong” and you don’t see what I’m saying?! Ok, never mind.

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Posted: 12 February 2014 11:01 AM   [ Ignore ]   [ # 353 ]
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Another study[ suggesting a downside to antioxidants Vit C and E:

Paulson G, et al. Vitamin C and E supplementation hampers cellular adaptation to endurance training in humans: a double-blind randomized controlled trial. J Physiol. Published online before print.

Abstract

In this double-blind, randomized, controlled trial we investigated the effects of vitamin C and E supplementation on endurance training adaptations in humans. Fifty-four young men and women were randomly allocated to receive either 1000 mg vitamin C and 235 mg vitamin E daily or a placebo for 11 weeks. During supplementation, the participants completed an endurance training programme consisting of 3-4 sessions per week (primarily running), divided into high intensity interval sessions (4-6x4-6 minutes; >90% of maximal heart rate (HRmax)) and steady state continuous sessions (30-60 minutes; 70-90% of HRmax). Maximal oxygen uptake (VO2max), submaximal running, and a 20 m shuttle run test were assessed and blood samples and muscle biopsies were collected, before and after the intervention. The vitamin C and E group increased their VO2max (8±5%) and performance in the 20 m shuttle test (10±11%) to the same degree as the placebo group (8±5% and 14±17%, respectively). However, the mitochondrial marker cytochrome c oxidase subunit IV (COX4; +59±97%) and cytosolic peroxisome proliferator-activated receptor-gamma coactivator 1 alpha (PGC-1alpha; +19±51%) increased in m. vastus lateralis in the placebo group, but not in the vitamin C and E group (COX4: -13±54%, PGC-1alpha: -13±29%; p≤0.03, between groups). Furthermore, mRNA levels of CDC42 and mitogen-activated protein kinase 1 (MAPK1) in the trained muscle were lower in the vitamin C and E group (p≤0.05, compared to the placebo group). Daily vitamin C and E supplementation attenuated increases in markers of mitochondrial biogenesis following endurance training. However, no clear interactions were detected for improvements in VO2max and running performance. Consequently, vitamin C and E supplementation hampered cellular adaptions in the exercised muscles, and although this was not translated to the performance tests applied in this study, we advocate caution when considering antioxidant supplementation combined with endurance exercise.

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Posted: 12 February 2014 12:21 PM   [ Ignore ]   [ # 354 ]
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Interesting study Brennan. I’m wondering how many of these we have to post before people will understand that vitamins are not harmless supplements and that they should be treated like any other drug that has the potential for unintended side effects

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Posted: 12 February 2014 04:39 PM   [ Ignore ]   [ # 355 ]
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Well, some potentially good news on the vitamin front.  IV administered vitamin C can boost chemo treatments of ovarian cancer.

Intravenous ascorbate (vitamin C) seems beneficial in ovarian cancer, inducing cell death in vitro and reducing chemotherapy-associated toxicity in vivo, according to a study published in the Feb. 5 issue of Science Translational Medicine.

Noting that recent studies have demonstrated that ascorbate may be involved in killing cancer cells, Yan Ma, Ph.D., from the University of Kansas Medical Center in Kansas City, and colleagues investigated downstream mechanisms of ascorbate-induced cell death. In addition, they examined the safety and toxicity of high-dose intravenous ascorbate in 22 patients with ovarian cancer in a phase 1/2a pilot trial.

The researchers found that, in ovarian cancer cells, millimolar ascorbate acted as a pro-oxidant, induced DNA damage and reduced cellular adenosine triphosphate, activated the ataxia telangiectasia mutated/adenosine monophosphate-activated protein kinase pathway, inhibited mammalian target of rapamycin, and triggered ovarian cancer cell death. In mouse models, the combination of parenteral ascorbate with conventional chemotherapeutic agents carboplatin and paclitaxel inhibited ovarian cancer synergistically. In patients with ovarian cancer, the combination reduced chemotherapy-associated toxicity.

I’m not familiar with the journal involved, and I’m assuming that our medical experts will chime in with details if needed.

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Posted: 12 February 2014 05:07 PM   [ Ignore ]   [ # 356 ]
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It seems the implications of this study may have been exaggerated in the media (I know—you’re shocked!):

A review from the UK National Health Service suggests a more cautious interpretation. Here are a couple of excerpts:

“Vitamin C keeps cancer at bay, US research suggests,” was the inaccurate headline on the BBC News website. The study it reports on did not find that high-dose vitamin C helped with cancer survival, although it did appear to show it reduced some chemotherapy-related side effects.

The part of the trial conducted on people was too small to prove whether vitamin C helped kill cancer cells or increased survival from cancer up to five years after diagnosis. The results were not statistically significant, and any beneficial effects could have been down to chance alone.

However, the research did suggest that vitamin C may reduce chemotherapy side effects for women, but again it was too small to prove it with any confidence. It’s also worth noting that the women knew whether they were given vitamin C, so the placebo effect may have influenced their reporting of side effects.

The folks at Science-Based Medicine also questioned the reporting of this research. The article includes a detailed analysis of the research. Here’s a snippet:

So what we have here is a small clinical trial with a 19% dropout rate that wasn’t even blinded. It reported zero difference in overall survival (both were, as one would expect for ovarian cancer at this stage, abysmal), and zero statistically significant difference in time to relapse/progression. In all fairness, there would have had to have been an enormous effect to produce a statistically significant effect on survival or progression in such a small study, but these are the two “hard” endpoints that would be least affected by the lack of blinding, although one notes that time to progression could be affected by lack of blinding when the definition depends on interpreting scans. It’s also hard not to note that the differences in toxicities are all in the mildest reported toxicities, grades 1 and 2 (out of a scale of 1 to 5, with a score of 1, which denotes mild toxicity that requires no intervention to 5, which is death). There were no statistically significant (or even close to statistically significant) differences in toxicities graded 3 or 4, which are the most troubling kind.

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Posted: 12 February 2014 11:27 PM   [ Ignore ]   [ # 357 ]
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mckenzievmd - 12 February 2014 11:01 AM

In this double-blind, randomized, controlled trial we investigated the effects of vitamin C and E supplementation on endurance training adaptations in humans. Fifty-four young men and women were randomly allocated to receive either 1000 mg vitamin C and 235 mg vitamin E daily or a placebo for 11 weeks.

Wow!  The RDA for Vitamin C is approx. 90mg.
The RDA for Vitamin E is 15 mg.

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Posted: 13 February 2014 06:54 AM   [ Ignore ]   [ # 358 ]
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VYAZMA - 12 February 2014 11:27 PM
mckenzievmd - 12 February 2014 11:01 AM

In this double-blind, randomized, controlled trial we investigated the effects of vitamin C and E supplementation on endurance training adaptations in humans. Fifty-four young men and women were randomly allocated to receive either 1000 mg vitamin C and 235 mg vitamin E daily or a placebo for 11 weeks.

Wow!  The RDA for Vitamin C is approx. 90mg.
The RDA for Vitamin E is 15 mg.

I hear you Vyazma.  It sounds like overdosing to me and overdosing on anything is dangerous and doesn’t do much good.  In fact, it does more harm than good. The recommended maximum adult dose of acetaminophen is 1000 mg every 4-6 hours for pain or fever.  More than that or taking it frequently in combination with other medications that have the same pain medicine can cause liver damage.  There was a time they thought acetaminophen was safe… until people started dying of liver damage from taking too much.  So these studies are having subjects take far more than the RDA.  Humm…. Interesting…

However, vitamin C is water soluble and any excess goes through the kidneys and out, unless one gets a kidney stone from high doses, then it can be very painful as it exits the body.  Vitamin E I can’t remember if it’s fat or water soluble, but overdosing is never a good thing.  That and I’ve never heard of using Vitamin C and E for performance endurance before, but I guess it’s good to know what an overdose doesn’t do.  Might be better to know what it does do though.

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Posted: 13 February 2014 08:27 AM   [ Ignore ]   [ # 359 ]
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Yes, the amount of these vitamins typically taken for non-nutritional reasons is often much higher than the RDA, which is really just the amount required to avoid a deficiency. As has been said often in this thread, most people get all they need from their diet, so any additional is “overdosing” to some extent, though the folks who think these vitamins have health benefits often take ridiculous doses.

Vit C is water soluble, so it doesn’t accumulate, but it still has effects while in the body. The antioxidant effects are the main reason people have hypothesized it might be beneficial, but it’s beginning to look like tinkering with our oxidative systems isn’t such a good idea.

Vit E is fat soluble (A,D,E,K are the fat soluble vitamins), so it can accumulate in the body.

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Posted: 13 February 2014 10:34 AM   [ Ignore ]   [ # 360 ]
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Brennan makes a very good point. I have often heard people say “It’s a water soluble vitamin so I dont have to worry about toxicity” which isnt true. All vitamins are drugs and need to be treated as such. Nearly every prescription drug is water soluble and many of them are excreted through the kidneys yet they all have potential side effects especially if the patient takes more than the prescribed dose, so water solubility does not protect one from side effects or from the risk of overdosing whether its a prescription drug or an OTC drug like vitamin supplements.

I’m glad to see that we all agree that dosing is important with vitamins and as Brennan and I have pointed out numerous times, the average American seems to get adequate amounts of these substances. The doses in these studies may be much higher than the RDA but they are right in line with the amounts found in the most common supplements that people take. In fact I find that many of my patients are taking 2,000iu of vitamin C in the winter time. By that measure it was a fair study if you are trying to determine the affect of commonly available supplements on the body.

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