Life Extension commissions its own study to check USC results

LEF scientists attempt to duplicate carotid thickening with high dose vitamin C - and fail!
"The results of The Life Extension Foundation's four-pronged carotid ultrasound test showed that in 23 out of 30 of these very high vitamin C supplement takers, there was no evidence of carotid plaque formation, obstruction (stenosis) or intimamedia thickening. Blood flow velocity through the carotids was completely normal in these 23 subjects.

"If we had set a cutoff of 60 years of age like the American Heart Association did, we would have found that none of our test subjects would have shown clinically significant carotid artery pathology. In other words, had we used the same narrow parameters (under age 60) that were presented at the American Heart Association meeting, we would have had no carotid artery pathology to report in this group of people who take very high doses of supplements."

Cover Stories

These widely publicized "hits" aimed at vitamin C and other antioxidants are no accident. One reason that these unsubstantied "cover stories" get so much press is that they do, in fact, provide cover to Medical Doctors who might otherwise get heat from patients who want alternatives to prescription drugs.

Most people don't like to think about it, but big medicine is in a very strange position. Medicine is profitable only if people require a doctor. Today, medical expenditures represent about 7% of the Gross Domestic Product. If tomorrow there appeared a scientific miracle that eliminated all disease and illness, we all benefit but Big Medicine would be ruined.

Unfortunately, adverse reactions to prescription drugs improves the economic viability of Big Medicine. These reactions are a leading cause of injury and death according to the American Medical Association. Super-safe non-prescription substances such as vitamin C are a threat to the bottom line.

It is a very queer position for doctors and pharmaceutical companies to be in.

FOR IMMEDIATE RELEASE                            
Sun Mar 12 06:30:16 CST 2000


Re: Recent media story linking vitamin C "pills" with "clogged" arteries 

The Vitamin C Foundation contacted Professor James Dwyer of 
the University of Southern California Medical School, one of the 
principal researchers mentioned in the 03/03/2000 news reports.  

"As we suspected, this research seems to be good news for elderly 
vitamin C takers whose carotid arteries have 'thinned' with age," 
said Owen Fonorow, foundation director and co-founder.  

"Dwyers team only looked at thickness. There is no evidence of 
occlusion or clogging."  The research findings show vitamin C 
supplements induce significant physiological changes, 
especially for smokers.  

The arterial growth was unexpected and alarmed the researchers, 
whose paper is in peer-review and has not yet been accepted for 
publication.  "Thickening has been tied to heart attack, but there 
is a difference between arteries growing thicker with and without 
plaque. Plaque lined arteries are less responsive to Nitric Oxide (NO) 
signals to dilate, sometimes leading to a cardiac event." But arteries 
with sufficient vitamin C intake can grow thicker without plaque. 
"This is exactly what you want to avoid heart disease," said Fonorow.  
"Vitamin C is needed for collagen. Stronger collagen reinforced blood 
vessels can better resist injury.  Plaque forms in response to injury." 

The USC team may be the first to measure the effect of vitamin C
pills on collagen production.  Their work provides strong evidence 
that elderly people should be taking vitamin C supplements.

According to  Dr. Dwyer at the University of Southern California:

1.  The USC paper has not been published.  (Their paper is 
unavailable in "peer review".)
2.  The USC team used a new  "B-mode" imaging technique 
which is still undergoing clinical trial for accuracy at the 
National Institutes of Health.
3.  This B-mode imaging technique has three indicators.  
The USC team only studied one;  carotid arterial thickening  or "IMT". 
USC tells us there is no reference in the paper to the other two
 occlusion indicators; plaque index and velocity ratio.
4.  According to correspondence, Dr. Dwyer and the USC team is 
unaware that arteries might get thicker with increased  vitamin C intake, 
or that this effect is entirely predicted by theory.   (Increased Vitamin 
C stimulates collagen production, but this is not well taught or 
well known in medical school.)
5.  Last year, the same USC research team (Dwyers, et. al) found  that 
stress leads to early atherosclerosis in men   (March 1999).  

Vitamin C researchers have often called vitamin C the 'missing stress 
hormone.' Most living organisms, other than humans,  produce in their 
bodies 8,000 to 11,000 mg of vitamin C every day adjusted for body weight.
But animals produce much more vitamin C when they are under stress.

Bottom line: There is no evidence of occlusion in the USC report.

Robert Cathcart III, MD of Los Altos California learned about 
the value of vitamin C from Linus Pauling. His medical practice 
uses high doses and says, "My experience with 25,000 patients since 
1969 indicates that the media report is ridiculous.  I know that follow-
up is not perfect  in private practice but I have had no patient 
who had a good heart when I first saw them and who took massive 
doses of vitamin C  who ever developed heart problems.  I have to
 add that I advise  all my patients to avoid sugar, chemicals, and 
highly processed foods, and put them on a number of other nutrients.

"If it turns out that there is thickening of the carotid, I think it is 
reversing the thinning that occurs with aging.  It is interesting 
that the effect is so dramatic in the reversing of the effect on 
smokers.  I have to congratulate you at the Vitamin C Foundation 
on unveiling the other two findings that could have been 
measured which were not reported.  Probably the finding that 
C helped would not be publishable."

This episode illustrates the potential risk to the public 
health and welfare when media outlets widely disseminate early 
scientific research before a peer-reviewed paper is published 
in a recognized journal.  The 03/03/2000 story  needlessly 
frightened people and may have scared many from taking their 
vitamin C pills.  This is not the first time. A similar story 
appeared in March of 1998 after a British team wrote a letter 
to Nature saying that vitamin C might cause DNA damage.   
Although the British researchers finding contradicted their 
own earlier work, and  although they could not get their 
findings through peer review, this ‘letter’ too was given 
world-wide publicity.

Note in the following technical information on the B-mode 
imaging process that there are three measures, yet the USC
 team tell us they only used one. The obvious question from 
'peer review' is what happened to the missing two measures 
that are used to infer occlusion?

Detailed B-mode images of the right and left common 
carotid artery, common carotid bifurcation, and the
first centimeter of  the internal carotid artery are obtained.     
Selected images are digitized for later measurement of 
intima-media thickness. After imaging, the sonographer 
obtains pulsed wave Doppler measures  of blood flow  
velocity at the mid common (2 cm proximal to    
the carotid bulb) and in the internal carotid artery 
at the point    of highest velocity distal to the flow 
divider. These are used to    calculate the degree 
to which plaque may be interfering with  blood flow.    
The scanning and reading protocols result in 
three primary carotid disease measures:

      1. average wall intima-media thickness  IMT;
      2. a measure of degree of focal plaque called the plaque index;
      3. and the velocity ratio, a determination of whether or not
         plaque is interfering with blood flow in the internal carotid

The occlusion indicators are not reported for reasons unknown.  
Now we need your help repairing the damage caused by the 
premature release of this unpublished research.  
We will post more information as it becomes available 
at the foundation's web site:

TERENCE MONMANEY wrote the initial story for the LA Times. 
DANIEL Q HANEY wrote the AP report. The Dwyers are 
Professors at the University of California, (323) 442-2637 (James) 
and (323) 442-2658 (Kathleen).  They have not yet published their paper. 
The President of USC is Steven B. Sample (213) 740-1111. 
The New York AP number is (212) 621-1602. 
The president of the Associated Press is Mr. Louis Boccardi.

Contact:  Mike Till, 1-800-443-3634
The Vitamin C Foundation


Vitamin C and Collagen Tutorial This is information is not presented to most medical students.

On March 03, 2000 the news hit. Vitamin C had been linked to cardiovascular disease. However, there is a slight problem. There doesn't seem to be a peer-reviewed, published paper to support the AP story that vitamin C "pills" may cause heart disease. There are other problems as well.

We want to be clear. We are not trying to imply that the researchers deliberately participated or falsified data. They were alarmed by the findings, because they didn't understand them. One reason is that the research of Linus Pauling and Matthias Rath has been effectively "shut out"of mainstream medical journals.

We formed the Vitamin C Foundation to help counter the improper premature release of research information, such as this 03/03/2000 story from the AP, before the results are peer-reviewed.

We could use your help and we will try to keep you posted.

Mr. Joe Kovacs
News Editor
World Net Daily

Dear Mr. Kovacs,

Yesterday 3/3/2000, WND carried an article warning about the dangers of Vitamin C in regard to causing arterial deposits. The article was constructed in a way as to suggest that the research supporting its claims was derived from a recent published study. It would be helpful to me to know the title of the published article and where it was published, (AP Editor, Daniel Q. Haney, should have these details if necessary).

I don't know if you are aware of the long term and sustained attempt, by the medical and pharmaceutical interests, to remove effective health aid products from the non-prescription category. Vitamin C, perhaps the most economically effective nutritional supplement ordinary folks have without having to run to a doctor, comes under attack from time to time in a now familiar pattern.

There is an initial bout of negative scare publicity from some bogus interpretation of a study, which always gets a lot of media attention. The scientific truth, debunking the interpretation, which follows later, is never presented to the public.

As a publication dedicated to individual freedoms as ordained by the Constitution, WND usually takes a position in favor of the individual over larger entities, government or corporate. I am sure that you will want to really carefully research any supposed dangers that vitamin C causes its consumers in the future, in order not to be a unwitting patsy in a high stakes game of more money for big medicine.

In the specific case of atherosclerosis, vitamin C has been found to be an antidote rather than a cause, and I refer you to a link at: Heart Attack Prevention - Linus Pauling Cure -- Vitamin C Lysine

A quick start on the "stamp out folk medicine" movement can be obtained by reviewing the history of the use of the sleep promoting amino acid tryptophane, now banned without cause by the FDA. One poisoned batch of tryptophane from Japan was all that it took.

Richard M. Humphrey

Our take until we can read the paper (if there is one!):

Tale of Two Stories

A recent report claims to tie vitamin C "pills" with a health hazard of "hard" arteries. Until we read the research, our hands our tied, but it is quite possible the research finding is exactly the opposite of the published reports.

This is the problem scientists run into when they try to interpret their experimental research findings without a benefit of theory. These USC scientists may have in fact measured collagen reinforced blood vessels. They apparently are unaware that Linus Pauling's theory would predict thicker blood vessels with higher vitamin C intake.

Medicine has known since the Brown/Goldstein Nobel prize that plaque forms in response to blood vessel injury. Lp(a) binds to lysine and proline residues in the collagen matrix that are exposed from injury. Thus it is highly unlikely the USC results are as reported by the AP.

The confusion in the media is cause and effect. The fallacy is that cholesterol is the cause of heart disease, but plaque build-ups are the effect of heart disease. According to Linus Pauling and Matthias Rath, heart disease is caused by too little vitamin C in the diet.

We did find an earlier paper by Dwyer and others covering the same research. Stress was found to be a factor in heart disease in men, but not women. To the point, stress has been repeatedly shown by experiment to decrease the body supply of ascorbic acid - vitamin C.

Here are two news reports:
[ Source: March 1999 ]

Job-related Stress and Cardiovascular Disease in Men and Women

Presentation: Stress in the Workplace and Early Atherosclerosis. The Los Angeles Atherosclerosis Study

Authors: Cheryl Nordstrom, Kathleen M. Dwyer, Noel Bairey Merz, Anne Shircore, Ping Sun, Wei Sun, James H. Dwyer.

Ref: poster presentation at the American Heart Association's conference on Cardiovascular Disease Epidemiology and Prevention (March 27, 1999).

Summary: This report concludes that job-related stress appears to have more of an impact on arterial health in men than in women.

Researchers at the University of Southern California-Los Angeles (UCLA) studied 464 healthy utility workers, age 40-60, to collect data; participants' stress levels were measured using a questionnaire and their carotid arteries were analyzed for plaque deposits using ultrasound imaging.

It was found that men who reported the highest stress levels had about five-times the risk of having atherosclerotic lesions in their carotid arteries, compared to those with the lowest stress levels, and that no such association between stress and the incidence of lesions was apparent in female participants.

The authors suggest that both better social support and the effects of estrogen on vascular health may play roles in protecting women against the cardiovascular disease- related effects of stress.

Sources: Med-Brief.

[ Source: March 2000 ]

Study links vitamin C pills with faster clogging of the arteries March 2, 2000
SAN DIEGO (AP) -- A new study raises the disturbing possibility that taking vitamin C pills may speed up hardening of the arteries. Researchers called their discovery a surprise and cautioned that more experiments are needed to know for sure whether megadoses of the vitamin actually are harmful.

Still, they said the finding supports the recommendations of health organizations, which generally urge people to avoid high doses of supplements and to get their nutrients from food instead.

Many people load up on vitamin C and other nutrients on the assumption that these supplements are good for their health, even though there is little scientific evidence this is true. In theory, vitamin C and some other nutrients might protect the circulatory system and other organs by suppressing the damaging effects of oxygen.

"When you extract one component of food and give it at very high levels, you just don't know what you are doing to the system, and it may be adverse," said Dr. James H. Dwyer, an epidemiologist who directed the study. He presented the findings Thursday at a meeting in San Diego of the American Heart Association. Dwyer and colleagues from the University of Southern California studied 573 outwardly healthy middle-aged men and women who work for an electric utility in Los Angeles. About 30 percent of them regularly took various vitamins.

The study found no clear-cut sign that getting lots of vitamin C from food or a daily multivitamin does any harm. But those taking vitamin C pills had accelerated thickening of the walls of the big arteries in their necks. In fact, the more they took, the faster the buildup. People taking 500 milligrams of vitamin C daily for at least a year had a 2 1/2 times greater rate of thickening than did those who avoided supplements. Among smokers, the rate was five times greater.

"If a person's physician has prescribed vitamin C, it is appropriate to be taking it," Dwyer said. "But if you are a healthy person and taking them in hopes of preventing cardiovascular disease, the heart association does not recommend it. This study would suggest that recommendation is prudent."

Dr. Shiriki Kumanyika of the University of Pennsylvania said the research shows the uncertainties of picking out a single vitamin among the plethora of nutrients in a healthy diet.

"It's a challenge to sort out what it is in what people eat that makes them live longer," she said. "We have to be careful about recommending foods or nutrients, because if we are wrong, we can do harm." In general, experts recommend that people get their vitamins and other nutrients from fruits, vegetables, whole grains and nuts. Clogged arteries -- what doctors call atherosclerosis -- are the major underlying cause of heart attacks and strokes. In the latest study, doctors looked for early signs of this process by twice performing ultrasound scans on the volunteers' carotid arteries, once at the study's start and again 18 months later.

Source: DANIEL Q. HANEY AP Medical Editor

Pauling Therapy for Heart Disease
Vitamin C Foundation

Study Abstract from Professor Dwyer

name="vitamin C abstract.txt"
filename="vitamin C abstract.txt"

March 9, 2000

From: James H. Dwyer, Ph.D., Professor, Keck School of Medicine of the University of Southern California, Los Angeles 90033-4500

Thank you for your interest in our research on the cardiovascular effects of vitamin C supplements. The abstract presented at the American Heart Association meeting=20 in La Jolla (March 2-3, 2000) is given below.

A news article by Terence Monmaney based upon this presentation at the AHA was published in the Los Angeles Times on page A3 of the Friday March 3, 2000 edition. =20 This article can be accessed through the website

Unfortunately, additional information about the study cannot be distributed,=20 since the paper describing the research is currently under review.


American Heart Association 40th Annual Conference on Cardiovascular Disease Epidemiology and Prevention

Vitamin C supplement intake and progression of carotid atherosclerosis, the Los Angeles Atherosclerosis Study

James H. Dwyer, Lisa M. Nicholson, Anne Shirecore, Ping Sun, Keck School of Medicine of the University of Southern California, Los Angeles; C. Noel Bairey Merz, Cedars-Sinai Medical Center, Los Angeles; Kathleen M. Dwyer, Keck School of Medicine

Several clinical studies have found that vitamin C supplements (CS) acutely improve=20 vasodilation and blood flow after hyperemia. However, evidence concerning long-term effects of chronic CS intake on mortality and cardiovascular disease is inconsistent. Methods. The relation between CS intake during the previous year and progress of arterial wall thickening was investigated in a cohort of 573 employees from a large utility company. Participants were aged 40-60 years and free of symptomatic cardiovascular disease at entry. Wall thickness was measured at baseline and 18-month follow-up as far wall intima-media thickness (IMT) of the left and right common carotid arteries using high resolution B-mode ultrasound. Regular intake of CS and other supplements over the previous year was measured with a questionnaire at baseline, while intake of vitamin C from food (CF) was determined from three 24-hr recalls. Results. The validity of self-reported CS intake at baseline was supported by plasma ascorbate. Plasma ascorbate levels increased across tertiles of CS intake: 0.61+/-0.02 mg/dL +/-SEM (non-users), 0.63+/-0.06 (20-190 mg/day), 0.75+/-0.05 (192-479), 0.89 (480-3355). In regression analysis, the logarithm of CS intake was a significant positive predictor of IMT progression in age-sex adjusted (p=3D0.001) and cardiovascular risk factor adjusted (p=3D0.005) models. Further adjustment for intake of vitamin E and multiple vitamin supplements did not reduce the strength of this association. The association was observed in both women (p=3D0.01) and men (p=3D0.03), and was dose dependent. IMT progression increased by 1.2, 2.1 and 2.7-fold across tertiles of CS intake, relative to nonusers of CS. This adverse association was stronger in baseline current smokers than in non-smokers, but the interaction was not significant in a covariate-adjusted model (p=3D0.09). In contrast, CF showed a small inverse relation with IMT progression. Conclusion: Regular use of vitamin C supplements may promote early atherosclerosis. Population use of these supplements for primary prevention of cardiovascular disease should await the outcome of randomized trials. (Circulation 2000;101(7):)

Assessment of B-Mode Ultrasound Technique to measure IMT in clinical trial at NIH The measurement method not yet proven.

Here is some information on the B-mode imaging process. Note there are three measures, yet the Dywer abstract only mentions one. The missing two measures are used to infer occlusion.
Detailed B-mode images of the right and left common carotid artery, common carotid bifurcation, and the first centimeter of the internal carotid artery are obtained. Selected images are digitized for later measurement of intima-media thickness. After imaging, the sonographer obtains pulsed wave Doppler measures of blood flow velocity at the mid common (2 cm proximal to the carotid bulb) and in the internal carotid artery at the point of highest velocity distal to the flow divider. These are used to calculate the degree to which plaque may be interfering with blood flow. The scanning and reading protocols result in three primary carotid disease measures:
  1. average wall intima-media thickness ;
  2. a measure of degree of focal plaque called the plaque index;
  3. and the velocity ratio, a determination of whether or not plaque is interfering with blood flow in the internal carotid artery.
Conspicuous by their absence in the Dwyer abtract are the plaque index and velocity ratio - indicators of occlusion. Stay tuned!

For the record, Daniel Q. Haney wrote the AP report that tied Professor James Dwyer and Kathleen Dwyer, et. al. at USC with research that links Vitamin C with Heart Disease. We have tried to contact the Dwyers, AP and various news outlets asking for the publication reference. Their response is posted, but they have not yet released their paper.

The Dwyers are Professors at the University of California, (323) 442-2637 (James) and (323) 442-2658 (Kathleen). The President of USC is Steven B. Sample (213-740-1111) The AP editor who wrote the story is Dan Haney. The New York AP number is 212-621-1602. The president of the Associated Press is Mr. Louis Boccardi.