(and CODEX which is a load of cack!)
findarticles.com2003 FebOpen ↗
March/97994380/p1/article.jhtml?term=
Nutritional medicine and addictions: an important over-
looked component in detoxification & recovery. (Letters to
the Editor). Townsend Letter for Doctors and Patients, Feb-
March, 2003
Editor: People with addictions to alcohol and drugs may be
considered some of the most under-nourished and nutrient
deficient populations in healthcare. Treatments for these
groups typically involve pharmacotherapy (medications),
counseling support services, and perhaps acupuncture
(depending on the treatment center). The use of
supplemental vitamins and minerals for these patients
generally falls under the area of diet and perhaps rest,
instead of actually advising them on "adequate" nutritional
supplementation. Research suggests that specific vitamins
may actually be used as an "add-on" treatment (similar to
medications) for these individuals irrespective of whether
a person is deficient or not. For example, the B-vitamin
niacin (B3) is typically used by physicians to improve
cholesterol levels in patients and not for the prevention
or treatment of vitamin B3 deficiency. Moreover, evidence
also suggests that nutritionalr without a statement
regarding upper safe limits.
As has been stated in previous communication with the US
CODEX delegation, there is an assumption that there is a
problem that needs to be fixed. Exactly what are the
documented side effects of food supplements consumed in high
doses and what is their incidence in the general population?
Is CODEX protecting two percent of the mega-dose vitamin E
users from headaches, or what? Would the establishment of an
"upper limit" be expected to eliminate or just reduce the
occurrence of side effects?
The CODEX Draft notes that the Codex Guidelines for Vitamin
and Mineral Supplements will not, in any way, adversely
affect the availability of safe and truthfully labeled
supplement products in the US marketplace or to US
consumers. While this sentence is encouraging to consumers
of food supplements, it is incomplete. There are other
concerns regarding the effect of CODEX.
The very establishment of upper limits on food supplements
would likely scare away consumers from these products at a
time when conventional medicine is beginning to warm up to
the idea of the value of food supplements for health
promotion. The first press releases issued upon the
establishment of upper limits are likely to create a
mistaken belief that food supplements are relatively unsafe.
Consumers are likely to assume that since, let's say 2000
milligrams of vitamin C is the upper safe limit, that 2000
milligrams is the toxic level and they should consume far
less so as to never experience side effects. In fact, if
2000 milligrams were established as a relatively safe upper
limit, it would likely have a safety margin built into it.
Exceeding the upper limit may produce no side effects
whatsoever in a majority of consumers. The consumer will
probably not be told that the upper limit is the lower
threshold for side effects. I have observed adults who have
never taken vitamin C supplements experience diarrh ea at
doses as low as 500 milligrams.
The CODEX Draft states "Maximum amounts of vitamins and
minerals in vitamin and mineral supplements per daily
portion of consumption as recommended by the manufacturer
should take the following criteria into account: (a)
upper safe levels of vitamins and minerals established by
scientific risk assessment based on generally accepted
scientific data, taking into consideration, as
appropriate, the varying degrees of sensitivity of
different consumer groups." Just how would CODEX address
the variable nutritional needs of humans of mixed genetic
and environmental backgrounds? Excessive folic acid may
mask a vitamin B12 deficiency, but fertile women who seek
motherhood need extra folic acid (some experts say up to
2000 mcg) to reduce the risk of birth defects in their
offspring. So is the caveat to be aware of a masked B12
deficiency to be discarded for women who take mega-dose
folic acid? An upper limit of 2000 IU for vitamin D has
been proposed. How would that accommodate blacks living
in northern climates (near the Canadian border) whose
skin pigmentation reduces the production of vitamin D
from sunlight?
Self-care of illness and disease may be inappropriately
discouraged by the establishment of a safe upper limit.
While self-care is not likely to be promoted by any health
professionals, frankly, many consumers have no health
insurance or suffer with disorders for which conventional
medicine has no answers. The fact is that informed consumers
who seek alternatives to the physician-promoted
pharmaceutical drugs may not be able to obtain food
supplements in convenient or cost-effective doses for the
self-care of disease if upper safe limits are established.
For reasons of liability, manufacturers of food supplements
are likely to steer clear of providing vitamins and minerals
in doses that exceed the upper limit. Thus consumers who
wish or need to consume food supplements in mega doses may
experience increased costs to obtain nutrients in small-dose
pills. The products would be available, but just not
convenient nor affordable.
The CODEX Draft states: "Supplements of some nutrients, such
as vitamin A and selenium, can be harmful if taken in large
amounts." This statement is again misleading if not a
falsehood. Vitamin A is potentially toxic to the liver, but
this problem only occurs in about 30 to 40 cases a year
while millions of Americans are believed to be deficient in
vitamin A. Selenium is potentially toxic, but selenium
poisoning has only occurred in artificial circumstances such
as when strip mining exposed mineral beds and increased
elemental mineral levels in drinking water. Organically-
bound selenium provided in plant foods (i.e. garlic) has
never been demonstrated to be toxic regardless of dose.
CODEX advocates science-based review of supplements but
offers examples which are inaccurate and disparaging.
The CODEX Draft states that "Some people need a vitamin-
mineral supplement to meet specific nutrient needs." This
sentence needs to be changed to "most if not all people at
some stage of their life will need vitamin-mineral
supplements to meet specific nutrient needs."
Growing children would be less healthy if we did not already
fortify our overly-processed foods. All childbearing women
require supplemental nutrition. All older adults are at
greater risk for age-related disease and malabsorption and
should supplement their diet. All full-grown males need to
chelate iron from their system to avoid iron overload.
Recent studies indicate 40% of Americans are deficient in
vitamin D, 40% short on vitamin B12, 80% deficient in
magnesium, 80% deficient in essential fatty acids and the
entire human population suffers from a genetic failure to
produce an enzyme that naturally produces vitamin C.
How can it be said in the CODEX Draft that "Most people who
have access to a balanced diet can usually obtain all the
nutrients they require from their normal diet. Because foods
contain many substances that promote health, people should
therefore be encouraged to select a balanced diet from food
before considering any vitamin and mineral supplement. In
cases where the diet is insufficient or where consumers
consider their diet requires supplementation, vitamin and
mineral supplements serve to supplement the daily diet"?
This statement is out of date and patently untrue. Even the
American Medical Association has now published reports which
advocate multivitamin usage for the population at large.
This is further evidence that CODEX is currently out of step
with a rapidly changing body of nutritional science.
The CODEX Draft says: "The absence of science-based Codex
guidelines, however, could adversely affect the ability of
US manufacturers to compete in the international
marketplace." How so? This sentence goes unexplained. There
are no CODEX guidelines in force today and manufacturers are
not impeded from entering the international marketplace. Is
this another non-problem in search of a fix? Please explain.
Are we to assume that if an upper safe limit is established
by the world community, and US CODEX does not agree, that
US manufacturers would be at some disadvantage? All US
manufacturers need do is reduce the dosage in their
products to comply with foreign requirements, which is
hardly much of an inconvenience. This would likely result
in higher-dose US products being coveted by the overseas
market. This is the case today where Canada and various
European countries limit the types or dosage of food
supplements. Foreign travelers in the USA often purchase
loads of food supplements to take home. The US-made
products are coveted, not rejected by consumers. It is only
the foreign governments, largely influenced by
pharmaceutical interests, which inhibit a free market.
The CODEX Draft states: "In the spirit of the protection of
international fair trade practices and the science-based
resolution of international trade disputes, we support the
development of CODEX guidelines for vitamin and mineral
supplements that do not unduly limit consumer access to safe
and tru medicines have protective properties in the body
including the brain and nervous system.
For several decades now it has been documented about some of
the potential dangers of nutritional deficiencies. For
example, chronic vitamin B1 (or thiamine) deficiency causes
a well-known neurological complication from alcoholism.
Vitamin B12 and folic acid deficiencies may also be a
culprit in anemia (megaloblastic) and in cases of
neurological and psychiatric conditions. But how about the
remaining vitamins and minerals, amino acids, and essential
fatty acids?
Zhou found long-term heroin abusers who used large
quantities of this street drug caused a decrease in vitamins
C, E, beta-carotene and an increase in damaging "oxidative
stresses" (a biological equivalent of rusting in the body).
The researchers advised that "the heroin abusers should
acquire sufficient quantity of antioxidants (vitamin C, E,
beta-carotene) so as to abate the injuries to their bodies."
In a study of chronic alcoholics, Majumdar discovered that
24 out of 25 patients (96%) were found to be deficient in
blood levels of vitamin C. Intravenous vitamin C injections
(500mg/day) were given to these patients for 5 days in order
to help replenish their bodies. Surprisingly, the levels did
not return to within the normal range in 16 out of the 25
(64%) with this strength and dosing schedule of intravenous
vitamin C treatment. According to the researchers: "it is
suggested that conventional detoxification therapy for
alcohol withdrawal syndrome should include poly-vitamins
including vitamin C. It is further suggested that more
prolonged replenishment therapy with vitamin C, preferably
by intravenous route, may be needed to normalize blood
levels in some chronic alcoholic patients."
It is important to note that vitamin C is vital for brain
function. The amount of vitamin C in cerebral spinal fluid
(CSF) is 3-5 times higher than that in plasma, and in brain
cells the levels may be another 3-5 times higher than the
CSF. Interestingly, one of the first early warning symptoms
of vitamin C deficiency is "fatigue."
Vitamin C may also act as a valuable aid in detoxification
treatment. Evangelou found patients who received high dose
vitamin C orally either alone or combined with traditional
treatment for heroin addiction manifested major withdrawal
symptoms ranging from 10% to 16.6% of the subjects. In
contrast, people who received conventional medical therapy
alone (without vitamin C) experienced major withdrawal in
56.6% of the cases. In addition, after four weeks of
followup, the patients receiving vitamin C expressed vivid
feelings of well-being and a strong improvement in appetite
and psychokinetic behavior without any signs of depression
or insomnia in contrast to the control group.
Giannini investigated the effects of vitamin C in 40 men
with acute phencyclidine (PCP) intoxication. The patients
were randomly assigned to intramuscular injections of the
neuroleptic medication Haldol, vitamin C, or Haldol plus
ascorbic acid. The addition of vitamin C to Haldol enhanced
the activity of Haldol in counter-acting PCP intoxication.
Several other nutrients besides vitamin C may benefit drug
and alcohol addictions. It is important to stress that an
imbalance or deficiency of any one nutrient has the
potential to act as an obstacle in the recovery process. For
example, a vitamin B1 deficiency cannot be corrected or
helped by giving another B-vitamin, or vitamin C, etc.
Surprisingly, the majority of standard detox and recovery
centers do not incorporate, advise, or suggest appropriate
nutritional supplementation or offer routine laboratory
testing in this area.
It may be important to incorporate optimal replenishment and
nutritional regimens for people who are in various stages of
addiction detoxification and recovery. Eating a well
balanced diet may not be sufficient. Moreover, when used
correctly, vitamins have the potential to complement
standard treatment protocols. My experience in private
practice has supported this concept including a high safety
margin. Due to the important role nutrients have on the body
and mind, and because of the potential negative
ramifications of nutritional deficiencies, nutritional
medicines should play a more active role in addiction
medicine. A good "one-a-day" multi-vitamin and multi-mineral
supplement(s) should be considered a basic and elementary
starting point.
Walter Lemmo, ND
604-788-8858
www.lemmo.com
References
(1.) Zhou, J., Yan, X., Peng, F., Cai, D., Yuan, H., Sun, L,
Ding, D., Xu,
S. (2000) Heroin abuse and nitric oxide, oxidation,
peroxidation, lipoperoxidation, Biomedical and
Environmental Sciences, 13, 131-139.
(2.) Majumdar SK, et al (1981). Vitamin C Utilization
status in chronic alcoholic patients after short-
term intravenous therapy. Internat. J Vit. Nutr.
Res., 51, 274-278.
(3.) Rebec GV, Pierce CR (1994). A vitamin as
neuromodulator: ascorbate release into the
extracellular fluid of the brain regulates dopaminergic
and glutamatergic transmission. Progress in
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(4.) Evangelou, A., Kalfakakou, V., Panagiotis, G.,
Vassilios, K,, Vezyraki,
P., Iliopoulou. L., and Vadalouka, A. (2000). Ascorbic acid
(vitamin C) effect on withdrawal syndromo of heroin
abusers, In Vivo, 14363-366.
(5.) Giannini, A., J., Loiselle, R., Di Marzio, L., and
Giannini, M., (1987). Augmentation of haloperidol by
ascorbic acid in phencyclidino intoxification, American
Journal of Psychiatry, 144(9), 1207. 1209.
(6.) Johnston, P., and Chahl, L.(1992). Chronic
treatment with ascorbic acid inhibits the morphine
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(7.) Libby, A. and Stone, I., (1977). The hypoascorbemia-
kwashiorkor approach to drug addiction therapy: A pilot
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(8.) Scher, J., Rice, H., Suck-oo, K, DiCamelli, R.,
O'Connor, H.(1976). Massive vitamin C soon adjunct in
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COPYRIGHT 2003 The Townsend Letter Group COPYRIGHT 2003
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