Vitamins and Cancer Treatment
Alpha-Lipoic Acid Therapy
ALA Protects Heart and Brain
ALA Against Aging
Ask Dr. J: Is the Atkins diet OK?
In the Health News
Diet and Disease
Recipe of the Month: Tempeh Reuben Sandwich
I have just returned from the meeting of the American College
for Advancement in Medicine (ACAM), in Washington, DC. The
main topic was innovations in cancer therapies. One of the
most important presentations was that of Dr. Kedar Prasad,
because he answered a question that has created much controversy
in recent years: should a cancer patient on chemotherapy or
radiation take high doses of dietary antioxidants?
The answer was clearly “yes,” because dietary
antioxidants, such as vitamin E, vitamin C, and natural beta-carotene,
not only decrease the side effects of the other treatments,
but they also have direct toxic effects on cancer cells without
harming normal cells. Dr. Prasad reported on the effects of
antioxidant nutrients in cell cultures, in animals, and in
In cell cultures, he found that vitamin E reduced the growth
of tumor cells, caused damage to their chromosomes, and led
directly to their death, all without adversely affecting normal
cells . Natural vitamin E was superior to the synthetic forms.
The typical daily doses that he suggests are 8000 mg of vitamin
C, 800 IU of vitamin E (as d-alpha tocopheryl succinate, the
most active against cancer cells), and 60 mg of natural beta-carotene
(also measured as 100,000 IU).
Dr. Stanislaw Burzynski presented his experience using “anti-neoplastons,”
which are small peptide molecules (short chains of specific
amino acids) that are intended to change the expression of
cancer cell genes. Dr. Hugh Riordan presented case histories
and a theoretical basis for using intravenous vitamin C in
high doses (up to 100 gms per day!). While case histories
do not prove the value of a therapy, the combination of test
tube studies and anecdotes can be impressive, and strongly
suggest that further studies should be done to verify the
treatment. I have used high dose vitamin C for viral infections,
chronic fatigue, and for cancer patients, many of whom (but
not all) do quite well. Fortunately, this therapy and Dr.
Burzynski’s treatment do not have side effects.
For years cancer specialists have been telling their patients
to stop their high doses of antioxidants when they are being
treated with radiation or chemotherapy, and it is becoming
quite clear that this is dangerous advice. Some of the theory
behind this recommendation is that the nutrients might protect
the cancer cells from the toxic effects of the radiation or
chemotherapy. In very low doses they might, but in the recommended
high doses they protect normal cells, while enhancing the
toxic effect on cancer cells (thus lowering the dose needed
for treatment and reducing potential harm). These supplements
may also prevent cancer recurrence and the development of
new tumors. The scientifically-unjustified antagonism to supplements
has likely harmed many patients.
Alpha lipoic acid (ALA) is a sulfur-containing antioxidant
that works in both lipid and water tissue components to protect
against free-radical damage. It is recognized for its role
in treating neuropathy, but it has many other functions, and
was one of the many nutrients discussed at the recent ACAM
meeting, particularly for its role in cancer prevention and
Dr. Prasad noted that ALA is one of the antioxidants that
is manufactured to some extent within the body. Many other
antioxidants are nutritional components that must be consumed
in the diet or taken as supplements, such as vitamins C and
E, and carotenoids. For high doses of ALA (and coenzyme Q10)
you must take supplements, as internal production is limited.
When a patient is being treated with chemotherapy or radiation,
low doses of antioxidants may enhance tumor growth, but high
doses inhibit growth. However, those made in the body may
act differently than those essential nutrients derived exclusively
According to other information (including the reports from
Dr. Riordan), for cancer patients not receiving chemotherapy
or radiation, or those who have finished their course of therapy
it is very beneficial to take high doses of ALA along with
vitamin C and many other antioxidants.
Studies on ALA show it is an excellent protection against
age-associated degeneration of the heart and brain. It is
particularly valuable when combined with N-acetyl cysteine,
another sulfur-containing antioxidant, and with acetyl-L-carnitine.
These nutrient supplements are especially protective against
oxidative damage to the sub-cellular engines called mitochondria,
as well as proteins and nucleic acids, and thus can reverse
memory loss in aging animals.
Heart muscle is dependent for energy on fat metabolism in
the mitochondria, a function that declines with age due to
oxidative stress. Studies on aging animals show that ALA restores
the effectiveness of L-carnitine in the heart. It increases
cellular energy production, supports detoxification of waste
products, and enhances cellular repair, thus reversing aging
The aging process involves degeneration of enzymes, hormonal
changes, altered protein production, defective chromosome
(DNA) reproduction, accumulation of toxins, decline of both
energy and antioxidant production,and oxidative damage to
proteins and lipids (from both internal metabolism and environmental
exposures). All of these processes are interrelated.
In order to slow down and reverse accelerated aging we need
to limit the damage at points in the process where we have
some control. We can influence hormonal balance, toxic exposures,
energy production, and oxidative protection. These in turn
affect the other processes. I am not suggesting that we can
stop aging altogether, but that we are witnessing accelerated
aging that can be controlled through our actions.
ALA is not only an antioxidant, but it is also a detoxifying
chelating agent, able to remove toxic metals from the body,
such as lead, mercury, and cadmium. Heavy metals increase
oxidative stress on the body and directly damage cellular
function by poisoning enzyme function, interfering with membrane
activity, and altering the metabolism of nutrients, such as
magnesium, calcium, zinc, iron and B vitamins. (Mercury is
released into the environment from coal-fired power plants
and accumulates in fish.)
ALA works even better at removing heavy metals when it is
combined with other chelating agents, such as dimercaptosuccinic
acid (DMSA) (taken orally) and ethylene diamine tetraacetic
acid (EDTA) (administered intravenously). DMSA with ALA is
particularly good at removing mercury, which accumulates from
environmental exposure, especially from fish. The Environmental
Working Group website lists the most contaminated fish (www.ewg.org).
Shark, swordfish, and tuna lead the list.
ALA regenerates other antioxidants, such as vitamins E and
C, and glutathione, and it also helps with repair of proteins,
including enzymes, and lipids that have been damaged by oxidation.
As a result, tissue aging through free radical damage can
be reduced. All tissues are affected, but it is most obvious
in skin, which is exposed to all of the metabolic toxins,
environmental exposures, and ultraviolet light, and is most
The free radical/oxidative damage to the skin is most apparent
in smokers and in those who have spent a good portion of their
lives outdoors unprotected from excessive sun exposure. The
collagen and connective tissue are damaged through “cross-linking”
of molecules and loss of elasticity, leading to intense wrinkling
We have all seen the wrinkled necks of cowboys, and the sagging,
aged skin of smokers. ALA provides protection against these
signs of aging, whether applied topically or taken internally.
Overall, it is preferable to take it as a supplement, because
it can then protect not only the skin, but also all of the
other tissues that might be similarly damaged but are not
Typical doses of supplemental alpha-lipoic acid vary for
different situations. For diabetic neuropathy, it is common
to recommend 1000 mg daily. For sugar regulation in diabetics
(along with chromium supplements) it may be enough to take
200 to 300 mg. For basic prevention and protection of the
skin and other tissues, I recommend 100 to 200 mg daily, but
for treatment of cancer I think the higher dose range is advisable.
When I am treating patients with metal toxicity, I suggest
either intravenous EDTA chelation, or oral DMSA (100 to 200
mg daily, a low dose that is safe and effective over time).
I combine these with ALA in most cases to enhance the detoxification
benefits. One of the leading researchers in oxidative damage,
Bruce Ames, recently wrote that high doses of B vitamins and
antioxidants, including ALA, could provide a “metabolic
tune up” and disease prevention.
Q. Recent reports suggest the Atkins diet is helpful for weight
loss. Do you recommend it? -PR, Lexington, MA, by Email
A. These studies were misrepresented in the press, suggesting
that a high-protein/high-fat diet was better than a low-fat
diet for weight loss. The “low-fat” diets derived
25 to 33 percent of calories from fat, not a healthier 15
to 20 percent.
The small difference in weight loss between the two groups
(13 pounds versus 4 pounds in people who weighed 288 pounds
at the start in one study) was gone at six-months or one year.
The diet was difficult to stay on, with many dropouts.
Triglycerides (but not cholesterol) went down more on the
low-carb diet, but this is partly because the “low-fat”
diet was not really low, and because simple carbohydrates
can raise triglycerides. It is important to distinguish between
the effects of simple carbohydrates (sugars and white flour)
and healthy complex carbohydrates (whole grains, beans, vegetables,
The long-term consequences of high-carb diets are easy to
observe in cultures that traditionally consume more carbohydrates
from grains, beans, and vegetables, such as Japan, where diabetes,
heart disease, and obesity are much lower than in the US (although
these are increasing as they add more meat and fast foods
to their diets).
I am also concerned about the risks of kidney disease from
excess protein in the diet, and increased cancer associated
with eating meat. Numerous studies still show the advantage
of a high-complex-carbohydrate, mostly-vegetarian diet for
health, longevity, and less obesity, cancer, diabetes, and
heart disease mortality.
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Prasad KN, et al., alpha-Tocopheryl Succinate...for
Adjuvant Cancer Treatment: A Review. J Am Coll Nutr 2003 Apr;22(2):108-17.
Prasad KN, ACAM Meeting Antioxidants and
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Riordan, H, ACAM Meeting High-dose Vitamin
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Guinot C, et al., Relative contribution
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a. Excessive summer sun exposure increases the risk of skin
aging and cancer, although some sun is valuable to produce vitamin
D and help reduce depression. The carotenoids lutein, lycopene,
and zeaxanthin from food and supplements, are excellent antioxidants
that maintain skin health and protect against sunburn and photo-oxidative
damage (Sies H, Stahl W, Non-nutritive bioactive constituents
of plants.... Int J Vitam Nutr Res 2003 Mar;73(2):95-100). For
the inevitable summer exposure (I get a lot in the garden),
taking these carotenoids (along with your alpha-lipoic acid)
b. I previously reported on high doses of coenzyme Q10 for
Parkinson’s disease. A new review indicates that mitochondrial
damage and oxidative processes are involved, and suggests
that coQ10, ginkgo biloba, and acetyl L-carnitine, can protect
the brain (Beal MF, Bioenergetic approaches for neuroprotection
in Parkinson’s disease. Ann Neurol 2003 March 24;53
Suppl 3:S39-47; discussion S47-8). Niacinamide and N-acetyl
cysteine may also help.
High fiber intake was shown years ago to reduce the risk
of many diseases, including colon cancer, but this conclusion
has recently been challenged by studies indicating otherwise
(Mai V, et al., Dietary fibre and risk of colorectal cancer...
Int J Epidemiol 2003 Apr;32(2):234-9). However, the range
of fiber intake in this study was too low to show benefits
(the highest intake was only 18 gms). Real high fiber diets
provide 30 to 50 gms or more. Now, a study of 500,000 people
in Europe shows that, indeed, fiber, particularly from whole
grains, vegetables, and fruits, does reduce cancer risk, but
you have to eat the higher amounts to make a difference, along
with less meat and fat.(Bingham SA, et al., Dietary fibre
in food and protection against colorectal cancer... Lancet
2003 May 3;361(9368):1496-501)
It always helps to have some quick food ideas. You can use
organic whole rye bread or toasted organic sprouted whole
grain bread (in the frozen section of the health food store,
from Alvarado St. Bakery or Ezekiel—they also make delicious
sesame burger buns). Tempeh burgers are available in several
flavors (lemon, barbecue, or tamari). As a variation, or if
you don’t like tempeh, you can try organic veggie burgers
(I like Amy’s California burgers). Avoid products with
non-organic soy, or texturized vegetable (soy) protein, also
called “TVP,” as this is highly processed. Heat
the burger, top with organic sauerkraut, sliced tomato, cucumber,
and/or grilled eggplant, and put mustard and tofu mayonnaise
on the bread. Serve with a soup or salad for a complete meal.