In Part One of this three part series I discussed how xenoestrogens are a group of synthetic or foreign compound that act like estrogen, promoting cancer development. The two primary ways to reduce your cancer risk from xenoestrogens is avoid or eliminate their exposure and/or stimulate the removal from your body. In Part Two, I discussed a number practical ways to reduce your exposure and in this final part I will address a number of ways you can help support the elimination of xenoesteogens from your body and reduce their harmful effects.

Block the effects of Xenoestrogens with Phytoestrogens

There is quite a bit of confusion about the safety and effectiveness of phytoestrogens; even among medical professionals. Phytoestrogen’s are a group of compounds found in certain plants that have an estrogen-like effect in the human body. Most people assume that this means they increase cancer growth but its important to understand that even though these compounds interact with estrogen receptors they are much weaker than human estrogen (estradiol) or most xenoestreogens (Kaur, Danylak-Arhanic and Dean 2008). This means they attach to the estrogen receptor without actually activating it, therefore preventing human estrogens or other chemicals from activating the receptor. This would explain the fact that human population studies have found that soy consumption actually has a protective effect against breast cancer (Kazor 2012). It is worth pointing out that some animal studies have found soy supplementation promotes the growth of cancer cells which has led to confusion and cautions regarding soy intake. However, the opposite effect has been found in humans so some experts suggest that there is a difference in the way humans and mice use phytoestrogens making animals poor test models. To further support the safety and benefit of phytoestrogens studies have also found that soy food consumption was significantly associated with decreased risk of death and recurrence in people that were also taking tamoxifen and aromatase inhibitors (commonly used drugs in breast cancer prevention. There is no evidence that soy negatively interferes with tamoxifen or anastrozole therapy (Fitz 2013). While there are multiple benefits to eating non-GMO phytoestrogens such soya beans (i.e. edamame), soya products (soya sauce, tofu, tempeh etc.), hops, flaxseeds, legumes, lentils, beans and alfalfa sprouts, it is apparent that frequent dietary intake can block the negative effects of human estrogens or other xenoestrogens.

Stimulate healthy hormone metabolism and elimination

Many people know that the liver is one of the most important detoxification organs however fewer know it also is responsible for the healthy elimination of hormones as well as toxins. There are 2 phases to liver detoxification that occurs 24 hours a day. Most over the counter detox kits will stimulate phase 1 which prepares a toxin to be removed. However they often do a poor job at stimulating phase 2, which is responsible for taking the molecule activated by phase 1 and safely excrete it. To eliminate harmful environmental toxins and xenoestrogens we need to support the both pathways and also make sure that our intestinal elimination is regular and complete. The following are simple ways to promote healthy elimination of xenoestrogens:

Stay hydrated – every cell in our body requires water to function optimally, which includes waste elimination. Water also flushes out excess waste that builds up around the cells and can impair cellular communication and elimination. Water also lubricates our bowels, which helps to prevent constipation and maintains regular intestinal elimination. The goal for most is to drink 4 large glasses of water a day (approx. 2 L).

Broccoli and broccoli sprouts - Cruciferous vegetables are perhaps the food group that has shown the most powerful anti-cancer effect (Clark 2008). Theses vegetables contain a group of natural compounds (the main one being sulforaphane) that support liver detoxification (specifically phase 2) and hormone elimination pathways (Altern Med Rev 2012). Broccoli and broccoli sprouts are the vegetables with the highest levels of these beneficial compounds. For optimal effect they should be eaten raw (heat inactivates the enzyme) and chewed well so the enzyme that activates sulforaphane is released.

Flaxseed - Flaxseeds are well-known as a source of omega 3 and dietary fibre but now emerging research suggests that they have unique and direct anti-cancer properties such as preventing the growth of new blood vessels (Flower 2013). The impact of fibre is especially important in hormonally sensitive cancers such as breast and prostate cancer because fibre can bind hormonal products excreted from the liver and ensure they are eliminated rather than be re-absorbed in the digestive tract. Ground flaxseeds provide a great source of inexpensive fibre plus hormone balancing properties.

Antioxidants – Every cell in out body uses antioxidants to protect itself from damage but the liver has the highest requirements in order to support both phases of detoxification. Its even produces large amounts of its own powerful antioxidant called glutathione. Colourful fruits and vegetables are rich in antioxidant compounds so they should be included in your daily diet. Studies have now shown that for cancer prevention variety (i.e. different colours) is even more important that quantity. Aim for at least 9 different colours of fruits and veggies daily.

Herbal support – Many people prematurely jump right to herbal detox kits without reducing their xenoestrogen exposure and modifying their diet. The basics listed above should be the first priority before finally taking a herb like milk thistle to protect the liver and stimulate glutathione production. Consult your Naturopathic doctor at pureBalance wellness centre about which detox product is right for you. There many different options and some are better suited to certain people especially if they have hormonal imbalances. Taking a herbal formula can sometimes cause people to feel worse or get major reactions so it’s always most effective to consult your ND.

So after learning about negative effects of xenoestrogens and how avoid them you can use a number of simple things to also promote their removal from your body. The most important things are to stay hydrated and eat healthy phytoestrogens, cruciferous vegetables, flaxseeds and colourful fruits and veggies.

References
1)    Kaur, Danylak-Arhanic and Dean. The complete natural nedicine guide to Women’s Health. Robert Rose inc. Toronto, 2002.
2)    Kazor, Tina. The Effects of Soy Consumption on Breast Cancer Prognosis: A review of the literature. The Natural Medicine Journal. Nov 2012. Accessed on 2013-07-30.
3)    Fritz et al. Soy, red clover, and isoflavones and breast cancer: a systematic review. PLoS One. 2013 Nov 28;8(11):e81968.
4)    Flower et al. Flax and Breast Cancer: A Systematic Review. Integr Cancer Ther. 2013 Sep 8.
5)    Sulforaphane Glucosinolate Monograph. Altern Med Rev 2012;15(4): 352-360.
6)    Clarke et al. Multi-targeted prevention of cancer by sulforaphane. Cancer Lett. 2008 Oct 8;269(2):291-304.

We all have heard of the benefits of probiotics especially when it comes to digestive health. However, now research is emerging that healthy bacteria in our digestive tracts do far more than regulate our digestion. Two recent studies found a link between healthy bacteria and better responses to anti-cancer therapies. Mice with a healthy population of gut bacteria had a better response to chemotherapy compare to animals that had did not have healthy gut bacteria. Even though the studies need to be replicated in humans, the authors suggested that gut bacteria play a key role in regulating the inflammatory response not only in the digestive tract but also through out the body. The results also highlight the potential dangers of antibiotic use (especially long periods) since they can damage healthy gut bacteria, lower their levels and potentially allow harmful strains to take over. Researcher were actually surprised at this connection but a more thorough understanding of the latest evidence on probiotics and gut bacteria clearly indicate that inflammation and immune system response is started at the level of digestive lining and is influenced by probiotics. 

Did you know that there are 10x more bacteria in your gut than cells in your body? There is little surprise that these bugs have a pivotal role to play in the maintenance of good health. Probiotics are already well studied in improving diseases such as IBS, crohns, colitis, allergies, skin rashes, autism, ADHD and colon cancer. Now there is evidence suggesting that before a person starts (or during) cancer treatment they should make an effort to maintain a healthy bacterial population. While this can be achieved quite simply with the proper probiotics supplementation some people may require more comprehensive treatment to restore their whole digestive tract. This is especially true in cases of antibiotic use (even in the past), digestive disorders (i.e. IBS, IBD) and food allergies (which most people have). 

I love the conclusion of this article, “We can harness our microbes to help us fight cancer,”... “Conversely, when we disrupt our microbes, it might make fighting cancer harder.”
This evidence underscores the emphasis on good digestive health not only for nutrient absorption but also as a key cancer fighting factor. Its is so easy to overlook the simple things when fighting cancer but often the simple things can be the most powerful. Don't overlook your gut bacteria as key cancer fighting allies. 

To read the full article, follow the link
Gut Flora Boost Cancer Therapies

References
1) N. Iida et al., “Commensal bacteria control cancer response to therapy by modulating the tumor microenvironment,” Science, 342:967-70, 2013.
2) S. Viaud et al., “The intestinal microbiota modulates the anticancer immune effects of cyclophosphamide,” Science, 342:971-76, 2013.

In part one of this three part article I discussed how xenoestrogens are molecules that act like hormones in the body and can promote the growth of cancer cells. As part of an integrative cancer prevention or treatment plan it is essential to identify and eliminate your exposure to these compounds in the same way as you must eliminate foods such as refined sugar.

The following are 2 simple but powerful ways to reduce your xenoestrogen exposure.

1)   Avoid plastic cups and food containers – some plastics contain a compound called Bisphenol A (BPA). It is leached when liquids or foods are heated, cooled or stored in plastic. BPA has been linked to promoting obesity in children, causing infertility, disrupting genes and stimulating the growth of cancer cells.1 In relation to cancer, even the amount of BPA from one plastic cup is potent enough to make chemotherapy less effective due to its estrogenic action in the body.2 Remember, cancers (especially hormone sensitive cancers such as breast cancer) growth in the presence of hormones, including xenoestrogens. The frightening part about BPA is that it can have a negative impact on fetuses causing hormones disruption in future generations.3

a.     What to avoid: Plastic food containers (especially hard plastics), plastics water bottles, the inside lining of cans, thermal paper (receipts) and other plastics. Especially do not heat or microwave any plastics since this causes more BPA to be released.
b.     Healthy alternatives: glass or ceramic food containers, glass or stainless steel water bottles, cans that are “BPA-free,”
c.      Beware: Plastic water bottles that claim to be “BPA-free.” They are still made out of plastic so they can leach other potentially harmful compounds.

2)   Avoid Commercial cosmetics, creams and perfumes – topical products are notorious for containing compounds that are not only difficult to pronounce but can disrupt your hormones. Parabens and phthalates are 2 of the most detrimental compounds. They are added to many topical creams and cosmetics as preservatives and thickeners. They both have been associated with hormonal changes lower sperm count, birth defects, obesity, diabetes, thyroid irregularities and cancer growth.4,5 Parabens are fairly easy to identify since the name usually contains the word “paraben” in it (i.e. methylparaben, ethylparaben). Phthalates are more difficult to pick out and they often are one of the molecules in the “fragrance.” Since fragrance is a secret formula, companies do not need to disclose the exact ingredients, which means that harmful compounds are most likely still in the product. 

Xenoestrogens are a group of environmental chemicals, which mimic estrogen in the body. This family of molecules have been linked to the development and promotion of hormonally sensitive cancers.  Research is just beginning to uncover the wide-ranging effects of this class of compounds. This topic is so important; I have devoted a 3-part article to expanding and explaining this important topic. As of 2003 there were over 160 xenoestrogens that may be involved in breast cancer development (Brody and Rudel 2003). Cancer types that have been well documented in literature to be related with environmental exposure include the reproductive system, breast, lung, kidney, pancreas, and brain (Fucic et al 2012). New research is always emerging that confirms the negative impact of environmental chemicals such as dioxins, phthalates and parabens which are found in pesticides, cosmetics, cleaners and processed foods. Specifically in cancer, there is evidence the xenoestrogens play a role in in all phases of cancer development including initiation, transformation, and invasion (Fernandez and Russo 2010). For example, a number of studies have now confirmed that a chemical (a polycyclic aromatic hydrocarbon) produced during meat frying and grilling strongly increases DNA damage in breast cells and promotes breast cancer growth (Rohrmann et al 2009). Two emerging concepts to consider is that individual differences in genes responsible for detoxification may predispose some people more than others to the harmful effects of xenoestrogens. Secondly, a very concerning aspect of xenoestrogens is that studies are now confirming that exposure not only poses a health risk immediately, but also increases susceptibility to cancer and other diseases later in life (Wadia et al 2007). There is still more research to be done to fully understand the broad health impact of xenoestrogens but the emerging evidence is frightening do to their wide spread prevalence and pervasiveness in our food products, water supply, and environment. As part of a hormonal balancing and breast cancer prevention plan, it is paramount to consider reducing the exposure to these compounds that contribute to detrimental estrogenic activity in the body. You must also support the natural detoxification pathways (i.e. phase 1 and 2 in the liver) that remove excess hormones and xenoestrogens. Most people are inefficiently removing these compounds after they are exposed which increases their damaging effects. Natural compounds found in vegetables and certain herbs like mike thistle can promote healthy detoxification and therefore indirectly balance your hormones and reduce your cancer risk. To learn more visit your naturopathic doctor at pureBalance wellness centre to safely and effectively stimulate the elimination of harmful xenoestrogens and reduce your cancer risk. Check out part 2 of this 3 part article where I highlight Top ways to reduce your exposure to xenoestrogens.
References
Brody and Rudel. Review Environmental pollutants and breast cancer.
Environ Health Perspect. 2003 Jun; 111(8):1007-19.
Fucic et al.  Environmental exposure to xenoestrogens and oestrogen related cancers: reproductive system, breast, lung, kidney, pancreas, and brain. Environ Health. 2012 Jun 28;11 Suppl 1:S8.
Rohrmann et al. Dietary intake of meat and meat-derived heterocyclic aromatic amines and their correlation with DNA adducts in female breast tissue. Mutagenesis. 2009 Mar;24(2):127-32.
Wadia et al. Perinatal bisphenol A exposure increases estrogen sensitivity of the mammary gland in diverse mouse strain. EHP. 2007;115(4):592–598

1) Even though a visit with a ND is not covered by OHIP most extended health plans now cover Naturopathic visits. Check yours to see if you are covered. This is actually a big advantage since ND's are not restricted by OHIP regulations (paid by the number of patients you see etc) and can take enough time to treat each patient thoroughly. 

2) Did you know that a typical visit your family doctor lasts on average 7 minutes? A first visit with your ND can be anywhere from 60-120 minutes and a follow up is approximately 30 minutes. This allows for enough time to address the root cause of your symptoms.

3) ND's have eight years of post graduate education; this consists of four years of university undergraduate studies and four years of medical college. This is equivalent to the length of education for medical doctors and chiropractors. Our education includes a residency program, preceptorship and a possibility of specialization.

4) ND's have are trained and certified in a wide variety of treatment modalities. These include:

• Nutritional therapy
• Orthomolecular medicine (vitamins and minerals)
• Botanical medicine
• Acupuncture
• Naturopathic manipulation/hands on therapy
• Injection therapy
• Intravenous therapy
• Homeopathy

5) In Ontario, ND's are now legislated under the Naturopathy Act (which is under the Regulated Healthcare Practitioners Act). This means they are government approved and supported. Full proclamation is slated for 2014.

6) ND's practicing in British Colombia and some US states are able to prescribe certain pharmaceutical drugs such as antibiotics. This allows them to act as primary care doctors and better help their patients. As part of a ND's education they are required to learn pharmacology and the safety if how natural substances interact with drugs.

7) Naturopathic medicine is evidence-based. As an example, a recent study (april 2013) published in the prestigious Canadian Medical Association Journal found that Naturopathic medicine reduced the risk of cardiovascular disease. There also is a large body of research supporting each of the therapies that are used by ND's. For example, try typing the word probiotics into pubmed to see how many references you get (hint: it's in the thousands).

8) ND's are the "Sherlock Holmes" of all healthcare practitioners. Many patients visit an ND after no other doctor or health care practitioner was able to help them or get to the bottom of their symptoms. ND's use a comprehensive assessment, physical exam skills and lab testing to assess all aspects of their patients.

9) ND's use both conventional and cutting edge lab testing to assess their patients. For example they look at standard blood values such as iron levels and white blood cells but also are able to use testing from around the world to assess for hidden infections such as Lyme disease or immune activation by food allergies.

10) Did you know the word "doctor" means "teacher?" Naturopathic doctors take their roles as teachers very seriously. Our goal is to teach our patients how to improve their health through dietary and lifestyle changes so they can have lasting and vibrant health without having to take drugs or supplements forever.

For more info check out the About Naturopathic Medicine page

Here is a great recipe that is a family favourite. Its a great time of year to use fresh peppers from local farmers. This recipe is great because you can easily put your own spin on it and add or remove ingredients according to your preference. For example, replace the ground chicken with organic ground tofu to make it vegetarian. 

THE STUFFING
·      You will need 6 green peppers (green peppers have a more stable bottom; easier to stand them upright on the tray when baking)
·      Grain-Fed Free Range Ground Chicken
·      A handful of almonds, chopped
·      2 cloves of garlic
·      Mushrooms, sautéed in olive oil and onion
·      Parsley, chopped finely
·      A handful of craisins
·      1 cup of basmati rice, cooked and seasoned with curry, salt, chili flakes
·      Spices to season: oregano, basil, chili flakes, salt, pepper, cayenne powder

Preheat oven to 175.
Cook basmati rice.
In a frying pan, add olive oil and sauté 2 minced garlic cloves until golden brown on medium heat.
Add onion and sauté with finely chopped mushrooms.
Add ground chicken and sauté until meat is browned.
Stir in the minced parsley, almonds and craisins and continue to cook on low heat and add in your choice of spices (oregano, basil, chili flakes, salt, pepper, cayenne powder).
Continue to cook for another 10 minutes to allow the spices to create a nice aroma.
Prepare your peppers by washing them thoroughly and cutting the top of the peppers.
Remove the meat from the stove and let cool for a few minutes.
Add your cooked basmati rice into the meat mixture.

THE SAUCE

·      Sauté onions and garlic
·      Use Tomato sauce from a glass container
·      1tbsp of Red Wine to taste
·      1tbsp of Organic Agave Nectar to sweeten
·      Season with spices (oregano, basil, rosemary, chili flakes, cayenne pepper, Himalayan salt)
·      Let simmer for 10-15mins

THE FINISH LINE

Put a tablespoon of your tomato sauce into the bottom of your peppers.
Follow by putting 2 tablespoons of the meat and rice mixture.
Continue layering the sauce and meat/rice mixture until you fill the whole pepper.
Line your baking rack with parchment paper and stand upright.
Place your peppers into the oven and let them bake for 20mins.
Remove peppers and sprinkle with pepper and a pinch of salt.
Serve by pouring a ladle of the tomato sauce on the peppers.

Enjoy!

Beets are the new super food for athletes. Below is a great video that highlights how and why beets are being eaten by top level athletes to naturally increase their endurance. The active ingredient responsible for these benefits are nitrates. Research has show that nitrates are converted by the body into nitric oxide. This occurs rapidly and without some of the limitations associated with L-arginine conversion. The scientific research actually is quite compelling with benefits being found for not just athletes but also for high blood pressure. 

More references:
A Single Dose of Beetroot Juice Enhances Cycling Performance in Simulated Altitude.
Beetroot juice and exercise: pharmacodynamic and dose-response relationships.Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis.
Many more

A recent study published in the prestigious scientific journal Nature Medicine has sent waves through the natural health community by linking L-carnitine, a nutrient in red meat, and heart disease.1 L-carnitine has recently been approved for public use by health Canada and has a large body of research supporting its health benefits. There is research supporting its use in heart disease chronic fatigue syndrome, infertility, erectile dysfunction, chronic obstructive pulmonary disease (COPD), diabetes. Some of the more specific cardiovascular benefits include increased survival after heart failure, increased exercise tolerance in patients with chronic angina, decreased total cholesterol and increased HDL cholesterol patients with hypertension and improvement in muscle recovery after exercise.2-5 How can such a well-studied nutrient all of a sudden cause the very thing that many integrative doctors and patients use it to prevent and even treat?

As with all new research, a closer look is required at the conclusions and methods from the study. Just a brief scan of the abstract and title shows that the intent of the study was not to highlight the negative effects of carnitine but rather show the significance of gut bacteria on the metabolism of cartinine and the possible link to cardiovascular disease.

“Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis.”

The study reported that specific strains of bacteria in mice converted L-carnitine to trimethylamine-N-oxide (TMAO) a compound linked to the formation of atherosclerosis. Furthermore, if mice that were pretreated with antiobiotics (which killed the gut bacteria) did not product TMAO suggesting that the specific strains of bacteria in the gut were the problem. The only human evidence portion of the study reported that people with higher plasma L-carnitine levels predicted increased risks for cardiovascular disease.

While it is easy or convenient to scan the title and summary of the study and conclude that L-carnitine increased the chance of heart disease but it simply does not say that. There is no doubt that vegetarians have a lower rate of heart disease but this study does not prove that L-carnitine from meat causes the problem. It simply shows that your intestinal bacteria can have an effect on the metabolism of nutrients and possibly alter the effects in the body. This actually is not a new concept. Emerging research has linked probiotics and gut flora to seemly unrelated conditions such as obesity, depression, allergies and inflammation. Interestingly, a recent study showed an increase in TMAO levels, foam cell formation and aortic atherosclerosis in mice that were fed phosphatidyl choline (PC), a nutrient commonly used to address cardiovascular conditions. Again, these observations were dependent upon specific gut flora.6

Another important point to remember is that the bacteria found in digestive system of mice varies greatly from that in humans so its premature to extrapolate the results. We should also consider that a diet high in red meat (which also happens to be high in carnitine) may have other negative effects on heart disease independent of carnitine. The human portion of the study showed people with higher plasma L-carnitine levels predicted increased risks for cardiovascular disease however this does not prove cause and effect. There are many things (saturated fat, environmental toxins etc.) found in red meat that can have a negative effect on cardiovascular health. L-carnitine may just be acting as a “biomarker” of red meat consumption rather than the culprit.

When considering new and emerging research it is always prudent to proceed slowly and carefully before drawing broad conclusions. The study discussed above highlights this perfectly and unfortunately media outlets like the New York Times splashed misleading headlines all over North America.7 Its does not show any definitive link between L-carnitine use and heart disease however it does demonstrate that there is a link between our gut bacteria, the formation of potentially harmful compounds that maybe linked to diseases. It also highlights that we need to continue to study nutrients like L-carnitine to fully understand how it is used and metabolized in the body. Based on the conclusions we can say that a person with existing heart disease should consider a move towards a more vegetarian or plant based diet (not just to avoid carnitine) and explore ways to promote a healthy gut flora.

In Health,
Dr Paul Hrkal

References:
1) Koeth RA, Wang Z, Levison BS, et al. Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis. Nature Med. 2013;19(5):576-585. 
2) Cherchi A, Lai C, Angelino F, et al. Effects of L-carnitine on exercise tolerance in chronic stable angina: a multicenter, double-blind, randomized, placebo controlled crossover study. Int J Clin Pharmacol Ther Toxicol. 1985;23(10):569-572.
3) Cacciatore L, Cerio R, Ciarimboli M, et al. The therapeutic effect of L-carnitine in patients with exercise-induced stable angina: A controlled study. Drugs Exp Clin Res. 1991;17(4):225-235.
4) Mancini M, Rengo F, Lingetti M, Sorrentino GP, Nolfe G. Controlled study on the therapeutic effect of propionyl-L-carnitine in patients with congestive heart failure. Arzneimittelforschung. 1992;42(9):1101-1104.
5) De Pasquale B, Righetti G, Menotti A. L-carnitine for the treatment of acute myocardial infarct. Cardiologia. 1990;35(7):591-596.
6) Wang Z, Klipfell E, Bennett BJ, et al. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature. 2011;472(7341):57-63.
7) Kolata G. Culprit in heart disease goes beyond meat’s fat. The New York Times. http://www.nytimes.com/2013/04/08/health/study-points-to-new-culprit-in-heart-disease.html?pagewanted=all&_r=0. Accessed june 26 2013.

For many years artificial sweeteners (AS) like aspartame and sucralose have been suspected of having a wide range of negative effects on our health. Unfortunately it has been difficult to definitely prove and raise public awareness since the stance of most scientists and government experts is that there is no harmful effect at the small doses found in a piece of gum or in a diet soda. However in you take a look at the research a little more closely, there actually is no shortage of evidence pointing to these negative effects. AS do not contain any calories but they have a powerful "excitotoxin" effect in the brain. This means that even though they contains no calories, they overstimulate nerve cells in the brain. This causes a cascade of negative effects including activating inflammation and immune cells to cause chronic damage. AS have also been linked to DNA damage which can lead to the development of mutations and eventually cancer.1 

The research is starting to pile up linking AS consumption to lymphomas, leukemias, cancers of the bladder and brain, chronic fatigue syndrome, Parkinson's disease, Alzheimer's disease, multiple sclerosis, autism, and systemic lupus. After understanding the "excitotoxin" effect of AS in the body, especially in the brain, these diseases should not be a surprise. The real paradox is many people use AS to lose weight but studies actually show the opposite is true. There is no doubt that refined sugar is unhealthy but AS is not better. Since AS stimulate the brain, it promotes more eating later and less portion control. Remember, AS are ULTRA sweet, sometimes 100's of times sweeter than sugar so this can really stimulate the part of our brain that will cause us to crave more sweets later.2 

A link that was always tough to nail down is to cancer. A recent study did show that leukemia risk increased in men who consumed more than 1 diet soda a day. The risk was greater than those that consumed sugar-containing soda. So again, AS comes out worse than even sugar.3 

There are numerous websites and youtube videos dedicated to showcasing the negative effects of AS. Many are hardline, unscientific and dramatic but there are a handful that provide excellent information on the negative effects of AS like aspartame. I encourage you to explore them for yourself to learn about some of the foods that contain AS. Here is a link to a interesting interview with an integrative neurologist, Dr Russell Blaylock, who has dedicated much of his career to educate people on excitotoxins.

I have also attached a really nice review of the topic from a more scientific perspective if anyone is interested. 

The bottom line for me is AVOID them. Even if they were safe (which they are not), they do not help you lose weight and may even cause you to over eat and gain more. They over-excite the brain and most likely cause cancer and neurological dysfunction. AVOID them and choose naturally occurring sugars from fruit, agave and raw honey. 

References
1) Bandyopadhyay A, Ghoshal S, Mukherjee A Genotoxicity testing of low-calorie sweeteners: aspartame, acesulfame-K, and saccharin. Drug Chem Toxicol. 2008;31(4):447-57.
2) Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008 Aug;16(8):1894-900.    
3)Schernhammer ES, Bertrand KA, Birmann BM, Sampson L, Willett WC, Feskanich D. Consumption of artificial sweetener- and sugar-containing soda and risk of lymphoma and leukemia in men and women. Am J Clin Nutr. 2012 Dec;96(6):1419-28    

I have already written extensively about the potential of vitamin C as one of the most promising natural anti-cancer therapies. A new study published in may 2013 has found that anti-cancer concentrations of vitamin C can be achieved using large Intravenous (IV) doses.1 

" Stephenson CM, Levin RD, Spector T, Lis CG. Phase I clinical trial to evaluate the safety, tolerability, and pharmacokinetics of high-dose intravenous ascorbic acid in patients with advanced cancer. Cancer Chemother Pharmacol. 2013 May 14."


While it is still just a phase 1 clinical trial, it is another piece of information that can be added to the growing body of research supporting the safety and potential effectiveness of vitamin C.

As a naturopathic doctor with a clinical interest in integrative cancer care, IV vitamin C is one of my most commonly used therapies. I find it improves quality of life, speeds recovery after chemo or radiation, prevents side effects if used before or duration radiation and can even prevent re-occurance of cancer. Despite common use and positive clinical effects, there still is need for more large-scale research in humans. This study further adds to the human evidence using vitamin C in cancer patients. With this recent study as a backdrop I am going to highlight the basic points of vitamin C use in oncology. 

Here are the facts we do know so far:
1)   Vitamin C does possess direct anti-cancer effects in test-tube and mice models at serum concentrations above 1–5 mM2
2)   Oral doses raise plasma (blood) levels to a maximum of 0.22 mM, well short of a direct anti-cancer effect.1
3)   Doses of greater than 60g of IV vitamin C are required to make plasma levels cytotoxic to cancer cells.3
4)   There have been 3 phase 1 clinical trials to date (now 4 with the most recent study published this month). These trials found IV vitamin C very safe and well tolerated but an anti-cancer effect was noted in only a few subjects. 1
5)   IV vitamin C is safe with the majority of chemotherapeutic agents. There is even some evidence suggesting that it improves effectiveness and reduces side effects.1,4

There are still a number of key questions that remain unanswered in vitamin C research. What is the optimal dosage of IV vitamin C? How often should infusions be done? Is there a consistent anti-cancer effect achievable with high doses?  Each clinician may have a different protocol depending on their interpretation of the evidence or clinical experience. Based on my clinical experience, I have found that there is no doubt that IV vitamin C, multi-mineral and multi-vitamin infusions improve the patient’s quality of life and prevent/resolve side effects associated with chemo or radiation. It is more difficult to discern the effect of high dose vitamin C since there are a number of other natural therapies often being used at the same time. This recent study attempts to shed more light on the effect of high dose vitamin C therapy in cancer patients.

What Does It Tell Us?

This new study pulled on all the experience and expertise of researchers and clinicians that have been working with high dose vitamin C for the last decade. 17 patients with various cancers were enrolled in the 4 week study and a number of different dosage groups were determined. Doses from 30-130g were administered. A specific IV protocol was used (vitamin C, calcium, magnesium and potassium) in order to maintain electrolyte balance during the infusions. The study determined that the optimal dose to maximize vitamin C concentration was 70g. Serum concentrations of 10-20nM were maintained for at least 5 hours at this dose. Higher doses did not have greater concentrations and did not last longer. The most common side effect was nausea and headaches but no serious side effects were noted at any dose. After 4 weeks, none of the patients have a measurable reduction is tumor size. The 4 week time frame is most likely not long enough to see a substantial tumor shrinking effect. Some patients did find an improvement in their quality of life.

So what can conclude from this study?

1)   The safety of high dose IV vitamin C therapy at dose greater than 100g.
2)   Quality of life may improve after 4 weeks but the time frame may be to short to see a substantial tumor shrinking effect.
3)   Doses of greater that 70g are needed to achieve a consistent maximal concentration greater than 30–40 mM in the plasma. We still are not certain what exact concentration has consistent anti-tumor effects in the mice. Based on this study and the other recent research the dose is most likely between 50 and 90g.1,5
4)   A peak concentration of approximately 49 mM was achieved with a dose of 70g with a half life of 2 hours. Concentrations of 10-20nM were maintained for at least 5 hours at this dose.
5)   Doses of greater that 80g don’t provide any additional benefit.

It is nice to see another study using vitamin C in cancer care. I have to commend the authors on a good background of vitamin C evidence and solid study design. The clear short comings are that it did lack blinding and randomization. While definitive evidence is still lacking, we now have a greater understanding of dosage and frequency of treatment. Multiple treatments per week at doses of 70g would most likely yield positive effects according to this study. It is important to remember that vitamin C therapy is not all about a direct anti-cancer effect. Many clinicians report beneficial effects at much lower doses. We still don’t fully understand the many ways that vitamin C works in the human body. I do not doubt that when it comes to cancer, it most likely is impacting multiple pathways that promote the healthy function of our immune system which kills cancer cells and strengthens the supporting structure of healthy tissue around tumors thus impairing growth and spread.  IV vitamin C remains one our best natural therapies against cancer and we eagerly await more research to shed more light on its effects.

In Health Dr Paul

References
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2) Leung PY, Miyashita K, Young M, Tsao CS (1993) Cytotoxic effect of ascorbate and its derivatives on cultured malignant and nonmalignant cell lines. Anticancer Res 13:475–480
3) Riordan HD, Riordan NH, Jackson JA, Casciari JJ, Hunninghake R, Gonzalez MJ, Mora EM, Miranda-Massari JR, Rosario N, Rivera A (2004) Intravenous vitamin C as a chemotherapy agent: a report on clinical cases. P R Health Sci J 23:115–118
4) Verrax J, Calderon PB. The controversial place of vitamin C in cancer treatment. Biochem Pharmacol. 2008 Dec 15;76(12):1644-52.
5) Chen Q, Espey MG, Krishna MC, Mitchell JB, Corpe CP, Bu- ettner GR, Shacter E, Levine M (2005) Pharmacologic ascorbic acid concentrations selectively kill cancer cells: action as a pro- drug to deliver hydrogen peroxide to tissues. Proc Natl Acad Sci USA 102:13604–13609