PS: Dr. Owen is one allowed to post lab reports & images pre & post treatment of various signs or is it against the forum rules?

Tue, 29 Jan 2008 23:08:12

Dear Owen,

Over the last several days I've been researching studies on Vit C in dialysis patients. It is apparent to me now that there is little chance that the dialysis doctors will be willing to go along with our protocol. While many reports document the deficiency of Vit C in these patients, there is a reluctance to prescribe high doses of C for fear of calcium oxalate crystals precipitating in bodily tissues. In the early days of dialysis calcium oxalate crystals not infrequently found their way into the skin and other organs causing morbidity and mortality. More recently, with better methods of dialysis, there have been fewer such cases. However, in a detailed study reported in a recent American J of Kidney Diseases, oxalate levels were shown to rise as Vit C levels rise. - in fact the calcium oxalate saturation levels were exceeded in 40% of the patients!

In the meantime I have talked with an alternative physician in Athens Georgia and he is definitely interested in participating in our study. As you suspected he would be, he is already using C and Lysine in many of his patients, but he feels that he can find a significant number of patients with high Lp(a) levels to enroll in the project. And in studying these patients we will not need to be as concerned with water restriction.

Even though financial reasons preclude our measuring directly resolution of atherosclerotic lesions, we should be able to collect some compelling evidence from a clinical standpoint as to the effectiveness of our therapy.

Mon, 21 Jan 2008 20:44:30

Dear Owen,

Your point about alternative doctors recommending multiple vitamin supplements is well taken. Now, back to the dialysis population and their doctors. I agree with you that dialysis patients would be the ideal group to study- especially long term. This is a group who deserve interventional treatment since their lives are so often shortened from the effects of athrosclerotic disease. It would be great if we could show a significant reduction in morbidity and mortality with such a simple therapeutic program,

All dialysis patients are prescribed a multiple vitamin preparation in which there are varying amounts of vitamin C depending upon the vitamin preparation their doctors choose. So I'm not sure how easy it will be to find patients with elevated Lp(a) levels. That would depend, of course, on a number of factors including patient compliance, amount of Vit C ingested and the amount removed during the dialysis procedure.. My concern is that these doctors might not want to give large doses of vitamin C to their patients. This concern was prompted by a recent report in Reuters about the possibility of a connection between larger doses of vitamin C in dialysis patients and renal lithiasis. I would want them to feel that our protocol is safe.

There are studies measuring levels and clearances of various substances on patients receiving dialytic treatment. Vitamin C is one of those studied and I will need to look up those reports. Since most dialysis patients have little or no urine, giving bicarb would not work. Measuring plasma pH could be done, but probably unnecessary. I think monitoring vitamin C levels would suffice and satisfy the dialysis physicians' concerns of safety. Since dialysis patients are required to limit their intake of fluids and especially those with high K we might have to modify some of the products to be given.

Since we know that 6000 mg of vitamin C and Lysine will lower Lp(a), .... I would like to have a fairly detailed protocol prior to discussing this study with my former associates. Please send me your ideas of specifically how the study would work. I can then give you my input from a Nephrologist stand point. We stand a better chance of these physicians agreeing to participate if we can show that their patients will derive direct benefit from t=
he results we obtain.

Wed, 23 Jan 2008 22:01:33

I sorry for the delay in responding but I've been trying to think this project through in depth and to its conclusion. I do think we can find 20 patients who would be willing participants in a study to determine if their risk for developing ASHD can be significantly reduced by the simple ingestion of Vitamin C and Lysine. But, as I understand your protocol, you want to compare the Vit C and Lysine alone vs. the Tower Ascorsine 9 drink. The question is can we find a physician (or two or more) willing to participate in the study. I might be able to make a case for their trying the Vit
C and Lysine based on the arguments of Rath and Pauling, But adding the Ascorsine mixture to the study, while it might lead to an even greater reduction in Lp(a), is throwing in other variables that have been one of the main criticisms of Rath and Niedzwiecki's paper in the Journal of Applied Nutrition, 1996. So it seems would be the case if we stick to the protocol you have in mind.

Don't think that I'm trying to find every fault that I can with your protocol. I'm trying to look at it from the standpoint of a practicing physician and from the view of a reviewer when we finish the study and submit it for publication. I, personally, would like to see answered definitively this question: Does a combination of Vit C and Lysine effectively and significantly reduce Lp(a) in patients at high risk for ASHD? It would also be interesting and worthwhile to know if a mixture such as the Ascorsine drink can do this even better. But in answering that question it would be much more difficult, in my opinion, to recruit physicians for the resea rch and to get it published.

The bottom line is I think I can line up the physicians and their patient s for a study evaluating the effects of Vit C and Lysine ( and maybe Proline) on lowering Lp(a) in high risk (for ASHD) patients. I would not want to tie in the Ascorsine product to the study. Is this a project that you feel is feasible without the Ascorsine? If so I can star=
t recruiting!

Sat, 26 Jan 2008

Owen,

Stevia could be a problem. It is not supposed to raise blood sugar but there may be some question about it lowering it. The volume and the ingredi ents of the Ascorsine would be more of a problem. These patients are on fluid restriction and the other ingredients in Ascorsine would (?) be of concern to the dialysis doctors.


I understand the dilemma. If we go with C and Lysine vs C with Proline we might establish that one or both of these combinations effectively reduces Lp(a). But we might not find any change. I'm assuming that the case studies you mention as documented in your book show variable results with C and Lysine and/or Proline whereas results with the Ascorsine drink show a more effective lowering of Lp(a)?

There is one well documented report of C and Lysine reducing Lp(a) in vivo. In 2001 a physician reported her own experience (Archives of Int. Med 2001;163) with C and Lysine. At the end of 6 months she had a 48% drop in her Lp(a) levels. Rath and Pauling showed that Ascorbate alone (J. of Orthomol. Med 2001) reduced Lp(a) levels an average of 27%. I'm sure you know of these studies. So is the question: will the Ascorsine drink show a more significant lowering?

I'm thinking that in the dialysis population we would be better of studying the effects of C with Lysine and C with Proline in pill or capsule form - does Tower manufacture both these products? If we decide to use a different group of patients then going with the physicians I mentioned previously would be preferable and I could envision their agreeing to the Ascorsine protocol.

Wed, 12 Mar 2008
Owen,
I agree that dialysis patients could be good candidates for the study except for the fact that the dialysis community (and I have re-reviewed the literature on the subject) is concerned with the effects of high dose C on oxalate metabolism.There have been reports of oxalate deposition in the eyes, heart, and skin of dialysis patients and the concern of some of the doctors managing these patients is that there is a connection between high C levels and the oxalate deposition. Additional studies are needed to help determine safe levels of C. The irony of all this is that many of the patients have low levels of C and may already have early signs and symptoms of Scurvy! I was not aware of this concern in the dialysis community when I first suggested a Vit C trial in dialysis patients.

I feel we should proceed with [alt doc] patients as the subjects of our investigation. From a practical matter (from my experience) patients would probably be willing to have their blood drawn once a month for ascorbate and Lp(a) levels although I am not sure we actually need them this often - it would depend I should think on how long the study is to last. Baseline Lp(a) and C levels in, say 20 patients, 30 if possible. Then select the ones with low C and high Lp(a). And begin the three different supplements. Is this what you envision? I think he is ready to start the study as soon as he knows how the blood testing is to be paid for.

What do you make of the new study in JAMA Nov 12 2008 about C in the non prevention of cardiovascular disease in men? Doses too low? Poor adherence? The results seem straightforward enough.

Haven't heard from you in some time. Are you still interested in the Lp(a) C study? My associate in Athens says he's still interested. So am I. As I mentioned in my previous E-mails the study with dialysis patients was vetoed by the Nephrologists I talked with.

Mon, 24 Nov 2008
I don't think this study would encourage other nephrologists t o give large doses of C to dialysis patients along the lines that you and I were discussing - primarily because the question of safe dose levels of C have not yet been established in the dialysis population. There is still concern as to the effect C has on oxalate levels. Systemic oxalosis used to occur in dialysis patients in the early days when dialysis treatments were inefficient (and when high doses of multivitamins were given).

Oxalate crystals were deposited in the various organs causing significant morbidity and mortality. So far I have not been able to find any report s that show at what levels of C does oxalate begin to be deposited in the tissues.

In any study such as the one we were proposing there would have to be careful monitoring of C levels along with oxalate levels and along with careful monitoring of oxalate deposits in the various organs. You mentioned, I believe, you were interested in retinal evaluation as a means of monit oring CV disease. This would be especially valuable in following such patients. One of my patients in the 60's died from systemic oxalosis with skin, retinal and cardiac manifestations of widespread oxalate deposition.

As I've said before the dialysis population is an ideal one for determining the effects of C on CV complications. If we could design a protocol that took into consideration all of the concerns regarding oxalosis - then we might be able to convince some nephrologists to undertake the research.

Your thoughts.