© Whole Foods Magazine
Stop America’s #1 Killer
An interview with Thomas E. Levy, M.D., J.D.
By Richard A. Passwater, Ph.D.
I have written many, many times about vitamin C in this column. Of course, vitamin C is essential to life, but few are aware of the evidence that we need much more vitamin C for optimal health than suggested by the dietary reference intakes (DRI) and the recommended dietary allowances (RDA). The media seems to particularly like to point out studies that suggest vitamin C is not so important. They are quick to headline “junk science” that suggests that vitamin C doesn’t perform one miracle or another. The funny part is that no one in our field ever claimed that vitamin C could resurrect the dead. Where do these ideas come from?
Well, it’s time to get back to the basics with vitamin C. In the 1970s, I had the honor and privilege of lecturing along with vitamin C pioneers including Drs. Linus Pauling, Albert Szent-Gyorgyi, Robert Cathcart, Frederick Klenner, Abram Hoffer and Irwin Stone. Figure 1 is a group photo of speakers at the World Congress honoring the 50th anniversary of the discovery of vitamin C (Palm Springs, CA March 18–19, 1978). I spoke on “Ascorbate Power” and the “Synergism Between Vitamin C and Selenium.” It doesn’t seem like nearly 30 years ago. That year we were celebrating the 50th anniversary of vitamin C and this year, we are celebrating the 50th anniversary of coenzyme Q10 (CoQ10). Time flies!
PHOTO CAPTION: The World Congress speakers honoring the 50th anniversary of the discovery of vitamin C (Palm Springs, CA March 1978). Plaque Awardees are: Front row (seated) from the left are researchers Herb Boynton, Irwin Stone, Drs. Albert Szent-Gyorgi, Lyle A. Baker, Richard Passwater, James Greenwood, Jr., and B. F. Hart. Fred Klenner. Second Row; Jay Patrick, Drs. Robert W. Lupo, Richard P. Huemer, R. Geoffrey Broderick, Treesa W. D. Currier, Robert L. Harmon, Wendell O. Belfield and Frederick R. Klenner. Top Row; Drs. William J. Saccoman, Alfred Libby, Robert L. Erdmann, Abram Hoffer, Robert F. Cathcart III, Hans Kugler, and C. Richard Hicks
After all these years of research that further elucidated the biochemistry and health benefits of vitamin C, I felt that the message was well understood. I guess not. The media doesn’t seem to understand. Therefore, I plan to devote several columns to vitamin C to review the fundamentals. I will first call upon cardiologist Dr. Thomas Levy.
Thomas E. Levy, M.D., J.D., is a board-certified cardiologist and the author of Stop America’s #1 Killer: Reversible Vitamin Deficiency Found to be Origin of ALL Coronary Heart Disease, Curing the Incurable: Vitamin C, Infectious Diseases and Toxins, plus three other ground-breaking medical books. He is one of the leading vitamin C experts in the world and frequently lectures about the proper role of vitamin C in the treatment of a host of medical conditions and diseases to medical professionals all over the globe. His latest book, Stop America’s #1 Killer, makes a compelling scientific case for the fact that atherosclerosis (i.e., narrowed and blocked arteries), the primary cause of heart death in the world today, is easily prevented and even reversed when enough vitamin C can continually bathe the inner lining of the arteries supplying the heart.
Passwater: Dr. Levy, why did you decide to become a cardiologist?
Levy: I am not completely sure why the heart has always fascinated me. When I was in the sixth grade in elementary school, I wrote a term paper on the heart and heart disease. Also, shortly after I began my first year of internal medicine residency at Tulane Medical School, I made an appointment to see the head of the Cardiology Department, where I expressed my desire to receive training in cardiology after my residency was completed. I always knew cardiology would be my chosen field, while most of my colleagues never seemed to be completely sure of their career choices.
In addition to my long-standing interest in the heart, I had always considered the best of the cardiologists to be the “master internists.” That is to say, it always seemed that the cardiologists were the most complete of medical doctors, commanding a greater knowledge of the total human medical condition than the many other internal medicine subspecialties. As well, cardiology always appeared to be the best area of medicine for making a difference in the quality of a patient’s life, beyond whether a chronically ill patient just continued to survive. Doctors who treated chronic pulmonary, neurological, hepatic, renal and blood diseases just never seemed to help that much, especially when compared with what the cardiologist could do for many of the heart patients.
Passwater: The last thing I would expect a cardiologist to do is wrote a book on vitamin C. What drew your interest to vitamin C?
Levy: I suppose this is where the forces of fate and destiny took a very active role in my life. Just over 10 years ago, I met Dr. Hal Huggins, the leading anti-mercury amalgam dentist in the world. At the time, Dr. Huggins had a clinic in Colorado Springs, where patients literally from around the world came to him for mercury amalgam removal and the removal of other forms of dental toxicity. In working as a medical consultant to Dr. Huggins, I became very impressed very rapidly with the amount of improvement that a diverse array of patients achieved in a very short period of time when their dental toxicity was appropriately addressed and removed. And it was in these patients that Dr. Huggins always gave 35–50 grams of vitamin C intravenously during the multi-hour sessions in the dental chair. The absolutely sickest of patients, including many who were wheelchair bound, would immediately feel fabulously after extended periods of dental work. I certainly never before had seen patients with different advanced degenerative diseases get several teeth extracted on one side of the mouth and promptly feel so good that they wanted to go out and eat a steak on the remaining teeth in the mouth the same evening of treatment. It wasn’t too long before I realized that these intravenous infusions of vitamin C must be having some very amazing effects inside the bodies of these very ill patients. I then realized that my life as a physician could never and would never again be the same. I had to find out and report on all that I could scientifically gather about toxins, vitamin C and health. It was a direct result of these experiences with Dr. Huggins and vitamin C that my first book, Uninformed Consent: The Hidden Dangers in Dental Care, was co-authored with Dr. Huggins in 1999.
Passwater: Why would you go to the trouble and bother of writing a book on vitamin C? It might even cause many other cardiologists to shun you.
Levy: I can never know when a medical colleague is being intellectually honest in rejecting any or all of the information that I have submitted to medicine and the public in my books and lectures. Subsequently, I can never sit in judgment on the mind, heart and soul of a physician who would attack my life’s work with tremendous venom and little or no scientific analysis. However, I can only do what I believe I have always done: continue to pursue what is best for my patients, wherever that may lead me. And it has now lead me to a clear scientific conclusion: Atherosclerosis, or coronary heart disease, is nothing more (or less) than what results from the presence of a chronic arterial scurvy, or vitamin C deficiency, in the arterial walls. My book, I believe, scientifically concludes that all known heart disease risk factors ultimately cause and mediate their pro-atherosclerosis effects through the final common denominator of a vitamin C deficiency in the intimal, or innermost lining, of the arterial wall. If this is true, as I believe the scientific evidence indicates, then it is of no importance to me whatsoever how other cardiologists regard me. Sure, it would be great to be loved and respected, but that is not the goal. If that eventually happens in my life, then great. I am only human, and affection is always better received than hostility and rejection. However, the only thing that counts is that the many patients who have put their lives and trust in my hands receive the most honest and competent medical care possible. If anyone can scientifically rebuff my medical claims, then I welcome that information and I can then take a different direction for the remainder of my life.
Passwater: What I particularly liked about your book—beside the science involved—is the way that you present the evidence much in the manner that a lawyer would in a trial. You are a JD. Why both cardiology and law? Does your extensive legal training help your scientific presentation?
Levy: This is difficult to answer in a completely logical manner. When I entered law school in 1995, it seemed at the time the next logical step for me to take in my life. I knew that I would face unknown legal obstacles in the future, as I had already witnessed working with Dr. Huggins. But I had the time, the money and the motivation, so I just jumped in with both feet, feeling all of my goals would ultimately be best served with a legal foundation ultimately supporting my medical pursuits. Although I passed the Bar for practicing law in both Colorado and the District of Colombia, I have not yet “practiced” law for a single day in my life.
I am pleased that you have noted the manner in which I have presented medical evidence in my books. In Curing the Incurable, that was precisely my goal. I wanted that book to serve as a solid support, in a court of law if need be, for any practitioner who was being legally pursued for the use of intravenous vitamin C. It still amazes me how many physicians truly believe that 50 grams of vitamin C intravenously will kill you, or at least surely destroy your kidneys. With that level of ignorance existing in the “highest” levels of medicine, we must accumulate as many objectively compiled pieces of evidence supporting the benefits of vitamin C as possible. So, yes, I feel my extensive legal training has had a significant impact in my scientific approach and objective analysis toward medicine, especially in my writings.
Passwater: What are some of the ways that vitamin C protects us against heart disease?
Levy: Although the mechanisms are the essence of the book, Stop America’s #1 Killer, there are a few points that can be emphasized. First of all, as a widely distributed and powerful antioxidant, vitamin C prevents the effects of oxidative stress in the arterial wall. This not only prevents the directly negative impact of free radicals and other pro-oxidants that might accumulate in the artery and damage it structurally, but it also prevents the immune cell-mediated response to unneutralized oxidative stress, which is perhaps the most important mechanism in the initiation and propagation of atherosclerosis. It is actually the body’s chronic attempt to repair and neutralize oxidative stress resulting from a localized vitamin C deficiency that initiates the accumulation of monocytic and phagocytic cells in the arterial wall. Second, vitamin C is the primary regulator of the quantity and quality of collagen in the arterial wall (and elsewhere). This directly affects how strong the blood vessel is and how resilient it is to multiple factors that could cause damage to it.
Passwater: What are your thoughts about the RDA for vitamin C and how much should we take for optimal health?
Levy: To recommend a daily intake of less than 100 mg of vitamin C is incredibly irresponsible at best. At worst, it is tantamount to assuring the victim of this recommendation a life sentence of one or more forms of chronic degenerative disease, only one of which is coronary heart disease. Vitamin C is much more than a vitamin that prevents flagrant clinical scurvy when taken in low doses; it is probably the most important nutrient that one can take on a daily basis. As such, there is no really well-defined upper limit to the amount of vitamin C that is best taken. As long as one has normal renal function and remains well-hydrated, the more one takes, the better. The recommendation to consume an amount daily of vitamin C that can be as little as 0.1% of the optimal daily amount not only ensures the eventual deterioration of health, but it also is an enormous insult to the integrity of thousands of vitamin C researchers who have diligently published article after amazing article in the medical literature over the past 60–70 years.
Passwater: There have been some fairly recent studies supporting your contentions. What about the “Higher Plasma Vitamin C Levels Associated with Reduced Coronary Artery Disease Risk” article?
Levy: A report published in the September 2006 issue of the British Journal of Nutrition revealed another promising finding derived from the EPIC-Norfolk cohort study, a prospective population study of 25,663 men and women aged 45–79 residing in Norfolk, England. S. Matthijs Boekholdt of Academic Medical Center in Amsterdam and colleagues at Cambridge University in England found that having higher plasma vitamin C (ascorbic acid) levels is associated with a lower risk of developing coronary artery disease independent of traditional risk factors and C-reactive protein (CRP) levels. C-reactive protein is a marker of inflammation whose serum levels were confirmed as predictor of death from coronary artery disease in earlier research led by Dr. Boekholdt.
EPIC-Norfolk participants completed health and lifestyle questionnaires between 1993 and 1997, and were followed until January 2003. Blood samples obtained during the subjects’ initial clinic visit were analyzed for total, LDL, and HDL cholesterol, C-reactive protein, vitamin C and other factors. Some 979 individual who were without history of heart attack or stroke at the time of their initial clinic visit developed fatal or nonfatal coronary artery disease during the follow-up period. These participants were age and gender matched by the researchers with 1,794 control subjects.
Increasing plasma levels of ascorbic acid were found to be associated with younger age, lower body mass index, lower systolic and diastolic blood pressure, reduced CRP and higher HDL levels. Participants whose vitamin C levels were in the top one-fourth of participants had a 33% lower risk of future coronary artery disease compared with those in the lowest fourth. The association was found to be independent of such traditional risk factors as age, diabetes, smoking, LDL or HDL cholesterol, systolic blood pressure and CRP level.
The authors explain that the free radical scavenging effect of ascorbic acid may help protect the arteries from developing atherosclerotic lesions. In addition, the vitamin helps reduce the oxidation of LDL particles. However, inflammation caused by atherosclerosis produces reactive oxygen species that reduce blood antioxidants which include vitamin C, leading to uncertainty concerning whether diminished ascorbic acid levels are a cause or an effect of the disease.
Although an inverse relationship has been observed previously between ascorbic acid and CRP levels, the authors conclude “that the risk reduction [in coronary artery disease] associated with higher ascorbic acid plasma concentrations, a marker of fruit and vegetable intake, is independent of classical risk factors and also independent of CRP concentration.”
I believe this study is solid evidence of the importance of vitamin C in preventing the development of coronary heart disease. The authors are right to be a bit confused as to whether low vitamin C levels are a cause or an effect of evolving atherosclerosis. In fact, both suggested scenarios are true. Vitamin C is consumed by the atherosclerotic process itself, and a preexisting low vitamin C level is the primary factor in the initiation and early development of atherosclerosis.
Passwater: Another fairly recent study is “Vitamin C (Ascorbic Acid) Supplements Improve the Response of the Sympathetic Nervous System During Exercise in Patients Who Have Had a Heart Attack (Myocardial Infarction),” published in the International Journal of Cardiology.”
Levy: The sympathetic nervous system is a part of the nervous system that controls heart rate and other involuntary body responses. Patients with heart disease sometimes have poor sympathetic function, the authors explain, but whether or not antioxidants can improve this complication remains unclear.
It is unclear to me exactly what Dr. Kazuyo Kato and colleagues from the Nippon Medical School in Tokyo are asserting regarding antioxidants and the sympathetic nervous system from the above paragraph. However, it is well-documented that vitamin C plays a prominent role in the blood flow in both veins and arteries. In arteries, vitamin C has been shown to block or relax spasm of the vascular musculature. Similarly, vitamin C has been shown to help dilate veins and improve blood flow.
Passwater: In your book, your “Exhibit 5” states that when the intercellular glue in the arteries becomes watery due to lack of vitamin C, the first step in atherosclerosis has taken place. Please elaborate.
Levy: The intercellular glue is a gel-like framework in which the cells of the blood vessel walls are imbedded. Comprised of large interconnected molecules called glycoproteins, the blood vessel wall remains healthy as long as these interconnections are maintained. However, when vitamin C is deficient in the blood vessel wall, these interconnections are broken, and the intercellular glue no longer can maintain its more rigid, gel-like nature. Instead, it becomes loose, runny and watery.
Once a localized vitamin C deficiency has allowed the intercellular glue to become loose and watery, this change in the physical consistency of the intercellular glue is felt to be associated with a more water-soluble nature. After this occurs, substances such as calcium, cholesterol and fats are free to abnormally diffuse into the blood vessel wall. The immune system is then activated to try to engulf and eliminate these substances, and the early phase of atherosclerosis has begun.
Passwater: I also find your “Exhibit 14”entitled, “Human arteries are commonly depleted of vitamin C . . .” interesting. Please elaborate.
Levy: This finding explains the derivation of the term “arterial scurvy.” Arterial scurvy is a form of focal scurvy, in which the cells lining the inside of the artery become selectively depleted of vitamin C, relative to the rest of the body. The most common reasons for such a depletion are inflammation and infection. When significant dental toxicity, a factor strongly associated with atherosclerotic heart disease, is present in the mouth and gradually released into the bloodstream, the inner wall of the artery is the first significant area of the body subjected to these microbes and microbial debris. Microbes and their toxic debris are both strong consumers of vitamin C as they induce localized inflammation and infection, and it follows that a focal vitamin C deficiency subsequently develops in the inner arterial walls, allowing the initiation of atherosclerosis as described above. Thus, the concept of arterial scurvy is very real and very descriptive of what is taking place in the blood vessel, not just a catchy phrase.
Passwater: Also, in your book, you string together a group of “exhibits” that really drive home a common point. What is the take-home message of your exhibits 25–27 and 30–33?
Levy: It has been shown that a localized vitamin C deficiency can cause cholesterol accumulation in the arterial walls, even when cholesterol was not added to the diet. This finding is especially important in appreciating how the vitamin C deficiency-induced changes in the arterial wall are the most important factors in determining subsequent cholesterol accumulation. More cholesterol in the diet and circulating in the bloodstream are just additional factors that accelerate the rate of cholesterol accumulation. However, the changes in the arterial lining alone are sufficient to initiate and propagate cholesterol accumulation there, even when a large amount of cholesterol is not present in the bloodstream.
Supporting these concepts further, research has documented that the characteristic lesions of atherosclerosis can be induced in guinea pigs solely by depriving them of sufficient vitamin C intake. It was also demonstrated that when guinea pigs were fed increased amounts of cholesterol, injections of vitamin C would prevent the development of arterial scurvy and the subsequent development of atherosclerosis. This finding was also reproduced in rabbits, as vitamin C administration was found to lessen the severity of atherosclerosis induced by a diet high in cholesterol and hydrogenated fat. The logical conclusion reached was that a sufficient vitamin C deficiency in the arterial wall made it easier for cholesterol and fats, whether elevated or not, to start depositing focally and initiating atherosclerosis.
Sophisticated research examined the movement of radioactively tagged cholesterol in rabbits. The findings of these researchers demonstrated at least a two-fold effect of vitamin C in the arteries of these animals. Less new cholesterol penetration into the arterial wall was noted, and an increased release of cholesterol already present in the arterial wall was noted as well.
Additional interactions of vitamin C and cholesterol have also been reported. High doses of cholesterol appear to be directly toxic to the body. Just like any other toxin that consumes or neutralizes vitamin C, high doses of cholesterol fed to rabbits and other animals results in a drop in active vitamin C levels in both plasma and cells. Conversely, it has been shown in humans that the chronic administration of vitamin C significantly reduced cholesterol levels.
An enzyme known as lipoprotein lipase, which helps to metabolize triglycerides and clear the clouded plasma seen after eating, shows substantially elevated levels in patients supplementing vitamin C. This finding is further supported by very substantial reductions of plasma triglycerides seen with vitamin C supplementation.
Passwater: Any comments about vitamin C and lysine in combination?
Levy: Vitamin C and lysine administered together appear to have a wonderful synergism in stopping/reversing atherosclerosis. The work of Linus Pauling indicated that lysine in supplemental form would help to debulk existing atherosclerosis lesions by binding to the strongly proatherogenic agent, lipoprotein(a) and facilitating its removal from those lesions. He also asserted that such binding with lysine would help prevent the initial binding of circulating lipoprotein(a) into developing plaque. The vitamin C would work well at preventing further atherosclerosis from developing, while the lysine is a great agent for actually reducing the size of atherosclerotic plaques already present.
Thanks, Dr. Levy. Your book is “must reading” for all interested in good health.
© 2007 Whole Foods Magazine and Richard A. Passwater, Ph.D.
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