L-Arginine: dubious supplement marketing

It's a recurring theme that once some biochemical is shown to have a useful or even vital role in the body, someone will produce a supplement and market it on the woo logic that if something is good for you, lots of it will be even better. This is patently nonsense: vitamins, for instance, are crucial to health but are toxic in high doses (as, famously, the explorer Douglas Mawson found out afer eating husky liver). It's even more nonsense in the case of the body's neurotransmitters and other signalling chemicals, which work on specific concentrations. Get the wrong level of dopamine, say, and you'll get radical neurological problems (again famously, as documented by Olive Sacks in Awakenings) But this doesn't matter to supplement promoters: the more you take, the merrier.
      I noticed this syndrome recently in the marketing of L-Arginine. The 1998 Nobel Prize in Physiology or Medicine was awarded to Furchgott, Ignarro and Murad "for their discoveries concerning nitric oxide as a signalling molecule in the cardiovascular system". Nitric oxide, they discovered, turns out to have a crucial role in various functions: blood pressure control, heart action, neurosignalling in relation to the gastronintestinal tract and memory formation,, as a biocide in the immune system, and in penis erection. It's synthesised in the body by an enzyme, nitric oxide synthase, acting on a common amino acid L-arginine, which is actually nonessential, as it's synthesised in the body.
      Given this role, it can easily be imagined that levels are critical. The vascular damage seen in diabetes appears to be down to low levels; conversely, the lethal shock seen in severe infections is down to overproduction of nitric oxide. The precursor to the nitric oxide, L-arginine, may itself be a double-edged sword: one study at Johns Hopkins had to be brought to a halt on safety concerns after L-arginine supplements appeared to worsen the risk of death in patients recovering from heart attack (see L-arginine Supplements Linked to Increased Risk of Death in MI Patients). What's the response of supplement vendors to this complex situation? Take moar L-arginine!

Bearing that in mind, about a week back I saw in the Exeter Express & Echo featured a story, Firm promotes body products: "A company specialising in offering a new dietary supplement range has a promotion in Exeter tomorrow.The founders of Arkworld claim their products can reverse biological age and repair, restore and rejuvenate the body through circulation". Arkworld is fairly ghastly in four respects. One, it's a multi-level marketing scheme. Two, it's designed around some laboured Biblical metaphor: "Everything we do as a company is going to be built around the Ark Story". Three, bad puns on the word Ark ("The Marketing Plan or should we say, Arketing Plan"). Four, the simplistic assumption that guzzling L-arginine is automatically good for you.
      Needless to say, their ADNO – Arginine Derived Nitric Oxide page doesn't tell you we synthesise our own ("Your body uses Arginine an Amino Acid we absorb from food") and simply asserts that more of it makes everything work better in all the systems where nitric oxide is involved. And that, of course, is achieved via two arginine supplements, Ark1 and Ark2, as well as the PINKDrink.
      The PINKDrink website makes a number of grandiose claims. "Nitric Oxide is referred to by scientists as the 'Miracle Molecule'" (nope: only on sites selling L-arginine supplements such as miraclemolecule.co.uk - and it needs to join the queue behind phosphatidylcholine, water, P57, DMT, melatonin, omega-3 and no doubt many more). "Arkworld's products have been created by leading scientists and product formulators, including the legendary Jeff Golini who cracked the Creatine Code". Legendary where? Apparently only on sites selling his body-building product Kre-Alkalyn, and for some reason this groundbreaking work doesn't appear in PubMed. Golini is one of the group behind Arkworld, listed as doctors though rather than medical doctors the group appears to be a mix of technical and marketing people headed by a dentist and a naturopath. As leading scientists, it's remarkable how few Google hits they get.
      The site also mentions the PINKDrink appeared on the BBC's Inside Out, which may be true but if you watch the clip from this episode about CADASIL sufferer Jack Shields, its role is fairly subliminal, as a brief glimpse of some powder said to be L-arginine. There's also an interesting factoid that "Columbia University refers to L-arginine as the 'magic bullet' for the cardiovascular system. Over 10,000 L-arginine citations were compiled by Columbia University researchers in their quest to document the clinical benefits of this simple amino acid". I have been unable to find a citation for this claim.

Addendum: if you want to comment, read the comments policy first. If you have actual evidence that I'm wrong - peer-reviewed research - by all means comment.  But I will bin any comments that just tell me I'm wrong and link to some promotional/sales website.

Poor reportage fires up Rife supporters

Via a Bad Science thread - Garage Invention Alternative for Chemo? - this ABC News piece, Cancer Victim Invents Possible Chemo Alternative, which tells the story of John Kanzius, a radio entrepreneur, engineer and cancer-sufferer, who has "invented the first generation of what would become a machine that uses radio waves -- not radioactivity -- to fight cancer". It goes on to mention the work of Dr. Steven Curley of the MD Anderson Cancer Center at the University of Texas. "Curley and his colleagues at the center took Kanzius' made-in-the-garage invention very seriously. They began testing the radio-wave technology on animals, and say they completely destroyed liver cancer tumors in rabbits".
      As the comments page and Google show, this has brought out of the woodwork fans of Royal Rife, who see this as vindication of Rife's pseudoscientific radio-based therapy machines. Wrong. A look at the original news release, Radio Waves Fire Up Nanotubes Embedded in Tumors, Destroying Liver Cancer, shows that the ABC News story has omitted a critical detail: the radio waves alone don't do anything. The method works only when the cancerous cells are primed with a radio-absorbing substance, in this current work carbon nanotubes, which heats up and kills them. Kanzius' patent is readable online - Canadian Patents Database CA 2562625 - and makes perfectly clear that heat generation by an RF-absorbing target material is intrinsic to the method. This does not support claims for Rife machines to destroy cancerous cells by targeting purported frequencies of the cells themselves.

Scam medicines: no new thing

Via a Bad Science topic: George Fulford and Victorian Patent Medicine Men: Quack Mercenaries or Smilesian Entrepreneurs? (PDF), an interesting article at the Canadian Bulletin of Medical History. Looking to the late 19th century, there are strong parallels with the present-day animosity between between mainstream medicine and quackery.
      The article focuses on what it argues was the more benign side of the business: patent medicines such as antacids and laxatives that maybe even did a little good. Nevertheless they came with extravagant claims that went well beyond their actual effect. Clarke's Blood Mixture, an iron supplement, claimed to treat "scrofula, scurvy, sores of all kinds, skin and blood diseases". Then as now, it was big business: the maker of Clarke's Blood Mixture, advertised in The Times, could afford to spend £20,000 a year on advertising. Also as now, they leaned heavily on testimonials rather than proven evidence. Encouragingly, the consumer sometimes won: in the classic Carbolic Smoke Ball Case and Medical Battery Case, vendors were successfully taken to court when their remedies failed to deliver.
      On the downside, sometimes court appearances made no difference. In 1905, in the Bile Beans Case, the maker of the laxative Bile Beans unwisely tried to sue an imitator, and was forced to disclose in court that the product's backstory ... Charles Forde, an eminent scientist, thoroughly investigated the healing extracts and essences of Australian roots and herbs and after long research he found himself the discoverer of a natural vegetable substance which was beyond all doubt the finest remedy yet discovered ... was totally fictitious. This didn't stop the product continuing to sell, successfully, well into the 1980s. Interactions between the British and American Patent Medicine Industries 1708-1914 (PDF) gives further insight into the large market for such products in the past.

Tangerine dreams

From the BBC, Tangerine peel 'kills cancer': the latest in a standard news formula of some substance that has been shown to kill cancer cells in the test tube, but without clinical trials to show whether or not it will do the same in patients. I picked up on this one because it's an interesting example of news reports that don't tell the full story. The article says:

A team from Leicester School of Pharmacy found Salvestrol Q40 was turned into a toxic compound in cancer cells, destroying them ... Lead researcher Dr Hoon Tan said his work was still at an early stage, but together with his colleagues he has formed a company to investigate further the potential to develop natural anti-cancer therapies".

This sounds very early days. You'd not guess from this rather cautious and academic description that the company concerned, Nature's Defence, is well under way promoting and selling Salvestrol to consumers through the sites Fruit Force, Salvestrolwellbeing.com and Campaign Against Perfection (all registered to Nature's Defence) as well as training resellers and naturopathic practitioners in Canada (Salvestrol.ca). Nor is it a very new story: a year ago, in Trademarked Science Trade-Offs, Le Canard Noir covered the same topic, questioning the ethics of what appears to be overpromotion: marketing a substance as having specific effects before clinical trials have demonstrated any such thing in vivo.
      As mentioned in the 2006 BBC story about the same group, Fruit 'could provide cancer hope', Cancer Research UK "does not endorse any supplement or drugs which have not been rigorously tested in clinical trials". And rightly so: the Cancer Act 1939 still stops anyone advertising anything that can be construed as offering a cure for cancer. Unsurprisingly, then, none of the UK Nature's Defence sites mention the c-word or are specific on what Salvestrol does - only that it's some kind of beneficial phytonutrient that needs topping up in the modern diet. (I wonder if they had to backtrack from their original 2004 website that skated far closer to explicit claims of anti-cancer action for their supplements - see Introducing Salvestrol Therapy). But now they don't need to say it: that part is neatly filled in by the BBC story, which is free to report the anti-cancer action because it's divorced from the commercial context and framed purely as a blue-sky academic possibility.
      One area where the BBC could improve its health coverage would be to take more care over stories that give, however inadvertently, publicity or endorsement to unproven neutraceuticals. A classic example, as Language Log noted in 2005 - Enhance breast size by 80% - was the free gift the BBC gave - Chewing gum can 'enhance breasts' to vendors of a breast-enhancement chewing gum. Google "Bust-Up Gum" BBC and see how many vendors are citing the story.

Homeopathic legal chill

This looks worth following. Check out Professor David Colquhoun's weblog Improbable Science for a new posting, Society of Homeopaths: cowards and bullies.
      This concerns a post at the Quackometer, The Gentle Art of Homeopathic Killing, which strongly condemned the Society of Homeopaths' continung failure - unlike the Faculty of Homeopathy - to cease endorsing the dangerous fiction that homeopathy can protect against malaria (and indeed failure to enforce its own rules against members making claims, expressly or implicitly, to cure named diseases).
      Rather than addressing these issues, the Society of Homeopaths chose to get the post removed by legal chill, and complained to The Quackometer's service provider. Not the best of tactics: this egregious move has actually guaranteed the article's discussion, and dissemination to sites less likely to cave in to pressure. More at Improbable Science.