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Stop fixing the adaptive response: why cardiovascular disease should be named chronic scurvy.

Note: In this article, the terms "chronic scurvy," "heart disease," and "cardiovascular disease" (CVD) refer to the accumulation of damage, most commonly in the coronary arteries, that is associated with high blood pressure, plaque deposits, and the increased incidence of heart attacks. This condition is also known by several other terms, such as "coronary artery disease" (CAD), "atherosclerosis," "hardening of the arteries," and "coronary heart disease" (CHD).

Introduction

Linus Pauling, PhD, championed a nutritional treatment for CVD/chronic scurvy called Pauling Therapy. It is based on research into the relationship between CVD and vitamin C and was first publicly described in 1991. In the 25 years since, despite its exceptionally high success rate, this therapy has rarely been used by mainstream cardiologists.

This article discusses renaming the condition from CVD to "chronic scurvy," which would focus attention on the true location of the pathology and, ideally, lead many more people to use Pauling Therapy to treat CVD.

The History of Pauling Therapy

The earliest known public pronouncement of the Pauling Therapy was in 1991, when Linus Pauling and Mathias Rath, MD, examined a body of research and concluded that there was a connection between vitamin C and CVD. That connection was based upon the observation that CVD is, at its core, an accumulation of damage to the collagen and elastin fibers in the artery walls. Vitamin C is required for the creation of replacement collagen fibers, as discussed in Pauling and Rath's resulting 1992 paper. Pauling and Rath's paper concludes:
   In this paper we present a unified
   theory of human CVD (cardiovascular
   disease). This disease is the direct
   consequence of the inability of
   man to synthesize ascorbate in
   combination with insufficient intake
   of ascorbate in the modern diet. Since
   ascorbate deficiency is the common
   cause of human CVD, ascorbate
   supplementation is the universal
   treatment for this disease. The
   available epidemiological and clinical
   evidence is reasonably convincing.
   Further clinical confirmation of this
   theory should lead to the abolition of
   CVD as a cause of human mortality for
   the present and future generations of
   mankind. (1)


Such was the success of their treatment therapy that perhaps Pauling and Rath then dusted off their hands and thought to themselves, "Done with that disease." Unfortunately, the rest of the world has moved at a glacial pace in taking advantage of their breakthrough ideas.

Although Pauling and Rath's resulting treatment has yet to hit mainstream medicine, it has not fallen entirely on deaf ears. The small group of people who are confident to research their own medical challenges and make their own medical decisions have frequently discovered some version of Pauling Therapy and are routinely reversing their CVD/chronic scurvy. (2) But what about the vast majority of people who depend upon conventional medicine for their heart disease treatment choices? When will they be advised by their cardiologists that their heart disease can be reversed in a matter of months instead of being mired in a managed disease for the rest of their lives? What follows is an attempt to point out what has gone wrong and how it might be fixed.

The Conventional Viewpoint

The conventional viewpoint for preventing and treating CVD is to focus the discussion on the plaque deposit-blood clot combination.

A person's perspective of plaque deposits may be theoretical--as in the case of a relative or friend--or it may be more visceral, as in the case of a medical professional or coroner. Once an individual sees the big, ugly plaque deposits that certainly played a large part in killing a friend or family member or patient, their attention is held. Upon examination, this deadly glob, which looks as far away from a healthy artery as possible, invokes a sense of repulsion. It then dominates the person's emotions and thoughts about treatment and prevention.

Doctors are often asked to look at a system that has failed, analyze what went wrong, and propose a solution. In the case of death from heart attack in a patient in whom a plaque deposit suddenly became 100 percent blockage, doctors instinctively look at the plaque deposits and then work backward. Almost all medical proposals refer to the deadly plaque deposit. Medical professionals discuss the fatty nature of the plaque, the cholesterol, the calcium buildup, the blood clot, how to remove these problems, and how to prevent them.

The medical community has been proposing solutions for heart attacks caused by these plaque-blood clot combinations for decades, but heart disease still remains the number one disease cause of death. (3)

A Holistic Viewpoint

The holistic approach for treating CVD is quite different. To understand how the nutritional treatment of chronic scurvy works, the plaque deposits must be viewed from a different perspective. If the disease itself is to be found, the area underneath the plaque deposits must be examined. It is there that weak and damaged artery walls are found. Patients who have plaque deposits in the coronary arteries have chronic scurvy.

Scurvy is essentially a bleeding disease. Chronic scurvy differs from "normal" scurvy only in degree and the body's response. Both have at their core the inability to repair and replace collagen fibers in the vascular tissue, which leads to the resulting failure of that vascular tissue to contain the blood. The difference between the two conditions of scurvy appears because whereas scurvy results from several months of near-zero levels of vitamin C, chronic scurvy results from years, if not decades, of inadequate levels of vitamin C, which allows the body a chance to mount a secondary defense.

Relevant comments from the Pauling and Rath paper state:
   The invariable morphological
   consequences of chronic ascorbate
   deficiency in the vascular wall are
   the loosening of the connective
   tissue and the loss of the endothelial
   barrier function. Thus human CVD is
   a form of pre-scurvy.

   The multitude of pathomechanisms
   that lead to the clinical manifestation
   of CVD are primarily defense
   mechanisms aiming at the
   stabilization of the vascular wall
   [emphasis added]. After the loss of
   endogenous ascorbate production
   during the evolution of man these
   defense mechanisms became lifesaving.
   They counteracted the
   fatal consequences of scurvy and
   particularly of blood loss through the
   scorbutic vascular wall. (4)


The arteries are a high-pressure system compared to the veins, and a primary purpose of the artery is to contain the body's blood. If enough damage accumulates in one area of an artery, it may become weak enough that breakthrough bleeding occurs.

Whenever there is damage to artery walls, the first order of business is to repair the damage. These repairs require a collection of nutrients. But what happens if one or more of those nutrients are absent or in short supply? Repairs get backlogged, and the arteries get weaker.

When the arteries get to the point where breakthrough bleeding becomes a danger and the required repairs cannot be made due to nutrient deficiencies, the body has a "Plan B." It builds up a layer of material on the inside of the artery wall to protect the damaged artery wall against the force of the blood pressure. This, of course, is plaque deposits but could be called "nature's perfect Band-Aid." This phrase can be used to remind people that the plaque deposits are not pathological but instead are an adaptive response to weakened artery walls. The body purposely develops plaque deposits, and they are saving the patient's life by preventing the possibility of breakthrough bleeding.

A quote from the Pauling and Rath paper shows that this idea was proposed 25 years ago:
   The genetic countermeasures are
   characterized by an evolutionary
   advantage of genetic features and
   include inherited disorders that
   are associated with atherosclerosis
   and CVD. With sufficient ascorbate
   supply these disorders stay latent.
   In ascorbate deficiency, however,
   they become unmasked, leading to
   an increased deposition of plasma
   constituents in the vascular wall and
   other mechanisms that thicken the
   vascular wall. This thickening of the
   vascular wall is a defense measure
   compensating for the impaired
   vascular wall that had become
   destabilized by ascorbate deficiency. (5)


The positive resolution of this scenario involves making sure that the nutrients required to catch up on the backlog of vascular tissue repairs are in abundant supply. When these nutrients are adequately supplied and the arteries are repaired (thus removing the reason for the plaque deposits), plaque deposits gradually disappear on their own.

Treating chronic scurvy nutritionally, because it directly addresses the cause, almost always works. (6) This is why, in this author's clinic, there is a saying that heart disease is easier to treat than low-back pain.

Why Name This Disease "Chronic Scurvy"

The following is a discussion of two different approaches to address CVD/ scurvy and how terminology makes a difference in the prescribed treatment.

Let's look at an example of a patient who consults with a holistic, nutritionally oriented physician. The doctor names the patient's disease "atherosclerosis," which describes the complex development of the plaque deposits in a major artery. The holistic doctor and the patient discuss a nutritional treatment in terms of how it would heal and remove the plaque deposits. When the patient leaves the consultation, his attention is focused on the plaque deposits. The patient then often returns to his cardiologist and asks, "How do I get rid of my plaque deposits?" Most of the time, the cardiologist will steer the patient into conventional treatment because conventional treatment appears to be designed to fight those "deadly plaque deposits." These patients will manage their chronic disease for the rest of their lives.

In a second example, a patient consults with a holistic, nutritionally oriented health care professional. This doctor and the patient discuss the patient's condition using the term "chronic scurvy." It is made clear to the patient that this is a disease of weakened connective tissue in the arteries, and the discussion centers around which nutrients are required to repair connective tissue. When the patient leaves the consultation, her focus is on treating chronic scurvy by nutritionally facilitating repairs to the artery walls.

The patient then wants to discuss this treatment recommendation further with her cardiologist. She asks her cardiologist, "How do I treat my scurvy?" Almost everyone who has grown up in the United States learned in grammar school that European explorers frequently died from scurvy when they were on long voyages and that scurvy was later determined to be caused by a vitamin C deficiency. So, the discussion in the doctor's office starts with vitamin C. Looking further into the disease, the patient will learn that scurvy is a connective tissue weakness that results in internal bleeding. Other nutrients to support collagen and connective tissue production may be added to the treatment.

It is worth noting that the nutritional protocols outlined by the two holistic doctors are probably almost identical, and both would work to reverse the disease. The difference is that naming the disease "scurvy" rather than "atherosclerosis" keeps the focus on the actual pathology in the artery walls. In this way, the treatment focus stays on the integrity of the arteries and does not wander back to the plaque deposits.

Medical Writers and Medical Researchers Make This Same Mistake

One might think that what a disease is named would have almost no effect on how it is researched and treated; but in the case of heart disease, a quick examination of information shows otherwise.

Medical writers and medical researchers tend to focus on plaque deposits. This author has reviewed many peer-reviewed journal articles on topics such as tracking and evaluating the "calcium score," using vitamin K2 to reduce calcium levels in plaque deposits, raising HDL and lowering LDL and total blood cholesterol, analyzing the ratios of HDL to LDL cholesterol, examining the dangers of oxidized cholesterol, tracking and lowering blood lipoprotein(a) levels, lowering blood triglycerides, and lowering the consumption of saturated fat. All of these approaches to treatment of CVD share the same problem. They address the problem of plaque deposits, thereby attacking the body's adaptive response to the underlying problem.

Unfortunately, no amount of treatment of an adaptive response is going to cure a major disease. Simultaneously, the real pathology of the damage to the artery walls is being ignored. It is as if people got lost in the desert of the "lipid hypothesis" of Ancel Keys in the 1950s and then, for the past six-plus decades, haven't been able to find their way back out.

The Prescription

Thus far, this article has discussed the vitamin C treatment for chronic scurvy in general terms. The actual formula is not so simple. The basic formula for Pauling Therapy includes vitamins C and E, zinc, copper, sulfur, and a couple of amino acids. Other optional nutrients can be added. Also, dietary improvements always help but are difficult to describe in a short article.

What follows is a common prescription used by the author's clinic for a chronic scurvy patient. Other doctors are likely to use similar nutritional prescriptions. As long as they contain an abundance of vitamin C, full-spectrum vitamin E, sulfur, and L-lysine, and also address the copper-zinc status of the patient, the treatment should work well.

In general, recommending specific brand names for vitamins and nutrients is best avoided; but when there are dramatic differences in the benefits received between brands, recommending the best and highest-quality products available is obligatory. Such is the case in the recommendations to follow.

Nutritional Supplement Recommendations for Treating Chronic Scurvy

* Vitamin C (pure ascorbic acid, not mineral ascorbates)--six or more grams per day, taken in small doses throughout the day. Vitamin C is required for the production of collagen and elastin fibers. It is also an important antioxidant that prevents free-radical damage.

Small doses of vitamin C in the form of mineral ascorbates might be safe to take; but at the recommended high doses here, the minerals used to make the ascorbate may develop into an overdose of minerals or create mineral imbalances. Purified L-ascorbic acid (the active isomer) is important because if the vitamin C is not purified L-ascorbic acid, then only half the indicated dose of vitamin C is actually obtained. The other half is D-ascorbic acid, which is not true vitamin C. (7)

Not all vitamin C is equally useful to the body. It is worthwhile to spend a little more money for the highest-quality product to get the most effective result, especially when treating an advanced case of chronic scurvy. There are three characteristics that are problematic with inexpensive vitamin C: 1) The product is not purified for the l-isomer; 2) the vitamin C is derived from corn starch; and 3) the product is manufactured in China. It is important to note that almost all high-dose vitamin C that does not specifically state to the contrary has all three of these problems. (8)

The vitamin C from the Vitamin C Foundation9 is recommended. They sell only purified L-ascorbic acid, their vitamin C is never derived from corn, and it is never manufactured in China.

* L-lysine--6 grams per day; L-lysine is used in the production of collagen fibers and causes the release of plaques in very small pieces, which avoids embolisms. (10)

* L-proline--1 gram per day; L-proline is similar in function and effect to L-lysine. (11)

* Vitamin E--Between 400 and 800 mg per day; like vitamin C, vitamin E is an important antioxidant. Including vitamin E in a treatment formula relieves the vitamin C of much of its antioxidant responsibilities so that more vitamin C can be used to produce collagen fibers. Vitamin E is also a mild anticoagulant.

Be sure to take Vitamin E products that provide all four tocopherols and all four tocotrienols. The best result for treating coronary artery disease (CAD) is obtained by taking a full-spectrum vitamin E that is highest in d-gamma tocopherol, because the gamma form of tocopherol is known to be the most effective form of vitamin E for the prevention and treatment of heart disease. (12) Some studies for CVD are designed to fail by using only d-alpha tocopherol, which does not do much to treat CVD and will actually suppress the levels of all the other types of vitamin E, including the gamma tocopherol. (13)

The company A. C. Grace makes a product called "Unique E," (14) which provides both tocopherols and tocotrienols (in two different bottles). These high-quality products are recommended for best results.

* Organic Sulfur-For best results, take one teaspoon of organic sulfur in chlorine-free water on an empty stomach upon waking in the morning. Wait 30 minutes before eating or drinking anything.

Organic sulfur delivers oxygen to cells, is excellent at removing a wide variety of toxins, and is required to form disulfide bonds in the creation of collagen fibers. (15) Organic sulfur is also known as MSM, but look for products that are described as "organic sulfur" because they tend to be more pure and therefore more effective. The only downside to organic sulfur is that it also "sulfates out" some beneficial minerals. Consequently, some users may develop mineral-deficiency problems after some months of use. To prevent long-term mineral deficiencies, increase the dose of magnesium and add a multi-mineral supplement.

* Magnesium (citrate or chelated) --400 mg per day; magnesium helps to keep energy levels up and helps to maintain a good heart rhythm. (16) Magnesium is also a mild anticoagulant.

* Co-Enzyme Q10--100 mg or more per day.

The heart uses more Co-Q10 than any other tissue in the body because Co-Q10 enables the use of higher amounts of energy. This nutrient is critical to CVD patients, where hypertension is common. Hypertension (high blood pressure) means that when the heart pumps blood, it has to pump against a higher pressure; thus, the heart has to work harder and requires more energy. Statin drugs suppress the body's normal creation of Co-Q10, so many CVD patients are weakening their hearts by taking statins. (17)

* Vitamin K--100 micrograms (meg) per day; vitamin K is a natural blood coagulant. (18)

Blood clots and the effects of blood-thinning drugs are sensitive topics for CAD patients. Vitamin K is included in this list to neutralize the anticoagulant effects of magnesium and vitamin E. This results in an overall formula that is roughly neutral in its coagulant/ anticoagulant effects.

* Copper--2 mg per day

* Zinc--20 to 30 mg per day

Copper and zinc work in opposition. High copper levels depress zinc, and high zinc levels depress copper. Copper is necessary for the production of collagen fibers and is an essential part of artery wall repairs. (19) An overdose of copper usually results in nausea, digestive problems, and occasionally mania.

Zinc is useful for the immune system and for tissue repair (such as for the artery wall). (20) An overdose of zinc depresses the immune system.

Consider buying copper in a copper/ zinc combination supplement so the two minerals do not get out of balance.

Vegetarians are likely to be deficient in zinc and are much more prone to copper overdose, so consider supplementing the zinc and relying on diet alone for copper.

People who have copper water pipes probably do not need to supplement copper because they get enough copper from drinking and cooking with their tap water.

* B Complex--Use dosage recommended on the label; vitamins B6, B12, and folic acid, the vitamins found in B Complex formulas, dramatically reduce high homocysteine levels that damage artery walls. (21)

* Rutin--500 mg per day; rutin is a bioflavonoid that assists vitamin C in its functions. (22)

* Omega-3 Fats (fish oil or flaxseed oil)--Between one teaspoon and one tablespoon per day.

Many studies have indicated that fish oil can be quite valuable in keeping the heart healthy. (23) However, these highly volatile unsaturated fatty acids are prone to rancidity. If a spoonful tastes bad, the product has turned rancid to the point that it is doing more harm than good. Throw it away and get a fresh bottle. Buy a small bottle so it can be used up while it is still fresh. Fish oil gel caps can also go rancid, but the gel caps conceal the taste. Once a week, bite one open and taste it to see if it is rancid.

It is important to take high-quality vitamin E while taking omega-3s; vitamin E protects omega-3s from oxidation after they are absorbed.

Conclusion

The pathology in heart disease is damaged artery walls. Plaque deposits are an adaptive response, like a Band-Aid over a damaged area, to prevent breakthrough bleeding. Treating an adaptive response does not heal the underlying problem. Treating plaque deposits with cholesterol reduction, manipulation of the HDL/LDL ratio, and other standard treatments are the logical equivalent to treating a skin abrasion by picking at the scab. On the other hand, providing an abundant supply of the nutrients required to repair arterial damage works almost every time, and it is less expensive. This approach uses normal body processes to heal naturally.

In order for the Pauling Therapy to become a mainstream practice, professionals need to realize that cardiovascular disease should be properly named "chronic scurvy," a bleeding disease brought on by damage to the artery walls. Treatment should start much as one would treat scurvy: with high and frequent doses of vitamin C along with a few additional, related nutrients. The focus should be almost exclusively on the efficient repair of the artery walls. Plaque deposits are not the pathology but are, instead, an adaptive and protective response to the damaged artery walls. Once the artery walls are repaired, the "dreaded" plaque deposits will disappear on their own.

References

(1.) Rath M, Pauling L. A unified theory of human cardiovascular disease leading the way to the abolition of this disease as a cause for human mortality. Journal of Orthomolecular Medicine. 1992; 7(1).

(2.) Fonorrow O. Linus Pauling's Therapy: About the Cause and Linus Pauling's Non-Prescription "Cure" for America's #1 Killer. http://www.PaulingTherapy.com.

(3.) Centers for Disease Control and Prevention. Leading causes of death. http://www.CDC.gov/fastats/ leading-causes-of-death.htm.

(4.) Rath, "Unified Theory," (see n. 1).

(5.) Ibid.

(6.) Fonorrow, "Linus Pauling's Therapy," (see n. 2).

(7.) Linus Pauling Institute. The bioavailability of different forms of vitamin C. http://LPI.oregonstate.edu/ infocenter/vitamins/vitaminC/vitCform.html.

(8.) Vitamin C Foundation. Top 10 reasons to supplement with vitamin C. http://vitamincfoundation.org/alerts. php.

(9.) Ibid.

(10.) Clean arteries: How to remove plaque from arteries naturally, https://saveyourheart.com/clean-arteries.

(11.) Ibid.

(12.) Jiang Q, et al. Gamma-tocopherol, the major form of vitamin E in the US diet, deserves more attention. American Journal of Clinical Nutrition. Dec. 2001;74 (6): 714-22.

(13.) Faloon W. Preliminary rebuttal to recent attacks against dietary supplements. http://www. lifeextensionvitamins.com/llliexretore.html.

(14.) Unique E. http://www.acgrace.com/unique-evitamin-e/.

(15.) McGean P. The Sulfur Study: Early results of an experimental study using organic sulfur. http://www. naturodoc.com/sulfurstudy.htm.

(16.) Magnesium. http://umm.edu/health/medical/ altmed/supplement/magnesium.

(17.) Co-Q10 benefits for heart health, http:// coqlOwellness.com/coqlO-benefits/.

(18.) Vitamin K. http://en.wikipedia.org/wiki/Vitamin_K.

(19.) Copper peptide GHK-Cu. http://en.wikipedia.org/ wiki/Copper_peptide_GHK-Cu.

(20.) Zinc. http://ods.od.nih.gov/factsheets/ZincQuickFacts/.

(21.) Sahelian R. B complex supplement health benefit, review of studies, dosage and side effects, http:// www.raysahelian.com/bcomplex.html.

(22.) Rutin. http://www.phytochemicals.info/ phytochemicals/rutin.php.

(23.) Gandelman G. Fish oil and heart disease. http://www. healthcentral.com/heart-disease/surviving-heartattack-36549-5.html.

Daniel Cobb, OMD

Originally published in the Well Being Journal, September/October 2016

Daniel Cobb is a Doctor of Oriental Medicine who practices in Santa Fe, New Mexico. He focuses on nutrition, detoxification, and control of the environment to treat chronic conditions and degenerative diseases. He can be reached at danielcobb2@yahoo.com or by calling 505-424-9527. Visit his website at http://danielcobbdom.com.
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