Letter from the Publisher

Postcard from Israel

At the beginning of the school year, children are often asked to write a report about their summer vacation – so I thought I would share mine. Deborah and I travelled to Israel in June to visit my aunt Lucy, who has lived in Tel Aviv since 1950. Most tourists only see Israel through the eyes of history, religion, and archaeology. Tel Aviv is the perfect spot to relax, walk on the beach, enjoy the café, and have a drink at a nightspot. Lucy loves to share stories of her life and bring us together with her friends. We enjoyed a sultry evening eating in the nearby old city of Jaffa with her friend Perry, who is a cancer surgeon. It was one of those perfect summer evenings that everyone cherishes – the right food and drink, the right company, the right setting by the beach at the port. We spent several days indulging in the mineral waters of the Dead Sea – I remind myself of those days whenever I soak in a bath of Epsom salts and hydrogen peroxide. Our experience in Israel was relaxing and restorative.

How different an experience we had of Israel and Gaza after returning to the U.S. in July – of rockets and bombs destroying buildings and people being maimed and killed. Picasso’s painting of Guernica comes to mind. The world clamors for a cease-fire while two opposing peoples are unable to come to terms and continue to inflict death and pain and suffering. It was and is a situation with few answers, and Lucy and Perry concede that Israel will always fight aggressively whenever its security is threatened. They see little hope for a future peaceful existence. Of course, revolutionaries are fighting in ever-increasing numbers, not just against Israel but also against government and public safety throughout the Middle East, and in Africa, Europe, and Asia. Is there any answer except to fight back against fanaticism?

Deborah and I found so much to enjoy relaxing at the Dead Sea and in Tel Aviv. We need to savor those moments knowing that violence and tragedy lurk around every corner.

The FDA Threat to Compounding Pharmacies Continues

In case you thought that compounding pharmacies have been out of the limelight, think again. In July a botched and prolonged execution in Arizona of an individual convicted of murder brought execution by lethal injection back onto the pages of the newspaper. Drug-induced execution has been carried out swiftly in the past – the prisoner dies within minutes, with no evidence of agony or discomfort. In the Arizona execution, the individual experienced shortness of breath repeatedly over a few hours. The problem is that the drugs used to kill the individual, pentobarbital and midazolam, are no longer formulated and manufactured by a drug company. Instead, a compounding pharmacy now prepares these injections. Drug companies have abandoned manufacturing drugs for lethal injection, wary of the political fallout and declining income. Still it is unsettling that the pharmaceutical company’s cocktail of pentobarbital and midazolam worked effectively while the compounded pharmacy’s formulation did not. Why would that be? Were the doses of the drugs too low? Were the drugs supplied to the compounding pharmacy improperly manufactured or adulterated? Did the compounding pharmacy fail to compound the drugs properly? These questions unfortunately come at a time when compounding pharmacies face severe scrutiny by the FDA.

It is not difficult to understand what the FDA intends to do about compounding pharmacies and prescriptions. In July the FDA confirmed that it intends to pursue tighter regulatory control over pharmacies and restrict what may or may not be compounded. However, the changes in regulations are still being designed and reviewed. In this issue of the Townsend Letter, the McGuff Compounding Pharmacy updates us on the proposed FDA regulations. There will be two compounding entities in the future: the compounding pharmacy and the outsourcing manufacturer. The compounding pharmacy will compound prescriptions including injectable medicines for individual patients. The outsourcing facility will manufacture drugs including injections that will be available for prescription. However, the outsourcing company will be limited to a restricted list of drugs that are not being manufactured by drug companies as approved by the FDA. Compounding pharmacies will be permitted to compound drugs and injections for individual patients only; theoretically there will be no general “office use” of prescription compounded drugs and injectables. In addition, there will be a list that the FDA is compiling of nonpermitted drugs that pharmacies may not use to compound. In the event that a drug is listed as forbidden-to-be-compounded, it will be effectively banned from use. The FDA is in the process of deciding what compounds and drugs will be placed on the “forbidden” list.

It is difficult to know what options there may be if the prescribing physician needs a banned drug. Injectable vitamins and minerals are broadly available as unregulated oral supplements. However, oral chelation drugs are generally less effective than intravenous drugs. Consider if there were a ban of disodium EDTA and calcium EDTA. Chelation treatment would be effectively stopped. What if DMPS and DMSA were prohibited? Mercury chelation would be unavailable. Suppose intravenous ascorbic acid and sodium ascorbate were not permitted. “Myers cocktails” and vitamin C infusions would be eliminated. A ban of compounded glutathione would be a great treatment loss. There are many other vitamin, mineral, amino acid, herbal, and other drugs that could be banned, obstructing patient care. The FDA threatens to eliminate all drugs and compounds that it considers ineffective; only those agents having a USP Monograph will be safeguarded.

It is important for practitioners to discuss the FDA regulatory process with colleagues to consider political, legislative and legal options. The Alliance for Natural Health (ANH-USA) is involved in battling the FDA over this compounding pharmacy regulation. Please join with the ANH-USA to protect access to compounded medications.

Timing of Vaccinations

Our daughter, Affinity, and son-in-law, Jeff were wed two years ago. At a pre-wedding dinner, we enjoyed conversing with our guests Michael Gerber, MD, and his wife, Inge. Michael and I have been friends for many years, sharing mutual interests in chelation and alternative medicine. At medical meetings, Michael delights in getting colleagues together to share new treatments and case histories. Michael enjoyed discussing holistic and homeopathic therapies with guests at the dinner. The conversation took an awkward turn when Dr. Gerber told some of Affinity and Jeff’s friends who were with babe in arms that they should not vaccinate their children, or at least delay it. The young parents are not involved in CAM and had been routinely vaccinating their babies – so they were unhappy with Gerber’s advice. While there is a strong antivaccination sentiment among natural–medicine oriented physicians, there may be some sound medical theory in sequencing the administration of vaccines in a particular way.

In this issue of the Townsend Letter, Jacob Schor, ND, FABNO, examines the unexpected improvement in life expectancy derived from vaccinations but only when certain vaccines are administered in a timely fashion. Schor reports about the “nonspecific” effects of vaccinations that reduce the risk of unrelated infections. Several studies have demonstrated remarkably beneficial nonspecific effects from the measles vaccine that would not be expected simply from preventing measles. Similar unexpected improvement in preventing illness has been seen with the BCG vaccine for TB and the currently disused vaccinia vaccine for smallpox. What Schor discusses that is particularly remarkable is that when the measles vaccine is administered immediately after the final DPT vaccine, there is a remarkable improvement in infant mortality. For reasons that are not clear, the DPT vaccine in females but not males poses negative risk effects. Administering the measles or the BCG vaccine after the DPT vaccine mitigates against those negative effects.

Additionally there is growing evidence that vaccines improve the immune system’s ability to fight cancer. Schor reports the reduction in the incidence of melanoma in patients who have been vaccinated for BCG. BCG is not a common vaccine in the US, but should it be considered in fair-skinned individuals who are at high risk for melanoma? Although alternative practitioners have advised patients to avoid receiving vaccinations there may be a need to rethink this issue.

Ebola: Newest Immigrant to US

Among the many milestones for 2014 has been the first-time welcoming to the US on Aug. 1 of Ebola carried within a sick individual. In fact this date also marks the first human transportation of Ebola to both North and South America and to any place outside of Africa. Two American medical workers who were aiding medical personnel in Liberia fighting the infection contracted Ebola. The CDC directed that the sickened individuals be airlifted to the special quarantine unit at Emory University Hospital in Atlanta, Georgia. Ebola is transmitted through contact with virus-containing secretions. Hospital workers are directed to wear hazmat quarantine suits and are scrupulous about avoiding contact. Nevertheless, no method is foolproof, and it will be a wonder if no Emory Hospital health worker contracts the infection. The contagion period lasts at least 3 weeks, and one can only imagine the gut-wrenching tension that “civilian” US medical workers will experience assigned to treat this patient.

At this time, the “treatment” consists of basic measures such as administering fluids and palliative drugs until the patient either survives the infection or dies. The current death rate is 60%. It is unclear if surviving patients will become carriers who may pass the infection to coworkers, family members, and friends. The World Health Organization and the CDC are now initiating a major increase in funding and sending more medical professionals to West Africa to contain the infection – a process that is thought now to likely last for 6 months.

In the interim, it would behoove health authorities to consider alternative medical therapies to help in containing Ebola. The top consideration would be the administration of intravenous vitamin C. Despite the fact that medicine has ignored the use of vitamin C for decades, it has been reported in many journals since the 1950s to either palliate, control or eradicate viral infections. Considering the danger posed by Ebola, it would be reasonable to use other medical alternatives including ozone, colloidal silver, colostrum, prebiotics, probiotics, proteolytic enzymes, vitamin D, vitamin A, and minerals, including magnesium and zinc. As the situation is rapidly worsening and threatening to become an uncontrollable epidemic, it would be reasonable to mandate intravenous vitamin C for all infected individuals as well as health workers treating these patients. Such a mandate would be unprecedented, but urgency calls for unprecedented interventions.

Jonathan Collin, MD