´Vitamin´ B-17: Separating Myth From Reality
(Chris Woollams) B-17 as a cancer ´cure´ is one of the most controversial subjects in ´Alternative cancer medicine´. Is there research to support it as an alternative cancer treatment? Is there research to support it as a complementary therapy? Here we bring you one of the most comprehensive reviews on the Internet today.
To a degree the controversy was re-opened in October 2014 when researchers (Makarevic et al; PLOSone) showed that natural B-17 (amygdalin) dose-dependently reduced growth and proliferation of cancer cells in vitro (See Cancer Watch - Click Here).
Frankly, when it comes to B-17, absolute rubbish is often talked. At CANCERactive (as with any commonly discussed ´alternative´ cancer therapy) we think it would be letting cancer patients down to either ignore B-17, or to laud it without some serious research evidence. We don´t promote, or endorse. We just provide information. You deserve an objective appraisal, using the correct facts. Because of recent ignorant comment we have spelled out our views a little more clearly - we have not seen any evidence in the last ten years that encourages us to change them:-
Ignorance and bias
A typically ignorant exchange happened on February 14th 2006, when the Daily Mail ran a headline ´Cancer Cures or Quackery?´ under which six alternative practitioners recommended ´alternative´ cancer cures (their words not mine) to a reporter posing as a cancer patient. To quote, ´One therapy was ´B-17 metabolic therapy or laetrile´ (sic).
Two cancer ´experts´, Professors Ernst and Baum, joined in the fray commenting that there was ´no research to support B-17´, and that B-17 was used ´by a few unscrupulous practitioners across the border in Mexico´.
1. People who have looked into this subject in depth (like Ralph Moss and Phillip Day) will
tell you, that there are at least five studies (three on animals, two with humans) that show some effect on cancer with B-17. But the fact is that the evidence base is poor. Very poor. There is no accepted placebo-controlled, randomised clinical trial data whatsoever with humans.
2 Treating people with Metabolic Therapy is not the same as giving them B-17. The world famous Oasis of Hope clinic in Mexico uses a variety of therapies including radiotherapy and chemotherapy. And it does use vitamin B-17 as a part of a package called Metabolic Therapy
, which may also include pancreatic enzymes, ozone therapy, Intravenous Vitamin C and more. Does it work, and if so which bit? Although there is no doubt a lot of anecdotal evidence, and I have talked at length with Contreras, no overall report or rigorous data seems to exist for Metabolic Therapy either, sorry.
3. The owners of the Oasis of Hope have not been chased out of America, nor are they ´unscrupulous´. Dr Francisco Contreras
M.D., the son of the founder Dr Ernesto Contreras M.D., and his hospital are in Mexico ... because they are Mexican. The Oasis of Hope advertises in America perfectly legally, and Americans travel to the clinic in Mexico, just as they might go to one in Chicago.
By April 14th the UK Food Standards Agency was getting in on the act. UK newspapers published warnings issued by the FSA thus: ´Cancer patients should be aware that Apricot Kernels - a suggested cure for the disease - can kill them´. Apparently, ´Reports from overseas say eating 20-30 could result in very serious health effects´.
Note: None of the articles specified the origin and the detail of these ´overseas reports´.
The FSA suggested that 1-2 pips per day was a safe intake. One article went on to add, ´Bitter apricot pips are thought to contain high levels of B-17, known as laetrile (sic) - described as an immune system booster and even as a cancer treatment´.
4. Bitter apricot pips contain amygdalin, not laetrile. Few people seem to grasp the difference but it is important:
(i) Apricot Kernels can contain up to 3 per cent of Amygdalin which is the natural form of B-17. It does not require any medical approvals. It is not even remotely a treatment for cancer.
(ii) Laetrile is something quite different - it is a synthetically prepared form of B-17 and is thus a drug and is subject to drug approval. Since there are no definitive phase III clinical trials on laetrile, quite correctly it has not received FDA approval. Full stop.
(iii) B-17 is not a vitamin. Krebs (see below) described it as a vitamin, but there is little evidence of any vitamin properties.
(iv) Contreras, the world´s expert on B-17, states unequivocally that he knows of no one who has ever died from eating apricot pips. He does not treat people with apricot pips and it matters not to him whether they help or hinder. He is providing an unbiased expert opinion.
(v) Apricot pips are not a cure for cancer. I know of no one who says they are. In the world. Eating a few each day, may have some preventative powers at best.
(vi) I also know of no one who has been treated by laetrile alone and has cured their cancer - I cannot even provide an anecdote.
5 The problem was that B-17 (laetrile, not amygdalin) became the focus of a mighty squabble between orthodox medicine and alternative medicine. ´Conspiracy theories´ abound in the world of alternative cancer treatments and views become entrenched. And this creates the mythology and the errors.
Our aim at CANCERactive is to try to sort out truth from mythology. We are not ´for´ alternative cancer treatments, but we do believe it is wrong to ignore them. Our aim is to try to provide the evidence or the lack of it. The truth is that pharmaceutical companies are looking at lots of compounds that can respond to features that are unique to cancer cells. B-17 theory is reasonably clear. But as with almost everything in cancer, theory rarely equals reality. B-17 should be properly researched once and for all, then everybody can stop this nonsensical debate.
6. You can crack open an apricot nut shell today in the UK - but it is, correctly, against the law to treat someone with laetrile.
a) Apricot Kernels, seeds, pips, whatever you want to call them. Some people do eat these as a cancer prevention aid; some people with cancer also eat them.
b) Laetrile (the synthetic form of B-17) can be obtained in tablet form but is more usually administered intravenously.
c) No practitioner in the UK has been allowed to prescribe or use synthetic B-17 since June 2004.
I know of no-one who claims that either Apricot Kernels, or synthetic
B-17 (laetrile) is a cancer ´cure´
d) Of the practitioners who used to use Intravenous B-17 and metabolic therapy in the UK, or people still using it around the world, like Contreras, I know of no-one who claims that Apricot pips or synthetic B-17 is a cancer ´cure´, not even Contreras, the expert.
And anyway, at CANCERactive we believe that there is quite simply no such thing as a single, ubiquitous cancer ´cure´; not B-17, vitamin D, Herceptin or Temozolomide. But lots of compounds can play a part.
The word cure, in my experience, is only ever used by the press, or by dubious websites who don´t really understand cancer. Again these sites may be staunch advocates of alternative therapies or Skeptic twaddle sites. Neither is helpful to the cancer patient.
Cancer is a multi-step process. There may be as many as 20 steps (according to John Boik of the MD Anderson Cancer Center in Texas). In my book, ´The Rainbow Diet - and how it can help you beat cancer´, I have assigned foods and natural compounds to each of the steps, but only where there is scientific research that they have an anti-cancer step activity. I know of no compound that is active against all 20 steps.
So, no drug cures all cancer cases all of the time. Why expect it, or claim it, for a vitamin, or B-17?
e) Finally, all drugs have side-effects. Those of Tamoxifen are well documented. The lack of proper research on synthetic B-17 has meant no safety measurements really exist for laetrile or amygdalin.
However, eating too many Apricot Kernels, or too much beetroot, or too much Asparagus, or drinking too much water will cause negative effects in the body. Amygdalin does cause problems if the liver is impaired.
So from this point on, when reading this article, at least put synthetic B-17 (laetrile) and Apricot Kernels (amygdalin) into a proper and separate perspective.
Neither I nor CANCERactive support or advocate laetrile as a cancer treatment or ´cure´. it is possible that apricot pips and natural amygdalin may help in preventing cancer as a part of a large number of natural bioactive compounds provided by nature (like polyphenols) that might protect and correct animals from disease.
So what is B-17?
Every area of the world supporting vegetation has such plants
B-17, or amygdalin, is a naturally occurring compound. In fact it is slightly wrong to think of it as a single entity like, say, vitamin C. There is a group of approximately 14 compounds that are water-soluble and found naturally in over 1,200 species of plant in the world. Every area of the world supporting vegetation has such plants.
The active ingredients are often described as nitrilosides or beta-cyanogenetic glucosides and there are at least 800 foods common in worldwide diets that are nitrilosidic.
Nitrilosidic foods include:
- alfalfa sprouts, bamboo shoots, mung bean sprouts
- barley, buckwheat, maize, millet
- blackberries, currants, cassava, cranberries, gooseberries
- loganberries, quince, raspberries, strawberries, yams
- brown rice, fava beans, lentils and many pulses like kidney beans, lima beans and field beans
- flax seed, linseed
- pecans, macadamia nuts, cashews, walnuts
- watercress, sweet potato
- almonds and the seeds of lemons, limes, cherries, apples, apricots, prunes, plums and pears.
In fact all the foods we don´t eat too much of these days!!
The consumption of barley, buckwheat and millet have given way to refined wheats, while pulses like lentils, which accounted for 30 per cent of our protein in 1900, now account for only 2 per cent.
Primitive tribes around the world still base their diets around B-17-rich foods. Cassava, papaya, yam, sweet potato in the tropics; unrefined rice in the Far East; seeds and nuts in the Himalayas; the salmon-berry eaten by Eskimos, or the arrowgrass of the arctic tundra feeding the caribou.
So why all the interest?
This absence of cancer seemed to be due to the difference of nutrition
Nutritionist and scientists alike studied the various tribes. Sir Robert McCarrison in the 1920s and John Dark MD twenty years later failed to find a single case of cancer amongst the Hunzas, the tribes of West Pakistan. V Steffanson found the same with the Eskimos and wrote "Cancer: Disease of Civilisation" as a result. Dr M Navarro of Santo Thomas, University of Manilla, noticed the same with the Philippine population who ate cassava, wild rice, wild beans, berries and fruits of all kinds. Dr Albert Schweitzer noted the same in Gabon. ´This absence of cancer seemed to be due to the difference of nutrition in the natives compared to the Europeans. Their diet was centred around sorghum, cassava, millet and maize´.
Studies of the consumption of B-17 varied from Dark´s finding that the Hunzas consumed at least 150-250mgs per day, to Dean Burke, head of the cytochemistry department of the National Cancer Institute in the USA in the seventies writing that the Modoc Indians in North America consumed over 8,000 mgs per day! (Dean Burke actually gave amygdalin the name B-17).
We leave these foods aside at our peril. The World Health Organisation has, after all, confirmed that in their view a large percentage of all cancers could be prevented by simple changes in diet.
B-17 as a cancer treatment?
Amygdalin was first isolated in 1830 and used as an anti-cancer agent in Russia as early as 1845.
But it was reborn by the father/son team Ernst Krebs senior and junior by 1955 had who isolated a purified form of the active ingredient (calling it laetrile) and, with others in the late fifties to seventies, sought to explain its action.
A seek and destroy missile?
Cancer cells differ in a number of ways from normal cells. One major difference is the way in which they produce their energy. In a healthy cell fuel is prepared in the cytoplasm of the cell, and then moved into the mitochondria or power stations to generate energy in the presence of oxygen. But cancer cells have lost their mitochondrial action and only the preparation process remains. This is modified and demands large quantities of glucose which burn in the cytoplasm in the absence of oxygen. Cancer cells have a whole different energy production system and different set of helper chemicals (enzymes).
B-17 is a seek and destroy missile
In a cancer cell, one of these enzymes, glucosidase, is present at 3000 times the level found in normal, healthy cells. Glucosidase has a unique action with B-17, breaking it down into hydrogen cyanide (which kills it) and benzaldehyde, (an analgesic).
However, in normal cells where glucosidase is virtually non-existent, a completely different enzyme, rhodenase which is involved in the normal oxygen burning process, actually renders the B-17 harmless, converting it to thiocyanate, a substance which helps the body regulate blood pressure, and vitamin B-12. So, the proponents argue, B-17 is a seek and destroy missile.
"I have read B-17 is dangerous - it contains cyanide"
As we explained above - the B-17 molecule, if broken a certain way, can produce cyanide. But the main enzyme that can do this is really only found in a cancer cell.
Also, frankly, it is rather a daft argument; rather like saying the glucose molecule contains carbon monoxide and that can kill you!
Skepti-twaddle about B-17 often refers to people dying of B-17 and cyanide but Contreras, who treats more people with B-17 than probably all other doctors in the world added together, knows of no cases.
Then there is the fact that ´containing cyanide´ could be claimed for many food groups (for example, isothiocyanates, or anthocyanins). These food groups actually play important roles in your health, including in cancer prevention.
Next, doctors regularly inject vitamin B-12 to enhance energy levels; you can buy vitamin B-12 on the high street. This common form is cyano-cobalmine. A layman might tell you this ´contains´ cyanide in the same way, too.
Vitamin B-12 is involved in over 300 enzymatic reactions in the healthy body, a deficiency is known to be linked to increased cancer risk. The more natural form of vitamin B-12 is methyl-cobalmine. If a compound containing cyanide is so bad, what is the medical profession doing it injecting it into lethargic pop stars and athletes?? If it contains cyanide and that is dangerous, why don´t doctors use the methyl version?
Nobody in their right mind would tell you not to consume B-12. So, steer clear of anyone who uses this palpably ignorant argument against B-17.
So why the controversy?
The use of synthetic B-17 is controversial because of conspiracy theories. It is a Skeptic versus Skeptic argument. The Skeptics against B-17 scream ´quackery´; the skeptics for B-17 scream ´cover up´:
The Federal Drug Administration (FDA) in the USA has not approved laetrile - the FDA state, correctly, that laetrile (not amygdalin or B-17) is a synthetic therapy and, as such, needs approval like any drug. There are no randomised, controlled phase III clinical trials on laetrile so it is definitely not going to be approved. Yet people around the world do prescribe and use it. QED, they must be quacks. That´s the official view.
But why has the same US Government Health Authority, the FDA, moved to ban the interstate shipments of apricot kernels and the planting of bitter almond trees? Trying to control a natural bioactive compound that logically might have some preventative benefits fuels the conspiracy theories! I noticed that my mother´s Asda "iced log" (a cake) contained 11 per cent apricot kernel paste! Presumably this cannot be moved between California and Nevada!
One skeptic argument runs ´If eating apricot pips could cure cancer, drug companies and major cancer charities would go out of business immediately´. Actually, these businesses need not panic. There is no research to suggest Apricot pips will cure cancer.
Let us look at the ´research´ issue ...
Has there been any research on B-17?
Three quarters of 80 cancer test patients had seen their cancer tumours go or reduce in size
Well yes, actually there has been some research - but not much. Ralph Moss and Phillip Day seem to be the experts here and they both record that there have been three animal studies and two human studies.
Following the Krebs´ work in 1955 a Senate Committee (often accused of being biased presumably because of drug industry connections) seemed unimpressed by evidence presented that three quarters of 80 cancer test patients had seen their cancer tumours go or reduce in size.
There was a stab at a clinical trial in the USA and this officially reported no effect with B-17. Moss was the Press officer in the team and showed his disgust at the public hearing, implying that the team had actually found a positive response and the powers that be were mispresenting the findings. He was fired.
However, talk to the experts that use B-17 and they will tell you that researching B-17 in a clinical trial is not the issue anyway. None doubts its efficacy, but several felt it was not as potent as other ingredients such as Intravenous, high dose vitamin C. ´B-17 only ´helps´ and is not a ´cure´ per se´, seems to be the general view. The issue, they argue, is to research the whole ´metabolic therapy´ package. The authorities have never done this. The people who use and advocate it simply cannot afford to conduct a full scale clinical trial. Impasse.
Why might it be more important to research the whole package? Cancers are clever and often form protective protein coats around the tumour to ward off the immune system. Various cancer clinics have thus developed their metabolic therapy packages to counter defences like these (metabolic therapy packages can contain bromelain, from pineapple and papain, from papaya, because they supposedly break down the protein coat). Other unique factors occur with cancer cells, so the metabolic therapy package may contain vitamins A, E and B complex, plus high dose intravenous vitamin C, high dose minerals, and pancreatic enzymes, each targeting a specific issue.
The difficulty then becomes "which bit worked?"
Having personally talked to leading B-17 practitioners in the USA and Europe, a few actually answer, ´who cares!´? Actually, I do.
Frankly, this is quite important but the answers are unsatisfactory if you are a cancer patient. On different pages we have reviewed the use of intravenous vitamin C megadoses and pancreatic enzyme treatment as used by Dr Gonzalez in his clinic in New York. They do seem to have, albeit limited, effects on their own, so I suppose it is possible that using all of them could have a greater effect. But, be clear, there is NO FORMAL RESEARCH on the metabolic therapy package and in reality it doesn´t even exist as different clinics use different concoctions.
Metabolic therapy packages could be working in several ways,
but there´s no research
Finally, laetrile has shown effectiveness against cancer cells in vitro, and in rats and mice. Interestingly, even the National Cancer Institute in America (which is negative about laetrile´s abilities), reports that by the late seventies over 70,000 cancer patients had been treated with laetrile and that there are copious individual case histories on its effectiveness. (Notwithstanding this, modern medicine demands a phase III clinical trial and there is none).
Krebs recommended eating ten apricot seeds per day for life (the seeds or kernels of apricots have the highest levels of B-17; up to 3 per cent); cancer treatments use four to six 500mg tablets of laetrile per day or intravenous injections.
So, can it kill me?
While there may not actually have been deaths from synthetic B-17 use, there is definitely an issue with overdosing. Excess B-17 and cyanide by-products have been known to build up in the liver of cancer patients. Each of us has different capacities to deal with such by-products but a cancer patient has an already impaired liver. A healthy liver has an enzyme, glucorinide that can detox the by-products, but in a cancer patient, this enzyme may be depleted. So, cyanide poisoning can result if excess is consumed. 1gm is the maximum recommended to be taken at any one time.
With the natural form of B-17, the US Nutrition Almanac recommends a maximum of 35 seeds per day; no more than five kernels at any one time in a 90 minute period. And they conclude that all cancer treatments using B-17 (synthetic, natural, or apricot kernels) should be properly supervised. Certainly, I have seen several prostate cancer patients who looked decidedly yellow all because they were trying to consume 50 kernels for breakfast!
Subjectivity and objectivity
As readers know, I travel the world giving speeches on cancer. I have interviewed a number of the world´s experts who use B-17 and metabolic therapy, including ´The Mexicans´, although maybe I met the wrong ones as these certainly were not unscrupulous!
I will say that on a totally subjective note:
a) I have seen many people, especially men with prostate cancer, who claim Apricot Kernels are the single reason their PSA scores have reduced.
b) Contreras himself claims that metabolic therapy can ´have a significant effect´ on some cancers - though not all. He is quite clear that there is no effect with Brain Tumours, Liver Cancer or Sarcomas.
I have seen overdosing with my own eyes. Be very, very careful.
c) As I said above, I have seen overdosing with my own eyes. Both men in their 60´s, both prostate cancer sufferers and both trying to eat 50 Apricot Kernels for breakfast. Both had gone a sort of yellowish-grey. Be very, very careful.
* Never take more than 5 in a 90 minute period.
* Never take more than 35 per day.
* Please tell your doctor, and have someone monitor your liver health.
So does B-17 ´work´?
Having read the original research on synthetic B-17 laetrile treatments and spoken to doctors and patients first hand, I find the ´evidence´ both for and against laetrile almost non-existent. I am neither an advocate, nor a critic. I just don´t know, even though I have tried to find out more.
The logic on B-17 seems reasonably sensible and certainly pharmaceutical companies are devoting significant resources to targeting exactly the same unique properties of a cancer cell. But, ass I repeatedly say, I don´t think any single entity is a ´cure´ for cancer - and that goes for B-17 too. Could it play some or other role in the total package? Experts like Contreras are adamant it can. I´m not at all as sure. Would I pin my hopes on it? No.
B-17 - even eating too many apricot kernels - can be dangerous
if your liver is impaired
With Apricot Kernels, and amygdalin, for me there is a different issue. I believe everybody should include nitriloside foods into their diet. I put five kernels with my home-made breakfast each morning, but then I eat copious amounts of food off the B-17 list above anyway. Personally, I believe there is a prevention argument, and eating half a dozen ´apricot pips´ a day is hardly a dangerous medical issue. They are (even at 50 per day) certainly not a ´cure´ for cancer. And I have never met anyone who claimed that their cancer was cured by eating apricot pips!
So, B-17 "Cancer cure or quackery?" The Bottom Line
There may well be an argument for including apricot kernels in your anti-cancer programme as a preventative bioactive compound, but eating 50 a day to ´cure´ cancer, no. In ten years not one person has so much as come up to me on my worldwide travels with even an anecdote.
And what of Laetrile - synthetic B-17 - as an out and out cancer ´cure´? I don´t think so. Those that use it don´t seem to rely on it on its own. And do I have reports of Laetrile ´curing´ cancer in the last ten years? Is there any new research? No, none.
Sorry, but that´s the honest, and hopefully objective, truth.
At last, the definitive, research-based book on how to build a diet to help beat cancer. Click here to read about it.
| If you are thinking of buying Apricot Kernels, you might like to see what is available as the Natural Selection Product of Choice. You can do this by clicking here.|
Readers might also like to read "Cancer: Why We´re Still Dying to Know the Truth" - by Phillip Day
2005 edition ISBN 0-9535012-4-8
Please be clear: At CANCERactive we do not consider the above compound to be a cure for cancer, despite what the research says or experts doing the research may claim. The above, is an article on the compound from published research and expert opinion in the public domain. At CANCERactive we do not believe that any single compound (drug, vitamin, whatever) is a cure for cancer. We believe that people can significantly increase their personal odds of survival by building an Integrated Programme of treatments. Equally, cancer prevention is best practiced through a width of measures.