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Zinc Signals - 2005 Hotel Galvez Galveston, Texas November 17 – 21, 2005 Drug Uses of Zinc in Common Colds, Leukemia, Angina Pectoris and… George A. Eby, M.S. George Eby Research Austin, Texas In the beginning… Valentine's day, 1979 my 3-year old daughter, Karen, was diagnosed with acute T-cell lymphocytic leukemia (ALL). Two weeks of chemotherapy (CCG protocol 161, regimen 2 ) and zinc gluconate = zero blasts Two weeks later, a massive proliferation of healthy reticulocytes. Two weeks more, ran 11 minute mile. Oncologist remarked, "Mr. Eby, her blood picture has set a new standard in improvement. I wonder why. Perhaps one of those enormous vitamin and mineral supplements you have been giving her beneficially interacted with our chemotherapy. You might look into that idea, because if you stop the operative supplement, she might get worse. Who knows, and I am only guessing, but it would keep you busy.” How zinc as cure for common colds was discovered Discovery of the benefit of zinc gluconate lozenges in curing colds was also accidental. Developed a cold while on chemotherapy. Chewed, but did not swallow, zinc gluconate before afternoon nap. Two hours later, cold vanished and she went outside to play. No relapse of the cold. Totally immunosuppressed by chemotherapy, but the cold was completely gone. A few properties of zinc Can be therapeutic High-dose zinc = 50 to 300 mg per day of ionic zinc. Doubling serum concentrations by IV for angina Ten times serum – broadly antiviral. Positively charged zinc species at pH 7.4. Potentiates interferon 10-fold – Berg, 2001 Inhibits intercellular adhesion molecule (ICAM -1) – Novick, 1997. Stabilizes cell/plasma membranes (2 to 100 X serum - including mast cells & goblet cells) – Pasternak, 1986 Antirhinoviral – Korant, 1974 Anti-herpes (ocular – Merck, 1948) + many others Astringent, and drying in common colds (nasal application – Merck, 1901). Zinc lozenges releasing ionic zinc are astringent & drying. Non-ionic zinc at physiologic pH is useless in biological systems & colds. NOTE: At this meeting, I learned that I was the first to distinguish between ionic zinc and “zinc” in human medicine. No wonder people don’t understand. Ionic zinc: (zinc chloride, zinc acetate Zn2+ only), zinc gluconate, zinc sulfate (Zn2+ and some positively charged ligand species) Non-ionic zinc: zinc oxide, zinc orotate, zinc oleate, zinc sterate First Eby study (1984): Percent with colds using ionic zinc (zinc gluconate): 100 80 % 60 Zinc Gluconate (23 mg) Placebo N=39 40 20 N=41 Total daily zinc = 207 mg 0 0 1 2 3 4 5 6 7 P = 0.008 day 1 P = 0.0005 day 7 Days Eby GA, Davis DR & Halcomb WW. Reduction in Duration of Common colds by Zinc Gluconate Lozenges in a Double Blind Study. Antimicrobial Agents and Chemotherapy, 1984, vol 25, no 1, pages 20-24. Second Eby study (1984): Percent with colds using non-ionic zinc (zinc orotate) No effect using 37 mg zinc orotate lozenges and 10 mmol zinc gluconate nasal spray. P = 0.23 on day 1, and P = 0.57 on day 7 I tried for 21 years to get this published. Editors said, “You expect me to believe 200 mg of zinc ‘cured’ colds and 300 mg did not?” No understanding of requirement for ionic zinc Total daily zinc = 300 mg The difference in these studies? Ionic zinc at physiologic pH 7.4 Days 1984 – 2005 all studies: No relationship between high-dose zinc & reductions in median or average durations of colds 7 6 5 4 3 2 1 0 -1 0 -2 -3 -4 -5 100 200 mg zinc 300 Mean Reduction in Duration (Days) Median Reduction in Duration (Days) Eby GA. Zinc Lozenges: Cold Cure or Candy? Solution Chemistry Determinants, Bioscience Reports, 2004, vol 24, no 1, pages 23-39. Why the mess? Zinc solution chemistry Ionic zinc must be measured at physiologic pH 7.4 in common colds Physiologic pH Effect of ionic zinc on common cold median and mean duration P=0.005 P = 0.02 Eby GA. Zinc Lozenges: Cold Cure or Candy? Solution Chemistry Determinants, Bioscience Reports, 2004, vol 24, no 1, pages 23-39. Eby’s U.S. Patents Even though there were valuable patents and successful clinical trials, commercial failure occurred. WHY? Specifically, why did commercial zinc gluconate lozenges fail? Clinical trial results were mixed and too confusing. Zinc lozenges for colds were generally believed to be bogus. Zinc gluconate, which has a bland, drying taste, has the strange property of becoming extremely bitter when mixed with sweet carbohydrates (other than fructose) in lozenges over time (low shelf life). This property doomed zinc gluconate lozenges for colds. Zinc gluconate required additives that eliminated both flavor issues and efficacy. Why did commercial zinc acetate lozenges fail? Zinc acetate lozenges were flavor stable, pleasanttasting and astringent, but major manufacturers wanted a non-astringent, candy lozenge. Major licensee found no efficacy from their own tests of chemically modified zinc acetate lozenge products having no astringency that passed their flavor tests. MAIN PROBLEM! Licensees would not use homeopathic drug claims, even though such use was the main key to marketing success. Lozenges are not a legal dietary supplement form under DSHEA of 1994. Why not nasal application? First use of intranasal zinc: nose drops of zinc sulfate – coryza (runny nose) (Merck - 1901) Many reports of use as decongestant early in 20th century. The cure for common colds should have been discovered in earliest part of 20th century (around 1901). Nasal application – no effect in over 100 years of research reports, exception - Hirt et al. – ENT, 2000, for Zicam zinc gluconate nasal gel. Nasal application of zinc - risk of permanent anosmia (contact with olfactory organ - termination of sense of smell) Extremely painful. Ionic zinc nasal sprays - preferred means to induce anosmia in research animals. Nasal application failed in our 2nd study. See: Eby GA. Ineffectiveness of Zinc Gluconate Nasal Spray and Zinc Orotate Lozenges in Common Cold Treatment and Potential for Harm: A Double-Blind, Placebo-Controlled, Clinical Trial. 2006. Alternative Therapies in Health and Medicine. In press. Why lozenges? Its magic! The magical mouth-nose BCEC! What is the mouth-nose BCEC? Biologically closed electric circuits (BCEC) – course throughout the entire body All except one (the mouth-nose BCEC) require surgery to observe. (Nordenström, 1983) The mouth-nose BCEC moves electrons from mouth to nose. This circuit is readily observed with a voltohm meter. Positively charged substances in the mouth, such as zinc, migrate with electrons via this circuit into nose. (natural electrophoresis) Positively charged substances introduced into the nose are repelled (like charges repel). Opening of nares and olfactory region – exceptions! Details of the mouth-nose BCEC Voltage between 60 and 120 millivolts. Voltage rises and falls one to two millivolts with the respiratory rhythm. Individuals (like me) with frequent colds, allergies and rhinitis have low resistance values between the mouth and nose between 1 and 10 Kohms Those with an average number of colds and few or no allergies have resistances between mouth and nose between 40 and 60 Kohms. People (like physicians) who are immune to common colds and have no allergies have mouth and nose resistances between 100 and 500 Kohms. Zinc ionization in treatment of allergy (Reversing the mouth-nose BCEC) Benefits from two 15 minute treatments lasted one year. Last mention of this treatment was in 1961. WHY? Franklin, BMJ - 1931 Mast cell granules – storage sites for ionic zinc – role in immunity? Does ionic zinc from mast cell granules: Stabilize goblet cells? Activate T-cells? Aid healing? Reduce inflammation? Ionic zinc 4 to 20 mMol – Struckhoff -1986 Considerable Zn2+ ions are released during mast cell degranulation of during colds & allergies (inflammation). Worsening of colds by negative zinc charge: a mast cell de-ionization effect? Some no longer marketed highly efficacious zinc acetate lozenges These zinc acetate lozenges were the only products ever to have been shown efficacious in two totally independent clinical trials of the same formulation against common cold duration and symptom severity. Petrus, 1998 Prasad, 2000 Why are they no longer marketed? Good data: Prasad – 2000, Petrus - 1998 Complaints about oral astringency, no drug claims, FDA label rules, and little or no marketing support The really big fish that got away “Zinc acetate in hard candy cooked with oleates and stearates to eliminate objectionable mouthfeel…” (& ionic zinc) Which is more important? Mouthfeel or efficacy? Warner Lambert U.S. patent 6,242,019 Failed in trials Currently marketed zinc lozenges (not believed to be effective) regardless of advertisements to the contrary No data No zinc ions due to citric acid additive Weak data Few zinc ions due to glycine additive No data Few zinc ions due to rapid Dissolution. What to do for colds and allergies? After the initial commercial interest subsided, this is the only zinc lozenge remaining that will actually shorten common colds by a week. What am I doing now? My Post Common Cold research: • Herpes • Leukemia • Angina pectoris • Arthritis • Navicular disease • Chronic sinusitis • other Eby GA, Halcomb WW. Use of topical zinc to prevent recurrent herpes simplex infection: review of literature and suggested protocols. Medical Hypotheses. 1985 Jun;17(2):157-65. Zinc ions have been reported to be antiviral to herpes simplex viruses. A number of treatments using zinc are reviewed which illustrate the effects of topically applied zinc in reducing the duration and severity of human oral and genital infections. Long-term topical application of zinc salts appears to greatly reduce or eliminate recurrences of genital herpetic infections. 35 references cited. Why suffer? Ocular – Visine AC? Zinc sulfate? NO! Sodium citrate Hi GeorgeI want to say THANK YOU SO MUCH for making this information about zinc and herpes public. I have had excellent results from use of topical zinc gluconate solutions, although it is not a cure for me, at least so far. It is, however, an amazing reducer of both the potency and recurrence of the virus. For your continued research and to help others, I thought I should report my results to you. I began using a 100 millimolar solution in January of this year. At the time I was having continuous outbreaks that were severe. My methodology was to mix 1 tsp of zinc gluconate. with 50 mL of hot tap water, stir until it dissolved (which makes a strong 100 millimolar concentration), and keep the measuring cup warm in a hot water bath in the sink. I then just applied the warm aqueous solution to the affected area with a wet Kleenex, and timed the exposure to 15 minutes. Then I left the area wet and let it air dry (which extends the exposure time another few minutes). This creates minor pain during an outbreak if the legions are broken first, but even that goes away in a few minutes. Later, after the area begins to heal, treatment is indeed ineffective, and in fact counter-productive, so I learned to not apply it to the affected area after scabs form. Concerning frequency of use: In general I used it once per day for about three months, except during outbreaks, and then I used it twice a day. I kept it wet each time about 15 minutes, leaving it wet at the end. You were right, never apply zinc gluconate powder to herpetic lesions because they will make a big, nasty, painful hole. The results have been a decrease in outbreaks from constant and severe to only about once in 4 - 5 months (an amazingly tiny one), and duration has been reduced from several weeks to 3 - 4 days. These results are against a backdrop of a much more stressful job than most people have (very long hours, as I run a large company), a lot less sleep than I should get, and eating poorly during the whole 9 month period. This methodology is a big success and a helluva lot better than popping pills every day. It has changed my life, I can sure tell you that. I owe you big time. Dave Eby GA. Treatment of acute lymphocytic leukemia using zinc adjuvant with chemotherapy and radiation — a case history and hypothesis. Medical Hypotheses. 2005;64(6):1124-6. Low blood levels of zinc are often noted in acute lymphocytic leukemia (ALL), but zinc is not administered as part of any modern chemotherapy program in the treatment of ALL. Upon noting low blood levels of zinc in a 3-year-old 11.3 kg girl, zinc at the rate of 3.18 mg/kg body weight/day was administered from the start of chemotherapy through the full 3 years of maintenance therapy. Dosage was split with 18 mg given at breakfast and 18 mg zinc with supper. The result was a bone marrow remission from 95+% blast cells to an observed zero blast cell count in both hips within the first 14 days of treatment which never relapsed. In addition to the reduction of blast cells to an observed count of zero (not a single leukemic or normal blast), red blood cell production and other hemopoietic functions returned to normal at a clinically remarkable rate. There were no side effects from zinc or chemotherapy at any time, and zinc is hypothesized to have improved the patient's overall ability to withstand toxic effects of chemotherapy. This report identifies zinc treatment as being vital to rapid and permanent recovery from ALL. The extremely broad role of zinc in pre-leukemic adverse health conditions, viral, fungal and tumoral immunity, hemopoietics, cell growth, division and differentiation, genetics and chemotherapy interactions are considered. If zinc could be shown to strengthen the function of chemotherapy and immune function, then it could be hypothesized that the relapse rate would be lessened since the relapse rate is related to both the rate at which a remission is obtained and the thoroughness of the elimination of leukemic blasts. Identical results also occurred in 13 other children with ALL whose parents chose to treat with zinc adjuvant. Since treatment with zinc and other identified deficient nutrients, particularly magnesium, did not appear injurious in ALL and they appear to be highly beneficial, controlled clinical studies of zinc (3.18 mg/kg body weight/day) with magnesium (8.0 mg/kg body weight/day) as adjuvants to chemotherapy in the treatment of childhood ALL are suggested. Treatment with zinc adjuvant is hypothesized to accelerate recovery from ALL, and in conjunction with chemotherapy, cure ALL. (76 ref) This A.P. article brought in 13 zinc for A.L.L. success stories Zinc for A.L.L. is worth it. Karen Eby, my A.L.L. conquering daughter, will be publishing her first neuroscience research paper before she goes to graduate school. Her paper is titled “Effects of Chronic Stress on Neurogenesis in Adult Golden Hamsters”. She was an honors student at U T Austin (3.9 GPA), and president of PSI CHI National Honors Society. She won 3 cash awards for her dogma-breaking chronic stress research. She wants to study effects of magnesium and other nutrients in traumatic brain injury and chronic stress, particularly from cranial radiation and chemotherapy . Eby GA, Halcomb WW. High-dose zinc to terminate angina pectoris: A review and hypothesis for action by ICAM inhibition. Med Hypotheses. 2005 Aug 3 (in press). We reviewed the literature related to the effects of high-dose zinc in arteriosclerosis-induced angina pectoris. Lipid peroxidation and LDL oxidation are believed to be critical for arteriosclerosis, and consequently angina pectoris. Administration of biologically available zinc was a beneficial treatment in a significant percentage of patients with severely symptomatic, inoperable atherosclerotic disease. In these patients, there was no difference in zinc concentration between patients with and without atherosclerosis in whole blood, erythocytes or hair, but there was a major difference between normal aorta and diseased aortas (40.6 ppm zinc in normal aorta vs. 23.2 ppm zinc in atherosclerotic aorta, 40.6 ppm zinc in normal aorta vs. 19.4 ppm zinc in atherosclerotic aneurysm aorta, and no difference between normal and aneurysm aorta), although copper was low in aneurysm aorta. Medication with high-dose zinc sulfate to raise zinc serum concentrations from 95 to 177 mug/dl resulted in objective improvement in 12 of 16 of these patients, including a patient that also had Raynaud's disease. Long term environmental exposure to zinc resulted in a 40% reduction in the incidence of angina of effort compared to people not exposed to environmental zinc (P<0.01) and a 40% reduction in the incidence of probable ischemia in exercise (P<0.001). The antioxidative action of zinc prevents oxidation of LDL cholesterol and consequently stops the main mechanism of atherogenesis. Zinc blocks calcium and its several actions on atherogenesis. Increased amounts of cytotoxic cytokines such as TNF-alpha, IL-beta and IL-8, often produced in the elderly, are blocked by high-dose zinc. We hypothesize that higher serum concentrations of LDL cholesterol resulting from 300 mg of zinc per day is caused by a release of low density cholesterol from cardiovascular tissues, beneficially flushing it into the serum where it is readily observed, thus decreasing arteriosclerosis, increasing circulation, terminating angina pectoris and restoring more youthful cardiac function. Although prevention of cholesterol-induced arteriosclerosis by zinc is predicted from findings related to oxidative stress and lipid peroxidation, removal of LDL is attributable to action of ionic zinc on ICAM inhibition. In stark contrast to current practice, high-dose zinc should be considered as basic in the strategy of prophylaxis and therapy of the atherosclerosis process to terminate angina pectoris and restore youthful cardiac function. Other drug uses of ionic zinc research questions Chicken pox, shingles (topical 100 to 400 mmol) Post herpetic neuralgia (topical 100 to 400 mmol) Other cardiovascular: blood pressure, platelet aggregation, sickle cell, inflammation, endothelial function, cholesterol, carbonic anhydrase, P.A.D. Anti-cadmium effect from tobacco (high-dose oral & IV) Anti-mercury effects in autism (high-dose oral & IV) Zinc acetate lozenges and allergies (colds in allergic people Petrus - 1998, reversing BCEC – Franklin, 1931) Menstrual cramps & bloating (30 - 90 mg/day – start 3 to 4 days before menses) Zinc acetate lozenges and mononucleosis (3-day cure) (continued) Other drug uses of ionic zinc research questions (cont.) Venomous bites and stings (including brown recluse spider bites, bee, yellow jacket, snake, scorpion & Portuguese-Man-O-War) (topical, IV & oral) Systemic scleroderma (high-dose oral – my sister-in-law) Gangrene (topical, high-dose oral, IV)– Ellingwood 1919 Small pox (Paris 19th century), bird flu, SARS, hepatitis C, (high-dose oral - IV) Burns and wound healing generally (high-dose oral, topical - IV) Crohn's Disease, leaky gut, and other intestinal inflammatory disorders NOTE: IV = 2-100 X serum concentration – CA Pasternak 1989 Zinc and its commercialization? Need patents that are protectable. Patents for “use of zinc to treat …” are usually worthless, because they are not protectable. Need a gimmick. Clear zinc oxide, zinc lozenges, zinc condoms, zinc test kits Civil law enforces patents Lawsuits necessary to enforce patents can be stressful and expensive - not guaranteed to be successful. Cultivate strong relations with decision makers in company to be licensed. Take vows of poverty, have a good wife, like my wife Patsy. Patience, patience, patience. Good luck! Side Effects from drug uses of zinc? Side effects from short-term zinc lozenges appear absent Too much zinc: Stomach upset, nausea, vomiting, diarrhea and a metallic taste Avoid long term (>2 week) oral doses (copper and iron issues). Iron depletion by zinc may be beneficial. Zinc toxicity = dizziness, headache, drowsiness, immune suppression, increased sweating, loss of muscle coordination, alcohol intolerance, hallucinations and anemia. With extreme over-dose or poisoning, loss of consciousness and death. Well people – low tolerance Sick people – high tolerance K. Brown, 2004