Dr. Malcolm Kendrick and vitamins

#1

I have been spending my hours reading Dr. Malcolm Kendrick’s blog again. It’s such a fascinating read, and I like how he continues to fight the mainstream tooth and claw regarding the cholesterol hypothesis, and also I just happen to like his writing style. Dr. Malcolm Kendrick has also been very focused on vitamins, such as:

vitamin B12 (helps decrease levels of homocysteine which has been linked to dementia, Alzheimer)

magnesium (the deficiency of which has been associated with higher risk of cardiovascular diseases)

vitamin D (deficiency of which leads to soft bones and is also associated with cardiovascular diseases, furthermore it is associated with a much lower defence against viruses)

vitamin C (without which you can end up with a serious lp(a) problem, and subsequent atherosclerosis)

Here is an brief abstract from Malcolm Kendrick’s blog post regarding vitamin C:

{Well, if you don’t have enough vitamin C, then you are more likely to end up with cracks in your blood vessels. These cracks will then be plugged by small blood clots, containing a lot of Lp(a). If you have a high Lp(a) level, then these small blood clots will be even bigger, and even more difficult to remove.

Which means that if you have a high Lp(a) level, it would be a splendid idea to ensure that you never become vitamin C deficient. Indeed, even if you do not have a high Lp(a) level it would be a splendid idea to ensure that you do not become vitamin C deficient. Because cracks in blood vessel walls are never a good thing. Ending up, potentially, as the focus for atherosclerotic plaques.}

https://drmalcolmkendrick.org/category/vitamins/

#2

I have read some of his work. I do find some of his references a bit dodgy. He uses a Guardian article to try and make a point about Covid selection and yet the article is poorly researched. This idea that Parsimonious Theory is always the best approach to every complex problem is just a pipe dream generally speaking(IMHO). In one of the studies/charts, he shows that in the winter (cold climates) where the temperature does fall significantly the incidence of Influenza does increase dramatically for the placebo group as compared to the group taking 800IU of vitamin D3. However, the chart also shows higher incidents of cold/influenza in the springtime for those taking Vitamine D3 than the placebo group. This is never mentioned. Too many variables could have played a role. I asked a doctor (wife) why? The simple answer was, “Maybe the vitamin loses its effectiveness over time or the dose is wrong.” A better strategy might be to super dose (5,000-15,000 IUs) in the fall, giving you protection over the winter and then again just before spring starts. This is the protocol I have used for myself in the last 3 years. No colds or Influenza, but did test positive for Covid. Very mild.
To understand COVID-19 better science needs to start at the origins, where did it begin? A great starting point is a recent book called, Viral: The Search for the Origin of COVID-19 written by Alina Chan and Matt Ridley.

#3

I think Kendrick’s idea (well, one of them) is that too low levels of vitamins and minerals are often overlooked in favour of drugs, and that the reccommended dosages are set too low, so that there isn’t sufficient benefit. Also that vitamin and mineral deficiencies aren’t sufficiently picked up on, because the reccommended levels are set too low.

I found his blog post regarding vitamin C the most interesting as it suggests having too low levels of vitamin C can lead to increased levels of lp(a) because of cracks in the blood vessels, I think this hypothesis deserves some attention.

And the fact that homocysteine - which he claims could be kept in check by sufficient levels of vitamin B12 - could lead to brain shrinkage, thus resulting in dementia and alzheimer.

His hypothesis on what actually causes heart disease tends to revolve around the damage to endothelial walls, which he claims could happen through covid, or too high glucose levels, among other things, and how that damage inevitably leads to blood clotting, as opposed to the hypothesis highly supported by the mainstream, that high LDL leads to cardiovascular events. He does, however, say that high levels of lp(a) is linked to cardiovascular events.

#4

He could be exactly right. But this idea is not new. In the 60s, Linus Pauling and fellow researcher Mathias Rath hypothesized that Lp(a) levels may be increased in some cases due to a vitamin C deficiency. They noted that Lp(a) is found mostly in the blood of primates and guinea pigs they used, which have lost the ability to synthesize ascorbate. They were unable to show the same results in humans. His research on high dosages of Vitamin C to stop the common cold have not been replicated. At best, they have been shown to slightly decrease some of the perceived symptoms. Pauling also believe that humans were able synthesis Vitamin C in the past. Most mammals and other animals, do have the ability to synthesis it

(Bob M) #5

While I love Dr. Kendrick’s cholesterol and heart disease theories (and ignore his covid theories, as I do with everyone else’s), I think he’s wrong about Lp(a) and vitamin c. Is there a single RCT about vitamin C lowering Lp(a)? I can’t find one.

Furthermore, my Lp(a) is somewhere in the top few percent, depending on the study. Typically mid 200 to 350+ mmol/l (higher when I fast; lower when I eat).

Yet I got a CAC scan done, and got a score of zero. If Lp(a) causes atherosclerosis, how can I get a score of zero? (I have verified high Lp(a) for at least 8 years; never got that metric tested before then, but I assume it’s been high for the last 40+ years; I’m 58 now.)

My Lp(a) is so high that I calculated one time that something like 70-80% of my LDL is Lp(a).

And when I looked into this, the trials that lowered Lp(a) lowered it not by much. The recommended value is <75 mmol/l. My NORMAL values are 2-4 times that amount. I would need to decrease my Lp(a) by huge amounts.

Lp(a) is primarily genetic, and there is little you can do to change it.

I also have no aortic stenosis, verified by many scans.

Moreover, I feel bad when I take vitamin C. I know on his board there are folks taking grams of it per day. But I feel bad if I take 1 gram a day.

I’ve tested this many times. Same result: feel bad.

I have not tested liposomal vitamin C though. It’s on my list of things to test.

Like with FH, there may be an effect on thrombosis or coagulation, but I don’t know how to address that. No one tells you what to do to reduce that effect.

(You've tried everything else; why not try bacon?) #6

Eric Verdin has demonstrated that the need for Vitamin C is less on a ketogenic diet. Apparently, what happens on a standard high-carb diet is that elevated insulin activates a gene complex that shuts off the body’s endogenous defences against oxidation, rendering exogenous anti-oxidants essential. On a low-carb/keto diet, β-hydroxybutyrate deactivates those genes again, allowing the body’s natural defences to function again.

There is no question that cholesterol is found in healing arterial damage. The question is whether the cholesterol caused the damage or is there to repair it. (Do the fire trucks we see at fires cause the fires, or are they there to help?) I like the damage/clotting idea, especially the way Dr. Kendrick explains it.

But again, the question is whether the high levels of Lp(a) are linked to cardiovascular disease because they cause the heart trouble, or whether it’s the cardiovascular disease that causes Lp(a) to rise, or whether the elevated Lp(a) and the cardiovascular disease are caused by something else. In the epidemiological studies showing the association, causality is very difficult to establish.

#7

I think what Dr. Kendrick was saying is that because something causes damage to endothelial walls, causes cracks in the blood vessels (through a virus, high glucose or some illness) the lp(a) rises to repair the cracks, the damage done, and that it is this continued repair that also leads to atherosclerosis. So, I think he’s not blaming lp(a) for heart disease, but saying increased lp(a) as a kind of cholesterol patch up job to repair damage here and there, is the result, the consequence more, so perhaps it is a marker then for something else going on.

(You've tried everything else; why not try bacon?) #8

That makes sense.

#9

Hi Bob, I don’t think Dr. Kendrick was saying lp(a) causes atherosclerosis, but rather that something elses causes some damage (a virus, an illness, persistant high levels of blood glucose) and lp(a) rises to repair the damage, so having high levels of lp(a), if this hypthesis is true, could be seen as a marker, indicating something else is causing the damage, and lp(a) is just the patch-up-team.

I don’t know enough about this, but have you ruled out you don’t have a clotting disorder? Or have you checked your inflammatory markers? If your lp(a) is consistently high and Dr. Kendrick’s hypothesis is right (I can’t say if it is or isn’t) then that would suggest some kind of inflammation going on. And it is the continued repair over time Dr. Kendrick, if I remember it correctly, was saying that could lead to atherosclerosis, so just because your CAC score was 0 (and that is wonderful) and no plaque has been discovered in your arteries (again, wonderful), it doesn’t mean that atherosclerosis couldn’t happen further on, not saying it will, I just don’t know enough. But perhaps there is some inflammation you haven’t yet addressed? And if that was the case, lowering it might lower your lp(a) as well? This is just me speculating of course.

Regarding vitamin C, I haven’t taken it myself so I can’t share my experience with it. I’ve been taking 3000 IU vitamin D without problems, but perhaps vitamin C is different. But if Paul is right regarding there no longer being such a need for vitamin C because our bodies on a ketogenic WOE will have inbuilt defence mechanisms against oxidation, perhaps that’s why when you took vitamin C it caused you nausea, because your body saw it as unnecessary? That’s just another wild speculation of course. I am as far from a doctor as an elephant is from a cat.

(KM) #10

And I go back to the question I’ve been having about supplementation - and fiber, and probiotics, and pretty much any additional interventions - for months now: Is the recommended supplement or vitamin actually necessary for “us”, or is it necessary to mitigate the effects of excess carbohydrate in the diet, which is something “we” are already doing by not eating the carbs in the first place. Without direct experiments with people eating low/zero carb, it seems difficult to say anything about it with certainty.

#11

Hi kib1, I agree that it’s hard to say.

For instance, for those on a carnivore WOE like myself, I feel there could be a potential problem of deficiency from (1) a lack of variety (I tend to stick with pork, cheese cream, butter and eggs mainly, though I do try to eat more fish) (2) Most of us, I’m sure, don’t eat anything raw, we tend to fry or grill the meat, fowl and fish. So I’d question how much of the nutrients we’re actually getting, as opposed to how it might have been say, for the hunter gatherers or the enuits.

Then, for those who do keto, there is another problem, in there existing in the plant world a lot of anti-nutrients. So one needs to know which food should be consumed with what, in order to not have one food block the absorption of that other food.

Then, not all of us can afford a greater variety in the carnivore world, and not everyone doing keto can afford organic produce, so there is also that. At one point it was probably true that none of us required supplements. Today, with our soils becoming rapidly depleted, and we know neither in the plant eaters’ world, nor the animal eaters’ world, is anything perfect, so it really comes down to what works for each and every one of us, what works in terms of how our bodies feel, and to as much as follow science and the birth of new hypotheses, also focus on that.

#12

KM, You are correct. There is no certainty. What might “work” for one person could be a disaster for another. I read last year a study on probiotics. The conclusion was unless you know empirically what bacterium you are missing, blindly supplementation with a probiotic is simply a waste of money and could be detrimental to your health. The better option was the use of prebiotics. Prebiotics are specialized plant fibres. They act like fertilizers that stimulate the growth of healthy bacteria in the gut. Prebiotics are found in many fruits and vegetables, especially those that contain complex carbohydrates, such as fibre and resistant starch. These carbs aren’t digestible by your body, so they pass through the digestive system to become food for bacteria and other microbes. The thought is that the body will do its job and create what it deems necessary. The gut biome, I think will be the next big thing in the health world.

#13

And yet I remember consuming a lot of these foods containing prebiotics. In fact, I followed the dietary guidelines of having a rainbow variety of fruit and vegetables. I ate a lot of them. And my gut health must’ve been truly terrible as I suffered both chronic inflammation, fatigue and constipation. I also had breast cancer, so my metabolic state, I suspect, was in a right mess.

Now, I don’t know if my carnivore WOE is the right WOE for me long term, but I can’t deny I’m feeling good. My joint and muscle pain much reduced, and as much as I think its important to keep oneself updated with science, I believe perhaps more in listening to one’s own body. Because when it comes down to it, it’s incredibly individual what works and what doesn’t.

The thing about confirmation bias is that, once you’re aware of it, you begin to find yourself sceptical to everything. You start catching yourself thinking, does this health promoter want to sell something? Is there a hidden agenda here? So it then, as well as remaining critical of new science discoveries and not just always fall victim to confirmation bias (we all do from time to time), becomes vital to listen to the body. The day my body proves me wrong about the carnivore WOE, gives me a sign I can’t ignore that it’s not the path to take, I’ll quit carni, no question.

#14

Optimization is different that a deficiency. There are no absolutes when it comes to food. I am sure that their gut biome was different and could do raw. The hunter and gatherer groups prized animal food. Probably because it was nutritionally dense and could sustain them for extended periods of time. Keep in mind, that for the hunter and gathering societies, it was a feast (after the big kill) or famine. The Inuit, have a genetic abnormality that they do not go into ketosis. Not sure why? But their diet now is more similar to a western diet, with less reliance on hunting for their own food. Their health is also suffering some of the more common issues that use to be rare in their communities.
So you find out that you are deficient in say X. What do you do about it?
Eat the best quality food you can afford.

#15

Except for what you want to believe /s Every doctor/expert in the food/diet space including YouTube is selling something, from pills, potions, books, lectures or eating programs all making claims that their way is the only way. (conflicts of interest)They ALL cherry-pick their data/studies that will reinforce their points of view. This would include the Keto and carnivore world as well. This is why I had my blood tested and a DEXA scan done before starting Keto. I knew empirically what was happening over time and did not rely on some self appointed guru telling me what to do. I continue to test, and if necessary, readjust.

#16

I don’t disagree with you ffskier. I do have my test (total blood count) from 22 October 2022, which was the day I started keto. And I do intend to have another full blood count, 6 months to a year from now. And if my body shows me a sign I can’t ignore before then, that carnivore is not the path for me, I’ll also readjust. I don’t believe in becoming attached to a WOE, treating it almost like a religion. I believe in the combo of listening to the body and amassing knowledge, knowing most of us (including me) have limited abilities to do this, but we can only do our best, can’t we? What type of things will you be looking at when next you have your blood tested?

#17

Most importantly, I will be looking at my ApoB and Apo A1-C ratio and seeing if there are changes good or bad. These tests have been shown to be significantly better at addressing ASCVD andCAD risk than just lipoproteins. If you don’t know your ApoB level, you are not fully taking advantage of the tools at our disposal to estimate your risk of cardiovascular and cerebrovascular disease. Look it up. My health is very important to me. Heart issues are the number one cause of death in the western world and there are actionable steps your can do to significantly reduce this risk. The 3 biggest steps are quit smoking, lower your blood pressure and lower your ApoB. Quickest way, for the last two is with medication. Most people do not even know they have high blood pressure.

#18

Allan D . Sniderman, MD

#19

I suppose GPs don’t routinely check for ApoB and Apo A1-C, or am I wrong?
What about lp(a) and CAC?

I think it’s safe to say heart health is something most of us think about (whether we’re looking in the wrong places for causes or not), as without a healthy heart our quality of life would truly suffer. And lots of us are confused by all the different hypotheses regarding causes, consequences and risk factors. I don’t see it as unnecessary to have blood tests to monitor our bodies’ response to our WOE, but the problems arise from GPs perhaps not quite as adept in deducing the results as we think.

Thanks for the link, I read the abstract, but can’t access the entire text without subscribing. But I will look ApoB up further.

#20

They do not for the most part. If you have a family history, then maybe. More and more doctors are trying to be being proactive. My doctor believes the more info he has about a patient the better he can help. Do not ignore family history.