Health Book Review

Book Review #9 The Alpha-Lipoic Acid Breakthrough, Burt Berkson, M.D., Ph.D., Three Rivers Press, New York, 1998

“In fact, as macabre as it may seem, many physicians would rather that their patients die than be saved by an unconventional approach. That fact is obvious.”-Julian Whitaker, M.D.

This sentence refers to a story Dr. Berkson recounts, in which two patients were dying from liver poisoning induced by poisonous mushrooms. These patients were assigned exclusively to his care and he was told that nothing can be done for them other than to watch them die, give some fluids and maybe provide some pain relief.  Dr. Berkson rejected this approach and was able to obtain alpha lipoic acid from the National Institute of Health (NIH). He had a degree in mycology so he knew that most mushroom-poisoning-cases death comes from liver failure. Alpha-lipoic acid (ALA) is a liver regenerator and had saved these two individuals, who had regenerated most of their livers. The following week another couple was admitted with mushroom poisoning. The hospital authorities gave them the same prognosis and ordered Dr. Berkson to not use alpha-lipoic acid on them. But he could not obey this order. Dr. Berkson used the left-over ALA to return these people to life. He accepted that he would be reprimanded. But luckily the NIH had taken great interest in these four cases, which is what prevented the hospital from terminating him. The hospital administrators branded him as a doctor who cannot follow orders. This took place in 1977, and by 1997 the people were still alive doing radio shows with Dr. Berkson regarding their remarkable recoveries. This book encompasses twenty years of medical practice by Dr. Berkson and thirty years of his research experience.

The book continues on to explore all the environmental toxins humanity is exposed to, including pesticides, herbicides and petrochemicals. The deadly history of DDT is also touched upon. The bottom line is that if we were not exposed to so many chemicals, we would be able to live a longer and healthier life because these chemicals exhaust our detoxifying systems. Please consult the book for very specific details. Against the background of this extensive pollution, ALA can make a significant contribution to maintaining health. Unlike most vitamins, the body already produces it in small amounts. Unfortunately, it’s production decreases with age.

ALA got this name because it dissolves in fat as well as water. It has two sulfur atoms and eight carbon atoms. It participates in a multi-enzyme process preparing fuel for the mitochondria, which is the “engine” of the cell. ALA essentially enhances mitochondrial function producing more energy for all cellular functions and repairs. In addition, ALA has an incredible ability to prevent damage to an organism’s genetic structure.

In Dr. Becker’s opinion ALA deficiency is central to the to multiple issues that arise in one’s health status. Key points from referenced reports regarding ALA:

-inhibits the reproduction of the AIDS virus 

-prevents cataract formation in the eye

-protects the kidneys from antibiotic and free radical damage 

-maintains the pancreas insulated against inflammatory shock

-prevents T-lymphocytes from committing suicide 

-increases the number of T-helper cells 

-reduces the toxicity of chemotherapy 

-shields the bone marrow from ionizing radiation, thus preventing leukemia 

-treats diabetes and liver disease 

-protects heart and brain cells from cell death after a heart attack or stroke

Dr. Berkson believes that a healthy diet should still, in fact be supplemented with an effective substance, such as ALA (among others), due to the overwhelming amount of chemical exposures on a continuous basis that we encounter in our environment. Even a seemingly healthy body needs help in such an environment.

The book goes into a very thorough explanation of cellular biology, including the function of all the cellular organelles. Please consult the book for a deeper understanding. The most important thing to know from this section is that the mitochondria is the power house of the cell and facilitates aerobic respiration, which requires the presence of oxygen. This creates the production of a high energy molecule called ATP (adenosine triphosphate). Organs like the heart have high energy requirements and will therefore have many mitochondria in each cell (about 2000 per cell). It is within the mitochondria that ALA plays a vital role. 

Energy Molecules

A monosaccharide is the simplest sugar, glucose is one example and it cannot enter the mitochondria without the presence of ALA. Therefore, ALA is vital for energy production. A disaccharide forms when two monosaccharides attach together, table sugar is an example. When many monosaccharides attach together in a chain, it’s called a polysaccharide, starch and cellulose are two examples. Starch and cellulose are molecules that serve to store energy. When required enzymes will chop off one monosaccharide at a time off the polysaccharide chain to fulfill energy requirements.

Fats are composed of fatty acids and are a source of energy. Proteins are composed of amino acid and are a source of energy as well. Fatty acids become converted to glucose when necessary. The glucose then proceeds to the mitochondria and ALA allows it to get in. Proteins are composed of amino acids in a long chain, which then twists creating a specific three-dimensional structure to accommodate the function of the protein. Amino acids become converted to glucose, when necessary. The glucose then proceeds to the mitochondria and ALA allows it to get in.

In order for glucose to become a source of energy, it must be broken down into two molecules of pyruvate, which is further converted to acetyl coenzyme A. Pyruvate cannot be converted to acetyl coenzyme A without ALA. 

The author provides a very informative overview of vitamins. Please consult the book for details. Below are some interesting highlights:

-Vitamin A- can be synthesized in the liver by combining two beta-carotene (water soluble) molecules together to form one vitamin A molecule (fat soluble).

-Vitamin D- is manufactured in the skin from cholesterol in the presence of sunlight. It stimulates absorption of calcium. A deficiency will lead to poor teeth and osteoporosis.

-Vitamin E- prevents free radicals from damaging membranes by preventing lipid peroxidation.

-Niacin (B3)- lowers LDL, increases HDL in the blood.

-Pantothenic acid- Dr. Berkson finds it to be the best single treatment as well as prevention of shingles, genital herpes and cold sores.

-Pyridoxine (B6)- necessary for amino acid metabolism. Lowers homocysteine levels.

-Folic acid- women with abnormal pap smears are generally deficient in folic acid. After supplementation the pap smears should normalize.

Features of Alpha-lipoic acid

-The very unique molecular structure of ALA allows it to be water-soluble and fat-soluble. Being fat-soluble gives it the unique ability of being an effective detoxifying agent (since many toxins accumulate in fat tissue). ALA can basically get into every little space of the body to enhance function. Due to this feature ALA can very easily pass through the blood-brain barrier.

-Recycles other antioxidants like vitamin C, vitamin A and glutathione. This allows the antioxidant to engage in its vital functions again.

-It works in every cell and in extracellular spaces.

-Due to its ability to get into every cell it can be used to prevent and treat my medical condition.

-Prevents collagen from cross-linking, which prevents wrinkles.

-Protects the lysosomes of the cell from leaking digestive enzymes (which would destroy cellular components).

-Protects DNA and RNA from sustaining damage from certain chain reactions.

Dihydrolipoic Acid

After ALA does what it does, it gets converted into dihydrolipoic acid (DHLA), which is the reduced molecule (has extra electron) and it is also active . Then when DHLA is oxidized (loses an electron) it becomes ALA. This molecule goes back and forth between the two forms exerting many beneficial functions. DHLA is the form that recycles vitamin C and indirectly vitamin E.

Glutathione 

This is an essential intracellular antioxidant and it is manufactured inside the mitochondria. It is composed of the amino acids: cystein, glutamic acid and glycine. Oral supplementation is not reliable because the ingested supplement cannot pass over the mitochondrial membrane. Thus, it must be produced inside the mitochondria to exert its effect. Glutathione is a component of enzyme systems that protect the body from disease. It has been shown by several scientists that ALA and DHLA cause the cell to increase significantly levels of glutathione.

Radiation Poisoning 

ALA has been shown to protect the bone marrow of mice from radiation injury. Alone or in combination with vitamin E, it is an effective treatment for radiation damage.

ALA as a Chelator

-It very effectively chelates heavy metals, like mercury, arsenic and others.

-Sources of mercury include fabric softeners, printer inks, dental fillings, house paints, common plastics, medications, wood preservatives, cosmetics and other industrial products.

-Many seeds and grains grown for food are treated with mercury compounds to discourage fungal growth.

-Acute ingestion of mercury causes thirst, burning in the throat, abdominal pain and vomiting. Mercury can cause kidney failure while inhalation of its vapors causes a life-threatening chemical pneumonia.

-Levels of mercury that are chronically high are associated with immunosuppression, neurological disease, allergies, arthritis, hair loss, muscle weakness and death.

-ALA chelates mercury and causes its excretion via the gall bladder.

-Arsenic is found in high levels in many city water systems. It is also found in smog, tobacco smoke, pesticides and other industrial chemicals. In acute poisoning there is abdominal pain, vomiting, diarrhea, and muscle cramps. Long term poisoning is often confused with ALS (Lou Gehrig’s Disease), Parkinson’s Disease or Multiple Sclerosis.

-ALA and DHLA can chelate copper, excess iron, cadmium, excess calcium, lead and zinc.

Cancer

The author tells the story of when he was pathology student, he had to evaluate breast tissue for cancer under the microscope. In the meantime, the patient was in surgery and the surgeon wanted to know if he should remove the whole breast.  Dr. Berkson was not convinced that it was cancer because it looked more like an infectious process based on his training in cellular biology. The chief pathologist however did not want to hear that it was not cancer. This incident led him to the conclusion that there are many cases of uninformed doctors leading uninformed and trusting patients. It made him think that there is a trend of overdiagnosis of cancer due to the possibility of a malpractice lawsuit if the doctor makes the wrong diagnosis. Perhaps the best way to “treat” cancer is by preventing it through a robust diet that safeguards the body.

The Role of ALA in Cancer 

-Free-radical damage decreases the amount of energy produced in a cell because it damages the mitochondrial membranes. When this damage occurs in the pancreas it may lead to diabetes; when it occurs in the heart it may lead to heart disease.

-Free radicals also interfere with the ribosomal production of normal proteins. 

-Free radicals damage the cells membrane which cases leakage and compromises cellular structure and function.

-ALA is incredibly effective at neutralizing free radical damage and hence offers protection to every cell in the body.

To understand how ALA protects against cancer two concepts must be explained: signal transduction and transcription factors. Key Points:

-Signal transduction- all cells have receptors on their outer membrane. These receptors become activated by specific molecules, this then activates a pre-programmed chain of events, which leads to a specific action. This can be compared to the stimulation of a human reflex.

-Transcription factors- are protein structures which are involved in gene-expression. They cause genetic material to do something specific. As an example, a viral infection stimulates transcription factors that turn on genes which then turn on production of interferon. Interferon then protects other cells from getting infected by the virus. Additionally heat-shock proteins are produced also by this chain of events which protect cells from high temperatures. Cell biologists have concluded that free radicals and toxins cause specific transcription factors to initiate a chain of events that lead to cancer.

-ALA has the ability to modify gene expression due to the influence it has on transcription factors. It does this by minimizing the effect of the free radical and by stabilizing the transcription factors. Theoretically, ALA can convert a malignant disease into a chronic one that is treatable.

-Searching for “signal transduction,” “transcription factor,” “NF kappa B” on the National Library of Medicine will yield an astonishing number of papers on the subject. 

-Medical researchers today (1998) are reversing cancer at several medical facilities around the world. A greater number of practicing oncologists just need to understand, accept and develop an understanding of cellular and molecular biology and cancer will become completely reversible.

ALA works even better when supplemented with:

-Vitamin A- reduces risk of epithelial cancers, blood and lymph cancers via immune system support; enhances the function of macrophages which eat the cancer cells; stimulates cytokine T-cells that kill cancer cells.

-Vitamin C- increases the strength of B-cells, T-cells and macrophages; B-cells make antibodies which mark the cancer cells and the T-cells come to destroy the cancer cells; macrophages engulf and digest the cancer cells. Vitamin C increases interferon levels in the blood (preventing viruses from infecting healthy cells), neutralizes free radicals and increases levels of glutathione.

-Vitamin E- is very useful because it exerts effects in a fatty environment because it’s a fat-soluble vitamin; it prevents free-radical cascades and membrane damage; ALA can do many of the jobs of vitamin E, but it recycles vitamin C, which in turn recycles used-up vitamin E; vitamin E accumulates in the cell membranes and protects us from environmental toxins. Cancer patients generally have low vitamin E levels. However, in high doses of vitamin E can be harmful; about 400 IU daily is sufficient.

-Glutathione- this is the most important antioxidant found intracellularly and it seems that in order for it to be effective it must be assembled intracellularly inside the mitochondria. White blood cells need high levels of glutathione to kill pathogens and cancer cells. ALA increases production and recycling of glutathione.

-Selenium- generally found in green leafy vegetables if they were grown on soil with sufficient selenium. It increases the activity of glutathione peroxidase, which is an enzyme that increases the power of white blood cells. Selenium is much more effective in the presence of ALA because it increases glutathione recycling.

ALA in Liver Function 

-The liver is one of the most important organs and when it becomes destroyed you are destined to die a slow, painful and horrific death. The liver cells, called hepatocytes, have an incredible ability to regenerate.

-One of the liver’s functions is to destroy old, worn-out red blood cells. When the membrane is ruptured the bilirubin pours out, and gives bile its dark green color.

-The liver stores blood, which becomes released when necessary.

-The liver manufacturers clotting factors for the blood.

-The liver converts fats and proteins into fuel for the body.

-The liver manufactures cholesterol, which is part of every healthy cell membrane.

-The liver forms glycogen from glucose.

-The liver removes poisons from the body.

The author tells the story of a young woman who was diagnosed with primary liver cancer. Then one of his mentors investigated a little further, it turned out that she had parasitic hepatitis (liver flukes), which is the most commonly diagnosed disease in the world. This beckons the question, how many liver-fluke infestations are diagnosed as liver cancer?

Liver toxins: acetaminophen, alcohol, cleaning fluid, many industrial chemicals and fungal toxins (aflatoxins and mushroom toxins). These poisons are free radicals or become converted to free radicals. The injury begins when the toxin comes in contact with the cell membrane, which sets of a chain of events. The mechanism of damage is generally lipid peroxidation, during which the fatty acids in the cell membrane are made useless.

Mushroom toxins generate free radicals, which destroy cellular organelles, enzyme systems, such as the RNA polymerase system. As a result, no new proteins can be produced. Hepatotoxic mushrooms specifically destroy RNA Polymerase II. This is the enzyme that transcribes DNA into messenger RNA, this halts protein production and the cell dies.

When Dr. Berkson injected ALA into the patients suffering from mushroom poisoning, they began improving very quickly. After two weeks they were back to normal with normal liver tests.

ALA modes of action in reversing poisoning 

-Competes for binding sites on carrier proteins that bring the toxins to the liver.

-The two thiol (sulfur) groups on ALA neutralize radicals, which is helpful once the toxins reach the cells.

-Greatly increases glutathione levels, which scavenge the toxins.

-Helps glucose enter injured cells.

-Liver toxins stimulate certain transcription factors that cause the cell to shut down and die. ALA has been shown to stabilize certain harmful transcription factors.

Diabetes

-The symptoms of diabetes include thirst, weight loss, excessive urination, hunger and glucose intolerance.

-In many cases there are autoantibodies that destroy the pancreas. These antibodies are often the same ones that destroy viruses like rubella, cytomegalovirus, and mumps. In this case if the autoantibodies attack the pancreatic cells diabetes type I will develop.

-High cholesterol and triglycerides are associated with type II (diabetes mellitus). This feature may damage the liver by the accumulation of fat causing it to enlarge, which can cause alterations in blood flow to certain parts of the liver, resulting in serious scarring. Unfortunately, a fatty liver does not detoxify blood well.

Complications of Diabetes Mellitus

-Somogyi effect- there is low blood sugar during the evening and a high fasting blood sugar in the morning. This is due to the release of stress hormones in the early morning. This effect also causes disturbing dreams and painful headaches in the morning. This can be alleviated by changing the time that insulin is administered.

-Diabetic neuropathy - is due to damage to the blood vessels that supply the nerves with blood.

-Microangiopathy- the thickening of the membranes of the tiniest blood vessels.

-Retinopathies- eventually leads to blurry vision, cataracts and often blindness.

-Nephropathy - persistently elevated sugar damages the glomeruli, the filtering units of the kidney.

-Macrovasscular disease- damage of the large blood vessels.

-Peripheral vascular disease- a loss of blood flow to the extremities. Eventually gangrene develops requiring amputation. In one patient after amputation, it was observed that the blood vessels of the lower legs were replaced with calcium deposits; they became rods of stone. The surgeon had a hard time breaking these with his surgical saw.

-Frequent infections- bacteria love the sugar-laden tissue of the feet.

For patients with diabetes Dr. Berkson recommends:

-Vitamin C 1000mg three times daily with meals; reduces glycation damage and decreases sorbitol (which causes cataracts in the lens of the eye).

-B vitamins- increase glucose tolerance and prevent nerve damage.

-Coenzyme Q10- vital for normal metabolism of sugars; enhances heart function.

-Chromium- increases glucose tolerance.

-Magnesium- increases insulin and has a protective effect against eye damage.

-Zinc- increases immune function.

ALA helps in diabetes because:

-Blood and tissues of diabetics have high levels of free radicals.

-Prevents oxidation of LDL cholesterol.

-Diabetics have low levels of glutathione; ALA recycles it.

-Diabetics tend to have excess levels of copper; ALA is a great chelator of copper.

-Evidence suggests that free radicals cause or contribute to diabetic neuropathy; ALA neutralizes them.

-ALA has a direct or indirect effect on the growth of nerve cells.

-Prevents cataracts by chelating certain metals from the eye.

Cardiovascular Disease, how atherosclerosis begins:

-First there is deposition of fat; these lesions are called fatty streaks, which are surrounded by an accumulation of macrophages; the fats in these lesions are contained in vacuoles and under the microscope the fats look foamy. These have been found in the arteries of children during autopsy.

-The formation of fibrous plaque is the next step; the fatty streaks become replaced by scar tissue. This plaque now begins protruding into the opening of the artery.

-In the next step cells die in the diseased artery wall and more fat, fiber, and calcium accumulate in the lesion. The lesion may rupture, which produces hard calcium-filled ulcers. These lesions become problematic when they occlude 60% or more of the artery opening; at this point there would be decreased blood flow and the sensation of pain in that area (chest pain when there is decreased blood flow to the heart). These lesions also tend to become infected. The bacterium Chlamydia has been found in 80% of patients who have arterial plaques.

Vitamins and Antioxidants 

-Beta-carotene is converted to vitamin A, which prevents the oxidation of LDL cholesterol (leads to atherosclerosis).

-B6, B12 and folic acid reduce homocysteine levels, which is an amino acid that injures the lining of the arteries thereby initiating atherosclerosis.

-Vitamin C is essential for the maintenance of the healthy protein structure of the arteries; lowers the amount of fats in the blood.

-Vitamin E- works in the fatty areas of the body to prevent oxidation of LDL cholesterol (this prevents injury to the arterial wall); neutralizes free radicals; may also prevent blood clots.

-Coenzyme Q10-plays a vital role in mitochondrial energy production. The heart is a high-energy demand organ so optimizing energy production will have many benefits.

ALA and blood vessel disease 

-Recycles glutathione, vitamin C and E; scavenges free radicals.

-Diabetes mellitus is a factor for blood vessel disease. High blood sugar creates harmful substances called advance glycation end products, which accumulate in the walls of arteries and cause macrophages to adhere; this combination generates free radicals; this then causes the depletion of glutathione, damage to cell membranes and DNA.

-ALA recycles and generates glutathione; stops the adhesion of macrophages 

-ALA recycles vitamin C and E, which inhibit the oxidation of LDL cholesterol (normally found in arterial plaques).

-ALA directly inhibits lipid peroxidation 

-ALA inhibits transcription factors NF kappa B, which is an early step in the development of plaques.

-ALA inhibits transcription factors NF kappa B from traveling from the cytoplasm to the nucleus where it can cause DNA damage.

-ALA essentially restores the body’s antioxidant defense system, which prevents a great amount of oxidative stress.

My comments 

I take issue with the fact that Dr. Berkson was branded “a doctor that does not follow orders.” This concept has no place in medicine. A physician should be able to critically think for him/herself to provide the best outcome possible for his/her patients. This medical-military structure must and will collapse!

As a society we have been taught that this pill is good for this condition and that pill is good for some other condition. I disagree with this. To illustrate the point, I sometimes ask people the following questions: Is water good for every cell of your body? Is oxygen good for every cell of your body? Sometimes I get blank stares because the answers are so obvious; yes, both water and oxygen are good for every cell in the body and thus for every medical condition. Likewise, because ALA works to boost power in every cell makes it beneficial for every medical condition. Taking this idea a step further, perhaps something that is “good” for the liver but “bad” for the kidneys is actually bad for the kidneys as well, and essentially, we are just being duped into believing something this absurd. This is something to think about.