I’m not going to keep you in suspense. The two proposed miracle cures are L-carnitine (an amino acid) and “Delta 8,” which in a previous Doc Gumshoe disquisition was unmasked as Delta 8 tetrahydrocannabinol, or Delta 8 THC (Δ8 THC), which is one of perhaps a hundred cannabinoids found in the cannabis plant, as well as in other plants. I’m torn between my desire to tear into the “advertising quacks who weary with tales of countless cures,” (In the words of The Mikado, who goes on to say “whose teeth I’ve enacted shall all be extracted by terrified amateurs”). I wouldn’t go quite that far, but it does strike me that the promoters/hustlers, in proclaiming that their products will “cure” all kinds of diseases and conditions, are, among other things, tarnishing the reputations of substances that might genuinely benefit some patients in dealing with some diseases and conditions. So I will balance my desire to extract the teeth of those advertising quacks with my wish to investigate whatever benefits these substances might provide.
We have to admit that before the quacks get into it, the process of linking a particular substance with a health benefit is mostly benevolent. It arises from a hard-wired response in ourselves and our fellow-humans to ascribe a cause and effect relationship whenever we see that an effect follows a particular action. We cannot see how the action produces that effect, but we infer the cause-and-effect relationship. If we eat a bowl of chicken soup and our cold symptoms get a bit better, the chicken soup must be why we feel better.
If we think about it, all cause-and-effect relationships are inferred rather than observed. The batter swings the bat and hits the pitched ball which then reverses its direction and goes flying off towards right field. It’s immediately obvious that the contact between the bat and the ball is the cause of the ball’s reversal of direction and travel towards the bleachers. But we cannot see what actually happened. We can only infer that there was a transfer of energy – kinetic energy – between the bat and the ball. We cannot see this transfer, but we know that it took place. Acceptance of this inference is hard-wired into the ways we interact with the world. The philosopher Immanuel Kant identified this as one of the categories of perception.
These inferred cause-and-effect relationships often lead to fruitful discoveries – a speck of mold falls into a Petri dish in which a colony of bacteria are growing, and the bacteria around that speck of mold disappear. A cause-and-effect relationship is inferred – something in the mold kills the bacteria – and from that inference (and quite a bit of further investigation) comes penicillin.
However, sometimes those inferences are wrong. A woman with breast cancer applied a salve made from a certain tropical fruit and her breast cancer vanished. A natural inference is that the salve cured the breast cancer. What else could possibly have brought about that cure? But then a certain amount of investigation dispels that inference: none of the constituents of the tropical fruit seem to have any effect on cancer cells in vitro, and the same kind of salve is applied to the breasts of other women with breast cancer with no results. This is an invented and oversimplified example of the fallacy that if event B takes place after event A, then event A must be the cause of event B. However, that fallacy is real and widespread, and is a result of the basic truth that we cannot actually perceive the cause-and-effect relationship anymore than we can actually perceive the exchange of kinetic energy between the bat and the ball. The tendency to make that cause-and-effect relationship is part of the working tools of our brains.
I have gone into perhaps excessive detail on this to make the point that making assumptions that particular substances are miracle cures is not necessarily based on a desire to defraud the public, but on a natural inference gone astray, perhaps guided by wishful thinking. The advertising quack takes over after those assumptions have been made.
So let’s take a look at these miracle cures. Delta 8 comes up first.
Might Delta 8 THC have any effects on cancer?
My initial inclination was to give this one a pass. The spiel, forwarded to me by Travis, has all the usual earmarks of a hustle promoting yet one more “miracle cure” that is overlooked – nay, suppressed! – by the medical establishment and its stooges in government.
The promotion consists of the usual endless video, but happily there are ways to avoid having to watch the whole thing. Here’s how it leads off:
“Over 6,226 Americans Reportedly Beat Their Cancer…Illegally
Micah Carter, age 2, had his advanced leukemia sent into remission in just 6 days
Daniel Hilliard, a former biochemist at a leading cancer hospital, beat stage 4 prostate cancer…without chemo
Carrie Sullivan, who also grows and sells Delta 8, had stage 4 ovarian cancer…and 90 days later it was gone
Katherine Marie, age 24, saw her “inoperable” brain tumor shrink after three MRI’s… without touching chemo
Thousands of Americans reportedly using a BANNED herb called “Delta-8” to miraculously cure their cancer… Here’s how you could join this group of renegade cancer survivors—without breaking the law…”
There you’ve got it. The cure is dubbed “Delta 8,” which is Delta 8 tetrahydrocannabinol – Δ8 THC for short. For a start, it’s not illegal by any means, so we can remove that particular thrill from the pitch. There are many, many cannabinoid analogues. The particular cannabinoid that has gotten the most medical attention is Δ9 THC, which may have some legitimate medical uses.
The spiel from the Institute for Natural Healing, which ends up being an ad for their Independent Healing newsletter, goes on to sound the usual notes, such as that if Δ8 THC got to be widely used, it would bankrupt the pharmaceutical industry. Here are some tidbits:
“…a molecular breakthrough BANNED by the White House … for the last 79 years, the government has done everything in its power to abolish this cancer treatment… if politicians are REALLY concerned with our health, why don’t they outlaw chemo or radiation? Why BAN this safe, potent cancer treatment instead?
Is it because it’s 100% natural and can be grown in any home garden? So nobody can patent it? Which makes it a threat to the trillion-dollar pharmaceutical interests? The same conglomerates who wield tremendous lobbying power in Washington…and depend on conventional cancer care for $125 billion annually?”
There is not enough of the Δ8 THC in the marijuana plant for a concentrate of this particular cannabinoid, which perhaps is why it was chosen as the subject for the promotion. In other words, you cannot grow it in your home garden. To obtain the Δ8 THC supplement, you will need to join the Institute for Independent Healing. And once you join up, you will receive valuable – nay, priceless! – information that will provide you with outright cures for countless other diseases, including Alzheimer’s, etc, etc.
The promotion of course includes the names and photographs of a number of people whose cancers have been cured by Δ8 THC in a very short time. But then, a tiny note at the end of the promotion concedes that the photographs are for illustrative purposes only. Are those people real?
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Notwithstanding, the medical research community has not neglected the cannabinoids in general and Δ8 THC in particular. Although Δ9 THC is by far more common and more studied than Δ8 THC, with 7,660 papers indexed in PubMed, Δ8 THC itself is the subject of 1,097 journal papers. Of these, 51 journal papers in some way link Δ8 THC with cancer, so perhaps there is something to the hype.
By the way, not all cannabinoids come from the cannabis plant – many other plants contain cannabinoids, including Echinacea, which you may know as coneflowers. And we synthesize our own cannabinoids, known as endocannabinoids. All these affect our cannabinoids receptors.
A just-published paper (Fraguas-Sámchez A., Drugs 2018 Oct 29) which surveyed medical uses of cannabinoids, lists the possible influence of cannabinoid receptors on a large range of physiologic processes. These include energy balance, appetite stimulation, blood pressure, pain modulation, nausea and vomiting control, memory, learning, and immune response. Medical conditions possibly related to changes in cannabinoid levels include Parkinson’s disease, Huntington’s disease, Alzheimer’s disease, multiple sclerosis, anorexia and irritable bowel syndrome. And alterations in the cannabinoid system may also be associated with the growth, migration, and invasion of some tumors. The paper asserts that cannabinoids have been tested in brain, breast, and prostate cancers, but does not report any conclusions. In other words, this is all in the realm of possible relationships, and exceedingly distant from any conclusions about efficacy.
And here’s what the National Cancer Institute’s Thesaurus says about Δ8 THC:
“An analogue of tetrahydrocannabinol (THC) with antiemetic, anxiolytic, appetite-stimulating, analgesic, and neuroprotective properties. Delta-8-tetrahydrocannabinol (delta-8-THC) binds to the cannabinoid G-protein coupled receptor CB1, located in the central nervous system; CB1 receptor activation inhibits adenyl cyclase, increases mitogen-activated protein kinase activities, modulates several potassium channel conductances and inhibits N- and P/Q-type Ca2+ channels. This agent exhibits a lower psychotropic potency than delta-9-tetrahydrocannabinol (delta-9-THC), the primary form of THC found in cannabis.”
To translate that into plainer English, Δ8 THC helps prevent vomiting and anxiety, stimulates the appetite, reduces pain, and perhaps protects nerves and the brain, against what they don’t say. Potassium channels and calcium channels are involved in all kinds of regulation in the body, including heart rates. And the lower psychotropic potential means that it won’t have the same effect as smoking weed.
And here’s Doc Gumshoe’s quick take on some of the journal papers that in some form touch on the relationship between Δ8 THC and cancer:
- Cannabinoids in general have been shown to inhibit in vitro growth of cancer cells and may modulate endometrial cancer cell death.
- Synthesized compounds based on Δ8 THC showed activity against some cancer cell lines, as well as anti-malarial and antimicrobial activity.
- A cannabinoid receptor type 2 (CB2), when targeted by certain agonists, induces cancer cell proliferation and the formation of a more aggressive cancer cell phenotype.
- Δ9 THC may reduce nausea and vomiting in cancer patients; this is reported with a low level of confidence.
- The CB2 receptor has potential efficacy in cancer-associated bone disease. (Note, Δ8 THC primarily interacts with the CB1 receptor.)
- In mice, Δ9 THC enhances the anticancer effects of radiation.
- Non-THC cannabinoids induce apoptosis (cell death) in prostate cancer cells.
- Cannabinoids may inhibit inflammatory activity by inhibiting cyclo-oxygenase 2 (COX-2), which leads to the formation of prostaglandins, a pro-inflammatory agent; inflammation may be linked to colon cancer.
- Cannabinoids such as Δ9 THC may reduce cancer cell proliferation, angiogenesis (the stimulation of new blood supply to cancer cells), cancer cell metastasis, and inflammatory processes.
- In the absence of CB2 receptors, Δ9 THC has the ability to stimulate proliferation of human breast carcinoma MCK7 cells and also upregulates human epithelial growth factor receptor type 2 (HER2) cells in breast cancer.
- Δ9 THC enhances breast cancer growth by suppression of the antitumor response in tumors that express low levels of cannabinoid receptors.
- At low controlled doses, Δ9 THC is toxic, but a transiently effective anti-emetic.
None of those papers came close to suggesting that Δ8 THC could actually treat any form of cancer.
Finally, ever-curious Doc Gumshoe looked into a couple of outfits that actually produce Δ8 THC. Neither one is anywhere as near over-the-top as the Institute for Independent Healing. Essentially, there are no promises of miracle cures. Here’s what they say. First, from Oregrown, a cannabis-grower in the state of Oregon:
“Delta 8 THC is a compound found in the cannabis plant. Traditionally, it’s not found in large enough amounts to form a concentrate. However, in our lab, we perform reactions to convert Delta 9 into Delta 8 THC.
Until recently, many thought it would be impossible to create a Delta 8 THC concentrate. Studies have shown that Delta 8 THC is similar to Delta-9 THC, but has slightly different effects and benefits. According to the National Cancer Institute, Delta 8 THC has anti-anxiety, pain relieving and brain-protecting properties. In a 1995 study performed by Shaare Zedek Hospital in Jerusalem, Israel, Delta 8 THC appeared to have antiemetic properties, and a 2004 study by the Hebrew University-Hadassah Medical School in Jerusalem, Israel found Delta 8 THC to be an appetite stimulant.
The use of cannabis as a medicine shouldn’t be taken lightly. There are lots of factors one would need to consider if they were looking to use cannabis medicinally. It’s recommended to consult a doctor when looking to begin any type of cannabis treatment. In my experience, there is no hard-and-fast rule to prescribing cannabis as a medicine. Patients who have found success using cannabis have had to use a trial and error approach to finding what works best for them.”
And this, from another grower called Evolab, this one in Colorado:
“The common THC that we all know and love is scientifically known as Delta 9 Tetrahydrocannabinol. The ‘delta’ in the name indicates where a specific double bond exists on the molecule. Delta 8 THC is an isomer of Delta 9 THC, meaning it has the same number of atoms in the molecular structure. Delta 8 THC is different than Delta 9 THC only by the exact position of this double bond which is shifted slightly on the molecule. This means that Delta 8 is subtly different than Delta 9 THC, and thus researchers speculate that it interacts with cannabinoid receptors differently than Delta 9. While both Delta 8 and Delta 9 are thought to activate CB1 and CB2 receptors, researchers are still studying precisely how the compounds differ in their impact on the overall endocannabinoid system.”
Both Oregrown’s and Evolab’s statements appear to be on the up-and-up. Evidently, they are legitimate pot-growers and not advertising quacks.
Doc Gumshoe’s carefully considered conclusion is that cannabinoids in general, and also perhaps Δ8 THC, have great potential in a number of related treatment areas, not just cancer, but that the research has miles to go before we treat. The exaggerated promotion is, in this case, not only misleading, but harmful. Whatever they are selling as Δ8 THC might just possibly do some good, but it could also do considerable harm. It could conceivably be carcinogenic. What is certain is that these particular advertising quacks are spreading misinformation about a product that might eventually be genuinely useful. In the meantime, their line of blarney could be casting a possibly important product in a shabby light.
Now, let’s take a look at the other “miracle cure.”
What, if any, are the health benefits of L-carnitine?
This promotion comes from Ouro Vitae, an outfit that had not previously come to Doc Gumshoe’s attention. It starts out fairly low key:
“If you’ve never heard of L-carnitine I won’t be surprised – most people haven’t – but it’s one of the most well-kept health secrets you need to know about. Around Ouro Vitae we’ve come to call L-carnitine the “Miracle Amino” because of how many unique healthspan increasing benefits it provides.
From heart health support, exercise performance improvement, cognitive enhancement, to libido restoration, L-carnitine is a remarkably effective natural remedy – one we don’t get enough of as we age.
Internally, L-carnitine is produced by the liver and kidneys and stored in muscle, brain, and heart tissue. Externally, it’s found mostly in meat, fish, poultry, and milk. Carnitine plays an essential role in maintaining the health of the mitochondria, which are often known as the “powerplant” of the cells.”
Nothing too over-the-top here. The pamphlet I’m quoting from is by Andrew McDermott, who, according to the Better Business Bureau, is one of the two employees of Ouro Vitae. Ouro, in case you’re wondering, is the Portuguese word for gold, so the name of their company is apparently “the gold of life.” And, cut right to the chase, a supplement called “Mito Male,” consisting of that “Miracle Amino,” is their principal product.
A good chunk of their promotional material is about mitochondria, and as far as I can tell, it’s reasonably accurate. Here’s how it goes:
“Your mitochondria produce the energy that every single cell in your body needs to survive. Your brain cells, heart cells, kidney cells, and even the Leydig cells that produce testosterone in your testes, all rely on the energy from your mitochondria to do their jobs.
However, the 21st-century rat race is robbing you of this precious lifeblood by the means of a poor diet, excessive pharmaceuticals, lack of sleep, environmental pollutants and other factors that come along with modern living. These are all mitochondria destroyers and if left unchecked, are key culprit in why you experience declining energy levels, droopy muscles and plummeting sex drive.”
But then it begins to veer from the straight-and-narrow.
“L-carnitine acts like a pipeline to transport fatty acids inside the mitochondria so they can be turned into energy. However, if this pipeline breaks or gets backed up the entire system starts to crash. The problem is, your natural L-carnitine levels decrease as you age.
In fact, a group of researchers at the University of Valencia Hospital in Spain discovered that carnitine production drops a whopping 50% between the ages 40 and 60 and continues to decline for the rest of your life. Think about that. By the time you hit 60 every mitochondrion in your body could be working at 50% capacity. Which means that every organ, blood vessel, and cell in your body could be working at just 50% capacity. That’s why Carnitine is one of the most vital amino acids in your body and why thousands of studies show it’s effective at increasing health span.”
Therefore we really, really need that L-carnitine supplement. The promotional piece goes on to list the benefits of L-carnitine, which are that it enhances a number of essential aspects of our lives, including libido and sex drive, cognition, heart health, mood, sleep, and strong bones. Nowhere does it say that L-carnitine supplementation cures or treats any disease. For that, we give Ouro Vitae some credit.
However, I have not found much evidence supporting that basic claim that carnitine production drops by 50% between the ages of 40 and 60 and continues to decline thereafter. Most of the carnitine in our bodies is of our own making – we synthesize it. Dietary carnitine comes from meats and animal proteins. It was first isolated from meat in 1905; the name comes from the Latin word “carnus” meaning flesh. However, even individuals who strictly avoid these (i.e., vegans) may manage to synthesize that amino acid in sufficient quantity. There are two forms of carnitine, D-carnitine and L-carnitine, chemically identical, but mirror images of one another. Only the L form is present in the body.
Here’s what Web MD says about L-carnitine:
“L-carnitine supplements are used to increase L-carnitine levels in people whose natural level of L-carnitine is too low because they have a genetic disorder, are taking certain drugs (valproic acid for seizures), or because they are undergoing a medical procedure (hemodialysis for kidney disease) that uses up the body’s L-carnitine. It is also used as a replacement supplement in strict vegetarians, dieters, and low-weight or premature infants.
L-carnitine is used for conditions of the heart and blood vessels including heart-related chest pain, congestive heart failure (CHF), heart complications of a disease called diphtheria, heart attack, leg pain caused by circulation problems (intermittent claudication), and high cholesterol.
Some people use L-carnitine for muscle disorders associated with certain AIDS medications, difficulty fathering a child (male infertility), a brain development disorder called Rett syndrome, anorexia, chronic fatigue syndrome, diabetes, overactive thyroid, attention deficit-hyperactivity disorder (ADHD), leg ulcers, Lyme disease, and to improve athletic performance and endurance.”
I would point out that the statement that L-carnitine is used for some of those conditions, or that some people use L-carnitine for some other disorders, does not mean that L-carnitine is effective for those conditions or disorders. It might work or not.
L-carnitine is FDA-approved for persons with carnitine deficiencies due either to certain genetic conditions or as a result of hemodyalisis for some serious kidney diseases. Aside from those two specifically approved uses, the benefits of L-carnitine supplementation are unclear. Here are a few conditions for which L-carnitine may be effective:
- In persons with chest pain or heart failure, L-carnitine taken orally or intravenously may improve exercise tolerance.
- In persons with serious kidney disease who need hemodyalisis, L-carnitine may improve markers of anemia and inflammation, but does not improve quality of life, muscle cramping, low blood pressure, breathing function, or exercise performance.
- In persons with inflammation of the heart, L-carnitine apparently reduces the risk of death.
- In persons with seizure disorders such as epilepsy who are taking valproic acid to prevent seizures, L-carnitine can prevent serious liver toxicity due to valproic acid overdosage.
- In men affected by infertility, L-carnitine may increase sperm count and motility.
- In persons with elevated thyroid levels, L-carnitine seems to improve symptoms such as rapid or pounding heartbeat.
Those are statements suggesting real possibilities of benefit, but nowhere near definitive indications – L-carnitine may help or seems to improve this or that condition. But when we come to the conditions for which there is insufficient evidence, the list goes on and on. Forty-one diseases or conditions are mentioned as possibly being treated or alleviated by L-carnitine, but without sufficient supporting evidence. For some of the conditions, evidence of effectiveness is totally lacking. I note that the Ouro Vitae bulletin did not mention any of these.
Using L-carnitine does not seem to present any major risks of adverse effects. The side effects mentioned are nausea, vomiting, stomach upset, heartburn, diarrhea, and seizures. The first five of those are the common side effects that go with a large number of drugs and supplements. Seizures are obviously of much greater concern. It is also pointed out that using L-carnitine with its isomer, D-carnitine is a bad idea, because the two forms nullify each other, so the user would likely end up with a carnitine deficiency.
Where do we come out? With regard to L-carnitine, it falls into the category of “might possibly help and likely won’t hurt.” It’s far from a miracle drug or a miracle amino acid. The likelihood that most of us are significantly deficient in carnitine is quite small. With regard to the sales pitch by Ouro Vitae, it’s a good deal more honest and straightforward than the large majority of the overhyped spiels that come over the transom. I would not categorize them as advertising quacks. In comparison with the hucksters pounding the Delta 8 drum, they are model citizens.
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In my view, there is no intrinsic difference between drugs and the substances promoted as miracle cures. As Doc Gumshoe has repeatedly proclaimed while pounding the pulpit, a great many – perhaps the majority – of drug originate in natural substances. And many of the so-called “miracle cures” have genuine potential – by no means are they all snake oil. In many cases, what separates drugs from the non-drug treatments is the quality of the evidence. L-carnitine may help with any of those conditions listed above, but it’s hard to say for sure exactly how to take it – how much, how often, what effects to look for. Delta 8 no doubt has physiologic effects and perhaps also potential benefits, but accepting it as a cure for anything at all at this point is a shot in the dark.
I’m looking forward to your comments on this. In advance, Doc Gumshoe does not in the least mind being targeted as the tool of the FDA and Big Pharma. It ain’t so, but I’ve been called worse, and it won’t break my bones. Best to all, Michael Jorrin (aka Doc Gumshoe)
[ed note: Michael Jorrin, who we like to call ”Doc Gumshoe,” is a longtime medical writer (not a doctor) who shares his mostly non-investing-related thoughts with the Gumshoe community a couple times a month. You can see all of his columns here.]