Can taking Vitamin C improve your public speaking and also do many other wonderful things?

Maybe, maybe not.  An article by Dale Cyphert on Managing Stage Fright says that Vitamin C:

“Reduces the effects of over-exertion, increases energy, stamina and general resistance to stress.  If you catch colds frequently are feel run-down, you night not have the energy left for giving a speech.”

But wait, there’s more! Vitamin C has been claimed to do all sorts of other amazing things. In a nine-minute infomercial, chiropractor Michael Pinkus claims that:

“....The bottom line is without enough Vitamin C and the right type of vitamin C you have low energy, pain, your immune system’s compromised, you’re more prone to cancer, heart attacks, cataracts, allergies, diabetes, the list goes on and on.”

He came up with a product called Super C22 which the Dr. Newton’s Naturals web page says:  

“...is packed with 22 of the most powerful forms of vitamin C, with each serving delivering 1500mg of vitamin C, or 2500% of the Recommended Daily Value. Let Super C22™ help to boost your energy, lower your blood pressure, and even shield against heart disease and stroke...

... You should be getting 3000-4000 mg of vitamin C daily for optimal health....”

At the very bottom of the page (in tiny type) there is the usual disclaimer that:

*”These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.”

Gee whiz! I have heard the longer infomercial on weekend early morning AM radio, and it sure sounded like claims to prevent lots of diseases. It aired Saturday after the 6:00 AM news on KBOI and ran till 6:30.

If you ask a chemist, he’ll tell you there really is only one form of Vitamin C, also known as L-ascorbic acid. It’s a fairly simple molecule of carbon (C), oxygen (O) and hydrogen (H), as shown above. What Pinkus should have said was they use Vitamin C from 22 different plant sources. Why 22? All I can think of is the irrelevant reason that there are 22 letters in the Hebrew alphabet.  

The U.S. National Library of Medicine is part of the National Institutes of Health. They have a MedlinePlus page about Vitamin C with sections on How effective is it? that uses the following categories for organization:

Effective for...
Likely effective for...
Possibly effective for...
Possibly ineffective for...
Insufficient evidence to rate effectiveness for...

The only thing Vitamin C really is effective for is Vitamin C deficiency. It is likely effective for... Iron absorption and tyrosinemia (a genetic order in newborns). Everything else falls in the third category possibly effective for or worse. (Under How it Works, it does say that Vitamin C also plays an important role in maintaining proper immune function). 

Under the last category, Insufficient evidence to rate effectiveness for, they list:

“Mental stress. Limited evidence suggests that vitamin C might reduce blood pressure and symptoms during times of mental distress.”

So, Mr. Cyphert’s claim about resistance to stress really isn’t supported.

Cataracts and Diabetes also are in that category, which disagree with Pinkus’s claims.

How about some cancers? Under the third category, Possibly effective for...,  they mention mouth cancer and other cancers. Under the worst category, Possibly ineffective for..., they list:

Lung cancer, Pancreatic cancer, and prostate cancer.

Under the last category, Insufficient evidence to rate effectiveness for, they list:

Bladder cancer, Breast cancer, Cervical cancer, Colorectal cancer, Endometrial cancer, Esophogeal cancer, Ovarian cancer, and Stomach cancer. Heart disease is also there.

What about pain? Chronic pain is listed under the third category, Possibly effective for.

How about low energy? That’s too vague to even be discussed.

What about that dose of 3000 to 4000 mg/day? It’s sky-high or mega - many times more than recommended. The MedlinePlus page says that the daily recommended dietary allowances (RDAs) are 90 mg for men and 75 mg for women. For women, 3000 to 4000 mg/day is 40 to 53 times what is recommended. That MedlinePlus page also says for adults and pregnant and lactating women not to take more than 2000 mg/day.

What might happen if you take too much?

The MedlinePlus page says that:

“Amounts higher than 2000 mg daily are POSSIBLY UNSAFE and may cause a lot of side effects, including kidney stones and severe diarrhea. In people who have had a kidney stone, amounts greater than 1000 mg daily greatly increase the risk of kidney stone recurrence.”

The last thing you need before or during a speech is severe diarrhea!

On December 21, 2014 a web page of seasonal news at Consumer Reports discussed 5 reasons to skip taking vitamin C for colds. They were:

1) It’s probably too late.
2) You might get kidney stones.
3) Your body will just eliminate it anyway.
4) It could give you diarrhea.
5) It’s not worth the money.

So, skip the excess Vitamin C, since you’ll literally just be pissing away your money.

The ball model of Vitamin C that I added captions to came from Wikimedia Commons.

Is taking a liquid homeopathic anxiety remedy more like drinking lemonade or playing an accordion?

In previous posts on this blog I have discussed both homeopathic and herbal remedies for anxiety. Recently I found the web site for a homeopathic remedy called Anxietin that added what to me was an entirely new claim in the area of complex homeopathy.


What’s in there?

First the familiar stuff. This liquid remedy has a combination of 21 distinct ingredients, so it can be a commercial brand. As is usual for homeopathy, most ingredients are made more mysterious by only giving their Latin names.  They include the following (with English translation):

Elements (2)
Aurum Metallicum (gold metal)
Phosphorus

Chemicals (9)
Argentum Nitricum (Silver Nitrate)
Arsenicum Album (Arsenic Trioxide)
Baryta Carbonica (Barium Carbonate),
Calcarea Phosphorica (Calcium Phosphate)
Glonoinum (Trinitroglycerine)
Kali Arsenicosum (Potassium Arsenite)
Kali Phosphoricum (Potassium Phosphate)
Muriaticum Acidum (Hydrochloric Acid)
Natrum Phosphoricum (Sodium Phosphate)

Plants (10)
Aconitum Napellus (Wolfsbane or Monkshood)
Alfalfa
Avena Sativa (Common Oat)
Chamomilla (German Chamomile)
Gelsemium Sempervirens (Yellow Jessamine)
Ignatia Amara (Strychnos Ignatia; contains both Strychnine and Brucine)
Lupulus Humulus (Humulus Lupulus; Common Hop)
Passiflora Incarnata (True Passionflower)
Staphysagria (Delphinium)
Stramonium (Datura Stramonium; Jimson Weed or Locoweed)


How much is in there?

Here’s where things get either interesting or silly. Their web site says that:

“Anxietin’s unique multi-potency formula contains three dilutions (10X, 30X, and LM1) of each active homeopathic ingredient, in equal amounts, in one bottle. These active ingredients are stabilized in our oligotherapeutic water base to help maximize absorption. Unlike most homeopathic medicines, Anxitetin does not contain irritating alcohol or sugar and is gluten free.” 

That formula isn’t really unique since it’s also sold as the less expensive Anxietrex Pet Anxiety Formula.

These three dilutions (or potencies) supposedly are like a musical chord (potency chord,  or accord, or homaccord), and somehow act together but distinctly from each other. That peculiar concept is about a century old. (There are other products like Aconite Plus that even contain four dilutions). This notion of potency chords throws out the idea of a chemical concentration, and I don’t buy it.

An LM1 dilution means that a substance is mixed with 50,000 parts of water and then shaken (succussed). Therefore its concentration would be 20 parts per million (ppm).

In homeopathy dilutions followed by an X mean that a substance is mixed with ten parts of water, shaken, and then diluted repeatedly. A 10X dilution thus contains 1 part in 10 to the tenth power, or 0.0001 ppm. A 30X dilution supposedly contains just 0.000000000000000000000001 ppm, but actually is completely immaterial (magic) since at 24X there wouldn’t even be one molecule left. So, the concentration of each substance would theoretically be the average of the first two, 20.0001 ppm. I doubt that the volume of the LM1 dilution could be measured so precisely that adding the 10X dilution would make any practical difference.

By the way, the label says that Anxietin also contains two preservatives - 0.1% potassium sorbate 0.1% (1000 ppm), and 0.0075% citric acid (75ppm). They are present at higher concentrations than those active ingredients. 
 

Will it help?

Who knows! I’ve previously blogged about how there wasn’t conclusive evidence that Argentum Nitricum, Gelsemium, or Passionflower would reduce anxiety in humans.

The image of a boy playing the accordion came from Wikimedia Commons.

What’s the story on valerian and anxiety?

On November 28th Joe and Teresa Graedon’s People’s Pharmacy had a brief article titled Public Speaking Phobia Dissolves with Herbs. Someone wrote them about how taking a valerian capsule had reduced her anxiety, which let her speak at her retirement party. If it worked for her, will it work for you?

People’s Pharmacy articles also appears as newspaper features. Sometimes the articles get different titles. The Durham, North Carolina Herald-Sun and the Athens (Ohio) Banner-Herald both used the same title. The Houston Chronicle said that Valerian takes the edge off public speaking, while the Jackson, Mississippi Clarion-Ledger just said Capsule may relieve anxiety. Which title is closest to the truth?

When we look up valerian at the National Center for Complementary and Alternative Medicine, we find their summary web page says that:

“* Research suggests that valerian may be helpful for insomnia, but there is not enough evidence from well-designed studies to confirm this.


*  There is not enough scientific evidence to determine whether valerian works for other conditions, such as anxiety or depression.”

In September 2009 I blogged about herbal remedies for anxiety, and mentioned two review articles about valerian - one by Ernst and a Cochrane review. Both concluded there was no clear evidence for it reducing anxiety.

Ten years earlier Carolyn Mar and Stephen Bent published An evidence based review of the 10 most commonly used herbs. They also said the evidence for valerian being effective then was inconclusive. (See the summary table in the full .pdf file version. It was printed too light to show in a scan for the single page.) In 2008 Stephen Bent took a look at the current top ten herbs in Herbal Medicine in the United States: Review of Efficacy, Safety, and Regulation, but valerian wasn’t on that list.

What can we learn from this? Just because something is popular doesn’t mean that it is effective (or completely safe). Do your own homework. Don’t uncritically believe someone else’s story, even if it got whispered right in your ear.

The image came from here at the Library of Congress.

An astroturfing comment about herbal remedies for anxiety

Someone with an empty Blogger profile of “A DiClementi” drove by and dropped (like a fresh dog turd) the following comment regarding my September 18 post on herbal remedies for anxiety:

“To cure anxiety attacks, herbs are the best medicine. No side effects, no giddiness, etc. Deep breathing exercises are excellent for anxiety and many people report positive results from meditation. Some other natural anxiety remedies to look into are St.John's Wort, SAMe, L-Theanine, and Tryptophan.

http://www.sociatropin.com”

Astroturfing has been defined as: “Generating public excitement in a subject by posting anonymous comments to blogs, wikis and other public venues.”

It only took me a few minutes with Google to find a profile showing that Anthony Joseph DiClementi actually is the Managing Director of SociaTropin, which is, of course, yet another herbal remedy with a long list of ingredients.

On October 5 he also posted word-for word the same comment on a blog post by Caitlin MacKenna about Kava Kava: A Natural Anxiety Reducer. He is wrong about there being no side effects for kava, as I discussed in my previous post.

They first distributed a press release about SociaTropin on June 1, 2008. A few day later Arlin Cuncic commented skeptically on her Social Anxiety Disorder Blog at About.com regarding the press release, and in comments Mr. DiClementi replied by stating, among other things, that:

“For full disclosure, I am the Director of Marketing and a Co-Creator of SociaTropin. I have personally taken this product for nearly 2 years and continue to use it to this day.

I want to be clear that SociaTropin is not a magic bullet or a miracle pill; it won’t give you a new personality or make you a different person.

But it does contain over 20 ingredients that have been shown in double-blind placebo controlled scientific studies to: enhance mood, relieve stress and social anxiety, and increase natural energy levels. The meta-analysis supporting SociaTropin’s ingredient profile is undeniable.”

The 13 ingredients explicitly listed on the web site are: Rhodiola Rosea, 5-HTP, Sensoril Ashwagandha (Withania somnifera), Bacopa, L-Theanine (as SunTheanine), St. Johns Wort (Hypericum perforatum), Cyracos Lemon Balm, Ginkgo Biloba, L-Tyrosine, Panax Ginseng (Panax quinquefolius L.), Bioactive Forms of Essential B Vitamins, Valerian, and Passion Flower. Under B vitamins they list “B6, B12, and other B vitamins”, but I am not clear if (or how) all this really adds up to “over twenty.”

I found Mr. DiClementi’s comment about his ingredients amusing, given that SociaTropin contains both passiflora and valerian. In my previous blog post I pointed out that there really is no good evidence that either ingredient is effective. Are the other eighteen (or more) ingredients any more effective?

As the Irish comedian Dara O’Briain says (at about 2:40 into the video clip I referred to in the previous post): “Get in the …sack!”

Herbal remedies for anxiety

A number of herbal products are advertised as remedies for anxiety, including anxiety related to public speaking. The real remedy for anxiety just is preparation and enough practice or rehearsal.

A tablet called Bravina “The Speech Pill” was advertised on page 23 of the February 2009 issue of Toastmaster magazine. Two angry letters to the editor appeared in the April issue. There also were blog posts from Darren Baker and Ian Whitworth. Some claims for Bravina were withdrawn after a review by the National Advertising Division (NAD) of the Council of Better Business Bureaus.

I Googled and quickly found another four products. (Of course there actually are more, but these five are a reasonable sample). All employ combinations of herbal ingredients. Their mixtures are much like the “secret herbs and spices” used in the coating that makes commercial fried chicken tasty. Some products also add vitamins and minerals.

For example, Bravina contains: St. John’s Wort, Motherwort, Passiflora, Ashwagandha, Valerian Root, Eleuthero Root, Panax, Ginko Biloba, and Octacosanol.

Clarocet NRI contains: St. John’s Wort, Passiflora, Winter Cherry, Rhodiola Rosea, and 5-HTP.

Confidrex contains: Niacinamide (Vitamin B3), Panax Ginseng, Potassium, Magnolia Bark, Pyridoxine (Vitamin B6), Magnesium, Blue Scullcap, Methylcobalamin (Vitamin B12), Fennel Seed, Passion Flower (Passiflora), L-Theanine, and 5-Hydroxytryptophan.

PureCalm contains: Passiflora, Lavender, and Lemon Balm. It comes from the same folks who brought you the homeopathic remedy called SocialFear ReliefTM, that I discussed last month.

Serydyn contains: Passiflora, Valerian Root, L-Theanine, Niacinamide (Vitamin B3), and Magnesium Taurinate.

Are these combinations of ingredients effective? Are they safe? If you look at the bottom of their web pages for the small, light print (or click on their disclaimers) they are careful to say that their claims have not been evaluated by the Food and Drug Administration (FDA), and caution that you should consult your physician.

Has the common ingredient in these five remedies, passiflora, been shown to be effective in random, placebo controlled clinical trials (as are used to test modern pharmaceuticals)? Clinical trials compare a drug with an inert substance (a placebo), and neither the doctors nor the patients know who got which remedy. I looked up passiflora and some other ingredients out in the PubMed medical journal abstracts database. For the full texts of articles you may have to visit either your public library, or your friendly local state university library.

In 2006 Ernst discussed Herbal Remedies for Anxiety – A Systematic Review of Controlled Clinical Trials. He evaluated evidence for: blue skullcap, gotu kola, guarana, kava, keenmind, lemon grass, passion flower (passiflora), and valerian. His conclusion was that:
“Apart from kava, none has been shown beyond reasonable doubt to be efficacious (effective).”
Unfortunately there also are doubts about whether kava is completely safe, which is why it does not appear in the five products previously mentioned.

I also looked at the most recent review article I could find (2009) on Natural Remedies for Anxiety Disorders: Potential Use and Clinical Applications by Kinrys et al. You can read the abstract here. They found that:
“…although there is currently no evidence supporting the use of natural remedies as first-line treatments of anxiety, the limited data available suggest an overall safe side effect profile for such agents and their potential and future clinical use for the treatment of anxiety symptoms.”
In other words, they may be safe, but have not yet been proven to be effective.

Both passiflora and valerian also have been evaluated in Cochrane reviews. You can read their full texts online for free. The 2007 review on Passiflora for Anxiety Disorder concluded that:
“RCTs [random clinical trials] examining the effectiveness of passiflora for anxiety are too few in number to permit any conclusions to be drawn.”

The 2006 review on Valerian for Anxiety Disorders also concluded that:
“…there is insufficient evidence to draw any conclusions about the efficacy or safety of valerian compared with placebo or diazepam for anxiety disorders.”

In a ten-minute YouTube video rant, the Irish comedian Dara O’Briain, whose wife reportedly is a physician, comments (at about 2:55 in the video) that:

“I’m sorry, herbal medicine? Herbal medicine has been around for thousands of years. Indeed it has. And then we tested it all, and the stuff that worked became MEDICINE. And the rest of it is just a nice bowl of soup and some potpourri. So, knock yourself out.”

Proceed with caution before you take herbal medicines. As TV commercials say, ask your doctor if it is right for you. Visit the reference section of your public library. Look up the effects (and side effects) of all the ingredients in a product before you just buy it and try it.

I would rather ingest some of the brightly covered, placebo pills shown above. A whole box is just a dollar. They have pleasant tropical fruit (candy) flavors. Their brand is the nicknames for Michael and Isaac.