Can anyone tell me why the new generation of "vet skeptics" are so insistent on remaining anonymous? I've been reading "skeptvet" and "skeptivet" but cannot determine from their "about" why they are qualified to question the experience and recommendations of specialists with more scientific training. Can someone help me here?

semantics

It's "veterinary medicine" or "veterinary practice". That's a noun with a descriptive adjective, telling you what we do.

"Veterinarian medicine" and "veterinarian practice" are incorrect. On so many levels. Don't do that.

Kthx.

Signed,
Grammar nazi

Grains #2 - not as allergenic as you thought

Grainless foods are popular these days. And sometimes rightfully so – I know many have seen a difference when they switch an ailing dog or cat from a standard grain-based food to one that is lower in "carbohydrates" (presumably starch). It’s wrong to blame the grains, though, in many cases (I’ve talked about this here before).

Quick tutorial: Carbohydrates are essentially fibers, sugars and starches. Some (starches and sugars, mostly) are digestible, and are degraded from large molecules on ingestion to small molecules that are absorbed in the small intestine for energy. Grains like barley, wheat, corn, and oats contain digestible and indigestible carbohydrates in addition to fatty acids and proteins – they are more complex than a simple carbohydrate such as starch. Digestible carbohydrates are also contained in root vegetables like potatoes and yams, yuca (or tapioca), taro root, etc.

My biggest quibble with companies that tout a ‘grainless’ label on a dry food is that they are not carbohydrate-less, which is in reality what most pet owners think they are getting when they search for a Paleolithic, low carb (i.e. low starch) diet. I’m just saying, pet owner beware, because you cannot make a dry food without some carbohydrate, and these companies will simply substitute a starch from potato, sweet potato, tapioca or the like to do it. That’s not necessairly a 'low carb’ food.

But I want to talk about today is why some animals do better when switched from a high starch, or even moderate starch food, to a low starch food.

Many people go looking for alternative pet foods because they are forced to – they have a chronically ill animal (“chronically ill” pretty much defining a condition not amenable to conventional therapy). You would almost have to live under a rock to avoid the advice you’d get from fellow pet owners, pet store employees and websites that grain-free diets fix everything from skin disease to GI disorders to cancer.

In the case of animals with chronic conditions of many types, the central problem may be a sick gut. We used to (and still do) call this a leaky gut, but more recently gastroenterologists have come to agree that the condition exists, and call it a hyperpermeable gut. Chronic inflammation of the gut may appear due to food allergy or less well understood inflammatory processes like inflammatory bowel disease. Even a transient gastroenteritis or antibiotic therapy can lead to inflammation of the gut lining.

There are probably many arthritic dogs on long term therapy with nonsteroidal anti-inflammatory agents such as Metacam®, Previcox®, Deramax®, and Rimadyl® walking around with leaky guts, as well. The syndrome even has a name – NSAID enteropathy. For your edification, a review from the Journal of Pharmacy and Pharmaceutical Science in 1999 stated unequivocally that in people, “NSAIDs produce inflammation of the small intestine in 40 to 70% in long-term users” (Davies 2000). And if you’re really interested, “Exposure of the small bowel mucosa to NSAIDs is thought to lead to the loss of intracellular integrity and increased permeability because the NSAIDs damage surface membrane phospholipids and cause an uncoupling of oxidative phosphorylation” (Feagins 2010). Interestingly, NSAID use is also associated with lower numbers of Lactobacillus in the bowel (the good bacteria) which are known to improve gut mucosal integrity. (Mäkivuokko, 2009)

So chronic inflammation in the gut begins to erode the most superficial layers of the mucosal lining. The microstructure of the gut consists of tiny folds called villi, and the villi themselves have surfaces composed of enterocytes (cells of the gut mucosa) that have microvilli on the end that is exposed to the gut lumen. These cells actively secrete enzymes and other products that aid in normal digestion, absorption, and even immunity, and these products become more active as they mature, moving from the deeper layers of the gut to the tips of the microvilli. So what happens when the most superficial layer of the gut is eroded away due to inflammation?

One of the earliest theories from holistic medicine writers was that the gut immune system is exposed to abnormally intact molecules of food, and the animal (or person) subsequently develops food allergy or gluten enteropathy. Since the immune system can potentially become sensitized to any protein ingested, the poor patient experiences signs of food allergy constantly, including skin inflammation and diarrhea, and if you read the more esoteric literature, arthritis and a wide variety of autoimmune diseases.

But another circumstance suggests a simpler explanation for the inconsistent stool we see in some of these animals that eventually improve on a ‘grain free’ or low carb diet. In the ‘stressed’ enterocyte, mature digestive enzymes – disaccharidases that digest starches and sugars – are lost because of erosion of the luminal end – the part that is exposed to the GI contents, NSAIDs, etc. Examples of disaccharidases include lactase, maltase, sucrase, trehalase, isomaltase, and others.

So, disaccharides that result from digestion of more complex carbohydrates in the stomach and upper intestine flow down into the small intestine where disaccharidase enzymes would further digest them into a form that is easily absorbed. If they remain in disaccharide form, they are not absorbed and in fact pull water into the intestine. The result is loose stool, or diarrhea.

The problem is compounded the longer it exists. Carbohydrate malabsorption will lead to increased bacterial fermentation, which will cause gas and discomfort. Bacterial overgrowth (due to a surfeit of nutrition for them) can itself lead diarrhea.

So the neighbor comes along and recommends a grain-free diet, and the dog or cat gets better, and once again, the grains get the blame, when in actuality, the *starch* should get the blame. While allergy may or may not be a component of the reaction seen when grains are fed to these animals, the carbohydrate overload seems to be a bigger problem. And as I said before, carbohydrates are certainly common in ‘grain free’ diets - grain free does not mean low starch.

The good news is this – and I can verify that clinically this is extremely common – these ‘allergies’ aren’t permanent, unless the patient has a genetic disaccharidase deficiency (which is vanishingly uncommon in dogs and cats). In general, balancing the bacterial populations with probiotics, changing the diet so that it contains lower carbohydrate levels and sometimes different proteins, and addressing the cause of the initial bowel inflammation is all that is needed. Whether or not the owner wants to go back to feeding a diet higher in carbohydrates depends on other factors, like owner philosophy, financial capacity to buy the more expensive meat products, and whether the dog or cat has a weight problem (carbohydrates are used in weight loss diets to ‘cut’ the fat while still giving some bulk to the diet).

I just had to get this out there. Temporary carbohydrate intolerance is different from real food allergies. It's a much better diagnosis for your pet though, as there are no permanent food restrictions.

References
Davies NM, Saleh JY. Detection and Prevention of NSAID-Induced Enteropathy.J Pharm Pharmaceut Sci 3(1):137-155, 2000

Feagins LA, Cryer BL. Do Non-steroidal Anti-inflammatory Drugs Cause Exacerbations of Inflammatory Bowel Disease? Digestive Diseases and Sciences 2010;55(2):226

Mäkivuokko H, Tiihonen K, Tynkkynen S, Paulin L, Rautonen N. The effect of age and non-steroidal anti-inflammatory drugs on human intestinal microbiota composition. Br J Nutr. 2010 Jan;103(2):227-34. Epub 2009 Aug 25.

Teaching your dog to walk on a treadmill

We do alot of obesity management in my practice. With many dogs (and cats), there comes a point where calorie restriction isn't enough. We need to institute exercise programs both to burn calories and also to increase the ratio of lean body mass to fat mass (lean body mass has a higher metabolic rate and therefore burns more calories). The animals with orthopedic problems need special handling and we usually recommend underwater treadmills or swimming for them. For dogs with good joints and no pain, the owner's own treadmill can do a world of good.

I was looking recently for information on how to train a dog to use a treadmill and found alot of them on YouTube. One was absolutely terrible - a guy simply gets on the treadmill and plops his dog on it, forcing the frantic dog to stay on it. In response to the variability of recommendations out there, I asked my technician, Vera, to research the issue. She wrote this and I think it's good:

How to Train Your Dog to Walk on a Treadmill

1) Purchase a treadmill. Many owners use a human treadmill but special animal treadmills are also available. You can find animal treadmills on these and other websites: www.hammacher.com, www.frontgate.com, and www.dogtrotter.net.

2) Allow your dog to get familiar with the treadmill in the room for a few days. Do not turn it on.

3) Allow your dog to smell the treadmill. Reward your dog’s behavior if s/he goes up to the treadmill by offering small treats. Placing small treats along the length of the treadmill is also recommended so that s/he gets comfortable stepping onto the treadmill.

4) After a few days, turn on the treadmill. Let your dog get familiar with the sound of the treadmill. Reward your dog’s behavior by offering small treats beside the treadmill while it is running. Do not place your dog on the treadmill at this time. Let your dog see you having a slow pleasant walk on the treadmill if using your own.

5) Once your dog is comfortable with the sight and sound of the treadmill, it is time to get him on the treadmill. Ask the dog to step onto the treadmill and while giving a stream of treats, turn it on to the lowest speed. Start the treadmill at the slowest speed. Offer small treats to keep him on the treadmill. You may want to stand in front of the treadmill so that your dog stays in position.

6) You can use your dog’s leash as an aid, but NEVER tie your dog to the treadmill.

7) Once your dog is comfortable walking on the treadmill, you can slowly increase to the recommended speed for your dog.

You may be able to find instructional videos using a google search. Use search terms such as “teach train treadmill dog.” The following youtube videos may be helpful in your training:

http://www.youtube.com/watch?v=I25QXJLXHNg
http://www.youtube.com/watch?v=1eXNOMkcFGc

These trainers used various methods but what they have in common is a slow introduction to the treadmill, avoidance of force, and lots of treats.

What do you think? Do you have a favorite method or success stories to tell?

Thanks for the kudos to Bark Magazine!

I'm honored! Bark Magazine gave me an honorable mention after their Top 100 best and brightest in the Feb/Mar 2010 issue.

I'm in some really heady company - see them here: http://thebark.com/content/barks-best-brightest-honorable-mentions

But look at the Top 100 - Bark Magazine, I think you got it right! (http://thebark.com/media/BestBrightest_58.pdf)

Thanks!

Diversion: 50 sushi tips for beginners

This great article was posted on the MRI Technician Schools website (http://www.mritechnicianschools.org/50-sushi-tips-for-beginners/).

'Cause where else would you expect to find the definitive guide to sushi etiquette?

Seriously - answers some of my long standing questions like, here are the out-takes from the article:

50 sushi tips for beginners

3. Use the pickled ginger (gari) as a palate cleanser.

Almost all Japanese dishes come accompanied by both a wad of wasabi and a small pile of lively pink or ecru gari. Eat a slice between sushi pieces to keep the palate feeling fresh and clean. Doing so imbues diners with the ability to taste the full complex flavor of every different roll, wrap, nigiri, or other sushi style.

[Article does not mention that pickled ginger has been studied for its ability to kill metazoan parasites. Not that they stop me from eating sushi - I'm just pointing this out for your edification).


8. Order sake with sashimi. Sushi tastes best with beer or tea.

Because sake is made from fermented rice, most sushi connoisseurs consider drinking it with sushi a redundancy. It complements sashimi fine, but those hoping for a beverage best suited to accompany nigiri, maki, or other sushi dishes would do best to drink hot tea or beer instead. Try to avoid rice beers, of course.


10. Chopsticks are optional when it comes to sushi.

Sashimi should be eaten with chopsticks, but it is not considered rude to consume nigiri or maki sushi without any utensils whatsoever. There are several different accepted techniques to hold the pieces and keep them together with the fingers.

11. Dip pieces of nigiri sushi into soy sauce (shoyu) topping side first.

Rice soaks up shoyu quickly, overpowering the delicate vinegar flavoring. While it may be awkward at first, turn nigiri pieces upside-down so that the sauce covers the topping instead. This allows diners better control of their condiments and does not compromise taste.

12. Eat nigiri pieces upside-down.

Doing so brings out the complex, carefully balanced flavors in the sushi best. Eating nigiri rice-first may cause palates to predominately taste the light, starchy vinegar over the topping.

13. Eat nigiri pieces in one or two bites.

Most nigiri comes with a subtle smear of wasabi between the topping and the pillow of rice. One to two bites ensures that the diner consumes the piece as it was meant to be tasted – with all ingredients painstakingly playing off one another. Three or more bites may mean missing out on all the itamae’s carefully constructed crafting.


15. Pour shoyu sparingly.

Again, prudently utilizing condiments minimizes waste, but cultural implications are also at play here. Pouring too much soy sauce may be interpreted as an insult to the sushi chef’s abilities, implying that his skills at balancing flavor are sub-par and require masking with liberal amounts of shoyu.

23. Buy the itamae a sake or beer to show appreciation.

Doing so does not take the place of a tip, of course, but many enjoy establishing a rapport with the sushi chef and treating him or her to a sake or beer as a way of showing appreciation for an exquisite meal.

24. If drinking from a carafe, dining companions should refill each other.

This typically holds for alcoholic beverages, but it also a nice, polite gesture when consuming tea from a shared container as well. Individuals must serve others before serving themselves, and wait patiently for their dining companions to follow suit when in need of more drink. Alternately, if serving oneself, be sure to offer others a refill first.

26. Be sure to tip both the waitron and the itamae.

At sushi establishments, it is advisable to leave tips for the waiter or waitress as well as the chef. If there is not a tip jar available at the bar, simply add it to the bill and indicate the split.

30. Do not eat raw freshwater fish.

Far more parasites are present in freshwater fish than those residing in saltwater because the majority cannot handle the high salinity of the latter’s environment. In fact, certain breeds of tapeworms explicitly thrive in the muscles of some freshwater species. Because of this very high risk of infection, it is never safe to eat raw fish from freshwater habitats.

32. If offered a hot towel (oshibori), practice proper protocol.

Some sushi bars and restaurants proffer hot towels to patrons before or after a meal. Clean hands, perhaps lightly and subtly pat around the mouth, then fold the towel neatly before returning it to the waitron.

33. Chopsticks should be set down in the preferred manner when not in use.

There are generally a few different ways to put chopsticks down when going unused. Some may elect to set them on their small saucer for shoyu, though sometimes special chopstick rests are available as well. At some bars or restaurants, the waiter, waitress, or sushi chef will create lovely origami knots from the paper chopstick holders for use as a rest.

39. Feel free to slurp noodles.

Some diners may appreciate a side of soba or udon noodles to accompany their sushi meal. Slurping them is not considered taboo in Japanese etiquette protocol – in fact, it helpfully sucks in air to cool off the usually piping hot dishes. Soup, however, is generally enjoyed in a far quieter fashion.

40. Miso soup may be eaten without a spoon.

Occasionally, sushi bars and Japanese restaurants will serve their soups without a spoon. This may seem unfamiliar to American diners, but it is actually not a mistake on the part of the waitron. If handed a bowl of soup that lacks any sort of utensil, simply lift it up and drink it directly from the bowl. This is not considered an etiquette violation in Japan, nor will it in an explicitly Japanese environment.


47. Order pieces of nigiri in pairs.

The tradition of serving sushi two at once comes from a time when diners would have to cut their pieces in half to eat them without choking. Beyond that, ordering one piece of nigiri or ordering four of something have unfortunate etymologies attached to them in Japanese. It is generally recommended to order in pairs to avoid awkwardness.

50. The only steadfast rule is practice common courtesy and politeness.

In the end, though, just about the only thing that truly matters in the sushi experience is whether or not patrons treat themselves and everyone around them with respect and courtesy. Being awkward with chopsticks or using too much soy sauce or flubbing pronunciations are window dressing, really – it will not carry any truly inescapable or demonizing stigmas. Relaxing, being polite, being nice, and having a great time is truly the spirit of eating sushi and eating it well.

Who knew MRI technician school had a liberal arts component?

Is Centrum toxic?

Is Centrum Toxic?
By Susan G. Wynn, DVM and Heather Vogl, DVM

I formulate a lot of homemade diets and a source of vitamins and minerals, usually as a multivitamin, is critical to prevent deficiencies. My default multi is Centrum for two reasons: 1. it has a nice balance of vitamins and minerals without too much of any and 2. it is obtainable all over the country in small towns and large ones.

Occasionally I get complaints because someone wants a 'healthier' multi and while it usually results in a much more complicated diet, I can do use those. I can't argue with this inclination as I, too, prefer a whole food-extracted multi rather than a synthetic, but there is no proof that one is better than the other. The synthetic vitamins and minerals are well absorbed and can fulfill the needs for these essential nutrients. The complaints I've gotten are apparently based on one website:

www.centrumistoxic.com

The author of the website (which was apparently written in 2006 and has not been updated since) uses a few techniques to scare readers. For every ingredient, the manufacture is described in detail, apparently to scare readers with unfamiliar chemical names. The author consistently claims that inorganic forms of minerals are toxic and inappropriately active in the body, but these claims are not referenced. The toxicity studies cited in general describe trials where very high doses were used, rather than normal dietary doses. The circumstances are often different as well, quoting epidemiologic studies reporting widespread environmental contamination.

It also is not a critical review, as references cited are selected to show the author's bias, and do not analyze the literature as a whole or even fairly describe study conclusions (look at calcium carbonate, below, for instance). Finally, the site is completely anonymous - even the "about us" page lends no clue as to who the author is and whether they work for other companies or have some similar conflict of interest, or even knowledge enough to interpret the data quoted.

Below are specific analyses of the author's claims.

Magnesium Oxide is claimed to be "biologically inactive, and is not found in this form in foods". Magnesium Oxide can cause a pronounced laxative effect in higher amounts...(how does it have a laxative effect if it is biologically inactive?). The Hazardous Substances Data Bank (HSDB) cited refers almost entirely to toxicity from inhaling particles of magnesium oxide. The toxic dose for an adult human is stated by the Hazardous Substances Dtabase as "0.5-5 G/KG, BETWEEN 1 OZ OR 1 PINT (OR 1 LB) FOR 70 KG PERSON (150 LB)". That's a minimum of 35,000mg. Centrum contains 50mg. Our conclusion: logical inconsistency, lack of supporting references, dishonest representation of toxicity study.

Potassium chloride is stated to have "one of the highest salt index ratings (116) among commercial fertilizers and can cause injury to plants which is known as "burning." (so does table salt and dog urine). The site says "Potassium toxicity involves the following symptoms: gastrointestinal distress, e.g. nausea, vomiting, abdmoninal discomfort and diarrhea." (prunes can have the same effect). People with kidney problems should be especially careful when ingesting potassium that is not from a food source.(actually, Noni juice has caused toxicity in this group of people as well). Come on people - potassium chloride is *salt substitute* which is sold as a condiment. People can eat 2000-3000 mg/day of this stuff. Centrum contains 80mg. Our conclusion: logical inconsistency, lack of supporting references.

Microcrystalline cellulose - this is what the website has to say “The safety of ingesting this synthetically produced chemical has not yet been unequivocally determined. We do not yet know if it is a carcinogen, ground water contaminant, has developmental or reproductive toxicity, or is an endocrine disruptor. Nonetheless, evidence exists that it is toxic in mammals.(intravenous application of microcrystalline cellulose (MCC), in a dose of 5 mg/kg twice weekly for 10 weeks,1979)”. The study quoted is the only one apparently published, and the experimental design was based on administering microcrystalline cellulose intravenously at a high dose. The equivalent dose for a human of normal weight is 350 mg. There is no listed amount on Centrum, but it cannot contain more than about 30mg if you calculate the weights of the other components in each tablet. Our conclusion: logical inconsistency, lack of supporting references, dishonest representation of toxicity study.

Ascorbic Acid: The site says “although not known to be directly toxic, there is growing evidence that ascorbic acid causes a mild physical dependency, whereby removal of this chemical causes vitamin c levels in the blood to drop below baseline. Its use has also been correlated with increased incidence of kidney stones, and may be indicated in other problems caused by calcification of soft tissue.” (no references given). The development of oxalate stones may be increased with ANY form of vitamin C. I don’t even know how to evaluate the ‘mild physical dependency claim’ since no reference is given. Our conclusion: logical inconsistency, lack of supporting references.

Ferrous fumarate is inorganic iron. The website claims that it is “pro-oxidative, stimulating the damaging effects in the body of substances known as free radicals.(1) There is evidence linking high inorganic iron intake to cardiovascular disease and cancer. Excessive iron accumulates in the liver, and may feed bacterial and viral infection.”. The studies cited used 120 mg of ferrous fumarate in people with Crohn’s disease and inflammatory bowel disease. The Crohn’s paper actually states in the discussion that these patients probably absorb more iron due to their deficiency status and possibly the state of the gut itself. Centrum contains less than half the amount used in those studies. From the Wikipedia link on page: Humans experience iron toxicity above 20 milligrams of iron for every kilogram of mass (that would be 1400 mg daily), and 60 milligrams per kilogram is considered a lethal dose. Overconsumption of iron in children is usually due to eating large quantities of ferrous sulfate tablets intended for adult consumption, which is a preventable toxicity. The Dietary Reference Intake (DRI) lists the Tolerable Upper Intake Level (UL) for adults as 45 mg/day. For children under fourteen years old the UL is 40 mg/day. Centrum appears to contain exactly the amount of elemental iron required by menstruating women (L Hallberg and L Rossander-Hulten. Iron requirements in menstruating women. American Journal of Clinical Nutrition, Vol 54, 1047-1058). Our conclusion: logical inconsistency, lack of supporting references, dishonest representation of toxicity study.

Calcium carbonate - the site claims “risk factors associated with inorganic calcium ingestion, i.e. calcification of soft tissue, osteoarthritis, constipation, kidney stones, hypertension and various other side effects of poorly utilized calcium. Lancet and the British Medical Journal, recently published the results of two extensive clinical trails [sic] which concluded that calcium plus Vitamin D does nothing to prevent bone loss”. Actually, these studies note that calcium/D3 DOES benefit bone mineral density and that other studies show that it does prevent fractures.... both new studies had significant compliance concerns, with only 60 percent of respondents taking their supplements more than 80 percent of the time by the two-year mark. Our conclusion: logical inconsistency, lack of supporting references, dishonest representation of toxicity study.

dl-Tocopherol is biologically unprecedented and may have adverse side effects. New research demonstrates that taking only 1 member of the E family, which includes 4 tocopherols (alpha, beta, gamma, delta tocopherols) and 4 tocotrienols (alpha, beta, delta, gamma tocotrienols), may cause a deficiency of the other members. It is believed that the ingestion of dl-alpha tocopheryl in isolation may cause a deficiency of the heart-protective form known as gamma tocopheryl, hence adversely effecting the functioning of the heart.” Our conclusion: lack of supporting references.

Ascorbyl Palmitate - The site’s evidence for toxicity includes a link to one in-vitro study (enhanced uv damage in keratinocytes) and a lab animal study on bladder stones and retarded growth. (For every in vitro study suggesting damage, there are multiples of that number suggesting a benefit from the antioxidant activity.). Our conclusion: logical inconsistency, dishonest representation of toxicity study.

BHT is claimed by the site to be “suspected to be mutagenic and carcinogenic. BHT has been banned for use in food in Japan (1958), Romania, Sweden and Australia. The US has barred it from being used in infant foods”. In a comprehensive review of toxicity studies done over the years, (Lanigan RS, Yamarik TA. Final report on the safety assessment of BHT(1). Int J Toxicol. 2002;21 Suppl 2:19-94), doses used on rats and mice ranged from 50mg/kg of BW to 1500mg/kg BW. Interestingly in some of those studies, the test animals lived longer than control animals. At any rate, the dose of BHT in centrum is a tiny fraction of 1 mg/kg BW. Our conclusion: lack of supporting references, dishonest reprentation of toxicity studies.

Chromic chloride – from the site: “Although trivalent chromium like Chromic Chloride is far less poisonous than the hexavalent form, it is definitely a toxic substance, known to exhibit genotoxic, mutagenic, teratrogenic (reproductive hazard) and is on the Hazardous Substance list. ( no reference given). Centrum contains 120 mcg (.12 millgrams) of chromic chloride, which according to Federal Drinking Water standards is above the 100 mcg per Liter limit for safe consumption”. The reference here is not given, so I don’t know if it refers to 100mcg of chromic chloride or 100mcg of elemental chromium (I suspect the latter). Human beings are supposed to drink 2 liters per day, resulting in a top dose of 200 mcg daily of elemental chromium. Centrum contains 35 mcg of elemental chromium, right in line with recommendations for adequate daily intake. Our conclusion: lack of supporting references.

Calcium stearate is stated as "may be toxic" with the following justification - "It is entirely synthetic, and does not occur in nature. No toxicological studies have been carried out on this substance to date." Our conclusion: lack of supporting references, completely made up ‘toxicity’ claim.

Crospovidone – “Very little research has been done on the toxicity of this biologically unprecedented synthetic, however, animal studies showed this substance was carcinogenic, caused inflammation, pneumonia, and other adverse effects”. I was unable to studies of oral toxicity on this compound – most reports were when surgical antiseptic solutions were used to lavage body cavities. Our conclusion: lack of supporting references.

Cupric oxide is said to be “ generally considered a toxic substance in its unbound form. Virtually all copper in the body is present as a component of copper proteins. Unbound or inorganic copper produces oxidative stress in the body, catalyzing highly reactive hydroxyl radicals. Centrum contains 2mg of cupric oxide, supposedly 100% of the RDA. And yet, Federal EPA drinking water standards consider anything above 1.3 mg per Liter to be a health risk” The site does not define whether they think Centrum contains 2 mg of cupric oxide or elemental copper, but Centrum actually contains 0.5 mg of elemental copper. The human water requirement is about 2 liters per day, making the safe upper limit for an adult human 2.6 mg/day. Our conclusion: logical inconsistency

Cyanocobalamin – “ human studies have reported allergic reactions to skin testing, and mice given 1.5-3 mg/kg body weight experienced convulsions, followed by cardiac and respiratory failure”. It is important to keep some perspective here – FOOD causes allergic reactions in many, many people, and the lab animal study used a low dose of 1.5 - 3 mg/kg of cobalamin, - the usual human dose is 0.006 mg/kg). The site also says that because “some people lack the proper enzyme to actively detoxify and convert cyanocobalamin, or are overwhelmed by the ingestion of too much cyanide, it can accumulate in the body resulting in toxicity”. This occurs at very high doses and in people with congenital abnormalities – and certainly not at the dose provided in Centrum. Our conclusion: logical inconsistency, dishonest representation of toxicity study.

FD&C Yellow 6 (Sunset Yellow) according to the site “has the capacity for inducing an allergic reaction. It is associated with ADD and ADHD. (no reference given) This colourant is prohibited as a food additive in Finland and Norway. According to Dr. Andrew Weil, ‘The chemicals used to create colour are energetic molecules, many of which are capable of interacting with and damaging DNA. Anything that deranges DNA can injure the immune system, accelerate aging, and increase the risk of cancer. Indeed, many synthetic food dyes once considered safe have turned out to be carcinogenic’." Remember, natural food items cause allergies. References were not provided here, but it is true that the European Food Safety agency is concerned about reports of Sunset Yellow causing hyperactivity in people. The recommended top daily dose is 1 mg/kg of body weight. The dose in Centrum is something less than 0.1mg/kg of body weight.

Hydroxylpropryl Methylcellulose is “used as an excipient in drugs and supplements like Centrum.There are no long term toxicological studies available on this synthetic substance”. And yet this site labels it as “may be toxic”. Our conclusion: lack of supporting references, completely made up ‘toxicity’ claim

Magnesium Borate is “may have adverse antibiotic action vis-a-vis intestinal flora”. Link given about ‘borates and their uses and toxicity’ is dead. Our conclusion: lack of supporting references.

Magnesium Stearate is “used to make large scale production tableting of supplements and drugs possible, this chemical excipient is produced through reacting sodium stearate with magnesium sulfate, in a way similar to the production of other hydrogenated oils (a component of the diet of most people). potentially dangerous substance whose Hazardous Substance Databank Number is: 664”. The link to non-human toxicity studies does not function. According to the MSDS form: Chronic Health Effects: This product has no known chronic effects. Repeated or prolong exposure to this compound is not known to aggravate medical conditions. Acute Health Effects: This product is not listed by NTP, IARC or regulated as a Carcinogen by OSHA. Our conclusion: lack of supporting references.

Manganese Sulfate/MnSO4H2O - According to this site: “Toxicological data indicates it is tumorigenic, mutagenic and teratogenic”. The conclusion of the study cited was actually: Under the conditions of these 2-year feed studies, there was no evidence of carcinogenic activity of manganese (II) sulfate monohydrate in male or female F344/N rats receiving 1,500, 5,000, or 15,000 ppm. There was equivocal evidence of carcinogenic activity of manganese (II) sulfate monohydrate in male and female B6C3F1 mice, based on the marginally increased incidences of thyroid gland follicular cell adenoma and the significantly increased incidences of follicular cell hyperplasia. The doses given to the test animals ranged from 60-7400mg/kg of body weight. Centrum contains a total of 2.3 mg of manganese, or about 0.03 mg/kg BW. Our conclusion: lack of supporting references, dishonest representation of toxicity study.

Nicotinic Acid (Niacinamide) - According to this site: “large doses are known to cause liver problems as severe as liver failure.“ Nicotine has a half-life of about 60 minutes, and the liver is equipped to break down remaining amounts of nicotine. The toxic dose of niacinamide is 3000mg/day (M. Knip, I. F. Douek, W. P. T. Moore, H. A. Gillmor, A. E. M. McLean, P. J. Bingley, E. A. M. Gale and for the ENDIT Group. Safety of high-dose nicotinamide: a review. Diabetologia 2000; 43 (11): 1337–45.). The dose in Centrum is 20mg. Our conclusion: lack of supporting references, dishonest representation of toxicity study.

Nickelous Sulfate is described thusly: “classified within the National LIbrary of Medicine's "Hazardous Substances Data Base" (HSDB) as an animal and human carcinogen. It is classified by the National Institute for
Occupational Safety and Health (NIOSH) as "immediately dangerous to Life and Health," and a potential occupational carcinogen.” One link cited does not work, and the other supplied link states: An increase in mortality was not observed in chronic studies in rats or dogs fed nickel sulfate in the diet at doses up to 188 mg/kg/day for rats and 62.5 mg/kg/day for dogs (Ambrose et al. 1976). Centrum contains 5 micrograms (0.005 mg) per tablet per their website. Our conclusion: lack of supporting references, dishonest representation of toxicity study.

Polysorbate 80: “Polysorbate 80 is produced using ethylene oxide (which is known to cause cancer in rats). “ The issue here is the polysorbate, not the ethylene oxide. Polysorbate is used in ice cream to maintain its consistency, and IV medications such as amiodarone to keep them in proper form for administration. According to a study in the periodical Reproductive Toxicity, In Europe and America people eat about 0.1 grams of polysorbate 80 in foods per day. The study cited is a test tube study, which has no relevance to a living system. Our conclusion: lack of supporting references, dishonest representation of toxicity study.

Potassium Iodide “Chronic overexposure can have adverse effects on the thyroid”. The very study cited concludes : The results of our studies suggest that excess KI has a thyroid tumor-promoting effect, but KI per se does not induce thyroid tumors in rats. In this study, the intake of potassium bromide was 55 mg/kg of body weight daily. The dose in Centrum is about 0.3 mg (providing 0.15 mg iodine), or 0.004 mg/kg of body weight. Our conclusion: lack of supporting references, dishonest representation of toxicity study.

Pyridoxidine Hydrochloride (B6). Site states: “Extremely large doses in range of 2 to 6 g/kg (2000-6000 mg/kg) produce convulsions & death in rats and mice. Lower doses (50mg injections) have interfered with the endocrine system of rats by suppressing pituitary secretions.” The lowest dose here is about 25-30 mg/ kg of body weight. The total dose in Centrum is 2 mg, or 0.03 mg/kg of body weight in a person. Our conclusion: lack of supporting references, dishonest representation of toxicity study.

Silicon Dioxide - Site states: “ Although this chemical is known to have extensive acute, subchronic and chronic toxicities in animal studies, silicon dioxide is considered an acceptable food additive by the FDA.” Silicon is a vital trace mineral found in many foods. The author states This is primarily because of a lack of understanding the difference between silica found in food, or mammalian tissues, and inorganic forms. The qualitative difference is profound, and though theelemental silica content may be the same in a chard of glass and a piece of celery, the biological difference is as profound as the difference between life and death.” There isn’t a single supporting bit of science for this claim. Our conclusion: lack of supporting references.

Sodium Aluminum Silicate. Site claims “known to be a neurotoxin for over 100 years, and today it is known to be a major causative factor in diseases like Alzheimers.” No source is cited. Nobody knows what causes Alzheimer's. The Material Safety Data Sheet states that this chemical is only a mild skin irritant and if inhaled fresh air should be breathed.

Sodium ascorbate – the site states: “sodium ascorbate may affect genetic material (mutagenic) based on animal tests”. The link provided on the site clearly states: Ascorbic Acid and Sodium Ascorbate were not genotoxic in several bacterial and mammalian test systems, consistent with the antioxidant properties of these chemicals. Our conclusion: lack of supporting references, dishonest representation of toxicity study.

Sodium Benzoate – the site states: “Sodium benzoate is a synthetic preservative which has been shown to have an antibiotic effect on the essential friendly gut flora. The link provided on the site states: Benzoic acid is produced by many plants as an intermediate in the formation of other compounds (Goodwin, 1976). High concentrations are found in certain berries (see section 6.1). Benzoic acid has also been detected in animals. Benzoic acid (chemically equivalent) therefore occurs naturally in many foods, including milk products (Sieber et al., 1989, 1990). Sodium benzoate IS toxic to cats, at doses of at least 50mg/kg. It is AAFCO-approved at 14mg/kg (0.1% of the diet). The dose in Centrum is less than 10mg total, or 2mg/kg for a cat (0.15mg/kg for people). Our conclusion: lack of supporting references, dishonest representation of toxicity study.

Sodium Borate - the site states: “Definitely toxic” but does not supply a reference. MSDS information: Acute oral toxicity (LD50): 2.66 mg/kg [Rat.]. Acute Toxic Effects on Humans: Ingestion of 5-10 grams has produced severe vomiting, diarrhea, shock and death. Chronic Effects on Humans: Not available. That is a huge amount compared to the amount in Centrum (<2% of tablet per label). And I cannot find it in the ingredient listing in Centrum anyway. Our conclusion: lack of supporting references, dishonest representation of toxicity study.

Sodium Citrate – the site states: May be toxic with no source cited. “an unhealthy liver may have difficulty with this substance potentially resulting in an accumulation of bicarbonate (the metabolic derivative of citrate) which can cause metabolic alkalosis.” The MSDS states that topical contact is only slightly hazardous and to wash hands. Ingestion of large doses may well cause metabolic alkalosis, but Centrum contains less than 10mg total which is far from a dangerous dose. Our conclusion: lack of supporting references.

Sodium Metavanadate is stated to be “a form of vanadium with known toxicity when ingested or inhaled. It is a skin, eye and respiratory irritant.” In the study cited, the lowest dose given to geese and ducks was 10mg/kg of body weight. My calculations suggest (based on sodium metavanadate containing 42% elemental vanadium) is that Centrum contains 0.023 mg of sodium metavanadate, for heavens’ sake! Our conclusion: lack of supporting references, dishonest representation of toxicity study.

You know, I’m tired of doing this. I’ve spent 1 ½ days debunking the claims made here, and the author of this website is so consistently wrong that I’m not going to finish with the rest of the list.

So would I take Centrum? Yes, if I felt I really needed a basic multi and nothing else was available. But is Centrum toxic? Resoundingly no. Just another example of why you need to learn what constitute good information, and to check out claims made by Internet sites, your chiropractor and if you are really skeptical, your doctor or veterinarian.