Laetrile

[[File:Laetrile.svg|thumb|right|165px|Laetrile]]
[[File:Amygdalin (chemical structure).svg|thumb|right|165px|Amygdalin]]
{{altmed}}
'''Laetrile''', or laevomandelonitrile, is a trade name used for a synthetic form of '''amygdalin''', a cyanogen compound found in the seeds of stone fruits of the ''Prunus'' genus (particularly apricots) that has been sold as a [[cancer]] cure for many years by [[quack]]s. In the last few years, it's often misrepresented as '''[[vitamin]] B<sub>17</sub>''' (even though it's [[pseudovitamin|not a vitamin]]).

Laetrile can refer to two different substances: amygdalin, which occurs naturally in apricot and peach pits and in minuscule amounts in some foods (bitter almonds, brewer's yeast, buckwheat, sorghum, apple seeds, etc.), and synthetic Laetrile, a distinct but chemically related substance.  The "laetrile" obtained in Mexico is usually in fact amygdalin.  Laetrile treatment is generally associated with the [[alternative medicine|expat altie]] community in [[Mexico]], and is not approved for use in the [[United States]]<ref group=note>FDA regulations ban its use in the United States in "interstate commerce", but 24 states passed laws specifically legalizing laetrile within those states between 1976 and 1981; from 1977 to 1987, an affidavit system was set up by federal court order where terminally-ill patients could legally obtain laetrile if a physician signed an affidavit authorizing it, but this was ended in 1987. It may still be legal in as many as 20 states as long as the laetrile never crosses state lines, a rather difficult proposition. Most usually to obtain it legally, people have to travel to [[Mexico]].</ref> due to a lack of evidence that it produces any effect other than cyanide<ref group=note>Not always mild.</ref> poisoning in the patient. In the State of [[Indiana]], a physician may prescribe "amygdalin (laetrile)" for use as a "[[dietary supplement]]".<ref>Indiana Code, Section 16-42-23-4.</ref>

==Proposed mechanism and the sad truth==
The cancer-killing effect of amygdalin is attributed to the hydrogen cyanide ions, or cyanides, formed as a result of its decomposition. In addition to this, amigdalin decomposes into compounds that are not important, including benzoaldehyde and glucose. Cyanide ions block the action of cytochrome oxidase in the respiratory chain, or simply cause cell death by asphyxiation.<ref>Heather B. Leavesley, Li Li, et al., "Interaction of Cyanide and Nitric Oxide with Cytochrome c Oxidase: Implications for Acute Cyanide Toxicity", ''Toxicological Sciences'', Volume 101, Issue 1, January 2008, Pages 101–111, [https://academic.oup.com/toxsci/article/101/1/101/1657982 doi:10.1093/toxsci/kfm254].</ref> So, in order for the ions to work, the cell must use cytochromes for its respiration and hence must use the respiratory chain. In most healthy cells, this is the case, as cellular respiration consists of three steps: glycolysis, the Krebs cycle,<ref group=note>One of the most known proponents of using amygdalin to cure cancer was a notorious American conman {{wpl|Ernst Krebs||.}} He is not to be confused with the German-born British biochemist and Noble laureate {{wpl|Hans Krebs||,}} who discovered the Krebs cycle.</ref> and the respiratory chain. However, cancer cells are far more dependent on glycolysis than the latter two.<ref>Pelicano H, Xu RH, Du M, et al. "Mitochondrial respiration defects in cancer cells cause activation of Akt survival pathway through a redox-mediated mechanism". ''J Cell Biol''. 2006 Dec 18;175(6):913-23. [https://doi.org/10.1083%2Fjcb.200512100 doi: 10.1083/jcb.200512100]. Epub 2006 Dec 11. PMID: 17158952; PMCID: PMC2064701.</ref><ref>Sajnani, Karishma et al. "Genetic alterations in Krebs cycle and its impact on cancer pathogenesis." ''Biochimie'' vol. 135 (2017): 164-172. [https://doi.org/10.1016/j.biochi.2017.02.008 doi:10.1016/j.biochi.2017.02.008].</ref><ref>Reznik, Ed et al. "Mitochondrial respiratory gene expression is suppressed in many cancers." ''eLife'' vol. 6 e21592. 18 Jan. 2017, [https://doi.org/10.7554%2FeLife.21592 doi:10.7554/eLife.21592]</ref> This means that the effect of cyanide on most cancer cells is very limited.

Proponents of the use of laetrile to treat cancer believe that cancer cells contain an enzyme ({{wpl|Beta-glucosidase|β-D-glucosidase}}) that breaks down amygdalin to cyanide ions, which are thought to damage the cell, while healthy cells contain another enzyme ({{wpl|rhodanese}}) that converts cyanide ions to rhodanides (thiocyanates) excreted in the urine with much less toxicity. However, cancer cells have been found to contain rhodanese in amounts comparable to that of liver and kidney. Some cancer cells have also been found to contain only trace amounts of β-D-glucosidase.<ref>Greenberg, D M. "The case against laetrile: the fraudulent cancer remedy." ''Cancer'' vol. 45,4 (1980): 799-807. [https://doi.org/10.1002/1097-0142(19800215)45:4%3C799::aid-cncr2820450432%3E3.0.co;2-6 doi:10.1002/1097-0142(19800215)45:4<799::aid-cncr2820450432>3.0.co;2-6]</ref><ref>Duke JA (2003). ''CRC Handbook of Medicinal Spices''. CRC Press. pp. 261–262. ISBN 978-0-8493-1279-3.</ref>

Laetrile fans often cite [[anecdotal evidence]] of individual cases where laetrile appeared to work, but in every case where a sufficiently large [[sample size]] was studied, laetrile has not been shown to be effective (i.e., no [[statistically significant]] results).<ref>"The claims that laetrile or amygdalin have beneficial effects for cancer patients are not currently supported by sound clinical data." from Milazzo, Stefania et al. "Laetrile treatment for cancer." ''The Cochrane database of systematic reviews'' ,11 CD005476. 9 Nov. 2011, [https://doi.org/10.1002/14651858.cd005476.pub3 doi:10.1002/14651858.CD005476.pub3]</ref><ref>"Substantial in-vitro and in-vivo testing in animal tumor systems has shown that amygdalin is entirely devoid of significant anticancer activity." from Dorr, R T, and J Paxinos. "The current status of laetrile." ''Annals of internal medicine'' vol. 89,3 (1978): 389-97. [https://doi.org/10.7326/0003-4819-89-3-389 doi:10.7326/0003-4819-89-3-389]</ref><ref>"Amygdalin (Laetrile) is a toxic drug that is not effective as a cancer treatment." from Moertel, C G et al. “A clinical trial of amygdalin (Laetrile) in the treatment of human cancer.” The New England journal of medicine vol. 306,4 (1982): 201-6. [https://doi.org/10.1056/nejm198201283060403 doi:10.1056/NEJM198201283060403]</ref><ref>"Therefore, the claim that laetrile has beneficial effects for cancer patients is not supported by sound clinical data." from Milazzo, Stefania et al. "Laetrile for cancer: a systematic review of the clinical evidence." ''Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer'' vol. 15,6 (2007): 583-595. [https://doi.org/10.1007/s00520-006-0168-9 doi:10.1007/s00520-006-0168-9]
</ref> In spite of all this, laetrile is still presented as a "suppressed" treatment by many [[conspiracy theory|conspiratorially-minded]] quacks.

Then there is the fact that eating tons of fruit seeds is a common suicide practice because it allows for a quick death due to overdose of cyanide. Numerous cases of cyanide poisoning after taking amygdalin have been reported.<ref>[http://www.huffingtonpost.com.au/2017/09/11/melbourne-man-has-cyanide-poisoning-after-self-medicating-with-apricot-kernels_a_23203662/ Melbourne Man Has Cyanide Poisoning After Self-Medicating With Apricot Kernels: But he still won't give up the daily ritual.] by Lara Pearce (12/09/2017 9:17 AM AEST | Updated 12/09/2017 9:27 AM AEST) ''Huffington Post Australia''.</ref><ref>Jeffrey R Suchard, Kevin L Wallace, Richard D Gerkin, "Acute Cyanide Toxicity Caused by Apricot Kernel Ingestion", ''Annals of Emergency Medicine'', Volume 32, Issue 6, 1998, pp. 742-744, ISSN 0196-0644, [https://www.sciencedirect.com/science/article/pii/S0196064498700770 doi:10.1016/S0196-0644(98)70077-0].</ref><ref>Sauer, H., Wollny, C., Oster, I. et al. "Severe cyanide poisoning from an alternative medicine treatment with amygdalin and apricot kernels in a 4-year-old child". ''Wien Med Wochenschr'' 165, 185–188 (2015). [https://doi.org/10.1007/s10354-014-0340-7 doi:10.1007/s10354-014-0340-7]</ref> There really is nothing holding you back from dying via those seeds: fruit is not a {{wpl|controlled substance||.}}

==See also==
*[[Pseudovitamin]]
*[[BS|Bullshit]]
==Literature==
* Braico KT. Humbert JR. Terplan KL, et al.: Laetrile intoxication: report of a fatal case. ''New Engl. J. Med.'' 238 240,1979
* Milazzo, S. et al. (2006): Laetrile for cancer: a systematic review of the clinical evidence. ''Supportive Care in Cancer''. 15(6), p.&nbsp;583–595.
* Herbert, V. (1979): Laetrile: the cult of cyanide. Promoting poison for profit. ''Am. J. Clin. Nutr. Bd.'' 32, S. 1121-58. PMID 219680 PDF
* 'Unproven Methods of Cancer Management. Laetrile. In: 1991, CA ''Cancer J. Clin. Bd.'' 41, p.&nbsp;187-192. PMID 1902140 PDF
* Moertel, C.G., et al. (1982): A clinical trial of amygdalin (Laetrile) in the treatment of human cancer. ''N. Engl. J. Med. Bd.'' 306, p.&nbsp;201-206. PMID 7033783
* Brant J, Graceffa J: Rutherford, Priviteria, and Chad Green: Laetrile's setbacks in the courts. ''Am. J. Law Med.'' 1980 Summer;6(2):151-71
* Irving J. Lerner: Laetrile: A Lesson in Cancer Quackery. ''CA Cancer J. Clin.'' 1981; 31:91-95. doi: 10.3322 

==External links==
*{{wpa|amygdalin}}
*[http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/laetrile.html History of laetrile at Quackwatch]
*[http://www.cancer.gov/cancertopics/pdq/cam/laetrile/patient/page2 National Cancer Institute FAQ]
*[http://www.mskcc.org/mskcc/html/69118.cfm Sloan-Kettering fact sheet on Laetrile]
*[http://www.cochrane.org/CD005476/GYNAECA_laetrile-treatment-for-cancer Cochrane review of the research on laetrile to treat cancer]
*http://caonline.amcancersoc.org/cgi/reprint/31/2/91
*[https://www.ncbi.nlm.nih.gov/pubmed/?term=cyanide+apricot+kernels Cases of cyanide poisoning caused by ingestion of apricot seeds].
*[https://www.casewatch.org/board/med/grout/reprimand.shtml Death of a 18-month old child with cancer via amygdalin]. 
*https://sciencebasedmedicine.org/faith-and-supplements-b17
*http://jarvissa.blogspot.be/2009/09/how-to-kill-yourself-with-apple-seeds.html

==Notes== 
{{reflist|group=note}} 

==References==
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[[Category:Cancer woo]]
[[Category:Chemicals]]

Categories: Cancer woo, Chemicals