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== Controversy ==<!-- This section is linked from [[Vitamin C]] -->
== Controversy ==<!-- This section is linked from [[Vitamin C]] -->


Rath's research remains controversial in medical circles.
Rath's theories, claims, and research remain controversial in medical circles.


Frank Ulrich Montgomery (former chairman of the Marburger Federation, roughly translated as Federation of German Physicians) and Michael Bamberg (executive of the German Cancer Foundation) have demanded legal procedures against Dr Rath following the death of a child (Dominik Feld) suffering bone cancer which metastisised to the lungs. The child's parents, prior to his death, had taken their son off chemotherapy treatment and put him on Dr Rath's nutritional supplement therapy.
Frank Ulrich Montgomery (former chairman of the Marburger Federation, roughly translated as Federation of German Physicians) and Michael Bamberg (executive of the German Cancer Foundation) have demanded legal procedures against Dr Rath following the death of a child (Dominik Feld) suffering bone cancer which metastisised to the lungs. The child's parents, prior to his death, had taken their son off chemotherapy treatment and put him on Dr Rath's nutritional supplement therapy.

Revision as of 22:28, 5 July 2008

Matthias Rath, M.D. (born 1955 in Stuttgart, Germany) is a German physician and vitamin entrepreneur.[1][2]

Rath studied medicine in Germany and subsequently worked as a scientist at the university hospital in Hamburg and the German Cardiac Center in Berlin. His research focused on new risk factors for cardiovascular disease and he has been quoted in standard textbooks on atherosclerosis and coronary artery disease.[3] He was the head of Cardiovascular Research at the Linus Pauling Institute in Palo Alto, California, USA.[4] He advocates the use of vitamins and other micronutrients as a treatment for cardiovascular disease,[5] [6] cancer,[7][8] and HIV/AIDS.[9]

According to Eversheds - Rath's solicitor - the Dr. Rath Health Foundation is "a not-for-profit body which conducts research into science-based natural therapies."[10] In 2005, according to Reuters, the Foundation distributed tens of thousands of pamphlets in poor black South African townships claiming that HIV medication was "poison" and urging HIV-positive people to choose Rath's vitamins instead.[11] Trials of these vitamins as a replacement therapy for HIV in poor black neighborhoods resulted in at least five deaths.[12]

Rath has been a controversial figure. The Sunday Times (Johannesburg) described him as a "controversial international campaigner for the use of natural remedies" whose "theories on the treatment of cancer have been rejected by health authorities all over the world."[13] Rath's promotion of vitamin supplements rather than antiretroviral medication to treat HIV/AIDS in South Africa has been the subject of widespread criticism,[1][2][14][15] and South African President Thabo Mbeki and Minister of Health Manto Tshabalala-Msimang have also been criticized by the medical and AIDS-activist community for their perceived support for Rath's claims.[14][16][17] In 2008, the High Court in Cape Town ruled that Rath had conducted unlawful trials of his vitamin therapies, and barred Rath from conducting unlawful clinical trials or advertising his products.[18]

Claimed discoveries

Cardiovascular disease

Rath has made numerous comparative studies of humans and animals and claims to have discovered that animals who can synthesise vitamin C naturally do not suffer heart attacks. Humans do not have this ability, thus need to obtain the vitamin C from a balanced diet. Rath advocates increased intake of vitamin C to prevent atherosclerosis, heart attack and stroke. He argues that vitamin C deficiency in Western diets causes microscopic lesions in the artery walls, which instead of being repaired are filled up with fats which later harden through dystrophic calcification, leading to typical symptoms of high blood pressure (reduced artery wall elasticity) and heart disease complications.[19][20] His research in the area of cardiovascular disease is summarized in his book ‘Why Animals Don’t Get Heart Attacks... but People Do.’[21]

Cancer

In addition, Rath claims discoveries in the area of cancer, in particular having identified natural ways to block the spread of cancer cells (metastasis).

He argues that the growth and metastasis of cancer are facilitated when the balance between mechanisms breaking down and building the connective tissue shifts towards breakdown. He points out that the body makes widespread use of these mechanisms during normal (physiological) conditions, e.g. a) during ovulation, when egg cells migrate from the ovary to the fallopian tube; b) during the restructuring of the uterus and the breast in pregnancy and lactation, when huge amounts of tissue have to be remodelled; c) during infections when white blood cells (leucocytes) migrate through the tissue to the site of infection.[22] He argues that in case of cancer, normal control of these mechanisms fails and the tissue degradation continues uncontrolled.

Rath claims that the uncontrolled release of degrading enzymes in cancer can be blocked by the natural amino acid lysine. He advocates that a high daily intake of lysine - in particular in combination with vitamin C – can block cancer cells from spreading.

Rath has published a series of articles claiming in vitro evidence of this approach for more than 30 human cancer cell types. These studies have also identified in vitro synergism between lysine, polyphenols and other micronutrients.[23][24][25][26][27][28] Organized in vivo clinical studies using this new approach to cancer have not been published. An independent review of Rath's claims by the Swiss Study Group for Complementary and Alternative Methods in Cancer (SKAK) in 2004 found "no proof that the vitamin preparations of Dr. Matthias Rath have any effect on human cancer" and advised against their use.[29]

Immune deficiencies

Rath and his research team advocate the use of micronutrients to improve the immune response against infections and help fight immune deficiencies.

They speculate that their studies of avian flu-infected chickens show that a composition of micronutrients can significantly reduce viral infectivity, but they do not measure viral replication directly.[30] While this research shows a small difference in disease-specific lesions between treated and untreated animals, use of the nutrient supplement is also associated with a doubling of the death rate over infected but nutrient supplement-untreated animals.

In a special feature article published in the 2007 Commonwealth Health Ministers Book, Rath and colleagues claim that studies conducted with both single and multiple nutritional supplements have shown that micronutrients act to control HIV infection and AIDS in three specific ways, which include: (i) suppression of virus multiplication and spread; (ii) restoration of cell-mediated immune responses and (iii) slowing the rate of AIDS progression and reducing the severity of AIDS-defining and disease-related symptoms.[31]

Controversy

Rath's theories, claims, and research remain controversial in medical circles.

Frank Ulrich Montgomery (former chairman of the Marburger Federation, roughly translated as Federation of German Physicians) and Michael Bamberg (executive of the German Cancer Foundation) have demanded legal procedures against Dr Rath following the death of a child (Dominik Feld) suffering bone cancer which metastisised to the lungs. The child's parents, prior to his death, had taken their son off chemotherapy treatment and put him on Dr Rath's nutritional supplement therapy.

Rath's efforts to persuade South Africans to use his vitamin supplements rather than antiretroviral medication to treat HIV/AIDS have also been controversial.[2][1][32][33]

Independent studies of efficacy

Swiss Study Group for Complementary and Alternative Methods in Cancer

In 2004, the Swiss Study Group for Complementary and Alternative Methods in Cancer (SKAK), an independent group which evaluates alternative medical treatments, examined Dr. Rath's vitamin preparations and the marketing claims made by Dr. Rath.[29] The Study Group reported that they "found no proof that the vitamin preparations of Dr. Matthias Rath have any effect on human cancer" and "advise against their use in cancer prevention and treatment while recommending a diet rich in fruit and vegetables."[29] Specifically, the Swiss Study Group report criticized Rath for:

  • Making sweeping, unsubstantiated claims of efficacy. Rath has claimed that his vitamin treatments can cure all forms of cancer, as well as most infectious diseases, including AIDS.[34][35] However, Rath notes at the end of his advertising brochure that sometimes, especially in cases of advanced illness, even his treatments cannot fully restore health.[35]
  • Citing anecdotal reports of success which could not be confirmed. In the case of one patient allegedly "cured" by Rath's methods, the Study Group found that "it is not even certain from a medical perspective if cancer was present."
  • Using a self-developed test of efficacy, rather than using widely accepted and verified tests and endpoints.

The conclusion of the Swiss Study Group regarding Dr. Rath's vitamin formulations was: "A cancer-curing effect has not been documented for any of these substances. Nor is there any proof that the preparations sold by Matthias Rath, some with high dosages, are useful in cancer prevention – leave alone curing cancer. Rath still owes proof regarding the correctness of his claims. Proof of effect cannot be provided by analogy with in vitro, animal or cell experiments. Because there is no proof for effect nor for the harmlessness of the preparations, SKAK advises against their use."[29]


Rath has been involved in a number of legal cases.

  • In 2005, the Advertising Standards Association of South Africa (ASASA) issued three separate rulings against Dr. Rath, finding that he had made false and misleading claims regarding the effectiveness of his supplements and describing his advertisements as "reckless in the extreme".[36][40] Rath disregarded the ruling and continued the misleading advertisements, leading the ASASA to rule that, "in light of the gravity of [Rath's] breaches", he was required to submit all further advertising to the ASASA for prior approval.[41]
  • In 2006, the High Court of South Africa found that Dr. Rath had defamed the Treatment Action Campaign (TAC), an AIDS non-profit organization, by publicly making false and misleading statements about the TAC. Rath was ordered to cease his defamatory remarks "to ensure that the TAC's continued participation in the debate is not hamstrung by defamatory and unfounded allegations."[36][42]
  • In 2006, the July 22 issue of the British Medical Journal (BMJ) published a news item reporting that Dr. Rath had gone on trial in Hamburg, Germany "for fraud" in relation to the death of Dominik Feld. However, the BMJ subsequently retracted the news item "on legal advice" and issued an apology to Dr. Rath, stating that the BMJ accepted that "the allegations we published were without foundation."[43] A subsequent libel claim by Rath was settled by the BMJ for ₤100,000.[44][45]
  • In 2007, the German Federal Constitutional Court issued a ruling in favour of Rath. The Federal Constitutional Court found that the prohibition of the broschure and poster "Stop the pharmacartel" and "Stop the codex-plans of the pharmacartel" by judgements of courts in Berlin in 2000/2001 was unjustified as it violated Rath's fundamental rights, e.g. the right of free speech.[46]
  • In 2008, the Cape Town High Court issued an interdict barring Dr. Rath from advertising his products as a treatment for AIDS, and stating that the clinical trials he has been running in black townships are illegal. The ruling also found that "Health Minister Manto Tshabalala-Msimang and her department had a duty to investigate Rath's activities."[47]

Criticism

Rath and the Rath Foundation have been criticized for disparaging the effectiveness of antiretroviral medication, and for misusing or misrepresenting the published medical literature in order to promote the use of multivitamin products.

Harvard multivitamin study

To support the use of multivitamins in HIV/AIDS, Rath has cited a study conducted by the Harvard School of Public Health, published in the New England Journal of Medicine,[48] suggesting that multivitamin supplementation slows the progression of HIV to AIDS.[49]

In May 2005, the study authors released a statement condeming Rath's "irresponsible and misleading statements, as in our view they deliberately misinterpret findings from our studies to advocate against the scale-up of antiretroviral therapy."[50] The study authors felt that Dr. Rath had misused their study results to argue that multivitamins should be used in place of antiretroviral medication. In their statement, the study authors affirmed the central role of antiretroviral medication in the treatment of AIDS, and indicated that multivitamins should be, at most, a supplementary treatment.[50]

Claims of WHO and UN support

Rath's advertising material has suggested that his nutritional supplements are superior to antiretroviral therapy in the treatment of HIV/AIDS, and implied that his claims were endorsed by the World Health Organization, UNICEF, and UNAIDS. However, these agencies issued a joint statement condeming Rath's advertisements as "wrong and misleading".[15][51]

Use of published medical literature

A study published in the British Medical Journal in 1998 examined some of the claims made by Dr. Rath and Health Now in support of Rath's multivitamin supplement blend.[52] The authors found that Rath listed 40 citations to support his product; however, on examination, only 8 of these citations were of actual clinical trials. After examining these clinical trials, the authors concluded that despite Rath's claims to the contrary, "no general clinical benefit of vitamins C and E and carotene can be proved from the works cited by Health Now."[52]

Other criticism

To address the "confusion" created by Rath's advertising campaign, the South African Council of Churches issued a statement that Rath's activities in South Africa "can only be interpreted as misguided strategies to promote Dr. Rath's own brand of nutritional supplements." The Council affirmed the importance of both antiretroviral medication and good nutrition for people with HIV, and pointed out that multivitamins are distributed by public health services and need not be obtained from Rath's organization.[53]

References

  1. ^ a b c The Denialists: The dangerous attacks on the consensus about H.I.V. and AIDS, by Michael Specter. Published in The New Yorker on March 12 2007. Accessed April 16 2007.
  2. ^ a b c "Denying science". Nat. Med. 12 (4): 369. 2006. doi:10.1038/nm0406-369. PMID 16598265.
  3. ^ ’Atherosclerosis and Coronary Artery Disease’, Volume 1, Page 160. Edited by Valentin Fuster, Russell Ross and Eric Topol. Published by Lippincott-Raven, Philadelphia, Pennsylvania, United States. Published 1996.
  4. ^ Swiss cancer centre Brief biography of Dr. Rath. as pdf - Accessed June 2006
  5. ^ 'Extracellular matrix-mediated control of aortic smooth muscle cell growth and migration by a combination of ascorbic acid, lysine, proline, and catechins.’ J Cardiovasc Pharmacol. 2007 Nov;50(5):541-7. Published 2007. Accessed February 29, 2008.
  6. ^ 'Anti-atherogenic effects of a mixture of ascorbic acid, lysine, proline, arginine, cysteine, and green tea phenolics in human aortic smooth muscle cells.’ J Cardiovasc Pharmacol. 2007 Mar;49(3):140-5. Published 2007. Accessed February 29, 2008.
  7. ^ 'Naturally produced extracellular matrix inhibits growth rate and invasiveness of human osteosarcoma cancer cells.’ Med Oncol. 2007;24(2):209-17. Published 2007. Accessed February 29, 2008.
  8. ^ 'Inhibition of pulmonary metastasis of melanoma b16fo cells in C57BL/6 mice by a nutrient mixture consisting of ascorbic acid, lysine, proline, arginine, and green tea extract.’ Exp Lung Res. 2006 Nov-Dec;32(10):517-30. Published 2006. Accessed February 29, 2008.
  9. ^ ‘Role of micronutrients in the control of HIV and AIDS’. Commonwealth Health Ministers Book 2007, pages 187-189. Published by Henley Media Group Ltd in association with the Commonwealth Secretariat. Published 2007. Accessed April 8, 2008.
  10. ^ 'BMJ pays out to doctor over 'child death' story.’ Press Gazette magazine. Published June 5, 2007. Accessed April 8, 2008.
  11. ^ SOUTH AFRICA: South African Activists Take On AIDS 'Dissident', by Gordon Bell. Published by Reuters on April 19 2005; accessed May 9 2008.
  12. ^ South Africa: TAC prevails over Rath. PlusNews Global, 13 June 2008. Accessed 15 June 2008.
  13. ^ Dissidents take their crusade to the streets, By Rowan Philip and Edwin Lombard. Published in the Sunday Times (Johannesburg) on November 30 2004; accessed May 9 2008.
  14. ^ a b Kapp C (2005). "SA health minister urged to stop vitamin-peddling doctor". Lancet. 366 (9500): 1837–8. doi:10.1016/S0140-6736(05)67739-2. PMID 16315355. {{cite journal}}: Unknown parameter |month= ignored (help)
  15. ^ a b U.N. slams AIDS 'dissident' for attack on drugs, by Stephanie Nebehay. Published by Reuters on May 12 2005; accessed May 9 2008
  16. ^ 'Minister defends vitamin guru’s views on AIDS, nutrition’ Business Day newspaper, South Africa. Published April 13, 2005. Accessed June 3, 2008.
  17. ^ TAC calls for Manto’s head over Rath. Published June 13 2008; accessed June 20 2008.
  18. ^ South African court bans AIDS vitamin trials. Published by Reuters on June 13 2008; accessed June 20 2008.
  19. ^ 'Hypothesis: Lipoprotein(a) is a surrogate for ascorbate.’ Proc. Natl. Acad. Sci. USA. Vol. 87, pp. 6204-6207, August 1990. Published 1990. Accessed March 25, 2008.
  20. ^ 'Solution to the Puzzle of Human Cardiovascular Disease: Its Primary Cause is Ascorbate Deficiency Leading to the Deposition of Lipoprotein(a) and Fibrinogen (Fibrin) in the Vascular Wall.’ Journal of Orthomolecular Medicine. Vol. 6, Nos. 3 & 4, 1991. Published 1991. Accessed March 25, 2008.
  21. ^ Why Animals Don't Get Heart Attacks... but People Do’. Fourth Revised Edition. Published 2003. Accessed March 25, 2008.
  22. ^ 'Plasmin-Induced Proteolysis and the role of Apoprotein(a), Lysine and Synthetic Lysine Analogs.’ Journal of Orthomolecular Medicine. Vol. 7, No. 1, 1992. Published 1992. Accessed March 25, 2008.
  23. ^ <http://www.ncbi.nlm.nih.gov/pubmed/17564322?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum> 'Anti-tumor effect of ascorbic acid, lysine, proline, arginine, and epigallocatechin gallate on prostate cancer cell lines PC-3, LNCaP, and DU145.’ Res Commun Mol Pathol Pharmacol. 2004;115-116:251-64. Published 2004. Accessed May 13, 2008.
  24. ^ <http://www.ncbi.nlm.nih.gov/pubmed/16734861?ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum> 'Antitumor effect of ascorbic acid, lysine, proline, arginine, and green tea extract on bladder cancer cell line T-24.’ Int J Urol. 2006 Apr;13(4):415-9. Published 2006. Accessed May 13, 2008.
  25. ^ <http://www.ncbi.nlm.nih.gov/pubmed/16594917?ordinalpos=16&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum> 'Inhibition of matrix metalloproteinase-2 secretion and invasion by human ovarian cancer cell line SK-OV-3 with lysine, proline, arginine, ascorbic acid and green tea extract.’ J Obstet Gynaecol Res. 2006 Apr;32(2):148-54. Published 2006. Accessed May 13, 2008.
  26. ^ <http://www.ncbi.nlm.nih.gov/pubmed/16142336?ordinalpos=18&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum> 'Inhibitory effect of a mixture containing ascorbic acid, lysine, proline and green tea extract on critical parameters in angiogenesis.’ Oncol Rep. 2005 Oct;14(4):807-15. Published 2005. Accessed May 13, 2008.
  27. ^ <http://www.ncbi.nlm.nih.gov/pubmed/15965275?ordinalpos=20&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum> 'In vitro and in vivo antitumorigenic activity of a mixture of lysine, proline, ascorbic acid, and green tea extract on human breast cancer lines MDA-MB-231 and MCF-7.’ Med Oncol. 2005;22(2):129-38. Published 2005. Accessed May 13, 2008.
  28. ^ <http://www.ncbi.nlm.nih.gov/pubmed/15879623?ordinalpos=21&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum> 'Antitumor effect of a combination of lysine, proline, arginine, ascorbic acid, and green tea extract on pancreatic cancer cell line MIA PaCa-2.’ Int J Gastrointest Cancer. 2005;35(2):97-102. Published 2005. Accessed May 13, 2008.
  29. ^ a b c d Report from the Swiss Study Group on Complementary and Alternative Methods in Cancer, stating that there is no evidence that Rath's treatments are effective. Accessed 21 Sept 2006.
  30. ^ 'Holistic efficacy of specific nutrient synergy against avian flu virus: pathology and immunomodulation.’ Veterinaria Italiana, 43 (1), 43-54. Published 2007. Accessed April 4, 2008.
  31. ^ ‘Role of micronutrients in the control of HIV and AIDS’. Commonwealth Health Ministers Book 2007, pages 187-189. Published by Henley Media Group Ltd in association with the Commonwealth Secretariat. Published 2007. Accessed April 8, 2008.
  32. ^ A New All-time Low, by Ben Goldacre. Published in "Bad Science" in The Guardian on January 20 2007. Accessed April 16 2007.
  33. ^ Death by Denial, from The New Republic. Published March 12 2007. Accessed April 16 2007.
  34. ^ Rath, M.: Durchbruch der Zellforschung im Kampf gegen den Krebs. 3d ed. 2002, MR Publishing B.V., Almelo, NL
  35. ^ a b Rath, M.: Cellular health Series – Cancer. 2/2001, MR Publishing, Sta. Clara, CA 95054
  36. ^ a b c d e "Quackery quashed, but Rath's legacy lives" Donaldson A and Huisman B, The Times, SA, 14 June 2008 Accessed 16 June 2008.
  37. ^ Press release describing Dutch court decision against Dr. Rath for defamation, accessed 19 Sept 2006.
  38. ^ Ruling by the British Advertising Standards Association against Matthias Rath for false and misleading advertising, accessed 19 Sept 2006.
  39. ^ Letter from the U.S. Food and Drug Administration warning Dr. Rath that his marketing campaign is in violation of the Federal Food, Drug, and Cosmetic Act. Accessed 19 Sept 2006.
  40. ^ Matthias Rath's ads 'reckless in the extreme', by Elvira van Noort. Published in the Mail & Guardian on August 30 2005; accessed May 9 2008.
  41. ^ Rulings against Matthias Rath for false and misleading advertising by the Advertising Standards Association of South Africa, accessed 19 Sept 2006.
  42. ^ Judgement of the High Court of South Africa ordering Dr. Rath to cease making defamatory and unfounded allegations against the Treatment Action Campaign. Accessed 19 Sept 2006.
  43. ^ Dr Matthias Rath: an apology. British Medical Journal, 23 September 2006. Accessed January 2007.
  44. ^ News in Brief, from the British Medical Journal, 2007;334:656 (31 March).
  45. ^ 'BMJ pays out to doctor over 'child death' story.’ Press Gazette magazine. Published June 5, 2007. Accessed April 10, 2008.
  46. ^ Judgement of German Federal Constitutional Court of July 12, 2007, no. 1 BvR 2041/02. Published 2007. Accessed April 16, 2008.
  47. ^ IOL News for South Africa and the World
  48. ^ Fawzi W, Msamanga G, Spiegelman D, Wei R, Kapiga S, Villamor E, Mwakagile D, Mugusi F, Hertzmark E, Essex M, Hunter D (2004). "A randomized trial of multivitamin supplements and HIV disease progression and mortality". N Engl J Med. 351 (1): 23–32. doi:10.1056/NEJMoa040541. PMID 15229304.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  49. ^ Dr. Rath's website, citing the New England Journal of Medicine study among others. Accessed 20 Sept 2006.
  50. ^ a b Statement from the authors of the Harvard School of Public Health study, stating that Dr. Rath has misused their study results. Accessed 20 Sept 2006.
  51. ^ Watson J (2005). "Vitamin guru provokes wRath of scientists, activists". Nat Med. 11 (6): 581. doi:10.1038/nm0605-581a. PMID 15937452.
  52. ^ a b Tröger U, Meyer F (1998). "Validity of advertising claims for multivitamin preparation Vitacor 20/90 on the internet". BMJ. 317 (7165): 1069–71. PMID 9774300. - article also available online in its entirety.
  53. ^ "Don't Be Confused by Unproven Medical Claims, SACC warns". Statement by the South African Council of Churches, issued April 18 2005. Accessed March 9 2007.
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