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ISSN: 0892-3973 (print), 1532-2513 (electronic)
Immunopharmacol Immunotoxicol, 2014; 36(1): 87
! 2014 Informa Healthcare USA, Inc.
DOI: 10.3109/08923973.2013.861846
LETTER TO THE EDITOR
Safety of studies analysing clinical benefit of amygdalin
Shailendra Kapoor
Private Practice, 73 Crossing, Mechanicsville, VA, USA
Chen et al.1 have provided interesting data in their recent
article in your esteemed journal. I would like to differ from
Chen et al. though, especially in the light of the safety issues
related with amygdalin therapy.
Oral administration of amygdalin is especially dangerous.
O’Brien et al.2 have recently described the case of a
32-year-old female who developed cyanide poising secondary
to amygdalin use as a supplement. The patient developed
systemic toxicity and diabetes insipidus but fortunately
recovered after appropriate therapy. Patients may also develop
neuro-myopathy3. Simultaneous consumption of vitamins
especially vitamin C accentuates amygdalin conversion to
cyanide thus further augmenting toxicity4. In addition,
vitamin C also attenuates cysteine levels in the body that
further decreases amygdalin detoxification. Animal studies
reveal that oral amygdalin may also cause teratogenic side
effects5. This has not been observed following intravenous
administration of amygdalin2. Those on a vegan die with
co-existing cynacobalamin deficiency are also at a higher risk
of developing overt cyanide toxicity.
These findings have been confirmed by Milazzo et al.6 in a
recent analysis of 36 different studies involving amygdalin
administration. According to Milazzo et al., amygdalin was
not of any clinical benefit in any of these studies. Moertel
et al.7 in another study involving 178 cancer patients again
refuted the claim that amygdalin is of clinical benefit in these
patients. Non-improvement in overall survival or no improve-
ment of symptoms was noted in any of these patients.
In addition, the toxic effects are more pronounced in those
with the congenital inability to detoxify cyanide2,3.
Address for correspondence: Shailendra Kapoor, Private Practice, 73
Crossing, Mechanicsville, VA, USA. E-mail: shailendrakapoor@
yahoo.com
It is obvious from the above data that clinical use of
amygdalin is accompanied by numerous side effects. The risk
benefit ratio is not favorable for amygdalin in this regard.
Based on the above examples, it is clear that further studies
involving amygdalin can cause dangerous side effects as well
as mortality.
Declaration of interest
The authors report no conflicts of interest. The authors alone
are responsible for the content and writing of this article.
References
1. Chen Y, Ma J, Wang F, et al. Amygdalin induces apoptosis
in human cervical cancer cell line HeLa cells. Immunopharmacol
Immunotoxicol 2013;35:43–51.
2. O’Brien B, Quigg C, Leong T. Severe cyanide toxicity from
‘vitamin supplements’. Eur J Emerg Med 2005;12:257–258.
3. Kalyanaraman UP, Kalyanaraman K, Cullinan SA, McLean JM.
Neuromyopathy of cyanide intoxication due to ‘‘laetrile’’
(amygdalin). A clinicopathologic study. Cancer 1983;51:
2126–2133.
4. Bromley J, Hughes BG, Leong DC, Buckley NA. Life-threatening
interaction between complementary medicines: cyanide toxicity
following ingestion of amygdalin and vitamin C. Ann Pharmacother
2005;39:1566–1569.
5. Willhite CC. Congenital malformations induced by laetrile. Science
1982;215:1513–1515.
6. Milazzo S, Ernst E, Lejeune S, et al. Laetrile treatment for cancer.
Cochrane Database Syst Rev 2011;11:CD005476.
7. Moertel CG, Fleming TR, Rubin J, et al. A clinical trial
14
20
of amygdalin (Laetrile) in the treatment of human cancer.
N Engl J Med 1982;306:201–206.
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