Multiple Sclerosis, Niacin, & Psychiatry with Todd Penberthy

Hello and welcome to another Unstress. The science in medicine is our topic today, and my guest is Todd Penberthy. Todd has a PhD in Research and Scientific Research. He's a science writer, his subjects of interest include Diabetes, Oncology, Integrative Psychiatry, which is what we touch on in this podcast. We talked a lot about the power of a particular nutrient, I won’t spoil it for you. We talked about one of the legends in Integrative Psychiatry and author of Molecular Medicine, Dr Abram Hoffer, multiple sclerosis, and so much more. I hope you enjoy this conversation I had with Todd Penberthy.

Todd Penberthy: Multiple Sclerosis, Niacin, Psychiatry & More Introduction

The science in medicine is our topic today, and my guest today is Todd Penberthy. Todd has a PhD in Research and Scientific Research. He’s a science writer, his subjects of interest include Diabetes, Oncology, Integrative Psychiatry, which is what we touch on in this podcast. 

We talked a lot about the power of a particular nutrient, I won’t spoil it for you, on psychiatry and it’s alerted and reminded me of its importance. We also talked about one of the legends in Integrative Psychiatry and author of Molecular Medicine, Dr Abram Hoffer, a name that you will be familiar with through this podcast. 

And also, we touched on neurodegenerative disease and, as an example, multiple sclerosis. And what an interesting discussion that is when we compare a pharmaceutical approach to an orthomolecular or biochemical or vitamin approach and compare the efficacy and the costs. And this, again, is a great model for how we are dealing with so many diseases in our modern world. So I hope you enjoy this conversation I had with Todd Penberthy.

Podcast Transcript

Dr Ron Ehrlich: [00:00:00] For a start, I would like to acknowledge the traditional custodians of the land on which I am recording this podcast, the Gadigal people of the Eora Nation and pay my respects to their elders past, present, and emerging.

Hello and welcome to another Unstress. My name is Dr Ron Ehrlich. The science in medicine is our topic today, and my guest today is Todd Penberthy. Todd has a PhD in Research and Scientific Research. He’s a science writer, his subjects of interest include Diabetes, Oncology, Integrative Psychiatry, which is what we touch on in this podcast. 

We talked a lot about the power of a particular nutrient, I won’t spoil it for you, on psychiatry and it’s alerted and reminded me of its importance. We also talked about one of the legends in Integrative Psychiatry and author of Molecular Medicine, Dr Abram Hoffer, a name that you will be familiar with through this podcast. 

And also, we touched on neurodegenerative disease and, as an example, multiple sclerosis. And what an interesting discussion that is when we compare a pharmaceutical approach to an orthomolecular or biochemical or vitamin approach and compare the efficacy and the costs. And this, again, is a great model for how we are dealing with so many diseases in our modern world. So I hope you enjoy this conversation I had with Todd Penberthy. Welcome to the show, Todd.

Todd Penberthy: [00:01:45] Glad to be here.

Dr Ron Ehrlich: [00:01:47] Todd, you are a science writer and researcher, and I’m just intrigued, and you covered quite a few areas, in particular, you know, diabetes and sleep disorders, which is something we’re very focussed on in our podcast as well. In fact, the list of things that you’re interested in are things we’ve covered before, so I’m interested there. But how does one become a science writer? Well, tell us a little bit about your journey.

Todd Penberthy: [00:02:11] Basically, you know, I started out in developmental biology and biochemistry and zebrafish as an animal model and then, you know, in academia, it’s kind of a begging game. There’s a certain point when my wife managed to get out of the labs and become a regulatory writer, which is bread and butter writing things for the FDA.

Then I found a course, her name is Emma Hitt. H-I-T-T. She’s near Atlanta, Georgia, and she still offers the course. And she really taught me everything to get out of the lab and get into… at the time, my first project was writing a huge document about a fairly new medical technology. You know, it was laser therapy for endometriosis. 

And so you review all the clinical trials, the quality of the trials, and whether the insurance covers it, all this kind of stuff. And then I started to learn about how you can become a journalist going to medical conferences, and since I live in Orlando, where the whole planet wants to come to, I could advertise my services at the proper boards. 

Then the next thing you know, I’m attending, you know, multiple sclerosis meetings, which is my own personal favourite disease that I believe is expected to be exceptionally responsive to high dose niacin therapy. Took off from there in so many directions.

Dr Ron Ehrlich: [00:03:49] When we talk about the science in medicine, the gold standard is really the randomised controlled trials, aren’t they?

Todd Penberthy: [00:03:58] Yeah.

Dr Ron Ehrlich: [00:03:59] Can you just give us basic 101? What a randomised controlled trial is? Just to remind our listeners because they would hear it a lot. And I think it would be interesting just to go back to some basics.

Todd Penberthy: [00:04:10] The gold standard currently is a double-blinded, randomised controlled trial, so double-blinded means that neither the person, the doctors administering the drug nor the patients receiving the drug have any idea what the treatment is. And sometimes it’s impossible because there’s an inherent activity for the drug but about anyways, that’s the gold standard.

And then so it’s randomised in that fashion and the controls are, I think, sometimes untreated and are usually not, I think they’re not usually involving necessarily the best treatment. I think they’re often involving kind of no treatment or just, you know, salt, you know, salt pill or something that’s not going to have any particular effect and they just have to show some kind of positive outcome. It’s my understanding.

Dr Ron Ehrlich: [00:05:21] Yeah.

Todd Penberthy: [00:05:24] I hope I answered your question.

Dr Ron Ehrlich: [00:05:25] Yeah, that’s fine. And another one that I don’t think we hear enough about is the difference between relative risk and absolute risk. You know, I mean, can you shed any light on the difference between those two?

Todd Penberthy: [00:05:41] Let’s say you want to look at death from cardiovascular disease with statins and so I think that roughly the numbers are if you have 200 high-risk people and then 2 died out of the high-risk people over a certain time window. But if you give them statins, then maybe one dies of that particularly restricted indication. 

Then this can be described, although this is very misleading and this is routinely done and for many forms, this is a huge, misleading approach. They would describe that reduction from a data point, which is only, you know, two people becoming one as a 50% reduction,.

Todd Penberthy: [00:06:41] I guess maybe if you got huge numbers, you would get more significant figures than really two becoming one, maybe, you know, 25 or 30 becoming 15 or something, but the truth is that’s an absolute reduction of… 

So it’s not really a 50% chance that it’s going to help you. It’s actually one out of 100, one out of 200. So a half of a percent chance that it could help you with respect to cardiovascular disease, just a half of a percent. And all come with the assumption that it is not perhaps causing you to die prematurely from some other side effects. 

So if you take the pill and this is a huge problem, I think with the vaccine right now, the whole lack of consideration in public transparency as far as the safety issues. But we don’t have to go there, necessarily.

Dr Ron Ehrlich: [00:07:51] Oh, I don’t mind. I don’t mind, Todd. If you don’t mind, I don’t mind. I think that actually is part of my question, really, because I’ve always seen the difference as the relative risk. So in your case, which you just mentioned 200 people, 2 died of a heart attack and then by giving the statin, only one dies. So the relative risk is with that is a 50% reduction in heart disease or death from a heart attack. And that’s a great way of marketing a product. And that’s all. 

Actually, I’ve never heard anybody in this whole pandemic, let alone we could go down some of these other areas of interest. I’ve never heard people talk about absolute risk. It’s always a marketing tool. The relative risk and what surprises me is so-called experts who are advising this constantly quote those marketing figures for the drug companies.

Todd Penberthy: [00:08:49] Yeah, they missed the basic point, and yeah, yeah, it’s just the basics are missing with the understanding at this. Yeah, it is shocking.

Dr Ron Ehrlich: [00:09:05] Now when you look at… When you’re exploring areas, you know, like you talking your multiple sclerosis is a particular area of interest for you. I mean, how big a problem is multiple sclerosis? What’s happening out there in the world? I mean, this is a serious neurodegenerative disease. What’s happening? I’ve not really explored multiple sclerosis. 

Todd Penberthy: [00:09:26] It is the most common autoimmune disease affecting the central nervous system. And I’m actually working on courses for progressive multiple sclerosis and telemedicine, which has recently taken off with the COVID pandemic. 

So now it’s increased like 100 fold the ability to do virtual medicine for people who are already having immune issues, this autoimmune disease. But as far as what’s going on, there are several biologics and there are several small molecules that are being used. You know, I provide a service with my writing and I really enjoy it. 

Todd Penberthy: [00:10:26] Multiple sclerosis involves loss of the, you know, your brain is actually the most fat-dense organ in your body. It’s full of fat. And to make those neurones, those excitable tissues conduct I guess it’s probably electricity really in neurones, but nerve conduction. And so you lose that fat, you’re losing the myelin because antibodies are going there in different cells are going in there and killing it, and to regenerate that myelin, all that fat, it requires an incredible amount of energy. 

You know, everybody knows from basic nutrition that fats have nine kilocalories per gram. Protein and carbohydrates are for kilocalories per gram, and this is all fat, mostly fat actually in everybody’s head, you know. And you need a ton of energy to reach to make it.

Todd Penberthy: [00:11:27] So that requires, for example, NAD, which comes from niacin or niacinamide, Vitamin B3 in a word. And of course, magnesium is required more than anything and thiamine and it gets to be pretty complicated as far as the autoimmune aspects. 

But in my proudest work, I can send it to anybody if they ever want it. In 2007, after getting to know Abram Hoffer and getting his mentorship and also having been at Medical College of Georgia, where a guy named Andrew Mellor and I’m blanking on the other guy, they discovered this enzyme.

Todd Penberthy: [00:12:16] It’s really interesting. It’s called IDO or indoleamine 2,3 dioxygenase. Let’s just call it IDO. And it’s made in the cells. So when a woman has a baby, she is able to… It’s the only time a human being can accept a foreign object and it’s in our body and the way we do this is we. 

This is probably too hard, so hard to explain. It’s pretty long. But around the baby, there’s this enzyme that’s made that depletes the extracellular tryptophan and so the T cells, they’re like kind of weak and they cannot attack the foreign new baby. But if you inhibit that enzyme, then there’s a lot more tryptophan and the T cells go crazy and they immediately abort the foetus. And so this is a basic mechanism for controlling the immune system, and it’s been shown now in every single autoimmune disease. 

The tryptophan levels are low and tryptophan is already the least abundant amino acid. And tryptophan is the only amino acid that you can make NAD from.

Todd Penberthy: [00:13:41] So if you have somebody who’s fasting for a long time and they don’t take any vitamins, the only way they’re getting that NAD is from the tryptophan. It’s a very important pathway. So in multiple sclerosis, it’s been shown the brain levels know, so what it looks like is every single autoimmune disease almost looks like a vitamin B3 deficiency that is anatomically localised to wherever the antibody is. 

So they’ve shown in the brain, NAD levels are low in multiple sclerosis patients and in cancer, this whole thing is happening to the T cells will make this ideal and they can evade the immune system now because of that. So there are companies always trying to inhibit that enzyme as a chemotherapeutic.

Dr Ron Ehrlich: [00:14:41] Yeah. Well, it’s interesting to hear you say tryptophan is a common denominator in all autoimmune conditions. Low tryptophan. And it’s interesting also that there are over 100 well there, I think there are 100 autoimmune conditions. So it’s interesting to see why would somebody get multiple sclerosis and someone else get rheumatoid arthritis and someone else cola… I mean, this is the genetic component, perhaps, but there are common pathways in these conditions.

Todd Penberthy: [00:15:13] Yeah. So my understanding with that is that basically, you have a situation where there are T cells that you want to get rid of these things because they’re autoreactive T cells that are causing these different diseases, whether it’s Graves’ disease, MS, Type 1 diabetes or, you know, Sjrögren Syndrome or Myasthenia Gravis or whatever it is your body is at that point, trying to get rid of those T cells is what I think is happening so that the body is making this enzyme that is depleting the tryptophan so the T cells will not keep attacking you just like your body makes this enzyme. 

When a pregnant woman’s body, makes this enzyme in the cells in the trough of my cells just to stop the T cells from attacking. But when this happens over and over and over again, it’s kind of like pellagra, but it’s localised to whatever the tissue is that’s affected in the autoimmune disease. And so I think at the end of the day, you know, this is a long, basic attempt to communicate, but at the end of the day. A lot of autoimmune diseases really respond well to sort of NAD therapies.

Dr Ron Ehrlich: [00:16:48] Yeah, which is focussed on B3. Vitamin B3.

Todd Penberthy: [00:16:52] Yes, and niacin is particularly exceptional because it has a completely separate, from our whole previous, this whole last 10 minutes of talk, pathway. The flush pathway is completely different. And it has on it, in its own right, unique activities that are incredible for actually, it turns out, multiple sclerosis and cardiovascular disease. 

It’s that pathway is the one that corrects all the lipids, you know, corrects your triglycerides, your VLDL, your HDL, your LDL, the LTA, all of them are corrected. Even your blood pressure are all corrected, total cholesterol. All those can be corrected by high dose niacin.

Todd Penberthy: [00:17:43] And that is not the case with the other vitamin B3s. It’s not nicotinamide riboside, not nicotinamide monocnucleotide and not niacinamide, but niacin. And it’s because the niacin has a separate pathway that is the flush pathway, which is just a whole nother exciting pathway. 

And again, we’re staying on the topic of multiple sclerosis. It’s particularly one of the most amazing things to me is one of the most exciting drugs to a lot of people, and multiple sclerosis is something called Dimethyl Fumarate, its trade name is Tecfidera, T-E-C-F-I-D-E-R-A, and that drug is an oral drug. It works by binding to the same receptor as niacin that causes the flush. And this just blows my mind because, you know, people have paid $5000 a month for Tecfidera. 

Dr Ron Ehrlich: [00:18:50] Yes.

Todd Penberthy: [00:18:51] And it’s still sold at really high prices when they could pay $5 a month for something that has not been withdrawn from the market previously because of safety issues and Tecfidera has. In Europe, it was used for some skin things and it had to be withdrawn, but it’s being used now and sold for, you know, huge amounts of money to multiple sclerosis patients. 

And the other entirely perfect characteristic of niacin for multiple sclerosis is the fact that it is a skeletal component of NAD, whereas dimethyl fumarate is just basically a monocarboxylate that activates the same flush causing pathway as niacin.

Dr Ron Ehrlich: [00:19:46] Firstly, you’ve mentioned Abram Hoffer, which we really should honour because he’s the father really of Orthomolecular medicine, and I don’t think I’m speaking out of the line there. I think most people would agree with me because I heard him speak in Australia in the 1980s. I did my first nutrition course in 1981, and he was out here in Australia doing the talk. 

So he’s an absolute legend, and I know he focussed a lot on B3 niacin and thankfully even my cardiologist, Dr Ross Walker, who’s an integrative cardiologist, has had beyond that too. It’s quite a flush. You do get a flush. Is that the sign that you were at the right level? Or do you just have to take time to get over that? You build up slowly with niacin, don’t you?

Todd Penberthy: [00:20:36] Yeah. Well, yeah, I think you want the flush. That’s the right dose of niacin.

Dr Ron Ehrlich: [00:20:44] Okay.

Todd Penberthy: [00:20:45] Because then you’re activating that pathway and it’s almost like, to me, it’s like exercise. You know you want a certain amount of, you know, but not too much. But niacin has such a huge safety profile that you know, you don’t really have to worry about it. I can we can talk about that to better. But I think as far as dosing niacin, the best way to do it is to try to have at least three flushes a day. 

And it’s really curious because you can have people who flush with as little as, the littlest I’ve known of I think it’s 25mg or 50mg. And then you have other people that they can’t flush and they’re more likely to be schizophrenic or to have a health issue that according to really good chemists who have been, he says that’s because there’s a lack of some kind of fatty acids, some kind of prostaglandins and the prostaglandins are definitely central to this pathway. PGE2 and PGD2.

Dr Ron Ehrlich: [00:21:57] If 25 to 50 is the lower end of the scale, 25 to 50 mg. You know you were saying, Oh gee, some people have even had a flush and by flush just to… It’s literally is a flush. Your face becomes red. That’s the flush response. That’s right, isn’t it?

Todd Penberthy: [00:22:15] Yeah, yes. Yes. And so the most common dosage, I think, would probably be said to be maybe one gram taken three times a day, but I would never recommend someone just start like that unless they’re like a very brave person. But it startles. It can be startling to the uninitiated. 

I had one guy who I mean, he came here from Vietnam. We used to call him Iron Man, and he was a stopper on my soccer team. He was a tough guy, but he got Guillain-Barré Syndrome and I gave him a ton of niacin. And I thought he, you know, he’s Iron Man. So but he took himself to the emergency room and he was so, he thought it was an allergic reaction. I tried to explain, but you know, yeah.

Dr Ron Ehrlich: [00:23:11] But it’s not. It passes. It is safe. It’s a little disconcerting, I know because I sometimes have a flush myself, maybe I have a natural B3 level. You mentioned Tecfidera is a $5000 a month and niacin and that has all sorts of side effects. Apart from the financial cost, it has physical side effects, which have prompted all governments to withdraw it from use. 

And then you can get in B3 niacin for $5 a month and you are perfectly safe and you and this is what actually the body needs, blah blah blah. And another comparison, we digress here for a moment, is the company Merck, which has a drug called ivermectin.

Dr Ron Ehrlich: [00:24:07] Ivermectin has been pilloried by the press as being a horse dewormer totally ignoring the fact that it won the Nobel Prise for medicine in 2015 for humans. Well, Ivermectin and I think it’s a few dollars. A few. Yes, well, it is. But interestingly, this question was why wouldn’t Merck, you know, promote this? And they’ve got… It’s off-patent. It’s not worth any money. 

But what they were doing was they were producing a similar drug called molnupiravir, which is $700 or $750 a dose of several capsules. So we have one that’s worth $2-3 and one that’s worth $750 manufactured from the same, the same manufacturer. And here you give me an example in the multiple sclerosis world of Tecfidera versus niacin. I mean, this is what medicine has become, hasn’t it?

Todd Penberthy: [00:25:13] Yeah, yeah. I, you know, I just firmly believe the profit motive doesn’t belong in medicine, and it’s just ruined everything. That’s just, that’s what I believe. Because the profit motive drives, you know, advertising and it sort of sneaks its way into education and everybody’s awareness. But it’s not coming from an impartial scientific method, what works best… yeah.

Dr Ron Ehrlich: [00:25:56] Hmm. And you’re also interested in integrative psychiatry. It’s another area that you’ve mentioned and you just touched on there – Schizophrenia. You know, if they don’t get the flush response, you know that maybe there’s an indication there. 

Tell us a little bit about your interest in integrative psychiatry because we’ve touched on this topic before with a couple of our guests as well. So when I saw you were interested in that. What’s your interest in that area?

Todd Penberthy: [00:26:29] Oh, thanks for asking. Yeah. So, you know, Abram Hoffer was the biggest influence in all my thinking and, you know, he is sort of the grandfather of that whole field to me. And Jonathan Prousky has been carrying the torch there, too. And Dr. Greenblatt, James Greenblatt. And yeah, Psychiatry is a unique, very challenging field of medicine because you can’t, there’s no simple readout. 

You can’t just look at the blood and say, you know, something cardiovascular risk in your plumbing, you know, like they do in cardiovascular and kidney function, you know, that has very straightforward metrics, you know, for the nephrologists, and diabetes – straightforward metrics. 

Todd Penberthy: [00:27:31] But psychiatry is so hard. I mean to have an unbiased, you know, metric and other than really, you know, talking to people and we all understand sort of how hallucinogens things like that really affect our behaviour. 

These chemicals, small molecules and niacin and their whole vitamin B3 thing are particularly exciting there because it’s central to all the chemistry and clearance and metabolism, proper metabolism of dopamine and serotonin, all the neurotransmitters and the associated schizo toxins like adrenal chrome, which comes from some of these catecholamines. 

And then because the NAD that comes from niacin or any vitamin B3 is used in almost all of the cytochrome P450 enzyme reactions, that means all drug metabolising enzymes, most drug metabolising enzymes, are dependent on the levels of NAD and the clearance of the zinobiotics and toxins and pollutants and carcinogens and the things that affect our brain, whether it’s alcohol, whether it’s methamphetamines. So NAD levels are important to tapering off psychiatric meds. All these things. So that’s where I guess my interest came from.

Dr Ron Ehrlich: [00:29:24] Actually, what you’re mentioning there is so important is because this is kind of we’re supposed to be practising evidence based medicine. And yet the evidence for using some of these drugs in psychiatry is very subjective, really. I mean, it’s like, let’s give a drug and see how to fix someone because we literally have no blood test or other metric to measure, like, is your blood pressure too high? 

Well, we need to lower it. Is your kidney function optimal? Well, we need to improve. Are your blood vessels occluded? We need to clear it. When we come to the brain, when we come to psychiatry, there is no test for, you know, these serotonin uptake inhibitors. Well, you’d think you’d be able to measure how effective that was, but you can’t.

Todd Penberthy: [00:30:22] Yeah, yeah, yeah.

Dr Ron Ehrlich: [00:30:25] And I mean, it is laughable, except it’s not very funny. I mean, so many people, so many people are on this medication. I mean, I’ve heard one statistic, Todd, and maybe you can tell me about it. You may not know this, but I think America, which has five percent of the world’s population, consumes 50 % of the world’s psychotropic drugs as per statistics. Does that surprise you? Sitting in Florida, I don’t know.

Todd Penberthy: [00:30:52] Oh, no, no, no. Like I said, I feel like money, drugs and I don’t know. We have a very much a consumer culture here in America where we just spend. And, you know, with Amazon and everything, you can just click and you know, we already have a consumer culture now we can just click. 

I think that sometimes with psychiatric issues, you know, what is success continues to be a question because sometimes you have psychiatric problems and it’s not just a problem. When it’s psychiatric, it’s not always just a problem for the individual, it’s people that have to live with them and all that. And then sedatives almost, I think, are almost appealing to the situation. But I don’t know.

I guess it’s not, I don’t know. I don’t want to be too negative about just criticising the whole thing, but it makes more sense to me to consider, you know, zinc, iron, a lot of things with integrative psychiatry, niacin, thiamine, magnesium, vitamin D, even all these things have psychiatric activities.

Dr Ron Ehrlich: [00:32:24] One of the themes that we’ve explored on this podcast is that it’s good for practitioners to be sceptical and curious. And when I heard that statement and that was shared by me from a Professor of Psychology, Julia Rucklidge, from New Zealand, she said it’s really important for doctors to be sceptical and curious. And when she said that, I thought, OK, that’s interesting, at which point in a doctor’s education does that curiosity kick in? 

Like, for me, you know, we did our undergraduate work on anatomy, physiology, biochemistry in the early years of our degree, and we just couldn’t wait to get those subjects out of the way until we started to learn the really important stuff like pathology and pharmacology. This is where we were being real people, real doctors, you know? So the curiosity, I think for many medical practitioners and so-called experts seem to have only kicked in in the medical education from the moment they were able to pick up. 

I’ve got it right next to me here. A prescription pad. You know. Show me where the next drug is coming from. Show me where the next whiz-bang science is coming from. Don’t bore me with the details of my early undergraduate training, whereas in fact, it was that early undergraduate training that held all the keys.

Todd Penberthy: [00:34:01] Yeah. Yeah. I mean…

Dr Ron Ehrlich: [00:34:03] And this is what you’re saying Abram Hoffer was curious. Was he, you know, open-minded all his life? Incredible.

Todd Penberthy: [00:34:11] His story is just too amazing. His life story. He’s got, there’s a book that everybody should read. I feel like it’s called Adventures in Psychiatry and it’s an autobiography. It’s like not enough people know about it. And I mean, the short version of his life story was basically he was raised on a farm in the middle of Canada. 

So, you know, that gives you a ridiculous, strong work ethic. And then he was a biochemist first, and he was with some Indians on a reservation trying to tell people they need this level of fortification. And they would listen to him. So he had that work ethic.

Todd Penberthy: [00:34:53] So he went back to med school and said he needed to become an M.D., so he did it. And then he was quickly put in charge of a big hospital of an asylum for people with mental health issues in Saskatchewan. And then he realised that these people with health issues, the mental issues resembled the […] the vitamin B3 or niacin deficient individuals that he had seen on the Indian reservation. So he thought, you know what, maybe these people need a much higher amount of niacin. And then he basically proved that’s the case.

The schizophrenics, don’t flush as much on average, there’s even a test-marketed now for that, a skin test. And eventually, when they recover, they begin to flush. And he asked Merck for niacin. 

He got a whole oil drum full of niacin powder, and he tried all these doses, and he found that if they were not, you know, schizophrenic for a really long time like years, those people sometimes were not reachable. But he was able to, you know, cure and recover a lot of them. 

Todd Penberthy: [00:36:21] And in the end, one of the last publications after maybe 50 years of medical practise and like ten thousand patients, many with high dose niacin, he published a paper with Jonathan Prousky near the end of his life in about 2009, roughly where they said that there are people who require as much as 16 grams of niacin a day, and they take it always in divided doses, whether it’s, you know, three times a day, four or five times a day or whatever. 

But there are some people because it’s really interesting if people that understand the central dogma, molecular biology that you know, a protein makes RNA and all that stuff. 

Todd Penberthy: [00:37:12] We can look at the sequence of all the genes and we can see which proteins have NAD binding domain. And there are now a number of genes where we can see that they have a different amino acid substitution and that NAD binding domain. So those enzymes, proteins, whatever the type of protein it is, need more NAD than the average person. 

So that means some… What I’m saying in the wrong way is that there are individuals who require higher levels of NAD for the protein to serve its function. And when we talk about NAD, it’s involved in over 400 gene functions. So the implications are vast. It’s involved in more functions than any other vitamin derived in any other vitamin, the vitamin B3, you know, the only thing more than niacin NAD is magnesium. All the minerals are different, but magnesium is like eight hundred genes.

Dr Ron Ehrlich: [00:38:28] You know, I guess the point about all of this, which kind of people might listen go, “Now, hang on. What is it? Is it B3? Is it magnesium? Is it C? Is it D? Is it zinc? Is it this is that it’s all of those things. That’s what makes the human body work. Not one, not one drug, not one drug versus a placebo.

Todd Penberthy: [00:38:49] Yeah, you need all of them to fire on all cylinders to have you got eight reaction pathways. You know, the reaction from tryptophan to NAD is like something like eight reactions it requires. B1, C, magnesium, glutamine and then some B6, and probably a bunch more. I don’t know. Maybe zinc, if you know you’ve got to have all of them. So… 

Dr Ron Ehrlich: [00:39:14] Which brings us back to one of our first questions is, you know, how does one do a double-blinded, randomised controlled trial on any one of those components? You know, I mean, it’s just an absurd model, which is being perpetuated as the gold standard. 

Todd, thanks for joining us today and sharing some of those insights, and I’d love to have a copy of that 2007 paper that you wrote as a summary of your time with Abram Hoffer because I think he had such an important contribution and it’s been great to talk today. So thank you so much for joining us. 

Todd Penberthy: [00:39:52] Yeah, thank you too much for the wonderful questions, and I’ll send the Dr Shankar Chaudhary link and also the book by Abraham Hoffer.

Dr Ron Ehrlich: [00:40:00] Fantastic. Thank you, Todd.

Todd Penberthy: [00:40:02] OK, thank you.


Dr Ron Ehrlich: [00:40:06] Well, we covered some territory there, and there may have been a little challenging keeping up, but I think essentially what was so interesting to hear about Dr Abram Hoffer, which is a name you may not have heard, but he is most certainly one of the pioneers of integrative psychiatry.

And this follows on really a discussion that we had some months ago with Julia Rucklidge, who’s a professor of psychology at Christchurch University, and she’s written a book called The Better Brain, which is all about using nutrients to treat psychological problems, end of which schizophrenia is one. But of course, there are many others as well.

Was so interesting to hear that story about Tecfidera because it is a model for how modern medicine is approached. You know, on the one hand, we have the patentable drug, which has side effects, and because of its new nature, it is put out there, and any long term effects will eventually become apparent to those that have taken it and paid for it. And eventually, many of these drugs end up being withdrawn. 

One thing you can always say about things like vitamin D, vitamin C, vitamin E, magnesium, zinc, calcium, the group vitamins is they are part of the human body, so it’s very unlikely that you will ever hear that they will be withdrawn from use because the body requires so many of them to function optimally. 

And in fact, I think it’s interesting to reflect on how this pandemic has been managed. I think it’s an opportunity here. I have currently identified five or six Ps that characterised this pandemic.

One of those Ps is Profit, another is Politics, another is Power, another is Patents which Tecfidera or Molnupiravir or Remdesivir. These are all patentable drugs, and you will hear a lot of these being championed, of course, whereas you will hear very little about those drugs that are off-patent and are literally worth just a few cents each tablet. 

There has no interest in our public health authorities. And the irony is that so many people have become marketing and compliance officers for Big Pharma, which has repeatedly been shown to be guilty of fraud and illegal marketing. But I digress.

Back on to my discussion with Todd. You know, he is part of that OrthoMolecular News Service and Abram Hoffer, who literally is a legend, the father of that. And I’m looking forward to getting Todd’s 2007 article that he wrote, which summarised so many of his dealings with Abram Hoffer and also to remind me and you, I hope of, another nutrient which is important and has incredible potential to correct biochemical imbalances, which lead to chronic degenerative diseases, which we know now as co-morbidities and B3 is one of those. 

And the flush that he’s talking about is literally, as we said, the flush of your face. And to find and to spread out doses over a few over a day and to get that flush reflex, well, I’m going to really explore that again. I think that was really interesting.

So we’ll have links to that article, which Todd referenced. He also talked about history now. This was another very interesting theme on our Ortho Molecular News Service Group. Shankar Choudhary is not on that group, but he was that physician was referenced because Todd’s wife had contracted COVID and Todd was seeking advice from the Ortho Molecular Group, and this is where this idea that I hadn’t heard this before. 

So I’m definitely going to be exploring this, that there is an allergic response amongst the plethora of responses that occur in this pandemic and with COVID 19 and the use of antihistamines.

Now he mentioned promethazine, but Claritin or Benadryl are also more common antihistamines and that was used successfully. And this Dr Chaudhary has used this approach on thousands in South Africa successfully. I think it’s interesting to actually reflect on countries like South Africa and India. Remember, the Delta variant came from India, and you would have thought such a virulent variant would have caused absolute devastation in India. 

And of course, the response by our so-called experts in our western world is, oh well, they’re not reporting deaths or, you know, they’re just not reporting what’s going on.

Well, I would have thought the perfect story which any pharmaceutical company and any newspaper who seemed to be the voices of pharmaceutical companies. So I thought I would have thought The Guardian or The Sydney Morning Herald or The New York Times or The Washington Post, all who are running stories on behalf of the pharmaceutical industry. 

I would have thought they could have easily sent reporters to India to report on the sheer devastation that the Delta variant has had on this non-vaccinated country, and it would have made it incredibly compelling material for marketing the vaccine even more than it is currently being marketed.

So it’s an open country. You could have gone to South Africa or India, and any of those newspapers could have sent reporters to report on it. But funnily enough, we haven’t heard about it. And why is that? Why are these developing countries that don’t have a lot of money to spend hundreds of billions of dollars on vaccination programmes and as left with off-market drugs like, you know, ivermectin or hydroxychloroquine or zinc or an antibiotic like azithromycin or doxycycline or histamines like Benadryl or Claritin or really, really cheap interventions. 

That’s what they’re stuck with, if you like. That’s what they’re able to use, all they’re able to use. And hey, guess what? They haven’t had millions of deaths, which you would have thought they would have had, because hey guess what? They haven’t been vaccinated to the same degree that we have in the West.

Aren’t we lucky in the West to have enough money to pay for all of these vaccines and to be able to afford all these new patentable drugs, which are yet to be proven and may one day be withdrawn because of these side effects? But you know, this is an example, and it was so interesting to hear Todd drawing that example of multiple sclerosis and Tecfidera, $5000 a month versus niacin, $5 a month. And Tecfidera has been removed for all sorts of side effects.

Look, this is a story about science and medicine, and I think the way we have approached this pandemic is a good example of how we’ve approached chronic diseases. It’s all about a pharmaceutical approach, long term management, lots of profits. It’s one reason why the pharmaceutical industry now generates something like 1.2 trillion US dollars a year in revenue. That’s what it does. 

And blockbuster drugs are those drugs that earn the company more than a billion dollars a year. They’re a huge deal for a drug company to land a blockbuster drug that generates $2 billion a year is something that is really important for a drug company. Well, Pfizer has generated $33 billion in its first year with the vaccine. So do the maths on that. Anyway, I will have links to Todd’s articles. Hope this finds you well. Until next time. This is Dr Ron Ehrlich. Be well. 

This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.