Complementary and alternative medicine Medicine Pseudoscience Quackery Science Skepticism/critical thinking

All drugs are poisons, and that’s OK

There are a number of aphorisms that one imbibes over many years of medical education, especially in medical school. Some are useful; some are not; but some stick with you for reasons that even you can’t figure out. For example, I still remember my first day of medical school over 30 (!) years ago. It started with an introductory session beginning at 8 AM that lasted about an hour, an “orientation,” if you will, after which classes began as normal. During this orientation, members of the medical school leadership, such as deans and the chairs of certain major departments, got a chance to speak to the brand new medical students, introduce themselves, and impart a little wisdom, such as they saw it. Not surprisingly, there was the usual “rah rah” about how lucky we were to be attending the University of Michigan Medical School, how we were the elite, the 170 or so students accepted out of over 3,000 applicants, the usual blather. I imagine that it’s the same sort of thing they do now in “white coat ceremonies,” but back then there was no real ceremony, and, as far as I’m concerned, it was good that there wasn’t. I personally find white coat ceremonies that nearly every medical school now indulges in when a new class enters the school to be just a little too reminiscent of rituals welcoming new initiates into a religion for my liking.

Be that as it may, one thing I remember from the thankfully nonexistent pomp and circumstance I experienced starting medical school. The first was one of the professors (I forget which one) telling us that, ten years after we graduated, we will have forgotten at least 75% of what we learned, but what we remembered would be the “right” 25% for our patients. He also told us that at 50% of what we learned would be out of date; so we would have to learn to learn.

Another aphorism that I distinctly remember from later in my medical school experience was delivered on the very first day of my pharmacology class. Within the first five minutes the professor told us that all medications were poisons. They all interfere with normal cellular processes in some way. The ones we use as physicians just interfere with cellular processes in a way that can be beneficial in disease, and, quoting Paracelsus, he noted that the dose makes the poison.

So, yes, all medications are poisons in that they “poison” an enzyme or other biomolecule. (Look for a quack near you to quote mine that statement by saying, for instance, “Orac says all medications are poisons” and leaving out the rest of the sentence.) I’ll give you an example: Aspirin. Aspirin, as many of you know, is acetylsalicylic acid. This particular molecule irreversibly inhibits an enzyme called cyclooxygenase (COX), which is involved in the production of mediators of inflammation, among other things. The exact details aren’t important, such as how aspirin inhibits the COX1 version more than COX 2 or how it does so by attaching an acetyl chemical group to the active site of the enzyme. The point is that aspirin permanently inactivates an enzyme. It poisons the cell. That’s how it works. In fact, when used as a “blood thinner,” aspirin permanently poisons a certain kind of cell, namely the platelet. Because a platelet doesn’t have a nucleus, it can’t make more COX. What it has when it’s made is all that it will ever have, and if that COX is irreversibly blocked, that platelet’s function is impaired for the rest of its lifespan. Again, without getting too technical, that’s how aspirin works as a blood thinner. It’s an antiplatelet drug.

Speaking of blood thinners, I couldn’t help but think of that medical school aphorism from pharmacology class as I read a particularly brain dead article published on the website of that über-crank and quack, Mike Adams, entitled POISON PRESCRIPTION: Warfarin rat poison widely used as prescription blood thinner. (Alternate Google cache link, given that Adams seems to have some sort of weird redirect thing going on.) Oddly enough, given the inflammatory language in this article and the general level of neuron-numbing medical ignorance on display, the article actually wasn’t written by Mike Adams himself. Rather, its author by someone named S. Johnson, who is apparently too embarrassed to use his or her first name:

Many drugs pushed out by Big Pharma are equivalent to rat poison, but only a handful can actually claim to be rat poison. Meet warfarin: a widely used blood thinner which, prior to being used to treat a common heart rhythm disorder called atrial fibrillation, was used as rat poison.

This is, of course, true. Warfarin and related chemicals have been used as rat poison. However, warfarin is also used as a useful drug. Thee is no inherent conflict in this concept, nor is “big pharma” trying to poison us like rats by using warfarin. Indeed, there is only a conflict between these two uses if you buy into the idea that anything pharmaceutical is evil and anything “natural” must be good and utterly forget the concept of the dose making the poison. Something that in small doses can have a useful therapeutic effect can be toxic in large doses. In small doses, warfarin inhibits coagulation by interfering with one set of proteins that promote coagulation. In high doses, not surprisingly, it causes massive bleeding. The former is useful in preventing thrombosis-related complications of various diseases, like atrial fibrillation. The latter is useful because rats will eat warfarin up until they start bleeding.

Johnson goes on:

The compound responsible for bleeding – dicumerol – was discovered in 1934. In the early 1940s, it started to be tested in people as a blood thinner. In 1945, a stronger version of dicumerol was patented and named after the Wisconsin Alumni Research Foundation (WARF).

Around that same time, a close cousin of warfarin, named coumafuryl, was marketed as a rat poison under the brand names Rat-A-Way and Lurat. Coumafuryl was considered an effective rat poison for its odorless and tasteless quality, making it easier to feed to rats.

Warfarin was originally too strong to be given to people. However, it was prescribed for medical use in 1954, and increased in popularity in the early 1990s for slashing the risk of annual strokes by two-thirds, from 4.2 percent to 1.4 percent.

Patients prescribed warfarin for atrial fibrillation will likely be dependent on the rat poison for the rest of their lives. Although warfarin is widely prescribed, particularly to the elderly, few patients are aware that they are literally ingesting rat poison. Warfarin is now one of the most widely used oral anticoagulants in the United States.

Yes, it is, and with good reason. It’s inexpensive, and it works. Johnson also neglects ot mention that the reason why warfarin/coumadin could be used in humans was the development of a blood test to measure how much of an anticoagulation effect it was having, which allowed for monitoring and dose adjustment and made its administration much safer.

Of course, coumadin does have a number of downsides, as Johnson notes. It requires monitoring. Bleeding complications are too common. Specific foods, particularly any food rich in vitamin K, can interfere with its effects. I know as well as anyone how tricky coumadin can be. During, any time I was on a vascular surgery rotation I’d be faced with trying to monitor and titrate patients’ coumadin doses based on their blood tests. Indeed, back then, before the development of better anticoagulant drugs, it was often my job to switch patients over from intravenous heparin to oral coumadin, and patients couldn’t go home until their blood values were within a therapeutic range. I know as well as anyone else that coumadin is a problematic drug, and physicians have always known it’s a problematic drug. so much of what Johnson writes is not anything any physician who prescribes coumadin doesn’t already know.

Next, Johnson points out that there are downsides to coumadin:

In particular, the researchers found that the rate of interracial hemorrhages associated with the use of blood thinners in the Cincinnati area increased from 0.8 cases per 100,000 people in 1998, to 4.4 cases per 100,000 people in 1999. For people 80 years of age and older, the rate jumped from 2.5 in 1998, to a shocking 45.9 in 1999.

“For many people, the benefits of preventing ischemic stroke continue to outweigh the risk of a hemorrhagic stroke. Our findings should not discourage the use of warfarin when it’s appropriate. Doctors can use these findings to make sure they are weighing the risks and benefits of warfarin use for their patients. For researchers, these results may stimulate efforts to develop safer alternatives to warfarin and better treatments for people with brain hemorrhages,” said lead author and neurologist Dr. Matthew L. Flaherty.

According to Dr. Michael B. Rothberg, a former associate professor at Tufts Medical Center, doctors should consider the risk of stroke versus the risk of bleeding when prescribing warfarin.

I wondered what article Johnson was citing; so I did some PubMed searches. This appears to be the report. Not surprisingly, there appears to be a bit of cherry picking going on here, because this report was from 2007, and a more recent report from 2014, which encompassed a nationwide study in Sweden, found the risk of warfarin-associated intracranial hemorrhage to be low. Still, there’s no denying that warfarin increases the risk of intracranial hemorrhage. How could it not. It “thins” the blood; it decreases the blood’s ability to coagulate. That’s its purpose.

As noted above, whenever a physician treats a disease or condition with a drug—or any other treatment, for that matter—it’s a question of balancing risks with benefits. All real physicians know that. It’s what they are trained to do. It’s only in the fantasy world of deluded idiots like Mike Adams, Joe Mercola, antivaccinationists, and the usual assortment of quacks and cranks that there are medications or treatments for illness that have real therapeutic effects that don’t also have risks and side effects. In some cases, these side effects and risks can be serious. Even when true, that doesn’t invalidate or otherwise render useless the treatment and its therapeutic effects.

Here’s an example I like to give. The treatments for cancer often include a combination of surgery (sometimes radical), chemotherapy (which is definitely very toxic), and radiation (which can be toxic). Given that the cancers for which these treatments are routinely used can kill you, on balance, the use of such “poisonous” treatments can be justified. Yes, they can cause horrible toxicity. But, also yes, they save lives. On balance, the benefits usually outweigh the risks. The science and art of medicine involve determining when the benefits do and don’t outweigh the risks and to proceed accordingly. It sounds straightforward, but it most definitely is not.

Of course, this being and all, there is no such thing as nuance. Demonization of pharmaceuticals is the name of the game. This becomes clear here:

Fortunately, there are alternative blood thinners out there without the dangerous side effects anchored to prescription drugs. Both cayenne peppers and vitamin C, for instance, are great for the blood vessels and heart in general. Other natural blood thinners include foods rich in salivates, a natural chemical that serves as a major ingredient for pain-relieving medications. Sources of salivates include cinnamon, turmeric, peppermint, oranges, raisins, blueberries and honey.

Here’s the problem None of these “alternative blood thinners” can do what warfarin does. If they could, physicians would use them. None of these “alternative blood thinners” can “thin the blood” to anywhere near the degree or with anywhere near the potency as coumadin. Moreover, there are now other drugs designed to have similar effects as coumadin, albeit through different mechanisms, drugs that don’t require the close monitoring that coumadin does. One example is Plavix and related drugs.

So why call warfarin rat poison in such a blaring headline and repeatedly in this article, as Johnson does? Yes, it’s true. You got us! Coumadin/warfarin was (and still is) used as rat poison! You brilliant Mike Adams drones! We evil pharma minions can’t pull one over on you!

So what if coumadin is rat poison?

All drugs are poisons, and that’s OK. They couldn’t work if they weren’t poisons. It’s the nature of the poison—and the dose—that determines their usefulness, and all drugs have risks to go along with their benefits. Damn that nuance.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

241 replies on “All drugs are poisons, and that’s OK”

interracial hemorrhages

I am trying to work out what Johnson meant to write there before Autocorrect intervened.

The compound responsible for bleeding – dicumerol – was discovered in 1934.

“1934”? Heaven only knows what sources Johnson is using, but every other source says 1938-1940 for the isolation and identification of the chemical (patented in 1941).

It’s a perfectly natural chemical, produced by fungi in damp clover silage; you’d think a NN author would be enthusiastically in favour of dicoumarol and its derivatives.

there are alternative blood thinners out there […] vitamin C

Vit C, a blood thinner?
True, vitamin C is needed to make resilient blood vessels, but that’s not the main problem of people in need of anti-coagulants.

Pro-tip: when your drain is clogged, wrapping duct-tape around your pipes isn’t really going to help with your issue.

These m0r0ns are dangerous.

We have evolved brains with ingrained patterns of thought that deal most easily with medium-sized things, such as other brain-carriers, and medium durations, like hours or days. Even excluding the very large and very small, the world is pretty complicated, but holding such a blinkered perspective makes it easier to expect that any problem should have a simple solution, if one can only find it. Medicines may be poisons, but they’re targeted poisons that can provide benefits far outweighing the costs. And that’s more complexity than a lot of people will admit into their mental models of the world.

You may be overlooking an obvious possibility, herr doktor: Johnson meant “intercranial hemorrhage,” where the patient is bleeding profusely between their heads. cf. Bill O’Reilly’s “I would have put a bullet right between [Al Franken’s] head.”

In particular, the researchers found that the rate of interracial hemorrhages associated with the use of blood thinners in the Cincinnati area increased from 0.8 cases per 100,000 people in 1998, to 4.4 cases per 100,000 people in 1999.”

Interracial hemorrhages? I can’t imagine what he really meant to say. Intracranial? Can you say Freudian slip?

@ hdb

I am trying to work out what Johnson meant to write there before Autocorrect intervened.

What about “salivates”? I don’t think Johnson is advising its lectorat to chew gun.

Did he mean “salicylates” – as in aspirin, with extra stomach ulcers?
(my own autocorrect says yes)

I learned from Agatha Christie novels that sodium citrate is an anticoagulant, useful for when you wish to splash around some unclotted blood and mislead investigators about the time when a murder occurred, but I will not vouch for its medicinal uses.

I don’t think Johnson is advising its lectorat to chew gun

Now I am unsure whether to put a sinister connotation on “chew gun”, or ascribe it to Autocorrect.

Sources of salivates include cinnamon, turmeric, peppermint, oranges, raisins, blueberries and honey.

This may or may not make your mouth water.

Ah Warfarin. What an excellent product, far better than the alternative of blood clots causing strokes. If you ever want to get the full experience of being a lab rat, get a blood clot. Going for a ‘natural’ less effective drug is simply not an option in the circumstances.

The main side effect was not being able to consume alcohol. Bad, but still better than death.

Seriously people like S. Johnson need an intercranial organ transplant.

I am trying to work out what Johnson meant to write there before Autocorrect intervened.

Yeah, probably, as was pointed out, Johnson’s attempt to type “intracranial” autocorrected to “interracial.” OK, everyone. We all know that Johnson used “interracial” instead of “intracranial” for whatever reason. No further comment on this autocorrect faux pas is necessary. 🙂

Oh, and crap. That link to Johnson’s article is now going to the damned “Top ten scientific achievements of Natural News and the Health Ranger (so far).” I really do think Mike Adams has set up some sort of redirect to that article for traffic from this site. You might have to go to the link and find the Google cache. The original link:

Google cache link:

(I’m posting this under a different pseud because I don’t want someone out there correlating my medical information with other data from my usual comments.)

This one gets me where I live.

I’m a survivor of two cases of deep vein thrombosis with pulmonary embolism. The first one very nearly killed me, as in, my blood pressure numbers were upside-down and two close friends had to carry me into the ER because I could barely walk. The doctor said I went in there “with two feet hanging over the grave” (I told him to be frank about what was up and whether it was going to kill me).

I expect to be taking my “rat poison” every day for the rest of my life, as it appears that if I don’t, I’ll be up for another DVT. Since DVTs have a 30% fatality risk, colloquial statistics (yeah I know) say I don’t get a third one, or if I do, I don’t live to tell the tale. I’m not scared of death as such, but all factors equal, I don’t like thermodynamic equilibrium, so I’d sooner stick around for a few more decades.

The side-effects are minimal and manageable, plus or minus that not being able to ride a bicycle is annoying to my ecology ethics. Reduced risk of stroke is a benefit.

So how can I say this in G-rated language? Quacky Mikey and his pernicious pals can all go straight to Hell with a capital H. That article may discourage someone from taking warfarin, for whom it would make the difference between life and death. That makes Mikey and his buddy guilty of long-distance murder. Too bad they can hide behind the 1st Amendment, and here’s to the day when that will no longer be possible.

Toads — I’m also using a different alias than usual for the same reason as you — too easy to correlate. I too had a pulmonary embolism – mine was much less severe, though it hurt like hell for a while. Felt like I’d broken a rib!

The ER response was to diagnose carefully and then send me home with a supply of fast-acting injectable anticoagulants and a scrip for coumadin. After a brief while I ended up on Eliquis (apixaban), which is way more expensive than coumadin but which doesn’t require constant monitoring. My understanding is that its main downside is that it doesn’t have an instant-off switch like coumadin (just inject vitamin K and coumadin stops working instantly), though the superb haemotologist I consulted with didnt’ seem to think that was a very serious issue.

I’m a little surprised you can’t ride a bike, unless it’s because you were so severely weakened. Are they afraid you’ll hit your head and get an intercranial (or is it “interracial”?) bleed?

Incidentally, if Big Pharma is conspiring to bilk us all by overcharging for coumadin, they’re going about it very strangely, since it’s cheap as dirt. It should be obvious to any properly conspiracy-minded observer that they were playing the long game — first they gave us a cheap drug that works but has drawbacks, anticipating that they would develop much more expensive alternatives later. Do your own research, sheeple!

Mikey doesn’t understand that whole dose/ poison thingie:
a few days ago he posted that a food additive common in meat products is being used to kill feral hogs. Actually, he doesn’t mind the feral hogs that traipse about his ranch. He probably feels for rats as well.

At any rate, the other loon @ prn instructs his enraptured audience to make up a rescue packet of supplements to always carry with them in case they might feel a heart attack or a stroke coming on:
garlic capsules, mega-doses of vitamin C, cayenne pepper, CoQ 10 etc. NEVER take an aspirin he scolds. No directions concerning doctors or hospitals either.
( I’ve heard this with variants involving which supplements a few times- but always with C, garlic and cayenne)

So I imagine that if someone followed his sage advice he or she would be saved and not need any medical services or else not be around long enough to sue him.

Speaking of mega-doses of vitamin C, there is something that has been on my mind lately: I suffer from severe iron deficiency. It is so bad that I regularly have to visit the hospital so that they can give my some sort of iron “slurry” via IV.

Recently I’ve been reading that taking vitamin C together with iron greatly boosts the uptake of iron. I purchased some iron tablets as well as one of those vitamin C tubes of “pucks” you dissolve in water. However, a singe “puck” contains 1000% of your daily intake of Vitamin-C! That is a whole lot and I am reluctant to go through with it because of it.

As we all know, vitamin C is a favoured “wonder drug” of the alt-med movement and as such I am having a very, veeeery hard time finding any accurate information on taking so much of it… help?

I’ve heard rumours of kidney stones, but again nothing concrete. :/

What I am worried about is that ONE “puck” has 1000%(!) of the daily recommended dose of vitamin C!

I’ve heard rumours of kidney stones, but again nothing concrete.

A kidney stone made of concrete would probably be extra-painful.

@ Amethyst:

My handy dandy nutrition guide says that vitamin C doesn’t seem to be toxic in doses of up to 5000 mg per day although people have ingested much more for long periods of time without apparent problems
BUT it can interfere with absorption of other nutrients/ meds, alter results of certain medical tests and cause gastrointestinal distress. People who take huge doses and then cutback may get “rebound scurvy”**

One of the loons I survey thinks nothing of prescribing doses of 20000 mg per day ( or even greater- 100K- if by IV).

** how’s that for a band name?

Too much water daily is toxic. So is too high a concentration of oxygen, especially when scuba diving. Gah. If we had too little gravity on planet Earth, we’d be drifting off. Too much and we’d be crushed. Too much sunlight can lead to skin cancer. Too little sun exposure can cause a vitamin D deficiency. I suspect many of these quacks know and understand these nuances. For them, however, it’s easier and much more profitable to prey on those who don’t, scaring them with the toxins gambit over and over and over.

I’ve heard rumours of kidney stones, but again nothing concrete.

Reminds me of a joke one of my professors in college would tell once a year, and only after constant badgering from the class. It was called “the wolf joke”

Q: What’s grey, covered in fur, made of cement and howls at the moon?

A: A wolf.

(the cement is to make the joke harder)

Chris — I’ll have to remember that next time I write an exam question.

Maybe we should stop eating garlic (a popular alt remedy) because it is a Poison! (it has anti platelet activity, and the AAFP suggests patients on a high daily garlic dose stop taking it 7-10 days before surgery due to risk of bleeding complications:

An article in today’s Wall St. Journal could fan the flames of the garlic woo-troversy. It highlights a vegan preschool, and mentions another that “bans what it calls “static foods” such as garlic and onions, which its director said ‘aggravate the calmness of the mind'”.

This is an obvious explanation for why many ancient cultures that valued garlic and onions died out, as well as why Mexico and Italy are not major world powers.

@Amethyst: yes, vitamin C *can* help with the absorption of some oral iron preparations. As a midwife, we recommended our patients take any iron with orange juice (or other juice), and used to prescribe an iron/vit C combo for those who were anemic. Drug names are escaping me and I have to run to a MD appointment or I’d google and list.

Don’t Jains ( or Sikhs?) ban garlic and onions as well?

Can’t look it up now-
also things that look like blood?

# 23 Dangerous Bacon

It highlights a vegan preschool, and mentions another that “bans what it calls “static foods” such as garlic and onions, which its director said ‘aggravate the calmness of the mind’”.

I would have thougth one would want the little rugrats to be excited and curous about the world around them. Still it reduces the stress on staff if the kids are a bit zombie-like.

This is an obvious explanation for why many ancient cultures that valued garlic and onions died out, as well as why Mexico and Italy are not major world powers.

If I remember the cook-book I was reading last night, China seems to use a lot of garlic and seems to be a world power again. Maybe the chilis and soy sauce counteracts the garlic effect?

BTW for those interested in Chinese cooking–and did not grow up in China–I highly recommend the book “Every Grain” of Rice by Fuchsia Dunlop.

My mom had double knee replacement several years ago then experienced a DVT and pulmonary embolism. She will be on Coumadin for life. My dad recently had his aortic valve replaced. He will also be on Coumadin for life. I am grateful for their lives and for the lifesaving effects of these drugs. Mikey and crew can go and smoke it.
Amethyst – I thought that excess vitamin C is quickly eliminated in the urine, and that it is fairly non-toxic. So you should be OK, taking the doses as long as you don’t go crazy.

Let’s not forget the Coumadin/coumarin OMG WORDS SO SIMILAR issue, which stops those of us in the U.S. from using delicious tonka beans and cheap Mexican “vanilla extract.”

But it’s from a PLANT how could it be DANGEROUS (*cough*)

The discussion of garlic and onions recalls a fine memory, where I was invited to an Iranian family’s table.
The appetizer was raw garlic and onions, to which I dug in as eagerly as the rest, to their surprise. This American has a love of spicy foods, rather than our reputation for bland foods. 🙂
I’d enjoy another appetizer like that again, but it might result in a divorce. 😉
No medicinal claims were made, it was a companionable meeting of the family of a friend and neighbor.

But, poisons… Garlic and onion are lethal to cats, chocolate is lethal to dogs, we oddly then concern ourselves with the welfare of rats.
Or something. As long as that something is sold by the one issuing the “warning”.
I’m reminded that I’ve had my dosage of really nasty poisons reduced, in the case of metoprolol, from 300 mg to 200 mg and likely soon, to 100 mg per day. That’s due to the methimazole being raised from 20 mg twice a day to 25 mg once, 20 mg the second dose.
For those not knowing, the latter is an anti-thyroid hormone drug, it prevents thyroid hormones from being made. Great in those with hypothyroid, not great to those with healthy thyroids, it’d be a poison eventually.
Metoprolol is a beta blocker, 300 mg is a rather strong dose, toxic as all get out to a healthy human that isn’t hypertensive! Total poison there and beta blockade can be a life threatening emergency. But, the dose makes the poison, otherwise it’s medicine.

One person was quite relieved to learn that when prescribed Lasix (furosemide) for heart failure, that it was also used in race horses to make them supposedly run faster, but the person had to stay away from the salt lick. Became the afternoon tea conversation for anyone willing to listen. Never saw veterinary applications of the whole host of drugs used on animals presented by Mikey. Should be good for a firestorm or did it happen and I missed it?.

Then there was the joke birthday gift of a box of Warfarin bought at the garden center to confirm to the recipient what the doctor truly thought of his patient with coumadin. The recipient fortunately found it hilarious, as did the prescribing physician when it was brought up.

Overheard at introduction to pharmacology ” one as*burn is the same as the next as*burn” done in the sort of appropriate drawl.

Well, doctor and I did discuss the relative merits of using rat poison, erm, anticoagulants for my atrial flutter.
Fortunately, that seems to be rapidly resolving as my BP and pulse remain within human limits and hopefully, the moderate LVH should resolve as well.

Damn! I’m fresh out of dog poison, aka chocolate! I’ll have to run off to the store and get some.

Round here, the warfarin-rat poison connection is well known by people taking it, and, apart from offering the opportunity for a bit of ribbing, is accepted as perfectly in order. Often it’s been the prescribing doctor who tells them, jokingly. No need to be furtive about it.

I’ve been told that what makes warfarin effective as rat poison is that it’s fairly slow-acting, so the critters go away after ingesting and die somewhere else. Rats are not that dumb, and avoid eating where there’s dead rats decaying, so laying out quick-acting poison would only kill one rat.

Don’t Jains ( or Sikhs?) ban garlic and onions as well?

Vaishnavas do (as well as mushrooms). They’re considered tamasic foods.

Without garlic and onions, pasta sauce is merely tomatoes and basil. 😉

I find that duel therapy 9.5 mg/kg ACA + 181 mg/kg EToH to be a superior blood thinning elixir.

It has the additional efficacy of increasing absorbtion of the EToH while decreasing it’s metabolism so that one gets a grin again and again. Also, it lets any excess bad blood harmlessly spew out through one’s jejunum.,_%D0%94%D0%B0%D1%80%D1%8C%D1%8F
This woman was diagnosed in 1998 with stage IV breast cancer and as far as I could get, she discovered in the gardening shop that her chemo drug had been used also as pesticide (active component was the same, I think) and she is still very much alive. Actually she started writing during the period of chemo. She could have chosen a quack, because the first oncologist she met had been very rude, but luckily she did not, and she is outspoken advocate for real medicine.

Chinese Buddhists don’t eat garlic, either. And maybe onions, I can’t recall.

Damn! I’m fresh out of dog poison, aka chocolate! I’ll have to run off to the store and get some.

One of our dogs is a fiend for chocolate, to the point where we no longer eat it in her presence. The drooling is beyond the pale.

Peter @ #33
Rats also can’t vomit, so even if they feel awful after eating something they are stuck with it. It’s amazing how fast they learn to avoid the bait, even if the rat unlucky enough to ingest the warfarin moves away from the bait. Rats ain’t stupid.

It just occurred to me: I hope the Food Babe does not decide to branch out into medicines. Mikey is bad enough but she a) commands a very large audience, b) is totally clueless about silly things like chemistry and biology and c) apparently likes to sell things.

She could kill a lot of people in no time.

Without garlic and onions, pasta sauce is merely tomatoes and basil.

The Vaishnava substitute is asafoetida. I doubt that it would play well in Italian cuisine, though.

Heck, the warfarin-rat poison connection was referenced on an episode of Arrow a couple of years ago. It’s hardly an unknown thing. Granted, the person making the connection on the show (and grabbing the poison to act as an emergency blood thinner) was a chemist and forensic scientist named Barry Allen…

Of course, Gilbert must have meant ~1700 mg/kg of EToH — The stated low value was obviously not efficatious; It’s possible he lives in a land that thinks a couple drinks warrants a moving violation and arrest… Sux to be him.

@ Amethyst #16

Please don’t take this as a medical advice, but as a pharmacologist, I can tell you that Vitamin C is perhaps the least toxic vitamin you can think of, and you can’t really overdose it. It is not stored, readily excreted in the urine. 10X the daily recommended intake (that is the minimum recommended) it not that much. Generally, you take greater care with liposoluble vitamins like A, D, E, K. Some group B vitamins have reversible side effects. In your case, I’d worry more about the iron than Vitamine C overdose.

It’s probably one reason the quacks feel safe about I.V. vitamin C. Possible side effects are more related to the procedure than the compound itself (unless it is tainted). It is remarkable in its almost complete lack of toxicity.

Friend of mines elderly mother always tells us she’s on rat poison when we visit, she thinks it’s hilarious.

Peter Dugdale, I was taught that the need for rats to go and die elsewhere is an important component of any rat poison for the reason you cite in the biodeterioration class I took. As the person taking it was part of a unit that reseached such things I think it’s very likely to be true

As I always like to do, I checked the NN store for the recommended natural alternatives. Mike sells cayenne tincture, vitamin C, tumeric tincture and honey. Cinnamon, peppermint, orange (peels) and blueberries are ingredients of various supplements and organic snacks. No raisins surprisingly, but he does sell grape seeds.

Never forget, Mike Adams is always in it for profit.

Zen Buddhist, shojin, cooking doesn’t use garlic or onions (or shallots, leeks, and similar vegetables) – one of my Zen cookbooks says that strong-smelling vegetables such as these were “believed to promote sexual energy” and were therefore forbidden to monks. Seems to me like a good reason to eat them, but perhaps not in a monastery.

“It’s probably one reason the quacks feel safe about I.V. vitamin C. Possible side effects are more related to the procedure than the compound itself (unless it is tainted). It is remarkable in its almost complete lack of toxicity.”

As with homeopathy. Their toxicity is only due to the patient using these rather than actual medicine, as Orac has written about many times.

@45 “It is not stored, readily excreted in the urine.”

That’s what I thought, so how on earth can mega-dosing Vitamin C be at all beneficial when the amounts your body doesn’t need are going to be excreted away?

[email protected]: Actually, I think you’ll find homeopathy is extremely neurotoxic, rapidly and irreparably destroying all capacity for rational thought within those who imbibe it. Heck, even just being exposed to homeopathic blather for any length of time is enough to knock a good 20-40 points of one’s own IQ. Nasty, nasty corrosive stuff.

I drove up 101 to the north end of the Olympic Peninsula this last weekend (went up to Hurricane Ridge). As I was driving along 101 there was sign saying, this way to Natural Health We have Hydrogen Water.

I am still trying to figure out what hydrogen water may be. I have a minor in physics/chemistry and can’t figure it out. Is a third hydrogen somehow added to the water molecule, is hydrogen bubbled through water?

Can anyone define this substance.

@35 and 36,

There was a funny short film called “Too Much Oregano” that won a prize. At Cannes about the time our host was doing his undergrad work at Ym
Other involves a back and forth argument between a restaurant reviewer and the chef about the spaghetti sauce.

Regrettably it doesn’t seem to be available for online viewing.

Our favorite food comment joke is “needs more garlic.”

Of course, Gilbert must have meant ~1700 mg/kg of EToH

Of course, Mitzi Dupree #44; You queen of the ping pong, you. How’s it working out with the ex and the self-medicating kids and all? Still jaundiced?

Oh how I wish the either french canadian or south african PgP would pop in and whoop me over the head with her metaphysical, bigoted bo stick — High, the memory carried on….

Regarding Vitamin C, the only potential problems I remember hearing about it involve somebody doing megadoses for long periods of time and then stopping. Normally your body is extremely efficient at capturing (and re-capturing) Vitamin C and moving it around (it has to be since we don’t produce it like most animals); but when you’re on megadoses your body can just rely on diffusion and not bother with being too careful. The result is that if you stop taking megadoses cold turkey it can take some time for your body to stabilize its Vitamin C handling again.

Granted, this is half-remembered from years ago, so take that for what it’s worth.

First things first: an interracial hemorrhage would be the result of a knife fight between me and Beautiful Rockin’ Wife.
Second, a couple of squares of dark chocolate or a grape or two would be a undersized snack for me but would be enough to kill Old Rockin’ Dog (A tragedy, there can never be too many cairn terriers in the world.).
Third, I had my mitral and aortic valves replaced in a single surgery, and it was precisely because of coumadin that I opted for bovine valves, well, that and I would go insane listening to two ball and cage valves clicking away for the rest of my life. Young Rockin’ Daughter rocks the vegan thing hard but couldn’t begrudge me anything as basic as my life. She finds solace in that my next set of valves will likely be printed instead of biological. Or does anyone know if there is a plant-based substitute for an aortic valve, maybe something to do with xylem, or phloem, or Venus flytraps? Or maybe Venous flytraps?

@ Rich: beats me. Hope some one knows.

For the past couple of years I’ve seen a product in grocery stores called “Waatah.” It’s water with oxygen injected into it.

I haven’t bought a bottle to see if it is in fact hydrogen peroxide. Since it’s incredibly toxic when ingested, I have to question the veracity of this company’s claims.

WAY too much vitamin C can give you the runs, which a visiting friend learned after thinking my Halls vit. C drops would be good for a sore throat and going through the whole bag – I got home and she said “great, a cold AND g.i. illness at once” and I quickly went to get a bag of Ricola. It is very short term, just stop the excess C. I doubt a single puck will do that to ya, though, Amethyst.

@panacea – if you search for “oxygen water” you will find many brands. As well as debunking.

Now I want to pit the oxygen water and hydrogen water enthusiasts against each other. If we don’t get a nice explosion from the reaction I will be disappointed but not surprised…

Now, I have nitrogen-oxygen water.
There’s an aerator on every tap. 🙂

Wzrd1 — You mean the air in your house is mostly nitrogen? Everyone knows nitrogen is worthless, and the air in any decent house should be 100% life-giving oxygen.

I’d demand a refund from the real estate agent, and tell him or her that Food Babe sent you. And maybe Gus Grissom.

Palindrom – No thanks, I have no desire to emulate Apollo 1 with a pure O2 fed fire, thank you. 🙂
I’ll stick with the lower test version of air naturally found on this planet. I’ll reserve Premium for medical emergencies and welding.
Besides, I’d suffer from a new form of oxidative stress when dinner burned in a high O2 atmosphere and I’m baking bread right now, burning it would upset me. 😉

P. Suede Onym @ 14:

For one thing, serious physical exertion for any length of time, or riding a bike even a mile, and I get blood in my urine. Annoying but manageable side-effect (unless someone here knows otherwise) since I can avoid the types of activity that cause it.

For another, any accident on a 2-wheeled vehicle that causes a whole-body impact (hitting the street) or head impact (even with helmet) = an ambulance ride to the ER to check for bleeding, which I can’t afford. And if there’s one thing in my life that I seek to protect above all others, it’s the chunk of gray stuff between my ears, so yeah fear of intracranial bleeding. Thus no electric scooters either. However I have my work life mostly on telecommuting, and my gasoline consumption is about 1/4 of average for Americans, including both work and personal trips. (Climate denialism is the ultimate deadly quackery, so we all need to do what we can to reduce our impacts.)

Lucky you getting discharged quickly with injectable blood thinners. My first one cost me ten days in the ICU including three days of morphine (it didn’t get me high and the only “withdrawal symptom” was the end of the constipation) and a week wearing a pressurized breathing mask (“hey do I look like an Air Force pilot?”;-)

The second one got me an overnight in regular inpatient and then a 2-week supply of injectable Lovenox (“grab the flab and give yourself a jab”;-) At which point I decided that if I went through life with only one inexpensive prescription to take every day, that would be OK, and all the better if it was a pill rather than a needle.

As for Evil Big Pharma, inexpensive lifesaving meds are part of Teh Conspiracy. Surely you know about Teh Conspiracy, to get us all believing in science-based medicine, so we won’t buy homeoquack woo-water or ask for magical hand-waving over our hospital beds. Think of all the well-meaning fuzzbrains we’re putting out of a job that way! Oh the humanity!

Mitzi Dupree: It’s possible he lives in a land that thinks a couple drinks warrants a moving violation and arrest… Sux to be him.
From what I’ve seen of Gilbert, his med of choice is a lot more potent than alcohol, though his general personality does not improve, no matter what substance he ingests. I suspect alcohol, marijuana and lsd which really ought not to be mixed. (Do your neurons a favor, one mind-altering substance per ingestion!)
As far as moving violations go, it depends on the drink, weight, and tolerance of the person. I’ve figured out a fairly surefire way to avoid tickets- it’s called a bus.

Gilly boy: -1- – that’s a middle finger. Sit and spin. It’s kind of cute, really, how wrong you are about me. If you could find somewhere else to be stupid, that’d be great.

Michael Finfer, MD
Edison, NJ April 7, 2016”
In particular, the researchers found that the rate of interracial hemorrhages associated with the use of blood thinners in the Cincinnati area increased from 0.8 cases per 100,000 people in 1998, to 4.4 cases per 100,000 people in 1999.”

Interracial hemorrhages? I can’t imagine what he really meant to say. Intracranial? Can you say Freudian slip?

TO: Michael Finfer, M.D. and Orac: wow! and both of you are MD.’s ? eh?
Differences in Stroke Between White, Hispanic, and Native …

Differences in Stroke Between White, Hispanic, and Native American Patients The Barrow Neurological Institute Stroke Database

Images for interracial hemorrhages
These images contain adult content.

See more images for interracial hemorrhages

Toads — Ouch, sounds like you have poor insurance and probably not the best of care (on top of having a really awful PE the first time, unlike the much less destructive one I had).

I am (emphatically) not a doctor — well, not a real doctor, merely a PhD — but blood in the urine from modest exercise sounds like it’s worth looking into. Hopefully you’re getting your coagulation checked regularly, since that’s pretty much required for Coumadin (that’s the downside. It’s cheap, but it’s high-maintenance).

Also, two PEs without provocation is, well, worrying. Did they ever do a thromobosis screen to see if they can figure out why these happen to you? I got one that uncovered a mutation that elevates my risk by a factor of several, making it all that much less bizarre.

Gah! Perfect example of a little information being touted as absolute knowledge, and being absolutely dangerous.
Which of course, is the MO of Mikey and his ilk. As well as the ‘buy my stuff’.

You know, I used to use a nitroglycerin spray under my tongue to control high blood pressure. Nitroglycerin! Big Evil Pharma had me taking dynamite! /sarcasm

Hydrogen water is obviously generated by joining atomic hydrogen into H2 in the presence of oxygen, which creates pure organic GMO-free free-range water that is cage- and cruelty free, without growth hormones or antibiotics, and free of BPA.

How do you find the time to write so many articles and do the doctor thing?

Because as a box of blinking lights, Orac suffers from none of the biological needs and wants of puny, fleshy human doctors.

Squirrelelite @54

Our favorite food comment joke is “needs more garlic.”

Crocodile Dundee?

We use that one a lot in as close to an Australian accent as 2 folk from the north east of England can manage (with apologies to Chris Preston and any other resident Ozzies).

@murmur, “needs more garlic” is a second joke, the only older joke is, “needs more barley”.
The background on the barley joke was, early in our marriage, I wanted chicken stew and my wife wanted to make chicken soup. So, “It needs more barley”, with barley subsequently added and hence, the soup turned into chicken barley stew.
I’m still infamous for using an entire onion of garlic in a batch of pasta sauce. That said, I make my sauce in batches of two gallons or so. The rest are canned in the pressure cooker or frozen (around a 30 – 70 mix or all canned, depending upon the season).

S. Johnson? There’s a disqus profile which uses that name:

They frequently post on a site called, whose domain should self-explanatory.

If it’s not the same S. Johnson, then it’s a great philosophical doppelgänger. As expected, he’s anti-vaccine (according to some choice quotes from his profile):

“That does not mean that he is wrong. Natural immunity has been shown over and over to be superior to vaccination (artificial immunity).…”

“You are missing the point. How can you even quantify how many people did not die because of the vaccine??? There is no measurement, nor is there one showing how many people were killed or maimed by vaccines.”

“Jeesh. People need to take care of themselves. Take plenty of vitamin C (2000 Mg / day), zinc, magnesium, iodine and vitamin D3. Your immune system will fight off just about anything if you give it what it needs. I haven’t had the Flu in over 10 years and never get “The Shot”. The worst I’ve had is a slight cold that lasted a couple days.”

-Knows the true cure for Ebola and is a population reduction conspiracy fan:

“Cure for Ebola = High doses of Vitamin C or Intravenous Vitamin C. It’s been known for years but is suppressed because the powers that be want less population.”

-A chemtrail fan:

“There are whistle blowers and pictures of the inside of the Chemtrail planes. Just google it.
There are also patents explaining the process. Now… not all planes that look equipped to spray are spraying but there have been whistle blowers and the patents do exist.”

-& is apparently a bitter middle aged man who believes that us hormonal women can flip like a switch at any moment (better watch out):

“Women can flip a switch. 2/3rd’s of divorces are initiated by Women in the U.S. Women are heavily influenced by society and men tend to be severely hurt emotionally while women mask and hide it. I speak from experience. 15 years of blissful marriage 90% of the time and one day, flip a switch. She even said that it was like a switch being flipped from 1 argument that lasted 20 minutes.”

“Women hold major grudges and never forget a mans mistakes. Ladies, you meed serious mental help. Stop treating men like Sh#t. We are not a meal ticket for you.”

“Going that route now. Snipped years ago and now 41 and Separated and sure to be divorced. My wife shut off emotionally (Hormones?). May as well try for all that tail I didn’t get in our 20 years together.”

If it’s not the same S. Johnson, then it’s a great philosophical doppelgänger.
He sounds nice.

I’m feeling quite smug now as I’ve known that Warfarin is both a blood thinner and rat poison for around 30 years. Can’t remember how that came up at school but clearly the UK education system is well ahead of the US in teaching children about effective and ineffective poisoning.

Incidentally, S. Johnson also seems to have plagiarised an article from who also seems a fairly cranky character but in a slightly more scientific way. I can’t decide if that’s better or worse.

Ah, Paracelsus. My favorite alchemist.

Yep, he knew all about “the dose makes the poison.” So much, in fact, he needed to prove it to everyone. So he and his brother alchemists decreed that alcohol was the Elixir of Life. He started drinking heavily, and subsequently died of liver disease.

Gee, an alcoholic who dies of liver disease. Too high of a dose, man.

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