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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


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

Address for correspondence: Shailendra Kapoor, Private Practice, 73

Crossing, Mechanicsville, VA, USA. E-mail: shailendrakapoor@
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