Written by Adele Stapf, Helen Cooke, Helen Seers and the CAM-Cancer Consortium.
Updated February 8, 2017

Amygdalin/Laetrile

What is Laetrile?

Description    

Amygdalin is a secondary plant compound belonging to the group of cyanogenic glycosides characterized by the release of cyanide upon enzymatic degradation.

Names

Amygdalin is also known as vitamin B17, mandelonitrile-beta-glucuronide (semi-synthetic), mandelonitrile beta-D-gentiobioside (natural product), amygdalina, and nitriloside. Laetrile is an acronym derived from ‘LAEvorotatory’ and ‘mandeloniTRILE’ and is used to describe a purified, semi-synthetic form of amygdalin.

Ingredients

Amygdalin is a secondary plant compound belonging to the group of cyanogenic glycosides, which are enzymatically degraded by beta-glucosidases to form cyanide. The compound is found in the seeds of apricots, peaches and bitter almonds and also in plants such as lima beans, clover and sorghum.  Minor amounts of amygdalin may be ingested when eating a balanced diet.

The chemistry of laetrile available in the United States is different from the one used in Mexico. The laetrile used in Mexico may be crushed apricot seeds rather than the semi-synthetic form of laetrile (mandelonitrile-beta-glucuronide) that is used in the US.1 Therefore it is conceivable that not all studies on laetrile have looked at the same compound.

Application and dosage

Amygdalin is usually taken orally in the form of bitter apricot seeds. Laetrile is available for oral administration as well as intravenous or intramuscular injection. Treatment is typically initiated intravenously for two to three weeks and then continued orally. Laetrile is also used as an enema form or applied directly to skin lesions.

History and providers

Amygdalin was first identified and isolated by French chemists in 1830 and was used as an anti-cancer agent in 1845 in Russia. By the 1920s amygdalin had reached the US, but the early pill form was considered to be too toxic and its use was discontinued. In the 1950s an apparently non-toxic, semi--synthetic intravenous form of amygdalin was developed by Ernst T Krebs in the U.S., and this became known as laetrile. In the 1970s laetrile gained popularity either as a single-agent treatment or as part of a metabolic treatment regimen that also included high-dose vitamin supplements and enzymes.2

Claims of efficacy/alleged indications/mechanisms of actions

Suppliers have postulated the use of amygdalin or laetrile as anti-cancer treatment. Proponents claim that amygdalin or laetrile has anti-cancer effects ascribing them to the cyanide released upon enzymatic degradation of the compound. They postulate that amygdalin is selectively effective against cancer cells only. This hypothesis involves an imbalance of the enzymes beta-glucosidases, beta-glucuronidase and rhodanase in cancer cells as compared to healthy cells. Malignant cells are claimed to be specifically vulnerable to cyanogenic glycosides because of two characteristics: firstly, a higher level of beta-glucosidases and beta-glucuronidase compared to healthy cells, which would lead to a more rapid intracellular release of cyanide from laetrile or amygdalin, and secondly, a deficiency in rhodanase, an enzyme that converts cyanide into the harmless compound thiocyanate.3 4

Many supporters of laetrile refer to anthropological evidence from epidemiological studies of secluded cultures consuming high levels of foods rich in amygdalin, e.g.  the Hunzakots of Pakistan, the Inuit of the Arctic or the indigenous Hopi and Navajo of North America.5 Expeditions have reported extraordinary longevity and the absence of cancer in these cultures, however the studies are often flawed due to language barriers, highly selected contacts and sometimes deliberate misinformation. They fail to provide clear evidence for a causal relationship between the uptake of amygdalin and the incidence of cancer.

According to a historical theory cancer develops as a result of a deficiency of a vitamin called "vitamin B17", which was the name the chemist E.T. Krebs gave to laetrile.6

Prevalence of use

The popularity of laetrile reached its peak in the United States in 1978 when it was reported that 70,000 people had been treated with it.2 Current prevalence data are not available.

Legal issues

In the US laetrile has had a long controversial history. This includes inaccurate theories of how it works, conspiracy theories of unpublished research studies supporting its use, banning of its use in the US by the Food and Drug Administration (FDA), and prison sentences for many proponents and suppliers (including ETKrebs himself). The controversy continues. In the United Kingdom the Medicines and Healthcare Products Regulatory Agency (MHRA) has assigned amygdalin/laetrile /B17 the status of a prescription-only medicine. The substance is not banned but it is unlicensed, and so access to it is subject to prescription by a medical doctor. This implies that doctors can supply it to a patient should they consider it an appropriate treatment, but do so at their own risk. There is no licensed product containing the substance laetrile/amygdalin/B17 in the UK. Drugs containing amygdalin are not approved by the regulatory authorities in Germany and are considered unsafe according to the German Drug Act.

Cost and expenditures

Drug preparations are available via the internet for approximately 100 US$ for 60-100 tablets. Since there are no clear guidelines on dosage and duration of treatment, it is not possible to provide the total cost of treatment.

Citation

Adele Stapf, Helen Cooke, Helen Seers, CAM-Cancer Consortium. Amygdalin/Laetrile [online document]. http://www.cam-cancer.org/The-Summaries/Dietary-approaches/Amygdalin-Laetrile. February 8, 2017.

Document history

Assessed as up to date in February 2017 by Barbara Wider.

Updated and revised in July 2015 by Adele Stapf.
Updated in April 2014 by Barbara Wider.
Assessed as up to date in December 2012 by Helen Cooke.
Most recent update and revision in December 2011 by Helen Cooke.
Fully revised and updated in July 2009 by Helen Cooke.
Summary first published in September 2005, authored by Helen Seers.

References

  1. Davignon, JP, Trissel, LA, & Kleinman, LM. Pharmaceutical assessment of amygdalin (Laetrile) products. Cancer Treatment Reports. 1978; 62 (1): 99-104.
  2. Chandler, RF, Phillipson, JD & Anderson, LA. Controversial Laetrile. Journal of Pharmacology. 1984; 232: 330-332
  3. Ellison, NM, Byar, DP, & Newell, GR. Special report on Laetrile: the NCI Laetrile Review. Results of the National Cancer Institute's retrospective Laetrile analysis.New England Journal of Medicine. 1978; 7;299 (10):549-52.
  4. Bulletin zur Arzneimittelsicherheit. Informationen aus BfArM und PEI. Ausgabe 3, September 2014. http://www.bfarm.de/bulletin, accessed 8th February 2017.
  5. McCarrison, SR. “Nutrition and National Health.” Journal of the Royal Society of Arts. 1936. lxxxiv, 1047, 1067, 1087.
  6. Milazzo S & Horneber M. Laetrile treatment for cancer. Cochrane Database Syst Rev. 2015 Apr 28;4:CD005476. doi: 0.1002/14651858.CD005476.pub4.
  7. Moertel, CG, Ames, MM, Kovach, JS, et al. A pharmacologic and toxicological study of amygdalin. Journal of the American Medical Association. 1981. 245 (6): 591-4.
  8. Moertel, CG, Fleming, TR, Rubin, J, et al. A clinical trial of amygdalin (Laetrile) in the treatment of human cancer. New England Journal of Medicine. 1982; 306 (4): 201-6.
  9. Braico, KT, Humbert, JR, Terplan, KL, & Lehotay, JM. Laetrile intoxication: report of a fatal case, New England Journal of Medicine. 1979; 1; 300 (5): 238-40.
  10. Sadoff, L, Fuchs, K, & Hollander, J, Rapid death associated with Laetrile ingestion, Journal of the American Medical Association. 1978; 14; 239 (15): 1532.
  11. Lee, M, Berger, HW, Givre, HL, et al. Near fatal Laetrile intoxication: Complete recovery with supportive treatment, Mount Sinai Journal of Medicine. 1982; 49 (4): 305-307.
  12. Bromley J, Hughes BG, Leong DC, Buckley NA. Life-threatening interaction between complementary medicines: cyanide toxicity following ingestion of amygdalin and vitamin C. Ann Pharmacother. 2005 Sep;39(9):1566-9.
  13. Sauer H, Wollny C, Oster I, Tutdibi E, Gortner L, Gottschling S, Meyer S. Severe cyanide poisoning from an alternative medicine treatment with amygdalin and apricot kernels in a 4-year-old child. Wien Med Wochenschr. 2015 May;165(9-10):185-188.
  14. Newmark J, Brady, RO, Grimley, PM, Gal, AE, Waller, SG, & Thistlethwaite, JR. Amygdalin (Laetrile) and pruasin beta-glucosidases: Distribution in germ free rat and in human tumor tissue. Proceedings of the National Academy of Sciences of the United States of America. 1981; 78 (10): 6513-6.
  15. Milazzo S, Lejeune S, Ernst E. Laetrile for cancer: a systematic review of the clinical evidence. Support Care Cancer. 2007 Jun;15(6):583-95.
  16. Yamada H, Nakamura T, Oguri K. Induction of rat hepatic cytochromes P450 by toxic ingredients in plants: lack of correlation between toxicity and inductive activity. J Toxicol Sci. 1998 Dec;23(5):395-402.