Renafood Redux, or: The Reply Comment that Ate the Blog

Given the relative obscurity of this cat blog and the fact that I update it once every never, I was really surprised to see a notification pop in my e-mail that somebody had left a comment on my Renafood post. A very long comment. From a vet working for Standard Process, the manufacturer of Renafood. I started replying to the comment, and suddenly realized that I’d written more than 1,300 words of reply. So: time for a new blog post! One about substantive issues, even, instead of pictures of fluffy kittens. I’m going to quote him verbatim in this post, so don’t feel like you need to run over to my Renafood post to read everything he wrote.

Dr. Cameron wrote:

I have been a practicing veterinarian since 1982, and I have used Standard Process supplements in animals (and my own family) for the past 20 years. I am now employed by Standard Process as a technical support veterinarian. I help veterinarians integrate nutrition into their clinical practices. I would like to respond to this post.

The author of the above post expresses skepticism on the value of using herbs, botanicals (plants) and glandular materials to support compromised organs (in this case, his/her cat’s kidneys). He/she lists multiple points of concern.

1. The author does questions the quality control of the ingredients in Renafood (or supplements in general). I would invite him to view a video of how supplements are made at Standard Process on our website (www.standardprocess.com). Standard Process Inc. produces all supplements under the same stringent regulations used in the manufacture of pharmaceuticals. We are inspected by the FDA, USDA and other regulatory organizations multiple times per year. Each supplement we produce is tested by our in-house laboratory up to six times before it is released to the public. Quality control is taken very seriously at Standard Process Inc.

My response:
Thank you for taking the time to respond to my post. Regarding the quality of your supplements: since I’m unable to inspect your factory, and given that you’re an interested party, I’ll take your word that your products do, in fact, contain what they do, unlike the majority of companies (who also make substantially similar claims regarding quality control).

Dr. Cameron wrote:

2. You don’t believe that herbal detoxification is possible. I would be happy to provide you with references of how herbs and foods can affect detoxification mechanisms in the body. After 28 years of practice and years of clinical experience with these products, I can attest to their value. The FDA does not allow supplement companies to make any claims on their products in relation to specific diseases, so will not be doing so. The fact is that most chronic disease have been linked to nutritional deficiencies, so providing quality nutrition to compromised cells can improve their ability to function.

My response:
If you are willing to point me to some peer-reviewed literature regarding a) the biochemistry behind herbal detoxification and b) the actual efficacy of herbal detoxification, I’d love to read it. I’ve tried for years, and the lack of good evidence eventually led me to my skeptical stance today. I would also like to point out that this statement:

The fact is that most chronic disease have been linked to nutritional deficiencies, so providing quality nutrition to compromised cells can improve their ability to function.

Has nothing to do with detoxification; malnutrition is separate and different from detox. Somebody suffering from scurvy needs vitamin C, not an herbal cleanse devoid of vitamin C. Furthermore, while accepting the relatively uncontroversial assertion that some chronic diseases are linked to nutritional deficiencies or other bad dietary practices, it doesn’t necessarily follow that taking commercial vitamin or glandular supplements will cure or correct the conditions. (Diabetes mellitus comes to mind; so do certain types of liver cirrhosis and gout.)

Dr. Cameron wrote:

3. Cell determinants. As I mentioned, we are severely restricted by the FDA as to what we can say about our ingredients, so the information is vague and difficult to get a clear picture.

My response:
I would first like to begin by disagreeing that the FDA restricts what you can say about how your ingredients work. The FDA regulates the health and structure/function claims a supplement company can make about its products, i.e., what the products’ health benefits are. As far as I know, there is no law or regulation that restricts the dissemination of truthful scientific information explaining the biological or chemical pathways in which particular compounds work. Most of the most stringent regulations directly relate to labels in particular; as far as I know, detailed information sheets aren’t “labels”. In fact, please refer to Section 403B of the Federal Food, Drug and Cosmetic Act:

(a) IN GENERAL.—A publication, including an article, a chapter in a book, or an official abstract of a peer-reviewed scientific publication that appears in an article and was prepared by the author or the editors of the publication, which is reprinted in its entirety, shall not be defined as labeling when used in connection with the sale of a dietary supplement to consumers when it—
(1) is not false or misleading;
(2) does not promote a particular manufacturer or brand of a dietary supplement;
(3) is displayed or presented, or is displayed or presented with other such items on the same subject matter, so as to present a balanced view of the available scientific information on a dietary supplement;
(4) if displayed in an establishment, is physically separate from the dietary supplements; and
(5) does not have appended to it any information by sticker or any other method.

(b) APPLICATION.—Subsection (a) shall not apply to or restrict a retailer or wholesaler of dietary supplements in any way whatsoever in the sale of books or other publications as a part of the business of such retailer or wholesaler.

Dr. Cameron wrote:

For more information on how protomorphogens, cell determinants, or glandular tissues can be of therapeutic value, look at the more recent subject of Oral Tolerance Therapy. OTT is touted as a ‘new and promising’ therapy for a number of diseases, using cell extracts from various glands to treat specific glandular diseases. This can help explain how eating some kidney can help a compromised kidney. This is what the catalog is talking about when supplying cell determinants.

My response:
From a quick check, Oral Tolerance Therapy seems to be a therapy related to autoimmune diseases, especially T-cell mediated disorders. To grossly oversimplify: the idea is to feed somebody with an autoimmune disorder (say, irritable bowel disease or rheumatoid arthritis) extracts from the relevant tissues to help reduce the immune system’s hyperresponsiveness and therefore reduce the attendant inflammation. However, even if it were proven to work consistently (and I think the science is still kind of uncertain on that), and assuming for the moment that protomorphogens work in the same way OTT does, most incidences of chronic feline kidney disease, as far as I know, are not due to autoimmune disorders. For example: my cat Eric’s polycystic kidney disease in particular had nothing to do with his immune system and everything to do with the fact that he’d inherited an autosomal dominant gene from one of his parents for PKD. The majority of feline kidney disease is, as far as I know, idiopathic. Additionally, the mechanism by which Oral Tolerance Therapy works also seems completely different from what is suggested in the Standard Process literature about protomorphogens. OTT works by desensitizing the immune system so it doesn’t attack the body’s own tissues. I can’t speak on how protomorphogens work, since the information sheet was confusing and opaque, but the sheet seems to claim that protomorphogens affect cell division directly, and to target specific cells or tissues in specific organs. If I’m wrong about this, I’m certainly open to being shown where and how.

Dr. Cameron wrote:

Your not understanding what cell determinants are does not qualify you to say they do not exist or cannot be of clinical value. But I will agree that the writing could be more precise.

My response:
If I’m wrong about this, then I’d love to be educated on the fact—in fact, I would love to have a primer on just exactly what protomorphogens are and how they work. I’ve sent a copy of the Standard Process fact sheet to biochemist friends of mine, and they’ve come right out and said that the “mineral template” idea is nonsensical and not how cell determinants work; they also pointed out that substances that could have the sort of dramatic effect on cells claimed by Standard Process would be along the lines of hormones, mutagens and teratogens, and almost definitely not qualify as a mere supplement—it would be regulated as a drug by the FDA. It doesn’t help that “protomorphogen” seems to be a trademarked term of art, so searching science journal databases doesn’t turn up anything, and Googling merely turns up information sheets and promotional materials written by Standard Process or by sites selling Standard Process supplements.

Dr. Cameron wrote:

4. Dr. Royal Lee spent his life fighting the FDA, and yes, he was brought up before them several times. He was an outspoken critic of the adulteration of foods that came into common practice starting in the 1920’s (bleaching of flour, high-heat processing of foods, processing of foods to increase shelf life, the addition of sugar to so many foods, etc.) He constantly wrote letters to the FDA and other industry leaders pointing out the negative health effects these foods were having. As a dentist, he saw oral pathology due to nutritional deficiencies. This is how he came to start Standard Process Inc. – using quality food sources to replace the trace nutrients that were being lost in the food supply. The FDA and others took offense at his criticism and did go after him. Some of his claims (back in the 1930’s and 1940’s) were that these processed foods would lead to increased obesity, heart disease, cancer and diabetes. Are we seeing any of these conditions today? Are they increasing in frequency? Do we eat a lot of processed foods? Do our animals? As veterinarians, we are seeing the same increase in the same diseases in our pets as in humans. Be sure you check other sources besides QuackBusters.

My response:
I think it’s misleading to imply that Dr. Lee was prosecuted because he spoke out against processed foods and refined sugars. He made specific health and medical claims about his supplements and the FDA cracked down on him, and their statements about Dr. Lee being the “largest publisher of unreliable and false nutritional information in the world” concern the false medical claims on his products. Whether or not he’d drawn attention by speaking out against refined foods and existing food processing methods is beside the point; he was guilty of medical fraud because of the various claims he made regarding the efficacy of his supplements for treating various acute and chronic diseases and disorders. If you’re looking for a source beyond Quackwatch, perhaps this particular Notice of Judgment from the FDA regarding Dr. Lee’s products will be more satisfactory. (This is merely the first I found of many; if you go to the Notices of Judgment archive and search for “Royal Lee,” many more hits come up.) Here are the diseases that Dr. Lee claimed various supplements cured, which I’ve excerpted from the bottom of page 2 and on through page 3 of the Notice:

(1) pneumonia, tuberculosis, influenza, colds, whooping cough, measles, and mumps

(2) puerperal sepsis, infection of ear, infections of genito-urinary tract, infections of mucous tract, infections of gastro-intestinal tract, infection of respiratory tract, infections of sinuses, focal infections, and infectious diseases

(3) high blood pressure, low blood pressure, overweight, and underweight

(4) arteriosclerosis, high blood pressure, aortic aneurism, aortic insufficiency, valve leakage, coronary occlusion, coronary thrombosis, or dementia

(5) arthritis, hemorrhagic conditions of the urine, albuminuria, heart disorders, menstrual and ovarian disorders, Bright’s disease, leg ulcers, anemia, wasting of muscles, paralysis, muscular weakness, chronic diseases, amenorrhea, colitis, cystitis, children’s diseases, women’s diseases, liver disorders, dysmenorrhea, eczema, gall-bladder disease, gastritis, eye disorders, and cardiovascular disturbances

(6) acne, acute or chronic alcoholism, angina pectoris, Addison’s disease, adrenal hypertrophy, agranulocytosis, apoplectic sequellae, atrophy of glands or muscles, achlorhydric anemias, backward children, burns, cataracts, chlorosis, chorea, diabetes mellitus, epilepsy, toxic goiter, hyperthyroidism, hyperglycemia, hypertension, hypotension, asthma, hay fever, hyperemesis of pregnancy, sexual impotency, insanity due to endocrine failure, menopause disorders, migraine, menstrual dysfunction, paralysis agitans, phlebitis, poliomyelitis, paralytic sequellae, pancreatic dysfunction, pernicious anemia, nephritis, ideopathic [sic] ovarian disorders, prostate enlargement, peptic ulcers, sclerosis, rheumatic fever and varicose veins

(7) atrophy of organs and glands (testes, liver, spleen, thyroid, pituitary and salivary), infections and degenerations of eyes, physical weakness, nervousness, insomnia, gland swelling in general, renal calculi, bronchitis, endocrinopathies of childhood, nervous indigestion, neurasthenia, disorders of pregnancy, sterility, hypogalactia, retarded growth, loss of hair, fatty infiltration and degeneration of the liver, symptoms of nerve degeneration, Paget’s dermatosis, gastro-enteritis, infantile gastro-intestinal disorders, glycosuria, malnutrition, sprue, low resistance, kidney and bladder disorders, renal dysfunction, formation of stones (calculi), excessive growth of lymphoid tissue, lympathic gland enlargement, loss of weight and vigor, low vitality, stunted growth, emaciation, enlargement of liver, kidney and spleen, acidosis, and [prevention of] carcinoma

The substances to which these claims were attached? Various vitamin and mineral supplements (including A, C, B-complexes) that included various plant and animal extracts, and Catalyn (mostly milk sugar and various wheat extracts, with other plant materials and some “glandular extracts”). I think the list speaks for itself. If still not convinced, I’m certainly happy to dig through more old FDA paperwork and show what exactly the FDA’s beefs were with Dr. Lee’s products and the sorts of medical claims he made about his vitamin and food supplements.

Dr. Cameron wrote:

You make many judgements without much background information. This is the negative side of internet freedom, because people reading your biased opinion will take it as fact. This is unfortunate.

I would be happy to discuss this with you if you would like more information.

Tom Cameron, DVM 800-848-5061

My response:
I’m not a biologist nor a chemist, but I’m trained in the scientific method, and I’m a skeptic and a critical thinker. I’m open to being educated regarding protomorphogens; I’ll admit that the paucity of literature on this topic makes it somewhat suspect in my eyes, but again, my research was hampered by the fact that protomorphogen is not a scientific term but a trademarked term of art, and the Standard Process sheet was not at all clear. I am more than happy to receive information regarding protomorphogens and the way Renafood is supposed to work. I would prefer links to publicly-available documents so that any readers can read exactly what I’m reading as well and draw their own conclusions, but if that’s not feasible, then I would appreciate it if you would e-mail me more information at my gmail.com address (my username is misshepeshu—I’m giving my e-mail address this way to confound spambots).

12 comments to Renafood Redux, or: The Reply Comment that Ate the Blog

  • Stephanie

    Yes, you are right. You are not a biologist, a chemist, a clinical nutritionist or even a vet. Hard for everyone to be experts in everything isn’t it? Going through law school, I bet you especially understand this point.

    Bottom line, nutrition on the cellular level is important, excuse me mandatory, in any disease state. I have seen first hand what nutrition can do, what Standard Process and other similar products can do, when medicine alone won’t fix the problem. I do hope that other cat owners will seek out the advice of a professional before drawing similar conclusions. That is assuming you have not treated as many cats in your day as Dr. Cameron has?

    Oh and the research is out there, just gotta look: http://jama.ama-assn.org/cgi/content/abstract/287/23/3127
    Attend any national or international vet conference for continueing education, and you will be pounded with evidence based medicine supporting the use of supplements in both the treatment of and prevention of, chronic disease and disorders.

    Candy Reply:

    “Bottom line, nutrition on the cellular level is important, excuse me mandatory, in any disease state.”

    I’d just like to point out that nutrition on every level is important in any state.

    “Attend any national or international vet conference for continueing education, and you will be pounded with evidence based medicine supporting the use of supplements in both the treatment of and prevention of, chronic disease and disorders.”

    I don’t think I make any sort of argument that vitamin supplements don’t work, or that nutritional deficiencies don’t exist or don’t adversely affect health. In fact, here’s what I said in this article:

    Furthermore, while accepting the relatively uncontroversial assertion that some chronic diseases are linked to nutritional deficiencies or other bad dietary practices, it doesn’t necessarily follow that taking commercial vitamin or glandular supplements will cure or correct the conditions. (Diabetes mellitus comes to mind; so do certain types of liver cirrhosis and gout.)

    Let me put it another way: some diseases due to malnutrition or bad dietary habits are amenable to being fixed with nutritional supplementation. Other diseases due to malnutrition and bad dietary habits aren’t.

    I’d also like to say that if a person is suffering from, say, lack of vitamins A, eating various foods rich in beta-carotene and vitamin A would probably fix the deficiency just as well as nutritional supplements. The article you link to note that most people probably don’t consume optimal amounts of vitamins via diet alone, but this doesn’t necessarily make an argument to take supplements–I’d argue that this is an argument for most of us (the ones without clinical problems) to examine our diet and to create one that’s full of nutrient-dense, fresh whole foods.

    Please note that I’m not arguing that nutritional supplements have no place in the treatment of disease, or for the prevention of disorders. Some people with certain types of anemia or with certain fat metabolism problems just plain can’t consume enough of the relevant vitamins and minerals from diet alone (B vitamins and iron in the case of anemia, A and D in the case of the fat metabolism disorder). If you take a cursory look at this blog, I think you’ll find that I talk at obnoxious length about the utility of adding certain sorts of nutritional supplements to cat food.

    I hope all of this makes clear that I’m specifically skeptical that Renafood works, and that it works in the way Standard Process claims it does (detoxification + protomorphogens), largely because the claimed mechanisms don’t comport with what I and what biochemists I’ve talked to know about science. Again, if somebody wants to point to credible research regarding herbal detox and how protomorphogens work, I’ll be more than happy to review it and retract any statements.

    Also note that I don’t think Renafood does any harm. I just don’t think it does any good, either, at least based on publicly-available information.

    Adam Reply:

    Stephanie: there’s a huge jump between that JAMA paper (whose recommendations are pretty sensible and fairly conservative) and the claims Standard Process make which pretty much amount to inventing new biological processes in order to have some new product to sell.

    I’d be interested to see the paper where they provide “cellular determinants” orally to cats and demonstrate the effects; I’d always assumed that one of the key features of the transcription factors that are involved in embryonic development was that they’re not present at the same concentration across the whole organism. OK, so maybe these are a different kind of thing, but we’re not told. If they’re DNA, RNA, or (as the factsheet heavily implies) protein, then giving them orally will be pretty useless if you want them to get into the bloodstream intact. Add to that the fact that they’re from a different species, and this is starting to look like the sort of extraordinary claim that epigramattically requires extraordinary evidence.

    Candy Reply:

    “If they’re DNA, RNA, or (as the factsheet heavily implies) protein, then giving them orally will be pretty useless if you want them to get into the bloodstream intact.”

    Thank you for pointing that out! I’ve meant to in the past, but have completely neglected to.

    Adam Reply:

    I kind of wish there was more detail that I could actually look up the literature about and see where they were coming from, but it’s all just science-flavoured snake oil (though in a rather special twist they go for the nature-detox-flavoured snake oil as well – they should learn to pick and choose!)

  • julia

    love this site update more often if you can…of course i’m sure life is busy. 🙂 rip eric

  • Jewel

    I’m with Dr. Cameron. Man have we experienced what can happen when eating right and taking standard process. It has changed our life!

    Candy Reply:

    I’m glad that you’ve had a transformative experience; however, I think eating right in and of itself works wonders. It’s the problem of confounding factors: it’s impossible to tell if health improvements are the result of a given substance if taking that substance is accompanied by a wide range of healthier behavioral and lifestyle changes. It’s why I’m a fan of double-blind controlled studies, even if they have their own limitations.

  • Robert

    Excellent posting!

    You are a complete rock star for taking on this issue on such a detailed level. Honestly, I don’t necessarily trust a vet that’s been practicing for 20 years.

    My vet of 40 years has prescribed so many medications to my animals that have turned out to be utterly useless or even harmful.

    My brought my dog for a case of dry eye, and was told I would need to give her Optimune every day at the cost of $40-50 a month. Instead, I use artificial tears once a day at the cost of $5 a year and she’s never had a problem since.

    My cat is in the beginning stages of renal failure and I don’t want to give him the KD food. I’m researching alternatives now.

    Candy, I would love to know how you’ve dealt with this. What is your cats regimen?

    Candy Reply:

    Hey Robert,

    Unfortunately, Eric died very abruptly of heart failure (almost definitely due to the potassium imbalances that result from end-stage kidney failure), so I didn’t even have the time to tweak his diet. Calcitriol therapy helped a little initially, but then his numbers skyrocketed a few weeks after and he stopped eating completely, so we moved into emergency mode: get the cat to eat anything he’s willing to tolerate, which meant everything from Fancy Feast to meat-only baby food to bits of ground meat balanced with a calcium supplement. If we’d had more time, I would’ve fed him a balanced raw diet supplemented with egg white and squash, with an added phosphate binder like aluminum hydroxide to control his phosphorus levels.

    Sorry to have gotten back to you so late–we moved house in the past few weeks and life has been the epitome of chaos.

    Candy Reply:

    To clarify re: the egg white: it would’ve been thoroughly cooked and chopped egg white–egg white is an excellent source of protein but very low in phosphorus. Raw egg white fed in large quantities is a Very Bad Idea because it contains avidin, a protein that binds to biotin (an essential B vitamin).

  • I have been an RN for 16yr, and a kidney RN for 10yr in the area of ESRD/CRF, and own a support group for CRF dogs. I have my dog on Renafood, among other things. I cannot tell you if it helps him, although he is in very good shape. I’m only here to vouch for what Standard Process has done for ME. I started taking Arginex about 10yr ago for recurrent UTIs that were very hard to manage. I had a holistic MD tell me to “take 1 at the first sign of a UTI”. It has been most helpful in eliminating that UTI, and is much preferred to repeated usage of antibiotics. After that, I have been so grateful to Standard Process and still take Arginex at first sign of a UTI. I don’t believe they are phony or quacks. I think this is great medicine.