Expert: Domenic Sica - 9/15/2009

Question
QUESTION: In the August issue of Hypertension, it was reported
that the Klotho gene which is known to extend life expectancy also:

1.  Reduced Hypertension.
2.  Reversed kidney damage caused by Hypertension.

http://www.ouhsc.edu/article-display.asp?idnum=1432

Klotho is also available as a protein and, conceivably, we could ingest it as a powder much like we do with protein drinks,

Do you know where I can buy Klotho powder?  I would love to control my Hypertension by drinking a chocolate shake daily instead of taking clonadine, bystolic, hydrocloralthizide plus 5 other Hypertension medicines.

ANSWER: Unfortunately, this has not been studied in man in such a way to state what the effect of such a powder would be on blood pressure. I am also not aware of where to purchase this and even if it could be found what would be an appropriate intake. I would doubt that it could substitute for an eight drug regimen for blood pressure control. Your blood pressure sound like it is quite resistant to therapy. What part of the country are you in the off chance that one of my colleagues may be near you and could see you.

Regards.

Domenic Sica, M.D.

---------- FOLLOW-UP ----------

QUESTION: I live in the 93534 zip code which is Lancaster, CA.

If you know of somebody in the area who specializes in
treating resistant hypertension I would be happy to get the contact information.

I have an upcoming appointment with a cardiologist that was recommended by Niel Treister who was the chief medical officer (not sure of the title) involved with CardioDynamics who designed the BioZ ( a ICG machine ).  Dr. Treister said they had gone to school together and was well trained in using both hemodynamics/Impedance cardiography as a way to treat resistant hypertension.


1.  If a person has terminal cancer what is downside of taking an unproven drug?

2.  If klotho power is truly a protein powder made up of amino acids like Arginine, Citrulline, cysteine, taurine, tyrosine, histidine, etc, in what why could it be dangerous?  I have know football, wrestlers, weight lifters, etc that took prodigious amounts of protein powder.  It seems reasonable that if klotho powder doesn't cause problems for mice, it won't cause problems for people.  But then again, I am not a doctor or a research scientists.

It is a shame that hundreds of thousands of people (am I exaggerating?) in the time it will take to develop a drug that is approved for use by the FDA.  If it works, use it on people that voluntarily opt for it.  I am sure there thousands of people in the USA with kidney failure that would say they wanted the treatment now, not 10 years from now.

One last comment:

The rate at which new drugs are developed is so fast that the FDA is getting farther behind every year.  The only good thing is they fast track some drugs that they precieve as being super important.

Answer
1. If a drug is unproven then it may not have much use for someone with terminal cancer. The downside would be if there are side-effects with the medication that might potentially hasten his/her demise.
2. I would not imagine that Klotho powder is dangerous per se. Just because it was used in mice for short-term experiments does not ensure that is safe in man over the long-term. The FDA does not regulate production of supplements, which also means the manufacturers of such a compound could potentially have different amounts of each component. You can see how confusing this is and its not simply being taking it and all is well.
3. Just using something such as this based on the experimental data is a stretch to say the least. The FDA would not approve a food supplement for use in the treatment of hypertension. As to whether the FDA is slow to approve drugs the answer is yes; however, they are under constant pressure to pull drugs from the development process by patient advocate groups at the earliest sign of a clinical problem with a compound being developed.
4. If you are willing to go to Los Angeles I can set you up with a colleague at USC.

Regards,

Domenic Sica, M.D.