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Sickle Cell - a Nutritional Deficiency Disease?

by Elena N. Marcus


We have reached the end of September, the ‘sickle cell anemia month,’ without any exciting news in the field.  Last December, the National Institute of Health stopped a clinical trial that tested the possibility of reducing the number of blood transfusions in children who are at risk of stroke.  Norvalis had been testing a new iron chelator, ICL-670 and comparing it with one that is already on the market.  Sickle cell patients often have to take iron chelators in order to remove the excess of this mineral caused by blood transfusions.

On the other hand, the news regarding the evidence that sickle cell crises can and have been avoided in clinical and epidemiological studies by administering a missing nutrient is almost three-quarter-century old.  In an 1973 article in the American Journal of Clinical Nutrition, Robert Houston reviewed the evidence that sickle cell is a thiocyanate-deficiency disease, and expressed outrage that this evidence had been ignored for 40 years.  And it is still ignored today by most those who suffer from the disease.


It has been known since the 19th century that sickle cell disease did not exist in Africa before Europeans penetrated this continent. The thiocyanate, present in plants called nitrilosides, such as cassava (manioc) and the African yam was abundant in diet staples of Africans.  Cassava is a native of South America, and was introduced here in the 1600s.  According to Houston,  studies show that West Africans had more thiocyanate in their blood and saliva than  African-Americans.  According to researcher Oji Agbai, the sickle cell anemia is common now in his native regions of  Northern Africa, among city dwellers who have replaced their native staples with rice and wheat.  Incidentally, there is evidence that thiocyanate protects against cancer and high blood pressure as well. According to the National Institute of Health, African-American men are more likely to suffer from high blood pressure, and African American women have more virulent breast cancers than Americans of European descent.  Thiocyanate found in foods such as broccoli is now recognized as an anti-cancer compound.

In the 1980s, anthropologist Fatima Linda Collier Jackson (then with the University of California at Berkeley), found a high incidence of sickle cell homozygous genotype (carrying two sickle cell genes) in regions of North Africa. Since it made no sense for carriers of genes that shorten life span to strive in a population, this finding forwarded the theory proposed by Linus Pauling a decade before, that sickle cell anemia is a nutritional deficiency diseases, in fact an adaptive condition.  According to this theory, the sickle cell anemia protects the carrier against the malaria parasite, plasmodium falciparum.  The parasite doesn’t strive well in blood, under conditions of scarce oxygen. However painful sickle cell crises may be, malaria is deadly. Before Jackson, anthropologist William H. Durham had previously studied the customs of West Africans and discovered that during the malaria season, strict religious decrees prevented locals from eating the thiocyanate-rich African yams even during food scarcity periods. 

Jackson further administered thiocyanate to guinea pigs, and found that the substance caused carbamylation, an effect upon the blood cells which is salutary against sickling episodes.

Biochemist  Oji Agbai ND, PhD from Tulsa, Oklahoma, author of Sickle Cell Anemia: A Solution at Last,   has created a micronutrient compound that contains potassium thiocyanate (KSCN) together with iodine. In his self-published book, Agbai relates a clinical study in which the KSCN improved the condition of a patient whose veins were so riddled with needles, that blood transfusions could no longer be performed.  He found that the KSCN prevented the red blood cells from becoming sickle-shaped  and lessened the number of crises by making the blood more soluble, and by dilating the blood vessels.


Agbai, who is a descendant from the North African tribe Igbo, together with medical authorities in Niger, have successfully tested the benefits of  KSCN in the sickle cell population in that country.


Furthermore, before  many new 'improved' and newly patented pharmaceuticals for high blood pressure came on the market, potassium thyocianate was commonly administered during the 1930s to lower blood pressure.

About one in every 500 African-Americans have sickle cell anemia, a disease that is due to a tendency of blood cells to ‘ dry out’ and assume a sickle shape (instead of the usual circular form), leading to oxygen starvation, anemia, and severe pain.   About one in 12 people of African descent have the sickle cell ‘trait,’ which means they carry a single gene for the condition.  The condition may also be present among people from the Middle East, India, South America, and Jamaica.

Only those individuals who are born with double sickle cell ‘allele,’being therefore homozygote for sickle cell, may actually have blood cells that ‘sickle.’  The anemia is characterized by extremely  painful crises, depression of the immune system, fatigue,  and diseases derived from low immunity.  The patients also suffer  from adverse effects of modern treatments which are often invasive and dangerous.  Blood transfusions and a drug called hydroxyurea are the most common palliative solutions.  The first places the patients at risk of iron overload and strokes (especially children), and the second is a known carcinogen. The life expectancy of a sickle cell patients is 45 years, and the  quality of life is considerably diminished.

In the 1970’s when Linus Pauling discovered the molecular basis of the sickle cell anemia, he contended it was a nutrient-deficiency disease.  Houston and others have followed in his steps with numerous valid arguments, including clinical reports from the 1930’s and 1940s of the benefits of thiocianate in sickle cell blood.  In his seminal article in which he lays out the evidence, both epidemiological and biochemical, Houston reviews the literature describing how Jamaicans who have immigrated to the United States have developed sickle cell anemia, a genetic ‘disease’ of which they had not even been aware.  When some of these Jamaican natives returned to their island (and to their native diets) the sickle cell anemia crises subsided completely.  Foods containing thiocyanate compounds are vegetables from the brassica family such as cabbage and broccoli, the seeds of  most fruits, flax seeds, bitter almonds, the grain millet, and some pulses (beans).  Africans have food preparation customs which lower the cyanate content of their staples, the cassava and African yam (no relation with potato), to safe levels.

Although currently it is studied as a anti-cancer micronutrient, thiocyanate suffered a bad rap due to the fact that, on its metabolic path in the body, it turns into cyanide. However,  pure cyanide, a molecule of carbon and one of nitrogen united by a triple bond, has existed long before any life form existed on Earth.  Human body, and other vertebrates as well, can handle minute amounts of this highly poisonous substance. In fact cyanide has a role in the synthesis of vitamin B12.  After making use of it, the body turns the cyanide back into thiocyanate  with the help of the enzyme rhodanide synthetase. Sufficient protein intake is needed for this conversion to take place. Additonally, individuals who eat thiocyanate-rich foods have to supplement with iodine.

There are dozens of plants containing thiocyanate or various compounds of cyanide, and one pioneer in revealing their health-giving properties, Ernst T. Krebs, has called them nitrilosides.  Krebs, who contended that thiocyanate should be accepted as a vitamin (B17), researched animal diets as a student of zoology and found that most animals, including those living at the North Pole, have a thiocyanate source in the diet.

Sickle cell patients were found to be clinical deficient in many micronutrients, including the amino acid Arginine, the minerals zinc, magnesium and the B vitamins.  Some studies show that these and other nutrients such as fish oil, and a combination of folic acid, aged garlic, l-Arginine, vitamins E and C have had beneficial effects on the health of these patients.  The mineral zinc, for example, was found to reduce leg ulcers, which are often associated with sickle cell anemia, while the mineral magnesium pidolate was found to reduce the crises.

One of the most staunch promoter of nutrition awareness among sickle cell patients, Berkeley nutritionist and health writer Clara Felix reported repeatedly on the sickle cell and thiocyanate connection in her newsletter, “The Felix Letter, A Commentary on Nutrition.” She kept track relentlessly of all the efforts towards research in this direction.    She also has described the cold shoulder that she encountered when she tried to bring Oji Agbai and other thiocyanate promoters to the attention of clinical practitioners, specifically at the Children's Hospital in Oakland.  Clara Felix so wanted that those children (from the sickle cell ward at Oakland Children Hospital for example) benefit from her passionate research. In her memory, her son Elliot, has founded a non profit sickle cell section in his acupuncture clinic  (http://www.clarafelixclinic.org).  The clinic has a holistic approach to disease that includes  nutritional supplements and counseling, heat massage, acupuncture and massage.
Copyright: Elena N. Marcus, October 3, 2005

Disclaimer:  This information is not intended to treat or prevent diseases, but is given here for merely educational purposes.