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Aspartame (Equal/Nutri-Sweet) Is NOT The Killer in Your Fridge

By Bob Aronson

Bob is the founder of this blog and the primary author.  He receives no monetary or other outside support nor does he allow anyone to see or review his posts before publication.  The topics are known only to him until they are published.


This  post is NOT an endorsement of Aspartame nor does it encourage its use.  Neither sugar nor their substitutes promote good health.  This is a response to the inaccurate and scientifically unverifiable claims leveled against Aspartame, but just because we found those claims to be false, readers should not assume we recommend its use. We do not.  If you think it is dangerous — don’t use it.

If you want more information about sugar and sugar substitutes read our blog on the subject here.  Please note, that this blog also does not recommend Aspartame as a sugar substitute. 

                                  Aspartame is NOT the Killer In Your Fridge!

There is a blog making the rounds that insists that Aspartame (Equal or Nutri-sweet) the sweetener found in most diet drinks is not only dangerous but deadly.  “Aspartame, A killer in Your Fridge”  pretends to have evidence but it is all circumstantial and doesn’t hold up under close scrutiny.   I’ll explain more in a bit.

 The blog disturbed me because as a transplant recipient I know how careful we have to be to protect ourselves from any number of real threats to our health.  Threats like skin and other cancers, viruses and brittle bones.  Our compromised immune systems are susceptible to some terrible afflictions and we just don’t need the added stress of worrying about imaginary threats supported by “Junk science” and spread by rumor, innuendo and incomplete or inadequate research.  That’s why I’m writing this blog.

Let me start by getting right to the point.  There is no solid evidence that Aspartame is any more harmful than the carbonation in your favorite soft drink.  No Solid Evidence!  There is anecdotal evidence but that’s kind of like hearsay in a courtroom.  The scientific community rejects it.  They prefer to make decisions based on real and proven scientific examination that studies foods, drugs and other items in a manner that leaves little or no doubt.

The “Gold Standard” of scientific examination is the double blind placebo study.  Here’s the simplest explanation I could find:

A placebo is the term for a dummy drug or a substance that looks, smells and tastes like the item that is being studied, but which has no active ingredient.  It is given to a patient in place of the substance under investigation. Clinical trials show that between 30% to 40% of people will show improvement when given a placebo because they believe it will work.

In drug trials, a control group is given a placebo while another group is given the drug being studied. That way, researchers can compare the drug’s effectiveness against the placebo’s effectiveness.

Using a placebo helps find out whether the active drug is really active. It also helps interpret side effects.  For example, if 10% of people in the active drug group report having a headache and 2% of people in the placebo group report a headache, then it is reasonable to think that the active drug can cause headaches.

If 10% of the placebo group also reported a headache, then it is reasonable to think that the active drug doesn’t cause a headache.

A double-blinded placebo study is where neither the administrators of the study nor the patients know which group the patient is in.

Blinding prevents different care or treatment being given based on the personal beliefs of either the doctor or patient.  A double-blind procedure is used to guard against both experimenter bias and placebo effects.  The blog in question is not based on double blind placebo studies.  It is all circumstance and speculation and totally without foundation.

The “Killer in Your Fridge” blog cites Individual cases where a person or even several persons appear to be affected is classified as anecdotal because there is no control group and because of the high probability of coincidence.  An example is, “My son got a vaccination and is now autistic.”  To many that sounds like real evidence.  It isn’t and that’s what the author of the “Killer in your Fridge”  blog, continues to cite over and over again.  It does not offer one scintilla of scientific evidence that aspartame is harmful.  When you skim away the sensationalism and look for proof you will find nothing more than speculation based on coincidence.

Make no mistake, we are not endorsing artificial sweeteners.   Just because something is approved as “safe for human consumption” doesn’t mean we should consume it.  While my research has not revealed any real dangers in consuming artificial sweeteners it also did not reveal a single benefit.   With that introduction here’s more detail on exactly what prompted me to write this blog.

aspartameA few days ago I got an email that included a post titled “A Killer in Your Fridge ~ Sweet Poison…A MUST READ.”   Being as I regularly report on health issues the headline got my attention so I read the blog which at first glance made a convincing case for establishing Aspartame the artificial sweetener as a killer of thousands maybe millions of people.  But something about the blog struck me as wrong.

I put down my Diet Mountain Dew, cleaned my glasses with a microfiber cloth and began to read the blog again.  On my second, more thorough read I found what I considered to be huge holes in the logic and a lack of solid scientific evidence.   You can reach your own conclusions by reading the blog at

A lot of what you read in the blog sounds quite convincing but upon close examination one finds that most of the so-called evidence is anecdotal meaning that the author points to one or two or even several people who contracted a certain illness and who also happened to be consuming aspartame in some form at the time.  While interesting and even eyebrow raising it is not considered evidence by the vast majority of the scientific community because the cited evidence amounts to little more than very timely circumstantial or anecdotal evidence.  That’s what’s known as “junk science” among true investigators that depend on large cohort (group) double blind studies.

A lot of negative charges have been leveled at Aspartame but there’s little or no real scientific evidence to back any of it up.  Here are some examples of what can be found on the internet

  • NutraSweet® killed my mother and has killed and/or wounded millions of innocent people in the US and abroad.
  • Aspartame converts to formaldehyde in vivo in the bodies of laboratory rats.
  • Did O.J. Simpson have a reaction to Aspartame that led to the deaths of Nicole Simpson and Ron Goldman?
  • The FDA, the International Food Information Council (IFIC), public Voice and others are scam non-profit organizations and pawns of the Nutra-Sweet Company.
  • After more than twenty years of aspartame use the number of its victims is rapidly piling up and people are figuring out for themselves that aspartame is at the root of their health problems.  Patients are teaching their doctors about this nutritional peril, and are healing themselves with little to no support from traditional medicine.
  • Donald Rumsfeld disregarded safety issues and used his political muscle to get Aspartame approved.

Much of the criticism of Aspartame is absolute nonsense but some is based on a study conducted in 2005 by the European Ramazzini Foundation, which tracked the health of aspartame-fed rats for their entire natural lives.  sick ratThe study linked aspartame consumption with an increased lifetime cancer risk.  But the U.S. Food and Drug Administration (FDA) says aspartame is safe in doses of 50mg per kilogram of body weight. That means that a 165 pound adult could safely drink 21 diet sodas a day.  The Ramazzani study fed Aspartame to rats in extremely high doses that ranged from 8 to over 2000 sodas a day…2000?   Do you know anyone who even drinks 8?

To be fair, let’s look at a couple of other studies.  Researchers from the University of Miami and Columbia University found that people who drink diet soda every day have a 43 percent higher risk of experiencing a vascular event over a 10-year period, compared with people who didn’t drink soda. Plus, this association held true even after taking into account known stroke and heart risk factors like diabetes and high blood pressure. And in a study published in the American Journal of Clinical Nutrition, French researchers found an association between Type 2 diabetes and self-reported diet soda consumption. Plus, when comparing the diabetes risk of drinkers of diet with drinkers of regular sodas, researchers found that diet drinkers had the higher diabetes risk.

But again, these studies are observational. It’s unknown if the diet soda is actually causing these conditions, or if people who are already at high risk for a heart attack, stroke and Type 2 diabetes tend to drink diet soda in an effort to lead a healthier lifestyle. Research on diabetes and diet soda consumption has been mixed so far; a review of studies from Harvard researchers published in 2011 showed no link between diet soda consumption and increased Type 2 diabetes risk.

While nothing can be considered 100 percent safe, aspartame has undergone extensive testing. With the exception of a few very mild side effects, aspartame appears to be quite safe. Those individuals, who experience problems after consuming aspartame, should eliminate foods and beverages that contain this sweetener from their diet.

The previous paragraphs pointing to the safety of Aspartame are supported by this evidence.

In 1965, James M. Schlatter, a chemist at G.D. Searle and Company, accidentally contaminated the tip of his index finger with an unassuming white powder. Later that day, a page in the book he was reading got stuck. He licked his fingertip to turn the page, and inadvertently gave birth to an entire industry, as well as a seemingly eternal controversy.

The substance on Schlatter’s finger, 200 times sweeter than sugar, was aspartame, the artificial sweetener known today by the brand names NutraSweet, Equal and Spoonful. Almost 50 years after Schlatter discovered aspartame’s incredible sweetness, disagreement still exists among scientists about whether it’s safe for human consumption.

Aspartame chemistry 2In essence, aspartame consists of two amino acids with an extra carbon atom stuck on one end. Aspartame breaks down completely into these three components in the small intestine, and they make their way separately into the blood.

One of aspartame’s two amino acids, aspartic acid, is non-essential, which means the body can manufacture it from other raw materials. Aspartic acid is also a neurotransmitter, which has led to speculation that aspartame consumption affects normal brain processes, possibly causing headaches, migraines, or worse. Almost all dietary protein contains aspartic acid, however, and the aspartic acid found in artificially sweetened foods and drinks pales in terms of quantity to the amount gained through a normal diet.

However, phenylalanine, the other amino acid in aspartame, is another story – but only for the small subset of the population. Phenylalanine is an essential amino acid, which means the body can only acquire it through the diet. For sufferers of the disease phenylketonuria, ingesting this amino acid leads to a dangerous buildup of phenylalanine that can damage the brain.

Although the amino acids comprising the bulk of aspartame are harmless for most people, the scientific jury is still deliberating about that extra carbon atom tacked on the end of the molecule. When an aspartame molecule breaks apart in the small intestine, this carbon disengages from the amino acids and forms a single molecule of methanol.

Methanol, also known as wood alcohol, is found in antifreeze and rocket fuel, among many other applications. Methanol’s effect on the body is similar in some ways to that of ethanol (the alcohol found in wine and beer), but unlike ethanol, the body deals with methanol by transforming it into waste products that include formaldehyde, a carcinogen that morticians use as embalming fluid.

If aspartame delivers methanol to your bloodstream, it would seem like a no-brainer to avoid the sweetener at all costs, but there’s a confounding factor: methanol is also found in all sorts of harmless foods, especially fruits and vegetables, in quantities comparable to foods that contain aspartame. In fact, aspartame-flavored soda contains less than half the methanol found in the same volume of many fruit juices.

This is where the dialogue gets contentious. To some researchers, it’s clear that methanol is harmless in the small quantities derived from aspartame-containing foods. However, a study conducted in 2005 by the European Ramazzini Foundation, which tracked the health of aspartame-fed rats for their entire natural lives, linked aspartame consumption with an increased lifetime cancer risk.

Some researchers, as well as the U.S. Food and Drug Administration, found fault with the study’s methods, while other scientists rushed to defend it, saying that at the very least, aspartame requires continued examination. At the heart of the debate is the fact that in rats, as in humans, a large percentage of individuals will succumb to cancer in very old age. It’s difficult for scientists to say whether cancer in a very old rat was caused by lifetime ingestion of a substance such as aspartame, or whether the cancer would have occurred naturally.

It is also important to point out that rats are not humans and often what occurs in a rat study doesn’t happen if later repeated in a human study.  The physical makeup of a rat is simply not the same as a human and while information gained from the animals may be helpful it is never regarded as proof of what will happen in people.

As the debate surrounding the long-term safety of aspartame persists, it’s important to consider the sweetener not in terms of its absolute safety, but whether it’s healthier than the alternative: sugar. Given rising levels of diabetes and obesity in the United States, it’s possible that for some people, a zero-calorie sugar alternative that carries some risks may still be a healthier choice than sugar. And in the meantime, new artificial sweeteners such as sucralose are flooding the market, which may or may not carry their own health risks.

There is one sure-fire healthy alternative to both artificial sweeteners and sugar, of course. don’t drink them.  Try a glass of ice water instead or perhaps unsweetened coffee or tea.

The European Food Safety Authority (EFSA) recently reviewed that 2005 Ramazzini Foundation study cited earlier. They found multiple significant flaws and concluded:

“The data on total malignant tumours do not provide evidence of a carcinogenic potential of aspartame.” 

As with any health issue it is unwise to adopt the results of one lab or one study.  When there have been hundreds of studies on a question, the cherry pickers will always have a lot to choose from. That is why systematic reviews are necessary,

Let me offer one more piece of evidence as to the safety of Aspartame. By Steven Novella September 15, 2010  

If you believe everything you read on the internet, then is seems that a chemical found in thousands of products is causing an epidemic of severe neurological and systemic diseases, like multiple sclerosis and lupus. The conspiraciesFDA, the companies that make the product, and the “medical industrial complex” all know about the dangers of this chemical but are hiding the truth from the public in order to protect corporate profits and avoid the pesky paper work that would accompany the truth being revealed. The only glimmer of hope is a dedicated band of bloggers and anonymous e-mail chain letter authors who aren’t afraid to speak the truth. Armed with the latest anecdotal evidence, unverified speculation, and scientifically implausible claims, they have been tirelessly ranting about the evils of this chemical for years. Undeterred by the countless published studies manufactured by the food cartel that show this chemical is safe, they continue to protect the public by spreading baseless fear and hysteria.

Hopefully, you don’t believe everything you read on the internet, and you don’t get your science news from e-mail SPAM, where the above scenario is a common theme. While there are many manifestations of this type of urban legend, I am speaking specifically about aspartame – an artificial sweetener used since the early 1980s. The notion that aspartame is unsafe has been circulating almost since it first appeared, and like rumors and misinformation have a tendency to do, fears surrounding aspartame have taken on a life of their own.

I am frequently asked my opinion about the safety of aspartame. Nutritionists often council to avoid the sweetener, citing unverified claims that it is unsafe. I was recently sent a chain letter warning that aspartame causes MS (which of course can be cured by simply avoiding aspartame), anda snopes logo Snopes informs me that this particular letter first appeared in 1998.

There are also hundreds of websites dedicated to smearing this much abused food additive. One site, run by Dr. Janet Starr Hull (she has a doctorate in Nutrition), responds to the latest report of aspartame’s safety by writing:

I will never accept the news of aspartame safety. I think it is a “business” decision to discredit/discount the research results that aspartame DOES cause cancer, major nerve disorders, birth defects, and brain imbalances. Think about it – can you imagine the chaos that will occur when the truth of aspartame dangers is accredited. The FDA has known about the dangers, the corporations have known about the dangers, and the medical community (if it is really worth anything) has known about the dangers.

The statement that “nothing will ever convince me” is a huge red flag that someone is defending an ideological position, one immune to evidence or reason. Admittedly, in context it could be a clumsy statement that something is very unlikely. It would be very difficult to convince me that the earth is flat – I’m really saying that the existence evidence is overwhelming that the earth is not flat. But that is not what Dr. Hull is saying. She is specifically saying that she will dismiss any evidence that is contrary to her belief that aspartame is not safe on the a-priori basis that such disconfirming evidence is part of a vast conspiracy.

Of course, Dr. Hull also sells an aspartame detox kit, which might lead a cynical person to conclude that she cares more about selling alternative health products and stoking her sales with some unreasonable fear than about scientific evidence.

What evidence does she have for such a conspiracy? The argument from final consequences logical fallacy – big industry wouldn’t want it. It’s also not very plausible. Products get pulled from the market all the time when new evidence suggests they are not safe. Also, the final safety net for the consumer is legal liability. Class action law suits have bankrupted companies, even when the underlying claims were false. Imagine if they were true. Look how much the tobacco industry has had to fork over.

Now I am not arguing that corporations are all good corporate citizens or wouldn’t dream of sweeping some inconvenient evidence under the carpet. But I am saying that a decades long conspiracy among industry, federal regulatory agencies, the medical community, and multiple research institutions and individual researchers – all under the nose of the press and lawyers looking for big class-action suits – is implausible in the extreme. I am also arguing that we should fairly assess all the evidence, not just cherry pick the evidence we like and dismiss the rest out of hand.

What does the evidence say about aspartame? A recent published review of all available evidence, including hundreds of studies, concluded:

The studies provide no evidence to support an association between aspartame and cancer in any tissue. The weight of existing evidence is that aspartame is safe at current levels of consumption as a nonnutritive sweetener.

Multiple reviews, going back to 1985, conclude the same thing. Since this latest review there have been more studies, in various countries (how big is this conspiracy?), showing no link between aspartame and brain cancer, and a lack of correlation between artificial sweeteners and gastric, pancreatic, and endometrial cancers.

Like all such research, there is noise in the data (but no apparent signal). There is no pattern of evidence to suggest that aspartame causes cancer, autoimmune disease, neurological disease, diabetes, or anything else its critics claim. What legitimate scientific controversy there is comes from the animal data, mostly in rats. Here the evidence for a carcinogenic or genotoxic (causing changes in the DNA) effect of aspartame is mixed and requires careful review. Some effects, such as a dose-dependent effect on renal tumors, are specific to rats and do not translate to humans. Other studies are plagued by significant flaws, such as properly calculating doses (a big issue when trying to extrapolate doses from rats to humans). And still others show flat effects without a dose response curve, suggesting that a confounding factor, and not aspartame, is responsible for any observed increase in tumors.

For example,

Animals studies are problematic and have produced mixed results, but no clear evidence of a neoplastic risk.

A separate question is whether or not aspartame causes headaches in some people. While there is not a lot of specific data on this, there are case reports of aspartame triggering migraines in susceptible people. Migraineurs frequently have multiple food triggers, and there is a long list of foods known to be potential migraine triggers. This is not evidence for toxicity. So while evidence is lacking to demonstrate aspartame is a headache trigger, this is not implausible and not particularly worrisome. What I recommend to patients with frequent headaches is to keep a headache diary, rather than trusting to memory (and confirmation bias) to detect real associations. If there is a clear pattern between a potential trigger and headaches, then avoid that trigger.

Yet another distinct question about artificial sweeteners (not just aspartame) is whether or not they contribute to obesity by interfering with brain’s association between sweetness and calories. The theory is that using zero-calorie sweeteners dissociates the sensation of sweetness from caloric intake, so that sweetness will cause less satiety, leading to increases in overall sugar and calorie consumption.

The question of aspartame and weight control is a complex one, and can be approached from many research angles. Here is a recent review of research. At present the question is very much unsettled. It seems that there is no significant metabolic and no demonstrated neuronal effect from artificial sweeteners. However, people who knowingly consume diet drinks do tend to overcompensate by consuming greater calories overall. While studies of substituting aspartame for sugar in a blinded fashion show that calories are reduced, contributing to weight loss.

By my reading, the current summary of available research is that consuming calories in drinks contributes to weight gain and obesity, substituting calorie-free drinks (whether water or diet drinks containing artificial sweeteners) does help reduce caloric intake and aid in weight control, but there is a tendency to overcompensate by increasing other caloric intake. Therefore it seems reasonable to use artificial sweeteners to reduce caloric intake from drinks, but to be careful to control overall caloric intake (so no, putting aspartame in your coffee does not mean you can eat the cheesecake).


Aspartame is a highly studied food additive with decades of research showing that it is safe for human consumption. As expected, the research is complex making it possible to cherry pick and misinterpret individual studies in order to fear monger. But the totality of research, reviewed by many independent agencies and expert panels, supports the safety of aspartame.

A conspiracy to hide the risks of aspartame, however, remains a popular internet urban legend that will likely not disappear anytime soon.

Finally…this report from National Public Radio.

Data Linking Aspartame To Cancer Risk Are Too Weak To Defend, Hospital Says

October 24, 2012 5:38 PM

Aspartame is a sugar substitute found in many popular foods, including diet sodas.

By Maggie Starbard NPR

We almost brought you news today about a study that appeared to raise some troubling questions about aspartame, the popular sugar substitute nprfound in many common foods like diet soda. Note the key word — almost.

A study due to be published at 3 p.m. Wednesday in the American Journal of Clinical Nutrition and released to reporters earlier in the week under embargo found some correlation between drinking diet soda and an increased risk of leukemia and Non-Hodgkin’s lymphoma, as well as a few other rare blood-related cancers.

But at 2:24 p.m. — about a half-hour before the paper was to publish — we and many other news outlets who had been working on the story got an email from the senior vice president of communications at Brigham and Women’s Hospital.

“It has come to our attention that the scientific leaders at Brigham and Women’s Hospital did not have an opportunity, prior to today, to review the findings of the paper,” Erin McDonough wrote in an email to us. “Upon review of the findings, the consensus of our scientific leaders is that the data is weak, and that BWH Media Relations was premature in the promotion of this work. We apologize for the time you have invested in this story.”

Now, the paper still got , although the editor of the journal, , told us that the reviewers pushed back during the editing process. They wanted to make sure “that the conclusion made it clear that chance was a plausible explanation of the findings,” he says. “The journal tried to ensure that the caveats were adequately presented.”

A co-author of the paper, Harvard’s , who sits on the of the ACJN, told us earlier today by email that “I do think this finding is strong enough to justify further study on aspartame and cancer risk.”

However, it seems as if senior scientists at Brigham and Women’s Hospital decided that the data weren’t ready for prime time. And all along, in the course of our reporting, the researchers we interviewed (who were not connected with the paper) had raised cautions.

“The results are really not that strong,” of the National Cancer Institute told us yesterday.

And from of MD Anderson Cancer Center: “I’m not convinced that this paper shows a relationship between blood-related cancers and drinking diet soda.”

of the American Cancer Society had pointed to inconsistent findings. For instance, the increased risk in Non-Hodgkin’s lymphoma was found only in men, not women. And regular, sugar-sweetened soda also seemed to lead to a similar increased risk of cancer.

And statistically, some of the findings teetered on the edge of significance.

The paper’s lead researcher, of Brigham and Women’s Hospital and Harvard Medical School, acknowledged to us yesterday that her manuscript had been turned down for publication by many other journals, including the Journal of the National Cancer Institute, the Journal of the American Medical Association, The Lancet and the British Medical Journal.

So why were journalists even covering the paper? Well, most of the experts we interviewed agreed with Willett that — despite the limitations — the findings were significant enough to justify further research.

As we earlier this week, Americans drink a lot of diet soda, and there’s some evidence that it can help maintain weight.

So we get it. Any evidence that there’s a potential health concern with something as popular and ubiquitous as diet soda has to be pretty solid.

As journalists at NBC , “the situation is a great example of why the public often finds science confusing and frustrating.”

We’ll keep you posted as we learn more.

Well, there you have it.  The Benefit of my research on the subject of Aspartame.  I think we should all avoid sugar and its substitutes but that’s up to each of you to decide.  If you insist on using aspartame or the products that include it do it in moderation.  That’s good advice for almost anything you consume…do it in moderation.

smaller stillBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 3,000 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

You may comment in the space provided or email your thoughts to me at And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Please view our new music video “Dawn Anita The Gift of Life” on YouTube  This video is free to anyone who wants to use it and no permission is needed. 

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just email me and ask for a copy of “Life, Pass it on.“  This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. 

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

Prison’s Deadliest Inmate, Hepatitis C, Escaping

In our continuing series on Hepatitic C we offer this story from NBC and the Associated Press  3/14/2007

Public-health workers warn of looming epidemic of ‘silent killer’

Marcio Jose Sanchez  /  AP

VACAVILLE, Calif.  — The most dangerous thing coming out of prison these days may be something most convicts don’t even know they have: hepatitis C.

Nobody knows how many inmates have the disease; by some estimates, around 40 percent of the 2.2 million in jail and prison are infected, compared with just 2 percent of the general population.

Eventually, when they are released, medical experts predict they will be a crushing burden on the health care system, perhaps killing as many people as AIDS in years to come. At the same time, they will be carriers, spreading the disease.

Hepatitis C can be treated, but many prisons do not test for it. Among the reasons: Budgets are tight, and treatment is expensive. So prison officials close their eyes to the gathering emergency and pass it along to the outside world.

“Right now there’s a golden opportunity to bring solutions to this problem before it hits,” said Dr. John Ward, director of viral hepatitis at the National Center for HIV/AIDS at the Centers for Disease Control and Prevention in Atlanta.

Hepatitis C is already the most common disease of its sort in the United States — a chronic, life-threatening, blood-borne infection. It is most commonly linked to infected needles used for drugs, though prison tattoos and body piercing with non-sterile equipment are also risky.

‘Silent killer’
What makes this virus particularly insidious is that as many as half of the people who have hepatitis C don’t even know they have it. The “silent killer,” already considered epidemic by the World Health Organization, often remains dormant for decades.

Some of the infected are lucky: One in five people who get hepatitis C will clear it out of their system naturally. But without treatment, one in four will suffer liver failure or develop liver cancer. Last year liver cancer was the only one of the top 10 fatal cancers in this country to increase, in large part because of hepatitis C.

More than $1 billion is already spent each year on this country on hepatitis C, and those costs are expected to soar unless prevention and treatment are expanded.

Without those changes, researchers project that liver-related deaths will triple from around 13,000 in 2000 to 39,000 by 2030. It’s also estimated that 375,000 Americans with hepatitis C will develop cirrhosis by the year 2015.

Anita Taylor, 48, is already there, in end-stage liver disease. Taylor speaks very slowly and moves with care. She often finds that she can’t say the words she wants to — they just won’t come out. Her body hurts most of the time. Her nose bleeds a lot.

‘Doctor gave me a death sentence’
A mother of two and former heroin addict, Taylor said she learned she had hepatitis C when she was jailed in Nevada in 1991 for being under the influence of drugs.

“They tested me and told me I had hepatitis C. They didn’t tell me there was a treatment and a cure,” she said. “And I didn’t know to ask.”

Taylor’s experience is not unusual.

“The doctor gave me a death sentence, recalls Leslie Czirr, a 36-year-old parolee. “He told me, ’There’s no cure for this and you will die from it unless you are hit by a truck first,”’

Czirr learned she had hepatitis C during a prenatal examination in 1996, at a time when she wasn’t in prison. Czirr has been arrested 10 times for drug possession and served almost eight years in prison on various drug possession and dealing charges.

She has started to suffer exhaustion, brain fog and aches. She recently enrolled in a county program to be treated — treatment, she said, she was denied at California’s Norco State Prison.

“I asked and asked, but they barely want to give you a Motrin,” she said. “I really want to get well, not just for myself, but so I’m not putting anyone else at risk.”

Limited studies indicate that fewer than 10 percent of prisoners who have contracted hepatitis C are treated. The reason vary. Medical staff have other priorities, and not all are well-informed about the disease. Prisoners with short sentences are often excluded because they won’t be able to complete treatment, and drug addicts who are inclined to return to risky behavior are often turned away because it is assumed they will simply reinfect themselves.

No funding for treatment
Usually, though, it comes down to money. Prison officials say that even if they wanted to provide the treatment, it is extremely expensive — about $9,500 per patient per year — and no federal funds have been earmarked to pay for it.

“It’s a hard sell to convince taxpayers why additional resources should be spent on the health care of the incarcerated when there are a lot of people who aren’t incarcerated who don’t have adequate health care,” said Dr. Joseph Bick, chief medical officer at the California Medical Facility at Vacaville.

Many of the inmates in Vacaville’s hospice unit — reserved for those given six months or less to live — are dying from hepatitis C-related ailments. Bick said half of the prison’s 3,200 inmates have a history of having been infected with hepatitis C, and at any given time about 40 of those men are receiving the intensive drug treatment to cure it.

“I’m pretty sure this is how I got it,” said Anthony Harris, an inmate at Vacaville. He rubbed his forearm hard, as if trying to remove the prison tattoo bearing his children’s names.

Harris, 51, is a former barber serving a life sentence for second-degree murder. In 2003, a doctor at another prison told him he had Hepatitis C; he researched the disease in the prison library and has sought treatment ever since.

“They gave me shots for Hep A and B, got rid of them. I’d like to get rid of the C too,” he said. “I’m entitled to that. But some docs will give you the treatment and others won’t. I keep making appointments. I keep asking.”

The course of treatment can take a year, and involves taking pills twice a day and weekly injections. Side effects are like those associated with chemotherapy — nausea, exhaustion, depression, debilitating aches and pains — and the cure only works about half the time.

But Bick said the high cost of treating prisoners for hepatitis C is a bargain compared to the bill that would come due if these cases are left untreated. “It’s a tremendous opportunity for us to have an impact on the larger health of the community,” he said.

Dr. Lynn Taylor, an assistant professor of medicine at Brown University’s medical school, agrees that prison is “perhaps one of the best setting for treatment of high-risk individuals.”

‘Window of opportunity’ for public-health efforts
“Prison can be a window of opportunity to reduce the reservoir of infection,” she said.

But there are no federal rules about testing and treating hepatitis C. Federal guidelines, issued by the CDC in 2003, said correctional facilities should “become part of prevention and control efforts in the broader community.” But they don’t recommend screening for all inmates.

Instead, the CDC urged medical staff to ask new inmates about their risk factors, and only those prisoners who seem likely to be exposed should undergo screening, which costs $5 to $10.

The CDC guidelines fell short, said Dr. Josiah Rich, a professor at Brown who directs the university’s Center for Prisoner and Human Rights. Rich’s studies confirm that convicted criminals are almost always willing to be tested for hepatitis C, but will often lie to prison authorities about their past drug use.

“We already know that more than one in three people coming through corrections has Hep C, so by definition everyone coming in is high risk. It’s absurd that they’re not testing everyone,” he said.

Rich concedes that testing every inmate will “jack up costs” for prisons.

“An individual is going to say, ’Hey, you tested me, you said I was positive, and now I want to be treated, and I’m going to sue you if I don’t get treated,”’ he said.

Lawsuits on the rise
Lawsuits are, indeed, on the rise.

The first significant case came in 1999, when officials at the Luther Luckett Correctional Complex in La Grange, Ky., refused to allow inmate Michael Paulley access to free hepatitis C treatment. Paulley, who was serving a 25-year sentence for rape and burglary, sued and won.

But the treatment came late and he died in 2004, the year he would have been eligible for parole. The litigation prompted broader testing and treatment in Kentucky, but Paulley’s physician, Dr. Bennet Cecil, a Louisville, Ky.-based hepatitis C specialist, said prisoners still die “all the time” for untreated hepatitis C.

“I think it’s immoral if a country, a state a society is going to incarcerate somebody and then deny them necessary medical care. I think that’s an outrage,” he said.

Prisons in at least a dozen states — Alabama, California, Delaware, Florida, Georgia, Idaho, Michigan, Mississippi, Nebraska, New York, Oklahoma and Virginia — are being sued over failure to treat hepatitis C.

But it’s tough going, said Oregon civil rights attorney Michelle Burroughs. Although she’s won a settlement that mandated testing for at risk inmates and treatment for those who are eligible, five of the 10 inmates she’s representing in a class-action lawsuit have died while the litigation proceeds.

5-year wait
“It’s appalling, horrendous, horrifying. Prisoners wait five years just to be evaluated,” she said.

Rep. Barbara Lee, D-Calif., recently reintroduced legislation that would mandate prison testing and treatment of hepatitis C. Earlier similar proposals in recent years have failed.

“The plain fact is that prisoners do not stay in prison. With more than 90 percent of incarcerated persons returning to their communities, it is clear that when a prisoner is infected, we are all affected,” Lee said.

In North Dakota, it didn’t take legislation, court orders or new regulations to prompt medical services director Kathleen Bachmeier to begin screening every inmate for hepatitis C after a methamphetamine epidemic tripled her state’s prison population in about a decade. As the intravenous drug addicts arrived, so did the hepatitis C.

“It became obvious to me that these people are going to cost the state a lot of money if we don’t do something about it,” she said.

North Dakota now treats anyone who meets certain medical criteria, whose sentence is long enough to complete the course of treatment and who is willing to try to quit using drugs.

“We look at this as a huge public health initiative,” she said.

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

You may comment in the space provided or email your thoughts to me at And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Please view our video “Thank You From the Bottom of my Donor’s heart” on This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

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