AL 721 Workalikes: Where To Get Them

AL 721 is an experimental AIDS treatment derived from egg yolks. It is known to be safe and without serious side
effects. All available information from laboratory studies, clinical trials, and anecdotal reports suggests that although
it is not a cure, it appears to be helpful even at severe stages of HIV infection.

The bad news is that despite promising early results, little testing has been done, and only a handful of people can
get the "real", official AL 721. For this potential treatment like a number of others, has fallen victim to a public-policy
nightmare of bureaucratic and commercial red tape. All but lost to institutional medicine, AL 721 has joined an
underground, grass-roots circuit of rational AIDS/ARC treatments, well supported by all existing evidence but largely
ignored by the official research system for institutional (not scientific or medical) reasons.

During the last year a number of AL 721 substitutes have been tried. But only in the last few weeks have good ones
become available.

This article reviews the background of AL 721, tells what you can get now or in the near future, and tells where to find
more information.


AL 721 Background

AL 721 consists entirely of substances found in ordinary egg yolk, so it could legally qualify as a food. Eating egg
yolk would not have the same effect, however, because the ingredients are not in the right proportion (a 7:2:1 ratio),
and also because the high cholesterol in egg yolk would interfere.

AL 721 was developed by cancer researchers at the Department of Membrane Research of the Weizmann Institute of
Science in Israel. The three components are: phosphatidylcholine (PC), the main ingredient of ordinary lecithin; phosphatidylethanolamine (PE), usually found with PC in lecithin; and "neutral lipids", ordinary fats like cooking or butter, which serve as a carrier for the PC and PE. Scientists found the 7:2:1 ratio (7 parts neutral lipid, 2 parts PC, 1 part PE) through educated trial and error in laboratory tests; this ratio showed a sharp peak in effectiveness in causing certain changes in cell membranes. The researchers were not looking for an antiviral, but for ways to modify the action of receptor sites on cells for other medical purposes, such as helping alcohol or narcotics addicts overcome their habit by relieving withdrawal symptoms.

AL 721 affects the membranes of cells, and also of "lipid coated" viruses, a class which includes AIDS, herpes, CMV, and Epstein-Barr. The first suggestion of possible use against AIDS appeared in a letter to the New England Journal of
Medicine, November 1985. Several scientists, including Dr. Robert Gallo of the U.S. National Cancer Institute, reported
that AL 721 greatly reduced AIDS virus infection of human cells in the laboratory.

Since AL 721 had already been given to humans and was known to be safe, the obvious next step would have been to try it with AIDS or ARC and see if it helped. But in almost a year and a half since the above article, only eight people have received AL 721 in scientific tests --with good results. About 15 others have received it quietly in Israel, often against the wishes of the U.S. licensee to the patent on AL 721, with good to excellent results. This writer does not know of any other human experience with the official AL 721 as an AIDS/ARC treatment, anywhere in the world.

A number of events in late March and early April of 1987 gave AL 721 much-needed public attention and credibility. A
Wall Street civil-disobedience demonstration precipitated major media coverage of AIDS treatment research and availability, letting the public know that the issue exists. In Israel, the researchers who developed AL 721 reported that the seven patients in their initial treatment group, all seriously ill in advanced stages of AIDS, all improved clinically with AL 721 treatment. And the U.S. National Institutes of Health announced that its AIDS Treatment Evaluation Units would
evaluate AL 721 in a "Phase I" dosage study. Incidentally, the stock of Praxis Pharmaceuticals, the manufacturer of AL 721, almost doubled in price in the last week of March, apparently reflecting the new credibility of that company's only product.

The "Home Formula"

The failure of official AIDS researcher to follow up on AL 721 and test it seriously, from November 1985 until March 1987 at least, has left a vacuum which home experimenters and a few physicians have filled. A number of AL 721 substitutes have been tried, but none worked well enough to attract much interest until the "home formula" (see below) appeared in January 1987 and quickly superceded all the earlier attempts. April 1987 saw the first of a new generation of egg-lecithin AL 721 substitutes which are probably better than the home formula; but we don't have much experience yet since people have used it for less than two weeks at this writing.

For the benefit of those who don't already have the home formula, we reproduce it here:

"PC-55 (tm) is a high-strength lecithin concentrate made by Twin Laboratories, Inc., Ronkonkoma, NY, and sold in health- food stores. It contains two of the three ingredients of AL 721; they are in a 5:2 ratio, close to the 2:1 used in AL 721. Neutral lipids can be added to PC-55 making it a membrane fluidizer comparable to AL 721. This material is a food nutrient, it is not a drug. It is safe. "Combine five tablespoons of PC-55 and 12 tablespoons of water in a bowl, and whip with an electric mixer or blender. Slowly add 6 tablespoons plus one teaspoon of butter (6 1/3 tablespoons butter) which has been melted (measure the butter before melting). Whip thoroughly three to five minutes. This mixture divided into ten even doses gives slightly over 10 grams of the lipids per dose. Each dose should weigh about 30.4 grams or 1.06 ounces.
"The individual doses can be placed into plastic sandwich bags for freezing. If you don't have a scale, you can measure out two tablespoons to each bag, then add a much smaller amount to divide the remainder. One person separates the doses in an ice-cube tray. Move each dose from the freezer to the refrigerator a few hours before use. This preparation spoils very rapidly at room temperature; it must be frozen unless used immediately.
"(An earlier version of this formula used cooking oil instead of butter. The proportions are 5 tablespoons PC-55, 5
tablespoons + 1 teaspoon oil, and 10 tbsp water.)
"The material is best eaten in the morning, spread on fat-free bread or mixed with fruit juice. The user should eat a
fat-free breakfast which might consist of fat-free cereals, skim milk, fruits, or vegetables. There are no restrictions on
lunch or dinner. An additional dose might be taken before going to bed. Patients treated in Israel are given two doses a
day for about four weeks, then single doses indefinitely. Some people with AIDS might experience diarrhea with this membrane fluidizer, especially with the additional dose. Eat brown rice and other solid foods.
"You can help others and yourself by keeping a record of your experience -- doses, dates, and any resulting effects.
"For information call Steve Gavin, (see phone number below)."

Mr. Gavin developed this home formula in January, 1987 and distributed it at meetings of persons with AIDS. This writer published the formula on January 30. We don't know how many people have used it by this time, but there must be several hundred. So far we have heard only good results; people have been happy with this preparation.

How does this home formula differ from the "official" AL 721? It differs mainly in its use of soy lecithin instead of
egg; the PC and PE from soy have minor chemical differences from the egg varieties. And instead of the "egg oil" neutral lipids used in AL 721, it uses butter, a substitute suggested by experts as the closest generally available. The substitutes were used because egg lecithin and egg oil are difficult to obtain. (Apparently the scientists who developed AL 721 selected the egg substances as the closest to those already found in the human body. No published studies anywhere suggested that the substitutes wouldn't work; but none proved that they would, either.)

Three months later those involved have little doubt that the home formula does work. Mr. Gavin has estimated that it
may be half to three quarters as effective as the official AL 721; this estimate may be conservative.


Egg-Lecithin AL 721 Substitutes

At the time of this writing (April 20), only one AL 721 workalike using egg lecithin is on the market: "Eggsact" from
INTREND, a new company in Santa Cruz, CA (see phone number below). INTREND was started by three people whom this writer has known socially for several years. Knowing that they were involved in the health-food business, I kept them informed about AL 721 and encouraged them to produce a workalike product. To prevent conflict of interest I avoided any financial involvement with the company (as with all other AIDS treatments and companies), and have no role in this operation besides volunteering information.

"Eggsact" uses egg lecithin for the PC and PE, and butterfat for the neutral lipid carrier. Butterfat had proven
successful in the home formula; INTREND chose it because of the difficulty of obtaining egg oil, and also to avoid possible legal problems with the AL 721 patent. The lecithin is not irradiated, and is a high-quality, injectable grade usually used for making pharmaceuticals. Although contamination would be unlikely, the product was tested for salmonella and staphylococcus, with none found; the level of peroxides, a measure of possible rancidity, was undetectable in the chemical tests used. The company will make copies of the test results available on request.

The PE ratio is probably low, below the theoretical 10 percent -- as it is in the home formula, and indeed in much of
the "official" AL 721. Almost no one has controlled the PE level at this time, and many experts doubt that it is critical.

Eggsact is nitrogen packed. It must be kept cold, at freezer temperatures for long-term storage. The company plans
to provide foil packaging, but for now it is using canning jars to make the product available immediately. Naturally this
material can be sold only as a nutritional supplement, not as a medicine, and the company cannot discuss medical claims or uses.

The cost of using Eggsact is $3. to $6. per day -- compared to 50 cents to $1 per day for the home formula, or $2.
to $4. per day for egg-based workalike soon to be available from the PWA Health Group (see below).

Several other companies are believed to be preparing to market AL 721-like products. At this time the only one we can confirm is Jarrow Formulas, 265 East Redondo Beach Blvd., Gardena, CA 90248. Jarrow plans to sell a product packaged so that it may not need refrigeration until opened. He intends to offer a very low rate to nonprofit groups, in addition to standard commercial distribution through health-food stores, physicians, and other health practitioners, but he cannot sell small quantities directly to individuals.

It is rumored that Praxis Pharmaceuticals is considering marketing AL 721 as a nutritional supplement, as well as
pursuing eventual approval as a pharmaceutical. If so, its product could become the gold standard against which the others are judged. It would be the only one able to use the name "AL 721".


PWA Health Group, and Healing Alternatives Buyers Club

At least two nonprofit organizations, in New York and San Francisco, will soon distribute an egg-based workalike very
close to AL 721. Unlike Eggsact, their product uses egg oil and controls the PE level. Orders must be placed a month or more in advance, as the manufacturer requires a minimum order of 100 kilograms (about $16,000), and then needs time to prepare it. The minimum individual order is one kilogram, for about $200.

The PWA Health Group started within the PWA Coalition in New York, but then became independent, as the charter of the PWA Coalition does not allow sale of a nutritional supplement. In San Francisco, a number of persons including this writer who have placed orders with the PWA Health Group started the Healing Alternatives Buyers Club, as a vehicle for distributing the local portion of the original order placed through New York. In the future, the Healing Alternatives Buyers Club will buy directly from manufacturers. And it will actively help facilitate the formation of similar groups elsewhere.

For address and phone information, see below.

AL 721 Precautions

Though AL 721 has few side effects, some cautions must be considered.

Recently physicians have noticed that some people who had used AL 721 become ill shortly after they discontinued it. In fact, two of the eight lymphadenopathy patients who received the treatment in scientific tests developed AIDS four to six weeks after their AL 721 was discontinued. These cases may be coincidence, and there is no evidence that AL 721 made anyone more ill than they would have been without it; but until more is known, physicians are advising persons not to start AL 721 or workalikes unless they plan to continue. It may be necessary to stop gradually, as with a number of other medicines. (Fortunately the home formula is always available in case supplies of AL 721 or other workalikes are interrupted.)

Too much lecithin can cause nausea, diarrhea, mental depression, and loss of appetite, but is not believed to have
lasting ill effects. In some cases nausea or diarrhea attributed to AL 721 turned out to be caused by intestinal parasites such as amebas or giardia instead; these parasites can be eradicated by medical treatment.

Animal studies have shown that large doses of lecithin given during pregnancy can accumulate in the fetus and reach
very high levels, causing subtle neurological damage in the offspring. Could proper amounts of AL 721 help to protect
unborn children of pregnant women who are HIV positive? Medical experts should examine this possibility.


For More Information

The PWA Health Group can be reached at Box 234, 70-A Greenwich Ave., New York, N.Y. 10011, or call (212) 995-5846.

The Healing Alternatives Buyers Club is at P.O. Box 411107, San Francisco, CA 94141; the phone will be (415) 861-
3056.

You can call Steve Gavin at (201) 677-2795.

To reach INTREND, the maker of Eggsact, call Bill Powell at (408) 429-1596.

For a packet of five articles by this writer on AL 721 and lecithin, including scientific background and references, send
one dollar to John S. James, P.O. Box 411256, San Francisco, CA 94141.