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supplements: vitamins, minerals, herbs, & "natural" products
update: January 21, 2016. The supplement industry is largely self-regulated and many of its products don't contain the ingredients that their labels say they do. This may explain why the best scientific studies of supplements have found no health benefits and some harm from the daily use of supplements. See Frontline's exposé, "Supplements and Safety," transcript or film, which aired on January 19, 2016. See also the lame response of the The American Botanical Council, echoed by the Society for Integrative Medicine, to the New York attorney general's investigation of supplements: "relying on DNA barcoding technology alone to validate botanicals is premature." If DNA barcoding is 'premature' then why did GNC, the largest of the supplement retailers, agree to use DNA barcoding to authenticate its products?
note: Several large studies have shown the futility of taking vitamin and mineral supplements on a daily basis as a hedge against some unspecified adverse health effects. Many people, however, consider daily supplements to be part of a healthy lifestyle. Some people may be overdoing it on some of the supplements, doing themselves harm instead of good. (For more on the potential harm supplements might do, see my comments here.) Should everybody avoid supplements of any kind, then? Of course not. Some people have vitamin or mineral deficiencies and supplementation is necessary for them to maintain good health.
Below you will find links to articles about persons or practices relating to vitamins, minerals, or herbs. You'll also find excerpts from various items on these topics that I've blogged about. As a bonus, I mention people who make a living selling supplements at inflated prices and encouraging others to do the same with the promise that by doing so you will be on your way to riches beyond your imagination, eternal youth, increased spirituality, or something of the sort.
There are too many companies and products involved in this kind of chicanery to list them all by name. The following links should help you decide whether a particular outfit or product is trustworthy. Before joining an MLM, many of which sell vitamins and minerals along with massive doses of hope, do yourself a favor and click here.
Cancer Patients: Cancer patients who are thinking of
trying an untested alternative therapy, please read the American Cancer Society's page on Herbs, Vitamins, and Minerals, and Dr. Stephen Barrett's
Message for Cancer Patients Seeking "Alternative" Treatments.
My research has led me to conclude that many of the claims about herbs, spices, or supplements "preventing cancer" or "boosting the immune system" need to be taken with a grain of salt. Nothing prevents cancer, but many things may lower the risk of cancer. You can lower your risk of cancer substantially by not smoking, not being obese, not abusing alcohol, exercising regularly, and eating a healthy diet. No herb or supplement will significantly stimulate T-cell growth or make T-cells more aggressive in their attack on cancer cells, but many nutrients are essential to a healthy immune system. Phytochemicals and antioxidants are necessary but not sufficient to ensure a healthy immune system. If you include many fruits and vegetables of various colors in your diet, you are probably helping your immune system as much as you need to.
When taking supplements consider the following:
- There may be side effects;
- There may be adverse reactions from interaction with other herbs or drugs;
- Controlling dosage and purity can be a problem with herbs;
- They may be unnecessary and, while not harmful, of no benefit;
- Natural doesn't imply beneficial or harmless;
- Although some supplements contain useful drugs, they may not be suitable for self-medication because optimal control of some medical conditions should be tailored to individual risk factors and be medically monitored; and
- There is always the possibility that there is a safer, more reliable, and cheaper alternative available.
Dietary supplements send more than 23,000 people to the ER each year "While that number is a small fraction — just 5 percent — of the number of ER visits involving pharmaceuticals, the issue is a cause for concern because the market for herbal and complementary nutritional products remains largely unregulated. Surveys have shown that about half of U.S. adults used at least one dietary supplement in the past month and that there were more than 55,000 products on the market as of 2012. Out-of-pocket expenditures on these products is estimated to be about a third of what people spend on prescription drugs."
Medical journal: 'Case closed' against vitamin pills
"Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided.... After years of study and mostly disappointing results, enough is enough. What we've found time and again is that the supplements are not working… we don't need to go on studying them forever....most of the 53% of U.S. consumers who use supplements are wasting money, to the tune of $28 billion a year."
Multivitamins in the Prevention of Cancer in Men The Physicians' Health Study II Randomized Controlled Trial
"Results: During a median (interquartile range) follow-up of 11.2 (10.7-13.3) years, there were 2669 men with confirmed cancer, including 1373 cases of prostate cancer and 210 cases of colorectal cancer. Compared with placebo, men taking a daily multivitamin had a statistically significant reduction in the incidence of total cancer (multivitamin and placebo groups, 17.0 and 18.3 events, respectively, per 1000 person-years; hazard ratio [HR], 0.92; 95% CI, 0.86-0.998; P = .04). There was no significant effect of a daily multivitamin on prostate cancer (multivitamin and placebo groups, 9.1 and 9.2 events, respectively, per 1000 person-years; HR, 0.98; 95% CI, 0.88-1.09; P = .76), colorectal cancer (multivitamin and placebo groups, 1.2 and 1.4 events, respectively, per 1000 person-years; HR, 0.89; 95% CI, 0.68-1.17; P = .39), or other site-specific cancers. There was no significant difference in the risk of cancer mortality (multivitamin and placebo groups, 4.9 and 5.6 events, respectively, per 1000 person-years; HR, 0.88; 95% CI, 0.77-1.01; P = .07). Daily multivitamin use was associated with a reduction in total cancer among 1312 men with a baseline history of cancer (HR, 0.73; 95% CI, 0.56-0.96; P = .02), but this did not differ significantly from that among 13 329 men initially without cancer (HR, 0.94; 95% CI, 0.87-1.02; P = .15; P for interaction = .07). Conclusion: In this large prevention trial of male physicians, daily multivitamin supplementation modestly but significantly reduced the risk of total cancer."
Vitamin junkies are flushing their money down the toilet, says nutritionist The large number of "worried well" who take supplements with a "better safe than sorry" attitude are wasting their money.
Vitamins 'may raise death risk from cancer' Oct 1, 2000
The Dangers of Dietary Supplements (ingore the ads and sidebars!)
Diet Supplements or Nutritional Supplements: A Ruse by Any Other Name is Still a Ruse by Harriet Hall, M.D. It makes sense to supplement the diet with essential nutrients if the food in the diet is deficient in those nutrients or if the patient is not able to absorb nutrients normally. There are specific situations where that applies, such as providing folic acid to women to prevent birth defects or providing vitamins and minerals to bariatric surgery patients whose digestive functions are compromised.
More harm than good? "Sales of vitamin supplements containing antioxidants are booming. But research suggests they don't always work - and may even increase the risk of disease....the findings on antioxidants and diseases such as cancer, heart disease and strokes have been shocking. A paper combining the results of all previous studies showed antioxidant vitamins were not beneficial, and some even made diseases worse. In particular, giving Beta-carotene supplements, which our bodies turn into vitamin A, to smokers probably increased the risk of lung cancer."
Athletes' supplement use ineffective Protein supplements, very popular with athletes, don't improve athletic performance or recovery time, a Canadian researcher says....The researcher found the athletes were mostly unaware the taking of supplements can result in levels of sodium, magnesium, niacin, folate, vitamin A and iron that exceed acceptable norms and make them susceptible to problems such as nausea, vision trouble, fatigue and liver anomalies.
Children’s Hospital of Philadelphia Becomes First in Nation to Disallow Use of Dietary Supplements "The hospital said the action was being taken because the Food and Drug Administration (FDA) does not routinely review the manufacturing of dietary supplements, and therefore cannot guarantee their safety and effectiveness. The move makes CHOP the first hospital in the United States to discourage patients from using these products without a doctor’s provision as a matter of policy."
Supplements industry finds 'natural ally' in Sen. Hatch "...in the past two years, 2,292 serious illnesses, including 33 deaths, were reported by consumers who used supposedly harmless nutritional supplements...."
GAO report on dietary supplement flaws released today in Senate hearing Nearly all of the herbal dietary supplements tested in a Congressional investigation contained trace amounts of lead and other contaminants, and some supplement sellers made illegal claims that their products can cure cancer and other diseases, investigators found....
CVS to Pay Nearly $2.8 Million in Consumer Refunds to Settle FTC Charges of Unsubstantiated Advertising of AirShield 'Immune Boosting' Supplement CVS Pharmacy, Inc. will stop making misleading claims that its “AirShield” dietary supplements can prevent colds, fight germs, and boost immune systems.
"Whistleblowers Facing Outrageous Criminal Prosecution" by Stephen Barrett, M.D. Two nurses who complained that a doctor was trying to sell herbal products to his hospital clinic patients are facing criminal charges as a result. In a bizarre case that has drawn national attention, Anne Mitchell and Vickilyn Galle are awaiting trial for "misuse of official information," which is a third-degree felony under Texas law....Mitchell and Galle have filed suit in federal court alleging not only illegal retaliation for patient advocacy activities, but also civil rights and due process violations.
As Economy Is Down, Vitamin Sales Are Up This New York Times article notes that scientific studies do not support the value of taking supplements, but many people seem to be ignoring the science. Sales are up, apparently, because it's cheaper to buy supplements than it is to go to the doctor.
Vitamins are not of equal value Americans love supplements, but there is no evidence the pills make most of us any healthier.
Colloidal Mineral Supplements: Unnecessary and Potentially Hazardous by James Pontolillo
new Antioxidants Facilitate Melanoma Metastasis: A team of researchers at the University of Gothenburg in Sweden has now shown that mice with melanoma fed an antioxidant had double the number of lymph node metastases and more malignant disease compared to animals with the same cancer who were not given antioxidants. [/new]
Antioxidants Speed Up Lung Cancer: Swedish scientists have discovered why two antioxidants accelerate tumor growth in mice, helping to explain the results of disappointing human trials.
"Although some people spend countless dollars on antioxidant supplements to improve their health, many studies have found that these would-be panaceas could actually exacerbate the diseases they claim to prevent.
These results fit with those from a long line of human clinical trials, in which antioxidants failed to prevent disease or made things worse. The first of these was published in the New England Journal of Medicine in 1994, and showed that male smokers who took beta-carotene supplements were more likely to develop and die of lung cancer than those who did not. Other trials found similar results for other antioxidants and other cancers, and some of those studies were even stopped early.
In 2012, the Cochrane Collaboration analyzed the results of 78 earlier trials and, based on the most careful of them, concluded that people who took antioxidant supplements (including both healthy people and those with chronic diseases) were more likely to die prematurely than those who did not."
Antioxidants and Exercise: More Harm Than Good? "The evidence is inconsistent and generally unimpressive when it comes to the effects of antioxidant supplements on exercise. So we’re challenged to make decisions based on incomplete information. In light of what we know about antioxidants and exercise, the trend in the data is strongly suggestive of zero benefit, at best, with the real possibility that there may be negative consequences to supplementation. Overlay the epidemiologic evidence that looks at mortality, cancer, and other outcomes, and the attractiveness of antioxidant supplements drops even further."
Antioxidants? It’s a Bit More Complicated by Harriet Hall, M.D. (a.k.a. the SkepDoc) "Study after study has shown no benefit of antioxidants for heart disease, cancer, Parkinson’s disease, Alzheimer’s disease, or longevity. One study did show that an antioxidant combination slowed the progression of established moderate-to-severe macular degeneration, but more research is needed to confirm those results."
Fish oil in the Observer: the return of a $2bn friend The media has been deceiving us about the benefits of omega-3 for children's learning.
High Dietary Fiber Intake May Not Reduce The Risk Of Colon Cancer "The largest study examining the association between the incidence of colon cancer and dietary fiber consumption was published (New England Journal of Medicine 1999; 340:169-76). The authors report that they found no such correlation in a study of 89,000 US nurses. This finding suggests that the hypothesis that dietary fiber prevents colon cancer is false or, at least, that the effect of fiber is too insignificant to be discerned. Moreover, there was no association between fiber intake and the development of colon polyps, which are believed to be precursors of colon cancer.
....a recently-published, scientifically strong study (New England Journal of Medicine 1999;340:101-7) demonstrated that calcium supplements prevent the formation of colon polyps, which are believed to be the precursors of colon cancer.....
Finally, in view of the other demonstrated benefits of higher fiber diets with respect to heart disease, high blood pressure, diabetes, and colonic diverticular disease (diverticulosis), higher dietary intakes of fiber can continue to be recommended. If fiber also helps prevent colon cancer, all the better."
Glucosamine and Chondroitin Sulfate for Arthritic Pain by Gabe Mirkin MD "Glucosamine ... can block the effects of insulin, causing blood sugar levels to rise, increasing likelihood of suffering the side effects of diabetes in susceptible people."
.... most doctors are still skeptical of the benefits of chondroitin sulfate....*
Effects of glucosamine and chondroitin on treating knee osteoarthritis: An analysis with marginal structural models. "Use of glucosamine/chondroitin did not appear to relieve symptoms or modify disease progression among patients with radiographically confirmed OA. Our findings, which are consistent with meta-analyses of clinical trials, extend the results to a more general population with knee OA."
Glucosamine: No cure for knee pain or deterioration, study says Supplemental glucosamine is commonly made from the shells of sea creatures, and marketers claim that it promotes joint health and supports the formation of cartilage. Roughly 10% of the U.S. population uses the supplement, study authors said....In the most recent study, Kwoh and his colleagues tested glucosamine's effects on adults between 35 and 65 who complained of knee pain.
Roughly half of the study patients, 98, were given daily, 1,500 mg doses of glucosamine hydrochloride in a 16-ounce lemonade drink. The other half, 103, were given lemonade drinks that did not contain the supplement.
The study subjects were given MRIs at the start of the trial and at the final 24-week examination. Test subjects also reported on their knee pain and provided urine samples.
The urine was tested for levels of C-terminal cross-linking telopeptide of type II collagen (CTX-II), a molecular marker for cartilage tissue degradation.
The MRI images, pain assessments and urinalysis provided no evidence that glucoasime was more effective than the placebo in improving joint health, authors concluded.
Study: Glucosamine, Chondroitin No Help for Arthritis: Analysis Shows the Supplements Aren't Effective to Ease Pain of Hip or Knee Osteoarthritis The popular supplements glucosamine and chondroitin don't do much to relieve the pain associated with hip or knee osteoarthritis, according to a new analysis of 10 studies.
Glucosamine: The Unsinkable Rubber Duck by Harriet Hall
Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee. Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain. Or, maybe not.
The return of the revenge of high dose vitamin C for cancer by David Gorski, Science Based Medicine
The healines read Vitamin C shows promise as cancer therapy (FOX News). Based on what? "What we have here is a small clinical trial with a 19% dropout rate that wasn’t even blinded. It reported zero difference in overall survival (both were, as one would expect for ovarian cancer at this stage, abysmal), and zero statistically significant difference in time to relapse/progression."
Taking large doses of vitamin C may moderately reduce blood pressure, according to an analysis of years of research by Johns Hopkins scientists. On the other hand, vitamin C supplements have been linked to increased incidence of kidney stones. Researchers in the blood pressure study stopped short of suggesting people load up on supplements....Taking an average of 500 milligrams of vitamin C daily — about five times the recommended daily requirement — reduced blood pressure by 3.84 millimeters of mercury in the short term. Among those diagnosed with hypertension, the drop was nearly 5 millimeters of mercury. By comparison, patients who take blood pressure medication such as ACE inhibitors or diuretics (so-called “water pills”) can expect a roughly 10 millimeter of mercury reduction in blood pressure.
An editorial in JAMA that accompanied the kidney stone article notes that causation is biologically plausible because ascorbic acid is partly metabolized to oxalate and is excreted in the urine. [Fletcher RH. The risk of taking ascorbic acid. JAMA Internal Medicine, Feb 4, 2013]
Vitamin C may shorten cold, not stop it "Combined, the studies involved more than 10,000 participants. The reviewers determined that people taking vitamin C daily, in doses as high as 1 gram, caught roughly the same number of colds as people who were not taking extra vitamin C....The combined trials also found that cold symptoms did not last quite as long in people who took extra vitamin C daily through several winter months. On average, colds for these people were about half a day shorter than for people who did not take vitamin C."
Cancer-causing Compound Can Be Triggered By Vitamin C "...when vitamin C reacts with even low doses of chromium 6 inside human cells, it creates high levels of cancer-causing DNA damage and mutations."
Vitamin D supplementation fails to reduce the incidence or severity of upper respiratory tract infections in healthy adults
A randomized, double-blind, placebo-controlled clinical trial has found that that monthly administration of 100,000 IU of vitamin D did not influence the incidence or severity of upper respiratory infections in healthy adults. The study included 320 healthy adults who received either a placebo or 200,000 IU for two months and 100,000 IU for 16 more months.
Pregnant women 'must take vitamin D supplements' The Department of Health [UK] advises pregnant women to ensure they receive a certain level of vitamin D - 10 micrograms per day. The researchers say this in effect endorses use of supplements, because diet and the sun provide too little. But the National Institute of health and Clinical Excellence (NICE) said in its guidance that it did not support supplements.
WebMD says: If you shun the sun, suffer from milk allergies, or adhere to a strict vegetarian diet, you may be at risk for vitamin D deficiency.
If you take a vitamin D supplement, remember that dose is important and too much can be detrimental.
Vitamin D and Cancer Prevention
"The National Cancer Institute (NCI) does not recommend for or against the use of vitamin D supplements to reduce the risk of colorectal or any other type of cancer."
Vitamin E pills may raise risk of prostate cancer "Men randomly assigned to take a 400-unit capsule of vitamin E every day for about five years were 17 percent more likely to get prostate cancer than those given dummy pills. That dose, commonly found in over-the-counter supplements, is almost 20 times higher than the recommended adult amount, which is about 23 units daily."
Vitamin E linked to lung cancer (Taking high doses of vitamin E supplements can increase the risk of lung cancer)
Taking Folic Acid Supplements Before Conception Linked To Reduced Risk Of Premature Birth "Taking folic acid supplements for at least a year before conception is associated with reduction in the risk of premature birth....The study design was observational, so the presence of other factors, such as healthier behaviors on the part of women who take folate supplements, may explain the findings. Further evidence as to whether folic acid prevents spontaneous preterm birth will require a randomized controlled trial." Premature birth significantly increases the chances of complications such as cerebral palsy, mental retardation, chronic lung disease, blindness, and defects of the spinal cord and brain. "Every woman of childbearing age should consume 400 micrograms of folic acid daily."* The FDA requires food manufacturers to fortify grain-based foods such as cereal, pasta, and bread with folic acid. "A 2 oz. serving of dry pasta will supply the equivalent of about 100 micrograms a day of folic acid or 25% of the recommended daily intake (RDI)."* A serving of some cereals provides 400 micrograms of folic acid. Click here for a list of some other good sources of this important B vitamin.
Folic acid may hike, not cut, colon polyp risk ...researchers speculate that some folic acid helps — as long as the colon is free of microscopic cancer cells. But once cancer starts, folic acid may feed its growth....based on data from 987 adults with a history of precancerous colon polyps. Those who took folic acid developed more growths, or adenomas, several years later than the people who took dummy pills.
Trial Stopped After Niacin Brings No Benefit to Heart Patients Although early research had suggested that the nutrient niacin might raise levels of "good" cholesterol and thwart heart attacks, a major clinical trial has been stopped 18 months early because it has shown no such benefit.
Taking a daily supplement of selenium will not ward off cancer, say experts who have reviewed the available evidence.
The Cochrane group looked at 55 studies that included over a million people.
Zicam-Induced Damage to Mouse and Human Nasal Tissue Our results demonstrate that Zicam use could irreversibly damage mouse and human nasal tissue and may lead to significant smell dysfunction.
Note: Herbal supplements are not subject to the same government regulations that drugs are. Many herbal products do not contain the ingredients they list on their labels. "The F.D.A. requires that companies verify that every supplement they manufacture is safe and accurately labeled. But the system essentially operates on the honor code."*
New York Attorney General Targets Supplements at Major Retailers "The New York State attorney general’s office accused four major retailers ... of selling fraudulent and potentially dangerous herbal supplements and demanded that they remove the products from their shelves.
"The authorities said they had conducted tests on top-selling store brands of herbal supplements at four national retailers — GNC, Target, Walgreens and Walmart — and found that four out of five of the products did not contain any of the herbs on their labels. The tests showed that pills labeled medicinal herbs often contained little more than cheap fillers like powdered rice, asparagus and houseplants, and in some cases substances that could be dangerous to those with allergies.
"Among the attorney general’s findings was a popular store brand of ginseng pills at Walgreens, promoted for “physical endurance and vitality,” that contained only powdered garlic and rice. At Walmart, the authorities found that its ginkgo biloba, a Chinese plant promoted as a memory enhancer, contained little more than powdered radish, houseplants and wheat — despite a claim on the label that the product was wheat- and gluten-free."
Herbal Remedies Can Cause Cardiac Problems Herbal medications such as St. John's wort and ginkgo biloba can affect the activity of prescription drugs, dampening or enhancing their effects. So can grapefruit juice.
Herbal Science International, Inc. Recalls Twelve Dietary Herbal Supplements Nationwide Because of Possible Health Risk Associated with Ephedra, Aristolochic Acid and Human Placenta
Stopper put on more herbal companies By Kirsty Needham and Jeni Porte
Herbal 'remedy' may trigger widespread kidney failure Use of the drug in Chinese medicines may be responsible for Taiwan's sky-high rate of kidney disease.
Herbal Medicine and Aristolochic Acid Nephropathy by S. Novella
"It has been a stunning triumph of marketing and propaganda that many people believe that treatments that are 'natural' are somehow magically safe and effective (an error in logic known as the naturalistic fallacy). There is now widespread belief that herbal remedies are not drugs or chemicals because they are natural. The allies in Congress of those who sell such products have even passed laws that embody this fallacy – taking herbal remedies away from FDA oversight and regulating them more like food than drugs."
Black Cohosh and Hot Flashes by Steven Novella
NCCAM studies show black cohosh is ineffective.
Cochrane Summary: The review of 16 studies (involving 2,027 women) found insufficient evidence to support the use of black cohosh for menopausal symptoms.
Dong quai has estrogen like effects and has been shown to increase growth of breast cancer cells in laboratory experiments.
Ginkgo doesn't prevent Alzheimer's disease "The idea of popping a pill or food supplement to prevent Alzheimer's is just an exercise in hope at this point," said Dr. Lon Schneider, director of the California Alzheimer's Disease Center.
Ginkgo doesn't work: Are there better ways to save your brain? Should you take ginkgo to slow down the effects of age on the brain? "The answer appears to be 'no,'" says Steven T. DeKosky, M.D., the vice president and dean of the School of Medicine at the University of Virginia.
Problems found with red yeast rice supplements Tests of 11 brands of red yeast rice supplements have found that some samples contained amounts of cholesterol-lowering compounds that varied by more than 10-fold, and some were contaminated with a potential toxin, according to a report released this week by ConsumerLab.com, an independent group that conducts product evaluations.
Cranberry juice for bladder infections
Cranberries (usually as cranberry juice) have been used to prevent urinary tract infections (UTIs). Cranberries contain a substance that can prevent bacteria from sticking on the walls of the bladder. This may help prevent bladder and other UTIs. This review identified 24 studies (4473 participants) comparing cranberry products with control or alternative treatments. There was a small trend towards fewer UTIs in people taking cranberry product compared to placebo or no treatment but this was not a significant finding. Many people in the studies stopped drinking the juice, suggesting it may not be a acceptable intervention. Cranberry juice does not appear to have a significant benefit in preventing UTIs and may be unacceptable to consume in the long term. Cranberry products (such as tablets or capsules) were also ineffective (although had the same effect as taking antibiotics), possibly due to lack of potency of the 'active ingredient'.
OxyElite Pro: dietary supplement linked to dozens of cases of acute liver failure and hepatitis, including one death and illnesses so severe that several patients required liver transplants. See also Hazards of Hindsight — Monitoring the Safety of Nutritional Supplements by Pieter A. Cohen, M.D
Prevagen "Prevagen, which has helped propel its manufacturer, Quincy Bioscience, into the ranks of fastest-growing companies in the U.S., shows evidence of serious side-effects and should be marketed and regulated as a drug, says the U.S. Food and Drug Administration. Anyone taking Prevagen should check with their doctor in light of the FDA’s disclosures about this so called “brain vitamin.” In a warning letter, the FDA accused the company of not reporting to the government “adverse events like seizures, strokes, and worsening symptoms of multiple sclerosis that had been reported to your firm as being associated with the use of Prevagen products.” Reports about the supplement to the company have also included chest pain, tremors, fainting and other serious symptoms, the FDA says."
A class-action suit has been filed against Quincy Bioscience LLC, which has marketed Prevagen for several years. The company claims that the product works by re-supplying memory-related proteins that decline as people age. The complaint charged:
- The product cannot work as advertised because its only purported active ingredient, apoaequorin (a protein), is completely destroyed by the digestive system and transformed into common amino acids no different than those derived from other common food products.
- The amount of amino acids Prevagen adds to the user's intake are trivial in comparison to normal dietary intake.
- Claims that clinical tests demonstrate that Prevagen will improve memory and support healthy brain function, sharper mind, and clearer thinking are false.
- Studies touted in Prevagen's marketing campaign "if they exist at all, are, on their face, so seriously flawed that they demonstrate nothing regarding Prevagen."
Over-counter-cold remedies From Dr. Steven Novella: "...despite the commonality of the cold, the overall success of modern medicine, and the many attempts to treat or prevent the cold – there are very few treatments that are actually of any benefit. The only certain treatment is tincture of time. Most colds will get better on their own in about a week. This also creates the impression that any treatment works – no matter what you do, your symptoms are likely to improve....Limited use of NSAIDs and decongestants may be helpful. Otherwise, if there is an intervention that is risk free and makes you feel better, do it. We all need to feel comforted when we’re sick. But don’t waste your time or money on other medications, supplements, herbs, or other concoctions. There are also endless snake-oil products out there, too many to deal with here. A good default position is simply not to believe any product that claims to prevent or treat the common cold. And don’t be compelled by the anecdotal evidence of your neighbor’s cousin’s boss. Everyone thinks they have the secret to treating the cold, but no one does. It’s all placebo effect and confirmation bias."
Diets, Supplements, and Health: It's Complicated The scientific evidence is too complicated for a simplistic "commonsense" view that supplements can't hurt you and they might help.
alternative health practices (One of the most popular AHPs is to use supplements for vitality, increased harmony, wholeness, and wellness.)
anthroposophic medicine (Steiner discovered that "a plant is a healing plant when it has a distortion or an abnormality.")
aromatherapy (Improve your life force or spirit with essential oils!)
Ayurvedic medicine (Find the right foods and herbs for your body type.)
Bach's flower therapy (Homeopathic aromatherapy for the soul.)
bioharmonics (One of the more popular claims in "energy" healing is how valuable supplements are to proper health and spirituality.)
Gerson therapy (quack cancer therapy)
holistic medicine (Holistic practitioners are often adamant that vitamins are good for the soul.)
homeopathy (Vitalism at its best!)
Joel D. Wallach, "The Mineral Doctor" (Claims that all diseases are due to mineral deficiencies and that just about anyone can live more than one hundred years if they take daily supplements of colloidal minerals harvested from a pit in Utah.)
multi-level marketing (There are probably more MLMs centering around vitamin and mineral sales than any other product.)
natural (Of course supplements aren't natural, even though some of the ingredients in them are. My favorite claim here is one by Dr. Atkins that his low-carb diet, which requires supplements, was the most natural.) See also external link Can natural remedies recover?
naturopathy (Their favorite cure for anything that ails you is a diet rich in vitamins and mineral supplements, often sold through their office.)
shark cartilage (Those who sell it swear it can cure cancer.)
Wicca (Wiccans favor herbs over conventional medicines.)
September 30, 2004. A
new study published in the
Lancet has found that vitamin supplements do no good in protecting
against cancer or other diseases. In fact, the study has found that some
supplements may even increase one's cancer risk.
January 15, 2001. The Institute of Medicine has issued the latest of four reports on recommended dietary allowances (RDA) of vitamins and minerals. The report is based on a four-year review of the scientific research into vitamins and minerals. The bottom line? "Nutritionists say a healthy daily diet, with at least five fruits and vegetables, can provide plenty of most vitamins." Nevertheless, 40% of Americans take supplements. Some need them. Some are probably being harmed by them. E.g. Vitamin A: "more than 3,000 micrograms daily can risk birth defects in pregnant women and liver damage for others." Vitamin E: more than 1,000 milligrams (1,500 international units) a day "could cause uncontrolled bleeding." Vitamin C: "more than 2,000 milligrams a day can cause diarrhea."
On the other hand, "many people over age 50 have trouble absorbing vitamin B12 from natural food sources and thus should eat fortified foods, like breakfast cereals, or a daily supplement to ensure they get 2.4 micrograms a day....[and] the amount of vitamin D older people need for strong bones has doubled, to 400 international units."
While the RDA has changed for many vitamins and minerals, the labels used on consumer goods generally follow the guidelines set down in 1968. To confuse matters even more, some products list the amounts of vitamins and minerals by milligrams or micrograms, while others use international units (a microgram equals 3.33 international units).
The USDA has set up a nutrient database online, so you can do a search for a product like milk and get a list of dozens of dairy products which you can then click on to find out what nutrients are contained in various sized servings.
April 13, 2000. WebMD reports that we're more likely to find vitamins conducive to good health in our kitchen than in our bathroom...if you have foods such as fresh fruits, vegetables and nuts in the kitchen. According to a recent report by the Institute of Medicine (IOM) pill supplements for vitamins C and E, selenium, and carotenoids have no proven role in preventing disease. IOM recommends a ceiling on daily consumption of selenium and vitamins C and E to reduce the risk of adverse side effects from overuse. The full report is available from IOM.
July 8, 2002. A five-year study involving more than 20,000 people aged 40 to 80 found that a daily dose of vitamin C, vitamin E and beta carotene does not reduce the risk of heart disease, cancer, or mental decline. Prof Rory Collins, a co-author of the report at Oxford University's Clinical Trial Service, said: "Over five years we saw absolutely no effect." At the end of the trial, people taking vitamins had exactly the same risk of heart disease, cancer, cataracts, bone fractures, asthma and mental decline as those who took a placebo. In contrast, cholesterol-lowering drugs reduced the risk of heart disease and stroke by around one third.
October 26, 1997. An article in the New York Times by Jane E. Brody reported the results of a 13-year study involving over 10,000 Americans which "found no evidence of increased longevity among vitamin and mineral supplement users in the United States." This is especially bad news, since most of the people who take vitamins are non-smokers who don't drink heavily and who eat more fruits and vegetable than the rest of us. (The study also found that supplements failed to help the longevity of smokers, heavy drinkers, and those with chronic diseases.) The results of the study have been out for four years. Nevertheless, it is estimated that some $6.5 billion a year is being spent by Americans on vitamin and mineral pills. (It might seem like $6.5 billion is a lot of money, but consider that Americans spend about $2.5 billion on Halloween candy and costumes.) Why do we spend so much on supplements? I suppose in part it is because some people really do have vitamin or mineral deficiencies and they need the supplements. Others may be taking supplements because they believe the pills will help fight cancer, give them more energy, help them live longer, improve their chi, rev up their spirit or vital energy, and so on. It is true that the information regarding nutrition, vitamins and minerals is bewildering, confusing and contradictory; that uncertainty gives some wishful thinkers hope that the stuff will do them good. Maybe. And maybe that is why vitamins and minerals are so popular among MLM programs. But why ignore the possibility that these pills might be doing some harm? Vitamin E can interfere with the action of vitamin K (which promotes blood clotting). Too much calcium can limit the absorption of iron and too much zinc can reduce the level of copper in the body (decreasing "good" cholesterol). Folic acid can react adversely with anticonvulsants and each year the greatest number of poisoning deaths among children is from iron supplements meant for adults.
April 28, 2003. An investigation into "alternative" medicines has led to the biggest medical product recall in Australian history, according to the Sydney Morning Herald. Two hundred nineteen products have already been banned and eventually 70% of "complementary" medical products may be forced from the marketplace. The investigation began when 87 adverse reactions were caused by a travel sickness pill, Travacalm. Nineteen people had to be hospitalized. At least one lawsuit has already been filed.
The federal parliamentary secretary for health, Trish Worth, said "some people were very, very ill and tried to jump out of planes and off ships because of the hallucinatory effect it had." Testing found dosages varied from 0 to 700 per cent of that listed on the label.
Travacalm is produced by Pan Pharmaceuticals, Australia's largest contract manufacturer of alternative medicines. Pan's license to produce medicines has been revoked. The Therapeutic Goods Administration is considering criminal charges against Pan and has already found that Pan falsified test results and substituted ingredients for those listed on labels.
Since Pan produces products for many different companies, consumers were advised to stop using any alternative supplements until specific products can be checked out.
Bob Carr, the Premier of New South Wales,
told reporters that it is time to end the hype over "alternatives" and
do some proper scientific assessments of remedies touted as "alternative
therapies." Carr said the public needed to be more skeptical about
complementary or alternative medicines. "Let's encourage a healthy
skepticism based on science," he said.
[thanks to Kerrie Dougherty]
The New Zealand Herald reports:: "The Food Safety Authority last night issued a list of 642 dietary supplements and vitamins sold in New Zealand that are made by or contain ingredients made by the disgraced Australian company.
It took three days to put the list together, mainly because complementary medicines do not have to be registered in New Zealand, so authorities have no record of what is being sold, who makes what, or where products come from."
January 18, 2000. Any nut in a storm. That seems to be the motto of the National Center for Complementary and Alternative Medicine. They've committed over $1.4 million over five years to study the crackpot cancer "cure" of Nicholas J. Gonzalez, who uses a variation on the Max Gerson treatment of coffee enemas and vitamins. The fact that Gonzalez has already been convicted of incompetence and malpractice does not seem to bother those spending other people's money on this bogus research.
July 11, 2001. The current issue of JAMA (vol 286 no 2) has an article warning patients about to have surgery of the dangers of taking herbs before surgery. I find this interesting since many people take herbs as an alternative to surgery. They think herbs like ginkgo biloba and ginseng can prevent diseases which might require surgery otherwise. The main danger is that the herbs might lead to excessive bleeding. The authors are not campaigning to eliminate herbs from the diets of millions of Americans, which would be fruitless since the numbers who believe in the magical nutritional and healing power of their herbs is growing exponentially, it seems. Rather, the authors are encouraging patients to inform their doctors of any herbs they might be taking. Many patients are not telling their doctors about their herbal intake, either because they don't realize that herbs contain chemicals that might react with anesthesia or other drugs given before or after surgery or because they don't want their doctor to know that they are hedging their bets with alternative medicine. For purposes of the law, herbs are called "dietary supplements" and are not subject to the same kind of scientific scrutiny as prescription or non-prescription drugs. So, perhaps herb users think of their herbs as "alternative vitamins and minerals."
The concern is not new and was reported on over a year ago by CNN, ABC, and HealthCentral. I reported on this concern last October. WebMD took up the issue last September. A report on the JAMA study can be found at the CNN site.
The mystical belief in the power of herbs has carried over from consenting adults who should be allowed to ingest whatever useless remedy they wish, to marketing herbs for our children and our dogs and cats. Andrea Candee, MH, i.e., "master herbalist", claims to know what herbs are "child-friendly." You can find out what they are if you buy her book. I can understand an Aborigine, with 40,000 years of tradition behind him or her, claiming to be a master herbalist. But I wonder where Candee got her title. The fact is that herbs have pharmacological properties, have been used in conventional drugs for years, and are being used by millions of self-medicators today. Those who produce and market herbs should do less to make people think their products are safe just because they are natural, and do more to inform people that herbs are drugs. When one's doctor asks what drugs you or your children or pets are taking, one should list not just prescription drugs but herbs as well. Your life or the life of those you love may depend on it.
September 1, 2002. Peggy Orenstein has an article in today's New York Times Magazine on the raw-food diet fad. She pays a lot of attention to Roxanne's, a raw-food restaurant in Larkspur (Marin county, about a 15-minute drive up 101 from the Golden Gate Bridge that connects San Francisco to Marin). It's one of the "in" places to dine in the Bay area; reservations must be made a month in advance for the privilege of eating food that has not been cooked. For some mystical reason, food may be heated to 118 degrees and still be considered raw at Roxanne's, which is run by Roxanne Klein, wife of Michael Klein, who made his fortune in data communications. Mr. Klein hasn't eaten cooked food in five years, is a vegan who eats honey, and subsists on about 800 calories a day (he says). Roxanne has been a vegan for 10 years and also hasn't eaten cooked food in five years. Orenstein describes Michael as gaunt with muscular arms. She describes Roxanne as making Kate Moss look fat. The Kleins claim they are the poster children for health and good living.
I haven't dined at Roxanne's, and probably never will, but I know several people who have. They gave it mixed reviews. The food was interesting, they said, and most of it was tasty. But the service was not what one would expect when paying something like $70 each for dinner (with wine). Why, you might ask, would anyone want to spend that kind of money to eat raw food? Well, why not? If the food is good and tasty, the wine of high quality, the service excellent, and the ambiance pleasant, who cares whether the soup is hot?
On the other hand, the raw-food craze seems to be based on some pseudoscientific notions. The Kleins think that eating raw food will ward off aging and disease. They seem to take literally the words of one of the raw-food pioneers, T. C. Fry, who claimed ''All the diseases of civilization -- cancer, heart disease, diabetes -- are all directly attributable to the consumption of cooked food.'' Fry took the proof for that claim to the grave seven years ago when he died at age 70. (It is said, however, that he was in perfect health when he died and didn't look a day over 60.)
Mr. Klein believes that cooking food destroys a food's natural enzymes and minerals, and depletes it of protein and vitamin content, while concentrating pesticide residues. Orenstein contacted David Klurfeld, a professor of nutrition and food science at Wayne State University in Detroit. He says that aside from a slight loss of some vitamins, cooking food is not detrimental and provides many benefits, such as making food taste better and sterilizing it in the bargain. According to Klurfeld, heat ''denatures'' a food's proteins, changing their shapes in ways that improve digestibility. The enzymes in a raw vegetable, says Klurfeld, "are specifically tailored to that food and even left intact rarely assist the human body."
Orenstein notes that one of Roxanne's multipurpose vegetables, the lowly parsnip, contains "small amounts of light-activated carcinogens, whereas the cancer-fighting nutrient in tomatoes is released only when cooked."
Well, I'd like to write more about this interesting topic, but from the smoke blowing by the study window I surmise that the barbequed ribs are done, well done.
February 9, 2000. Despite the lack of scientific studies to support any benefit to periodically douching the colon, many people are self-medicating with colonic irrigation (colon hydrotherapy) in the hopeful belief that it will help them live longer and more healthily. Katherine Rauch of WebMD reports on one naturopath who prescribes colonics for "asthma, arthritis, sinus problems, chronic fatigue and constipation." The fact that there is no scientific evidence to support such treatment is little deterrent to true believers in "nature's remedies."
One conventional MD is quoted as saying that the dangers from colonic douching "include spreading infection from contaminated equipment and harmfully altering the chemical balance of the colon." Dr. Ross Black notes that "A major function of the colon is to absorb minerals such as potassium and send them through the bloodstream. Colonics could wipe out these minerals and thereby cause deficiencies."
February 25, 2003. Dorsey Griffith, the Sacramento Bee Medical Writer, gives naturopaths the thumbs up in an article on their push to be licensed as "healing arts practitioners" in California. This will give them the legal right to practice medicine here. (Only eleven other states license naturopaths to practice medicine. However, Nevada, Idaho, and Massachusetts may join California in adding to that list.) Anything that is natural and non-toxic is a potential therapy for these folks, including colonic irrigation and coffee enemas. Some of them do seem to keep up on the latest scientific research on nutrition, but like most "alternative" health care providers, their membership usually includes many who disdain science and work by intuition, sympathetic magic, and spirit guides. Their favorite cure for anything that ails you is a diet rich in vitamins and mineral supplements, often sold through their office.
The main "balance" in this article in the form of noting that licensure is opposed by the AMA and by chiropractors. Nevertheless, the headline writer (in the print edition) did us all a favor with the head over the continuation of the article, which reads: Bill: Most therapies harmless, a study by UCSF concluded
Now that's a real attraction: We use therapies, most of which are harmless! Come on Down!
April 18, 2001. Sales of St. John's wort, a medicinal herb used by many people as a mood elevator, have declined from $310 million in 1998 to $195 million last year, according to Grant Ferrier, editor of the Nutrition Business Journal. Mark Blumenthal, of the American Botanical Council, does not think that the reduced sale reflects the increased realization that the herb isn't all that it has been cracked up to be. According to the WashingtonPost.com, he "speculated that the reduced sales were caused by recent reports of problems with herbal supplements and findings that St. John's wort could interfere with AIDS medicines, cardiac drugs and oral contraceptives."
A study published today in the Journal of the American Medical Association found that St. John's wort was no better than a placebo in treating severely depressed patients. (The study involved 200 patients for eight weeks.) This contradicts the results of an earlier study by Ronald Brenner, chairman of psychiatry at St. John's Episcopal Hospital in New York City. (His study involved 30 mildly to moderately depressed patients for six weeks.) A third study may resolve the issue for a while. The National Institute of Mental Health and the National Center for Complementary and Alternative Medicine are doing a joint study on the effectiveness of the herb in treating major depression. The study is very large and will be the most comprehensive study ever done on St. John's wort.
June 10, 2000. "A few years ago, spending $15 million to investigate an herbal supplement would have been labeled by many a waste of taxpayer money, a foolish exploration into the realm of hocus-pocus." So writes Bruce Taylor Seeman in "Testing the claims for gingko." Now that Americans spend some $15 billion a year ($300 million on gingko alone) on "supplements" it has become fashionable to spend tax dollars investigating folk remedies such as Ginkgo to improve memory. The National Center for Complementary & Alternative Medicine, part of our national Institutes of Health, has launched a five-year, $15 million test of Ginkgo as a preventative for Alzheimer’s disease. Perhaps some politician saw the ad on television featuring an actor who plays a doctor on TV touting the benefits of Ginkgo. I know that when I saw the ad my first thought was "we ought to be spending millions to investigate this matter."
In 1994, Congress passed the Dietary Supplement Health and Education Act, which deregulated the herbal products industry. Dietary supplements do not have to be proven effective before putting them on the market. They are, however, forbidden to exaggerate benefits--whatever that means. Sellers of Ginkgo have claimed that it increases the flow of blood to the brain, which it does, and that therefore it improves memory and cognitive functions, which is speculation. Gingko has also been touted as a cure for depression, hepatitis, asthma, tinnitus, hardening of the arteries and impotence.
Dr. Steven DeKosky, a neurologist at the University of Pittsburgh is leading the gingko study. He characterizes Ginkgo is as "a mild blood thinner and an antioxidant." Antioxidants are readily available in many fruits and vegetables and there are many strong blood thinners already available, so why study gingko? Other than the fact that it is a fashionable herb? Because it might be cheaper than food or drugs to perform whatever useful function it might perform? I don't know. Gaia Herbs sells their Extra Strength Ginkgo Leaf for about $16 an ounce (regular strength is about half as much as the extra strength). That doesn't sound cheap to me. Maybe it will be safer? Safer than raisins or berries, which also are good sources or antioxidants? Until the law is changed, there is no requirement that such "supplements" as gingko be safe, much less useful.
It is hoped, of course, that something useful will be learned about Alzheimer's disease while studying the effects of gingko.
November 12, 1997. "Athletes swallow expensive doses of hope" was the title of an article by Chris Hays in the Sacramento Bee. The article did an excellent job of explaining why it is so difficult to get unbiased information about body-building supplements: the main source of information comes from body building magazines which are all owned by the supplement manufacturers themselves. Even so, Hays claims that "everyone agrees" that creatine "works." A typical ad on the internet reads
Creatine monohydrate provides safe nutritional support for athletes seeking peak performance in short-duration, high intensity workouts. By supporting the body's natural ability to regenerate the primary energy immediately available to working muscle, creatine monohydrate has the potential to increase optimal work output in activities such as weight-lifting and sprinting.
Creatine is a nitrogenous organic acid, C4H9N3O2, found in the muscle tissue and which supplies energy for muscle contraction. Joseph Clark has written an scientific paper on the use of creatine in sports. It is very technical sounding but he notes that "30% of the population have a diet and metabolism such that they do not benefit from creatine supplementation." The only negative side effects mentioned were water retention and heat intolerance. The positive benefits include such things as an increase in muscle peak torque production while decreasing plasma ammonia accumulation. The author does note that a healthy body self-regulates the production of chemicals (creatine is synthesized in the liver and kidneys, using three amino acids derived from food intake) and will shut down production when more of the chemical would be redundant. Furthermore, beyond a certain amount of some chemicals the body simply will not use them; hence, further supplementation is pointless or harmful (if the body can't eliminate the excess, for example). (This is why certain supplements are probably pointless, such as DHEA. Taking a supplement may shut down its natural production by the adrenal glands.)
January 21, 2000. CNN.Com reports that at least one pharmaceutical firm is treating herbal medicines like conventional ones. "CVS Corp. of Woonsocket is asking customers to tell their pharmacists what herbal supplements they use. The information is entered into a computerized program that cross-checks them for adverse combinations."
March 2, 2000. Taking vitamin C supplements could speed up hardening of the arteries, according to a study of "573 outwardly healthy middle-aged men and women who work for an electric utility in Los Angeles." Those taking vitamin C supplements showed "accelerated thickening of the walls of the big arteries in their necks....the more they took, the faster the buildup," according to the (now defunct) Nando Times.
October ?, 1998. Los Angeles Times. Andrew Weil, M.D., "In the medicine chest, a place for herbs." This article begins by making a plea for herbal remedies while claiming that the New England Journal of Medicine attacked herbal remedies in a recent editorial. He also claims that a study done at Stanford University indicates that some 70% of us are using "alternative" medicine, i.e., medicine that does not include drugs or surgery. However, the article quickly degenerates into a paranoid whining about how the big bad bullies of real medicine have hogged all the money for research and that's why naturopaths and homeopaths can't do science. Weil thinks we should fund "integrative medicine" (i.e., whatever spiritual hocus-pocus is suggested by whatever shaman who happens to be in the neighborhood). If only these quackmeisters had the funds they could prove the real value of shark cartilage or bee pollen. But the big bullies at the A.M.A. have all the resources. The same kind of pathetic plea was made in the 1950s and 60s by parapsychologists. The only reason they couldn't prove ESP, remote viewing, etc., and collect their deserved Nobel Prizes was that the real scientists had a good ol' boys club and excluded them from participation. They couldn't get university jobs where all the research was done. So now they have departments and labs all over the world and what have they discovered that is of any value to anyone? They've proved only that whining loud enough and long enough pays off. The same tactic seems to be working for the "alternative" folks. The National Institutes of Health has upped the budget for the "Alternative" division to some $20,000,000 a year, according to James Randi.
October 21, 2000. Today's Sacramento Bee has an article by Shari Roan of the Los Angeles Times regarding an ancient herbal remedy that seems to be effective in treating prostate cancer. Chinese herbal medicine will probably get a big boost from the results of two studies which used PC-SPES, a combination of eight different herbs including saw palmetto and ginseng, to treat end-stage prostate cancer. "The herbal remedy appears to have estrogen-like properties. Estrogen is a female hormone and is one of the oldest proven treatments for prostate tumors, the authors note."
This month, the Journal of Urology is publishing the results of a study done on 69 men by Dr. Aaron E. Katz, associate professor of urology at Columbia College of Physicians and Surgeons. After one year, 88% had a reduction in PSA. ("PSA is a protein in the blood that is elevated in men with prostate cancer and certain other benign conditions.") However, "the men had a variety of other treatments for their cancer, including surgery, radiation treatment or hormone therapy." According to Dr. Ian M. Thompson, Jr. chief of urology at the University of Texas Health Science Center in San Antonio, the results of this study are "exciting and disturbing." The good news is that PS-SPES seems to work; the bad news is that we don't know how, what dose is right and safe, or what the long-term side effects might be.
Next month the Journal of Clinical Oncology will publish the results of a study by Dr. Eric J. Small et al. with similar positive results. Dr. Small, of UC San Francisco, was concerned about the effect of his study since "we don't even know what [PS-SPES's] long-term side effects are." The Katz and other studies have found breast enlargement, reduced libido and blood clotting, among other things, as side effects. In other words, the side-effects are similar to those with estrogen treatment.
An earlier study on PC-SPES, published in the New England Journal of Medicine (September 17, 1998), concluded: "PC-SPES has potent estrogenic activity. The use of this unregulated mixture of herbs may confound the results of standard or experimental therapies and may produce clinically significant adverse effects." However, it is unlikely that the side effects will be as severe or as permanent as those from microwave treatment for enlarged prostate: burnt urethra or partial penile amputation.
Because PC-SPES is considered an herb rather than a drug, the U.S. Food and Drug Administration (FDA) has not tested or recommended it. Herbal remedies are essentially unregulated. Thus, their purity as well as their effectiveness may vary with their source.
Coincidentally, it is reported today in DrKoop.com that the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health, has announced $7.8 millions in grants for various studies on alternative therapies, including one "to examine whether...PC-SPES may reduce DNA damage in cancer cells and improve the immune system in prostate cancer patients."
February 23, 1996. Ann Landers, (from the Davis Enterprise). Today, Ann Landers gave a boost to alternative medicine quackery by not responding to the illogical reasoning of P.W. from Taiwan regarding Western medicine men versus Chinese herbalists. P.W., a European married to a Taiwanese, wrote that while in Europe his wife had become pregnant three times and each time she miscarried due to fetal chromosomal abnormalities. Their European doctors declared the couple to be "healthy" and apparently gave them every indication that they were just unlucky. This evaluation was "depressing," says P.W.
The barren couple went East and in Taiwan their gynecologist gave them "a bag full of herbs" which they were instructed to take for a year. Halfway through the "treatment" Mrs. W. became pregnant. At the time the letter was written their son was 10 months old.
P.W. implored Ann: "Please, Ann, tell your readers in the West that couples who cannot have a child do not necessarily have a problem. The problem might be with their specialists, whose Western knowledge of the human body is sometimes quite limited." Now, I think most Western physicians would admit that their knowledge of the human body is often limited, but it hardly relates to P.W.'s situation. He assumes that the Chinese herbalist, who spoke of "harmony and balance in the body and mind," was instrumental in his wife's pregnancy. Furthermore, he assumes that the Western specialists were wrong in attributing their problem to bad luck. What evidence does P.W. have for these notions? The only "evidence" he has is the fact that his wife got pregnant after taking the herbs. This bit of post hoc reasoning is totally insufficient to warrant P.W.'s conclusions and Ann Landers should have let him know that. Instead, she replied:
I'm for whatever works. Considering the number of people who die from botched and unnecessary surgery and improper medication, herbal medicine could be a viable alternative.
Ann doesn't consider how many people die or continue to suffer when they take herbs instead of getting proper "Western" treatment with surgery, medicine, or drugs. But worse than that she seems oblivious to the insufficiency of evidence presented by P.W. The fact that his wife got pregnant after taking herbs does not prove the herbs had anything to do with her getting pregnant. It might have been "luck" [the luck of natural events taking their course] or divine intervention, for that matter, that explains the pregnancy. However, P.W. had ruled out divine intervention because his wife's father, an herbal doctor, told him "there are no miracles in healing." To which P.W. commented in a fitting non sequitur: "those so-called miracles just show how little some traditional doctors know."
Ann doesn't ask what herbs they took and she certainly indicates no interest in whether anyone has done a controlled study on the effectiveness of these herbs. She's for "whatever works." What does that mean? It seems to mean, "I'm for believing whatever you feel like believing when you are happy with some event." P.W.'s happy he has a son, so he is welcome to believe that the herbs did it and that the European physicians who told him he and his wife were healthy but unlucky didn't know what they were talking about. Furthermore, this proves herbalists with their notions of harmony and balance and other gibberish are not just valid, but superior notions to the Western notions of the body and cause-effect relations. What bunk!
January 2, 2001. Soon, British Columbia will be the only place in North America where traditional Chinese medicine (TCM) practitioners will be recognized as doctors by a regulatory body, according to the TheGlobeandMail.com. Two years ago, the British Columbia's Health Professions Council recommended that Chinese medicine practitioners be regulated. Last month, the B.C. Ministry of Health agreed.
TCM doctor Henry Lu, founder of the International College of Traditional Chinese Medicine in Vancouver, supports the move. "Many diseases that have been treated by Western medicine are not quite successful," he said. True, but that doesn't mean TCM will be any more successful. Randy Wong, the registrar at the college, thinks the licensing will help in several ways. He notes that currently anybody can call himself a TCM doctor and set up practice in B.C. Licensing will weed out the bad guys.
"Wong said it will take at least two years to license TCM doctors in B.C. after bylaws on education and the prescription of herbs are approved by the government and the TCM community."
Canada has what we in America call Socialized Medicine, but so far the government has not agreed to pay for TCM visits and treatments.
Licensing will also be a step towards integrating TCM with traditional medicine. The final step will be when the government starts to pick up the tab for TCM.
The article did not go into the reasoning behind The Ministry of Health's decision. Maybe they see this as a way to save money. Maybe they see that TCM is growing in popularity, and if allowed to continue unregulated could prove unhealthy for the province. Maybe they really believe it works as well as the medicine they now provide their citizens. Even if they don't believe there is anything important to TCM, the politically correct thing to do is regulate it. At least the government will have some control over what herbs are being distributed and can regulate their purity. Whereas, in America all you have to do is call your product a food or supplement, rather than a drug or medicine, and you can distribute it with minimal interference from the Federal Drug Administration or other government agencies. Teenagers in health shops who have read a few pamphlets distribute health advice and recommend herbs to customers as if they were physicians with years of knowledge and experience. The government might like to say let natural selection work this out but it might also feel a strong paternalistic urge to protect its citizens from unscrupulous purveyors of mugwort and ginkgo biloba.
March 7, 2000. Anecdotes are circulating among anesthesiologists that herbal products, taken by many advocates of "alternative" medicine, may be causing unexpected bleeding and difficulty in blood clotting during surgery, according to CNN.com. And I thought people who took such herbs did so to avoid surgery!
November 21, 2000. The December 2000 issue of Consumer Reports (CR) says that tests on St. John's wort were "reassuring." They tested 13 brands and all "contained a reasonably standardized dose of dianthrones." St. John's wort is a mood modifier popular among self-medicators who are looking for a pick-me-up with minimum side-effects. There is "fairly solid" evidence, says CR, that St. John's wort "can help people with clinically significant mood disorders." And the only major side effect is increased sensitivity to sunlight. CR does note that "self-treatment can be dangerous, particularly with depression, which causes some 20,000 reported suicides a year in the U.S." CR also notes that St. John's wort "decreases the effectiveness of a host of medications, including oral contraceptives, cholesterol-lowering statin drugs, beta-blockers, and calcium-channel blockers for high blood pressure and coronary heart disease, protease inhibitors for HIV infection, and many other prescription drugs."
CR also tested 12 brands of SAM-e (s-adenosyl-methionine) and found that "manufacturers are generally producing a reasonably stable standardized product," though they found four examples of misleading labeling. SAM-e "helps cells regulate the brain chemicals dopamine and serotonin" and is also used by self-medicators as a mood elevator. CR notes that the side effects of SAM-e can include upset stomach, insomnia and mania. And it is not cheap, costing $55-$260/month for 400-mg daily dose.
Finally, CR reports that 13 of 15 brands of kava pills contained approximately the amount of kavalactones that their label said. Extract of the root of the kava plant has long been used by Pacific islanders. It allegedly relieves anxiety and elevates mood. "Kava can magnify the potency of other antianxiety medicines and reduce the effectiveness of several other drugs, notably Parkinson's drugs containing levodopa." Side effects include blurred vision and impaired coordination.
CR does warn those taking prescription drugs to consult with your doctor or pharmacist before self-medicating with herbs. There may be drug interactions and some of these could be serious, even life-threatening.
February 26, 1997. Today Katherine Quartz spoke at Sacramento City College and I was able to attend and get some more information on the case. She was part of a panel which included her lawyer, a Native American who is also a psychologist and a woman who heads an Indian Services Agency. Her son, Thomas, was also in attendance.
Apparently, an Indian who lives on a reservation is not a citizen of the United States and is under the jurisdiction of Indian tribal laws and courts. Had Ms. Quartz never left her reservation, she would have been free to seek any kind of treatment she wished for her son. But she had gone to Portland, Oregon, to go to college. This fact was used by authorities in Oregon and California to impose their laws on her. She did seek out a pediatrician for her son when he first got ill. She did not seek out an Indian healer at that time, she said, because the only healer in her area was gravely ill himself. The diagnosis of Hodgkins was not immediate, but was not made until four months after the first visit with a physician. When chemotherapy was offered as the only reasonable therapy for her son, she says she told the doctors she wanted to do some research first. She did and concluded that chemotherapy was not a reasonable modality of treatment. She then took her son to a practitioner of traditional Chinese medicine, who treated her son with acupuncture and herbs. (She asserted a belief that "herbs can go in and break up tumors," though she gave no source for this notion.) She then took her son to a naturopath who treated him with herbs.
She says that her troubles began when she tried to get a CAT scan of her son, which she says she wanted in case any questions came up later about the efficacy of the treatments she'd chosen for her son. X-rays had shown significant reduction in tumor size and growth, she says. But a CAT scan would provide better evidence, she believed. Her treatment by the medical doctors in Oregon she went to for the CAT scan was less than respectful of Indian ways. She was told that chemotherapy was the only correct medical treatment for her son and that she was endangering his life by seeking alternative treatments. One pediatrician even wrote to authorities investigating the case that Ms. Quartz's thought processes were impaired. His evidence seemed to be limited to the fact that she disagreed with him on the proper medical treatment for her son.
Given the unique status of Indians--they are basically members of a foreign nation, but have unique status granted in the U.S. Constitution--the Tribal appellate court's ruling is binding and California cannot order the boy back into chemotherapy. According to Ms. Quartz, her son received five chemotherapy treatments against her will. He looked fine today, but she said that after the treatments he looked awful. His hair fell out and he developed mouth sores and other signs of physical debilitation (which are common side effects of chemotherapy). She says that her research discovered that her son might be made sterile by chemo and that the statistics were not exactly as promising as they might seem. According to her lawyer, the survival rate was 90% if the patients were followed for ten years. But if they were followed for fifteen years, the survival rate was less that 10%. Both claim that there is evidence that while chemo might stop a cancer, it so debilitates the immune system that the effects after ten years are devastating.
In her quest to seek the best course of treatment for her son, Ms. Quartz was charged with child endangerment and had her son taken away from her. She was charged with kidnapping for taking him from a hospital. She claims a police officer held a gun to her head and told her she was killing her son by not getting him into chemotherapy. A medical doctor abused his authority to try to get her declared mentally incompetent because she dared to favor alternative medicine to traditional medical treatment. Her behavior as a mother was exemplary and her seeking out an Indian healer is consistent with her life on a reservation for the past sixteen years. I don't know if I would have made the same decision as she did about the chemotherapy, but I know that I would have done research, too. And if I came to the conclusion that the therapy recommended by my physician was not the best for my child, I would not put my child into the therapy. Furthermore, I would not expect to be labeled mentally incompetent or a child abuser simply because I came to a different conclusion than my physician.
As readers of my pages know, I hold no sympathy for alternative medical treatments. But I have even less stomach for authoritarian bullies whether they carry guns or a stethoscope.
(Ms. Quartz says her son has been given a "clean bill of health" but she doesn't say by whom. Master herbalist Joseph?)
July 19, 2000. "Are 'functional foods' dangerous? Opponents renew call for stricter FDA regulations," is a CNN.com story about cashing in on the growing fascination with "alternative" medicine and "natural" drugs. Manufacturers of ice cream, cereal, teas, soft drinks, etc. are adding herbs along with unsubstantiated claims about improving memory and enhancing immune systems. The so-called nutraceuticals are popular with consumers, despite the lack of evidence in support of the claims being made.
"According to the General Accounting Office, the investigative division of the U.S. Congress, American consumers spent about $31 billion last year on dietary supplements and herbal food products."
[thanks to Jon Henrik Gilhuus]
#30. Pat wrote: "I would like to know the truth about the claimed health benefits of drinking apple cider vinegar [ACV] and honey tonics." I always turn to Quackwatch for information on questionable medical practices and I suggest everybody else do the same.
A recent issue of Dr. Stephen Barrett's Consumer Health Digest just happened to have a way to find the answer:
Three apple cider vinegar marketers warned to curb claims. The FDA has warned three Internet marketers of apple cider vinegar tablets to stop making claims that their products are effective against various diseases:
- HCC DemoMarketing, LLC, of Germantown, Tennessee, was told to stop suggesting that its products are useful for arthritis, osteoperosis [sic], and sore throats.
- The FDA has not approved METABOLISM Apple Cider Vinegar Brand Dietary Supplement Capsules as a drug, therefore the safety and effectiveness of this product is unknown.
- Apple-Cider-Vinegar-Diet-Pills.Com, of Dayton, Ohio, was warned to stop claiming that their pills can relieve arthritis pain, fight infection, fight osteoporosis, control cholesterol, help people with high blood pressure, and relieves sore throats, laryngitis, and nasal congestion.
- Sharon L. Bush, of Birmingham, Alabama, was warned to stop suggesting that her pills are useful against arthritis, prostate problems, multiple sclerosis, and high cholesterol levels.
ACV tabs are also part of the lucrative diet-pill scam business. See "Vinegar and Weight Loss: The Sour Truth Will vinegar pills help me lose weight?" by Elizabeth Somer, MA, RD. The Nutrition Forum (Vol 14 No. 6 November/ December 1997) contained the essay "The Sour Truth about Apple Cider Vinegar" by Beth Fontenot, MS, RD.
- Sandy at Junkfood Science has a thorough debunking of the apple cider mythology: Houston... we have a problem — Apple cider vinegar remedies
Jay wrote to complain about his doctor who has a sales office in his examination room.
A quick missive to THANK you for exposing the despicable, coercive tactics of MLM [multi-level marketing] recruiters. One of the worst I have encountered in recent years is a physician I visited who had all sorts of vitamins, supplements and magnetic therapy (!) products prominently displayed in his office. As he was poking away at my foot with all manner of sharp instruments, he began to pitch me on these products, especially a magical magnetic mattress cover that sold for THOUSANDS of dollars! How totally unethical! And how much of an argument am I going to give the guy who's holding the scalpel? I think MLMs ARE a cult!
I have no idea why Jay thinks this guy is involved in an MLM. Trying to sell you something is one thing; trying to recruit you to sell the product is another. Both would be unethical, in my view, for a doctor to do out of the examination room.
Spector, Reynold. 2009. Science and Pseudoscience in Adult Nutrition Research and Practice. Skeptical Inquirer. May/June. (In randomized studies done with large numbers of people often versus placebo, no supplement has been proved effective against cardiovascular disease, cognitive decline, or prevention of cancer. "Megavitamins do not work.")
Specter, Michael. 2010. Bad medicine: Why echinacea won’t fix your cold I filled out the form. Two minutes after I pressed "submit", Dr Weil responded, recommending a large number of dietary supplements to address my "specific health concerns". In all, the Vitamin Advisor recommended a daily roster of 12 pills, including an antioxidant and multivitamin, each of which is "recommended automatically for everyone as the basic foundation for insurance against nutritional gaps in the diet". My new plan would cost $1,836 a year (plus shipping and tax). Still, what is worth more than our health?
West Meets East The Future of Medicine? by Qing Wang Yale Scientific magazine
Last updated 25-Jan-2016