May 7th, 2007 by Dr. Val Jones in Quackery Exposed
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The global economy is a mixed blessing – while we may
benefit from access to less expensive goods and services, by using them we rely
on the quality standards of their country of origin. In an alarming expose, the New York Times
reveals how far behind China
is in the application of quality and safety standards to their food and
pharmaceutical products.
I have voiced concerns in this blog before about the
melamine/pet food scandal and the implications it may have for humans, as well
as the fact that many Chinese citizens trust western medicine over their own
traditional practices for matters of serious illness. But this latest Times article has further
described the risk that counterfeit Chinese products can pose to the global community:
Toxic syrup has
figured in at least eight mass poisonings around the world in the past two
decades. Researchers estimate that thousands have died. In many cases, the
precise origin of the poison has never been determined. But records and
interviews show that in three of the last four cases it was made in China, a major
source of counterfeit drugs.
“Everybody wants to
invest in the pharmaceutical industry and it is growing, but the regulators
can’t keep up,” Mr. Zhou said. “We need a system to assure our safety.”
… Families [in Panama] have
reported 365 deaths from the poison, 100 of which have been confirmed so far.
When it comes to your health and the safety of the medicines
you use, you’re only as safe as the weakest link in the manufacturing or regulatory
process. Prescription medications are
carefully regulated in the US,
but there is no such oversight in the herb and supplements market. So buyer beware… Check out places like consumerlab.com to get
some objective information about safety before you pop those “health pills.”
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
April 8th, 2007 by Dr. Val Jones in News, Quackery Exposed
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The number one Google news item today is a report of a mouse study (published in Nature Medicine, but apparently still embargoed to the public as it is not listed on their website) that suggested that an herbal supplement could (in combination with antibiotics) “eradicate” urinary tract infections.
In usual fashion, the buzz preceded the science, and now we have thousands of people on the lookout for forskolin (a root extract of coleus) tablets from the local health food store. Do these have any possible merit?
A recent review of the literature about this herb was conducted by the good docs at Harvard, and turned up “no conclusive evidence for its [forskolin’s] use for any health condition.”
My friend Dr. Charles also read the reports of this “miraculous” new cure – which posits that recurrent urinary tract infections are caused by pockets of bacteria that hide inside bladder walls. Dr. Charles rightly points out that there are many different points of entry for bacteria, and that an herb which (and we don’t know that it even does this) relaxes bladder walls would surely not affect the alternate routes of entry, hence it cannot be curative in all cases.
So my friends, I’m sorry to say that there is little justification for enthusiasm yet. But we will follow the research with interest, in case human subjects do indeed show benefit in the future.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 26th, 2007 by Dr. Val Jones in Medblogger Shout Outs
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Wow, this was one of the best rants I’ve heard in a while (thanks to Kevin MD for linking to this article in his blog) – looks as if this writer is neither friend to homeopathy nor big pharma:
“Some homeopaths [say] that their cures are not amenable to scientific proof. That’s fine, if you want to call the multimillion dollar industry what it is: faith healing…
Homeopathy rests on three unproven tenets: First, ‘Like treats like.’ Because arsenic causes shortness of breath, for example, homeopaths prescribe its ‘spirit’ to treat diseases such as asthma. Second, the arsenic or other active ingredient is diluted in water and then that dilution is diluted again and so on, dozens of times, guaranteeing—for better and worse—that even if the dose has no therapeutic value, it does no harm. And third, the potion is shaken vigorously so that it retains a ‘memory’ of the allegedly curative ingredient, a spirit-like essence that revives the body’s ‘vital force.’
So what about the fact that some homeopathic patients get better? Part of the effect comes from the ritual of consultation with a practitioner who treats the patient like a person rather than a body part on an assembly line. And just taking anything can help; the placebo effect is real. In gold-standard, double-blind studies, placebos presented as possible cures sometimes rival pharmaceuticals for effectiveness, or beat taking nothing at all.
Nor are the effects simply psychological. When volunteers took a placebo that they were told contained painkillers, they experienced relief, while researchers watching PET scans of the subjects’ brains tracked increased levels of the body’s own pain-relieving endorphins. In other studies, research subjects given placebos instead of antidepressants also showed chemical changes in their brains. FDA data for six top antidepressants showed that 80 percent of their effect was duplicated in placebo control groups.
Which brings us to the patient’s dilemma: Have faith in 19th century magic or rely on a pharmaceutical industry that suppresses negative outcomes (including death), promotes drugs for nonexistent diseases, repackages old drugs in new bottles to circumvent patent expirations, bribes doctors with perks and cash and hires ghost writers to author favorable studies? Given the hype, toxicity, and expense of many drugs and Big Pharma’s snake-oil tactics, the side effects of water (laced with “memory”) start looking pretty damn good. If your condition is relatively minor, self-limiting or untreatable, you may be a lot better off drinking homeopathy’s Kool-Aid-less Kool-Aid.”
Ouch. What do you think of Mr. Allen’s remarks?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 21st, 2007 by Dr. Val Jones in News
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Complementary and alternative medicine (CAM) is important and popular, but ignorance about its potential harms can be dangerous to consumers. Physician passivity about the subject may also be doing consumers a disservice. Two interesting articles underscore this:
From the NIH:
In spite of the high use of complementary and alternative medicine (CAM) among people age 50 or older, 69 percent of those who use CAM do not talk to their doctors about it…
A telephone survey, administered to a nationally representative group of 1,559 people age 50 or older, revealed some reasons why doctor-patient dialogue is lacking. Respondents most often did not discuss their CAM use with doctors because the physicians never asked (42 percent); they did not know that they should (30 percent); or there was not enough time during the office visit (19 percent).
From MSNBC:
If you’re banking on a daily vitamin to make up for any deficiencies in your diet, you may be getting a whole lot more — or less — than you bargained for.
Of 21 brands of multivitamins on the market in the United States and Canada selected by ConsumerLab.com and tested by independent laboratories, just 10 met the stated claims on their labels or satisfied other quality standards.
Most worrisome, according to ConsumerLab.com president Dr. Tod Cooperman, is that one product, The Vitamin Shoppe Multivitamins Especially for Women, was contaminated with lead.
The same product also contained just 54 percent of the 200 milligrams of calcium stated on the label.
The analysis also showed that Hero Nutritionals Yummi Bears, a multivitamin for children, had 216 percent of the labeled amount of vitamin A in the retinol form, delivering 5,400 International Units (IU) in a daily serving. That’s substantially more than the upper tolerable level set by the Institute of Medicine of 2,000 IU for kids ages 1 to 3 and 3,000 IU for those 4 to 8.
Because too much vitamin A can cause bone weakening and liver abnormalities, the Yummi Bears “could be potentially doing more harm than good,” Cooperman said. “Vitamin A is one of those vitamins where you really don’t want to get too much.”
It’s important for physicians to educate themselves about CAM therapies and make it a part of their practice to ask their patients about the supplements they take. The Natural Standard databases are a great resource for physicians and consumers, and will be available soon at Revolution Health. Natural Standard, initially created by a team of Harvard physicians, systematically reviews the evidence behind the efficacy claims of various herbal remedies and supplements.
What resources do you use to evaluate the safety and efficacy of the herbs and supplements you’re taking?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 2nd, 2007 by Dr. Val Jones in News
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Many people use glucosamine and chondroitin sulfate as a natural therapy to treat their arthritis pain. This seems like a reasonable thing to do since glucosamine is a critical building block for cartilage, and chondroitin can help keep joints properly hydrated. And as we know, osteoarthritis is caused by joint wear and tear and decreased cartilage health.
Unfortunately, the research results have been fairly underwhelming.
Here is how one author* summarized the latest research:
“It seems prudent to tell our patients with symptomatic osteoarthritis of the knee that neither glucosamine hydrochloride nor chondroitin sulfate alone has been shown to be more efficacious than placebo for the treatment of knee pain. If patients choose to take dietary supplements to control their symptoms, they should be advised to take glucosamine sulfate rather than glucosamine hydrochloride and, for those with severe pain, that taking chondroitin sulfate with glucosamine sulfate may have an additive effect. Three months of treatment is a sufficient period for the evaluation of efficacy; if there is no clinically significant decrease in symptoms by this time, the supplements should be discontinued. Furthermore, there is no evidence that these agents prevent osteoarthritis in healthy persons or in persons with knee pain but normal radiographs.”
So I guess the bottom line is that these supplements are no magic cure for knee pain – they aren’t known to be harmful (except to the wallet) but they aren’t sure to be helpful either.
*Hochberg, Marc C.
Nutritional Supplements for Knee Osteoarthritis — Still No Resolution
N Engl J Med 2006 354: 858-860
Val Jones is a licensed practitioner of Rehabilitation Medicine and Senior Medical Director of Revolution Health’s portal. No information in this blog is intended to diagnose or treat any condition. The opinions expressed here are Val’s and do not necessarily reflect those of Revolution Health.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
