A customer strolled up to the counter one night when I was working in a retail pharmacy:
“My doctor says I have prediabetes. I don’t want to take any drugs. Do you have something natural I can use to cut my blood sugar?”
I looked at him in the eye, and pointed at his sizeable midsection. “Sir, if you’re at risk for diabetes, and you don’t want to take medication, the single best thing you can do for yourself is lose some weight.”
He grinned and asked, “Great – what supplement can I take to help me?”
This type of discussion occurs all the time. A patient has been assessed by their physician, and informed that they have a medical problem of some sort. The patient, reluctant to accept the physician’s evaluation, heads to the pharmacy for a second opinion. In some cases, the patient may question the physician’s advice: “All my physician wants to do is prescribe drugs.” Yet there’s a disconnect when it comes to strategies for management. More often than not, non-drug approaches are rejected out-of-hand (probably because the sample I speak with have already made the decision to buy something). And in those that are leery of medical management, there’s often a willingness to consider anything that’s available without a prescription – particularly if it’s perceived as “natural.” Natural products are gentle, safe, and effective, while medicine is thought of as unnatural, harsh, and potentially dangerous. This is the naturalistic fallacy, nothing more. Purveyors of supplements leverage the naturalistic fallacy into the marketing strategy of choice for almost all supplements and “alternative” medicines. And it leads to bad health care decisions. (more…)
I have nothing against berries. I, in fact, enjoy many kinds of berries in my diet. My favorite fruit, the banana, is actually a berry (botanically speaking). I am disturbed, however, at the extent to which various kinds of berries are being sold as the latest superfood cure-all.
Dr. Oz, for example, has been pushing the lingonberry (a relative of the cranberry and blueberry) as “a new superfruit for longevity.” An attached article on his site states:
“Today, scientists are showing its value in both human and animal studies that are proving to have positive results.”
Curiously, there are no links or references to these studies.
Polyphenols and Antioxidants
We are still in the midst of the “antioxidant craze” – if you read the justification for just about any so-called “superfood” or longevity supplement you are sure to read about antioxidants. I have already covered antioxidants, but briefly: Cell metabolism in part creates oxygen free radicals which are molecules that steal electrons from other molecules, causing a cascade of reactions that can damage proteins and other chemicals in the body. Anti-oxidants are chemicals that can stop free radicals and limit the damage. They therefore decrease “oxidative stress” on cells. So far it sounds like anti-oxidants are therefore a good thing and we should be gobbling up as much as we can. However – free radicals and anti-oxidants exist in cells in a homeostasis. Free radicals are used by the immune system, for example, to fight invading organisms. They are also important signaling molecules, triggering other cell-protective mechanisms.
ASEA is a diet supplement described as a “life-changing” health aid that can benefit everyone.
“ASEA is trillions of stable, perfectly balanced Redox Signaling Molecules suspended in a pristine saline solution—the same molecules that exist in the cells of the human body. Redox signaling is a function that is central to all life. Signaling molecules are created within every cell in the body. After the age of 12, our cells make fewer and fewer of these molecules. ASEA is the world’s only source for replenishing them.”
- Promotes enhanced immune function
- Supports the vital activity of cellular communication
- Provides superior “support” to athletes
- Boosts efficiency of the body’s own antioxidants by 500%
- Protects against free radical damage
ASEA doesn’t (can’t legally) claim to be effective for any disease, but since a number of diseases are related to immune function, free radical damage, etc., it’s only natural to assume that ASEA would benefit a host of conditions. The claims are deliberately vague, and there is the usual disclaimer that it has not been evaluated by the FDA and is not intended to treat or prevent any disease; but testimonials and innuendo suggest all kinds of specific benefits ranging from better sleep to cancer.
What’s in this miracle product? The ingredients are listed on the label: water and salt.
The Summer Olympics are coming up, which means that, in addition to world-class athletic performance, the public will be exposed to a variety of sports-related pseudoscience. This is not unique to the Olympics, of course. The world of sports competition is rife with pseudoscience, false claims, dubious products, superstitions, and magical charms. The most egregious example of this recently has been the energy bracelet scam – multiple companies have and are marketing little bits of rubber, plastic, or metal that you wear on your wrist and they claim (based on parlor tricks rather than evidence) will improve athletic performance. They give classically pseudoscientific explanations for the alleged effect, such as negative ions or energy frequencies. In fact the new icon of the entanglement of sports with pseudoscience is the Power Balance Stadium.
Occasionally the scientific community takes notice of such claims and bothers to review them. Also, in the internet age, the information is actually available to the public (rather than buried in an obscure journal). A recent joint investigation by BBC Panorama and the British Medical Journal (BMJ) recently found a shocking (to them) lack of evidence for many claims made to market performance-enhancing products. The BBC reports:
A team at Oxford University examined 431 claims in 104 sport product adverts and found a “worrying” lack of high-quality research, calling for better studies to help inform consumers.
High quality studies would be nice, but the article fails to ask the question – who is going to fund those studies? What incentive do manufacturers have in proving their products don’t work?
While much of CAM is ridiculous or implausible, herbal remedies are an exception. Plants produce pharmacologically active substances; in fact, the science of pharmacology grew out of herbalism. Some herbal remedies have not been scientifically tested, but others have been tested and are clearly effective. Nevertheless, these are seldom if ever the best choice for treatment.
One natural remedy stands out. Red yeast rice has been tested and has been shown to lower cholesterol as well as a statin drug. That’s hardly surprising when you realize that it contains the exact same ingredient as the pharmaceutical drug lovastatin.
Only it doesn’t any more.
I contribute biweekly to Science-Based Medicine and could easily devote every post to writing about weight loss supplements, and never run out of topics. As soon as one quick fix falls out of favour, another inevitably replaces it. Some wax and wane in popularity. And pharmacies don’t help the situation. I cringe every time I walk down the aisle where weight loss products and kits are located. Detox? Hoodia? The “fat blaster”? Here are pharmacists, well educated and perfectly positioned to provide good advice to consumers, but standing behind a wall of boxes with ridiculous weight loss promises. Yet pharmacists tell me that these products are not only sought out by customers, but they actually sell well. It’s a lost opportunity to provide good advice, and consumers pay the price.
Perhaps because consumers associate these products with pharmacies, I get regular questions about weight loss programs. I end up developing some degree of familiarity with many of them, if only to be able to credibly redirect away from some of the more harmful plans and approaches. It’s that philosophy that I used recently when I was asked about how to best to manage a “plateau” on the HCG diet. I’d never dispensed human chorionic gonadotropin (HCG) before, but knew of its use for the treatment of infertility, where it promotes egg release. But weight loss? I couldn’t think of a mechanism for how HCG could promote weight loss. So I did some digging, and found a long, rich vein of pseudoscience that dates back decades. (more…)
Note: This article originally appeared in Skeptical Inquirer, 28(1), 48-50 & 55, January/February 2004. I’m recycling it now because I have been at The Amazing Meeting in Las Vegas instead of home at my computer writing new posts. It’s still timely: despite multiple debunkings and FTC actions, vitamin O is still for sale. Amazon has it for $4.80 an ounce. I’m no Mark Crislip; but I like to think this article borders on the Crislipian. Enjoy!
Oxygen is not just in the air; it’s on the shelves. It has been discovered by alternative medicine and is being sold in various forms in the health supplement marketplace. Back when I was an intern, we used to joke that there were four basic rules of medicine: (1) Air goes in and out. (2) Blood goes round and round. (3) Oxygen is good. (4) Bleeding always stops.
Alternative medicine has latched on to rule number three and won’t let go. The rationale, apparently, is that oxygen is required to support life; therefore more oxygen should make you more healthy. It’s not clear how this relates to alternative medicine’s advice on anti-oxidants, but that’s irrelevant. OXYGEN IS GOOD, so we should put it in our soft drinks and breathe it at oxygen bars. Take an oxygen tank home with you — you might feel better. The oxygen vendor might feel better, too. Dr Andrew Weil, the renowned health guru, tells patients with chronic fatigue to ask their doctors to prescribe oxygen for a home trial. Sure, why not? The money it costs will literally vanish “into thin air,” but who cares? OXYGEN IS GOOD.
Ignore the fact that you could find out whether you need oxygen by testing your blood oxygen saturation with that little-clip-thingy-they-stick-on-your-finger-in-the-emergency-room (aka pulse oximeter). Who cares if your blood is fully saturated with oxygen already? OXYGEN IS GOOD. If your oxygen saturation is a little less than 100 percent, there is no evidence that raising it will help with anything. If it is a lot less, and you do need oxygen, any competent doctor should be able to figure that out. But try an oxygen tank anyway: OXYGEN IS GOOD. Is this starting to sound like a mantra? It should. This is religious belief I am talking about, not science. (more…)
A recently published study claims to have shown that a proprietary mixture of velvet bean and Chlorophytum borivilianum improves sleep quality. The journal, Integrative Medicine Insights, is online, peer-reviewed, PubMed indexed, open-access, and it charges authors $1848.00 to publish their article. It advertises editorial decisions in 3 weeks and publication in 2 weeks after acceptance. I can see two reasons why authors might be willing to pay that much for publication: to speed the process of getting important research results out to the public, or because their research is poor quality and they know it would be rejected by other journals.
The quality of this study is unfortunately typical of much of the research on alternative medicine.
Description of Study
The full text is available for download here. The title is “A Dietary Supplement Containing Chlorophytum Borivilianum and Velvet Bean Improves Sleep Quality in Men and Women.” They gave a proprietary supplement mixture to 18 young healthy subjects with self-reported impairment of sleep quality (defined as routine difficulty falling asleep, waking more than twice during the night, and awaking in the morning feeling tired) and had them fill out a questionnaire about sleep quality before and after the trial. They also measured heart rate, blood pressure, CBC, metabolic panel, and lipid panels.
I can’t keep up with Dr. Oz. Just when I thought the latest weight loss miracle was raspberry ketone, along comes another weight loss panacea. This time, it’s green coffee beans.
Eveyone knows Dr. Oz, now. Formerly a guest on Oprah, he’s got his own show which he’s built into what’s probably the biggest platform for health pseudoscience and medical quackery on daytime television. In addition to promoting homeopathy, he’s hosted supplement marketer Joe Mercola several times to promote unproven supplements. He has been called out before for promoting ridiculous diet plans, and giving bad advice to diabetics. And don’t forget his failed attempt to actually demonstrate some science on his show, when he tested apple juice for arsenic which prompted a letter from the FDA about his methodology. His extensive track record of terrible health advice is your caution not to accept anything he suggests at face value. So when the sign in front of my local pharmacy started advertising “Green coffee beans – as seen on Dr. Oz”, I tracked down the clip in question. The last time I saw Dr. Oz in action when when he had SBM’s own Steven Novella as a guest, where there was actually a exchange (albeit brief) about the scientific evidence for alternative medicine. Replace Dr. Novella with a naturopath, and you get this: (more…)
What should you do if you feel tired? Taking a nap isn’t always possible. The ever-inventive capitalist marketplace has come up with another option.
5-hour Energy is a flavored energy drink sold as 2 oz “shots.” It was invented by Innovation Ventures in 2004. It is intended to counteract the afternoon slump, to increase alertness and energy, to help you stay sharp, improve attention, leave grogginess behind and sail through your day.
According to the label, its ingredients are:
- Niacin 30 mg — 150% of the RDA
- Vitamin B6 40 mg — 2000% of the RDA
- Folic acid 400 mg — 100% of the RDA
- Vitamin B12 500 mcg — 8333% of the RDA
- Energy blend: taurine, glucuronic acid, malic acid, N-acetyl L tyrosine, L-phenylalanine, caffeine, and citicoline. Total amount of blend: 1870 mg. The caffeine content is not specified on the label, but it is supposedly comparable to a cup of the leading premium coffee.
It contains only 4 calories, with no sugar. (more…)