Articles

Archive for Herbs & Supplements

Utah Senator Orrin Hatch: A pit bull in defense of the supplement industry

Editor’s note: This weekend was truly NIH grant crunch time. I have to get my final version of my R01 to our university’s grants office by Tuesday, or it might not get uploaded by the July 5 deadline. (Funny how electronic submission, which was supposed to make applicants’ lives easier, seems to have made them harder.) Consequently, I decided to take a few minutes and spiff up a post I did not long ago for my other blog and use it here, mainly because it is particularly relevant to our usual SBM topics. I’ll be back next time with something new.

The weakness and ineffectiveness of the law in the U.S. regulating dietary supplements has been a frequent topic here on Science-Based Medicine, including the continued failure of efforts to address the serious shortcomings of current law and the illogic at its very heart. Indeed, over the last decade or so that I’ve paid attention to relevant issues regarding supplements continually amazed at how much supplement manufacturers can get away with and for how long. For example, one of the most recent atrocities against science occurred when Boyd Haley, disgraced chemistry professor at the University of Kentucky and prominent member of the mercury militia wing of the anti-vaccine movement, tried to sell an industrial chelator as a dietary supplement to treat autistic children. True, that was too much even for the underfunded, undermanned FDA to ignore, but it was amazing how long he got away with it. Apparently it takes someone trying to market a chemical compound that can’t by any stretch of the imagination be characterized as a “nutrient” or “food” to be so obviously against even the travesty of a mockery of a sham of a law regulating supplements (the Dietary Supplement Health and Education Act of 1994, or the DSHEA) that the FDA could take action.

Of course, here at SBM, we’ve written numerous posts on the shortcomings of the DSHEA. Basically, this law created a new class of regulated entities known as dietary supplements and liberalized the sorts of information that supplement manufacturers could transmit to the public. The result has been this:

It [the DSHEA] also expanded the types of products that could be marketed as “supplements.” The most logical definition of “dietary supplement” would be something that supplies one or more essential nutrients missing from the diet. DSHEA went far beyond this to include vitamins; minerals; herbs or other botanicals; amino acids; other dietary substances to supplement the diet by increasing dietary intake; and any concentrate, metabolite, constituent, extract, or combination of any such ingredients. Although many such products (particularly herbs) are marketed for their alleged preventive or therapeutic effects, the 1994 law has made it difficult or impossible for the FDA to regulate them as drugs. Since its passage, even hormones, such as DHEA and melatonin, are being hawked as supplements.

One might wonder how such a bad law could survive for so long (seventeen years now), but it has its defenders. One man, in particular, defends the DSHEA against all regulatory threats, foreign and domestic. His name is Senator Orrin Hatch (R-UT), and he was just the subject of a writeup in the New York Times last week referring to him as a “natural ally” of the supplement industry:
(more…)

Posted in: Herbs & Supplements, Pharmaceuticals, Politics and Regulation

Leave a Comment (30) →

“CAM” Education in Medical Schools—A Critical Opportunity Missed

Mea culpa to the max. I completely forgot that today is my day to post on SBM, so I’m going to have to cheat a little. Here is a link to a recent article by yours truly that appeared on Virtual Mentor, an online ethics journal published by the AMA with major input from medical students. Note that I didn’t write the initial scenario; that was provided to me for my comments. The contents for the entire issue, titled “Complementary and Alternative Therapies—Medicine’s Response,” are here. Check out some of the other contributors (I was unaware of who they would be when I agreed to write my piece).

Posted in: Acupuncture, Basic Science, Chiropractic, Energy Medicine, Herbs & Supplements, History, Homeopathy, Medical Academia, Medical Ethics, Science and Medicine

Leave a Comment (10) →

Failed Flaxseed and Bad News Brownies

Well, it’s been a tough month for herbs since my last monthly soiree here at SBM.

Just last week at the American Society for Clinical Oncology (ASCO) meeting, a group out of the Mayo Clinic presented data from a study showing that a well-characterized flaxseed extract was ineffective against hot flashes in postmenopausal women. But as Steve Novella noted here earlier this week, negative clinical trials data on supplements rarely influence the behavior of those who continue to advocate for their herbal use.

Flaxseed, known to contain phytoestrogen compounds such as secoisolariciresinol diglucoside (SDG) and enterolactone, has been purported to relieve hot flashes.

But I think the hypothesis was flawed in the first place: while these compounds bind the estrogen receptor, they have largely been shown to be estrogen receptor modulators that act in a negative manner. Work from the group of Dr. Lillian Thompson at the University of Toronto has repeatedly shown in an estrogen-dependent animal model of human breast cancer that flaxseed components act in a predominantly anti-estrogenic manner. One might suspect that hot flashes would be made worse by flaxseed, although this was not the case in the study presented as ASCO.

(more…)

Posted in: Cancer, Clinical Trials, Herbs & Supplements

Leave a Comment (49) →

Black Cohosh and Hot Flashes

Black Cohosh, an herbal “supplement” (i.e. unregulated drug) remains popular for the treatment of hot flashes and other autonomic symptoms resulting from menopause. This product is yet another good example of the double standard that the supplement industry and ideological promoters are allowed to employ.

The NCCAM website gives this summary:

Black cohosh, a member of the buttercup family, is a plant native to North America. It has a history of use for rheumatism (arthritis and muscle pain) but has been used more recently to treat hot flashes, night sweats, vaginal dryness, and other symptoms that can occur during menopause.

While the information is available if you look through the links below, their summary makes no mention of the fact that their own studies show black cohosh is ineffective. In their “at a glance” summary they characterize the scientific evidence as “mixed.”

(more…)

Posted in: Herbs & Supplements

Leave a Comment (16) →

Oil of Oregano

Paradoxically, the less evidence that exists to support the use of of a treatment, the more passionate its supporters seem to be. I learned this early in my career as a pharmacist. One pharmacy I worked at did a steady business in essential oils. And king of the oils was oil of oregano. Not only were there several different brands of the basic oil, they were different forms, including capsules, creams and even nasal sprays. Not aware of any therapeutic benefits, I would ask customers what they were using it for. I rarely heard the same condition described: skin infections, athlete’s foot, head lice, colds, sore throats, “parasites”, “yeasts”, diabetes, allergies and ringworm were apparently no match against the judicious use of oregano oil. Intrigued, I took a closer look.

Long before our scientific understanding of bacteria and antimicrobials, infected wounds were packed with different products in an attempt to minimize the odour, and hopefully speed healing. It’s likely that someone happened upon a fragrant herb and discovered that it seemed to help treat wounds (or at least, cover some of the smell). Given there have been some amazing drugs with powerful effects that have emerged from natural products, it’s certainly plausible that oil of oregano could have biological and therapeutic effects. Oregano (Origanum vulgare) leaves contain a wide variety of chemical compounds, including leanolic acids, ursolic acids, and phenolic glycosides. Phenolic compounds make up to 71% of the oil. Carvacrol, thymol, cymene, and terpinine and are found in oregano leaves and do appear to have biological effects. It’s these chemicals that are proposed to be the parts with beneficial effects.

The claims made by one manufacturer are unambiguous:

Oreganol P73 is the most powerful germ killer with scientifically proven results against almost every virus, bacteria, parasite, and fungi. The complexity of the phytochemical matrix in Oreganol P73 possesses a broad spectrum of antimicrobial properties that are safe for prolonged use. The oil can be used topically and internally. Oreganol P73 is the medicine chest in a bottle, especially since it is proven never to harm the internal organs, even when used daily for health maintenance.

So if we accept the manufacturer’s claims at face value, there should be evidence demonstrating oregano oil is both safe and effective when used internally and externally. There is apparently also adequate long-term safety data to demonstrate that it can be safely used on a daily basis.
(more…)

Posted in: Herbs & Supplements

Leave a Comment (30) →

The Top Ten Pet Supplements: Do They Work?

An Embarrassment of Riches?

Much has been written here about the dietary supplement business, a multibillion dollar industry with powerful political connections, and about the woeful inadequacy of regulation which allows widespread marketing of supplements without a solid basis in science or scientific evidence. 

The veterinary supplement market is a pittance compared to the human market, but still a billion-dollar pittance that is growing rapidly. Unfortunately, the resources available for good quality research in veterinary healthcare are also a pittance, and it is not at all unusual for our pets to suffer, or even be euthanized, as a result of treatable diseases for want of money to pay for needed care. So $1 billion a year spent on nutritional supplements may not be such a good deal if these products don’t effectively prevent or treat disease. 

The variety of supplements available is staggering. Many proprietary concoctions of vitamins, minerals, herbs, and other ingredients are marketed for health maintenance, “boosting the immune system,” retarding aging, or treating specific diseases. A comprehensive review of this multitude of moving targets is impossible. But the lion’s share of the pet supplement market goes to a few specific compounds, so I will focus on these. Most of these ingredients are also among the most popular supplements for humans, so there will be substantial overlap with previous discussions of the plausibility and evidence for many of these substances. (more…)

Posted in: Herbs & Supplements, Veterinary medicine

Leave a Comment (26) →

European Union “Ban” On Herbal Products

Regulations have just gone into effect in the EU regarding the sale of herbal products. The regulations seem reasonable, but they have sparked near hysteria on the part of herbal sellers and advocates of “natural” medicine. They are calling the regulation a “ban” on herbal products, which much of the media has parroted, but it is not a true ban, just a requirement for registration.

The law was sparked by cases of toxicity from over-the-counter herbal products. For example, aristolochia is a toxic plant species that is either used deliberately or can be accidentally or carelessly substituted for other plant species. It is known to cause kidney damage – even leading to kidney failure is some cases. Another herb, kava, has been linked to liver damage.

The new EU law, which went into effect May 1, 2011, will require herbal products to be licensed, or prescribed by a licensed herbal practitioner. In order to be licensed evidence for safety of the product must be presented. It is estimated that it will cost between 80,000 and 120,000 British pounds to get an individual herbal product licensed.

(more…)

Posted in: Herbs & Supplements, Politics and Regulation

Leave a Comment (105) →

Hash Oil for Gliomas? What Would You Do?

A friend asked me to look at the evidence for hash oil as a treatment for glioma. His teenage daughter was recently diagnosed with brain cancer: a grade 3 anaplastic ependymoma. It recurred very rapidly after surgery and radiotherapy and the latest tissue diagnosis shows an aggressive grade IV glioma. Her prognosis is not good. No further attempts at curative therapy are indicated; the oncologist prescribed only palliative therapy with temozolomide. Her father, who had recently lost his wife to cancer (breast cancer metastatic to lungs and brain), was understandably devastated. As he puts it, he remains “focused on the belief that just maybe a cure can be found.” He stumbled on what he calls “earth-shattering news” regarding hash oil. He and his friends established a private wiki website which they are constantly updating with information about THC (tetrahydrocannabinol, the active ingredient in marijuana and hash) and other possible cancer cures: everything from curcumin to diet. He asked me to look at the information he has accumulated. He said

I hope to convince you in the same way I have done with my daughter’s GPs and her neuro-oncologist at BC Children’s Hospital.

The oncologist was not exactly convinced. He didn’t say he thought hash oil was likely to work; he only said it would be reasonable to try it as a complementary therapy. He said

the data published so far appears very preliminary, most of its potential effectiveness in vivo so far appears in colonic disease, having said that there doesn’t appear to be any obvious down side as a complementary therapy and may have synergistic effect, so may be reasonable as add on to temodal if she tolerates it

I wasn’t convinced either.

I will discuss two issues here:

  1. What does the evidence say about gliomas and hash oil?
  2. When is it reasonable to try an unproven treatment as a last resort?

(more…)

Posted in: Cancer, Herbs & Supplements

Leave a Comment (115) →

Do calcium supplements cause heart attacks?

Calcium is good for us, right? Milk products are great sources of calcium, and we’re told to emphasize milk products in our diets. Don’t (or can’t) eat enough dairy? Calcium supplements are very popular, especially among women seeking to minimize their risk of osteoporosis. Osteoporosis prevention and treatment guidelines recommend calcium and vitamin D as an important measure in preserving bone density and reducing the risk of fractures. For those who don’t like dairy products, even products like orange juice and Vitamin Water are fortified with calcium. The general perception seemed to be that calcium consumption was a good thing – the more, the better. Until recently. (more…)

Posted in: Herbs & Supplements, Science and Medicine

Leave a Comment (19) →

Dr. Oz on alternative medicine: Bread and circuses

NOTE: Dr. Novella has written up a detailed description of his experiences on The Dr. Oz Show. Please read it. Also note that the online video for Dr. Novella’s appearance is now available:

  1. Controversial Medicine: Alternative Health, Part 1
  2. Controversial Medicine: Alternative Health, Part 2
  3. Controversial Medicine: Alternative Health, Part 3

When I first learned that our fearless leader and partner in crime for this blog, Dr. Steve Novella, Yale neurologist, blogger, and host of the popular skeptical podcast the Skeptics’ Guide to the Universe was going to be on The Dr. Oz Show, I was concerned. After all, this is the same physician who had in essence given up science-based medicine in favor of media stardom based on the promotion of alternative medicine. Of late Dr. Oz has been getting worse, too, promoting pseudoscience and what can only be described, in my opinion, as quackery. The snake oil that Dr. Oz has promoted over the last several months includes Dr. Joe Mercola, one of the biggest promoters of “alternative” health, whom Dr. Oz first had on his show about a year ago and then defiantly defended in a return appearance in early 2011, to be followed by a rapid one-two punch in which Dr. Oz had an ayurvedic yogi named Cameron Alborzian, who promoted highly dubious medicine, including “tongue diagnosis,” to be followed a few days later by something I would never, even in my most cynical assessment of Dr. Oz, expected, namely the appearance of faith healer Issam Nemeh on his show. ext Dr. Oz endorsed a diet that he once eschewed as quackery and then, to top it all off, invited psychic John Edward onto his show, asking Is talking to the dead a new kind of therapy? All of these offenses contributed to the reasons why in 2011 the James Randi Educational Foundation awarded him the The Media Pigasus Award for the second year in a row.

So right from the start I wasn’t very optimistic about how this whole thing would turn out. Fortunately, however, I was pleasantly surprised. Steve managed to hold his own in a completely hostile environment with only minor stumbles, while Dr. Oz peppered him with “Have you stopped beating your wife?”-style questions. At one point, Steve even managed to hand Dr. Oz his posterior. Alas, I doubt it will make any difference to Dr. Oz’s viewers, but we can always hope to change a few minds. I also realize that, however a big deal being on Dr. Oz’s show was to Steve and many members of the skeptical movement (especially supporters of SBM), to Dr. Oz it was just one segment in one episode of one season of a daily talk show made up of 150 episodes, each containing four or so segments. Not to detract from Steve’s achievement at all (it’s truly amazing that he managed to get on the show and do as well as he did, given how badly the deck was stacked against him), but to us this is big; to Dr. Oz it’s just another segment of another episode. It’s entertainment. As giddy and anxious as we at SBM have been the last two weeks, we have to keep things in perspective.

So what happened?
(more…)

Posted in: Acupuncture, Herbs & Supplements, Science and the Media

Leave a Comment (16) →
Page 15 of 24 «...101314151617...»