Yes. This meta-analysis below is more recent than the one you linked and was well-designed, taking into account limitations observed in previous reviews.

Actually, it was what I found on ScienceBasedMedicine after reading Doubts on Ginkgo Biloba as a Memory Aid in the NY Times the day before.

It’s a great introduction to the SBM worldview and has some good sound-bytes/basic things to share with family and friends when they bring up these topics. I wish I would’ve found this video when I was a kid (or even last year!)

http://www.biomedcentral.com/1471-2318/10/14

With respect to Harriet’s original post, I don’t want to drag this more off-topic into a war of which review is best so I’ll leave it at this.

I know in many European countries, like Germany for example, herbs like Ginkgo biloba and St. John’s Wort are sold by prescription, reimbursed through insurance, and are “medically accepted”.

Even after evidence shows that Ginkgo Biloba does not work?

“What do you mean by “mainstream acceptance”? Which indications are you referring to?”

I mean acceptance by a consensus of medical scientists, not by public popularity. Vitamin D deficiency is a proven indication for supplemental vitamin D. Using it for flu prevention in lieu of vaccination is not. The claims for diet supplements must be evaluated individually, and this is not the place to do that. You missed the real point: that these things are not “CAM” but drugs that fall squarely in the province of “medicine.” They become quackery lumpable with Reiki only when they are promoted without the kind of scientific scrutiny we apply to prescription drugs.

The omega 3 fatty acid DHA carries the health claims “Source of DHA (Omega-3 fatty acid) for the maintenance of good health; reduces serum triglycerides; when used during pregnancy and breastfeeding, DHA supports healthy neural and vision development of an infant; helps support cognitive health by improving memory and learning functions in an aging population.” Would you not agree this is “mainstream acceptance”?

These seem to be merely bland structure-function claims.

What do you mean by “mainstream acceptance”? Which indications are you referring to? I’m going to assume you don’t mean the general public as the sales figures alone would testify to their acceptance, but surely this is only because they are naïve sheep easily misled by clever marketing. So we are left with medical mainstream acceptance. Is there actually such a thing as widespread mainstream medical consensus across the globe? Are you referring to just the US? Certain select countries? I know in many European countries, like Germany for example, herbs like Ginkgo biloba and St. John’s Wort are sold by prescription, reimbursed through insurance, and are “medically accepted”. I’m less familiar with their regulations though so I’ll stick to what I know best and refer to Canada where Health Canada, our equivalent of the FDA, regulates herbs and supplements with product licenses. Safety, efficacy, and manufacturing that adheres to GMP (Good Manufacturing Practices) are the major things that need to be proved before being licensed. Ginkgo biloba standardized extracts, as one example, carry a health claim of “Helps to enhance cognitive function and memory in an aging population and also supports peripheral circulation”. The omega 3 fatty acid DHA carries the health claims “Source of DHA (Omega-3 fatty acid) for the maintenance of good health; reduces serum triglycerides; when used during pregnancy and breastfeeding, DHA supports healthy neural and vision development of an infant; helps support cognitive health by improving memory and learning functions in an aging population.” Would you not agree this is “mainstream acceptance”?

@lilady – I’m not familiar with red rice yeast as a supplement other than just hearing it is supposed to be “good” for lowering cholesterol. I’ve never used it, haven’t evaluated the claims, and don’t have cholesterol issues so I can’t really comment on it. I’m grateful I don’t have any hereditary diseases like that but if I did I would look into what diet and supplements and herbs could do first and then something like Lipitor would be a last resort – mostly due to side effects and extra cost. I’m not sure why you picked this particular example though as each herb or supplement would have to be evaluated separately – one of the points I was originally making.

http://www.sciencebasedmedicine.org/index.php/red-yeast-rice-and-cholesterol/

Now tell us, if you have been diagnosed with heterozygous familial hypercholesterolemia , why would you even consider *trying* red yeast rice supplements that contain various amounts of *natural* atorvastin (Lipitor) or no atorvastin or red yeast rice supplements that have been adulterated with Lipitor, when your doctor has prescribed measured doses of a statin drug along with a LDL-lowering medication and is monitoring their effectiveness?

http://emedicine.medscape.com/article/121298-treatment#aw2aab6b6b4

“what was the purpose of a presentation like this?”

The purpose was to explain that the category of “CAM” is meaningless, that all treatments must be evaluated by the same standard, and that science is tricky, that you can’t automatically assume something works better than placebo just because you can find positive studies.

“You lapsed into this later in your talk when you referred to “CAM people” as though they are all one particular tribe or race. ”

There’s no such thing as CAM. “CAM people” are the tribe of people who believe CAM exists.

“things like vitamin D, omega 3 fatty acids, Ginkgo biloba, probiotics, CoEnzyme Q10, or St. John’s Wort”

This assumes there is a category of CAM to which these things belong. There isn’t and they don’t. You picked things that are being studied in scientific medicine but that have not yet gained mainstream acceptance for the indications they are being promoted for. These things fall squarely in the province of “medicine” and must be evaluated by the same standards we use to evaluate drugs.

I hope you weren’t trying to make a point that vague, undetermined correct dosages of supplements leads to damaging one’s health. How would we then explain well determined exact dosages of common pharmaceuticals still causing in excess of 100,000 deaths each year?

What do you imagine these two sentences actually have to do with each other? And why don’t you cite your source?

There can be too much of a good thing. Gary Null inadvertently sounded a note of caution when he managed to poison himself with one of his own products.

I am just saying that those two topics are discussed here, and not just in the form you alluded to as placebos.

Especially when it comes to herbal medicine and certain supplements, anyone claiming it’s all placebo effect or woo tells me they have not ever bothered to read the literature. By the same token, other elements of CAM are embarrasingly lacking.

Actually, this statement tells me that you have not read this website very much. The issue that often comes up with herbal medicine is that it does have real active ingredients, but it is the dosing that is what is undetermined. Also, some supplements can be damaging if they are used to excess.

It seems you are painting this website with one big broad brush.

The tone and mindset of most of the blog posts and comments on this site have a lot of in common with this.
Being skeptical is seen as somehow “superior” or a badge of honour in itself yet skeptics can be just as stupid and religiously close minded as people who claim that their mineral supplements can cure diseases and keep you young forever. People were skeptical that the original manned Moon landing happened or that the Earth revolved around the Sun. All too often, skeptics concede rational, open mindedness for confirmation bias and preaching to the choir. For example, this constant lumping of CAM together into one mega-modality is a symptom of prejudicial thinking and it short-circuits potential for any honest, fresh, open-minded consideration of the subject. For example, any look through the research available thus far will tell you that there is a lot of good quality research available regarding herbs (generally standardized extracts) but very little to support homeopathy and reiki. Yet, they get lumped in and treated as one for some reason under this CAM banner when it comes to criticism. I find this remarkably short-sighted and narrow minded.

I could look at a website like this and one like NaturalNews.com and make a lot of parallels about the degree of firmly convinced group-think and the general circle-jerk reinforcing of confirmation bias. Oh but we are based on science you proclaim! As you brought up, “science” can be used to show anything
you want to show. What matters is the intent and the design, which stems from the mindset of the scientist and anyone who reviews scientific studies. All too often sites like this simply cherry pick research or examples in order to make a point that has already been decided upon beforehand. The recent one on organic food not
having any “health benefits” over conventionally grown food being a good example. Us vs. Them is boring. The self-righteous vs. the villified other is boring, even if some people seem to derive some sort of egotistical pleasure from it.

I understand in many ways the natural supplements industry, to whatever degree it can all be lumped together as on the same page, has brought such a reaction on itself in response to exaggerated marketing claims but the baby should not be thrown out with the bath water. The truth is that there really is value in some of these supplements and herbs and it can be found in the literature. It’s mind-boggling to me that so many people are stuck in an extremist dichotomy of either “it’s good for whatever ails ya” to “it’s all rubbish and just placebo effect”. Especially when it comes to herbal medicine and certain supplements, anyone claiming it’s all placebo effect or woo tells me they have not ever bothered to read the literature. By the same token, other elements of CAM are embarrasingly lacking.

Back to the presentation, to me it was fairly simplified and shallow in its treatment of CAM. It provided a few self-congratulatory chuckles to audience members. As with most posts on this site, it chose to focus on the negative and the extreme rather than give any balanced view. Personally I don’t think things like vitamin D, omega 3 fatty acids, Ginkgo biloba, probiotics, CoEnzyme Q10, or St. John’s Wort for example have any relation at all to Reiki or Intercessory Prayer or Astrology and its a disservice to continue to link them.

As unofficial president of the chimerical Harriet Hall, MD fan club I must take exception to the preceding comment!

Unlike the typical televangelist who is trained and well-versed in theatrical excesses and exuberance, Dr. Hall is a distinguished medical professional and person of science. Her claim to fame is her ability to ferret out the [expletive deleted] from the body of scientific knowledge and present it in a scholarly fashion. Indeed she performs her duties with great expertise!

I think that’s an excellent idea! In fact, two companion courses would seem to be ideal – a literature course entitled “Skeptical Reading of Scientific Literature” which would focus on the many ways both scientists and pseudo-scientists hide the weaknesses in their arguments and on ways of filling in the blanks intended for liberal arts majors who are interested in scientific controversy and the use (and misues) of science to inform public policy, and a general science course entitled “Scientific Reasoning” which would focus on understanding and applying scientific method, recognizing paradigm shifts, true vs. manufactured controversy, and recognizing pseudoscience and misapplications of scientific method.

Take it from someone who reads naturopathic web sites usually daily,

this is quite the mixture of meanings.

If it were boring, I don’t think one would stay up.

And if it weren’t boring, I don’t think I would be dry.

Ah, the nature of dumb-assed-ness.

Something I reflect upon daily.

-r.c.