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Mayo Clinic on Home Remedies

I write a lot of critical articles. It’s nice to be able to write a positive one for a change. I received a prepublication proof of The Mayo Clinic Book of Home Remedies: What to Do for the Most Common Health Problems. It is due to be released on October 26 and can be pre-ordered from Amazon.com. Since “quackademic” medicine is infiltrating our best institutions and organizations, I wasn’t sure I could trust even the prestigious Mayo Clinic. I was expecting some questionable recommendations for complementary & alternative medicine (CAM) treatments, but I found nothing in the book that I could seriously object to.

It is organized alphabetically, starting with acne and airplane ear and progressing through bedbugs, boils and bronchitis, dandruff, depression and diabetes to warts, wrinkles and wrist pain. Each entry consists of (1) a description of the problem and its symptoms, (2) treatments you can try at home, and (3) when to seek professional medical help. It concludes with a short section on emergency medicine that covers anaphylaxis, bleeding, burns, CPR, choking, fracture, heart attack, poisoning, seizure, shock and stroke.

Nowhere does it mention acupuncture, chiropractic, energy medicine, or homeopathy. It gives good, clear guidance about when a health problem should not be treated with home remedies. Its recommendations about diet and exercise are solid. It doesn’t recommend anything that can’t be supported by published studies and common sense. When it recommends herbal remedies and diet supplements, it is cautious about what it claims. For instance, glucosamine and chondroitin are listed for osteoarthritis, but they point out that further study is required and they say “because the supplements may help and appear to be safe, it may not hurt to give them a try.” Not exactly a strong recommendation!

For elevated cholesterol, it recommends weight loss, diet, exercise, limiting alcohol, avoiding tobacco; and then it says “Experiment with natural products. Although few natural products have been proven to reduce cholesterol, some may be helpful. You could consider…” artichoke, barley, psyllium, flaxseed, garlic, oat bran, and plant sterols. I can’t really argue with that, especially if the patient is monitored by a doctor (which of course would be required to get blood tests that would tell if the natural products have had any effect).

For gout, they recommend against megadoses of vitamin C and their mention of cherries is fair and balanced:

Studies show an association between cherries and lower levels of uric acid in your blood, but it isn’t clear if the cherries have any effect on the signs and symptoms. Eating cherries and other dark-colored fruits, such as blackberries, blueberries, purple grapes and raspberries, may be a safe way to supplement gout treatment, but discuss this strategy with your doctor first.

It includes appropriate warnings. For instance, in the article on bladder infections, it says that for prevention you can try cranberry juice (“though still not proven in rigorous study”), but don’t try it if you’re taking Coumadin, since it may lead to bleeding. In the cholesterol section, it warns against red yeast rice because it contains lovastatin and there is no way to determine the quantity or quality of the drug.

The book recommends a few things that a rigorous scientist might hesitate to recommend because of insufficient evidence. But unlike many less trustworthy sources of medical advice, this book will not tell a patient to try anything that might be dangerous, anything that has been tested and found not to work, anything that is based on belief rather than on evidence, or anything that might delay or interfere with needed medical treatment. It is safe, sensible, and woo-free.

It isn’t perfect, but it’s pretty good. I would feel comfortable recommending it to a layman who wanted to know “what home remedies can I try?” or who wanted a home reference book about what can be done instead of calling the doctor and when calling the doctor is the more prudent course.

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17 thoughts on “Mayo Clinic on Home Remedies

  1. Since “quackademic” medicine is infiltrating our best institutions and organizations, I wasn’t sure I could trust even the prestigious Mayo Clinic.

    Well, it turns out that your first impulse was correct, Harriet. The Mayo Clinic is responsible for plenty of quackademic utterances, even if not in this book. I’ll post some examples within the next few days.

  2. TsuDhoNimh says:

    Probably a good book to give to college students.

    A home remedy applied immediately often means the medical remedy isn’t needed, or can be minimized.

  3. TsuDhoNimh says:

    Probably a good book to give to college students.

    A home remedy applied immediately and correctly often means the medical remedy isn’t needed, or can be minimized.

  4. Harriet Hall says:

    Kimball,

    I agree. I have seen a number of non-science-based utterances on the Mayo Clinic website. That’s why it was such a pleasant surprise to find this home remedy book unobjectionable.

  5. jeremywhiner says:

    That’s kind of funny — I sent David Gorski an e-mail with an attached photo of a publication I saw in a Whole Foods Market just last week. “Mayo Clinic Guide to Alternative Medicine 2011.” In the subtext it says “Yoga – Vitamins – Herbs – Acupuncture – Meditation”

    I didn’t inspect it further, however.

  6. reta rick says:

    Thanks for your excellent articles Dr. Hall,

    The other day i saw, on the checkout endcap at Whole Foods,
    a book put out by the Mayo Clinic entitled: The Mayo Clinic guide to Alternative Medicine 2010. I perused it expecting the worst, but it wasn’t as bad as I’d feared. Still, why the Mayo Clinic would tarnish thier good name with this is beyond me. Anyway, thought you should know.

  7. Jann Bellamy says:

    Dr. Atwood said:

    “The Mayo Clinic is responsible for plenty of quackademic utterances, even if not in this book. ”

    Apparently, they put all of that stuff in this book:

    “Mayo Clinic Guide to Alternative Medicine 2011,” which is just out. An example, re: “healing touch.”

    “. . . the practitioner first moves his or her hands a few inches above the recipient’s body. This is done to assess the recipient’s energy condition.”

    And, of course, “there is some impressive anecdotal evidence that healing touch works. However, more study is needed to confirm these findings.”

  8. superdave says:

    sounds like a decent book, but i saw this great parody thread on the bottom of the amazon page for it. I think regular readers will get a kick out of it,

    http://www.amazon.com/tag/health/forum/ref=cm_cd_dp_rft_tft_tp?_encoding=UTF8&cdForum=Fx1EO24KZG65FCB&cdThread=Tx2DJLGGF7UYJ36

  9. OK, OK, y’all blew my cover. It is the “Mayo Clinic Guide to Alternative Medicine 2011” that I’ll mainly be reviewing. And it’s a doozer.

  10. superdave – hehe – kyle the mac and cheese daddy made my day.

  11. Kevin Folta says:

    The real quack stuff is in the Miracle Whip Clinic Guide. A lot like the Mayo Clinic, just not obeying the same adherence to standards.

  12. xwolp says:

    I think it’s important to have more science based home remedies, some of them are quite effective and – if nothing else- rather pleasing.
    Recently I came across a BBC series titled “Grow your own drugs” which follows the same guidelines that I only wish the usual alternative medicine pitchers would abide to: I am not a doctor; clear it with your physician; do a 24h allergy test first; do not use if you are pregnant or taking any of these drugs; seek medical advice if symptoms do not clear within X days.

  13. Joe says:

    The Mayo Clinic web site http://www.mayoclinic.com/health/drug-information/DrugHerbIndex links to information about herbs from “Natural Standard” which is a quack site. It is headed by an MD and a PharmD; but it relies on NDs and other substandard practitioners.

    They have a deceptive rating system (A, B, C, D, F) in which a ‘C’ represents a nearly complete lack of evidence, rather than being ‘okay.’ Moreover, several years after Saw Palmetto and Echinacea have failed high quality tests, they are still rated as effective by the quacks.

    The NIH (NCCAM) also relies on these quacks. In that case, a clerk was charged with finding a database to provide the information and the clerk chose Natural Standard. One wonders why an educated person at NIH (or Mayo) does not catch the mistake.

  14. marilynmann says:

    If by plant sterols you are referring to supplements containing plant sterols or foods supplemented with plant sterols, there unfortunately is no good evidence that plant sterols lower the risk of heart disease. In fact, it is possible that plant sterols actually promote heart disease.

    1. There is a rare genetic disorder called sitosterolemia, characterized by very high serum plant sterols, in which patients develop premature heart disease. It is similar to homozygous familial hypercholesterolemia, except with very high plant sterols instead of very high LDL. The unfortunate victims develop xanthomas containing plant sterols and arteries clogged by plant sterols.

    2. Plant sterol supplements have been shown to increase serum plant sterols in healthy people.

    3. The safety of these elevated levels of plant sterols has not been established.

    4. No clinical trials have been done to test whether plant sterol supplements reduce the risk of heart attacks.

    5. There are studies that have found plant sterols in atherosclerotic plaque (e.g., from people who have had endarterectomies) and in aortic valves of patients with aortic stenosis.

    6. There are animal studies showing harm from plant sterol supplementation.

    I could go on, but my basic point is that plant sterol supplements cannot be recommended at the present time.

    References:

    Weingartner, et al. Vascular effects of diet supplementation with plant sterols. J Am Coll Cardiol, 2008; 51:1553-1561, doi:10.1016/j.jacc.2007.09.074

    Teupser, et al. Genetic Regulation of Serum Phytosterol Levels and Risk of Coronary Artery Disease. Circulation: Cardiovascular Genetics. 2010;3:331-339, doi: 10.1161/CIRCGENETICS.109.907873

    O. Weingartner, M. Bohm, and U. Laufs
    Controversial role of plant sterol esters in the management of hypercholesterolaemia
    Eur. Heart J., February 2, 2009; 30(4): 404 – 409.

  15. cloudskimmer says:

    The Mayo Clinic Book of Alternative Medicine has been out for awhile; my library has the 2007 edition and skimming it reveals lots of credulous advocacy of so-called alternative medicine. A great disappointment from what was once a highly respected institution.

  16. marilynmann says:

    In 2007, the results of a RCT of garlic on cholesterol concentrations on adults with moderate hypercholesterolemia were reported in Archives of Internal Medicine. The trial evaluated raw garlic and two commonly used garlic supplements. None of the forms of garlic, including raw garlic, when given at an approximate dose of a 4-g clove per day, 6 d/wk for 6 months, had statistically or clinically significant effects on LDL-C or other plasma lipid concentrations.

    Gardner, et al., Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Arch Intern Med. 2007;167(4):346-353.

    In addition, a meta-analysis was published in 2008 that did not find beneficial effects of garlic on total cholesterol, LDL, triglycerides, or apoB. Khoo, et al., Garlic supplementation and serum cholesterol: a meta-analysis. Journal of Clinical Pharmacy and Therapeutics. Volume 34, Issue 2, pages 133–145, April 2009.

    Based on the above, it seems like a waste of time and effort for anyone to try to lower their cholesterol with garlic.

    Marilyn Mann

  17. mayonnaise says:

    Let me preface my comments by saying that I received my internship and residency training at Mayo Clinic (Minnesota) and was later a member of its staff for several years before starting my private practice.

    While the vast, vast majority of Mayo’s physicians are strongly science-based and while very good bench research and clinical research is done in the Mayo system, it, too, has suffered a small but noticeable influx of woo. This *is* a shame, since it does tarnish the otherwise great name of Mayo Clinic.

    As a former insider, my guess as to why this has happened is that Mayo Clinic has slowly changed from being a physician-run institution to an administrator-run organization. As such, political correctness, such as “respecting” the ideas of woo and being more “sensitive” to different opinions (read: unscientific nonsense) has trumped science…at least a little. Note that even the other big name medical institutions of Harvard and Johns-Hopkins have allowed the cancerous growth of quackademic medicine to invade its ranks, perhaps for similar reasons.

    I still have a lot of respect for my colleagues in the trenches there, but the woo needs to go lest those few cancerous cells in their midst cripple the entire organism. Mayo Clinic should be more “sensitive” to the influence they have when they endorse–or even sort of endorse–any woo-based practices.

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