If there’s one thing that unites all countries and cultures, it’s our love of caffeine. Whether it’s coffee, tea or other foods, caffeine is the most widely consumed drug in the world — more than alcohol, and more than tobacco: 90% of adults worldwide consume caffeine daily. At doses found in food and beverages, the effects are predictable and the side effects are slight. But natural or not, caffeine is a drug; isolate the pure substance, and the risks change. It would be difficult for most people to drink 16 cups of coffee in a row, but that’s the equivalent of just one teaspoon of caffeine powder. If that doesn’t hospitalize you, a tablespoon of the powder will probably kill you. Yet despite the risks, there are no restrictions on the sale of caffeine powder. You can buy a 1kg bag for $35, which provides the caffeine of about 5,000 cups of coffee. Caffeine powder is freely available to buy because regulators treat it differently – not because of its inherent properties, but because it’s “natural” and sold as a dietary supplement rather than a drug. This is a regulatory double-standard that harms consumers. It’s leaving a body count. And it needs to change: (more…)
Archive for Herbs & Supplements
The FDA recently announced it would send field staff out to collect samples of commercially-manufactured raw dog and cat food. The samples will be analyzed for Salmonella, Listeria monocytogenes and E. coli, all of which have been found in raw pet food, in the animals who eat it, in their feces, on their bodies after eating it, in the areas they inhabit, and on their owner’s bodies. Not surprisingly, this has led to both pet and human infection and illness. If the FDA finds pathogens, it could result in a recall, a press release and Reportable Food Registry Submission. The next day, the CDC joined the effort to curb illness caused by pathogens in raw pet food by posting information on safe handling.
Because of the risk to public health, and the lack of any proven benefit of raw pet food diets, the FDA does not recommend them.
However, we understand that some people prefer to feed these types of diets to their pets.
And why is that? For some of the same reasons humans follow absurd diet fads: the “lone genius” discovery, it’s “natural,” anecdotal evidence, appeal to antiquity, anti-corporate sentiment, and “holistic” practitioner recommendations.
We are at a disadvantage. We have to rely on reality to validate the practice of medicine. Anatomy, physiology, pharmacology, chemistry, the basic sciences that made up the first two years of medical school education and a huge chunk of pre-med. And we have to rely on the truth, as slippery a concept as that can be. I can’t just make up a disease or a therapy.
It would be so much easier to not have to worry about reality in deciding on a disease and treatment for people with symptoms.
I came across “Healthy Life: Leaky Gut Syndrome” in my feeds. I am always attracted to exclamation marks! They must mean something important! Or surprising to the author!
It’s called “leaky gut syndrome” and patients say it can wreak havoc on everyday life, but some doctors say there’s no such thing!
Naturopaths, along with some chiropractors, acupuncturists and a few “integrative” physicians, are advising patients that they should be tested for MTHFR genetic mutations. Typically, the naturopath will start with the pitch that “conventional” medical doctors are ignoring your genes as a possible source of your health problems. (And it is mostly naturopaths who are doing this – just Google “naturopath MTHFR genetic mutation” and see what comes up.) NDs know better, of course – it could be a MTHFR genetic mutation causing your maladies.
Just what is the MTHFR gene? Allow me to introduce some actual scientific information here. According to Genetics Home Reference, a service of the National Library of Medicine,
the MTHFR gene provides instructions for making an enzyme that plays a role in processing amino acids, the building blocks of proteins. This particular enzyme is important for a chemical reaction involving forms of the vitamin folate (also called vitamin B9), a reaction required for the multistep process that converts the amino acid homocysteine to another amino acid, methionine. The body uses methionine to make proteins and other important compounds.
Back to pseudoscience. Next comes the scare tactic: telling you how a MTHFR mutation might affect your health: anxiousness, adrenal fatigue, brain fog, cervical dysplasia, increased risk of many cancers (including breast and prostate), low thyroid, leaky gut, high blood pressure, heart attacks, stroke, Alzheimer’s disease, diabetes, and miscarriages. (more…)
In the news: a woman in Fort Wayne, Indiana is suing the Arbonne International company in Allen Superior Court, claiming that its product contained toxic levels of green tea extracts, causing her to develop acute liver failure.
Green tea accounts for 20% of tea consumption worldwide. It has become more and more popular because of its many reported health benefits; the consumption of green tea in the US has risen by 40% just since 2000. A less-processed form of tea, green tea contains higher levels of antioxidants and polyphenols than other teas. It was traditionally used to control bleeding, heal wounds, aid digestion, improve heart and mental health and regulate body temperature. More recently, research has suggested that it has many health benefits.
The evidence for health benefits
The University of Maryland Medical Center has a helpful webpage that summarizes all the relevant research and provides a long list of references. Green tea may reduce the risk of heart disease (but the FDA prohibits that claim on labels; they concluded there was no credible evidence to support it). Green tea lowers total cholesterol and raises HDL. Population studies suggest that it may help protect against several kinds of cancer, but the evidence is mixed: other studies suggest that it may actually increase the risk of some cancers, and it may interfere with cancer chemotherapy. It may help in inflammatory bowel disease, diabetes, liver disease, and weight loss. There is even preliminary evidence that it might prevent dental cavities, might be useful in arthritis, might help treat genital warts, and might even prevent symptoms of colds and flu. Studies show that drinking green tea is associated with reduced risk of dying from any cause. At first glance, it might sound like a panacea, but the evidence is still questionable. Much of it is from small, preliminary studies that have not been replicated or that contradict each other. (more…)
I enjoy feedback from readers. Yes, there’s the regular hate mail accusing me of being a Big Pharma Shill. But there’s the occasional appreciative comment from someone that found a post helpful or informative. The most gratifying feedback is when someone tells me that something I wrote led to a more informed health decision. Often it’s because I was able to answer a question that they couldn’t find a science-based answer to. I’ve answered thousands of questions in my pharmacy career, and have only blogged a handful of them (so far). One of my most fascinating experiences was a stint working evenings in a pharmacy that happened to have a large “natural” health focus. It’s there I began to scrutinize alternative medicine more closely, because it was virtually all the store sold. Homeopathy, ear candles, copper bracelets and salt lamps were all for sale. If it was unproven, proven ineffective, or defied some law of physics or chemistry, this pharmacy probably sold it. But the customers loved these products. I was dumbfounded. Some would buy dozens of supplements, costing hundreds dollars per month, on the advice of their naturopath, treating some vague or non-specific complaints. Others swore by homeopathic remedies, for themselves and their pets. It was common to meet people who were treating conditions that either didn’t exist, or hadn’t been properly diagnosed, like naturopath-diagnosed “food intolerances” or “hormone imbalances”. There were also the occasional “pH balancing” advocates that insisted I was misguided and uneducated for reassuring them that their body’s pH was just fine, despite what their urine test strips were telling them. (more…)
Ron Rosedale, MD has devised a “powerful program based on the new science of leptin.” “Finally — the ultimate diet for fast, safe weight loss, lifelong health, and longer life…” He suggests it will prevent or improve high blood pressure, diabetes, heart disease, osteoporosis, arthritis, and a host of other ills. He repeats the CAM canard that “doctors only treat symptoms” and claims that his diet corrects the underlying cause of obesity, premature aging, and many diseases. That underlying cause is hormone (leptin) dysfunction. His is essentially just another low carb diet, only with more fat and less protein than other versions. His recommendations are ridiculously elaborate and are not supported by good evidence. His diet extrapolates from basic science, is based on speculative hypotheses, and has never been tested to see whether it works and is safe, much less whether it is superior to other diets.
If this sounds vaguely familiar, it should. He is doing what so many proponents of fad diets have done in the past, and he does it poorly. His book is a puerile effort compared to Gary Taubes‘ Good Calories, Bad Calories; Taubes at least marshaled an impressive mass of scientific data, presented a cogent argument, and ultimately acknowledged that more studies would be needed to test his recommendations. (more…)
Cervical dysplasia is a precancerous condition picked up by Pap smears. It is most often caused by human papillomavirus (HPV) infection. Mild cases may resolve spontaneously and can be followed by observation with frequent Pap smears, but cervical dysplasia can progress to cancer. The standard treatment is to remove the abnormal cells with a cone biopsy (using a knife) or a Loop Electrosurgical Excision Procedure (LEEP) using a wire loop heated by electricity. Those procedures not only treat the disease, but they provide a pathology specimen that can be examined to rule out more serious or invasive disease. Both LEEP and cone biopsy are 85-90% effective in removing all the abnormal cells. If cancer is suspected, a cone biopsy is preferable because LEEP may damage the edges of the specimen and make it more difficult to interpret. Otherwise, LEEP is often preferred because it is less expensive and doesn’t require anesthesia or an operating room. I have discussed misguided attempts by alternative medicine practitioners to treat cervical dysplasia before.
Surgery is often perceived as scary and not “natural,” so it’s not surprising that a “natural” treatment has been devised to replace surgery. Escharotics are corrosive salves that get their name from the thick dry scab that they can produce called an eschar. The “natural” escharotic treatment alternative for cervical dysplasia involves applying a solution of bloodroot (Sanguinaria canadensis) and zinc chloride. They claim that the solution selectively kills abnormal cells of the cervix while leaving healthy cells unaffected. That claim is almost certainly false, and the efficacy and safety of escharotic treatment has not been properly tested or compared to conventional treatment. (more…)
One of the greatest triumphs of marketing over evidence was the incredible rise of vitamin supplement use in the 20th century. Supplement makers successfully created a “health halo” around vitamins, and taking your vitamins became a virtue, something mothers told their children to do. The evidence, however, does not tell such a simple story.
In recent years it has become increasingly apparent that there are unintended consequences to taking vitamin supplements, and in fact there may be a net negative health effect. This is especially true for those who are healthy and don’t need vitamins, and for those who exceed the recommend dosages.
A recent review of the last 20 years of literature on the subject, presented at the American Association for Cancer Research 2015 meeting, found an overall increased risk of cancer among vitamin users. Dr. Tim Byers presented the study, which echoes the result of a 2012 review that he and others published. He specifically refers to two famous studies showing an increased risk of cancer from vitamins.
Naturopathy is chock-full of quackery. No doubt about it. Here at SBM and elsewhere, the seemingly limitless nonsense that can be incorporated into naturopathic practice has been documented time and again: detoxification, food “sensitivities,” anti-vaccination ideology, fake diseases (chronic yeast overgrowth, adrenal fatigue, chronic Lyme disease), bogus tests (also here), homeopathy, chelation therapy, assorted other odd-ball treatments, lack of ethical standards, and just general wackiness.
So, let’s give naturopaths licenses to practice primary care! What a good idea.
This affinity for nonsense is perfectly understandable, given their pseudoscience-filled education and foundation in vitalism. Once the scientific method is chucked in favor of “philosophy,” what’s to stop them from simply making things up? As far as I can tell, nothing. But why inflict this on the public under the guise of promoting health, safety and welfare?
To be fair, naturopaths aren’t the only ones who incorporate quackery into their practices. There are chiropractors, acupuncturists, reiki masters, doctors of Oriental Medicine, and “integrative medicine” practitioners. But what sets naturopaths apart, in my mind, is the sheer range of pseudoscience they will accommodate without the slightest hint of doubt in its efficacy or safety and their unwavering belief in their ability to diagnose and treat patients with the expertise and skill of medical doctors. “Delusional” is not too strong a word to describe their utter lack of awareness of their ignorance or the danger to patients they may pose. (more…)