Herbs & Supplements

Archive for Herbs & Supplements

BrainPlus IQ: Lying with Advertising

BrainPlus IQ: If it turns your brain blue, consult a doctor.

BrainPlus IQ: If it turns your brain blue, consult a doctor.

I got an email urging me to check out a wonderful new product that boosts brain performance: it “doubles IQ, skyrockets energy levels, and connects areas of the brain not previously connected.” It is BrainPlus IQ, a dietary supplement that falls into the category of nootropics, substances that enhance cognition and memory. After looking into it, my first thought was that if it doubles your IQ you might become smart enough to realize you have been scammed. The advertising for this product is as reprehensible as anything I have seen (and I have seen a lot).

The link in the email was to a “Discovery” website article titled “Anderson Cooper: Stephen Hawking Predicts, “This Pill Will Change Humanity” and It’s What I Credit My $20 Million Net Worth To.” According to the article, Stephen Hawking said his brain is sharper than ever because he uses BrainPlus IQ. It quotes Denzel Washington, saying he gave a speech at a science convention (unnamed) in New York City, saying BrainPlus IQ enabled him to memorize movie lines after reading them just once. He brought to the stage MIT scientist Peter Molnar, who said he had tested BrainPlus IQ against Adderall in 1,000 patients and found it was 600% more effective and subjects doubled their IQ in 10 days. It has “absolutely no harmful ingredients, it’s non-addictive, and 79% of participants double their IQ within 24 hours.” It was supposedly described as “Viagra for the brain” in Forbes magazine. (more…)

Posted in: Herbs & Supplements, Neuroscience/Mental Health

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Phenibut Is Neither Proven Nor Safe As A Prosocial Wonder Drug

Editor’s note: With Mark Crislip away on yet another vacation, we present an inaugural guest post from Abby Campbell, a practicing MD, Ph.D and contributor at HealthyButSmart.com. Welcome Abby!

Ball-and-stick diagram of the phenibut molecule

Ball-and-stick diagram of the phenibut molecule

On average for the past year, phenibut has been typed into google 49,500 times a month. Phenibut is a supposed wonder drug that claims to promote sociability and lessen anxiety.

When people run that search in Google, they find stores that sell phenibut, as well as blogs and forums where people discuss and make recommendations for the use of phenibut. The main qualification of these people is that they themselves have taken the drug.

What a searcher doesn’t find is any reference to any credible research. Yet another supplement market has been born driven by anecdotal social marketing, and no one seems to care about the evidence.

What is phenibut?

Phenibut is a designer drug which was synthesized by a group of Russian scientists in the 1960s. Perekalin and his colleagues in St. Petersburg added a phenyl ring to butyric acid to make what we now call phenibut. The addition of the phenyl group to the butyric acid enables the compound to cross the blood-brain barrier and enter the brain.

This basic chemical structure of the compound explains the origins of the name ‘phenibut’. Phenibut is also known as fenibut and is sold under the brand names of Noofen and Citrocard.

Phenibut is structurally similar to the neurotransmitter GABA (gamma amino butyric acid). GABA occurs naturally in the human nervous system and has a calming effect on the brain.

GABA itself does not cross the blood brain barrier and so is not viable as a drug or supplement to reduce anxiety. The addition of the phenyl ring by the Russian scientists overcame the problem of penetration into the brain. However this means that phenibut is not totally identical to human GABA which means that we can’t just extrapolate information on GABA to phenibut, as some websites have done. (more…)

Posted in: Basic Science, Herbs & Supplements, Science and Medicine

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What are health professionals telling consumers about dietary supplements?

Is that pharmacist making an evidence-based recommendation?

Is that pharmacist making an evidence-based recommendation?

The popularity of dietary supplements continues to grow. A few weeks ago I described how dietary supplements have become a $34 billion industry, despite the fact that there’s very little evidence to support their use. While there are absolutely some medical circumstances where specific supplements may be warranted, the vast majority of supplements are taken for general purposes, such as “wellness” or to prevent perceived deficiencies. There’s also the belief that “more is better”, a sentiment that seems unique to supplements (compared with drugs), perhaps because supplements are widely believed to be safe, effective and yet simultaneously free of any adverse effects. While none of these assumptions are inherent to any “supplement”, this thinking has had a clear influence on regulators and consumers: (more…)

Posted in: Herbs & Supplements, Science and Medicine

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“Donald Trump’s presidential election win stuns scientists”

Trump is OK with pseudoscience

Trump is OK with pseudoscience

Scientists in the U.S. and from around the world are weighing in on Donald Trump’s election as the next president of the most powerful country on earth:

Trump will be the first anti-science president we have ever had . . . The consequences are going to be very, very severe.

Michael Lubell, director of public affairs for the American Physical Society in Washington, DC:

I am simply stunned. . . Trump’s election does not bode well for science or most anything else of value.

Neal Lane, a Democrat who led the National Science Foundation and served as White House science adviser under President Bill Clinton, now a physicist and university professor at Rice University in Houston, Texas:

It’s going to be critically important for researchers to stand up for science.

Jennifer Zeitzer, director of legislative Relations at the Federation of American Societies for Experimental Biology in Bethesda, Maryland:

I do breast cancer research for my PhD . . . Scared not only for my future but for the future of research and next years @NIH budget.

Sarah Hengel, a graduate student at the University of Iowa in Iowa City:

This is terrifying for science, research, education, and the future of our planet . . . I guess it’s time for me to go back to Europe.

María Escudero Escribano, a postdoc studying electrochemistry and sustainable energy at Stanford University in California:

(more…)

Posted in: Critical Thinking, Herbs & Supplements, Legal, Obstetrics & gynecology, Politics and Regulation, Public Health, Science and the Media, Vaccines

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Supplements: Still popular despite little evidence they’re useful

Coconut Oil Chews

Despite the marketing, there is no need for you to take most supplements. And no-one needs coconut oil chews.

As healthcare systems struggle to cope with growing and aging populations, there is renewed interest in eliminating wasteful, and possibly harmful, care. The Choosing Wisely campaign suggests that up to 30% of health care services may be unnecessary. Driven by the medical profession itself, Choosing Wisely is challenging both patients and health care providers to have an honest dialogue about the appropriateness of care. What is increasingly obvious is that ineffective and inappropriate medical care can’t be counted on to disappear naturally, even when the evidence is clear and is acknowledged by health professionals.

Dietary supplements are an enormously popular category of consumer products (I hesitate to call them health products), usually taken with the objective of promoting or supporting health. In the US alone, supplements are a $34 billion dollar industry. I’ve posted several times about trends in supplement use, looking at some of the larger studies to understand who takes supplements, and why. As a pharmacist who has worked in both community (retail) and hospital pharmacy practice, my own observations seem in line with what the evidence shows. The extent to which some consumers embrace supplements as part of their health activities is remarkable. I have seen people spend hundreds of dollars per month on dietary supplements based solely on the advice of a naturopath or other alternative medicine provider. And as a former hospital pharmacist responsible for doing medication histories with new patients, I would regularly encounter seniors taking dozens of different types of vitamins, over-the-counter medications, supplements and tonics, often with contradictory purposes: the “natural” laxatives with the anti-diarrheal medicine, or combinations of products for a single use, like melatonin and diphenhydramine for sleep. Cleaning up the supplement schedules to something rational (or at least safe) was one of the more challenging aspects of my role. Like medication, consumers can get very attached to their supplements, sometimes attributing beneficial effects to them that were highly implausible, and more likely reflected placebo effects. Convincing people that the supplements they’re taking are unnecessary, and even potentially harmful, can be difficult. Some have been so convinced of the merits of their (usually self-driven) supplement strategy that they would take suggestions very personally, as if I were questioning their own judgement. Such is the nature of the supplement industry: A triumph of marketing and an unquestioned boon for manufacturers, but billions in spending with little evidence that supplements have any real health benefits whatsoever. (more…)

Posted in: Herbs & Supplements

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Corydalis: An Herbal Medicine for Pain, with Some Thoughts on Drug Development

Corydalis. Better than opium?

Corydalis. Better than opium?

Ever since William Withering published his classic treatise on Foxglove in 1775, science has been testing herbal medicines and trying to establish a scientific basis for the ones that work. As many as half of today’s prescription drugs were derived from plants. A new study published in Current Biology by Zhang et al. has identified a compound in a traditional herbal remedy that is effective in relieving pain in rats and works by a novel analgesic pathway. They used rigorous scientific methods and their findings do not represent an endorsement of traditional herbal medicine practices. (more…)

Posted in: Herbs & Supplements, Traditional Chinese Medicine

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Natural Health Products: Loosely regulated, little evidence of benefit, and an industry intent on preserving the status quo

Shouldn't you know that the pills you are paying for are safe, and actually do something?

Shouldn’t you know that the pills you are paying for are safe, and actually do something?

This week’s post will revisit a topic I recently covered, but it’s time-sensitive and needs your input. Health Canada, the Canadian equivalent to the US Food and Drugs Administration, is considering revisions to the way in which it regulates dietary supplements, which are called “natural health products” in Canada. It is rare that a regulator acknowledges that a regulatory system isn’t working, and publicly expresses a commitment to being more science-based. There is a time-limited opportunity for the public (including all of you non-Canadians!) to provide comment on how supplement regulation could be more closely aligned around scientific principles, rather than the supplement industry’s priorities. Whether you take dietary supplements or not, we can probably all agree that consumers should have access to safe products as well as credible, relevant information about these products, in order to make informed health decisions. It will likely not surprise you that these ideas are seen as threats to supplement manufacturers, who benefit from little regulatory oversight and few restrictions on what can currently be claimed about any product’s effectiveness. Since my last post, there have been some new reactions to the consultation that are worth discussing. (more…)

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

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Is there a distinct standard of care for “integrative” physicians? The Woliner case

Board certification in family medicine and "integrative" medicine: different standards of care?

Board certification in family medicine and “integrative” medicine: different standards of care?

Florida Atlantic University student Stephanie Sofronsky was diagnosed with Hodgkin’s lymphoma in 2011, after review of her case by oncologists and pathologists at Moffitt Cancer Center in Tampa, the NIH/National Cancer Institute, and the Mayo Clinic in Jacksonville. By June of that year, a PET scan showed the cancer had progressed to her pelvic region. She decided to be treated locally by oncologist Neal Rothschild, MD, and met with him to discuss chemotherapy and ongoing management of her cancer. At this point, with Stage III Hodgkin’s lymphoma, she had an 80-85% chance of being in complete remission with appropriate treatment.

Unfortunately, at the same time, Sofronsky was also seeing Kenneth Woliner, MD, a family medicine practitioner. Despite the fact that world-renowned cancer specialists agreed that Sofronsky had Hodgkin’s lymphoma, and knowing that she was about to start chemotherapy, Dr. Woliner told Sofronsky that cancer was “low on his list” of possible medical concerns and that increased lymphoctyes shown in her tests were not indicative of cancer, insinuating that oncologists “often overreact” to the presence of lymphocytes and recommend chemotherapy before making an actual diagnosis. Dr. Woliner suggested instead that Sofronsky have her house tested for mold, which could be causing allergies, and therefore her symptoms. Convinced, Sofronsky pursued treatment for her allergies and cancelled her follow-up appointment with Dr. Rothschild.

Sofronsky complained repeatedly to Dr. Woliner of symptoms that were, as our good friend Orac points out, consistent with progressing lymphoma – back pain and pain and swelling in her lymph nodes, abdomen and legs, to the point of having to use a cane. Yet, Dr. Woliner, over the next couple of years, continued to attribute her symptoms mostly to her allergies and also thyroid issues and some other minor illnesses. On February 7, 2013, at her last visit to his office and in significant distress from pain and severe leg swelling, he ordered a 100 mg shot of iron, despite the fact that her blood tests showed she was not iron deficient. She rapidly decompensated and died in the hospital three days later of from complications of untreated Hodgkin’s lymphoma. (more…)

Posted in: Cancer, Ethics, Health Fraud, Herbs & Supplements, Legal, Politics and Regulation

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Plavinol and Other Natural Remedies for Diabetes: “Condimentary Medicine”?

Is this an effective medicine or a condiment?

Is this an effective medicine or a condiment?

We don’t yet have a cure for diabetes, but we have insulin; it controls the disease and allows Type 1 diabetics to lead a relatively normal life instead of suffering and quickly dying as they all did in the pre-insulin era. We know to counsel Type 2 diabetics about weight loss, diet, and exercise; and when those measures are not enough, we have prescription medications that work very well to control symptoms and help prevent complications.

For some people, that’s not good enough. They want to find “natural” remedies to supplement or replace conventional treatments. In a recent article on SBM, Scott Gavura quoted a pharmacy customer who said “I don’t want to take any drugs. Do you have something natural I can use to cut my blood sugar?” Scott went on to cover the questionable evidence for cinnamon in that article. Many other “natural” remedies have been proposed. Here’s an alphabetical list: acetyl L-carnitine, aloe, alpha-lipoic acid, banaba leaf (not banana!), basil, berberine, bilberry, biotin, bitter melon, cinnamon, chromium, coQ10, crepe myrtle, fenugreek, fish oil, fructo-oligosaccharides, green tea, ginseng, glucomannan, gymnema, hibiscus, Indian kino tree extract, magnesium, mistletoe, olive leaf, onion, psyllium, purslane, resveratrol, starch blockers, thiamine, vanadium, and vitamins. I compiled that list from just three websites; I’m sure there are many more natural remedies that I missed. These natural remedies have been recommended on the basis of rather shaky preliminary evidence that they lower blood sugar, usually by only a small amount. Even the CAM-friendly National Center for Complementary and Integrative Health (NCCIH) concluded:

There is not enough scientific evidence to suggest that any dietary supplements can help prevent or manage type 2 diabetes.

They also warn that “Some dietary supplements may have side effects, including interacting with your diabetes treatment or increasing your risk of kidney problems.” (more…)

Posted in: Herbs & Supplements

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Fixing the supplement market for consumers

vitamins and supplements

Unsubstantiated claims could be on their way out in Canada

When it comes to regulating and selling dietary supplements, should consumer interests be higher priority than those of manufacturers? While regulations are seemingly created to protect consumers, governments around the world have consistently given manufacturers the upper hand, prioritizing a company’s desire to sell a product over a consumer’s right to a marketplace with safe, effective products. Nowhere is this more the case than in Canada and the United States, where similar regulatory approaches have led to an industry boom and massive sales, but also a confusing marketplace for consumers and no persuasive evidence that all those supplements have any meaningful effects on our health. Drug store shelves in 2016 are packed with hundreds of products with unsubstantiated claims and untested products, and little credible information to guide selection. Since its beginnings, the contributors to this blog has been consistent in calling for more appropriate regulation: one that puts consumers first, not manufacturers, and evaluates all products (drugs, supplements or otherwise) with a consistent standard of science and evidence. Today, it looks like one regulator is preparing to move in that direction. Health Canada, Canada’s equivalent to the FDA, has proposed a new regulatory approach that is expected to block manufacturers from selling products with unsubstantiated and often misleading health claims. And they are asking for your input. Carly Weeks in The Globe and Mail writes: (more…)

Posted in: Herbs & Supplements, Politics and Regulation

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