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Archive for Herbs & Supplements

Red Yeast Rice and Cholesterol

While much of CAM is ridiculous or implausible, herbal remedies are an exception. Plants produce pharmacologically active substances; in fact, the science of pharmacology grew out of herbalism. Some herbal remedies have not been scientifically tested, but others have been tested and are clearly effective. Nevertheless, these are seldom if ever the best choice for treatment.

One natural remedy stands out. Red yeast rice has been tested and has been shown to lower cholesterol as well as a statin drug. That’s hardly surprising when you realize that it contains the exact same ingredient as the pharmaceutical drug lovastatin.

Only it doesn’t any more.
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The HCG Diet: Yet another ineffective quick fix diet plan and supplement

I contribute biweekly to Science-Based Medicine and could easily devote every post to writing about weight loss supplements, and never run out of topics. As soon as one quick fix falls out of favour, another inevitably replaces it. Some wax and wane in popularity. And pharmacies don’t help the situation. I cringe every time I walk down the aisle where weight loss products and kits are located. Detox? Hoodia? The “fat blaster”?  Here are pharmacists, well educated and perfectly positioned to provide good advice to consumers, but standing behind a wall of boxes with ridiculous weight loss promises.  Yet pharmacists tell me that these products are not only sought out by customers, but they actually sell well. It’s a lost opportunity to provide good advice, and consumers pay the price.

Perhaps because consumers associate these products with pharmacies, I get regular questions about weight loss programs. I end up developing some degree of familiarity with many of them, if only to be able to credibly redirect away from some of the more harmful plans and approaches. It’s that philosophy that I used recently when I was asked about how to best to manage a “plateau” on the HCG diet. I’d never dispensed human chorionic gonadotropin (HCG) before, but knew of its use for the treatment of infertility, where it promotes egg release. But weight loss? I couldn’t think of a mechanism for how HCG could promote weight loss. So I did some digging, and found a long, rich vein of pseudoscience that dates back decades. (more…)

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Oxygen Is Good, Even When It’s Not There

Note: This article originally appeared in Skeptical Inquirer, 28(1), 48-50 & 55, January/February 2004. I’m recycling it now because I have been at The Amazing Meeting in Las Vegas instead of home at my computer writing new posts. It’s still timely: despite multiple debunkings and FTC actions, vitamin O is still for sale. Amazon has it for $4.80 an ounce. I’m no Mark Crislip; but I like to think this article borders on the Crislipian. Enjoy!

 

Oxygen is not just in the air; it’s on the shelves. It has been discovered by alternative medicine and is being sold in various forms in the health supplement marketplace. Back when I was an intern, we used to joke that there were four basic rules of medicine: (1) Air goes in and out. (2) Blood goes round and round. (3) Oxygen is good. (4) Bleeding always stops.

Alternative medicine has latched on to rule number three and won’t let go. The rationale, apparently, is that oxygen is required to support life; therefore more oxygen should make you more healthy. It’s not clear how this relates to alternative medicine’s advice on anti-oxidants, but that’s irrelevant. OXYGEN IS GOOD, so we should put it in our soft drinks and breathe it at oxygen bars. Take an oxygen tank home with you — you might feel better. The oxygen vendor might feel better, too. Dr Andrew Weil, the renowned health guru, tells patients with chronic fatigue to ask their doctors to prescribe oxygen for a home trial. Sure, why not? The money it costs will literally vanish “into thin air,” but who cares? OXYGEN IS GOOD.

Ignore the fact that you could find out whether you need oxygen by testing your blood oxygen saturation with that little-clip-thingy-they-stick-on-your-finger-in-the-emergency-room (aka pulse oximeter). Who cares if your blood is fully saturated with oxygen already? OXYGEN IS GOOD. If your oxygen saturation is a little less than 100 percent, there is no evidence that raising it will help with anything. If it is a lot less, and you do need oxygen, any competent doctor should be able to figure that out. But try an oxygen tank anyway: OXYGEN IS GOOD. Is this starting to sound like a mantra? It should. This is religious belief I am talking about, not science. (more…)

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Why Do They Do Studies Like This?

A recently published study claims to have shown that a proprietary mixture of velvet bean and Chlorophytum borivilianum improves sleep quality. The journal, Integrative Medicine Insights, is online, peer-reviewed, PubMed indexed, open-access, and it charges authors $1848.00 to publish their article. It advertises editorial decisions in 3 weeks and publication in 2 weeks after acceptance. I can see two reasons why authors might be willing to pay that much for publication: to speed the process of getting important research results out to the public, or because their research is poor quality and they know it would be rejected by other journals.

The quality of this study is unfortunately typical of much of the research on alternative medicine.

Description of Study

The full text is available for download here.  The title is “A Dietary Supplement Containing Chlorophytum Borivilianum and Velvet Bean Improves Sleep Quality in Men and Women.” They gave a proprietary supplement mixture to 18 young healthy subjects with self-reported impairment of sleep quality (defined as routine difficulty falling asleep, waking more than twice during the night, and awaking in the morning feeling tired) and had them fill out a questionnaire about sleep quality before and after the trial. They also measured heart rate, blood pressure, CBC, metabolic panel, and lipid panels.
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Dr. Oz and Green Coffee Beans – More Weight Loss Pseudoscience

I can’t keep up with Dr. Oz. Just when I thought the latest weight loss miracle was raspberry ketone, along comes another weight loss panacea. This time, it’s green coffee beans.

Eveyone knows Dr. Oz, now. Formerly a guest on Oprah, he’s got his own show which he’s built into what’s probably the biggest platform for health pseudoscience and medical quackery on daytime television. In addition to promoting homeopathy, he’s hosted supplement marketer Joe Mercola several times to promote unproven supplements. He has been called out before for  promoting ridiculous diet plans, and giving bad advice to diabetics. And don’t forget his failed attempt to actually demonstrate some science on his show, when he tested apple juice for arsenic which prompted a letter from the FDA about his methodology.  His extensive track record of terrible health advice is your caution not to accept anything he suggests at face value. So when the sign in front of my local pharmacy started advertising “Green coffee beans – as seen on Dr. Oz”, I tracked down the clip in question. The last time I saw Dr. Oz in action when when he had SBM’s own Steven Novella as a guest, where there was actually a exchange (albeit brief) about the scientific evidence for alternative medicine. Replace Dr. Novella with a naturopath, and you get this: (more…)

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5-hour Energy

5-Hour_Energy

What should you do if you feel tired? Taking a nap isn’t always possible. The ever-inventive capitalist marketplace has come up with another option.

5-hour Energy is a flavored energy drink sold as 2 oz “shots.” It was invented by Innovation Ventures in 2004. It is intended to counteract the afternoon slump, to increase alertness and energy, to help you stay sharp, improve attention, leave grogginess behind and sail through your day.

Ingredients

According to the label, its ingredients are:

  • Niacin 30 mg — 150% of the RDA
  • Vitamin B6 40 mg — 2000% of the RDA
  • Folic acid 400 mg — 100% of the RDA
  • Vitamin B12 500 mcg — 8333% of the RDA
  • Energy blend: taurine, glucuronic acid, malic acid, N-acetyl L tyrosine, L-phenylalanine, caffeine, and citicoline. Total amount of blend: 1870 mg. The caffeine content is not specified on the label, but it is supposedly comparable to a cup of the leading premium coffee.

It contains only 4 calories, with no sugar. (more…)

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Quackademic medicine trickles out to community hospitals

One of the major themes of this blog has been to combat what I, borrowing a term coined (as far as I can tell) by Dr. R. W. Donnell, like to refer to as “quackademic medicine.” Quackademic medicine is a lovely term designed to summarize everything that is wrong with the increasing embrace of so-called “complementary and alternative medicine” (CAM) or, as it’s increasingly called now, “integrative medicine” (IM) into academic medical centers. CAM/IM now a required part of the curriculum in many medical schools, and increasingly medical schools and academic medical centers seem to be setting up IM centers and divisions and departments. Fueled by government sources, such as the National Center for Complementary and Alternative Medicine (NCCAM) and private sources, such as the Bravewell Collaborative (which has been covered extensively recently not just by me but by Kimball Atwood, Steve Novella, and Mark Crislip), academic medical centers are increasingly “normalizing” what was once rightly considered quackery, hence the term “quackademic medicine.” The result over the last 20 years has been dramatic, so much so that even bastions of what were once completely hard-core in their insistence on basing medicine in science can embrace naturopathy, Rudolf Steiner’s anthroposophic medicine, reiki and other forms of “energy healing,” traditional Chinese medicine, and even homeopathy, all apparently in a quest to keep the customer satisfied.

Of course, in a way, academia is rather late to the party. CAM has been showing up in clinics, shops, and malls for quite a while now. For example, when I recently traveled to Scottsdale to attend the annual meeting of the American Society of Breast Surgeons, I happened to stop in a mall looking for a quick meal at a food court and saw this:

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POM: Not So Wonderful

“POM Wonderful” is a brand of pomegranate juice. It is manufactured by a company owned by Linda and Stewart Resnick, California billionaires who pretty much single-handedly created a multi-million dollar market for pomegranate juice where none existed before. Or, as LA Times columnist Michael Hilzik wrote,

It has long been clear that the most wonderful thing about Pom Wonderful pomegranate juice is the spectacular marketing skill that persuades consumers to fork over their hard-earned cash for a liquid that sells for five to six times the price of, oh, cranberry juice.

He’s right about the expense: a daily 8 oz. dose of POM Wonderful juice costs about $780 annually according to a recent Federal Trade Commission case, which we’ll get to soon.

The Resnicks parlayed their success selling pomegranate juice into two additional products, both dietary supplements, in the form of POMx pills and POMx liquid. The Resnicks and their companies have shelled out $35 million in sponsored research to determine what health benefits might arise from ingesting pomegranate juice or its components, research they have not been shy about using in touting their products. The couple apparently has a flair for taking the mundane and making it appear, well, wonderful to the consumer – they also own Fiji Water and the Franklin Mint, among other business interests.

In 2010, the Federal Trade Commission (FTC) filed a complaint against Resnicks, one of their business partners, and two of their companies (which I’ll refer to collectively as “POM”), alleging unfair and deceptive trade practices. POM, according to the FTC complaint, made false and misleading claims that its POM products treat, prevent, and reduce the risk of heart disease, prostate cancer and erectile dysfunction.

An Administrative Law Judge (ALJ) agreed with the FTC and on May 17, 2012, issued a 335-page decision and cease and desist order, ruling POM lacked competent and reliable scientific evidence that drinking 8 ounces of POM Wonderful Juice daily, or taking one POMx pill, or one teaspoon of POMx liquid, treats, prevents or reduces the risk of heart disease, prostate cancer, or erectile dysfunction. In the Matter of POM Wonderful, LLC, et al., F.T.C. No. 9344 (May 17, 2012).

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Reporting Preliminary Findings

While scanning through recent science press releases I came across an interesting study looking at the use of a pharmaceutical grade antioxidant, N-Acetylcysteine (NAC), in the treatment of certain symptoms of autism. This is a small pilot study, but it did have a double-blind placebo controlled design. The press release reports:

During the 12-week trial, NAC treatment decreased irritability scores from 13.1 to 7.2 on the Aberrant Behavior Checklist, a widely used clinical scale for assessing irritability. The change is not as large as that seen in children taking antipsychotics. “But this is still a potentially valuable tool to have before jumping on these big guns,” Hardan said.

But concluded:

“This was a pilot study,” Hardan said. “Final conclusions cannot be made before we do a larger trial.”

I also noticed that two of the authors list significant conflicts of interest – patents on the use of NAC, and one has equity in the company that makes it.  It occurred to me that a larger question than the efficacy of NAC for these autism symptoms is this – if this is a pilot study only and we should not base any firm conclusions on the results, then why the press release?

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Bee Pollen Supplements – Not Safe or Effective

Among the myriad of supplements being offered to the public are various bee products, including bee pollen. The claims made for bee pollen supplements are typically over-hyped and evidence-free, as is typical of this poorly regulated industry. The claims from bee-pollen-supplements.com are representative:

The benefits are enormous and the substance has been proven by many health experts. This particular substance is known as an effective immune booster and one of the best ways to achieve a sound nutritional regime.

The pollen from the bee has been proven to increase sexual functions in both men and women. It stimulates our organs, as well as our glands and is known to improve the natural increase on a person’s lifespan.

What you never find on such websites are references to published peer-reviewed studies that substantiate the specific claims being made. There are also concerns about safety which have not been adequately studied.

Safety

A recent case report highlights one safety concern regarding bee pollen products – allergic and even anaphylactic reactions. The Canadian Medical Association Journal reports:

A 30-year-old woman with seasonal allergies but no history of allergies to food, drugs, insects or latex had an anaphylactic reaction after taking bee pollen. She had swelling of the eyelids, lips and throat, difficulty swallowing, hives and other life-threatening symptoms. After emergency treatment and discontinuation of the bee pollen supplements, there were no further reactions.

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