Tag Archives: snake oil

Jellyfish Memory Supplement Prevagen Is A “Clear-Cut Fraud” According To The FTC: Stop Buying This And Other Useless Brain Supplements

A JAMA viewpoint article entitled “The Rise of Pseudomedicine for Dementia and Brain Health ” caught my eye recently and I immediately thought of the widely advertised,  jellyfish-derived and totally useless supplement,  Prevagen.

The  article, written by three prominent neurologists and dementia researchers at UC San Francisco, discusses the lack of science behind the $3.2 billion  industry promoting unproven supplements for improved cognition and  brain health.

Unproven supplements like Prevagen (made from jellyfish! and with a hard to pronounce crucial ingredient!) utilize a facade of “proven benefits” and succeed by promoting themselves as science-backed on radio, television and the internet.

The JAMA articles notes that this industry thrives due to the increasing prevalence of Alzheimer’s disease, and it’s lack of effective treatments.

Consumers, it goes on to say,  who are intent on finding methods to prevent dementia need to know three things:

  1. There is no known dietary supplement that prevents cognitive decline for dementia,.
  2. Supplements do not undergo FDA testing for safety or review for effiacy.
  3. Some supplements may cause harm. For example, Vitamine E-increases risk of hemorrhagic stroke and in high doses, increase risk of death.

The Facade of Science-Backed Research.

Companies like Quincy Bioscience, the maker of Prevagen,  utilize sophisticated techniques that supply false scientific backing for brain health interventions.

The website for Prevagen states “prevagen improves memory” and “has been clinically shown to help with mild memory loss associated with aging.”

A tab promises to show the research behind this claim:

As the JAMA articled pointed out, these bogus brain supplement companies quote scientific articles which appear valid yet lack essential  features such as “sufficient participant characterization, treatment randomization and fail to include limitations.”  These bad papers are often published in predatory open access journals.

In the case of Prevagen, despite marketing which includes “The Science Behind Prevagen” there isn’t even a single study published  in the peer-reviewed scientific literature, predatory or otherwise.

If you click on the “view the study” link  you will be taken to a PDF of the “Madison Memory Study” which is a study sponsored by Quincy Bioscience, performed by an employee of Quincy Bioscience and published in house by Quincy Bioscience.

In the world of real science, this type of study is ignored and considered extremely preliminary until it is reproduced by a reputable unbiased  scientific lab and published in a peer-reviewed journal. The chances for biased results are way too high to trust.

FTC Files Suit Against Quincy Bioscience

According to the Federal Trade Commission (FTC), which charged Quincy Bioscience with false and deceptive advertising in 2017, the initial version of this company study found that Prevagen was no more effective than a placebo at improving any of the nine cognitive skills, including memory, that the company measured.

“The marketing for Prevagen is a clear-cut fraud, from the label on the bottle to the ads airing across the country,” said New York Attorney General Eric Schneiderman. “It’s particularly unacceptable that this company has targeted vulnerable citizens like seniors in its advertising for a product that costs more than a week’s groceries, but provides none of the health benefits that it claims.”

“The marketers of Prevagen preyed on the fears of older consumers experiencing age-related memory loss,” said Jessica Rich, director of the FTC’s Bureau of Consumer Protection. “But one critical thing these marketers forgot is that their claims need to be backed up by real scientific evidence.”

The suit seeks to fine Quincy and force it to pay back consumers who bought the pills

Since then Quincy went back and “re-analyzed” their in-house data coming up with 3  parameters that improved and challenging the FTC in court. This process is called p-hacking and any significant findings gathered through this process are highly suspect.

A great article on the Prevagen case from the McGill University Office  of Science and Society summarizes the problems with this re-analysis.

This is an after-the-fact, unplanned exploration of the data to see if anything else of interest happened in the trial. Some might call it a fishing expedition. Scientists do this all the time, but with a big caveat: post hoc results are considered tentative, not conclusive. Before they’re accepted as valid outcomes, they need to be confirmed by additional studies.

That’s because random events happen all the time in scientific studies. Some of them may seem statistically significant, but they’re flukes and not the result of cause-and-effect.  And the more post hoc analyses you do (like the more than 30 Quincy Bioscience did), the more likely you’ll encounter these chance results.

Scientists guard against accepting them as real by setting a high bar for statistical significance and by not accepting post hoc findings until they’ve been tested again.

Despite the total lack of proven efficacy and the  lawsuit  by the FTC the company continues to heavily market Prevagen and reap millions of dollars in profits from the gullible. Prevagen is sold at the pharmacies of the companies below which should immediately remove this snake oil if their aim is to help consumers.

 

 

Anamnestically Yours,

-ACP

For more in-depth analysis see below.

Jann Bellamy at Science-Based Medicine delves deeply into the case and cases against Prevagen in “Prevagen goes P-hacking.

Prevagen goes P-hacking

And see here for the McGill University office of Science and Society: Separating Sense From Nonsense

Why Stem Cell Injections For Arthritis Are Snake Oil

The skeptical cardiologist has had a few patients undergo stem cell injections for knee osteoarthritis. My sense based on a brief look at the literature in this area was that these stem cell clinics were unproven and over-priced. They typically cost 5 or 6 thousand dollars an injection, are minimally effective (no better than placebo injections), and are not covered by insurance.

I felt compelled to research the area more deeply when I discovered that Ozzie Smith, the Hall of Fame former Cardinal shortstop, had his name attached to a stem cell clinic in St. Louis and actively promoted it on their website. Ozzie, heretofore, my favorite Cardinal, auctioned off  his 13  Gold Gloves and 11 All-Star Game rings in 2012 and now, sadly, is lending his name to a shady area of pseudoscientific medicine.

In the course of my research I came across an incredibly detailed well-written and researched article posted on John Byrne, MD’s Skeptical Medicine website entitled Dubious Stem Cell Clinics.

After reading Byrne’s article I realized that there was no purpose in proceeding any further with my own research-this is what I would post if I had the requisite time, intelligence and skill-so I hope all will read the original.


Byrne notes that although  stem cell treatment is being investigated for all kinds of conditions

, as of 2018, the only legitimate stem cell treatments used in clinical practice are in bone marrow transplantation, burn treatment, bone grafting in orthopedics and corneal generation from limbal stem cells in ophthalmology. And of those, only bone marrow transplantation in cancer patients has a consensus from large scale clinical trials. There currently are no other legitimate treatments that are warranted for general use by current science. We simply are not at that level.

Despite Ozzie Smith’s ringing endorsements there is no evidence for  any benefit of orthopedic stem cell injections or PRP injections, another unproven treatment offered at the Ozzie Smith IMAC Regenerative Center

Experts in the field of stem cell therapy who are not out to make a quick buck are pretty unanimous in this assessment as Byrne notes:

George Daley, MD, PhD, a member of the Harvard Stem Cell Institute’s executive committee and past president of the International Society for Stem Cell Research, added,

“we are seeing a growing number [of legitimate clinical trials] but all such uses are experimental … and there is great skepticism as to whether we have” the scientific knowledge and basis even to “predict that these will be effective.” “It may,” he said, “take decades before there is certainty.” “The only stem cell therapies that have been proven safe and effective,” he said, “are those constituting what is known as bone marrow transplantation for treatment of some cancers.”

However, such limitations do not prevent contemporary snake-oil salesmen from selling dubious treatments to desperate people by making unwarranted claims about stem cell therapies. “Stem Cell” is the new “Magnetic” and “Quantum” in the world of quackery.As with many scams, it is sold using “sciency” words and riding on the coattails of legitimate science.

“Like snake oil salesmen, clinics claiming astonishing curative results from stem cell treatments often do not have licensed physicians administrating the treatments, no scientific evidence supporting their work, and they rely on testimonials for advertising and promoting the value of their product.” 

Byrne goes on to give the history of stem cells, discuss the types of stem cells and why translation of their promise to clinical results has been slow.
In a fascinating section he compares the hijacking of “quantum” for use by pseudoscience peddlers to the hijacking of “stem cell.”

With the promise of what sounds like a magic technology, these clinics offer treatments for conditions across a wide range including orthopedics, pain management, neurologic problems, immune diseases, respiratory diseases, urologic, sexual, cosmetic, cardiovascular and dermatologic disorders. They advertise treatments for aging, diabetes, hair loss, muscular dystrophy, vision problems, gastrointestinal disorders, Alzheimer’s and autism.

Products are on sale now promoting magical-sounding claims of skin rejuvenation with the words “stem cell” attached to their names. Many products promote plant-based stem cell creams (yes, you read that correctly). One company’s advertisement claims, “(our) cutting edge technology brings an innovative anti-aging skin care line. Plant stem cells are the source of unlimited energy and the key to herbal growth and regeneration”.

I found this paragraph to be spot on in describing the techniques of the modern snake-oil salesman and worthy of noting:

Many sites use the language of pseudoscience to make specific-sounding claims, but in reality, are vacuous. Motor City StemCell claims that their products “Control the immune system”, “regulate inflammation” and “provide trophic support”. The operative words here are “control”, “regulate”, and “supports”. Skeptics recognize these as “weasel words”. They do not make specific claims for which the claimants may be held to account. Other weasel words include “boosts” and “enhances”.

When such words are used, often they are accompanied by the Quack Miranda Warning:

“These statement(s) have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.” 
The tactics of selling snake oil have become sophisticated over the years, but the overall strategy has remained the same. Find vulnerable customers (“marks”); make bold claims of a “cure for everything”; claim 100% safety and efficacy; use sciency-sounding technobabble; point to legitimate research as if it supports your claims; promote testimonials from happy customers; charge high fees for unproven or implausible
products and services; attack your critics as being closed minded, or in the pocket of “Big Pharma”; repeat.
Based on my  own research into this area  I totally agree with Byrne’s conclusion
Stem Cell research is a promising field. There may be a day in the future in which there are many disorders that can be effectively and safely treated with stem cell therapy. That day is not here yet.

 

However, we currently have many clinics across the world offering treatments under the guise of “Stem Cell Therapy”. Their claims go well beyond the current science and are therefore not justified. These treatments are not regulated or endorsed by agencies such as the FDA. The consumer will pay large sums of money — tens or hundreds of thousands of dollars — to receive unproven, unregulated “treatments” at their own expense, often under the guise of a “clinical trial”. No legitimate research organization charges participants to participate in clinical trials.

These treatments have unknown risks and unproven benefits. They are marketed with fancy websites, testimonials and expensive dinner seminars by providers — some of whom are actual MD’s or DO’s and should know better — with no regard to scientific standards or ethics. They will use scientific-style jargon and promise miraculous cures for just about anything that ails you. This is a scam.


Yes, indeed this is a scam. And we will have to add some of these attributes to my #1 red flag of quackery.
Weasel words and the Quack Miranda Statement are definitely highly specific markers for quack web health sites.
Protrophicly Yours,
-ACP

Quackery Promotion By Mainstream Media: Part I, Reader’s Digest and Naturopathy

As the skeptical cardiologist surveys the heart health information available to his patients and the lay public, he sees two broad categories of misinformation.

First we have the quacks and snake oil salesman. These are primarily characterized by a goal of selling more of their useless stuff online.

I’ve described this as the #1 red flag of quackery. Usually I’m inspired to investigate these charlatans because a patient asks me about one of their useless supplements.

The second category is more insidious: the magazine or internet news site seems to have as its legitimate goal, promoting the health of its readers. There is no clear connection to a product.

Web MD, which I wrote about here, is an example of this second type.  Hard copy versions of these types of media frequently make it into doctor’s waiting rooms: not because doctor’s have read and approved what is in them. These companies send their useless and misleading magazines for free to doctor’s offices, and the staff believe it to be legitimate.

How does glaringly inaccurate and often dangerous information get into media that ostensibly has as its goal promoting its readers health? Most likely, it is a result of media’s need  to constantly produce new and interesting ways for readers to improve their health.

Clearly, readers will not continue subscribing, clicking and reading such sources of information if there isn’t something new and exciting that might prolong their lives: gimmicks, miracles cures, and “natural” remedies are more alluring than the well-known advice to exercise more, watch your weight, stop smoking and get a good night’s sleep.

Reader’s Digest and Stealth Quackery

A patient recently brought in a printout of Reader’s Digest’s “40 things cardiologists do to protect their heart” which is typical of the second category.

Reader’s Digest was a staple of my childhood. My parents subscribed to it consistently and I would read parts of it. It was small and enticing. Allegedly its articles were crafted so that they could be read in their entirety during a session in the bathroom.

To this day it has a wide circulation. Per Wikipedia”

The magazine was founded in 1920, by DeWitt Wallace and Lila Bell Wallace. For many years, Reader’s Digest was the best-selling consumer magazine in the United States; it lost the distinction in 2009 to Better Homes and Gardens. According to Mediamark Research (2006), Reader’s Digest reaches more readers with household incomes of $100,000+ than Fortune, The Wall Street Journal, Business Week, and Inc. combined.[2]

Global editions of Reader’s Digest reach an additional 40 million people in more than 70 countries, via 49 editions in 21 languages. The periodical has a global circulation of 10.5 million, making it the largest paid circulation magazine in the world.

Reader’s Digest used to run a recurring educational feature on the various body parts and organs of Joe and Jane which intrigued me.

Here’s the first paragraph of “I am Joe’s heart:”

I am certainly no beauty. I weigh 340 grams, am red-brown in color and have an unimpressive shape. I am the dedicated slave of Joe. I am Joe’s heart.

The health information in this series was generally accurate but the presentation lacks the kind of sizzle that apparently attracts today’s readers.

The article my patient brought to my attention is typical of the mix of good and bad information and fluff that mainstream media can produce to attract followers:

Not So Bad But Not Clearly True Medical Advice

#1. I keep a gratitude journal. An internist “at NYU” is quoted as saying: “Studies have recently shown that expressing gratitude may have a significant positive impact on heart health.”

Fact Check: following the links provided provides no evidence to support this claim.

#2  I get 8 hours of sleep a night, every night.  This cardiologist seems to have been misquoted, because her comment is actually “getting a good night sleep is essential. I make a point of getting seven to eight hours of sleep every night…Poor sleep is linked to higher blood pressure.”

Fact Check. One review noted that:

Too little or too much sleep are associated with adverse health outcomes, including total mortality, type 2 diabetes, hypertensionand respiratory disorders, obesity in both children and adults, and poor self-rated health.

Another broke down mortality according to number of hours of sleep.

A J-shaped association between sleep duration and all-cause mortality was present: compared with 7 h of sleep (reference for 24-h sleep duration), both shortened and prolonged sleep durations were associated with increased risk of all-cause mortality (4 h: relative risk [RR] = 1.05; 95% confidence interval [CI] = 1.02–1.07; 5 h: RR = 1.06; 95% CI = 1.03–1.09; 6 h: RR = 1.04; 95% CI = 1.03–1.06; 8 h: RR = 1.03; 95% CI = 1.02–1.05; 9 h: RR = 1.13; 95% CI = 1.10–1.16; 10 h: RR = 1.25; 95% CI = 1.22–1.28; 11 h: RR = 1.38; 95% CI = 1.33–1.44; n = 29; P < 0.01 for non-linear test)

Thus, in comparison to those who sleep 7 hours, those who sleep 5 hours have a 5% increase in mortality and those who sleep 11 hours have a 38% increase in mortality.

These data are based entirely on observational studies so it is impossible to know if the shortened sleep is responsible for the increased mortality or if some other (confounding) factor is causing both.

My advice: Some people do fine with 6 hours and 45 minutes of sleep. Some require 8 hours 15 minutes for optimal function. Rather than obsessing about getting a specific amount of sleep time, it makes more sense to find our through your own careful observations what sleep time works best for you and adjust your schedule and night time patterns accordingly.

#3. I do CrossFit.

Fact Check. There is nothing to support CrossFit as more heart healthy than regular aerobic exercise (which the vast majority of cardiologists recommend and perform).

#4. I meditate. “Negative thoughts and feelings of sadness can be detrimental to the heart. Stress can cause catecholamine release that can lead to heart failure and heart attacks.”

Fact Check. There is a general consensus that stress has adverse consequences for the cardiovascular system. Evidence of meditation improving cardiovascular outcomes is very weak.

A recent review

Participation in meditation practices has been shown to reduce depression, anxiety, and negative mood and thus may have an indirect positive effect on CV health and well-being. This possibility has led the American Heart Association to classify TM as a class IIb, level of evidence B alternative approach to lowering BP.32

Non randomized, non blinded studies with small numbers of participants have suggested a reduction in CV death in those performing regular TM.

However, we need better and larger studies before concluding there is a definite benefit compared to optimal medical therapy.

Thus far, the recommendations have been pretty mundane: exercise, stress reduction and a good night’s sleep is good advice for all, thus boring.

Seriously Bad Advice From Quacks Mixed In With Reasonable Advice

In order to keep reader’s interest (and reach 45 things) Reader’s Digest is going to need to add seriously bad advice.

My patient had circled #34. “I mix magnesium powder into my water. If sufficient magnesium is present in the body, cholesterol will not be produced in excess.”

This bizarre and totally unsubstantiated practice was recommended by Carolyn Dean MD, ND.

What do we know about Dr. Dean?

-She was declared unfit to practice medicine and her registration revoked by the College of Physicians and Surgeons of Ontario in 1995. From quackwatch.org :

  • After being notified in 1993 that a disciplinary hearing would be held, Dean relocated to New York and did not contest the charges against her.
  • Dean had used unscientific methods of testing such as hair analysis, Vega and Interro testing, iridology and reflexology as well as treatment not medically indicated and of unproven value, such as homeopathy, colonic irrigations, coffee enemas, and rotation diets.

-The initials after her name (ND, doctor of naturopathy) should be considered the second red flag of quackery. See quackwatch.org (here) and rational wiki (here) and the confessions of a former naturopath  (here ) for discussions of naturopathy. As noted at science-based medicine:

Naturopathy is a cornucopia of almost every quackery you can think of. Be it homeopathy, traditional Chinese medicine, Ayurvedic medicine, applied kinesiology, anthroposophical medicine, reflexology, craniosacral therapy, Bowen Technique, and pretty much any other form of unscientific or prescientific medicine that you can imagine, it’s hard to think of a single form of pseudoscientific medicine and quackery that naturopathy doesn’t embrace or at least tolerate.

-She has a website (Dr. Carolyn Dean, MD,ND, The Doctor of The Future) where she incessantly promotes magnesium as the cure for all ills.

-She has written a book called “The Magnesium Miracle” (hmm. wonder what that’s about).

-She sells her own (really special!) type of magnesium (see red flag #1 of quackery).

-She writes for the Huffington Post (I’m considering making this a red flag of quackery).

-She is on the medical advisory board of the Nutritional Magnesium Association (an organization devoted to hyping magnesium as the cure for all ills and featuring all manner of magnesium quacks).

Prevention Magazine 

Reader’s Digest is not alone in allowing the advice of pseudoscience practitioners to stand side by side with legitimate sources.

For example, Prevention Magazine in its August 2017 issue highlights “35 All-Time Favorite Natural Remedies” with the subheading

“Go ahead, try them at home: Experts swear by these nondrug cures for back pain, nausea, hot flashes, and other common ailments.”

Who are these “experts”? Let the reader beware because the first quote comes from “Amy Rothenberg, past president of the Massachusetts Society of Naturopathic Doctors.”

Finding The Truth

It’s getting harder and harder for the lay public to sort out real from fake health stories and advice.

When seemingly legitimate news media and widely followed sources like Reader’s Digest and Prevention Magazine  either consciously or inadvertently promote quackery, the truth becomes even more illusive.

Readers should avoid any source of information which

  1. Profits from selling vitamins and supplements.
  2. Utilizes or promotes  naturopaths or other obvious quacks as experts in health advice.

IamJoesfootingly Yours,

-ACP

How To Spot a Quack Health Site: Red Flag #1, Primary Goal Is Selling Supplements

During the process of compiling the Cardiology Quackery Hall of Shame, the skeptical cardiologist has recognized that the #1 red flag of quackery is the constant promotion of useless supplements.

Such supplements typically:

-consist of “natural” ingredients

-are a proprietary blend of ingredients or a uniquely prepared single ingredient, and are only available through the quack

-have thousands of individuals who have had dramatic improvement on the supplement and enthusiastically record their testimonial to its power

-have no scientific support of efficacy or safety

-despite the lack of scientific data, the quack is able to list a series of seemingly valid supportive “studies”

-aren’t checked by the FDA

-apparently cure everything from heart disease to lassitude

I received an email today from a reader complimenting me on my post on the lack of science behind Dr. Esselstyn’s plant-based diet. The writer thought I would be interested in the work of a  Dr. Gundry.

I found on Dr. Gundry’s website an immediate and aggressive attempt to sell lots of supplements with features similar to what I describe above.

Dr. Gundry’s bio states “I left my former position at California’s Loma Linda University Medical Center, and founded The Center for Restorative Medicine. I have spent the last 14 years studying the human microbiome – and developing the principles of Holobiotics that have since changed the lives of countless men and women.”

Need I mention that “holobiotics” is (?are) not real.

Bonohibotically Yours,

-ACP

After writing this, I googled “red flag of quackery” images in the foolish hope that I might find a useable image. Lo and behold the image I featured in this post turned up courtesy of sci-ence.org. Here it is in all its glory, courtesy of Maki

2012-01-09-redflags2-682x1024

 

 

 

Snake Oil Du Jour: Turmeric

Part I of the skeptical cardiologist’s intermittent efforts at exposing the dark underbelly of the “superfood” snake oil parade deals with turmeric.

This key ingredienet of curry, has been seized upon by the useless and dangerous supplement/vitamin/nutraceutical industry recently and a patient asked me if he should take it.

A Google search yields overblown titles such as

-The amazing health benefits of turmeric  (MNN.com, a bogus website)

-6 Health benefits of Turmeric (Huffington Post, the health portion of which is full of hucksters)

-10 Proven Health Benefits of Turmeric and Curcumin (authoritynutrition.com, a bogus nutrition website)

-7 Powerful Turmeric Health Benefits and Side Effects (DrAxe.com, a bogus health website)

As I started researching turmeric I came across an outstanding summary of the topic on science-based medicine by Harriet Hall. I stopped the research and decided I would just put a link to that blog post on my site but never get around to it.

Today, however, another patient told me he was taking turmeric.

Consequently, I’m posting Harriet Hall’s article below in its entirety.

Turmeric: Tasty in Curry, Questionable as Medicine « Science-Based Medicine.

turmericA correspondent asked me to look into the science behind the health claims for turmeric. He had encountered medical professionals “trying to pass turmeric as some sort of magical herb to cure us from the ‘post-industrial chemical apocalypse.’” It is recommended by the usual promoters of CAM: Oz, Weil, Mercola, and the Health Ranger (who conveniently sells his own superior product, Turmeric Gold liquid extract for $17 an ounce).

Turmeric (Cucurma longa) is a plant in the ginger family that is native to southeast India. It is also known as curcumin. The rhizomes are ground into an orange-yellow powder that is used as a spice in Indian cuisine. It has traditionally been used in folk medicine for various indications; and it has now become popular in alternative medicine circles, where it is claimed to be effective in treating a broad spectrum of diseases including cancer, Alzheimer’s, arthritis, and diabetes. One website claims science has proven it to be as effective as 14 drugs, including statins like Lipitor, corticosteroids, antidepressants like Prozac, anti-inflammatories like aspirin and ibuprofen, the chemotherapy drug oxaliplatin, and the diabetes drug metformin. I wish those claims were true, because turmeric is far less expensive and probably much safer than prescription drugs. It clearly has some interesting properties, but the claims go far beyond the actual evidence.

The Natural Medicines Comprehensive Database has reviewed all the available scientific studies and has concluded that it is “Likely Safe,” “Possibly Effective” for dyspepsia and osteoarthritis, and “Insufficient Reliable Evidence” to rate effectiveness for other indications, such as Alzheimer’s, anterior uveitis, colorectal cancer, rheumatoid arthritis, and skin cancer.

Mechanism of action

The “14 drugs” website says turmeric is one of the most thoroughly researched plants ever, with 5,600 peer-reviewed studies, 175 distinct beneficial physiological effects, and 600 potential preventive and therapeutic applications. They provide a database of 1,585 hyperlinks to turmeric abstracts. Naturally I can’t read all of them, but a sampling indicates that they are almost entirely animal and in vitro studies. The NMCD has conveniently provided a list of the most pertinent studies.

The pertinent preclinical studies, in animal models and in vitro, indicate that curcumin has anti-inflammatory properties; can induce apoptosis in cancer cells and may inhibit angiogenesis; has antithrombotic effects; can decrease the amyloid plaque associated with Alzheimer’s; has some activity against bacteria, Leishmania, HIV; etc. These effects sound promising, but animal studies and in vitro studies may not be applicable to humans. As Rose Shapiro pointed out in her book Suckers, you can kill cancer cells in a Petri dish with a flame thrower or bleach. Preclinical studies must always be followed by clinical studies in humans before we can make any recommendations to patients.

Preliminary clinical research

There are preliminary pilot studies in humans suggesting that:

Clinical research on turmeric is being funded by the National Center for Complementary and Alternative Medicine (NCCAM), but the NCCAM website is not very encouraging. Under the section What the Science Says, it reads:

  • There is little reliable evidence to support the use of turmeric for any health condition because few clinical trials have been conducted.
  • Preliminary findings from animal and other laboratory studies suggest that a chemical found in turmeric—called curcumin—may have anti-inflammatory, anticancer, and antioxidant properties, but these findings have not been confirmed in people.
  • NCCAM-funded investigators have studied the active chemicals in turmeric and their effects—particularly anti-inflammatory effects—in human cells to better understand how turmeric might be used for health purposes. NCCAM is also funding basic research studies on the potential role of turmeric in preventing acute respiratory distress syndrome, liver cancer, and post-menopausal osteoporosis.

Side effects

Turmeric is generally considered safe, but high doses have caused indigestion, nausea, vomiting, reflux, diarrhea, liver problems, and worsening of gallbladder disease. The NMCD warns that it may interact with anticoagulants and antiplatelet drugs to increase the risk of bleeding, that it should be used with caution in patients with gallstones or gallbladder disease and in patients with gastroesophageal reflux disease, and that it should be discontinued at least 2 weeks before elective surgery. Purchasers of supplements are not given that information.

Conclusion

The “14 drugs” website recommends that everyone:

use certified organic (non-irradiated) turmeric in lower culinary doses on a daily basis so that heroic doses won’t be necessary later in life after a serious disease sets in.

There is no evidence to support any part of that recommendation. And the scientific evidence for turmeric is insufficient to incorporate it into medical practice. As with so many supplements, the hype has gone way beyond the actual evidence. There are some promising hints that it may be useful, but there are plenty of promising hints that lots of other things “may” be useful too. Since I have no rational basis for choosing one over another, I see no reason to jump on the turmeric bandwagon. On the other hand, I see no compelling reason to advise people not to use it, as long as they understand the state of the evidence well enough to provide informed consent and know that they are essentially guinea pigs in an uncontrolled experiment that makes no attempt to collect data. I will keep an open mind and stay tuned for further evidence in the form of well-designed clinical studies in humans.

So, the bottom line on turmeric, our “snake-oil du jour” is

-there is nothing to support its use for any health condition

-potential dangerous side effects

-interacts with legitimate prescription meds

-crucial ingredient in curry

My advice-DONT”T TAKE IT!

Gostephencurryily yours,

-ACP

WebMD: Purveyor of Bad Health Information And Snake Oil

Part of my motivation for writing this blog is to provide a source for reliable cardiovascular health information patients can access online.

It’s not easy to get reliable health information and even media organizations that might normally be perceived as trustworthy are often corrupted, inaccurate and potentially dangerous to patients.

WebMD is such an organization.

WebMD’s motto is  WebMD – Better information. Better health..

A stack of magazines produced by WebMD appeared on my office desk for some reason recently and I decided to look closely at what might be sitting in my patient waiting room amongst the 5 year old Architectural Digests and Car and Driver magazines.

I think it is particularly important to closely vet any health advice magazine that appears in the waiting room because our patient’s will assume we agree  with what is within the pages.

First off, recognize that this magazine, like most health magazines exists primarily to serve as an advertising vehicle: by my count 48 out of its 92 pages are ads of one sort or another.

Dominated by Direct-To-Consumer Advertisements

A lot of these ads are direct to consumer (DTC) ads for expensive and/or new medicatons that doctors apparently haven’t recognized the value of. There are new diabetic medications, new multiple sclerosis medications, new weight loss pills and new asthma inhaler medications guaranteed to cost more than the ones your doctor currently has you on.

For example, the weight loss drug, Belviq, helped increase the number of obese individuals  who were able to lose 5% of their body weight. However, before you take it you might want to read the page which lists  the  potentially serious adverse effects which include:

  • valvular heart disease
  • slowing your thinking
  • hallucinations
  • depression/suicide
  • slow heart beat

Also, be aware this is a federally controlled substance because it may lead to abuse or drug dependence.

There are even DTC ads for medications that treat diseases I have never heard of.  Take Nuvigil (armodafinil) which Teva is promoting for Shift Work Disorder. “Take Note:” the headline announces “excessive sleepiness due to shift work disorder may be burning out your wakefulness.”

We can debate the value of DTC advertising but at least the big Pharma DTC ads are promoting medications approved by the FDA.

This is not the case for the majority of products being advertised in the Web MD magazine. The vast majority of ads are for useless and ineffective snake oil products.

Snake Oil Ads

First out of the snake oil box: Sambucol black elderberry extract, promoted for “immune support.” A recent review of this stuff concluded that more studies were needed before concluding that it had any benefit on reducing flu duration.

Second up: Zyflamend, “Discover an herbal approach to pain relief after exercise:”Ten pure herbs, One potent formula. ” I’m not sure why they picked “pain relief after exercise” as their target here, the compound has not been shown to treat anything. New Chapter, the purveyor of this uselessness promotes a wide variety of snake oil supplements along with fish oil, the mainstream snake oil.

Next snake oil contender:ZZquil:Sleep Like You Got Upgraded. The non-habit forming sleep aid.ZZquil contains diphenhydramine (benadryl) a sedating antihistamine. There’s no reason to buy this forulation of benhydramine. If you feel the need to sedate yourself with a relatively benign drug, just buy generic diphenhydramine pills. Try 25 to 50 mg which cost less than 5 cents a pill.. Put the container back in the medicine cabinet when you’re done and you will have it available next time, unlike the ZZquil which you are bound to throw out after a while,.

Meaningless Celebrity Fluff Articles, Inaccurate Diet and Fitness Blurbs

The only significant original content in the magazine is  two celebrity fluff articles: one on the shoulder injury of NBA player Kevin Love, the other an interview with Olivia Munn (“We talk to the actor about her versatility and how she learned self-acceptance”)

In between the DTC ads and the snake oil ads are one-page blurbs full of misinformation on weight loss, fitness, and diet.

Screen Shot 2016-02-07 at 6.32.29 AM For example, the fitness blurb takes recommendations from a celebrity fitness trainer which seems to emphasize doing Burpees or Burpee-like activities a potentially dangerous activity I have discussed  here.

Screen Shot 2016-02-07 at 6.34.12 AMThe crowning achievement of this “magazine” has to be the heart health quiz which asks the question if men or women have a higher risk of heart attack and gives the wrong answer.

The scientifically accurate answer is that men  have a much higher risk of heart attack or risk at any given age than women.

 

 

After encountering this horribly inaccurate quiz I was entering intoIMG_6140 male asdvd
my ASCVD risk calculator app, the numbers
for a 69 year old female patient I was seeing. Her 10 year risk for heart attack and stroke was 7.9%. When I changed the gender parameter to male, the risk jumped to 15.2%.

Basically, for any set of risk parameters, if you enter male versus female, the 10 year risk of heart attack and stroke nearly doubles.

Thus, WebMD, the magazine,  is a useless and potentially harmful combination of:

  • DTC ads promoting expensive, marginally beneficial medications
  • Snake oil products with no benefit and potential risk
  • Celebrity fluff pieces with no useful medical information
  • Brief, often inaccurate blurbs on diet, exercise, weight loss.

This magazine, although free, should not be in doctor’s waiting rooms.

Given this production from WebMD I would also advise patients to avoid the WEbMD website as it cannot be considered  a trusted source of medical information and, like the print format, primarily exists as  an advertising vehicle.

Serenity Now,

-ACP