MD, PhD, MAE, FMedSci, FRCP, FRCPEd.

antioxidants

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Large-scale randomized trials have found that multivitamin–multimineral (MVM) supplements and cocoa flavanols may benefit several age-related chronic conditions among older adults, but it remains unclear whether these two supplements directly slow the biological aging process. This prespecified ancillary study evaluated the 2-year effect of a daily MVM (Centrum Silver) and cocoa extract (500 mg cocoa flavanols per day, including 80 mg (−)-epicatechin) on five DNA methylation measures of biological aging (PCHannum, PCHorvath, PCPhenoAge, PCGrimAge and DunedinPACE) among 958 participants (482 women and 476 men) in the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS).

Compared with placebo, daily MVM supplementation modestly reduced the rate of increase of second-generation epigenetic clocks, with a between-group difference in yearly change of −0.113 years (95% confidence interval (CI) −0.205 to −0.020; P = 0.017) for PCGrimAge and −0.214 years (−0.410 to −0.019; P = 0.032) for PCPhenoAge. MVM had a stronger effect on PCGrimAge among those with accelerated biological aging at baseline (−0.236 [−0.380 to −0.091]).

Compared with those with normal or decelerated biological aging (−0.013 [−0.130 to 0.104]; P = 0.018 for interaction). Cocoa extract did not have an effect on the five epigenetic clocks tested. Although the statistically significant but small effects of daily MVM supplementation on slowing biological aging are encouraging, additional studies are needed to determine the clinical relevance of daily MVM supplementation on epigenetic clocks and whether such effects can help explain the beneficial effects of MVM supplementation on aging-related chronic conditions.

Experts who were not involved in the new study urged caution. While the researchers saw an effect with two epigenetic clocks, three other epigenetic clocks included in the study showed no statistically significant change to their speed. “The multivitamin produced small favorable changes in two epigenetic aging markers, but not across all the clocks that were measured,” says José Ordovás, a professor of nutrition and genetics at Tufts University. “That makes the finding interesting, but it is still far from showing that multivitamins broadly slow aging or improve longevity.”

One of the study’s strengths is that the researchers carefully matched the characteristics of people in the vitamin group to those in the placebo group, says Zachary Clayton, an assistant professor of medicine at the University of Colorado Anschutz, who was also not involved with the research. “However, the magnitude of the observed differences was modest, and their clinical significance remains uncertain,” he says. The study doesn’t take a person’s exact diet or physical activity during the two-year period into account, and those factors can’t be ruled out as having an effect on biological aging, he adds.

Still, in nutrition science, randomized clinical trials of this kind are rare. They aren’t generally required to sell supplements like multivitamins, even if the makers claim specific health benefits. Additional trials, the authors note, “are needed to confirm these findings and determine the role of [multivitamins] in extending healthy aging not only among older adults, but also across the lifespan.”

In addition to these criticisms, I would add a few further points:

  • Scientists emphasize that “biological age” as measured by DNA methylation is a biomarker, a surrogate endpoint, but not a direct health outcome. It is currently unknown if a 2-month reduction in an epigenetic clock actually translates into a lower risk of disease, disability, or a longer life.
  • The 2-year duration of the study is a great achievement for such a trial; yet it still is considered relatively short for assessing biological aging, which is a process that accumulates over decades. Longer-term data is needed to see if these small changes persist or lead to meaningful health differences.
  • The fact that those study participants who started “biologically older” saw the most benefit could be a statistical artifact known as “regression to the mean” rather than a true systemic effect of the supplements.
  • The study participants were primarily of Caucasian descent and over the age of 60. This limits the ability to generalize the findings to younger populations or diverse ethnic groups.
  • Epigenetic alterations are only one of several “hallmarks of aging.” Because the study did not measure other factors like DNA damage, protein stability, or cellular communication, it provides only a very narrow “snapshot” of the aging process.
  • The multivitamin might not have “slowed aging” in a general sense, but could have corrected minor, undiagnosed nutrient deficiencies in some participants, which then reflected positively on their biomarkers. If that were true, supplementation of non-deficient volunteers would have no effect.

Currently, he serves in Trump’s administration as “Administrator of the Centers for Medicare & Medicaid Services” (CMS). He also is (or was?) a “Global Advisor & Stakeholder” for the company ‘iHerb’, and was appointed to that role in 2023. The company itself is a global e-commerce platform that was founded in 1996 and has its headquarters in California. iHerb specializes in health and wellness products. iHerb’s mission is to make health and wellness products accessible to everyone. The company operates as a direct-to-consumer retailer. iHerb sells a wide variety of products, including:

  • Vitamins, minerals, and supplements (VMS)
  • Sports nutrition
  • Beauty and personal care products
  • Grocery items
  • Baby and pet care products

Crucially, iHerb sells several products with leucovorin, i.e. folinic acid, the drug that, even though unproven, is now officially used for autism in the US. As far as I can see, most of the products that Oz promotes are not based on sound evidence. 

Based on available information from a financial disclosure analysis, Mehmet Oz’s work as an advisor for ‘iHerb’ has earned him as much as $25 million in company stock. The disclosure, which lists asset values in ranges rather than precise figures, shows that this stock was part of his overall financial portfolio.

Several experts have raised concerns that Oz’s financial interests in various healthcare and supplement companies, including iHerb, could create a conflict of interest. As the Administrator of the Centers for Medicare and Medicaid Services (CMS), a position that oversees a vast budget and a significant portion of the U.S. healthcare system, his past and present ties to the industry have been highlighted as potential issues. The concern is that a government official in such a powerful position could use their influence to benefit their own financial holdings or those of companies they are affiliated with. This is especially relevant given that Medicare Advantage, a program he would oversee, allows customers to use prepaid cards to buy over-the-counter medicines and supplements—a market that companies like iHerb are in.

Mehmet Oz has publicly disclosed his financial interests. A financial filing shows that his investments in ‘iHerb’ represented one of his largest financial holdings. In a filing with the Office of Government Ethics, Oz has committed to divesting his equity holdings in healthcare companies, including his iHerb stock, within 90 days of confirmation. He has also pledged to resign from his advisory role with ‘iHerb’. The Office of Government Ethics has stated that based on its review, it believes Oz is in compliance with applicable laws and regulations concerning conflicts of interest. The situation remains a point of public discussion and has drawn the attention of consumer advocacy groups. For example, the group Public Citizen has asked the Federal Trade Commission (FTC) to investigate whether Oz’s social media posts promoting iHerb violated FTC guidelines on undisclosed endorsements, as his posts did not always clearly state his financial connection to the company.

Based on current public information, there are serious questions and concerns about whether Mehmet Oz has divested all of his interests as pledged, particularly with respect to his holdings in ‘iHerb’. The latest publicly available filings detail his assets and his intent to divest, but do not show the final completed sale. iHerb itself has publicly stated that the company is no longer affiliated with Dr. Oz and is not working with him or the administration. However, this does not independently confirm the liquidation of his personal vested stock.

A failure to timely follow the pledge can and should trigger a chain of events that leads to serious civil and criminal penalties, as well as significant political repercussions.

It has been reported that the US surgeon general nominee, Casey Means, earned hundreds of thousands of dollars promoting supplements and other health and wellness products, details likely to invite new scrutiny about potential conflicts of interest for the author and entrepreneur.

Means, a close ally of health secretary Robert F. Kennedy Jr. and the sister of White House adviser Calley Means, has not yet been scheduled to appear before Congress for her confirmation hearing. But a filing dated Sept. 10 and posted by the Office of Government Ethics suggests her nomination cleared conflict-of-interest checks within the federal government.

The supplements industry has ties with several members of the Trump administration, including Medicaid director Mehmet Oz and health adviser Calley Means. An AP investigation this summer found that Casey Means had repeatedly failed to disclose her partnerships with supplements companies and other businesses promoted in her
newsletter, social media accounts, and elsewhere.

Among the payments included in the new disclosures for newsletter sponsorship and partnership fees are $12,000 from herbal remedies firm Apothekary; $27,431 from algae supplements company ENERGYbits; $16,461 from fiber supplements company Florasophy; $27,000 from probiotics company Pendulum Therapeutics; $46,000 from
supplements company Pique; $536 from prenatal vitamin company WeNatal; and $16,104 from basil seed supplements company Basil Seed Works. Means received a total of more than $130,000 in sponsorship fees from supplement company Amazentis, including a $55,000 book tour sponsorship.

_________________

In May this year, I wrote this about Means:

RFK Jr wrote on X: “The Surgeon General is a symbol of moral authority who stands against the financial and institutional gravities that tend to corporatize medicine. Casey Means was born to hold this job. She will provide our country with ethical guidance, wisdom, and gold-standard medical advice.” Yet her suitability for Surgeon General is a contentious issue.

Means holds a 2014 MD from Stanford University and a bachelor’s degree in human biology. She is an advocate for addressing chronic diseases through nutrition, exercise, and lifestyle changes. Her book “Good Energy”, co-authored with her brother Calley, argues that metabolic dysfunction is a root cause of most chronic illnesses. As a “wellness influencer”, Means has demonstrated an ability to communicate health concepts to a broad audience.

Critics point out that Means dropped out of her residency at Oregon Health & Science University months before completion. This means she is not board-certified and has very limited clinical experience; for instance, she never saw patients without supervision. Her medical license has been inactive since 2024, and she has done as good as no own original research. Unlike past Surgeons General, who had extensive backgrounds in public health administration and infectious disease, Means has no government or public health leadership experience. Her focus is on functional medicine and wellness, both areas that lack rigor and are close to quackery.

It gets worse: Means has expressed skepticism about vaccines, suggesting in a 2024 newsletter that the current vaccine schedule contributes to the decline of pediatric health. Her endorsement of dangerous nonsense like energy healing and raw milk seems worrying. Moreover, Means also co-founded Levels, a company selling continuous glucose monitors to non-diabetics, and markets supplements and other dubious health products. RFKJr’s claim that Means will offer “ethical guidance” seems particularly odd: she has no training in medical ethics and some of her past actions are outright unethical. Physicians like Dr. Neil Stone have therefore called Means “grossly underqualified”.

The Surgeon General must provide science-based guidance, oversee >6,000 officers, and address diverse and serious public health issues. Means’ inexperience and narrow focus limits her effectiveness. Crucially, her history of promoting of vaccine skepticism and quack medicine undermines trust in science-based policies.

In summary, Means seems wholly unsuited for the job of Surgeon General. In the interest of the US public health, her appointment should not be confirmed by the Senate.

SAY NO MORE!

The present paper described a rare and lethal adverse event following leech therapy. A 63-year-old man was referred to Nemazee Teaching Hospital (Shiraz, Iran) in December 2020 with a two-week history of progressive right lower extremity swelling, erythema, and ecchymosis. One week before symptom onset, he had undergone leech therapy on the lateral calf and upper thigh of the right lower extremity, administered by a traditional healer.

Physical examination revealed gangrene of the right leg and absence of all pulses. Color Doppler sonography of the leg and computed tomography angiography (CTA) of the thoracic aorta to the lower extremities revealed complete thrombosis of all right lower extremity arteries, extending to the right iliac artery and abdominal aorta. With a diagnosis of arterial occlusive disease and septic thrombophlebitis, the patient received intravenous antibiotics and anticoagulant therapy. Due to the ineffectiveness of medical treatments, a right lower extremity amputation was
performed.

The patient expired 5 days postoperatively due to septic shock and multiorgan failure.

The adverse effects of leech therapy include:

  1. Infection: Leeches can introduce bacteria like Aeromonas hydrophila into the wound, potentially causing infections
  2. Allergic reactions: Some people may be allergic to leech saliva, which can cause an allergic reaction
  3. Prolonged bleeding: Leeches inject an anticoagulant, which can lead to prolonged bleeding at the site of the bite
  4. Scarring: Leech bites can leave scars
  5. Anemia: In rare cases, excessive bleeding caused by leeches can lead to anemia
  6. Pain or discomfort at the site of the leech bite
  7. Swelling or redness around the bite area
  8. Itching or rash after the leech is removed
  9. Potential for transmission of diseases
  10. Psychological distress or anxiety related to the use of leeches

The effect of leech therapy consists mainly in the anticoagulation due to the hiriduin from the leech (it is also advocated for ‘detox’ [which is nonsense] and for pain [where the effect is too small to matter]). I would argue that this desired effect is achievable more safely by conventional means and that the risk/benefit balance of leech therapy is squarely negative.

In other words: don’t do it!

 

Yes, we have met him before. Recently, I came across Vickers again though one of my recent posts describing the story of a young Cambridge student who died following his advice.

Vickers describes himself as follows:

Dr. Patrick Vickers is the Creator and Founder of the Advanced Gerson Therapy Protocol; the world’s premier protocol for the treatment of cancer and degenerative disease. Chronicled in the epic documentary, The Truth About Cancer: A Global Quest, and a repeatedly invited guest on countless podcasts around the globe, Dr. Vickers is one of the most recognizable faces in natural medicine and the face of the Gerson Therapy around the world. His patient is also chronicled in the documentary, The Beautiful Truth.

At the age of 11, after witnessing a miraculous recovery from a chiropractic adjustment, Dr. Vickers’ passion for natural medicine was inspired. Born and raised outside of Milwaukee, Wisconsin, Dr. Vickers obtained undergraduate degrees in Pre-Med from the University of Wisconsin-Madison and LIFE University in Marietta, Georgia before going on to receive his Doctorate of Chiropractic from New York Chiropractic College in Seneca Falls, New York in 1997.

While a student at NYCC, Dr. Vickers befriended the iconic Charlotte Gerson; the last-living daughter of Dr. Max Gerson, M.D. who Nobel Peace Prize Winner, Dr. Albert Schweitzer, called, “The most eminent genius in medical history,” as Dr. Gerson was reversing a vast majority of degenerative diseases, including terminal cancer, up until his death in 1959. To date, eight movies have chronicled Dr. Gerson’s work.

Upon graduation and recognizing Dr. Vickers fervent passion for Dr. Gerson’s therapy, Charlotte Gerson invited Dr. Vickers to come live with her and study Dr. Gerson’s handwritten files of all his active patients from 1905-1959. Dr. Vickers remains one of the few people in the world to ever study Dr. Gerson’s personal files.

Fifteen years ago, seeing a desperate need to preserve Dr. Gerson’s legacy and the progression of his therapy, Dr. Vickers created the Advanced Gerson Therapy Protocol and Clinic which, rapidly, became the world’s premier clinic for the treatment of cancer and advanced disease.

With the rapidly changing, increasingly dangerous. societal, political and economic conditions in Mexico and around the world today, making it nearly impossible to efficiently, safely and peacefully carry out the Gerson Therapy in a clinical setting. Dr. Vickers has recently created his Three-Month, Advanced Gerson Protocol Home Program to replace all former, clinical operations. With no evidence to suggest that clinical outcomes are increased by receiving the Gerson Therapy in a clinical setting, Dr. Vickers remains dedicated to providing the most comprehensive, patient-centric protocol for cancer and degenerative disease while guaranteeing the greatest personalized attention and cost-effective solution available anywhere in the world today.

_____________________________

Allow me to make just 7 short point based on Vickers statements:

  1. Dr. Patrick Vickers: he is a chiro and not a proper doctor (are US chiros allowed to treat cancer?*).
  2. the world’s premier protocol: I see no evidence for this claim.
  3. miraculous recovery from a chiropractic adjustment: it ought to be ‘miraculous’, as chiropractic adjustments are not based on evidence.
  4. Dr. Gerson was reversing a vast majority of degenerative diseases, including terminal cancer: there is no sound evidence that Gerson ever reversed a single case of cancer.
  5. the world’s premier clinic for the treatment of cancer and advanced disease: this must be the most pompous untruth I’ve heard for a long time.
  6. the most comprehensive, patient-centric protocol for cancer and degenerative disease: this must be the second most pompous untruth I’ve heard for a long time.
  7. cost-effective solution: I see no evidence for this claim.

________________________

As Vickers seems a bit shy about disclosing all the facts, let me try to add to his CV what he seems to have forgotten:

Vickers founded and directed the Northern Baja Gerson Center in Rosarito, Mexico. The clinic offered treatments like:

Hyperthermia therapy (water based treatment)
Oxygen enhancement therapies
Ozone therapy
Hyperbaric oxygen chamber
Laetrile (B17)
High dose intravenous vitamin C
Chelation
Beamer math
Coley’s toxins therapy
Dendritic cell therapy
Infrared therapy
Frankincense oil
Natural enzymes
CoQ10

Due to “challenges” in operating clinics in Mexico, Vickers transitioned to offering his “Three-Month Advanced Gerson Protocol Home Program” whichincludes Gerson-specific supplies (e.g., coffee, flax oil, potassium powder), high-dose supplements like curcumin, selenium, CoQ10, and niacin, educational videos and regular consultations with Vickers and his team. The program is as unproven as Gerson’s original therapy. Vicker’s Medline-listed papers seem to amount to exactly zero!

Vickers asserts that Gerson Therapy is heavily censored by medical authorities and media due to its threat to the conventional medical industry. He cites alleged suppression of Dr. Gerson’s work as evidence. Vickers claims his therapy has the potential to disrupt the trillion-dollar medical industry. Vickers is active on platforms like YouTube, Facebook, and Instagram, sharing patient stories. He is a frequent guest on podcasts like BetterHealthGuy, Rational Wellness, and CancerTalks, discussing the Gerson therapy. Vickers’ approach is rooted in a belief that conventional cancer treatments are limited or even detrimental and that the Gerson therapy offers a more natural, effective alternative. None of these claims are supported by sound evidence.

The Gerson therapy’s demanding nature (e.g., ~13 hours of juicing daily, multiple enemas) , ineffectiveness and high cost renders it little more than a truly dangerous, disagreeable rip-off. And what does that make a chiro pretending to be a dotor advocating it as a cancer cure?
Perhaps I let you answer that question for yourselves.
*

In the United States, chiropractors are not legally allowed to treat cancer as a primary condition. Chiropractors are not licensed to diagnose, treat, or manage cancer, as this falls under the purview of medical doctors and other licensed healthcare providers. However, some chiropractors may offer supportive care to cancer patients, such as pain management or improving mobility. Any claim by a chiropractor to “treat” or “cure” cancer would likely be considered outside their legal scope and could be misleading or dangerous. 

Donald Trump has recently made a range of appointments in the health sector of the US. They will strongly influence conventional and so-called alternative medicine (SCAM) in the US as well as worldwide. It therefore seems worth to look at the backgrounds and qualifications of these men and women and critically evaluate their fit for leadership roles in healthcare. In part 1 of this series, we looked at Robert F.Kennedy Jr. and David Weldon. Now I will focus on Trumps nominations for Surgeon General

Janette Nesheiwat – Surgeon General

We featured Janette once before.  She trained as a family and emergency medicine physician, became the medical director at CityMD and also a Fox News contributor. She has no significant public health leadership experience. As the Surgeon General, she would require shaping national health policy and communicating science to the public, areas where she has no training or experience. She also lacks expertise in public health and epidemiology. Her Fox News role and online vitamin sales raise doubts about her prioritization of evidence-based public health over media-driven health promotion. The Surgeon General is the nation’s leading spokesperson on public health, overseeing the U.S. Public Health Service Commissioned Corps and issuing science-based health advisories. Nesheiwat would be a disaster for such a position.

Nesheiwat’s nomination was eventually withdrawn by Trump. This suggests internal concerns about her fitness for the job.

Casey Means – Surgeon General

RFK Jr wrote on X: “The Surgeon General is a symbol of moral authority who stands against the financial and institutional gravities that tend to corporatize medicine. Casey Means was born to hold this job. She will provide our country with ethical guidance, wisdom, and gold-standard medical advice.” Yet her suitability for Surgeon General is a contentious issue.

Means holds a 2014 MD from Stanford University and a bachelor’s degree in human biology. She is an advocate for addressing chronic diseases through nutrition, exercise, and lifestyle changes. Her book “Good Energy”, co-authored with her brother Calley, argues that metabolic dysfunction is a root cause of most chronic illnesses. As a “wellness influencer”, Means has demonstrated an ability to communicate health concepts to a broad audience. 

Critics point out that Means dropped out of her residency at Oregon Health & Science University months before completion. This means she is not board-certified and has very limited clinical experience; for instance, she never saw patients without supervision. Her medical license has been inactive since 2024, and she has done as good as no own original research. Unlike past Surgeons General, who had extensive backgrounds in public health administration and infectious disease, Means has no government or public health leadership experience. Her focus is on functional medicine and wellness, both areas that lack rigor and are close to quackery.
It gets worse: Means has expressed skepticism about vaccines, suggesting in a 2024 newsletter that the current vaccine schedule contributes to the decline of pediatric health. Her endorsement of dangerous nonsense like energy healing and raw milk seems worrying. Moreover, Means also co-founded Levels, a company selling continuous glucose monitors to non-diabetics, and markets supplements and other dubious health products. RFKJr’s claim that Means will offer “ethical guidance” seems particularly odd: she has no training in medical ethics and some of her past actions are outright unethical. Physicians like Dr. Neil Stone have therefore called Means “grossly underqualified”.
The Surgeon General must provide science-based guidance, oversee >6,000 officers, and address diverse and serious public health issues. Means’ inexperience and narrow focus limits her effectiveness. Crucially, her history of promoting of vaccine skepticism and quack medicine undermines trust in science-based policies.
In summary, Means seems wholly unsuited for the job of Surgeon General. In the interest of the US public health, her appointment should not be confirmed by the Senate.

As we all know, the FDA cannot require that dietary supplements be proven effective before they are sold. Yet, Robert F. Kennedy Jr. once said the FDA is exhibiting an “aggressive suppression” of vitamins, dietary supplements, and other substances and that he will end the federal agency’s “war on public health”.

With Kennedy now in the driver’s seat, the supplement industry expects to make bolder health claims for its products and to get the government, private insurers, and flexible spending accounts to pay for supplements, essentially putting them on an equal footing with FDA-approved pharmaceuticals.

The day Kennedy was sworn in as secretary of Health and Human Services, Trump issued a “Make America Healthy Again” agenda instructing health regulatory agencies to “ensure the availability of expanded treatment options and the flexibility for health insurance coverage to provide benefits that support beneficial lifestyle changes and disease prevention.” Kennedy added that dietary supplements are one key to good health. Supplement makers now want programs like health savings accounts, Medicare, and even benefits from the Supplemental Nutrition Assistance Program, or SNAP, to pay for vitamins, fish oil, protein powders, herbal remedies and probiotics.

In speeches and in a pamphlet called “The MAHA Mandate,” Emord and alliance founder Robert Verkerk said Kennedy would free companies to make greater claims for their products’ alleged benefits. Emord said his group was preparing to sue the FDA to prevent it from restricting non-pharmaceutical products.

With their ‘Mandate’ Emord and Verkerk want “to shift the healthcare paradigm towards one that restores the health of the American people through a holistic and individual-centered approach that works with, rather than against, nature”.

But do they ever question whether:

  • vitamins do anything at all to people who eat a normal diet?
  • fish oil is effective and safe for which conditions?
  • protein powders have any effects beyond eating a steak?
  • herbal remedies generate more good than harm?
  • probiotics work for which conditions?

The short answer is no. To me, it seems that the MAHA are as uninterested in the evidence regarding efficacy and safety (quite possible they know how flimsy it is) as they are keen on the promotion of quackery.

Kampo medicine is the Japanese form of traditional herbal medicine that is still very popular in Japan. The word Kampo means ‘Chinese style’ in Japanese. Kampo developed out of traditional Chinese herbal medicine after it was introduced into Japan in the 7th century. In the early 20th century, Kampo was further influenced by modern Western medicine and science. The Kampo system is a pragmatic and simplified version of Chinese herbal medicine. Kampo medicines are standardised and not individualised as in Chinese herbal medicine. They are based on the current symptoms of the patient, interpreted in the philosophy of Kampo. Kampo diagnostics consider hypofunction and hyperfunction, heat and cold, superficies and interior, and yin and yang.

Today, Kampō is fully integrated into the Japanese national health care system, and numerous Kampo preparations are registered in Japan and reimbursable from public funds. These standardised formulas contain mixtures of herbal ingredients. They are manufactured under proper quality control. The most commonly used plants include liquorice, ginger and Chinese peony root. Most Japanese doctors routinely prescribe Kampo medicines, and most patients combine Kampo with Western medicine. Since 2002, the teaching of Kampo has been included in Japanese curricula of medical and pharmacy education.

The efficacy of Kampo medicines is often less solidly documented than one would hope or expect. There is a remarkable shortage of high-quality clinical trials. One review concluded that “Kampo medicines potentially play some roles in preventing or ameliorating side effects of anticancer agents. Supportive care with Kampo medicines for patients with cancer might lead to physical, mental, and nutritional improvement.” As Kampo medicines contain pharmacologically active ingredients, they can also cause adverse effects and might interact with synthetic drugs. Yet, the risks of Kampo are currently woefully under-investigated.

This case of severe liver injury following the administration of the Kampo medicine ‘Saibokuto‘ attempted to identify the likely causative crude drug inducing liver injury through a systematic literature review.

A 29-year-old woman developed severe liver injury approximately two months after Saibokuto administration, necessitating steroid pulse therapy for recovery. A literature search was conducted. Using PubMed and the “Igaku Chuo Zasshi (ICHUSHI) database,” two individuals independently selected studies published between January 1997 and February 15, 2023. The search focused on studies involving human subjects, published in either English or Japanese, and specifically investigated Kampo medicines categorized as over-the-counter or prescription drugs suspected as causative agents of drug-induced liver injury (DILI). Studies on health supplements, discontinued Kampo medicines, and autoimmune hepatitis, were excluded. As it is ethically impossible to rechallenge drugs that cause liver injury, this review primarily relied on case report literature.

Through the review, 37 cases (men/women: 12/25, including present case) were analyzed, including 32 reports (36 cases) from 3,055 studies that met the inclusion criteria. Notably, 65.9% of cases were associated with Scutellariae radix, with onset occurring within 45 (1-730) days and recovery within 35 (7-184) days.

The authors concluded that their case study and literature review underscore a prevalent association between liver injury and Kampo medicines containing Scutellariae radix. Vigilant liver function monitoring, particularly within the first 2 months of administration, is recommended, especially for formulations containing Scutellariae radix.

Radix Scutellariae (scullcap) is the dried root of the medicinal plant Scutellariae baicalensis Georgi. It has a long history of application in traditional herbalism. Six flavones seem to be its major bioactive constituents. All six flavones are pharmacologically active.

Scullcap has been advocated to treat arthritis, lung problems, hay fever, seizures, HIV or AIDS, and hepatitis. Scullcap applied to the skin has been used to treat psoriasis, sores or swelling, and hemorrhoids. The evidence that it is effective for any condition is far from convincing. Adverse effects of scullcap are equally under-researched.

The paper discussed above is a poignant remeinder of the ‘appeal to tradition‘: not everything that has been used for centuries is safe. Only proper scientific investigations will determine the risk/benefit profile of a therapy.

The year 2024 brought many disappointments. But let’s not dwell on those, lets get in the mood for tonights celebrations! And what could be more fitting for that than a review of the positive cardiovascular effects of wine drinking? After all wine involves both aromatherapy as well as antioxidants, botanical medicine and naturopathy! As luck would have it, we even have some recent evidence on this very subject.

The objectives of this systematic review and meta-analysis were:

  • (i) to examine the association between wine consumption and cardiovascular mortality, cardiovascular disease (CVD), and coronary heart disease (CHD),
  • (ii) to analyse whether this association could be influenced by personal and study factors, including the participants’ mean age, the percentage of female subjects, follow-up time and percentage of current smokers.

The searched several databases for longitudinal studies from their inception to March 2023.

A total of 25 studies were included in the systematic review, and 22 could be included the meta-analysis. The pooled risk ration (RR) for the association of wine consumption and the risk of CHD using the DerSimonian and Laird approach was 0.76 (95% CIs: 0.69, 0.84), for the risk of CVD was 0.83 (95% CIs: 0.70, 0.98), and for the risk of cardiovascular mortality was 0.73 (95% CIs: 0.59, 0.90).

The authors concluded that their research revealed that wine consumption has an inverse relationship to cardiovascular mortality, CVD, and CHD. Age, the proportion of women in the samples, and follow-up time did not influence this association. Interpreting these findings with prudence was necessary because increasing wine intake might be harmful to individuals who are vulnerable to alcohol because of age, medication, or their pathologies.

What, you suspect that this paper was sponsored by the wine industry?

No, you are mistaken! It was funded by FEDER funds, by a grant from the University of Castilla-La Mancha, and by a grant from the science, innovation and universities.

So, maybe just for tonight we put the worries about our livers aside and enjoy a (non-homeopathic) dose of wine.

Cheers!

A journalist from the DAILY MAIL alerted me to the fact that yet another celebrity having decided to sell dietary supplements, interviewed me on the subject, and eventually published an article about it. One would not have thought that the Beckhams are short of money – so, why did David Beckham turn into a snake-oil salesman? I am far from being able to answer this question. What I now do know is that, via his firm ‘IM8’, he has started marketing two supplements (one of his slogans is ‘Built by Science, Trusted by Beckham’):

Daily Ultimate Essentials: All-in-One Supplement

This is a ‘multi-everything’ supplement. The only truly remarkable thing about it is its price tag. There are hundreds of similar products on the market. Almost all of them are much cheaper, and none is helpful for anyone who is healthy and consumes a balanced diet, as far as I can see.

Daily Ultimate Longevity: Healthy Aging

The implication here seems to be not a trivial one; the name clearly implies that we live longer, if we regularly bought this supplement. Not onlly that, we would also be healthier! I can see no evidence for either of these claims, yet a simple calculation tells me that we would be considerably poorer, if we fell for this advertising gimmick.

On the website, we learn a bit more:

At IM8, our commitment to science goes beyond innovation—it’s the foundation of everything we do. A world-class team of experts from space science, medicine, and academia has united with one goal: to revolutionize wellness. We’ve pioneered CRT8™ (Cell Rejuvenation Technology 8), designed to enhance cellular rejuvenation and push the limits of what’s possible in health.

Each of our products undergoes rigorous third-party testing and clinical trials, ensuring purity, efficacy, and results you can trust. With IM8, you’re getting scientifically driven core nutrition for optimal health and longevity.

___________________

I feel embarrassed for the ‘world-class team of experts from space science, medicine, and academia’ who give their good name to this hyped up nonsense. Moreover, I ask myself whether David Beckham’s new attempt to increase his wealth might be a case for the Advertising Standards Authority (ASA).

 

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