MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

herbal medicine

1 2 3 17

This study assessed the patterns of dietary supplement usage among cancer survivors in the United States in a population-based setting. National Health and Nutrition Examination Survey (NHANES) datasets (1999-2016) were accessed, and adult respondents (≥ 20 years old) with a known status of cancer diagnosis and a known status of dietary supplements intake were included. Multivariable logistic regression analysis was then used to assess factors associated with dietary supplements intake. Moreover, and to evaluate the impact of dietary supplements on overall survival among respondents with cancer, multivariable Cox regression analysis was conducted.

A total of 49,387 respondents were included in the current analysis, including a total of 4,575 respondents with cancer. Among respondents with cancer, 3,024 (66.1%) respondents reported the use of dietary supplements; while 1,551 (33.9%) did not report the use of dietary supplements. Using multivariable logistic regression analysis, factors associated with the use of dietary supplements included:

  • older age (OR: 1.028; 95% CI: 1.027-1.030);
  • white race (OR for black race vs. white race: 0.67; 95% CI: 0.63-0.72);
  • female gender (OR for males vs. females: 0.56; 95% CI: 0.53-0.59),
  • higher income (OR: 1.13; 95% CI: 1.11-1.14),
  • higher educational level (0.59; 95% CI: 0.56-0.63),
  • better self-reported health (OR: 1.36; 95% CI: 1.17-1.58),
  • health insurance (OR: 1.35; 95% CI: 1.27-1.44),
  • history of cancer (OR: 1.20; 95% CI: 1.10-1.31).

Using multivariable Cox regression analysis and within the subgroup of respondents with a history of cancer, the use of dietary supplements was not found to be associated with a difference in overall survival (HR: 1.13; 95% CI: 0.98-1.30).

The authors concluded that dietary supplement use has increased in the past two decades among individuals with cancer in the United States, and this increase seems to be driven mainly by an increase in the use of vitamins. The use of dietary supplements was not associated with any improvement in overall survival for respondents with cancer in the current study cohort.

Many cancer patients, when they first get diagnosed, are tested for vitamin D levels and found to be low or borderline. Consequently, they get a prescription for supplements. Other than this, there is rarely an indication to take any vitamins or other dietary supplements. Yet, cancer patients take them because they think these ‘natural’ preparations can do no harm (and because the industry can be persuasive [there is big money at stake] and the odd breed of ‘integrated’ oncologists might even recommend them). Sadly, this assumption is not correct. The biggest danger, in my view, is the possibility of supplements to interact with one of the many drugs that cancer patients need to take. So, in a way, it is reassuring that, on average, there is no detrimental effect on overall survival.

The paper will probably also reignite the perennial discussion about the effects of vitamin C on the natural history of cancer. My understanding is that there is none (and this verdict seems to be supported by the findings reported here). But I am, of course, aware that this is a ‘hot potato’ and that some readers will think differently. To them I say: please show me the evidence.

Black salve is a paste for external use made from a variable mixture of herbal and non-herbal ingredients. It usually contains bloodroot and/or chaparral and/or zinc chloride which are all ingredients that render the products corrosive. This means black salve destroys living cells that come in contact with it.

Black salve is said to originate from native American tribes who used the paste as a treatment for various conditions. It was adopted by conventional medicine during the Victorian era as a treatment for a range of skin problems, including skin cancers. When effective treatments became available, it became obsolete.

Black salve was recently re-discovered by some practitioners of so-called alternative medicine (SCAM) who now recommend it as a natural treatment for various skin conditions, including cancer. Black salve is readily available, for instance, via the Internet. Several national regulators have issued warnings to consumers not to use it. Consumers have little means of telling what is the nature, quality or strength of the black salve they might be purchasing.

No compelling evidence exists that black salve is efficacious for any condition, especially not for any type of skin cancer. Rigorous clinical trials testing its efficacy are not available. A recent review[1] of the published evidence concluded as follows: Black salve is not a natural therapy. It contains significant concentrations of synthetic chemicals. Black salve does not appear to possess tumour specificity with in vitro and in vivo evidence indicating normal cell toxicity. Black salve does appear to cure some skin cancers, although the cure rate for this therapy is currently unknown. The use of black salve should be restricted to clinical research in low risk malignancies located at low risk sites until a better understanding of its efficacy and toxicity is developed. Where a therapy capable of harm is already being used by patients, it is ethically irresponsible not to study and analyse its effects. Although cautionary tales are valuable, black salve research needs to move beyond the case study and into the carefully designed clinical trial arena. Only then can patients be properly informed of its true benefits and hazards.

Due to its erosive nature, black salve burns away the tissue with which it comes into contact. Numerous case reports of the resulting deformations have been published.[2],[3] Many horrendous pictures of patients maimed by their use of black salve are available on the Internet and give a dramatic impression of the harm caused. Black salve is unquestionably a treatment that can cause considerable damage and should be regarded as unsafe. One paper concluded that it is vital that members of the public are aware of the potential effects and toxicity of commercial salve products.[4]

In conclusion, black salve is not of proven efficacy as a treatment of any condition. It is well documented to cause much harm. Its use should be discouraged. Practitioners who employ or recommend it are, in my view, irresponsible to the extreme.

References:

[1] Croaker A, King GJ, Pyne JH, Anoopkumar-Dukie S, Liu L. A Review of Black Salve: Cancer Specificity, Cure, and Cosmesis. Evid Based Complement Alternat Med. 2017;2017:9184034. doi:10.1155/2017/9184034

[2] Ong NC, Sham E, Adams BM. Use of unlicensed black salve for cutaneous malignancy. Med J Aust. 2014;200(6):314. doi:10.5694/mja14.00041

[3] Saltzberg F, Barron G, Fenske N. Deforming self-treatment with herbal “black salve”. Dermatol Surg. 2009;35(7):1152-1154. doi:10.1111/j.1524-4725.2009.01206.x

[4] Lim A. Black salve treatment of skin cancer: a review. J Dermatolog Treat. 2018;29(4):388-392. doi:10.1080/09546634.2017.1395795

Guest post by Ken McLeod

‘Ayurvedic Medicine,’ or Ayurveda, is an alternative medicine system which originated in India as long as 5,000 years ago, according to its proponents.  Science-based medicine refers to it  as pseudoscientific and the Indian Medical Association (IMA) characterises  it as quackery. [1] Ayurvedic practitioners claim that its popularity through the ages vindicates it as safe and effective.

That last bit is of course the appeal to antiquity, or the appeal to tradition (also known as argumentum ad antiquitatem. [2] This proposes that if something was supported by people for a long time it must be valid.   That is bunkum; many ancient ideas have long since been discredited; the Earth is not flat, no matter for how long people thought it was.

Nevertheless, ‘Ayurvedic Medicine’ has many practitioners and supporters in the supposedly rational West, including Bondi Junction here in Australia.  Despite the many warnings about it, [3] people still go to practitioners, and occasionally they are injured.

One such injury and the consequent complaint to the New South Wales regulator, the Health Care Complaints Commission, (HCCC), has resulted in a Public Warning dated 18 September concerning levels of heavy metals in Ayurvedic Medication.  [4]

The HCCC said:

‘The NSW Health Care Complaints Commission is concerned about a complaint received regarding the prescription of “Manasamithra Vatika,” (Manasamitram Pills) an Ayurvedic medication.

‘The complaint related to prescription of this medication to a child for treatment of autism.

‘This medication was found to contain concerning levels of lead and other heavy metals.’

That’s all very bland, no headlines there.  But then it got into:

“The Commission strongly urges those individuals seeking alternative therapies to be vigilant in their research prior to proceeding with any natural therapy medications or medicines and to discuss any such proposed therapies with their treating registered health practitioner.”

Not so bland there; that’s very comprehensive; ‘any natural therapy medications or medicines’ and ‘discuss any such proposed therapies with their treating registered health practitioner.” ‘Note the HCCC’s emphasis on “registered.”  That rules out Ayurvedic Medicine practitioners, homeopaths, and other assorted cranks; go to a real doctor.

Surely that is headline material; a regulator responsible for promoting the health of citizens warns them to go to real doctors before going to these quacks.

Then it gets better, (or worse if you are an Ayurvedic Medicine practitioner).  At the same time the HCCC issued an Interim Prohibition Order against Mr Rama Prasad (“Ayurveda Doctor Rama Prasad.”) [5] The HCCC’s Order says:

‘The NSW Health Care Complaints Commission (“the Commission”) is currently investigating Mr Rama Prasad in relation to his prescribing of the Ayurvedic Medication “Manasamithra Vatika” (Manasamitram Pills) to both children and adults and about his claims that his treatments can reverse several aspects of autism in children.

‘The Ayurvedic Medication “Manasmithra Vatika” (Manasamitram Pills) was found to contain elevated levels of lead and other heavy metals.

‘One case with mildly elevated blood level was notified to the South Eastern Sydney Public Health Unit after consuming this product.

‘Clients residing in NSW who are considered to have been placed at possible risk have now been contacted by NSW Health public health personnel.

‘The Commission has issued an interim prohibition order in relation to Mr Rama Prasad, under section 41AA of the Health Care Complaints Act 1993 (‘The Act’). Mr Prasad is currently prohibited from providing any health services, either in paid employment or voluntarily, to any member of the public.

‘This interim prohibition order will remain in force for a period of eight weeks and may be renewed where appropriate in order to protect the health or safety of the public.’

That should send chills down the spine of any Ayurvedic Medicine practitioner.  A complete Prohibition Order ordering Prasad not to engage in providing any health service as defined in the Act  [6] for eight weeks, which may be renewed or even made permanent, depending on what the investigation finds.  The Act includes a comprehensive list of activities that comprise a ‘health service’:

‘health service includes the following services, whether provided as public or private services:

  • (a)  medical, hospital, nursing and midwifery services,
  • (b)  dental services,
  • (c)  mental health services,
  • (d)  pharmaceutical services,
  • (e)  ambulance services,
  • (f)  community health services,
  • (g)  health education services,
  • (h)  welfare services necessary to implement any services referred to in paragraphs (a)–(g),
  • (i)  services provided in connection with Aboriginal and Torres Strait Islander health practices and medical radiation practices,
  • (j)  Chinese medicine, chiropractic, occupational therapy, optometry, osteopathy, physiotherapy, podiatry and psychology services,
  • (j1)  optical dispensing, dietitian, massage therapy, naturopathy, acupuncture, speech therapy, audiology and audiometry services,
  • (k)  services provided in other alternative health care fields,
  • (k1)  forensic pathology services,’

Note the inclusion of ‘health education.’  This is where so many cranks fall foul of the law;  setting yourself up as a health educator makes you subject to the Act.   Even if you claim to be a master chef, homeopath or Ayurvedic Medicine Practitioner, you are not exempt.

It’s early days yet in this particular saga, and there are many questions to be answered, for example:

  • – How did this “medicine” get past Australia’s Therapeutic Goods Administration, (Australia’s equivalent to the US FDA)?
  • – Did the TGA list or register it?
  • – If not why not? If it was who is responsible?
  • – Was this detected only after a child was so sickened that they were taken to hospital?
  • – Why is the practitioner concerned still advertising his Ayurvedic medicine courses? [7]  Is this a breach of his Prohibition Order which prohibits ‘health education services’?’

So stay tuned for updates as this case progresses.  In the meantime note that an Australian Health regulator is advising the public to seek advice from real doctors before going to alternative therapists, including ‘Ayurvedic Medicine’ practitioners.  That is a real headline.

[1] https://en.wikipedia.org/wiki/Ayurveda

[2] https://en.wikipedia.org/wiki/Appeal_to_tradition

[3] Such as from the Victoria Dept of Health at https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/ayurveda

[4] https://www.hccc.nsw.gov.au/decisions-orders/public-statements-and-warnings/public-warning-under-s94a-of-the-health-care-complaints-act-concerning-levels-of-heavy-metals-in-ayurvedic-medication

[5] https://www.hccc.nsw.gov.au/decisions-orders/media-releases/2020/mr-rama-prasad-ayurveda-doctor-rama-prasad-interim-prohibition-order

[6] Health Care Complaints Act 1993 https://www.legislation.nsw.gov.au/view/html/inforce/current/act-1993-105

[7] https://www.enlightenedevents.com.au/events/certificate-in-clinical-ayurveda-dr-rama-prasad

I have to admit that I had not heard of Dr Bernhoft before. I was alerted to him through the discussions about him on this blog. So, I had a look. What I found amazed me.

On his website, Bernhoft states the following:

Dr. Bernhoft is one of the nation’s leading practitioners in the field of environmental medicine. He comes to his expertise not only through extensive academic and professional training and decades as a practicing physician and surgeon, but also from the uniquely motivating perspective of having been a patient himself who had to fight desperately for his life and was literally forced to find a way to heal himself from an illness that left his MD colleagues at a loss for diagnosis and treatment…

His personal quest for survival carried him into cutting-edge advanced medicine, including gene-environment interactions. He found out that his gene which codes for an enzyme called MTHFR was hypoactive, and a second, which produces GSTM1 was absent, leaving him susceptible to poisoning by a wide range of metals and chemicals…

Because of his unique personal experience, combined with his outstanding professional credentials, he is one of the most effective spokespeople in the cause of environmental healing.

His ‘outstanding professional credentials’ consist of amongst others ‘28 peer reviewed medical articles‘, he claims. My Medline search located just 11:

  1. Cadmium toxicity and treatment. Bernhoft RA.ScientificWorldJournal. 2013 Jun 3;2013:394652. doi: 10.1155/2013/394652. Print 2013.PMID: 23844395 Free PMC article. Review.
  2. Mercury toxicity and treatment: a review of the literature.Bernhoft RA.J Environ Public Health. 2012;2012:460508. doi: 10.1155/2012/460508. Epub 2011 Dec 22.PMID: 22235210 Free PMC article. Review.
  3. Clinical detoxification: elimination of persistent toxicants from the human body.Genuis SJ, Sears ME, Schwalfenberg G, Hope J, Bernhoft R.ScientificWorldJournal. 2013 Jun 6;2013:238347. doi: 10.1155/2013/238347. Print 2013.PMID: 23844383 Free PMC article. No abstract available.
  4. Incorporating environmental health in clinical medicine.Genuis SJ, Sears M, Schwalfenberg G, Hope J, Bernhoft R.J Environ Public Health. 2012;2012:103041. doi: 10.1155/2012/103041. Epub 2012 May 17.PMID: 22675371 Free PMC article. No abstract available.
  5. Cholangitis after endoscopic sphincterotomy in patients with stricture of the biliary duct.Kracht M, Thompson JN, Bernhoft RA, Tsang V, Gibson RN, Blumgart LH.Surg Gynecol Obstet. 1986 Oct;163(4):324-6.PMID: 3764637
  6. Composition and morphologic and clinical features of common duct stones.Bernhoft RA, Pellegrini CA, Motson RW, Way LW.Am J Surg. 1984 Jul;148(1):77-85. doi: 10.1016/0002-9610(84)90292-7.PMID: 6742333
  7. Pigment sludge and stone formation in the acutely ligated dog gallbladder.Bernhoft RA, Pellegrini CA, Broderick WC, Way LW.Gastroenterology. 1983 Nov;85(5):1166-71.PMID: 6618107
  8. Vesicular transport of horseradish peroxidase during chronic bile duct obstruction in the rat.Renston RH, Zsigmond G, Bernhoft RA, Burwen SJ, Jones AL.Hepatology. 1983 Sep-Oct;3(5):673-80. doi: 10.1002/hep.1840030508.PMID: 6618434
  9. Peritoneovenous shunt for refractory ascites: operative complications and long-term results.Bernhoft RA, Pellegrini CA, Way LW.Arch Surg. 1982 May;117(5):631-5. doi: 0.1001/archsurg.1982.01380290081014.PMID: 7073482
  10. Biliary stricture.Way LW, Bernhoft RA, Thomas MJ.Surg Clin North Am. 1981 Aug;61(4):963-72. doi: 10.1016/s0039-6109(16)42492-8.PMID: 7280936
  11. The effects of a low level of dietary cadmium on blood pressure, ’24Na, ’42K, andwater retention in growing rats.Doyle JJ, Bernhoft RA, Sandstead HH.J Lab Clin Med. 1975 Jul;86(1):57-63.PMID: 1151143
Few, if any of them identify him as a leading expert in anything. Confused by this contradiction, I re-consulted Bernhoft’s website and found this:
We carry a wide selection of physician grade supplements, from beneficial probiotics, trace minerals, fish oils and other multivitamins that help detoxify and support the immune system. 
That puzzled even more. As far as I am aware, the term ‘physician grade’ is not a officially recognised qualifier; it seems to be a meaningless word that misleads consumers. More importantly, I can find no good evidence that probiotics, trace minerals, fish oils and other multivitamins help detoxify and support the immune system. Could this be another invented myth?
But my confusion was about to increase even further when I noticed that Bernhoft has another website; and on this one he no longer is an expert in in environmental medicine, but ‘an Ojai California Bioidentical Hormones Specialist‘. Is this another invented term?, I asked myself.
Now, I was understandably keen to learn more and discovered that Bernhoft makes many claims on his website:

The following are typical symptoms of hormone imbalance in both men and women:

  • Hot flashes and night sweats
  • Fatigue
  • Anxiety, depression, and irritability
  • Low libido
  • Memory lapses and trouble concentrating
  • Weight gain
  • Headaches
  • Insomnia and sleep apnea
  • Lack of muscle tone

Regardless of your age, gender, or specific symptoms, you can find relief with Bioidentical Hormone Replacement Therapy (BHRT).

Naturally, I am keen to learn what conditions Bernhoft’s BHRT can cure. Brace yourself, the list is long:

Women’s Conditions Treated With Bioidentical Hormones

Robin A. Bernhoft, M.D. at the Bernhoft Center for Advanced Medicine specializes in Bioidentical Hormone balancing for women, which includes addressing the symptoms of hormonal imbalance and customizing individual treatment programs using Bioidentical Hormone Replacement Therapy. Robin A. Bernhoft, M.D. will test each woman’s hormone levels to determine deficiencies, dominances, and imbalances, and he will work closely with each woman to find the correct dosages to restore optimal health. Some of the conditions that Doctor Bernhoft uses Bioidentical Hormone Replacement Therapy to treat in women include:

ADRENAL FATIGUE SYNDROME

When you suffer from chronic or poorly managed stress, your adrenal glands do not release the level of cortisol you require to remain healthy and emotionally stable. You may struggle with anxiety, depression, insomnia, fatigue, cravings for sweets, and several other symptoms due to adrenal fatigue. Along with proper nutrition, balancing your hormones with Bioidentical Hormone Replacement Therapy helps you manage stress better by bringing your cortisol levels in balance.

ALOPECIA

Having too much of the estrogen hormone or an underactive thyroid may cause you to lose hair on your head, arms, legs, or pubic area. If you are diabetic, poor blood sugar control can also cause this problem. Robin A. Bernhoft, M.D. can take a quick blood test to determine if hormonal imbalance is causing this issue. If so, replacing your body’s lost hormones with Bioidentical ones can help you re-grow scalp and body hair.

ANXIETY AND DEPRESSION

When feelings of anxiety and depression are unrelated to a specific life event, they are often the result of unbalanced levels of estrogen, progesterone, and cortisol. You may feel weepy, irritable, nervous, guilty, and many other troublesome emotions. Having a hysterectomy or going through menopause tends to increase your risk of anxiety and depression. When anti-depressant medication doesn’t work, it’s more likely you’re experiencing hormonal depression that is treatable with Bioidentical Hormone Replacement Therapy.

CHRONIC HEADACHES

Women who are approaching middle age complain of chronic headaches more often than younger women do. This is often because of pending menopause or being at a certain point in their menstrual cycle. An unbalanced amount of the hormone progesterone may also be the cause of this misery. If Robin A. Bernhoft, M.D. discovers a problem with your progesterone, he may recommend that you start Bioidentical Hormone Replacement Therapy along with a daily dose of the vitamin B12.

CHRONIC FATIGUE SYNDROME

It’s normal to feel tired when you are under stress or don’t get enough sleep, but chronic fatigue lasting throughout the day is probably a sign of hormonal imbalance. Unfortunately, it causes other problems such as irritability, depression, and lowered resistance to illnesses. Low estrogen levels are often the cause of severe fatigue in women. Balancing your hormones with Bioidentical Hormone Replacement Therapy gives you the energy you need to meet everyday responsibilities and enjoy satisfying relationships.

CYSTITIS

Cystitis, or bladder infections, occurs when bacteria from outside of the body enter through the urinary tract and cause an infection. Hormonal changes that begin in perimenopause may also cause recurring bladder infections. This is because the bladder, urethra, and vagina lose muscle tone and strength as levels of estrogen slowly decline. Fortunately, you can correct this imbalance by receiving Bioidentical Hormone Replacement Therapy. When the muscles near your bladder are stronger, it’s harder for bacteria to invade.

FIBROIDS

Uterine fibroids are masses of tissue that grow within the wall of your uterus, in it, or on it. It can result in irregular menstrual bleeding or uterine cancer in rare cases. Normally, estrogen stimulates cell growth in your body while progesterone balances it. Fibroids may be the result of unbalanced levels of estrogen, cortisol, xenoestrogens, and progesterone. Bringing all of these necessary hormones in balance with Bioidentical Hormone Replacement Therapy can help to reduce the risk of fibroids.

INSOMNIA

Insomnia, which is the consistent inability to fall or stay asleep, is both a cause and an effect of hormone imbalance. The hormonal changes of PMS, perimenopause, and menopause can all cause sleeplessness. Chronic insomnia can also make hormone imbalance worse. When your hormones are balanced through Bioidentical Hormone Replacement Therapy, it has a less inhibiting effect on your ability to fall asleep and stay asleep throughout the night.

IRRITABLE BOWEL SYNDROME

IBS is a term that describes pain with bowel movements, urge frequency, a feeling of incomplete bowel emptying, abdominal distension, and several other symptoms. Many women report worsening IBS symptoms just before their period starts. This may occur due to the fluctuation of estrogen and progesterone in the second half of the cycle. Having unbalanced levels of estrogen and progesterone can slow motility in the gut. However, balancing these hormones can greatly alleviate IBS.

LOW SEXUAL LIBIDO

Lack of desire for physical intimacy is due to an imbalance in the amounts of estrogen, progesterone, and testosterone in your body. When the latter two hormones start declining, it may cause estrogen dominance. This problem is also associated with weight gain, mood swings, and painful intercourse, all of which further decrease your libido. Balancing estrogen in your body so it doesn’t dominate other hormones is essential to restore your desire for sex.

MENOPAUSE

Menopause is the clinical term for 12 consecutive months without a menstrual period. As you start menopause, your estrogen, progesterone, and testosterone hormones may fluctuate wildly. Although there are dozens of symptoms associated with menopause, the most common ones include hot flashes, night sweats, low libido, mood swings, and weight gain. Replacement therapy with Bioidentical Hormones can help eliminate or reduce multiple symptoms at the same time.

PERIMENOPAUSE

Although the average age of menopause is 51, you may begin perimenopause as early as your mid 30s. Common symptoms include breast tenderness, changes in the menstrual cycle, skin changes, sexual dysfunction, and loss of bone density. These problems occur due to decreasing levels of estrogen and other essential hormones as you age. If your blood work confirms hormonal imbalance, Bioidentical Hormone Replacement Therapy can help you feel more comfortable.

SYMPTOMS OF PRE-MENSTRUAL SYNDROME

In a normal menstrual cycle, estrogen rises for the first two weeks and then begins to fall. During the second half of the cycle, this process repeats itself with progesterone. If you’re highly sensitive to hormonal changes, you may experience worsening symptoms of PMS. Some of these include bloating, irritability, fatigue, tension, and weight gain. If your PMS symptoms are severe enough to interfere with your quality of life, consider Bioidentical Hormone Replacement Therapy with Doctor Robin A. Bernhoft.

THYROID DISORDERS

You have a thyroid imbalance when your thyroid, which is a small nodule at the base of your neck, produces too little or too much of this hormone. When you go to a traditional doctor complaining of fatigue or difficulty losing weight, he or she may test your TSH level. However, this may not be enough to determine hormone imbalance. Robin A. Bernhoft, M.D. conducts several medical tests to see if you are a good candidate for Bioidentical Hormone Replacement Therapy.

Men’s Conditions Treated With Bioidentical Hormones

Robin A. Bernhoft, M.D. also specializes in Bioidentical Hormone Replacement Therapy for men, which includes addressing symptoms of hormonal imbalance and customizing individual treatment programs using Bioidentical Hormones. Robin A. Bernhoft, M.D. will apply the newest and most effective methods for restoring optimal hormone balance using Bioidentical Hormone Replacement Therapy. He offers medically supervised programs, which include the most advanced delivery methods to help bring hormone levels back into balance. His programs can also treat the symptoms of andropause, helping men regain their health and confidence. Some of the conditions Robin A. Bernhoft, M.D. uses Bioidentical Hormone Replacement Therapy to treat in men include:

ADRENAL FATIGUE

Your adrenal glands release the hormone cortisol in response to stress, exercise, excitement, and low blood sugar. As you age, your body has a harder time balancing your cortisol levels. This can cause unrelenting fatigue, anxiety, sexual problems, and a wide range of other symptoms due to cortisol imbalance in your adrenal glands. Hormone restoration through Bioidentical Hormone Replacement Therapy can help speed up sluggish adrenal glands and provide you with more energy.

ALOPECIA (HAIR LOSS)

Dihydrotestosterone (DHT), which is part of the testosterone hormone, is responsible for hair loss on your scalp, face, chest, back, arms, legs, and groin area. When this hormone is unbalanced, it causes the follicles of your hair to regress and die. High levels of DHT can result in premature balding or thinning hair. If a full head of hair is important to you, remember that Bioidentical Hormone Replacement Therapy can stimulate hair growth.

ANDROPAUSE

By the time men reach age 70, they may have only 10 percent of the testosterone hormone they had at age 25. This explains why many men begin experiencing symptoms associated with low testosterone around age 40. Andropause is a term that describes the many physical and emotional changes that occur due to the imbalance of hormones. Testosterone replacement is essential to help you experience long-term symptom relief.

ANXIETY AND DEPRESSION

Low levels of testosterone cause an overall feeling of discontent in some men, which is the hallmark characteristic of hypogonadism. Balanced levels of this hormone are so essential that men with hypogonadism receive a diagnosis of clinical depression 400 times more often than men with normal hormone levels do. If you feel hopeless, low on energy, and irritable, ask Robin A. Bernhoft, M.D. to check your testosterone level. Bioidentical Hormone Replacement Therapy can help balance your hormones and improve your outlook on life.

CHRONIC FATIGUE

When fatigue is chronic, you lack the energy to focus or keep up with everyday responsibilities. Declining levels of testosterone are often to blame for this problem. Chronic fatigue is also worsened by other symptoms of andropause, including night sweats, insomnia, sleep apnea, increased stress, and irritability. It’s important to note that all-day fatigue is different than feeling tired. Fortunately, balancing your testosterone and other hormones with Bioidentical Hormone Replacement Therapy helps to improve fatigue and all of its associated symptoms.

CHRONIC HEADACHES

Cortisol, the stress hormone, can go into overdrive when you are under constant, unrelenting stress. This can cause daily headaches of varying intensity. The drop in testosterone starting at age 30 can also play a role in chronic headaches; Robin A. Bernhoft, M.D. can pinpoint an exact cause with a simple blood test. If your hormones are unbalanced, treatment with Bioidentical Hormone Replacement Therapy can help alleviate headache pain.

ERECTILE DYSFUNCTION

You have erectile dysfunction when you can’t get an erection at all or maintain one long enough for satisfying sexual activity. A diminished level of testosterone is the typical cause. This also happens when the brain fails to signal the release of nitrous oxide, which is responsible for blood flow to the penis. Too much of the stress hormone cortisol also plays a role in erectile dysfunction. Balancing testosterone and cortisol with Bioidentical Hormone Replacement Therapy can eliminate or improve this problem.

GASTROINTESTINAL DISORDERS

Gas, bloating, constipation, diarrhea, heartburn, belching, and slow digestion may all be related to imbalanced hormones in your body. Specifically, these problems could originate due to problems with normal thyroid functioning due to too much cortisol or estrogen. Many traditional doctors don’t treat digestion problems correctly because they don’t understand the connection to hormones. When diet, exercise, and medication aren’t working, consider replacing lost hormones through Bioidentical Hormone Replacement Therapy with Doctor Bernhoft.

INSOMNIA

Because testosterone normally replenishes itself while you are sleeping, struggling with insomnia lowers your testosterone production. This causes a vicious cycle because low testosterone levels cause many sleep disturbances, including insomnia and sleep apnea. While difficulty falling or staying asleep and decreased testosterone production are both normal signs of aging, you don’t have to allow them to affect your quality of life. Providing your body the testosterone it needs through Bioidentical Hormone Replacement Therapy can greatly improve restful sleep.

IRRITABLE BOWEL SYNDROME

Elevated stress levels and a weakened immune system can both cause IBS, which may present itself as abdominal pain, gas, bloating, or frequent diarrhea. In many cases, both stress and immune system deficiency are related to unbalanced levels of hormones. This can trigger an attack of IBS. Determining what triggers your symptoms, including certain foods and hormone imbalance, is the first step to helping you feel better. Bioidentical Hormone Replacement Therapy helps to balance the hormones responsible for triggering IBS symptoms.

LOW LIBIDO

The desire to have sex less often and erectile dysfunction are often related, but it’s possible to have one without the other. Testosterone stimulates the nerves in the brain to become sexually aroused, so this sensation naturally diminishes as you age. Smoking, drinking too much alcohol, and a poor diet are additional reasons your libido may be low. When combined with a healthy lifestyle, therapy with Bioidentical Hormones helps to improve your sexual desire and functioning.

LOW TESTOSTERONE

Low testosterone, which your doctor may also refer to as male menopause, hypogonadism, or andropause, is the term used to describe the multitude of symptoms many men experience as they approach middle age. Your testosterone production actually starts declining one percent every year at age 30. Sexual dysfunction, mood problems, weight gain, and low energy are common problems associated with low testosterone that are correctable with Bioidentical Hormone Replacement Therapy.

THYROID DISORDERS

Low thyroid levels in men can cause cold intolerance, fatigue, hair loss, weight gain, dry skin, and constipation; as many as one in seven men struggle with hypothyroidism. When the thyroid produces an excess of hormones, hyperthyroidism is the result. This condition has many additional symptoms, including muscle weakness, trembling hands, insomnia, and heart palpitations. Having your thyroid level checked by a hormone specialist such as Robin A. Bernhoft, M.D. and completing Bioidentical Hormone Replacement Therapy are essential to help you feel better.

Ojai, California Bioidentical Hormone Replacement Therapy specialist, Robin A. Bernhoft, M.D. at the Bernhoft Center for Advanced Medicine has helped countless men and women to overcome conditions related to hormonal imbalance or decline. Before beginning a Bioidentical Hormone Replacement Therapy program, Robin A. Bernhoft, M.D. tests the levels of all essential hormones in order to get to the root of patients’ imbalances. He then designs a personalized program using dosages that are unique to each patient. Vast numbers of men and women have been able to achieve peak levels of health with Doctor Bernhoft’s specialized Bioidentical Hormone Replacement Therapy programs.

Yes, I did try to find evidence for these claims. It’s a big job and a frustrating one too, as I was less than successful.

Now I am positively exhausted! Maybe I too need some of Bernhoft’s BHRT ?

 

During the last decades, the sales-figures for so-called alternative medicine (SCAM) have been increasing steadily and substantially. A recent report predicts this trend to continue:

… The global market for alternative and complementary medicines is projected to experience substantial growth in the next few years. The rising expenditure of the healthcare facilities is considered as the major factor that is likely to encourage the growth of the overall market in the coming years. In addition, the increasing number of initiatives being taken by Governments across the globe to promote alternative and complementary medicines is projected to accelerate the market’s growth. Thanks to these factors, the global alternative and complementary medicine market is likely to exhibit a promising growth rate in the near future.

A significant rise in the number of initiatives by NGOs and government organizations to encourage the use of alternative and complementary medicines is estimated to bolster global market in the near future. In addition to this, technological advancements in this field and the rising inclination of consumers towards these medicines and practices are likely to offer lucrative growth opportunities for the leading players operating in the alternative and complementary medicine market across the globe. However, the lack of scientific results is expected to hamper the overall growth of the market in the next few years…

From a regional perspective, Europe is considered as one of the leading segment, thanks to the significant revenue contribution in the last few years. This region is expected to account for a large share of the global alternative and complementary medicine market with the rising use of botanicals. In addition to this, the increasing awareness among consumers regarding the availability of effective alternative and complementary medicines and the benefits they offers are expected to encourage the growth of the Europe market in the coming years.

Furthermore, with the rising popularity of medical tourism, the alternative and complementary medicine market in Asia Pacific is projected to witness a steady growth in the next few years. Moreover, the presence of a large number of new players operating in this region is likely to offer promising growth opportunities over the forecast period. The Middle East and Africa segment is anticipated to experience a healthy growth in the alternative and complementary medicine market in the near future.

The global market for alternative and complementary medicines is presently at a highly competitive stage and is predicted to experience an intense level of competition among the leading players in the coming years. The prominent players in the market are focusing on the expansion of the product portfolio so as to attract a large number of consumers across the globe. This is likely to help them in creating a brand name and acquiring a leading position in the global market. Some of the leading players operating in the alternative and complementary medicine market across the globe are Herb Pharm, Yoga Tree, Quantum Touch Inc., Helio USA Inc., Pure encapsulations, Inc., Pacific Nutritional Inc., Deepure Plus, Herbal Hills, Iyengar Yoga Institute, The Healing Company, and Nordic Naturals.

Yes, I know, this is little more than hot air mixed with platitudes and advertisements to purchase the full report. I used to buy such documents for my department and research but was invariably disappointed. They provide are expensive and of very little of value.

Yet, one thing has been confirmed over the years: the prediction of steady growth of the SCAM-industry is rarely wrong (certain sections, such as homeopathy, have been shrinking in some regions, but the industry as a whole is financially healthy). The scientific evidence seems to get less and less convincing, yet consumers buy more and more of these products. They may do little good and have the potential to cause quite a bit of harm, but consumers continue to waste their money on them.

The question is: why?

There are, of course, many reasons. An important one is that the gullible public wants to believe in SCAM, and the SCAM-industry is highly skilled in misleading us. What is worse: many governments, instead of limiting the damage, are mildly or even overtly supportive of the SCAM-industry.

Whenever I contemplate this depressing state of affairs, I realise that my blog is important. It is only a drop in the ocean, I know, but still…

 

 

 

Dr Mathias Rath, the German born purveyor of multiple food supplements, and his organisation puzzle me a great deal. As previously reported, the ‘Dr Rath Foundation’ published an article about me. In it, the author got my name right, but not much more. Here is its opening passage [the numbers in square brackets refer to my comments below].

Professor Edzard Ernst: A Career Built On Discrediting Natural Health Science? [1]

Professor Edzard Ernst, a retired German [2] physician and academic, has recently [3] become a prominent advocate of plans that could potentially outlaw [4] the entire profession of naturopathic doctors [5] in Germany. Promoting the nonsensical idea that naturopathic medicine somehow poses a risk to public health, Ernst attacks its practitioners as supposedly having been educated in “nonsense” [6]. Tellingly, however, given that he himself has seemingly not published even so much as one completely original scientific trial of his own [7], Ernst’s apparent attempts to discredit natural healthcare approaches are largely reliant instead on his analysis or review of handpicked negative studies carried out by others [8].

  1. When I was appointed at Exeter to research alternative medicine in 1993, I had already been a full professor at Hannover, Germany and subsequently at Vienna, Austria. If anything, coming to Exeter was a big step down in terms of ‘career’, salary, number of co-workers etc. (full details in my memoir)
  2. I am German-born, became an Austrian citizen in 1990, and since 2000 I am a British national.
  3. I have been critical about the German ‘Heilpraktiker’ for more than 20 years.
  4. This refers to the recent ‘Muensteraner Memorandum’ which is the work of an entire team of multidisciplinary experts and advocates reforming this profession.
  5. ‘Heilpraktiker’ are certainly not doctors; they have no academic or medical background.
  6. This is correct, and I stand by my statement that educating people in vitalism and other long-obsolete concepts is pure nonsense.
  7. Since I am researching alternative medicine, I have conducted and published about 40 ‘scientific trials’, and before that time (1993) I have published about the same number again in various other fields.
  8. This refers to systematic reviews which, by definition, include all the studies available on a defines research question, regardless of their conclusion (their aim is to minimise random and selection biases)  .

Rath states about himself that “Dr. Rath heads a research and development institute in nutritional and Cellular Medicine. His institute is conducting basic research and clinical studies to scientifically document the health benefits of micronutrients in fighting a multitude of diseases.”

But this is equally puzzling.

Firstly, because research does not aim ‘to scientifically document the health benefits of ‘ anything; it is for testing hypotheses; Rath surely must know that. Secondly, on Medline, I find dozens of publications by Rath. These refer mostly to mechanistic in-vitro or animal studies about the mode of action of vitamins and other natural compounds.

But ‘clinical studies‘?

None!

Hold on! My Medline searches did deliver one clinical trial – just one – (Rath himself lists more, but they seem to be meaningless observational studies without a control group). It was published as an abstract on his own website. Here is the abstract:

Healing of bone fractures is a prolonged process that can be affected by nutrition. Our objective was to critically evaluate the effect of supplementation with an essential nutrient complex, containing ascorbic acid, lysine, proline, and vitamin B6 on healing time of tibial fractures.

Design:

Random double-blind placebo-controlled study

Setting:
Dr. Jamdar Hospital, Jabalpur, India

Subjects and Intervention:
113 patients with unilateral displaced closed or grade I open tibial fractures were randomized to receive either standard care with placebo or with supplementation with an essential nutrient complex containing ascorbic acid, lysine, proline, and vitamin B6. Qualifying patients, on admission to the study, were clinically examined, radiographs of the affected limbs taken, fractures reduced under anesthesia, and above knee plaster casts applied. Radiographs were taken at each follow-up visit to confirm reduced alignment of fracture and proper callus formation.

Primary Outcome Measure:
The primary outcome measure was the number of weeks required for fracture to be healed. Healing was defined as absence of abnormal mobility at fracture site clinically, absence of pain elicited by stressing the fracture or by walking, and radiographic confirmation of callus formation.

Results:
Data analysis demonstrated reduced fracture-healing time associated with experimental supplementation. For PP analysis group, fracture healing time in 75% of the supplemented group of patients (N=21) was 17 weeks or less and 19 weeks or less in 75% of the placebo group patients (N=36). The percentage of patients with fractures healing in 10 weeks or less was 33.3% for the supplemented group and 11.1% for the placebo group. However, the difference in healing time between the two groups did not reach statistical significance.

Conclusion:
Results showed encouraging trends that fracture-healing time is reduced by supplementation with an essential nutrient complex containing ascorbic acid, lysine, proline, and vitamin B6. In addition, the nutrient supplemented participants reported improved feeling of well-being with use of the supplement.

This is odd in several ways:

  1. Even though the conclusions hide it quite well, the trial was in fact negative, i. e. it failed to show a significant difference between the verum and the placebo in the primary outcome measure.
  2. The trial was never published as a peer-reviewed full paper. The website refers to its publication as a ‘letter to the editor’ (LTTE) in the notorious JACM (a LTTE is not normally peer-reviewed).
  3. Why was it never properly published?
  4. Could it be because there was no ethics approval [none was mentioned in the LTTE]?
  5. Could it be because there was no informed consent [none was mentioned in the LTTE]?
  6. The LTTE mentions that a larger study with 200 patients is planned. This was 16 years ago, and to date there is no trace of such a trial.

Rath’s latest contribution to the world of science is a paper implying that his supplements could play a role in the fight against the present pandemic; it is entitled ‘Effective and safe global public health strategy to fight the COVID-19 pandemic: Specific micronutrient composition inhibits Coronavirus cell-entry receptor (ACE2) expression’. Here is the abstract which clearly shows that Rath has not a jot of clinical evidence:

Optimum micronutrient intake is the only scientifically proven way to improve general immune resistance against infections, a fact documented in every leading textbook of biology.  This study provides scientific evidence that, in addition, specific micronutrient compositions are powerful tools in the fight against the COVID-19 pandemic.

Both, SARS-CoV-2 – the virus that causes the current pandemic – and other coronaviruses enter body cells via a specific receptor, the Angiotensin-Converting-Enzyme 2 (ACE2). The ACE2 receptor is expressed by many cell types, including lung epithelial cells as well as endothelial cells of the vascular system.

Based on our earlier research that demonstrated that specific micronutrients can block several mechanisms of viral infections, we tested the efficacy of these natural compounds in suppressing the expression of the ACE2 receptor on human endothelial cells and small airway epithelial cells.

Our results show that a micronutrient composition comprising vitamin C as well as certain amino acids, polyphenols, and trace elements is able to suppress this viral ‘entry door’ into the body under both normal and inflammatory conditions, which are associated with infections.

Thus, vitamin-rich nutrition and micronutrient supplementation should be implemented as effective, safe and affordable public health strategies to fight the COVID-19 pandemic and help prevent future outbreaks.  Optimizing the micronutrient status of the entire population should form the basis for any global strategy to help prevent future pandemics across the world, including the developing nations.

The Wiki-page on Rath lists 10 (!) legal cases in which he has been involved. This looks like he easily sues people who disagree with his often bizarre views and sales techniques. Considering this suspicion, I better be careful what I say here. Therefore let me conclude by meekly repeating the title of this post which comes from my friend Ben Goldacre who, together with THE GUARDIAN won a famous and expensive legal battle against Rath:

Rath is an example of the worst excesses of the alternative therapy industry.

 

 

 

PS

What I like best about the many supplements sold by Rath is the footnote in the patient leaflets:

THIS PRODUCT IS NOT INTENDED TO DIAGNOSE, TREAT, CURE OR PREVENT ANY DISEASE

Acute radiation-induced proctitis (ARP) is a common side effect following radiotherapy for malignant pelvic disease. It occurs in about 75% of patients and often proves difficult to treat thus causing much pain and suffering. Aloe vera has been advocated for the prevention of ARP, but does it work?

This study evaluated the efficacy of Aloe vera ointment in prevention of ARP. Forty-two patients receiving external-beam radiotherapy (RT) for pelvic malignancies were randomized to receive either Aloe vera 3% or placebo topical ointment during radiotherapy for 6 weeks. Participants applied ointments especially manufactured for the study rectally via applicator, from the first day of starting radiotherapy for 6 weeks, 1 g twice daily. They were evaluated based on the severity (grade 0-4) of the following symptoms weekly: rectal bleeding, abdominal/rectal pain, diarrhoea, or faecal urgency. RTOG acute toxicity criteria and psychosocial status of the patients were also recorded weekly. Lifestyle impact of the symptoms, and quantitative measurement of C-reactive protein (CRP), an indicator of systemic inflammation, were also measured.

The results demonstrated a significant preventive effect for Aloe vera in occurrence of symptom index for diarrhoea (p < 0.001), rectal bleeding (p < 0.001), and faecal urgency (p = 0.001). The median lifestyle score improved significantly with Aloe vera during RT (p < 0.001). Intervention patients had a significant lower burden of systemic inflammation as the values for quantitative CRP decreased significantly over 6 weeks of follow-up (p = 0.009).

The authors concluded that Aloe vera topical ointment was effective in prevention of symptoms of ARP in patients undergoing RT for pelvic cancers.

This is by no means the first study of its kind. A previous trial had concluded that a substantial number of patients with radiation proctitis seem to benefit from therapy with Aloe vera 3% ointment. And another study has shown that the prophylactic use of Aloe vera reduces the intensity of radiation-induced dermatitis.

The new trial seems to be methodologically the best so far. Yet it is not perfect, for instance, its sample size is small. Therefore, it would probably be wise to insist on more compelling evidence before this approach can be recommended in oncological routine care.

At present, we see a wave of promotion of Traditional Chinese Medicine (TCM) as a treatment of corona-virus infections. In this context, we should perhaps bear in mind that much of the Chinese data seem to be less than reliable. Moreover, I find it important to alert people to a stern warning recently published by two Australian experts. Here is the crucial passage from their paper:

We wish to highlight significant concerns regarding the association between traditional herbal medicines and severe, non-infective interstitial pneumonitis and other aggressive pulmonary syndromes, such as diffuse alveolar haemorrhage and ARDS which have emerged from Chinese and Japanese studies particularly during the period 2017−2019. Initially the association between traditional herbal therapies and pneumonitis was based on isolated case reports. These included hypersensitivity pneumonitis associated with the use of traditional Chinese or Japanese medicines such as Sai-rei-to, Oren-gedoku-to, Seisin-renshi-in and Otsu-ji-to (9 references in supplemental file). Larger cohorts and greater numbers now support this crucial relationship. In a Japanese cohort of 73 patients, pneumonitis development occurred within 3 months of commencing traditional medicine in the majority of patients [], while a large report from the Japanese Ministry of Health, Labor and Welfare, described more than 1000 cases of lung injury secondary to traditional medications, the overwhelming majority of which (852 reports) were described as ‘interstitial lung disease [].

Currently the constituent of traditional herbal medicines which is considered most likely to underlie causation of lung disease is Scutellariae Radix also known as Skullcap or ou-gon, which has been implicated through immunological evidence of hypersensitivity as well as circumstantial evidence, being present in all of those medicines outlined above []. Notably, skullcap is a constituent of QPD as used and described in the paper by Ren et al. relating to COVID-19 []. Scutellariae Radix-induced ARDS and COVID-19 disease share the same characteristic chest CT changes such as ground-glass opacities and airspace consolidation, therefore distinguishing between lung injury due to SARS-CoV-2 and that secondary to TCM may be very challenging. The potential for iatrogenic lung injury with TCM needs to be acknowledged []…

Morbidity and mortality from COVID-19 are almost entirely related to lung pathology []. Factors which impose a burden on lung function such as chronic lung disease and smoking are associated with increased risk for a poor outcome. Severe COVID-19 may be associated with a hypersensitivity pneumonitis component responsive to corticosteroid therapy []. Against this background the use of agents with little or no evidence of clinical efficacy and which have been significantly implicated in causing interstitial pneumonitis that could complicate SARS-CoV-2 infection, should be considered with extreme caution.

In conclusion, the benefits of TCM in the treatment of COVID-19 remain unproven and may be potentially deleterious. We recognise that there is currently insufficient evidence to prove the role of TCM in the causation of interstitial pneumonitis, however the circumstantial data is powerful and it would seem prudent to avoid these therapies in patients with known or suspected SARS-CoV-2 infection, until the evidence supports their use.

Declaration of Competing Interest: There are no conflicts to declare.

I have to admit that the ‘Asian Journal of Pharmaceutical Research and Development‘ did not formerly belong to my reading list. This will have to change, I guess, because any journal capable of publishing such a hilarious spoof ought to be read regularly.

The article in question is entitled ‘An Integrative Medicine Is Prudential Hope for Covid-19 Therapeutics‘ and is authored by Mayank dimri, Rajendra Singh Pawar, Virbal Singh Rajwar, Luv Kush from the SBS University Balawala, Dehradun- Uttarakhand, India. The paper is so unique that I simply could not resist showing you an excerpt. I hope  you have as much fun reading it as I had when I was alerted to this masterpiece.

Antiviral Astrological Rationality The viral infectivity is governed by Saturn, Rahu and Ketu. COVID-19 is geminian virus, ruled by mercury. It rules lungs / respiratory system and also health/ nutrition house (6th). Antiviral astrological advices are: Stay away from crowds, maintain maximum cleanness and personal hygiene, dietary regimens should be enriched by vitamins, vegetables, nuts and fruits. The foods and drinking water should be warm. The cold and unhealthy environment may be avoided.

The complimentary / alternative integrative medicine conceptualized ethical use of traditional re- medies with
self-responsibility. The concept of herd immunity (epidemological) relates to population. The orthomolecular
medicine10prescribe nutritional supplements for restoration of antiviral immunity. Both have antiviral benefits for fighting global pandemic of COVID-19.

The desirable antiviral activities are anti-replicating to block viral replication, anti-inflammatory for preventing
viral inflammation. Immune stimulatory for strengthening innate immunity and anti-mutagenic for curbing viral mutations.

The ayurvedic herbs have antiviral phytochemicals. Some of them are listed here: Ursolic acid, Apigenin, Rosmarinic acid, Oleanolic acid, Elenoic acid, Hypercin,Liquiritigenin, Acetoside, Glycyrrhizin etc. They have anti RSV activity and possibly prevent viral entry to host cells. The plant extract of Plantago asiatica and Clerodendrum trichotomum proved to be effective antiviral. Fifatrol is an ayurvedic prized medicine against viruses. It is useful in treatment of viral upper respiratory infections and relief from nasal congestion. It is a supportive therapy against COVID-19 virus.

The synergism of vitamins (A, C, D, E) acts as revitaler for fighting against COVID-19. Vitamin C has great potential
as antiviral for respiratory infections. It prevents cytokine induced lung damage and natural immune booster.

Eucalyptus oil has multiple benefits.It is supporter of respiratory system, immune booster and anti-inflammatory. Aromadendrene is an aroma therapeutical, present in oil and moderate antiviral….

I know that the last few months have not been easy for many of us. Therefore, we should be all the more thankful for those who lighten our spirits with some comic relief…

 

 

… or did they actually mean what they wrote?

When I discuss published articles on this blog, I usually focus on recent papers. Not so today! Today I write about a small study we published 17 years ago. It was conducted in Canada by researchers whom I merely assisted in designing the protocol and interpreting the findings.

They trained 8 helpers to pretend being customers of health food stores. They entered individually into assigned stores; the helpers had been informed to browse in the store until approached by an employee. At this time they would declare that their mother has breast cancer. They disclosed information on their mother’s condition, use of chemotherapy (Tamoxifen) and physician visits, only if asked. The helpers would then ask what the employee recommend for this condition. They followed a structured, memorized, pretested questionnaire that asked about product usage, dosage, cost, employee education and product safety or potential for drug interactions.

The helpers recorded which products were recommended by the health food store employees, along with the recommended dose and price per product as well as price per month. Additionally, they inquired about where the employee had obtained information on the recommended products. They also noted whether the employees referred them on to SCAM practitioners or recommended that they consult a physician. Full notes on the encounters were written immediately after leaving the store.

The findings were impressive. Of the 34 stores that met our inclusion criteria, 27 recommended SCAMs; a total of 33 different products were recommended. Here are some further findings:

  • Essiac was recommended most frequently.
  • The mean cost of the recommended products per month was $58.09 (CAD) (minimum $5.28, median $32.99, maximum $600).
  • Twenty-three employees (68%) did not ask whether the patient took prescription medications.
  • Fifteen (44%) employees recommended visiting a healthcare professional; these included: naturopaths (9), physicians (5) and nutritionists (1).
  • Health food store employees relied on a variety of sources of information. Twelve employees (35%) said they had received their information from books, 5 (15%) from a supplier, 3 (9%) had formal education in SCAM, 2 (6%) had in-store training, and 12 (35%) did not disclose their sources of information.

Since our paper has been published, several other investigations have addressed similar issues. Here are a few excerpts:

But why do I mention all this today?

The answer is that firstly, I think it is important to warn consumers of the often dangerous advice they might receive in HFSs. Secondly, I feel it would worthwhile to do further research, check whether the situation has changed and repeat a similar study today. Ideally, a new investigation should be conducted in different locations comparing several countries. If you have the possibility to plan and conduct such an experiment, please drop me a line.

1 2 3 17
Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories