herbal medicine
Many garlic supplements are heavily marketed as a treatment of infections.
But are they really effective?
To answer this question, we clearly need clinical trials.
The aim of this RCT was to examine the impact of garlic tablets on nosocomial infections in hospitalized patients in intensive care units. It was carried out on 94 patients, admitted to the intensive care units in Kashani and Al-Zahra hospitals. Patients were randomised into case and control groups. The case group administered one 400 mg garlic tablet (Garlic tablets 400 mg, Gol Darou Company) daily for 6 days and the control group received placebo. During the study, inflammatory blood factors and infection occurrence in the two groups were compared. During the study period, 78 intravenous catheter tips were sent to laboratory for culture of which 37 cases were in the intervention group and 41 in the control group. Culture results of Catheter tips was positive in 5 cases all of which were in the control group. Frequency distribution of catheter tip culture was significantly higher in the control group than that of the intervention group. The authors concluded that garlic supplementation has shown to be effective in patients admitted to ICU, who are highly susceptible to nosocomial infection, and it can be used for the prevention of septicemia and urinary tract infections. However, further research with larger sample size is needed.
The trouble is not just that this trial was less than rigorous, but that there are so very few similar investigations to confirm or refute the anti-infectious activities of garlic.
In this study, healthy human participants (n = 120), between 21 and 50 y of age, were recruited for a randomized, double-blind, placebo-controlled parallel-intervention study to consume 2.56 g aged garlic extract (AGE)/d or placebo supplements for 90 d during the cold and flu season. Peripheral blood mononuclear cells were isolated before and after consumption, and γδ-T and NK cell function was assessed by flow cytometry. The effect on cold and flu symptoms was determined by using daily diary records of self-reported illnesses. After 45 d of AGE consumption, γδ-T and NK cells proliferated better and were more activated than cells from the placebo group. After 90 d, although the number of illnesses was not significantly different, the AGE group showed reduced cold and flu severity, with a reduction in the number of symptoms, the number of days participants functioned suboptimally, and the number of work/school days missed. The authors concluded that AGE supplementation may enhance immune cell function and may be partly responsible for the reduced severity of colds and flu reported. The results also suggest that the immune system functions well with AGE supplementation, perhaps with less accompanying inflammation.
There is plenty of in vitro evidence to suggest that garlic and its compounds have anti-bacterial, anti-viral and anti-fungal effects. Yet, for a range of reasons, this may not translate into clinical effects. To find out, we need clinical trials. So far, such investigations were almost entirely missing.
The two recent studies above are, I think, a good start. They are far from perfect but their findings are nevertheless mildly encouraging. For once, I do agree with the standard conclusion in alternative medicine:
More and better clinical trials are justified.
The ‘Daily Mail’ is not a paper famed for its objective reporting. In politics, this can influence elections; in medicine, it can endanger public health.
A recent article is a case in point, I think.
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Traditional Chinese medicines could help prevent heart disease and the progression of pre-diabetes, according to research. Some herbal treatments proved as effective in lowering blood pressure as Western drugs and improved heart health by lowering cholesterol, scientists found. Certain alternative medicines could lower blood sugar and insulin levels, too.
Chinese medicines could be used alongside conventional treatments, say researchers from Shandong University Qilu Hospital in China. Or they can be beneficial as an alternative for patients intolerant of Western drugs, they said in their review of medical studies over a ten-year period. Senior review author from the university’s department of traditional Chinese medicine said: ‘The pharmacological effects and the underlying mechanisms of some active ingredients of traditional Chinese medications have been elucidated. Thus, some medications might be used as a complementary and alternative approach for primary and secondary prevention of cardiovascular disease.”
It’s potentially good news for people living with diabetes, which is now a global epidemic and has proved a tricky condition to manage for many people. High blood pressure is very common too, affecting more than one in four adults in the UK, although many won’t show symptoms and realise it. If untreated, it increases your risk of serious problems including heart disease, the number one killer globally.
The Chinese have used herbs for treating diseases for thousands of years and have become increasingly popular in Europe and North America, mainly as complement to Western medicine. But the researchers also warn that much of the research conducted have limitations and so their long-term effects are not proven.
Key findings
Herbs for high blood pressure
The blood pressure-lowering effect of herb zhongfujiangya was found to be similar to that of oral anti-hypertension medication benazeprilm, which goes by the brand name Lotensin. Similarly, patients treated for eight weeks with herbal tiankuijiangya had a lower reading than those given a placebo. Herbal Jiangya tablets were found to ‘significantly lower’ systolic blood pressure, that is the amount of pressure in your arteries during contraction of your heart muscle compared to a fake treatment. The herb Jiangyabao also had a significant effect compared to a placebo, but just at night. But overall, compared to the drug Nimodipine, a calcium channel blocker, it worked just as well. Qiqilian capsules also proved more effective compared to a placebo.
Herbs for diabetes
The team report some Chinese medicines medications – such as xiaoke, tangminling, jinlida, and jianyutangkang – have a ‘potent’ effect on lowering blood sugar levels and b-cell function, which controls the release of insulin. Some remedies – such as tangzhiping and tianqi – might prevent the progression of pre-diabetes to diabetes, they note.
Herbs for cholesterol
The researchers looked at research on dyslipidemia, the term for unbalanced or unhealthy cholesterol levels. They found that jiangzhitongluo, salviamiltiorrhiza and pueraria lobata, and zhibitai capsule all have a ‘potent lipid-lowing effect’.
Herbs for heart disease
Some traditional Chinese medicines such as qiliqiangxin, nuanxin, shencaotongmai, and yangxinkang, might be effective in improving function in patients with chronic heart failure, they wrote.
Limitations with trials
But Western scientists often reject Chinese medicine for specific reasons, warned Dr Zhao’s team. Chinese medicines are frowned upon because they do not go through the same exhaustive approval process as trials conducted domestically, they pointed out. Plus, one treatment can be made of many different ingredients with various chemical compounds, making it hard to pinpoint how their benefits work. ‘One should bear in mind that traditional Chinese medicine medications are usually prescribed as complex formulae, which are often further manipulated by the practitioner on a personalized basis,’ said Dr Zhao.
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Apart from the fact that this article is badly written, it is also misleading to the point of being outright dangerous. Regular readers of my blog will be aware that Chinese research is everything but reliable; there are practically no Chinese TCM-trials that report negative results. Furthermore, the safety of Chinese herbal preparations is as good as unknown and they are often contaminated with toxic substances as well as adulterated with synthetic drugs. Most of these preparations are also unavailable outside China. Moreover, Chinese herbal treatments are usually individualised (mixtures are tailor-made for each individual patient), and there is no good evidence that this approach is effective. Crucially, the trial evidence is often of such poor quality that it would be a dangerous mistake to trust these findings.
None of these important caveats, it seems, are important enough to get a mention in the Daily Mail.
Don’t let the truth get in the way of a sensational story!
Let’s just for a moment imagine what would happen if people took the Mail article seriously (is there anyone out there who does take the Mail seriously?). In a best case scenario, they would take Chinese herbs in addition to their prescribed medication. This might case plenty of unwanted side-effects and herb-drug interactions. In addition, people would lose a lot of their hard-earned cash. In a worst case scenario, they would abandon their prescribed medication for dubious Chinese herbal mixtures. This could cause thousands of premature deaths.
With just a little research, I managed to find the original article on which the Mail’s report was based. Here is its abstract:
Traditional Chinese medicine (TCM) has more than 2,000 years of history and has gained widespread clinical applications. However, the explicit role of TCM in preventing and treating cardiovascular disease remains unclear due to a lack of sound scientific evidence. Currently available randomized controlled trials on TCM are flawed, with small sample sizes and diverse outcomes, making it difficult to draw definite conclusions about the actual benefits and harms of TCM. Here, we systematically assessed the efficacy and safety of TCM for cardiovascular disease, as well as the pharmacological effects of active TCM ingredients on the cardiovascular system and potential mechanisms. Results indicate that TCM might be used as a complementary and alternative approach to the primary and secondary prevention of cardiovascular disease. However, further rigorously designed randomized controlled trials are warranted to assess the effect of TCM on long-term hard endpoints in patients with cardiovascular disease.
In my view, the authors of this review are grossly over-optimistic in their conclusions (but nowhere near as bad as the Mail journalist). If the trials are of poor quality, as the review-authors admit, no firm conclusions should be permissible about the usefulness of the therapies in question.
As the Mail article is obviously based on a press release (several other papers worldwide reported about the review as well), it seems interesting to note what the editor of the Journal of the American College of Cardiology (the journal that published the review) recently had to say about the responsibility of journalists and researchers:
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…I would like to suggest that journalists and researchers must share equally in shouldering the burden of responsibility to improve appropriate communication about basic and clinical research.
First, there is an obligation on the part of the researchers not to inflate the importance of their findings. This has been widely recognized as damaging, especially if bias is introduced in the paper…
Second, researchers should take some responsibility for the creation of the press release about their research, which is written by the media or press relations department at their hospital or society. Press releases are often how members of the media get introduced to a particular study, and these releases can often introduce errors or exaggerations. In fact, British researchers evaluated 462 press releases on biomedical and health-related science issued by 20 leading U.K. universities in 2011, alongside their associated peer-reviewed research papers and the news stories that followed (n = 668). They found that 40% of the press releases contained exaggerated advice, 33% contained exaggerated causal claims, and 36% contained exaggerated inference to humans from animal research. When press releases contained such exaggeration, 58%, 81%, and 86% of news stories, respectively, contained further exaggeration, compared with rates of 17%, 18%, and 10% in the news when the press releases were not exaggerated. Researchers should not be excused from being part of the press release process, as the author(s) should at least review the release before it gets disseminated to the media. I would even encourage researchers to engage in the process at the writing stage and to not allow their hospital’s or society’s public relations department to extrapolate their study’s results. Ultimately, the authors and the journals in which the studies are published will be held accountable for the information that trickles into the headlines, not the public relations departments, so we must make sure that the information is accurate and representative of the study’s actual findings.
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Sound advice indeed.
Now we only need to ALL follow it!!!
The title of the article actually was ‘SIX REASONS TO TRY A WEATGRASS COLONIC’. I will only repeat parts of the introduction, but please do take the time to read the full text, particularly if you feel sad or depressed – it is hilarious!
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If you’ve ever had a colonoscopy, then you may be familiar with colonics. Colon cleansing is normally used to prepare for medical procedures. However, some alternative medicine practitioners might offer colon cleansing for other reasons, such as detoxification. During a colon cleanse, large amounts of water are flushed through the colon, along with other ingredients, such as herbs, teas, juice or coffee. This takes place with a tube that’s inserted into the rectum. In some cases, and depending on the colonic, smaller amounts of water along with other substances are left in the colon for about 30 minutes before being removed.
Wheatgrass is a humble weed that has a wide variety of health benefits for the body due to high concentrations of chlorophyll, active enzymes, vitamins and other nutrients. According to Israeli research on wheatgrass, lab studies suggest that it may have anticancer potential. In animal experiments, wheatgrass demonstrated possible benefits in cancer prevention and as an aid to cancer treatment — particularly chemotherapy. In clinical trials wheatgrass was found to improve chemotherapy and decrease chemotherapy-related side effects.
Wheatgrass has also been found to support the immune system and help repair damaged cells. It’s also shown promise for conditions such as:
- Rheumatoid arthritis
- Ulcerative colitis
- Hematological diseases
- Diabetes
- Obesity
- Oxidative stress (the body’s ability to repair damage)
Wheatgrass colonics cleanse and nourish the colon, according to digestive wellness center Vitallife. And effects are felt almost immediately. This is attributed to wheatgrass’s dense nutrient profile, which contains over 90 minerals, and the high absorption rate of the colon. Both factors allow for easy and fast entry into the bloodstream.
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The article motivated me to come up with my SIX REASONS TO AVOID A WHEATGRASS COLONIC. Here they are:
- The treatment is not effective.
- It is uncomfortable.
- It is not safe.
- It costs money.
- It has no plausibility.
- There are better therapeutic options for whatever condition you want to treat.
I know, some of my reasons are not entirely scientific or fully evidence-based. But, if you read the article which inspired me to write this post, you will discover, I am sure, that my version is a whole dimension better than the original.
The BMJ has always been my favourite Medical journal. (Need any proof for this statement? A quick Medline search tells me that I have over 60 publications in the BMJ.) But occasionally, the BMJ also disappoints me a great deal.
One of the most significant disappointments was recently published under the heading of STATE OF THE ART REVIEW. A review that is ‘state of the art’ must fulfil certain criteria; foremost it should be informative, unbiased and correct. The paper I am discussing here has, I think, neither of these qualities. It is entitled ‘Management of chronic pain using complementary and integrative medicine’, and here is its abstract:
Complementary and integrative medicine (CIM) encompasses both Western-style medicine and complementary health approaches as a new combined approach to treat a variety of clinical conditions. Chronic pain is the leading indication for use of CIM, and about 33% of adults and 12% of children in the US have used it in this context. Although advances have been made in treatments for chronic pain, it remains inadequately controlled for many people. Adverse effects and complications of analgesic drugs, such as addiction, kidney failure, and gastrointestinal bleeding, also limit their use. CIM offers a multimodality treatment approach that can tackle the multidimensional nature of pain with fewer or no serious adverse effects. This review focuses on the use of CIM in three conditions with a high incidence of chronic pain: back pain, neck pain, and rheumatoid arthritis. It summarizes research on the mechanisms of action and clinical studies on the efficacy of commonly used CIM modalities such as acupuncture, mind-body system, dietary interventions and fasting, and herbal medicine and nutrients.
The full text of this article is such that I could take issue with almost every second statement in it. Obviously, this would be too long and too boring for this blog. So, to keep it crisp and entertaining, let me copy the (tongue in cheek) ‘letter to the editor’ some of us published in the BMJ as a response to the review:
“Alternative facts are fashionable in politics these days, so why not also in healthcare? The article by Chen and Michalsen on thebmj.com provides a handy set of five instructions for smuggling alternative facts into medicine.
1. Create your own terminology: the term ‘complementary and integrated medicine’ (CIM) is nonsensical. Integrated medicine (a hotly disputed field) already covers complementary and conventional medicine.
2. Pretend to be objective: Chen and Michalsen elaborate on the systematic searches they conducted. But they omit hundreds of sources which do not support their message, which cherry-picks only evidence for the efficacy of the treatments they promote.
3. Avoid negativity: they bypass any material that might challenge what they include. For instance, when discussing therapeutic risks, they omit the disturbing lack of post-marketing surveillance: the reason we lack information on adverse events. They even omit to mention the many fatalities caused by their ‘CIM’.
4. Create an impression of thoroughness: Chen and Michalsen cite a total of 225 references. This apparent scholarly attention to detail masks their misuse of many of they list. Reference 82, for example, is employed to back up the claim that “satisfaction was lowest among complementary medicine users with rheumatoid arthritis, vasculitis, or connective tissue diseases”. In fact, it shows nothing of the sort.
5. Back up your message with broad generalisations: Chen and Michalsen conclude that “Taken together, CIM has an increasing role in the management of chronic pain, but high quality research is needed”. The implication is that all the CIMs mentioned in their figure 1 are candidates for pain control – even discredited treatments such as homeopathy.
In our view, these authors render us a service: they demonstrate to the novice how alternative facts may be used in medicine.”
James May, Edzard Ernst, Nick Ross, on behalf of HealthWatch UK
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I am sure you have your own comments and opinions, and I encourage you to post them here or (better) submit them to the BMJ or (best) both.
I know, many of you think that proponents of alternative therapies are a bit daft, intellectually challenges or naïve. This may be true for some of them, but others are very much on the ball and manage things that seemed almost impossible. Who, for instance, would have thought it possible to combine all of the following features, concepts and principles in one single alternative approach:
- healing,
- creativity,
- simplicity,
- balance,
- alkalizing,
- maintenance,
- going green,
- tradition,
- holism,
- synergism,
- beauty,
- the deepest level,
- new way of living,
- goodness,
- medicinal food,
- adaptogen,
- vitality,
- immunity,
- live food,
- etheric potion,
- cosmic beam,
- wellness,
- longevity,
- alchemizing,
- elixir,
- superior states of clarity.
You may think it impossible, but Amanda Chantal Bacon has skilfully combined all of them. A true feast, I hope you agree. Amanda believes that “food is as much about pleasure as healing; creativity as sustenance; and simplicity as the exquisite.” Amanda has several cards up her sleeve; one trump card is to alkalize. Alkaline foods, she claims, “balance your pH, making your body an inhospitable environment for disease. Disease can only exist in acidic states, so keeping an alkaline climate in your body is the ultimate form of protection. Existing in an alkaline state is a key to maintaining a calm and joyful life. Alkalinity will promote not only peace within but also an overall glow with radiant skin and sparkling eyes. A simple tip to remember: just go green when in doubt. Our favorite daily alkalizers are green juice, almonds, lemon and apple cider vinegar.”
Amanda is as creative as she is productive. She invented several formulas for the good of her customers: “When I compose a recipe, I draw inspiration from both my far flung travels and my local farmers markets; the traditional pairings of my culinary training and the chefs I have worked with; holistic remedies and artisanal producers. When I create a juice or a milk or a cookie I want it not only to taste extraordinary, but also to work synergistically to heal and enhance your beauty, brain, body and spirit at the deepest level.”
In her pursuit of good health, well being, holism and deeper levels, Amanda created a firm called ‘Moon Juice’ which is “for people interested in a new way of living. Not a way where you have to erase your past, but a way fueled by excitement to help yourself live better. Our only intention is to add goodness and beauty to your life.”
“In 2006” Amanda explains, “I began studying the power of raw, medicinal foods to heal the hypothyroid condition I had had since I was a teen, in addition to my severe allergies to wheat, sugar, and cow dairy. Although I was still working as a chef in fine dining, at this juncture my whole diet changed. I ate primarily vegetables and legumes from the farmers market, and foods that would serve as hormonal adaptogens. Within a few months, I noticed a radical shift. My next round of blood work revealed that my thyroid hormone levels were back to normal. Working in fine dining was amazing, but my own transformative experience – backed up by extensive blood tests, the scrutiny of several physicians, renewed feelings of vitality, and a shift in my personality, immunity, appearance, and thought – inspired me to create Moon Juice. These live, medicinal foods changed me from the inside out. That is what Moon Juice is – not just our products – but rather a healing force, an etheric potion, a cosmic beacon for those seeking out beauty, wellness, and longevity. There is nothing I want more than to share this experience and education with as many people as I can.”
Well?
Perhaps there is something that Amanda might want even more: your money?
Amanda is not selfish; no, she wants everyone to benefit from her inventions. Therefore, she sells her products; the one I liked best was Brain Dust™ . This is “an enlightening edible formula alchemized to align you with the mighty cosmic flow needed for great achievement. An adaptogenic elixir to maintain healthy systems for superior states of clarity, memory, creativity, alertness and a capacity to handle stress.” The ingredients of Brain Dust are Organic Astragalus, Shilajit, Maca, Lion’s Mane, Rhodiola, Ginkgo and Organic Stevia. Of course, such an exquisite product has to come at a price: you can purchase one jar (14 servings) of Brain Dust for US$ 30.
As I said, not all of them are daft!
How Jackfruit Kills Cancer… This title hardly left any doubt that jackfruit (Artocarpus heterophyllus Lam) is effective in curing cancer. The website [url disabled by admin because of suspected phishing site] continued in this vein:
“Jackfruit contains phytonutrients like lignans, saponins, and isoflavones, which have anticancer, antihypertensive, anti-ulcer, antioxidant, and anti-aging properties (2).
Isoflavones are also beneficial phytoestrogens that have been proven to reduce the risk of breast, endometrial, and prostate cancers (4,5).
Saponins, on the other hand, kill cancer cells by directly binding to cells as well as boosting white blood cell activity and preventing cell differentiation and proliferation (6,7).
Lastly, the cancer-preventing abilities of the fruit are due in part to dietary TF-binding lectins (8). The pulp has the ability to reduce the mutagenicity of carcinogens and combat the proliferation of cancer cells (9).
In addition, the fruit contains carotenoids, flavonoids, and polyphenols that lower blood pressure, fight stomach ulcers, boost metabolism, support nerve function, and play a role in hormone synthesis. They also contain polysaccharides that boost immunity by interacting with white blood cells, including T cells, monocytes, macrophages, and polymorphonuclear lymphocytes (10).
Each part of the fruit and tree can be used: the flowers help stop bleeding in open wounds, prevent ringworm infestations, and heal cracks in dry feet while the root is used to treat skin diseases, asthma, and diarrhea. Additionally, the wood has a sedative and abortifacient effect…”
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To many desperate cancer patients, this would sound convincing, not least because the references provided by the author look sophisticated and seem to back up most of the claims made.
But where are the references to clinical trials showing that jackfruit does cure this or that type of cancer? Where is the evidence that it does “lower blood pressure, fight stomach ulcers, boost metabolism, support nerve function, and play a role in hormone synthesis”? Where are the data to prove that it does “boost immunity”?
I did conduct a ‘rough and ready’ Medline search and found precisely nothing; not a single clinical trial that would confirm the multiple claims made above.
You are not surprised?
Neither am I!
But what about the desperate cancer patients?
How many fell for the scam? How many gave up their conventional cancer treatments and used jackfruit instead? How many consumers know that it is not unusual for plants to contain lignans, saponins, isoflavones and many other ingredients that have amazing effects in vitro? How many know that this rarely translates into meaningful health effects in human patients?
We will never know.
One thing we do know, however, is that articles like this one can cost lives, and that alternative cancer cures are and always will be a myth.
Traditional and folk remedies have been repeatedly been reported to contain toxic amounts of lead. I discussed this problem before; see here, here, and here. Recently, two further papers were published which are relevant in this context.
In the first article, Indian researchers presented a large series of patients with lead poisoning due to intake of Ayurvedic medicines, all of whom presented with unexplained abdominal pain.
In a retrospective, observational case series from a tertiary care center in India, the charts of patients who underwent blood lead level (BLL) testing as a part of workup for unexplained abdominal pain between 2005 and 2013 were reviewed. The patients with lead intoxication (BLLs >25 μg/dl) were identified and demographics, history, possible risk factors, clinical presentation and investigations were reviewed. Treatment details, duration, time to symptomatic recovery, laboratory follow-up and adverse events during therapy were recorded.
BLLs were tested in 786 patients with unexplained abdominal pain, and high levels were identified in 75 (9.5%) patients of which a majority (73 patients, 9.3%) had history of Ayurvedic medication intake and only two had occupational exposure. Five randomly chosen Ayurvedic medications were analyzed and lead levels were impermissibly high (14-34,950 ppm) in all of them. Besides pain in abdomen, other presenting complaints were constipation, hypertension, neurological symptoms and acute kidney injury. Anemia and abnormal liver biochemical tests were observed in all the 73 patients. Discontinuing the Ayurvedic medicines and chelation with d-penicillamine led to improvement in symptoms and reduction in BLLs in all patients within 3-4 months.
The authors of this paper concluded that the patients presenting with severe recurrent abdominal pain, anemia and history of use of Ayurvedic medicines should be evaluated for lead toxicity. Early diagnosis in such cases can prevent unnecessary investigations and interventions, and permits early commencement of the treatment.
The second article German researchers analysed 20 such ‘natural health products’ (NHPs) from patients with intoxication symptoms. Their findings revealed alarming high concentrations of mercury and/or lead (the first one in “therapeutic” doses). 82 % of the studied NHPs contained lead concentrations above the EU limit for dietary supplements. 62 % of the samples exceeded the limit values for mercury. Elevated blood lead and mercury levels in patients along with clinical intoxication symptoms corroborate the causal assumption of intoxication (s).
The authors concluded that, for NHPs there is evidence on a distinct toxicological risk with alarming low awareness for a possible intoxication which prevents potentially life-saving diagnostic steps in affected cases. In many cases patients do not communicate the events to their physicians or the local health authority so that case reports (e.g. the BfR-DocCentre) are missing. Thus, there is an urgent need to raise awareness and to initiate more suitable monitory systems (e.g. National Monitoring of Poisonings) and control practice protecting the public.
The authors of the 2nd paper also reported a detailed case report:
Patient, male, 31 with BMI slightly below normal, non-smoker, was referred to the neurological department of the university clinic with severe peripheral poly neuropathy and sensory motor symptoms with neuropathic pain. The patient was in good general state of health until approximately 3 weeks before hospital admission; he spent his holiday in Himalaya region and came back with headaches and fatigue. He was taking pain medication without any relieve; his routine blood values were normal. He claimed to take no further medications. Since poly neuropathy and fatigue could be caused by pesticides or other poisoning, i.e. heavy metals, we have been consulted for taking a detailed exposure history. While in the clinic, 3 different NHPs were found in form of globules, (a, b, c for morning, lunch time and evening respectively), which he imported from his trip to Asia and ingested 3 times a day against stress. We have analyzed these 3 NHPs and found: 45 μg/g, 53,000 μg/g and 28 μg/g lead (for morning, midday and evening globules, respectively) and additionally 15.72 μg/g mercury in the “evening globules”. Since, his blood metal levels were: 340 μg/L Pb and 15 μg/L Hg a diagnosis of heavy metal intoxication was made. Slowly occurring clinical recovery after starting chelation therapy corroborated with the causal assumption proposed. He was released for further consultancy to his family physician. The administrated treatment and the improvement of his status corroborate lead and mercury intoxication.
The researchers finish their paper with this stark warning: In many countries, even in Germany, no comprehensive nutria vigilance- or poisoning monitoring system exists, from which the application of natural health products and the consequent intoxication can be estimated. There is also an urgent need for comprehensive scientifically evaluated studies based on efficient national monitoring to protect the consumer from heavy metal intoxications. There are no comparable surveillance systems like the US ABLES program for lead- and no surveillance systems for mercury exposures allowing any comparisons. Exposure to lead and mercury from environmental sources remains an overlooked and serious public health risk.
The aim of this paper was to systematically review effectiveness, safety, and robustness of evidence for complementary and alternative medicine in managing premature ejaculation (PE). Nine databases were searched through September 2015. Randomized controlled trials (RCTs) evaluating complementary and alternative medicine for PE were included. Studies were included if they reported on intravaginal ejaculatory latency time (IELT) and/or another validated PE measurement. Adverse effects were summarized.
Ten RCTs were included. Two assessed acupuncture, five assessed Chinese herbal medicine, one assessed Ayurvedic herbal medicine, and two assessed topical “severance secret” cream. Risk of bias was unclear in all studies because of unclear allocation concealment or blinding, and only five studies reported stopwatch-measured IELT. Acupuncture slightly increased IELT over placebo in one study (mean difference [MD] = 0.55 minute, P = .001). In another study, Ayurvedic herbal medicine slightly increased IELT over placebo (MD = 0.80 minute, P = .001). Topical severance secret cream increased IELT over placebo in two studies (MD = 8.60 minutes, P < .001), although inclusion criteria were broad (IELT < 3 minutes). Three studies comparing Chinese herbal medicine with selective serotonin reuptake inhibitors (SSRIs) favored SSRIs (MD = 1.01 minutes, P = .02). However, combination treatment with Chinese medicine plus SSRIs improved IELT over SSRIs alone (two studies; MD = 1.92 minutes, P < .00001) and over Chinese medicine alone (two studies; MD = 2.52 minutes, P < .00001). Adverse effects were not consistently assessed but where reported were generally mild.
The authors concluded that there is preliminary evidence for the effectiveness of acupuncture, Chinese herbal medicine, Ayurvedic herbal medicine, and topical severance secret cream in improving IELT and other outcomes. However, results are based on clinically heterogeneous studies of unclear quality. There are sparse data on adverse effects or potential for drug interactions. Further well-conducted randomized controlled trials would be valuable.
One has to be an optimist to agree that this constitutes ‘preliminary evidence for the effectiveness of acupuncture, Chinese herbal medicine, Ayurvedic herbal medicine, and topical severance secret cream in improving IELT and other outcomes.’ In the discussion section, the authors stress that “…all 10 studies were classed as having an overall unclear risk of bias because of unclear reporting of allocation concealment (all 10 studies) and unclear blinding of participants and personnel (five studies).” This hardly allows even a preliminary conclusion, in my view.
So, what DOES this review show? I think it demonstrates that
- alternative therapies are being touted and occasionally tested for even the most unlikely conditions,
- the quality of the studies is generally too poor to justify the research (particularly in an area as intrusive as PE),
- clinical trials often seem to be used not for finding answers but for promotion,
- in alternative medicine, trialists regularly violate research ethics by failing to report adverse effects.
In the realm of alternative medicine, the Internet is a double-edged sword. It can be most useful to many, particularly to those who are able to think critically. To those who do not have this ability, it can be outright dangerous. We have researched this area in several way and always arrived at this very conclusion. For instance, we evaluated websites providing advice for cancer patients and concluded that “the most popular websites on complementary and alternative medicine for cancer offer information of extremely variable quality. Many endorse unproven therapies and some are outright dangerous.”
This makes it abundantly clear that, for some, the Internet can become a danger to their health and life. Recently I was reminded of this fact when I saw this website entitled ‘Foods that will naturally cleanse your arteries’. Its message is instantly clear, particularly as it provides this impressive drawing.
.
The implication here is that we can all clear our arteries of atherosclerotic plaques by eating the right foods. The site also lists the exact foods. Here they are:
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Salmon
Salmon is one of the best heart foods as it is packed with healthy fats which reduce cholesterol, triglycerides, and inflammation. However you must make sure that the fish is organic.
Orange juice
Orange juice is rich in antioxidants which strengthens the blood vessels and lowers blood pressure. Simply drink 2 glasses of fresh orange juice a day and you’re good to go.
Coffee
According to numerous studies 2-4 cups of coffee a day can significantly reduce the risk of stroke and heart attack by 20%. However don’t drink excessively as it may cause problems with your digestion.
Nuts
Nuts are packed with omega-3 fatty acids, healthy properties and unsaturated fats which regulate your memory, cholesterol and prevent joint pain.
Persimmon fruit
The persimmon fruit is packed with fiber and sterols which help lower cholesterol. It makes a great addition to salads and cereals
Turmeric
Curcumin, the active ingredient in turmeric provides a large variety of health benefits. It helps reduce tissue inflammation and prevents overactive fat accumulation. Feel free to add it to your meals or to your tasty cup of tea.
Green tea
Aside from having a soothing effect, green tea helps energize the whole body, boost the metabolism and lower the absorption of cholesterol. Just drink 1-2 cups of green tea a day and you have nothing to worry about.
Cheese
Cheese can also help lower blood pressure and cholesterol.
Watermelon
Watermelon is the most delicious summer fruit. But aside from its amazing taste, it also improves the production of nitric oxide which enhances the function of the blood vessels.
Whole grain
Whole grains are rich in fiber content which helps lower cholesterol and cholesterol accumulation in the arteries. Consume more whole grain bread, brown rice and oats.
Cranberries
Cranberries have been long known to be the richest source of potassium. Due to this, they can easily lower bad cholesterol and increase the good one. 2 glasses of cranberry juice a day can lower the risk of heart attack by 40%.
Seaweed
Seaweeds are packed with vitamins, proteins, minerals and carotenoids which easily regulate your blood pressure.
Cinnamon
Cinnamon prevents buildups in the arteries and lower cholesterol.
Pomegranate
It is an exotic fruit that provides a healthy portion of phytochemicals. These improve the production of nitric oxide, and boost circulation. Add pomegranate seeds to your salads.
Spinach
It is high in folic acid and potassium. You need this to lower your blood pressure, strengthen muscles, and prevent heart attack.
Broccoli
Broccoli is rich in vitamin K, which help lower blood pressure and cholesterol when eaten steam-cooked or raw.
Olive oil
Olive oil helps maintain your health at its peak. Be sure to use cold-pressed oil as it is rich in healthy fats which lower cholesterol and reduce the risk of heart attack by 40%.
Asparagus
Asparagus prevents inflammation, clogging and lowers cholesterols. Implement it to dishes, noodles, soups or potatoes.
Blueberries
Blueberries are high in potassium and as we mentioned above, potassium is the key to reducing bad cholesterol and increasing the good one. Drink 2 glasses of blueberry juice a day.
Avocado
Avocadoes are without a doubt – one of the healthiest fruits known to man. They’re rich in healthy fat and improve the balance of bad and good cholesterol.
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As far as I know, there is no good evidence for the claim that any of these 20 foods will clear arteriosclerotic arteries. There is some evidence for fish oil and some for green tea to reduce the risk of cardiovascular disease. But surely, this is quite a different matter than reversing atherosclerotic plaques.
What’s the harm? I believe the potential for harm is obvious: people at high risk of suffering a major cardiovascular event who read such nonsense and believe it might think they can abandon the treatments, drugs and life-styles they have been advised to follow and take. Instead they might eat a bit more of the 20 ingredients listed above. If they did that, many would die.
I think many of us who know better have become far too tolerant of dangerous nonsense of such nature. We tend to think that either nobody is as stupid as to follow such silly advice, or we assume that taking a bit of daft advice will not do much harm. I fear we are wrong on both accounts.
A recent article in the Guardian revealed that about one third of Australian pharmacists are recommending alternative medicines with little-to-no evidence for their efficacy, including useless homeopathic products and potentially harmful herbal products.
For this survey of 240 Australian pharmacies, mystery shoppers were sent in to speak to a pharmacist at the prescription dispensing counter and ask for advice about feeling stressed. The results show that three per cent of the pharmacists recommended homeopathic products, despite a comprehensive review of all existing studies on homeopathy finding that there is no evidence they work in treating any condition and that ‘people who choose homeopathy may put their health at risk if they reject or delay treatments’. Twenty-six percent of all pharmacists recommended Bach flower remedies to relieve stress. A comprehensive review of all existing studies on Bach flower remedies found no difference between the remedies and placebos. Fifty-nine per cent of people were just told the complementary and alternative product recommended to them worked, and 24% were told the product was scientifically proven, without any evidence being provided to them.
Asked about these findings, Dr Ken Harvey, a prominent Australian expert, said they demonstrated that some pharmacists were failing in their professional duty to consumers. “Pharmacists are giving crazy advice, and it is dangerous in some cases,” he said. “My view is that pharmacists, if they are going to sell these products, need to have a big shining sign over the shelves of the complementary and alternative medicine section that says ‘these products have not been assessed by the government regulators to see if they work, please talk to pharmacist’.Pharamacists are giving poor advice and they clearly have a conflict of interest,” Harvey said.
If you had hoped that in other countries pharmacists behave more responsibly, I must disappoint you. The information available shows that, when it comes to alternative medicine, pharmacists across the globe act much more like shop-keepers than like health care professionals. They are in the habit of putting profit before their duty to abide by the rules of evidence-based practice. And, in doing do, they violate their own ethical codes so regularly that I ask myself why they bothered to even implement one.
On this blog I have written so often about this issue that one could come to the conclusion that I have a bee under my bonnet:
- Pharmacists: to sell quackery means you are quacks – or have I got that wrong?
- Pharmacists must use their professional judgement to prevent the supply of homeopathic remedies
- A pharmacist’s defence of homeopathy
- When will pharmacists finally stop selling homeopathic remedies?
- The homeopathic emergency kit: it must be good, it’s recommended by pharmacists
- Why do pharmacists sell bogus medicines?
- Pharmacists should finally get their act together…or lose credibility
The truth, however, is not that I am the victim of a bee.
The truth is that this is a very important public health issue.
The truth is that pharmacists show little signs of even trying to get to grips with it.
The truth is that pharmacists who sell bogus medicines put profit before professional ethics.
The truth is that such behaviour is not that of health care professionals but that of shop-keepers.
The truth is that I intend to carry on reminding these pharmacists that they are behaving like charlatans.
