osteoarthritis
Spanish colleagues and I just published an article entitled “Is Osteopathic Manipulative Treatment Clinically Superior to Sham or Placebo for Patients with Neck or Low-Back Pain? A Systematic Review with Meta-Analysis”. Here is its abstract:
The aim of this systematic review and meta-analysis was to compare whether osteopathic manipulative treatment (OMT) for somatic dysfunctions was more effective than sham or placebo interventions in improving pain intensity, disability, and quality of life for patients with neck pain (NP) or low-back pain (LBP). Methods: A systematic review and meta-analysis was carried out. Searches were conducted in PubMed, Physiotherapy Evidence Database, Cochrane Library, and Web of Science from inception to September 2024. Studies applying a pragmatic intervention based on the diagnosis of somatic dysfunctions in patients with NP or LBP were included. The methodological quality was assessed with the PEDro scale. The quantitative synthesis was performed using random-effect meta-analysis calculating the standardized mean difference (SMD) with RevMan 5.4. The certainty of evidence was evaluated using GRADEPro. Results: Nine studies were included in the qualitative synthesis, and most of them showed no superior effect of OMTs compared to sham or placebo in any clinical outcome. The quantitative synthesis reported no statistically significant differences for pain intensity (SMD = −0.15; −0.38, 0.08; seven studies; 1173 patients) or disability (SMD = −0.09; −0.25, 0.08; six studies; 1153 patients). The certainty of evidence was downgraded to moderate, low, or very low. Conclusions: The findings of this study reveal that OMT is not superior to sham or placebo for improving pain, disability, and quality of life in patients with NP or LBP.
As always, it seems important to stress that our review has several limitations. Firstly, the searches were conducted in the most relevant databases; however, some studies not indexed in these sources may have been missed. Secondly, the diverse NP and LBP diagnosis, as well as the lack of data reported by some studies, complicates the interpretation of the results and may weaken our conclusion. Thirdly, the primary studies pragmatically applied interventions based on diagnoses of various somatic dysfunctions, resulting in a high degree of heterogeneity among the treatments applied.
Despite these limitations, it is fair to say, I think, that OMT is not nearlly as solidly supported by reliable evidence as most osteopaths try to make us believe. In essence, this means that, if you suffer from NP or LBP, you best concult a proper doctor or physiotherapist.
The aim of this article was to review the use of homeopathy in rheumatic diseases (RDs). PubMed and Embase databases were examined for literature on homeopathy and RDs between 1966 and April 2023. 15 articles were included.
The diseases treated were
- osteoarthritis (n=3),
- rheumatoid arthritis (n=3),
- ankylosing spondylitis (n=1),
- hyperuricemia (n=1),
- tendinopathy (n=1).
The age of the patients varied from 31 to 87 years, and male gender ranged from 56.7% to 100%. The homeopathic treatments varied from a fixed medicine to an individualized homeopathy.
Most studies (9/15) demonstrated improvements after homeopathy. Side effects were not seen or minimal and were comparable to those of the placebo groups.
The authors concluded that this review shows homeopathy is a promising and safe therapy for RD treatment. However, the data needs to be reproduced in future more extensive studies, including other rheumatic conditions.
This paper amounts to an insult of its readership!
Not only is it badly written but also [and more importantly] it is missing almost everything that makes a systematic review. Despite this the authors claim that it “adhered to PRISMA standards”. This is certainly not true.
Amongst the missing items, the most important ones are probably the evaluation of the methodological quality of the inclued primary studies as well as a critical assessment of the evidence. The authors concede that their paper has limitations: “the number of participants was low. Second, a few RDs were evaluated: osteoarthritis, rheumatoid arthritis, fibromyalgia, hyperuricemia, ankylosing spondylitis, and
tendinopathy.”
When reading this, I asked myself: are they clueless or dishonest?
In my view, the authors (from Brasil and Israel) and peer-reviewers of this paper should be ashamed of such shoddy work and the editors of the journal publishing this nonsense should withdraw the paper asap.
This study aimed at examining the feasibility issues of comparing individualized homeopathic medicines (IHMs) with identical-looking placebos for treating knee osteoarthritis (OA).
Forty eligible patients participated in this double-blind, randomized (1:1), placebo-controlled feasibility trial in the outpatient clinics of a homeopathic hospital in West Bengal, India. Either IHMs or identical-looking placebos were administered, along with mutually agreed-upon concomitant care guidelines. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was the primary outcome measure, along with derived Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores from KOOS. The EQ-5D-5L questionnaire and Visual Analog Scale (VAS) were the secondary outcomes. All were measured at baseline and after 2 months. Group differences and effect sizes (Cohen’s d) were estimated using an intention-to-treat approach. p-Values less than 0.05 (two-tailed) were considered statistically significant.
Enrolment/screening and trial retention rates were 43% and 85% respectively. Recruitment was difficult owing to the coronavirus disease 2019 (COVID-19) lockdown. Group differences were statistically significant, favoring IHMs against placebos in all the KOOS sub-scales: symptoms (p < 0.001), pain (p = 0.002), activities of daily living (p < 0.001), sports or recreation (p = 0.016), and quality of life (p = 0.002). Derived WOMAC scores from KOOS favored IHMs against placebos: stiffness (p < 0.001) and pain (p < 0.001). The EQ-5D-5L questionnaire score (p < 0.001) and EQ-5D-5L VAS scores (p < 0.001) also yielded significant results, favoring IHMs over placebos. All the effect sizes ranged from moderate to large. Sulphur was the most frequently prescribed homeopathic medication. Neither group reported any harm or serious adverse events.
The authors concluded that, although recruitment was sub-optimal due to prevailing COVID-19 conditions during the trial, the action of IHMs was found to be superior to that of placebos in the treatment of knee OA. Larger and more definitive studies, with independent replications, are warranted in order to substantiate the findings.
Sorry, but I don’t understand this: the authors stated multiple times that this was a feasibility study (which tests feasibility and not effectiveness), and then they promptly report effectiveness data for which the trial was grossly under-powered (i.e. too small). Why are they doing such nonsense? Perhaps their affiliations provide a hint?
- 1Department of Materia Medica, D. N. De Homoeopathic Medical College and Hospital, Kolkata; affiliated to The West Bengal University of Health Sciences, Kolkata, West Bengal, India.
- 2Department of Repertory, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
- 3Department of Organon of Medicine and Homoeopathic Philosophy, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
- 4Department of Practice of Medicine, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
- 5Department of Surgery, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
- 6Department of Homoeopathy, East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, West Bengal, India.
- 7Department of Community Medicine, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
I do symathise with the pressures of reporting positive findings, if your salary comes from homeopathic institutions. Yet, I cannot help but pointing out:
THESE FINDINGS ARE INVALID AND FALSE-POSITIVE!
Osteoarthritis of the knee (OAK) is a chronic degenerative musculoskeletal disorder that strongly affects the elderly population and decreases their quality of life. Pain, stiffness, and restricted knee movements are the major characteristic features of OAK. There are no studies available on the effect of the liver 7 (LR 7) acupuncture point on pain and range of motion. This study therefore tested the effectiveness of the LR 7 acupuncture point on pain and range of motion in chronic OAK patients.
Thirty-five subjects aged between 40 and 65 years were recruited from Government Yoga and Naturopathy Medical College, Chennai. Participants were included in the study after they fulfilled the eligibility criteria. The duration of acupuncture was 20 minutes (5 days/week) for 2 weeks. Baseline and post-intervention assessments were performed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the degree of knee flexion and extension was measured using a goniometer.
Pre- and post-trial outcomes were compared using paired t-tests. LR 7 acupuncture reduced the WOMAC score from 49 to 30 (p < 0.001), indicating that pain was alleviated. Treatment increased the range of knee flexion from 110 to 115 degrees and reduced knee extension (p < 0.01) from 16 to 9 degrees (p < 0.001). These findings indicate that acupuncture treatment improved the range of knee movement.
The authors concluded that the present study showed that 10 sessions of LR 7 acupuncture for people with OAK significantly reduced pain and increased range of motion. We conclude that LR 7 acupuncture is an adjuvant therapy for alleviating pain and managing OAK.
On several levels, this is a shocking paper:
- There already are many controlled clinical trials of acupuncture for OAK; thus there is no reason whatsoever to conduct and publish a trial that is methodolagically inferior to this body of evidence.
- The conclusions are incorrect; as the study had no control group, it is impossible to establish causaality between the treatment and the outcome. The pain reduction might have been caused by phenomena that are unrelated to acupuncture, e.g. placebo effect, regression towards the mean, social desirability.
- The authors state that they are “grateful to principal and faculities of government of yoga and naturopathy medical college and hospital for their support”. This means that they were misguided by a governmental medical college and hospital in planning and running a study that is a waste of resources and thus arguably unethical.
Research of this nature is dangerous:
- It undermines the trust people put in science.
- It makes a laughing stock of more serious attempts to test the value of acupuncture.
- It misuses the cooperation of patients who give their time and good will to advance our knowledge.
- It wasts precious resources.
- It is an incentive for others to do similarly nonsensical pseudo-science.
- It misleads patients and carers into believing in quackery.
The only valid conclusion that can be drawn from this paper is, I think, this:
The people involed in planning, conducting, supporting and publishing this study have little understanding of clinical research and should receive adequate education and training before they are allowed to continue.
This study evaluated efficacy of krill oil supplementation, compared with placebo, on knee pain in people with knee osteoarthritis who have significant knee pain and effusion-synovitis. It was designed as a multicenter, randomized, double-blind, placebo-controlled clinical trial that took place in 5 Australian cities. Participants with clinical knee osteoarthritis, significant knee pain, and effusion-synovitis on magnetic resonance imaging were enrolled from December 2016 to June 2019; final follow-up occurred on February 7, 2020.
The patients received
- 2 g/d of krill oil (n = 130)
- or matching placebo (n = 132) for 24 weeks.
The primary outcome was change in knee pain as assessed by visual analog scale (range, 0-100; 0 indicating least pain; minimum clinically important improvement = 15) over 24 weeks.
Of 262 participants randomized (mean age, 61.6 [SD, 9.6] years; 53% women), 222 (85%) completed the trial. Krill oil did not improve knee pain compared with placebo (mean change in VAS score, -19.9 [krill oil] vs -20.2 [placebo]; between-group mean difference, -0.3; 95% CI, -6.9 to 6.4) over 24 weeks. One or more adverse events was reported by 51% in the krill oil group (67/130) and by 54% in the placebo group (71/132). The most common adverse events were musculoskeletal and connective tissue disorders, which occurred 32 times in the krill oil group and 42 times in the placebo group, including knee pain (n = 10 with krill oil; n = 9 with placebo), lower extremity pain (n = 1 with krill oil; n = 5 with placebo), and hip pain (n = 3 with krill oil; n = 2 with placebo).
The authors concluded that, among people with knee osteoarthritis who have significant knee pain and effusion-synovitis on magnetic resonance imaging, 2 g/d of daily krill oil supplementation did not improve knee pain over 24 weeks compared with placebo. These findings do not support krill oil for treating knee pain in this population.
This is a rigorous and well-presented study. Apart from the ineffectiveness of krill, it confirms two issues very clearly:
- Placebo effects plus regression to the mean can lead to symptomatic improvements.
- Adverse effects occur even with placebo therapy.
Krill is a small crustacean consumed by whales, penguins and other sea creatures. It is a source of omega 3 fatty acids. The alleged benefits of krill supplements include anti-inflammatory effects. So, it could theoretically help reducing the inflammation that is part of knee osteoarthritis.
A review including five trials with 700 patients using krill oil for knee pain was recently published. Results showed no significant difference between krill oil and placebo for knee pain, knee stiffness, and lipid profiles. However, krill oil demonstrated a significant small effect in improving knee physical function. Trial sequential analysis provided certainty that krill oil enhances knee physical function compared to placebo and indicated no improvement in knee pain, but the findings for knee stiffness need to be confirmed by further research. The authors concluded that krill oil supplementation did not significantly improve knee pain, stiffness, or lipid profile, although it may help knee physical function. Based on these findings, krill oil supplementation is not yet justified for knee pain.
The two papers should settle the issue: KRILL IS NOT EFFECTIVE FOR KNEE OSTEOARTHRITIS. Will this stop the many manufacturers of krill supplements selling their products to gullible consumers? I would not hold my breath.
What is it about Reiki that fascinates me?
It must be the exemplary poor science that its proponents use trying to convince us that it is valid.
This randomized controlled trial investigated the effect of Reiki on pain, functional status, and holistic well-being in patients with knee osteoarthritis (OA). The sample consisted of 42 patients.
- The control group received standardized treatment only.
- The intervention group received face-to-face Reiki (nine positions; 39 minutes) and distance Reiki on two consecutive days in addition to standardized treatment in addition to standard treatment.
The results show that the Reiki group had lower pain scores than the control group as measured by the Visual Analog Scale (p < .001) and the Western Ontario and McMaster Universities Arthritis Index pain score (p < .001). Those participating in the Reiki group had improved holistic well-being scores specifically for the subscales of Sadness, Perception of Sadness, Spiritual Disruption, Cognitive Awareness, and General mood.
The authors concluded that Reiki is a safe, noninvasive, and cost-effective alternative treatment technique that has the potential to reduce symptoms of pain and improve holistic well-being in patients with knee OA.
So many falsehoods in one sentence!
Is this a new record?
Let’s analyse these conclusions a little, shall we?
- Reiki is safe: this does not follow from the data because the sample was far too small for assessing rare safety issues, safety was not measured, and half of the Reiki group might have dropped dead a week after the study.
- Reiki is non-invasive: that might be true.
- Reiki is cost-effective: cost-effectiveness was not an endpoint; the statement is thus not supported by the data.
- Reiki reduces the symptoms of pain and improve holistic well-being in patients with knee OA: I disagree! The observed outcomes are much more likely caused by the considerable amount of extra attention and treatment time given to the Reiki group, and the results were entirely unrelated to any specific effects of the therapy.
So, I feel the need for re-phrasing the conclusions as follows:
Reiki is an implausible treatment and the outcomes of this study are unrelated to any alleged specific effects of this therapy.
The McTimoney College of Chiropractic just announced that it has established a new four-year program in veterinary chiropractic for college students:
It means that those without a prior degree can undertake the training and education necessary to enter this coveted career. To date, animal chiropractors were required to have a prior qualification in human chiropractic or a degree in the relevant sciences.
Applications for the new program are being accepted from September 2023. Students will attend Abingdon-based University, Oxford, and a variety of practical locations, enabling the development of academic knowledge and the application of practical skills together . Modules include anatomy and physiology, veterinary science, practice and professionalism, and clinical skills, with a research dissertation running over the four-year course.
University director Christina Cunliffe said the new program was an exciting step in the development of chiropractic care for animals.
“Building on our decades of experience graduating confident, competent, and highly-skilled animal chiropractors, now is the time to open up this exciting career opportunity to college students.”
For the past 50 years, McTimoney College of Chiropractic has been training and educating human chiropractors to the highest regulatory standards. Over the past 20 years, animal chiropractic has developed to meet the requirements for this gentle, holistic treatment in the veterinary world.
Prospective students are invited to a Open House at McTimoney College of Chiropractic in Abingdon on February 16.
McTimoney Chiropractic for Animals identifies areas of stiffness, asymmetry, and poor range of motion within the skeletal system, particularly the spine and pelvis. This affects the muscles that surround these structures, as well as the nerve impulses that pass from the central nervous system to the periphery of the body. The adjustments are very light and fast, stimulating an instant response in the affected soft tissues and joints, promoting relaxation of muscle spasms, improving nerve function, and helping the skeletal structure regain better symmetry and movement again.
In many cases, animals suffer from underlying conditions such as arthritic changes or degenerative diseases that force them to compensate in their posture and movement in an attempt to remain comfortable. However, these offsets become increasingly entrenched and can be painful or uncomfortable, requiring chiropractic care to provide some relief. In other cases, the animals are working hard or competing and as such accumulate tension and asymmetries due to the demands of their work. Once again, chiropractic care helps relieve pain and promote performance, whether it’s faster speeds over hurdles for racehorses and events, better jumping style in showjumpers, or more extravagant movements for dressage stars.
Two recent graduates of the school’s Master of Animal Handling (Chiropractic) program did not hesitate to recommend the university. Natalie McQuiggan said that she had wanted to do McTimoney Chiropractic from a very young age, “but the process of doing it always seemed really daunting.
“But from the start, the staff and teachers were lovely and welcoming, and queries were answered promptly. I have really enjoyed my two years in the Master of Animal Handling (Chiropractic) program and would recommend anyone thinking of doing it to just do it.”
Pollyanna Fitzgerald said the university offered a supportive and welcoming learning environment, allowing her to grow and develop as a student and future professional. “There is always someone to talk to and offer encouragement when needed. As a student I have learned a lot and have been encouraged to believe in myself and it has been a wonderful place to learn.”
A free webinar, McTimoney’s Animal Chiropractic as a Careeron January 24 at 7:30 p.m. (GMT), is open to those who wish to learn more about the McTimoney technique and its application, and the training paths available to those interested in becoming a McTimoney Animal Chiropractor.
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I think this announcement is puzzling on several levels:
- I was unable to find an ‘Abingdon-based University, Oxford’; could it be this institution that is a college and not a university?
- Christina Cunliffe seems to be (or has been?) affiliated with the McTimoney College of Chiropractic which is a bit odd, in my opinion.
- The college does not have ‘decades of experience’; it was founded only in 2001.
- Most importantly, I am unable to find a jot of good evidence that veterinary chiropractic is effective for any condition (see also here, here, and here). In case anyone is aware of any, please let me know. I’d be delighted to revise my judgment.
If I am right, the new course could be a fine example of quackademia where students are ripped off and taught to later rip off the owners of animals after the academically trained quacks have mistreated them.
Placebo effects are a fascinating subject. In so-called alternative medicine (SCAM), they are particularly important because much of SCAM seems to rely on little more than placebo effects. Therefore, I think this new paper is of some relevance to us.
The aim of this systematic review was to quantify the placebo effect of intraarticular injections for knee osteoarthritis in terms of pain, function, and objective outcomes. Factors influencing placebo effect were investigated.
Out of 2,363 records, 50 articles on 4,076 patients were included. The meta-analysis showed significant improvements up to the 6-month follow-up: Visual Analogue Scale (VAS)-pain −13.4 mean difference (MD) (95% confidence interval [CI]: −21.7/−5.1; P < 0.001), Western Ontario and McMaster Osteoarthritis Index (WOMAC)-pain −3.3 MD (95% CI: −3.9/−2.7; P < 0.001). Other significant improvements were WOMAC-stiffness −1.1 MD (95% CI: −1.6/−0.6; P < 0.001), WOMAC-function −10.1 MD (95% CI: −12.2/−8.0; P < 0.001), and Evaluator Global Assessment −21.4 MD (95% CI: −29.2/−13.6; P < 0.001). The responder rate was 52% (95% CI: 40% to 63%). Improvements were greater than the “minimal clinically important difference” for all outcomes (except 6-month VAS-pain). The level of evidence was moderate for almost all outcomes.
The authors concluded that the placebo effect of knee injections is significant, with functional improvements lasting even longer than those reported for pain perception. The high, long-lasting, and heterogeneous effects on the scales commonly used in clinical trials further highlight that the impact of placebo should not be overlooked in the research on and management of knee osteoarthritis.
The authors furthermore confirmed that “the main finding of this meta-analysis is that placebo is an important component of the effect of injective treatments for patients with KOA, with saline injections being able to provide relevant and long-lasting results not only in terms of pain relief but also with respect to stiffness resolution and function improvement. These results are both statistically and clinically significant and can be perceived by patients up to 6 months.”
I would dispute that!
To explain why it might help to read our 1995 BMJ paper on the subject:
We often and wrongly equate the response seen in the placebo arm of a clinical trial with the placebo effect. In order to obtain the true placebo effect, other non-specific effects can be identified by including an untreated control group in clinical trials. A review of the literature shows that most authors confuse the perceived placebo effect with the true placebo effect. The true placebo effect is highly variable, depending on several factors that are not fully understood. A distinction between the perceived and the true placebo effects would be helpful in understanding the complex phenomena involved in a placebo response.
In other words, what the authors picked up in their analysis (i.e. the changes that occurred in the placebo groups between the start of a trial and after placebo application) is not just the placebo response; it is, in fact, a combination of a placebo effect, concomitant interventions/care, regression towards the mean, natural history of the condition and possibly other factors.
Does it matter?
Yes, it does!
Placebo effects are not nearly as powerful and long-lasting as the authors conclude. And this means virtually all their implications for clinical practice are incorrect.
This study describes the use of so-called alternative medicine (SCAM) among older adults who report being hampered in daily activities due to musculoskeletal pain. The characteristics of older adults with debilitating musculoskeletal pain who report SCAM use is also examined. For this purpose, the cross-sectional European Social Survey Round 7 from 21 countries was employed. It examined participants aged 55 years and older, who reported musculoskeletal pain that hampered daily activities in the past 12 months.
Of the 4950 older adult participants, the majority (63.5%) were from the West of Europe, reported secondary education or less (78.2%), and reported at least one other health-related problem (74.6%). In total, 1657 (33.5%) reported using at least one SCAM treatment in the previous year.
The most commonly used SCAMs were:
- manual body-based therapies (MBBTs) including massage therapy (17.9%),
- osteopathy (7.0%),
- homeopathy (6.5%)
- herbal treatments (5.3%).
SCAM use was positively associated with:
- younger age,
- physiotherapy use,
- female gender,
- higher levels of education,
- being in employment,
- living in West Europe,
- multiple health problems.
(Many years ago, I have summarized the most consistent determinants of SCAM use with the acronym ‘FAME‘ [female, affluent, middle-aged, educated])
The authors concluded that a third of older Europeans with musculoskeletal pain report SCAM use in the previous 12 months. Certain subgroups with higher rates of SCAM use could be identified. Clinicians should comprehensively and routinely assess SCAM use among older adults with musculoskeletal pain.
I often mutter about the plethora of SCAM surveys that report nothing meaningful. This one is better than most. Yet, much of what it shows has been demonstrated before.
I think what this survey confirms foremost is the fact that the popularity of a particular SCAM and the evidence that it is effective are two factors that are largely unrelated. In my view, this means that more, much more, needs to be done to inform the public responsibly. This would entail making it much clearer:
- which forms of SCAM are effective for which condition or symptom,
- which are not effective,
- which are dangerous,
- and which treatment (SCAM or conventional) has the best risk/benefit balance.
Such information could help prevent unnecessary suffering (the use of ineffective SCAMs must inevitably lead to fewer symptoms being optimally treated) as well as reduce the evidently huge waste of money spent on useless SCAMs.
S-adenosyl methionine – SAMe for short – is a popular dietary supplement available freely via the Internet. It is a naturally occurring methyl radical donor involved in enzymatic transmethylation reactions in humans and animals. It has been used for treating postpartum depression, cholestatic jaundice, osteoarthritis, and numerous other conditions. SAM-e has poor oral bioavailability. SAM-e has so far been thought of as safe. The most frequent adverse effects reported were gastrointestinal, such as nausea, and skin rashes.
I have been involved in two systematic reviews that produced positive evidence for the effectiveness of SAMe:
- One review found “consistent evidence that … S-adenosyl methionine was effective in the management of osteoarthritis.”
- Another review showed that for fibromyalgia “the effects of … S-adenosylmethionine … showed at least one statistically significant improved outcome compared with placebo.”
Now the safety of SAMe has been questioned by new research. A team from Manchester and Kyoto universities reported that the supplement can break down inside the body into substances that cause a wide range of medical problems, including kidney and liver damage. Their study showed that “excess S-adenosylmethionine disrupts rhythms and, rather than promoting methylation, is catabolized to adenine and methylthioadenosine, toxic methylation inhibitors.”
Jean-Michel Fustin, of Manchester University, said experiments that he and his collaborators had carried out had revealed that SAMe breaks down into adenine and methylthioadenosine in the body. These substances are known to be toxic, he added. “This discovery came out of the blue,” Fustin said last week. “When we gave the supplement to mice we expected they would become healthier. But instead we found the opposite. We found that when SAMe breaks down in the body, it produces very toxic molecules, including adenine which causes gout, kidney disease and liver disease.” Fustin added that, although their study was carried out on mice, their results were relevant for humans. “We have not yet tested the supplement on men and women but we have added it to human cells in laboratory cultures and have found it had the same effect as it had on mice.”
Their study, which was funded by the Medical Research Council and the Japanese Society for the Promotion of Science, makes it clear that the health benefits of SAMe are questionable, to say the very least, Fustin added. “It is unclear what dose of it might be safe, so there is a good chance that a safe dose will be exceeded if someone takes this supplement – if a safe dose exists at all.”
