supplements
As we all know, the FDA cannot require that dietary supplements be proven effective before they are sold. Yet, Robert F. Kennedy Jr. once said the FDA is exhibiting an “aggressive suppression” of vitamins, dietary supplements, and other substances and that he will end the federal agency’s “war on public health”.
With Kennedy now in the driver’s seat, the supplement industry expects to make bolder health claims for its products and to get the government, private insurers, and flexible spending accounts to pay for supplements, essentially putting them on an equal footing with FDA-approved pharmaceuticals.
The day Kennedy was sworn in as secretary of Health and Human Services, Trump issued a “Make America Healthy Again” agenda instructing health regulatory agencies to “ensure the availability of expanded treatment options and the flexibility for health insurance coverage to provide benefits that support beneficial lifestyle changes and disease prevention.” Kennedy added that dietary supplements are one key to good health. Supplement makers now want programs like health savings accounts, Medicare, and even benefits from the Supplemental Nutrition Assistance Program, or SNAP, to pay for vitamins, fish oil, protein powders, herbal remedies and probiotics.
In speeches and in a pamphlet called “The MAHA Mandate,” Emord and alliance founder Robert Verkerk said Kennedy would free companies to make greater claims for their products’ alleged benefits. Emord said his group was preparing to sue the FDA to prevent it from restricting non-pharmaceutical products.
With their ‘Mandate’ Emord and Verkerk want “to shift the healthcare paradigm towards one that restores the health of the American people through a holistic and individual-centered approach that works with, rather than against, nature”.
But do they ever question whether:
- vitamins do anything at all to people who eat a normal diet?
- fish oil is effective and safe for which conditions?
- protein powders have any effects beyond eating a steak?
- herbal remedies generate more good than harm?
- probiotics work for which conditions?
The short answer is no. To me, it seems that the MAHA are as uninterested in the evidence regarding efficacy and safety (quite possible they know how flimsy it is) as they are keen on the promotion of quackery.
Constipation is characterized by persistent difficulty in defecating. It is a common disorder in the community particularly affecting the elderly and those with intellectual disabilities and neuropsychiatric disorders. It can also be caused by numerous medications including analgesic, antidepressant, antihypertensive and anticholinergic agents. It may be asymptomatic or it may produce abdominal pain/cramps, bloating, nausea and anorexia progressing to urinary incontinence and fecal impaction, or paradoxical diarrhea due to overflow.
This review demonstrated that constipation may also kill you. A wide range of mechanisms associated with constipation may result in death including:
- bowel obstruction,
- stercoral colitis with ulceration,
- perforation and peritonitis,
- respiratory compromise,
- abdominal compartment syndrome,
- venous thrombosis with pulmonary thromboembolism.
Moreover, constipation may exacerbate pre-existing diseases and treatments such as laxative and enemas may be lethal. The autopsy examination of a case with constipation and megacolon should take into account all of the pre-existing conditions, as well as the possibility of underlying disorders such as Hirschprung disease. Review of the decedent’s medical and drug history and level of supportive care will be important. Toxicological evaluations may be useful.
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Constipation is defined as having fewer than three bowel movements per week or experiencing difficulty in passing stool. The condition is common and often difficult to treat. WebMD recommends diet and lifestyle changes, such as:
- Drink an extra two to four glasses of water a day, unless your doctor tells you to limit fluids for another reason.
- Try warm liquids, especially in the morning.
- Add fruits and vegetables to your diet.
- Eat prunes and bran cereal.
- Exercise most days of the week. When you move your body, the muscles in your intestines are more active, too.
- Don’t ignore the urge to poop. Listen to your body when it’s telling you it’s time to go.
- Eat foods with probiotics such as yogurt and kefir.
- Skip processed meats, fried foods, and refined carbs such as white bread, pasta, and potatoes. You can eat lean meats such as poultry and low-fat dairy products.
- Keep a food diary and make a note of any foods that constipate you.
- Adjust how you sit on the toilet. Raising your feet, leaning back, or squatting may make it easier to poop.
- Take an over-the-counter fiber supplement (Metamucil®, MiraLAX®, Citrucel® or Benefiber®). Start with a small amount at first.
- Avoid reading or using your phone or other devices while you’re trying to move your bowels.
- Drink less alcohol and caffeinated drinks, which can make you dehydrated.
- Talk to your doctor about bowel training. It can help train your body to pass stool shortly after breakfast every morning.
- Don’t rush when going to the bathroom. Give yourself time to relax, which can help your digestive muscles relax.
- Talk to your doctor about any medications that could be causing your constipation.
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Because conventional options are often not as successful as hoped, many sufferers turn to so-called alternative medicine (SCAM). But is SCAM really a solution?
A recent review found that “acupuncture or electroacupuncture and herbal medicine are effective in treating
constipation, whereas findings on massage and moxibustion are inconclusive.” Our own assessment [‘Oxford Handbook…’ (2008)] of the evidence disagrees and rated as follows:
- Beneficial: Psyllium
- Likely to be beneficial: abdominal massage, biofeedback, fibre
- Unknown effectiveness: acupuncture, aloe vera, ayurvedic medicine, meditation, Padma Lax, probiotics, herbal tea.
Whichever way we turn it, constipation is a more serious condition than many of us think, and neither conventional healthcare nor SCAM are convincingly successful in helping those who suffer from it.
It does not happen every day that the prestigeous German FRANKFURTER ALLGEMEINE ZEITUNG publishes an in-depth analysis of TCM (Traditional Chinese Medicine) and even discusses several of the themes that we, here on this blog, have often debated. Allow me, therefore, to translate a few passages from the recent FAZ article entitled “Der Fluch der alten Dinge” (The Curse of Old Things):
… TCM has countless followers in many countries. ‘TCM is a wonderful medicine that thinks ‘holistically’, that sees not just one organ but the whole person and that offers very good treatment options,’ says Dominik Irnich. He heads the German Medical Association for Acupuncture. Although there is not evidence for all indications, TCM is ‘a scientifically based option for a number of diseases, the effects of which have been proven many times over’…
Meanwhile, Beijing wants to utilise the positive image of TCM to present itself in a good light and promote exports. The current five-year plan also provides for the creation of around 20 TCM positions for epidemic prevention and control. Critics, on the other hand, see patients at risk due to insufficiently tested therapies – and medicine as a whole: many studies are hardly valid and distort the state of science…
The top leadership of the Chinese Communist Party is using the ‘old things’ to increase its global influence and utilise TCM not only in its own country, but also as an export hit. The global TCM market is estimated to be worth many billions of euros annually, but there are no reliable figures – not least because it often includes illegally traded products such as rhino horn or donkey skin, which has led to mass killings.
Officially, Beijing prosecutes illegal trade and promotes science-based medicine, but the interests are intertwined. Even under Mao, traditional methods were used in China as a favourable alternative to imported medicines, and Beijing is currently increasingly allowing them to be reimbursed. At the same time, China’s leadership is trying to anchor TCM products in healthcare worldwide, for example as part of a ‘health Silk Road’ in Africa. During the Covid-19 pandemic, the state not only used TCM products en masse in its own country, Chinese foreign representatives also distributed them to Chinese people in Europe. This included a product based on gypsum, apricot kernels and plant parts called Lianhua Qingwen. According to a report published by the consulate in Düsseldorf, this was distributed even though the sale of medicines outside of pharmacies is generally punishable by law.
Beijing has also been successful at the level of the World Health Organisation (WHO), which promotes traditional medicine from China. ‘This was part of the interests and election programme of former Chinese Director-General Margaret Chan,’ says WHO consultant Ilona Kickbusch. The WHO drew up standards for acupuncture training, including knowledge of the ‘function and interactive relationship of qi, blood, essence and fluid’, as the document states.
In 2019, the WHO member states decided to add a chapter on ‘traditional medicine’ to the standard classification of diseases. Doctors can now code alleged patterns of ‘qi stagnation’ or yang deficiency of the liver. The umbrella organisation of European science academies EASAC criticised this as a ‘significant problem’: doctors and patients could be misled and pressure could be exerted on healthcare providers to reimburse unscientific approaches. Nature magazine found: ‘The WHO’s association with drugs that have not been properly tested and could even be harmful is unacceptable for the organisation that has the greatest responsibility and power to protect human health.’ …
In general, the study situation on therapies that are categorised as TCM is extremely confusing. The evidence is ‘terrible’, says the physician Edzard Ernst, who has analysed such procedures. ‘There are thousands of studies – that’s part of the problem.’ Many studies come from China, but it is known that a large proportion are invalid or falsified. It is almost impossible to report critically on TCM there: according to media reports, a doctor was imprisoned for three months in 2018 after criticising a TCM remedy. In 2020, Beijing even considered banning criticism of TCM, but refrained from doing so after an outcry.
According to Ernst, the quality of even some of the meta-analyses from the respected Cochrane Collaboration is ‘hair-raising’ due to the inclusion of unreliable studies, and according to some Chinese researchers, acupuncture works for everything. Prof. Unschuld said at an event a year ago that he was asked in China not to address critical issues.
‘In a country without the open and free critical culture that is common in democratic countries, the control mechanisms are missing,’ says Jutta Hübner, Professor of Integrative Oncology at Jena University Hospital. The inclusion of Chinese studies, which almost never report negative results, can create a much too positive image of TCM at a formally very high level of scientific evidence, without the results being reliable…
Instead of allowing the research to be carried out by proponents, it would be desirable ‘if the universities in particular remembered that they have the duty to be critical,’ says physician Edzard Ernst. However, some university clinics prefer to advertise TCM methods in order to attract patients and money.
- slightly improved BPH symptoms measured with the International Prostate Symptom Score (IPSS) at follow-ups of up to 12 months (standardized mean difference [SMD] -2.06, 95% confidence intervals [CI] [-3.22, -0.91] very low certainty evidence, 6 studies),
- reduced prostate specific antigen (PSA) levels (mean difference [MD] -0.37 ng/ml, 95% CI [-0.50, -0.23] low certainty evidence, 4 studies)
- had little effect on quality of life (SMD -0.59, 95% CI [-1.57, 0.38] very low certainty evidence, 2 studies).
The main reasons for downgrading the evidence were study limitations (studies judged to be at an unclear or high risk of bias), inconsistency (considerable heterogeneity), and imprecision (small effect sizes and wide confidence intervals around effect estimates). All six studies reported no adverse-effects.
- positive but not truly honest about the limitations of the evidence (we see this regularly on my blog);
- or they are sufficiently critical and thus arrive, like our above paper, at unequivocal (and sadly not very helpul) conclusions.
As this is so, we see very few SRs that conclude “there is sound evidence to show that SCAM xy is effective (or ineffective)”. Yet, such verdicts would be what consumers need.
The cause of the first scenario (false-positive conclusion) is that reviewers are biased and want to demonstrate that SCAM works. Such authors behave unethically, in my view, because they mislead the public and might cause untold harm. The cause of the second scenario (unequivocal conclusion) is the poor quality of the primary studies. This phenomenon too is mostly due to over-enthusiastic researchers who want to prove their SCAM instead of testing it. Conducting a clinical trial is far from easy or cheap. It is beyond me, why so many SCAM trialists do not try their best to do it well!
If you think of it, the most likely reason is that they are not really interested in finding the truth but mainly want to promote their agenda. If you don’t believe me, have a look at my ALTERNATIVE MEDICINE HALL OF FAME and the amazing men and women in it.
It is time, I think, that SCAM researcher learn the most basic principle of their profession: science is not a game where you set out to confirm what you believe. Science works by
- formulating a hypothesis,
- doing your very best to prove your hypothesis wrong,
- only if it cannot be proven wrong, assuming that it probably is correct.
To put it bluntly: investigators who use science to prove their point are not scientists but pseudo-scientists, and sadly SCAM has more than its fair share of such charlatans (drunken men using a lamp-post for support rather than enlightenment!). To put it even more bluntly: to prevent serious harm – because that sort of thing does a lot of real harm! – researchers who repeatedly show themselves to be incapable of doing unbiased science (again, see my ALTERNATIVE MEDICINE HALL OF FAME), should be banned from doing research.
Today is World Cancer Day. It is an international day observed every 4 February to raise awareness about cancer, encourage its prevention, and mobilise action to address the global cancer epidemic. Cancer and so-called alternative medicine (SCAM) are closely linked, for instance, through the fact that large proportions of desperate cancer patients use SCAM, many in the hope to cure their disease. I have therefore often tried to instill some rational thought into the debate by discussing the emerging, largely negative evidence on SCAM for cancer. Here are just a few recent examples:
- Homeopathy as a therapy for cancer? A new review from India
- Geopathic stress allegedly can cause health issues such as arthritis, multiple sclerosis and cancer – BUT, PLEASE, DON’T BELIEVE SUCH NONSENSE!
- Homeopathic Cancer Therapy? No, no and no!
- Medicinal Mushrooms for Cancer?
- Bioenergy therapies for cancer: implausible, ineffective, and an unethical waste of money
- Camel urine as a treatment for cancer patients?
- Homeopathy for cancer? Unsurprisingly, the evidence is not positive.
- When an undercover journalist tests alternative cancer healers
To mark the day, I had a look at what people post on ‘X’ about SCAM and cancer cure. Here are some of the more amazing assumptions, claims and comments that I found (warts and all):
- The Princess of Wales, Kate Middleton has been diagnosed with Cancer – there is a high probability she has Turbo Cancer, caused by COVID-19 mRNA Vaccines she took in 2021.
- Blue butterfly pea flowers (Clitoria ternatea) is one of the best CANCER KILLING and CANCER PROTECTIVE plants available to man.
- Dandelion root far more effective in fighting cancer cells than chemotherapy.
- In Kenya, research shows 76% of cancer patient who turn to traditional medicine instead of chemotherapy have drastically improved.
- I’ve just been diagnosed w cancer and will approach it with nutrition, suppl,and cont’d exercise… other alternative therapies as well. Been an RN for decades and have witnessed the horrors and pitfalls of modern medicine. Must b your own best advocate.
- I had a niece, a cousin and a friend die same week of the big C. was an eye-opener for me cause chemo did not help them at all….so looked at the alternative medicine….down in Mexico. but it was too late. cancer spread like wildfire.
- I pray to God that no one has to suffer through cancer but I agree with you 1000% alternative medicine as a matter fact we already know that there are three that can cure cancer. I ivermectin is one and I can’t remember the other two.
- Cancer has been proven to be eliminated with alternative medicine you denounce without a single study. I’m starting to think you hate the American people.
- Next time you or your loved one gets cancer, use “alternative medicine“.
- Most Doctors use drugs for treatment of symptoms because that’s how they are trained. No nutrition or alternative medicine is taught or encouraged. In cancer treat Drs are required to only recommend chemo because they could lose their license for alternative nedicine referrals.
- Spiritual causes of illness, including cancer, are often explored within alternative approaches to healing and holistic philosophies. Although traditional medicine does not recognize spiritual causes, many spiritual traditions and energetic practices.
- I pray that you look to alternative medicine, don’t listen to the current medical model as it is designed to keep people sick, western medicine does not heal. Chinese medicine does like others around the world. A primary cause of cancer is parasites. Western medicine doesn’t look.
- Chemotherapy is brutal, attacking both cancer and healthy cells. Alternative solutions do exist, but mainstream medicine often won’t offer them. Take control of your research, explore your options, and question everything.
- I cured my cancer symptoms using alternative medicine, including Ayurveda. Not drugs.
- I’m a double cancer survivor and I was in a clinical trial testing chemo in 2013-2014. Chemo is poison and big pharma. Alternative medicine is better. Changed must be made. I love that PresidentTtump has done this. And I can’t wait for RFKJr to lead HHS.
- Cancer kills you if you follow the advice of the medical establishment. There are many alternative cures for cancer and even more ways to prevent it in the first place. Do some research into naturopathic medicine if you truly want to be healthy.
- Maybe Trump should redirect that 500 billion to alternative medicine/supplement/ivermectin research that will eradicate cancer. And what is causing cancer. Don’t need a mRNA cancer vaccine. We already have the tools to stop cancer.
- Please get checked for parasites which is what cancer is. Try alternative medicine and see how that works – I bet it does.
- I have a friend who cured her own breast cancer with alternative methods. There are cures out there. Mainstream medicine just won’t recognize them.
- Everything is fake in medical field nowadays. Not only petition but also pathogen hypothesis medical academic papers about virus, cancer etc.. We need to build an alternative medicine field ASAP.
- …
- …
[I could have gone on almost for ever]
I had not expected to find much wisdom on ‘X’, but what I did find truly horrified me. For every sensible Tweet, there seem to be 10 imbecillic and dangerous ones. Imaging a desperate cancer patient reads these lies, misleading claims, nonsensical statements and conspiracy theories!
To set the record straight, let me state these two simple facts:
There is no SCAM that would change the natural history of any form of cancer.
What is more, there never ill be one! As soon as a treatment might look promising as a cancer cure, it will be investigated by mainstream scientists and – if it turns out to be helpful – integrated into conventional oncology. In other words, it will become evidence-based medicine.
You don’t believe me without evidence?
Ok, then please read my book on the subject.
PS
And yes, there are some SCAMs that might have a role in improving QoL, but that’s a different topic.
This open-label, randomized, controlled trial was aimed to assess the effectiveness and safety of Vuong Hoat (VH) natural health supplement for reducing the negative impact of low back pain, improving the quality of life, and enhancing functional activities in patients with lumbar degenerative disc disease (LDD).
The study involved 60 patients suffering from low back pain caused by LDD. The participants were randomly assigned to:
- a study group (SG) comprising 30 subjects who received VH in conjunction with the same electro-acupuncture,
- a control group (CG) comprising 30 subjects who received treatment with electro-acupuncture.
These treatments lasted for 28 days.
The clinical progression and tolerability of both groups were compared based on seven objective measurements:
- visual analog scale index,
- Schober test,
- fingertip-to-floor distance,
- spinal flexion,
- spinal extension,
- spinal tilt,
- spinal rotation.
Already after 14 days of treatment, the SG showed a significant improvement in overall outcomes compared to the CG. Specifically, 43.3% of SG patients achieved very good results, 53.3% had good results, and 3.4% had moderate results, whereas corresponding figures for the CG were 6.7%, 76.7%, and 16.6%, respectively (P < .05).
After 28 days of treatment, both groups demonstrated a shift toward very good results, with the SG continuing to show better outcomes than the CG (P < .05). In the SG, the very good results increased to 76.7%, good results decreased to 20%, and moderate results were 3.3%. On the other hand, the CG had 46.7% very good results, 43.3% good results, and 10% moderate results. Notably, no side effects were reported from the VH treatments during the study.
The authors concluded that their findings of this study indicate that VH health supplement is a safe and effective approach for managing low back pain and limited spinal movement in patients with LDD.
I have several concerns and questions, some are trivial others are not:
- What does VH contain? I have no free access to the actual paper but even the abstract should mention this information.
- How do the investigators know that low back pain was caused by LDD? Lots of people have LDD without pain and vice versa.
- The A+B vs B design is known to produce false positive results due to its failure to control for placebo effects; why not use a placebo (which would have been very easy in this case)?
- Contrary to the authors statement, the outcome measures are NOT objective.
- It seems highly implausible that no side effects of VH occurred. Even placebos cause side-effects in ~6% of all cases.
- Conclusions about safety are NEVER warranted based on just 30 patients.
- Why does an allegedly respectable journal publish such rubbish?
Probiotics are live microorganisms promoted claimed to provide health benefits when consumed, generally by improving or restoring the gut microbiota. Prebiotics are compounds in food that foster growth or activity of beneficial microorganisms such as bacteria and fungi. Both are sold as dietary supplements, and there is hardly a human disease or symptom for which these supplements are not said to be effective.
One such claim is that the ingestion of prebiotics during pregnancy and lactation has immunomodulatory benefits for the developing fetal and infant immune system and provide a potential dietary strategy to reduce the risk of allergic diseases.
This study sought to determine whether maternal supplementation with dietary prebiotics reduces the risk of allergic outcomes in infants with hereditary risk.
A double-blind randomized controlled trial was conducted in which pregnant women were allocated to consume prebiotics (14.2 g daily of galacto-oligosaccharides and fructo-oligosaccharides in the ratio 9:1) or placebo (8.7 g daily of maltodextrin) powder. The treatment lasted from less than 21 weeks’ gestation until 6 months postnatal during lactation. All eligible women had infants with a first-degree relative with a history of medically diagnosed allergic disease. The primary outcome was medically diagnosed infant eczema by age 1 year, and secondary outcomes included allergen sensitization, food allergy, and recurrent wheeze by age 1 year.
A total of 652 women were randomized between June 2016 and November 2021 (329 in the prebiotics group and 323 in the placebo group). There was no significant difference between groups in the percentage of infants with medically diagnosed eczema by age 1 year (prebiotics 31.5% [103 of 327 infants] vs placebo 32.6% [105 of 322 infants]; adjusted relative risk, 0.98; 95% CI, 0.77-1.23; P = .84). Secondary outcomes and safety measures also did not significantly differ between groups.
The authors concluded that they found little evidence that maternal prebiotics supplementation during pregnancy and lactation reduces the risk of medically diagnosed infant eczema by age 1 year in infants who are at hereditary risk of allergic disease.
It is rare that we come across a well-planned, well-conducted and well-reported study of pro/prebiotics. When we do, it often casts doubts on the numerous claims made for these products.
Here we have such a study.
I congratulate the Australian authors for conducting it.
Kampo medicine is the Japanese form of traditional herbal medicine that is still very popular in Japan. The word Kampo means ‘Chinese style’ in Japanese. Kampo developed out of traditional Chinese herbal medicine after it was introduced into Japan in the 7th century. In the early 20th century, Kampo was further influenced by modern Western medicine and science. The Kampo system is a pragmatic and simplified version of Chinese herbal medicine. Kampo medicines are standardised and not individualised as in Chinese herbal medicine. They are based on the current symptoms of the patient, interpreted in the philosophy of Kampo. Kampo diagnostics consider hypofunction and hyperfunction, heat and cold, superficies and interior, and yin and yang.
Today, Kampō is fully integrated into the Japanese national health care system, and numerous Kampo preparations are registered in Japan and reimbursable from public funds. These standardised formulas contain mixtures of herbal ingredients. They are manufactured under proper quality control. The most commonly used plants include liquorice, ginger and Chinese peony root. Most Japanese doctors routinely prescribe Kampo medicines, and most patients combine Kampo with Western medicine. Since 2002, the teaching of Kampo has been included in Japanese curricula of medical and pharmacy education.
The efficacy of Kampo medicines is often less solidly documented than one would hope or expect. There is a remarkable shortage of high-quality clinical trials. One review concluded that “Kampo medicines potentially play some roles in preventing or ameliorating side effects of anticancer agents. Supportive care with Kampo medicines for patients with cancer might lead to physical, mental, and nutritional improvement.” As Kampo medicines contain pharmacologically active ingredients, they can also cause adverse effects and might interact with synthetic drugs. Yet, the risks of Kampo are currently woefully under-investigated.
This case of severe liver injury following the administration of the Kampo medicine ‘Saibokuto‘ attempted to identify the likely causative crude drug inducing liver injury through a systematic literature review.
A 29-year-old woman developed severe liver injury approximately two months after Saibokuto administration, necessitating steroid pulse therapy for recovery. A literature search was conducted. Using PubMed and the “Igaku Chuo Zasshi (ICHUSHI) database,” two individuals independently selected studies published between January 1997 and February 15, 2023. The search focused on studies involving human subjects, published in either English or Japanese, and specifically investigated Kampo medicines categorized as over-the-counter or prescription drugs suspected as causative agents of drug-induced liver injury (DILI). Studies on health supplements, discontinued Kampo medicines, and autoimmune hepatitis, were excluded. As it is ethically impossible to rechallenge drugs that cause liver injury, this review primarily relied on case report literature.
Through the review, 37 cases (men/women: 12/25, including present case) were analyzed, including 32 reports (36 cases) from 3,055 studies that met the inclusion criteria. Notably, 65.9% of cases were associated with Scutellariae radix, with onset occurring within 45 (1-730) days and recovery within 35 (7-184) days.
The authors concluded that their case study and literature review underscore a prevalent association between liver injury and Kampo medicines containing Scutellariae radix. Vigilant liver function monitoring, particularly within the first 2 months of administration, is recommended, especially for formulations containing Scutellariae radix.
Radix Scutellariae (scullcap) is the dried root of the medicinal plant Scutellariae baicalensis Georgi. It has a long history of application in traditional herbalism. Six flavones seem to be its major bioactive constituents. All six flavones are pharmacologically active.
Scullcap has been advocated to treat arthritis, lung problems, hay fever, seizures, HIV or AIDS, and hepatitis. Scullcap applied to the skin has been used to treat psoriasis, sores or swelling, and hemorrhoids. The evidence that it is effective for any condition is far from convincing. Adverse effects of scullcap are equally under-researched.
The paper discussed above is a poignant remeinder of the ‘appeal to tradition‘: not everything that has been used for centuries is safe. Only proper scientific investigations will determine the risk/benefit profile of a therapy.
The use of so-called alternative medicine (SCAM) is popular among cancer patients. SCAM includes vitamins, minerals, phytotherapy, homeopathy, nutritional supplements and probiotics. SCAM use may lead to unwanted risks by interacting with anticancer drugs; therefore, it is important for healthcare providers to be aware of SCAM use by their patients. This article describes the prevalence and potential risk of SCAM use in an adult Dutch cancer population. This is the first study in which SCAM use was investigated using medication reconciliation.
A descriptive, observational study was conducted at Amsterdam UMC between August 2021 and July 2022. Data regarding the use of SCAM was obtained by medication reconciliation reviews with inpatients and outpatients with cancer who received systemic anticancer treatment. Acquired data were evaluated by the research team, and the risks of interactions were classified into relevant, potential, unknown or no interaction. Ultimately, patient-specific recommendations on the use of SCAM were provided.
Of the 100 included patients, 73% used SCAM during the past year and 41% used SCAM actively while receiving anticancer treatment. The most common SCAMs were vitamins and multivitamins (both 28%). Some 10% of SCAM were classified as having a relevant interaction with one or more concurrently used anticancer drugs. No association between age or gender and SCAM use was found, while outpatients used significantly more SCAM than inpatients (72.7% vs 32.1%; p=0.001). Patients received personalised advice from the hospital pharmacy about their SCAM use.
The authors conclused that more than 40% of oncology patients investigated in this study used SCAM while receiving anticancer treatment, leading to unwanted risks. This prevalence is higher than reported in other studies, possibly due to the use of medication reconciliation interviews. To guarantee safety and efficacy of anticancer treatment, communication between healthcare professionals and patients about SCAM is essential.
I concur wholeheartedly with the authors’ conclusions. In fact, I have warned about the dangers of SCAM-cancer drug interactions for about 30 years.
Did my warnings have any effects?
I am sad to say that probably they resulted in very little.
Findings like the above beg the question: WHY DO CANCER PATIENTS USE SCAM?
One answer is that they a desperate, and I entirely understand and sympathise with their fear. But patients should realise that the risks of using SCAM is not offset by any benefit.
The authors of the above investigation state that the most frequently reason for using SCAM was the hope for an improvement in the immune system. But – as pointed out many times on this blog – SCAM cannot not do that. Yes, it is often advertised for this purpose, but such claims are bogus.
No SCAM improves the natural history of any cancer and many SCAMs have the potential do make it worse. Those SCAM entrepreneurs who claim otherwise are, in my view, criminal. And those patients who fall for their bogus claims surely deserve better.
“An American doctor invented a drug that claims to cure COPD within three days.” Does this announcement herald a medical sensation or a bogus and potentially dangerous falsehood?
The inventors proudly opt for the former: “we have created a revolutionary pill that combines over 60 natural herbs specifically designed to treat respiratory diseases such as chronic obstructive pulmonary disease, chronic bronchitis, and pulmonary fibrosis”
There are also videos promoting a “revolutionary pill” that allegedly cured chronic obstructive pulmonary disease (COPD) “within three days” went viral on Facebook. The videos featured public figures like Fox News anchor Jesse Watters, as well as the alleged developer of the drug, surgeon and TV personality Mehmet Oz, popularly known as “Dr. Oz”. Although the images used in the videos varied from post to post, all the videos we found used the exact same narration and promised “to pay one million dollars” if the drug failed to cure COPD. However, these videos showed clear signs of manipulation.
Altered or artificial intelligence-generated videos featuring celebrities and major TV networks have been profusely used for scams over the past few years. Science Feedback documented several examples of such doctored videos falsely promoting diabetes cures and cannabidiol (CBD) gummies as a treatment for a wide range of medical conditions. “Dr. Oz” has often been mentioned either as a developer of these products or as endorsing them, though he’s repeatedly denied any involvement in these ads. In a 2019 article for the Wall Street Journal that he also shared on Facebook and Twitter, Oz stated that these ads weren’t “legit” and warned about potential scams exploiting his image.
Likewise, the COPD videos posted on Facebook are also false. First, COPD currently has no known cure, so any product claiming to cure it is simply a scam. Second, the poor synchronization between video and audio suggests that the audio isn’t authentic.
‘SCIENCE FEEDBACK‘ thus conclused as follows:
Chronic obstructive pulmonary disease (COPD) is a chronic progressive lung disease for which no cure currently exists. Along with medication, lifestyle changes like quitting smoking, avoiding polluted environments, and keeping physically active can help manage the symptoms and slow down the progression of the disease. Products claiming to cure COPD are deceptive and potentially dangerous, as they may contain harmful ingredients or interact with medications in unpredictable ways.
I could not agree more and might add that – as always in suspect cases – if it sounds too good to be true, it probably is.
