Quackery and natural health products
Mike Fitzpatrick, in a recent letter to the Lancet, mocks the motivations behind a public demonstration for health freedom planned for 15 June 2003 in London, with contemporary events to be held in Paris and Stockholm.
Taking a recent protest against mobile phone radiation as an example of irrational behaviour, Fitzpatrick goes on to say: "Some patients refuse, as a matter of high principle, to take antibiotics or steroids (drugs of proven efficacy and well-known side-effects), while readily consuming ginko biloba and ecchinaccia (drugs of unproven efficacy and unpredictable side-effects).
With a sharp pencil, Ron Law from New Zealand unmasks the twisted pro-pharma logic at the base of this letter, informing us that "more tha 50% of pharmaceutical drugs are prescribed off-label meaning that they are of unproven efficacy, and of course, we know that pharmaceuticals have very predictable side-effects and that they are directly responsible for many more hospital admissions and deaths than car accidents."
Dear Dr Fitzpatrick
I've read your letter to the Lancet.
I'm not sure what ginko biloba is but a herb with slightly different spelling got a reasonably big tick -- with normal 'we need more studies' -- assessment in a recent Cochrane review.
Likewise, have never heard of ecchinaccia, perhaps it's a novel pharmaceutical analogue of a very common and efficacious herb.
I'm aware that more tha 50% of pharmaceutical drugs are prescribed off-label meaning that they are of unproven efficacy, and of course, we know that pharmaceuticals have very predictable side-effects and that they are directly responsible for many more hospital admissions and deaths than car accidents.
For the record, worldwide (according to the WHO database in Uppsala) there have been, at last count, 5 deaths associated with Ginkgo Biloba -- 4 of them also involved aspirin which is known to kill 1:1,200 users of even low dose, 'baby' aspirin -- about 50,000 deaths each year.
As for echinacea, I'm not aware of a single death associated with its use...
As for "US journalist Melvin Benarde," is he an authority on these things? If so, he'd know that dietary supplements are regulated in the US under DSHEA (Dietary Supplement Health & Education Act). According to Janet Henney, the former FDA commissioner -- the FDA have all of the power they need to regulate supplements appropriately. Perhaps he knows something she didn't?
I put your phrase, "US journalist Melvin Benarde," in quotes because I recall a book review you wrote in the BMJ a year or so ago referring to Melvin Benarde as an epidemiologist.
Is your US journalist Melvine Benarde the same Melvine Bernard who, according to your book review, viewed, television, radio, and newspapers as "the scoundrels at whose doorsteps must be placed our current pandemic of mediagenic diseases." and who cited recent scares over "an extraordinary range of potential causes of cancer," including "asbestos, dioxin, hot dogs, breast implants, pesticides, coffee, liquor, hair dryers, mouthwash, dietary fat, magnetic fields and cellular phones." And who blamed the media for creating "an epidemic of anxiety, year after persistent year of alarm." ??
These are hardly words of a journalist -- perhaps, being a general practitioner, you have applied an unproven pharma-medica cult level of evidence such as of the type that was the focus of a whole edition of the BMJ last week...?
Your BMJ review said something like, "Benarde discusses the "five-a-day for better health" campaign launched in the United States in 1991, recommending more fruit and vegetables to prevent colorectal cancer. He reports major studies published in 1999 and 2000 confirming no evidence of benefit; claims that such dietary changes prevent heart disease and stroke also remain unsubstantiated. (This lack of evidence did not deter the launch of The National School Fruit Scheme in Britain in 2000.) The media can scarcely be blamed for this and many similarly dubious health promotion campaigns that are sponsored by doctors and health ministries."
Are you saying that "doctors and health ministries" have a legitimate right to promote dubious health promotion campaigns, AKA, quackery?
In your BMJ Book Review, I recall you saying, "To combat the irresponsible manipulation of popular anxieties about health, Benarde proposes "SL: scientific literacy," a national campaign to provide basic scientific education for all. I think that this is a good idea, but suggest that rather than beginning with the schools, it should start where most health scares originate, in the medical establishment and the government."
What you have written about in the Lancet regarding the FSA saying that, "although most vitamins and minerals are useless but harmless, high doses of some may be damaging to health" is simply another of these health scares originating in the medical establishment and the government.... I would have thought that you would have been fully supportive of a people movement wanting rid of such subversive and quackish behaviour.
Perhaps you could provide a single valid scientific paper that would give cause for the FSA to recommend a daily limit of 1000 mg for vit C, or 10 mg for vit B6.
Au revoir
Ron Law
Doctoring the risk society
The right to quackery
Readers of this column who may have missed the chance to join the demonstration against mobile phone masts (Mast Madness, April 26) have another opportunity to take part in a postmodern protest. A national demonstration in London later this month (June 15) will assert the rights of consumers of "alternative and natural" health products.
Campaigners are outraged at attempts by the European Union and the British government to regulate the production of the wide range of herbs and potions, vitamins, and supplements that are currently sold (at high prices) over the counter without any of the strict controls that apply to prescription drugs. They are further incensed at the Food Standards Agency for pointing out that, although most vitamins and minerals are useless but harmless, high doses of some may be damaging to health.
It's a free country, and I believe that people should be entitled to contribute to the profits of the mainstream drug companies and the alternative health corporations if they wish to do so. People are entitled to their idiosyncrasies. Doctors are familiar with patients who take a magnifying glass to the data sheet of their prescribed medication to select the most congenial side-effect. The same patients will happily spend large sums on alternative health products that are, as the US journalist Melvin Benarde puts it, "unregulated, untested, unstandardised and of unknown effects".
Some patients refuse, as a matter of high principle, to take antibiotics or steroids (drugs of proven efficacy and well-known side-effects), while readily consuming ginko biloba and ecchinaccia (drugs of unproven efficacy and unpredictable side-effects).
When, in the twilight of his career, the biochemist and double Nobel laureate Linus Pauling failed to substantiate his claims that megadoses of vitamin C could cure the common cold, heart disease, and cancer, his scientific stature was diminished. Yet Pauling's reputation has remained a powerful stimulus to the sales of vitamin C, although the FSA recommends a daily limit of 1000 mg--Pauling was taking up to 40 times this amount when he died of prostate cancer in 1994.
Purveyors of vitamins and herbs have long made dubious scientific claims to justify their exploitation of the gullible and the vulnerable. Now the already devalued rhetoric of rights is further degraded by its deployment in the service of quackery.
posted by Sepp Hasslberger on Sunday June 8 2003
updated on Tuesday December 21 2010URL of this article:
http://www.newmediaexplorer.org/sepp/2003/06/08/quackery_and_natural_health_products.htm
