Using parental guilt to sell dubious supplements

If you don't buy this for your child, they'll fail.

If you don’t buy this for your child, they’ll fail.

The supplement industry wants you to buy their products, and they’re not above using a little parental guilt to make you into a customer. In the photo above, the promoter is my local pharmacy, where the large window display caught my eye:

Give your Child The Tools to SUCCEED in School!

Who doesn’t want their child to succeed? And if you knew a supplement could give you or your child a learning edge, would you consider it? I’d imagine many do. Supplements have a remarkable health halo. As a pharmacist myself, I’ve noticed this when speaking with patients – few consumers identify any potential risk or downsides to supplement use. Some don’t even think of them as medicine at all. The marketing has resonated: Supplements are perceived as “safe”, “natural” and “effective”. But whether you’re giving your child a prescription medicine to treat attention deficit hyperactivity disorder, or you’re giving a supplement to “improve focus and brain function”, you’re still administering a chemical substance to a child with the intent of changing brain function. We’d probably think twice before pouring an unknown substance in our car’s gas tank, especially one claimed to boost performance. We’d probably ask for some evidence that it works, and some assurance it wouldn’t harm our vehicle. A decision to use a drug or supplement in a child deserves just as much consideration of benefits and risks. Continue reading

Under threat of class action lawsuit, maker of “homeopathic” medicine settles, and exits North America

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I’ve written more times that I want to about homeopathy, the elaborate placebo system of “remedies”. It looks like medicine, and pharmacies stock it on shelves alongside products that contain medicine. But with homeopathy the common “strengths” or “potencies” of products are usually so dilute there’s no possibility of a single molecule of the original substance remaining in the remedy. What’s further, the original substance isn’t medicine, either. They can be derived from from substances like Stonehenge (yes, that Stonehenge), shipwrecks, ascending colons, light bulbs, and even vacuum cleaner dirt. While homeopathic products are deemed “safe and effective” by Health Canada’s Natural Health Products Directorate, the awareness that homeopathic products contain no active ingredients and have no medicinal effects has become increasingly well known. In 2011, I noted that manufacturer Boiron had been served by two class action lawsuit, and that this might be the beginning of a trend.

The legal action route seems to be having an effect – which is good, given pharmacies and even regulators have refused to act. Homeopathy manufacturer Heel has decided to exit the North American market completely: Continue reading

Side effects of your supplement may include liver failure

liver

“Safe and natural.” It’s a marketing phrase attached to dietary supplements that’s often accepted as self-evident. The marketing works. Supplements have a strong health halo. But evidence suggests that this reputation may be undeserved. Not only are there continued questions about whether most supplements have any health benefits whatsoever, there is also evidence that they can be harmful. We can’t even be confident that what’s on the label is actually in the bottle. Just two days ago I was notified of another long list of supplements and remedies that the FDA had identified that were contaminated with prescription drugs. These warnings about products sold as supplements appear regularly. Some time ago I asked, “What’s in your supplement?“, and noted that contamination and poor product quality standards continue to raise questions about whether supplements can be used safely at all, because the harms, when they occur, can be catastrophic. No matter how you feel about their efficacy, we can probably all agree no consumer should lose an organ from taking a health supplement. But it can happen. Continue reading

The truthiness of naturopathic “facts”

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This is another post in the naturopathy versus science series, where a naturopath’s advice is assessed against the scientific literature. It’s a cross post from Science-Based Medicine, where the original post has (at last count) 436 comments:

When you think medicine, your first thought may be “physician”. But the practice of medicine today is a collaboration, as few health professionals, even physicians, can deliver health care completely independently. As a pharmacist I’ve worked closely with physicians, nurses, and other health professionals my entire career. Collaboration starts early, and the setting is usually the teaching or academic hospital, which is always crawling with students, interns, and residents from all professions. Teamwork and trust are essential. In order for different professions to work effectively together, there has to be a common foundation. For medicine, that foundation is science. From basic science principles through a common understanding of fields like biochemistry and physiology, health professionals all work from the same basic understanding about how the body works and what the principles of medicine actually are. If I give a recommendation to a physician or a nurse, I’m basing that assessment on an evidence base that we both rely on. It’s not “pharmacist evidence” versus “physician evidence”, it’s “medical evidence”. This is reality-based healthcare. Continue reading

Pharmacists and the pharmacy profession must move with the times

pharmacy

It’s time for community pharmacy to stop selling quackery, argues pharmacist Anthony Cox:

Pharmacists have long been providing advice to prescribers based on evidence. Before EBM became widely used in the 1990s, pharmacists ran medicine information centres and answered complex drug queries using the best available evidence. Pharmacists were involved in the development of EBM and its propagation via drug and therapeutics committees, and more recently working with the National Institute for Health and Care Excellence (NICE).

By its very nature, pharmacy is an evidence-based profession in both primary care and hospital care and the industry is undergoing a period of change. Future models of community pharmacy practice that focus on management of long-term conditions will place an even greater reliance on EBM.

Well, that is the case with prescribed medicines. When it comes to OTC products, pharmacists’ approach to evidence seems to be forgotten, with a “what the public wants, the public gets” attitude taking precedence.

More here

Photo from flickr user jeepersmedia used under a CC licence.

Which prenatal vitamin is best?

Pregnant2

Vitamin supplementation is unnecessary for the vast majority of people. You wouldn’t know this walking through a drug store, where you’ll usually find an entire aisle packed with supplements. Alternative health providers like naturopaths tend to be strong supporters of supplementation, but this advice seems to be based mainly on the belief that “vitamins are magic” rather than good science. The best research hasn’t established a strong evidence base for taking supplements. We definitely need vitamins in our diet to live. But that’s where we should be getting those vitamins – from our food, instead of from pills. If you eat a reasonable and balanced diet, and have no medical conditions that require special consideration, vitamin supplementation won’t offer meaningful health benefits. In the absence of any deficiency, vitamin supplements seem to be useless at best and harmful at worst. Continue reading

NuVet: An Unproven Pet Supplement With Questionable Marketing Practices

Nuvet Plus Supplement Vitamin Canine
I’m a dog person. I always wanted a dog as a child, and while my extended family all had dogs, we never had one in our home. I finally got my wish just over a decade ago. My wife and I were referred to a breeder with an excellent reputation for raising healthy, family-friendly Labrador Retrievers. Within moments of meeting a tiny black lab, we immediately put a deposit down. When we took Casey home a few months later she was healthy – a ball of kinetic energy. The breeder offered us a health guarantee – free of hip and elbow dysplasia, supported by certifications from the dog’s parents and grandparents. The breeder recommended we use a specific brand of food (which we ignored), and other than vaccinating her and promising not to breed her, there were few conditions for the guarantee. We were excited “parents” and that first year was a lot of fun.

At about 12 months of age, Casey started limping. At first we thought it was a temporary consequence of boisterous play. It was initially subtle, but then became very obvious – she started walking differently, and it didn’t go away. The x-rays confirmed what we feared: elbow dysplasia. Our breeder was deeply apologetic – consistent with the guarantee, she offered to replace our dog. Giving up our pet was out of the question, so we started looking at treatment options. The veterinarian offered surgery, but even he wasn’t enthusiastic, citing the very real likelihood it would do nothing. Knowing the toxicity of anti-inflammatory drugs, I wasn’t optimistic that would be tolerable for the long run. Instead we went the supplement route. Continue reading

Science-Based Medicine Blog Sued: Another attempt to use the law to squelch criticism

Edward Tobinick

 

Many of you are aware that I’m a contributor to the Science-Based Medicine blog. Today the founder and executive editor of SBM, Steven Novella, has announced that he and the SBM blog are being sued for writing about questionable Alzheimer’s disease treatments by a Florida physician, Dr. Edward Tobinick. Dr. Novella has indicated that he intends to fight, rather than pull the blog post:

The claims and practice of Dr. Tobinick have many of the red flags of a dubious medical practice, of the sort that we discuss regularly on SBM. It seems that Dr. Tobinick does not appreciate public criticism of his claims and practice, and he wants me to remove the post from SBM. In my opinion he is using legal thuggery in an attempt to intimidate me and silence my free speech because he finds its content inconvenient.

Of course, we have no intention of removing the post as we feel it is critical to the public’s interest. This is what we do at SBM – provide an objective analysis of questionable or controversial medical claims so that consumers can make more informed decisions, and to advance the state of science in medicine.

We also feel it is critical not to cave to this type of intimidation. If we do, we might as well close up shop (which I suspect the Tobinicks of the world would find agreeable). Defending against even a frivolous lawsuit can be quite expensive, but we feel it is necessary for us to fight as hard as we can to defend our rights and the work that we do here at SBM.

Continue reading

Sorting out the science of “multiple chemical sensitivity”

Multiple Chemical Sensitivity

One of the challenges to providing science-based care is managing debilitating symptoms in patients who lack a clear diagnosis. If a comprehensive workup on an ill patient reveals nothing conclusive, patients and their health care providers are equally puzzled and frustrated. A diagnosis is seen as giving legitimacy to symptoms, and can be the first step towards defining a science-based treatment plan. Vague or “medically unexplained” symptoms are among the most difficult therapeutic challenges. To patients, the science and profession of medicine has failed to “deliver” and the patient can be left feeling their condition lacks legitimacy. These patients are at the greatest risk for alternative medicine approaches, such as unorthodox diagnoses and treatments. In this world, the lack of objective evidence is no barrier to defining conditions and their treatments. One of the most problematic tactics used is the attribution of these symptoms to conditions known as fake diseases. Continue reading

There’s no reason to exempt Natural Health Products from Bill C-17

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From Consumer Health Products Canada:

So, when is a therapeutic product not a therapeutic product? It’s a head-scratcher. Under Vanessa’s Law, disinfectant toilet bowl cleaners and hand sanitizers will be “therapeutic products,” while some cold medicines and, potentially, even low-dose statin cholesterol-reducing drugs, will not. (Health Canada has just proposed switching red yeast rice containing up to 1mg lovastatin from prescription to NHP status.) Consumer Health Products Canada believes that arming Canadians with the tools they need to take more control over their own health is vitally important to public health and to the sustainability of our health care system. Our member companies produce and sell the vast majority of the OTCs and NHPs that Canadians use in their own self-care. We embrace the provisions of Vanessa’s Law because they are entirely consistent with the law-abiding, safety-first way our members conduct business. But, if passed with the currently proposed, lop-sided definition of “therapeutic products,” we fear that Vanessa’s Law will distort the marketplace for consumer health products and could undermine consumer confidence in the roughly 50% of our member’s products that fall under the Natural Health Products Regulations.

More here.

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