Part Fills for August 30

Used under CC licence

Links and updates of interest to SBP readers.

Pharmacy Practice

Steven Barrett of the excellent Quackwatch publishes the Consumer Health Digest, a weekly roundup of news and events related to health fraud. I normally agree with Dr. Barrett’s evaluation, but I want to comment on a recent issue, which summarized Consumer’s Reports (mediocre) analysis of supplements and herbal products:

Another part lists eleven “supplements to consider,” but the comments that accompany them are too skimpy to provide adequate guidance. In addition, some should be used only as part of a comprehensive, medically designed and supervised regimen and at least two (glucosamine and St. John’s wort) have done badly in well-designed clinical trials. The list is accompanied by advice to “talk to your doctors before starting any supplement.” This advice is impractical because (a) doctors could not possibly handle the resultant volume of discussion, (b) many pharmacists do not give trustworthy advice about supplements, and (c) most pharmacists are not qualified or legally permitted to advise people on how to treat their medical or psychological problems.

These statements about pharmacists are unfortunate and incorrect. Pharmacists are both qualified and obligated to provide advice about supplements. Provision of this information is entirely within a pharmacist’s scope of practice. Whether they consistently provide science-based information, is another question altogether.  The only survey I’ve seen of pharmacist advice has suggested it’s far more reliable than other sources of information about supplements.

More on Pharmacy Practice

I noticed this article from the New York Times about community pharmacists struggling against mail order. I was disappointed to see this observation:

Entrepreneurial and determined to compete with the mail-order business, my pharmacist has spiffed up the store’s decor and added all manner of homeopathic products and all-natural cosmetics to his shelves.

Is homeopathy what it’s going to take for community pharmacy to compete? I hope not.

Natural Health Products and Licensure

A few weeks ago I pointed out that Health Canada was preparing to create a special exemption for unapproved Natural Health Products, with the hope that pharmacies will start selling them again. (Recall that Canadian pharmacies have been explicitly instructed not to sell unapproved NHPs.) Well, Health Canada has created that exemption, and you’ll soon see unapproved products back on pharmacy shelves. But you can spot them. These products will have an “Exemption Number” or “EN” on them. As I pointed out, I’m not satisfied that Health Canada’s exemption provides me with adequate assurance to recommend consumers use unapproved products. But there’s a straightforward solution for those that want fully-reviewed products:  Avoid any product with an EN number on it, or any product with no number on it at all.  Products with a “NPN” number mean all regulatory requirements have been met.


In the United Kingdom, ten Primary Care Trusts pull all funding for homeopathy.

For those that argue “What’s the Harm with Homeopathy?”: Homeopaths treating malaria with homeopathy.


From Torontoist, a really interesting profile of some University of Toronto research: Many Wouldn’t Give the Shot a Shot, Says New U of T Research on HIV. It has some lessons for all vaccine advocates.

New at Skeptic North

Check out my  book review of Snake Oil Science.

Kim Hebert did a great post a few weeks ago about a homeopath that advocated homeopathy as first aid treatments.  The homeopath, Bryce Wylde, responded with “21 of his favourite scientific documents”. This is a typical tactic from proponents of homeopathy, and it’s termed The Gish Gallop. It’s not typical, however, for someone to actually go through a huge list of references, and appraise all of them. Kim has written up a comprehensive post that critically appraises every article.  Guess what? Homeopathy hasn’t been shown to work more effectively than a placebo.  Listen to Kim Hebert talk about the 21 studies, homeopathy, and the response so far, on this episode of Skeptically Speaking. Kim starts at about the 12:30 mark.

Great article by Michal Kruse: Umbilical Cord Blood Collection: Hype or Hope?

The Hard Facts about Soft Water.

Erik Davis put belief systems like homeopathy into context, in the excellent post The Spooky Pull of Sympathetic Magic.

Can you tell which remedy has been approved by Health Canada’s Natural Health Products Directorate for safety and efficacy, and which product is completely fabricated?  Check out Health Canada Approves, a new series on Skeptic North.

From Science-Based Medicine

High Fructose Corn Syrup: Tasty Toxin or Slandered Sweetener?

Does peer review need fixing?

Antioxidant Supplements for Macular Degeneration – and see my take, here.

Why bother? – Post from Peter Lipson, on why we need to keep scrutinizing “alternative” medicine.

“Integrative” oncology: Trojan horse, quackademic medicine, or both?

NEJM and Acupuncture: Even the best can publish nonsense

Enjoy your week – and look forward to some new posts shortly.

Does peer review need fixing?