Cinnamon for for diabetes? Why “natural” doesn’t mean safe or effective

Here’s a scenario I encountered that will be familiar to many pharmacists. It starts with a customer seeking advice at the counter:

“My doctor says I have prediabetes. I don’t want to take any drugs. Do you have something natural I can use to cut my blood sugar?”

I looked at him in the eye, and pointed at his sizeable midsection. “Sir, if you’re at risk for diabetes, and you don’t want to take medication, the single best thing you can do for yourself is lose some weight.”

He grinned and asked, “Great – what supplement can I take to help me?”

This type of discussion occurs all the time. A patient has been assessed by their physician, and informed that they have a medical problem of some sort. The patient, reluctant to accept the physician’s evaluation, heads to the pharmacy for a second opinion. In some cases, the patient may question the physician’s advice: “All my physician wants to do is prescribe drugs.” Yet there’s a disconnect when it comes to strategies for management. More often than not, non-drug approaches are rejected out-of-hand (probably because the sample I speak with have already made the decision to buy something). And in those that are leery of medical management, there’s often a willingness to consider anything that’s available without a prescription – particularly if it’s perceived as “natural.” Natural products are gentle, safe, and effective, while medicine is thought of as unnatural, harsh, and potentially dangerous. This is the naturalistic fallacy, nothing more.

Neuragen for Nerve Pain

Today’s post is from SBP contributor Avicenna. Here’s his bio and his prior posts.

An estimated 2 to 3% of the developed world  –  roughly 1 million Canadians and 10 million Americans  –  suffer from a debilitating form of chronic pain, called neuropathic pain (NP) or neuralgia.(1,2) What’s worse is that these numbers are expected to rise because of an aging population and the subsequent increase in diabetes and shingles, two common diseases associated with NP.(3,4) More simply called nerve pain, NP is quite a challenging medical condition to treat since current treatment options provide only modest relief, and usually with problematic side effects.

I’ve recently had a few patients asking me about a new over-the-counter treatment for NP. The product is called Neuragen which is a homeopathic mixture in a solution of five essential oil extracts.(5,6) Neuragen comes in either a “concentrated” dropper-bottle (5 mL or 15 mL ) or an 8 gram gel jar.  Canada-based Origin Biomed, Neuragen’s manufacturer, boasts of impressive pain relief with Neuragen, including “Effective for up to 8 Hours”, “Effective for more than 80% of sufferers”, and “Highly effective for 63% of sufferers”.  Before looking at the evidence for Neuragen, let’s look at what we’re trying to treat: a condition called neuropathic pain.

Mulberry for Weight Loss: Not just unproven, but implausible

I don’t normally read the freebie newspapers in Toronto as their content is the journalistic equivalent of the lead in the Toronto water supply: both slowly sap your intellect away.

But I ride public transit and those papers are littered everywhere, rolling around the TTC. So against my better judgment I picked up the paper on May 20,  skipped past the article from the “holistic nutritionist” (a topic for another day) and stumbled across this advertisement:

“The Man Who Made the Whole Town Lose Weight”

Impressive headline.  Reading further it turns out that “Johnny Petterson”, a local health food store owner in Alesund, Norway, had started selling mulberry leaf tablets to his customers, and they lost weight – after only 10 days.  According to the advertising copy, Johnny has helped over 1500 customers lose weight. Apparently this product is for sale at major pharmacies in Canada. So it’s time to do a bit of digging into this scientific breakthrough unearthed by a health food store owner.

Here’s excerpts from the ad (here is a similar PDF) – and my comments.