Category Archives: Alternative Medicine

Vitamin E and Selenium May Increase the Risk of Prostate Cancer

The October 12 Journal of the American Medical Association reports a slight increase in the risk of prostate cancer from vitamin E and selenium. The increase from selenium is not considered statistically significant. Vitamin E’s increase just met the criteria and is considered more likely to be real. This increase in risk, for both agents, is important in that they were being evaluated as preventatives. They obviously don’t work.

This report includes 54 464 additional person-years of follow-up and 521 additional cases of prostate cancer since the primary report. Compared with the placebo (referent group) in which 529 men developed prostate cancer, 620 men in the vitamin E group developed prostate cancer (hazard ratio [HR], 1.17; 99% CI, 1.004-1.36, P = .008); as did 575 in the selenium group (HR, 1.09; 99% CI, 0.93-1.27; P = .18), and 555 in the selenium plus vitamin E group (HR, 1.05; 99% CI, 0.89-1.22, P = .46). Compared with placebo, the absolute increase in risk of prostate cancer per 1000 person-years was 1.6 for vitamin E, 0.8 for selenium, and 0.4 for the combination.

Medicynical Note: This is not stunning news as vitamin and mineral supplements have little efficacy–unless there is dietary deficiency. Perhaps our pill popping culture will take note.

Dietary Supplements: An Illusion that became a Delusion

The use of vitamin supplements have become almost a religious belief in our culture. We bought the notion that If some is good, more must be better.

But, there is little evidence of efficacy of vitamins in healthy people who eat a balanced diet. There is however increasing evidence of harm.

After adjustment for multiple potential confounders, use of multivitamins and vitamin B6, folic acid, iron, magnesium, zinc, and copper supplements was associated with greater all-cause mortality through 19 years of follow-up (HRs 1.06 to 1.45), according to Jaakko Mursu, PhD, of the University of Eastern Finland in Kuopio, and colleagues.

Use of a daily calcium supplement, on the other hand, was associated with a lower risk of death (HR 0.91, 95% CI 0.88 to 0.94), the team reported in the Oct. 10 issue of the Archives of Internal Medicine.


“We cannot recommend the use of vitamin and mineral supplements as a preventive measure, at least not in a well-nourished population,” they wrote. “Those supplements do not replace or add to the benefits of eating fruits and vegetables and may cause unwanted health consequences.”

Antioxidants — The 23 Billion Dollar Placebo

Interesting take on antioxidants in Slate, noting:

As it turns out, we have no evidence that antioxidants are beneficial in humans. (Though if you’re a Sprague-Dawley rat, there’s hope.) In fact, as Emily Anthes wrote last year in Slate, the best available data demonstrate that antioxidants are bad for you—so long as you count an increased risk of death as “bad.”

Medicynical Note: Before we jump on the bandwagon of antioxidant cynicism, think of the disruption of belief systems, the unemployment (naturopaths, nutritionists, chiropractors, life coaches and gurus, life extension specialists), and the depression from understanding that vitamins have very limited benefit, and perhaps do harm when taken in excess. That we don’t really have the potential to live to 130 years old, that this particular belief system has no basis.

Vitamin D Supplementation– All Hype? Little Evidence of Efficacy

The prestigious Institute of Medicine released a report November 30th indicating that the hype over Vitamin D supplementation is just that, hype:

The committee provided an exhaustive review of studies on potential health outcomes and found that the evidence supported a role for these nutrients in bone health but not in other health conditions. Overall, the committee concludes that the majority of Americans and Canadians are receiving adequate amounts of both calcium and vitamin D. Further, there is emerging evidence that too much of these nutrients may be harmful.

Regarding the efficacy of Vitamin D on health problems the study concluded:

It reviewed a range of health outcomes, including but not limited to cancer, cardiovascular disease and hypertension, diabetes and metabolic syndrome, falls, immune response, neuropsychological functioning, physical performance, preeclampsia, and reproductive outcomes. This thorough review found that information about the health benefits beyond bone health—benefits often reported in the media—were from studies that provided often mixed and inconclusive results and could not be considered reliable.

Medicynical Note: I recently went to our local health food Coop and was amazed, (as I always am) at the two to three aisles of vitamins , food supplements and such ironically being marketed to people who are deeply interested in maintaining their precious bodily fluids (see General. Jack D. Ripper).

The notion that there be some proof of efficacy of these supplements before taking megadoses seems foreign to our culture and perhaps has to do with our belief in miracles, religiousity, aggressive marketing and doing what we are told to do.

Glucosamine, Chonroitin = Placebo

Back from vacation.

Alternative medicine in most instances is an expensive placebo. There are benefits to alternative providers and the drug does provides something to do for patients who must do something–even if it’s no better than doing nothing.

The British Medical Journal this week published a meta-analysis of several trials of the use of glucosamine and chondroitin–alternative treatments for arthritis. Even my vet recommends these drugs.

Unfortunately these agents don’t work! The study concluded:

Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.

Medicynical Note: The broader issue “efficacy” should be considered in both the marketing of medications and payment by insurance. In this case the “drug” is inexpensive (though there are 2 billion dollars in sales annually around the world) and it’s not a huge issue except as a matter of honesty in marketing.

But there are a number of expensive drugs that offer results little or no better result than placebo but at prohibitive cost. Should insurers pay? Medicare has no authority to deny payment for drugs that are FDA approved even those with little benefit. It’s a reason why our system is bankrupting us.

Alternative Medicine–it’s not medicine

Nice review of five of inexplicably popular alternative modalities with references here.

As you’d expect reiki, reflexology, zone therapy, homeopathy, magnetic therapy, and kava don’t work. Also inexplicably some insurers cover such nonsense.

Another alternative medicine that isn’t medicine–Ginkgo

It’s been claimed that Ginkgo improves cognition and may delay or prevent dementia. It doesn’t. It’s in the JAMA here.

Inspired Alternative Nonsense–Bioidenticals

An editor’s note in an article on bio-identical medication/supplements says it best:

  • “Ten years and $2.5 billion in research have found no cures from alternative medicine. Yet these mostly unproven treatments are now mainstream and used by more than a third of all Americans.”

Medicynical Note: There is evidence in a few instances that supplements may make things worse.

The article goes on to note;

  • “Alternative remedies are especially popular with upscale, educated women who like to research and find their own solutions to medical problems. They like the idea of personalized treatments versus off-the-shelf prescription drugs. However, instead of a safer option, they are getting products of unknown risk that still contain the estrogen many of them fear, women’s health experts say. “

Medicynical note: Billions of dollars are wasted each year on nonsense like bio-identicals. The bottom line is that these in-vogue substitutes often contain the same type medication as the regular product with the same risk, under the guise of a “safe” alternative. We are a quite amazing people.

Colonic cleansing–Nonsense, Nonsense, Nonsense

There seem to be innumerable products on the market that tout the benefit of “detoxification” and the idea that wastes build up in the colon and need cleansing. This is the basis of the widely used naturopathic remedy of colonic irrigation and various detox forumulas.

Consumer’s reports notes:

“We found insufficient reliable evidence that colon-cleansing products are safe or effective for improving general health. But we did find some cause for concern. When they are administered too often, laxatives and enemas might prevent normal bowel movements or lead to a potentially deadly depletion of vital electrolytes.”

And regarding waste accumulation:

“Waste does not accumulate in firm masses on intestinal walls, spreading toxins into the bloodstream, says Mark DeLegge, M.D., a spokesman for the American Gastroenterological Association in Bethesda, Md. He suggests staying regular by eating foods that are rich in fiber, including vegetables (broccoli, carrots, spinach, and squash), fruits (apples, bananas, and pears), whole grains (barley, whole or rolled oats, and whole wheat), and legumes (beans, lentils, peanuts, and peas).”

Medicynical note: Quackery has endless variations.

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Bad News for Vitamin Manufacturers, Naturopaths, Megavitamin advocates– Vitamins don’t work, may hurt you

It’s been apparent for some time that vitamins taken in pill form have little positive benefit and may hurt you, particularly when taken in large doses. This article in the LA Times summarizes where we are, it ain’t pretty.

“two long-term trials with more than 50,000 participants offered fresh evidence that vitamin C, vitamin E and selenium supplements don’t reduce the risk of prostate, colorectal, lung, bladder or pancreatic cancer. Other recent studies have found that over-the-counter vitamins and minerals offer no help in fighting other cancers, stroke or cardiovascular disease.”

Vitamins may harm you:

“These things are ineffective, and in high doses they can cause harm,”

“One trial that followed 29,000 male smokers in Finland for an average of six years found that men who took beta carotene were 18% more likely to be diagnosed with lung cancer and 8% more likely to die during the study than men who didn’t.”

“A second trial involved 18,000 American men and women who were smokers or former smokers or who were exposed to asbestos at work. That study found that after an average of four years, lung cancer rates were 28% higher among those who took beta carotene and vitamin A, and their overall risk of death during the trial jumped by 17%.”

“Those who took vitamin E were just as likely to develop heart disease, stroke and a variety of cancers as the women who took a placebo, according to results published in 2005 in the Journal of the American Medical Assn.”

Get the idea? Vitamins taken as dietary supplements are ineffective and a waste of moneythat’s 10 billion dollars a year in health care expenditures wasted.

There is much more in this article, so read it and if you are a vitamin manufacturer, weep!!!

Medicynical disclaimer: The case of Vitamin D’s beneficial effects may be different since a deficiency of vitamin D (compared with normal levels found in people) is thought to be associated with an increase the risk of some medical problems. The question remains whether correcting the deficient level by taking supplements helps. We simply don’t know but are recommending it.

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