My kids know that I enjoy a spirited argument. During the days when the dinner table was
our public forum, I tried hard to offer a responsible voice of dissent on the
issues before us. I admit now that the
view I espoused was not always my own, but one that I felt merited inclusion in
the discussion. I still do this with
them and to others in my life who are willing to succumb to probing of the
mind. I willingly subject my own mind to
the same process.
Because I am a gastroenterologist, folks assume that I have
special expertise in nutrition. I
should, but I don’t. Perhaps, medical
education has evolved since I was in medical training, but in my day, a soft
subject like nutrition was bypassed. I
am hopeful that I can remedy this knowledge vacuum in the years ahead.
These days, nutrition is part of the burgeoning tsunami of
wellness medicine, a discipline that races beyond known science as it seeps
into the marketplace.
Several times a week, I am queried on my view of probiotics,
which are bacteria that confer health benefits on the human who ingests
them. If you were to survey the public, I suspect
that a majority would express that probiotics promote health and are effective
in treating or preventing various maladies.
These products are included in the billion dollar enterprise
of alternative medicine that is not subjected to any Food and Drug
Administration (FDA) oversight. Their
claims are very difficult to study and there is no standardization in the
industry of what constitutes probiotic treatment. This a different universe that
conventional drugs inhabit. These
medicines, prescribed by physicians, are subjected to rigorous oversight by the
FDA and must demonstrate safety and efficacy.
Alternative product purveyors, free from these constraints, can appeal
to our New Age beliefs with promises that are seductive but unproven. They promise better health but don’t have to
prove anything.
If you were in the business of selling medicine, would you
choose to spend gazillions dollars and several years praying your drug gets
through the FDA, or promote a probiotic that a public is ready to swallow on
faith? If you’re stuck on this question, then
consider my alternative blog MDWhistleblower for Dummies for remediation.
Do probiotics treat or prevent disease? Are these companies overpromising? Clearly,
the marketing claims are a light year or
two beyond verifiable and supportive science.
I know that many of us want probiotics to be the panacea for
what ails us. I know that wellness and
preventive medicine have become a religion for many of us. I suggest that we need some Old Fashioned wisdom
to restrain New Age converts.
Don’t misunderstand me.
I’m not dissing Alternative Medicine acolytes. Does their stuff really work or is belief
of efficacy sufficient? Why aren’t
these companies utilizing the scientific method to determine if their potions
are just placebos? Kick this issue around your own dinner table
and make sure that dissent is on the menu.
Posts
7 comments:
I think that the benefits of probiotics and other similar medicines could be proven by science that they work if the pharmaceutical industry was willing to put the money towards the research rather than their current medicinal options.
It's interesting. I always wonder why people put so much faith in probiotics. I get a lot of stares when people ask me "which probiotic is the best to prevent yeast infections" and I respond, "I don't know". I often tell them about the lack of studies and then they bring up something about Dr Oz. It happens often. Usually pharmaceutical companies have to design, execute and publish studies before they generate enough hype to bring in the big money. But somehow the hype and money came first and we're still waiting on the studies. I think people assume efficacy because the probiotic concepts and mechanisms are really easy to wrap your head around. Whereas, the general public might not be so welcoming to the idea that beta-blockers can save lives post-MI.
"I suggest that we need some Old Fashioned wisdom to restrain New Age converts." I selected this quote from the article because it says so much about using common sense to evaluated any piece of information that is making a medical claim or any claim in general
Don't hold your breath waiting for high quality studies on probiotics. As I point out in the post, the manufacturers have a strong incentive to forego scientific scrutiny and to market their products directly to a public who has an insatiable appetite for all things wellness and will pay cold hard cash for the promise of a panacea. Why take the risk of proving efficacy if your customers are already satisfied with your claims and are emptying warehouse shelves at a dizzying pace?
I think it's quite ingenuous that many of the companies touting various supplements quote all sorts of shoddy "clinical trials" and almost never put their miracle product up against a placebo.
The Herbalife weight loss shake is a case in point. It does very well in the market, but independent studies show it is no better than placebo.
Christine, why do you think these potions are so popular? Doesn't the public care about scientific demonstration of efficacy? Are we still all willing to buy snake oil and other cure alls? Thanks for commenting.
what about studies about certain probiotics used for h pylori or c diff diarrhea?
"Probiotics for the treatment of pediatric helicobacter pylori infection: a randomized double blind clinical trial."
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