September 21, 2017 general

The medical buzz word is “evidence-based”. Freely translated, that means science has supposedly verified whatever practice is being discussed. Sounds good, right? Unfortunately, “evidence” is not some unequivocal black and white fact etched in stone tablets. As it turns out, what constitutes “acceptable” evidence is in the eye of the beholder. The variables listed below apply not only to medications and surgical procedures, but also to dietary supplements. But do keep in mind that the health stakes are a lot higher when science misleads us into taking drugs or having surgeries that turn out to be problematic. Obviously, we are less likely to get in trouble with side effects if wobbly science pushes us to use olive oil, do Tai Chi or take resveratrol.

Lack of knowledge. Check out this shocking example of insufficient information used in research. A large randomized trial showed that selenium yeast (methylselenocysteine) cut the risk of dying of cancer in half. The supplement also dramatically reduced the incidence of some cancers (e.g. prostate down by 63%, colon by 58%, etc.). The National Cancer Institute then began what was billed as a study to “replicate” the results of that research. If they had really done that, it might have saved untold numbers of lives. Unfortunately, they used a different form of the mineral.  Other selenium pills (e.g. selenomethionine and sodium selenite) have not been shown to be comparable. What the poorly structured second study ended up accomplishing was to needlessly scare men worried about their prostates away from selenium and vitamin E. (We can hope it was just ignorance, not intent to impugn supplements. Listen to my interview with one of the original researchers and decide for yourself.)

Who is behind the study? Most often a pharmaceutical company directly or indirectly decides what gets studied. That is because there is a tremendous amount of money to be made using the results. Sure, supplement companies make money, but usually not enough to pay for the very high cost of clinical research. Even if they had the funding, most natural substances cannot be patented. Therefore, all the competitors could sell it without spending a dime. And, alas, the more impressive the results from tests on supplements, the more likely it is that the FDA will not allow them to ever speak about the results. If they do, they risk being prosecuted for imitating a drug. (Basically, “How dare you cure people without drugs?”)

Not asking the right questions. Most studies look at a tiny factor such as a change in a cholesterol number…assuming it makes a difference in the long run. To seldom do they look at what we really care about—e.g. does it help us live longer and better? If the prevailing idea is for instance, that fibromyalgia is all in all in someone’s head (and there is no drug for it), no study is done. Also, reviews show that a high percentage of everyday practices in doctor’s offices have never been proven to work. It is just assumed that they do until when they are finally studied and are proven ineffective or even dangerous.

Failure to control all the factors. Perhaps the most common flat out error is not controlling all the factors. An example would be comparing weight loss drugs without making sure one group wasn’t exercising more than the other. If the scientists haven’t heard of something or have been biased against it, they don’t even bother to ask the subjects about it. For example, if they have been taught that fluoride in the drinking water is safe and are unaware of the power of gut bacteria, they might not consider those factors while researching something like autism.  

Study subject issues. If middle-aged men were studied it is a mistake to assume the results necessarily apply to women, kids or seniors.

PREJUDICE IN PUBLICIZING STUDIES. This is the biggie. Pharmaceutical companies are permitted to hide negative studies and publish only the ones that make their drug look good. The news media, medical journals, agencies and organizations can pick and choose which studies to ignore and which to publicize. Human nature being what it is, they tend to reject results that conflict with their pre-existing world view. Also, with cutbacks in media, not much real reporting gets done, i.e. the kind where they dig into past studies looking for trends vs parroting dogma from “experts”. For example, recently it was not on the evening news where it should have been when a study showed over 7 times more miscarriages among women who got the flu shot two years in a row! (The information was known long before the study came out. Meanwhile, how many babies died?) The whole vaccine issue is one where contrarian views are not even allowed because of media prejudice. When the news is forced to publicize findings that run counter to their prejudices, they usually follow up with a rebuttal from the industry involved or at least say that “more study is needed”.

I have a much longer list, but you can now see why what the “experts” tell us today may be the opposite of what they said 10 years ago. To protect ourselves, I think it makes sense to review science news with (1) some common sense and (2) a historical / worldwide context. For example, if there are populations around the world that are healthier than we are and they do the opposite of what we are being told…maybe don’t jump on that bandwagon just yet.