SERVING UP NONSENSE IN THE FORM OF PICK-ME-UP PILLS

For those of you living in Australia reading this editorial, you will be well aware of the Sydney Morning Herald’s reputation as an excellent newspaper that provides a balanced argument for the general public on all matters of news and current affairs. For those of you living outside of Australia, this editorial is still extremely relevant. In the Wednesday 25 January edition of the Herald, Professor John Dwyer who is a retired Professor of Medicine from the University of New South Wales, wrote an article in the comments section of the Herald with the above title. In that article he had a number of complaints which were prompted by specific advertising for a variety of complementary therapies over the summer period in Australia.

One of the television advertisements that he took great exception to was one that I appeared on for the company Nature’s Own (with whom I have a commercial arrangement). Nature’s Own is a vitamin company which makes a series of high quality supplements available across the counter in Australia for the general public. For all of you regular readers of this newsletter, you will be well aware of my support of the sensible use of supplementation and I had this view long before I developed a commercial arrangement with any company. I would like to highlight the points made by Professor Dwyer and counter them, not to defend myself, but to defend the overall position of the complementary world, who have been unfairly attacked in this article.

His first point was that the Nature’s Own commercial which promotes a combination multivitamin and fish oil preparation is misleading in that it suggests to people by taking this vitamin you will help to avoid heart disease. Firstly, if you had the opportunity to view this commercial you would realize that I am promoting a healthy lifestyle and suggesting the addition of a high quality vitamin supplement and fish oil will supplement this healthy lifestyle. I strongly support this position and believe from numerous observation trials of people living healthy lifestyles and consuming multivitamins and/or fish oil, that there is a substantial reduction in their future risk for heart disease.

Professor Dwyer trots out the often quoted ’evidence based medicine’ to support his argument and then goes on to discuss how randomized clinical trials of antioxidants have shown no benefit in the prevention of heart disease to allegedly support his argument against the Nature’s Own commercial. One would have thought in an article where one is promoting the benefits of the scientific method, that Professor Dwyer would have been aware that antioxidants are not multivitamins nor are they fish oil. He has therefore used evidence from (what I’d believe to be) flawed clinical trials (see previous newsletters) of poor quality synthetic antioxidant vitamins which I agree have shown no benefit in the medium term prevention of heart disease and then Professor Dwyer has extrapolated these trials to encompass the multivitamin /fish oil argument. This line of thinking certainly does not demonstrate a good scientific method.

It is important to make the point that there has never been a randomized, mortality or major event trial of multivitamins over a medium to long term period and therefore the only science that can be derived regarding multivitamins are from observational trials or the more short term trials which incidentally, in the majority, have shown a significant benefit in the prevention of heart disease and in some cases, cancer.

There has only been one randomized trial of fish oil in the prevention of heart disease and again this showed a significant benefit.

Therefore, in this regard, Professor Dwyer’s argument is nonsense.

He then went on to criticize Medibank Private and its coverage for a range of alternative therapies where, in particular, the commercial was more focusing on acupuncture and massage than what he referred to as the nonsense therapies of reflexology and iridology. Many people in the conservative medical world are now recognizing acupuncture as an excellent adjunct for the treatment of musculo skeletal disease disorders and other chronic pain conditions such as headaches. I personally have had a great response in the treatment of my own tennis elbow from a course of acupuncture, which thankfully has not recurred.

He also mentions massage as part of the nonsense therapies and I am sure many physiotherapists would take exception to this rather bizarre claim against a very well accepted standardized therapy.

He then went on to state that a number of naturopaths in recent times have been charged with causing the deaths of patients. I can only recall one in recent times and I agree entirely with Professor Dwyer that this individual should be thoroughly investigated and possibly even charged for contributing to the death of a patient with end stage kidney disease. The patient in question was on dialysis and was given ridiculous and inappropriate treatment by a very questionable naturopath. Surely this does not mean we should criticize all of the naturopaths in society who, from my experience, offer their patients an excellent service and have helped numerous people, often when conventional medicine has not been able to improve their lot. I have not heard much noise from Professor Dwyer and many other elements of conservative medicine, criticizing unnecessary medical operations, medical procedures and the burgeoning diagnostic radiology. A year or so ago in The Lancet (which I reported in the newsletter), a large study suggested that 500 extra cancers per year in Australia were due to diagnostic radiology.

It is said that the commonest cause of death in society is cardiovascular disease, closely followed by cancer and the third commonest cause of death in western society is western health care. Many of these deaths are unavoidable because of complications of surgery and adverse reactions to drugs along with the increasing infection rates from bacteria such as ’Golden Staph,’ but also some are due to negligent and unnecessary practices by the medical profession and there are many more deaths caused by negligent doctors compared with negligent naturopaths. I do not believe any deaths through negligence are justified, but certainly don’t pick on one particular element of health professionals and ignore the main stream casualties.

The fourth point made by Professor Dwyer is that all vitamins really do is create expensive urine and are worthless and of no benefit. He makes the important point that there are hardly any vitamin deficiencies in Australia and other developed countries. Although I agree entirely with this argument, vitamins are not used as replacements for deficiency but used to combat the fact that the body is being stressed by the excessive exposure to synthetic poisons which is rife in our society, along with the incredible increase in stress from all manner of situations such as work, poor home environments, lack of activity and, at times, excessive activity such as the stress as seen in high level sportsmen. How often do we see sportsmen having to pull out of competitions because of viruses or because of persistent minor injuries. It is my position that a healthy lifestyle with adequate appropriate supplementation can minimize a lot of these issues. Again, to use a personal example, despite now being firmly entrenched in middle age, I am still able to play high level soccer, squash and tennis and I attribute my ability to do this to a very healthy lifestyle and a comprehensive supplement range using high quality natural vitamins. I therefore believe that not only do vitamins create expensive urine but they also create expensive blood which is exactly what you want. Of course any additional vitamins that you may take that your body doesn’t need will be excreted very safely via the urine.

He then went on to criticize a high quality company such as Blackmores and states, and I quote, ’there was no excuse for Blackmores to market an Executive Stress Formulation of Vitamin B or for the company promoting Nature B to advise radio listeners to take extra vitamins on New Year’s Eve for example to compensate for immoderate alcohol consumption.’

If Professor Dwyer took the time to research the contents of Blackmores Executive Stress B Formulation he would realize that much of the stress relieving components of the formulation are herbal with the B Group Vitamins adding some support.

I do agree that no company should be suggesting their vitamins will help compensate for excessive alcohol consumption or any poor lifestyles and when I heard Professor Dwyer talk on the radio to follow up this article, I was disturbed that he was suggesting that this was a common practice. If the public chooses to falsely believe that vitamins will compensate for a poor lifestyle then they are purely fooling themselves.

I have long stated in all of my publications and in any of my lectures that you cannot be healthy and be overweight, smoke or have addictions or have an extremely stressful lifestyle. Healthy lifestyle to me is always the most important aspect of anyone’s health and this is why vitamins, minerals and trace metals along with herbal preparations are called supplements, as they are supplements to this healthy lifestyle. If indeed, the Nature B company did make the suggestion about taking extra Nature B and consuming excessive alcohol, I agree with Professor Dwyer that this is irresponsible, but as I did not personally hear this myself I can make no real comment.

Professor Dwyer then goes on to comment about the fact that antioxidant supplements have been shown to be of no benefit in cardiovascular disease. I agree entirely with this point that the very poorly designed limited studies that have been performed on this subject, despite involving thousands of patients, have shown no benefit from the use of antioxidant vitamins in the prevention of cardiovascular disease. I have argued this point in numerous newsletters previously but will reiterate the fact that I believe the reason that there has been no benefit is based on the fact that firstly they pick the wrong population to study, secondly, only single vitamins were used which I believe are inappropriate and in the three studies where they used combination vitamins, these were all synthetic and it is my firm opinion that synthetic vitamins are of no value and, in fact, on some occasions can cause harm. This brings up another point of Professor Dwyer’s in that in one study the antioxidant Beta Carotene increased the risk of lung cancer in smokers. Again, if you read the science properly, it was only those people who smoked more than 20 cigarettes per day and consumed Beta Carotene that had a slightly increased risk of lung cancer. The reason for this is that the Beta Carotene used in the study was the synthetic version of Beta Carotene which is an extremely weak antioxidant and rapidly becomes overwhelmed by the toxic effects of cigarette smoke and its ability to generate trillions of free radicals and thus becomes pro-oxidant itself and helps the cigarette smoke induce more lung cancer. This is hardly a reason to stop people from using natural vitamins as a supplement to good health.

It is with the next line of reasoning that Professor Dwyer and I start to develop more similar attitudes. He then went on to criticize the television shopping networks where more spurious claims are made by the complementary medical world such as a product known as Oxygen 4 Life where, and I quote, ’buy and consume this liquid preparation and apparently pure oxygen will stream into your muscles, relieving fatigue and promoting wellbeing. ’I agree with Professor Dwyer that this claim appears somewhat spurious and can see no real science behind what this company is trying to promote. Having been approached by numerous companies who make claims such as these, I have always found their claims somewhat spurious and have always declined to have any involvement in promoting their products.

Finally, Professor Dwyer goes on to say that he believes the Therapeutic Goods Administration, which is the Australian equivalent to the American FDA should really come down hard on all of these companies that are promoting such bogus health claims. With my comments about the increasing hazards of modern medicine and the disturbing rates of medical negligence, isn’t it important that we go by the old adage that it’s important to clean up your own backyard before you start trying to get rid of the rubbish in your neighbour’s back yard. I am sure Professor Dwyer and I do agree that science is important and appropriate sensible regulation by the government bodies involved should also be encouraged. I must however state that if you are going to have science as the basis for your arguments against particular therapies and interventions, it is much better to use a scientific argument rather than the subjective and biased arguments used by Professor Dwyer.