Feature article from the March, 2006 Newsletter

A Double Standard

In a recent issue of a prestigious medical journal1 there was a report on a study of the herb Echinacea. The herb is used by millions of people to prevent or lessen the severity of colds. The study concluded that Echinacea has no benefit.

However, proponents of the herb point out that (1) the study utilized less than one third the recommended dose2, (2) the herb was not given as frequently as is recommended, and (3) the study used a form of the herb that is different from the form in the commercial products.

When those who conducted the study were asked why they did not investigate several dosage levels, as is done with prescription medications, the answer was, in summary: “We didn’t have the money”. So apparently their philosophy is that you do the study you can afford, even if the results are unreliable or even false.

According to Mark Blumenthal of the American Botanical Council: “The award for the best sound-bite on this trial goes to Michael McGuffin, president of the American Herbal Products Association, who cogently stated in an interview on National Public Radio’s All Things Considered, ‘It’s like conducting a study on the effect of a third of an aspirin and wondering why you still got a headache.’ ”

In that same issue of the New England Journal of Medicine was an article asserting that any further investigation of Echinacea or several other herbs would be a waste of time and money. It’s interesting that a journal purporting to be a neutral party, would express so strong an opinion, especially since the article offers no legitimate reason.

The above is not unusual where “alternative” medical treatments are concerned, particularly those that do not produce a profit for the providers of orthodox treatments. The orthodox medical community is hostile to less expensive alternatives, and even at best holds “natural” treatments to a much higher standard then scale than mainstream allopathic approaches. The attitude is understandable (none of us likes competition), but it is a disservice to the public because it can stifle promising investigations. Consider for instance, that many “wonder drugs” are derived from plant sources. Among the best-known examples are the heart drug Digitalis and the antibiotic Penicillin. What if investigations of those plants were conducted in the same slapdash manner as the one cited at the beginning of this article, and the plants were then dismissed as useless?

To be sure, there is profit in herbs and vitamins (though the lack of patentability results in profits that are a small fraction of those from allopathic medications). Also, there are fraudulent remedies and quack treatments. Often it’s not easy for us as laymen to judge the legitimacy of an efficacy claim or a recommendation for or against a treatment. However, we can do the following:

Determine the source of a claim or a review, and think about whether the source has a vested interest;
Read actual study reports, not just third party synopses;
Be particularly suspicious of claims that a treatment either is effective against a wide variety of dissimilar conditions, or is effective in nearly or all cases;
Read dissenting opinions.

Even after doing as much investigation as you can, you might be unable to formulate your own opinion. In that case, ask the opinion of your health provider(s), but pay attention to whether they too might have biases or vested interests.

1. New England Journal of Medicine, July 28, 2005
2. In fact, in June one of the study’s co-authors, David Gangemi, PhD, of Clemson University, responding to a question about the low dosage used in the trial after his speech at the “Medicines from the Earth” symposium in North Carolina said, “I think in retrospect if we go back and we look at some of the other products that are out there maybe we’re only one tenth the level we should be” (emphasis added). Prof. Bauer has stated that he believes the results of this trial cannot be extended to all commercial Echinacea preparations since there are 3 species and numerous plant parts and preparations types, as noted in the New England Journal of Medicine paper.

W. A. Shapiro