Call it swimming against the tide of alternative medicine. It is a futile effort costing taxpayers tens of millions of dollars a year.
Last week’s study showing that the widely touted and sold supplement DHEA does nothing to slow the effects of aging was only the latest major piece of research with powerfully negative results from the National Institutes of Health Center for Complimentary and Alternative Medicine. Previous placebo-controlled trials proved the uselessness of St. John’s Wort for depression and saw palmetto for enlarged prostates, shark cartilage for cancer, echinacea for the common cold and glucosamine plus chondroitin sulphate for arthritis.
But it doesn’t matter much — few seem to care.
The NIH launched its office of Complementary and Alternative Medicine (CAM) in 1991 in response to the public’s huge interest in finding ways around mainstream medicine. At first, those heading the effort brought dubious credentials. Much of the research ranged from mediocre (meaningless animal studies) to laughable (passing magnets over sore knees).
But, in 1999, with the name changed to the National Center for CAM, Dr. Stephen E. Straus took over. Straus, who spent much of his career at the National Institute on Allergy and Infectious Diseases, enjoys a reputation as an accomplished scientist. In his time as director, the Center for CAM has spent much of its $122 million annual budget on clinical trials putting most popular alternative treatments to the same rigorous tests as those required of pharmaceuticals and medical devices before approval by the Food and Drug Administration.
Except for acupuncture, already proven effective in China, almost all the research has come to the same conclusion: the stuff doesn’t work.
The powerful industry that sells these products ignores the results and often finds allies who believe in them because of an anecdote or advertisement.
After the chondroitin results appeared, Jane Brody, the longtime health columnist for the New York Times who has always prided herself in offering advice based on scientific research, wrote that she would continue taking chondroitin for her knee pain because “it transformed my 11-year-old spaniel from an arthritic wreck into a companion with puppylike agility, giving him nearly six more active years."
CAM means many things — often just the search for care beyond the 12-minute visit to a harried physician. Some treatments under the alternative medicine heading, like massage, clearly do no harm and could make anyone feel better. CAM can offer a vehicle for a sick person simply to spend time with someone attentive to their symptoms.
As long as it doesn't kill anyone
So-called “dietary supplements,” such as DHEA, saw palmetto and chondroitin, present the biggest problem.
Marketers often sell them under the guise of a mom-and-pop alternative to big pharma. Yet the $29 billion-a-year dietary supplement industry wields such power that it got Congress to pass a law in 1994 that basically frees it to peddle almost anything that doesn’t kill people with claims of medical benefit that need not be proven.
No doubt some of the thousands of products sold as dietary supplements work well, but the industry that sells them has neither motivation nor desire to know which ones work and which don’t.
Neither do many of those who advocate their use, such as the guru of alternative medicine Dr. Andrew Weil.
On his Web site someone recently inquired if a supplement called NT was useful for fatigue. “I'm not convinced by the scant literature on the subject that there's anything to recommend taking NT Factor for fatigue,” Dr. Weil replied, in a surprisingly forthright response.
But, then he added that the fatigue sufferer might want to try “Siberian ginseng (Eleutherococcus senticosus), coenzyme Q10, the Ayurvedic herb ashwaganda or cordyceps, a traditional Chinese medicinal mushroom that may help fight fatigue and boost energy levels.”
I can find no evidence that any of these relieve fatigue any better than NT.
It gets better.
Dr. Weill concluded his answer by advising that a better-studied treatment might be something called Juvenon. At the bottom of the Web page appeared an ad from the manufacturer of Juvenon with the quote “I take Juvenon every day — Dr. Andrew Weil.”
Such crass commercialism would put most big drug companies to shame.
Dr. Weill has claimed he approaches medicine with a new way of thinking. But, in the end, no matter what the hype, either something is effective or it isn’t. If no one really cares, maybe we should stop spending millions to find the answer.