Consumer Health Digest #04-02
Your Weekly Update of News and Reviews
January 13, 2004
Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., and cosponsored by NCAHF and Quackwatch. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.
Naturopathy critically appraised. Medscape General medicine has published what appears to be the first penetrating analysis of naturopathic quackery to appear in a modern medical journal. The article notes:
"Naturopathic physicians" now claim to be primary care physicians proficient in the practice of both "conventional" and "natural" medicine. Their training, however, amounts to a small fraction of that of medical doctors who practice primary care. An examination of their literature, moreover, reveals that it is replete with pseudoscientific, ineffective, unethical, and potentially dangerous practices. Despite this, naturopaths have achieved legal and political recognition, including licensure in 13 states and appointments to the US Medicare Coverage Advisory Committee. This dichotomy can be explained in part by erroneous representations of naturopathy offered by academic medical centers and popular medical Web sites. [Atwood K. Naturopathy: A critical appraisal. Medscape General Medicine 5(4) 2003]
The full text of the article is online but site registration is required to access it.
Consumer Reports nixes "ephedra-free" products. Consumer Reports has warned that bitter orange and green tea extract, which are replacing ephedra in some supplement products, are not necessarily safe or effective for their intended purposes. The January 2004 issue warns that (a) both substances are stimulants, (b) some products combine them, with or without caffeine, which may pose dangers beyond the sum of their individual ingredients, (c) bitter orange has effects similar to ephedra, and (4) too much green tea, especially combined with other stimulants, can cause jitters, headaches, insomnia, gastrointestinal upset, and possibly worse problems. CU's consultants recommend avoiding all so-called weight-loss and energy-boosting supplements because no such product has been proven safe or effective. [Ephedra-free, but is it safe? Consumer Reports, January 2004]
Man indicted for selling counterfeit Viagra. A federal grand jury in Los Angeles has charged Khoa Twan Do (aka Chris Do) of Glendale, California with selling counterfeit Viagra tablets that were manufactured in the People's Republic of China. The indictment alleges that Do conspired with a manufacturer in Beijing to import at least 40,000 counterfeit Viagra tablets into the United States for resale through his business, Health Plus. The charges include one count each of conspiracy, trafficking in counterfeit goods, and selling a counterfeit drug, which together carry a maximum possible penalty of 18 years in prison and a fine of more than $2 million. The FDA helped the U.S. Department of Justice with the investigation. [Glendale man indicted for trafficking in counterfeit Viagra tablets. DOJ news release, Jan 9, 2004]
Investigator finds serious chiropractic deficiencies. Anesthesiologist John W. Kinsinger, M.D., has reported what happened during phone calls and visits he made to nine chiropractors in Oklahoma City, Oklahoma. He states:
Chiropractors like to tell people that they have sufficient training to make appropriate diagnoses and to refer people for medical treatment when needed. I have tested this assertion in several ways. This article reports on five phone calls and six visits. . . . During most of these, I complained about conditions whose treatment is not within chiropractic's legitimate scope. In 1990, I telephoned five local offices to test whether the chiropractor would encourage people with serious medical problems to come for chiropractic care. All of them did so. I subsequently visited one of them who diagnosed several problems I didn't have -- and another who said that my x-ray films (which were normal) revealed serious pathology. In recent years, I have made four office visits in which I described the classic symptoms of a serious medical problem. In each case, the chiropractor missed the diagnosis and failed to make an appropriate referral.
Chiropractors encouraged to market cholesterol testing. BIOSAFE Medical Technologies, Inc., of Lake Forest, Illinois, has invited chiropractors to profit from promoting cholesterol testing to their patients. Its special Web site for chiropractors states that BIOSAFE tests can increase their practice revenue through the sale of the tests themselves, through patient consultation fees, and through the sale of products and/or services. The test kit includes a blood collection card, an alcohol prep pad, disposable lancets, a gauze pad, a bandage strip, instructions, a patients authorization form, and a prepaid return envelope. The test specimen is prepared by nicking the subject's finger and placing three drops of blood onto a the collection card, which is mailed to the laboratory for analysis. Patients can order test kits directly from the company or have them processed through a practitioner's office. In either case, reports can be sent to both patient and practitioner.
Anyone can purchase BIOSAFE Cholesterol Panel test kits through the company's Web site for $29.95. Chiropractors can obtain them in lots of five for about $21.00 each and resell them to patients. Or they can bundle kits with follow-up consultation for which they charge whatever they believe is appropriate. The test itself appears to be valid and has FDA approval for direct distribution to patients. However:
- Most chiropractors do not know enough about cholesterol management to appropriately counsel patients who have abnormal test results.
- Chiropractic colleges teach very little about this subject, and chiropractic textbooks, journals, and continuing education courses contain almost nothing.
- A large percentage of patients with abnormal cholesterol levels will require drugs that chiropractors cannot prescribe.
- Chiropractors who do not know their limitations may prescribe dietary supplements and/or herbs that are ineffective or less effective as prescription products.
- Patients referred to a medical doctor will probably require retesting by the laboratory that the doctor customarily uses. In such cases, BIOSAFE screening may turn put to be an unnecessary expense.