Consumer Health Digest #13-40

Your Weekly Update of News and Reviews
October 24, 2013

Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. 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.

UK hospital ordered to narrow herbal claims. The British Advertising Standards Authority (ASA) has ordered the Royal London Hospital for Integrated Medicine (RLHIM) to stop making overly broad claims that herbal products available through its Western Herbal Medicine service are effective against digestive disorders, urinary disorders, allergies, women's health problems, joint problems, stress, skin problems, hormonal problems, fatigue syndromes, and recurrent infections. The ASA's adjudication noted that although the RLHIM provided evidence that provided supported some specific claims within these ten categories of disease, it had not provided sufficient robust evidence to cover the broad range of conditions that could be inferred from the listings. The hospital, formerly called the Royal London Homeopathic Hospital, is part of the University College London Hospitals Foundation trust, which is part of the United Kingdom's government-run National Health Service. In June 2013, the ASA ordered the RLHIM to stop making misleading claims for acupuncture. The complaints in both cases were made by the Nightingale Collaboration, which noted that in reviewing the evidence for health claims, "the ASA has made very clear that unblinded, uncontrolled, non-randomized trials are likely to be unacceptable." [Herbalism on the NHS: complaint upheld: Our fourth complaint against the Royal London Hospital for Integrated Medicine shows yet another a very fragile evidence base—but what will UCL Hospital Trust do about it? Nightingale Collaboration Web site, Oct 23, 2013]

US hospital bans dietary supplements from its pharmacy. The Children's Hospital of Philadelphia has announced that its Formulary—the list of medications approved for dispensing to patients—will no longer include most dietary supplement products (the category of products that includes vitamins, minerals, herbs, botanicals, amino acids, enzymes and animal extracts). The hospital's updated policy acknowledges that some medical conditions may require supplementation with nutrients that the hospital has determined are proven to be of high quality and safe. Parents who insist on giving their hospitalized children products that are not listed in the CHOP Formulary must sign a hospital waiver assuming responsibility for providing the product. [Children's Hospital of Philadelphia becomes first in nation to disallow use of dietary supplements: New hospital policies will improve patient safety, education. CHOP news release, Oct 8, 2013]

Reviewers advise against chelation for autism. An international team that surveyed the scientific literature for studies on chelation treatment for autism has concluded that it is unsubstantiated and lacks a plausible rationale. [Davis TN and others. Chelation treatment for autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders 7:49-55, 2013] Their report concluded:

Perhaps the greatest concern in regards to the selection of chelation treatment for children ASD is the lack of construct validity. In some ways, chelation therapy represents the "cart before the horse" scenario in that the hypothesis supporting of the use of chelation treatment failed to be validated prior to the application of chelation. Chelation treatment aims to eliminate specific metals from the body. However, empirical evidence has yet to support the hypothesis that the core ASD symptoms are caused by the presence of such metals in the body. Because empirical evidence does not support the hypothesis that the core ASD symptoms are associated with specific levels of metals in the body, the use of chelation to remove metals from the body in order to ameliorate ASD symptoms could be seen as unfounded and illogical.

Moreover, even if metal poisoning contributed to the ASD symptoms, it would still be unclear whether chelation treatment would have the ability to reverse existing neurological problems caused by such exposure, or whether it would only be able to prevent further damage (i.e., worsening of symptoms). In other words, even if the metal poisoning theories held true, it does not necessarily lead to an expectation that chelation would ameliorate current communication and social skills deficits and behavioral impairments, rather than prevent additional or more extensive impairments.

Based on the results of this review, evidence to support the use of chelation as a treatment for children with ASD is extremely weak. The weakness of the evidence base, the lack of a sound rationale for use of chelation as an ASD treatment, and the potential negative side effects strongly argue against the use of chelation treatment for ASD.

Judge increases pressure on Kevin Trudeau. U.S. District Judge Robert Gettleman has ordered infomercial scammer Kevin Trudeau to remain in jail until he reveals where he has hidden his assets. Trudeau told Gettleman that he lacks the money to pay the judgment that the Federal Trade Commission obtained against him, but the judge said that he didn't believe him. [Jannsen K. Infomercial king Kevin Trudeau to stay in jail. Chicago Tribune, Oct 24, 2013] Casewatch has background information on Trudeau's history.

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This page was revised on October 27, 2013.