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NCRHI News, March/April 2000

Volume 23, Issue #2

NATIONAL SURVEYS PRODUCE REMARKABLE FINDINGS ON
ALTERNATIVE HEALTH PRACTICES AND DIETARY SUPPLEMENT MISUSE

Survey findings by Consumers Union and Prevention magazine have confirmed what NCRHI has contended all along. Most alt-comp products and services have little value, and consumers expect the government to regulate health products and services to protect the public from quackery. If the media would accurately report how the alt-comp health care fad got started in the first place, we believe that the public would be outraged. In case you don't know, the NIH involvement with alt-comp medicine happened because political insiders Senator Tom Harkin and former Congressman Berkley Bedell abused their power positions and installed alternativists where only scientists had gone before. The deregulation of dietary supplements occurred largely because of the abuse of power by Senator Orrin Hatch and Congressman Bill Richardson, and political contributions given to legislators by the health food, herbal and vitamin supplement hucksters when the door was opened by the well-intended 1990 Nutrition Labeling and Education Act. The story that needs to be told is that the entire Congress has gone along with these abuses. Such is either an indication of a "give us the money and the public be damned" attitude within congress, or the revelation that our national legislators are incompetent, (ie, scientifically and medically illiterate, and without a clue of the fundamental nature of consumer protection laws and how they came to be). These revelations cry out for campaign finance reform and the creation of a way to assure the public that science, and not personal health biases, will form the basis of public policy in health care.

PREVENTION MAGAZINE ASSESSES DIETARY SUPPLEMENT USE

Prevention magazine's 1999 survey of dietary supplement use was conducted by Princeton Survey Research Associates from April 27 to May 16, 1999, with the FDA providing technical assistance in developing the survey. It consisted of telephone interviews with a nationally representative sample of 2,000 US adults.

Major Marketing Findings

People purchase from large stores: pharmacies, chain drug stores, discount stores, and grocery stores, not health food stores. The market is characterized as a self-care market, not an alternative care nor supplements market.

Utilization

Perceptions of safety

Beliefs about regulation:

Reasons for use:

Length of time consumers will use herbal remedies without results:

How consumers use herbal remedies:

Reasons for using herbal remedies instead of a prescription:

Reasons for using herbal remedies instead of OTC products:

Sources people named for finding out about herbal remedies were:

Sources used: Johnson BA, "Prevention magazine assesses use of dietary supplements," Herbalgrant 48,2000:65; and Natural Health Line, 3/10/00.

CONSUMER REPORTS READER SURVEY ON ALT MED USE

Consumers Union (CU) has added measurably to our knowledge about peoples' perception of their experiences with nonstandard medicine with an article entitled, "The mainstreaming of alternative medicine," (Consumer Reports, May, 2000, pp. 17-25). Billing the report as a survey of the real life experiences of more than 46,806 "well-educated, information-seeking Consumer Reports readers," the findings are not generalizable to the entire population, but the survey provides insight on the kinds of people who are more likely to use seemingly innovative health products and services." The study population resembled people prone to quackery in that respondents had higher education and income than national norms. The population differed in that 70% of the respondents were male, whereas females generally have been found to be greater users of questionable medicine. CU acknowledged that its findings "may not be directly comparable to other studies" because it is a select group.

CU also acknowledged that its survey "could not control for the quality of ingredients in supplements, for their dosage, or for the impact of people's expectations (the 'placebo effect') on any form of treatment," and that its survey results did not constitute a clinical test of any type of therapy (p. 18). Nearly 4% of more than 8,000 readers who took herbals and other dietary supplements experienced side-effects (eg, nausea, drowsiness, dizziness); few said the treatments made their conditions worse. CU failed to inform its readers that the real drug strength of homeopathic remedies cannot be known from their labels since only the number of dilutions of the "mother tincture" which is of unknown concentration is provided. Further, a significant proportion of both dietary supplements and homeopathic remedies may be adulterated (i.e., contain toxic or pharmacologically active ingredients not disclosed on labels). The most useful application of the CU survey is in the area of how people subjectively perceived their use of various types of therapy. Readers scored their subjective experiences with various alternatives, proven and unproven. Scoring results were favorably slanted because those who reported that treatments made their conditions worse (2% of responses on p.20: "Reading the Bar Graphs") were excluded from the graphs. Getting worse was said to have "held steady for all types of therapies." However, 2% represents over 900 patients who may have been the most seriously ill. The report was also biased in that all pictured testimonials, and a majority of those within the text, were favorable to alternative therapies. All statements comparing treatments in the article reflect statistically significant differences in reader response. An overall scorecard on what helped (or didn't) on 43 medical conditions is provided, plus, reports on readers' experiences with ten common medical conditions: allergies, arthritis, back pain, depression, headache, high blood pressure, high cholesterol, insomnia, prostate problems, and respiratory infections.

Reader Scores (Estimated from published bar graphs)

Problem/Method

% Using

Helped Much

Helped Somewhat

Helped Little/None
Allergies
Prescription drugs
Exercise
Megaitamins
OTC drugs
Homeopathy
Echinacea


81
12
 5
50
 3
10


51
37
32
27
34
18


32
33
38
42
27
29


15
28
29
32
37
47
High Cholesterol
Prescription drugs
Exercize
Diet
Garlic


75
55
52
12


56
41
28
18


33
36
38
32


10
23
32
50
Respiratory Infections
Prescription drugs
Exercise
OTC drugs
Megavitamins
Garlic
Echinacea


79
 12
49
 8
 6
22


60
40
25
25
22
21


23
31
42
43
33
32


13
26
32
32
42
43
Insomnia
Prescription drugs
Exercise
OTC drugs
Melatonin


53
44
39
35


32
15
10
12


32
40
42
22


34
42
45
60
Arthritis
Prescription drugs
Exercise
Megavitamins
Deep tissue massage
Physical therapy
OTC drugs
Chiropractic
Diet
Glucosamine
Echinacea
Garlic
Acupuncture
Ginkgo biloba
Magnet therapy


64
53
 5
  5
29
42
11
  7
36
  4
  5
  4
  5
  7


30
28
27
30
27
18
25
22
24
21
15
23
13
17


40
42
38
32
35
42
33
28
28
28
23
22
28
25


28
27
32
35
36
40
38
48
48
46
49
51
56
56
Back Pain
Deep tissue massage
Chiropractic
Exercise
Physical therapy
Acupressure
Prescription drugs
Meditation
Progressive relaxation
Acupuncture
OTC drugs
Diet
Glucosamine
Magnet therapy
Garlic


16
40
66
49
  4
50
  3
  3
  7
35
  4
  9
  6
  3


43
49
35
35
37
25
21
22
29
13
20
18
19
12


31
22
39
30
26
36
40
33
22
39
28
31
18
21


24
23
22
31
  5
38
38
44
47
46
50
51
60
65
Depression
Prescription drugs
Exercise
Diet
Meditation
St. John's Wort


85
44
  8
11
30


59
35
33
27
17


25
42
28
42
21


13
22
39
41
55
Prostate Problems
Prescription drugs
Exercise
Saw palmetto


64
11
37


37
39
21


36
31
30


26
29
46

Comment. Echninacea has been the single herb sales leader for several years and the reason is its alleged cold fighting benefits, but it didn't fare well here. Melatonin failed to live up to its publicity for insomnia, as did St John's wort for depression. One of the curious findings was the poor performance of saw palmetto, which is one of the few herbal substances that has some research backing. However, poor product quality may have been responsible for the low level of satisfaction. ConsumerLab.com is an independent testing company that permits promoters to use its flask-shaped seal of approval on products which pass its criteria-in this case meeting German testing standards concerning the quantity of active ingredients. Only one of 27 leading brands of saw palmetto products passed. (Blumenthal M. "ConsumerLab.com tests ginkgo and saw palmetto products," Herbalgram 48, 2000:66). Other noteworthy findings were the relatively high ratings given to chiropractic back pain, and the poor performance of magnet therapy for arthritis and back pain. Magnets for pain relief have been aggressively promoted by sports celebrities and multilevel marketing hucksters for the past decade. Also, the stunning failure of highly touted melatonin to help insomnia was outstanding. The lesson we can take from these findings is the unreliability of testimonials on various methods. At best, testimonials only provide a narrow view of one person, or a few people's experiences.

CHIROPRACTIC PEDIATRIC CARE IS CAUSE FOR CONCERN

A descriptive survey of 90 responding chiropractors practicing in the metropolitan area of Boston. 160 of the 658 DCs listed within 6 data sources (yellow pages, state board of registration, International Chiropractic Association member ("Straight" DCs), American Chiropractic Association ("Mixer" DCs) practitioner referral list, International Chiropractic Pediatric Association list, and Council on Chiropractic Pediatrics list) in the Boston area, with a focus on those DCs most likely to treat children. All DCs belonging to pediatric societies and all practices with the name "family" were selected. Non-respondents contacted by telephone gave the following reasons for not participating: Lack of interest, little experience with children, and being too busy. Three questions were included to assess DC beliefs and clinical judgment about pediatric care: (1) whether they recommended childhood immunizations; (2) how many times they would see a patient before deciding that chiro care might not be helping a condition; (3) what actions they would immediately take if presented with a 2-week-old neonate with a temperature of 38.4 degrees C? with the multiple choices of (a) referral to an MD or DO; (b) taking more history and treating the patient; or (c) filling in a blank section with their own responses.

Findings: All 90 respondents were white and 65% were men. Mean age was 40 years with SD=7 yrs; 88% held BA/BS and 4% master's degrees; 2% had obtained diplomate degrees in chiro pediatrics (70% of these were ICA members). 41 % belonged to ACA, 22% belonged to ICA, 4% belonged to both. For 89%, spinal adjustment was their main therapeutic technique; 62% were diversified, 40% used Activator, and 37% sacrooccipital. Children and adolescents constituted I I % of patient visits to the DCs selected for a greater likelihood of treating children; 79% modified their therapeutic techniques for children (eg, using light force, Activator device, small table, head-toggle piece, on mother's lap, familiarizing child with technique by using a doll).

Responses on clinical judgment:

(1) Do you recommend childhood immunizations?

(2) How many times would you see a patient before deciding that chiro care might not be helping a condition?

(3) What actions would you immediately take if presented with a 2-week-old neonate with a temperature of 38°C?

[Lee ACC, Li DH, Kemper KJ. "Chiropractic care for children," Archives of Pediatric & Adolescent Medicine. 2000; 154:401-7]

Comment. Experience has taught that while delusional, true believers in the chiropractic paradigm will proudly proclaim their deviant beliefs and practices, more shrewd chiropractors will not respond to surveys that ask them to tell on themselves regarding practices that are apt to be harshly criticized by outsiders. Therefore, we have to conclude that the study reported above is, at best, only the tip of the iceberg. The only way to know for certain what goes on within the chiropractic cottage industry ­- which operates behind closed doors with little or no opportunity for oversight by others -- is to have undercover agents attend chiropractors as patients.

HUPERZINE A FOR MEMORY ENHANCEMENT?

Huperzine A is being touted to improve memory and treat Alzheimer's. It is derived from Chinese club moss. Huperzine A is sold by itself as Memorall, or combined with ginkgo. Pharmacist's Letter says that there may be something to it. Huperzine A is a potent cholinesterase inhibitor similar to Aricept (donepezil) and Cognex (tacrine). Cautions: can cause cholinergic effects (nausea, sweating, blurred vision); should not be combined with other cholinergic drugs. Avoid in patients with conditions that can be worsened by too much cholinergic stimulation: asthma, COPD, heart disease, peptic ulcer disease, seizures. [Pharmacist's Letter, April, 2000]

DR NICHOLAS GONZALES ORDERED TO PAY DAMAGES
IN DEATH OF A CANCER WHO WAS ALSO HELD
RESPONSIBLE FOR HAVING CHOSEN BOGUS THERAPY

On April 20, a Manhattan jury ordered Dr. Nicholas Gonzales to pay $282,000 in damages to the husband of Hollace Schafer, a 40-year-old college professor who died of Hodgkin's disease in 1995. Gonzales, 52, has aggressively promoted offbeat cancer cures for many years. As a student, he claimed to have examined and found useful the work of William Donald Kelley, the de-licensed Texas dentist who was treating the late movie actor Steve McQueen at the time of his death. Kelley's ability treat cancer was based upon his unfounded claim that he had cured himself of cancer. A reading of his book One Answer to Cancer, reveals that his "cancer" was self-diagnosed using a bogus test he invented himself. The method consisted of reading the shape of the blood bubble that oozes from a pinprick of the finger. From that Kelley claimed to be able to tell how old the tumor was and how long it would take to cure it. Kelley then "cured" himself using a bogus treatment that he invented. According to Kelley, the key to beating was not eating protein after I pm (he did not specify standard or daylight saving time). Gonzales took the Kelley regimen farther by adding coffee enemas, massive doses of vitamins and other nonsense. Gonzales' medical license was suspended in 1993, but he was reinstated after agreeing to undergo retraining. The jury found Gonzales guilty mainly of failing to use appropriate testing to track Shafer's cancer (he used hair analysis).

An aspect of the case that should give pause to consumer advocates was the fact that the jury found that the patient was more responsible for her death than Gonzales (51% v 49%). Shafer was deemed to be an intelligent woman who researched her treatment options and chose Gonzales. In other words, social Darwinism rules: People unable to spot a quack deserve whatever they get.

HULDA CLARK WALKS

Hoosier Times, April 19. The judge has dismissed the case against Hulda Clark ruling that too much time had passed from when Clark practiced medicine without a license and was charged and prosecuted, thus denying her the right to a speedy trial. Comment. Quackophiles are delighted, victims disappointed, and quack watchers not surprised as another promoter of medical nonsense walks away. Judges forget that taking people's money under false pretenses is theft, diverting their trust in medicine to themselves is mental slavery, and when their disciples die needlessly it is murder. We believe the judge was wrong to dismiss Clark because she is still engaging in the same type of behavior.


Newsletter contents copyright 2000, National Council Against Health Fraud, Inc.
Items may be be reprinted without permission if suitable credit is given.

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