Just because it sounds like science doesn’t mean it ain’t crazy

Is this someone coughing, or me screaming at the author of this POS article?

Is this someone coughing, or me screaming into a kleenex about how dumb this article is?

Today this article from Slate was brought to my attention: “Something to Sneeze At: Natural remedies that claim to ‘boost your immune system’ don’t work, and it’s a good thing they don’t.” And it really pissed me off.

I’m thinking that if you’re reading a blog about herbal medicine, you will probably have a similar eye-rolling response to this, but I want to rant anyway because some of what this article says is downright dangerous.

The article links to a selection of “natural immunity boosters” promoted by Dr. Mehmet Oz, and dismisses them as “expensive placebos.” These, apparently, are meant to represent all natural remedies. It then goes on to say that you don’t want to boost your innate immune system at all because it causes all the unpleasant “symptoms” we think of as being sick. Excessive immune response, after all, is responsible for autoimmune disorders and allergies. In fact,

“The mainstay of treatment for symptomatic cold viruses is to suppress, not boost, our crude and clunky innate immune responses. That’s why we take fever reducers and antihistamines.”(emphasis original)

Let’s rip this article apart, shall we?

Bogus claims

I’m no fan of Dr. Oz, and I shudder to think that he is now the figurehead for natural remedies among the general public, but alas, he probably is. Let’s look at the specific things being promoted on this page of his website (which, remember, we are supposed to consider representative of all natural remedies, if we accept the implication of the Slate article):

  1. larch (claimed to reduce the number of colds by 23%)
  2. oregano oil (to boost immune system and “cleanse your gut”)
  3. Japanese mushrooms (shiitake, enoki, etc.; a source of antioxidants)
  4. cruciferous vegetables (to “support your liver and immune function by boosting the liver’s ability to flush out toxins”)
  5. avocados (to support adrenal function)
  6. ginger (to “break down the accumulation of toxins in the organs”)
  7. black currants (to promote health vision and supply Vitamin C)
  8. oats (to lower cholesterol)
  9. pomegranates (which “contain ellagic acid and punic alagin which fight damage from free radicals and help preserve the collagen in your skin”)
  10. pumpkin seeds (as a source of magnesium, which may help lower blood pressure)
  11. sage extract (as an expectorant)
  12. eggs (just as a source of vitamins and minerals)
  13. graviola (“traditionally used to kill parasites, ameliorate liver problems, reduce fevers, and help treat colds and the flu. Scientists have studied graviola since the 1940s and most research has been centered around annonaceous acetogenins, a group of natural compounds that appear to have some anti-tumor properties – meaning they may help fight various types of cancer cells and thus help boost immune function”)
  14. green veggies, mushrooms, onions, seeds, and berries (for overall nutrition)

On this list, 4 items are promoted just for general good nutrition (Japanese mushrooms, black currants, eggs, and collectively, green veggies, mushrooms (again), onions, seeds, and berries). I don’t think anyone can critique that; these are all nutritious foods, hardly “expensive placebos.”

A further 7 items are foods for which specific health-enhancing claims are advanced (cruciferous veg, avocados, ginger, oats, pomegranates, pumpkin seeds, and graviola). I’m not going to do the research right now to determine whether the specific claims are valid, but again these are all nutritious foods. Will they cure cancer? Probably not. Will consuming them help your body perform its necessary normal functions? They sure will.

The remaining 3 items are herbal preparations (larch, oregano oil, and sage extract), and are the only ones that could possibly be considered “potions” and “snake oil”, as the Slate article paints natural remedies. I will come back to these later. I don’t know anything about larch, but am a big fan of sage. For expectorant purposes, I would probably take a tea rather than an extract, or even just inhale the scent of the essential oil, but extract would work. I am very dubious about the oregano oil claims. First of all, the website doesn’t make clear whether Oz is talking about infused oil or essential oil. Taking oregano essential oil to “cleanse your gut” is massive overkill. Essential oils are super-concentrated; they are super expensive to make in terms of the amount of plant material required to make them; and you rarely need to take something that strong internally. Furthermore, although oregano does have antimicrobial properties, how is it supposed to tell the difference between the beneficial gut flora and the pathological ones? You are much better off just eating oregano!

Back to the Slate article: “Research on these products [i.e., Dr. Oz’s recommendations as stand-in for all natural remedies],” it says, “shows that they are expensive placebos.”

Does research show that? If you click on “expensive placebos” in the article, it links to The Cochrane Library (“independent high-quality evidence for health care decision making”). The implication being that at The Cochrane Library site we will find evidence to refute the claims of natural remedies.

What we find there are 16 links to “intervention review” articles–reviews of experimental data previously published by the Cochrane Collective–on various substances used to treat cough and cold. Only 7 of these reviews pertain to what might be termed “natural” or “alternative” remedies (unspecified “Chinese medicinal herbs,” echinacea, garlic, heated humidified air, honey, Vitamin C, and zinc). Two points stand out here: (1) None of those is among the items promoted on Dr. Oz’s website; and (2) only one of the natural remedies examined was found to definitely be not at all helpful, and even then the authors called for more research:

  • On “Chinese medicinal herbs”: “Chinese herbal medicines may shorten the symptomatic phase in patients with the common cold. However, the lack of trials of low enough risk of bias, or using a placebo or a drug clearly identified as a control, means that we are uncertain enough to be unable to recommend any kind of Chinese medicinal herbs for the common cold.”
  • On echinacea: “Echinacea products have not here been shown to provide benefits for treating colds, although, it is possible there is a weak benefit from some Echinacea products: the results of individual prophylaxis trials consistently show positive (if non-significant) trends, although potential effects are of questionable clinical relevance.”
  • On garlic: “There is insufficient clinical trial evidence regarding the effects of garlic in preventing or treating the common cold. A single trial suggested that garlic may prevent occurrences of the common cold but more studies are needed to validate this finding.”
  • On steam: “Steam inhalation has not shown any consistent benefits in the treatment of the common cold, hence is not recommended in the routine treatment of common cold symptoms until more double-blind, randomised trials with a standardised treatment modality are conducted.”
  • On honey: “Honey may be better than ‘no treatment’ and diphenhydramine in the symptomatic relief of cough but not better than dextromethorphan. There is no strong evidence for or against the use of honey.”
  • On Vitamin C: “given the consistent effect of vitamin C on the duration and severity of colds in the regular supplementation studies, and the low cost and safety, it may be worthwhile for common cold patients to test on an individual basis whether therapeutic vitamin C is beneficial for them. Further therapeutic RCTs are warranted.”
  • On zinc: “Zinc administered within 24 hours of onset of symptoms reduces the duration of common cold symptoms in healthy people but some caution is needed due to the heterogeneity of the data. As the zinc lozenges formulation has been widely studied and there is a significant reduction in the duration of cold at a dose of ≥ 75 mg/day, for those considering using zinc it would be best to use it at this dose throughout the cold.”

In conclusion, (1) only a fatuous idiot would consider Dr. Oz’s recommendations to be representative of the vast array of natural/alternative remedies on the market; (2) most of what Oz recommends is just food anyway; (3) no refutation of the efficacy of Oz’s suggestions is provided by the Slate article or The Cochrane Library site.

That is pathetic. If I had handed that in as a term paper, my advisor would have given me the dreaded disappointed-face. Of course, he would assume the paper was just incompetently researched and written, not a cynical and disingenous attempt to discredit alternative medicine…which is what this is.

Dangerous implications

But what’s worse is the implication that all natural remedies are snake oils, used only by ignorant bumpkins who don’t understand science, and the claim that immune suppression is actually desirable. Go ahead, re-read that quote up above. Apparently our immune systems are so “crude and clunky” that we’re better off just disabling them rather than letting them do their job.

There are a couple things to be considered here in regard to “immune boosting.” First, many herbal medicines are marketed as boosting the immune system because the Food and Drug Administration does not allow manufacturers to claim or imply that the herb is in any way a medicine or cure. Herbs are treated as food supplements, and about the only thing we can legally say about them is that they will support the body in doing something it already does anyway. When it comes to illness, therefore, all we can say is that an herb supports the immune system. Even if that’s complete BS in terms of how the plant actually works.

I believe the choice of the term “boost” is in order to make the product more attractive to consumers. Here’s the other thing about herbal medicines–they are no way to get rich. You can’t patent them, and you can’t truthfully mass-market them. Less-scrupulous manufacturers and sellers try to amplify the potential market for a medicine by (1) suggesting that herbs are taken in the same way as pharmaceuticals, (2) implying that everyone can benefit, and (3) using language designed to sound efficaceous and medicinal to as many people as possible. Hence “boost.” It sounds more active than “support” or “nourish.”

Don’t suppress your immune system!

The immune system produces the “symptoms” that we think of as sickness (fever, chills, boogers, vomit, diarrhea, etc.). All of these either attempt to flush the pathogen out, or kill it with heat. Over-the-counter medications are designed to suppress these symptoms, and many people imagine this means they are suppressing the cause of the sickness (the germ or virus). But they’re not. They can only suppress the symptom by suppressing the immune system itself. This in turn means that the virus or bacteria live longer in your system and are contagious longer. (There are reams of scientific studies to support this. It would take me hours to track them all down. Go to Google Scholar and do a search and be amazed.)

Be afraid. Be very afraid.

Be afraid. Be very afraid.

Rather than hobbling your immune system, next time you have a cold or flu try being nice to your body. During the first 24 hours of symptoms, hit it hard with elderberry and/or echinacea, Vitamins C and D, and zinc. Then feed it nutrient-dense but easily digestible foods like homemade soups (hard to make when you’re sick, I know–I’m making some up in advance and freezing them just in case), and stay hydrated with lots of water or tea. Juice is OK in moderation–it’s very high in sugar, and once you’re sick, the amount of Vitamin C in orange juice isn’t going to do much good. Keep taking elderberry (tea, tincture, or syrup). If you have chills, don’t take antipyretics to lower your fever (in fact don’t take these at all) but help it with warming herbs like ginger.* Get as much rest as possible, and don’t neglect the recuperation period.

Even better, before you get sick, make sure you are getting good nutrition, lots of vitamins and minerals. Get sunshine, exercise, and meditate. (Don’t you dare tell me you can’t. Practice makes perfect.) You can take adaptogenic herbs such as ginseng or astragalus–an appropriate selection for your specific needs–nourishing infusions (nettles are awesome), and nutritive tonics. There are some crazy, BS natural “remedies” out there which you are wise to avoid. But to lump all alternative medicine in with wacky oregano oil gut-cleanses and lemon juice and olive oil detoxes is throwing the baby out with the bath. It’s also worth bearing in mind that most doctors aren’t scientists. Not. Even. Close. Moreover, medical practice exists within the overall context of a culture and it is subject to the body- and health-related beliefs of that culture. They are beliefs, not truths. Look–don’t trust me, and for God’s sake don’t trust Dr. Faust (<–his actual name), the author of the article in Slate–do the research, use common sense, question the assumptions, trust your own experience.

Too often, I see people I know–intellectually brilliant people, many of them–only being skeptical of a scientific-sounding claim if they already doubt it. Don’t do that. I know life is short and we can’t perform our own experiments on everything–sometimes we have to just trust what other people tell us. But choose those people wisely. Make them earn it. And if they tell you you should suppress your immune system when you’re sick, laugh in their stupid faces.

*Always, always, always use your common sense. If your fever is very high or shows no signs of abating after a couple days, or if you are immuno-compromised, seek medical help.

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