The Healthy Skeptic goes on sabbatical

June 30, 2009 in Uncategorized | 3 comments

gone fishin' signIf you’re a subscriber, you may have noticed that the frequency of posts has slowed down a lot over the past few months. I’m now entering my final year of class and clinical internship (grad school for acupuncture & integrative medicine), and I’m also preparing to start a clinic when I graduate.

Unfortunately, this leaves me little time to write anything for the blog. I’ve decided that I’m going to take the next year off from writing new posts. I will still respond to questions, so feel free to comment on what’s already up on the blog. And who knows, maybe I’ll get inspired occasionally and find some time to write an article.

Thanks for your interest and support over the last year.

When drug trials go terribly wrong

June 11, 2009 in Depression, Medical Industrial Complex | Leave a comment

picture of peopleTHS reader Christopher Lane brought this article to my attention, and asked me to forward it on to my readers. Yet another tragic consequence of dangerous and overused psychiatric drugs.

Mary Weiss, a mother in Minnesota, was one such person who wrote me last month. I’d been on the radio, talking about issues tied to my book. Ms. Weiss wrote an email afterwards, telling me about her son, Dan Markingson, who’d been diagnosed with schizophrenia, though she herself has serious doubts that the diagnosis was accurate.

Her son was encouraged to participate in a clinical trial at the University of Minnesota and other campuses comparing Seroquel, Risperdal, and Zyprexa for schizophrenia, schizoaffective disorder, and schizophreniform disorder, a loosely defined diagnosis for people suffering from “mood disorders with psychotic features.” The trial was sponsored by AstraZeneca, maker of Seroquel, which put the researchers and university in an obvious conflict of interest. Dan was given 800 mg of the drug.

Over 70% of patients in the trial dropped out. But Dan was strongly dissuaded from doing so and remained in it for five months. He’d been given a directive warning that if he failed to continue in the trial, he would be put in a regional treatment center. His mother did not know about the directive until it was too late.

Follow this link to read the full story.

Antidepressants not as effective as research suggests

April 28, 2009 in Depression, Medical Industrial Complex | 3 comments

big pharma cartoonA new report due to be published in the May issue of the American Journal of Psychiatry shows that antidepressants aren’t all they’re cracked up to be.

But, faithful readers, you already knew that. Right?

The report is part of the National Institute of Mental Health-funded Sequenced Treatment Alternatives to Relieve Depression (STAR*D) project – the largest study of the treatment of depression conducted in the United States. It showed that findings from clinical studies used to gain FDA approval of antidepressants are not applicable to most patients with depression.

Researchers at the University of Pittsburgh Graduate School of Public Health compared symptoms and outcomes in depressed patients who met phase III study inclusion criteria to those who did not. Phase III studies for antidepressants determine the effectiveness of the drug in comparison to a placebo.

The inclusion criteria for these studies aren’t standardized or subject to any federal guidelines. Typically this means that patients with milder forms of depression, chronic depression, or other psychiatric or medical conditions in addition to short-term depression are excluded from studies.

In other words, the majority of “real world” patients with depression who end up taking antidepressants are excluded from clinical studies. It should be obvious why this is a problem. In a normal, clinical setting many patients with depression do also have other illnesses, such as diabetes, chronic fatigue syndrome or irritable bowel syndrome (IBS). It’s not unusual for them to have anxiety and insomnia, as well. In fact, it wouldn’t be presumptuous to expect that a depressed person might be suffering from a number of conditions that are either contributing to or caused by their illness.

Yet the only people that “qualify” for the clinical trials which determine whether antidepressants get approved by the FDA are those with short-term depression, no history of depression, no other psychiatric conditions such as anxiety, and no physical illnesses like heart disease or diabetes. This is the only subgroup of the general population for which we have any data on the efficacy of antidepressants.

By the same token, this means is that we have almost no clinical data on how antidepressants work for the “real world” patients who are most likely to be taking them. Indeed, after assessing 2,855 patients treated with citalopram (Celexa), the study authors found that fewer than one in four, or 22.2%, of the patients met the usual criteria for inclusion in phase III clinical trials.

According to study lead author, Stephen Wisniewski, Ph.D., professor of epidemiology and co-director of the Epidemiology Data Center, University of Pittsburgh Graduate School of Public Health, “This raises major concerns about whether results from traditional phase III studies can be generalized to most people with depression, who also often suffer from anxiety, substance abuse and other medical and psychiatric problems.”

When Wisniewski and his colleagues looked at the efficacy of antidepressants in those who did not meet phase III inclusion criteria - meaning the majority of people who take the drugs in real life - they found that their outcomes were much worse than those who did qualify for the trials. The depression remission rate in the patients who met the criteria was 34.4 percent, compared to only 24.7 percent in the ineligible group.

So, here’s the bottom line: antidepressants are nowhere near as effective as research suggests.

And that is really bad news for the drug companies, because research already suggests that antidepressants aren’t very effective at all. In fact, as I explained in a previous article, antidepressants are no more effective than placebo for most people. If antidepressants are no more effective than placebo in the patients that do meet phase III criteria, and we know that antidepressants are less effective for patients who don’t meet phase III criteria (the vast majority of “real world” depression patients), then couldn’t we assume that antidepressants are less effective than placebo for most patients?

Yes, we could.

For more information on this topic, check out this index of my articles (as well as selected off-site resources) on depression and antidepressants.

Are your comments getting through?

April 26, 2009 in Uncategorized | Leave a comment

comment bubbleA reader emailed me this morning to let me know that many of his comments to the blog have not gotten through. That was a surprise to me, because I never saw them in my moderation queue.

I’ll be the first to admit that I’m not a tech expert. I’ve done my best to set the blog up so that it’s both user and operator friendly. Earlier I had a problem with a spam plug-in that was blocking comments with links, so I switched to Bad Behavior which is supposed to be better in that regard. However, this reader’s comments had a number of links and I suspect that is why they were blocked.

Is anyone aware of an anti-spam plugin for WordPress that does a good job blocking spam but allows comments with links (or at least allows them to be moderated)?

Please do let me know if you have posted comments that haven’t made it through. I’d like to know about it so I can resolve the problem.

Thanks for your help.

Where’s the beef?

March 26, 2009 in Cancer, Food & Nutrition, Myths & Truths | 18 comments

roast beefYou might have seen an article in your newspaper or online touting a recent study published in the Archives of Internal Medicine that “strongly” linked red meat consumption with cancer and an increased risk of death. Heck, how could you miss it? Google shows 547 new articles about the study, and it was mentioned in just about every major newspaper in the U.S.

(That’s not an accident, by the way. It’s an intentional attack by the tyrannical meat-hating scientific majority, the same folks who brought us the “cholesterol causes heart disease” and “saturated fat is bad for you” myths.)

Trouble is - as is so often the case - the study is deeply flawed. In fact, anyone with training in research methodology might find themselves wondering “where’s the beef?” after they read it. In the end it’s just another piece of worthless propaganda parading as medical research. It tells us a lot more about the biases and motives of the researchers, and the incompetence of the media reporting on it, than it does about the effect of red meat consumption on human health.

Here are my “top 10″ reasons to ignore this study and continue to eat your grass-fed, organic red meat:

  1. It was an observational study. Observational studies can show an association between two variables (i.e red meat consumption and death), but they can never show causation (i.e. that eating red meat caused the deaths). A simple example of the difference between correlation and causation is that elevated white blood cell count is correlated with infections. But that doesn’t mean elevated white blood cell counts cause infections!
  2. The relative risk reduction (RRR) was slightly over 1.0. Most researchers don’t pay attention to an RRR under 2.0, due to the notorious difficulties involved with this type of research.
  3. Two articles were published in the American Journal of Clinical Nutrition at around the same time that directly contradicted these results. The first study pooled data from 13 studies and found that risk of colorectal cancer was not associated with saturated fat or red meat intake. The second study found that there was no difference in mortality between vegetarians and meat eaters.
  4. The authors didn’t adequately control for other dietary factors known to increase morbidity and mortality. As another commentator pointed out in her analysis of this study, “Americans get their “cancer causing” red meat served to them on a great big white bun with a load of other carbohydrates (soda, chips, fries) and inflammation-causing n-6 vegetable oils (chips, fries, salad dressings) on the side.” It’s more likely (based on other studies, including the two mentioned above) that the increase in deaths was caused by the junk food surrounding the red meat and not by the meat itself.
  5. The basis of measurement is a “detailed questionnaire”. Questionnaires about one’s diet are always error prone as remarkably few people remember accurately what they eat on any given day, let alone over a period of years. Furthermore, most people lie about what they actually eat, especially now that proper diet has been given a quasi-religious significance and eating poorly is equated with being morally inferior.
  6. Check out this quote from the Archives of Internal Medicine study:

    “Red meat intake was calculated using the frequency of consumption and portion size information of all types of beef and pork and included bacon, beef, cold cuts, ham, hamburger, hotdogs, liver, pork, sausage, steak, and meats in foods such as pizza, chili, lasagna, and stew”.

    In other words, even those people who ate things like hot dogs and hamburgers (with buns made of refined white flour), and who ate pizza (on refined white flour crusts) were included in the ‘red meat’ group. Also, those who ate processed or cured meats, such as ham, bacon, sausage, hot dogs, or cold cuts (with possible nitrates) were included in the ‘red meat’ group. And those who ate prepared food (with unknown additives and preservatives) such as pizza, chili, lasagna, and stew were also included in the ‘red meat’ group. Therefore, this study does absolutely nothing to prove that red meat, and not these processed and highly refined foods, is the culprit.

  7. The quality of the meat consumed in the study was not taken into account. Highly processed and adulterated “factory-farmed” meats like salami and hot dogs are lumped together with grass-fed, organic meat as if they’re the same thing. It’s likely that very little of the meat people ate in the study was from pasture-fed animals. Factory fed animals are fed corn (high in polyunsaturated, omega-6 fat), antibiotics, and hormones, all of which negatively impact human health.
  8. We don’t know anything about the lifestyles of the different study groups. Were they under stress? Did they lose their jobs? Did they have other illnesses? Did they live in a toxic environment? All of these factors contribute significantly to disease and mortality.
  9. We don’t know if the people in the study ate more sugar, processed food, artificial sweeteners, preservatives, additives or fast food - all of which are known to cause health problems.
  10. We don’t know if the people who ate more red meat were better off financially than the people who ate less red meat, and thus had more exposure to the “medical industrial complex” - which, as you know from my previous article, kills more than 225,000 people per year and is the 3rd leading cause of death in this country.

I could go on, but I think you get the idea. Nothing to see here, folks. Move along.

Me? I’m gonna go have a big, juicy, grass-fed steak.

Further recommended reading

  1. Meat and Mortality. A great critique of the study by Dr. Michael Eades, author of Protein Power.
  2. More on Meat & Sustainability. A Challenge to Environmentalists.
  3. The Red Scare. Another insightful analysis over at Mark’s Daily Apple.

Too much stress makes you stupid - and depressed

March 19, 2009 in stress | 5 comments

stressTwenty years ago doctors were still telling us that stress had nothing to do with conditions such as depression, autoimmune disease and cancer. Patients suffering from these conditions often knew otherwise. But the conviction of patients alone wasn’t enough to change the doctor’s minds.

Times have changed. These days, new studies linking stress to disease are released almost daily. We now have a much better understanding of how stress causes disease. In fact, we have a new field - psychoneuroimmunology - dedicated entirely to the study of those mechanisms.

Many researchers (myself included) have come to believe that stress is the single most important causative factor in the disease process. Heart disease and cancer are the top two causes of death in the U.S. each year. Stress has been conclusively linked to both of these conditions. That means stress is at least partially responsible for the majority of deaths each year.

This is where research conducted in animals has provided critical information. Initial data by investigators, such as Robert Sapolsky at Stanford University, suggested that stress might promote the death of neurons, suggesting that the volume reductions in patients with PTSD might reflect the loss of nerve cells. More recent research by Bruce McEwen and colleagues at Rockefeller University indicates that stress can cause neurons to shrink or retract their connections.

A new paper by Hajszan and colleagues at Yale University suggests that stress-related reductions in synapses in the hippocampus are directly related to the emergence of depression-like behavior. This is yet another contribution to the already significant body of medical literature correlating stress with depression.

So how can you minimize the harmful effects of stress in an increasingly stressful world?

  1. Practice mindfulness. In particular, mindfulness-based stress reduction is a clinically proven way to reduce stress. You can order instruction CDs here.
  2. Get plenty of sleep. The most powerful approach to improving sleep quality I’m aware of is called the Sounder Sleep system. Order CDs or download MP3s here.
  3. Enjoy life. Recent studies have indicated that experiencing more pleasure is one of the most potent ways to reduce stress. Listening to music, making love, receiving a massage, taking a walk in the woods, cuddling a pet… all of these activities are highly therapeutic. Watching TV and surfing the Net don’t have the same effect.
  4. Eat well. Follow these nutritional principles to increase your capacity to handle stress.

The fatal flaw of prescription drugs

March 10, 2009 in Medical Industrial Complex | 7 comments

bandaidDrugs comprise the major treatment modality of scientific medicine. A recent article in the New York Times revealed that over half of Americans regularly take prescription drugs for chronic health problems. Sadly, many people don’t realize that the drugs they’re taking could be making their condition worse.

Most drugs don’t cure illness. They just suppress symptoms. Unfortunately, drugs also suppress functions. Though drugs provide symptom relief in the short term, over time they may worsen the underlying condition because they interfere with our body’s self-healing mechanisms. For example, many people take ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) to cope with arthritis and inflammatory conditions. While NSAIDs are effective in reducing pain and inflammation in the short-term, they are also known to reduce blood flow to cartilage. Since blood carries all of the nutrients and immune substance necessary for tissue repair, NSAIDs can actually worsen the original problem when taken chronically.

The second problem is that, by definition, drugs correct a specific imbalance by causing at least one other and often several other imbalances. When a drug is introduced into the body to address a malfunction in one biochemical pathway, that drug inevitably interacts with many other pathways.

The mapping of these pathways in recent genetic research underscores the danger of pharmaceutical drugs. The diagram below shows the interactions among a small set of cellular proteins found in a fruit fly. Proteins encased in ovals are grouped according to specific pathway functions. Connecting lines indicate protein-protein interactions. Protein interconnections among the different pathways reveal how interfering with one protein may produce profound “side effects” upon other related pathways.1

protein map
Complicating the phenomenon of so-called “side effects” is that biological systems are redundant. The same protein molecule may be used in several different systems of the body, but it has a completely different function in each of them.

Histamine is a perfect example of this. Histamine is a chemical that initiates the cell’s stress response. When histamine is present in the bloodstream of the arms and legs, it starts a local inflammatory reaction in those tissues. But if histamine is present in the blood vessels of the brain, it enhances the growth and function of specialized neurons there.

One of the most amazing features of the body’s signaling system is its specificity. When you have a poison oak rash on your arm, histamine is released in that specific area only to activate an inflammatory response to the allergen. Likewise, if you’re under significant stress, histamine is released only in the brain to enhance the function of neurons.

Unfortunately, pharmaceutical drugs have no such specificity. When you take an antihistamine to deal with the itchiness of an allergic rash, the drug is distributed systemically. It affects histamine receptors wherever they are located throughout the whole body. So, while the antihistamine will curb the blood vessels’ inflammatory response and reduce the allergic symptoms of the rash, it will also enter the brain and affect nerve function - which causes drowsiness.

The recent hormone replacement therapy (HRT) debacle is a tragic example of the inherent risks of pharmaceutical drugs.  Estrogen is best known for its function on the female reproductive system.  However, more recent studies have shown that estrogen also plays an important role in the normal function of blood vessels, the heart and the brain.  That ‘s why synthetic estrogen hormones that were prescribed to alleviate menopausal symptoms ended up causing cardiovascular disease and neural dysfunctions such as strokes.

No matter how “targeted” drugs are, they are still relatively crude, blunt instruments when compared to the body’s highly sophisticated immune system. Prescription drugs are are much more like sledgehammers or shotguns than the “magic bullets” they are made out to be.

In the next article, we’ll take a closer look at the consequences of side effects caused by prescription drugs. Until then, I welcome your questions and comments!

  1. Lipton, B. H. (2008). The Biology of Belief: Unleashing the Power of Consciousness, Matter, & Miracles (illustrated edition.). Hay House. ↩

The failure of U.S. healthcare

February 28, 2009 in Medical Industrial Complex, Myths & Truths | Leave a comment

failureThe U.S. spent 16 percent of its Gross Domestic Product (GDP) - a cool $2 trillion - on health care in 2005.1 Considering this enormous expenditure, we should have the best medicine in the world. We should be reversing disease, preventing disease, and doing minimal harm. However, careful and objective review shows the opposite.

The U.S. ranks just 34th in the world in life expectancy and 29th for infant mortality. Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from bottom) for 16 available health indicators.2

40 million people in this country do not have health insurance. The exorbitant cost of health care seems to be tolerated based on the assumption that better health results from more expensive care, despite studies that as many as 20% to 30% of patients receive contraindicated care.3

Even worse, a recent study by Dr. Barbara Starfield published in 2000 in the prestigious Journal of the American Medical Association demonstrated that iatrogenic incidents (events caused by medical intervention) are the 3rd leading cause of death in this country, causing more than 250,000 deaths per year. Only heart disease and cancer kill more people.

Dr. Starfield estimates that, each year, medical errors and adverse effects of the health care system are responsible for:

  • 116 million extra physician visits
  • 77 million extra prescriptions
  • 17 million emergency department visits
  • 8 million hospitalizations
  • 3 million long-term admissions
  • 199,000 additional deaths
  • $77 billion in extra costs

As grim as they are, these statistics are likely to be seriously underestimated as only about 5 to 20% of iatrogenic incidents are even recorded4, and outpatient iatrogenic statistics only include drug-related events and not surgical cases, diagnostic errors, or therapeutic mishaps5. Other analyses which have taken these oversights into consideration estimate that medical care is in fact the leading cause of death in the U.S. each year.

Starfield believes that a major contributor to the poor performance of the United States on health indicators is the high degree of income inequality in this country. Countless studies in the medical literature document the adverse effects of low socioeconomic position on health. New research suggests the adverse effects not only of low social position but, especially, low relative social position in industrialized countries.6

Perhaps the words “health care” have given us the illusion that medicine is about health. In fact, western medicine is not a purveyor of healthcare but of disease-care. When the number one killer in a society is the health care system, that system has no excuse except to address its own urgent shortcomings. Unfortunately, until this happens partaking in allopathic medicine itself is one of the highest causes of death as well as one of the most expensive ways to die.

  1. Park, A. America’s Health Check Up. 11/20/2008. Time Magazine Online. ↩
  2. Starfield B. Primary Care: Balancing Health Needs, Services, and Technology. New York, NY: Oxford University Press; 1998. ↩
  3. Schuster M, McGlynn E, Brook R. How good is the quality of health care in the United States? Milbank Q. 1998;76:517-563 ↩
  4. Leape LL. Error in medicine. JAMA . 1994 Dec 21;272(23):1851-7. ↩
  5. injuryboard.com. General Accounting Office study sheds light on nursing home abuse. July 17, 2003 . Available at: http://www.injuryboard.com/view.cfm/Article=3005. Accessed December 17, 2003 ↩
  6. Wilkinson R. Unhealthy Societies: The Afflictions of Inequality. London, England: Routledge; 1996. ↩

Cholesterol-lowering drugs reduce brain function

February 25, 2009 in Food & Nutrition, Heart Disease | 2 comments

devolutionResearch by an Iowa State University scientist due to be published this month in the journal Proceedings of the National Academy of Sciences indicates that cholesterol-lowering drugs (statins) may lessen brain function.

The results of the study show that drugs that inhibit the liver from making cholesterol may also keep the brain from making cholesterol, which is vital to efficient brain function.

“If you deprive cholesterol from the brain, then you directly affect the machinery that triggers the release of neurotransmitters,”, said Yeon-Kyun Shin, the lead researcher. “Neurotransmitters affect the data-processing and memory functions. In other words - how smart you are and how well you remember things.”

Cholesterol is abundant in the tissue of the brain and nervous system. Myelin, which covers nerve axons to help conduct the electrical impulses that make movement, sensation, thinking, learning, and remembering possible, is over one fifth cholesterol by weight. Even though the brain only makes up 2% of the body’s weight, it contains 25% of its cholesterol.

We now know that the formation of synapses, or connections between neurons, is directly dependent on the availability of cholesterol.

The formation of these synapses are what give us the ability to remember and learn. The benefits of sleep for memory formation and learning are in part a result of increased cholesterol synthesis during sleep.

“If you try to lower the cholesterol by taking medicine that is attacking the machinery of cholesterol synthesis in the liver, that medicine goes to the brain too. And then it reduces the synthesis of cholesterol which is necessary in the brain,” said Shin.

This study is yet another strike against statin drugs, which have numerous side effects and are not effective in reducing mortality for the vast majority of the population. Please see my recent article, The Truth About Statin Drugs, for more on why statins are probably not a good idea for you and your loved ones.

Technical difficulties!

February 13, 2009 in Uncategorized | Leave a comment

computer crashI had some serious technical difficulties this morning with the blog. As a result, I had to re-insall all of my WordPress plugins.

I’m pretty sure things are back to normal, but if you notice anything out-of-whack please do let me know.

Bad Behavior has blocked 1231 access attempts in the last 7 days.