Gettysburg Medical News
The Clinical View
7 March 2007
by Phillip Hoffsten

 What Doesn’t Help?  What Doesn’t Hurt?

You cannot pick up a magazine or a newspaper or listen to the TV or radio without some claim for this, that, or the other potion or medication that will grow your hair back, save your life, or improve your love life.  Friends and relatives or someone you met on an airplane are more than willing to provide advice on what you must not do or must not eat in order to protect all of the above.  It all really gets very old.

A healthcare professional uses “evidenced-based medicine” as the basis of their advice (see “What is Evidence-Based Medicine?” online at www.macpierre.com for 12 July 2002).  Specifically, the prescription medications used by doctors, physician's assistants, and nurse practitioners have been rigorously tested in trials with many patients to certify both the prescription drug safety and effectiveness.  Trials for drug effectiveness employ a large number of patients matched for their disease severity.  Half the group then receives the test drug and the other half not.  The two groups are then monitored over time to determine which group is safest and most effectively treated.  Once the drug is on the market, there is continued surveillance to be sure that safety and effectiveness are maintained.  For a prescription medication the chemical composition, amount of drug in each pill and the absence of impurities must meet strict specifications.

All of the industrial and governmental systems devised to protect the public are human generated and therefore are imperfect.  Mistakes do happen and when they do, our media are quick to spectacularize the event and terrorize the public.  But the prescription drugs in our country are as safe as can be done as supported by nurses, pharmacists, and your healthcare providers.

And yet “nutritional supplements” and “alternative medicines” continue to be a booming industry.  These products are not regulated in regard to purity, content, effectiveness, or safety.  They are freely available over-the-counter to anyone who wants to buy them for whatever expectation.  In the February 26, 2007 issue of the medical journal Archives of Internal Medicine a study was published regarding the use of garlic to lower blood cholesterol levels.  Three thousand five hundred years ago garlic was touted as a medicinal agent in Egyptian hieroglyphics.  Today it is said by those who sell it to prevent heart attacks, cancer, hair loss, or infections.  In the study mentioned above, neither aged garlic, raw garlic, nor garlic powder had any effect on blood cholesterol levels in the many people studied over a six month trial.  Garlic does not help.  By the way, neither does oatmeal.  If a person is going to be effective in lowering their bad cholesterol it will take a massive change in diet, a substantial weight loss, a major exercise program, or unfortunately a prescription medication.  For the great group of Americans the first 3 choices have not been shown to be of any help.  We just do not effectively diet, exercise, or lose weight.

Other products that do not help include Vitamin E (see “Vitamin E: The Wonderful Idea That Did Not Work.” online at www.macpierre.com for 26 Jan 2005).  The antioxidant industry made apparently perfect sense to draw the analogy that aging represented our bodies burning up.  Therefore, something that prevents oxidation (burning up) must prevent aging and maintain function.  To this time vitamin B12, vitamin B6, folic acid, selenium, and beta carotene have been tested as anti-aging medications.  None have shown to be of any help to preserve health or lengthen life.  And by the way, Echinacea does not prevent colds (see “Echinacea” online at www.macpierre.com for Sept. 4, 2005).  But, all of these products do make money to the people who sell them.

Turning the coin over, there are a number of cockamamie ideas about products or practices that will cause you early death or loss of function.  Coffee has been one such product.  Some adults drink coffee although they would never give it to their children; I have never understood why.  Stomach irritation in some people is real; but I would believe those people have the sense not to use it.  However, the idea that coffee shortens life or function just is not true.  Coffee does not hurt.  In fact, it may help prevent diabetes mellitus.

When I was a child I don't know how many times I was told to quit eating chocolate because it made my acne worse.  Indeed, the extra calories that come from a Hershey bar are not a good idea.  But giving up chocolate really does not cure acne although it would leave a poor kid with a chocolate deficiency.  Chocolate does not hurt.

There remain staunch groups in our society who believe alcohol is not only harmful but also evil.  As I indicated in a previous column, those members of our society who have the restraint to have two drinks per day live longer than those that do not drink at all (see “Alcohol” online at www.macpierre.com for Jan 3, 2007).  Used appropriately, alcohol does not hurt.

To emphasize the sad, sad truth there are things that do help and some that hurt.  Things that do help are calorie restriction to control our over-weight problem.  Exercise in moderation is a huge help to maintain our function better than any other activity the medical profession has to offer.  Controlling blood pressure by decreasing salt in the diet and the use of medication is a huge help to maintain heart and mind.  A normal blood pressure is 120/80 mm Hg. or less.  Controlling the bad LDL cholesterol to 70 mg% or less by diet or medication is a help to prevent heart attack and stroke.  Controlling blood sugar to the normal range is a help to prevent eye, kidney, and nerve damage in diabetics.  A cigarette habit is the single worst hurtful health trait a person can have.

There is no one nutritional supplement or alternative medication to solve our health problems.  Specifically, garlic does not help.