Chinese herbal medicine may provide novel treatment for alcohol abuse

But wait a minute. I think a neglected to put an “an” before “herbal medicine works.” For it was one Chinese herbal treatment, right?

Yes and no.

Yes, in that the ‘herbal medicine’ was the plant Hoventia.

No, in that it wasn’t administered as Chinese medicine is. Rather, the experiment used a component isolated from the plant, the chemical dihydromyricetin.

The research team determined that dihydromyricetin may provide a molecular target and cellular mechanism to counteract alcohol intoxication and dependence, leading to new therapeutic treatments — all based on an ancient “folk medicine” treatment that has been used by humans for at least 500 years.

While I applaud this scientific finding, I question the misleading language used in the write up. For example, this title would be more accurate:

“Treatment based on a Chinese herbal remedy may provide . . . “

Once a laboratory isolates the active chemical in an herb, extract or manufactures it, and then applies the methods of science to that chemical, I no longer consider it a Chinese medicine. Rather, it is traditional/conventional medicine working off an idea for a new treatment from Chinese medicine.

[recycled material - first appeared here]

A news release about a new study on Kava as a treatment for anxiety caught my attention. In it I found some bad and some stupid. Fortunately–and contrary to what usually happens–there was a link to the published article itself, and there I found a bunch of good. Usually I tend to encounter hidden bad when I dig deeper.

First, the bad. Then the good. Finally, the stupid.

The bad. The news release reported that “the placebo-controlled study found Kava to be an effective and safe treatment option for people with chronic anxiety and varying levels of depression.” Beyond that general statement, the report gave zero numbers. No precision with that element of scientific language. “It worked,” is not very helpful in evaluating a treatment.

Also, while the study was deemed “safe,” raising “no major health concerns,” the trial lasted a pathetically brief three weeks. Three weeks!

Upon clicking a link to an abstract from the Springer journal Psychopharmacology, I found the option to view the full text in .pdf. And so I did. And, surprise, surprise! I discovered that the researchers did some very good science.

The good. Besides being placebo-controlled, the trial was randomized and double-blinded. Okay, there were only 37 subjects that completed the trial. Still, it is good to know, and reasons for drop-outs were explicitly stated.

And the treatment was indeed significantly effective. For example, on the primary measure (Hamilton Anxiety Scale: total range of 0 to 56) anxiety scores fell an .8 points in the placebo group and 9.9 points in the Kava group. That indeed rates as “effective.”

Now for the stupid. Statements like this, made by the lead researcher, perpetuate ignorance and folklore:

“We’ve been able to show that Kava offers a natural alternative for the treatment of anxiety, and unlike some pharmaceutical options, has less risk of dependency and less potential of side effects,” Mr. Sarris said.

First, no, Mr. Sarris, you have not shown less risk of dependency and side effects with a single, three-week trial of 37 subjects.

Second, “a natural alternative”? Oh come on. Please. Be a little more scientific and don’t perpetuate stupid misunderstandings. Here is the difference between “natural” and “conventional” medicines: the connotations of words. Natural brings to mind forests and flitting fairies perhaps, conventional conjures up images of laboratories.

Any safe medicine consists of chemicals manufactured or extracted to a concentrated and standardized dose. In terms of this study, the “natural Kava” came in tablets containing 250 mg. kavalactones. Subjects didn’t drink it out of a coconut shell while listening to tribal drumming.

Seen another way, alternative treatment are simply para- and/or pre-conventional. They have yet to be fully tested and distilled to higher potency. And safer form as well, for many raw, alternative treatments contain undesirable chemicals along with the effective ones.

Science done well provides so much good. But yes, along with the good we can find doses of bad and stupid. Maybe some day there will be a way to better extract and concentrate the good, for the good of the general public.

—

For years I took a multivitamin. Just in case. One some level I thought, “They’re vitamins, which are good for you.” And maybe, “More of a good thing can’t be bad.”

I was wrong.

Over the last few years, new research has been making it increasingly clear that not only to multivitamins fail to improve over-all health and extend life (at least for the average person), they will harm your wallet in the least, if not possibly endangering your health.

Two recent studies accentuate the point. First, from Eurekalert we have:

Certain dietary supplements associated with increased risk of death in older women

Consuming dietary supplements, including multivitamins, folic acid, iron and copper, among others, appears to be associated with an increased risk of death in older women.

The above conclusion comes to us by way of self-reported data provided by nearly 40,000 women — health questionnaires completed over a couple decades. Because it wasn’t a controlled experiment, we cannot be certain that the association of increased mortality and vitamin supplement use wasn’t due to some other factor. It is possible, for example, that the individuals who took the vitamins were trying to treat themselves for some ailment, or were attempting to compensate for some otherwise risky lifestyle factors.

But I wonder. My hunch is that the health-conscious crowd is more likely to shell out the cash for vitamins. But maybe not. I haven’t seen any data on this.

Some details from the news release -

The authors found that use of most supplements was not associated with reduced total mortality in older women, and many supplements appeared associated with increased mortality risk. After adjustment, use of multivitamins, vitamin B6, folic acid, iron, magnesium, zinc and copper, were all associated with increased risk of death in the study population. Conversely, calcium supplements appear to reduce risk of mortality.

The authors conclude:

“Based on existing evidence, we see little justification for the general and widespread use of dietary supplements,” the authors conclude.

That’s the conclusion I came to some time ago. And, as a result, have saved . . . oh, a hundred dollars, if not more.

Next, from ScienceDaily we have:

Study Shows Increased Prostate Cancer Risk from Vitamin E Supplements

I took vitamin E capsules for awhile. Then I noticed an increased propensity to bruise. So I stopped. What do you know — vitamins can have side-effects!

The finding:

Men who took 400 international units (I.U.) of vitamin E daily had more prostate cancers compared to men who took a placebo, according to an updated review of data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT). The findings showed that, per 1,000 men, there were 76 prostate cancers in men who took only vitamin E supplements, vs. 65 in men on placebo over a seven-year period, or 11 more cases of prostate cancer per 1,000 men. This represents a 17 percent increase in prostate cancers relative to those who took a placebo. This difference was statistically significant and therefore is not likely due to chance.

That’s good science. What we have here is the results of a placebo-controlled experiment.

So take vitamins at your own risk. Yes, risk. Any chemical, whether or not we believe it is naturally good, is still a chemical. And chemicals can and do react with the thousands of molecules in our body in many ways: good, benign, and bad.

—

[Related post: Science Quickie: Vitamins and How Something Good Can be Bad]

[recycled material - first appeared here]

Last night I listened to the latest edition of the The Skeptics’ Guide to the Universe podcast. In one segment the crew discussed the recent study/meta-analysis of a homeopathic remedy I blogged about a couple days ago [Imperfect Research Into Homeopathic Remedies]. Much of their criticisms and concerns echoed mine. At the end of the segment the show host, Steven Novella, asserted, in so many words, that emphasizing evidence-based medicine is not sufficient. Rather, the issue should be whether or not medicine is science-based.

What’s the difference? As I see it, science-based medicine bases its hunches and hypotheses and theories upon a pre-existing body of scientific knowledge. The ideas and explanations that provide the superstructure for the data — if you will — rests upon the solid foundation of what we already know about human physiology and chemistry, etc. Not strictly and completely, but at least substantially.

Over the past few years there has been a trend for alternative treatments to start gathering data. Evidence. Which is good. Data is the most important element to doing science. But there is more to science than data.

In the past and still today there was/is precious little data to support the majority of claims about alternative treatments. Most of the data was of very poor quality — anecdotes and testimonials and trials lacking adequate controls. But that is changing. Which is good. If a treatment works, we should verify it does. Or in many if not most cases, if it doesn’t.

But there is more to medicine than that, if it is to be a science. In science we have data, but not just data. There are hypotheses and theories. Hypotheses will propose a relationship between variables. Theories will offer testable explanations of some class of events. A strong theory will reveal the actual real-world mechanisms the produce the phenomena in question. Testable mechanisms.

While the one study I criticized did provide some data, and hence partly qualified as science, the entire field of homeopathy fails in another regard: the theoretical superstructure of their “knowledge” appears to be bogus. For one, no principles or tests have shown that diluting a medicine actually makes it stronger. In fact, the opposite is true. And as for the like-curing-like idea central to homeopathy (the homo, “same” part), that, too, appears to be bogus.

So yes, encourage and applaud the gathering of data. But there is more to a robust understanding than that. But, in terms of combating pseudoscience and sham treatments, we have to start somewhere. So yes, start with tests. Good tests.

Proponents of “alternative medicine” may accuse we skeptics of “moving the goalposts” by asking for more than data that some specific treatment works better than placebo. But intellectual progress depends upon it. In a sense, by scrutinizing both the effectiveness AND supposed mechanisms of action, we are saying, “let’s take a closer look at this.”

Can taking a closer look be a bad thing?

It’s a natural treatment, therefore it must have only an upside to its use. Right?

Wrong.

The greatest secret to the alleged safety of “natural remedies” is their potency. Limited strength means limited potential for adverse effects. (Side effects being an unfortunate consequence of our Tinker-Toy biology. Medicines that influence the element of one organ/system/process are likely to influence the same elements in others.)

A second secret is that so-called natural remedies and their effects, good and bad are not studied and tracked and scrutinized with the same bureaucratic record-keeping as are conventional medicines.

As for the adverse effects of herbal remedies, a recent article highlights the issue. In people with compromised health, these effects may more readily manifest.

Acai berry, cumin, herbal tea, turmeric and long-term use of garlic – all herbal supplements commonly believed to be beneficial to your health – may negatively impact chemotherapy treatment according to a new report presented at the recent American Society of Clinical Oncology (ASCO) meeting in Chicago. Researchers from Northwestern Memorial hospital say there is growing evidence that these popular supplements may intensify or weaken the effect of chemotherapy drugs and in some cases, may cause a toxic, even lethal reaction. [source]

Cue rationalizations now. Claim that chemotherapy is the real culprit in the adverse reaction.

Granted, the above is no slam-dunk finding from controlled research. But it makes a point. An important point.