Pondering Placebos

Lately I came across an article by two doctors listing five supplements that people should not take for brain health. The purpose of the article was to condemn the hype behind supplements preying on senior citizens. There is some truth to this, though the marketing hype behind supplements is still dwarfed by the marketing budgets of pharmaceuticals (Pfizer and others spend more on marketing than on research and development).

I read the article with an open mind, quite ready and willing to join in the skepticism of the supplements they cited. The first listed was Gingko biloba. OK, I could see why they would start off with that. Gingko is a Chinese herb that has been used to treat almost everything for thousands of years. I was not surprised that a thorough study failed to show an ability to slow dementia. I was surprised when the doctors stated that the results indicated a slight, though insignificant, increase in dementia.

GinkgoBiloba_55068328Gingko increases blood flow, a finding not in question. Unless you have a bleeding disorder, increasing blood flow is a good thing pure and simple, perhaps the reason why thousands of years of Chinese medicine turned to gingko for so many things. While an herb that increases blood flow may not directly curb dementia, it could provide indirect help precisely for someone with a blood flow problem. On the other hand, there is no mechanism of action for how gingko could increase dementia, save perhaps for people prone to something like aneurysms.

I turned to some reliable (read, unbiased with no apparent economic agenda) sources and some primary studies. The review was mixed, with reference to studies both in support and denial of gingko’s positive effects for brain health. The study the doctors cited was indeed the most convincing, though only the good doctors deemed it worthy to suggest that gingko might actually increase dementia.

That got me to wondering what the placebo really stands for in American clinical trials. A placebo is a fake pill in a drug or supplement trial, used as a control both for comparing the effects of the real pill and to make sure positive benefits from treatment are not merely psychological. For most Americans, a fake pill for no treatment means, in effect, bad treatment: a stressed life with ample processed foods in the diet and insufficient exercise. I seriously doubt that gingko contributes directly to dementia in anybody in the first place; I’m absolutely sure that increased blood flow does nothing but benefit someone with a healthy lifestyle, absent some type of bleeding disorder.

While I was pondering that mystery I turned to the second supplement on the list, coconut oil. The authoritative doctors faulted coconut oil for lacking “clinical proof” or “any scientific evidence.” Ah, but the real kicker was when these good doctors informed their readers that the brain only uses glucose for energy. Hmmm.

The case for coconut oil lies in the ketones provided that serves as an alternative energy source for the brain. I was not the only one to quickly point this out in a comment section, though I took the extra step of linking a scholarly, peer reviewed paper about ketones passing through the blood brain barrier when the body is starved. How the hell can two doctors being recognized as authorities not know that?!

I also noted that, unlike with gingko, there were no trials to prove coconut oil’s ineffectiveness, only a lack of clinical trials to prove positive benefits for brain health. That’s enough to list coconut oil in the top five of dubious supplements? Or is it more like a top five supplement used as an alternative to pharmaceutical products? For the record, I do think there is overblown hype behind coconut oil as it becomes such a lucrative, money making product, but scientific evidence for some of its alleged benefits does indeed exist.

That brings me back to gingko. An increase in dementia? Really? If not a significant finding why would those good doctors even bring it up, given that gingko at least causes the real effect of increasing blood flow? I suspect there was an agenda that went beyond providing advice for us poor, exploited senior citizens.

Yes, there is money to be had with supplements, leading to hype designed to separate us from our money. Yet there is even more money to be had with medications and even more hype and marketing to sell them. With this in mind I’m starting a new brain health resource page with links to resources that do not appear to have any agenda beyond just providing good information. I may add more, but for right now I link you to WebMD and the University of Maryland medical site as resources to be trusted for medications, supplements and alternative treatments.

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3 Responses to Pondering Placebos

  1. Christy Windmeyer says:

    My cousin is an RN and points me to WebMD all the time when I have questions about various medications AND supplements. It’s always been quite reliable for answering my questions and giving me more information than I could probably every absorb. Thanks for continuing to share w/us.

  2. chuck le ber says:

    Over 10 years ago the coroner for Toronto wrote a book that linked the first diagnosis of Alzheimers Disease in a country to the introduction of ground meats. The diagnoses followed the introduction by 25 years or so. I heard about it on CBC radio.

    I had not heard of Early Onset Alzheimers until a surgeon client had to quit his practice at age 50.

    In spite of a bad situation, I feel you are doing a good thing.

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