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D-vitaminsThe health care pendulum appears to have taken a bad swing to the extreme with vitamin D.  Too many Americans may be taking unnecessary tests to see if they’re deficient of this important nutrient. Too many of us are taking unneeded amounts of it.

Federal experts report that blood tests for vitamin D among Medicare beneficiaries, most 65 and older, increased 83-fold from 2000 to 2010. Testing rates rose 2.5-fold from 2009 to 2014 among those with commercial insurance.  Among a recent sample of 800,000 patients in Maine, nearly one in five had at least one test for blood levels of the vitamin over a three-year period. More than a third got two or more tests, often for vague complaints like malaise or fatigue. Labs and doctors are telling patients who have undergone tests and who have readings in the normal range of 20 to 30 nanograms of the vitamin per milliliter of blood that they suffer a deficiency.

This all is leading to what some experts are terming a “pandemic” of over-testing, faulty diagnosis, and excess consumption of a nutrient, based on sparse evidence and misplaced belief that, as the New York Times reports, “vitamin D can help turn back depression, fatigue, and muscle weakness, even heart disease or cancer. In fact, there has never been widely accepted evidence that vitamin D is helpful in preventing or treating any of those conditions.”

23andMetest-300x229Federal regulators have reversed themselves and approved a company’s controversial plan to sell direct to customers saliva-based tests that can predict their genetic risk for diseases like Alzheimer’s and Parkinson’s.

Officials of the federal Food and Drug Administration emphasized that the tests cannot show conclusively if individuals will develop conditions for which they may have genetic risk. They said any health test results should be discussed fully with doctors.

The FDA said it would keep close tabs on the online-order products of  23andMe, which previously had sought to market its saliva tests not only for consumers’ genealogies but also for their health interests. The FDA slapped down the firm’s first foray into health measurements:  23andMe in 2013 had charged $99 for a test that it claimed gave information, genetic and otherwise, on 240 conditions and traits. Regulators halted those tests, requiring 23andMe and others in the field  to prove their products’ accuracy and to clarify that users understood what they were paying for and any test data.

1-Britax-B-Agile-stroller-in-travel-system-mode-256x300Despite years of public and regulatory pressure, manufacturers continue to dump risky nursery products into the market, sending tens of thousands of children each year to emergency rooms for treatment. These injuries also increased markedly during the last years of a newly published study.

In a study published in the journal Pediatrics, researchers from the Nationwide Children’s Hospital said they scrutinized records on more than a million injuries of youngsters in emergency care for more than two decades (from 1991 to 2011), finding that 66,000 youngsters each year require treatment—almost an incident every eight minutes—due to issues with baby walkers, bouncers and changing tables.

Baby carriers, cribs and mattresses, and strollers caused the preponderance of injuries requiring ER attention, with 81 percent of the injuries affecting youngsters’ head, face, or neck. Most of the injuries were not major and were caused by toddlers falling from nursery products, which the researchers wrote are all too common:

repatha®-evolocumab-product-shot-5-HR-300x189With all the public attention now focused on soaring drug costs, Big Pharma just can’t seem to stay out of the spotlight. Drug makers are keeping up their eyebrow-raising actions, as are purveyors of so-called “stem cell” treatments, and it’s worth noting some of what’s happening with these:

Will insurers, MDs, patients pay for $14,000-a-year cholesterol fighting drug?

adderallIf aliens beamed down from another planet, how shocked might they be by modern patients’ willingness to ingest crazy stuff in the name of their health or well-being? Is it surprising or distressing that in the 21st century so many patients swallow so much hokum and downright dangerous thinking?

Let’s start with an excellent but deeply distressing New York Times Sunday Magazine story about “Generation Adderall,” a painful dissection of how many young people have become dependent, even addicted, to drugs that their parents started them on, in the name of improving their focus and academic performance. The author reports that Attention Deficit Hyperactivity Disorder, or ADHD or even shorter ADD, has risen as a diagnosis for young people, increasing from 3 to 5 percent of American school kids in 1990 to 11 percent now. The remedy for this, of course, has been prescribing drugs:

In 1990, 600,000 children were on stimulants, usually Ritalin, an older medication that often had to be taken multiple times a day. By 2013, 3.5 million children were on stimulants, and in many cases, the Ritalin had been replaced by Adderall, officially brought to market in 1996 as the new, upgraded choice for ADHD—more effective, longer lasting.

drugpriceBig Pharma’s dubious hype of its sometimes risky products marched on last week, with the industry racking up a half-billion in regulator penalties and settlements but no seeming end to its questionable strategies and tactics:

$465 million penalty, settlement for EpiPen maker

Medical_studies-02.0In case health information consumers already haven’t learned to turn a jaundiced eye on the flood of “news” about the latest, greatest  medical research, the Vox news site has compiled some eye-opening charts and concrete examples to show what a fool’s errand it can be to look at a lone published study and think it describes a genuine therapeutic breakthrough.

The site’s story starts by reminding that experts in 2003 looked at 101 studies published over four years in top journals  that promised therapeutic advances.  After a decade, just five of those big deals made it to market — and only one of the 101 was still in widespread use.

That efficacy gap hasn’t acted as any kind of deterrent to the torrent of research publication, as the Vox chart shows.

spermeggjpgA reported rash of new lawsuits offers a poignant, sadly recurrent reminder: Aspiring parents who rely on commercial sperm banks for critical reproductive tissues must heed an ancient consumer prescription: caveat emptor. The New York Times says litigation, from Florida to California, Canada to the UK, all raises serious questions about the light or nonexistent regulation of assisted reproduction centers and the materials and services they tout. As the Times describes it, the latest suits highlight “claims of deception and negligence, and [add to] an array of challenges beyond the longstanding issue of undetected genetic problems,” in donor sperm.

The sperm banks, the paper notes, stand accused of “careless record-keeping, or mishandling or misappropriation of sperm banked for a client’s personal use. Others say the banks use hyped, misleading descriptions to market their donors.” The Times reports on cases in which banks have given out wrong tissues that may lead to offspring with serious genetic-related conditions, and from donors with bad or difficult histories, including cases in which mothers assert they have learned, post hoc, that they will bear children of a different race.

Regulators exercise minimal oversight over these operations, often mostly to ensure sanitary conditions in storage facilities and steps to try to curb transmission of disease.

nu logoA well-known research university and some excitable journalists have sown confusion about prostate cancer and the value of the PSA screening test.  The mess can be traced to a study by physicians from Northwestern University and the University of Chicago, and published in the journal Prostate Cancer and Prostatic Disease. Their article reports an “increase” in one of the most aggressive forms of the disease, metastatic prostate cancer, and suggests it might be caused by less use of the PSA blood test.

Northwestern’s PR machine hyped the study, saying that “Metastatic prostate cancer cases skyrocket.” NU’s news release—which was picked up by all too many media outlets (the Times shames them in visual fashion atop its story)—also tied this to “lax screening.” That was an allusion to recommendations by a blue-chip national panel that has advised against routine prostate cancer screening using the prostate-specific antigen (PSA) test. The group said the screenings often resulted in false alarm “false positive” results, leading to invasive, harmful, unnecessary, and costly follow-on procedures.

As the online watchdog site HealthNewsReview.org points out, the Northwestern researcher author is a PSA testing proponent, a “true believer.” The site, as well as experts from the American Cancer Society and others, have debunked the study, saying it fails to demonstrate either that this form of prostate cancer has “skyrocketed” or that there is a proven link to reduced PSA screening.

risperdalA Tennessee teen-ager suffered such emotional distress after growing enlarged breasts as an undisclosed side-effect of an anti-psychotic medication that the drug’s maker should pay him $70 million in damages, a Philadelphia jury has decided.

That verdict, only for compensatory damages, was the latest rebuke to Johnson & Johnson over its drug Risperdal. Jurors found that J&J “intentionally falsified, destroyed, or concealed records,” that warned that the medication could cause gynecomastia, the abnormal enlargement of the breasts in men.

J&J has lost a half dozen similar cases already, and it faces more than 1,500 damage lawsuits in Pennsylvania court. In one previous decision, a jury in 2015 awarded an autistic Alabaman $2.5 million after he developed 46DD sized breasts after taking Risperdal.

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