The Costly Appeal of Alternative Medicine

In a review of the book “Do You Believe in Magic?” Temma Ehrenfield in the Weekly Standard writes that more than half of all Americans take vitamins; that they, and even people who don’t take them, generally believe they are harmless.

But many studies, Ehrenfield says, show that high doses of vitamins can increase the risk of cancer. So begins her discussion of the popularity of “natural,” or alternative medicine, and her assessment of the gullibility of humans.

We’re not ready to stand up for the vitamins-and-cancer claim (whose referenced studies Ehrenfield fails to cite), but we do agree with the recent editorial in the Annals of Internal Medicine that called on Americans to stop wasting money on vitamin and mineral supplements.

That report referred to National Center for Health Statistics that more than half of American adults consumed some type of supplement (especially multivitamins or multiminerals), and that U.S. consumers spent $28 billion on them in one year.

It also invoked three new studies in support of its argument. One found no consistent evidence that supplements affected cardiovascular disease, cancer, or mortality from any cause among healthy individuals without known nutritional deficiencies. Another study concluded that, over 12 years, cognitive function and verbal memory didn’t improve among the subjects who took a daily multivitamin than among those who took a placebo (fake pill). And a clinical trial to see if a multivitamin could help prevent heart problems and fatalities among patients who had had a heart attack concluded that it didn’t.

Those results mirrored other studies showing “no clear benefit” from taking multivitamins, antioxidants, folic acid and B vitamins, according to the editorial.

As reported in the Los Angeles Times, those studies show a lack of improvement and a waste of money, but, per Ehrenfield’s concern, what about harm? Trials of beta-carotene, vitamin E and high doses of vitamin A were associated with an increased risk of premature death.

The journal writers, however, said no conclusions could be drawn yet for the potential value of vitamin D supplements.

We agree that people too often are swayed by questionable – and dangerous – claims about alternative therapies. Earlier this year, “Conventional and Alternative Medicine: A Delicate Co-Existence,” an issue of our monthly newsletter, examined the uneasy integration of alternative medicine into traditional practice, and the need to fully examine its claims before choosing it as your health-care guide.

“Magic” author Dr. Paul Offit enumerates several reasons for the appeal of unproven remedies:

• Champions of alternative medicine are definitive and comforting – they tell us how to live.
• Contemporary doctors are pressed for time, and “healers” offer care that feels more sympathetic and individualized.
• Alternative practitioners claim to represent ancient wisdom from cultures that seem superior to our own – modern medicine is ever-changing and scary.
• Alternative medicine offers the sense that you can take control, that you don’t need scientists or doctors to tell you what to do.
• Many Americans think that modern medicine has “rejected nature.”

Offit, chief of the Division of Infectious Diseases at the Children’s Hospital of Philadelphia, delves into America’s affection for mega-vitamins with the same vigor as discloses how political lobbyists and the money they spend on behalf of the supplements industry win exemptions from regulation.

His deft comparison of supplement-pushers with old-timey hucksters of Curry’s Cancer Cure (hydrogen peroxide, iodine, laxatives and cocaine) and Radio-Sulpho Cancer Cure (Epsom salts and Limburger cheese) animates medical history. “Offit,” Ehrenfield writes, “is more like an angry atheist. Though he never sounds hostile, his true and persuasive message is that nonsense can be deadly and its purveyors need more policing.”

Yep. Still, the distrust of modern medicine can make even whip-smart people like the late Steve Jobs put off, or reject, conventional medical treatments. (See our blog, “Was Steve Jobs’ Death Hastened by ‘Magical Thinking?”) Jobs tried a variety of alternative cancer treatments instead of the early surgery that might have saved his life.

Offit goes after Linus Pauling, brilliant, but irrational in his claim that, despite much negative evidence, high doses of vitamin C, combined with other supplements, could cure colds, treat cancer and address a host of other problems (including AIDS) without side-effects.

Offit spends quality time discussing the placebo effect – a beneficial effect or improvement in a health condition produced by a placebo drug (an inert, or fake, pill) or treatment that can’t be attributed to the properties of the placebo itself, so is due to the patient’s belief in that treatment. He suggests that our collective sense of alternative medicine derives from the power of the placebo effect and the idea that we can use it to our advantage.

Ehrenfield admits that she’s taken an alternative cold remedy – oscillococcinum – but notes that Offit says it’s a better choice than conventional cough and cold treatments that contain pseudoephedrine. It can cause hallucinations, seizures, and heart problems in young children.

So, as we suggested in the newsletter, mainstream and alternative healers each have a place on the health-care continuum; it’s a matter of informed perspective, the knowledge required to choose wisely.

As Ehrenfield, writes, problems occur when mainstream healers reflexively dismiss alternatives and when alternative healers offer placebos when lifesaving therapies are available and indicated; when they charge exorbitant prices for their remedies or promote therapies as harmless when they’re not.

And when we indulge in magical thinking and scientific denial at the risk of great harm.