First Do No Harm: Even Vitamins May Harm

I have been meaning to write about these recent studies for awhile. I will just direct you to the New York Times blog that covers it quite extensively. That Vitamin users would have higher rates of cancer is pretty counterintuitive, and may not prove to be the case. But there clearly is no good reason to take them according to the research. So, as always, eat your fruits and veggies and the money you save by not buying vitamins, you can spend on some organic produce instead. The vitamin industry is going strong, $9.6 billion in sales last year.

Two new studies add to the growing body of evidence that taking extra doses of vitamins can do more harm than good.

A study of vitamin E and selenium use among 35,000 men found that the vitamin users had a slightly higher risk of developing prostate cancer, according to a report published Tuesday in The Journal of the American Medical Association. A separate study of 38,000 women in Iowa found a higher risk of dying during a 19-year period among older women who used multivitamins and other supplements compared with women who did not, according to a new report in The Archives of Internal Medicine.

The findings are the latest in a series of disappointing research results showing that high doses of vitamins are not helpful in warding off disease.

“You go back 15 or 20 years, and there were thoughts that antioxidants of all sorts might be useful,” said Dr. Eric Klein, a Cleveland Clinic physician and national study coordinator for the prostate cancer and vitamin E study. “There really is not any compelling evidence that taking these dietary supplements above and beyond a normal dietary intake is helpful in any way, and this is evidence that it could be harmful.”

Prostate Cancer Test Under Attack

There is more evidence for the "over kill" of the PSA test. This NYTimes article lays it all out and it's heartbreaking for those who might have had unnecessary surgery, but this decision by the United States Preventive Services Task Force to suspend recommendations for routine PSA testing may save other men from needless surgeries and side effects. I've covered this topic here and here. There was a long article in the magazine section of the New York Times over the weekend also. It made the blunt comment that it's trading one death for another, trading time in early life for a few weeks at the end. They also made the point that this emphasis on PSA has taken the focus off the really invasive tumors and how to differentiate them.

"The panel says research shows that over all, the test does not save lives and leads to unnecessary surgery and radiation treatment for slow-growing cancers that would never have caused harm. As for faster-growing, invasive cancers, there’s no proof that P.S.A. tests and earlier treatment offer any overall benefit."

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Bad Science

Such scant posting lately, I apologize.  I was involved in an academic conference and couldn't seem to multi-task.
Here's a  link to ponder.  It is a TED talk on pseudo science, and covers in the latter half, the tricks that the pharmaceutical companies use to bury the negative results of their own studies. I will be posting quite a bit on the conference I just attended and my poster presentation and feedback.

Electroacupuncture's effect on thermal pain perception correlation with fMRI

This study looks at fMRI in 5 subjects during heat pain, and then with Optimal electroacupuncture and Minimal electroacupuncture.  Both types of acupuncture suppressed the brain activation from heat pain, but the optimal electroacupuncture more so. They used 5Hz electroacupuncture which is a somewhat unconventional choice, since most studies look at either 2Hz or 100Hz.
This type of suppression could be of great clinical value in cases of chronic pain, since one school of thought is that the brain recruits more and more "real estate" the longer it goes on.  So if you can suppress those inputs, perhaps the vexing chronic pain pattern may diminish. Full article at the link.  (For more information about my practice, please click here.)

The analgesic effect of electroacupuncture on acute thermal pain perception-a central neural correlate study with fMRI

Shivshil Shukla,¹ Artour Torossian,² Jeng-Ren Duann,³ and Albert Leung⁴

Received December 8, 2010; Accepted June 7, 2011.

Background

Electrical acupuncture (EA) has been utilized in acute pain management. However, the neuronal mechanisms that lead to the analgesic effect are still not well defined. The current study assessed the intensity [optimal EA (OI-EA) vs. minimal EA (MI-EA)] effect of non-noxious EA on supraspinal regions related to noxious heat pain (HP) stimulation utilizing an EA treatment protocol for acute pain and functional magnetic resonance imaging (fMRI) with correlation in behavioral changes. Subjects underwent five fMRI scanning paradigms: one with heat pain (HP), two with OI-EA and MI-EA, and two with OI-EA and HP, and MI-EA and HP.

Results

While HP resulted in activations (excitatory effect) in supraspinal areas known for pain processing and perception, EA paradigms primarily resulted in deactivations (suppressive effect) in most of these corresponding areas. In addition, OI-EA resulted in a more robust supraspinal sedative effect in comparison to MI-EA. As a result, OI-EA is more effective than MI-EA in suppressing the excitatory effect of HP in supraspinal areas related to both pain processing and perception.

Conclusion

Intensities of EA plays an important role in modulating central pain perception.

Bisphosphonates require caution, new labelling for Fosamax, Actonel, and Boniva

To file under "Beware of Blockbuster Drugs."  See previous post entitled :Drugs causing the problems they're supposed to prevent

Stronger Cautions Backed on Bone Drugs for Women
By DUFF WILSON

Two advisory panels to the Food and Drug Administration on Friday recommended increasing the cautionary language on the product labels of bone-building drugs taken by more than five million women in the United States.

But they stopped short of specifying what the safety warnings should say and did not recommend limiting use of the drugs to a proposed five years. About 11 percent of women 55 and older take the drugs to prevent bone fractures...
The benefits of the drugs have only been proven for three to five years, not longer, F.D.A. staff members said, warning about links to those rare conditions after longer use....

Several women who have suffered the unusual fractures testified at the meeting.

Dr. Jennifer P. Schneider, whose thigh broke as she was standing in a New York subway, presented her own review of 111 cases.

Almost all took the drug for more than five years, most for a pre-osteoporosis condition called osteopenia, she said. Many felt pain in the thigh before the bone suddenly broke.

The first such drug, Fosamax, was marketed by Merck in 1995. Others include Actonel and Atelvia from Warner Chilcott and Boniva from Roche Therapeutics. Worldwide sales last year were $7.6 billion.

At a conference at UCSF last year, "Controversies in Women's Health,"  I was very interested in the topic of bisphosphonates which was on the agenda.  The professor who gave the talk made light of any nasty side effects, but he also had published conflicts of interests.  He had done some of the initial work funded by the pharmaceutical industry.