I just read a really interesting article from Science-Based Medicine entitled Rx, OTC, BTC – Wading Into Pharmacy’s Alphabet Soup by the newest SBM blogger, Scott Guvara, and it triggered some thoughts I’ve had for quite some time. The article itself talks about how we determine what drugs are safe for general use, and what are not. It’s a very good read, and presents a very interesting picture of how the decisions are made for these sorts of drugs. But it got me thinking about a number of unrelated conversations I’ve had with people on topics ranging from prescription drugs to alternative medicine to general health.
First and foremost, as ridiculous as it seems, I feel the need to state up front my assertion, which is that anything we take into our body has side effects. Our bodies are chemical processing plants, and they are anything but perfectly versatile. Side effects, at least as I consider them, are essentially the unexpected chemical reactions that can take place within the body. Sometimes, these reactions can be problematic, and thus we call those adverse side effects.
When last I said that to someone, they countered with oxygen. Our bodies do not have adverse reactions to oxygen, and thus clearly my entire point was incorrect. Well, that’s only partially true. As my good friend Wikipedia will tell you, there is such a thing as oxygen toxicity, a condition that comes from “breathing molecular oxygen at elevated partial pressures”. SCUBA divers know all about the potential for this rather uncommon reaction. Oxygen is clearly a fairly well understood and necessary chemical for us, but under the right conditions, it can have negative side effects.
Conditions play a huge part in the equation of side effects. This could range from having other chemicals in the system that create a conflict to the overall health of the person involved and any number of factors. The idea of having a finite list of possible interactions for any product is a pipe dream at best. There is simply too much complexity in the equation. Some foods, for example, can create byproducts during digestion that, when mixed with other food byproducts, trigger any number of possible reactions. Eat a handful of Mentos and swig back a can of Diet Coke if you don’t believe me.
Now, at this point I sound like I’m saying that labeling foods and drugs and whatnot is never going to be complete, so we probably shouldn’t bother. In fact, it’s far from that. I’m simply saying that the chemical processing that takes place in our systems is complicated, and the only way to know for certain about side effects is by seeing them happen. This means we have to study the chemicals, be they drugs, food, or what have you, and take note of the reactions what effects we can. And of course, it’s ludicrous to assume that we can properly test every single thing we have the potential to injest as it interacts with every other thing.
Along comes some health food supplement with a strong marketing department. They slap words on the bottle that say things like “Contains Blinga-Blinga-X! Reduces cholesterol! No side effects!” What rigor has this claim been put through? Well, if Blinga-Blinga-X is an FDA-approved chemical being used for a condition that it was intended for, we can assume that it has at least been put through an appropriate level of testing. However, the minute that we are using it for off-label use or if the chemical does not qualify as something that is screened by the FDA (a common problem with supplements) then we can only rely on the manufacturer’s testing.
So where am I going with this? I remember having an argument with my father about Manatech products. He kept insisting that they had no side effects, and I kept arguing that this was impossible. What they had was no proven side effects. My mother claims to have cured her macular degeneration by taking a shit-tonne of one of their products, I believe it was Phyt-Aloe (click to see the ingredients), but I may well be mistaken. At any rate, I can (as a skeptic) attest to the fact that her eyes are better and that her opthamologist found no evidence of degeneration when last she was checked. From what we know, antioxidants may well benefit this condition, and with all the vegetables listed in the ingredients for Phyt-Aloe, it seems likely that this would be the reason there was impact based on the (over) use of the product.
However, what anti-oxidant was it that she was taking? According to this page, which is the medical treatment section of the above linked article on macular degeneration, the antioxidants that have been shown to help specifically are zinc, vitamins A, C, and E, selenium, copper, lutein, and zeaxanthin. I don’t know the chemical breakdown of broccoli or turnip, but we do know that at least some of these chemicals exist in at least some of the ingredients for Phyt-Aloe. Well, there are overdoses for all of these chemicals: zinc, vitamin A, vitamin C, vitamin E, and selenium. Both lutein and zeaxanthin I was unable to find entries for (hardly a rigorous search, to be fair), but I’m sure you can mess up and take too much.
Come to think of it, my mom has had real gastrointestinal problems for quite some time, and I wonder if there might be a cause hidden in this cure? She takes a LOT of supplements every day, and I’m wondering if, given the details in the overdose links above, they might actually be causing her issues rather than curing them. I’ll have to send an email, and it’ll be an email that will no doubt make them hate me a little bit more than they already do… Eep.
Or let’s look at the homeopathic claim that their tinctures do not have any side effects. Of course, the obvious and easy comment to make would be that one can overdose on water, though that hardly seems to be a threat from homeopathy given the size of dose that people are taking. And clearly, you cannot overdose on a chemical that isn’t present in the water, so this much is absolutely true. If diluted enough, you could make homeopathic hemlock and run no risk of actually encountering enough of the potentially fatal chemical to achieve a reaction. But water has memory, or so they claim. And if that’s the case, if the water molecule remembers the chemical properties of the thing you’re diluting, then it would have to have exactly the same risk for side effects as the chemical itself. It can’t possibly be argued that water is smart enough to discern the subjectively positive effects of a chemical, remember them, and somehow ignore the subjectively negative effects. The claim is that water has memory, not selective memory. So if water really remembers (which I can assure you, it does not) then our brilliantly diluted solution of homeopathic hemlock would be thoroughly lethal to injest.
My dad’s argument about the natural products he takes is that they are natural, and therefore good. We know what brocolli does to us, so if something is made from brocolli, we can easily assert that we know what it will do. Clearly, this is not the case. Like it or not, cute vegetables, even the organic free range hippie kind, are still made up of chemicals that could trigger a brutal side effect. In the case of pharmaceutical drugs, we test to find these side effects, and we continually monitor the reported findings to ensure that we are doing the best we can to assure safe use. This is not the case with other products like supplements. Remember, kids, taking a supplement company’s word for it is no different than taking a pharmaceutical company’s word for it.