Rolly polly

[ewt]

[Poll #862953]



NOTE: I am not suggesting that anyone take any supplements, particularly if currently on prescribed medication. The combination of, say, St. John's Wort and SSRIs, for example, can result in Serotonin toxicity.

Comments

[pfy.livejournal.com]

There are a lot of 'alternative health' quacks spouting absolute bollocks about supplements, so it's important to do your own research (e.g. checking MedLine) to make sure that there's actually some decent evidence that what you're taking is useful. There definitely are supplements out there that can be very helpful for certain conditions, but you have to be able to apply a little critical thinking to separate the reality from the quackery.

I didn't check with my GP when I started taking omega-3/6/9 capsules, but I reasoned that a couple of millilitres of vegetable oil was probably not going to do me much harm. Certainly none of the information sheets for any other meds I use mentioned avoiding fry-ups or sesame-seed bagels.

[ewtikins.livejournal.com]

Certainly none of the information sheets for any other meds I use mentioned avoiding fry-ups or sesame-seed bagels.

I love you!

There definitely are supplements out there that can be very helpful for certain conditions, but you have to be able to apply a little critical thinking to separate the reality from the quackery.

*nog* I tend to think my critical thinking skills are reasonably average. Then I see the way some people think, and decide that perhaps they are excellent.

[andrewhickey.livejournal.com]

If you want to find 'absolute bollocks about supplements' then MedLine is certainly the place to go. They don't index several important journals which deal with nutrition and refuse even to explain why. See, for example, http://www.agoravox.com/article.php3?id_article=5213 , http://www.bmj.com/cgi/eletters/331/7531/1487#124851 . Medline seem to think that Readers Digest is more worthy of indexing than the Journal of Orthomolecular Medicine (in which much of the later work of Linus Pauling was published).
Medline's indexing process is largely political, and gives a hugely inaccurate picture of the current state of nutritional medicine.

[(Anonymous)]

There's so much irony here you could stick fridge magnets to it.

Just out of curiosity, are you related to the Steven Hickey mentioned on those pages?

[pfy.livejournal.com]

That was me, by the way. *grumble grumble logging in grumble*

[andrewhickey.livejournal.com]

Yes, I'm related to him (though the links spelled his name wrong, it's Stephen). I deliberately chose links mentioning him so my own bias in this matter would be entirely obvious up front.
But as well as being related to him, I'm also collaborating with him on a series of papers, and have worked with a few of the other people mentioned in the links, and am familliar with the work of the rest. Have you actually read their papers, or looked at any of the evidence they present at all, or are you just slandering working scientists (who have actually, you know, done actual research into the subjects in question) without reading their work?
If Medline refuse to index the journals that present any evidence for supplements working, then if you check Medline you *cannot* see any evidence for them, only evidence against.
By all means, people should seriously research their supplement intake - in fact, in a perfect world, people would research anything they put into their bodies, although that is, of course, impractical - but looking on Medline is just looking for one side of the argument. If the work of Linus Pauling - the inventor of molecular biology and of modern chemistry, and the only person ever to win two unshared Nobel prizes - is less worthy of indexing than Time magazine, then something is seriously wrong.
And incidentally, you seem to be misusing the word 'irony'. I do not think it means what you think it means.

BTW my apologies if any of this post comes off as rude - I'm posting this before my first coffee of the day...

[ewtikins.livejournal.com]

I know pfy rather well and respectfully submit that Medline was only one example of the resources one might use to make a decision regarding medication or supplementation.

Thank you for pointing out some of the obvious problems with this particular resource. In general, I'm aware that there are difficulties with getting serious scientific studies of supplement effects a) done at all and b) published in reputable journals - where "reputable" is defined as "how mainstream medical science sees the reputation of the journal", whether that is accurate or not. With regard to Medline, why are they refusing to index the journals this data has been published in?

[ewtikins.livejournal.com]

With regard to Medline, why are they refusing to index the journals this data has been published in?

Scratch that, you said.

What is your opinion of other resources available?

Medline

[(Anonymous)]

Perhaps Medline's journals are largely driven by and exist because of scientific research which is, at some point, financed by large, pharmaceutical companies whose interests in the well-being of the public is not at the heart of their operations! Oh, don't you love a capitalist society...
Mum

Re: Medline

[andrewhickey.livejournal.com]

You might say that, I couldn't possibly comment ;)

Re: Medline

[pfy.livejournal.com]

In this particular case, I have a hard time believing in a conspiracy by pharmaceutical companies to suppress evidence that supplements work. After all, pharmaceutical companies make lots of supplements, and I'd expect them to welcome any evidence that could lead to increased sales. Imagine the scene in the boardroom:

"Now, first item on our agenda: these scientists have found evidence that our products actually work."
"We'll get their research funding cut off immediately, sir."
"Good work, Johnson. And send the boys round. Now, on to item two: for some reason, we're not making much profit..."

Re: Medline

[andrewhickey.livejournal.com]

Pharmaceutical companies have a very great interest in ensuring that people use patentable compounds to alleviate their illnesses rather than non-patentable substances. If a company makes chemotherapy which costs $100 per dose, say, and which has to be taken for the rest of the patient's life, then if it is discovered that vitamin C cures the cancer their chemotherapy treats, even if they also sell vitamin C, they stand to lose vast amounts of money. One doesn't have to believe in an actual conspiracy to see the possible bias...

Re: Medline

[pfy.livejournal.com]

On the other hand, it takes a lot more money to develop and test an entirely new drug than it does to make vitamin pills. And if the drug companies wanted to, couldn't they develop related, more effective compounds that they could patent? (like the way aspirin was developed from salicin and patented by Bayer)

And, if these companies are suppressing effective cures for cancer, I can't believe that nobody with inside knowledge has ever had a friend or family member with cancer, or suffered from cancer themselves. I know big corporations can act unethically, but am I to believe that every single person who knew about it would condemn their own loved ones, or even themselves, to chronic illness or death simply for a bigger annual bonus? Even if we're talking about individual bias rather than organised conspiracy, it's still pushing the limits of credulity.

I can believe that there are effective treatments for cancer out there that need more research before they can be conclusively said to work (though I don't know whether vitamin C is one - I'd have to do a lot more reading on the subject to say), and I can believe that doctors would initially be cautious about putting patients on a new treatment, but I remain unconvinced that there are cover-ups going on. There's too much at stake for everybody to go along with it.

But, having said that, if one of those company insiders came forward and admitted to suppressing a cure for cancer, I'd change my mind. What would it take to change yours?

Re: Medline

[andrewhickey.livejournal.com]

The drug companies in fact are heavily researching into related, patentable compounds (although they've never even come up with any that work *as* well).
I'm not suggesting any organised conspiracy - what I'm saying is that if you have two people looking at the same data, and one of them stands to lose a billion pounds if the answer you get from the data is 'no', then the that person may well think the answer is 'no' *and believe it*.
They're generally not suppressing research, but what tends to happen is that effective treatments get put in the box that says, as you put it, "need more research before they can be conclusively said to work ", and that then funding that research just isn't a very high priority.
Also, people are more likely to overlook flaws in research if it fits the result they want. For example, Moertel's study of the effectiveness of vitamin C in treating cancer for the Mayo clinic is often claimed to have 'proved' that vitamin C is ineffective. It does no such thing - it's the most flawed study I've ever come across, in fact (among other things, the researchers didn't seem to know the difference between an oral and an intravenous dose, didn't take account of the short half-life of vitamin C within the body, and didn't even seem to know the difference between sodium ascorbate and ascorbic acid), but that paper was accepted as conclusive for 25 years by almost everyone, just because it fitted with the conclusions they'd already come to.
Again, I am not accusing *anyone* of malice, or even of acting unethically - merely of letting their own interests guide which areas they think are worth following up.
What it would take to change my mind is for anyone at all to do a study of vitamin C on cancer patients, with the study lasting more than, say, a year, with the doses being as high as those advocated by doctors like Hoffer and Cathcart who have successfully treated patients, and with those doses properly spaced over the course of a day, and for that study *not* to show a significant increase in life expectancy. Because every single study that has followed those rules has shown increases nothing short of miraculous, but I'm always willing to change my mind if the other side present *any evidence whatsoever*, which as yet they haven't...

Re: Medline

[pfy.livejournal.com]

The drug companies in fact are heavily researching into related, patentable compounds

Interesting. Could you tell me which companies, or how you found this information? If you have proof of this, then it would be circumstantial evidence that the drug companies themselves think vitamin C is an effective treatment (or at least, that they aren't convinced it's ineffective).

Also, people are more likely to overlook flaws in research if it fits the result they want.

I'll agree with that.

What it would take to change my mind

If the trial you describe was randomised, placebo-controlled, double-blind, and large enough for significant results to be obtained, then I would definitely call it solid evidence one way or the other. If others then replicated the results, while addressing any flaws in the previous trial, then I'd be pretty much convinced. At the moment, vitamin C therapy for cancer is so controversial that nobody can afford to be less than utterly meticulous in their research if they want to be taken seriously by their opponents (after all, people have been arguing about this for decades now). At the moment I don't know of any such trials, but if you know of any, then I'd be grateful for references or pointers.

[andrewhickey.livejournal.com]

I apologise for coming off too strongly there - both comments were written after a lack of sleep. As far as other resources, Google Scholar is the best one I know of, in that they do index far more journals than Medline. The real problem is that there's no central site doing something akin to what Medline claims to do but with transparency - Google Scholar makes no distinction as to the reputability of the journals in question, while Medline claims to but uses arbitrary (and, to my mind, frankly bizarre) criteria. Your best bet is to combine the two and then try to find others as well...

Again, I do apologise for the harsh tone of my comments, but I've seen allegations of quackery thrown at far too many people I know personally to have done valuable work...

[pfy.livejournal.com]

Firstly, apologies for taking a while to respond - I've not had much chance to get to a computer in the last couple of days.

or are you just slandering working scientists (who have actually, you know, done actual research into the subjects in question) without reading their work?

You're accusing me of slander based on what I've written above? Come on. Do you have any idea how ridiculous that makes you look?

I've read some papers on supplements, yes, mainly ones related to my own personal medical problems. I have not said that all supplements are snake-oil or that all researchers and vendors in the field are charlatans, as you seem to be implying. In fact, I have explicitly said the exact opposite. But there most certainly are people out there who are making untestable, vague claims (up to and including "improves ALL major body system functions"!) simply in order to sell supplements to people. That is why I said that people should review the evidence for themselves.

If Medline refuse to index the journals that present any evidence for supplements working, then if you check Medline you *cannot* see any evidence for them, only evidence against.

When I was considering taking a particular supplement, an article search on Medline found me papers that presented evidence it could be useful (far from flawless evidence, admittedly, but enough to make me think "OK, I'll give this a try"). So I can say with certainty that Medline does index journals that publish articles that present evidence for supplements working.

Your dislike of Medline appears to stem from the fact that they don't index the Journal of Orthomolecular Medicine and (in your words) "refuse even to explain why". Am I right in thinking that the JOM is not a peer-reviewed (http://en.wikipedia.org/wiki/Peer_review) journal (their website isn't explicit on the matter, but implies that it isn't)? If so, then according to the Journal Selection for Medline (http://www.nlm.nih.gov/pubs/factsheets/jsel.html) factsheet, that is probably why it's not indexed. Of course, this doesn't explain why they index Reader's Digest, so I've written to ask them that and will post any reply I get. But, if you don't want to use Medline for whatever reason, there are other journal search engines out there.

And incidentally, you seem to be misusing the word 'irony'.

No, I don't believe so. But, it being irony, you do have to have a particular viewpoint to see it as ironic.

BTW my apologies if any of this post comes off as rude

I spent my early years on the Internet in some of the kookier corners of Usenet, so let's just say I've seen worse ;-)

[andrewhickey.livejournal.com]

My apologies if I went over the top - neither comment was written when I was properly awake (I've been working three jobs recently, so I'm not entirely coherent some of the time).
I don't actually know if the JOM is peer-reviewed, having never submitted to it (you're right - the website seems ambiguous on this point). However, Medline does index many non-peer-reviewed journals, while there are several peer-reviewed journals that deal with orthomolecular medicine which are not indexed. If you look, peer review is merely one of the things they 'may' consider. JOM is far from the only worthy journal that is ignored with no reason given, it's merely the one that a group of people are choosing to use to highlight a more general problem.

[pfy.livejournal.com]

I mentioned peer review because it sounds as though that feature is given particular weight, although I don't doubt that it's possible to get a non-peer-reviewed journal indexed if they consider it particularly worthy in some other respect.

The website says over three-quarters of titles get rejected (http://www.nlm.nih.gov/pubs/factsheets/j_sel_faq.html), so it seems that they're pretty ruthless. As far as I can tell, all the articles are all indexed manually, which could well explain why only a minority of journals are accepted for indexing. I do agree that it would be good to have more transparency in the review process, though, even if it was no more than a one-line reason for rejection/acceptance.