Do You Believe in Magic? Topol, Offit on Alternative Medicine

The Confusion Over Vitamin D

Dr. Topol: I'm with you. I know full well what you are alluding to there -- the delay. Now what about vitamin D? You were kind of positive about some indications for vitamin D. But there is a lot of confusion about what should be a population level of vitamin D that is good for people. Do you have any comments about that particular supplement?

Dr. Offit: Suddenly we are all vitamin D deficient, and the level has changed and now the normal range has been revised so that everybody seems to be vitamin D deficient. Certainly, vitamin D is of value for the child who is exclusively breastfed. The mother doesn't get outside very much. The child doesn't get outside very much. Absolutely, vitamin D is of value there. Otherwise, regarding bone thinning -- the use of vitamin D plus calcium -- I think the data just aren't clear. They are certainly not compelling, and I think 10 years from now we are going to look back and ask, "What is this vitamin D craze?" and be past it.

Dr. Topol: You know, out here in California, my patients come in and they typically have a list of 20 or 30 supplements and vitamins that they're taking. Some of it I have never heard of -- just ridiculous stuff. But invariably, they are taking high doses of vitamin D, and typically they're taking vitamin E, which as you point out is harmful. So it is pretty scary what goes on out there.

Chelation Therapy for Coronary Disease

Dr. Topol: Now another trial that is new since the book came out is the chelation trial for coronary heart disease, and a lot of us felt that it was kind of crazy to put National Institutes of Health (NIH) money, big money, into a chelation trial. But that was reported in JAMA, and it created quite a stir a few months back. What are your views about chelation for prevention of coronary disease?

Dr. Offit: I think there are no data to support its use. I think it is clear that certainly chelation can be harmful. I mean, the Centers for Disease Control's (CDC's) Morbidity and Mortality Weekly Report^[2] has reported a handful of children and adults who have died owing to chelation therapy because chelation therapy can chelate calcium, which is important for electroconductivity of the heart, and there have been heart attacks from this therapy. And certainly children with autism who have been treated with chelation therapy have died because of chelation therapy.

So if you look at that chelation trial -- which surprisingly was published in JAMA, given the inferior quality of that study -- it really didn't isolate the one variable they meant to look at: chelation. There were a number of variables in that study, and I think as a consequence it was a useless study. It was a lot of money that was wasted. I think that the consumer should say that at this point and for right now, there are no data to support the use of chelation and there are no clear benefits, although there certainly are clear risks. I would argue that the risks outweigh what are at best theoretical benefits.

Dr. Topol: As you pointed out, there were a lot of other things in the chelation mix that were administered to study participants. And they had a lot of issues with that trial.

Cite this: Eric J. Topol, Paul A. Offit. Do You Believe in Magic? Topol, Offit on Alternative Medicine - Medscape - Oct 02, 2013.

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