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

Dangerous Side Effects of Little Consequence

Dr. Topol: But Paul, what I don't understand is that you have got large randomized trials published in the highest-impact, most highly regarded journals that take down, like you said, vitamin E, beta-carotene, and vitamin A for various things -- and yet no information goes to the public. There is no oversight. How is this going to get fixed? This is really a very sorry state, don't you think? And you just reviewed another poignant example.

Dr. Offit: You know this better than anybody. I mean, when Vioxx (rofecoxib) was eventually clearly shown to increase one's risk for heart attacks, you knew it. The FDA regulated Vioxx. They put out media releases, and ultimately that product was taken off the market.

Here, because the FDA really doesn't have oversight, they are really only in a reactive mode. When will they get to the point where they take vitamins off the market because they have clearly been shown to be a problem? I don't see it happening until the FDA regulates them, and until the consumer gets smarter and says, "I want to know what I am buying. I want to know whether or not these claims are real or whether there are harms that are in this product. I insist that the industry be regulated."

But that is not how people think about these products. They think about this as their medicine -- their specific, own personal medicine. I can walk into the GNC store and shrink my prostate and reduce my stress and boost my immune system. I don't want the government telling me about this, even though what the government may tell you if they regulated it is that these aren't what they claim to be and the harms are not apparent, but they are there.

Dr. Topol: We are just laying out the facts-- the facts from rigorous research, which set this straight -- and that is the one thing I would have loved to have seen toward the end of your book: recommendations on how we can fix this mess that we are in. That's OK. There is a lot there.

There are a few other things I want to touch on with you. This is just great to have the chance to interact. Now let's talk about the Lyme disease stuff you write about. You called out former Attorney General Richard Blumenthal, who now is a senator of Connecticut, [about his actions on Lyme disease]. I don't know if you saw the New York Times editorial saying that he is introducing further legislation on this.^[6] Do you want to comment about how chronic Lyme disease is just kind of intermixed with this tough topic? You had a whole chapter on it.

Dr. Offit: Well, in a better world, obviously politicians wouldn't get involved in science. I think when Orrin Hatch gets involved, and as has former Rep Dan Burton (R, Indiana), we basically had champions of the alternative medicine industry. It should never be about that. It should always be about the data. Is the science there to support a claim? Is the science there to support safety? In a better world, that should be the only thing that we look at.

Blumenthal became very sympathetic, for whatever reason, for those who believe that, despite treatment for their Lyme disease -- or even in those who never had Lyme disease -- that these chronic symptoms were because of this so-called long-term Lyme or post-treatment Lyme disease, which we now know doesn't exist. I think he really did a lot of harm to those people. It certainly meant that there were a lot of people who received antibiotics far longer than they needed to and suffered the consequences of long-term antibiotic therapy, or worse, these crazy kinds of therapies that are associated with this made-up disease, chronic Lyme. I think this is probably an area that is unique in the alternative medicine world. Usually where alternative medicine thrives is where medicine has little to offer.

For example, we don't know the cause or causes of autism. Clearly, we don't have a clear treatment for autism. There are certain cancers, such as pancreatic cancer or brainstem glioblastomas, for which we have very little to offer. That is often where you will see the alternative therapist -- the charlatan, frankly -- step up and say, this is what your doctor doesn't want you to know, this is what the pharmaceutical companies don't want you to know, but we have a treatment.

What is unique about chronic Lyme disease is that they basically made up a disease: "You can have chronic Lyme even if you live in a state that doesn't have ticks that carry Lyme bacteria." So they sort of broadened their market and then used some of these therapies -- malaria therapy, for example -- and that was criminal.

Alternative Medicine and Celebrities

Dr. Topol: We have covered the politicians and the doctors. The last topic we didn't really touch on too much was the celebrities. You called out 2 major ones: Suzanne Somers and Jenny McCarthy. At one point, you even ask why the public is so into Suzanne Somers when there is a really good resource like Siddhartha Mukherjee, an oncologist, who wrote a wonderful book on cancer, The Emperor of All Maladies. Why can't the public have a go-to figure who is trustworthy and knowledgeable, rather than somebody who just invents facts and has an immense impact through media support? Why can't we get this thing straight?

Dr. Offit: I think we tend to trust celebrities and their message because we feel that we know them. Celebrities have been selling products since the beginning of time. Because you see them on the big screen or you see them on the little screen, that familiarly breeds a certain level of trust. We don't know scientists. Name a famous scientist in the past 10 years whom people would know by sight. I don't think we could name one, so that is it.

Siddhartha Mukherjee is a Rhodes Scholar. He trained at Cambridge and then Harvard. He has an expertise and experience in cancer. He wrote a Pulitzer Prize-winning book that really explained cancer for the general public, and yet he is not the person the media go to when they are trying to explain cancer; it is Suzanne Somers. And who is she? She was Chrissy on Three's Company. She was the promoter of the ThighMaster. That is what recommends her to this, and it is sad, but it has always been true. I don't see that changing.

Dr. Topol: And Jenny McCarthy now is going to be on The View and have undue influence. She has already hurt so many kids with the autism vaccine myth -- it's just endless. How are we going to take the reins on this problem? Is there any solution in sight?

Dr. Offit: I don't think The View was ever the Algonquin Round Table, but this is pretty bad even for them. It's a little depressing. I am going to predict that she actually doesn't say much. I think that the antivaccine movement, at least as represented by her, has really lost a lot of steam lately, and this may sound a little counterintuitive, but I think Andrew Wakefield really hurt them. It is not only that he was wrong; it is that he misrepresented data and was wrong, and I think a lot of people were put off by that.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.