L20: "Cures for Sale" - Reality Vs Distortion

Question 1

What is a wart? Is it common?

Answer 1

• Caused by a virus
• Many people experience warts in their lifetime
• It is not life threatening but it is bothersome

Question 2

What are some traditional wart remedies? Why were they believed to be true?

Answer 2

• Rub with: miracle flowers, radish, raw potato and bury in clay
• Use dandelion flower milk
• Put an equal number of stones in a bag and bury it
  These were believed because in reality, 80% of warts will disappear on their own in less than 2 years due to your immune system.

Question 3

What is evidence based/conventional medicine?

Answer 3

• What is taught in school
• Does this drug work?
• What are the side effects?
  There is no such thing as a perfect drug: if the drug works, it alters your biology and thus will lead to side effects in some.
• Benefits outweigh side effects
• How does this drug compared to what is already available? Is there anything safer and better already available?
• Works better than a placebo
• Dpcumented

Question 4

What is “alternative medicine”?

Answer 4

• No reliable evidence that they work
• Based on hearsay or folklore
• Marketing techniques: testimonials, tradition, belief system, folklore
• <40% of products used are reported to physicians and many have risks associated to them
• Can have dangerous drug-drug interactions
• Anyone can call themselves a herbalist and sell it

Question 5

What must you know about a drug before you put it on the market? How is this determined?

Answer 5

• Very long and expensive process including many stages of research, including preclinical trials and clinical trials, that must be approved.
• Must know the mechanism of action of the drug, its pharmacokinetics, where it can be stored, its bioavailability, its acute and chronic toxicity, mutagenicity, if it is a teratogen.

Question 6

What are the 2 methods used in drug evaluation?

Answer 6

1. Double blind

2. Randomization

Question 7

What is a double blind?

Answer 7

Neither the person giving the drug, nor the person receiving the drug, know if they are given the placebo or the active drug so that there is no psychological influence.

Question 8

What is randomization?

Answer 8

Random distribution of placebo and active drug so that one group isn’t in greater health than the other.

Question 9

What is a placebo?

Answer 9

Placebo means “I will please”
A sugar pill.
For a drug to be approved on the market it needs to have demonstrated significant superiority to the placebo.

Question 10

Are placebo’s effective? What can influence this?

Answer 10

• Influence: Relationship to caregivers, ritual of taking medicine, and strength pf belief (the stronger we believe in the medicine, the greater the response)
• Effectiveness: around 35% will respond positively
• If you tell the subjects to watch out for side effects, about 15% will respond negatively: called “nocebo”

Question 11

What are cold sores/fever blisters caused by? How can they be treated?

Answer 11

Caused by herpes simplex virus.

Treated by an antiviral drug that interferes with the replication of the virus without affecting human cells.

Question 12

What’s the difference between pharmaceutical companies and natural remedies?

Answer 12

Pharma companies need to invest huge amounts of money to develop new products, the majority of which do not reach the market.
But anyone can sell natural remedies without proving anything.

Question 13

Where do most natural remedies come from? What effect can this have?

Answer 13

They come from plants. Most plants are toxic.

Question 14

What is Homeopathy?

Answer 14

A belief system of “like counteracts like” which means that we can fight a disease by giving something else that creates the same symptoms of said disease.

Question 15

Did the original Homeopathy theory work?

Answer 15

No, it resulted in making the situations worse.

Question 16

How did they modify the Homeopathy idea?

Answer 16

Potentisation: making something potent by diluting it.

• They believed that the properties of the drug would remain even after the drug was gone.
• Believed that vigorous shaking between the dilutions would “potentize” the water.
• Belief that the water retains a “memory” and can act “spiritually”

Question 17

What are the steps of potentisation?

Answer 17

1. Start with the initial compound (mother tincture) and sequentially dilute it 1:100
2. Succussion: bang the vial between each dilution
3. Repeat 30 times
   - In doing so, you transfer the “magical compound” from the original compound into the water molecules, spiritualize/potentize the water.
   - Final concentration 1/10^60 = basically just water, nothing left.

Question 18

What makes people buy homeopathic remedies?

Answer 18

• There are “journals” and “academies” which back up homeopathy to make it sound legitimate
• Practitioners give patients a lot of attention and care before recommending the products to influence the patients
• Easy to purchase: drug store & internet
• Remember, the placebo affect of these drugs can be very strong if you feel as though someone really cares for you. Psychological benefit.

Question 19

Are homeopathic drugs a “harmless placebo”?

Answer 19

No.

• It’s unethical to say that something can cure something else when there is no evidence
• If people actually do need treatment, taking homeopathic remedies delays the time it takes for them to go to a real doctor which may worsen their situation.

Question 20

What is “snake oil” believed to do as a homeopathic remedy?

Answer 20

Snake oil, which is actually just oregano oil, is sold as an antibiotic.
Other variations of snake oil are claimed to replace vaccines against whooping cough.

Question 21

What is a homeopathic nosode?

Answer 21

• Sugar pills

- Claims: immunize against influenza, whopping cough, measles, diphtheria, and polio. Better than vaccination.

Question 22

Do dietary supplements cure Hepatitis C?

Answer 22

No

Question 23

What is wrong with herbal remedies?

Answer 23

• They are plant based which means we are taking in chemicals from plant extracts which may have side effects.
• Plants have thousands of chemicals, some of which are toxic, which can make us sick.
• Herbal poisoning is a big concern (can lead to liver failure)
• Plants take in chemicals from the soil, so plant chemical composition is different depending on which field it is from.

Question 24

What are the prime targets for herbal remedies?

Answer 24

1. Conditions that resolve on their own (colds, aches, and pains, etc.)
2. Conditions with a high psychological component (ex: mild anxiety, insomnia) because these respond well to placebos
3. Chronic conditions that naturally cycle (ex: gastrointestinal conditions, allergies, chronic types of arthritis)
4. Attempts to improve appearance, reverse aging, etc (ex: cosmetics)
5. “Cure” a terminal illness (ex: heart failure, cancer, etc.)

Question 25

What is Ginkgo Biloba?

Answer 25

A herbal remedy marketed as a cure for cataracts and for erectile dysfunction.

Question 26

What is Shen min?

Answer 26

A herbal remedy marketed to treat alopecia, hair loss, and baldness.

Question 27

What are HGH supplements?

Answer 27

Claims to help you lose weight without exercise, recovers hair color, strengthens immune system, etc.

Question 28

What is snake-oil? What is today’s version?

Answer 28

• Snake-oil comes from the fact that door-to-door salesmen used to sell snake oil as a “cure all” (headaches, whooping cough, tuberculosis, etc)
• Modern version is oregano-oil which is marketed as an antibiotic to cure bacterial and fungal infections, parasites, viruses, inflammation, etc.

Question 29

What is a herbal remedy that claims to make PMS symptoms disappear?

Answer 29

Chasteberries

Question 30

What is “Vaegra”?

Answer 30

A herbal remedy for erectile dysfunction that doesn’t work because it doesn’t have Viagra in it. They called it Vaegra because it sounds like Viagra so people would buy it.

Question 31

What are Actra-Rx and Yilishen?

Answer 31

They are Herbal Remedies sold on websites as dietary supplements for treating erectile dysfunction and enhancing sexual performance for men. Illegally contain prescription-strength quantities of sildenafil (Viagra). Viagra needs to be monitored. Potential serious drug interactions.

Question 32

Do herbal cosmetics work?

Answer 32

No

Question 33

What is Yohimbine?

Answer 33

Herbal Remedy sold for body building, male sexual performance, and impotence. It contains an active drug that is an alpha 2 blocker in the periphery and the CNS. It can cause seizures and paralysis.

Question 34

What do Vitamin E supplements do?

Answer 34

Increase the risk of prostate cancer.

Question 35

What is Peelu all-natural toothpaste?

Answer 35

Packaged like Colgate or other brands but doesn’t contain any pf the active ingredients. Leads to cavities.

Question 36

What is Leritone?

Answer 36

It’s supposed to increase memory and make you smarter. The main ingredient is cerebral phospholipids (WHICH IS ACTUALLY GROUND UP COW BRAIN).

Question 37

What are the hazards of taking herbal remedies?

Answer 37

• You don’t know what you are getting “herbal roulette”
• No quality control (no relationship with what is written on the bottle and what is actually inside. Manufacturing conditions are not monitored).
• Ineffective

Question 38

What is Echinacea? How is it advertised?

Answer 38

It is an herbal remedy sold as an antibiotic. It is not an antibiotic.
It is advertised as “The King pf Blood Purifiers” for treating acne, boils, and difficult skin conditions. It is also advertised to stimulate the immune system to ward off any winter ailments.
In reality, it is an equivalent to a placebo.

Question 39

What is Ephedra? What is another name for it? What is it claimed to treat?

Answer 39

Ephedra is a strong stimulant in the amphetamine family and it is also called “Ma Huang”.
Claims:
- Sold for weight loss (to correct obesity), asthma, increase athletic ability.
- Claims that weight gain is caused by a problem in your nervous system due to metabolic defects, and that concoctions of Ephedra, caffeine, and aspirin (ECA) can cure the problem with your nervous system.
- Claims that you only need to take the pill, and you don’t need to exercise or watch what you eat.
- Claims that scientists have known this for a long time but are hiding it from you to make money from prescription medicine.

Question 40

What are the side effects of taking Ephedra?

Answer 40

• Myocardial infarct

- Stroke

Question 41

What is Kava? What are the side effects?

Answer 41

Herbal remedy sold for stress, anxiety and insomnia.

Side effects: CNS effects, hallucinations, hepatotoxicity.

Question 42

What is the basis of Chinese traditional remedies? Give examples

Answer 42

It is a mixture of over 30 compounds using plants, animal products, sea creatures, and insects.
Poisoning may occur in a potpourri of substances.
Ex:
- Spiders used to prevent bed wetting in children
- White rhino horn sold as an aphrodisiac, sexual stimulant, and for impotence
- Different parts of the tiger cures different diseases

Question 43

Have Chinese traditional remedies proven to be useful?

Answer 43

Sometimes.
In China, they test individual compounds. If they’re useful they’re incorporated into conventional medicine when evidence is there, but big concoctions are not a good idea.

Question 44

What is a problem when combining herbal remedies and other drugs?

Answer 44

Drug-drug interactions. One of the problems is the affect on the CYP450 enzymes.

Question 45

What is St. John’s wort?

Answer 45

Was used to treat depression, has serious side effects such as photosensitivity, has drug interactions, and is potentially fatal.

Question 46

What are the negative drug-drug interactions?

Answer 46

• St John’s Wort increased CYP3A4 activity and decrease the levels of many drugs.
• Midazolam levels were affected because Midazolam (a benzodiazepine used as a sedative during minor surgeries) is metabolized by CYP3A4.
• Statins are also decreased, and statins are taken by people who have big risks of heart attacks, so now their risks of heart attacks are elevated due to st. John’s Wort.
• Interactions with anti-epileptic medicines (risk of seizures), oral contraceptives (risk of pregnancy), HIV protease inhibitor (go out of HIV remission), chemotherapy drug like Imatinib (now can die from acute myelogenous leukaemia), immunosuppressants like cyclosporine (can reject the transplant), etc.

Question 47

What is a garlic supplement? What is a negative effect?

Answer 47

It is concentrated garlic.
It causes the induction of CYP450s, so another drug you are taking will not be effective due to rapid metabolization, and you can bleed to death.