The Stephan trial and evidence-based healthcare

[troutman]

http://skepdic.com/vitacon.html

update: January 21, 2016. The supplement industry is largely self-regulated and many of its products don't contain the ingredients that their labels say they do. This may explain why the best scientific studies of supplements have found no health benefits and some harm from the daily use of supplements.

Several large studies have shown the futility of taking vitamin and mineral supplements on a daily basis as a hedge against some unspecified adverse health effects. Many people, however, consider daily supplements to be part of a healthy lifestyle. Some people may be overdoing it on some of the supplements, doing themselves harm instead of good.

Should everybody avoid supplements of any kind, then? Of course not. Some people have vitamin or mineral deficiencies and supplementation is necessary for them to maintain good health.

Below you will find links to articles about persons or practices relating to vitamins, minerals, or herbs. You'll also find excerpts from various items on these topics that I've blogged about. As a bonus, I mention people who make a living selling supplements at inflated prices and encouraging others to do the same with the promise that by doing so you will be on your way to riches beyond your imagination, eternal youth, increased spirituality, or something of the sort.

There are too many companies and products involved in this kind of chicanery to list them all by name. The following links should help you decide whether a particular outfit or product is trustworthy.

[CaptainCrunch]

Originally Posted by troutman

http://skepdic.com/vitacon.html

update: January 21, 2016. The supplement industry is largely self-regulated and many of its products don't contain the ingredients that their labels say they do. This may explain why the best scientific studies of supplements have found no health benefits and some harm from the daily use of supplements.

Several large studies have shown the futility of taking vitamin and mineral supplements on a daily basis as a hedge against some unspecified adverse health effects. Many people, however, consider daily supplements to be part of a healthy lifestyle. Some people may be overdoing it on some of the supplements, doing themselves harm instead of good.

Should everybody avoid supplements of any kind, then? Of course not. Some people have vitamin or mineral deficiencies and supplementation is necessary for them to maintain good health.

Below you will find links to articles about persons or practices relating to vitamins, minerals, or herbs. You'll also find excerpts from various items on these topics that I've blogged about. As a bonus, I mention people who make a living selling supplements at inflated prices and encouraging others to do the same with the promise that by doing so you will be on your way to riches beyond your imagination, eternal youth, increased spirituality, or something of the sort.

There are too many companies and products involved in this kind of chicanery to list them all by name. The following links should help you decide whether a particular outfit or product is trustworthy.

This is huge to me and thanks for posting it. I used to be a supplement monster, I was taking a whole bunch of them, but the more I researched the more I decided that I couldn't trust the labels and that's pretty dire.

There's no quality control, anyone can go out and open a store or sell this crap from their houses and say anything they want to sell them.

Like I said, I got really pissed when I looked at this couple's store ad and they were selling one medication that dealt with and cured bi-polar disorders, depression and anxiety. Three of the corner stones of real mental health stories that we read about every day.

I personally think that people see these ads where these supplements will cure their slow brain functions, or restore their perfect health, bring back massive boners and their hair line and at that point they just buy out of desperation.

This is an industry that really needs to be regulated and tested and professionalized.

Because right now with the way people can get in and sell them following a Tupperware party or Mary Kay business model is dangerous. there are too many people that listen to these quacks that took an online course as opposed to a medical professional. The worst is the holistic cancer industry that deems itself fit to siphon 10's of thousands of dollars from the desperate by selling the wrong kind of hope.



And we've seen more then one death occur because of it.

[troutman]

A friend roped me into trying Usana vitamins. I had a lingering cold at the time, and thought I would try them, knowing that they were probably useless.

She didn't disclose to me that it was MLM.

http://usanawatchdog.blogspot.ca/

[NuclearFart]

Originally Posted by Azure

My problem with 'doctor recommended' is that doctors can sometimes be a few years behind when it comes to certain things. Example, Vitamin D intake. Almost all research is showing that most people in Canada have a deficiency, and that supplementation of up to 4,000 IUs per day is needed in order to get optimal blood levels. My family doctor is still recommending nothing more than 1,000 IU per day.

Not that hard to go read some recent research and put what they taught you in med school on the back burner as things tend to change.

Did you actually read and critically assess some of the original papers and come to this conclusion, or are you just regurgitating what some biased website is telling you? I suspect it's the latter, and this is a prime example how all this holistic/alternative BS gets propagated.

In the absence of official consensus guidelines published by actual experts critically appraising the evidence, what you are proposing is NOT the standard of care. It has nothing to do with "being behind", but everything to do with being safe and efficacious based on what we know. At your proposed doses maybe you're right, maybe you're wrong, maybe it doesn't matter, maybe its a waste of your money, or maybe it's the next thalidomide.

[NuclearFart]

Originally Posted by CaptainCrunch

And we've seen more then one death occur because of it.

Steve Jobs should be the poster child of this.

[CaptainCrunch]

I remember when I was in Florida a couple of years back and I saw ad after ad after ad for these Holistic Cancer centers which don't rely on modern medicine but talk about curing, that's right curing your cancer through supplements and minerals and natural drugs.

And then you go onto these funding sites and there's posts after posts after posts of people raising funds to send family members to these centers.

As sad as it is, and I've seen it, until they come up with the magic bullet treatment to cancer on a genetic level, the treatment is god awful and soul wrenching for the person and their family, but still far in advance to what it even was in terms of 10 years ago. But at least if these people get proper treatment their survivability rate is way higher.

But selling people on untested therapies like laughter therapy and eating the latest earth worm extract and giving hope (which is fine) while not properly treating the cancer using modern properly tested and quality controlled medicine is criminal.

Its ok to give hope as long as you can back it up, but this stuff just seems like the ultimate con game.

[Azure]

Originally Posted by NuclearFart

Did you actually read and critically assess some of the original papers and come to this conclusion, or are you just regurgitating what some biased website is telling you? I suspect it's the latter, and this is a prime example how all this holistic/alternative BS gets propagated.

In the absence of official consensus guidelines published by actual experts critically appraising the evidence, what you are proposing is NOT the standard of care. It has nothing to do with "being behind", but everything to do with being safe and efficacious based on what we know. At your proposed doses maybe you're right, maybe you're wrong, maybe it doesn't matter, maybe its a waste of your money, or maybe it's the next thalidomide.

I'm not talking about any link I posted. I'm talking about GPs not being up to date in recent research.

Another example? Dietary cholesterol has zero to do with your cholesterol levels. Also, saturated fats aren't nearly as terrible as they were made out to be in the 90s by the low-fat parade.

[Azure]

Originally Posted by Hes

Right in your link it says "safe upper limit is 4000IU". That is not the recommended amount.

Skeptical raptor is a good site to weed out the noise from studies.

Science based medicine website better for you?

https://www.sciencebasedmedicine.org...not-to-screen/

Caveat : I take 1000IU / day in winter/fall.

Safe upper limit is still quite a bit more than what the RDA is in most places.

Which is my point. How long will it take for the RDA, which used to be what, 400 IU, will be updated based on more recent research?

[Knut]

^ most recommendations are 1000 IU from what I have seen / heard.

But this is a perfect example of people thinking they are smarter than doctors because they used some Google-Fu. In Alberta family doctors need 150 hours of continuing education every 3 years. They also do not just go with what the newest study says. You need multiple studies for things to change. Which makes a lot of sense from a patient safety perspective.

[Azure]

Originally Posted by rubecube

Not to mention the amount of actual vitamin D in over the counter supplements isn't actually verified.

That isn't fair.

In general, if you buy cheap supplements of any kind, Omega 3, protein powder, creatine, etc, etc....you usually get what you pay for. But there are companies and 3rd party sources doing lab tests on many supplements that the government is for whatever reason not choosing to test.

Like anything else, you have to actually do your research before you buy something.

[Azure]

Originally Posted by Hes

^ most recommendations are 1000 IU from what I have seen / heard.

But this is a perfect example of people thinking they are smarter than doctors because they used some Google-Fu. In Alberta family doctors need 150 hours of continuing education every 3 years. They also do not just go with what the newest study says. You need multiple studies for things to change. Which makes a lot of sense from a patient safety perspective.

Are they?

http://www.hc-sc.gc.ca/fn-an/nutriti...vita-d-eng.php

Says 600 IUs per day. Why is it taking so long for the government to update that even though most people tested are deficient? Especially in Canada.

Its not about thinking the general human is smarter. In this day and age we can quickly get access to peer reviewed research for just about anything, and people tend to use that to update what we know about many things before it becomes officially recognized by a governing body.

[Knut]

^ well the government recommendations are typically 2-3 years behind what reality is.

Here is a report sent to GPs from 2012. It recommends between 800 - 2000 IU of vitamin D
http://www.topalbertadoctors.org/dow...October+31.pdf

[Azure]

Originally Posted by Hes

^ well the government recommendations are typically 2-3 years behind what reality is.

Here is a report sent to GPs from 2012. It recommends between 800 - 2000 IU of vitamin D
http://www.topalbertadoctors.org/dow...October+31.pdf

Well that is nice to see.

Of course the problem is that most people who are healthy don't go see their GP that often, and it is important to keep optimum vitamin D levels from you an early age to decrease the risk of the many things that vitamin D deficiency can cause.

Also, like the article mentions, blood tests for Vitamin D deficiency are usually not required so it might not even be something that is being talked about. I know I have to actually ask my GP to do a Vitamin D test to see where I stand.

See what my problem is though?

[Knut]

Not really. The current research on vitamin D supplementation is showing limited benefit to those at risk for bone density issues. More research is needed on other benefits.

It is recommended that infants and toddlers have 400IU per day of vitamin D. Formula's typically are vitamin D enriched and there a vitamin D drops for people breastfeeding.

Vitamin D testing is currently not recommended. It is an expensive test and an unnecessary burden on lab services.

[Azure]

Calling the test costly is interesting considering maintaining proper Vitamin D levels could alleviate a lot of health concerns down the road, and as such a lot of costs to the system.

Preventive medicine is extremely important and should be encouraged not discouraged.

[Knut]

Here is the issue plain and simple. Further testing needs to be done.

There is no consensus on the definition of vitamin D deficiency.
There is no consensus on optimal levels.
Testing methods are not standardized and results vary between laboratories.
There are no studies evaluating the direct benefit of screening.
There is adequate evidence that treatment of asymptomatic vitamin D deficiency has no benefit on cancer, diabetes, mortality, or even on fracture risk in persons not at high risk of fracture.
There is inadequate evidence on the benefit for other outcomes including psychosocial and physical functioning.
Although the evidence is adequate for a few limited outcomes, the overall evidence on the early treatment of asymptomatic, screen-detected vitamin D deficiency to improve health outcomes is inadequate.
There are no studies evaluating the direct harms of screening.
There is adequate evidence that the harms of treatment of vitamin D deficiency are small to none.

https://www.sciencebasedmedicine.org...not-to-screen/

[Knut]

Originally Posted by Azure

Calling the test costly is interesting considering maintaining proper Vitamin D levels could alleviate a lot of health concerns down the road, and as such a lot of costs to the system.

Preventive medicine is extremely important and should be encouraged not discouraged.

Yes. But the evidence is just not there to support that vitamin D deficiency is a big Health crisis

[corporatejay]

vitamin D is code for "dick", right?

[Azure]

Originally Posted by Hes

Yes. But the evidence is just not there to support that vitamin D deficiency is a big Health crisis

I'm not trying to say it is a big health crisis. I'm saying that proper supplementation levels are easy and cheap to obtain, and that they could possibly help with future health problems. There is research that suggest as much, and if it isn't conclusive enough, more needs to be done.

[AcGold]

So logically this is how I figure it; allow parents to have right to decide their childrens treatment up to a point. If the child is near terminally ill the government should be able to step in with the childs consent, if the child is physically unable to consent then the government can step in as well.

Can't step in if the parents and the child deny help. That way people maintain their freedom and we can learn from mistakes and the most stubborn of the masses will be lessons. So pneumonia isn't cured with herbs and smoothies, I figured, but good to know. If I have a kid I'll be sure to take them to a hospital. I don't see the need to remove all personal freedoms, maybe make it mandatory to report serious injuries or something. I don't know it just seems to be an over reaction the other way so often.