Natural Irony

Natural Irony

If it is natural it must be safe and effective. A common enough belief, even though most of us if left alone in nature would not survive a week. 

The naturalistic fallacy is closely related to the fallacious appeal to nature, the claim that what is natural is inherently good or right, and that what is unnatural is inherently bad or wrong.

The naturalistic fallacy is probably more common in users of alternative medicine, but I can't find the proof. I went looking at  all the surveys of alternative medicine use that proliferate like mushrooms after a rain, I could find none that correlated use of pseudo-medicines and various cognitive biases such as the naturalistic fallacy. It is a study waiting to be done.  I prefer the adage that for humans there is nothing unnatural, just untried.

But when it comes to herbs and supplements, people sure like to try.

A study was recently published on the use of St. Johns Wort: Use of St. John's Wort in Potentially Dangerous Combinations.

The results are scary:

SJW was mentioned in 2,230,000 visits (120,000 visits/year). On average, visits mentioning SJW had 3.1 other drugs mentioned. Of the visits at which SJW was listed, 28% (620,000 visits over the 18-year study period) also listed a drug that is unsafe to use with SJW. Leading medications that could interact with SJW and that were listed at SJW visits included SSRIs (13.7%), benzodiazepines (9.8%), warfarin (4.2%), statins (3.3%), verapamil (1.0%), digoxin (1.0%), and oral contraceptives (0.6%, Table 1).

These drug-drug interactions can cause important complications such as serotonin syndrome, bleeding and pregnancy.

One of the authors suggested that part of the solution to the problem would be labeling:

Labeling requirements for helpful supplements such as St. John’s wort need to provide appropriate cautions and risk information.

As if what is on the label represents what is in the bottle:

Two bottles labeled as St. John’s wort, which studies have shown may treat mild depression, contained none of the medicinal herb. Instead, the pills in one bottle were made of nothing but rice, and another bottle contained only Alexandrian senna, an Egyptian yellow shrub that is a powerful laxative...Of 44 herbal supplements tested, one-third showed outright substitution, meaning there was no trace of the plant advertised on the bottle — only another plant in its place.

What is needed is not labeling, but treating herbs and supplements with the same standards we apply to food and drugs.

Who would have thought that the incompetency and fraud in herbs and supplements could actually be protecting patients. 

Ironic.

Points of Interest 7/1/2104
Points of Interest 06/30/2014