Daily Dispatch - The power of "placebo"

From: Marc Micozzi, MD
Date Mon, Mar 18, 2013 Daily Dispatch - The power of "placebo"

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The power of "placebo"
Dear Reader, Harvard researchers conducted a study about 10 years ago that may have you questioning St. John's wort (SJW). This herb is one of the best, proven ways to combat mild to moderate depression. And it's natural. But the Harvard study concluded that SJW isn't any more effective than a placebo for treating depression. Of course, everyone believed the study. It was Harvard, after all. And they don't mess up studies. Or do they? The truth is, even Harvard researchers can get it wrong. In fact, this study shows all that can go wrong when a high-powered mainstream medical research team conducts research on traditional, natural therapies that they do not understand. There were so many ethical, scientific and theoretical problems with the Harvard research that I use it as a case study to teach my medical students at Georgetown and Penn. You can also find all the details in Chapter 2 of my textbook, "Fundamentals of Complementary & Alternative Medicine," now going into its 5th edition. Everyone heard about this Harvard study. But the mainstream press missed several key details. First off, the study didn't just compare SJW with a placebo for depression. The study actually compared three treatments: a popular SSRI antidepressant drug, SJW, and a placebo. And, yes, the results showed that SJW did not appear effective for depression compared to the placebo. However, you probably didn't hear this key point about the study... The SSRI also did not appear effective for depression compared to the placebo. And it wouldn't have taken much for an SSRI to be considered effective. According to the FDA, if a drug shows just a 20 percent improvement over the placebo, that's good enough. But the SSRI didn't even do that. And there's a reason why: The placebo group wasn't a true placebo group. For this study, Harvard researchers couldn't just give the placebo group a sugar pill and send them on their unhappy way. It would be unethical. And similar to how they treated depression in the 19th century. Back then, they threw the mentally ill in a cell and fed them bread and water. But this is the 21st century! Even Harvard has its standards. So everyone in the study--participants in all three treatment groups--received 16 hours of intensive therapy from a highly trained Harvard mental health professional. And then they took an SSRI, SJW or a placebo. And the results showed that participants in all three groups experienced a small boost in mood. But the SSRI and SJW groups simply didn't experience greater improvements than the placebo group. But that's because the intensive talk therapy was the key factor. It was so effective, it washed out the effects of any pill. So what this Harvard study really proved is that personal interaction with a human being in a therapeutic context is so effective that it washes out the effects of any pill-- whether an SSRI or SJW. Surprised? You shouldn't be. Here's a lesson we can learn from this flawed study...
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In an era of modern drugs and modern medicine, we should not forget the value of old-fashioned behavioral and talk therapies. To be sure, we've come a long way in treating mental illness. During the 18th and 19th centuries, the mentally ill were treated like criminals. Or worse. They were confined, incarcerated and abused. But before that--during ancient times and the Middle Ages--the mentally ill or mentally deficient were usually given some kind of role in the community. Either tolerated as the "village idiot." Or sent out to tend sheep in the pastures and the mountainsides. This practice is still common among some traditional peoples of the Mediterranean, for example. Without meaning to offend modern sensibilities, the "village idiot" was a very well known figure in earlier times. In the 16th century, Shakespeare used the term in his famous quote: "like a tale told by the village idiot; full of sound and fury, yet signifying nothing." This in turn gave William Faulkner the words for his 20th-century masterpiece, "The Sound and the Fury" about mentally disturbed people in the South. Moral reformers took notice of the mentally ill in the 19th century. Their treatment for mental illness was simply known as "moral therapy." This treatment resembles what the ancients knew about keeping the mentally ill within the community. The reformers of the 19th century also placed the mentally ill within the community. In boarding homes or rooming houses. Living within the community, the mentally ill experienced the "normal" behaviors and practices of people going about their daily lives. They weren't confined to "looney bins." They didn't see just other "crazy" behavior--and the doctors and nurses who ministered to it. Instead, they developed a fund of normative experiences. And they were reinforced for sane behavior. And they were consistently discouraged against inappropriate behaviors. This is very much what behavioral therapists talked about in the 20th century. They reinforced the desired behaviors. And discouraged the inappropriate behaviors. Too bad in the 21st century, these behavioral therapy approaches appear to be few and far between. In the meantime, if you suffer from mild to moderate depression, don't overlook St. John's wort. And don't base your opinion about SJW on this flawed Harvard study, in any case. It may take a few weeks before you feel a boost from SJW, but this is true of SSRIs as well. And SSRIs are far more dangerous, as I've discussed in recent Daily Dispatches and in the upcoming April Insiders' Cures newsletter. And you may want to consider finding a good behavioral therapist. There are even some great ones at Harvard. Always on the side of science, Marc S. Micozzi, M.D., Ph.D. Source: 1. JAMA. 2002 Apr 10;287(14):1807-14.
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The material provided on this site is for educational purposes only and any recommendations are not intended to replace the advice of your physician. You are encouraged to seek advice from a competent medical professional regarding the applicability of any recommendations with regard to your symptoms or condition. Copyright (c)2013 by OmniVista Health Media. Thank you for your interest in the Dr. Micozzi's Insiders' Cures. We do not allow republication of our full newsletters and articles. However, you can post a portion (no more than 90 words, 1-2 paragraphs) of our content with a live link back to our homepage, drmicozzi.com, or a link to the specific article you are quoting from. Please note: We sent this e-mail to: jorgeus.george@gmail.com because you subscribed to this service. Manage your subscription: To end your Daily Dispatch subscription, visit: Unsubscribe here To manage your subscription by mail or for any other subscription issues, write us at: Order Processing Center Attn: Customer Service P.O. Box 925 Frederick, MD 21705 USA

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Daily Dispatch - Toxic chemicals--unsafe at any dose

Chemical disrupters, obesinogens coming from:   canned foods, food packaging, plastics, agricultural chemicals, foam, and jet fuels are cause of obesity (and diabetes)?  in USA

From: Marc Micozzi, MD <drmarcmicozzi@drmicozzi.com>
Date: Mon, Feb 25, 2013 at 9:45 PM

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Toxic chemicals--unsafe at any dose
Dear Reader, It's politically correct to say a diet high in fat and calories "should" lead to obesity and diabetes. But is it true? Many scientific studies do not demonstrate this cause-and-effect- relationship. This includes my own Ph.D. dissertation research conducted at the National Institutes of Health (NIH) almost 30 years ago. In fact, your chances of becoming obese and developing a chronic disease later in life may have more to do with what you ate as a child than what you eat now. It may even depend on your exposure in childhood to certain chemicals that "turn on" fat cells that remain later in life. The questions began in 1977. Mrs. Ray Kroc--wife of the founder of McDonald's--wanted to find out what causes obesity, diabetes, and other modern ills, which have since become an epidemic. I know. It's ironic given the popularity of McDonald's among many overweight men and women in this country. But Mrs. Kroc had the courage to be interested in separating truth from fiction. Mrs. Kroc was not afraid of learning the truth. And she was quite willing to pay to find out. Back in those days, generous private citizens still funded a lot of medical research. So, in the hopes of finding some answers, Mrs. Kroc offered to fund my research project. As I told her back then, it is very difficult to perform "cause-effect" type research. We generally have to rely on statistical studies. These studies are good at proving "associations." But it's harder to prove the specific cause--or causes--of diseases. I did begin to research chronic diseases, however, in the 1980s at NIH. And my research strongly suggests the importance of nutrition during childhood. I found that diet, nutrition and body composition during childhood are more relevant at casting the die for long-term health consequences. In particular, breastfeeding is critically important. It appears to help stave off chronic disease later in life. And it appears to help the breastfeeding mother avoid breast cancer as well. On the other hand, poor diet and overeating as a child, seems to put people "on track" to develop chronic diseases later in life. This research led to my Ph.D. dissertation at University of Pennsylvania. I published my findings in medical and human biology journals. But sadly, this avenue of thought didn't gain much traction after I left NIH. Fortunately, the research does continue elsewhere...
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Years ago, lab scientists developed a strain of mice that, like many humans, are susceptible to obesity and diabetes. Today these mice tell us more about what truly underlies these problems than most statistical studies. Recently, scientists from University of California, Irvine studied the effects of certain toxic chemicals on mice. For this study, UC Irvine researchers divided genetically identical mice into two groups. Both groups received the same diet. And they exercised the same amount. In fact, the two groups were identical in every way but one... Researchers exposed one group of mice at birth to a vanishingly small amount of a hormone-disrupting chemical. Any guesses what happened next? The mice in the group exposed to the chemical grew up and became obese. And the mice in the other group did not. And, remember, this was just one exposure. At only one-part-per-billion. Yet it had lifelong consequences. Originally, scientists worried about these chemicals because they appear to cause cancer and sexual malformations. New research shows they also influence the formation of fat. You see, these endocrine disrupters belong to a class of chemicals that mimic hormones. And, therefore, they confuse the body. They also can lead to the formation of more and larger fat cells. That's why scientist Bruce Blumberg, a professor at UC Irvine, calls them "obesogens." And they go largely unregulated by the FDA. In fact, you'll find obesogens in canned foods, food packaging, plastics, agricultural chemicals, foam, and jet fuels. Another recent study led by Blumberg showed the long-lasting effects of obesogen exposure. It found that problems caused by obesogens pass down to descendants of exposed laboratory mice, generation after generation. Another study showed that women with pesticide residues in their blood bore babies who were already overweight at 14 months. Scientists don't know for sure if obesogen exposure past puberty has any effect on obesity. As my earlier Ph.D. research suggests, the damage probably occurs much earlier. As I discovered in the 1980s, important health exposures occur in the womb, during childhood, and before puberty. So, what is the medical profession doing about this?
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A recent survey cited by Scientific American magazine found only 19 percent of doctors warned pregnant women about pesticide exposure. Only eight percent of doctors warned expectant mothers about the chemical BPA in plastics and papers. And only five percent talked about phthalates in cosmetics and shampoos. And what's the government doing? The federal government hasn't changed federal chemical laws since 1976. Senator Frank Lautenberg from New Jersey wrote the "Safe Chemicals Act." And he has put it in front of Congress every year since 2005, but he is not running for office again. The law would require stringent safety testing of the toxic chemicals that surround us. This might also give the FDA more to do than just persecute dietary supplements. The government already mandates that supplements must be "pure" and free of contaminants in the U.S. Apparently, it has no problem with toxins in food packaging, however! Unfortunately, the Safe Chemicals Act has long been stalled in the "do-nothing" Congress. Instead of focusing on toxic chemicals in our food and consumer products, the government wages a quasi-scientific war against tobacco, fuel additives, and affordable energy sources. So, what can you do? Read the labels of consumer products and stay away from these chemicals. Above all, keep your children away from them. Some chemicals to put on your do-not-touch list include: tributyltin, bisphenol A, diethylhexylphthalate, and perfluorooctanoate. Also, eat organic foods whenever possible. These do not use pesticides. Avoid storing food or water in plastics. Choose stainless steel or glass instead. Lastly, some of the legitimate detox regimens can help remove toxins that accumulate in body tissues, especially fat tissue. You can find more information about these regimens in the February 2013 issue of my Insiders' Cures newsletter. If you haven't become a subscriber yet, you can get started here. Always on the side of science, Marc S. Micozzi, M.D., Ph.D. Sources: 1. http://www.uci.edu/features/2009/10/feature_obesogens_091019.php 2. http://mend.endojournals.org/content/23/8/1127.abstract 3. Molecular Endocrinology August 1, 2009 vol. 23 no. 8 1127-1134 4. Harley KG, Aguilar Schall R, Chevrier J, Tyler K, Aguirre H, Bradman A, Holland NT, Lustig RH, Calafat AM, Eskenazi B. Environ Health Perspect (): .doi:10.1289/ehp.1205548 5. http://www.scientificamerican.com/article.cfm?id=toxins-all-around-us 6. http://articles.chicagotribune.com/2012-07-25/news/ct-nw-chemical-law-20120726_1_american-chemistry-council-senate-committee-chemical-companies
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The material provided on this site is for educational purposes only and any recommendations are not intended to replace the advice of your physician. You are encouraged to seek advice from a competent medical professional regarding the applicability of any recommendations with regard to your symptoms or condition. Copyright (c)2012 by OmniVista Health Media. Thank you for your interest in the Dr. Micozzi's Insiders' Cures. We do not allow republication of our full newsletters and articles. However, you can post a portion (no more than 90 words, 1-2 paragraphs) of our content with a live link back to our homepage, drmicozzi.com, or a link to the specific article you are quoting from.

Daily Dispatch - Hands off the hand sanitizer (triclosan in it)

---------- Forwarded message ----------
From: Marc Micozzi, MD <drmarcmicozzi@drmicozzi.com>
Date: Thu, Dec 20, 2012 at 9:45 PM
Subject: Daily Dispatch - Hands off the hand sanitizer

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Hands off the hand sanitizer
Dear Reader, The cure is worse than the disease. Historians attribute the Renaissance scientist and statesman Sir Francis Bacon with that apt quote. And it certainly describes modern medicine's treatment of the flu and other common viruses. To combat what was once considered a minor annoyance, modern doctors hand out flu vaccines and drugs like lollipops. Over-anxious mothers squirt antibacterial gel on their toddlers' hands after every play date and story time. But all these tactics to control flu may be fruitless...and even dangerous. The flu vaccine and antiviral drugs are being uncovered as ineffective for key populations and fraught with side effects for many. Plus, in a new study, Norwegian scientists found a strong link between triclosan-the agent found in hand sanitizer that I discussed in more detail in the November issue of Insiders' Cures-and the development of allergies in children. But let me get back to Sir Francis for just a moment... Sir Francis Bacon (1561-1621), the First Viscount St. Alban, was a British natural scientist and philosopher. He also served as Attorney General and Lord Chancellor of England. A true Renaissance man. In Bacon's time, people worried more about infections such as the Black Death or the Plague than they did about a minor case of the sniffles. And even in the 20th century, the flu (with the exception of the pandemic of 1918-19) was mostly just an annual inconvenience that resulted in a few lost days of work or school. It went away as quickly as it arrived. In the 21st century, however, the academic-government-industrial-medical behemoth has grown faster than the virus itself. With a new industry to "control" the flu. Plus, legions of tax-supported science bureaucrats dole out misinformation to the public. They make it sound like it's your civic duty to get a flu shot. So now we have something else to combat, in addition to the flu. And it's even more ferocious-and voracious. But those who have studied the immune system find that some exposure to certain viruses and bacteria actually can help. It keeps the immune system strong, balanced and "in tune."
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Plus, the normal infectious diseases of childhood such as chicken pox (which now have been largely eradicated) were thought to actually contribute to the development of a healthy immune system in children. However, increasing evidence suggests that younger generations have weakened immune systems. Today, kids drink cow's milk, eat processed foods, and skip the normal diseases of childhood. Together, these changes can wreak havoc on their natural immunity. And adding to the problem of disordered immunity in children comes a new concern. The new research from Norway I mentioned above shows that exposure to the popular "anti-bacterial" agent triclosan sensitizes children with asthma to inhaled and seasonal allergies. It also increases their susceptibility to rhinitis. Triclosan is a toxin. That fact cannot be disputed. Yet you'll now find triclosan in toothpaste, mouthwash (which is toxic to the microbiome even without triclosan), deodorant (which may contain other toxicities), soap, sportswear, toys, and plastic kitchenware. You'll also find it in the ubiquitous hand sanitizer gels labeled as "anti-bacterial." Bacon also said that, "knowledge is power." I try to empower you to make informed decisions about your health both in my Insiders' Curesnewsletter and here in the Daily Dispatch. Hopefully, you now know enough to skip the hand sanitizer and use good old regular soap and water to wash your hands (and your face too). And if you happen to get the flu, drink plenty of fluids and get some rest. Always on the side of science, Marc S. Micozzi, M.D., Ph.D. Sources: "Triclosan exposure and allergic sensitization in Norwegian children." Allergy 2013; 68(1):84-91.
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The material provided on this site is for educational purposes only and any recommendations are not intended to replace the advice of your physician. You are encouraged to seek advice from a competent medical professional regarding the applicability of any recommendations with regard to your symptoms or condition. Copyright (c)2012 by OmniVista Health Media. Thank you for your interest in the Dr. Micozzi's Insiders' Cures. We do not allow republication of our full newsletters and articles. However, you can post a portion (no more than 90 words, 1-2 paragraphs) of our content with a live link back to our homepage, drmicozzi.com, or a link to the specific article you are quoting from. Please note: We sent this e-mail to: jorgeus.george@gmail.com because you subscribed to this service. Manage your subscription: To end your Daily Dispatch subscription, visit: Unsubscribe here To manage your subscription by mail or for any other subscription issues, write us at: Order Processing Center Attn: Customer Service P.O. Box 925 Frederick, MD 21705 USA

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