Never again
Until the last week or so, I had been on a 7 year plus streak of undisturbed youthful middle age health. Not a sniffle, not a day when I didn't feel pretty good about the fact I was "never sick." My downfall started a couple of weeks ago, when I noted my wife purchased "Airborne" effervescent tablets, bearing that that smugly overconfident claim that the tablets boost one's immune system. The product is well-loved by millions, and its comfortable appeal is elevated by the fact it was invented by a second grade teacher. I pointed out to Sally that Airborne recently settled litigation related to advertising claims. From Airborne's Web site comes this "To our loyal customers" letter:
As you know, Airborne was invented by Victoria Knight-McDowell, a school teacher, as an immune booster. Since its creation, millions of satisfied customers have used Airborne to boost their immune systems too. We are so proud that we make a product embraced by so many.
As some of you may have heard, we reached a settlement related to advertising claims. We reached this settlement because we thought it was the best way to avoid protracted and costly litigation. There may be additional settlements related to advertising claims, but we are working to put these matters behind us.
What is really important though, is for you to be reassured that Airborne helps support your immune system—just like it always has. We hear from people every day that "swear by Airborne." Airborne's popularity has grown because of the incredible word-of-mouth recommendations made by so many satisfied customers .
But my anti-Airborne karma caught up with me. As soon as I started to cast doubt on the lovefest for Airborne, my own health has slid miserably while my wife is as healthy as ever. I have been in the midst of flu like symptoms for the past week. How wrong I was to take unperturbed good health for granted. When I return to full health, I might have to just check out those effervescent tablets...
Labels: FDA
posted by Tom Karst @ 5:19 AM
1 Comments:
Don't jump in the pool yet. Read on.
Deconstructing airborne: how to recognize medical nonsense
Mark Crislip
It is estimated that it takes a decade of medical training before anyone can truly be expert in a medical field. You probably do not have ten years to spend getting to know the ins and outs of medicine. How, then, to recognize if a medical product is legitimate, questionable, or just plain garbage? Airborne Effervescent Health Formula is a popular 'cold remedy' that by some accounts sells 100 million dollars a year of product. Using Airborne as an example, let's go through the warning signs that a product may not be worth your hard-earned money.
Warning Sign #1: The product is pitched directly to the media, not to the medical community. With prescription pharmaceuticals, you can quickly discover if the indication is backed by legitimate scientific studies: look them up in the Physicians Drug Reference (the PDR). Every drug indication in the PDR has been studied and approved by the FDA. Legitimate, effective, medications are backed by randomized, placebo-controlled clinical studies published in peer-reviewed medical journals where the results are published in the PDR.
Not so with the directly marketed products. Herbal supplements and vitamins are not required to have proven safety and efficacy against any disease or condition. As long as they have a disclaimer such as "These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease," they are legal to sell to the public. Read Airborne's disclaimer.
Warning Sign #2: The discoverer says that a powerful establishment is trying to suppress his or her work. It is often said that big pharmaceutical companies suppress data on the effectiveness of herbal preparations and will not perform studies because when clinical trials prove the efficacy of these supplements, people will use the cheap supplements instead of expensive pharmaceuticals. Unfortunately, many of these supplement companies are owned by big pharma, so they win either way. And, for $7.50 for ten tablets, Airborne isn't cheap.
Warning Sign #3: The health benefit involved is always at the very limit of detection. Airborne's website says: "Each ingredient in the Airborne formula has been repeatedly documented in published studies to contribute to a strong, healthy immune system." Only by a long stretch. Enter the ingredients of Airborne into Pubmed and search the medical literature. Be impressed with what you do not find.
"... Airborne had a marked effect on reducing the duration of symptoms. Our Medical Advisory Board members are currently formulating a study that ... will further support Airborne's immune boosting properties." Which is it? Does it boost immune function, or does it reduce duration of symptoms? They aren't the same thing.
The immune system is a complex series of interacting proteins and cells. There is no meaningful way to measure the immune system in an average person, much less boost it. As long as you have reasonable diet and exercise, there is no way to measure any alleged weakness in your immune system.
What's in Airborne? Vitamins, herbal extracts, and amino acids that do nothing to prevent or treat a cold. Echinacea and Vitamin C, the most commonly touted cold remedies, when tested in careful clinical studies, are ineffective in treating colds. Only Zinc, as a throat lozenge but not an effervescent tablet, has been effective in decreasing cold symptoms. Zinc is Airborne's gateway drug. As long as their products contain Zinc, they can truthfully claim that the active ingredient has been proven in clinical trials to decrease cold symptoms.
Warning Sign #4: Evidence for a discovery is anecdotal. I hear it all the time: I thought I had a cold coming on, so I took [fill in the blank] and I did not get a cold, or the flu. I always tell medical residents that the three most dangerous words in medicine, especially when applied to treatments, are "in my experience...," The problem with anecdotes in medicine is that they suggest causalities where none exist. But humans love anecdotes. A personal story for most people is far more impressive than the soundest clinical trial. "40,000 customers contact [Airborne] every year ...," but that claim is meaningless to support that Airborne works.
Warning Sign #5: The discoverer says a belief is credible because it has endured for centuries. Airborne contains a hodgepodge of Chinese herbs used for a variety of infectious disease. Most have never been tested rigorously or, in the case of echinacea, definitively shown not to work. There is little from 2000 years ago, or even 20 years ago, that I would use today. I would not wear 2000-year-old clothes or grow food with 2000-year-old farming techniques. Why use 2000-year-old medical therapies? Our ancestors were invariably wrong in large part, as they did not have a scientific method to understand the world. And, unfortunately, they died young as a result.
Warning Sign #6: The discoverer has worked in isolation. Airborne was "created by a second-grade teacher." Americans do love the idea of the lone, underdog inventor, toiling away in a basement before becoming rich from inventing the pet rock or MS-DOS, or Airborne. I suppose that those who have the most exposure to snotty noses are those most expert in avoiding and treating them. But by the same reasoning I should own a brewery: experience in an area does not mean expertise.
Warning Sign #7: The discoverer proposes new laws of nature to explain an observation. Beware of any therapy that maps the entire body onto one area: the iris, the foot, bumps on the head. I saw an ad for a company in the Gadget Universe catalog that claims all the acupuncture sites are actually located in the hand. Now I get worried whenever I clap my hands. Also beware of the word "natural." Infections are natural. Death is natural. Natural is neither good nor bad. But like "organic," it sounds good.
Mark Crislip, MD, is board-certified in both internal medicine and infectious diesease. He has practiced infectious disease medicine in Portland, OR, for 16 years. He is the publisher of Quackcast, a website and podcast devoted to the skeptical evaluation of supplemental, alternative and complementary medicines, available at www.quackcast.com.
COPYRIGHT 2007 Pediatrics for Parents, Inc.
COPYRIGHT 2007 Gale Group
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