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Medications, supplements, and vitamins -Oh My!

Apr 03, 2008 - 1 comments

Now and then the forum's attention turns to supplements, vitamins, herbal remedies and similar things to ingest, apply, insert or otherwise deploy in our efforts to deal with or get over panic and anxiety. Frequently, it all starts with questions like, "Will this work?," "Has anyone tried this?" Or with statements such as "I read (saw, heard) that (name of thing) can really help..."

The chief difference in the INFORMATION about FDA-approved medications, and everything else, is that the information about the "approved" medication has been developed using very thorough testing whose purpose is to produce results which are regaded as statistically reliable. This means that the results of using the medication can be predicted to within a certain degree of accuracy across a broad population (not individually). The testing also includes a great deal of reporting on the results: we not only observe that it works 70% of the time, we also have seen that it seems to do nothing 10% of the time. And in rare cases, people who used this stuff died or went crazy. The reporting also tell us HOW the drug works, or tell us that no one really knows how it works. The information sheet that comes with the med may say something like: "The mechanism of therapeutic action is unknown at this time," which is just a fancy way of saying, "we dunno how this stuff works." And remember that FDA approval does NOT necessarily mean the stuff works. It can mean either that the drug is approved as "safe," (probably won't hurt you) OR that is approved as "safe and effective," meaning, "probably won't hurt and may very well actually help. Maybe." One thing that is very conspicuous by its absence is a claim of efficacy along the lines of, "Wow! This stuff is really great!"

By contrast, the data about vitamins, supplements, herbs, teas, etc., tends to be developed in a less reliable or less thorough manner than drugs in the FDA studies. This does not mean, necessarily, that there is no scientific basis or objective lab work to support such information as there is. Certain kinds of fatty acids in olive oil, for example, have been the subject of a lot of good science. And where it tends to be present in the normal diet of certain populations, there tends to be a lower rate heart or circulatory problems (or whatever it is). No question about it, highly credentialed people using impeccable survey and testing methods figured it out, and you'll see the study results in a professional journal right next to that big ad for Zoloft. Now the question is, does this mean that using more olive oil will therefore be good for you?

You might think so, based on the studies, but wait!  Scientists have ALSO noted that the Italians (as an example) also happen to eat less of everything, on the average, than folks in the US, and also tend to walk more. Could THAT have anything to do with it their better health? Turns out, there is also a scientifically valid correlation between taking in fewer calories over a broad range of food stuffs, while getting some exercise -and being healthier. Note the weasily word, "correlation." That word simply means that when there is a change in "X" there is also a predictable change in "Y." It does NOT mean that X CAUSES Y.

Am I splitting hairs? Not at all. Let's take your car. No? OK, let's take MY car. Please. I push down the gas pedal, and the more I push, the faster I go. Would you say that the gas pedal therefore causes the car to go faster? It is convenient to think of it that way, and most of us do, but under what circumstances would tromping the gas pedal NOT work? The battery could be dead. You could be out of gas. Or maybe you forgot to start the car. Or it is still in neutral or park. And if you dunno why, THEN you get a mechanic. The point is this; that while the gas pedal is an essential component of moving -and the most obvious one- it is really just one element in a complex mechanism. And so, we establish a correlation between the pedal and movement. The actual cause is more complex, a chain of events in which all parts must be present and working.

OK, now let's take your body and brain. Please. If you think your car is a complicated little shop of horrors, you ain't seen nuthin', yet. Your body and brain are infinitely more complex and not only that, they are dynamic -always changing. On that basis alone, would it make sense to expect a direct cause and effect relationship between your mental state and drinking green tea, consuming salmon, or chugging magnesium tablets? We certainly can say that if what we introduce is profound (LSD) we will be immediately aware of it because of the well established properties of the substance. But at the more subtle level of nutrients, supplements, vitamins and such, seldom do we see -and seldom would we expect to see- profound and immediate cause-and effect results. What we WOULD expect to see is statistically derived changes over broad populations, sampled or studied over long periods of time. And that, in fact, is what we DO see (if we see anything at all). A complicating factor: Many of the observations derived from such studies are based on information which was developed independently for some other purpose. Example: increased sales of olive oil are associated with lower cholesterol (I made that up -have no idea if true). The sales data was developed for economic purposes, and the cholesterol was independently developed as part of a public health assessment. Some university researcher wanted to know if there was some connection between the two sets of data, so she got some students to punch the numbers into a spreadsheet, and -whaddya know- they found it! That researcher -if a true scientist- would adamantly DENY that the study proved a cause and effect relationship between ingesting more olive oil and lowering your cholesterol. At the end of her reseach paper (and I GARR-ON-TEE this) you will see, under the "Conclusions" heading, something like this. "We were unable to verify the validity of the data in public records used as the basis of this research, and thus our results should be regarded as speculative. Otherwise, we do note a statistically significant correlation between increased unit sales of edible olive oil and a small but significant decline in cholesterol counts over the period of time covered by this research. We believe that our findings warrant more thorough investigation."

Now, THAT'S HOW it works in the real world of research. But, what do think appears in the newspaper, the AARP magazine, Today's Health, The Wall Street Journal and the TV news? THIS is what you see:


And what do you think will now appear on the label of your olive oil? "Lowers bad cholesterol."

Sound familiar? You BET it does.

And I hold out to you that there is a higher correlation between selling product and claims about positive reseach than there is between the factors studied in the research itself.

Now, all the above applies to those substances which have a pretty good reputation and long acceptance as being "good for you." The other stuff, for which claims of effectiveness are based on very questionable research, is a different story altogether. Here, the "research and studies" may be a simple compilation of what folks said about the stuff, and a host of testimonials which, oddly enough, don't include the ones who got no or bad results. It drives me over the edge, sometimes, when I hear a store clerk recommend an herbal remedy by saying, "Well, the studies show...".

Oh REALLY? That's when I ask for citations and the names of the studies, so I can look 'em up. Virtually always, the answer is something like, "Well, that's what the distributor told us."

I may be coming across as kind of negative on the supplements, natural remedies, and nutrients area, but I am really not. What I AM saying is that where there are no professional standards or enforced regulation and control of study, research and reporting methods, you A) cannot possibly expect all developers and purveyors to use the same (or even any) testing, research and reporting  methods, and B) you absolutely can expect to see claims of effectiveness way beyond anything ever claimed for the stuff that DOES get the regulation.

So, what do the approved drugs -and everything else- have in common? What they share is a consumer market that wants and expects fast and effective results. They want what they want and they want it NOW. And among those consumers are panic and anxiety patients who have every reason and motive, aside from simple greed, to seek relief from their affliction. And as most panic folks will tell you, with rare exception, it doesn't work that way. And so, the expectation that taking a vitamin or supplement or some similar thing will suddenly or even noticeably turn things around on a cause-and-effect basis is likely to be unrewarded.

But wait! Does this mean you should NOT take those supplements? Heck, no, it doesn't mean that at all. Good over-all health and nutrition is essential support for many body/brain issues, incuding panic. And if your body and mind are well fed and nourished and exercised, guess what? You FEEL better. And if you feel better, feel healthy, then whatever you are doing for the panic and anxiety can ONLY be more effective. Not only that, but the action of some medications may challenge your body's nourishing process, so nutritional support is a good thing.

As to those substances whose properties are claimed to be medicinal -as opposed to nutritional- if there is no evidence you can find that it will hurt you -then maybe there IS something there that will help you -science just hasn't gotten around to doing the studies yet. Remember aspirin? Started out with folks chewing the bark of willow trees, I think. There are plenty of drugs that can be traced back to something in nature, and science is constantly fiddling with wacky stuff just to see what it will do. So -maybe, I said, "MAYBE," that little capsule of "eye of newt" may help.

The point here is not to be misled into thinking there is a magic bullet, a special missing ingredient. Grapefruit peel juice! Who knew?! For panic people, the most productive work is done within your own brain, your perceptions, psychological defenses, sense of identity, self -esteem and a host of other factors who origins and roots are often traced to your early years. The answer, ultimately, lies within YOU -not in a fish, not in vegetable, not in a test tube. If anything works at all, it works by supporting your efforts on your own behalf.

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462570 tn?1273632977
by Tink70, Apr 03, 2008
I liked your journal. (Are you a Virgo with a Sun or Moon in Aries??? Analytical and precise but with a great sense of humor and stabbing sarcasm that has been tempered with age!)   I have studied holistic medicine (ie. supplements, herbs, vitamins, minerals) for about 10 years and have used quite a few.  I should probably publish my own little "journal" on what seemed to work and not work but as you said, there are more factors then just the supplement and I am unique to myself and etc, etc.  What works for me may not work for you.  I do like to ask if anyone has taken something that I am considering so as to get a few comments or reactions about it.  It adds to my own knowledge.  For example: the doctor prescribed LYRICA for me for my fibromyalgia and I found this website and went to the Fibro forum and posted a question on whether or not people had taken it and if so what happened and what they thought about it -  got 7 replies and 5 out of seven said "Yuck - Ewwy - made me have Brain Freeze/Fog, knocked me out and made me feel like I had a hangover the next day.  Well!  Based on MY own personal physical factors - I said to myself - "Self - YOU don't need to even try this medication!"  (See - I'm a recovering alcoholic and based on the info about the drug that I have (pregabalin - works on gaba receptors, yada, yada) and info I have gained on how alcohol effects/effected my brain when in active addiction and the "first hand experiences of people who has taken it and had my same ailment)- I could see that essentially this drug would probably be like drinking a whole bottle of my favorite whiskey.  I don't need that!  I have worked too hard for the past two years to stay sober "one day at a time".  Now - will it actually be like that if I take it, considering I am unique and yada, yada?  Dunno - but I dont want to find out....Cause even one day of mild panic, mild depression, elevated blood sugars and pain level of 10 in my body is better than 10 days when I was drinkin'!
So, with that said - I totally get your journal.  I also really dislike the fact that people will just pop anything their docs give them without question.  Have you READ the lists of side effects to most of these meds?????  Scary!!!!
I have done extensive research on St. Johns Wort (as I do with ANY supplement OR prescribed medication) already and this is the last stop for me....other people's opinions of the drug or supplement.   (And by the way - there are so many wonderful sites that do actual studies on holistic products and NCCAM is one of them if you are intereseted in purusing it.)  Keep up the  journals.  You have a fantastic sense of humor and I got such a joy out of your journal.  I am always on the look out for advice in all areas of life from those who have gone before me.  "The difference between wisdom and knowledge is action....and sometimes you gotta be over a certain age to have acted!"
Hope all goes well....

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