Looking for health in all the wrong places

The American public now has unprecedented freedom to explore new directions in health.

Never before have we had the enormous resources now available to add to our health experience: nutritional supplements, endless books on health and diet, the internet, online discussion groups, insurance products to permit spending on self-directed health services like medical savings accounts and flex-spending. The Track Your Plaque program is just one facet of this emerging and exciting area of self-empowerment in health. Compare what you can achieve with such a program with the situation of just 25 years ago, when the most you might get to reduce your risk for heart disease was to take the (largely ineffective) drug cholestyramine, probucol, and a low-cholesterol, low-fat diet.

Unfortunately, it also means that people have unrestrained potential to be tripped up, to be misled down some dead end of health that fails to accomplish desired goals, maybe even dangerous. The more freedom we have, the greater the choices, the more room we have to screw up.

Among the unproductive strategies I've witnessed recently:

--Nattokinase--The staying power of this scam continues to shock me. There is no rational basis for its use. A woman today declared that she would like to stop the warfarin that she was taking to prevent stroke from atrial fibrillation by taking nattokinase. This would be a mistake that could cost her a major and disabling, even fatal, stroke. Though warfarin is far from perfect, it at least achieves its goal of reducing stroke risk. Nattokinase does not. Nattokinase does nothing but make money for the people who sell it.

--Poly-nutritional supplements. You've heard of polypharmacy, the phenomenon of taking numerous medications with overlapping effects and side-effects, usually because of multiple doctors, each prescribing drugs without knowledge or interest in what colleagues are prescribing. I'm seeing the same phenomenon with supplements: 20,30, or more supplements per day, all in the hopes of heightening health. A focused few supplements is, in my view, superior to a shotgun approach of trying to improve health by taking hawthorne, silymarin, chrysin, calcium, Chinese herbs, and 25 other supplements.

--Chelation--Based on the notion that heavy metal toxicity causes heart disease; removal of heavy metals cures it. I've read some of the books on chelation, in addition to the slim scientific data, to decide whether there was anything to it. In my view, it is a complete and utter scam. It does make money for its practitioners, however. That's not to say that heavy-metal chelation doesn't have a role in health--it does. But it serves no purpose in coronary disease prevention and control.

--Colonic purges--Achieved by a number of routes, some oral, others via enema. Promotions for purging are often accompanied by a pile of scum that apparently lined somebody's intestinal tract. Purges purportedly, well, purge it from the intestine. This is also plain nonsense. There is no such toxic scum lining anybody's intestinal tract. However, if calorie restriction or a fast results inadvertently from the effort, perhaps some good comes from it.

--Statin drug alternatives--The unprecedented $27 billion dollar a year success of the statin drug industry, accompanied by the enormous marketing push by their manufacturers, has spawned an entire industry of statin alternatives. They range from red yeast rice, to guggulipid, to various concoctions of sterol esters, Chinese herbs, chitosan, and a variety of others. Some actually do reduce cholesterol a few points. Preparations like red yeast rice even pose a side-effect profile not too different from the prescription statin agents. Unfortunately, even among those agents that work, the effects tend to be small to trivial. While I am no lover of statin drugs nor the statin drug industry, I find these preparations to be anemic imitators. You'd be better off with raw nuts and ground flaxseed than wasting your money on these cheap imitations.

--Worries about liver toxicity--A day doesn't go by that I don't have at least several questions about suffering toxic liver effects from niacin, vitamin D, statin drugs, etc. I have treated thousands of patients for heart disease in its various stages and forms and have used many different strategies. How many times have I seen serious liver toxicity? A handful of times and usually from either mis-use of the agent or drug, or in a person with several other coexisting diseases. (Other serious health conditions, like kidney failure, raise the toxicity of drugs and supplements.) Liver toxicity in the vast majority of otherwise healthy people is close to being a non-concern.

Readers of The Heart Scan Blog and of the Track Your Plaque website know that I celebrate expansion of knowledge and information access to the public. However, I am concerned that the flip side of this growing self-empowerment is expanding potential for mistakes. It reminds me of an attorney friend, who, when diagnosed with prostate cancer, explored all manner of alternative treatments, from laetrile to heavy metal chelation to high-dose lycopene tablets. At the initial stage of diagnosis, his cancer was readily treatable. He now has widely metastatic cancer.

Maintain an open mind, but think before you commit to some crazed claim of cure, some "secret" to health, somebody's brazen but concealed attempt at steering profits in their direction.

With freedom comes responsibility. Otherwise, you might be looking for love . . .oops, I mean health . . . in all the wrong places.

Comments (11) -

  • Anonymous

    2/12/2008 6:52:00 AM |

    What are your views on certain supplements that show promise in regard to heart health, but haven't been fully proven yet? Such as resveratrol, grape seed extract,  pomegranate, green tea, krill oil, aged garlic, cocoa, etc.

    Are they safe and worthwhile to take,  or would you consider them a risk for certain patients?

    Unfortunately, we can't always go to our family doctor or cardiologist (at least generally speaking), give them a list of supplements that potentially could be beneficial, and ask their opinion. 99% of the time they'll be clueless, or simply give vague suggestions, or possibly worse, give bad advice. I had one cardiologist recommend flush-free niacin to me  (the non-beneficial type), for instance.


    2/12/2008 5:52:00 PM |

    Its very hard as a health conscious consumer, to know what supplements to use, and at what dosage. There is so much conflicting information available.
    I take a small handful of vitamins, amino acids and minerals daily. I eat really well, and exercise regularly, and still have trouble controlling my hypertension.My recent heart scan showed a score of 99.  I have been looking to supplements to help, but so far the help has been minimal. Am I looking for help in all the wrong places too?

  • GerryL

    2/12/2008 7:32:00 PM |

    It can get frustrating even for those with a long time interest in nutrition and health. Along with my dietary and exercise regimen I take folic acid to help lower triglycerides. Then I come across a report from a newsletter that cited the Norwegian Vitamin Trial (NORVIT) and said " Folic acid supplementation was found to lower homocysteine levels by 28%., but to increase relative risks of heart attack, stroke, and death by 20%, along with a more than a 30% increase in cancer." The source recommends that NO folic acid supplements be taken outside of naturally occurring food sources.
    Another newsletter by another doctor advises against  any supplementation of Vitamin D outside of natural sunshine.

  • Anonymous

    2/12/2008 9:20:00 PM |

    Please clarify your comments on Nattokinase: is this not the same food item that's high in vitamin K2, which if I understand it correctly, helps to put calcium into the bones (along with D3), so that there's less calcium going to the arteries and causing plaque.

    If my understanding of K3, and that nattokinase has very high amouns of K3 in it, is correct, then are you saying that Nattokinase is not a suitable replacement for blood thinners or stroke prevention, but that it does have desirable effects for directing calcium to bones, instead of arterial plaques?

    I went in for a colonoscopy recently, and did various preps for it, the most powerful one for me was the mag citrate. My photos from the colonoscopy showed pink healthy looking tissue (whew), which led me to think that expensive colon cleanses probably weren't necessary. I'd never done one, but had read about them in the past.

    When I did read about them, I remember wondering if hydrogen peroxide enemas did the same thing as those oxy-cleansers. Thankfully I've never had to perform one of the more 'exotic' enemas, but I do remember our teachers warning us to use plastic gowns and stand clear if we ever had to give one.


  • moblogs

    2/12/2008 11:33:00 PM |

    I think it's desperation that often leads to the wrong places. I don't have any heart problems but it is an almost certified route to the grave in my family tree later in life, so with remaining youth I'm able to research things calmly. I visit here mainly as my own research gels with things you say.
    I think the key thing is to entertain claims that are referenced and peer reviewed; even a good 'oddball' thought makes it into PubMed. And then there's no reason why an abstract couldn't be printed and discussed with an open minded doctor to look at a route that might be best for the patient.
    I think in a sadistic way we like doctors to be fairly arrogant and say "this is your problem, do as I say", but we also know that at the end of the day it's you who cares about you the most. And it's simply terror that leads people into the first arms of saviour they see.

  • jpatti

    2/13/2008 10:06:00 AM |

    My opinion regarding "resveratrol, grape seed extract, pomegranate, green tea, krill oil, aged garlic, cocoa, etc." is... these are not supplements, these are foods.  

    A whole heck of a lot of folks take a lot of ridiculously expensive "supplements" that can easily be replaced by actual food.

    You know what phosphatidyl choline is?  An expensive supplement... or a dead-cheap product lecithin used in baking to assist emulsification.  In short, it makes your smoothies smoother for almost no money.

    Cocoa?  Who would *supplement* cocoa? I mean... COCOA?  Is eating chocolate now some sort of chore that is easier to accomplish by taking a pill?  I eschew sugar, but don't find it difficult to get sufficient cocoa in my diet even so.  I seriously doubt there's many folks running around suffering cocoa deficiencies.  I mean, if you deeply despise chocolate, maybe take a cocoa supplement, but for the rest of us, eating cocoa is generally a lot more pleasant when it's NOT wrapped in a capsule.

    I take supplements.  In fact, I take rather a lot of them.  I take a multivitamin (without iron), vitamin D3 (just started a supplement with K2 also), and fish oil, which I recommend to everyone, most especially those with metabolic syndrome.  These are cheap and sure don't hurt - one of the easiest things you can do for your health.

    I also take a B complex, panthothenic acid, niacin, calcium, CoQ10 and milk thistle - each for specific reasons relative to my own health.  

    But resveratol and cocoa?  Why not a glass of wine and a piece of dark chocolate?  

    Why take a pomegranate supplement, eating pomegrantaes works pretty darned well for me.  Pomegrantaes are darned yummy.

    Turmeric, cinnamon and garlic are all lovely foods - and were so before anyone ever did any research into them.  

    CLA is the new wonder fatty acid - and you can get gobs of it by eating pasture-raised meat and dairy, which is a heck of a lot more pleasant than swallowing pills.

    Food is better than pills.  

    OK, we know about vitamin K2 now, but it's a fairly new discovery.  People who just went around eating cheese were getting it even before it was in pills.  

    The nutrients that will be discovered next month, next year and next decade are in foods *today*.  

    Just eat good food... a wide variety of organic vegetables, as much fruit as your blood glucose tolerates, lots of wholesome meat and dairy from pasture-raised or wild animals, good fats like olive and avocado oils, grains like barley and buckwheat, nuts and seeds, lots of fresh herbs and spices - you'll "cover" all the supplements they aren't even selling yet.

  • Anonymous

    2/13/2008 2:08:00 PM |

    I meant "K2" in my comment above.


  • Anonymous

    2/13/2008 5:39:00 PM |

    My opinion regarding "resveratrol, grape seed extract, pomegranate, green tea, krill oil, aged garlic, cocoa, etc." is... these are not supplements, these are foods.


    As the originator of the post with reference to the above 'supplements', I somewhat agree -- I just used a general term of 'supplement' to describe them. You can get some of them via food.

    But I can't drink wine, so resveratrol and grape seed would have to be in capsule form. And for high doses of resveratrol, supplements are the only way, as it would take several bottles of red wine daily. Aged garlic is different than regular garlic, and is a lot easier to take as a supplement. It's also a lot kinder on your breath and digestion.  And I don't think many people will be sitting down and eating a nice bowl of krill.

    My main question was in regard to them being considered worthwhile to take (in any form), and how do we go about verifying what is beneficial, without a doctor to rely on.

  • Anonymous

    2/13/2008 10:29:00 PM |

    Decrying all supplements is similar to running down all prescription drugs. One has to be selective. Some prescription drugs are helpful for some people. So it is with supplements. If the supplement supplies something your body needs it may help. For example, 15 years ago I found that Saw Palmeto helped my prostate. It still does today, and others have found it helpful too.

  • Rich

    2/15/2008 5:50:00 AM |

    The NIH study on chelation should have some results soon.



  • HeartCipher

    5/8/2008 9:13:00 PM |

    There seems to be a clear correlation in my ALT value between my taking the LEF Mega Silymarin product.  When I've taken it, my ALT goes down.  But I've usually stopped taking it after just a few months.

    I'm now thinking that I need to give it a good 6 month to a year trial.

    The "Jedi Master" I've been working with just today told me that I need to be cautious about the possibility of having NAFLD.

    So, it seems to me that Mega Silymarin is a must do.