The importance of critical thinking in discerning reputable sources

The volume of material published and shared by anti-fluoride, anti-vaccine, pro “alternative” health – all which fall under the deceptive catch phrase of “pro-choice” – is notably bereft of critical thinking.

No doubt there will always be some attracted to the notion of oppressive governments and dark conspiracies. Research indicates the psychological predisposition to conspiracy theory is highly resilient. Yet the persistence of the claim vaccines are the cause of a host of childhood ailments, that homeopathy is effective or that fluoride is a poison added to water supplies, may in part indicate poor cognitive manipulation of available information.

It is not uncommon to find preposterous claims circulating as a purported superior health choice. Such material is favoured by those who contend they are exercising “pro-choice” as a result of having “done my research”. It’s clear that no independent, accredited source has evaluated this “research”. It is more evident that the person has not sought reputable source material or thoroughly investigated critiques of the main aspects of their research. Let’s try claims by one so-called alternative. Homeopathy.

A good example would be claims made by homeopath Isaac Golden. Golden claims homeoprophylaxis (homeopathic immunisations) are a safe and effective alternative to vaccination. In a very short time one can find that homeopathy has not been shown to offer any measurable effect beyond placebo.

Consider the National Health and Medical Research Council statement on homeopathy [PDF].

The media release opens:

The National Health and Medical Research Council today released a statement concluding that there is no good quality evidence to support the claim that homeopathy is effective in treating health conditions. Its release follows a thorough review of the evidence, conducted as part of NHMRC’s responsibility to provide advice and support informed health care decisions by the Australian community.

The conclusion is based on the findings of a rigorous assessment of more than 1800 papers. Of these, 225 studies met the criteria to be included in NHMRC’s examination of the effectiveness of homeopathy. The review found no good quality, well-designed studies with enough participants to support the idea that homeopathy works better than a placebo, or causes health improvements equal to those of another treatment.

A little more time reading evidence based material will reveal the mechanism of homeopathy to be impossible. In short it simply cannot work without rewriting aspects of physics and chemistry. Homeopaths often actually admit this – while being dishonest about observed effects.

Homeopathy Plus

Golden himself makes much of having completed a PhD in homeoprophylaxis, leaving the uneducated listener or reader under the impression that this thoroughly discredited pseudoscience is in fact a safe option in health science. Or as opponents of vaccination insist: a Choice. Indeed Golden claims homeopathic vaccines are an option which is “comparably effective but which is non toxic, which provides no danger, no long term side effects”.

In June this year “Dr. Isaac Golden’s Academy” was offering a YesCourse.

IsaacGolden_YesCourse

Yet in his PhD abstract Golden admits;

The effectiveness of the program could not be established with statistical certainty given the limited sample size and the low probability of acquiring an infectious disease.

Indeed. Not to mention the reality of an ethics committee. Let’s be clear. No success was demonstrated with this paper. So Golden also writes:

However, a possible level of effectiveness of 90.3% was identified subject to specified limitations. Further research to confirm the effectiveness of the program is justified.

Possible efficacy, subject to specified limitations, that requires further research is a very, very clear way of documenting no effect. I apologise but there are no prizes for guessing Golden has not gone on to search for, much less publish, the possible efficacy. This won’t prevent him waxing lyrical on “my own PhD” as a source in defence of homeoprophylaxis.

Furthermore Golden’s work has been cited by Fran Sheffield of Homeopathy Plus in defence of her own business. The danger of Golden’s ambitious work and lax clarification can be summed up in Sheffield’s marketing. Referring to his inability to establish efficacy to any degree, she advertised:

Dr Isaac Golden confirmed that homeoprophylaxis provides the same degree, or better protection, than vaccines with none of their side effects or complications

In 2010, following a complaint from Dr. Ken Harvey, the TGA’s Complaints Resolution Panel ordered that a Retraction be published on site. Sheffield ignored the request. Regarding the TGA Therapeutic Goods Advertising Code, Sheffield was also noted to have acted in a misleading manner, abusing the trust and exploiting the lack of knowledge of consumers. A summary and key details can be found here at the Skeptics’ Book of Pooh-Pooh.

The notion that parents who choose alternatives are not actually researching or seeking reputable advice on their apparently “informed choice” is in this case further highlighted by ongoing offending by Fran Sheffield and Homeopathy Plus! In May 2012 the ACCC announced it had responded to complaints from the medical industry about bogus claims on the Homeopathy Plus! website. Namely that the pertussis vaccine was ineffective and that Homeopathy Plus! offered an effective homeopathic immunisation for pertussis.

On February 21st 2013 the ACCC instigated Federal Court proceedings against Homeopathy Plus! as the pseudoscience recalcitrant persisted in endangering the health of Australian children and infants. The claims made were in breach of the Competition and Consumer Act 2010, and were misleading and deceptive. The ACCC media release included;

The Australian Competition and Consumer Commission has instituted Federal Court proceedings over allegedly misleading claims on a homeopathy website regarding the effectiveness of the whooping cough (pertussis) vaccine.

The ACCC has taken proceeding against Homeopathy Plus! Australia Pty Ltd and against the owners of the Homeopathy Plus! website.

The claims on the Homeopathy Plus! website include statements that the whooping cough vaccine is “unreliable” and “largely ineffective” in preventing whooping cough and that homeopathic remedies are a safe and effective alternative for the prevention and treatment of whooping cough.

On December 23rd, 2014, the ACCC reported that the Federal Court had found both Homeopathy Plus! and Frances Sheffield had engaged in misleading conduct and made false or misleading representations regarding the effectiveness of the whooping cough vaccine and homeopathic remedies as an alternative in breach of the Australian Consumer Law. Sheffield and Homeopathy Plus! had engaged in misleading and deceptive conduct. Put simply, Fran Sheffield had continued to use her website to lie to unfortunate visitors who were not in the habit of critically investigating such claims.

Harking back to the echo of Isaac (My own PhD) Golden we read (emphasis mine);

The Court also found that Homeopathy Plus! and Ms Sheffield engaged in misleading and deceptive conduct and made false and misleading representations to the effect that there was an adequate foundation in medical science for the statement that homeopathic treatments are a safe and effective alternative to the whooping cough vaccine, when in fact no such foundation exists and the vaccine is the only treatment currently approved for use and accepted by medical practitioners for the prevention of whooping cough.

I should be clear. This is only one arm of a notable junk science making as a matter of course outrageous claims. To see that so many can be fooled into believing plain water can protect from disease in a manner no-one can explain, is to some, mind boggling. But to be even clearer the information to debunk such nonsense and thus protect yourself and family is there to be found.

It is plain that scam artists, conspiracy theorists and so on cannot be swayed by the findings of official investigations or years of scientific consensus. Thus it is better to ignore those who claim to hold an apparent truth or a wonderful therapy and subject their claims to robust and varied critique.

Critiques can be made for all of the pseudosciences purporting to offer a superior or natural alternative to evidence based medicine. The same applies to the unwarranted attacks on vaccines, fluoride, medical intervention and so on. A far better way to approach these topics is to do so with the confidence to review material from a bipartisan standpoint. Where claims of conspiracies or corporate corruption for profit are made be very skeptical.

Make a habit of visiting consumer advocacy groups, such as Choice. Spend some of that research time looking over the Therapeutic Goods Administration and the Australian Competition and Consumer Commission. We looked at both of these and the NHMRC, above. Let’s say the best your new friends at Essence Of Moonbeam are offering in response is a claimed conspiracy, the mocking of “sheeple” or bemoaning the trampling of rights (or that “informed choice”). I’d say you’re pretty safe in concluding genuine evidence has caught up with debunking their claims.

No-one can develop the skills or knowledge base from the Internet to argue that “my research” on one topic is sufficient to make decisions that are traditionally overseen by specialists or experts. The skill we can develop is that by which we can discern between a reputable source and a disreputable source. And this process should include discussions with genuine, experienced practitioners.

There is too much information on individual areas of health to allow us to investigate fully and believe we may come away educated and/or able to advise others. Where new trends are jostling for our attention and money there are recurring themes that help reveal them to be useless.

The skills we develop in discerning the reputable from bogus information sources are increasingly the skills that will benefit us in more ways than seeking optimal health.

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Medical Observer Interview: Dr. Ken Harvey

Former editor of the Medical Journal of Australia and GP Dr Annette Katelaris interviews Dr. Ken Harvey.

Dr. Harvey originally graduated from the University of Melbourne. Initially specialising in infectious disease and medical microbiology Ken’s interest in antibiotic resistance led to a study of the forces that drive prescription. Ken moved to the School of Public Health at La Trobe University to continue his work on medicinal drug policy.

He now holds the position of Adjunct Associate Professor in the School of Public Health at La Trobe.

INTERVIEW – CAMs regulation and pharmaceutical industry influence – Assoc Prof Ken Harvey – Obserations

Noted public health advocate Associate Professor Ken Harvey on what’s lacking in regulating complementary medicines, and the influence of the pharmaceutical industry on ‘the hand that writes the script’.

Ken talks about his extensive role in prodding Australia’s regulator of complementary medicines and shortfalls in the present system for regulating these “listed” therapeutic products. He is also asked about the personal impact of holding shonky products, advertising and ultimately – dishonest, unforgiving individuals – to account. Ken’s interest in information technology makes him a welcome source of advice to overhaul the TGA’s Electronic Listing Facility.

For a self confessed “stubborn bastard” in chasing blatant advertising breaches, it’s clear that Australian consumers are in Ken’s debt. Ken holds life membership of the Australian Consumers Association, Choice, and is also a member of their Policy Advisory Group. Dr. Harvey is Chair of Health Action International, Asia Pacific (HAIAP). He was a member of the WHO expert group that drafted their Ethical Criteria for Medicinal Drug Promotion. [22 page PDF]

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INTERVIEW AUDIO

Or direct download MP3 here. 21 min 13 sec. 21.4 MB
Listen or download file at chirbit.
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Interview Source – © Medical Observer, Sound Cloud. Published August 26th, 2013.

 

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Meryl Dorey fights to keep misleading title

I have seen evidence that there was even an attempt to have me deported from Australia via complaints to the Dept of Immigration…

– Meryl Dorey adds another angle to her profile as a Freedom Fighter –

Not for the first time, a salient point was serendipitously driven home on the Facebook page Stop The Australian Vaccination Network.

Last Friday night a young lady unleashed some criticism that highlights the cunning purpose of the Australian (anti) Vaccination Network’s name.

Apologies for the overt racism in there. This is far from the neatest example but it does show how persuasive first impressions can be. No doubt this has been Meryl Dorey’s intent all along. To divert attention away from her role as an antivaccine lobbyist.

Simply claiming to not be antivaccine is rather pointless however. Years ago (circa 2005) the proud antivaccine conspiracy group Vaccine Truth made a mockery of the USA NIIC phrase. Meryl took the opportunity to lift the same phrase straight from them.

Before becomming the Australian Vaccination Network in 1996, her group of antivaccine lobbyists was the Vaccine Awareness Network. Thus I was slightly amused to see an AVN contributor suggest to Meryl they switch to “Australian Vaccine Awareness Network”. More amusingly this was supported by Meryl’s most vocal Pit Poodle.

The misleading name has secured media attention and a cornucopia of false balance. Genuinely concerned and in-need parents have been fooled. People have donated money believing advanced safety testing of vaccines was an AVN priority. They scored a Charitable Fundraising Authority. Life was quite comfortable until Stop The AVN formed and exposed schemes, scams, fraud and theft.

This led in part to an investigation by the NSW Health Care Complaints Commission. It found that the AVN website:

  • Provides information that is solely anti-vaccination
  • Contains information that is incorrect and misleading
  • Quotes selectively from research to suggest that vaccination may be dangerous

Under the Health Care Complaints Act 1993, the HCCC had recommended the AVN put an unambiguous disclaimer on its website to convey:

  • The AVN’s purpose is to provide information against vaccination, in order to balance what it believes is the substantial amount of pro-vaccination information available elsewhere.
  • The information provided by the AVN should not be read as medical advice.
  • The decision about whether or not to vaccinate should be made in consultation with a health care provider.

Whilst the AVN insist that the HCCC findings were “overturned” on appeal, this is not the case. A Supreme Court ruling found the HCCC had acted outside it’s jurisdiction in posting a public warning. Ms. Dorey’s aim to have the findings abolished was firmly rejected. The HCCC public warning was removed.

The AVN disclaimer is available here, which essentially covers the points sought by the HCCC. There is thus no doubt. The AVN is an antivaccination lobby group. They are antivaccine, against vaccination, purport to offer alternatives to vaccination and falsely claim to posses a “data base” of vaccine injuries.

Recently as Dorey promoted her latest conspiracy-themed seminar series there was renewed focus on the salient point in question. What Jane McCredie has referred to as:

This country’s most prominent anti-vaccination group, the confusingly named Australian Vaccination Network…

Medical Observer recently reported under Anti-vax lobby rejects AMA call for a name change:

Australian College of Midwives executive officer Ann Kinnear told MO her organisation forwarded an email invitation to an AVN event to about 1400 NSW members before angry midwives told her the Health Care Complaints Commission had in 2009 declared AVN an anti-immunisation lobby.

“Subsequent information that’s come to hand has made me realise it’s a mistake,” Ms Kinnear said. […]

“If a major health organisation understandably is taken in, members of the public would have little hope of realising that they were not accessing independent, credible advice,” AMA (NSW) CEO Fiona Davies said.

Dr Brian Morton, chair of the AMA’s council for general practice, said AVN’s name was “duplicitous, it confuses the public, they are anti-vaccination and they certainly don’t report the evidence”.

Last weekend a suitably tabloid themed heading from the Sunday Telegraph carried some further developments. Doctors unite to smash the anti-vaccine group:

NSW Health Minister Jillian Skinner and Fair Trading Minister Anthony Roberts have been urged to force the change on the NSW-registered group in a letter signed by Associate Professor of La Trobe University Dr Ken Harvey.

His call is backed by experts from the Australian Medical Association and the University of Sydney.

As the AVN is registered with the Office of Fair Trading the government can in fact order a name change.

Dorey of course continues with the line the AVN is not antivaccination but “pro-choice”.

Predictably Ms. Dorey has afforded her critics ownership of the term “smash”, despite it appearing only in the headline of the story.

She must have been delighted. In a rambling, stumbling diatribe Dorey included:

They would have spent hundreds of thousands of dollars to date trying to “Smash” our small, volunteer-run organisation… We are David to their Goliath and because we stand for truth, freedom and democracy… […]

The idea that a group of doctors can unite to SMASH an organisation that questions a medical procedure sounds more like economic protectionism than true concern to me.

Wait. Economic protectionism? As in restriction of international trade? Subsidising locally produced goods or produce? Taxing imports via the application of tariffs? I think, comrade, that Meryl has been hanging out with her fellow freedom fighters at Conspiracy Central a bit too much.

Which gets to the reasons a name change has become more and more an issue of public safety. The AVN has become less and less about opposing vaccines and merely spreading fear and confusion on the topic. This is the result of a hard working group of volunteers, concerned GPs, medical organisations, certain journalists, reputable parenting forums and the self sabotage of the AVN by Meryl Dorey herself.

Today Meryl Dorey can be found on conspiracy podcasts playing laser tag warriors with some of the more unhinged members of society. If not skepgoating individual skeptics as part of an organised hate group, it’s absurdities such as the above claim that, “hundreds of thousands of dollars” has been spent targetting her alone.

The constant criticism of conventional medicine is commonplace, as is quite evident in this “media release” . Setting out to send a message of defiance on name change, it again squeezes in the notion of being “under attack”.

Let me choose one example to drive home how antivaccine Ms. Dorey really is. Here’s an ABC article warning on the dangers of co-sleeping, including Baby Talk audio. On July 6th, the ABC also reported criticism from the Victorian coroner regarding inconsistent warnings. Almost half of all sudden infant deaths involve co-sleeping. The coroners criticism was welcomed by experts in the field.

Here is Meryl Dorey advising a member of her group in November last year:

Yesterday Meryl sought to encourage another member to contact the families of SIDS cases to “find out if the children were vaccinated before their death”.

Dr. Ken Harvey would appear to be completely correct in his observation that, “The deceptive name of the organisation has potentially deadly consequences”.

Quite so, and this is simply one example that carries a single insight into how far out of step Dorey is with safe advice. More so, the AVN is less and less representative of adherents to alternatives to medicine and even genuine vaccine opponents. As polarising as certain choices clearly are, few Aussies accept there is a war to be fought or that General Dorey is their leader. Added to this is the reality that many new parents are now well aware of the AVN’s lethal, conspiratorial approach.

I’m not sure what the AVN should be called. Something in ancient Sanskrit maybe? Just don’t dare suggest they’re antivaccine.

What would ever give you that idea?

SensaSlim Shonky Shows Up TGA

By now you most probably know that SensaSlim won the Choice Shonky for “making snake oil look good”. Or rather, “SensaSlim (and friends)”.

Delightfully the TGA receive an honorary Shonky for their mind blowing apathy and inbred inability to delist the rubbish. Choice report:

The TGA, who deserve an honorary Shonky for their role in this, have had ample reason and opportunity to delist the product, ensuring it can no longer be sold in Australia, but have declined to do so. Even after the TGA’s advertising Complaints Resolution Panel recommended its delisting due to non-compliance with regulations, they have sat tight and done nothing.

Of course the TGA who can, according to the TGA simply do no wrong, rejected this award in the same hilarious manner they reject any responsibility for regular TGA failures. Reported in The Australian, “Unproven slimming spray wins a shonky”:

The TGA revoked Sensaslim’s approval to make such claims, but it has not delisted the product for sale, as suggested by its panel, earning it an “honorary Shonky”. A spokesperson says the Shonky is unwarranted: “The TGA continues to take regulatory action against SensaSlim Solutions to remove it from the Australian Register of Therapeutic Goods.”

The spray continues to be sold by several Australian internet pharmacies. This prompted [Ken] Harvey to write to the Pharmacy Board of Australia this week, alerting it to possible “breaches by pharmacists” of legislation prohibiting them from misleading advertising.

Which is exactly why the spray should have already been delisted. People are still being ripped off. More on the failing effectiveness if not relevance of the TGA can be read here at Australian Skeptics.

Just recently on October 27th the Parliamentary Secretary for Health and Ageing, Catherine King, hinted at regulatory change. Speaking at the Complementary Healthcare Council of Australia’s (CHC) National Conference King agreed that the Auditor General’s report into the TGA this year highlighted concerns. Pharmacy Daily report:

These issues, including poor compliance rates, resulted in recommendations for improving the process of regulation for complementary medicines and the handling of advertising complaints. Specific recommendations listed in the report, including: the timely completion by TGA of key guidance material for complementary medicines; improving the integrity of the self-assessment process for listing complementary therapies whilst limiting the use of inappropriate claims and indications, have been accepted by the TGA and are now in the planning stages for implementation.

King also said planning is now occurring for further report recommendations including making information available to the public on each listed complementary medication; improving the quality of the regulatory framework through the use of risk profiles; and the development of documented procedures for handling advertising complaints including timelines for completing investigations.

An informal working group had also identified that the current system doesn’t “sufficiently encourage compliance”. Indeed. It cannot be understated how appalling the TGA behaved in setting in train some of it’s regulatory powers, such as seeking original and stated evidence from sponsors of ARTG products, only upon discovering the Auditor General was to investigate. Put simply, the TGA can at any time ask for the evidence of any ARTG listed “alternative to medicine” product and act accordingly. Put rather more simply, they don’t.

Despite having several months to discern whether SensaSlim (and a plethora of other scam products) meet requirements Pharmacy News reported last week on the TGA dodging any criticism surrounding Sensaslim. Not happy about it’s honorary Shonky for apathy in the face of urgency, it was noted that:

… a TGA spokesperson insisted it was reviewing whether the product met the requirements for listing on the Australian Register of Therapeutic Goods (ARTG). “It is nonsense to say that the TGA has taken no action in relation to SensaSlim,” the spokesperson said. “The TGA continues to take regulatory action against SensaSlim Solutions to remove it from the ARTG.

As for the SensaSlim Scam itself, well the European and American markets – always the primary target – are now copping it. The same flashy websites once active in Australia, with exactly the same claims are misleading consumers on those continents. The UK Medicines and Healthcare Products Regulatory Agency cannot act to have the misleading advertising removed unless:

  • The site is hosted in the UK
  • The profits are banked in the UK
  • The product is distributed from the UK
  • And is a medicinal product

Profits from sales of SensaSlim go via PayPal into the bank account of Peter Foster’s QLD girlfriend Liana Emberg. Liana is understandably keeping quiet. Emberg was one of seven SensaSlim scam scally wags who had their bank accounts frozen by the ACCC.

Somehow I doubt poor Liana is losing out.

Check out all 2011 Shonky Awards here (SensaSlim 2:40)

Blackmores’ black heart: Would you like lies with that?

One can be forgiven for wondering exactly how pharmacist members of The Pharmacy Guild of Australia, will keep a straight face when giving advice about medication.

Not that they don’t have the training to do so. Far from it. Which is what makes the money spinning deal to push Blackmores’ “companion products” to certain medications particularly galling. By it’s very nature this “Coke and fries” (to use Blackmores term) deal is predicated on pharmacists pre-empting doctors and making on the run diagnoses. Diagnoses that they aren’t equipped to make and that may also prove deleterious.

The scam works like this. Blackmores have identified key prescription medicines and isolated potential “nutritional consequences”. They’ve proposed a “companion product” to the prescription with scant regard to the fact that no standing recommendations exist. More so, research into this approach to supplements is both ambiguous and has revealed negative effects.

The four areas you should be terrified about are:

  • Proton pump inhibitors and magnesium deficiency with muscle cramps, vertigo, hyper-irritability, excitability and the inevitable poor concentration. But if you can remember where you’re going for long enough you can limp to the chemist, stagger from wall to wall and unleash your hyper-rage upon stock to ensure a swift diagnosis.
  • Antibiotic treatment, upset GI microflora and the need for probiotics helped along by icky stories of bloating, farting and diarrhoea. Fear not you gaseous, smelly, splattering assault upon polite society, for they have just the probiotic for you.
  • Anti-hypertensives and zinc deficiency along with poor immunity, poor appetite, impaired sense of taste and smell. Topped off with poor skin health (delayed wound healing), GI tract issues with the inevitable diarrhoea which compounds zinc deficiency. Can’t eat, can’t heal, can’t taste, can’t smell and you’re stuck in the toilet. There’s a plus in there somewhere but no doubt you need a zinc supplement.
  • Statins (cholesterol lowering drugs) and myalgia plus (get this) “muscle soreness”. Along with cramping, weakness and fatigue, you clearly need Coenzyme Q 10 and vitamin D3. What a pity you’re already too shattered to get out of bed.

Of course dealing with the nutritional consequences, may have… er, consequences. For example Blackmores go on to tell consumers, CoQ10 may:

• Have hypotensive effects in patients with hypertension and may have additive effects on antihypertensive medications

• Interfere with some types of chemotherapeutic agents. Use with caution

• Decrease the anticoagulant effect of warfarin

• Decrease blood glucose levels in people on hypoglycaemic therapy

Vitamin D3 may theoretically cause hypercalcaemia if taken with thiazide diuretics. Caution is advised in those with hyperparathyroidism, malignancies that increase serum calcium levels or other risk factors for hypercalcaemia. Zinc may decrease absorption and blood levels of tetracycline and quinolone antibiotics unless doses are separated by at least 2 hours.

Magnesium may decrease the absorption and efficacy of tetracycline and quinolone antibiotics, bisphosphonates and chlorpromazine unless doses are separated by at least 2 hours. If using [Blackmores’ probiotic] with antibiotics to which [Blackmores’ probiotic] is sensitive, separate doses by at least two hours.

This is enough to make you pause and think about chatting at length with your doctor. There’s a few other useless spooky observations that the (s)CAM industry simply rock at pulling off. Such as vitamin D deficiency being widespread and associated with poor CV health. Magnesium contributes to healthy teeth, bones, muscle/nerve function, electrolyte balance and normal energy metabolism. Myalgia is one of the most common reported adverse effect of statin use.

Many patients – particularly older ones – may already have poor nutrient intake… 1/3 of Aussies over 18 don’t get the RDI of magnesium. My favourite is the veiled suggestion GP’s aren’t capable of doing their job: “…the TGA have advised prescribers to be alert to hypomagnesaemia in people taking PPIs”. To which I can easily imagine Professor Farnsworth from Futurama saying, “Why yes… which is exactly why cowboy’s like you should stay the hell away from grown up science”.

With the help of Dr. Ken Harvey, who we know here from the SensaSlim saga, we can pin down the extent of frivolity being advanced by this joint venture. The statin claims are particularly bold, given side effects. Also, noting Wyman et al;

Some small clinical trials seem to show that coenzyme Q10 supplements can be used to lower blood pressure and to treat or prevent myalgia caused by hydroxymethylglutaryl coenzyme A reductase inhibitors (statins). However, larger trials are needed to determine if they are truly effective for these purposes.

On the topic of probiotics, The March 2011 issue of Therapeutic Guidelines Antibiotic, states;

There is some evidence that prophylactic probiotics reduce the incidence of antibiotic-associated diarrhoea but the appropriate combination of agents has not been established, so probiotics cannot be recommended for routine use. In immune-compromised patients, occasional cases of probiotic-associated bacteraemia have occurred

Regarding zinc and magnesium supplementation there is no standing recommendation for use with anti-hypertensive therapy and PPI use respectively. As Farnsworth just reminded us, being on the lookout for symptoms is for trained health professionals. Blackmores’ hijacking of professional guidelines is just another trick for selling for the sake of it.

Consumers Health Forum of Australia chief Carol Bennett claims in Fairfax that the entire caper is unethical and urges consumers to demand evidence and report pharmacists who lean on fears. Geraldine Moses, who is a drug safety researcher reminds us of the folic acid related seizures epileptics sustained after taking a supplement to combat the reduction in folate specific to epilepsy medication.

Today The Age reported;

PHARMACISTS have been accused of putting money ahead of patients’ interests after striking a controversial deal to market dietary supplements with prescription medicines.

The Pharmacy Guild of Australia, which represents 94 per cent of Australia’s 5200 pharmacies, has agreed to start recommending a range of Blackmores products to patients when they pick up prescriptions for anti-biotics, blood pressure drugs, cholesterol medicine and proton pump inhibitors.

Last week, Blackmores chief executive Christine Holgate told Pharmacy News the deal meant they could provide ”the Coke and fries” with prescription drugs while providing pharmacies with ”a new and important revenue stream”.

Her comments prompted sharp criticism from doctors and consumer advocates who said it risked turning pharmacies into McDonald’s-like businesses that push products onto patients who do not need them. Under the deal, when a prescription is filled, a prompt in the pharmacist’s computer system will remind them to discuss a particular Blackmores product that has been designed to offset possible side-effects of their prescription drug.

[……]

Australian Medical Association president Steve Hambleton said the move was outrageous and smacked of commercial interest rather than clinical need.

He said he did not know of any solid evidence backing the combination of dietary supplements with the prescriptions included in the deal. ”I think the evidence for Coke and fries is about the same as the evidence for these products,” he said. Dr Hambleton said the recommendations had the potential to confuse patients, who should trust their doctors to prescribe them what they need without any conflicts of interest.

Geraldine Moses, a drug safety researcher and pharmacist based at Brisbane’s Mater Hospital, said she was concerned about the deal because of good evidence that the more drugs a person took, the more likely they were to have adverse reactions and interactions. She said while Blackmores may have evidence showing that prescription drugs reduce particular nutrient levels and that their supplements increase those nutrient levels, it was incorrect to presume that replenishing those levels was the right thing to do.

Outrageous, unethical and potentially dangerous according to experts. This is undoubtedly a grab for money targetting a demographic that is unable to afford trumped up scams with potential risks. Given the appalling performance of the alternative product industry in the recent Auditor General’s Report and concerns raised about regulation of same in the TGA Transparency Review in July, the Pharmacy Guild should be ashamed of itself.

I wish Professor Farnsworth could get a piece of them.