I’d Rather Have a Long List of Scary Warnings than Nothing at All

I recently participated in a coversation—or maybe I’m conflating two or more conversations, but no matter—in which my interlocutor said that she prefers alt-med natural remedies because mainstream drugs all have a long list of scary potential side effects.

But when I asked whether alt-med drugs actually lower cholesterol or help prevent heart attacks or whatever they claim to do, she said that people who sell alternative medicines tend to avoid making medical claims. They’ll say the product “enhances well-being” or some such, but not “this product helps regulate LDL”.

Because what happens is this: if you make a specific claim about physiological effects or the like, that’s a medical claim, and the FDA expects you to back it up. So Pfizer comes along and says, “this new drug, XYZ, improves blood-clotting.” The FDA says, “Oh, yeah? Show me.” And so Pfizer performs studies, or cites independent studies, that show that yes, as a matter of fact, patients who receive XYZ tend to clot better than patients who don’t, even after taking into account other possible explanations, like luck or the placebo effect. And the FDA says “All right, you’ve made your case. You can claim that XYZ improves blood-clotting in your advertisements.” At least, that’s how we want it to go; how we hope that it goes.

Unfortunately, the world is complicated, and it’s never as simple as “take this drug and you’ll get better.” Different people have different bodies and react to things differently—for instance, I have a friend who doesn’t drink caffeine because it puts him to sleep. So at best you’ll have “take this drug, and it’ll most likely help, but it might not do anything.” More often, you get a drug that does what it’s intended to do in the majority of cases, but also has a list of possible, hopefully rare, side effects. But the more participants in the study (which is good), the greater the chance that one of them will have a heart attack or something that can be plausibly be attributed to the drug being studied. So the Scary List O’ Adverse Effects grows.

So yeah, traditional herbal remedies that don’t have words like “vomiting” or “stroke” on the label look appealing by comparison. But that’s only because the people selling the herbs aren’t required to test them, or to publish the negative results. If someone out there did make a specific claim, like “echinacea helps relieve flu symptoms”, and the FDA said “Oh, yeah? Show me”, and they showed ‘em, and ran tests and studies and such, there would almost certainly be some adverse side effects to report. If you’re not seeing any, then either someone’s hiding them, or else no one’s looked for them.

In the real world, everything has problems. Saying you prefer alternative remedies to conventional medicine because it doesn’t have a scary list of adverse effects is like getting your financial advice from a psychic instead of an investment banker because instead of scary disclaimers about lawsuits and patents and the possibility of losing all your money, she just has the friendly statement “For entertainment purposes only.”

2 thoughts on “I’d Rather Have a Long List of Scary Warnings than Nothing at All”

  1. I like something that Orac once said (not his exact words): For a substance to have therapeutic effect, it must perturb the body’s chemistry in some way (to block inflammation, or reduce cholesterol, or raise serotonin levels, or poison the bacteria, or whatever….). And you never rule out the possibility that such perturbation will have some other effect as well, maybe even something very bad. So “alternate” remedies can only promise no side effects by having no effect whatever (which is true in the case of homeopathics [usually, but see: Zicam], or false in the case of many herbals).

    1. Yup. There you go.
      This seems to be a similar to an observation I once ran across: “Show me a completely smooth operation, and I’ll show you someone who’s covering mistakes. Real boats rock.” Google tells me this is from Frank Herbert’s Chapterhouse: Dune.

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