How Alternative Medicine Fails Us

rhodiola-roseaI’m forever fending off the alternative medicine brigade who seem to clump around this website and email me all kinds of supposed miracle cures that will spell the end of all health ills. One herbal remedy I recently focused on is Rhodiola rosea, in which I critiqued a promotional email from a vested interest in the product. They made all kinds of claims for this material on the back of very limited clinical trials. Needless to say advocates of alternative medicine commented aplenty.

As a chemist, I take what I hope is a healthy and skeptical view of all the biochemical and physiological claims these people make for their products. I’m just worried that there are so many people who are perhaps desperate to fix their lives that they become easy prey for such marketing. Anyway, for those who feel a chemist has no place criticising their beloved remedy, I turned to a pharmaceutical expert in Sheryl Torr-Brown of the Future Trends in Health blog to provide some additional support for my argument. She has many years experience in pharmaceutical science and has no axe to grind and offers an honest appraisal of my original post and some of the comments left by Sciencebase readers.

A glance at the scientific literature covering this herb seems to be minimal and biased in the main, she told me, and as such she agrees with my argument.

“When dealing with alternative medicine,” she says, “it is not enough to be right if you want to avoid the attacks. You also have to be sensitive to the highly personal views of those who find benefit in the drug albeit most likely due to placebo effect.”

This is perhaps an important point. Yes, the placebo effect is valid, but these remedies are usually very expensive and people are often spending their hard-earned money on what amounts to sugar pills, something that should be avoided perhaps especially in the current economic climate when every penny counts.

“A major point that most of the non-scientific public do not understand is that there is no such thing as a safe drug, natural or not,” adds Torr-Brown, “The dose is the poison, as the father of modern toxicology, Paracelsus said in the fifteenth century. Anything and everything will be toxic if you have enough of it or it gets into the wrong place. Unfortunately, people are tired of Big Pharma advertising and the media frenzy around drug withdrawals.”

She points out that ‘natural’ is sounding better and better to many folks, despite the existence of natural belladonna, natural cobra venom, oh, and natural background radiation. In the age of the Internet, it is now very easy to get positive anecdotes about anything. “Basically, one can decide what one wants to believe and then go find the evidence to support it,” Torr-Brown adds, “For scientists, we look for controlled studies to prove a point, whereas the general public are happy with a personal story or two of success.”

Many people, including several of the original, negative commenters on my R rosea post, are grasping to find something that works for them. “You cannot discount [some of these views] from a human perspective, but it makes no sense scientifically, adds Torr-Brown, “I am shocked by the number of people I know who pay huge amounts of money for the latest panacea only to give it up after a couple of months, usually due to lack of interest.”

  • Innocent children and the most vulnerable can be hurt the most
  • £200m boom as demand for ‘natural’ cures soars
  • Rhodiola rosea
  • How not to do a study on the efficacy of “alternative” medicine
  • Rhodiola rosea

K Barry Sharpless Live

A recent live Webcast gave Professor K. Barry Sharpless, the 2001 Nobel Prize Winner in Chemistry, the opportunity to explore the intricacies of scientific discovery and how it is that when observation is concerned, good luck favours only the prepared mind.

Video no longer available, sorry.

Neither the video nor the sound quality were great anyway. The organisers also ran a one-on-one interview with Sharpless. You might have also watched student reactions to the Sharpless lecture.

New Year Science Books

If you’re New Year’s resolution is to read more books, then check out the latest additions to my bulging shelves, order them quickly on Amazon and you may just have them in time to fulfill that New Year’s resolution:

Experimental heart – a racy read set in the world of pipettors and gene splicing, a first novel by Jennifer Rohn. creator of LabLit.com who blogs on Nature Network at Mind the Gap. Richard Grant has a more substantial review of Dr Rohn’s book under the title: I’m a professional cynic but my heart’s not in it.

Mars 3-D by Jim Bell – does what it says on the tin, super 3D images of the Red Planet with a free set of red-green spectacles, my kids were very impressed.

Exploring the Mystery of Matter – ATLAS – a gripping read of what we can expect once the LHC experiment is finally up and running.

Hubble – Imaging space and time – the most cosmic coffee table book you could ever wish for from National Geographic

The Science Book – also from NG, this mighty tome tells you “everything you need to know about the world and how it works, would make a fantastic gift for a homeschooler.

Also for review this week is yet more cosmic stuff this time on DVD: “The Universe” (they don’t for small-scale names these days, do they?) Complete season 2 of the History Television Network rroduction (five DVDs)

Vote for Sciencebase

UPDATE: Sciencebase was placed third in the Shorty Awards science category, apparently that gets me a free ticket to the awards ceremony, but unfortunately won’t pay my airfare or accommodation…regardless thanks for all your nominations and votes!!!

Sciencebase is currently #4 #3 in the Shorty Awards science category, please check out the site and if you think it worthy give us your vote via the awards nomination page or on Twitter.

The Shorty Awards honour the world’s top Twitterers in a variety of categories.

Here’s what nominators have said about sciencebase so far:

“I want 2 nominate @sciencebase in #science, b/c how can u get round twitter sciencebase in this category? He’s gr8 & has wit!” – @laikas

“I nominate @sciencebase for a Shorty Award in #science because he keeps his hand on pulse of science.” – @freesci

“I nominate @sciencebase for a Shorty Award in #science because he’s informative, witty, relevant and kind.” – @Jennifer_P

Your vote would be much appreciated!

Sperm, Discharge, Heroin, and Alzheimers

alkaline-batteriesBatteries are included (unfortunately) – A chemical cocktail of toxic gases is released when you burn alkaline batteries, according to the latest research from Spain. The investigating team highlights the issue with respect to municipal waste incineration, which is used as an alternative to landfill and suggests that recycling is perhaps the only environmentally viable alternative.

Today, UK government departments BERR and Defra, in conjunction with the Devolved Administrations,
today published a Consultation Document containing draft Regulations setting out proposed systems for the collection, treatment and recycling of waste portable, industrial and automotive batteries.

Cutting heroin analysis – Analysing samples of street heroin just got easier as researchers have developed a statistical method for removing uninformative signals from their near-infra-red spectra of seized samples.

Sperm and eggs – Scientists in Sweden have determined the precise molecular structure of a protein, ZP3, essential to the interaction of the mammalian egg coat and sperm. The work could eventually lead to improved contraceptives, has implications for fertility studies, and might, in some sense, explain how new species arise.

Untangling Alzheimer molecules – Magnetic resonance spectroscopy provides new clues about how a dipeptide molecule blocks the formation of the toxic amyloid beta-peptide aggregates in the mouse brain. The discovery could put paid to the theory that amyloid beta-peptide causes Alzheimer’s disease and suggest a therapeutic lead that focus on the real culprit at an earlier stage.

Alchemy Under the Spotlight

atlantic-bathymetryThis week, The Alchemist is digging in the dirt to find out about the carbon cycle and climate change, taking his whisky (or is it whiskey) with or without water, and discovering how to juggle molecules, on the other hand. Also in biochemical news this week, the crystal structure of a plant hormone receptor is revealed while researchers in Israel focus on blocking the protein misfolding that occurs in Alzheimer’s disease.

And, under the December physical sciences Spotlight

It’s all in the marine mix – Mixing of surface waters in the Atlantic Ocean seems to have reverted in the winter of 2007/2008 to “normal” levels for the first time in almost a decade…

Well, wooden you know? – New materials that look and behave like plastics can be produced from a renewable raw material known as liquid wood. The bioplastics promise to displace petroleum as a feedstock for certain applications…

Running with knives – Stabbing is the most common form of murder in the UK and Ireland. However, while forensic scientists understand the basics of the process…

Rx Reviews Redux

A new(ish) website has launched that aims to provide unbiased patient-generated data on the benefits of 7000 prescription medications and their side-effects.

Rateadrug.com hopes to do for pharma products what dooyoo and ciao do for gadgets by bringing the crowd to the debate. Patients can anonymously rate and review any of the prescription drugs they take and view other people’s experiences for free.

“All information on this site is unique, community data that is not biased by pharmaceutical or corporate objectives,” says spokesman Jack Dowd. He adds that, “The site provides patients with truly independent survey results about the risks and benefits of their medications. The more people that start using the site to rate their prescription medications (a quick 5-minute survey), the greater this resource will become.”

Using a prescription drug appropriate to your condition and your genetics can have significant, and often life-saving benefits, but with physicians particularly in the UK and a few other places emphasising how patients should help manage their own illness it is important to know what problems may arise or whether asking for a different prescription might actually be better for them.

Not all medications hit everyone in the same way, because of various factors including your SNPs (single nucleotide polymorphisms), that affect your body’s enzyme and receptor activity. “What’s effective and side-effect free for one person might not be the best drug for someone else, yet most harried doctors prescribe the same drug for 90% of their patients with similar conditions – regardless of individual sensitivities,” the site’s developers say. They hope that Rateadrug will prevent the next Vioxx from happening.

A side project of Rateadrug is involving pre-med students through the PreMed Prescription Rating and Experience Program (PREPP) where the students help senior citizens become more proactive with their drug intake by reporting their experiences through Rateadrug.com.

The site blurb suggests you use the reviews together with your doctor’s advice and FDA disclosures to achieve the best possible outcome for your (or your loved ones) medical condition. Of course, spammers and corporate shills will be readying themselves to distort the results in their favour, unless preventative measures are put in place. “To prevent spam and ensure a real person is taking each survey we require email verification where the user has to click on a link that we email to them,” Dowd told Sciencebase, “We also flag accounts that submit more than one rating for a specific drug. We’re committed to providing quality, real-user data and will continue to ensure that our results are not skewed by spam or anyone trying to influence the results of a specific drug.”

The site also drops a cookie on to your machine so that it knows how many people log in from a specific computer or IP address. If it looks like there are a lot of ratings for the same drug from the same IP address, they will flag those ratings for manual checking.

I asked Dowd to expand on how they are addressing security and validity issues. “At the moment we receive 20 or fewer ratings per day, and carefully review each one,” adds Dowd, “As the volume increases significantly it will become more difficult to impact and distort results – real ratings should outweigh any attempts to skew ratings. But, we will do our best to prevent this type of tampering.”

“Right now, we have a database of over 7000 drugs, but only about 300 have been rated and reviewed by users/patients,” he adds. Dowd and his colleagues hope that as more people find out about this site, the numbers will grow. “Our intention is to provide real ratings by real people and will do everything we can to assure this as we progress,” he told me.

According to CEO Mark Deuitch, RateADrug is currently hoping to get large numbers of patients to review the cholesterol-lowering statin drugs Lipitor, Lescol, Mevacor, Pravachol, and Zocar, anti-depressants such as Lexapro, Prozac, Effexor, Paxil, Zoloft, and Pristiq, and drugs used to treat insomnia including Ambien, Lunesta, Sonata, Rozerem, and Benzodiazepines.

In related news from the UK’s National Health Service: Drug reference information in the British National Formulary will become a key element of the new NHS Evidence portal due to be launched in April 2009. As a result, responsibility for provision of this information for the NHS will transfer from the Department of Health to the National Institute for Health and Clinical Excellence (NICE), as part of the development of NHS Evidence.

Melamine Detector

MelamineA fast and inexpensive melamine detector is reported in the RSC’s journal ChemComm this week. The research follows hot on the heels of the melamine in milk scandal of 2008 and the petfood contamination in 2007 and earlier. The two techniques are based on mass spectrometry and could be adapted to provide on-site kits that would require little training to use.

Melamine, commonly used as a fire retardant and polymerized to a plastic resin, was added to milk during processing to artificially boost its apparent protein content.

David Muddiman, professor of mass spectrometry at North Carolina State University, Raleigh, US, describes the techniques as “marvellous examples of how innovative, direct analysis ionisation methods, when coupled with mass spectrometry have the ability to address contemporary problems facing the world. The [researchers have removed all the major obstacles allowing for mass spectrometry not only to compete, but to take the lead in these types of analyses.”

More details here.

Social Media for Science Librarians

roddy-macleodI’m still following the social media for scientists trail and asked my good friend Roddy MacLeod of Heriot-Watt University, Edinburgh, who runs the Internet Resources Newsletter whether he had any thoughts on gathering up social media resources and scientists into a directory or other online resource. It would be useful, for instance, to know which scientists are on Twitter, who is using Ning sites and who can be poked, with a testtube, on Facebook.

I asked MacLeod what he thought of the idea of collating all the scientists on Twitter, Facebook, LinkedIn etc. “The question maybe is whether all the scientists would like to be gathered up. After all, it’s the individual who is in control of his/her own environment in these general social networks, and maybe that’s the way it should be.”

“I did a wee post on some social networking services on the spineless blog, but mostly leave that to SciTechNet and Brian Kelly et al,” he told me. “One thing I reckon is that as social networking sites like IET Discover and 2collab, and others multiply, it’s going to get more difficult for librarians. They can’t be expected to join and participate in all the possible specialised social networks, unless they specialise in a very particular subject, so they’ll end up missing a lot of potentially useful stuff. “There are so many, I can barely keep up,” he confessed, “Some interoperability between them would be great, because otherwise you have to spend time creating a brand-new profile for each one.”

He adds, that we [information scientists and librarians] are in a similar situation as they were with the burgeoning spread of trade journals, but at least librarians could scan those occasionally, so keeping up was easier. Many of the thousands of trade journals are free.

MacLeod echoes a commentator in my previous SM post regarding financing of these sites: “I reckon that only the well-supported social networking services will survive (those backed up by large professional societies or major publishers),” he told me, “Some of the smaller ones may end up like those discussion forums on some sites where no-one actually discusses anything.” There already are plenty of cob-webs on the net. “Yes, there are the very general all-subject ones, the well-supported general ones such as IET Discover and 2collab, some niche ones which are likely to survive,” adds MacLeod, “and some chancer ones that are trying to jump on the bandwagon. This means some wasted effort as we wait to see which ones will take off and survive, but there is no other way.”

tictocs-logoMacLeod will soon be busy promoting ticTOCs, which will potentially help all researchers, including those unaware of RSS newsfeeds or who don’t care for that technology and keen RSS aggregators alike. “ticTOCs will serve both types of user in different ways allowing them to keep up-to-date with the research literature.”

To use ticTOCs as a current awareness service, you don’t need to know anything at all about RSS. ticTOCs ingests RSS feeds behind the scenes, but it’s perfectly possible, using ticTOCs to find, display, expand and then save (to the MyTOCs feature in ticTOCs) tables of contents to keep current without any mention or knowledge of RSS. “To me, this is the main use of ticTOCs because,” adds MacLeod, “as a Forrester report recently pointed out many people don’t understand/use/can’t be bothered with RSS. However, for the minority who are happy to use RSS, ticTOCs can be used as a tool to find relevant table of contents feeds, and then export them to the person’s favourite feed reader.”

The important point about RSS and TOCs is described in Lisa Rogers’ article in FUMSI. What librarians and every researcher needs is RSS feeds for journal TOCs. Moreover, publishers must produce TOC feeds in a standardised way, says MacLeod. This will allow both individuals, and services such as ticTOCs and others (see 6 mentioned in IRN) to better utilise feeds, and this in turn will help get current journals better exploited. “What ticTOCs has found is that publishers currently don’t produce journal TOC RSS feeds in a standard way,” MacLeod says, “they insert all sorts of things in various fields, they put the authors in various fields, they often don’t include abstracts, often don’t include the DOI, often don’t cite authors in a standard way, etc.

Rogers’ article goes some way to explaining what publishers should do, and CrossRef will be coming out with more Recommendations for publishers with respect to tables of contents RSS feeds in the future. “This is also very important for publishers because of the increasing emphasis on papers being deposited in Institutional Repositories after 6 months of being published,” adds MacLeod, “So, the publishers need to exploit their current content as soon as possible after publication as possible.”

Water of Life

A while back, I visited the Bushmills whiskey distillery (it was my second visit in as many decades) always a pleasure, especially the tasting panel at the end of the tour just before you spend all your money on, ahem, souvenirs.

Whisky is a broad category of distilled drinks made from fermented grain mash and aged in wooden casks. Different grains are used for different varieties, including barley, malted barley, rye, malted rye, wheat, and maize (corn), certainly a favourite at holiday time and the subject of many a New Year’s Resolution. The fermentation liquid is distilled, sometimes several times, to produce neat spirit, which is then aged in casks. Different barrels, virgin oak barrels, pine barrels, used sherry casks, charred barrels, are used to produce different flavours.

It’s quite ironic that there are some 200 to 300 chemicals in the finished product including carbonyl compounds, alcohols, carboxylic acids and their esters, nitrogen- and sulfur-containing compounds, tannins and other polyphenolic compounds, terpenes, and oxygen-containing heterocyclic compounds, and esters of fatty acids any one of which would probably be banned under health and safety rules if you were inventing whisky as a product today. Indeed, the nitrogen compounds include pyridines, picolines and pyrazines, carcinogens on the rocks, any one?

Anyway, one aspect of the whole process from grain to bottled liquor that fascinates me is that the distilled liquid, the spirit, is an almost pure ethanol-water mix (an azeotrope). In fact, the tourguide at Bushmills told us that this was so and that the flavour is then all to be found in the aging process in the barrel. But, if that’s so, then it doesn’t explain the wide range of flavours of whiskys matured in similar casks, nor does it explain how the peaty fireside phenols of some Scotch whiskys, the Islay type for instance, are carried into the bottle.

As is my current wont, I twurned to Twitter to ask about this and hooked up there with Michelle Jones of justaddbourbon.com who asked some of her friends in the bourbon trade about the spirit of the water of life, so we’ve got a Stateside answer.

“Look at it this way, distillation provides the palette by which aging can work its magic. There is no doubt that American Whiskey was once a very harsh tipple. Once aging was introduced, it mellowed the whiskey considerably. But even that doesn’t wholly answer the question. Aging contributes differently based on time. Short aging might contribute a little more sweetness whereas long aging contributes smokiness and oakiness. But most people pick out mintiness and a long finish from Heaven Hill whiskeys. That is a result of the distillation process.”

Whisky lactone (3-methyl-4-octanolide) is present in oak, which is the most commonly used barrel material and endows whiskies with an essence of coconut aroma, while the diketone diacetyl (2,3-butanedione) gives the buttery aroma of most spirits. Commercially charred oaks used for aging barrels are particularly rich in phenols, with some 40 different phenolic compounds, having been revealed in charred oak barrels, each one of which can add to the flavour. The coumarin scopoletin is also present in whisky.

Oh, and just in case you thought I was being inconsistent with the whiskey/whisky spelling, it’s impossible to know which one should be used whiskey is often for Irish and American, and whisky for Scotch and Canadian, but it’s Maker’s Mark Bourbon Whisky (original distillers were Scottish) and Woodford Reserve Bourbon Whiskey (waiting on an answer as to whether they have Irish origins), and they’re made just 80 miles apart in Kentucky.