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Chicken Soup and the Placebo Effect

Natural Remedies that Really Work: A New Zealand Guide by Shaun Holt
Craig Potton Publishing, $40. Reviewed by :JR

natural-remedies-that-really-work-a-new-zealand-gu-9781877333804.jpgThere’s no doubt in my mind that chicken soup cures the common cold. And nothing beats royal jelly if you’re feeling rundown. Depressed? Try Vegemite.

You want evidence? Okay, I admit it, I don’t have any hard (or even soft) evidence but chicken soup isn’t called Jewish Penicillin for nothing – and I once read a brief in a newspaper that claimed scientists had confirmed its medicinal properties. As to royal jelly the doctors at the Harbin Medical School, where I taught English in 1989, swore by it. And the Vegemite? It’s got something to do with Vitamin B…

But then maybe it’s just the placebo effect.

Associated Press recently reported a study in the BMJ – formerly the British Medical Journal – that found half of American doctors regularly give patients placebo treatments – usually drugs or vitamins “that won’t really help their condition”.

The BMJ study doesn’t probe why the doctors give the placebo treatments. It does reveal that as well as the harmless dishing out of sugar and vitamin pills as placebos 13 percent of doctors hand out antibiotics and the same number prescribe sedatives despite knowing they’re not needed.

The last time I visited my GP – about four years ago now – he had just been to a conference on harnessing the power of placebo. A strong advocate of evidence-based medicine and the need for doctors to be up front and honest about the evidence or lack thereof for any particular treatment he found himself in something of a dilemma.

The reason that double blind drug trials include a placebo control is that it’s recognised that some people benefit simply from the belief that they are taking a medicine that will cure them

As my doctor said, by being dismissive of treatments that weren’t evidence-based – the evidence suggested he could be jeopardising his patients’ chances of benefiting from the placebo effect.

He was quick to point out that it wasn’t just alternative medicines that lacked hard evidence for their efficicy. The over prescribing of antibiotics, he suggested, was partly a result of the desire of both doctors and patients for a quick-fix.

If the mysterious placebo effect is an example of the mind’s ability to cure the body, plainly, the best way to harness it is take a cure that is evidence-based and in that way harness both the placebo effect and whatever curative powers the treatment has.

But the process of looking for that evidence could place you in a double or nothing situation. To go back to my chicken soup example, the fact that I believe it works, most probably means it does, to some extent at least, work. But I’ll reluctantly admit I’m not 100% convinced it works, so maybe it would work better if I knew there was hard evidence backing it. On the other hand if I was to find out that studies had definitively shown that there was nothing it it would probably destroy whatever placebo effect it has.

And that in a nutshell is the dilemma I faced when Shaun Holt’s book came through the mailbox. Should I risk having my chicken soup illusions shattered and thus put at risk any placebo effect it may be having on my health, or take the plunge and have my belief confirmed and possibly amplify its effect?

I took the plunge: there’s nothing on chicken soup. Go figure.

Shaun Holt – a medical doctor with degrees in both medicine and pharmacy – admits to having been highly sceptical of natural health products but changed his mind after noticing a number of natural health studies appearing in some of the top 20 or so medical journals.

Holt begins the book with a list of headlines published during a three month period in Britain’s Daily Mail. To sample just a few:

Beer for Menopause, Pomegranate juice for prostate cancer, Hair dyes cause cancer, Manuka Honey is the Answer to Everthing, Curry Stops Azheimer’s.

As Holt points out the articles – often briefs – often contradict each other are rarely provide you with enough information to take up the remedies in any case. Just how much beer should a menopausal woman drink and having dyed her hair for the last 20 years should she be more worried about dieing of cancer?

Holt and some colleagues launched the excellent website Natural Health Review to help people evaluate locate natural remedies that are backed by scientific evidence.

And now there’s a book: Natural Remedies That Really Work: A New Zealand Guide.

Research studies in the book are divided into 16 categories, which include among other things: Weigh Management, Fitness and physical activity, pain management, central nervous system and mental health, cancer prevention, and child health.

Each chapter contains a number of remedies that have been found to work. The remedies are described and evaluated with links to relevant websites provided.

Dr Holt hasn’t included any studies on the effect of vitamin B on depression but there is a study on B Vitamins and the Risk of Parkinson’s Disease.

I’ve decided to reproduce it in full because I can’t think of a better way of illustrating the usefulness (or otherwise) of the book.

The Effect of B Vitamins on the risk of Parkinson’s disease

• Over 50000 people participated in this study to investigate the effects of dietary intake of folate, vitamin B12 (cobalamin) and vitamin B6 (pyrodoxin) on the risk of developing Parkinson’s disease.

• The study followed the participants, who were all over 55, for an average of almost 10 years, measuring their dietary intake of these vitamins.

• The reults showed that a higher intake of vitamin B6 significantly decreased the risks of developing Parkinson’s.

Evaluation This study can be classified as a large, important study, published in a prestigious medical journal. Parkinson’s disease affects 5 million people worldwide, with symptoms most commonly appearing between the ages of 55 and 60. Although the mechanism of action is unclear, this study found that vitamin B6 may reduce the risk of Parkinson’s.
http://www.neurology.org/cgi/content/abstract/67/2/315


Application
In this study, those individual with the highest intake of vitamin B6 (more than 1.73 mg per day) had a 31% decrease in the risk of developing Parkinson’s disease, while no association was observed for folic acid and vitamin B12.

The recommended daily (RD) for vitamin B6 is 1.5mg for men and 1.4 mg for women. Vitamin B6 can be obtained from eating liver, chicken, fish, grean beans and bananas in particular, or an be taken as a supplement. Wheatgerm, muscle meats, liver, kidney, whole grains and legumes are all good sources. Desiccated liver and brewer’s yeast are recommended as supplemental soures

For more information about New Zealand RDIs for vitamins and minerals, and healthy eating tips, visit the following websites.

http://www.nhmrc.gov.au/pulication/synopses/-files/n35.pdf

As a note of caution, mixing vitamin B6 with levodopa (Dopar, Larodopa), used for Parkinson’s disease may reduce the medicine’s effectiveness.

Because of the potential for side effects and interaction with medications, dietary supplements should be taken only under the supervision of a knowledgeable healthcare provider. For further information on possible interactions between non-prescription and prescription medicines, visit the following website:

http://www.everybody.co.nz/page-77702432-28e7-4e42-b1c4-77c9768b6ea0.aspx

It’s an impressively thorough book but I can’t see myself regularly consulting it. That said, if I or anyone in my family found themselves facing a serious illness I suspect I would grab it from the shelf. And who knows, next time I see some brewer’s yeast I may throw it in the supermarket trolley in the hope of delaying the onset of Parkinson’s disease.

I also can’t help thinking that it might make a better website – continually updated and easily searchable – than a book.

LINKS

Chicken Soup evidence and more and more