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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Snake Oil Supplements

January 10th, 2008 · 64 Comments

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Raise your right hand if you don’t take any herbal supplements.

Gee, I don’t see any hands, and I probably wouldn’t see more than a handful if you were here with me literally instead of virtually.

People with diabetes probably take more supplements than other people. About 36 percent of American adults use complementary and alternative medicine (CAM), much of it in the form of supplements. We spend $20 billion a year for supplements.

Aside from the drain on our bank accounts, we don’t have any good proof that any supplements work. None of them.

Supplements are, of course, supplemental to the foods that we eat, our diet. We certainly differ in what we think is a good diet, although we haven’t subjected diets and individual foods to clinical trials. That could be coming, but we haven’t yet mastered the testing of supplements.

“There is no compelling, credible scientific evidence to suggest that any CAM therapy benefits any medical condition or reduces any medical symptom (pain or otherwise) better than a placebo.” This is the conclusion that R. Barker Bausell, Ph.D., reaches on page 254 of his book, Snake Oil Science: The Truth About Complementary and Alternative Medicine (Oxford, 2007, $24.95). He is a bio-statistician and a professor at the University of Maryland. Dr. Bausell was formerly research director of the University of Maryland’s Complementary Medicine Program.

With his direct and entertaining style, Dr. Bausell’s book is accessible to both a lay and professional audience. He addresses people with diabetes at several points, specifically on page 292, “If you have a potentially life-threatening condition, don’t discontinue your insulin…or other treatment, because no CAM therapy is going to come close to matching these drugs’ potency.

Snake Oil Science came out in October, but I didn’t hear about it until Christmas day, when I read Abigail Zuger’s glowing review in The New York Times. I rushed right out and bought my own copy as soon as I could.

Dr. Bausell’s book is the perfect complement to The Natural Pharmacist and Complementary & Alternative Medicine (CAM) Supplement Use in People with Diabetes: A Clinician’s Guide. I previously reviewed this website and book here.

Why then do we subject ourselves to so many useless supplements? Dr. Bausell says that the placebo effect is the key to how well CAM works. “CAM therapies are nothing more than cleverly packaged placebos,” he writes on page 275.

The trouble is that most of these therapies do work — although weakly, temporarily, and subjectively. While the placebo effect is the main culprit, other stumbling blocks include regression to the mean, the Hawthorne effect, and what he calls “natural history.”

Dr. Bausell uses the term natural history in the statistical rather than the usual sense. It’s natural for a disease to get better or worse during the course of an illness whether or not it’s treated. We also commonly start treatment when the disease is at its worst. When it naturally gets better, we credit the treatment instead of our body.

Because our minds play these tricks on us, we don’t have any options besides randomized, double-blind, placebo-controlled trials when we evaluate any therapies. These trial are the gold standard. But while they are necessary to protect our bodies from our minds, they aren’t sufficient.

They need to be large studies too. Dr. Bausell says that credible trials must have at least 50 patients per group and preferably more than 100.

Watch out too when a lot of the people in the trials drop out. For the trials to be credible they must have relatively minor attrition — preferably less than 20 percent, but certainly less than 25 percent.

Studies published in “high-quality journals” are better than the thousands of other journals, even if they are “peer-reviewed.” The runaway leaders among general (non-disease-specific) American medical journals, Dr. Bausell writes on page 178, are the New England Journal of Medicine and the Journal of the American Medical Association (JAMA). My guess is that in diabetes specifically, they may be Diabetes and Diabetes Care, which the American Diabetes Association publishes.

We have a relatively objective way to determine which journals are high quality. That is to look at what is called “journal impact,” which is based upon the number of times a give journal’s research articles are cited by other researchers.

Also, those trials that independent investigators validate are the most credible. Multi-center trails are one of the best ways to get this independent replication.

We also have to watch out for what Dr. Bausell calls bias from scientific acculturation, where certain countries publish essentially nothing but positive results. In practice that means that 98 percent of conventional Chinese trials produced positive results, as did 97 percent of Russian trials.

If you want to keep taking the supplements in your pillbox or add new ones, these are the most important points to consider in your checklist. I take some supplements myself knowing full well that we have no proof of their effectiveness — but I am too old to wait for proof.

So I carefully consider the clinical trials of the supplements I’m interested it. Dr. Bausell brought to my attention studies of three supplements that I have been taking. As a result, as soon as my current supplies run out I will stop taking milk thistle (Silybum marianum) to protect against liver disease, saw palmetto to reduce the symptoms of BPH, and possibly ginkgo to improve my memory. The first two of these have highly credible studies showing that these supplements are no better than placebos. The ginkgo study meets Dr. Bausell’s standards, but I wonder.

The ginkgo study was a “randomized, double-blind, placebo-controlled, parallel-group trial.” But it lasted only six weeks.

I wondered if six weeks is long enough to prove or disprove whether herbs or drugs can establish the necessary neural connections. I wondered enough about this to ask Dr. Bausell directly.

“I agree with you to a certain extent about the length of, say, a six-week study,” he replied. “But my guess is that if this particular trial had been extended it would have still been negative. You can always find reasons why a study doesn’t come out the way you expect: the dose was wrong, the wrong outcome measure was employed, the length was wrong, the inclusion/exclusion criteria were inappropriate, and so forth. What I tried to do was look at the gestalt of evidence for the entire field.”

So I am surely wasting my money on some (if not all) of the supplements I take. So be it. Still, I want to warn you away from at least the wildest claims for snake oil supplements.

This is a mirror of one of my articles that was originally published on Health Central.

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64 responses so far ↓

  • 1 Vikram Reddy // Jan 15, 2008 at 11:42 am

    Is there any discussion about multi-vitamins, fish oil, etc?

  • 2 David Mendosa // Jan 15, 2008 at 12:26 pm

    Dear Vikram,

    The author considers vitamins and foods outside the scope of his book. They are both mainstream now.

    David

  • 3 Ron // Jan 27, 2008 at 10:10 am

    I probably wasted my money, but just purchase a product called Ultimate Reds advertised on radio. Claim is that this reduces “free radicals” that destroy celluar regeneration and could help in controlling blood sugar. It is powder mixed with water containing antioxidants extracted from fruit. I have just been diagnosed with Type II diabetic and am on Metaformin.

    Is this a con by a supposedly doctor on the radio?

    Website is http://www.drnewtons.com

  • 4 admin // Jan 27, 2008 at 11:35 am

    Dear Ron,

    The man behind “Ultimate Reds,” according to a site that sells it is Michael Pinkus. He is a chiropracter and not an M.D. Please read about him at http://www.quackwatch.com/11Ind/Pinkus/pinkus1.html

    David

  • 5 Ron // Jan 27, 2008 at 7:41 pm

    Thanks for the info, David. Not very comforting after reading your website link.

    I know there are other similiar products from Purity Products “Super Reds” but they just claim its good for cardiovascular health.

    There are also capsules containing cinnamon that claim they help with glucose control also. I assume this might be just a come on also and no proven fact.

    I guess I must be a CAM junky.

  • 6 admin // Jan 27, 2008 at 8:13 pm

    Dear Ron,

    Most of us are CAM junkies! As to cinnamon, there is conflicting information, but the latest isn’t too good.

    I take l-arginine for cardiovascular health — but it is far from proven. I also eat a lot of fish and take fish oil supplements and try to keep my ratio of Omega-3 fatty acids to Omega-6 up. There is a lot more proof about that for cardiovascular health.

    David

  • 7 Victor // Feb 19, 2008 at 12:47 am

    Nice! Thanks!

  • 8 Sergio Spinola // Feb 20, 2008 at 10:13 am

    There are many scientific protocols on the Web, the only one I know are the ones on Ginko wich is proven to strenghten and keep flexible arteries and vein walls. There is one supplement very important for us, Bilberry, really effective in eye protection.
    Kind regards
    Sergio

  • 9 Sergio Spinola // Feb 20, 2008 at 10:45 am

    Hi! this is a protocol on Saw Palmetto, it looks good to me, and the conclusions are that palmetto is as effective as finisteride:

    http://jama.ama-assn.org/cgi/content/full/280/18/1604

    Vol. 280 No. 18, November 11, 1998

    Saw Palmetto Extracts for Treatment of Benign Prostatic Hyperplasia

    A Systematic Review

    Timothy J. Wilt, MD, MPH; Areef Ishani, MD; Gerold Stark, MD; Roderick MacDonald, MS; Joseph Lau, MD; Cynthia Mulrow, MD, MS

    JAMA. 1998;280:1604-1609.

    Kind regards

    Sergio

  • 10 rick shide // Feb 25, 2008 at 1:52 pm

    the proof is in the pudding, europe is way ahead of the US in alternative medicine and the results are there for all to see.

    I suffered from severe GERD, so bad that I would spray my bedroom walls with gastric fluid while fighting for air. My psoriatic arthritis was so bad I had a very difficult time with mobility. I was scheduled for Aortic arch replacement surgery since my aorta had grown to over 5cm, according to tests at both Mayo and the U of Minn hospitals.

    So I threw away my Nexium and my Enbrel and started on high doses of pro and prebiotics, EFAs such as fish oil, vascular support supplements such as hyalauronic acid, and cellular support supplements such as MSM, it total 25 supplements.

    My GERD is completely gone, it took two months. My psoriatic arthritis symptoms are completely gone, I’m more limber than I can ever remember, my range of motion constantly amazes me. I no longer need the aorta replacement since my last diagnostic has it at 4cm.

    I trust nutrition *much* more that what I consider the true snake oils – prescription drugs. I’m 56 and will no longer take prescription drugs unless absolutely necessary. 90% of all prescription drugs world-wide are consumed by Americans.

    Please don’t start attacking alternative medicine, it’s been my boon, not bane, and you are doing your readership a big disservice my minimizing it.

    Perhaps Dr Bausell’s relationship to big pharma should be investigated.

  • 11 Diane Gill // Feb 27, 2008 at 11:55 am

    My father-in-laws brother recommended saw palmetto to him, he started it and it reversed his bph. I personally know many other people who have benefitted from herbal and vitamin supplementation.
    The problem is that there really are a lot of quacks out there because there is a lot of money to be made in this biz. On the other side, big pharma is just getting bigger, shoving meds into ignorant victims.
    It takes a lot of work to find the real, effective, herbals, vitamins AND meds. There is truth and beauty in everything, right beside all the crap. Information is so accessible through the internet, but there is so much of it, that to wade through it all is virtually impossible for most people. Do we trust our doctor who’s on big pharma’s payroll? Do we trust our alt practitioner who may be in it for the money?
    Knowledge is our greatest asset, and personal experience. Doctors can be helpful, so can the alts. We have to get as much info as possible so that we don’t follow blindly.
    For vitamins & minerals, I know that SISU brand works. Trophic Iron chelazome really works when i’m anemic and it’s not constipating.
    RDA in vitamins are usually very low. If you have a problem that you may have heard would be helped by a certain vitamin, ie: B6, google vitamin B6 max dose. (B6 reduces hypertension). There can be a fine line between the amount needed to make a difference and toxic doses, so get the info before dosing. Also read about competing vitamins – calcium inhibits absorption of iron and other things, take by itself. take iron and selenium together. Vitamins can be incredibly helpful in the right doses and the right combinations, I know by personal experience.
    The best herbal supplement, by the way, is garlic. FRESH GARLIC, NOT GARLIC CAPSULES. Crush a clove with the side of a big knife, chop it finely, pray for a blessing on it (if you are inclined), put timer on for 10 minutes, swallow the garlic with water. don’t do this on an empty stomach. D o this three times a day if you’re sick, once a day if not. take a break from it after a week, up to several months if you’re healthy, then return. It will kill strep bacteria completely (strep stays in your body), it will fix your organs if taken over a long time, (prolapsed uterus in my personal eperience). Eating garlic with food is good, but taken in this manner is much more helpful. I believe that this treatment can prevent and reverse cancer, but haven’t got any proof, personal or otherwise, of that. Use a small bunch of fresh curly parsley to scrub the smell out of your hands, eat another small bunch of parsley to get rid of the body smell. I wish everyone that sees this would try this garlic therapy, and let me know if it helps them at gill7seven@yahoo.ca.

  • 12 Diane Gill // Feb 27, 2008 at 12:07 pm

    I put in the info about vitamins in there because there are a lot of crap vitamins. SISU is a company has studied vitamins and balanced them to make them more useful to you. There are other good vitamin/herbal companies out there also, like Sunrider and others. Muscle testing is a good way to find out if a supplement will help you or not. If anyone wants more info about that, email me at above email

  • 13 Makita // Mar 1, 2008 at 2:34 pm

    Very Nice! Thanks!

  • 14 Amer // Mar 3, 2008 at 2:58 am

    I believe in the approach of integrative medicine. Take whatever any form of medicine offers which is supported by some valid evidence. Unfortunately, not every remedy is DBRPC tested so you have to make a choice.

    I am strong believer of supplementation of diet with naturally occuring foods only. Also, I have seen health recoveries with the use of homeopathy, which, arguably is one of the safest of all forms of medicine.

    Its main problem is finding a good & traditional homeopath. I am lucky to have found one.

    Regarding chana daal, I didn’t read the entire details on this site, I would like to mention that its origin is “black channa” which probably is “black chick pea”. The process is simple, the black skin of the black chick pea is removed and its seperated into two halves.

    Our eastern medicine (called hikmat) has been using it for centuries for dyring up chronic phelgm in chest or nose. Roasted “black channas” if consumed, half a cup daily, will show improvement within 1-2 weeks.

    I used to eat channa daal (its a regular part of eastern cuisine) before I knew about its link with black channas. Now I eat black channas more as they are “whole”. The best recipe is black channa curry which you can take from any Pakistani or Indian family.

    Regards

  • 15 Amer // Mar 3, 2008 at 3:06 am

    100% agree with the comments posted above about garlic. I can vouch personally, its probably the most potent anti viral, bacterial & fungal naturally occurring product.

    I have stopped, reversed & prevented, countless times common cold, sore throat and what not.

    I am delighted to read someone else also using it.

    I eat it first thing in morning, when needed and cap it with fresh apple.

  • 16 Amer // Mar 3, 2008 at 5:45 am

    What is the fasting serum insulin for a normal healthy person.

  • 17 John Whitling // Mar 5, 2008 at 3:00 pm

    Have you REALLY stopped taking Saw Palmetto? I would like to know because if I even miss a day or two of taking it, I have problems again. I agree that there’s a lot out there we don’t need to take but thus far Saw Palmetto is something that really works for BPH. Given that you wrote this in january 08 maybe you’ve reconsidered ..

  • 18 Robin J Crane // Mar 31, 2008 at 12:19 pm

    So this means that everything done in medicine before pharmacuticals (since the first treatment EVER) was useless? Nothing worked until Big Pharma? Somehow I’m just not buying that.

  • 19 Dave Perry // Mar 31, 2008 at 2:10 pm

    Hello David:

    I read your great comments about Snake Oil supplements. There certainly are a lot of false claims and shaky research out there.

    But I have to disagree on one point.

    There are supplements on the market, subjected to numerous double-blind placebo clinical tests lasting longer than 6 weeks, that cause considerable reductions in blood sugar and weight.

    If you read Dr. Harry Preuss’ book, “The Fat-Loss Pharmacy”, he talks about supplements that he’s conducted tests on at the Georgetown University Medical Center, with good results.

    Separate tests at Harvard, Creighton and other reputable medical centers confirm his findings.

    In the interest of full disclosure, I work with a 61 year old diabetic who researched Dr. Preuss’ findings and decided to formulate his own supplement after successfully using them to address his Type 2 diabetic condition.

    I have no affiliation with Dr. Preuss or his book.

    But I’ve met him once and he made the point that high fructose corn syrup (found in just about every processed food today), is one of the leading culprits accelerating the diagnosis of Type 2 diabetes in the U.S.

    And he stands by his research on supplements that can effectively and safely help overcome the impact of HFCS.

    Dr. Preuss’ doesn’t have a website, but you can find his book in stores or online.

    Hope this helps.
    Dave Perry

  • 20 Karen Vaughan // Apr 16, 2008 at 2:07 pm

    I am a trained clinical herbalist and I have issues with a number of the trials cited. In fact it is true that there is a lot of bad research on herbs, usually done by people who don’t use them. When an herb is tested with the wrong part of the plant, a third of a standard dosage, in a form (say capsules) that is poorly assimilated or using material that not only isn’t assayed, but is frequently misidentified, then the testing doesn’t prove anything. When only one constituent is studied, it doesn’t mean the whole herb works, especially if it is given in other than oral form. Similarly tests in vitro have virtually no relevance to actions in people unless the herb is topically applied- and this applies to many studies cited by the supplements industry.

    Just because a supplement isn’t tested doesn’t mean it isn’t useful. I would love it if all herbal supplements were tested, under the guidance of an AHG Registered Herbalist who could vet the dosage and material, but the financial incentive just isn’t there.

    Still there are other valid ways to know if supplements are useful. If something has been used in various parts of the world for the same indication, chances are that it works. If it has been used over 300 years, there is a good chance it is better than placebo since useless medications, botanical or otherwise, tend not to last over a hundred years.

    I wouldn’t give up milk thistle because I think both the studies and clinical experience are good. Saw Palmetto is great, but the standardized stuff is standardized to the wrong marker for BPH and some of the material is Chinese and not the proper species, which doesn’t grow there. For Saw Palmetto I usually give my clients Herbalist & Alchemist or HerbPharm. Cinnamon was studied in small studies but shows similar rates to Metformin and is easier on the liver, but will not add additional benefit to Metformin if you take it already. Garlic works fresh, as cited previously, with pill form significantly weaker. Turmeric is a great anti-inflammatory but requires large doses, like a teaspoon a day, and when mixed with 5% black pepper has equivalent value to the expensive 40x standardized stuff. I buy mine from an Indian grocery or get the fresh stuff from Hawaii. Gymnema, which has been studied extensively in India can reduce insulin requirements (so you need to check) but may not be good for insulin resistance.

    And snake oil? High in Omega 3s, and perhaps unfairly maligned.

    If you are interested in how tests can be misleading, see Jonathan Treasure’s “Medscape and the Mainline Manufacture of Misinformation” at http://www.herbological.com/images/downloads/HH2.pdf
    Hope that is useful.

    Karen Vaughan, MS Oriental Medicine
    (RH) American Herbalists Guild

  • 21 Dave Perry // Apr 27, 2008 at 2:10 pm

    Hello David:

    I don’t know if you’ve had a chance to read Dr. Preuss’s book on clinically-tested supplements for blood sugar and weight control.

    But you can also find his video comments on ihealthtube.com.

    There are 3 videos featuring Dr. Preuss.

    He explains which supplements work, why most doctors don’t understand which work and which don’t. And describes how he evaluates supplements to separate the effective herbs from the snake oil.

    Thanks,
    Dave Perry

  • 22 David Mendosa // May 21, 2008 at 6:16 pm

    Dear T,

    You should always be concerned about a rash. Maybe you need to consult a dermatologist.

    If you have type 2 diabetes, you can control it without any diabetes pills or insulin. It may seem difficult, but only at first. The solution is a very low-carb diet, like the one that Dr. Bernstein has taught for years. I know now and follow that diet myself and no longer have to take any diabetes medication.

    Best regards,

    David

  • 23 Kleist // May 29, 2008 at 9:38 am

    Keep in mind that the only way the huge pharmaceutical industries can make money is by charging inflated prices for patent-protected drugs. Since any common substance in general use over the years cannot be patented, a multi-billion dollar industry with all of its political influence is committed to those common substances, which can be inexpensively obtained, not being found to be useful for cure or treat conditions now treated by expensive and high-profit patentable drugs. Through its control over scientific journal expense subsidies and its connections with the medical community, Big Pharma sees to it that non-patentable medications are never given adequate funding for the studies which could prove their effectiveness. Once this has been done and all funding has been re-directed to endorsing its own products, Big Pharma goes around shouting to the rooftops that there are no studies endorsing alternative therapies and many studies supporting its products. The whole vicious cycle is a huge fraud on the public.

    One example speaks volumes. For decades Big Pharma used to repeat the mantra that studies of vitamin E in the treatment of disease showed it to be entirely useless. What few people bothered to check as they decided en masse never to buy any vitamin E was that the studies on which this ‘proof’ of ineffectiveness was based had studied patients taking 5 IU of vitamin E a day — a miniscule amount compared to what is now known to be the safe dosage of around 1600 IU a day.

    Medicine is so burdened by interests of greed and social control that it is more political than scientific, and I find the comments here about supplements being a waste of money to demonstrate a lack of awareness of just how political medicine in fact is.

  • 24 james // Jun 19, 2008 at 10:36 pm

    I do not believe Dr. Bausell has higher standards of proof than the many doctors and companies that utilize CAM procedures and supplements. For example regarding Saw Palmetto

    “In a double-blind, placebo-controlled study of 110 patients with BPH, 160 mg bid of a Serenoa extract given for 30 days significantly improved nocturia, dysuria, post-voiding residual urine, flow rate, patient self-rating, andthe physician’s overall assessment.

  • 25 Sill // Jun 20, 2008 at 3:17 pm

    What are other reputable herbal /vitamin companies that I can check out?

  • 26 Larry // Jul 7, 2008 at 2:11 pm

    I have found that VitaCost (www.vitacost.com) has reasonable prices and high quality. It appears to be run by board certified MD’s. Their multi-vitamin formulas are state of the art.

  • 27 Sergio Spinola // Jan 11, 2009 at 10:44 am

    Milk thistle is actually prescribe at the Mayo clinic
    and if those guys do it, it should be almost OK for all of us. Unless some major negative breaktrough.

  • 28 Dave B // Feb 11, 2009 at 9:30 pm

    I’m a medical researcher who has worked with research studies and statistics all his life. I have looked at all the research available on the web on supplements for diabetes for several years now and I have to concur 100% with Doctor Bausell. There is no meaningful research supporting most supplements, even multi-vitamins or vitamin E. Magnesium (epsom salts), fish oil pills, and flax seed oil pills are the only exceptions, and they work largely on the heart disease which invariably accompanies type 2 diabetes.

    Dave B

  • 29 David Mendosa // Feb 12, 2009 at 9:10 am

    Dear Dave,

    Thanks for adding your support. The general level of belief in the efficacy of supplement is so high that my article supporting Dr. Bausell has generated a lot of resistance.

    I also appreciate your naming the three exceptions. Magnesium is something that I continue to take. For years I used fish oil pills but switched to something comparable — and I think better — krill oil pills about a year ago. For salads I use flax seed oil and often add to what I eat something similar — and I also think better — chia seeds. I’ve written separate articles here about krill oil and chia seeds and about magnesium elsewhere on my website.

    Many thanks,

    David

  • 30 Herbal Malc // Apr 8, 2009 at 12:33 am

    Hi

    The evidence for many supplements is mixed. This is partly because there is no money to test them.

    However, there are many people who report huge succes from using them – eg the guy with GERD above – a great story. Studies are hard to interpret unless you are a scientists in the field. I rely on experts to interpret them for me. Eg Life Extenion at lef.org offer great information, better than I could find out myself.

  • 31 Karen Vaughan // Sep 5, 2009 at 9:00 pm

    There are a lot of bad scientific studies out there on all sides of the aisle. But what I have found with herbal studies is that:
    1) Material is rarely assayed to make sure the species or strength is what they say. And often it isn’t.
    2) Often the wrong part of the plant is used – eg. echinacea purpurea stems, which have no traditonal use.
    3) The dosage is nowhere near the dosage used by clinical herbalists (and such people certified by the American Herbalists Guild are available.) If I take half an aspirin, my headache won’t go away- does that mean aspirin doesn’t work?
    4) The wrong species is often used. And heck, half the time they can’t spell the herb’s name. Would anyone publish a study that misspelled the name of the pharmaceutical they are testing?
    5) They confuse isolates with the whole herb. Note that beta carotene is an isolate, as is vitamin E which is always found mixed in nature with tocopherols and tocotrienols. Much of the so called “herbal” research is on a constituent and if that constituent doesn’t work, there is no evidence that the plant itself doesn’t. With the shitake mushroom most of the research is on fractions, but the one study that showed that the whole herb worked better than any of the fractions is rarely cited. You can’t patent the whole herb.
    6) The sample size is too small, the study period is too short, and there is no followup. My son was conceived the month after I “successfully” completed a birth control study, while still on the method.
    7) The questions are wrong or the standards for efficacy are set unrealistically high. I have seen any number of studies that failed to look at the side effects (usually much less with supplements) or wanted major depression treated with St. John’s wort which treats minor depression, or which posits some fantastic potential that has never been associated with the herb in order to claim “it doesn’t work for…” And in the case of St. John’s wort it did improve people’s major depression, but they set the bar so high that they discounted it.
    8) The data showed improvement but the writeup discounted it. For instance when St. John’s wort was tested head to head against Zoloft and other SSRIs, none of them did better than a placebo, but the headlines said “St. John’s wort does no better than a placebo” forgetting all about the pharmaceuticals and ignoring that the herb actually beat out the placebo or most of the SSRIs.
    9) And finally, do you know how many studies use so-called placebos that are not inert? I have seen any number of herbal studies where they tested against another herb that they claimed had no value, but in fact was an active medicinal herb for the condition. (They knew that sugar pills would look different, so they decided to use an herb.) Obviously the difference between an active herb and the tested herb will minimize the efficacy.

    Karen S. Vaughan, L.Ac., MSTOM
    Registered Herbalist (AHG)
    http://www.acupuncturebrooklyn.com
    253 Garfield Place
    Brooklyn, NY 11215

  • 32 David Mendosa // Sep 6, 2009 at 4:27 pm

    Dear Karen,

    Thank you so much for your thoughtful and comprehensive comment.

    Best regards,

    David

  • 33 Helen // Oct 4, 2009 at 2:36 am

    Hi, A couple of my liver enzymes are outside normal. Does that mean I have non faty liver diease? Should I take saw palmetto /milk thistle to improve this? Can it be reversed? I exercise everyday and have lost 70 pounds in 8 months?
    I was intersted to read that losing weight too quickly could effect my liver? Do you think this is the case? I reduced my carbs significantly and that was the result?
    Many thanks for your very helpful site and all your advise.
    Kind regards
    Helen

  • 34 David Mendosa // Oct 4, 2009 at 6:33 am

    Dear Helen,

    You probably do have fatty liver disease as I once had and wrote about it at http://www.healthcentral.com/diabetes/c/17/1363/fatty-liver/

    Saw palmetto won’t help, but milk thistle probably will. Your fatty liver can be reversed; mine was.

    Your exercise certainly helps as I wrote at http://www.mendosa.com/blog/?p=325

    I too have read that losing weight too quick is hard on the liver. But nobody ever defines “too quickly.” I had a fatty liver when I was heavy, as most people do, and when I lost weight — quite quickly — I was able to reverse my fatty liver. You can too.

    Best regards,

    David

  • 35 Marian // Mar 7, 2010 at 8:04 am

    Hi David,

    Great information here on your website.

    Your post from Feb 12, 2009 mentioned that you now take krill oil pills instead of fish oil. A year later is that still the case and what is your current dosage? I’m interested in trying the krill oil to reduce inflamation and blood sugar levels.

    I’m insulin resistant and prediabetic at age 52.

    If not too much trouble, could you list the supplements and dosages you currently take or
    do you have that information somewhere on your website?

    I did see your average daily diet – inspired by Dr Bernsteins diet protocol?

    Thank you!

    Marian

  • 36 David Mendosa // Mar 7, 2010 at 1:57 pm

    Dear Marian,

    Yes, indeed, I do still take krill oil pills. But I have increased my dose to 3 capsules per day.

    Best regards,

    David

  • 37 Debbie // Jul 20, 2010 at 11:04 am

    Dear David,
    Other than krill oil, what supplements do you currently take? I am confused about whether I should continue taking cinnamon, CQ10, calcium citrate, etc.

    Thanks!
    Debbie

  • 38 David Mendosa // Jul 22, 2010 at 12:58 pm

    Dear Debbie,

    The only other supplement I take is vitamin D.

    David

  • 39 Kend S // Aug 8, 2010 at 5:12 pm

    It is a real wonder the human race survived all this time without the big pharma. One friend who has had to take insulin for almost 50 years began taking Ultimate Reds in March. Not taking it for diabetes but other things. He went from having to take about 2 insulin shots a day to 2 to 3 a week. His doctors didn’t believe it until testing. They just can’t understand why, it’s not supposed to happen. They planned on putting him on dialysis but can’t come up with justification now. They make him come back every 2 weeks now but all his levels are getting better. At almost 80 this just doesn’t happen.
    Another friend who hearing this decided to begin taking Ultimate Reds, because at 54 was newly diagnosed with diabetes from a influenzae damaged pancreas and completely destroyed his ability to make insulin. His ability to produce insulin was gone, gone never to return. After 3 months of taking Ultimate Reds the doctors took him off insulin. His blood sugar levels had stabilized and he has had no periods where it has gone up except the 3 day lapse when he ran out before his next shipment arrived. Several others are getting the immense placebo effect of this now as well.
    OF COURSE THESE ARE purely placebo effects since all thinking people know unless the FDA, AMA, and Big Pharma’s rings are kissed then it’s not real science. I’m not saying every supplement is good or without effect, good and or bad; JUST LIKE DRUGS.
    In the past decades medical schools have become like law schools, they produce some physicians and some doctors. Advocates and physicians help people, Lawyers and Doctors help big business.
    Mr. Mendosa, why not kick the vitaman D and get some sun to make your own?

  • 40 David Mendosa // Aug 8, 2010 at 7:27 pm

    Dear Kend,

    For Ultimate Reds, please see the comment and my reply at http://www.mendosa.com/blog/?p=244

    As to getting in the sun to make vitamin D, I do get a LOT of sun with all the hiking and photography that I do. Please read my “Fitness and Photography for Fun” blog at http://www.mendosa.com/fitnessblog . But older people do not make enough vitamin D from the sun, and I just celebrated my 75th birtday. So I take at least 5000 IU of vitamin D3 every day to keep my vitamin D level up where it needs to be.

    Best regards,

    David

  • 41 Marian // Aug 8, 2010 at 9:33 pm

    Unable to see your comment on Ultimate Reds. Can you check to see if link you posted is active?
    Thanks,
    Marian

  • 42 David Mendosa // Aug 9, 2010 at 9:03 am

    Dear Marian,

    While I don’t understand why you can’t see my comment — it’s right here about our correspondence, I am copying the comment I responded to and mine below:

    #

    Ron // Jan 27, 2008 at 10:10 am

    I probably wasted my money, but just purchase a product called Ultimate Reds advertised on radio. Claim is that this reduces “free radicals” that destroy celluar regeneration and could help in controlling blood sugar. It is powder mixed with water containing antioxidants extracted from fruit. I have just been diagnosed with Type II diabetic and am on Metaformin.

    Is this a con by a supposedly doctor on the radio?

    Website is http://www.drnewtons.com
    #

    4 admin // Jan 27, 2008 at 11:35 am

    Dear Ron,

    The man behind “Ultimate Reds,” according to a site that sells it is Michael Pinkus. He is a chiropracter and not an M.D. Please read about him at http://www.quackwatch.com/11Ind/Pinkus/pinkus1.html

    David

  • 43 Renae // Sep 23, 2010 at 12:16 pm

    Dear Mr. Mendosa,
    Per your hearty recommendation of Vitamin D3, I just purchased a bottle which offered Vitamin K2 along with the 5000 IU of Vit. D. In my excitement over the Vit. K addition, I didn’t take note that the pills were sublingual. In your wise judgement, is that a positive or a negative? Also, they are small white tablets instead of gel capsules as I expected. What do say about that? Thank you for your response. I am grateful and truly look to you for wisdom in being victorious over diabetes. Renae

  • 44 David Mendosa // Sep 23, 2010 at 12:27 pm

    Dear Renae,

    Honestly, I know hardly anything about sublingual pills. But I would think, unless anyone corrects me, that they would work as well, but at the cost of being inconvenient.

    David

  • 45 Marian // Sep 26, 2010 at 2:02 pm

    Hi David,
    I have been taking 1200 mg 2x of Alpha Lipoic Acid daily to treat diabetic neuropathy of my feet for 2 months now. I still have some numbness in my right foot, but little to no stinging/tingling sensations. I will continue to take this to prevent further degradation of my micro vascular system. I have attached a link with some research. In your studies have you run into any information on this supplement?
    http://www.umm.edu/altmed/articles/alpha-lipoic-000285.htm

  • 46 David Mendosa // Sep 26, 2010 at 7:06 pm

    Dear Marian,

    Personally, like you, I don’t think that ALA is snake oil. I take it myself on the recommendation of Dr. Richard K. Bernstein. Please read his recommendations in “Dr. Bernstein’s Diabetes Solution.”

    Best regards,

    David

  • 47 Gil // Nov 23, 2010 at 10:47 am

    I do feel that the placebo effect does play a big role in the supplement industry, but there are some products that have been researched and proved to help people. it’s important for individuals to do there research and truly find the answer for themselves.

  • 48 Padmesh // Jan 11, 2011 at 2:05 am

    Rick Shide,

    Your post was enlightning. Pleas let me know the specific supplements for PSA.

    Regards,
    Padmesh

  • 49 larry // Jan 12, 2011 at 4:49 pm

    David- ever hear of treating diabetes by reducing inflamation in the body? Theory being, the inflamation at the celluar level increases coritisol and adrenal production.

  • 50 David Mendosa // Jan 12, 2011 at 6:14 pm

    Dear Larry,

    Yes, indeed. You might want to read my articles about it here. I have written at least five about inflammation.

    David

  • 51 larry // Jan 12, 2011 at 8:27 pm

    Thanks David- what would it be listed under?

  • 52 David Mendosa // Jan 12, 2011 at 9:18 pm

    Dear Larry,

    You can go to http://www.mendosa.com/search.htm and click on the button for Search my “Diabetes Developments” blog and search for the word inflammation.

    Best regards,

    David

  • 53 Chris@Apple Roof Cleaning // Feb 6, 2011 at 8:29 pm

    Wow, I have HEP C and take Milk Thistle to help my Liver!

  • 54 larry // Feb 7, 2011 at 6:58 am

    David- do you know anything about Intergrative Health of Orlando and their claim to cure diabetes?

  • 55 David Mendosa // Feb 7, 2011 at 7:54 am

    Larry, we can control our diabetes and put it into complete remission if we have type 2. Type 1s will always have to inject insulin but can control it that way. Both type 1s and type 2s can be healthier than ever by controlling diabetes.

  • 56 Chris@Apple Roof Cleaning // Feb 7, 2011 at 8:13 am

    I agree very much Dave, I am Type 2 and excercise is crucial to me and my blood sugar. I messed up at Taco Bell and had a so called mango/strawberry smoothie type drink. I barely made it home it spiked me so high!

  • 57 Perfect Skin Kardashian // Feb 13, 2011 at 7:27 pm

    Incredible post there bro. d^^bI hope you keep on updating this page!!!

  • 58 Ed // Apr 1, 2011 at 5:08 pm

    Alpha Lipoic Acid is no joke. It reversed my retinopathy to almost nothing. It is a prescription drug in Germany used to treat peripheral neuropathy in diabetics. Now I’m trying another powerful antioxident “astaxanthin” Google scholar search that.

  • 59 Flora Steele // Apr 24, 2011 at 7:44 pm

    For perspective on drug/herb testing, we might look at stevia.

    This is a “sweet leaf” that is obviously effective; it tastes sweet. It’s also obviously pretty safe in normal amounts; it’s been used in South America for centuries.

    But (in its natural form) it’s not patentable, so there’s no reason to invest in the great expense of safety tests. If Company A bears that expense and it is approved by the FDA, then Company A will find hundreds of competitors selling it. So few tests will get done looking for good or harmless ‘links’.

    Otoh, Companies B, C, D, etc who have patented artificial sweeteners stand to lose sales if customers can buy cheap stevia instead. So they have motive to fund tests looking for harmful ‘links’ — and plenty of cash to fund them with.

    (Lately some patented stevia products have been tested and passed.)

  • 60 Joshua // Jul 6, 2011 at 9:54 pm

    Thanks for the great perspective. I agree there are piles of charlatans out there, many trying to cash in on our ailments. But to be fair, there ARE many good studies out there, done with high quality, standardized substances that can be beneficial, incuding some of the substances you mention- particularly Milk Thistle (silymarin), Saw Palmetto, and Ginkgo Biloba. It is important that the raw materials are reputable in the study- this is often the area overlooked by otherwise competent researchers.

  • 61 Aisha // May 20, 2012 at 12:34 pm

    Piggybacking off the cinnamon comments and questions….

    I have Type 2 Diabetes and so do several members of my husband’s family. Cinnamon does work, at least for us.

    I take it after food but my grandmother takes it before food (especially if she’s going to eat a lot of carbs or sugar/fruit). Some take it every time they eat (I only take it once a day). Some take a lot of capsules at once and some only take one (like me). It depends on your own body. Like everything, though, the pills should NOT be taken without doctor approval especially if you’re on other medication.

  • 62 Peter // May 23, 2012 at 11:52 am

    re Milk Thistle, if you haven’t seen this site, then try:

    http://goo.gl/jZhun

    cheers

    pete

  • 63 David Mendosa // May 23, 2012 at 12:36 pm

    Dear Pete,

    Thank you so much for you very short post! Not for milk thistle, because the site you link doesn’t show any conclusive benefit. But because it appears to be the old and highly valued Natural Pharmacist with a different name. I have bookmarked the home page of what they now call “Natural & Alternative Treatments” at http://alleghanyregional.com/your-health/index.dot?id=120459&db=hlt&ebscoType=healthindex&lang=English&widgetTitle=EBSCO%20Health%20Library%20Index

    David

  • 64 Peter // May 23, 2012 at 2:52 pm

    I really like that site! I use that and yours as my main sources of good input for my T2D :-)
    Yes, I know that the page I reference doesn’t have conclusive benefit of Milk Thistle, but it is a tad more encouraging than your comments above relating to Dr Bausell would lead me to believe :-)
    Can you provide a link to his study?
    …and thank you so much for the work you have done and are doing to keep this website alive, strong and interesting :-)

    pete

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