Vitamin B12-the new placebo?

A drug company has been perplexed at a shortage of Vitamin B12 created by a surge in use. A spokesman for the company said “doctors had so far failed to come up with a convincing explanation” and “Vitamin B12 was also used to treat chronic fatigue syndrome (CFS) and as a vitamin booster.”

It is clear from these comments that Vitamin B12 is being used as a placebo as there is no evidence at all that it is of any benefit in the treatment of CFS. In the course of my employment as a locum I have seen plenty of evidence that a lot of doctors are administering Vitamin B12 when there is no scientific indication. The deliberate use of placebos in this manner shows a complete lack of understanding of the consultation dynamic, a failure to understand the nature of the placebo effect, and a superficial grasp of basic science. If these doctors allowed patients sufficient time, listened and acknowledged their concerns in an empathetic manner, there would be no need for placebo injections.

Placebo vitamins can be dangerous. A three-year-old child choked to death after inhaling an animal-shaped vitamin C and echinacea tablet. A pathologist was of the opinion that “the tablet was too large for a child of three to be able to swallow”. Nowhere in the article was there any comment or criticism of the dietary supplement industry which promotes these totally unnecessary products.
Dominion Post June 25, 2004
Dominion Post May 26, 2003

Hey Noni Noni?

There is indeed “much ado about nothing” over Noni juice. It comes from a Polynesian plant and is widely touted as a cure-all for everything and anything, a sure sign of a quack remedy. A recent review (Bandolier 122) found no evidence that it is effective for any medical condition and commented: “Diluted noni juice does funny things to cells in test tubes, but then so might diluted orange juice.”

A Google search found over 600 websites complete with a medical PhD endorsement and the usual pseudoscientific language and testimonials.

Breast Implants — a silly con?

Welch’s law has struck again as claimants prepare to take their share of a US$2.35 billion fund set up by Dow Corning Corp in response to thousands of silicon breast implant liability lawsuits. This is despite the fact that a number of studies have conclusively proved that the claims of silicon-related illness were a delusion. These lawsuits caused a major upheaval in the American justice system and a review of the definition of an expert witness. Legal process was suborned by “expert” witnesses who managed to convince the courts that claimants should be rewarded and in today’s culture of complaint, it pays to attribute your “illness” to someone with deep pockets. The US insurance industry often influences the outcome of these cases as it is frequently cheaper to settle than to fight a long and expensive legal battle.

Abuse Claims

Medical practices are constantly changing but this has not stopped litigants from seeking to apply today’s standards in order to prove abuse and mistreatment in the past, in some cases going back several decades. An article in the Dominion Post (June 17, 2004) reports “invasive internal examinations” by a health camp doctor around 1983. An Act NZ MP has accused the doctor of committing and misdiagnosing sexual abuse.

At this time there were many erroneous beliefs about the examination of children and the signs that might be present indicating sexual abuse. It was believed, for example, that “reflex anal dilatation” was an indicator that abuse had taken place. Many children were taken from their families, and parents, normally the male, were accused of sexual abuse. It is now known that such simplistic forensic tests were flawed and we all know what happened when similar deluded ideas were applied to the behaviour of children at the Christchurch Civic Creche.

Hangover Cure

The product RU-21 contains dextrose and ascorbic acid and the makers claim that it prevents the build up of acetaldehyde which causes the hangover. Dr Mike MacAvoy of ALAC is quoted as describing the product as “ridiculous”. There is an associated claim that the pill was developed by the KGB so its spies would not suffer hangovers after drinking sessions. There is no scientific evidence that such a product will have any effect at all on the metabolism of alcohol.

This is the perfect product for silly binge-drinking yuppies (RU-stupid?), the same sort of people who buy energy drinks. These products are placebos and with proper marketing will prove hugely successful and make some people very rich.
Sunday Star Times June 13, 2004

Benefit Fraud

Many political commentators have noted the tendency of the latest budget to create a new class of beneficiaries. The Labour Government (aka the Nanny state) knows what’s best for us and will not be satisfied until we are all receiving some kind of targeted benefit. This mentality is behind the large increases in people on invalid (IB) and sickness benefits (SB). WINZ figures show that those receiving the IB rose from 45,519 to 71,394 over a seven-year period while the SB rose from 34,044 to 41,948. I have said before that the reason so many people receive these benefits is because they can!

A Christchurch GP has finally made a stand and refused to assess casual patients being referred from a neighbouring Work and Income Office. I support him as there are too many “rubber stamp GPs” signing these applications and there is no audit process at all. I have challenged various ministers about these abuses and they fall back on the same tired arguments that only doctors can assess work capacity. It is also remarkable how many career criminals appear in the courts described as either invalid or sickness beneficiaries.

The latest scam that I heard about is university students who want to have a holiday so they get their student health office to endorse them as being “stressed” or “depressed”. I recently did a locum on the West Coast and met plenty of people who met the criteria of “benefit bludgers”. One young man proudly told me that he had saved enough money from whitebaiting to pay for a new car. He was on a sickness benefit for “stress”.

In a truly amazing development, the same Christchurch GP is now the subject of a complaint by aggrieved beneficiaries!
Christchurch Press June 14, 2004

Taking the P*ss?

In a letter to the editor, a correspondent claimed that there were definite health benefits from drinking a daily glass of your own urine. I had a look on the internet and found a staggering 365,000 links to some truly disgusting websites. Deciding that New Zealanders couldn’t be that daft I narrowed the search to “NZ” and got 2000 hits and found none that directly referred to drinking urine. This could be a good test for the next conference — make a 30C dilution of urine and see if anyone is prepared to drink this homeopathic preparation.

John WelchJohn Welch

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