Brain supplements are a waste of money.

If you’re getting on in years you may have noticed that a lot of web advertising these days consists of pitches for supplements that are supposed to improve “brain health” and prevent things like Alzheimer’s and Dementia. The industry that makes these products pulls down $3.2 billion every year showing that there’s lots of folks worried about falling victim to these conditions as they age. There’s just one problem with these products: None of them have been demonstrated to do a damned thing other than drain your wallet.

“This $3.2-billion industry … benefits from high-penetration consumer advertising through print media, radio, television and the internet,” the neurologists wrote. “No known dietary supplement prevents cognitive decline or dementia, yet supplements advertised as such are widely available and appear to gain legitimacy when sold by major U.S. retailers.”

Are brain supplements a big waste of money? – MarketWatch.com
Image by Melanie Simon from Pixabay

It’s bad enough that these bullshit products are sold alongside legitimate medicines at your local pharmacy, but apparently there are also licenced medical personnel that are pushing pseudo-medical treatments:

“Some of these practitioners may stand to gain financially by promoting interventions that are not covered by insurance, such as intravenous nutrition, personalized detoxification, chelation therapy, antibiotics or stem cell therapy. These interventions lack a known mechanism for treating dementia and are costly, unregulated and potentially harmful,” the article states.

There are a lot of companies out there that are eager to cash in on your fears. According to the MarketWatch article, the FDA ‘issued a statement saying it posted 17 warning and advisory letters to domestic and foreign companies that illegally sell 58 products — many of them dietary supplements — that claim to prevent, treat or cure Alzheimer’s disease and other serious health conditions. […] “These products may be ineffective, unsafe and could prevent a person from seeking an appropriate diagnosis and treatment.”’

Unfortunately, the MarketWatch article takes a nosedive in the latter half by talking with a naturopath who proscribes Homeopathic treatments which is another big woo-woo bullshit industry. To her credit she agrees that using dietary supplements that aren’t backed by solid research is a problem, but that’s about the only credit she deserves. Homeopathy is an even bigger batch of nonsense than the dietary supplement industry. At least the supplements contain actual ingredients.

Don’t fall for the bullshit. The causes of Dementia and Alzheimer’s are complex and promising research is ongoing, but so far nothing has been shown to be an effective preventative of these conditions. Not only are brain health supplements just a waste of money, but they’re also potentially harmful and could end up interacting with other prescription drugs you may be taking in negative ways.

Hell, this is true for dietary supplements in general. Most do nothing other than cost money. Some are dangerous when taken with other prescription medication. Vitamin supplements are arguably useful, but only when your doctor says you actually need them. If you’re already getting all the vitamins you need from your diet then you will literally piss away anything extra you get from a supplement.

Dr. Oz will never let your health get in the way of his ratings.

dr-oz-memeThe popularity of celebrity doctors always baffles me. Whether its Dr. Phil — whose license to practice psychology has been retired since 2006 — or, more recently, Dr. Oz.

In all fairness I have to admit that I’ve only ever watched a few episodes of Dr. Oz and those were mainly because someone else was watching it at the time, but that was enough to call into question any medical advice he has to offer. You see, he’s really big on “alternative” medicines and diet pills and he promotes them heavily on his show. Stuff like raspberry ketone or green coffee extract both of which he has proclaimed as “miracles in a bottle” on his show and both of which haven’t been shown to do jack or shit when it comes to weight loss. However, the lack of scientific evidence beyond a sketchy study or two isn’t enough to prevent Dr. Oz from promoting them heavily.

At it turns out, these outrageous claims by Dr. Oz have been egregious enough to land him in front of a Senate subcommittee that’s looking into the whole green coffee extract nonsense. There he was grilled by Senator Clair McCaskill, Chair of the Senate Committee on Commerce, Science, and Transportation’s Subcommittee on Consumer Protection. She did not go easy on him:

“When you feature a product on your show, it creates what has become known as ‘Oz Effect,’ dramatically boosting sales and driving scam artists to pop up overnight using false and deceptive ads to sell questionable products,” the Senator explained. “I’m concerned that you are melding medical advice, news and entertainment in a way that harms consumers.”

via Dr. Oz Grilled By Senator Over “Miracle” Weight-Loss Claims – Consumerist.

It’s a fair statement and you’re probably guessing that Dr. Oz ended up feigning ignorance or trying to claim the products really do work. Nope, he admits that — at best — the products he promotes as “miracles” are crutches that can not replace proper diet and exercise:

Dr. Oz openly admitted that the weight-loss treatments he mentions on the show are frequently “crutches… You won’t get there without diet and exercise,” and that while he believes in the research he’s done, the research done on these treatments would probably not pass FDA muster.

“If the only message I gave was to eat less and move more — which is the most important thing people need to do — we wouldn’t be very effectively tackling this complex challenge because viewers know these tips and they still struggle,” said the doctor. “So we search for tools and crutches; short-term supports so that people can jumpstart their programs.”

In short, he knows better. As he should if his medical degree is legitimate in any sense of the word. McCaskill wasn’t letting him off the hook so easily:

Sen. McCaskill quoted three statements that the great and doctorful Oz had made about different weight-loss treatments on his show:

•(On green coffee extract) — “You may think magic is make-believe, but this little bean has scientists saying they found the magic weight-loss for every body type.”

•(On raspberry ketone) — “I’ve got the number one miracle in a bottle to burn your fat” (raspberry ketone)

•(On garcinia cambogia) — “It may be the simple solution you’ve been looking for to bust your body fat for good.”

“I don’t get why you say this stuff, because you know it’s not true,” said McCaskill. “So why, when you have this amazing megaphone, and this amazing ability to communicate, why would you cheapen your show by saying things like that?”

At this point the good doctor defended his claims on the basis that he believes the products in question do work despite the lack of any reason to do so and then admitted that his claims result in scam artists jumping to sell this crap to everyone dumb enough to listen to him, often using his likeness and statements to endorse it:

“I do personally believe in the items that I talk about on the show,” responded Dr. Oz, who acknowledged that statements he’s made in the past have encouraged scam artists and others looking to make a quick buck on people looking for an easy way to lose weight.

“I do think I’ve made it more difficult for the FTC,” he continued. “In the intent to engage viewers, I use flowery language. I used language that was very passionate that ended up being not very helpful but incendiary and it provided fodder for unscrupulous advertisers.”

Call me old fashioned, but when you’re making medical claims I would think you would want to avoid “flowery” language. However, this raises another point: The intent of Dr. Oz’s show isn’t to give you sound medial advice. It’s to entertain you. He feels he has to engage his viewers by making outrageous claims because apparently the truth won’t get him the ratings that really pulls in the big bucks.

“My job, I feel, on the show is to be a cheerleader for the audience and when they don’t think they have hope, when they don’t think they can make it happen, I wanna look — and I do look — everywhere… for any evidence that might be supportive to them,”

In short, he’s selling false hope. He’s willing to promote whatever quackery he can find that offers the smallest of hopes based on the flimsiest of evidence. Sure, that’ll probably make you feel good, but it isn’t doing you any favors. He’s perpetuating nonsense that does nothing but lighten your wallet. The worst part is, he knows it. A lot of the other pseudoscience bullshit peddlers out there at least have the excuse that they’re not really doctors or trained in medicine. Dr. Oz is and he admits that he knows better, but that won’t get him the ratings he needs.

Potential new circumcision recommendations have ‘intactivists’ all hot and bothered.

Pic of circumcised banana.

It's like this. Except with your dick.

To circumcise or not to circumcise, that is the question pondered for thousands of years by new parents of baby boys. For most of that time the decision was usually pretty simple: Are you Jewish or Muslim? If so then you remove the skin-hoodie. If not, God has no interest in your foreskin so you can keep it. (Technically the Jews considered it an edict from God whereas the Qur’an doesn’t specifically mention it, but many Muslims do it anyway because fuck you, we’re Muslims, and we do shit like that.)

Then, sometime around the dawn of the 20th century as the Germ Theory of Disease finally started to take hold, the idea that having a foreskin could be unhealthy (because, for God’s sake, think of where you stick that thing) caught on in Western societies and the practice went from being a quirky religious rite to a matter of good health and cleanliness. Also, a lot of people thought it helped to curb masturbation which was also considered a very bad thing. Masturbation that is, not the curbing of it.

In recent years there’s been quite a debate over whether there actually is any health benefits from trimming a man’s sausage with a number of studies indicating that any health benefits were probably minimal at best and were offset by the disadvantages (decreased sensitivity, etc.). “Intactivisits”, folks who advocated against circumcision as unnecessary and unethical, launched campaigns to not only discourage the practice, but to help men who have been “victimized” by their parents come to grips with what they considered the mutilation of their favorite organ. A few took the problem well in hand and came up with products designed to help you regrow a foreskin if you were so inclined.

Needless to say, they won’t be to happy to read about this:

Pic of ant-circumcision marchers.

I understand you're passionate about this, but there's no need to make yourself a dick over it.

The Centers for Disease Control and Prevention and the American Academy of Pediatrics, currently neutral on whether to circumcise, are drafting new policies in light of recent studies suggesting circumcision helps prevent transmission of HIV and other sexually transmitted diseases.

Both agencies say they plan to publish their new recommendations this year, though they’ve been saying that for the last two years.

Anti-circumcision activists — dubbed “intactivists” because they advocate leaving penises intact — fear official endorsement could encourage more parents to subject their sons to what they consider an unethical and purely cosmetic procedure.

“That would be a disaster,” said John Geisheker, executive director and general counsel for the advocacy group Doctors Opposing Circumcision. “We hope they waffle again.”

My guess is that the chances the CDC or AAP will go back to recommending circumcision are probably small. At best they might offer a flaccid endorsement, but will otherwise continue to leave it as a choice for parents to make. Various studies have suggested that being circumcised may help reduce the spread of sexual diseases, reduce the risk of penile cancer, and so on. That said, the intactivists do have a point:

“We’re talking about amputating tissue from a child in order to prevent disease that adult behavior can prevent,” Geisheker said.

[…] Both sides agree that most parents circumcise their sons not for health but to conform to cultural norms, which raises ethical questions about whether parents should be able to irrevocably alter their kid’s appearance.

“You’re removing healthy, erogenous, highly nerve-supplied tissue from a human being who has not given his or her consent, and you’re doing it for nontherapeutic reasons,” Geisheker said.

On the one hand I can agree that circumcision is ethically questionable, but on the other I think the Intactivists are way more aroused by this than they should be. As a circumcised male myself I have to admit that I don’t miss what I never knew I had and I can’t think of any outstanding mental or physical health issues that are a result of my lack of foreskin. Any decrease in sensitivity that I’ve suffered from due to the lack of my dick-turtleneck hasn’t impaired my ability to enjoy sex over the years in any noticeable way.

That said, I tend to come down on the side of if there isn’t significant health benefits in it then it’s probably best to leave things where they are crowd. But then I feel the same way about unnecessary plastic surgery. There’s certainly nothing that says if for some reason a man later in life decides he wants a circumcision that he can’t elect to have one, but probably best to leave that up to each male’s prerogative unless you can demonstrate the aforementioned significant health benefit.

So that’s that then. My only real reason in writing about this was to see how many masturbation and dick jokes I could squeeze in without using lubrication. I think I rose to the occasion quite well, though it was a little hard going there for awhile.

Stem cells appear to have cured AIDS in a test subject, but there’s a catch.

Doctor’s in Germany appear to have cured a man suffering from AIDS with transplanted stem cells:

A 42-year-old HIV patient with leukemia appears to have no detectable HIV in his blood and no symptoms after a stem cell transplant from a donor carrying a gene mutation that confers natural resistance to the virus that causes AIDS, according to a report published Wednesday in the New England Journal of Medicine.

“The patient is fine,” said Dr. Gero Hutter of Charite Universitatsmedizin Berlin in Germany. “Today, two years after his transplantation, he is still without any signs of HIV disease and without antiretroviral medication.”

[…]  HIV uses the CCR5 as a co-receptor (in addition to CD4 receptors) to latch on to and ultimately destroy immune system cells. Since the virus can’t gain a foothold on cells that lack CCR5, people who have the mutation have natural protection. (There are other, less common HIV strains that use different co-receptors.)

People who inherit one copy of CCR5 delta32 take longer to get sick or develop AIDS if infected with HIV. People with two copies (one from each parent) may not become infected at all. The stem cell donor had two copies.

The interesting thing is that the Doctor’s were doing the stem cell treatment not to try and cure the man’s AIDS, but to deal with his leukemia. The effect on his AIDS was just a side benefit. The key word to remember in all of this is that it “appears” to have cured him of AIDS. The truth is there are problems that make this unlikely to be used as a general treatment for AIDS:

While promising, the treatment is unlikely to help the vast majority of people infected with HIV, said Dr. Jay Levy, a professor at the University of California San Francisco, who wrote an editorial accompanying the study. A stem cell transplant is too extreme and too dangerous to be used as a routine treatment, he said.

“About a third of the people die [during such transplants], so it’s just too much of a risk,” Levy said. To perform a stem cell transplant, doctors intentionally destroy a patient’s immune system, leaving the patient vulnerable to infection, and then reintroduce a donor’s stem cells (which are from either bone marrow or blood) in an effort to establish a new, healthy immune system.

Levy also said it’s unlikely that the transplant truly cured the patient in this study. HIV can infect many other types of cells and may be hiding out in the patient’s body to resurface at a later time, he said.

“This type of virus can infect macrophages (another type of white blood cell that expresses CCR5) and other cells, like the brain cells, and it could live a lifetime. But if it can’t spread, you never see it—but it’s there and it could do some damage,” he said. “It’s not the kind of approach that you could say, ‘I’ve cured you.’ I’ve eliminated the virus from your body.”

Still, it holds some promise in at least some situations and it opens up an avenue of research that could bear fruit someday in the fight against AIDS. With a disease like AIDS you take your victories where you can get them.

Palcebos work better in kids than adults.

So says this rather brief article at Wired.com:

It’s a strange finding nestled inside a weird phenomenon:  children are 50 percent more likely than adults to respond favorably to placebos.

So concludes a Public Library of Science Medicine review by French pediatricians of anti-epilepsy drug studies. If replicated in other drugs, researchers may need to adjust their analyses of clinical drug studies involving kids.

What could account for the tendency of kids to feel better after taking a drug designed to do nothing? The reasons, write the researchers, “remain largely unknown and mostly speculative.”

This seems pretty simple to me. The placebo effect is at least partly based in belief and children will believe almost anything someone they trust tells them in sincerity. Kinda makes sense that they’d work better in kids. That’s probably oversimplifying things a bit, but I’d be surprised if that wasn’t true.

U.S. in last place in preventable deaths.

This article pretty much speaks for itself:

U.S. last in preventable death rate – UPI.com

BETHESDA, Md., Jan. 8 (UPI)—The United States ranks last among 19 industrialized nations when it comes to deaths that could have been prevented.

The report by The Commonwealth Fund, published in the journal Health Affairs, said 101,000 deaths per year could have been prevented by access to timely and effective healthcare. The top performers were France, Japan and Australia.

Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine looked at deaths “amenable to healthcare before age 75 between 1997-98 and 2002-03.”

The researchers found that while other countries saw these types of deaths decline by an average of 16 percent, the United States experienced only a 4 percent decline. “It is notable that all countries have improved substantially except the U.S.,” said Nolte, lead author of the study.

There is no good excuse for this. None.

Appeals court upholds ruling blasting Q-Ray Bracelet as “fraud.”

Every now and then the makers of quack medical products and other woo-woo snake oil nonsense get a well deserved smack down. The makers of the Q-Ray Ionized Bracelet, which I’ve written about previously here, got one back in September of 2006 when the FTC sued them for fraud and the court ruled in the FTC’s favor. The makers of the Q-Ray Bracelet filed an appeal and the results of that case were just announced yesterday (PDF file). Here’s a sample:

EASTERBROOK, Chief Judge. WIRED Magazine recently put the Q-Ray Ionized Bracelet on its list of the top ten Snake-Oil Gadgets. See http://blog.wired.com/gadgets/2007/11/10-awesome-gadg.html.

The Federal Trade Commission has an even less honorable title for the bracelet’s promotional campaign: fraud. In this action under 15 U.S.C. §§ 45(a), 52, 53, a magistrate judge, presiding by the parties’ consent, concluded after a bench trial that the bracelet’s promotion has been thoroughly dishonest. The court enjoined the promotional claims and required defendants to disgorge some $16 million (plus interest) for the FTC to distribute to consumers who have been taken in. 448 F. Supp. 2d 908 (N.D. Ill. 2006), modified in part by 472 F. Supp. 2d 990 (N.D. Ill. 2007).

According to the district court’s findings, almost everything that defendants have said about the bracelet is false. Here are some highlights:

  • Defendants promoted the bracelet as a miraculous cure for chronic pain, but it has no therapeutic effect.
  • Defendants told consumers that claims of “immediate, significant or complete pain relief” had been “test-proven”; they hadn’t.
  • The bracelet does not emit “Q-Rays” (there are no such things) and is not ionized (the bracelet is an electric conductor, and any net charge dissipates swiftly). The bracelet’s chief promoter chose these labels because they are simple and easily remembered—and because Polaroid Corp. blocked him from calling the bangle “polarized”.
  • The bracelet is touted as “enhancing the flow of bio-energy” or “balancing the flow of positive and negative energies”; these empty phrases have no connection to any medical or scientific effect. Every other claim made about the mechanism of the bracelet’s therapeutic effect likewise is techno-babble.
  • Defendants represented that the therapeutic effect wears off in a year or two, despite knowing that the bracelet’s properties do not change. This assertion is designed to lead customers to buy new bracelets. Likewise the false statement that the bracelet has a “memory cycle specific to each individual wearer” so that only the bracelet’s original wearer can experience pain relief is designed to increase sales by eliminating the second-hand market and “explaining” the otherwise-embarrassing fact that the buyer’s friends and neighbors can’t perceive any effect.
  • Even statements about the bracelet’s physical composition are false. It is sold in “gold” and “silver” varieties but is made of brass.

The magistrate judge did not commit a clear error, or abuse his discretion, in concluding that the defendants set out to bilk unsophisticated persons who found themselves in pain from arthritis and other chronic conditions.

It doesn’t get much clearer than that. The court agrees with the FTC that the product is bullshit and that every claim made about it is an outright lie. What do the lawyers for Q-Ray have to say? Well, they think the judge was being unfair::

Defendants maintain that the magistrate judge subjected their statements to an excessively rigorous standard of proof. Some passages in the opinion could be read to imply that any statement about a product’s therapeutic effects must be deemed false unless the claim has been verified in a placebo-controlled, double-blind study: that is, a study in which some persons are given the product whose effects are being investigated while others are given a placebo (with the allocation made at random), and neither the person who distributes the product nor the person who measures the effects knows which received the real product. Such studies are expensive, not only because of the need for placebos and keeping the experimenters in the dark, but also because they require large numbers of participants to achieve statistically significant results. Defendants observe that requiring vendors to bear such heavy costs may keep useful products off the market (this has been a problem for drugs that are subject to the FDA’s testing protocols) and prevent vendors from making truthful statements that will help consumers locate products that will do them good.

“But it costs money to prove our products actually do what we claim they do! How can you expect us to maintain our absurd profit margins if we have to show our products work!?” This next bit contains an important point which I think a lot of folks don’t realize so I’m going to underline them for you:

Nothing in the Federal Trade Commission Act, the foundation of this litigation, requires placebo-controlled, double-blind studies. The Act forbids false and misleading statements, and a statement that is plausible but has not been tested in the most reliable way cannot be condemned out of hand. The burden is on the Commission to prove that the statements are false. (This is one way in which the Federal Trade Commission Act differs from the Food and Drug Act.) Think about the seller of an adhesive bandage treated with a disinfectant such as iodine. The seller does not need to conduct tests before asserting that this product reduces the risk of infection from cuts. The bandage keeps foreign materials out of the cuts and kills some bacteria. It may be debatable how much the risk of infection falls, but the direction of the effect would be known, and the claim could not be condemned as false. Placebo-controlled, double-blind testing is not a legal requirement for consumer products.

Did you get that? Most medical products sold that are covered by the FTC (read: that aren’t drugs) are not required to undergo placebo-controlled double blind tests to prove their claims. Any testing done is not only at the whim of the company, but the methodology can be whatever the hell they want it to be. This is as true for so-called “herbal supplements” and “homeopathic remedies” as it is for craptastic medical devices. If it ain’t a drug (and even if it is, but that’s a different discussion for another time) then you should skeptically consider any claims of “clinically proven” or “proven in studies” made in an advertisement.

This is why everyone needs at least a basic amount of scientific literacy. We get bombarded with claims of miracle cures constantly and the government isn’t going to stop them until they’ve made enough money and gotten enough pissed off consumers to complain that the FTC considers it enough of a problem to do something about it. I get emails from people trying to defend these companies all the time that all say the same thing: “Well they wouldn’t be allowed to sell it if it didn’t work.”

Bzzt! Wrong! Thanks for playing, but you’re a complete idiot! They can sell it for years before action might be taken against them and even then it could take awhile before anything happens. The Q-Ray Bracelet has been around for the better part of a decade and when the FTC first turned its eyes towards them the makers simply changed their commercials to remove any specific claims about what the bracelet does. It featured a lot of people standing around talking about how when they first put it on they could instantly feel a difference (difference in what?) and how they felt better and more energized since they started wearing the bracelet (which means what exactly?) and that was enough to buy them a few more years. Even after losing the lawsuit in 2006 it’s taken over a year for the appeals court to uphold it and guess who’s been selling bracelets the entire time? The best defense against getting ripped off by bogus medical claims is to have enough science under your belt to smell the bullshit being shoveled your way.

Still, reading the comments of the judge in this case, who wasn’t buying the argument at all, does a lot to warm the heart:

But how could this conclusion assist defendants? In our example the therapeutic claim is based on scientific principles. For the Q-Ray Ionized Bracelet, by contrast, all statements about how the product works—Q-Rays, ionization, enhancing the flow of bio-energy, and the like—are blather. Defendants might as well have said: “Beneficent creatures from the 17th Dimension use this bracelet as a beacon to locate people who need pain relief, and whisk them off to their homeworld every night to provide help in ways unknown to our science.”

Not that the lawyers didn’t try to prove the bracelets work, but when you see what they were claiming as the basis of their proof, well, if you’re like me then you’ll probably laugh out loud and scare your coworkers and/or family members:

To this defendants respond that one study shows that the Q-Ray Ionized Bracelet does reduce pain. This study, which the district court’s opinion describes in detail, compared the effects of “active” and “inactive” bracelets (defendants told the experimenter which was which), with the “inactive” bracelet serving as a control. The study found that both “active” and “inactive” bracelets had a modest—and identical—effect on patients’ reported levels of pain. In other words, the Q-Ray Ionized Bracelet exhibits the placebo effect. Like a sugar pill, it alleviates symptoms even though there is no apparent medical reason. … Defendants insist that the placebo effect vindicates their claims, even though they are false—indeed, especially because they are false, as the placebo effect depends on deceit. Tell the patient that the pill contains nothing but sugar, and there is no pain relief; tell him (falsely) that it contains a powerful analgesic, and the perceived level of pain falls. A product that confers this benefit cannot be excluded from the market, defendants insist, just because they told the lies necessary to bring the effect about.

Isn’t that amazing? The lawyers for the Q-Ray Ionized Bracelet have admitted under oath in a court of law that the product is no more effective than swallowing a sugar pill at relieving pain and, this is the really good part, they had to lie about its benefits otherwise there would’ve been no benefit at all. So the product does work, at least somewhat, and our lies were justified because they make the product work!

As a side note: Those few idiots who still send me emails occasionally telling me that I have no proof that the Q-Ray Ionized Bracelet is complete bullshit can stop sending those emails now. The lawyers have fessed up in court to the truth.

The appeals judges apparently weren’t completely unsympathetic to the argument that the placebo effect is of some use to some people, but that wasn’t enough to justify the defendants in this case. The following quotation is quite lengthy, but it does an excellent point of answering the placebo effect argument:

Yet the Federal Trade Commission Act condemns material falsehoods in promoting consumer products; the statute lacks an exception for “beneficial deceit.” We appreciate the possibility that a vague claim—along the lines of “this bracelet will reduce your pain without the side effects of drugs”—could be rendered true by the placebo effect. To this extent we are skeptical about language in FTC v. Pantron I Corp., 33 F.3d 1088 (9th Cir. 1994), suggesting that placebo effects always are worthless to consumers. But our defendants advanced claims beyond those that could be supported by a placebo effect. They made statements about Q-Rays, ionization, and bio-energy that they knew to be poppycock; they stated that the bracelet remembers its first owner and won’t work for anyone else; the list is extensive.

One important reason for requiring truth is so that competition in the market will lead to appropriate prices. Selling brass as gold harms consumers independent of any effect on pain. Since the placebo effect can be obtained from sugar pills, charging $200 for a device that is represented as a miracle cure but works no better than a dummy pill is a form of fraud. That’s not all. A placebo is necessary when scientists are searching for the marginal effect of a new drug or device, but once the study is over a reputable professional will recommend whatever works best.

Medicine aims to do better than the placebo effect, which any medieval physician could achieve by draining off a little of the patient’s blood. If no one knows how to cure or ameliorate a given condition, then a placebo is the best thing going. Far better a placebo that causes no harm (the Q-Ray Ionized Bracelet is inert) than the sort of nostrums peddled from the back of a wagon 100 years ago and based on alcohol, opium, and wormwood. But if a condition responds to treatment, then selling a placebo as if it had therapeutic effect directly injures the consumer. See Kraft, Inc. v. FTC, 970 F.2d 311, 314 (7th Cir. 1992) (a statement violates the FTC Act “if it is likely to mislead consumers, acting reasonably under the circumstances, in a material respect”).

Physicians know how to treat pain. Why pay $200 for a Q-Ray Ionized Bracelet when you can get relief from an aspirin tablet that costs 1¢? Some painful conditions do not respond to analgesics (or the stronger drugs in the pharmacopeia) or to surgery, but it does not follow that a placebo at any price is better. Deceit such as the tall tales that defendants told about the Q-Ray Ionized Bracelet will lead some consumers to avoid treatments that cost less and do more; the lies will lead others to pay too much for pain relief or otherwise interfere with the matching of remedies to medical conditions. That’s why the placebo effect cannot justify fraud in promoting a product.

Well said I thought. It’s worth reading the whole document as the discussion on the remedy—the makers of Q-Ray have to forfeit $16 million plus interest in profits back to consumers—as it includes decisions on objections raised by the company to the terms and reveals just how dishonest they are. In particular is the fact that if you bought a bracelet by phone you had 30 days to get you money back, but if you bought it through their website (which the infomercial heavily encouraged you to do) then you only got 10 days for a refund.

A good summary of ADHD.

I’ve not written about ADHD in awhile, but I still regularly get emails from folks who stumbled across some of my past entries on the topic via Google searches. Most of these emails are looking for basic information on what ADHD is and I have a handful of different links I send out in reply. In the future, however, I may just send them a link to this entry at Retrospectacle:

ADHD was found to be the result of a deficiency of a specific neurotransmitter—here, norepinephrine. Like all neurotransmitters, norepinephrine is synthesized within the brain; however norepinephrine synthesis requires dopamine as an intermediate step. Specifically, the basic building block of each norepinephrine molecule is dopa; this molecule is converted into dopamine, which is then converted into norepinephrine. This is the normal process. Theoretically, if this dopa-to-norepinephrine synthesis is altered (say by certain genes), low levels of norepinephrine and ADHD-like symptoms could occur. Conversely, drugs which provide extra levels of norepinephrine relieve the symptoms of ADHD.

Its likely that the full spectrum of ADHD symptoms is not solely attributed to the prefrontal cortex, but rather entire pathways which interact together. These pathways do include the frontal/prefrontal areas (attention, impulse control) but also the limbic system (regulates emotions), the basal ganglia (this is the brain’s “router,” directing information), and the reticular activating system (affects attention and impulses, motivation). Since these areas communicate with each other, its likely that neurochemical problems in one area may affect others.

It’s a good overview of the current understanding of ADHD and how to treat it and it provides links to sources with greater details on a couple of topics covered. As for me, I’ve been off the Adderal I was taking back when I had insurance for over two years now, as has Courtney, and while we’re both coping with our ADHD better than we had prior to counseling and medication, it’s still a struggle at times.

For example, every so often I struggle with impulse control where I get it in my head that I have to purchase something new. I’ve been battling that particular issue for the last few days as I’ve been lusting to go out and buy a Playstation 3 or a Nokia 770 or a new video game or something, anything, new that I can play with for awhile. I understand why I get into these phases, it’s because the new toy acts as a stimulant for awhile as I sit down and learn how to master it. It takes a lot of internal argument to convince myself not to give in to the impulse. With the PS3 that’s not too hard as I just have to look at my checking account balance and compare it to the cost of a PS3 and I can quell that impulse pretty quickly. The Nokia 770 is a bit harder to douse as Buy.com is selling them for $140 ($130 if you use Google Checkout) and that’s not entirely beyond my means though I really shouldn’t spend the money. The fact that it would be exceptionally useful at work right now with all the downtime I have to fill doesn’t help convince me not to get one.

When I was on my ADHD medication these bouts came around much less frequently and were much easier to overcome than they are when I’m not on my medication, but I’m definitely doing a lot better than I did before I knew I was ADHD. I’ll probably get through this latest round of impulse control without spending any money or at least I should be able to make it to my birthday on the 25th of August where that itch will be scratched by a gift or two and some b’day cash I can spend freely. These are the days, however, when I wish I could afford to be back on Adderal.

Anyway, the article is a good overview and worth checking out. I found it via Pharyngula.