November 7, 2003
Newhouse News Service
Shark cartilage and mistletoe as possible cancer treatments? Ginkgo biloba as a means of preventing dementia? Milk thistle to cure chronic hepatitis? Prayer and positive energy to fight brain tumors?
Those and other alternative approaches to modern medicine are undergoing scientific scrutiny at the federal government's National Center for Complementary and Alternative Medicine in Bethesda, Md.
The center, an arm of the National Institutes of Health with a budget of $114 million, was created by Congress in 1998 to examine unconventional ways to heal the body, mind and spirit. In the process, it has become a frequent target in the bitter debate over alternative medicine.
"There are those skeptics who want to circumvent the research process," said Richard Nahin, a scientific adviser to the agency. "Our feeling is everything is entitled to be studied in a fair and objective fashion given the fact that these products are already being used. We have to do the research so we can provide meaningful information."
Critics complain the research is wasting tax dollars, promoting false hopes and giving an aura of legitimacy to implausible and even quack theories and therapies.
One of the skeptics is Wallace Sampson, a retired clinical professor of medicine at Stanford University Medical School and the editor of Scientific Review of Alternative Medicine, a peer review journal.
"Eighty (percent) to 90 percent of these studies don't have to be done. They are investments in absurd propositions and methods already disproved," Sampson said.
He called alternative medicine "an institutionalized social cult movement that perpetuates itself using governmental agencies for funding and promoting products and therapies that are worthless. Most scientists recognize it is baloney."
Baloney or not, millions of Americans have turned to alternative medicine for help and well-being.
Roughly $32 billion was spent in the United States last year on alternative medicines and treatments, according to Patrick Rea of the Nutrition Business Journal, a publishing and market research firm. Americans spent another $18.7 billion on vitamins, minerals and dietary supplements, he said.
Those supplements have come under particular scrutiny in recent months. Products containing ephedra, an herbal stimulant used to lose weight and build muscles, have been linked to deaths, heart attacks and strokes. The Federal Trade Commission has gone after some supplement manufacturers for making false claims about cures for cancer, heart disease and multiple sclerosis.
It is those sorts of claims that the center is seeking to validate or debunk. Toward that end, the center is underwriting several hundred studies and clinical trials at universities and medical centers around the country.
So far, the most significant completed clinical trial focused on St. John's wort, the popular herb found in over-the-counter dietary supplements.
The $6 million study concluded last year that St. John's wort does not help patients with moderate to severe depression, as widely claimed, and warned that interactions with certain drugs could prove dangerous.
Other studies have found that garlic supplements can cause potentially harmful side effects with the anti-HIV drug saquinavir, and that concentrations of ginseng in 25 commercial products differed by as much as 10-fold from what was stated on the label.
On the positive side, a team of investigators demonstrated that hops, red clover and chasteberry -- three of eight botanical preparations commonly used to treat menopause -- showed significant estrogenic activity and deserve more study. Using imaging technology, scientists also discovered evidence that acupuncture reaches the nervous system and reduces pain.
Two major clinical trials funded by the agency are now in progress -- a $15 million, five-year study examining whether extracts from the Ginkgo biloba tree decrease the incidence of Alzheimer's disease, and a $30 million, five-year effort to find out whether chelation therapy is a safe and effective treatment for coronary artery disease. The therapy is a chemical process in which an amino acid is injected into the blood to remove harmful substances.
Steven DeKosky, a neurologist at the University of Pittsburgh and the principal investigator of the Ginkgo biloba clinical trial, said more than 3,000 patients are enrolled, with half receiving a placebo. He said the two groups will be compared to see whether there are differences in memory, thinking and personality.
"The cost of the study is less than one-tenth of what Americans pay
for Ginkgo over-the-counter every year," said DeKosky. "If it works and
we can prove it using the scientific method, it opens new options. If it
doesn't work, we can tell people not to buy it and to be cautious."
Copyright © 2003, Newhouse News Service