From: ((Steven B. Harris))
Subject: Re: Herbalife Independent Distributor
Date: 18 May 1995
Newsgroups: misc.health.alternative

In <3pg8e0$aqf@newsbf02.news.aol.com> barneybull@aol.com (BarneyBull)
writes:


>Maybe you can help me.  I am looking for information about medicinal
>herbs.  Do you know anything about this or have any suggestions where to
>look?


If you want someplace to START, you might check out Varro E. Tyler's
book called The Honest Herbal, Haworth Press, NY, now in 3rd edition
(1993).  It's in print and any large bookstore can order you one.  Tyler
is nice because he cuts though a lot of the B.S. about what is sold in
health food stores (he's fairly skeptic, so if HE says an herb does
something, it likely does).  He doesn't discuss any Eastern herbalism,
however.

Warning: truth is painful, and you may find out some things about
Herbalife you wish you hadn't.

                                         Steve Harris, M.D.

From: sbharris@ix.netcom.com (Steven B. Harris )
Subject: Re: question about "natural progesterone"
Date: 19 Jul 1995
Newsgroups: sci.med,misc.health.alternative

In <DByAvt.J6D@spdcc.com> dyer@spdcc.com (Steve Dyer) writes:

>In article <3ugm40$gi4@newsbf02.news.aol.com>, GailB1 <gailb1@aol.com> wrote:
>>I know of three sources of natural progesterone cream that are made from
>>wild yam extract.
>
>If this stuff actually contains progesterone, then it's hardly "natural",
>since wild yams don't contain any hormonally active steroids, only plant
>sterols (mainly diosgenin), which have to go thru a complex chemical
>process in a multi-million-dollar facility to be converted to
>progesterone. By this "logic", all birth control pills are "natural",
>since they're made from similar raw materials. Your body does NOT convert
>wild yam to hormones. Or, as I've said before, why not convince
>post-menopausal women to eat a dozen eggs a day? _Great_ source of
>cholesterol, the *true* precursor to all the active steroids in the body.
>(Gee, I wonder why cholesterol doesn't work the way yams are supposed to?
>Well, aside from the tiny problem that your body doesn't increase its
>production of hormones by loading it with precursors [or
>pseudo-precursors], I'll bet that cholesterol pills have a slight PR
>problem compared to the cachet of "wild yams".)
>
>Much more likely is that this stuff just contains yam goo with no
>hormones in it at all. OR it may possibly contain progesterone, but if it
>comes from yams, it's hardly "natural" by the time it's mixed in a jar.
>
>   >Womens personal reports have stated relief from
>   >menopausal symptoms of hot flashes, and night sweats.
>
>Is this an ad? It's so _carefully_ phrased--note that she didn't say "it
>relieves menopausal symptoms of hot flashes, and night sweats." Since
>placebos work very well for many women, too, I'd want to see any
>controlled studies before coming to any conclusion about the
>effectiveness of this stuff.
>
>   >Many use these creams in conjunction with herbs such as Black Kohush
>   >and Damiana, dong Quai and others, as well as Borage, Primrose and/or
>   >Flaxseed Oil.
>
>...because it doesn't work that well by itself.
>
>   >There are some good books on the subject. It may take some
>   >experimenting to find the right formula for yourself.
>
>Translation: "Keep trying until the symptoms decrease on their own."
>
>--
>Steve Dyer
>dyer@ursa-major.spdcc.com


I will never cease to be amazed.  Today a menopausal woman can now go
her physician and get (if she wishes) tablets or capsules containing
the exact hormones her own body used to make (estrone, estradiol,
progesterone, etc).  These prescription items are excoriated by the
alternatives as "drugs and chemicals" and said to be "unnatural".
**Or** the woman can smear herself with yam goo or ingest various other
plant extracts containing hormone active molecules which aren't like
anything EVER found in her body, and which are made by the plant to
screw up the reproduction of plant-eating animals, certainly not to
relieve human females of their hot-flashes.  This dosing with strange
plant substances not normally found in the body, and not normally found
in the diet either, is said to be "natural."   Go figure.  Truly this
entire herbal treatment of menopause is a masterpiece of advertising
and form, over truth and substance.


                                             Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 12 Apr 1999 08:10:42 GMT

In <7eqbqo$s9t$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>   Joe and Teresa Graedon write the People's Pharmany column
>and do the NPR program.
>
>   This week they write:  (a summary)
>
>   Americans love German automobiles.  Buy a BMW or a
>Mercedes-Benz and your family and friends will line up for
>rides.  Their...quality control is admired around the world.
>
>   But when it comes to herbal medicines, the FDA does not
>consider German resarch up to our standards....  Although
>researchers in Germany have studied herbs intensively for the
>past two decades...the FDA regards it as inconsequential.
>
>
>    Most German physicians prescribe and dispense
>herbs...but the FDA seems puzzled.

   Especially since attempts to replicate German results (Echinacea
trial recently) have not been sucessful.  If there is one since herb
the Germans have done more research on, that's it.  It should have
worked great to prevent respiratory infections.  It didn't work at all.

    Nobody doubted that excellence of German engineering in WWII.  It
was German medicine that went awry in that time.  And the reasons are
not entirely irrelevent today.  The Germans have long had a streak of
what I've called Ueberman (umlaut u: on chest) meets natural hygiene.
The idea being that people of superior genetics and proper hygiene and
habits and hup hup good fresh air and Lederhosen mountain climbing
(think of Hitler youth) just don't GET sick.  So what's the point of
drugs?  Back to nature.  If you need drugs, there must be something
inferior about you anyway.  Perhaps it's okay if you are then used as a
guinea pig for new ones.  All that is very German.




>    Few  USA medical schools...provide any education in this
>area.

    All medical schools provide education in this area.  There is now a
herbal PDR, based mostly on German Commission E monographs.  It's
widely used, and pharmacists are widely interested in the subject, and
pharmacists teach pharmacy in medical school.  We are still in the
process of sort out bogus from good research, and doing quality control
on products, however.


> Consumers are left in the dark too by labels which
>can say only 'take as needed.'

   Consumers would be just as much in the dark if they had a package
insert and a copy of "Herbal Remedies for Idiots" (which exists--
author is Christopher Hobbs, and-- yes-- as a doctor I own a copy of
that one, too).   To know what herb to use you have to know what's
wrong with your first.  Herbs for symptomatic relief are fine, but
they're not much of an advance in medicine.  At best, they supplement
aspirin, Maalox, and cortisone creme.



>   Canadian health authorities have just taken steps to make
>sure their citizens are better protected than those in the
>USA.

    Taken steps to ban a lot of stuff, you mean.  Which, if it happened
here, you'd complain was the AMA trying to preserve it's monopoly.  Can
you buy chromium picolinate and melatonin in Canada, George?  I can't
wait to see how they clamp down on herbs.


>....Our government needs to take its lead from our more
>civilized neighbords to the north.


    Why don't you frigging emigrate to Utopia, George?  Just take a
bearing with your compass and start walking.


>  The feds need to figure
>out how to protect consumers and prove them information
>without depriving them of useful products.....


    The consumer can get his own useful information.  If necessary, he
or she can consult an herbalist, or buy one of those books.  Or the
Commission E monographs, now translated.

>    Comment:  of course, when Chinese rice was discovered to
>be at lowering cholesterol as the commercial product, the
>FDA immediately triend to BAN the lower-cost herbs!!!  The
>Graedon's don't mention this except by reference in the last
>sentence quoted.

     I believe you're talking about a fungal product.  These do lower
cholesterol, but nothing works as well as the best commercial
pharmaceuticals.


>    But once again European medicine is 20 years ahead of
>the USA, while we lag behind yet again.  We know drug prices
>are rising quickly, but we refuse to look at the
>alternatives.

     We'll look when the alternatives are proven as good as the drugs,
in head to head double blind tests.


>   And you know what?  Is it because if it does not come on
>a prescription, we don't want the consumer to have it
>because it takes away from fee-for-service?  I think so.


    You think wrong.  It's actually all those high-minded citizens such
as yourself who want to "protect" consumers.


>   Further, we must start to recognize any drug approved in
>Europe.  It automatically should be approved here pending
>any further studies the FDA might want.  A notice might be
>added, "Used widely in Germany but the FDA does not
>recognize German science so beware......"   That ought to do
>it.
>   (PS: Thalidomide was 45 years ago and we have had drugs
>pulled too.....)


   PS, Thalidomide was 38 years ago (banned in Europe 1961).  Most
cases in Germany.

    I propose, rather than automatic approval of any European drug, and
automatic 4 year delay before approval in the US.  During that time
we'd do nothing.  If nasty stuff hasn't surfaced by then, approval
shoudl be automatic.  Heck, we might be able to do away with the FDA
entirely.  This is the process that basically happens now, anyway,
except the FDA tries hard to look busy while Europeans are our guinea
pigs.  Let's just formalize the process.


                                   Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 12 Apr 1999 08:22:40 GMT

In <7eqh68$29b$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:
>
>In article <7eqdod$dob$5@fir.prod.itd.earthlink.net>,
>Kurt Ullman <kurtullman@sprintmail.com> wrote:
>>In article <7eqbkt$s1j$1@nina.pagesz.net>, henryj@nina.pagesz.net (George
>>Conklin) wrote:
>>>   Joe and Teresa Graedon write the People's Pharmany column
>>
>>>   But when it comes to herbal medicines, the FDA does not
>>>consider German resarch up to our standards....  Although
>>>researchsrs in Germany have studie herbs intensively for the
>>>past two decades...the FDA regards it as inconsequential.
>>
>> Actually the FDA considers nobody's research on anything up their
>> standards. This happens all the time in "real medication", too.
>>
>
>   Oh sure they do.  Drugs are approved.  But what needs to
>be done is to accept Germany's 20 years of work in this field
>so we don't have a 40-year lag in our knowledge until we
>catch up.   Joe Gradedon recommends:
>
>www.ars-grin.gov/duke/
>
>as a reliable place for information.
>
>   Any comments?



   Yes, I think the Germans need to catch up with themselves, first.



Arch Fam Med 1998 Nov-Dec;7(6):541-5
Echinacea root extracts for the prevention of upper respiratory tract
infections: a double-blind, placebo-controlled randomized trial.
Melchart D, Walther E, Linde K, Brandmaier R, Lersch C

Center for Complementary Medicine Research, Technische Universitat,
Munich, Germany. Muenchener.Modell@lrz.uni-muenchen.de

OBJECTIVE: To investigate the safety and efficacy of 2 extracts of
echinacea for preventing upper respiratory tract infections. DESIGN:
Three-armed, randomized, double-blind, placebo-controlled trial.
SETTING: Four military institutions and 1 industrial plant.
PARTICIPANTS: Three hundred two volunteers without acute illness at
time of enrollment. INTERVENTIONS: Ethanolic extract from Echinacea
purpurea roots, Echinacea angustifolia roots, or placebo, given
orally for 12 weeks. MAIN OUTCOME MEASURE: Time until the first upper
respiratory tract infection (time to event). Secondary outcome measures
were the number of participants with at least 1 infection, global
assessment, and adverse effects. RESULTS: The time until occurrence of
the first upper respiratory tract infection was 66 days (95% confidence
interval [CI], 61-72 days) in the E angustifolia group, 69 days (95%
CI, 64-74 days) in the E purpurea group, and 65 days (95% CI, 59-70
days) in the placebo group (P = .49). In the placebo group, 36.7% had
an infection. In the treatment groups, 32.0% in the E angustifolia
group (relative risk compared with placebo, 0.87; 95% CI, 0.59-1.30)
and 29.3% in the E purpurea group (relative risk compared with placebo,
0.80; 95% CI, 0.53-1.31) had an infection. Participants in the
treatment groups believed that they had more benefit from the
medication than those in the placebo group (P = .04). Adverse effects
were reported by 18 subjects in the E angustifolia group, 10 in the E
purpurea group, and 11 in the placebo group. CONCLUSION: In this study
a prophylactic effect of the investigated echinacea extracts could not
be shown. However, based on the results of this and 2 other studies,
one could speculate that there might be an effect of echinacea products
in the order of magnitude of 10% to 20% relative risk reduction. Future
studies with much larger sample sizes would be needed to prove this
effect.

Publication Types:
  Clinical trial
  Randomized controlled trial


PMID: 9821828, UI: 99037590

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 13 Apr 1999 03:43:10 GMT

In <7esing$8kc$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>In article <7es9q2$4e8@dfw-ixnews9.ix.netcom.com>,
>Steven B. Harris <sbharris@ix.netcom.com> wrote:
>
>>     I believe you're talking about a fungal product.  These do lower
>>cholesterol, but nothing works as well as the best commercial
>>pharmaceuticals.
>
>  Well, it worked as well without the side effects too.
>Your biases in this post are simply flaming.


Comment:

    Your posts are simply ignorance.  "Cholestin" works because it
contains the exact same molecule, called lovestatin, as the first of
this series of HMG-CoA reductase drugs to marketed commercially (under
the name "Mevacor").  So it obviously has exactly the same side effect
risk as Mevacor, because it is same substance.  The FDA's ruling that
it was a drug was not based on the fact that it lowered cholesterol a
lot (of course it does), but upon a section of the law which states
that natural products cannot be sold as natural products for a specific
new purpose AFTER some drug company has discovered this purpose and
effect *first,* and marketed them as pharmaceuticals first.  This does
not apply to herbs and medicines which have traditionally been used for
some purpose.  This is much like a "use patent," and is intended to
encourage pharmaceutical companies to seek novel compounds which have
novel effects, in natural products.  It's not as though the Chinese had
been extracting this stuff from rice fungus for thousands of years in
these amounts and using it to lower cholesterol or prevent heart
disease (had it been known and used this way, the FDA would NOT have
been able to invoke this clause).  The idea that the Chinese have long
used rice to lower cholesterol, or prevent atherosclerosis or heart
disease or angina, or anything like it, is poppycock.  The *drug*
company found the stuff, and the people who sell "Cholestin", now that
they know what it is, and where it is, and what it does if it's
extracted, concentrate it to unnnatual amounts and sell it in capsules.
 That's cheating, because it relies on a drug company's prior discovery
and knowledge.  Alas, recently a Federal judge was unable to see this.
The effect on further research into natural products is predictable.
It will be further hampered.  Why bother to show that some compound in
foods does something unique in medicine, if somebody's just going to
steal the idea once you've paid the millions in research costs to show
it works?

   As for my comment that cholestin/lovastatin does not work as well as
the best available commercial products, this is exactly true.  We've
come a long way from lovastatin.  The new drug atorvastatin (Lipitor)
lowers cholesterol 27% vs lovastatin's 22%, and at half the dose.  And
the max dose for Lipitor, and its max effect, is far higher than it is
for lovastatin.

    I'll be glad to provide documentation for all of this.  If you want
to dispute what I've said above, I'll be glad to further prove you a
fool.  It'll be a pleasure, in fact.  So go ahead.  Say I'm wrong,
George.  That I don't know what I'm talking about.  Put yourself on
record.

                                        Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 13 Apr 1999 06:54:51 GMT

In <3712CEED.5A7C546D@cs.uoregon.edu> Bret Wood
<bretwood@cs.uoregon.edu> writes:

>"Steven B. Harris" wrote:
>>
>>     Your posts are simply ignorance.  "Cholestin" works because it
>> contains the exact same molecule, called lovestatin, as the first of
>> this series of HMG-CoA reductase drugs to marketed commercially (under
>> the name "Mevacor").So it obviously has exactly the same side effect
>> risk as Mevacor, because it is same substance.
>
>I'm not trying to defend George, but I just wanted to point out that
>your "obvious" conclusion may be obvious, but is isn't necessarily
>correct.
>
>I don't know _anything_ about cholesting, lovestatin, HMG-CoA
>reductase, or Mevacor, but I do know a bit about scientific reasoning,
>and yours is fallacious here.  (Unless you have some evidence which
>specifically compares the side effects of Cholestin and Mevacor.
>
>If cholestin is an herb which _contains_ lovestatin, then it will
>probably have the same effect, and the same side effects as isolated
>lovestatin, but you are completely discounting the potential of
>other (perhaps even unknown) substances in the cholestin which
>augment the action of the drug, supresses some side effects, binds
>with it to form a completely different active metabolite, or
>any of a number of other things.
>
>I think most herbal remedies are just junk passed off to desperate
>or gullable people, but I get tired of seeing people basing their
>arguments on "obviousness," when the obvious thing isn't neccessarily
>the correct thing.


Comment:

    I've seen some herbal-type people suggest that the other
ingredients in herbal preparations somehow often magically mitigate the
side effects of the "active" ingredients, as though God Almighty put it
all together that way on purpose (sometimes this is explicitly
claimed).  Either way, the subtext is mythical nonsense.  The active
ingredients in many herbs are generally toxins or birth control
estrogenic substances, which plants make for chemical warfare purposes,
since they don't have teeth or claws, and can't run.  Digoxin in
foxglove isn't there to cure your heart failure.  There aren't any
other magic things in foxglove to make it safer for you if you take the
dried "digitalis" leaf (rather the reverse-- there are other poisons
with even longer half-lives than the pure digoxin doctors now use
instead).

   Sure, the other things in an impure extract *might* modify the side
effect of the lovastatin in it.  But guess what?  Most of those things
that occur in the natural product have necessarily been removed by the
people who make "Cholestin."  This is not one of those things you could
hope to get enough of, in any food, to have much effect.

    By the same rationale, when you take a capsule of commercial
lovastatin as Mevacor with your dinner, you're taking it with thousands
of chemicals from any different plants and other foodstuffs, all of
which can _potentially_, in theory, modify side effects.  Sometimes we
find that such things actually happen with drugs (grapefruit juice,
milk, many other known food interactions).  They aren't really
prominant with lovastatin side effects.  To imagine that it doesn't
make a lot of difference in *side effects* whether or not you take your
lovastatin with a full dinner of any given makeup, Chinese, Indian, or
Italian, or an empty stomach (and it doesn't), but bring up in all
seriousness the idea that whatever stuff they leave in concentrated
Cholestin (natural lovastatin) capsules after a massive commercial
concentration effort, might make the stuff completely benign--- is to
live in some kind of never never land, where anything drug companies do
is bad, and anything anybody else does with drug and natural product
chemistry is possibly-- even probably-- sweetness and light and no
problems. Get a grip, Bret.

                                       Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 13 Apr 1999 11:34:34 GMT

In <37130A8B.A88BF58C@cs.uoregon.edu> Bret Wood
<bretwood@cs.uoregon.edu> writes:

>All I commented on was your claim that the two products _obviously_
>have the same side effect profiles.  It is NOT obvious.  I clearly
>stated that I thought most herbal stuff is crap, and that I know
>NOTHING about this herb or medicine in particular.  All I was saying
>is that your claim was NOT obvious.  Your claim is extremely likely.
>It is almost certain.  But to a scientist (you did claim that doctors
>are scientists didn't you?) it is not obvious, because there are
>significant uncontrolled variables in the comparison.


   There are always uncontrolled variables. What your genes are.  What
you ate last.  The phases of the moon.  The side effect profiles of
drugs are a function of the amount of drug there is in the system, and
there are few exceptions.  Perhaps I should have qualified my statement
to say that the side effect profiles are certain beyond reasonable
doubt to be the same for the same drug delivered in such a dose as to
give the same effect.  It's possible that there's something magic in
the natural concentrated lovastatin from natural sources that stops
side effects at the same dose of lovastatin necessary to give the same
cholesterol drop.  It's also *possible* that Mars is inhabited, with
the cities underground, and they're going to invade us day after
tomorrow.  However, it's obvious to me that this is a silly idea and
isn't going to happen.  Is it obvious to you?


>Understanding that the side effect profiles are certainly identical
>requires a knowledge of the manufacturing processes of the extract.

   No, if you believe your own argument, there is no amount of
knowledge you could have that would make it obvious.  There are always
hidden variables (what warehouse was that Cholestin stuff stored in,
and at what temperature?) which you'll never know.  If you choose to
regard all possiblities, no matter how small, as eliminating all sense
of the obvious, then you must not have one.  Which makes it difficult
for me to know how you manage to argue with such certainty.


>It requires a knowledge of the actual side effects of the medicine.

   Not really.  Won't help you at all.


>It requires a knowledge of any other medicinal properties the herb
>might have.

    This is not an herb.


>  Or you can just trust research which says that they
>are the same.  Personally, I doubt that you are relying on the
>"obviousness argument" when you say that the side effect profiles
>are identical.  I suspect that you have actually heard or read
>that there is no significant difference between the herbal extract
>and the drug.

    No, only the company's report that of the trial that 2 capsules of
their lovastatin lowered cholesterol by 22%, which is just about what a
standard dose of Mevacor does.  I don't know if they published the side
effects.  I cannot even find a study published at all.  My information
is from the FDA announcements that they find Cholestin a drug.

> If that is the case, then your info is not obvious,
>it is something you learned from a trusted source.


>There are common examples (such as calcium) where the bioactivity
>of a substance is massively affected by things which are only
>beginning to be understood.

   But all due to absorption differences.  I know of no reports where
activity of a certain amount of calcium getting into the blood in a
certain time, depends on how it got there.


>  Your claim of obviousness ignored
>the fact that you need a decent amount of specialized information
>to realize that there are no differences between the two sources
>of medicine.

    No, as I explained above, no amount of information will save one
from the argument you make.  There are always things you don't know,
and someone can always say that it's not obvious if you don't know
them.  Thus, nothing is obvious.  But is it obvious that nothing is
obvious?   Deep difficulties there.

>I could claim that cyanide is toxic.  Hydrogen cyanide is toxic.
>Potassium cyanide is toxic.  Cyanogen is toxic.

   It is free cyanide ion, CN-, which is toxic. For well-known reasons,
including binding to cytochrome a3.  Cyanogen is rapidly broken down to
CN- in the body.

> Yet for some reason, Vitamin B-12 isn't toxic.  What is it about
>cyanocobalamin which prevents the cyanide from being toxic?

   We've had this discussion before.  B12 is 2% cyanide, so a dose
equivalent to a lethal dose of cyanide (100 mg or so) would be 5 grams.
I don't know if 5 grams cyano-B12 has not toxicity.  5 grams of
hydroxo-B12 does not, but this is administered FOR cyanide toxicity,
because it binds cyanide every tightly.  Probably tightly enough that
it does not get transferred to your cytochromes to poison you.


> Personally, I don't
>know.  And it is NOT obvious to a layman why cyanocobalamin isn't
>analagous to other cyanide complexes when it comes to "side effects"
>such as cyanide toxicity.

    Hydroxo-B12 has a greater affinity for CN- than any other complex I
know of.  And, FYI, none of the compounds you name above is a cyanide
"complex" (usually refering to coordinated transition metal complex).
They are cyanide salts, freely soluable in water to yield CN-, save for
the case of CN-CN (cyanogen) which is rapidly metabolized to B12.  True
cyanide complexes, such as ferric ferrocyanide (the blue color of which
gave cyanide its name) are indeed significantly less toxic than cyanide
salts.  So much so that they used to be included in chemistry sets for
kids, something you'd hardly do with KCN.

>To repeat my initial point, I wasn't claiming that the herb is any
>better than the drug.  I was merely pointing out that it isn't
>OBVIOUS that the herb is identical to the drug.  (And as I said in
>my initial post on the subject, I don't have any specific knowledge
>about any of these drugs or herbs.)  I trust you when you say that
>they are identical.  But I still disagree that it is obvious that
>they must be identical.

   No, it's obvious they'll have the same side effects.  Same drug gets
into your blood stream.  Your liver has no idea where it came from (not
being clairvoyant).  And differences would be extremely surprising.
But so would an invasion from Mars.

>In the history of scientific reasoning, claims of obviousness have
>been used more often to cover the weak link of an argument than to
>describe truely obvious facts.


   Yep.  And what one person sees is obviously going to happen is not
obvious at all to someone else.  Such is life.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 14 Apr 1999 06:24:32 GMT

In <7evada$u05$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>   And the comment that nothing works as well as
>'commercial pharmaceuticals is simply uproven bias and
>arrogance.


    You asked for it.  The proof is below, where one of the newer
agents is compared head to head with Mevacor.  The Mevacor results,
BTW, are almost exactly those which were reported for Cholestin (22%
cholesterol drop) and which got the FDA on the company's tail.  The
never agents do better.  You can give 8 times the amount of
atorvastatin used below, without toxicity.  You can't do that for the
comparable dose of lovastatin/Mevacor/"Cholestin."


Am J Cardiol 1997 Jun 1;79(11):1475-81

Comparison of one-year efficacy and safety of atorvastatin versus
lovastatin in primary hypercholesterolemia. Atorvastatin Study Group I.

Davidson M, McKenney J, Stein E, Schrott H, Bakker-Arkema R, Fayyad R,
Black D

Chicago Center for Clinical Research, Illinois, USA.

This double-blind study to evaluate long-term efficacy and safety of
atorvastatin was performed in 31 community- and university-based
research centers in the USA to directly compare a new
3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor (reductase
inhibitor) to an accepted drug of this class in patients with moderate
hypercholesterolemia. Participants remained on a cholesterol-lowering
diet throughout the study. One thousand forty-nine patients were
randomized to receive atorvastatin 10 mg, lovastatin 20 mg, or placebo.
At 16 weeks the placebo group was randomized to either atorvastatin or
lovastatin treatment. At 22 weeks, patients who had not met low-density
lipoprotein (LDL) cholesterol target levels doubled the dose of
reductase inhibitor. Efficacy evaluation was mean percent change from
baseline in LDL cholesterol, triglycerides, total cholesterol,
high-density-lipoprotein cholesterol, and apolipoprotein B (apoB).
Safety profiles as determined by change from baseline in laboratory
evaluations, ophthalmologic parameters, and reporting of adverse events
were similar for the 2 reductase inhibitors. After 52 weeks, the
atorvastatin group maintained a significantly greater reduction in LDL
cholesterol (-37% vs -29%), triglyceride (-16% vs -8%), total
cholesterol (-27% vs -21%), and apoB (-30% vs -22%) (p <0.05). More
patients receiving atorvastatin achieved LDL cholesterol
target levels than did lovastatin patients (78% vs 63%, respectively),
particularly those with coronary heart disease (37% vs 11%,
respectively). Atorvastatin is highly effective and well tolerated in
patients with primary hypercholesterolemia with no increased risk of
adverse events.

Publication Types:
  Clinical trial
  Multicenter study
  Randomized controlled trial


PMID: 9185636, UI: 97329123

----------

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: Backlash against HMOs: a declaration of war (was Doctor-bashing)
Date: 14 Apr 1999 06:51:30 GMT

In <7evbfv$vf3$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>   Your usual rant, and it is wrong.   Next you are going to
>tell us that Europeans don't live longer than we do because
>Europe does not know how to count dead adults either, or to
>construct life tables.

    Europeans don't live longer than Utahns do.  Again, George, it's
not the medical system, it's how people live.  I work in Utah's medical
system.  It's the same system as in California, except that the people
here are not so self-destructive, and families are cohesive and take
care of their elderly better.  And the hospitals are more efficient, in
part because they are on land which isn't worth so much (there being
less crowding).  For all of which the Feds punish us by paying half as
much for a day in the hospital in Utah.   We outlive Californians
anyway.  In a way this may seem to make your point.  But ultimately, if
you keep going, you see it blows you away.



>   National studies of incidence of cancer suggested that
>people who ate a lot of tomatoes had lower rates of prostate
>cancer, a mere correlation in your little book of horrors.
>So they looked for the suggested chemical involved.  Now
>that that has been found, and the chemistry suggested, it
>just showed that the original correlation was right all
>along.

    No, it hasn't.  Not yet.  It won't be shown to be correct until a
prospective study is done.  You'll remember the two disasters with beta
carotene and lung cancer, don't you, George?  Don't get too hung up on
correlation.   Nature bites.

> That should make your skin crawl.  Something worked,
>when all you do is worship failure and hatred.


    The beta carotene studies in smokers should make your skin crawl.
If you knew about them.   The difference between you and me is that,
when it comes to tomatoes and prostates, I know about lycopene and what
it's supposed to do and why it's supposed to work, and the evidence for
and against.  You, by contrast, know nothing.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 14 Apr 1999 07:31:21 GMT

In <37133A29.B2813A4D@cs.uoregon.edu> Bret Wood
<bretwood@cs.uoregon.edu> writes:
>
>
>
>"Steven B. Harris" wrote:
>>
>> In <37130A8B.A88BF58C@cs.uoregon.edu> Bret Wood
>> <bretwood@cs.uoregon.edu> writes:
>>
>> >All I commented on was your claim that the two products _obviously_
>> >have the same side effect profiles. It is NOT obvious. I clearly
>> >stated that I thought most herbal stuff is crap, and that I know
>> >NOTHING about this herb or medicine in particular. All I was saying is
>> >that your claim was NOT obvious. Your claim is extremely likely. It is
>> >almost certain. But to a scientist (you did claim that doctors are
>> >scientists didn't you?) it is not obvious, because there are
>> >significant uncontrolled variables in the comparison.
>>
>>    There are always uncontrolled variables.
>
>You dropped a word.  I said _significant_ uncontrolled variables.


    There are always uncontrolled variables which you cannot be
absolutely sure are not significant.  I cannot be absolutely sure about
those Martians.

>Indeed, I used the term complex to discuss cyanocobalamin in comparison
>to other compounds which are not complexes.  (My graduate research
>was entirely based on the study of a specific type of coordination
>compounds.  And the term coordination compound, and coordination
>complex tend to be treated as equivalent terms, which has apparently
>led to some bad habits....)
>
>Anyway I was under the impression that cyanide is much more toxic
>than you stated in the discussion on the subject a few months ago.
>That's why I was curious about it.  But now it seems that HCN gas
>shouldn't be as feared as it is.  As long as you know that it
>smells like roasted almonds, it seems you should be able to leave
>the room before you inhale a lethal dose.  I guess all the murder
>mystery authors need to rethink some of their plots.  :)

    It all depends on how much the concentration goes up before the
person walks into it and takes a breath.  The fatal dose of cyanide is
100 mg, remember?  That's roughly 120 mL of HCN gas.  Roughly a fifth
of a normal breath-- not even a deep breath.

   Which is why warden Duffy always told his convicts to hold their
breaths in the California gas chamber until the HCN concentrations got
high.  At that point one breath delivers enough cyanide to knock you
out in a few seconds.  It's much the same with H2S.  One breath and
you're dead.  You just have to hope you get a nice concentration
gradient to warn you beforehand.   And it's not *obvious* that you
always will.

                                        Steve Harris

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 15 Apr 1999 03:06:06 GMT

In <37145BBC.FD8F9C65@cs.uoregon.edu> Bret Wood
<bretwood@cs.uoregon.edu> writes:
>
>
>
>"Steven B. Harris" wrote:
>>
>>     It all depends on how much the concentration goes up before the
>> person walks into it and takes a breath.  The fatal dose of cyanide is
>> 100 mg, remember?  That's roughly 120 mL of HCN gas.  Roughly a fifth
>> of a normal breath-- not even a deep breath.
>
>Yeah, but all gasses are toxic at 100% concentration.  :)
>
>I was under the impression that just a trace of HCN in the air could
>be very dangerous.


   It can.  You get 1 breath at 20%, about 10 breaths at 2% (we're
neglecting dead space, but what's 20 or 30% error among friends? when
we're talking about 30 seconds?), 100 breaths (5 minutes or so) at 0.2%
(2000 ppm), 50 minutes to death at 200 ppm, etc.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: Backlash against HMOs: a declaration of war (was Doctor-bashing)
Date: 15 Apr 1999 05:01:33 GMT

In <7f1s25$ef5$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>   Herman, the article clearly states that the author,
>"cautioned against routine use of lycopene supplements
>without further evidence."
>
>   Ok, he has a study of a mere 47,000 people.  That is not
>enough.

    He doesn't have 47,000 people randomized prospectively to lycopene
supplements or not.  He has post hoc statistics on that many eating
tomatoes.  Can you figure out the difference?



>  So he has his study of actual pathology reports.
>That is not enough.  Then there are 57 studies reported so
>far, and in 35 the results were statistically significant.
>That is not enough.  A 45% reduction in prostate cancer is
>'not enough'?  Would 100% be enough if it did not involve
>paid-for 'medical advice'?


>   So what would be enough?


A prospective study of lycopene supplements.  Otherwise you have to
recommend eating tomatoes until more is known.


> What do you bet that if
>lycopene could be patented and sold for $15 a pill, people
>would be encouraged to get frequent 'checkups' and a
>a prescription with NO REFILLS?  That the ACS would flood
>the airways with propaganda that a 'breakthrough' in cancer
>had been found?


    Not until a prospective randomized study had been done which showed
a reduction in cancer.  When you find one for lycopene, let me know.

    Though I have to say that in all honesty, very nearly the situation
you describe DOES exist for selenium.  There is bias against
supplements, no doubt about it.

    However, it's not a complete bias, just a relative one.  Orthodox
doctors put people on niacin for cholesterol routinely, for many years.
They still sometimes do.

   Please note that the medical profession has been burned before in
assuming they knew the active ingredient in some food product whose use
was associated with less cancer.  In 1983, everybody knew that beta
carotene consumption correlated with less lung cancer in smokers.
Pearson and Shaw were pushing it a nutrient to make smoking safer.  So
finally the establishment, under intense pressure, did studies to see
if giving beta carotene as a supplement really did lower lung cancer
risk in smokers.  It raised it.  Wups.  Okay, maybe it was the *alpha*
carotene... <gulp>.   There are a lot of things in a carrot.  And in a
tomato.

                                           Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: Backlash against HMOs: a declaration of war (was Doctor-bashing)
Date: 15 Apr 1999 05:14:18 GMT

In <7f1sei$eq5$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>>    [Who's] going to make any money selling baby aspirin?  How many baby
>>aspirin per tomato, economically?  Does that mean doctors never
>>prescribe low dose aspirin?  Come now.
>
>   The author of the article on lycopene 'cautioned against
>routine use of lycopene supplements without further
>evidence.'  How much evidence was there on aspirin's use in
>cardiology before it became generally accepted advice?


    Several prospective double blind studies of aspirin as a heart
attack preventive.  One of them done on tens of thousands of middle
aged Harvard physicians.  As it happens.  The same study has shown no
benefit, cancer-wise from beta carotene (too few smokers in this group
to see actual harm).  Beta carotene was the last big carotenoid bruhaha
epidemiologically, until it was actually tested in a controlled
fashion.



> A
>study with a N of 45,000 and a reduction of 45% in cancer
>rates is pretty spectacular.  Now the new research shows
>that PSAs can be lowered...that seems pretty good.

    Unless you know that Proscar lowers PSAs also, but does
NOT prevent prostate cancer.  And unless you know that there are
plenty of epidemiologic studies of things that looked good until they
found that what they were looking at was only a marker variable or
"confounder."


    Women who take estrogen after menopause have 50% fewer heart attack
deaths, epidemiologically.  Does that mean we know for sure if estrogen
prevents heart attacks?  No, for these women weren't randomized.  And
this is not even a case of people eating a complex food.

    A randomized study of estrogen after menopause is going on right
now.  At five years, so far, no significant difference in heart
attacks.  Interesting.  We watch and wait.

                                         Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 15 Apr 1999 07:03:52 GMT

In <7f21lh$kf4$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>In article <7f1cb0$knh@sjx-ixn1.ix.netcom.com>,
>Steven B. Harris <sbharris@ix.netcom.com> wrote:
>>In <7evada$u05$1@nina.pagesz.net> henryj@nina.pagesz.net (George
>>Conklin) writes:
>>
>>>   And the comment that nothing works as well as
>>>'commercial pharmaceuticals is simply uproven bias and
>>>arrogance.
>>
>>
>>    You asked for it.  The proof is below, where one of the newer
>>agents is compared head to head with Mevacor.  The Mevacor results,
>>BTW, are almost exactly those which were reported for Cholestin (22%
>>cholesterol drop) and which got the FDA on the company's tail.  The
>>never agents do better.  You can give 8 times the amount of
>>atorvastatin used below, without toxicity.  You can't do that for the
>>comparable dose of lovastatin/Mevacor/"Cholestin."
>
>   Ok, so the Chinese remedy is as good as the commercial
>preparation.  But that is not what you posted.  You posted
>that nothing works as well as the commercial preparations.



Comment:

    Strictly speaking, since that what I wrote, you've got me there.
Mevacor is still on the market, so I guess it's a "commercial
preparation."  I haven't used it in years, since there are better ones,
but it's still around.

    It's not a Chinese remedy. It's a concentrate made by a little
venture capital company called Pharmanex, in Simi Valley, CA.  The guff
about it being used for thousands of yours as a circulation improver in
China is propaganda for public consumption (I defy you to find me this
stuff used for that purpose in any textbook of traditional Chinese
medicine more than 10 years old).  Yes, there is a red rice with yeast
used in China as a flavor agent.  Yes, the yeast makes lovastatin, as
do many fungi (even some mushrooms).  No, it doesn't make enough that
eating 2.5 grams of red rice lowers your cholesterol 22% (a meal of the
stuff would surely give you Lovastatin poisoning).  Instead, the
Chinese, noted for illegal copying of everything from CDs to Levis,
found out about the cholesterol lowering properties of the fungal
-statin compounds from American pharmaceutical company research.  They
rooted around in their store of foods and found something which
contained some lovastatin, which they then concentrated greatly (and
artificially) and shipped it to Pharmanex, which put it in capsules.
The FDA confiscated 10 tons of the stuff.  The stuff in the capsules is
not what the Chinese put on their Peking Duck, however.  It's just
ripoff of intellectual property.

   Now, mind you, had the Chinese actually been using red rice to
prevent heart attacks 20 years ago, and Merck and Pfizer found out
about it from THEM, I'd be on Pharmanex's side.  But that's not the way
it happened.

   The irony of this is that a Federal judge (in Utah, of course)
overturned the FDA, and now Cholestin can be sold.  All this does is
discourage natural products research even further.  Never again is a
company going to do any expensive research on a natural herbal extract,
if they can have no proprietary pay-off for putting up the research
capital.  They're going to tinker with the molecule first, so that they
can patent it.  At minimum.  And they surely won't say where they got
it.  So the herbalists get "Cholestin" free, off pharmaceutical company
capital, and research.  But don't look for it to happen again.

   Hope it was worth it, guys.

                                               Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 15 Apr 1999 13:17:55 GMT

In <371584CF.7A778F67@cs.uoregon.edu> Bret Wood
<bretwood@cs.uoregon.edu> writes:

>"Steven B. Harris" wrote:
>>
>> The active
>> ingredients in many herbs are generally toxins or birth control
>> estrogenic substances, which plants make for chemical warfare purposes,
>> since they don't have teeth or claws, and can't run.
>
>You are missing a couple of important points.  The first is the
>ecological factor in evolution.  There are many examples of
>symbiotic relationships between plants and animals.  The concept
>of "fruit" is a counterexample to your claims.

   But fruits are not counter to my claims.  You will notice that not
too many medicinal herbs come from fruit.  Rather fewer than you'd
expect on chance, in fact.  You have to count laxatives and GI active
substances to get most of the rest.  Which fruits have every reason to
produce.  Yes, some parts of plants "want" to be eaten.  But it's not
the general rule.



>Second, there are more biochemical similarities between various
>animal species than differences.  So even if a plant only has a
>symbiotic relationship with some bacteria, or a type of ant, it
>would STILL make it very possible that there are numerious
>potentially beneficial bioactive substances in that herb.

   Most plants are poisonous to most would-be eaters, particularly in
the tropics where there is no cold season to give plants a head start
on insects.  Yes, most poisonous plants have a few things that can eat
them-- koalas for eucalyptus and so on.  But they're exceptions.  If
you're not a koala, eucalyptus will kill you.


>There is more interrelationship between the animal and plant
>worlds than you seem to be willing to accept.


   It's not the animal and plant *worlds*, it's a few specific
relationships.  Mostly, however, plants want to be left alone (parts
that turn color are drawing attention to themselves, but you'll notice
that most parts of most plants stay green).  Plants certainly don't
want their photosythetic leaves eaten, their roots dug up, and their
stems crushed.  The relationship between most plants (and certainly
most parts of plants) and most animals, is the same as the relationship
between zebras and lions.

                                    Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 16 Apr 1999 11:19:34 GMT

In <7f4g3p$scl$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>In article <3715874B.E58DF756@cs.uoregon.edu>,
>Bret Wood  <bretwood@cs.uoregon.edu> wrote:
>
>>The family practitioner doesn't want to admit that most drugs
>>are prescribed because they work, NOT BECAUSE WE KNOW WHY THEY
>>WORK.  (Antibiotics being one of several exceptions)
>
>   A quick look through the PDR will confirm the above
>statement.


    The PDR is not good for confirming statements of fact in science,
becausee it is not a scientific document.  It is a legal document.  Its
science is almost always way out of date and meedlessly incomplete.
That's because its purpose is not to increase the reader's
understanding, but to decrease the drug company and the government's
responsibility if something goes wrong with the drug's use.  Not the
same thing by half.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 16 Apr 1999 11:37:56 GMT

In <7f4ge3$sk9$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>In article <7f430o$hut@sjx-ixn9.ix.netcom.com>,
>Steven B. Harris <sbharris@ix.netcom.com> wrote:
>
>>
>>Comment:
>>
>>    Strictly speaking, since that what I wrote, you've got me there.
>>Mevacor is still on the market, so I guess it's a "commercial
>>preparation."  I haven't used it in years, since there are better ones,
>>but it's still around.
>
>   Besides, homocystine is the real culprit so it is time to
>move on.

    Not without a prospective randomized trial showing benefits from
lowering homocysteine.  Give us a break.


> And what about the studies which show about a
>third reduction in heart attack risk from taking drugs like
>Cipro?

    I know of no prospective randomized ones.  What about them?


>>   The irony of this is that a Federal judge (in Utah, of course)
>>overturned the FDA, and now Cholestin can be sold.  All this does is
>>discourage natural products research even further.  Never again is a
>>company going to do any expensive research on a natural herbal extract,
>>if they can have no proprietary pay-off for putting up the research
>>capital.  Th
>
>   That is why government needs to do this kind of research
>for the benefit of the population.  Food is very important
>in how long we live, but up till now people like the diary
>industry have determined government policy of 'food groups.'


    Your solution for information socialism is research funding
socialism.  Typical.  And you want it controlled democratically.  But
you don't want the government to do the research the people want,
because the people don't know what's good for them.  Boy, does your
idea have problems.

    Teaching people costs money.  What that means is that, so long as
freedom of speech is preserved, people who have money will have the
advantage in being heard.  Thus, democracy plus freedom of speech =
fact that money buys votes = government bias toward ideas of those who
are rich.  All of this is inevitable, since it follows as a matter of
logic and common definition of words (do let me know where you're
having trouble making these connections, if you are).  Since the
government is inevitably going to be biased in favor of the rich in a
free-speech democracy, I suggest making the government as small as
posssible, so that this bias will work least harm.  The government is
inevitably going to come to the conclusion that milk is good for you.
What matter is whether or not you have a gigantic beast of a government
which controls the education of your children, and therefore drums this
policy into them, as a matter of propaganda.  And takes your tax money
to pay milk ranchers subsidies to expand in ways a free market would
not permit.  And so on.

   I'm really tired of people who want a great big powerful democratic
government, but a great big powerful government which is interested
mostly in the common man and his concerns, and what's "good" for him
(which, incidentally, is not generally what he's always interested in).
As Milton Friedman points out, that's like wanting a barking cat.  You
can want one all you like, but barking simply isn't the nature of cats.
You might just as well be arguing for an appearance of the Easter
Bunny.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,sci.med.cardiology,alt.activism,talk.politics.medicine
Subject: Re: U. S. Trails the world in herbal medicines
Date: 16 Apr 1999 11:42:54 GMT

In <7f4h3t$t71$1@nina.pagesz.net> henryj@nina.pagesz.net (George
Conklin) writes:

>  Another example is the fight over homocystine vs.
>cholesterol.  Cholesterol won out as a political battle, not
>because it worked.

    Yes, because it worked.  I assume you're familiar with the 4S and
WOSCOPS studies?  If so, please state in what way the cholesterol
hypothesis failed to work.  If not, please familiarize yourself with
the area you're talking about.