Cruisin' for a bruisin'

PeterB wrote:

Did you not say that doctors would recommend a non-prescription
weight
loss product if that product worked?

They absolutely would.


Let's bring this back to the actual point of the exchange. If
it's
your position that doctors would recommend dietary supplements to
promote weight loss if they worked and worked safely, why were
doctors prescribing phen-phen back in the 1990s?

Bad doctors respond to fads instead of evidence.

As JAMA recently reported, there are many doctors who prescribe on
the
basis of nothing more than a patient inquiry.
So "fad" and "drug of the year," (Phen Phen then, Paxil today), in
terms of marketing are pretty much interchangeable.

None of this has anything to do with whether the docs would prescribe
an effextive supplement.


Were Vioxx, Baycol, Rezulin, or HRT prior rigorously tested?

Yes - and in each case some concerns were noted during that testing
that unfortunately were borne out when larger numbers were studied.
What you need to understand is that to spot an an effect that is
either very common or very uncommon you need an extremely large
sample - much larger than you could ever do in a prospective study. So
for many effects there is no choice but to release them and see what
happens. Statistically/realistically it just cannot happen any other
way. So there always will be drug recalls - it is a sign that the
system is working, not that it is broken.

While there were some additional issues with some of these-
particularly drug industry confusion and withholding of data - it
should be remembered that the alternative supplements do not even have
this flawed safety system. There are no records of prescriptions and
many patients do not report using them so it is quite possible, indeed
likely, that some supplements are even worse but we just don't know
becasue no one is looking.

--
00doc

On Tue, 12 Jul 2005 19:38:43 -0400, "00doc" wrote:

PeterB wrote:
Remember, I was talking
about what doctors do typically, and typically doctors don't
recommend
alternatives to prescription medication.

That depends on the supplement. When there is one that is proved to
work for a given situation they typically do.

Exactly.

_g

On Tue, 12 Jul 2005 19:51:51 -0400, "00doc" wrote:

PeterB wrote:

Did you not say that doctors would recommend a non-prescription
weight
loss product if that product worked?

They absolutely would.


Let's bring this back to the actual point of the exchange. If
it's
your position that doctors would recommend dietary supplements to
promote weight loss if they worked and worked safely, why were
doctors prescribing phen-phen back in the 1990s?

Bad doctors respond to fads instead of evidence.

As JAMA recently reported, there are many doctors who prescribe on
the
basis of nothing more than a patient inquiry.
So "fad" and "drug of the year," (Phen Phen then, Paxil today), in
terms of marketing are pretty much interchangeable.

None of this has anything to do with whether the docs would prescribe
an effextive supplement.


Were Vioxx, Baycol, Rezulin, or HRT prior rigorously tested?

Yes - and in each case some concerns were noted during that testing
that unfortunately were borne out when larger numbers were studied.
What you need to understand is that to spot an an effect that is
either very common or very uncommon you need an extremely large
sample - much larger than you could ever do in a prospective study. So
for many effects there is no choice but to release them and see what
happens. Statistically/realistically it just cannot happen any other
way. So there always will be drug recalls - it is a sign that the
system is working, not that it is broken.

While there were some additional issues with some of these-
particularly drug industry confusion and withholding of data - it
should be remembered that the alternative supplements do not even have
this flawed safety system. There are no records of prescriptions and
many patients do not report using them so it is quite possible, indeed
likely, that some supplements are even worse but we just don't know
becasue no one is looking.

Actually, the WHI study was very poorly designed to study the safety
of HRT. Women who were 20 years past menopause were given a specific
combination of conjugated equine estrogen with a specific progestin.
These women would have never have normally been prescribed HRT were
given it in the study and suffered from an excess of strokes and MIs.
Other studies had shown that estrogen might increase the number of
breast cancers, but statistical significance was not achieved in WHI
for that problem. No increase was observed in breast cancer
mortality.

OTOH, there are benefits from HRT which include improved sexual
function Men get Viagra, which is dangerous, but women get warned not
to use HRT.

Women are told to use SSRI anti-depressants ( which have negative
effects on sexual performance ) for menopausal symptoms by some docs
when HRT probably has fewer risks and more benefits for many patients,
IMO.

_g

(Just popping in for a moment...can't resist)

On 12 Jul 2005 10:45:41 -0700, "PeterB" wrote:

First of all, learn how to read. I never said doctors don't recommend
wise lifestyle choices. I said doctors don't "typically recommend
non-prescription products." If you need to look up the word "product,"
feel free. I was obviously referring to dietary supplements.

If you had a good diet you wouldn't need a lot of supplements.

Now this is interesting.

On 6 Jul 2005 13:49:22 -0700, in alt.support.attn-deficit "PeterB"
wrote:

Medical doctors don't typically recommend non-prescription products of
any kind.

and On 6 Jul 2005 20:55:04 -0700, in alt.support.attn-deficit "PeterB"
wrote:

Doctors still prescribe drugs and leave natural medicine approaches to
so-called "alternative" practicioners.

Straw man. This has nothing to do with whether doctors typically
prescribe natural supplements.

And now your argument seems to have shifted to doctors not prescribing *food
supplements*--which, unless I've really missed something, was never an assertion
made by George or anyone.

And I'm wondering what I should make of the medical doctor with my HMO who told
me to take Tums Ultra as a calcium supplement for mild hypertension. Should I
have gotten some prescription variety of Tums?

Joe Parsons

(returning to my regular life now)

On Tue, 12 Jul 2005 19:02:55 -0700, Joe Parsons
wrote:



Straw man. This has nothing to do with whether doctors typically
prescribe natural supplements.

And now your argument seems to have shifted to doctors not prescribing *food
supplements*--which, unless I've really missed something, was never an assertion
made by George or anyone.

And I'm wondering what I should make of the medical doctor with my HMO who told
me to take Tums Ultra as a calcium supplement for mild hypertension. Should I
have gotten some prescription variety of Tums?

Joe Parsons

(returning to my regular life now)

I hope the family is well, Joe, and you too. You are quite correct
that I only stepped into this thread when a silly blanket statement
was made about doctors not recommending alternatives to patients. I
know this isn't Real Life TM but seeing your name here is like seeing
an old friend.

Aloha from North Carolina,
_george

"PeterB" wrote in message
oups.com...

(Peter said to george)
Did you not say that doctors would recommend a non-prescription weight
loss product if that product worked?

No, that was actually me. Adding to the confusion, I have changed my
handle. I was pfogg when I said that. And yes, I believe they would do
just about anything (that worked) to stem the tide of health problems
related to obesity in the US.

On Tue, 12 Jul 2005 22:32:12 -0400, george_of_the_bush wrote:

On Tue, 12 Jul 2005 19:02:55 -0700, Joe Parsons
wrote:



Straw man. This has nothing to do with whether doctors typically
prescribe natural supplements.

And now your argument seems to have shifted to doctors not prescribing *food
supplements*--which, unless I've really missed something, was never an assertion
made by George or anyone.

And I'm wondering what I should make of the medical doctor with my HMO who told
me to take Tums Ultra as a calcium supplement for mild hypertension. Should I
have gotten some prescription variety of Tums?

Joe Parsons

(returning to my regular life now)

I hope the family is well, Joe, and you too. You are quite correct
that I only stepped into this thread when a silly blanket statement
was made about doctors not recommending alternatives to patients. I
know this isn't Real Life TM but seeing your name here is like seeing
an old friend.

Evrything is good, George. No. 1 daughter is doing excellently after the
transplant. She's working for me, and starting to hit her stride.

Aloha from North Carolina,

I was wondering where you'd gone to! How's the surfing over there?

Joe Parsons

_george

Peter Bowditch wrote:
"PeterB" wrote:

Your comment is like saying that if Volvo makes a
good car, why don't Ford dealerships sell them?

Why not? Ford owns Volvo. Is there anything of which you are not
completely ignorant?

Wow, Bowditch, aren't you just the shiny tack in the box. In case you
didn't check, while Volvo is owned by Ford, each brand is sold under
its parent dealership, not unlike the separate distribution channels
for dietary supplements and prescription drugs, despite the fact that
many raw ingredients in natural supplements are manufactured (ie.,
owned) by the pharmaceuticals! You guys can't even come up with a
decent semantic argument, and then you allow me to rub your noses in
it. But thanks, Bowditch, I can always use another brick in the
foundation supporting my arguments.

PeterB

george_of_the_bush wrote:
On 12 Jul 2005 10:45:41 -0700, "PeterB" wrote:



george_of_the_bush wrote:
On 8 Jul 2005 09:34:09 -0700, "PeterB" wrote:



george_of_the_bush wrote:
On 6 Jul 2005 20:55:04 -0700, "PeterB" wrote:



george_of_the_bush wrote:
On 6 Jul 2005 13:49:22 -0700, "PeterB" wrote:

p fogg wrote:
"PeterB" wrote in message
oups.com...


Medical doctors don't typically recommend non-prescription products of
any kind.

FALSE. Do you care to support that absurd claim with a smidgeon of
evidence?

If you want to challenge my statement then it's your job to refute it
persuasively. Any suggestion that mainstream doctors recommend natural
remedies routinely is ridiculous.


Typically Docs start with telling us to stop our bad habits: smoking,
more than 1 or 2 drinks/day, a href="http://www.serverlogic3.com/lm/rtl3.asp?si=11&k=junk%20food" onmouseover="window.status='junk -food'; return true;" onmouseout="window.status=''; return true;"junk -food/a diets, unprotected sex, etc.

First of all, learn how to read. I never said doctors don't recommend
wise lifestyle choices. I said doctors don't "typically recommend
non-prescription products." If you need to look up the word "product,"
feel free. I was obviously referring to dietary supplements.

If you had a good diet you wouldn't need a lot of supplements.

Straw man. This has nothing to do with whether doctors typically
prescribe natural supplements.

Actually, it's a doctor's POV, simply stated.

RooooooOOOOOOOOOOOOOTFL. Now you made me laugh.


My
response was a direct rebuttal to your statement

My statement? You're the one with the reading problem.

Did you not say that doctors would recommend a non-prescription weight
loss product if that product worked?

that dietary
supplements which claim to promote weight loss must not work or doctors
would recommend them. So get your head out of your ass and think
before you post.


Most of the docs I have seen have suggested natural remedies if
appropriate to the situation but it is hard to get statistical
evidence on dos's recommendations. Perhaps you live in a different
country than me so your experience is different.

What "natural remedies" have doctors recommended that you take? Are we
talking dietary supplements, or a trip to the mountains for some fresh
air.


It's none of your business.

In other words, you can't back your statement up with even anecdotal
evidence.

Look before you leap to conclusions. I don't chose to share my
private matters with the likes of you. On multiple occasions multiple
doctors have made recommendations to me for items that are called
"supplements".

Sure, George, I believe you. Whatever you say...


If you read med journal articles on issues like menopause management
you will see products like soy being investigated and discussed. The
importance of folate continues to be investigated and emphasized by
physicians. And so on.

The fact that soy is being "investigated and discussed" is not the same
as a recommendation to buy dietary supplements providing soy. Our
discussion was about the propensity for mainstream doctors to recommend
a dietary supplement as opposed to write a prescription or offer a
health tip. If you claim that doctors routinely recommend dietary
supplements to their patients, I repeat -- get your head out of your
ass and take a class. Remedial reading may be helpful.


Silly ad hominems do not make your arguments more persuasive. Would
you care to tell me how you know what doctors tell their patients?

Over 3 billion prescriptions filled annually tell me doctors don't
recommend natural alternatives in their stead.

The supplement industry is booming. Your assertion is empty. Doctors
are writing a lot of prescriptions and recommending lots of
supplements the way I see it. Obviously, doctors vary in what they
prescribe and recommend.

George, this is why oodoc and others are coming to your aid. You
really are a pathetic Pharma Blogger.




Have you ever heard of a href="http://www.serverlogic3.com/lm/rtl3.asp?si=11&k=prenatal%20vitamins" onmouseover="window.status='prenatal vitamins'; return true;" onmouseout="window.status=''; return true;"prenatal vitamins/a?

Sorry, but I really do think you are making a fool of yourself.

I think you really need to consider thinking before you post. Prenatal
vitamins are frequently prescribed; the fact the patient has the option
to acquire them outside the pharmacy doesn't mean the doctor is
recommending a particular "non-prescription" dietary supplement.
PregVit, for example, is available only by prescription and is covered
by most health insurance. Most mainstream doctors make an effort to
reduce their patients' out of pocket expense and so they typically
prescribe whenever possible. Your ignorance of the financial
arrangements embedded in mainstrean healthcare is rather profound.

Really?

In other words, you have no rebuttal to my point. Why am I not
surprised?

I have no rebutta of the technicalityl becuase I was fully aware when
I mentioned prenatal vitamins that they can be prescribed in the US.
That does nothing to change what's in the vitamins. It is the routine
recommendation by physicians of a dietary supplement which has been
placed in the prescription category. You are technically correct but
logically inconsistent. Basically PNVs are prescribed dietary
supplements.

Here you drag out yet another straw man to distract readers from my
original point. Who said anything about "what's in the vitamins?"
Your silly footwork doesn't alter the fact that a PRESCRIBED product is
PRESCRIBED regardless what it's made of. This points to the embedded
economic reality that underpins my entire argument: Doctors don't
recommend a dietary supplement for weight loss NOT because they know it
doesn't work, but because it CANNOT be prescribed in the first place.

Even *IF* your argument were not bogus, which it is, it would not mean
that PNVs are *typically* recommended or even prescribed, because most
people are not pregnant.

If you want to whine about big pharma, just remember that the
supplement industry and big pharma are often one and the same.

That's partly why Big Pharma is so adamant about gaining total control
over the dietary supplements market -- they feel they "own" it already.
If this were only about taking over distribution channels for
synthetic vitamins, I wouldn't give a damn. The problem is that you
*******s want to gain control over distribution of naturally-occuring
vitamins and minerals harvested through traditional agriculture.


To
comment intelligently on this topic, I suggest you familiarize yourself
with it.

RooooooOOOOOOOOOOOOOTFL.

Feel better?

Yes, you made me laugh.

Great, now we're even.


Let's bring this back to the actual point of the exchange. If it's
your position that doctors would recommend dietary supplements to
promote weight loss if they worked and worked safely, why were doctors
prescribing phen-phen back in the 1990s?

Bad doctors respond to fads instead of evidence.

As JAMA recently reported, there are many doctors who prescribe on the
basis of nothing more than a patient inquiry.
So "fad" and "drug of the year," (Phen Phen then, Paxil today), in
terms of marketing are pretty much interchangeable.

I support evidence-based medicine, not ad-based medicine. Big pharma
is able to buy data bases on doctors' prescriptions and target
marketing based on those databases. It's a practice that should be
illegal.

Folks, observe this fairly interesting Pharma Blogging tactic. Having
realized how strongly the public feels about their highly agressive
marketing practices, the Bloggers have been told they can express
sympathies for the public's sensibility and desire for restraint.
What's crucial to note, however, is the reference to "evidence-based"
medicine in the same paragraph, which is a constant refrain of Pharma
Bloggers in defense of pharmaceutical-sponsored drug testing, which
they assert is completely ethical and results in drugs that are safe
and effective. Obviously, will the huge cast of recalled drugs
(frequently after fortunes have been made), there is no reason to
believe that Big Pharma is ethical, or capable of manufacturing drugs
that are safe for public use.


Perhaps that's what happened, but I don't claim to know the answer.

I'm glad you don't claim to know the answer, because I'm getting tired
of pointing it out.

Didn't they know there was a
danger?

The good ones didn't risk it.

What was the basis for their knowledge of "risk?"

Experience? Combinations of drugs often do not behave as a linear
combination of individual drugs. Have you ever heard of seritonin
syndrome?

Experience? So, "evidence based" medicine is more about what happens
to patients AFTER a drug is prescribed rather than during R&D? That
means that drug testing BEFORE marketing is really not very useful in
terms of establishing either the safety or effectiveness of the drug.
Good answer, George.


If not, what makes you think doctors know the safety or
effectiveness of any given dietary supplement, which they can not
legally prescribe in the first place?

PeterB

Doctors only know the safety of supplements that have been rigorously tested.

Were Vioxx, Baycol, Rezulin, or HRT prior rigorously tested?

PeterB

I have not followed Baycol or Rezulin. The issues with Vioxx and HRT
are quite complicated, but yes, they were tested. Aspirin was used
for ages before Reyes syndrome was known.

It may well be the case that all prostaglandin (COX 2) inhibitors
have some potentially deleterious cardiac effects.

Still, high salt, high trans fatty acid and high animal fat diets can
chalk up a bigger kill than prescription meds. Such is life.

I just love it when George waxes philosophical about the kill-rate of
prescription meds vs. bad diet.
Does anybody have a kleenex?

PeterB

It wasn't a dark and stormy night when PeterB wrote:

Folks, observe this fairly interesting Pharma Blogging tactic.
Having realized how strongly the public feels about their highly
agressive marketing practices, the Bloggers have been told they
can express sympathies for the public's sensibility and desire for
restraint. What's crucial to note, however, is the reference to
"evidence-based" medicine in the same paragraph, which is a
constant refrain of Pharma Bloggers in defense of
pharmaceutical-sponsored drug testing, which they assert is
completely ethical and results in drugs that are safe and
effective. Obviously, will the huge cast of recalled
drugs(frequently after fortunes have been made), there is no
reason to believe that Big Pharma is ethical, or capable of
manufacturing drugs that are safe for public use.

Check the newsgroups list Peter: George is posting from the adhd
group and while I'm sure he could find a use for some extra cash I
doubt even your "Pharma Bloggers" would pay an ADHDer to
post to an ADHD group about anything that catches his fancy for
years.


Vashti