American Board of Internal Medicine Foundation’s Choosing Wisely: http://www.choosingwisely.orgWE HEAR ABOUT NEW TREATMENTS, new drugs, nutritional supplements, and alternative treatments all the time. Hardly a week goes by without a new treatment of some kind being reported in the news. Drug companies and nutritional supplement companies run commercials during the television news and place large ads in newspapers and magazines. Our e-mail boxes are filled with promises of new treatments or cures from spammers. We are bombarded in the market or pharmacy with signs and packaging for over-the-counter alternative treatments. Not only that, our health care providers may recommend new procedures, medications, or other treatments that we don’t know much about.
What can we believe? How can we decide what might be worth a try?
An important part of managing our own care is being able to evaluate these claims or recommendations so that we can make an informed decision about trying something new. There are some important questions that you should ask yourself in the process of making a decision about any treatment, whether it is a mainstream medical treatment or a complementary or alternative treatment.
Was it reported in a scientific journal, a supermarket tabloid, a print or TV ad, a Web site, or a flyer you picked up somewhere? Did your doctor suggest it?
The source of the information is important. Results that are reported in a respected scientific journal are more believable than those you might see in a supermarket tabloid or in advertising. Results reported in scientific journals, such as the New England Journal of Medicine, Lancet, or Science, are usually from research studies. These studies are carefully reviewed for scientific integrity by other scientists, who are very careful about what they approve for publication. Many alternative treatments and nutritional supplements, however, have not been studied scientifically, so they are not as well represented in the scientific literature as medical treatments are. If this is the case, you need to be extra careful and critical about analyzing what you read or hear.
In the past, many studies were done with easy-to-get people, so older studies were often done on college students, nurses, or white men. This has changed, but it is still important to find out if the people that got better were like you. Were they from the same age group? Did they have similar lifestyles? Did they have the same health problems as you do? Were they the same sex and race? If the people aren’t like you, the results may not be the same for you.
A woman returns from a two-week stay at a spa in the tropics and reports that her arthritis improved dramatically thanks to the special diet and supplements she received. But is it appropriate to attribute her improvement to the treatment when the warm weather, relaxation, and pampering may have had even more to do with her improvement?
It is important to look at everything that has changed since starting a particular treatment. It is common to take up a generally healthier lifestyle when starting a new treatment—could that be playing a part in the improvement? Did you start another medication or treatment at the same time? Has the weather improved? Are you under less stress than before you started the treatment? Can you think of anything else that could have affected your health?
Does it require that you stop taking another basic medication because of dangerous interactions? If the other medication is important, this will require a discussion with your health care provider before making a change.
Does it eliminate any important nutrients or stress only a few nutrients that could be harmful to you? Maintaining a balanced diet is important for your overall health. Be sure that you’re not sacrificing important vitamins or make certain that you’re getting them from another source if you change your eating habits. Also be sure to avoid putting excessive stress on your organs by concentrating on only a few nutrients to the exclusion of others.
Some treatments take a toll on your body. All treatments have side effects and possible risks. Discuss these matters thoroughly with your health care provider. Only you can decide if the potential problems are worth the possible benefit, but you must have all the information in order to make that decision.
Many people think that if something is natural, it must be good for you. This may not be true. “Natural” isn’t necessarily better just because it comes from a plant or animal. In the case of the powerful heart medication digitalis, which comes from the foxglove plant, it is “natural,” but the dosage must be exact or it could be dangerous. Hemlock comes from a plant, but it is a deadly poison. Some treatments may be safe in small doses but dangerous in larger doses. Be careful.
Except in Germany, no regulatory agency is responsible for determining if what is listed on the label of a nutritional supplement is actually what’s in the bottle. Supplements don’t have the same safeguards as medications. Do some research about the company selling the product before you try it.
Do you have the money to give this treatment the time it needs to produce an improvement? Is your health strong enough to maintain this new regimen? Will you be able to handle it emotionally? Will this put a strain on your relationships at home or at work?
Do you have the necessary support in place?
If you ask yourself all of these questions and decide to try a new treatment on your own, it is very important to inform your health care professional about it. After all, you are partners, and you will need to keep your partner informed on your progress during the time you are taking the treatment.
The Internet can provide information about new treatments very quickly and is therefore a resource for up-to-date information about these treatments. But be cautious. Not every piece of information on the Internet is correct or even safe. Seek out the most reliable sources by noting the author or sponsor of the site and the URL (Internet address). Addresses ending in .edu, .org, and .gov are generally more objective and reliable; they originate from universities, nonprofit organizations, and governmental agencies, respectively. Some .com sites can also be good, but because they are maintained by commercial or for-profit organizations, their information may be biased in favor of their own products. One source of useful information about questionable treatments is Quackwatch, a nonprofit corporation whose purpose is to combat health-related frauds, myths, fads, and fallacies (http://www.quackwatch.org). Other sites are accessible from the Quackwatch site. Sometimes it is wise to say no to conventional medical treatments as well. For example, various medical speciality organizations after reviewing the medical evidence have recommended that nearly 50 common treatments and procedures should NOT be done (see www.choosingwisely.org). (For more information on finding resources on the Internet and elsewhere, see Chapter 3.)
Making decisions about new treatments can be difficult, but a good self-manager uses the questions presented in this chapter and the decision-making steps in Chapter 2 to achieve the best personal results.
American Board of Internal Medicine Foundation’s Choosing Wisely: http://www.choosingwisely.org
ConsumerLab: http://www.consumerlab.com
National Center for Complementary and Alternative Medicine: http://nccam.nih.gov
Quackwatch: http://www.quackwatch.org