All Those Little Brown Bottles …

Even though I record all the TV shows I want to watch and skip through the commercials during playback, I’ve been half-consciously aware that pharmaceutical ads seem to dominate commercial airtime.  As I was watching a Biography Channel episode about Arnold Schwarzenegger a few days ago, it seemed as if every other commercial I skipped past was for some sort of drug.  So today, I played the episode again and tallied them.

There were 27 commercials, not counting promos for upcoming episodes on Biography.  Seven were for prescription drugs.  (There was also an ad for a cream to remove dark circles under the eyes, and one claiming that NutriSystem will help type 2 diabetes keep their blood sugar under control.)

Something is very, very wrong when a quarter of the prime-time ads on TV are directed at sick people.  And these aren’t even products you can just walk into a store and buy — you must, as the ads remind you, “talk to your doctor about …”

Here are some of the medical products I saw advertised, along with the conditions they’re intended to treat and abbreviated version of the obligatory warnings.

Advair (asthma).  May increases risk of death from complications of asthma.  May increase risk of hospitalization for asthma in children and adolescents.

Symbicort (chronic obstructive pulmonary disease).  Do not take more than twice per day.  Increases risk of lung infections, osteoporosis, and some eye problems.

Oracea (rosacea) Side effects include stomach upset, sore throat, sinus infections.  Stay out of direct or artificial sunlight while taking.  Talk to your doctor if you’re taking blood thinners or have kidney disease, as there may be serious side effects.

Nexium (heartburn, acid reflux).  Talk to your doctor about an increased risk of osteoporosis-related bone fractures if you take multiple daily doses.  Side effects include headache, diarrhea and abdominal pain.

Fabulous.  While you’re in traction because of an osteoporosis-related femur fracture, you’ll be delighted you’re not experiencing heartburn.

Cymbalta (chronic pain, osteoarthritis)  Taking with aspirin or blood thinners may increase bleeding risk.  Severe liver problems, some fatal, were reported, as were abdominal pain and yellowing of the skin or eyes.  Dizziness or fainting may occur upon standing.  Other side effects include confusion, dry mouth and constipation. Tell your doctor if you experience unusual changes in behavior, mood swings, or thoughts of suicide, as these can increase in children, teens and young adults.

By the time the announcer finished with the long list of warnings for Cymbalta, I was laughing out loud — mostly because I was seeing all these happy-looking people going by on the screen while hearing about fatal liver problems, confusion and suicides.  Look!  We’re happy!  Or maybe we’re just confused!

I half-expected one of the happy people to face the camera and say, “Let’s see … my chronic back pain is finally gone, but I’m constipated, I have yellow eyes, I faint when I stand up, I’m confused, my belly hurts, and I my liver isn’t working anymore.  You know what?  I think I’ll kill myself.”

I’m grateful drugs exist for the people who need them.  But we shouldn’t need so many of them, and as Dr. Mary Vernon emphasized in a recent podcast interview, taking a drug to mask the symptoms of disease isn’t the same as being healthy.  We learned that lesson again (well, some of us; many doctors and researchers won’t) a few days ago when yet another drug that artificially raises HDL failed to reduce heart disease:

The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health has stopped a clinical trial studying a blood lipid treatment 18 months earlier than planned. The trial found that adding high dose, extended-release niacin to statin treatment in people with heart and vascular disease, did not reduce the risk of cardiovascular events, including heart attacks and stroke.

During the study’s 32 months of follow-up, participants who took high dose, extended-release niacin and statin treatment had increased HDL cholesterol and lowered triglyceride levels compared to participants who took a statin alone. However, the combination treatment did not reduce fatal or non-fatal heart attacks, strokes, hospitalizations for acute coronary syndrome, or revascularization procedures to improve blood flow in the arteries of the heart and brain.

The DSMB also noted a small and unexplained increase in ischemic stroke rates in the high dose, extended-release niacin group. This contributed to the NHLBI acting director’s decision to stop the trial before its planned conclusion.

Triglycerides were pushed down, HDL was pushed up, but the rate of heart disease didn’t change.  Why?  Because chemically improving the markers for health isn’t the same as improving health.  As I pointed out in a previous post, my neighbor’s grass is a beautiful shade of green because he constantly fusses over his lawn to keep it healthy.  My lawn is patchy because I don’t care about lawns.  If I paint my lawn green, that won’t make it any healthier.  Sadly, many researches just can’t seem to grasp that concept:

“As we continue to search for new approaches to treating cholesterol problems, it is important to remember the value of existing treatments. The key to treating high cholesterol so patients can reduce their risk of cardiovascular disease is to lower the level of LDL cholesterol, through well-established drug treatments such as statins and lifestyle changes,” said Patrice Desvigne-Nickens, M.D., NHLBI project officer for the AIM-HIGH trial.

Head. Bang. On. Desk.

We just saw a drug that successfully manipulates cholesterol levels fail to reduce heart disease — while slightly increasing strokes — and yet the good doctor is still promoting chemical manipulation.  By gosh, if you change the risk factors, you must be changing the actual outcomes.  Riiiiight.  Paint your lawn green, and the grass becomes healthy.

This doesn’t even provide the entertainment value of being a new story.  Some years ago, Pfizer announced it had developed a combo drug that significantly improved cardiovascular risk factors.  The early press releases were breathless:  the miracle combo boosted HDL by 44 to 66 percent, while lowering LDL by 41 to 60 percent.  Wow!

The results were somewhat less spectacular:  Pfizer had to pull the plug on a clinical trial of the combo drug three years early because people taking the combo drug had a 60% higher mortality rate.  Hmmm … maybe Mother Nature, unlike NHLBI researchers, doesn’t think it’s a good idea to chemically manipulate our production of cholesterol.

We’re going to see this story repeated at least two more times.  Merck is currently developing and testing a drug that artificially raises HDL.  And earlier this week, a reader sent me a link to this online article:

Polypill ‘halves risk of stroke and heart attack’

A new 10p-a-day ‘polypill’ containing aspirin and statins halves the risk of heart disease and stroke, according to the world’s first international trial of the drug, reported The Daily Telegraph. The news story is based on a randomised controlled trial of a polypill in 378 people who all had a slightly increased risk of vascular disease. The researchers found that people who took the polypill had improvements in their blood pressure and levels of “bad” LDL cholesterol (equivalent to a 46% reduction in cardiovascular risk) over 12 weeks, compared to those who took a dummy pill.

If you’ve seen my Science For Smart People speech, you know what “lowers your risk” actually means.  So the polypill “halves the risk” of heart disease, does it?  Whoop-ti-do.  I’ve got news for you:  Pfizer’s combo drug dramatically raised HDL and lowered LDL, which means it dramatically “lowered the risk” of heart disease for the people taking it.  The only bad news is that more of those people died.

High HDL and low triglycerides don’t confer good health.  They’re markers for good health.  Chemicals that remove the blotches from your face, beat down your elevated blood sugar, or mask the pains of heartburn and arthritis don’t eliminate the underlying imbalances that caused those conditions in the first place.

If you want real health, eat real food.  Get some real exercise and some real sleep.  You’re not going to find real health in a little brown bottle, no matter how many times you “talk to your doctor about …”


70 thoughts on “All Those Little Brown Bottles …

  1. Paul451

    The advertisements you see on TV and in magazines are a function of the age of the Baby Boomers. Forty years ago it was ads for Slinkies, Yoo-Hoo, and TV dinners. Now it’s for various drugs – none of which were available to our parents who will probably live longer than we will because they ate so much less sugar than us – that are almost without exception for conditions related to aging and having a lousy diet.

    When the boomers hit the Medicare rolls en masse, it’s going to be veeeeery interesting.

  2. Susan

    What I’ve always wanted to do is gather up a list of all the “ask your doctor” meds and take it to my next appt so I can jokingly ask him if any of them are “right for me.” But I’m afraid he’d probably give me a scrip for one or more of them. As it is, he pushes statins at me so he can maintain his “rating” by adhering to the accepted guidelines. I keep trying to convince him he needs new guidelines, but I’m afraid it’s a lost cause.

    Re the ads for Intuniv (AKA, guanfacine), the latest ADHD drug: I always laugh when I hear the announcer say, “don’t take Intuniv if you’re taking guanfacine.” Don’t take it if you take it. What?

    That would actually be fun. Go to a doctor and ask about 30 or 40 different drugs you saw advertised.

  3. Jess

    I have to wonder how the people that peddle this poison can possibly sleep at night; it’s certainly a sad reflection of what the world has become.

    My grandparents are in their mid 60s, but look at least 80. My grandmother lives with excruciating pain from bones too brittle and frail to ever fix, and my grandfather is obese, diabetic, and depressed. The reason? My sweet grandmother is very easily swayed by what she sees and reads. She’s spent countless hours looking for the solution to their poor health, and because of the horrible drugs and worse diet being pushed, she and my grandfather are slipping away long before they should be. Their pantry is full of the latest superlowfathighfiberextrahealthy garbage being pushed as food these days, and they’ve wasted thousands of dollars on hundreds of worse-than-useless pills and supplements. They’re the perfect example of what happens when you follow the government’s health advice to the letter, and it’s so, so tragic.

    You’d think at some point my grandmother would wake up and realize that trying another tactic would be wise, but she just can’t deal with the reality that people would actively sell advice and products that hurt other people. Who would have thought that faith in mankind could be such a dangerous virtue?

    That’s what bothers me the most, knowing how many people are truly trying to take care of themselves, but acting on bad information. The people who prefer to live hard, die young, and leave a good-looking corpse are asking for it, but not people like your grandparents.

  4. Robinowitz

    A few months ago, I was concerned that I wasn’t quite making enough milk for my breastfeeding infant…so I asked my gyno about it at my 6 week check-up. She prescribed me a med that wasn’t made to increase milk supply but it was a side effect. She said she’d taken it herself. I filled the script and then went home and googled it to see the side effects, since doc didn’t feel they were important enough to mention. Turns out the med caused some scary, whacked-out psychotic side effects (suicidal thoughts and tendencies, etc.) to some! And she prescribed this to a hormonal, sleep-deprived first-time mom with a history of depression! I couldn’t believe how ready she was to just recommend a medicine I didn’t even need just to maybe trick my body into making a bit more milk. I’ve no intention of taking any meds while breastfeeding–and the milk came in eventually–but I was desperate at the time. Now I’m even more disgusted with the medical professionals that just prescribe meds for everything rather than actually trying to get to the cause of the problem.

    There are some great doctors in the world, but there a lot of pill-pushers as well.

  5. Chris

    We don’t have T.V., only Netflix, so i dont see any commercials, but I’ve been spending my vacation repainting all week so was able to listen to radio all day. Every other commercial on radio is for “male enhancement” pills. I haven’t heard any listed side effects, so I’m assuming the pills are concentrated saturated fat!

    Male enhancement? As in a … uh … size thing?

  6. fredt

    Tom, I do enjoy the entertainment. And I truly sorry about my attitude toward big business. Something like this is just more evidence that we are just marks to big business, to be used as a source of dollars to be fleeced. Buyer beware. Capitalism at its best. Good Marketing. Get what you can while the getting good. Greed. Sell what people are buying. Fleece’im. Then the government required warning of the “side” effects, which are hugely understated, and have little effect of purchasing decision of the purchasers, but are politically correct.

    The concept of side effects was created by a lawyer and is an understatement. These are more truly unwanted effects.

    I think it is sad that our populations (I am Canadian) are suffering so much that these drugs are even wanted. Here I sit, drug free, nearly free of all sugar, grain, oil, and other manufactured food sources, and nearly medically complaint free. (I could stand to loose a bit of weight.)

    We are indeed viewed as markets by businesses, and I don’t have any with problem with that when the markets develop naturally. You will rarely hear anyone complain, for example, that Apple Computers and Netflix are just after our money — of course they are, but we happily buy their products, which developed in mostly free markets. The health-care and insurance industries, by contrast, have been so squashed out shape by governments at all levels, we frankly have no idea what our system would be like without all the market distortions. We do know, however, that when people pay out of pocket and thus don’t have their choices limited by regulated third-party payers, they disproportionately choose to visit naturopaths, chiropractors, etc. — people who don’t treat their problems with drugs. When I lived in Illinois, the state outlawed one of the alternative disciplines (maybe naturopaths; I don’t recall exactly), thus limiting people to visiting the pill-pushers.

  7. Chris

    Response for Chris: “Male enhancement”….I didn’t want to be filed under the catagory of “too much information”. But our marriage is alot “friskier” since my husband and I saw your documentary, ditching the carbs, eating the fat. One thing is we feel a little trimmer and sexier, and uh…..”the size thing.”

  8. CeeBee

    This post reminded me of an interview I heard recently with one of the authors of the book Overdiagnosed: Making People Sick in Pursuit of Health. I can’t remember which of the authors was interviewed, maybe Dr. H. Gilbert Welch. Anyway, the upshot of the discussion was that the idea of “early detection” and routine screening is actually doing more harm to people than good. People are so worried about what might possibly be wrong with themselves that they are making themselves sicker by undergoing treatment or taking medications that may or may not help them at all.

    This doctor did not put all the blame on Big Pharma, he said that hospitals and physicians shared the blame for this situation as well.

    Overdiagnosed is on my list to read later this year and I thought I’d recommend it to you.

    I’ll give it a look.

  9. Keen

    The worst ones for me are the ones where the “side effects” are exactly the same as the thing being treated. Like allergy medicines where the listed side effects include runny or stuffy nose, watery or itchy eyes, etc.

    “No, no, see, our pills just have some side effects remarkably similar to the original condition. They’re totally different from pills that do nothing. Really.”

    It’s a brilliant business model if you think about it. We should develop a pill for gastric reflux, and when people complain that they still have gastric reflux after taking the pill, we explain that it’s a side effect. That’s even better than George Carlin’s suggestion that we should tax all foreigners living abroad.

  10. Walter

    That’s what bothers me the most, knowing how many people are truly trying to take care of themselves, but acting on bad information.

    That’s what bothers me most too. This realization also has the effect of making you less judgmental. When you see someone who trusts authority doing it all wrong, but convinced that they are doing it all right and still failing, but sincere in their efforts….

    I’ve heard quite a few stories from people who tried following the standard advice and ended up suffering negative consequences. These were conscientious people who were simply given bad information.

  11. Bruno

    Wow, you are painting with a pretty broad brush here. I agree they use drugs too much to mask symptoms instead of cure disease, and that the number of ads on TV for them is ridiculous. But some of your statements above go way beyond that. You seem to be implying that by eating meat and cheese the need for some of these drugs will just go away.

    It seemst you’re becoming nearly as much of a zealot as those telling us to eat low fat high carb diets. You’ve simply traded one form of zealotry for another. What’s next, “eat this and you’ll never get cancer” ?

    I’ve come to realize that there is something about human beings that does not allow them to remain balanced and deal with complexity and more importantly, size up the “trade offs” in life. Perhaps they find the simplicity of extremes easier to process mentally. I know people who exist on a diet of processed junk and they have tons more energy and more robust health than I. I know people who eat strict diets and are a mess. People are different. Diet is not a panacea.

    If you’ve ever had a bad reflux problem you’d gladly trade relief for the slight chance of bone problems in old age. There is more to health than “healthy eating”. I’m sure you know that. I know you’re excited about your new information on diet but I suggest you reign yourself in before you lose credibility with any but a tiny cadre of fellow zealots. Life isn’t that simple.

    By the way. My doctor knew about the dietary information in your documentary long before it came out, has helped lots of people lose weight using that method, and he prescribed me Prilosec (chemically almost identical to Nexium).

    I have had acid reflux. I’ve also had asthma, restless legs, frequent belly aches and psoriasis. I don’t have any of those conditions anymore because I figured out they were related to grains and sugars and stopped eating them. So no, I’m not claiming meat and cheese will prevent them; I’m claiming giving up the foods that cause them in the first place will prevent them. If you’ve been paying attention to the comments over the months, then you already know many people have had similar experiences, including the sound mixer for Fat Head, who changed his diet after watching the film and was able to stop taking his daily dose of Prilosec, which he’d been on for years. If the idea that improper diets cause diseases and proper diets therefore prevent them sounds like zealotry to you, fine. Take your drugs.

  12. Ricardo

    You don’t need statins to lower Cholesterol. High Cholesterol is the result of low testosterone you don’t need drugs to bring Cholesterol down whats needed is an increase in testosterone levels. Cholesterol is the building block for testosterone, if testosterone is low cholesterol will be high naturally.

  13. Amber

    It’s a good thing you’re on a ketogenic diet. With all that head-banging, you need the therapeutic effects it exerts on brain trauma! 😉

    Rosacea is one of the few remaining health complaints I have that hasn’t yet responded to a very low carb, whole foods based diet. I suspect it has an infectious component, and that’s why Oracea (which is an antibiotic) sometimes works. I have yet to try the antibiotic route, because the one that is used, as you rightly point out, is rather nasty, and I’ve been either pregnant or breastfeeding since shortly after having it diagnosed almost 2.5 years ago.

    As soon as we are weaned, I intend to try it, and if it works, (in a permanent sense — I wouldn’t be satisfied to have to use it chronically), I’ll be glad to have taken it, and would conclude that I had had a persistent infection which was cured.

    In a similar vein, there can sometimes develop deficiencies that no amount of food will fix; what is needed are large therapeutic doses of a substance over a period of time. I’m all in favour of such interventions when a diet optimal for a healthy person just isn’t enough to heal a system gone awry.

    Sure, you can look at the ailments these drugs are designed to treat, and some people will suffer from them no matter what they eat. But we have far more customers for those drugs than we should.

  14. Ricardo

    If more doctors were to check for things like Growth, Testosterone, DHEA, and Thyroid Hormone and correct some of them it would most likely explain all the disorders their trying to treat.

  15. Susan

    As Ricardo points out, many docs fail to check for levels of these various important hormones. Funny thing is, the levels of most if not all of these hormones are intimately related to our cholesterol levels. But the docs are so busy chasing the holy grail of low cholesterol that they could seemingly care less about what that pursuit may be doing to all these other substances.

    Myopic jerks!

  16. Jesrad

    Here in France ads for drugs are much rarer as their legally-acceptable content is far stricter, so instead… It’s the ads for carbage foods that are designed like pharmaceuticals’. Fat-free whatever, heart-healthy margarines and whole-grains panaces everywhere. We even have the “male enhancement” part covered with industrial pasta meals that are solds as giving orgasms.

  17. Marilyn

    Amber, my rosacea clears once I’ve
    1. dusted my desk thoroughly – especially if I’ve been working with old books (or in the good old days, if my cats had been “helping” a lot at my desk)
    2. cleaned my glasses thoroughly
    3. washed my face frequently with very warm water — and NO SOAP. I use white facecloths so there’s no dye residue. Might be an old wives’ tale, but it seems to make a difference.

    Also, I never EVER put any face creams, soaps, etc., on my face, no matter how “hypoallergenic” or “healthy” or “natural” they might be. Haven’t for thirty years. Water only!

    Hope it works as well for you as it does for me.

  18. Ricardo

    In response to Susan. Less Cholesterol = less hormones. Less Hormones Equals more disease. Good for business.

  19. donny

    Eating a high carb diet while taking medicine that mimics the blood profile of a low carb diet doesn’t sound like a good idea. We may not like how the body responds to a particular diet, triglyceride and hdl-wise, that doesn’t mean it makes any sense for us to get in the driver’s seat. Maybe the body’s doing its best in a bad situation.

    That’s why I think beating down our cholesterol with drugs is a bad idea. I assume the body is making it for a reason.

  20. ethyl d

    I’m reading a book titled Overtreated right now and am in the chapter on how drug manufacturers market their products. Truly disgusting. The book’s definitely worth a read for anyone interested in the medical industry.

    And there’s blame to assign to everyone to some degree for the health mess we’re in: government, doctors, patients, hospitals, pharmaceutical companies, researchers, journalists….They all play their part in keeping up the madness.

    It was indeed a group effort.


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