December 16th, 2014

Tamiflu for Flu Symptoms and Viral Infections? The Emperor has No Clothes!

Introduction

Oseltamivir, brand name Tamiflu, was released onto the market in 1999 for the treatment of influenza. Despite is wild popularity – over 6 billion prescriptions for a 5 day course costs about $135 – results from detailed analysis have called its effectiveness into question. Even the FDA seems to know the drug does not work, as it requires the manufacturer (Roche) to print the following disclaimer on Tamiflu labels.

Tamiflu has not been proven to have a positive impact on the potential consequences (such as hospitalizations, mortality, or economic impact) of seasonal, avian, or pandemic influenza.”

In 2009, when there was great fear of the bird flu outbreak that never occurred, the United States and other countries stockpiled over $3 billion despite the lack of scientific validation of safety and efficacy of Tamiflu.

New published data and analysis has lead to even more experts to ask a couple of simple questions: Why is Tamiflu still on the market? And, why are so many physicians still prescribing it?

Background Data:

More than 90% of the clinical research done on drugs in the United States is funded by drug companies and conducted by clinical research organizations (CROs) who are obviously trying to produce data that the drug company will be pleased with. Furthermore, since the research is technically owned by the drug company who is paying for the study, they control how it is interpreted, manipulated, and disclosed.

Most research published on drugs in medical journals are written by “ghost authors.” In the case of the initially published studies on Tamiflu, two former employees of Adis International, a large public relations company, came forward with documents showing they had ghostwritten these articles with specific instructions from Roche’s marketing department on how results should be presented.

Roche claims to have conducted ten studies on Tamiflu, but up until recently only two of these were ever published and those two showed the drug had very little effect on complications compared to a placebo. In 2009, the Cochrane Review concluded that no credible evaluation of the data from these Roche-sponsored studies has ever occurred. Even the data from the two published studies has been called into question. When the Cochrane reviewers went to the lead authors of the two published studies, one author said he had lost track of the data when he moved offices and the files appeared to have been discarded. The other said he’d never actually seen the data himself, and directed the Cochrane team to go directly to the company.

The bottom line is that in 2009 Cochrane researchers concluded that the research on Tamiflu and a related drug (Relenza) is “fragmented, inconsistent, and contradictory”, leading to speculation that these drugs may have no “therapeutic and public health policy advantage.”.

New Data:

Roche finally relented and eventually granted reviewers access to original clinical trial data. Researchers were able to analyze 20 full internal reports on the effects of Tamiflu and 26 reports on the effects of Relenza. In total, the reports included more than 24,000 people.

The analysis was conducted by the Cochrane Review which conducts systematic reviews of primary research that are internationally recognized as the highest standard in evidence-based health care. In April 2014, the most recent review on Tamiflu and Relenza (zanamivir) was published.

After analyzing all of the presented data, these Cochrane researchers concluded there were no differences for hospital admissions, reductions in confirmed pneumonia, or other complications of influenza in groups taking either Tamiflu or Relenza. There were some improvements in reducing the time to alleviation of influenza symptoms, but these were not clinically significant reductions. For example, in one trial (WV15912), symptoms were reduced in the group taking Tamiflu, but only by 1-hour. That’s right, Tamiflu reduced symptoms by 60 minutes compared to the placebo group.

The drugs were not without an effect as the data did show an increased risk of adverse effects, such as nausea, vomiting, psychiatric effects and renal events in adults and vomiting in children.

Commentary:

Despite all of the questions on the effectiveness and safety of Tamiflu, the Centers for Disease Control and Prevention strongly recommends the use Tamiflu to anyone even suspecting having the flu, possibly to justify the expenditure of stockpiled drug. It just does not make medical sense in light of all of the evidence.

Detailed analysis has also shown that most physicians do not make decisions of what drug to use on the basis of scientific research or cost, they base their decision almost entirely on the effectiveness of the drug company’s marketing and advertising efforts. And, even if they are relying on journal articles for their information, they are not necessarily getting the truth. In my book, What the Drug Companies Won’t Tell You and Your Doctor Doesn’t Know, I provide a very detailed account of the issues. Here are what key people at the major journals have to say about the drug companies and their own journals.

  • According Richard Smith, for 25 years the editor of the British Medical Journal, “major medical journals are just an extension of the marketing departments of major drug companies.”
  • Richard Horton, editor of the Lancet: “Journals have devolved into information laundering operations for the pharmaceutical industry.”
  • Marcia Angell, for 20 years the editor of the New England Journal of Medicine, comments on the drug industry “primarily a marketing machine” that is intent on co-opting “every institution that might stand in its way.”
  • From the JAMA: it is estimated that 95% of medical studies in the most prestigious journals contain false or misleading statistics.

The current situation with Tamiflu once again highlights one of the key problems with drug company sponsored research. The drug companies are sponsoring these studies for simply one reason, to sell their drugs.

Reference:

Jefferson T, Jones MA, Doshi P, et al. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Cochrane Database Syst Rev. 2014 Apr 10;4:CD008965.

Dr. Michael Murray
12/17/2014

December 15th, 2014

7 Tips For Better Communication In All Of Your Relationships

coupleA major cause of stress for most people is the realm of interpersonal relationships. Whether with your partner, at home with family members, with friends, and on the job, relationships are tough. Everyone has unique needs and desires, and unique ways of expressing them. Humans are social beings. We need to relate to each other to nourish our mind and soul. But the reality is that relationships — as well as lack of relationships — can deplete our minds and souls of energy, particularly when it comes to the ever-difficult question of communication.

In short, the quality of any relationship ultimately comes down to the quality of the communication. Learning to communicate effectively goes a long way in reducing the stress and conflicts of interpersonal relationships.

Here are seven tips to effective communication, regardless of the type of interpersonal relationship:

1. Learn to sit still.

Allow the person you are communicating with to share their feelings and thoughts — uninterrupted. Empathize with them: put yourself in their shoes.

If you first seek to understand, you will not only experience the obvious outcome of better understanding, but will also find yourself being better understood by others

2. Learn to be an active listener.

This means that you must actually be engaged and interested in what the other person is communicating. Don’t just sit there silently for the sake of appearing attentive. This won’t be productive at all, for either party.

Listen to what the other person is saying without thinking about your response. Don’t be afraid to ask many, many questions to gain more information or clarify what they are telling you. Good questions encourage better communication.

3. Restate the other person’s feelings back to them.

This is not a presumptuous action, but an empathetic one. Trying to restate or reflect back to the other person your interpretation of what they are telling you shows you have carefully listened and are putting effort and care into the interaction. Plus, it is a very simple technique — and it goes a long way. Restating what you think is being said may cause some short-term conflict in some situations, but it is certainly worth the risk …

4. Don’t be impatient.

Don’t interrupt, period. Wait until the person or people you want to communicate with are done speaking. If they are not ready to listen, no matter how well you communicate, your message will not be heard.

5. Don’t try to talk over the other person.

If you find yourself being interrupted, relax; don’t try to outtalk the other person or gloat about how you never interrupt. If you are courteous and allow them to speak, eventually they will respond likewise (unless they are extremely rude). If they don’t, point out to them that they are interrupting the communication process by not reciprocating.

You can only do this if you have been a good listener. Double standards in relationships seldom work.

6. Help the other person become an active listener, too.

This can be done by asking them if they understood what you were communicating. Ask them to tell you what they understood you to have said. If they don’t seem to understand what it is you have said, keep at it until they do.

7. Don’t be afraid of long silences.

Human communication involves much more than spoken words. A great deal can be communicated during silences. Unfortunately in many situations silence can make us feel uncomfortable. Relax. Some people need silence to collect their thoughts and feel safe in communicating. The important thing to remember during silences is that you must remain an active listener.

Dr. Michael Murray
12/15/2014

December 9th, 2014

How Exercise Changes the Way You Look at Food

2913348690_87a5c17b1e_zIntroduction:

Exercise is a critical component to a health promoting lifestyle and its beneficial impact for weight management is without question. A new study, however, shows that exercise influences a lot more than metabolism and burning extra calories. It can actually influence your brain to make healthier food choices.

Background Data:

Regular exercise and physical fitness is associated with a number of factors that can improve appetite control, including positively affecting blood sugar levels and insulin sensitivity. In addition, regular exercise can alter gut appetite-regulating hormones such as ghrelin, peptide YY (PYY), and glucagon-like peptide 1 (GLP-1). For example, a growing body of research indicates that an acute period of exercise can suppress appetite for 2–10 hours afterwards. There is also evidence that the suppressive effect of exercise on appetite is related to exercise intensity, with greater suppression occurring after higher intensity exercise. Since people who engage in regular high-intensity exercise do so on a daily basis, the influence of exercise on gut-derived hormones, may be another important mechanism explaining an ability to maintain appetite control and body weight management.

New Data:

To further understand the effect of exercise on appetite, researchers in London, UK, utilized functional magnetic resonance imaging (fMRI) to compare brain responses to visual food stimuli after intense exercise and rest. The study involved 15 lean healthy men in their early twenties. The subjects had the fMRI after two 60-minute runs at approximately 70% maximum aerobic capacity and at rest. During the MRI assessment images of high- and low-calorie foods were viewed.

Results definitely showed that exercise significantly suppressed subjective feelings of hunger, while also increasing thirst and core-body temperature. Furthermore, exercise was shown to significantly suppress the secretion of the gut-derived hormones ghrelin and PYY linked to stimulation of appetite.

In regards to the response to images of food, exercise definitely altered the brain’s response. When images of high-calorie junk foods were shown after exercise, it significantly suppressed responses in reward-related regions of the brain. In contrast, exercise significantly increased activity in reward-related regions of the brain in response to images of low-calorie, healthier foods.

The results of this study show that exercise influences central brain responses to external cues of appetite that are related to exercise-induced changes in various gut-derived, and other peripheral signals involved in appetite-regulation. The take-away message is that exercise positively affects food choices that reinforce health and weight management.

Commentary:

This study raises a lot of interesting thoughts. My initial reaction was if intense exercise leads to a preference towards healthier, low-calorie foods, does lack of exercise lead to a preference to high calorie, less healthier food choices? My feeling is the answer is yes. I would explain the effect of exercise indicating the following: when food is plentiful, our ancient ancestors would not be as physically active. Hence, mechanisms within the body would be geared towards “fattening up” to prepare for food shortages. In contrast, when our predecessors were more physically active it was a sign they were in the hunting and gathering mode. Staying “hungrier” and leaner would allow them to be better at these tasks.

The bottom line for modern humans is that regular (i.e., daily) intense exercise appears to make weight management easier by a multitude of physiological effects, and it also helps change our brains in a way that leads towards a preference towards lower calorie foods.

Reference:

Crabtree DR, Chambers ES, Hardwick RM, Blannin AK. The effects of high-intensity exercise on neural responses to images of food. Am J Clin Nutr. 2014 Feb;99(2):258-67.

Dr. Michael Murray
12/10/2014