For those who have read what I have previously written about probiotics, you’ll know that I am cautiously optimistic about their potential usefulness as a medical therapy, despite the tendency towards overstating the results of the limited clinical trials so far done in veterinary species. The theoretical principle, that administering living organisms orally can have beneficial effects on the GI tract and, potentially, systemically, is certainly reasonable. And there is clinical evidence supporting benefit in humans for some causes of diarrhea and other GI tract disease. The literature concerning veterinary use is very limited and preliminary, with both possible risks and benefits reported but no clear, indisputable evidence for clinical benefit. Still, I certainly think additional research is warranted, and I do sometimes use some probiotic products in my own patients for antibiotic-associated diarrhea.
However, I have a number of concerns about probiotics. Little is known and less understood about the composition and function of the normal GI flora, and what role, if any, organisms not normally found in the gut can have when given therapeutically is unclear. Independent testing of many probiotic products has also identified serious quality control problems, so it is currently impossible to trust that what you think you are getting is really in many of the commercial probiotics. However, my biggest concern about probiotics is that their widespread acceptance and use goes well beyond what is justified by the available evidence, and this can easily lead to direct harm and even more easily to the kind of indirect harm that comes from substituting unproven remedies for well-demonstrated ones. Exaggerated claims and unscientific, deceptive marketing practices are common in the promotion of such products, and this raises the chances of their doing more harm than good. The assumption of safety and efficacy that is often made about CAM products has certainly proven, in the case of some such products, to be unfounded, with real harm resulting.
One of the most egregious examples of this is a product which I recently looked into after hearing a number of my clients talking about using it in their pets. Primal Defense is marketed by Garden of Life, and the marketing materials are a laundry list of exaggerated and unsupported claims. Some examples:
“Healthy people usually have a ratio of approximately 85% good to 15% potentially harmful organisms in the intestinal tract. In some cases, even those who appear to be well might have an unfavorable ratio as a result of daily exposure to environmental toxins and a modern lifestyle. “
Here we have the usual vague “toxin” gambit, suggesting that normal life is full of poisons that we need their product to protect us from.
” Large scale use of pesticides, herbicides and other chemicals has changed the bacterial balance of the soil. In order to obtain the benefits we historically acquired from consuming foods cultivated in healthy soil, Garden of Life developed a Homeostatic Soil Organism Probiotic Blend utilizing 12 species of beneficial microorganisms.”
The idea that modern agricultural practices can affect soil ecology is pretty obvious. The suggestion that this somehow creates deficiencies in nutrients or human/pet gut ecologies that we need this product to correct is totally manufactured and unsubstantiated in any way.
The very use of the term “Homeostatic” is a bit of pseudoscience marketing, since this term has no recognized meaning with regard to probiotics and was apparently made up just for the purpose of making this product sound “sciency.”
The story, however, gets a lot scarier. The marketing of this product involves a great deal of outright lying and deception. The founder of Garden of Life, Jordan Rubin, was fined by the Federal Trade Commission (FTC) for false advertising in connection with Primal Defense and other product in 2006. This including fabricating claims about clinical research studies to support his product claims. He was also ordered by the Food and Drug Administration (FDA) to desist from making false and unsubstantiated health claims in 2004. Mr. Rubin has also claimed to have several academic credentials, including a NMD (naturopathic medical doctor) and PhD. Both degrees, and other credentials he has claimed, come from unaccredited correspondence schools, one of which was actually ordered to close by the state of Hawaii in 2003 for fraudulent practices.
Marketers of Primal Defense frequently state that there is clinical evidence to support their claims for the product. However, no real clinical trials seem to have been published in any recognized scientific journals. For example, claims are made on a number of websites regarding a clinical trial of Primal Defense supposedly published in the journal Progress in Nutrition (Goldberg, P.A. “Primal Defense Homeostatic Soil Organisms As Applied To Medically Unresponsive Chronic Disease Conditions In Adults” Progress In Nutrition Supplement Volume 4 January 2002). The journal is not listed on PubMed, Science Citation Index Expanded, or any other resources listing legitimate scientific journals. The accusation has been made that it is a fake journal funded by Garden of Life, but I cannot confirm this. In any case, it is clearly not a legitimate peer-reviewed scientific publication, and the author is a chiropractor who seems to publish predominantly in chiropractic journals and newsletters, not real science journals.
A bit more investigation into Mr. Rubin explains pretty clearly his lack of respect for legitimate scientific research or academic credentials. He is the paragon of faith-based medicine whose books, including The Maker’s Diet and Patient Heal Thyself, detail his belief that his own GI disease was cured through a combination of prayer and changes in diet based on “biblical principles.” As he puts it:
“My father had just gotten through telling me he had spoken to an eccentric nutritionist on the phone. My father didn’t want me to get my hopes up so he had investigated the man’s program himself. The nutritionist told my father he believed I was ill because I was not eating the diet of my ancestors, based upon Biblical principles.
When my father told me about all of this, naturally, I was curious…It fit into my belief system. In an effort to start all over, I took myself off all nutritional products and read the Bible to see what people ate thousands of years ago. I also learned that the longest living cultures in the world had one thing in common: they consumed living foods that abounded with beneficial microorganisms.
A few weeks later, I got on a plane, still bound to my wheelchair, and headed for southern California to live closer to the man who would teach me how to eat from the Bible. After integrating into that particular nutritionist’s program some of my own findings about nutrition and health from the Bible I saw some improvement…During my forty days and nights of parking my motor home close to the beach, I prayed, listened to music and planned everything around buying, preparing and eating my food…The combination of the Biblical diet and the HSOs had restored my health.”
The use of science to try and justify Mr. Rubin’s unscientific nutritional theories are pure marketing, taking advantage of the respectability that real science has earned through the results it produces. His approach is ultimately based, as so much CAM is, on personal revelation, and supported primarily through anecdote and testimonial. His books, his Garden of Life company, his Biblical Health Institute, and all the other pieces to his lucrative nutrition business are paradigms of snake oil marketing.
Such a marketing approach can turn a potentially legitimate, if not yet ready for primetime, therapy like probiotics into pure quackery. If you can’t trust Mr. Rubin’s claims about his own credentials or the research evidence behind his products, why should you have any faith in his products themselves, even if they claim to be something potentially useful like probiotics? CAM marketers like to attack the honesty and ethics of mainstream medical product manufacturers, such as pharmaceutical companies and commercial pet food makers. And all too often, there are real reasons to be skeptical of these industries. But for all that, they have an established, public record of legitimate science behind many of their products, often thanks to vigorous government regulation requiring it. Companies like Garden of Life illustrate why the unregulated supplement industry (aka Big CAM) is not only not entitled to the assumption of better ethics that they often receive, but it quite likely gets away with even more ethically questionable practices than the mainstream medical and diet industries, which are at least better supervised and regulated. I do not often feel justified in prescribing probiotics, but when I do I certainly have no intention of using a product such as Primal Defense marketed by a man who not only bases clearly unscientific advice and products on personal divine revelation but who seems to have no discomfort promoting his ideas and products with obvious and egregious deceit.
Came across this thread when searching on probiotics. My mom has been diagnosed with cdiff and I have seen many posts that probiotics help. I understand there is also promising research in this area. I happen to know that people lived healthy lives long before scientific evidence existed for many things. I also know scientific research has benefited us as a society, so I know that there are things made available in the earth that will heal…science may not have caught up or vailidated it yet. Just because science (“man”) has not validated does it make it no less real? I went to the doctor for muscle tightness and fatigue..She told me I had fibromyalgia and needed to take Lyrica. Imagine my surprise..no testing, no other attempts to diagnose and treat. I then researched Lyrica and was amazed at the listed side effects. I also listen to some of the ads on TV for drugs and the speech they give about potential side effects and it makes me realize there is so much we don’t know. Then I look at some the Eastern alternative medicine and the success people have and wonder why the US is hesitant to research and include it as an alternative paths to treatment given the numerous side effects of the synthetic drugs. It seems to me they both have pros and cons.
In summary, if a probiotic can help my mother with cdiff I would be willing to try it. For sure all of the antibiotics she has taken for other health reasons has lowered her resistance to the synthetic approach. I am not knocking the antibiotics, given by doctors who believed that it what she needed to heal, but after the antibiotics have caused weakened system and unhealthy bacteria take over, the doctors don’t seem to have a complete answer. Sean, what probiotic did your mom take? What dosage and for what period of time? I appreciate your response and others who have had success combating cdiff with probiotics.
As you now from reading my article, I am optimistic about the potential of probiotics, though there is a lot yet we don’t know. That said, “try it and see” is a dangerous way to decide which therapies work and which don’t. That gave us bloodletting, lobotomies, ritual sacrifice, and every other failed health intervention in the history of the world. It isn’t a question of “man” vs “nature.” Nature is what it is, and it doesn’t care what we think or know. Science is simply the best way yet to figure out how nature works. It isn’t perfect, but it’s doubled our lifespan, cut infant and maternal mortality down from common to rare, and eliminated diseases that plagued us for thousands of years. No “ancient wisdom” of east or West ever did this, so anecdotes of miraculous successes don’t prove science is behind truth, only that people are eager to believe.
Best of luck to you and your mom.
Could it be, perhaps, you don’t have fibromyalgia. And if not, you’ve unecessarily psyched yourself out over a drug you actually may not need.
Did you think to seek a second opinion?
Trust and believe I didn’t start taking the Lyrica and today 3 years later I am fine. I did continue to seek natural care approaches, as it was clear the doctor was as Skeptvet noted in a post was trying to “experiment with me and take a let’s try it and see approach.” I say all of this to say it seems to me there is much to be learned in both camps and to be locked into one way and one way only seems to limit the potential for learning and true knowledge.
I’ve been doing quite a bit of Internet exploration regarding probiotics and just recently read a Consumers Report article on Probiotics.
They listed certain criteria that manufacturers of probiotics should definitely practice. THE Number 1 criteria was that you get what you pay for. Meaning that most of the other products they studied hadn’t had any independant results and when the product was tested in the Consumer Reports lab they found a significant amount of dead bacteria, and fillers that did nothing at all.
Secondly, it should have 35 billion + colony forming units (CFU’s) per serving and all 14 of the beneficial strains of good gut bacteria strains.
Third, The probiotic should be flexible. It shouldn’t need to be refrigerated; you should be able to take the probiotic when it fits YOUR schedule and can be taken with or without food.
Of the probiotics tested, only one brand meet the expected minimum criteria of Consumer Reports. That brand was Keybiotiics. The only thing they felt that impacted Keybiotics negatively was it is severely hampered by limited availability. You can only order it online. Their list price is $39.99 per bottle, which is close to the top tier in pricing. However, they are running a 3 bottle special of $89 (which would drop the price to < $30/bottle), or 6 bottles for $159 ($26.50/bottle).
I'm not currently taking this brand, but it's Number 1 on the Consumer Reports recommendations, so when I finish my bottle, I will be making the switch. I don't see any problem with ordering something online.
For some, the fact it is totally Vegetarian adds another positive to this brand.
In case it crossed your mind, I am retired, do not and have never worked for Keybiotics, don't have any investment in the company and none of my relatives are even remotely associated with this company (unless you think that my cousin who works for "Brown" is connected because he delivers boxes that could possibly contain this product – OK, I was reaching).
I was ill for over 8 weeks when I went to see my Doc. Her initial diagnosis was IBS because the symptoms seemed to fit. Over the month before going in for a follow-up, I developed Thrush, which is a condition in the mouth caused by the Candida bacteria. It's most commonly found in women and is the same thing as a 'yeast infection'. I was given a prescription for a liquid probiotic taken three times per day as a mouth rinse.
When I returned for my "IBS" problem, which had only improved slightly, my Doc, who believes that there are many remedies for conditions that aren't recognized by practitioners of Western Medicine, put the two events together and surmised I had what is generally referred to as "Candida Overgrowth". She suggested I start taking a probiotic because there was some medical literature stating "it might be beneficial".
I went to the local GNC and picked up a Refrigerated Garden of Life probiotic and commenced using it immediately. A full dose was three large capsules, and the GNC guy recommended I start out with 1/3rd dose daily and work up from there. I had gone to 2 tablets a day when I read a medical article that if gut problems were severe, the starting dose was where one should start – even though there was no "scientific proof" of its efficacy.
Three days ago I began taking one capsule three times a day and this morning woke up with a lot less gut pain. I hope that as I continue to take probiotics that the pain, the alternating diarrhea and constipation, the bloating and the gas will go away.
@skeptvet. Just a point of reference for your skeptical outlook, There is one medicine used to treat all diseases, yes, ALL DISEASES, and is effective over 25% of the time. The name of that medicine? Placebo.
If nothing (placebo) works, then I'll be the last person to suggest spending more for something that cures only part of a disease or lessens side affects. Especially important is the simple cost/benefit analysis.
Well, not eally. Placebo effects create the impression of improvement, particularly for subjective symptoms like pain, nausea, etc or for phsyiologic variables strongly influenced by the sympathetic and parasympathetic nervous systems, like blood pressure, heart rate, etc. Placebos won’t shrink a tumor, knit a borken leg, stop and autoimmune disease, imrpove lung function in asthma, imrpove tuberculosis, or any of a million other problems that come with illness. So while the subjective psychological benefits of placebos are fine to take advantage of, they cannot safely substitute for truly effective therapies when there are serious physical ailments.
All I have to say about this is that the all knowing and caring government has been pushing the diet of sugars and low fat for decades and I believe it is the cause of the majority of heart disease among other things. To ignore the damage that the religion of government has done to this country and its citizens is quite naive.
PS I’m an atheist.
ANd, I’m going guess, a Libertarian? In any case, your feelings about “the religion of government” don’t really have any bearing on the evidence for or against this product, or on the generally poor quality control for probiotics compared to more tightly regulated medical products.
Since when does the government push “diets of sugars”? LOL.
This outstanding probiotic healed my autistic son’s leaky gut within 2 months. I applaud Jordan Rubin for his research.
Its appalling what’s going on with conventional food practices and utterly sad what it’s doing to the environment (not to mention the people!) It’s time we re-establish the nutrient rich HSO content of our soil and support eating REAL food again
In a world where people are very defensive when it comes to critically evaluating products and services they use, I appreciate this article by Skeptvet. Once a person becomes convinced of a product’s efficacy, there almost no turning back. No amount of “real” evidence to the contrary will sway them.
I have read many reports similar to FlashReader’s, that indicate that even if the particular ingredient does work, many supplements that were test, didn’t contain the key ingredient. Some even had sawdust or gypsum. Of course this creates my own quandary because the anecdotal evidence for the Primal Defense “appears” to be pretty strong. But it’s disappointing not to see some peer reviewed studies.
Guess I typically don’t buy the logical fallacy that “science simply hasn’t caught up yet.” The credibility given to products from well made studies is enormous. Lack of bonafide studies should be a red flag, because who wouldn’t want the “seal of approval” which would be a huge financial boon to their product.
Education usually wins me over. Use faith-based verbiage and I simply stop reading. Conspiracy used to mean something different and not be the shut out word.
Anyway, my little doggie has massive skin problems and I feed him the best commercial food available, hesitant to go raw food the same as I am with every popular diet just bc so many ppl swear by them. I may cook for him, but from so much research I’m afraid he won’t get everything he needs, without still having to buy supplements, probiotics, etc. I do a lot of research online, and since I teach about online research I know that less and less is true compared to the amount of information that becomes more and more available to the public, thanks in part to the constant barrage of marketing and strong opinions. But as soon as I hear someone’s story crumbling I too am skeptical. Thanks to this blog about this brand – I’ll look into other brands. But I am still interested in continually sourcing the problem to the problem, which my multitude of vets have not been able to help us with. Little doggie’s itchy leathery skin that sometimes smells bad, bleeding from scratching/licking, allergic to fleas and other things, yeast, immune system, cortisone, limited ingredients, grain-free, insecticides and other poisons… we just want the source of the problem. Reoccurring. Though definitely staying away from soil-based brands, check out this article:
Thanks for this article. Some good research & referencing along with a sane approach is a breath of fresh air.
love that hard science it is soooooo trustworthy
Report Details Fraud and Abuse by Pharmaceutical Companies
Sep 12, 2011 – A new research article concludes that industry-wide changes are … The study was published in the September 12 issue of the Archives of Internal Medicine. … In this report, the authors updated statistics for healthcare fraud, …
Big Pharma researcher admits to faking dozens of research studies …
Feb 18, 2010 – When they claim to have “scientific facts” supporting their position, what they really … Here’s what is says: “Scientific medicine” is a total fraud.
Exposing Pharmaceutical Drug Damages & Drug Deaths to Humans …
Death By Medicine – scientific studies show medical treatment may be the leading … “A definitive review and close reading of medical peer-review journals, and government health statistics shows . … Is most Cancer Research a Giant Fraud?
Trial sans Error: How Pharma-Funded Research Cherry-Picks …
http://www.scientificamerican.com › Health › Features
Feb 13, 2013 – Excerpt from Bad Pharma: How Drug Companies Mislead Doctors and … The ‘ ranges’ are given, subgroups are perhaps explored, statistical tests are …… While it is not fraud, it does create a lean to research literature that …
This is known as the tu quoque fallacy. The fact that pharmaceutical companies do bad things has nothing to do with whether science works or whether TCM is a load of nonsense. Once again, you are demonstrating the vacuity of your position by choosing to attack those who disagree with you rather than providing any real evidence to support your own claims.
Hi there: Just wanted to comment that my husband started taking just the plain, old-fashioned Primal Defense by Garden of Life about 3 years ago to help him with his morning “movements” and stomach issues. He was a skeptic, and so I was surprised when he asked me to buy a second bottle. Meanwhile, he found an added benefit. About 6 months after taking 1 Primal Defense every night before bed (take it away from food), the toenail on his big toe fell off. It had fungus, which we used oil of oregano to try to keep down to a minimum. When it grew back, it was fungus-free for the first time in years. No more oil of oregano needed, and its been that way ever since. PS: He’s been “regular” too, with no more belly-aches.
I’m glad your husband is doing well, but as always I have to point out that such anecdotes don’t really tell us much about whether things like this work or not:
Medical Miracles: Should We Believe?
I quit buying probiotics because I’m never really sure what I’m actually buying. I make kefir instead. Works like a charm.
Skeptvet, you should read brain maker sometime. Research in this arena has taken off tremendously since you wrote this. Also, there are third party testers consumer Labs etc. that will show the actual counts compared to the number marketed. GOL normally does quite well…didn’t know all the other stuff about the guy though.
I’d be interested in the specific research you mention. I do try to keep up with the probiotic literature in vet med, and I write about the subject from time to time. A couple of studies, unfortunately, have shown pretty unreliable labeling for most veterinary products, so I still don’t think we can have confidence in most of them without better regulatory oversight. Efficacy studies are mixed, with some encouraging reports and others not showing hoped-for benefits. Let me know if there is a particular study you have read that looks interesting.
Yes sir. Just a quick question if I may: just coming off of a six week regimen of intravenous antibiotic treatment to rid me of a staff infection, I am of the opinion that my gut flora has been pretty much destroyed. Only one out of three of my doctors even mentioned probiotics. Can you give me an idea of what is accepted among current medical understanding on how to restore the flora. I’ve read a bit of discussion on fecal reintroduction is the only effective solution. Any input?
As a veterinarian, I absolutely cannot and should not offer healthcare advice for humans. I would suggest you talk to your doctor about the issue and ask for his or her recommendation.
I have the Crohn desease, and I was suffering for more than 3 years, on and off medication like Entocort that was subscribed by the specialist in the hospital. Then a bit more than a year ago I read about a carbon hydrate diet which I started and I also started taking the Primal Defense pills because this was the one that had almost all the suggested microorganisims not only the bifido bacteria. I was fine in less than three months, and I am still good, althoug I have given up on the diet as well.
When someone suffers from heavy diarrhea for years, and doctors can’t help, will be ready to try non tested stuff, and if it works, can only be thankful to the maker, no matter how he gets it out on the market.
PS. Sometimes official, subsidised medicinces turn out to be causing severe issues on the long run so no guarrantees for anything I guess.
I understand your logic, and I’m glad you are doing better, but I just have to remind everyone why such stories aren’t a reliable way to judge any medical therapy:
Why We’re Often Wrong
The Role of Anecdotes in Science-Based Medicine
Why We Need Science: “I saw it with my own eyes” Is Not Enough
Don’t Believe your Eyes (or Your Brain)
Medical Miracles: Should We Believe?
In defence of this product (just to declare my hand): I have coelliacs so take probiotics with the idiotic idea that it helps. This product did one thing – stoool samples shouwed a higher number of probtioics 90 days post supplementation. Also, GERD went away and stomach looked flatter.
Nice website, by the way.
You are a Vet so why are you so dead set against Rubin’s ideas? You don’t treat human beings. Did you try his diet and his supplements or are you simply speaking your opinion because you feel like it?
1. It matters to me as a vet because people treat animals with this product, and if it is snake oil then this harms my patients.
2. “Try it and see” is not a reliable way to determine if a healthcare product is safe and effective. That’s what science is for.
3. Why are you sharing your opinion?
This probiotics saved my life so far. I had three years of severe motility issues. They started me on xifaxan. I took two strong doses. My issues began immediately after my gallbladder was removed and I had pancreatitis. All of this after the birth of my son. I already had IBS, so my GI tract was awful. The thing is, I have tried so much and the only medicine that works is xifaxan and primal Defense. It regulates me. It takes the horrible pain away. However it does give me acne. This concerns me which led me to this article. Now I stopped the probiotics, no acne but pain returned. I just can’t win
How are all of these testimonials not evidence?
For all the reasons I’ve explained in the links I post whenever someone suggests testimonials are evidence. In brief:
1. They are unreliable because uncontrolled observation is very prone to error and misinterpretation
2. There is a bias in the posting of testimonials. People with positive experiences are more likely to share them than people with negative experiences, so they misrepresent what people are actually experiencing.
3. Similar testimonials can be found to support every single treatment ever invented, including those proven to be useless or even harmful. If we accept testimonials as evidence, than everything works. It’s a test no treatment ever fails.
4. Tens of thousands of year of trial-and-error and anecdote led to virtually no improvement in human health and longevity. A mere couple of centuries of relying on science instead has double our life expectancy, dramatically reduced death, disease, and suffering, and proven that science work better than stories.
I encourage you to read these articles that discuss in much more detail why anecdote simply don’t help us evaluate medical treatments.
Why We’re Often Wrong
The Role of Anecdotes in Science-Based Medicine
Why We Need Science: “I saw it with my own eyes” Is Not Enough
Don’t Believe your Eyes (or Your Brain)
I cannot find anything info on Consumer Reports re Keybiotics. WHERE DID
YOU GET THE INFO THAT Keybiotics meets Consumer Reports requirements
As the best probiotic?
I was looking up Primal Defense and came across your opinion about probiotics and I just want to say that my mother aquired cdiff which was treated by the medical profession while she was hospitalized with pnemonia and both medication they tried did not get rid of the cdiff and they sent her home with diarreha so bad she had to wear adult diapers and could not leave the house my chiropractor told me to get her some Primal Defense by Garden of Life and after taking one bottle of it her diarreah from the cdiff was gone and just to make sure it didn’t return I got her another bottle to take. Her cdiff never returned, it worked for her that was back in 2004, so I strongly recommend this probiotic for anyone with an imblance due to the treatment of antibiotics.
There is certainly good evidence for the use of probiotics in diarrhea treatment, so I am surprised that was not suggested for your mother. That said, there is not evidence for this product specifically, and the term “probiotic” covers an enormous range of very different things. While I’m glad things worked out, I always have to remind people that such anecdotes don’t actually prove anything, and you can find exactly the same kinds of stories for every therapy ever invented, including many that we know with certainty don’t work. Here are some more detailed discussions about what we can’t rely on anecdotal experiences instead of controlled research to decide which treatments work and which don’t:
Why Anecdotes & Testimonials Can’t Be Trusted
Why not make kefir from kefir grains or kombucha , it’s better than any probiotic bottle out there and easy.
Care to provide any evidence for this claim?
Of all the testimonials posted on this site it appears that, in general, people believe what they choose, and that is their right, but seem to totally dismiss the ‘advise’ of an educated individual.
Skeptvet is merely offering an opinion, as he is a QUALIFIED veterinarian, I would give his view more consideration than most of the BS, claptrap and old wives tales some contributors have felt the need to ‘share’
Science has been proven wrong many times and will be many times more, but how on Earth would we survive without it.
I just wanted to add: It has been my personal experience, when people turn to products like Garden of Life probiotics, it is because the highly scientific, researched way of conventional medicine that you tout has failed them(or their pets) miserably. It happened with me and many, many people I know. Quantitative anecdotal research is also valid. If it works for me, why should you care?
If you think something has worked for you based on uncontrolled trial-and-error, that’s fine for you (though it doesn’t mean what you believe it does). However, such stories can sway other people into making unwise choices and trusting untrustworthy remedies. People have a right to hear all perspectives, not just those that are positive, about the value of such products and of anecdotal evidence. To turn the question around, if you believe what you believe regardless of what I have to say, then why should you care that I say it?
So glad to find you. Dealing with a very sick dog. Pancreatitis. Have been fed the raw diet and then adding in all of the vitamins and of course the supplements. Do not know where to turn to help him pull through. Any suggestions.
Kim and my pal Tucker 12 year old Labradoodle
Of course, I can only recommend you find a local veterinarian you trust to work with. If you don’t feel comfortable with the general practice doctors in your area, a board-certified internal medicine specialist might also be appropriate for a dog with serious health issues.
Man I was just looking for something to make my dogs feel better. I enjoy reading this blog, it’s prevented me from buying literally everything I was going to buy. You doctors need to get it together. I’m a lawyer. I’d have lost my license by now and we’re actually encouraged to disagree and argue with each other!
So which ANIMAL doctor do I listen to? The one who says use the probiotics and it will change your dogs’ lives or let em keep scratching?
Maybe I’ll buy the things and test them on myself. If I’m feeling good, the hounds ought to as well. They eat everything off my plate when I’m not looking anyway…
No offense Doc. This is a great resource. I read it all the time, and no offense to everyone on here with human problems either. Like I said, I’m a lawyer so unlikable by nature 🙂
As a lawyer, you undoubtedly understand that some kinds of evidence are more reliable and credible than others, and that eye-witness evidence is particularly untrustworthy. That applies to medicine as well, so the bottom line is that you should have greater confidence in claims backed by scientific research evidence than those based on opinion or personal experience. This doesn’t mean, of course, that we know the answer to every question or that scientific evidence is always right. There is always uncertainty, and science only helps us clarify how much uncertainty there is. Those who claim there is a clear and unquestionable right answer when there is little or know scientific evidence to support their claims, should be viewed especially skeptically.
Finally, there is inevitably some point at which you have to decide who is credible and trust their advice. Just as I have to choose a lawyer and then trust them to know the law, rather than trying to represent myself or second-guess their every decision, so pet owners have to choose a vet they trust and then take a certain leap of faith. We can’t all be experts in every subject. Sadly, sucks and doctors who practice evidence-based medicine look a lot alike, so your frustration is understandable. But from my point of view, science reduces the error in human observation and judgement, and trusting those who rely on science rather than ancient traditions or their personal experience, seems the better bet to me.
People can do a study of one and document their experience. This is not “anecdotal evidence”, it is scientific. If treatment coincides with a cessation of symptoms, discontinuation coincides with a recurrence of symptoms, and this process can be repeated, that is scientific evidence that the treatment is effective. Note that I said evidence, not proof. Proof doesn’t seem to exist anymore.
Also, placebos have immense value. Why not let them be if they appear to be helping? Why are you so eager to burst people’s bubbles?
A well-documented anecdote is, at best, a case report, but it is still an anecdote, not a controlled study. Such anecdotes can suggest hypotheses to test, but they do not demonstrate cause and effect reliably because the association between what is done and the outcome can always be explained by factors other than the ones we choose to pay attention to. I can, for example, note every detail of the day on which I wash my car and, when it rains, still mistakenly conclude that washing the car caused the rain. The level of detail doesn’t change the fact that a pair of events in sequence is not always a cause and effect relationship.
Placebos can only improve our perception of our symptoms, not our actual disease. This may have some benefit, but it comes at the cost of lying to patients and of potentially discouraging the use of therapies that actually work. This study, for example, found that people taking placebos for an asthma attack felt better, but their lung function was just as bad as without treatment, and only a truly effective medicine made their lung work better. Feeling better is great unless it fools you into thinking you are better and don’t need treatment that actually works on the disease itself.
As for “proof,” we agree to the extent that in science we only ever have a degree of confidence in our findings, and this is unlikely to ever be 100%. Still, we know some things well enough that to doubt them is counterproductive. It is clear enough that one cannot fly off of a tall building by the power of one’s mind alone, and even if this cannot be ‘proven,’ we should take the knowledge that supports this conclusion pretty seriously.