Mythbusting Monday 29 July: Why we're interested in alternative medicine & dieting

Welcome back for another mythbusting Monday.

For me, this week’s topic was all about my own curiosity I have to say. After I reached out to you and asked for the reasons you’re interested in natural therapy, alternative treatments or diets, I got lots of responses. Firstly, let me say how grateful I am for the honest answers I got. It made for really fascinating reading.

The responses basically fell into broad categories such as having control over your health, wanting a natural alternative or wanting to avoid the side effects of medicines. I’ve complied the most common ones and I’m going to give you some thoughts and some science for each one.

Before I get into that though, this is not an exercise in shaming anyone who is into natural treatment or diets. If that’s what you want and it works for you, that’s fine. It is after all, your body. What I want to do here is just give a little food for thought about some of the things you told me to help you or someone else do this safely or to promote discussion. I am not really into being to adversarial when it comes to this kind of thing because I think it just makes everyone mad.

Let’s get started!

🥦 Medicine doesn’t always work

I know! As someone who prescribes medication and performs surgery, one of things that we have to tell people is that not every medicine or operation will give everyone the desired results. The reasons for this can be vast; the diagnosis might be off (some conditions are notoriously hard to diagnose), complications might happen, or sometimes for reasons we’re not always clear on, what works for one person may not work (or at least not as well) for the other person. It’s my job to inform people of this and let them guide our decision making to what they do or don’t want to do.

My advice here is that if your treatment isn’t working, don’t lose all hope. There are often alternatives that work better for some people, anti-depressants are a good example of this. If you’re not feeling better, make sure to discuss it with your doctor.

🥦 It’s natural

Natural is always better right? If something is natural, I think we think that it’s going to be safer or less likely to give side effects. This isn’t always the case. A couple of examples of this spring to mind. The first on is St John’s Wort which is a popular herbal remedy to boost mood and treat depression. It actually isn’t too bad at this and has actions similar to anti-depressants called SSRI’s (such as prozac). Despite being all natural, St Johns Wort has some pretty important side effects like making skin more sensitive to burning, allergic reaction, gut upset and it interacts with a number of medicines, including the contraceptive pill. Other herbal remedies that can cause problems, despite being ‘natural’ include the ‘G’ herbs: garlic, gingko blob, ginseng and ginger. These all thin the blood and can make bleeding issues more likely.

The other side of the coin is that a number of medicines that we use now are actually derived from ‘natural’ sources. Aspirin for example was made from willow, a plant rich in salicylates, which aspirin is one of them.

The point is natural is not always better and neither are all synthetic compounds. If you want to take natural anything, make sure you tell your doctor or pharmacist what you’re taking so they can ensure that you know the possible side effects and interactions.

🥦 Engaging or owning your own approach to health

I hear you all on this one. Medicine has a very long and unpleasant background of being paternalistic. Until recently, many people would wholly defer to their doctor and tell them to do whatever they thought was right. Not long before that, the doctor would just tell you what was going to happen, no discussion necessary.

We all have a right to get health care that suits us and part of that is by exercising our own autonomy. I fully support this, and this can absolutely be done with medicine (or even surgery) by having a frank discussion with your doctor. Thankfully, doctors are being trained in person-centred care (and have done for a while) so you should be able to find someone who gets you.

🥦 It’s relatively easy

I have to be honest, I didn’t understand this one! While I will totally concede that say a diet is easier than major surgery, keeping to a diet or wellness regimen can be complex depending on what it is. I mean popping a pill a day is certainly easier than cooking (well it is for me because cooking is not my strong suit!) What may be different though is that you’re engaged and invested in that routine and therefore you can follow it. If you’re not invested in other care, you won’t keep it up.

🥦 Celebrities or marketing

This makes total sense. Celebrities and influencers have an incredible amount of power over us. Because we see them as successful and authoritarian in one area (themselves or even a character they play), we tend to extrapolate this authority to all areas of their life. Take Gwyneth Paltrow for example. She’s a successful actor, singer, businesswoman, she’s beautiful and youthful and she divorced her husband in what seemed to be the most amicable separation ever. Because we see her as a goal-kicker in all these areas, we value what she has to say in other areas, even if she has no qualification or background to be able to give advice here.

What I would say to this is that celebrity can be used for good or bad. Celebrities who share health struggles can encourage people to get a health check such as a mammogram. But they should definitely not be stepping outside of their expertise when it comes to advising on health and history is littered with countless examples of where this goes awry. If Paltrow advised me on how to win an Oscar, I would listen to her. But if she told me that vaginal steaming is the way to go, it’s time to change the channel.

🥦Belief in a miracle

We all want miracles, or at least a quick fix. Without regulation, people advertising alternative therapy or diets can promise this even though the science isn’t real or the results aren’t there. And trust me, they do. The claims made by many people in the wellness sphere don’t stack up but because we want to believe so badly, we do.

I totally understand wanting a miracle, needing a miracle. And holding out hope is not a bad thing. Trying anything when it seems that nothing else has worked is understandable. None of us can say what we would or wouldn’t do if faced with illness. So if you need a miracle, I get that. Just make sure you’re doing it safely and nobody is taking advantage of you when you need hope the most.

🥦 Side effects of drugs

The dreaded side effect, it is enough to make people want to give the pills a miss sometimes. During drug testing and after they hit the market, all medications are stringently monitored for side-effects. Each time you get a drug, there will be a list of possible side effects and they will be ranked from very common (around 1 in 10) to rare (1 in 1000 to 1 in 10000). During testing, the effects are often pitched against a placebo. Sometimes the side effects that we see are the same between the two groups but any possibilities are still listed.

If you have side effects from a medication, it’s important to know that there are sometimes alternatives. For statins for example, for people who have muscle aches, there are other statin drugs or other cholesterol drugs that can lessen or eradicate those side effects. Chatting to your doctor or pharmacist about alternative is a good first step.

🥦 Lack of transparency from drugs

Big pharma really has a bad name and really shows how mud sticks. Legitimate concerns or even conspiracy theories have led to people being genuinely concerned about what doctors and pharmaceutical companies are up to with our health. I think it’s important to request transparent information and for drugs, this information is readily available from your doctor, your pharmacist or from websites like NPS MedicinesWise in Australia.

Here in Australia, the pharmaceutical industry and especially its interaction with doctors is so tightly regulated and we can’t even get a pen from big pharma let alone cash for prescribing their drugs.

🥦You “feel” better

Here’s another one I totally get. When you hit the veggies hard for example, you do feel better. And I think that this is a great reason why to eat certain foods for example. The usual caveat applies; make sure its safe, make sure you’re not having your hard earned money whittled away and make sure you tell your doctors so they can know of things to be aware of in terms of drug interactions and so on.

🥦 It’s perceived as safer

I talked a little about natural therapies above, and how safety may be not what we think it is, but let’s talk about diets for a second. Diets seem pretty benign right? You eat certain foods and you feel better or you look better. Diets are a great example of something that seems safer but may not be. Going on a diet can lead to a number of problems such as disordered eating, eating disorders, nutritional deficiencies, ailments like constipation and in some cases, we don’t know the long term safety of diets. For example, animal-protein heavy diets such as keto have had questions raised about their links to heart disease and bowel cancer. (It’s not proven yet, but there are enough questions to warrant us being circumspect). Being safe is important whether we’re talking about medicine, surgery, diets or supplements and sometimes, the natural, alternative or diet pathway isn’t as safe as it seems.

I hope you found this interesting. I absolutely did and your answers gave me so much to think about, as an individual, as someone who is obviously interested in ensuring safe and quality information abounds and as a doctor. So thank you for sharing your thoughts with me.

If you found this interesting - give it a share. And if you want to discuss this further, head back to my Instagram and let’s continue the conversation in the comments.

Mythbusting Monday 22 July: Can You Die of a Broken Heart?

Welcome to another Mythbusting Monday. This week we’re tackling this headline:

“Broken Heart Syndrome and Cancer Are Connected, Scientists Say”

So the question is, can you actually die of a broken heart?

When we experience stress such as heartbreak of grief, we know that there is a physical reaction that can cause a number of physical issues, such as:

💔 Lower thyroid hormone level

💔 Activating of clotting in our blood, making it sticky

💔 High blood pressure

💔 Disrupting plaques in our arteries

💔 Cortisol and adrenaline let glucose and fat stores out

💔 The immune system runs unchecked which may lead to disease

💔 Higher heart rate

💔 Reduced heart rate variability

💔 Electrical instability of the heart

💔 Behaviour changes: poor sleep, not exercising, using drugs or alcohol, eating poorly

For most of us, despite the fact that there is a physical component to our emotional turmoil, we will be absolutely okay. There are a few circumstances when grief or stress can actually lead to serious physical illness.

Why do old people die close to one another?

Generally when we hear of a couple ‘dying of a broken heart’ close to each other, they tend to be elderly people perhaps who have underlying medical issues. All of those physical changes above can be weathered if we are otherwise fit and healthy, but that disruption to your body if you’re not can be problematic. In elderly people, we know that they have an increased risk of dying after losing their partner which persists for a few months.

What is broken heart syndrome?

Broken heart syndrome is also known as takotsubo cardiomyopathy or stress-induced cardiomyopathy. In this illness, which isn’t very common, following an emotional shock, people turn up to hospital with symptoms that look like a heart attack. However, when we look at the heart arteries they are pristine and they haven’t had a heart attack. Instead, the heart muscle doesn’t pump well and it looks like a Japanese fishing pot which is where the term ‘takotsubo’ first came from.

As I mentioned it’s rare. It tends to happen most commonly in post-menopausal women, who receive an emotional shock. It’s rare in men, and if it does happen in men, it is more likely due to a physical shock. Women aren’t all delicate; the reason is probably due to the effects of loss of oestrogen.

The risks of takotsubo cardiomyopathy include heart failure, rhythm problems, leaking heart valves and recurrence. That being said, the risks of that is generally low and most people recover well with medical therapy only. In rare cases, people can actually die of a broken heart.

What is the link with cancer?

In all of the news articles, they’re referring to this study published in the Journal of the American Heart Association. In the study, they looked at a registry of people who had had takotsubo and determined who had cancer. They found that 16.6% of patients who had takotsubo had also had cancer. Of those who had cancer and also takotsubo, they were more likely to be older than those without it and more likely to have had a physical trigger than an emotional one. This suggests that there may be a link between the two illnesses, factors that we don’t know about. It may also mean (although we need more info) that we should have a good look at anyone who has takotsubo to assess their cancer risk.

Want to read more? Click here to see where you can order a copy of Can You Die of a Broken Heart? to read all things heart related.

Mythbusting Monday 15 July: Diet and Cancer

Cancer is incredibly common: 40% of us worldwide will receive a diagnosis of cancer in our lifetime. So of course, any way of preventing cancer is of great interest to us. Here are some points on cancer and diet from Mythbusting Monday, including some of your best questions.

What is cancer?

Cancer is not just one disease but rather a big group of different diseases. There are literally hundreds of types of cancer and the thing that they share in common is that they are a growth of abnormal cells, based on our normal cells that have lots the ability to self-regulate so they grow and divide more rapidly than a normal cell. Some of the more common cancer types are colon cancer, lung cancer, breast cancer and leukaemia. That is just a drop in the ocean.

It’s important to understand that cancer is not just one disease but whole host of them because then you will understand that there are so many causes, some known and some unknown.

Does diet cause cancer?

Cause is a strong word. Saying something causes cancer implies that if you do (or don’t do something) that the end result is cancer. It’s just not that simple. Cancer happens when the cell’s regulation is lost and that can be affected by many things, such as:

  • Ageing

  • Radiation

  • Genetics

  • UV radiation from the sun

  • Alcohol

  • Smoking

  • Some viruses (eg, HPV and cervical cancer, EBV can cause lymphoma)

  • Some dietary factors such as lack of fruit and vegetables or whole grains

  • And some factors that we don’t actually know

Is the uptick in breast cancer due to food?

No, not solely anyway. Breast cancer does have some lifestyle associations including dietary factors and exercise. But increases in breast cancer numbers is thought to be due to better screening programs picking up more tumours and an ageing population because cancer increases as we age. It’s hard to tease out and say this proportion of breast cancer is due to dietary factors because like all cancers, it happens as the result of many, many factors.

Does sugar cause cancer?

Again no one thing causes cancer and sugar is definitely the demon of the moment. There have been some studies that have been talked about a lot lately where sugary drinks increased the risk of being diagnosed with but not causing more cancer death. Again this is an association not a cause but it definitely warrants more investigation. That being said, when it comes to sugary drinks, there are plenty of good reasons to cut down (dental health, weight gain, heart disease and so on) but to say that sugar causes cancer is a bridge too far at the moment based on what we currently know.

Does eating red meat or processed meat cause cancer?

There is a reasonable amount of evidence to suggest that moderate consumption (ie. not every day) of red meat can reduce the risk of bowel cancer. There is also evidence to suggest that processed meats and charred meats may also increase cancer risk. Studies show an increase in cancer risk of the bowel around 1.1 to 1.43 times baseline. So if your original risk of bowel cancer was let’s say 10% and you eat a steak every night, your risk of bowel cancer may go up to 11-14%. There are some proposed mechanisms like substances in cooked meat that may directly damage cells, leading to the loss of regulation that leads to cancer. May. More work to be done but recommendations say to limit red meat to three times a week and this advice is sound for bowel cancer risk but also general health and sustainability issues.

Do food additives cause cancer?

Another demon of the week. People are very worried about chemicals and additives in food at the moment. Generally, stories about the dangers of chemicals aren’t supported by science. Same goes for pesticides, unless you’re bathing in them.

Is fasting beneficial in cancer?

There have been some studies that have investigated the effects of fasting on the effectiveness of chemotherapy which showed some promising results. However, there is nothing firm yet. We also need to keep in mind that getting enough nutrition for people who have cancer and are undergoing treatment is very important since cancer likes to sap all your body’s stores. There have also been some very early studies including animal studies that have come up with a maybe, but the evidence is just not good enough to recommend intermittent fasting at the moment.

Can diet cure cancer?

No. Just no.