Questionable Claims Regarding Health- Do They Make Sense?

Posted by (Pseudonym deleted), 12/29/2016:

“I was recently at a nursing seminar, where we had a great nurse practitioner lecturing us. Within her lecture she spoke about the ineffectiveness and the uselessness of acetaminophen, which came as a bit of surprise due to it's over use and prescription by so many GPs on a regular basis. Apparently recent research and papers show that acetaminophen, commonly known as Tylenol in North America, which has been the go to for acute and chronic pain, is actually completely useless for such. The only thing that acetaminophen is helpful for is as an anti-pyretic. With the marketing and the push behind Tylenol the layman continues to use and abuse acetaminophen, when the only thing it’s really doing is ruining their liver. Not to mention a study showed that acetaminophen had about the same effective as a placebo. I wish it was more common knowledge, we're already doing enough to ruin our livers, we need not take acetaminophen to help the vodka already on board.

Just an interesting fact I'd thought I'd share.”

The person who posted this took a bit of abuse from other poster, but also got some good information and conversation. So commenters applied reason, others offered links to studies. One commenter seemed to know what study the NP had read and discussed the details of it.

Responses to the original post included this comment:

“I think I know the review they were talking about. It looked at effectiveness of acetaminophen only on the context of acute and chronic low back pain, and concluded that it was no better than placebo. However that is just a single type of pain, and one that is notoriously poorly responsive to medication. (Some similarly blinded studies have shown opioids to have little or no effect on chronic back pain.)

Evidence does show the drug to be effective in other situations. For instance it does provide relief in both tension headache and migraine.

The greatest effectiveness comes when used in combination with other analgesics. For example in dental pain studies, ibuprofen plus acetaminophen was shown to be more effective than oxycodone, and far more effective than ibuprofen alone.

Tl;dr - the drug is not as great as was long assumed, but calling it "completely useless" is overdramatic and inaccurate.”

My comments were as follows:

“I think the NP you saw who was stating that acetaminophen is ineffective and useless was engaging in a bit of hyperbole. At least, I hope that's what she was doing. I would expect that a NP would have a solid grounding in research- finding, reading, and interpreting research evidence- and has the critical thinking skills to apply research evidence to practice.

Generally, if someone makes a statement that is completely contrary to norms, they would be required to provide a lot of evidence to support the claim.

"Extraordinary claims require extraordinary evidence." - Sagan.

Every now and then, some people find a pet topic that they latch on to and try to convert others to their "truth". Perhaps the Nurse Practitioner who inspired the discussion of the 'uselessness of acetomenophen' has this as his or her "pet topic."

An example of this kind of "pet topic advocacy" is the small but vocal group of folks that hate milk. They think that milk is gross on many levels and have put forth a mighty fight to get others to not drink milk. (Seriously- look it up online if you wish, but be prepared to get grossed out.)

Another person who 'goes against the tide' in this way was that guy, Dr Burzyski, that was/is using urine to "cure" cancer.

Sure signs of "questionable" health claims include overly broad statements (“Tylenol is useless for pain.”) and ‘cures that solve every health problem’. For example, Dr Burzyski's supporters think urine cures cancer, heart disease, allergies, diabetes, etc.

I work with someone who is really into this kind of "alt" medicine stuff. She thinks all diseases can be cured with food or baking soda or some other "new-old" thing, and has a hard time separating "good" information from "bad" information. She is suspicious of "establishment" and "Western" medicine, and "big pharma" too, but latches on to almost any "alt" therapy that comes her way with very few questions.

Her last jag was drinking vinegar. She added vinegar to her foods, drank dilute vinegar mixed in water or other liquids, and consumed special smoothies that she made at home and brought to work. She would offer us little cups of her drink to try so we could see how awesome and "not vinegar-y at all" it was.

She's a big fan of "the cures "they" don't want you to know about" type stuff.

More recenlty, she says she has cured her depression, anxiety, and sleeplessness with "Blessed Basil". She showed me the bottle. This 'special' basil was collected in the "wild" and is "organic". I'm not convinced that you can call "wild" collected basil organic. Where did it come from? Has this "wild" basil patch been monitored to ensure that it is free of raw human or animal waste (or is that "organic?), local land management practices, nearby crop dusting chemicals, etc., on it.

The label did not state when the basil was blessed or who blessed the basil, but I guess that doesn't matter so much. (Or does it?)

She was pretty tickled that she got this bottle of "Blessed Basil" for a discount. It was originally $50, but she got it for a mere $35!

The instructions on the bottle said to take the dose (I forgot the dose- a teaspoon? A capsule? I seem to recall that it appeared to be loose powder in the bottle, but I didn't open the bottle.) twice a day, but my newly-converted-basil-advocate said you can really take “up to two doses 5 times a day!”

But, it is also true that sometimes going against the tide is good.

Ignaz Semmelweiss tried really hard to get the OB's at the Vienna Lying-In Hospital to wash their hands. He was convinced that hand washing would prevent "Childbed Fever". This was before the germ theory of disease, but Semmelweiss noted that the docs would go to the morgue in the morning to see and examine the women who had died overnight. The docs would examine their deceased patients, wipe their hands on their lapels (because a dirty lapel was a sign of a hard-working doc!), and would then go do their rounds on the floor to see and examine their laboring patients.

Then Semmelweiss noticed that the male morgue manager died of "childbed fever"

I recall that the mortality rate for women who had their babies in that hospital at that time was something like 40% (but I could be wrong about that). There were so many babies left over after their mothers died that the hospital also operated an orphanage.

Women who survived their stay but couldn't afford to pay the hospital bill were pressed to serve as wet nurses in the hospital orphanage until the debt was relieved.

In the meantime, Semmelwiess installed hand washing stations and attempted to get the docs to wash.

He was mocked and abused for his theory and removed from the facility.

Later, at another facility, he began to stand out on the street and hand out flyers to the women entering there advising them to make sure their doctor washed his hands before touching them.

Semmelweiss was eventually admitted to a mental hospital where he died from either an infected cut on his finger or he may have been beaten to death by guards.

He went against the consensus of the day and was abused for it. He was right, but had no way to prove it at the time.

The difference between claims of the "uselessness" of a common medication, cure-alls, and what Semmelweiss advised was that one of them "made sense" while it also focused on only one problem.