Incomplete and Inaccurate Research Reports

Scientific Validation of Herbs Part 3

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3) Incomplete and Inaccurate Research Reports
Let’s consider the study design we were talking about earlier regarding Cimicifuga and hot flashes. Perhaps someone decides to run that study and finds out that a standardized extract of Cimicifuga (30 mg three times a day) does not reduce the number of hot flashes in Caucasian women that have just undergone a hysterectomy. By the time the results hit the news all you learn is that the study demonstrated that Cimicifuga doesn’t work. However, this doesn’t mean that a woman undergoing natural menopause wouldn’t see a reduction in hot flash intensity with using half that dose. The results of the study are interesting, but may not apply to you unless your situation is identical.

In addition, many people rely of scientific summaries or research abstracts for information. Unfortunately, these are often designed to be sensational or intriguing. Even if they are accurate, they are written with a world limit and a lot of information has to be left out. I have found that upon reading the full article the results are not really as clinically relevant as the abstract would lead one to believe.

Why don’t people read the full article? It is an access issue. Researchers and students have access to the full scientific reports as part of their institutional perk. For a private individuals one article can sometimes cost more than $30. There has been a shift in recent years to require research done with public funds to be accessible to the public, but it doesn’t really solve the problem of restricted access to other research. Hard to make an educated decision when you are unable to get access to the full report.

4) Research bias
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Scientific Validation of Herbs

In the last decade or two there has been a lot of emphasis on evidence-based practices. My opinion on this focus can be best summed up by Simon Mills (a medical herbalist):

“…perhaps the fact that 90% of all scientists in history are alive today is a reflection of an age out of touch with itself.”

Operating within the construct that the only reasonable drug, herb or practice to use is one that has been validated scientifically is an incredible limitation for a number of reasons.

1) Lack of Research
First imagine everything that exists. For this example I will depict “everything”, including the entirety of knowledge, as a circle.

All that isIn the next picture, the black dots on the circle represent our present day scientific knowledge. Actually, this is probably an exaggeration, we know much less, but I wanted you to be able to see the dots. The number one limitation of basing what herb or drug to choose on scientific knowledge is the extreme lack of knowledge we have. In addition, notice how spread out the dots are. We know a little bit about a wide range of topics, but we don’t have a complete picture of the integrated whole.

scienceI personally have found very few research studies that reflect what would truly inform actual clinical practice. It is too hard and too limiting to do a study that reflects reality. Reality is too complex, so studies are designed to be simple and only ask a simple question.

Not only does the question need to be simple, it needs to be specific. For instance, “Does Cimicifuga (black cohosh) reduce hot flashes?” is too general. First, the type of extract of Cimicifuga needs to be specified and a complete chemical profile performed. Second, the dosing needs to be specified. Third, what is the population? Are we talking surgical menopause? Are we talking natural menopause. Do the women have a hot flash twice a day or ten times a day? Other considerations are the women’s ethnicity, culture, lifestyle, dietary habits, etc. Fourth, what do we consider a reduction? Will this be less instances of hot flash or a reduction in intensity? How do you measure intensity?

Studies that reflect clinically relevant question are rare. For instance, I once reviewed an excellent study on irritable bowel syndrome that compared the efficacy of a stock traditional Chinese herbal formula with a custom blended formula prescribed by a traditional Chinese medical doctor. The doctor did better than the stock formula. That validated my opinion that herbs need to matched to people, not disease names, so I liked the study.

What were the limitations of the study? Well, maybe that doctor just happened to be better than your typical doctor. Indeed, the study really only validated the one doctor, but not the idea that custom formulation based on an individual’s constitution is better. In addition, scientifically, no conclusion is considered valid unless it can be replicated by another independent researcher. This study was not repeated, as is common with herbal research. Who’s going to pay for a study that cannot be used to make a profit?

2) Research Flaws
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