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The Facts behind Four Common Healthcare Myths

 

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Myth #1: Herbal medicine must be safer than “regular medicine.”

Fact: Herbs have been used in medicine for thousands of years. Even today, approximately one-fourth of all “conventional” medicines are derived from plants. For example, aspirin is produced from willow bark and narcotics from opium poppy. With the increased suspicion surrounding synthetically produced medications, the word herbal has become synonymous with “safe” in the minds of many. While this may be true in some cases, it is important to remember that a significant number of “herbal” products are not evaluated or manufactured according to the strict guidelines that are in place for conventional medications. This basically means that many herbal medicines worldwide may be produced without proper quality control mechanisms and marketed without proof of their efficacy and safety. According to a statement from the World Health Organization in 2004 “…the majority of adverse events related to the use of herbal products and herbal medicines that are reported are attributable either to poor product quality or to improper use.” While FDA’s around the world are implementing policies and guidelines to address safety issues, these measures are not yet as comprehensive as they are for conventional medicines in many countries.

Bottom Line: Safety is an important concern with any medicine. Both herbal and synthetically produced medicines can have inherent side effects and can interfere with other medications. You should approach the use of herbal medicines as you would the use of any medicine.

Myth #2: A mild fever with colored nasal discharge and a wet cough definitely indicates a bacterial infection and requires antibiotics.

Fact: These are common cold symptoms. Viruses cause colds and do not respond to antibiotics; colds usually last 7-10 days. While many patients request antibiotics from their physicians when they have common cold symptoms, this can expose them to associated risks and side effects rather than providing any benefits. In addition, taking antibiotics unnecessarily can cause resistance, making them less effective when you do need them.

The acute respiratory infections group from the Cochrane Collaboration* reviewed numerous well-designed studies comparing antibiotic therapy to placebo in people with symptoms of acute upper respiratory tract infections for less than seven days, or colored nasal discharge less than 10 days in duration. They concluded there is “no benefit for antibiotics for these conditions and their routine use is not recommended.”

Keep in mind, however, that bacterial infections can sometimes follow viral infections and, as a result, it is important to be vigilant and recognize symptoms that may be associated with bacterial infection such as shortness of breath, severe headache, high fevers, or persistent symptoms lasting more than 7-10 days. This is especially important if you smoke or have chronic medical conditions such as, but not limited to, diabetes and lung disease or are taking medications that can interfere with your immune response.

Bottom Line: There is nothing wrong with seeing your doctor when you have a cold to evaluate its severity and determine if your condition warrants antibiotic use. In fact, your doctor can also give you advice and/or medications to help relieve your symptoms. Remember, however, that antibiotics will not prevent a cold from getting worse, keep it from spreading to others, or make it go away more quickly.

* Cochrane Collaboration is a group of group of over 28,000 volunteers in more than 100 countries who review the effects of healthcare interventions tested in biomedical randomized, controlled trials.

Myth #3: More screening tests mean you are receiving better healthcare.

Fact: Unnecessary “just in case” testing may lead to more physical or emotional harm than good. Patients undergoing this kind of testing are potentially at increased risk of infections, medical errors, complications and risks associated with the test itself. In addition, they are also at risk for complications associated with potentially invasive and/or expensive follow-up testing in the event of a false-positive result (when the test appears abnormal despite there being no real abnormality).

For example, some believe that undergoing a CAT scan for “screening” is the right thing to do. In fact, scientific evidence suggests that, unless you have signs, symptoms or risk factors that justify this test, the future risks associated with radiation exposure statistically outweigh any likely benefits from having the test done. Another example is tumor markers. These are a group of tests that are generally useful in patients with a diagnosis of cancer. While many have been useful in assessing patient response to therapy, they have generally not been found to be medically useful for cancer screening. For a test to be a useful screening tool, it must have a high sensitivity (the ability of the test to identify people who have the disease) and specificity (ability of the test to identify people without the disease). With the debated exception of the Prostate Specific Antigen (PSA), most tumor markers are not sensitive or specific enough to be effectively used as tools for cancer screening in healthy populations with no risk factors for the disease being tested. In fact, if used without discretion in populations with a low probability of having a specific condition, most tumor markers have a higher likelihood of showing false positive results than showing true positive results.

Bottom Line: More tests do not mean better healthcare. Tests and procedures are justified when there are solid, evidence-based reasons for performing them, when the anticipated benefits exceed the likelihood of risk associated with testing and when their results will clearly change how a person’s care is managed or their quality of life. It is important to consult your physician regarding which, if any, screening tests are right for you.

Please refer to the following links for information on screening tests and tumor markers:
http://www.cancer.org/acs/groups/content/@nho/documents/webcontent/acsq-009104.pdf
http://www.cancer.org/acs/groups/content/@nho/documents/webcontent/acsq-009098.pdf
http://www.cancer.gov/cancertopics/factsheet/Detection/tumor-markers

Myth #4: An aspirin a day helps keep the doctor away

Fact: There is strong evidence-based support for daily intake of low dose aspirin to prevent a second heart attack or stroke. In addition, the American Diabetes Association (ADA) and the American Heart Association (AHA) jointly recommended aspirin to prevent a first heart attack or stroke in moderate to high-risk individuals. This includes diabetics greater than 40 years of age or diabetics who have additional risk factors (family history of cardiovascular disease, hypertension, smoking, abnormal cholesterol levels, or protein in the urine). On the other hand, a 2007 U.S. Preventive Services Task Force recommendation encourages aspirin use in all men age 45 to 79 years when the potential benefits of preventing a heart attack outweighs the risks of bleeding from the digestive tract. It is also recommended that women age 55 – 79 take aspirin when the potential benefits of preventing a stroke outweighs the risk of bleeding from the digestive tract. However, they discourage routine aspirin use for cardiovascular disease prevention in women younger than 55 years and in men younger than 45 years without risk factors.

Bottom Line: Not everyone should take aspirin regularly for prevention. Since its regular use increases the chances of dangerous bleeding, it is important for patients, in consultation with their physicians, to weigh the potential risks versus the benefits of taking aspirin based on their individual medical profiles.

Saeid Mirafzali, MD MHSA
Internal Medicine Physician
Shanghai United Family Hospital & Clinics

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