David DiSalvo

Neuronarrative

Six of the Biggest Placebo Scams at your Drugstore

Snake oil has nothing on these products

Posted Sep 04, 2010

The funny thing is that real snake oil--oil derived from the Chinese water snake--is actually more evidence-based than any of these products. Genuine snake oil contains more EPA Omega 3 fatty acids than salmon, and there's plenty of decent evidence backing up the benefits of Omega 3s. So if you can find real snake oil (you might have to go to China), buy it.

If you see any of the products below, not only should you not buy them, but make sure people who you like enough to save from getting scammed don't fall for them either.

[Brief preamble: The placebo effect can produce "real" results, of a sort, if the person using the product believes it will work. But those effects are generally short lived, and the core problem will remain untreated. What I'm focusing on in this post are products that are marketed as doing something without (non-placebo) medical evidence supporting the claim.]

Homeopathic Allergy Medication

The idea behind these products is that repeated exposure to allergens in small doses builds resistance. The formulations contain micro doses of pollens, dust, mold, and the rest of what us allergy sufferers avoid at all costs. As with all homeopathic meds, the underlying theory is "like cures like."

Perhaps by coincidence, or by design, that theory bears some resemblance to immunotherapy. People who receive allergy shots, as I did for about 20 years, are getting dosed with the stuff they are allergic to. An immune response follows, and over time the body can (but often does not) become immune to the allergens. This didn't work for me, but I know people who it has worked for so I'm not knocking it.

The crucial difference between medical immunotherapy and homeopathic allergy therapy, and what makes the latter ineffective, is how the dose is introduced into the body. Allergy shots directly enter the blood stream. Homeopathic allergy products are taken orally, and most of the ingredients never make it beyond your stomach acid. What little does get through is too diluted to have any effect. The upshot is that sellers of homeopathic allergy meds are relying on a medically sound theory to sell their product, even though the product does not work the same way--or at all.

Head On

Headache? Just roll a little Head On across your forehead and get ready for sweet relief. Everything about this product screamed "fake!" from the start and yet millions of people bought it thinking the mystery balm would somehow penetrate their skull and neutralize the ouchy thing in their head. And if that doesn't do the trick, there's always extra strength Head On, brimming with extra strong mystery brain balm.

Thankfully, legal pressure forced the makers of this ridiculous product to stop advertising that it cures headaches. If you're a true believer you can still buy it for about 10 bucks a tube. But, don't.

Magnet Therapy

This one goes under several brand names, so I'll have to generalize: any product claiming its magnets will cure, relieve, manage, reverse, massage, etc. is a scam. I don't care if the product makers guarantee results. What they're relying on is that your belief in the product will be strengthened by the alleged guarantee, which reinforces the placebo effect. Magnet therapy products are also expensive, another placebo reinforcing factor.

There is no credible evidence supporting any of the medical claims for magnet therapy. The studies that are generally cited by proponents are small, inconclusive pilot studies that were never replicated. Every other major study of magnets has shown that they do precisely nothing. The original lie that launched the magnet therapy industry was made by a doctor in the early 1970s, who swore his magnets could cure cancer-an obnoxiously fraudulent claim that was never proven, and never will be. It's a scam.

Phenylephrine

Most people remember the days when you could walk into a drugstore, grab a box of decongestant tablets off the shelf and buy them without feeling like a criminal. But meth heads were buying up so much of the cold meds containing pseudoephedrine, a key ingredient in making crystal meth, that the once cheap and accessible decongestants became a controlled substance behind the counter (via the Combat Methamphetamine Epidemic Act of 2005).

The replacement for pseudoephedrine was phenylephrine, an active ingredient marketed as equally effective as pseudoephedrine. Just one problem with that claim--it's not, and it may not be effective at all. In aerosol form (nose sprays), a high level of the active ingredient is absorbed, but studies have shown that only about 38% of phenylephrine is bioavailable once the med in pill form hits your stomach acid. At the standard 10 mg dose, that's a tiny amount of the substance left for absorption. Multiple studies have shown that the dose is no more effective than a placebo.

The only notable exception was a study paid for by pharmaceutical company, and producer of products containing phenylephrine, GlaxoSmithKline, that claimed to show an effect superior to placebo. I think I'll stick with the non-vested-interest studies and call this one a big, honking, runny-nosed placebo scam.

Airborne

Airborne, the vitamin pill you drop in water and down like Alka Seltzer, was a market sensation a couple of years ago. Travelers especially loved it because it was marketed as an "immunity boost" against all those nasty germs other travelers are breathing on you in planes and airports. All along it was a placebo scam, and the company was forced to pay a $23.3 million settlment for false advertising. Flooding your body with vitamins doesn't boost immunity, it just makes really expensive urine. Below, the incomparable Dan Ariely talks about the death of his favorite placebo effect.

Diet Pills

Ephedra, the main ingredient in many diet pills, was banned by the FDA several years ago after being linked to multiple deaths. The ban was lifted in December 2009, prompting a new round of industry marketing. The reality, however, is that only one company is currently manufacturing genuine ephedra products (containing the approved 10 mg of naturally occuring ephedrine alkaloids). All the rest are either selling ephedra substitutes, fake ephedra, and/or scrambling to retool their manufacturing process, which they changed back when the drug was banned. All of them rely on the placebo effect to keep people coming back for more.

People frequently do lose weight on ephedra; the reason is twofold: one, the ingredient revs their metabolism, burning more calories, and the products also contain huge doses of caffeine adding to the effect. This is dangerous. Forcing your body to artificially accelerate for extended periods can damage blood vessels, not to mention skyrocket anxiety levels. And if you happen to have a heart condition, even one you don't know about yet, much worse could happen.

The other reason people lose weight is because they pair the pills with increased activity. This is partly due to the metabolism effect, and partly placebo effect (i.e., "the pill is helping me workout more").

When ephedra becomes widely available again (and it won't be long), it will be just as risky as it was before, and wisely avoided.

Copyright 2010 David DiSalvo