Every day, I get emails about the latest wonder medication or nutritional supplement. Before I try it, I need to evaluate it. I've been using nutrients in a certain way for a very long time, and have been happy with the results my patients are getting. It takes a lot to get me to change. Here’s how I assess those promotional emails and articles.

Are there references?

    The first question I consider is whether there is scientific backup for any claims. And to verify that, I check the cited references. If there are no references, that is a red flag.

Do references back up the point made?

    Even if there are references, it is astonishing how often the references do not support the claim. For example, a quick search online will find statements that coffee enemas massively increase glutathione, a peptide that helps the body dispose of toxins. The first author to state this provided a specific scientific reference. When I reviewed the reference, it described an experiment where mice were fed a diet of 20% green coffee beans, and their glutathione levels went up dramatically. Eating coffee beans is not the same as doing coffee enemas! But this misleading claim about glutathione has been quoted and requoted many times over the years.

    Another example, with far more serious consequences, comes from the mainstream medical field. During the 1990s and 2000s, pain experts taught doctors that narcotics were not addictive when prescribed for pain. This led to over-prescribing and an epidemic of opioid addiction. In reality, the claim about low risk of addiction was not based on solid evidence, but on a single letter published in the New England Journal of Medicine in 1980. Once this letter was cited by an expert, various writers referenced one another without examining the original flimsy evidence for themselves.

Are the references good quality?

    Once I find the references, the next question is whether the research is good quality. Unfortunately, there is a fair amount of research fraud. Dr. Alan Gaby has written several articles on this topic.

    If the references are primarily in poor quality journals or if the results seem too good to be true – they may not be true.

Is it beneficial?

    If the research looks legitimate, the next question is whether the new approach or substance offers enough benefit to justify the cost. Here, I try to apply some common sense. For example, the argument for using a new and expensive form of a nutrient may be highly theoretical. The product may penetrate the blood-brain barrier more easily, or be better absorbed from the gastrointestinal tract than its parent compound. But is that good?

    It may or may not be. The underlying assumption in that line of reasoning is that the body is broken and stupid, unable to adequately recognize what it needs to absorb or where it needs to go. I believe the body can regulate itself and that if it is provided with the right nutrients, it can heal.

    I recently received a promotional email with the title “New Study on Lactoferrin and Brain Health.” The first paragraph states that scientists have found that lactoferrin can support and protect your brain. The cited reference discusses how lactoferrin stimulates the growth of nerve cells in cell cultures, a highly artificial environment. Does this mean that lactoferrin will make your brain work better? We would have to assume that lactoferrin can survive the digestive process, be absorbed intact, cross the blood-brain barrier, and have the same effect it did in the lab. Since lactoferrin is found in a number of foods, I’m inclined to skip the supplement for most people.

    I realize that good quality research is difficult to carry out in medicine in general, let alone in the nutritional world. (Here's a good article on this topic.) But if the sales material for a supplement is blaring how fabulous it is, they had better have the documentation to back it up.

    All of this is to explain why I am not the first one to jump on the bandwagon of the newest and most loudly promoted product in the pharmaceutical or nutritional world. I am cautious – I read through their documentation, look at their references, and if it passes my first review, I try it out in a few patients that are most likely to benefit based on what the product is claimed to address.

    Having said that, if you are my patient, please let me know if you hear about something you think might help.