Much of what's told to public about health is medical dogma

[samhexum]

https://nypost.com/2024/09/16/lifestyle/four-things-doctors-and-modern-medicine-got-totally-wrong/#:~:text=Doctor doesn't always know,been unfounded and even dangerous.

In his new book, “Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health,” Dr. Marty Makary examines how some of the medical establishment’s biggest health recommendations in recent decades have been unfounded and even dangerous.

“Much of what the public is told about health is medical dogma — an idea or practice given incontrovertible authority because someone decreed it to be true based on a gut feeling,” writes Makary, a surgeon and professor at John Hopkin University.

Four instances where many doctors got it wrong.

In 2000, the American Academy of Pediatrics (AAP) issued a recommendation that children under age 4 and pregnant and lactating women avoid peanuts if there was potentially a high risk of allergy.

That recommendation was based on a UK recommendation connected to a 1996 study from the British Medical Journal that actually found no association between pregnant mothers eating peanuts and their baby developing an allergy.

Furthermore, the study’s lead author, Jonathan Hourihane, told Makary that he opposed the guidance. “It’s not what I wanted people to believe,” he said. “It’s ridiculous.”

In the wake of the AAP guidelines, peanut allergies saw a huge increase — and became increasingly deadly.

“Suddenly emergency department visits for peanut anaphylaxis — a life-threatening allergic swelling of the airways — skyrocketed, and schools began enacting peanut bans,” writes Makary.

In 2007, roughly 5% of medical claims for anaphylactic food reactions were for peanuts; by 2016, 25% were.

By 2019, there were reports that one in every 18 children in America had a peanut allergy.

“The AAP recommendation had created a vicious cycle,” Makary writes. “The more prevalent peanut allergies became, the more people avoided peanuts for young children. This, in turn, caused more peanut allergies. “

Today, many doctors recognize that early exposure to peanuts is best, but “the remnants of the peanut avoidance recommendation still linger,” write Makary. The US and UK have the highest rates of peanut allergies in the world.

For decades HRT was considered something of a godsend for women in menopause, helping with symptoms such as hot flashes and depression, while also lowering the risk of heart attacks and Alzheimer’s.

But in 2002, the National Institutes of Health (NIH) declared that HRT resulted in a “26% higher incidence of breast cancer.“

The pronouncement came from a study of nearly 17,000 women by Stanford and Harvard researchers, but it wasn’t backed up by the actual data.

There was no “statistically significant difference in the rates of breast cancer among women on HRT compared to those who took a placebo,” writes Makary. “The authors had misrepresented their data. But amazingly, hardly anyone noticed.”

Those who did and spoke out were drowned out by the masses. “US prescriptions for HRT plummeted by 80%, and they remain low to this day,” Makary notes. “Tragically, a generation of millions of women were denied a life-changing treatment.”

There’s no question that antibiotics save lives, but Makary notes that they’re wrongly thought to have no downsides — and are being overprescribed to potentially devastating effect

With ear infections in children, doctors once did a careful examination to distinguish between a bacterial and a viral infection, the latter of which is much more common and can’t be treated with antibiotics.

Today, doctors, aside from specialists, might not have the knowledge or time to make such a distinction — or it might be a telehealth visit — so they’ll just write a prescription for antibiotics to cover their bases.

But, he writes, “the overprescribing of antibiotics is causing more harm that we may realize” — namely to gut health, which can potentially lead to a host of health issues.

For a study published in 2021, Mayo Clinic followed all children born in Olmsted County, Minnesota for 11 years. Of those kids, about 10,000 were given an antibiotic in their first two years life. They had significantly higher rates of obesity, asthma, learning disability, ADHD and celiac disease compared to the roughly 4,000 children who did not receive antibiotics early in their life.

Mayo Clinic doctors recently repeated the study, and it yielded similar results.

Other research has suggested that everything from the rising number of food allergies to higher rates of breast and colon cancers in recent decades may be due, in part, to our declining microbiome health.

Finally, fluoride was first added to tap water in America starting in the 1940s to prevent tooth decay, and it’s now in roughly two-thirds of American homes. (In Europe, only about 3% of residents have it.)

An analysis by the Cochrane Collaboration — an international non-profit that reviews medical research — found “very little contemporary evidence” that water fluoridation successfully prevented cavities, noting that studies suggesting otherwise were dated, poorly designed and did not take into account the fact that many people now use fluoride toothpaste.

Meanwhile, some research has raised concerns about the effect of fluoride on gut health and IQ in babies, as it can settle in fetal brain regions and effect neurotransmitters.

A 2019 study in JAMA Pediatrics found that “maternal exposure to higher levels of fluoride during pregnancy was associated with lower IQ scores” in young children.

More research is needed, but Makary notes this is yet another assumption we shouldn’t take for granted.

“If someone tells you that fluoridation of the water supply is entirely safe and essential for public health, that is an opinion, not a fact.”

[+ nycman]

8 hours ago, samhexum said:

Today, doctors, aside from specialists, might not have the knowledge or time to make such a distinction — or it might be a telehealth visit — so they’ll just write a prescription for antibiotics to cover their bases.

That’s a very broad generalization, that I don’t think is true. The "Watchful waiting" strategy has been the standard of care for a long time in the US. Also, I think the real reason “Watchful waiting" is a successful strategy for ear infections is the rise of Pneumococcal and H. Influenza vaccination in infants. Thus vastly decreasing the risk that any ear infection is bacterial. 

He makes some good points, but overall (like most medical providers who seek the spotlight) I fear some of his positions are overstated in order to attract attention. 

[SirBillybob]

The good news about the Mayo study is that for parents promoting childhood obesity, early life antibiotic uptake does not significantly militate against the goal of having a population consisting of a majority of overweight offspring.

The graph colours are inexplicably non-contrasting. With eye strain, the females are the slightly more green hue and males blue hue, hence boys a bit higher probability irrespective of antibiotic uptake. The broken lines represent early antibiotic uptake (binary yes-no not stratified for number of prescription courses)

Many families override medical dogma, so there’s that.

Edited 12 hours ago by SirBillybob

[+ Pensant]

I’m a moderate skeptic vis-à-vis the medical-industrial complex.

Edited 10 hours ago by Pensant