Wednesday Bubble: Warn me
This week’s Bubble is straight out of the buyer beware files. Introducing Warmi ‘Better Menopause Relief.’
Warmi, according to the manufacturer website, is “a unique vegetable and fruit extract supplement. It contains 85% organic ingredients in a vegetable capsule and is 100% Vegetarian.” Moreover, Warmi provides safe, natural, full spectrum menopause relief” meaning that in a single study of 122 women, Warmi “also enhanced hormonal balance, mood, cardiovascular and bone health, vaginal dryness and intercourse discomfort — even overall quality of life. Many benefits were noted in just 30 days.”
Evidently, Warmi delivers, all that and more.
How, you ask?
Warmi’s active ingredients are:
- Gluocosinates, plant chemicals that are found in cruciferous vegetables such as cabbage, which are believed to help fight cancer and possibly, promote heart health.
- Beta-sitosterol, a substance found in plants and suggested to have properties similar to cholesterol. It is used in some European countries for benign prostatic hyperplasia (enlarged prostate) and according to the Warmi website, has been shown in laboratory animals to have some sort of weak estrogen effect that “may benefit the reproductive system.”
- Hesperidin, a flavonoid found in citrus fruits which has shown promise in laboratory animals to potentially reduce blood pressure and cholesterol and work as an anti inflammatory and produce pain killing effects. The Warmi website says that it may also ‘help bone metabolism.’ Note that this claim is based on one study done in mice, which demonstrated a decline in the loss of bone density.
So, Warmi is made up of cancer and heart protective ingredients, may alleviate pain, and…helps with menopausal symptoms? But how does it work? In the FAQ section of the product website, it says that while “The exact mechanism of Warmi is not fully understood but is believed to be associated with certain estrogen receptors.”
I’m sorry…WHAT?!
All I can think of when I think ‘Warmi’ is “warn me.” Yes, warn me that medical and scientific claims without substantiation are to be questioned, that comparisons to existing alternative strategies are difficult without well-designed research, and that unpublished, unreviewed product data are just that: unpublished, unreviewed and non-vetted.
Forewarned is forearmed.
Enough said.
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Dazed and Confused – Revisited
Two years ago i wrote a post about the confusion surrounding therapies, effectiveness, and discerning right from wrong when it comes to clinical trials. Herbal and integrative therapies are perfect examples of the grey areas; many trials have not incorporated some of the most important tenets supporting the use of these strategies, most important of which is individualization. Hence, I wanted to share the post with you again, and hopefully, spark some dialogue that might lead to improvements in how we study and write about the therapies that are offered to patients.
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A gal pal mentioned to me this morning that she often feels so confused about study findings proving or disproving the value of certain medications or herbs that she often just throws up her hands and does nothing. Many of us are as dazed and confused as she is so that I thought that a few key points about clinical studies might help.
Mike Clarke from the School of Nursing and Midwifery at Trinity College in Dublin wrote a great article a few years ago about the need to standardize results of studies for a specific disease ( in this case, rheumatoid arthritis). He defined the problem as follows:
“Every year, millions of journal articles are added to the tens of millions that already exist in the health literature, and tens of millions of web pages are added to the hundreds of millions currently available. Within these, there are many tens of thousands of research studies which might provide the evidence needed to make well-informed decisions about healthcare. The task of working through all this material is overwhelming enough without then finding the studies of relevance to the decision you wish to make…”
So what do you do? A few key points:
- Consider that every study has the potential for bias. Perhaps researchers are using 7 instruments to measure depression and only highlight findings from 3 of these in order to preserve the most positive or significant results. Clearly, the reader is being led towards certain outcomes and away from others.
- Study designs, types of patients studied, age of patients studied, gender, you name, can differ so it’s difficult, if not impossible to draw definitive conclusions when comparing results of one to another.
- Another issue of great interest to practitioner of Western medicine is whether or not a study is controlled. This means that two groups are compared that are identical in every way except one group is given an experimental treatment and the other, a placebo or standardized treatment. Note that often, real world conditions are often recreated rather than conducted in a real world setting and many studies are not controlled, meaning that the science behind the findings is questionable.
- Alternative and complementary medicines are still incompletely understood among many practitioners of Western medicine. What’s more, products are not regulated as carefully as medicinal agents and manufacturing practices vary. Consequently, studies of these agents or modalities are often inconclusive. And of course, often underfunded and under-appreciated.
No wonder we all feel so dazed and confused!
I’ve written several times about the importance of consulting a practitioner or medical expert before embarking on any regimen for perimenopausal symptoms. Even if you only see someone once, at least that dialogue may be useful for defining a regimen that may work best for you and what you’re going through. And if you live off the beaten track without access toa good practitioner, well then excellent resources like Medline or the American Botanical Council may be be of help in discerning what’s what.
The short answer is that there are no short answers. But with careful guidance and a bit of prudence, you may just be able see the light and smooth out the bumps on this rollercoaster ride we’re all on.
Read MoreWednesday Bubble: herbs and breast cancer
Can herbal medicines used for hot flashes, namely black cohosh and phytoestrogens, be safely used in women who’ve had breast cancer?
If you’ve had breast cancer, you’ve probably been told to stay away from herbal medications, right? Yet, women who’ve had breast cancer know that hot flashes are a common side effect of many cancer therapies. Research also suggests that the older a woman is at the time she receives chemotherapy, the more likely she is to develop menopause as soon as treatment stops. Moreover, roughly 80% of women taking Tamoxifen have hot flashes and about a third of those women rate them as severe. Hormones are not even an option due to the increased breast cancer risk.
The good news is that an extensive analysis of scientific studies shows that black cohosh might be safe for women who have had breast cancer. Although the researchers note that the evidence for the effectiveness of black cohosh for alleviating hot flashes is mixed, they cite research from the National Institutes of Health and other reviews that suggest that use of black cohosh in former breast cancer patients requires only standard screening. They also report that there is “little reason for excluding patients with estrogen-responsive tumors from using black cohosh.” In fact, recent laboratory studies, although not yet carried out in humans, suggest that black cohosh may actually protect the breast from developing tumors.
The case for or against the use of phytoestrogens (e.g. soy, red clover, chaste tree berry and flaxseed) in women with breast cancer is not quite as clear as it appears to be for black cohosh. In one of the largest reviews examining soy or red clover for menopausal symptoms, the outcomes were equivalent to placebo. Other studies have shown that they might be beneficial for women with mild to moderate symptoms who start menopause early. Moreover, while red clover in particular does not appear to affect certain breast cancer risk markers, reports about phytoestrogens in general, especially in estrogen positive cancers is conflicting. Still, the American Cancer Society does not advise against eating soy-rich foods by women who’ve had breast cancer. Some studies have also showed improved prognosis.
If you are wondering if there are any drawbacks, one of the largest challenges is that there are not that many studies looking at herbal medications in women with breast cancer and the ones that do exist are mostly short in duration. The researchers point out that because herbs can take awhile to work, a three month study might be too short to form a conclusion.
Clearly, more study is needed. In the interim, it appears both black cohosh and soy might be safe to try if you’ve had breast cancer. As always, the most important consideration is to speak to a certified practitioner who is well versed in herbal medicine and make sure that she or he works with your oncologist.
One size fits all
Like Zappa, I’ve never been one to be confined to a box. Or to be so presumptuous to believe that I am like any other woman out there (except, perhaps my mother but that’s an entirely different topic!). So why do manufacturers continue to assume that a single neutraceutical or combination supplement is going to address all of the major attributes of perimenopause, e.g., hot flashes AND night sweats AND mood swings AND sexual desire and so on and so on and so on? Am I missing something here?
One of the reasons I continue to encourage women to speak to a licensed practitioner is so that they can obtain advice that is individualized and personalized to their unique needs. I may be having night sweats every other night and regularly waking at 3 am, while you might be experiencing hot flashes every two hours. Should we believe that a single pill that combines, say, isoflavones, black cohosh and chaste berry will be helpful for both of us?
So, once again, I was dumbstruck when I ran across a site for yet another menopausal supplement: Menozac™, your one-stop pill for:
- hot flashes
- night sweats
- vaginal dryness
- forgetfulness
- mood swings
- bloating
- anxiety
- emotional issues (which in turn, will benefit sexual issues)
Have you tried Menozac™? Was it “all that and more?” Did you “graduate to maturity and being free of the responsibility of being fertile?” Did Mother Nature’s “helper” save you from being bedeviled by the menopause?
I swear, I didn’t write this copy. I simply took poetic license with it. In fact, it’s so “all that” that I don’t believe that I am creative enough to come up with the degree of hype that permeates each sentence.
Dear readers – please be safe, be diligent, do your homework and make conscious decisions. Be skeptical. Be suspicious. Ask questions. Speak to a trained expert. Read. Explore.
One size does not fit all.
Read MoreThat Old Black Magic
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Remember black cohosh? That wonderful herb in the buttercup family of plants that is commonly used to address hot flashes, mood swings, night sweats and other vasomotor symptoms? Black cohosh has been used in traditional folk medicine for centuries and was introduced to the settlers by Native American Indians, who incorporated the herb into their traditional medicines for women’s ailments.
I’ve discussed the utility of black cohosh for sleep and other disturbances in a previous post.
Personally, I’ve been using a standardized black cohosh formulation in combination with some Chinese herbs, (as recommended by acupuncturist and Chinese medicine specialist Elaine Stern) with great success for many months now. Hence, I am a huge fan. And in my book it is that ‘old black magic.” Still, I believe that it’s important to address warnings that link black cohosh to liver damage. Here’s what you need to know:
Based on recent statements that have been recently issued in Australia and the United Kingdom, The U.S. Pharmacopeia’s Council of Experts extensively analyzed data from 30 case reports, side effects reports and other sources to evaluate the association between black cohosh and liver damage. They concluded that there was enough evidence from case reports to suggest a possible link and proposed that a cautionary statement be included on manufacturer labeling.
So, what’s the bottom line? Overall, there are been few reports of liver damage but they have provoked enough concern to raise a red flag amongst several regulatory agencies worldwide. Here, the U.S, the National Institutes of Health Office of Dietary Supplements says that millions of people have safely used black cohosh without any apparent negative health effects.
As always, if you choose to go the herbal route, speak to an health professional who is well-versed in herbal medicine first. Try to select standardized formulation (it usually says it right on the label), which can help to insure that optimal and safe manufacturing processes have been followed and that you’re getting a pure form of the herb. Finally, be aware of potential side effects. In addition to liver damage, black cohosh has been linked with headache, dizziness, visual disturbance, constipation and intestinal discomfort, mostly at higher than recommended doses. Finally, remember that herbal medicine is medicine, and like Western preparations, requires vigilence, common sense, and can result in adverse effects if not used correctly.
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