Tuesday, May 22, 2012

What Do You Put Your Faith In?

Many things are done on the basis of faith. Religion is one example, relationships are another.  However, proper practice of medicine should be based on evidence not blind faith.

Making the headlines yesterday was the United States Preventive Services Task Force recommendation that doctors discontinue routine testing for Prostate Specific Antigen (PSA) in healthy men. This recommendation was based on two studies, one which showed no difference between men tested versus not tested, and the second study which showed that among tested men, there were many false positives that led to further unnecessary testing e.g. biopsies, which led to complications e.g. infections.

Not surprising, many urologists and oncologists came out against this don't test recommendation. What's the answer? My view is that if you have symptoms, you should test, and if not, you should not test. I believe this is true in many medical situations not because I have an opinion but because the facts support that conclusion.

Yesterday, I exchanged a number of correspondences with a lady on LinkedIn regarding the need to test everyone for Vitamin D deficiencies.  She emphatically believes that it is necessary to test everyone because most people who don't take Vitamin D supplements are deficient; I don't agree.  My reason for not agreeing is because that's not what the science shows. As I wrote the other day about Vitamin D and The Endocrine Society, the facts are inconclusive as to the effects of mega-dosing with Vitamin D. This lady insisted that she needed twice the normal lower level of Vitamin D to be healthy. It's not surprising that so many people are confused by what they need because rumors and false information often circulate unabated without correction about supplements. You may remember my blog titled Supplementum, The New Religion. It was a parody of Americans' growing blind faith in supplementation in the absence of compelling evidence.

I can understand why many put their faith in things that aren't true. We sometimes just want to believe; sometimes we just need to believe.  Oftentimes belief is a good thing if it gives you solace or helps you navigate an often confusing world. That's all fine as long as such belief does not lead to dangerous situations and irreversible harm. While I believe that it is important to be vigilant, I don't believe that it is proper to test for no reason. In the Longevity Project book, the authors concluded that a little bit of neuroticism is good for your long term health, but chasing diagnoses in the absence of symptoms is full blown neuroticism and that's not healthy.

My biggest issue with supplement marketers is that they give people false hope by promoting science fiction as fact, when there are better solutions available that won't be pursued because of reliance on placebo-like products. If people had all the facts, the supplement market would be a fraction of its size and it knows it. That's why it fights the FDA with everything it has because the FDA wants the facts to be known.

Faith works, but when it comes to your health, I think you would be better off relying on evidenced based medicine. I know I do.

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