Monday, May 13, 2013

Thoughts Are Not Facts: A Short Tale About Lycopene

A patient recently came to see me for an Annual Wellness Visit. This is a service paid for by Medicare that involves completion and review of a health risk assessment. As part of the process, I review the patient's list of supplements and advise if they are appropriate.

The patient told me that her doctor had recently sold her a bottle of lycopene to help alleviate her symptoms of urinary frequency, the need/urge to urinate more than usual.  Lycopene is a nutrient found in foods like tomatoes and watermelon and is considered an antioxidant because it is believed to neutralize free radicals.  It is often associated with reducing the risk of prostate cancer, but studies are inconclusive.

In this particular patient's case, she stated that since starting the lycopene, her frequency of urination had decreased.  This was not conjecture or fanciful imagination. Her getting out of bed at night to urinate had definitely gone down.  As anecdotes go, this one seemed fairly reliable and good evidence of the power of lycopene to help. If this person had been asked to swear out testimony about the benefits of lycopene, she would have done so without hesitation.

There was only one problem. Starting lycopene had nothing to do with why she had decreased her urge to pee.  First of all, I was suspicious because even if lycopene was responsible, its mechanism of action would not have made such a difference in such a short period of time.

More importantly, something else was going on. This patient usually took a diuretic pill for her blood pressure. A diuretic forces the kidneys to excrete more water and people who take them often complain of urinary frequency to the drug's effects.  As it turned out, around the same time that the patient started taking the lycopene, she had nearly depleted her diuretic medication and started taking it every third or fourth day instead of daily as required.  Under a reduced diuretic regimen, she was experiencing an obvious decrease in water expulsion.

The patient did not realize the overlay of this fact with her changed situation.  I made the connection for her. The mystery was solved. She now understood that the lycopene was not responsible.

Please don't get me wrong. I am not opposed to consumption of lycopene in fruits. In fact, friends, relatives, and even some strangers will tell you that I am a rabid fan of watermelon.  I can never get enough.  The only precaution I must take when eating watermelon is not too eat too much too late in the day or I will have to wake multiple times during the night to go to the bathroom.

The moral of today's story is just because a patient (or you) thinks that a supplement is helping you, doesn't mean it's true. It may be, but unless you have a scientifically valid way to verify it, you may be ignoring something else and wasting your time on unhelpful, if not potentially harmful, pills. You may even be experiencing a placebo effect or there may be other valid reasons for what you are experiencing. Be careful my friends.

1 comment:

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