Tuesday, January 21, 2020

Book Review: 'Overkill: When Modern Medicine Goes Too Far' by Paul A. Offit

For too long, Americans have been taking their medical advice from the likes of Jenny McCarthy and Gwyneth Paltrow, says Dr. Paul Offit. Overkill is his (hopefully not futile) attempt to get the scientific truth out there. The book’s chapters dispel longheld beliefs/myths either propagated by doctors or supported by them. Each topic is filled with randomized clinical studies that show unambiguously, simply and directly that common knowledge is flat-out wrong.

  1. One very basic falsehood is that fever is bad and must be addressed with meds to reduce it. Fever is the body’s immune response, its way of delivering help. Increased heat means blood carries aid to the damaged area faster. The heat allows the body’s defenses to operate more quickly and intensively. It is a sign the body is dealing with the problem. Chilling a fever, lowering body temperature and defying the help with anti-pyretics defeats the system and means a slower recovery (and sometimes death). An infinite number of studies shows this is true. Brain-frying from too high a fever is a myth; the body knows how high it can go in the battle to restore health. If you have a fever, bundling up, not cooling down is what will help.

  1. Antibiotics are misprescribed 75% of the time, Offit says. Doctors prescribe them for conditions such as viruses, for which they have no use at all. Patients demand them, and will give a doctor a poor rating if s/he doesn’t quickly prescribe them. Offit shows that taking antibiotics all the way through is not only pointless, but damaging. This is the very opposite of popular thinking that everyone must take the full course in order to completely defeat the bacteria causing an illness. He says as soon as the bacteria begin to abate (ie. the patient begins to feel a little better), it means the body has taken charge and will eliminate the intruders itself. Usually 3-5 days’ worth of antibiotics suffices. Two and three week courses achieve nothing other than strengthening the bacteria that survive.

  1. Vitamin D is a scam. Study after study proves beyond question it has no effect. Yet the marketing and promotion by certain doctors say the opposite – that vitamin D has been shown to improve bone strength or any number of other claims. Not one is true. Everyone wants vitamin D to be effective for treatment, so the studies continue. But it has never once come through. Same for beta carotene. Incredibly, it evens says on my own blood test report how valuable and important very high levels of vitamin D are, according to the loudest mouth on the subject, who is also behind the continual raising of the minimum level required. He has engineered it so that everyone automatically has a vitamin D deficiency. That is not medicine. It is marketing for big profit. And it works

  1. Antioxidant supplements don’t work. They don’t do the job people buy them for. No studies show them being effective at anything. People spend billions on antioxidant supplements for absolutely nothing, except overdosing on them can cause cancer and heart ailments, and people love to up their own dosages. Massive doses of vitamin C have also shown to be completely useless in preventing or shortening colds. The whole culture of self-dosing with vitamin C came from one very famous doctor, who continually denied the results of gold-standard clinical studies and refused to admit he was wrong. It costs Americans billions.

  1. Testosterone doesn’t work. It does not provide any of the promised changes in well-being. No studies show it effective for any of the promises made. Testosterone declines naturally as men age. An extreme decline may be hypogonadism, but testosterone supplements do not cure that, either. It does not increase bone density, lighten depression or cure erectile dysfunction. Like any steroid, overuse can (easily) lead to aggression, hostility and violence. And it increases the risk of heart attack and stroke, with no upside.

  1. Aspirin is not the miracle drug everyone thinks it is. It is not safe or harmless, and also not effective for things like high blood pressure and hypertension. It causes bleeding in a lot of people. Offit shows the most amazing thing about aspirin is that it keeps reinventing itself. Just when the medical establishment has given up on its current main attraction as being invalid, it comes up with another. Baby aspirin does not prevent first strokes or heart attacks. But it does have an effect preventing a second stroke or heart attack, and also helps prevent colon cancer.

  1. Food allergies can be prevented by feeding those foods to infants. Preventing infants from encountering them sets up a confrontation with the immune system later, when it locks up.

  1. The only effective sunblock is clothing. Sunscreens are effective up to a point, but none screens out 100%. Proof of UV ray damage is volunteered daily by people using tanning beds, a national suicide cult, it seems. Like a mice experiment, tanning bed users have shown us the difference between UVA and UVB rays (UVC rays don’t make it to the ground), and how the different cancers manifest. There are three types of skin cancer: squamous (surface), basal (deeper) and melanoma, which can occur anywhere and even affect people who get little sun. Sunscreens actually increase the risk of melanoma, so they are not a panacea. Worse, sunscreen creams make people believe they can take more sun without risk. This is totally false. Sunscreen should be at least SPF30 and be applied every two hours.

  1. Reflux meds do not help babies. Babies spit up and cry. They do it not because they are defective but because they are young. Lying on their backs after eating allows acidic stomach fluids up the esophagus in their underdeveloped systems. And reflux meds can be fatal to babies. The problem usually ends by the first year anyway.

  1. Prostate cancers are something men die with, not usually of. The standard test, PSA, is riddled with false positives and false negatives. Doctors know this, but prescribe it continuously anyway. Taking action on the basis of a PSA score is riskier than doing nothing. The “cures” are usually worse than doing nothing. 50 of 80 who choose prostatectomy or radiation will suffer complications. 15 will develop erectile dysfunction, 15 incontinence, and five will die even if the prostate is completely removed. Per 100, one life will be saved. For 99 it will be a waste of time. Mostly, it’s a moneymaker for the healthcare system. Offit quotes the discoverer of PSA in a New York Times op-ed: “I never dreamed my discovery four decades ago would lead to such a profit-driven public health disaster.”

  1. Thyroid cancers can now be detected with ultrasound machines, and as a result, the number of thyroid cancers detected has soared. Unfortunately, the cancers detected are papillary and not really cancers. Still, victims have to go through biopsies, surgery, chemotherapy or radiation and must replace the thyroid’s secretions by meds, which are very tricky to get right, and often result in numerous other undesirable conditions. And for all this, the death rate from thyroid cancer has not changed in two decades, Offit says. The flood of early, frequent screenings has not saved lives, but caused pain and anguish across the country.

  1. Breast cancer screenings don’t save lives. Studies around the world show that mortality from breast cancer remains the same whether there is screening or not. For one thing, breast cancers have been studied so finely we are able to discriminate among variations, and have a deep arsenal of effective treatments for them. For another, the anguish of undergoing biopsies, surgery, chemotherapy or radiation therapy – for a false positive, is unacceptably high. As with prostate cancers, many diagnosed with breast cancer will die with it and not of it.

  1. Heart stents are very popular. Patients demand them, and doctors accede to their wishes. They don’t work. They have no effect on mortality according to the studies. They are a waste of time, money, and are a surgical risk.

  1. Arthroscopic knee surgery does not fix meniscal tears or arthritic knees. The studies prove it. Programs of physical therapies and education (eg. posture) do better, without surgery.

  1. Mercury dental fillings are not poisonous, except to the oceans, where old fillings end up. The quality of the mercury does not lend itself to disease, or everyone would have died of it. All kinds of people claim to have been instantly relieved of a menu of symptoms with the removal of their filings. Offit says this is despite the fact that by removing the fillings, the patient absorbs a tremendous amount more mercury than if they were left alone. The ADA’s Council of Ethics, Bylaws and Judicial Affairs says “Removal of amalgam restoration solely for the purpose of removing toxic substances from the body when such treatment is performed at the recommendation of the dentist, presents a question of fraud or quackery.”

  1. Ankle sprains are extraordinarily common, and everyone “knows” to treat them with RICE: rest, ice, compression and elevation. Except that’s 0 for 4. None of those things work. Their exact opposites are what is needed. Even the doctor who came up with RICE admits he was wrong. But that hasn’t stopped anyone. What victims should do is let the warmth of inflammation do its work, and rather than rest, wiggle their toes as if writing with a pencil.

  1. Teething does not cause fever. It turns out that infants lose their immunity from birth bacteria at just about the time teeth come in. So those who come down with fevers are the victims of coincidence, not caused by teething.

Overkill is refreshingly candid, clear and simple. It clears the air, adding a small doses of certainty where the fog of common knowledge usually reigns.

Editor's note: This review has been published with the permission of David Wineberg. Like what you read? Subscribe to the SFRB's free daily email notice so you can be up-to-date on our latest articles. Scroll up this page to the sign-up field on your right.