Blog | Friday, December 4, 2015

Hear ye, hear ye, probiotics cure all!


A probiotic rep came to our office bearing lunch and billions of bacteria. Who on their staff, I queried, counts the bacteria verifying that each packet has 3 billion disease-busting germs? I suspect that these quantities are only estimates and that consumers may be unwittingly subjected to either an inadequate dosage or a toxic amount. Caveat emptor!

I surmise that plaintiff law firms are hiring germ counting experts hoping to establish with clear and convincing evidence that the product's label is false and misleading. Soon, we can expect to see TV commercials when we will hear an authoritative announcer asks, “If you or someone you love took probiotics and developed fatigue, joint pains, weight loss, weight gain, nightmares, daydreaming, lack of energy, excess energy, loss of a sense of humor, extreme frivolity, lackluster performance reviews at work, basement flooding or any other adverse life outcome, then you may be entitled to compensation. Call 1-800-GETCASH. Operators are ready to speak with you in 9 languages.

After the announcer states his message, scary music plays and we see black and white footage of suffering zombies.

Probiotics, unlike conventional prescription drugs, are not subjected to Food and Drug Administration (FDA) approval. Hence, the germ guru who brought deep fried food to our office is free to discuss all possible uses of the agent despite the absence of any scientific basis underlying his claims. Drug reps detailing prescription medicines do not enjoy a similar level of free speech. In fact, they are securely gagged and are prohibited from discussing off label use of their products, even if we ask them about it. If these guys and gals stray off message, not only will they be summarily terminated, but their companies may be heavily fined, as many have learned.

Does this make sense? Prescription drug reps, whose products have been rigorously tested and are used off label routinely, can't even whisper or use hand signals to communicate important but unofficial information to doctors. In contrast, a purveyor of probiotics, whose products are unregulated and unproven, can sing like a canary extolling the benefits of billions of germs that we're told can fight all kinds of illness, foreign and domestic.

I've always felt that the FDA is too strict in restricting the content of conversations between drug reps and doctors. This is an overreaction from pharmaceutical industry abuses with aggressive marketing of off label use to physicians. As a result of this hyper response, physicians are deprived of an important information resource from reps who have a very deep knowledge of a narrow subject. Who wins here?

Who needs prescription drugs anyway, now that I know that probiotics are the panaceas that can cure all?

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.