Pills, Potions and Pence

It appears initially strange to me that, in the same week that a meta-analysis suggested that our 'health' obsession with vitamins causes, in some cases, more harm (including fatalities) than good (http://www.guardian.co.uk/science/2008/apr/16/medicalresearch), there has apparently been a £200m boost on spending on 'natural' therapies in the UK(http://lifeandhealth.guardian.co.uk/health/story/0,,2275099,00.html). This keenness for 'alternative' therapies is apparently particularly expressed by women over 35 and may be linked to policies that have directed people to discuss some of their health issues with their local pharmacist (many of these 'chemists', in addition to dispensing, do sell vitamin tablets, herbal remedies etc). I have never really quite understood why people assume that 'natural' means good and synthetic means bad. Many toxins (from bacteria, scorpions and snakes) are 'natural' but I wouldn't routinely dose myself with them. Its also weird that people always assume that, if one pill is good for you, 2 will be twice as good etc (this is of particular relevance to the vitamin issue where over-dosing, especially with some of the fat-soluble agents, appears to be a real problem causing liver damage etc). The 'take-home' message on vitamins and necessary trace elements (like selenium) seems to be that the healthiest option is to eat a balanced diet (it will contain all that you need) and, if you can't or don't do that, to go easy on the vitamin tablets. It is recognised that a minority of the herbal remedies do have actual beneficial effects (hardly surprising, as a number of our medical drugs were derived from them) but, even here, it is difficult to know what amounts of active ingredients the preparations contain, to be fully briefed on potential side-effects or be certain that their ingestion does not impair the effectiveness of prescribed clinical agents (especially if you don't tell our doctor that you are taking them). New European legislation on herbal remedies is coming on stream and may prove helpful. It is even odder that homeopathic medicines remain resolutely in vogue when there seems to be no possible biological mechanism for their claimed actions (many contain less active ingredient than distilled water). Placebo actions (that may actually be helpful to some individuals) and the endorsements of supporting celebrities seem to have powerful effects on human behaviour. I am not certain that these are always benign when it comes to health and commerce.