Strengthen your liver!

What? You didn’t know your liver was weak? Neither did I, but I was looking at one of the alternative med sites and a banner add got me to thinking…

It suggested (demanded, really) that I strengthen my liver. Let’s skip the problem with offering advertising space to unsavory products, and instead examine the claims of the product.

Claim 1: Strengthening your liver. I have an idea what a weak liver is and how to measure it, but page 1 of the website doesn’t provide much enlightenment.

Claim 2: “There is a large amount of research showing that Sho-saiko-to improves liver function*. There is evidence that Sho-saiko-to benefits people by helping to improve their liver function.” This is accompanied by a standard disclaimer that states, “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.” Bullshit. It is certainly claiming medical benefit, and then they are trying to cover their asses by adding a contradictory disclaimer. I call that, um, lying.

How about the claim itself about “a large amount of research”? I did a Medline search of Sho-saiko-to, and found 150 articles, mostly studying the effects of various herbal preparation on rats. But here’s my favorite part. Click on this link for “research data”–they apparently don’t have the same access to Medline as I do.

Tell me a little more about this “liver” thing.

The liver is a large, important organ. It manufactures clotting proteins, removes certain toxins, and basically serves as a big chemical factory. There are a number of ways to damage a liver, the most famous being alcohol and hepatitis. We can measure both liver damage and liver function by imaging, blood tests, and biopsies. When a liver is severely damaged, it looks shrunken and lumpy (cirrhotic), and fails to do its job. We see a rise in toxins, and a propensity toward bleeding. Once someone is becoming delirious and having bleeding problems, they are on there way out.

So how do we maintain “liver health”? First, don’t damage your liver intentionally with alcohol. Avoid viral hepatitis, by avoiding IV drug use and unsafe sex. Really, maintaining “liver health” doesn’t require effort. What if it is already damaged? Viral hepatitis can be treated better than ever, and quitting drinking avoids further damage. When the liver is completely kaput, transplant is the only answer.

So what is this stuff anyway? What should we do with it?

Well, it costs $60.00 per month. It contains an herb that is not proven to do anything in particular in humans. But, it does have a long tradition of use in traditional Japanese medicine. So, let’s give it the benefit of the doubt. Let’s test the stuff.

This is what needs to be done: First, define the condition you wish to treat–viral hepatitis? liver failure of any cause? Define the parameters to be measured–liver enzymes? clotting time? Find a sample population that has the disease in question, randomly assign them to the herb or placebo, and measure the outcomes of interest over time. Subject the numbers to proper statistical analysis. Then we’ll have an answer.

That sounds hard

It is. Science is work. But when done properly, we get to help people with all kinds of nasty diseases get better. When done improperly or not at all, it’s called quackery.

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  1. Shirah

     /  November 6, 2011

    XKCD sums this one up, nicely. The alt text is what really makes the cake, though.

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