June 09, 2009

Lack of evidence for arctic root "natural medicine"

Arctic root or roseroot is one of the most common "natural medicines" in the market and it's praised and popularized all over the commercial media. Its purported effects include "giving you energy", making you more alert and awake, helping you handle stress, think faster and counter tiredness and depression. More often than not these extraordinary claims are backed by references to scientific studies, lending credence to the efficiency of the substance.

In an op-ed published today in Swedish daily newspaper Dagens Nyheter a student associated to our lab, her thesis advisor (both statisticians) and my professor review the analyses they have made of the available roseroot studies. The results are not surprising. Out of the 11 studies published in the last ten years the ones that are scientifically relevant show no effects, something that the advertisements fail to mention of course. Out of the ones that do, the vast majority are faulty in several fundamental ways. One very small study could see some significant positive results, but the study would have to be repeated with a larger number of test subjects to be considered reliable.

There are also murky circumstances surrounding some of the positive studies. In one instance several of the authors could not be found in their reported home institutions in Russia, another had left his institution many years ago and yet another institution could not be located at all. The only author that could be contacted is a Swede and the co-founder of the company that fabricates the roseroot pills, the deceptively named Swedish Herbal Institute. He had to admit he had not seen any of the original data in the study. This person is also the co-author of another study that was originally published in Russia. The first author of this original study could be contacted and he had not given his permission to re-publish the article in an English-language journal.

So peddlers of miraculous remedies will resort to dishonest and questionable tactics in order to make money; what else is new? But this does not speak for or against the efficiency of roseroot. There's a delicate distinction that needs to be made. The conclusion of the op-ed is:

We don't claim that roseroot is completely ineffective. It might have an effect in some context - but the question remains which effect and in which context. The scientific studies have shown no convincing results. The unreliable advertisements are worrying.

Quite simply, there is no scientific reason to believe that these "natural medicines" will have the effects they promise.

The statistical analyses that are summarized in the op-ed will be published in the scientific journal Planta Medica. My apologies, the article in Planta Medica has already been published. Link here.

Here are some of the more hilarious comments made on Dagens Nyheter's website. You can always count on the crazies to come running for these things.

I agree that this is just stupid. Don't biologists collect insects with nets, right? Why would a professor in insect-catching know anything about roseroot? And don't statisticians collect people's opinions about the EU-elections for example? What does this have anything to do with roseroot? It's laughable!

It's obvious that everything that comes from nature is completely harmless for us humans since we also come from nature. But chemical substances don't come from nature and are obviously dangerous to us. There are no chemicals in nature, just natural things!

Everything can't be proven right or wrong with "science". People aren't stupid. We make our own research and whatever work we continue using.

Poe's law in action?

Blomkvist, J., Taube, A., & Larhammar, D. (2009). Perspective on Roseroot Studies
Planta Medica DOI: 10.1055/s-0029-1185720

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  1. AnonymousJune 09, 2009

    How about looking into the rampant corruption in conventional medicine. Pharma drug side effects are one of the biggest killers today.

  2. dear anonymous,
    what rampant corruption? Your comment is a fine example of old time slurs from quacks selling so called natural medicine.
    You are always attacking conventional medicine without the slightest bit of evidence, but at the same time use directly fraudulent so called scientific articles in trying to sell your own effectless treatments. The article in DN is a example of that.

  3. Sadly the paper isn't available as open access, I would have liked to read it myself. I think the commercialization of scientific publications is a real problem nowadays. Researchers should always publish open access. And yes, I know that this often means paying a lot of money for your own the publication's publication. The scientific community should work on finding a better solution here.

  4. Oh my...den första kommentaren gav mig dagens skratt:)

  5. @Florian: I'd be happy to send the article to you. I hope you still use your old e-mail adress.

  6. Hello Daniel - I'm a writer (for the journal SCIENCE, published by the American Association for the Advancement in Science) and also a businessman. For several years, I imported the products of Swedish Herbal Institute into the USA (no longer the case). I'd like to comment on your editorial.

    First off, I'll tell you that I became interested in Roseroot because I tried it myself and it had an effect, not because I had read any science one way or the other about it. It is plain and simple when you try something and it improves your life. As a scientist myself (well, perhaps a "wannabe" scientist) I value your comments about the statistics and the need for more comprehensive testing of roseroot. But can you understand that a small company like Swedish Herbal Institute does not have the resources of a company like Astra, Pfizer, etc? Also, those companies are working with compounds that they can patent -- Swedish Herbal Institute is simply marketing a natural product with no possible intellectual property. Because of this, it is very hard to invest millions into the same kind of trials you see from pharma companies.

    I think you've done an innovative Swedish company a wrong by referring to the name of the company (SHI) as "deceptive." It is indeed an institute. The owner of the business, a fine gentleman who deserves your respect, has dedicated his life to the discovery and elucidation of the medical benefits of natural products. As Mark Blumenthal says about Swedish Herbal Institute here in the USA (Blumenthal heads the USA's largest non-profit association in the field of herbs, the American Botanical Council), "they are one of the top herbal research companies in the world."

    Even though I have no current business relationship with these people (and actually my relationship did not end on a positive note) I would still tell you that there is NOTHING deceptive about the company, the people, or their mission. One simply has to try the herbal products that come from roseroot to see that they have an effect -- something far greater than the placebo effect. (I'm still taking Rhodiola rosea, although a different brand, seven years later.)

    I think its very possible that a blogger (you, me or any other writer) can hurt good people without recognizing it. This is one of those cases. Please approach this topic with an open mind and the recognition that companies like this one, who truly care for users of their products, need to be shown some degree of respect for having the guts to invest in research when the law (and common sense) says that they don't need to do this.

    Dave Jensen, author, http://www.shamvswham.com

  7. Thanks for taking the time to leave a comment Dave.

    The roseroot subject merits a brief revisit, so I'm going to make a new post about it. Until then, I would be interested in reading some of your work for the AAAS. I didn't find anything in the actual Science mag other than a small reference from 1998.

    Also, I find it quite surprising that you as a science writer can write that "one simply has to try the herbal products that come from roseroot to see that they have an effect". That's not very good science, now is it?

  8. Also, you say you're no longer associated with the Swedish Herbal Institute yet on the website of your business, which you link to on your blog, a roseroot product from SHI is offered: http://www.proactivebio.com/viewproduct.php?id_product=6

  9. Dave JensenAugust 19, 2009

    Hi Daniel, you're searching in the wrong place and seem to be looking for some kind of conspiracy . . . you'll find over ten years of my columns on the AAAS website. I'm a monthly columnist for the AAAS. As you know, I told you that I am a "wannabe" scientist -- my columns are on business and career issues. I've worked in the field of the life sciences for nearly 30 years, primarily in the biotechnology industry. I stand by what I said in my letter above, that when it comes to my personal health, if I try something and it has a positive effect, that's all I need in order to incorporate it into my life. I don't need to be a clinician in order to recognize when my body likes something and it is good for me. Besides, people have been eating roseroot for a thousand years. If it was poison, or did something harmful, we'd know about it by now, right? In your second comment you mention ProBio, which still has some Adapt in stock (we are no longer associated with SHI -- stated for the second time). That's a tablet form of the roseroot product sold in liquid in Sweden called Chi-San.

    The point of my letter wasn't to get into a usenet-style argument with you. I am simply suggesting that companies of this size who go to the expense and trouble of publishing clinical data on herbs are rare. These are good people at SHI. They are not forced to do this by regulation, they do this out of their own instincts. You can poke holes in their work if you want to, but I still say that the herbal products industry is better off because of them, and that more companies should emulate those like Swedish Herbal Institute who invest something back in research. Thanks, Dave

  10. Dave JensenAugust 19, 2009

    Daniel, I'm signing out of this discussion at this point, because it looks like you are going to use me in some forthcoming argument. I'd like to restate that my views above are separate from and not related to the Swedish Herbal Institute in any way. I am not associated with that firm, and simply felt that I wanted to right a wrong that I saw being done to good people. Take it as valuable commentary, or manure, at your option. Good luck to you and your blog, Best wishes, Dave

  11. I appreciate you sending me the link to your columns. Since you stated on your first post that you wrote for Science, I looked on the Science Mag website and the default web search did not include the career pages quite simply. No conspiracies here, just laziness at most.

    Thanks also for clearing up the situation with the remaining SHI products on your business website.

    I didn't plan on making a new post just to have an argument with you. There are some points you made that are worth answering and there are some things left to be said about the subject.

    Frankly, a big reason is also that I don't like writing anything lengthy in this comment window; it's small and won't let me copy/paste.

    I think we just have different views on the role of companies such a SHI. I really find little merit in what they have done regarding roseroot. I think it's pretty clear to anyone that they have not gone through any sort of scientifically satisfying process in generating or publishing the data, as mentioned by my original post and overviewed in the article published in Planta Medica. The poor scientific scrutiny and the strange cicumstances behind the publication of the articles that Georg Wikman of the SHI was involved in submitting should make any reasonably skeptical person realize that there were serious faults in the editorial process. Holes in the data doesn't even begin to cover it. I encourage you to read the article in Planta Medica cited in my above post if you haven't already done so.

    The fact that they have a commercial interest in the product and continue to promote is as "clinically tested" just gives anyone the more reason to be skeptical.

    In all honesty, if I were the proprietor of a business that sold any of their products, it would prompt me to remove all of their items from my stocks.

    I really don't see how the good folks of SHI, or any organization for that matter, should be exempt from critical and scientific scrutiny of their work simply because they are nice caring people who provide a service some people want. How exactly would it hurt them? It makes no sense to me. In fact, they should welcome the opportunity to defend their statements in the leading morning newspaper of the country and one of the prominent journals in their field. That is, IF they have anything to back up their claims.

    So please don't confuse the critical review of their work with some sort of personal attack. I couldn't care less about them personally. They are welcome to continue providing those that feel roseroot works for them with their product, but to do so under the false pretences that the product has a confirmed clinical effect is simply unacceptable and worthy of criticism from any angle.

  12. Sorry Daniel, I would probably have to agree with anonymous and Dave on this matter! Doctors are just pawns to the major drug companies and the particular pharmaceuticals they are selling or should I say ‘pushing’ its basically all a money game. Botanicals are the basis of pharmaceuticals, where do you think western medicine comes from genius?

  13. Nice taste in music though!

  14. As a lay person, I refuse to take any "tested and FDA approved" pharma - they legally hve to post all the terrible side effects and does that make them a better product? I take many vitamin supplements suggested by medical doctors as well as a naturapathic doctor that I also see....
    How about the "approved pharmas" that were eventually pulled off the market when evidence shows they were harmfull after all?

  15. There is solid published evidence http://www.ncbi.nlm.nih.gov/pubmed/19016404

    1. One study does not make solid published evidence. If this is the best there is then the evidence is very poor indeed.

      This study was described in the review article that this post is about. I recommend that you read it. This is the direct quote:

      "As far as we can tell, this study appears to be the only one among those that we have investigated that has used a satisfactory experimental protocol and appropriate statistical methods. However, we question the authors' description of the trial as a phase III trial. It would seem more appropriate to call it a phase II b trial considering the small sample size and multiple endpoints. Also, as in Fintelman and Gruenwald [7], the authors have uncritically cited references 2, 3, 9 and 11 as describing effects of Rhodiola rosea."


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