Category Archives: Oprah

Goodbye, Dr Oprah – and Good Riddance.

I wrote once that not only is Oprah Winfrey not a doctor, she plays a really bad one on TV. From promoting Jenny McCarthy and the anti-vaccine movement, to allowing Suzanne Somers a bully-pulpit for her medical woo, to pushing Prudence Hall and her high-dose hormone treatments without acknowledging their potential risks, to leading the church of the Secret as a way to avoid facing the harsh realities of cancer, Oprah did more harm than good when it comes to health.

And while the publishing industry may be hanging crepe, the medical community is breathing a sigh of relief that Oprah has left the airwaves, at least for now. After all, we “conventional” docs were repeatedly relegated to a seat in the audience by Oprah, who usually presented us as naysayers and officials in the Church of Medicine to Oprah’s self-appointed Galileos of Woo, rather than the health experts we are. Of course, it was all couched in terms of female empowerment, a tactic that Oprah long ago taught marketers can be used to sell anything and everything to women.

My axe to grind against Oprah is not just professional, it’s personal. For I saw my sister, nearing the end her life, turn to the Secret, believing that if she just believed enough in herself, she would be cured. Rather than strengthen her, the Secret drained her, turning her away from the supports around her towards an ever elusive goal that never allowed her the possibility of acceptance and preparation for her departure.

I have to admit that I was surprised when my good friend Linda wrote her own Ode to Oprah Winfrey, in which she thanked the Queen of daytime talk for 25 years of wisdom, excusing Oprah’s medical gaffes as nothing more than misplaced good intentions. Well-intentioned though Oprah may have been at some point, I believe she long ago lost the connection between good intentions and their results.  In this regard, one particular lesson Linda learned from Oprah can be applied to Oprah herself, and it is this –

When people show you who they are, believe them.

Well, as far as this doctor is concerned, Oprah long ago showed me who she was, and that is nothing more than the biggest marketing Alpha Girl the media ever created, a woman who refused to use her intelligence to look beyond the marketing messages of her so called medical experts to even try to understand the science behind the issues she was promoting, and who never once considered the potential negative impact of those marketing messages on the health of her viewers. My disappointment in her has been profund, for I really did like her immensely.

Of course, we all know that Oprah isn’t really gone. With the creation of her own network, she will, like the hydra, create ever more marketing opportunities for anyone with a product to sell, relegating to her cadre of producers the authority granted her by her worshipping public.

Happily, so far, when it comes to medical topics, OWN has done pretty well. They purchased the Discovery Channel’s documentary series “Deliver  Me“, about three Ob-Gyn docs in urban LA. And Laura Berman’s episode on herpes was spot on, with weblinks to ASHASTD.org, a great resource for health info on herpes and other STD’s. Hmm…maybe OWN’s producers haven’t drunk as much of the Oprah Woo-Aid as I think they may have.

Then again, Dr Oz is still out there…

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More on Oprah and her Medical Woo from around the Web – feel free to add links in the comments section.

Farm and Cattle Woo

Google is an amazing thing – it occasionally tosses you a link that lands you in an alternate universe of folks you’d never encounter in real life.

Like cattle ranchers.

I’ve just spent the good part of an hour wandering their world – reading about their concerns (water, wolves, the economy), seeing how cattle breeding has changed (You pick a sire at Bullsemen.com, then do genomic profiling on your stock – did you know that cows bred for docility have more tender meat ?) and learning that ranchers are not immune to marketing from the world of scientific Woo.

Check this out – it’s called SOP Life Vibration or “Serio Bio-Hygienization”. They’re selling it to farmers and ranchers in Europe and the US as the latest and greatest answer to bacterial growth and odors in farm feed and bedding.

SOP Bio-HygienizationSOP products are formulated with the innovative Sirio Operating Process technology to improve the environment of the farm in a more effective and longer lasting way than current available means.

SOP® products are natural and scientifically tested. They are not enzymes, bacteria nor disinfectants. Using a process of “frequential bio-conditioning” they selectively favor the activity of the “beneficial” micro-organisms and create unfavorable conditions to inhibit the development of the “pathogenic” ones.

A 100% natural product. Through a bio-frequency method, SOP® is created with strategic wavelength and harmony. This same technology is comparable to the electronic systems used for radio broadcasting.

“100% natural” “Bio-hygeinization”  “Frequential bio-conditioning”

I smell a Woo. And that makes me nervous.

After all, I’m a meat eater.  If someone’s putting something wacky into and around my food source, I want to know about it. So I decided it was worth my while to find out what the heck was in this SOP® stuff .

What’s in SOP’s products?

Just try to find that out.

I read this huge SOP brochure targeting organic farmers in the UK – nada. Googled every possible permutation of the name SOP – nothing but Woo. Poured over a batch of scientific papers from some university in Italy – nothing but brand name without product description.

Even the farmers using the stuff have no idea what they are sprinkling around their cattle stalls.

Okay, so now I was really nervous…

And then I stumbled across this little tidbit that someone from the SOP marketing branch accidentally let slip through –

SOP® products are made with calcium sulphate as a carrier agent which has undergone the SIRIO OPERATING PROCESS treatment. This technology is capable of transferring specific bio-frequencies from the carrier to the environment, starting up, in this way, the process of bio-hygienization. The correct and constant distribution of a very small quantity of SOP® gives great results which are fully evident within only 5 months from the beginning of treatment.

Calcium sulphate. Bingo.

It’s also known as Gypsum. And it’s been safely used for generations on farms as fertilizer and as a drying agent. You mix gypsum with straw bedding, and the straw stays drier. So it grows less bacteria and fungi. And smells better. Gypsum is also an organically-approved fertilizer.

So, of course SOP products work. They’re nothing but Gypsum. And since calcium sulphate comes from rocks, they can legitimately call the stuff natural. (Unless they’re recycling it from used drywall, in which case they should tell us that.) Heck, I’ll even grant that they might have worked out the ideal amounts and concentrations of calcium sulphate to be used for optimal results.

So why all the smoke and mirrors? I can only guess – money.

You can pick up agricultural grade gypsum for 5-8 bucks per 100 lbs. Something tells me the SOP folks are charging more than that – but I can’t prove it, since they don’t post prices anywhere.

Bottom Line

SOP® products appears to be nothing more than re-packaged calcium sulphate, a chemical safely used for years on ranches and farms to control moisture and optimize soil composition. Assuming that’s the only chemical in this product, no harm is being done, except perhaps to rancher’s wallets.

And while I don’t have the time to find our about the rest of the SOPGroup’s products (I’ve wasted enough time on this post so far), I suspect their entire operation is just a smoke screen for a farm chemical company that figured out a new way to sell the same old stuff at a higher price.

And that alternate universe of cattle ranchers?

Turns out it’s not much different than mine.

We’ve got Medical Woo, they’ve got Farm Woo. Both use similar tactics – fancy marketing, smoke and mirrors and patented trademarks for ridiculous unexplainable technology – to grab our dollars.

In the end, we’ve all got to be skeptical about what’s being marketed to us and demand transparency from those selling us products that ultimately may end up in our bodies – either directly or through the food chain.

Oprah – I’m not a doctor, but I play a really bad one on TV

In their Newsweek Cover story whose link is entitled “Why Oprah’s Health Advice Can make You Sick“, writers Pat Wingert and Weston Kovsova have finally broken the cone of mainstream media silence that surrounds Oprah, letting everyone else in on the dirty little secret that we doctors have known for some time now – Oprah is practicing bad medicine without a licence.

Because the truth is, some of what Oprah promotes isn’t good, and a lot of the advice her guests dispense on the show is just bad. The Suzanne Somers episode wasn’t an oddball occurrence. This kind of thing happens again and again on Oprah….She has the power to summon the most learned authorities on any subject; who would refuse her? Instead, all too often Oprah winds up putting herself and her trusting audience in the hands of celebrity authors and pop-science artists pitching wonder cures and miracle treatments that are questionable or flat-out wrong, and sometimes dangerous.

Oprah’s embrace of the Woo-Woo factor in health hasn’t served either herself or her viewers. By giving her stage over to wackos like hormone-crazy Suzanne Somers and anti-vaccine nut Jenny McCarthy, while treating legitimate medical authorities as nothing more than naysayers, Oprah has behaved irresponsibly and abused the huge power that the American TV viewing public has bestowed upon her as the Queen of the daytime talk show.

Oprah’s Response

Oprah’s response to the Newsweek article is self-serving and disingenuous. She hides behind what she calls the ‘intelligence” of her viewers to sift through the crap she presents them to find what’s right for them.

For 23 years, my show has presented thousands of topics that reflect the human experience, including doctors’ medical advice and personal health stories that have prompted conversations between our audience members and their health care providers. I trust the viewers, and I know that they are smart and discerning enough to seek out medical opinions to determine what may be best for them.

I believe my viewers understand the medical information presented on the show is just that—information—not an endorsement or prescription.

Not an endorsement or prescription, Oprah? Like the woman you took to your doctor for a “hormone makeover” after touting the miracles you experienced from those same hormones? That non-endorsement?

Drs Northrup and Oz – Not just innocent bystanders

Wingert and Kosova also take on Christian Northrup, Oprah’s menopause Guru, for her new age medical opinions that are just plan bad advice. Northrup recommends iodine supplementation, unnecessary in almost anyone, and soy, which actually interferes with thyoid hormone absorption. Worse still are her theories about the causes of thyroid disease.

As she explains in her book, “in many women, thyroid dysfunction develops because of an energy blockage in the throat region, the result of a lifetime of ‘swallowing’ words one is aching to say.

When it comes to menopause, Northrup is on safer ground, in my opinion. Her book is by and large medically correct in terms of menopausal treatments, and thankfully, she does not package HRT as anything other than what it is – a pharmacologic treatment with risks as well as benefits. But any little credibility Northrup has is squandered by her failure to challenge Suzanne Somers’ outlandish claims about HRT, and her willingness to appear side-by-side with Somers in forums such as the Oprah show, giving tacit approval to the wholesale marketing of bioidentical hormones as the fountain of youth.

Like Northrup, Dr Oz sat by unquestioning while Suzanne Somers and Dr Hall have spouted incorrect medical information.

One could argue that Oprah is the victim of bad advice from these two doctors, whose need for her endorsement has led to their unwillingness to challenge her in public. But I disagree. What would happen if Dr Northrup Or Oz were to actually argue with Suzanne Somers on Oprah’s show? I’ll tell you what – they’d get relegated to a seat in the audience along with the rest of the good doctors who dare to speak the truth to the emperor. Oprah would find some other quack to sit next to Suzanne Somers while she spews her fallacies. Don’t kid yourself. This is, after all, the woman who gave the entire CDC a whopping 30 second written statment in response to Jenny McCarthy’s anti-vaccine nonsense.

No, Oprah is no victim here – she is utterly in control.

Should Dr Oprah be Sued for Malpractice?

I think it’s time Dr Oprah deals with what every other doctor in America has to deal with – a malpractice case. In fact, I’m shocked that someone hasn’t sued her by now for an adverse outcome related to a treatment she has touted (or in the case of vaccines, advised them to avoid). Here’s one suit she may have narrowly avoided –

In March 2007, the month after the first two shows on The Secret, Oprah invited a woman named Kim Tinkham on the program. She had been diagnosed with breast cancer, and her doctors were urging surgery and chemotherapy. But Tinkham wrote Oprah to say that she had decided to forgo this treatment and instead use The Secret to cure herself. On the show, Oprah seemed genuinely alarmed that Tinkham had taken her endorsement of The Secret so seriously. “When my staff brought this letter to me, I wanted to talk to her,” Oprah told the audience. “I said, get her in here, OK?” On air, Oprah urged the woman to listen to her doctors. “I don’t think that you should ignore all of the advantages of medical science and try to, through your own mind now because you saw a Secret tape, heal yourself,” she said. A few weeks earlier, Oprah could not say enough in praise of The Secret as the guiding philosophy of her life. Now she said that people had somehow gotten the wrong idea. “I think that part of the mistake in translation of The Secret is that it’s used to now answer every question in the world. It is not the answer to all questions,” she instructed. “I just wanted to say it’s a tool. It is not the answer to everything.”

While Oprah did the right thing and brought that woman onto her show to tell her to get to a conventional doctor, are there women who missed the follow up recant? How about those women out there taking hormones without being advised of their risks, or failing to vaccinate a child who subsequently becomes ill from a vaccine-preventable disease?

Maybe some clever lawyer will see dollar signs in Newsweek’s cover and get a class action suit going on behalf of Oprah’s viewers whose trust she has betrayed. After all, those are some deep pockets there at Harpo Productions.

I wouldn’t hold my breath.
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Previous posts about Oprah on this blog

The medical blogsosphere take on Oprah

Seven Things To Know About Hormones – My Take

The Wall Street Journal gives a nice response to Oprah’s recent HRT hype with an article entitled “Seven Things You Should Know about Hormones. This, of course, is not to be confused with George Carlin’s Seven Words You Can’t Say on TV, which is really funny but won’t help you decide whether or not to take estrogen…

Here’s my take on the seven things –

1. ‘Bio-identical’ hormones are available in FDA-approved forms
I agree. The stuff Suzanne Somers and Oprah are getting compounded is exactly the same chemical ( probably purchased from the same supplier) as Big Pharma uses to make their estradiol patches and creams and progesterone pills.

2. Hormones from compounding pharmacies aren’t safer than conventional HRT.
I completely agree. Any compounding pharmacist or doctor who sells HRT without warning patients about the risks should be put out of business. We don’t stand for this behavior from Big Pharma, and we shouldn’t accept it from these folks. They are couching their sales pitch around women’s wellness and selling women a purported fountain of youth, while trashing Wyeth for doing the same thing with Prempro. FDA – Get on it. And if you don’t have the authority, Congress needs to give it to you. Women’s Rights Groups should be all over this one, but they are unfortunately being duped by these shysters into thinking they are all on the same side.

3. Don’t trust saliva tests.
Ditto. Most of the folks doing saliva testing make money on the testing. Be wary of any doc who has a financial interest in what test he/she orders. Or what vitamins you take.

4. There’s a critical window of time for starting HRT.
Not so fast. It’s a hopeful hypothesis, but it’s just not proven yet. A lot of the docs pushing the hypothesis are also consultants and speakers for pharmaceutical companies who sell HRT. In my heart of hearts I think and hope that they are right, but I’m not willing to tell a patient to count on it. We need studies to prove it.

5. The increased risk of breast cancer appears related to progesterone rather than estrogen.
The key words here are “appears to be”. It’s not written in stone yet, so don’t count on it. And don’t go taking estrogen without progesterone if you still have your uterus – that’s a recipe for uterine cancer. I’m not about to trade one risk for another with my patients.

6. Estrogen applied to the skin, in patch, cream or gel form, may have a lower risk of blood clots and strokes than in pill form.
Agree. This is the one piece of new data that makes the most sense to me and that I am willing to put out there. I prescribe transdermal estrogen preferentially over oral whenever I can. We know clot risk is related to dose and there are well-done studies showing the lesser impact of transdermals on serum clotting factors. There’s no reason to think this won’t translate this to lower incidence of blood clots. Stroke incidence is a little more tricky, since strokes are multifactoral, but if clotting times are closer to normal, that’s one less factor to worry about.

7. Stay tuned.
This, of course, is the hardest part about HRT. It’s not like your menopause is going to wait for the next big randomized, placebo controlled trial. You have to make a decision with imperfect information and uncertainty. And that’s difficult for some women to understand and accept.

Easier to do what Oprah and Suzanne have done and latch onto the compounding pharmacy crowd, who sell certainty and security along with their drugs. But it’s a false security and very dangerous. I find it so sad that these two intelligent women are letting themselves be taken in this way. And even sadder that they are bringing other women along with them into their fantasy of hormonal certainty.

If you’re interested
Here are TBTAM’s Ten Rules for Prescribing HRT.

Now if you’ll excuse me, I have to get back to You Tube…

Oprah’s Talking Hormones

I should have expected it. Today, while counseling a patient about hormone replacement, I heard those three little words that I predict will haunt me from this day forward – “But Oprah says..”

Yes folks, Oprah’s in menopause.

“You feel flat and you feel tired, you haven’t had a good night’s sleep in two years [and you’re] just going through the motions, trying to get through the day,” Oprah says. “You feel like your life force is being sucked out of you.”

Now Oprah’s taking hormone replacement, which of course means that America’s women are heading back on the HRT roller-coaster, wondering if they should be forgetting everything they heard in 2002 and doing the same thing as Oprah.To get the conversation going, Oprah’s doing a two-part series on her TV show and running special issue on the topic in her magazine next month. (Thanks, Linda, for the heads up.) I figured I’d better head over to Oprah’s web site and see what ‘s going on.

So what exactly is Oprah saying?

To her credit, Oprah seems to be trying to frame the HRT issue as a debate – “Should you replace your hormones?” she asks. A reasonable question, I’d say.

Her magazine features a well-written article that frames the issues nicely and is medically up to date and fairly well-balanced. Everything you need to know is in there, albeit with a little too much paragraph space given to the theories that support HRT use and not enough to the facts that recommend against it. Still, it’s a good start.

But Oprah’s blowing it with her show.

She gets points for working with Christiane Northrup, the author of the book The Wisdom of Menopause, and the leading medical guru to the public on HRT. While Northrup’s book is a bit too long and a bit woo-woo for most of my patients, it is medically correct, and I really liked her Public TV Special last year.

Oprah also featured a short segment with Dr Wolf Utian from the North American Menopause Society, who faced off against Suzanne Somers on Larry King last year. Utian warned about the risks of HRT – and both he and Northrup recommended that women work in close partnership with their doctor in managing their menopause.
Unfortunately, Northrup’s measured wisdom and Utian’s warnings were no match in grabbing the audience’s attention compared to the anectodal testimonies of Robin McGraw and others about bioidentical hormones.It’s the “HRT changed my life and you should take it too” school of menopause management by girlfriend.
HRT is touted as the cure for everything from weight gain to depression, and as long as its bioidentical, there are no risks. These folks have free rein to spout whatever theories and beliefs they have, unchallenged by Oprah, Northrup or Oprah’s own medical guru, Dr Oz.

Dr Oz dropped the ball

To my disappointment, Dr Oz failed to question the unsubstantiated statements made by Dr Prudence Hall, a practitioner he interviews who prescribes ridiculously high doses of estrogen and progesterone to her patient without once mentioning their potential risks.

This is not informed choice – it’s pure salesmanship, and both the patient and Oz fall for it hook, line and sinker. Oz even puts Hall’s crazy regimen up on the screen as if it were gospel – 2 mg of estradiol and 150 mg of progesterone twice a day – 8 times the starting doses I use in my practice, and much more than most women need even at the start of treatment.

DR OZ – Who should take hormone replacement?
DR HALL – Anyone who has a low hormone should have that hormone replaced.

Huh????? I though we got away from this craziness with the WHI.

Oprah, I’m disappointed.

You had such good intentions, but you’re giving way to the hype, and taking your viewers along with you. Like poor Michelle, who you promise to take to Dr Hall for her “Oprah Hormone Makover”-

OPRAH:…It’s ultimately up to you to make the choice for what’s right for your body. We just want women to start to feel better and to be in charge of your own health. Because you don’t have to feel this bad. Look at Michelle. Michelle, there is hope for you.

MICHELLE: I’m going to get myself some of these hormones.

OPRAH: Yeah. Yeah.

MICHELLE: Sign me up!

This is not letting Michelle make her own decisions, Oprah. This is pulling her into your club. HRT is not a makover that you offer your viewers for free. It’s a medical treatment, with risks and benefits about which every woman deserves to be properly informed. Your show, unfortunately, is not informing. It’s hyping.

Things are no doubt going to get even worse when Oprah gives the stage over to Suzanne Sommers later this week for part 2 of her HRT series. (Northrup will be airing a Webcast Thursday evening that will be worth listening to, but I don’t think is going to be on the show again.).

Disclaimer

I take HRT, and I prescribe it to my patients who want to use it for treatment of menopausal symptoms. Every one of my patients who takes HRT is informed of the potential risks, and their decision to use it or not is made in light of their own risk factors, symptoms and concerns.

In the end, most of my menopausal patients don’t need HRT or don’t want the risks, and we either find them non-hormonal alternatives or they find other ways to handle their symptoms. It’s called informed choice.

I prescribe FDA-approved regimens, mostly bioidentical but not always, and sometimes custom-made formulations for women who can’t find the right regimen among the approved products. I recommend the lowest dose for the shortest time, and prefer transdermal estrogen over oral forms if possible.

I also offer alternatives to HRT, including SSRI’s and neurontin for hot flashes, low dose vaginal estrogen for dryness (along with over the counter non-hormonal remedies for the same), and encourage all my patients to eat well, exercise, avoid dietary and stress triggers for hot flashes and take care of themselves.

If you want to learn about HRT

Check out the readings listed at the bottom of this post. Or my series on HRT. Or talk to your doctor.

And remember, just because Oprah’s doing it, does not mean it’s right for you. Use her show to start the conversation, but take the responsibility to inform yourself and do what’s best for your menopause.
Not Oprah’s.
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Menopause Reading list
-The Menopause Guidebook by North American Menopause Society – The Cliff Notes of menopause management. Everything you need to know without the hype.
–Is It Hot in Here, or Is It Me? by Barbara Kantrowitz and Pat Wigert Kelly – The What to Expect while you’re in Menopause book. Q&A format, easy to read in short segments.
–The Wisdom of Menopause by Christiane Northrup. The Torah of Menopause – Everything’s there, along with the book of Job. Read it and believe.
–Our Bodies, Ourselves for the New Century. If you liked the original, you’ll love this version.
–Medicine Net answers FAQ’s about bio-identical HRT and Oprah.
–TBTAM on HRT – my four part series. Everything I needed to say.