Medicandus

Medicandus

A very integrative Christmas post..

Before I begin this post in earnest, I’d like to thank regular readers and commenters for their efforts this year in Medicandus. Although posts have become a little thin in the last couple of months due to the debilitating effects of a seasonal bout of overcommitment, I have a lot of interesting discussions planned for next year. I wish all regular readers well in the New Year and I hope you all are able to celebrate whatever you see fit in a spirit of fellowship, contentment and goodwill.

Since ‘integrative medicine’ is supposed to be about combining things, it seemed like a good idea to examine in detail the health claims of the symbols of our festive season. So here we go…

Gold, frankincense and myrrh

Gold is of course a well recognised treatment for rheumatoid arthritis. As a student I can vividly recall giving gold injections to patients during a general practice rotation. Sadly in a way, it has been superseded by a new generation of remarkably effective antirheumatic drugs. There was something positively alchemical about recommending injections of prescription strength gold as a treatment for patients. It was however fairly toxic to the kidneys and caused a lot of rashes. It was also only quite modestly effective.

Frankincense and myrrh are the subject of quite a number of health claims. They show promise as a potential source of cancer treatment, though how you could apply the resins directly to tumour cells without toxicity presents somewhat of a challenge, to put it mildly. I was fascinated to see this paper describing synergism in bacterial killing potency between oils of frankincense and myrrh. Perhaps the Magi were bringing baby Jesus some treatment for his pinkeye.

Holly

Holly has been associated with Yuletide observances since well before the Christian era, most likely because of its evergreen symbolism of hope and eternal life. Some species of holly contain theobromine, which is the main caffeine-like molecule that gives chocolate its superb addictiveness. Some Asian species of holly are used to make super-strength caffeinated herbal teas which are not surprisingly used by the locals as a pick-me-up and general tonic. The Chrismassy type of holly (Ilex Aquifolium) isn’t particularly medically promising, apart from hilariously inane treatments like Bach flower remedies for jealousy!. Interestingly, the Canadian Medical Association Journal warns that putting holly on the Christmas pud has been associated with cases of holly toxicity. Given that holly toxicity presents with gastrointestinal distress, one wonders how many cases of holly poisoning might get put down to excess alcohol or other overindulgences.

Mistletoe

Mistletoe is a very interesting example of the importance of doing proper research. it has been known for a long time that extracts of mistletoe can have anti-tumour properties in test tubes, similar to frankincense and myrrh. It certainly has pharmacologically active constituents. However, before we go around putting everybody on homeopathic mistletoe, we should examinethis really well-conducted study. To summarize, it’s a stringently conducted, ethically run study in real cancer patients at a major oncology centre. One reason why it’s ethical is that the study is comparing the outcomes between those who get the standard chemotherapy agent (gemcitabine in this case) and those who get the gemcitabine plus mistletoe. Predicted toxicity of the mistletoe was carefully monitored, as was potential interaction between the drug and the herbal extract. In other words, it was a study run by professionals who knew how to produce a convincing study. The scene was well set to allow a potential effect to be clearly seen. The outcomes result was resoundingly negative, ie the mistletoe had no effect in addition to the gemcitabine. All of the patients on mistletoe developed antibodies to it, which may be a very important reason why this drug that looked good in a test tube had no effect in the real world.

Reindeer

Although they may sound like fun, it seems that looking after reindeer is a big health risk that Santa’s elves may have to deal with. If they are anything like the Sami population who herd reindeer in northern Scandinavia, they may have severe mental health problems, especially with anxiety and depression. On the upside, they seem to have a lower cardiovascular risk compared to the rest of the Swedish population.

Hanging around reindeer may not be such a great gig, as the risk of getting a parasitic infection seems quite high. The magnificently named Odd Halvorsen has written an epic paper on how Rudolph may have gotten his red nose from any number of parasitic infections that affect arctic reindeer.

Turkey

The Christmas turkey is a classic roast meat, but a potential health hazard on any number of fronts. Once you have stitched the stuffing inside it using skin staples preferably, be sure to properly thaw it and then cook it through, as food poisoning from salmonella, listeria, golden staph and a spectacularly revolting customer called clostridium perfringens are all relatively common if you don’t pay enough attention to cooking and plating up.

Oh, and don’t fall for the one about the tryptophan in turkey making you sleepy. Cheese and pork both contain way more tryptophan per gram than turkey, yet somehow the ham and cheddar sanger never gets any blame for causing sleepy schoolkids in the first lesson after lunch. A couple of hundred grams of turkey on an empty stomach would just about get you to 500mg of tryptophan. Most users of tryptophan supplements take 2-5g a day.

Some breathless overenthusiasts have gone as far as calling turkey a ‘superfood’ along with other commonplaces as tomatoes and yoghurt. It is a reasonably lean source of protein, but it really has no other special properties apart from tasting awesome in a sandwich while watching the Boxing Day test.

So once again thankyou all for your support of The Conversation and have a truly excellent festive season however you observe it. See you all next year!