Here in Sweden where I live we try to avoid antibiotics. Of course we use it when it’s needed but not directly when we get a infection. Firstly because it promotes antibiotic resistance which is a growing world problem. Some bacteria has got so resitant so that antibiotics doesn’t work on them anymore. Secondly because it can wipe out also good bacteria which can be bad for the health.
Curious question, what’s your take on this when it comes to rapamycin? Do you take antibiotics directly when you think you have an bacterial infection?
Any purported “natural antibacterial” is generally a bad idea. It’s a common naturalistic fallacy - for one, many antibiotics we use are literally from nature - extracted from natural bacteria warfare.
One of the most common purported “natural” options being coconut oil. If it actually works, you’re not targeting the right bacteria and risk screwing over your “healthy” gut flora. If it doesn’t work, you’re blowing money and you may even potentially cause harm, since it may disrupt the gut barrier permeability if you ingest lots of it - which if it does - could mess up drug bioavailability. I’m not going to debunk every single thing I’ve heard as it takes 10x effort to debunk BS, so I’ll leave it at that. This doesn’t mean I’d never consider a “natural” intervention either - I’ve used synbiotics and sometimes recommended kefir (or an alternative if they can’t afford it/allergic) before to patients with antibiotics when clearly indicated for them - it’s just that even with access to some of the best researchers in microbiology - I guarantee you gut bacteria claims are often way overhyped.
The main reason one would prescribe “empiric antibiotics” these days is when there’s some idea of the likely pathogens, the source is fairly clear, or it’s clearly serious (ie sepsis). It’s not just antibiotic resistance, there are potential side effects - some of which are serious depending on the antibiotic. If we’re not clear what the bug is - cultures could be done and empiric antibiotics are either switched or discontinued depending on the preliminary or conclusive results (usually within 48-72 hours) and assessment.
Doing antibiotics on your own is not usually recommended and is a contributor to antibiotic resistance as patients either use old antibiotics or antibiotics prescribed to someone else like doxycycline and that can have side effects if they got expired doxy or didn’t even read the FDA label and took metallic ions which reduce absorption. Even with something as simple and common as moderate acne that doesn’t respond, I’d be very careful with patients to consider starting a subantibacterial dose to avoid drug resistance to doxycycline.
The most common errors without supervision is the dose, length of antibiotics (many people don’t finish the whole antibiotic regimen when they “feel better”) or route of administration is incorrect or not familiar with the bug (or possible bug) and susceptibilities, leading to not only resistance but ineffective care and sometimes late attention to sepsis and death. Another big issue is C diff. Not a great experience.
The second main issue that is generally notable is many people don’t realise synbiotics/probiotics may be recommended in many antibiotic regimens. But they won’t know when it moves the needle or not.
I’ve done infectious disease research before in a BSL-4 lab with an NIH/NIAID grant and rotated with infectious disease physicians several times. I still don’t feel entirely confident about getting all the antibiotic regimens right in many cases such that a ID consult is warranted, and that’s despite having a “cheat sheet” compiled in the institutional handbook for empiric antibiotics in most common diseases. The “best” antibiotic regimen differs depending on the locale.
So whatever is recommended by anyone doesn’t necessarily translate at all and you shouldn’t rely on anything you read on the internet to necessarily apply in your case.
“Of course, the fact that a product inhibits bacteria in a laboratory culture doesn’t mean it is effective (or safe) in the human body. In fact, products that kill bacteria in the laboratory would be more likely to cause argyria because they contain more silver ions that are free to deposit in the user’s skin.”
If you read enough about a variety of many different definitively proven quacks from many different sources without regard to the perceived “school of thought”, both historically and more modern, including quacks who are MDs/“allopathic” - there is a tendency to make a claim along the lines of a magical “cure-all” that “(allopathic) doctors don’t know/don’t want you to know about”. Yet “somehow” clinical trials proving this are absent or severely limited and unreliable (ie predatory journal). Even the preclinical evidence is in a similar fashion and/or doesn’t make sense.
Meanwhile, there are plenty of “mainstream” research scientists that look into anything that might have a signal of efficacy - even psilocybin, MDMA, or ketamine. It’s not a lack of open-mindedness. Heck, I used psilocybin in a clinical trial for generalized anxiety disorder (current NNT is ~2) several years ago, then later used it with psychiatrist (previous professor who understands the literature and trial evidence very well) being alright with it. It now has a very high likelihood of being FDA approved by late 2023-2024 as a designated “FDA Breakthrough Therapy”. I have no qualms about offlabel medications or even suggesting clinical trial participation when quality information is used to make a clinical decision, preferably with more quality brains in the room with different perspectives that are willing to go through the strongest arguments of both sides.
Big Pharma isn’t necessarily that trustworthy, but “Big Alternative Medicine” is almost always less reliable or trustworthy on average, at soon to be half a trillion dollar market cap with far better return on investment than “Big Pharma”. Even “Big Pharma” companies may invest or sell “alternative medicine” - they are essentially amoral. There is actually an even bigger profit margin and CAGR to be had without having to prove the proposed intervention. They will exploit “naturalistic fallacy” and every kind of human cognitive bias to make profits.
There are some possibly rational use in limited circumstances but one should be meticulous about the rationale and evidence - as with any proposed intervention from any source. Is it biologically plausible? Is the case for causality strong? Is the potential benefit vs risk vs costs tradeoff meaningful?
You’re entitled to your opinion. I’d suggest you consider the position that is being maintained without regard to perceived “school of thought” and what is actually factually incorrect, rather than your personal perception of the source.
There are non-pharmaceutical compounds with significant antibiotic action in vivo. For example, a combination of monolaurin and oil of oregano was more effective than vancomycin in mice with staph infections. Link. (Vancomycin is often called the antibiotic of last resort). You have to wonder if lives and fingers and such could have been saved if trials had been done in humans with resistant staph. I guess we’ll never know because such a trial is unlikely to happen with non-patentable compounds.
This makes no sense to try against MRSA until it goes through human trials. We literally have no idea if and how oregano oil works and we have no information to estimate what an appropriate dose might be, if it even works.
Trading a potential small 10% gain on a tiny underpowered trial in rats on a questionable journal may also cause large potential harm. For example, we do know oregano oil may induce abortions in mice (at least vancomycin has been used in pregnant women in 2nd or 3rd trimester with no known cases of nephrotoxicity or hearing loss) and the McCormick Science Institute (the spice company) wants you to believe in oregano oil despite the lack of evidence: http://cfprod.mccormick.com/msi2prod/assets/Singeltary%20Nutr%20Today%2045,129,2010.pdf
Vancomycin is generic and we already have tested it thoroughly in humans. No one should gamble their life on something not even tested in humans with significantly powered placebo-controlled randomized trials when there is already an option which is still valid when considering benefits vs risks. Seems like Steve Jobs went that route and you can see what happened to him.
It’s not illegal to make general (even though most are unsupported) health claims on supplements. But it’s illegal to make unsupported claims about the prevention, diagnosis, or treatment of disease by a manufacturer as health fraud. And it is very much inappropriate when it comes to something as deadly as MRSA sepsis.
This is a very common illegal occurrence with things that have the support of large for-profit companies like McCormick that try to influence the general public but are unwilling to go prove it. If there was enough compelling data on oregano oil or monolaurin, just isolate the chemical and mechanism then patent a derivative of that chemical with an actual plausible mechanism - then try it on MRSA in humans. If it really had such great odds in humans, then why aren’t researchers testing it?
Anyone can look at the long list of health fraud claims for monolaurin or oregano oil:
Even if you’re not a big fan of the FDA (which I find to be a reasonable case in some instances), it’s clear that you can compare those illegal violations independently and prove these were clearly inappropriate claims that could prove deadly when used for MRSA sepsis when these claims are given carelessly and/or illegally to maximize profits.
I provided an example of published empirical evidence of a couple non-pharmaceutical compounds having antibiotic efficacy in vivo. If it was tested in human trials, it would be cases like finger infections with MRSA that didn’t respond to vancomycin and other prescription antibiotics. And it would be more likely to happen in a country like India, not the US. Personally, if I was told my finger might have to be amputated because nothing was working for MRSA, I would be looking in journals for an alternative like this to try before they chopped my finger off.
For that matter, despite all the smug dismissal of natural medicine for Covid, hospital trials in India have had positive results using things like Turmeric in multiple published trials. One combo has made it to Phase III trials.
Nobody in “mainstream” medicine cares if it’s from a natural source or not, despite any imagined smug dismissal.
Psilocybin is from a natural source and it’s gotten the “FDA Breakthrough Therapy” designation. Scientists are plenty open-minded. The only thing that matters is if it has a good shot of working based on benefits vs risks, not whether it is “natural” or not.
Even Tu Youyou got a Nobel Prize for the “natural” malaria treatment “artemisinin” which was used in traditional folk medicine. She was not “mainstream” and doesn’t have any formal MD or PhD education or training. It is used for malaria in “mainstream” medicine. There is an imagined division of “mainstream” and “alternative” medicine, usually based on for-profit companies and ideologies trying to sell you something that most of the time doesn’t make sense potential benefit vs potential risk wise. The word “natural” is often abused.
I literally don’t subscribe to any specific ideology or “school of thought”. The only point of a MD is to be able to actually have broad access to broad clinical experience, far better research opportunities, and prescription ability. I don’t necessarily follow the “standard of care” that “mainstream medicine” generally recommends, if there is compelling evidence.
I don’t think “allopathic medicine” (originally used to distinguish between homeopathy - which has basic tenets that literally violate the laws of Physics) or more accurately “mainstream medicine” has “all the answers” and it’s likely “precision medicine” will soon have a good amount and once it’s proven - it will likely end up being part of “mainstream”. All I care about is whether something is even plausible and whether it would work, based on science.
It’s easy to make a claim without sufficient evidence. Your own citations point that out if you actually read it thoroughly. Curcumin is poorly absorbed and usually Bioperine is added - not as low cost as they are claiming and it can easily mess up other meds. Ayurvedics can have provably toxic high levels of heavy metals either intentionally or unintentionally due to the cost of quality assurance. That’s enough for me to not take their “low cost” claim seriously as I have looked into the actual cost if you want the best quality with frequent enough independent and reputable third-party testing.
Even though in the original form, Ayurveda initially stated it exists for “health promotion” rather than the treatment of specific diseases - I have no qualms about any “natural” Ayurvedic components being tested in trials or the highest quality curcumin supplements being used in very specific conditions as an adjunct if everything - including drug interactions - are carefully considered. The problem is not many people actually do this. I’ve seen it happen literally and there are plenty of case reports showing heavy metal toxicity or proven Ayurvedic herbs with heavy metals like mercury above the limits.
If you look carefully, even though the claim of the manufacturer is there are no heavy metals, the manufacturer of this supplement used in the trial already made an illegal claim for disease prevention in their marketing materials, despite trying to slightly hedge against it. The trial investigators were obviously sponsoring the trial with some overstatements of non clinically significant results. Hard to trust a supplement manufacturer that is intentionally making illegal claims for COVID profit, rather than just sticking to legal health claims.
