Q: I was reading a story in the newspaper that the British Medical Journal has accused Roche Pharmaceuticals of failing to provide full access to the research data on Tamiflu. The article said that there's really no evidence that Tamiflu can actually stop the flu. Do you agree? Do you recommend that people still take it if they have the flu?
A: Even if the anti-viral treatment for flu works as stated, it only reduces the duration of flu symptoms in adults (ages 18-65) by an average of 1.3 days; by just one day in folks older than the age of 65; and by roughly 36 hours in children. So the benefit of a five-day course of Tamiflu is modest at best.
For some time, investigators have been concerned about Tamiflu for two reasons: 1) Tamiflu's manufacturer, Roche, claims that there are 10 studies that show Tamiflu's effectiveness. However, only two studies showing its superiority over placebo were actually published in scientific journals. Further, the original data from those studies is lost and unable to be independently verified, reviewed and critiqued in the usual peer-reviewed fashion; and 2) Roche has been unwilling to provide all requested data that supports the effectiveness of Tamiflu.
The FDA still currently approves Tamiflu for the treatment of uncomplicated influenza A and B in persons age 1 and older who have been symptomatic for no more than two days. However, they also acknowledge that the benefit of such treatment is modest at best. Tamiflu has not been shown in any clinical trials to reduce the rate of hospitalization, flu complications or death compared to folks receiving a placebo dummy pill.
Q: I'm taking Synthroid for a slow thyroid due to Hashimoto's thyroiditis. I read about how a low dose of naltrexone of just 1 mg has been proven to reverse the symptoms of Hashimoto's thyroiditis. My doctor is unwilling to prescribe it for me. Why wouldn't my doctor recommend something that can cure my slow thyroid?
A: Even if low-dose naltrexone works as well as the hype surrounding it, it cannot cure hypothyroidism and would need to be continued for life. At its purported best, it will get you on a reduced dosage of thyroid replacement hormone or possibly no thyroid replacement, forever substituting it with a compounded low dose of the opioid receptor blocker drug naltrexone. A pill for a pill.
For reasons that aren't clear, your body is destroying thyroid hormone-producing as though it were invading tissue. Even if this miracle drug could somehow modulate that activity, no claim has ever been made that it can cure Hashimoto's thyroiditis and put things back to a pre-disease state. I'd stay on thyroid replacement hormone, since that's proven to work.
Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: Ask Dr. H, P.O. Box 767787, Atlanta, GA 30076. Due to the large volume of mail received, personal replies are not possible. —M.S., West Chester, Pa. —A.M., Atlanta