Natural Supplements for COVID19-Background, Rationale, and Clinical Trials.

Worldwide, the turmoil of the SARS-CoV-2 (COVID-19) pandemic has generated a burst of research efforts in search of effective prevention and treatment modalities. Current recommendations on natural supplements arise from mostly anecdotal evidence in other viral infections and expert opinion, and many clinical trials are ongoing. Here the authors review the evidence and rationale for the use of natural supplements for prevention and treatment of COVID-19, including those with potential benefit and those with potential harms. Specifically, the authors review probiotics, dietary patterns, micronutrients, antioxidants, polyphenols, melatonin, and cannabinoids. Authors critically evaluated and summarized the biomedical literature published in peer-reviewed journals, preprint servers, and current guidelines recommended by expert scientific governing bodies. Ongoing and future trials registered on clinicaltrials.gov were also recorded, appraised, and considered in conjunction with the literature findings. In light of the controversial issues surrounding the manufacturing and marketing of natural supplements and limited scientific evidence available, the authors assessed the available data and present this review to equip clinicians with the necessary information regarding the evidence for and potential harms of usage to promote open discussions with patients who are considering dietary supplements to prevent and treat COVID-19.

Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care: The Consortium Pain Task Force White Paper.

Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices.

Herbal cancer cures on the Web: noncompliance with The Dietary Supplement Health and Education Act.

BACKGROUND AND OBJECTIVES: A significant portion of the US population uses the Internet to obtain health information; nearly half of Internet users admit that this information influences decisions about their health care and medical treatments. Concurrently, approximately one third of the population uses herbal supplements; a higher percentage is noted for subgroups of cancer patients. The Dietary Supplement Health and Education Act (DSHEA) of 1994 contained regulatory standards for herbal supplements, including restricting any claims for disease prevention, treatment, or cure. This study determined the degree of compliance with the DSHEA, as applied to Internet sites focusing on the subject of herbal supplements and cancer. METHODS: Internet searches were conducted using six popular search engines and three master search engines in October-December 2000 using the linked terms herb and cancer. The Internet sites identified through this search process were examined for categories of information including claims regarding prevention, treatment, or cure; commercial nature; DSHEA and physician consultation warnings; country of origin; and use of research and testimonials. Additionally, commercial sites were reviewed to identify tactics used to promote products or services. RESULTS: Each of the six primary search engines provided between 11,730 and 58,605 matches for herb and cancer. Further cross matching with the three master search engines identified 70 non-repeating sites that appeared on all three master search engines. Of these 70 sites, nine were irrelevant matches or no longer functioning. Of the remaining 61, 34 (54%) were commercial sites (CS) and 27 (42.8%) were noncommercial sites (NCS). Of the CS surveyed, prevention, treatment, and cure were discussed 92%, 89%, and 58%, respectively. CS provided testimonials, physician consultation recommendations, and DSHEA warnings 89%, 38.8%, and 36.1% of the time, respectively. CS provided research with references 30.6% of the time versus 92.6% of the time in NCS. All international commercial sites surveyed claimed herbal cancer cures. CONCLUSIONS: Although the DSHEA was enacted and amended to decrease unlawful claims of disease prevention, treatment, and cure, the results of this study indicate that such claims are prevalent on commercial Internet sites. A majority of sites claim cancer cures through herbal supplementation with little regardfor current regulations, and such claims were more common on sites operated from outside the United States.