Dr Nick Manassiev accuses me of putting out ‘wrong medical information’. He claims that I provide no references. However, my text is quite clear that the information is my attempt to summarise the evidence reviewed in our two books.1,2 In other words, all the necessary references can be found there because constraints of space would not have allowed me to proceed in any other way.
Is saw palmetto equivalent to conventional drug treatment? (Yes, I did mean to compare only oral treatments.) Even though the data are not entirely uniform (they rarely are), the Cochrane review concluded that it produced similar improvements in urinary symptoms and flow as finasteride and is associated with fewer adverse events.3
St John's wort has been tested in more than 30 well-conducted randomised controlled trials. Again, the results are not entirely uniform but collectively the data are positive. In five randomised controlled trials (total sample size = 2251), St John's wort was tested against conventional antidepressants and the meta-analytic risk ratio was 0.96 (95% CI = 0.85 to 1.08).4
Hawthorn is backed up by a positive Cochrane review of 14 randomised controlled trials,5 and a recent randomised controlled trial with 2681 patients showed that, during 18 months of hawthorn treatment, deaths due to cardiac causes were reduced by 20% compared to placebo.6
In my article, I do acknowledge that comparing one (complementary) with another (conventional) treatment is by no means straight forward. In fact, I state that: ‘This is where things change from complicated to nebulous.’ But I do nevertheless insist that the information I provided is based on the best available evidence.1,2
While I deplore the aggressive tone of Dr Manassiev's letter, I rejoice in the fact that one commentator found my judgements of complementary therapies unjustifiably negative,7 while Manassiev believes they are unjustifiably positive. As long as I receive flak from both sides, my position is probably not entirely wrong.
REFERENCES
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