Media woo merchants just don't get it


Do dietary deficiencies of magnesium or vitamin B6 cause Tourette's syndrome? 

Er, no.

If a production company decides they're going to make a program looking into treating Tourette's with magnesium and B6 will the advice that it's all nonsense put them off making the program? 

Er, no. 

Apparently the program is called The Food Hospital. I can't bear to look at the link to it because I know I'd only get upset. 

Somebody from there emailed me out of the blue to ask my opinion and I gave it to her. Turned out a bunch of other experts told her the same thing as me. Has that put off her making the program? (See above if you can't guess the answer.)

I spend much of my working life persuading people with severe mental illness to keep taking their medication and to stop smoking. It is really, really unhelpful for me to have popular programs on popular channels raising the possibility that the correct treatment for mental illness might be a bit of extra magnesium.

Before leaving this topic I cannot resist drawing your attention to one of only four papers in the whole of PubMed which even mention Tourette's and magnesium in the same breath. It's here: http://www.ncbi.nlm.nih.gov/pubmed/12424821. The title is "Hypothalamic digoxin deficiency in obsessive compulsive disorder and la Tourette's syndrome."  And if you're not already baffled by the concept of a hypothalamus that secretes digoxin (!) I recommend you check out the abstract and see if there is one single sentence that anybody who'd been to medical school could make any sense of at all. It truly reads like it's been automatically generated by one of those computer programs which writes modern rubbish poetry.


Anyhow, the whole shameful email thread is reproduced below. What can you do?


Hi.

I actually disagree strongly with you and I think that this kind of media activity is extremely damaging to the interests of medical science and hence indirectly patients. There is in fact a lot of harm associated with this sort of thing. It's one example among many of the way ignorant and misguided media professionals do damage without even realising it.

The honourable thing for you to do would be to NOT MAKE THE PROGRAM but I know that's never going to happen so I'll just leave it.

Regards

- Dave Curtis

From: Sue Edwards [mailto:Sue.Edwards@betty.co.uk]
Sent: 01 August 2012 16:43
To: Curtis David (EAST LONDON NHS FOUNDATION TRUST)
Subject: RE: C4 expert Tourette's Syndrome

Dear Prof Curtis

Thank you so much for your reply. Really helpful.

Just so you know, I’ve spoken to a handful of Tourette’s specialists all of whom say a similar thing to yourself – that the study is small and poor. However, if we qualify this in the programme there is ‘no harm trying’.

It’s clear that Tourette’s is a very hard condition to trial, basically because the symptoms seems to wax and wane in severity naturally anyway so very difficult.

Having said all of this, I think C4 think it’s an interesting condition and the mechanistic concept is interesting to explore – we’ll see if it makes any difference and qualify it by saying that it could just be placebo effect anyway.

Thanks again

Sue

From: Curtis David (EAST LONDON NHS FOUNDATION TRUST) [mailto:davidcurtis@nhs.net]
Sent: 01 August 2012 00:26
To: Sue Edwards
Subject: RE: C4 expert Tourette's Syndrome

Hi.

I'm not an expert in Tourette's but I do have the following comments.

I don't think "jumping up and down" is a good example of the kind of tic you get in Tourette's.

Your document does not seem to mention the most striking and specific feature of Tourette's - coprolalia and copropraxia (making obscene utterances and gestures).

You seem to be merging with some vague notion of hyperactivity and misbehaviour. This is not Tourette's.

I'm afraid the diet-related stuff you're referring to is absolute, unmitigated, unscientific nonsense. What a pile of crap! The stupid theories about magnesium and B6 don't at all mesh with the kind of motor disorders one sees in Tourette's syndrome. The "scientific" paper you cite is example of the worst kind of research imaginable - an open, unblinded study of a bunch of children who most likely don't have Tourette's in the first place. Look where it's published. Some crappy journal that nobody has ever heard of. Do you think you can find one decent journal that gives the time of day to any of this nonsense? Have a look on PubMed. There's 4,000 publications on Tourette's syndrome and only two on B6 - the two you mention. There's three on magnesium but one of those is from India based on 15 subjects and absolutely nonsensical and seems to include the notion that digoxin, a medication used to treat heart failure, occurs naturally in the brain. The first paper came out in 2002 and as people are desperate to find better treatments if there was anything at all in this there'd be more published by now.

If you go ahead with this project you will be producing an example of the very worst kind of "science" "journalism". I don't expect me writing this will stop you because you probably have too much invested already but you asked my opinion and this is it.

Regards

- Dave Curtis


--
Professor David Curtis MD MD PhD FRCPsych
Consultant and Honorary Professor in Psychiatry
East London NHS Foundation Trust
Glasshouse Fields Centre
68 Glasshouse Fields
London  E1W 3AB
020 7791 5207

Please use this email address for Trust and clinical communications:

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From: Sue Edwards [mailto:Sue.Edwards@betty.co.uk]
Sent: 31 July 2012 19:25
To: Curtis David (EAST LONDON NHS FOUNDATION TRUST)
Subject: C4 expert Tourette's Syndrome

Dear Prof. Curtis

I have been recommended to get in touch with you; I hope you might be able to assist? I am working on the second C4 series of The Food Hospital  - it looks at how diet can help improve a whole host of conditions. One condition we are keen to delve into is Tourette’s Syndrome which I know you specialise in.  

I have read some research that has found some improvements in symptoms by adjusting diet. Specifically - by supplementing with magnesium and B6.

Would you mind reading our document (attached) and checking whether our approach is reasonable? I would highly value any of your comments/corrections as I am obviously no expert.

I feel that it is very important that C4 presents factual information to the public – your input would be an invaluable service in this regard.  

I’m afraid we are up against a very tight deadline. Is there any chance you would you be able to come back to me by the end of the week with any information/corrections/suggestions? We are due to film with this patient next week.  

Or, if you feel this is not your area would you be able to steer me towards someone you think might be able to help?

Thank you, I really appreciate your time.

Kind Regards

Sue


sue edwards
science producer
betty
the heal's building
8 alfred mews
w1t 7aa
t: 0207 290 0533
f: 0207 290 0679
sue.edwards@betty.co.uk


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