A very big question in medicine is, does this treatment work?

It’s an enticing question because many things do work.

But the charm of the question hides a sad fact, most things do not work.

How can this be?   In a world in which we are surrounded by one story after another about medical breakthroughs, isn’t true that medical science tends to succeed?  Don’t most treatments work?

The sad fact is that is very, very, very hard to change what our bodies are committed to doing, even if we do not want our bodies to do so.

Here is an example, scoliosis.  The scoliosis I am talking about is the fairly common form that happens mainly to girls during puberty.  It is a condition in which the spine begins to bend side-to-side during the rapid growth spurt of puberty.  No one knows why this happens, but it is a very well known, widely observed phenomenon, it definitely happens.

And the  fact that it happens demands a treatment, that works.  Many treatments have been attempted, including posture exercises, physical therapy, chiropractic manipulation, acupuncture, and at the greatest extreme, wearing a binding brace to keep the spine from growing side-to-side.

None of these interventions have ever “worked.”  That is, they all try, but the scoliosis remains present.

What is Meant by Working?

By working, I mean the treatment gets rid of the problem.

Another example illustrates, polio.  Prior to the 1950’s polio was a scourge everyone knew about.  Lots of interventions were tried over the millenia to get rid of it, not one worked.

Then came the polio vaccine.  How do we know it “worked?”   Simple, where it is used, polio no longer exists.  This intervention works so well that the planet is coming very close to being free of the disease, entirely and forever!

That’s working.

Do probiotics work for eczema or asthma?

Again, by working I mean that the intervention gets rid of the problem, like polio vaccine got rid of polio.  Now, maybe it works less than 100%, what if a treatment got rid of 1/2 of all eczema and asthma, wouldn’t that be good?  Yes, I would say it worked half the time, clearly better than nothing.

So how about probiotics?  If you give your newborn probiotics will your infant have a lower chance of developing eczema, of developing asthma?

Someone found out.

http://pediatrics.aappublications.org/content/140/3/e20163000

They gave about 100 babies probiotics daily from birth to 6 months of age.  They also gave about 100 babies a blank medication, without probiotic activity.  Then they checked back at age 2 to see who had eczema and at age 5 to see who had asthma.

The answer?  Giving probiotic had no or negligible impact on your child’s chance of developing eczema or asthma.

IN short, probiotics did not work in the effort to prevent eczema or asthma.

Now, maybe giving it for 2 years, or not giving it until 1 year of age, or some other process would show probiotics to work to prevent eczema or asthma.  But, I doubt it.  If they really worked to prevent eczema or asthma, some serious impact should have been noticed.

Further, most things don’t work.

How can most things not work?

Like scoliosis, eczema, and asthma, most situations are the result of complex functions of our incredibly complex bodies.  The idea that exposing our body to a bit of a compound will change what its complex path will be should be seen as quite a long shot.

Further, a stroll down the over-the-counter medication aisle of most stores will show a large number of pills and elixirs sold that do not work.

Sure, there are dramatic medical success stories, I would count the polio immunization and the discovery of antibiotics amongst them.

But then look at cancer, it has been extremely difficult to find treatments that work, taking decades of study across millions of people, trying large varieties of interventions.  Progress has clearly been made, items that work have been identified, but even today, we have not achieved a complete eradication of this set of conditions.

The body is complex, it’s hard to push it in a new direction.

BOTTOM LINES

1. A test of probiotic use in early infancy found it had no or little ability to prevent the development of eczema or asthma.
2. This is disappointing, but not surprising.  You may be surprised to find that most proposed interventions turn out not to work.

At Advanced Pediatrics, we continue to pose the same two questions to any proposed intervention whether it be pharmaceutical, herbal, naturopathic, really any treatment:

• Does it work?
• Does it harm?

For us to recommend an intervention, there must be evidence that it works and that it causes far less harm than benefit.

To your health,
Dr. Arthur Lavin