Vitamin and enzyme supplements

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Alison, a highly intelligent patient, came in last night clutching something a friend had cut out of one of the Sunday papers. Alison is in her late sixties, had a heart attack four years ago, has two coronary artery stents and has a cholesterol of 4.1. She is on Simvastatin. Her friend is also on a statin. They compared notes. The friend started to get painful joints on the statin and so started taking CoQ10. Her joints are much better. Alison is a keen walker and, after a few miles, her knees hurt and so reasonably enough she has concluded that CoQ10 might help. And you can buy CoQ10 for "only" £15.19 from Boots. What is more, Boots advertise CoQ10 on the internet, with a lot of other vitamin and enzyme supplements.

Kaneka Q10 (Coenzyme Q10)
Natural source, high quality and purity. Important for the production of energy from food as well as being a powerful antioxidant.  Boots

Reading the question/answer under Drug Dilemma illustrated above, note that the answer is from Ingrid Haltink MBant DipION who is a "Consultant Nurtritionist." Like Patrick Holford only not as famous. Patrick Holford is one of the leading nutritionists in the country. He is so famous that many doctors now watch his every move.

Every GP in the country is faced with situations like this. There are so many red-herrings and plausible but scientifically nonsensical strands in Alison's presentation that it is difficult to know where to begin. How should the conscientious GP advise Alison? What I would like to say to her is that Co Q10 is medical wibble; that a lot of people in their late sixties get painful knees and that such pain is variable and intermittent. Temporal proximity does not prove a casual relationship. Suck a tea-bag and you may find the pain goes away. Statins classically cause painful muscles but not, usually, painful joints. I would like to say that many nutritionists are purveyors of medical wibble, and that anyone can call themselves a consultant. Heavens, we even have consultant nurses now. 

As any experienced GP will tell you, this sort of frontal assault rarely works. And Alison has more ammunition. She reads The Times and so is a big fan of Thomas Stuttard, their red wine imbibing, PSA obsessed medical correspondent.

When discussing coQ10 in supplement form with patients, doctors usually insist that it shouldn't be used in place of any prescribed medicine. Its value is as a supplement. Nor should it be used by a patient taking Warfarin, or suffering from any disease that results in bleeding or bruising. Boots has introduced a new natural form of coQ10 called Kaneka Q10 and from today is offering a seven-day trial pack to those with a lack of energy attributed to low levels of the coenzyme. There is a money-back guarantee if the patient's energy doesn't improve. Thomas Stuttaford in The Times

That is one of the most disgraceful bits of "medical" (sic) journalism I have ever read. How dare he use his position to advertise nonsense like this? Trouble is, people of Alison's generation think The Times is still a paper of record. They also think that if something is in a national newspaper, it "must be true". So I took refuge behind the excellent Ben Goldacre. He writes a blog called "Bad Science". Alison does not "do" blogs but she has heard of the Guardian, and Ben writes in The Guardian, so what he says must be true.

Pep, zing, oomph, energy. You won't find them here

Doctors love pills: so do the public, and the media, and of course so do pill companies. When one pill dies, another must take its place. Are you feeling tired? Demotivated? I bet you are. But there is a solution - a pill - pushed by no less than Dr Thomas Stuttaford of the Times. Just two days ago in an article about "office tiredness" he cheerfully rehashed a press release on Boots' exciting new pep pills. He opines at length on how tired we all feel in the office. So tired....  (Ben Goldacre)