Wikipedia has become the number one general reference source; and has tightened up considerably on accuracy and objectivity the past two years, as far as one can judge for topics within one’s own in- depth knowledge. But then Wiki is only as good as the experts who bother to check & upgrade entries in their field.
For Bipolar Disorder Wiki indeed defies the Drug Industry and still lists the natural element lithium carbonate first as the recommended drug for maintenance therapy, ahead of dozens of new competitors for that $multibillion market.. that’s a good precedent for a natural element used as a drug the past >150 years.,
For eg aspartame,Chronic Fatigue, Hormone Replacement Therapy, Menopause; the Womens’ Health Initiative and andropause- androgen decline in aging males– the respective Wiki articles pretty accurately sum up the opposing views and evidence without apparent bias.
eg overweight it sensibly defines as BMI above 25kg/sqm, and obesity above 30kg/sqm. It notes that obesity is already the second leading cause of death in USA, reducing life expectancy by 20% in men and 5% in women- the causes including the pervasive endocrine disruptors (estrogenic and insulin –desensitizing) – that saturate our homes, offices and food chain; and only 20% of Americans successfully maintain longterm weightloss with diet and exercise.
It notes under Biguanides that they were found in the 1920s to lower high blood sugar, but were then ignored due to the simultaneous commercial production of insulin.
But in the field of $trillion competitive drug marketting for the most common chronic diseases, Wikipedia articles still appears dominated by those with the biggest commercial interests ie the Disease Industry…
Under weightloss drugs it’s Obesity entry (updated to this month) lists only the antiobesity drugs recommended by the now-ancient 2005 (Am Coll Physicians) position paper: sibutramin, orlistat, diethylpropion, fluoxetine, bupropion, amphetamines- even though there are no even medium-term let alone longterm trials validating these for high benefit to risk ratio, they are all (now including rimonabant) severely limited if not contraindicated by major adverse effects.
Metformin is dismissed in one line: “to treat diabetes.. Metformin may lead to mild weight loss in comparison to sulfonylureas and insulin.. in obese type 2 diabetics”. And the Wiki metformin entry does not even mention it’s overwhelming benefits in treating overweight- prediabetes and in reversing obesity in longterm use (up to 4 years reported so far in primary trials)- that we have been publicising for the past decade.
Similarly with another trillion-dollar industry – hypertension:
Under Reserpine, wikipedia correctly says “Reserpine is one of the few antihypertensive medications that has been shown in randomized controlled trials to reduce mortality..”
So WHY under the Wiki hypertension entry treatment is “Reserpine listed as a second line choice by the JNC 7”? It has been common cause for some years now that so many mechanisms are at play in increasingly common “essential” hypertension, that once antihypertensive drug therapy becomes advisable, it is best to start with a combination that addresses as many of the causative mechanisms as possible for the lowest risks. The evidence, and daily experience, continue to grow that combined lowdose reserpine plus lowdose amiloride + thiazide amilothiazide (ie three drugs) is remarkably effective for the great majority of mild to moderate hypertension patients, at a (South African) retail cost of perhaps $6 a year, without any of the risks and costs of all modern heavily marketed antihypertensive drugs (see wiki entries for each of these!. It is noteworthy that UK and EU authorities have removed reserpine from formularies – , as have the RSA state clinics and Hypertesion Society – without giving scientific reasons since there are none – but as in USA and most other countries, where reseprine is still available, experts agree that the triple combination of these three is the best bedrock antihypertensive therapy there is.
Similarly, under analgesics and non-steroidal antiinflammatories NSAIDS: because there is none, Wiki (like the Drug Industry) can quote no evidence to justify acetaminophen- paracetamol or any other NSAIDs including aspirin as the drug of first choice for mild pain, since these drugs are notorious for potentially lethal adverse effects. There are no trials to show that, safety aside, NSAIDs are any better than many natural drugs available in simple combination orally and topically eg fish oil, MSM, cat’s claw, arnica, boswellia, bromelain, capsaicin etc, and proven by centuries of common and safe effective use..
On erectile dysfunction ED Wiki is even less reliable, stating incoherently (“last updated 30 December 2008” that “It is rare, but some men receive hormones for their erection problem” . This appears either to underestimate the percentage of ED cases around, or denigrate the many in whom testosterone deficiency plays an important role. The rule of medicine is, don’t be rigid about “normal ranges”- for especially the common hormone deficiencies, be aware of both hormone resistance and relative deficiency/ imbalance. And it ignores the fact that many using eg Viagra (which can occasionally kill, maim or blind) do not need Viagra, which trials show does not work without enough testosterone around- and appropriate testosterone does vastly more global good.
Wiki fails to point out the glaringly obvious that, having created a new common disease of Erectile Dysfunction, Pfizer has worked hard to cover up the risk, and low need for, Viagra. Pfizer flatly refused our request to disclose let alone publish the serum testosterone mean and range in the men who were enrolled in their vast Viagra trials- they and FDA at first claimed privacy! Then when we invoked the freedom of information principle, they concocted a new blockade, that such info could only be made available on an institutional application… but since institutions depend on Industry for research funding, a couple of local and USA institutions backed off submitting the formal applicatiion Pfizer and the FDA demanded. So whats new?.
As Wiki says, “Viagra soon became a great success: annual sales of Viagra in the period 1999–2001 exceeded $1 billion.” ..but Wiki does disclose the many major complications that Viagra can cause, although it does not mention that Pfizer and the FDA summarily shut down the reporting of deaths on Viagra in about 2000/2001, by when reported sudden deaths (let alone strokes, heart attacks, blindness etc) on Viagra had passed 1000. Pfzer blithely ignores the hard fact that appropriate use of testosterone replacement (let alone anabolic steroid abuse) has never been associated with increase in sudden death the past 70 years – quite the contrary since it suppresses class 3 arrhythmia- the opposite of Viagra . And Wiki reports that even a diehard antagonist of anabolic steroid abuse at the FDA Dr Gary Wadler admitted under interrogation that there is no evidence that anabolic steroids are “highly fatal”, when in UK this year “anabolic steroids are classified as class C drugs for their illegal abuse potential, which puts them in the same class as benzodiazepines and canabis”- addictive drugs but vastly safer than the addictive sugar, cigarettes and alcohol ) . http://en.wikipedia.org/wiki/Anabolic_steroid .
Probably most users of the internet include Wiki in any subject search, but Wiki should always be verified by primary sources if available, since a lot of what Wiki publishes is simply opinion. We know only too well that a lot of belief in medicine is simply that- dogma unverified by either hard longterm observational or trial data, Shaughnessy and Slawson’s gold standard “Patient Orientated Evidence that Matters”. www.annals.org/cgi/content/full/126/8/667
So we all owe it to Wiki to check topics in which we believe we are experts, and contribute to veracity with verifiable refereces where we can. For the Disease Industry and the inexhaustible media they fund for their benefit, ignorance (in patients let alone doctors) is bliss when it prevents the public- lay and health- from seeing through marketing deceptions.
Best wishes for a better new year,