We're assuming you've already heard about the retracted research paper suggesting that the medication hydroxychloroquine was ineffective as a treatment of COVID-19.
Retracting this paper is saying, "Oops. Sorry. Forget everything you just read," was a pretty big deal considering multiple research studies and medical treatments were halted based on its findings.
Interestingly, another paper written by these same co-authors was also retracted; this one suggesting certain medications were not a concern for patients with COVID-19.
Really? Not one, but two retracted papers in, not one, but two of the largest, most prestigious journals in the world, about a global pandemic that desperately needed accurate, real-time information to potentially save thousands of lives. As if the world didn't already have enough to cope with.
Here's the thing. As unfortunate and concerning as these retractions are, they are not isolated incidences.
In 2013, a journalist submitted a completely bogus paper to over 300 open access journals, which was accepted for publication by over half of them.
Terms like the "retraction index" have been created to offer more information than the "impact factor" of a journal.
And websites like RetractionWatch.org have been created for the subject. For example, you can check out their leaderboard of retracted authors, search their database (43 retractions on curcumin papers), or see the top 10 most cited retracted research papers. (You may recognize #2 from my lectures.)
Why all these retractions?
One might merely be due to a better peer-review process and scientific scrutiny, which would be a good thing. Another reason would be due to author misconduct on a research paper, which is just sad, and potentially a sign of the times where people seek fame and academic "likes" over advancing the field of science.
Unfortunately, you can't really take things back, especially today. Whether it's an emotional Facebook post, an angry twitter rant, or in this case a fraudulent scientific paper that temporarily changes the course of medicine, once it's out there, it's out there.
It's a great time to remember this quote from Marcus Aurelius, "Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth."
Could Toxins be Good for Us?
You’ve probably heard the phrase, “What doesn’t kill me makes me stronger,” attributed to Friedrich Nietzsche’ from a text he wrote in the late 1880s.
What he didn’t know was that scientifically speaking, he was talking about hormesis.
In short, hormesis is the term to describe how some stressors, which are toxic in high amounts, can be beneficial or protective in low dosages.
Take exercise, for example. When performed correctly, it is a mild stress that causes our body to adapt and become stronger. Too much exercise can be damaging.
Other hormetic stressors include temperature, certain chemicals, oxygen deprivation, and calorie restriction. They each follow a biphasic dose-response, which means that at a low dose, it is beneficial, but at a higher dose, it is toxic.
Think about some of the prescriptions and practices in the health industry today - laundry lists of supplements, avoiding and detoxing every toxin, drinking jugs of water, consuming high amounts of favored macro and micronutrients, and so on. As a health-conscious industry, are we overdoing it? (It wouldn’t be the first time.)
It turns out, there’s a recent review article that evaluated this idea in animals. The authors identified and summarized the scientific literature relating to hormesis and well-known hormetic stressors such as temperature, oxygen deprivation, and ionizing radiation. Interestingly, they also included toxic chemicals and dehydration.
They referenced several articles demonstrating how low doses of otherwise toxic chemicals such as cadmium, arsenic, insecticides, pesticides (even glyphosate, gasp!), appear to have hormetic effects at low doses in some insects.
(Hilariously, they said there were probably a lot more studies demonstrating a hormetic effect of pesticides but didn’t publish them as such because authors of those papers suggested instead that the pesticide didn’t work.)
It turns out that “mild” or “slow” dehydration leads to higher survival in a host of creatures, possibly by increasing antioxidant enzymes and membrane remodeling genes.
Crowding, or being smushed with too many other larvae in the same jar, was also hormetic. But before you get excited about living in a high-rise apartment complex, the increased survival came partly from reduced food availability, caloric deficit, and improved mitochondrial efficiency.
So what can we infer from all this? Probably not much as it was a review paper on mostly insects. That said, the idea or hormesis is not a new one. Perhaps mild discomfort isn’t such a bad thing. This summer, instead of turning on the AC, maybe sweat it out a bit. Maybe ditch the app that tells you to drink gallons of water every day. Or, when you get a hunger pang, instead of eating right away, ride it out for another hour.
Is the Coronavirus Over?
If you've noticed, we've stayed out of the COVID-19 conversation since the beginning for a bunch of reasons. Now that the dust is settling a bit on it, we decided to weigh in on a couple of quick things.
As lockdowns lift and public gatherings multiply, we are likely going to learn a lot about the Coronavirus in the next three to five weeks.
As you've probably heard, the WHO recently suggested that asymptomatic individuals are not contagious. While that sounds good, 1) they've been wrong before, and 2) there are at least a few papers (1, 2, 3) suggesting otherwise.
Most of the conversation about the virus has been on how deadly it is: another less-discussed concern is the potential long-term health consequences in people who contract the virus. Unfortunately, this list is growing with too many papers to include here.
As with all moments in life, we are presented with a choice, and it's our responsibility to make informed decisions accordingly. Now more than ever, it's evident that critical and independent thinking is the ultimate survival skill.
Have you heard about our full-scale learning experience, Clinician's Code? Learn more and apply here.