Relative Risk VS Absolute Risk… An Important Public Health Message

Now, in this week’s episode, I spoke to science writer Dr Todd Penberthy, and we covered quite a range of topics. Todd is very passionate about his science. He’s had some amazing mentors in his life. I’ve had the pleasure of connecting with him through my association with the Orthomolecular Medicine News Service. 

The Orthomolecular Medicine News Services

The Orthomolecular Medicine News Services is definitely a resource you should have a look at because it has, I think, over 15 or 20 years of some brilliant articles written by some brilliant people about how the body works, how it goes wrong and how to fix it.

Yes, how to fix it, not just to manage it, but how to fix it. This gets to the very point of many of the subjects we’ve covered in these last particularly few months, and that is the importance of biochemistry. Now, I’m kind of like constantly coming back to this for you. 

Like many health practitioners, I just couldn’t wait and I was one of those health practitioners who couldn’t wait to pass biochemistry in my early undergraduate years and second year and physiology. I just get those subjects out of the way before I could get on to something really important, like studying pathology or learning how to fix things or manage them anyway. 

Certainly, we studied pharmacology as well, and that was a major major focus. Pathology, disease and pharmacology. How to manage the disease. Very important.

Biochemistry

However, biochemistry is arguably even more important. Todd is a science writer and I take the opportunity to do a little bit of a review of what double-blind, randomised controlled trials are. They are the gold standard, and they’ve become that because the pharmaceutical industry, test their drugs by using a double-blind, randomised controlled trial. 

Basically, it means when the patient and the doctor doesn’t know whether they’re giving a drug or a sugar pill or some very ordinary placebo. it’s interesting that is the gold standard. That’s a very good model if you like for testing a drug against a sugar pill, but it’s not a very good way of testing what goes on in the human body because biochemistry is about millions, if not trillions, of biochemical processes that go round and round and round. 

We talked about this with Olivia Lesslar. We’ve talked about this with many of our guests, but it’s a complex issue, and it’s not surprising that many doctors couldn’t wait to forget about it but that doesn’t make it any less important. It’s also not surprising why so many doctors reach for the prescription pad because that’s a hell of a lot easier. The reductionist model. Show me a disease and I’ll show you a pharmaceutical product to manage that disease. We talked about that.

How we manage chronic disease in our society

Another issue we talked about is one that has really surprised me during this pandemic, and it’s surprised me on so many different levels because we have so many so-called experts and you’ll notice that I often refer to them as “so-called experts” because really, you know, I think one of the things this pandemic has highlighted is this is a way we manage chronic disease in our society, a very reductionist model. Show me the disease and I’ll show you the medication to manage it.

When you talk about chronic diseases, which have a very long timeline-like cardiovascular disease or cancer or autoimmune conditions, or diabetes or obesity that could go on for four, five, 10, 15, 20 or 30 years, it’s very easy to appear to be an expert when what you’re talking about is the latest and greatest medication that’s come out, but it’s a little less impressive when one realises that very little is spoken of in terms of how to cure these problems, and lip service is played to lifestyle. 

It’s all about lifestyle, diet and exercise. Just get on and eat properly and exercise and you’ll be right. Well, there’s a lot more nuance to it than that, and some of our public health messages have been found wanting because, again, of the influence of the food and chemical industry on so many public health issues. Please reference my podcast and go and listen to it on YouTube, The Elephant in the Room, where I talked about the industry influence.

One of the things that surprise me in this those so-called experts get up and talk is they talk about the 95% efficacy of vaccination and that sounds very impressive, that sounds very impressive, but what they don’t tell you is there is a difference between relative risk and absolute risk. 

Difference between relative risk and absolute risk

Let me give you an example and one example might say heart disease. You might have three in a hundred chances of, well, say, two in hundred. Let’s make the maths easy. You might have a two in 100 chance of contracting heart disease, but if you took a statin, that would reduce your risk from two in 100 to one in 100. 

The two in a hundred and the one in a hundred are the absolute risk, which when you look at it, is rather slim. I mean, your chance of getting that particular disease is safe two in a hundred. If you took this medication, it’s one and a hundred. So absolute risk is pretty low anyway, and it does reduce slightly. But that is a 50% reduction. 

If you take this drug, you’ve got a 50% less chance of getting heart disease and that is a very different story than if I said, you know what, your chance of getting this disease is two in a hundred. 

If you take this medication, which incidentally, might have some side effects like liver function or muscular problems or nerve problems, myopathy or neuropathies could affect your memory, but you could reduce your risk from two in a 100 to one in a 100. You might give a second thought to that. That is absolute risk.

But if I said to you, “Hey, you could reduce your risk of heart disease by 50%”, you’ll say, “Give me that medication, I want it.” Well, the same is true of vaccines. When you are talking about a 95% efficacy at reducing hospitalisations or death, you might think that’s incredibly impressive. But I am 66 years old and my chance of being hospitalised or dying is 0.4%. 0.4%, that is my absolute risk. And by taking a medication, a vaccine might reduce my risk to 0.2% or 0.1% or whatever, but it’s a small difference in absolute terms. But it’s a 95% difference in relative terms.

Now you will never hear any so-called expert talk to you about absolute risk. What disturbs me about that is that relative risk is a marketing tool for the pharmaceutical industry, and absolute risk is a tool for informed individuals to make informed decisions. You can make your own mind up about that. 

We also talk a lot about biochemistry in this in this week’s episode, and we get into some pretty technical chats about Vitamin B3, and that was a nutrient that I had given and kind of forgotten about. Of course, I should remember because my cardiologist, Dr. Ross Walker has had me on that and the whole flush and the flushing of taking vitamin B3 is actually a really important process that we should actually embrace.

Double-Blind, Randomised Controlled Trial

That’s another one. Again, if you’re wondering, here’s another nutrient well, yes, here’s another nutrient because we need many nutrients to function optimally. This is why a randomised, double-blind, randomised controlled study of Vitamin D or Zinc will pick out any single nutrient. And you just cannot do that kind of study. Does that mean it’s not valid? I often use the analogy of parachutes. 

Now, let me give you another example of double-blind, randomised control, and I ask you whether you would accept this or not. Now it may shock you to learn that there has never been a double-blind, randomised controlled study done of parachutes that would involve getting 20 volunteers and giving them all a parachute. 

Somebody, a volunteer or not, the pilot has snipped the cords on 10 of those parachutes and rolled them all up and put them into a packet, mix them all up and given them randomly to people. So neither the people nor the pilot knows who has got the parachutes that will work and the parachutes that don’t work, and they go up 10000 feet. 

All 20 people jump out of the plane and we observe what happens not surprisingly, perhaps those with parachutes land safely and those with faulty parachutes die.

Therefore, we can conclude using a double-blind, randomised controlled trial that parachutes are actually, by the gold standard in medicine, are really effective. It might surprise you to learn that studies have never been done, and yet we still use parachutes.

I mean, really if the gold standard is double-blind, randomised control, there is no evidence to support that parachutes actually do work. In the same way, we are unable to do a double-blind, randomised controlled trial of Vitamin D or Zinc as a single nutrient because the body just doesn’t work like that.

Health has become profit-driven

Now, Todd also mentioned something in passing, and you may miss it but I thought I would bring it to your attention. He said, it’s sad but health has become profit-driven. I think there are two aspects to why we find ourselves with such poor health in our western world and that is because food has become a commodity and that has affected the quality of the food making profitability of food production more important than actually the nutrient density of the food we’re eating. 

Food has become a big business. It’s become big business for the fertilisers that are sold to farmers to produce crops that they can produce cheaply to take to market and et cetera, et cetera.

Food has become a commodity that is driven by profit, not by health, and it should be. Not only that but health care has also been driven by profit. You only have to look at the fact that the pharmaceutical industry generates 1.2 trillion US dollars a year in revenue to learn that and billions of dollars in profit. He said that and I agree with him, profit should not be what drives food or health both those industries should be totally devoid of profit. It should all be about human health.

COVID management

Another thing that Todd shared with me and this was something I really hadn’t factored into the COVID management of, you know, when you contracted the disease, the disease COVID, there’s another element to it, which has is important, and that is the allergic response, the histamine response. 

Now you will not have heard this from the so-called experts. This is about public health as relates to this pandemic but there are many off-label drugs that have been found to be off-patent drugs, which have been found to be useful in the treatment of COVID. So when you get a diagnosis, there are many off-label treatments, some of which I’ve spoken about in the many paces of the pandemic.

Recently in a Healthy Bite, some of those are Ivermectin, which is which won the Nobel Prise for Medicine in 2015 and has been shown to be a very effective anti-parasitic drug, but also an anti-viral drug for humans as well as animals. 

Now, if animals are the measure, then we really shouldn’t be taking antibiotics because animals consume far more antibiotics than humans do but that’s a whole other story. Another one is hydroxychloroquine. Another one is fluvoxamine, which is an antidepressant. And all of these are taken in combination with vitamin D, magnesium, zinc, with quercetin. Quercetin is one of those supplements that makes zinc more available to the cell, and here is another one. Antihistamines like Benadryl or Claritin.

There are antihistamines, which are very important in downscaling this whole cascade of inflammation, which occurs. That was something that I was was new to me. There were some great things in this week’s podcast. Todd is very much a science writer and he alerted me to B3 and told us about the legendary doctor Abram Hoffer, who is the Father of Integrative Psychiatry but also alerted me to the work of a South African doctor called Dr Shankara Chetty. His work with antihistamines. 

It’s not surprising that in South Africa, in India, in South America, where there aren’t billions of dollars to spend on vaccines, they’re using these old medications in combinations with supplements to manage this disease. You would have thought, that it wouldn’t be hard to report on this in the western world. Deaths would be people would be dying by the millions in India, in South America, in South Africa, in Africa, you know, and you say, well, they’re not reporting it.

Well, it wouldn’t be hard for The Guardian or The Sydney Morning Herald or the New York Times or The Washington Post, who all seem to be pumping out a message very conducive to spending billions on a vaccine, which is experimental. 

I used to think vaccines were all about avoiding disease when I took my smallpox, cholera, measles, whooping cough. It was all about not getting the disease and it turns out with these so-called vaccines, we do actually get the disease. We can still be hospitalised from the disease and we can certainly transmit the disease. That’s not what I used to call a vaccine, but that’s a whole other story but things like there are vaccines of the old fashioned type coming out Novavax and the South Australian vaccine COVAX from Professor Nicholas Petrovsky. 

They’re the old fashioned kind of vaccines, which hopefully will give us some immunity about getting the disease as well as transmitting it. Anyway, I thought I would just alert you to this week’s podcast with Todd Penberthy and it was a really interesting talk. I hope this finds you well. Until next time.

 

 

This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.