This edition: Hep B shots for babies, bacopa memory supplement and omega-3s for autism
By Harriet Hall, MD
Question: Why on earth do they give Hepatitis B shots to newborn infants? It’s a sexually transmitted disease, and infants don’t have sex.
Answer: Vaccine recommendations weren’t just made up out of thin air. There are very good reasons to give Hep B at birth.
Since 1982, when the hepatitis B vaccine became available in the U.S., more than 100 million people have been vaccinated with no reports of serious side effects. Since 1982, the incidence of acute hepatitis B has declined by about 82%.
A landmark study in 1997 showed that a 12-year nationwide vaccination program against hepatitis B virus in Taiwan resulted in a significant reduction in the number of cases of childhood liver cancer. It works. We have a vaccine that can prevent cancer; it would be foolish not to use it.
In summary, hepatitis B vaccine is safe, effective, reduces the incidence of liver cancer, and provides the best protection for children when it is given at birth.
Answer: The evidence so far is interesting, but not convincing.
The review you found concluded:
“This meta-analysis suggests that Bacopa monnieri has the potential to improve cognition, particularly speed of attention but only a large well designed 'head-to-head' trial against an existing medication will provide definitive data on its efficacy on healthy or dementia patients using a standardized preparation.”
There is some evidence to suggest that Bacopa improves memory free recall with evidence for enhancement in other cognitive abilities currently lacking [emphasis added] perhaps due to inconsistent measures employed by studies across these cognitive domains. Research…is in its infancy, with research still yet to investigate the effects of Bacopa across all human cognitive abilities. Similarly, future research should examine... varied dosages and across different extracts.”
Meta-analyses are better than single studies, but they are only as good as the studies they review. A single large well-designed study can trump the results of a meta-analysis, and the results of meta-analyses do not predict future scientific conclusions.
I checked the Natural Medicine Comprehensive Database, which I consider the most reliable source. They rate Bacopa as “possibly effective” - below their ratings of “likely effective” and “effective.”
They reviewed all the published studies and here’s what they said:
“POSSIBLY EFFECTIVE for cognitive function. Some clinical research shows that taking a specific Bacopa extract (KeenMind, Flordis), 300-450 mg daily for 12 weeks, seems to improve some measures of verbal learning, memory, and information processing in healthy men and women. Another clinical trial shows that taking a different Bacopa extract (BacoMind, Natural Remedies) 300 mg daily for 12 weeks also significantly improves measures of verbal learning, memory, and retention in healthy adults over 55 years of age.
In children aged 6-8 years, taking one teaspoon of Bacopa extract three times daily for 3 months seems to improve visual motor function and immediate memory compared to pretreatment.”
The appropriate dosage or best preparation has not been established.
They report adverse reactions of increased stool frequency in 30% of patients, nausea in 18%, and abdominal cramps in 16% of patients in clinical trials, with other less common side effects of dry mouth, fatigue, flatulence, bloating, decreased appetite, headache, insomnia, and vivid dreams. They also report interactions with various types of drugs and various diseases and conditions. Their information is up to date as of 12/23/2014.
My approach to this kind of thing is to withhold judgment pending better studies and more complete information. I’ll stay tuned, with interest. That is, if my aging brain can remember to stay tuned without the help of Bacopa. :-)
Answer: In my opinion, probably not.
A recent Cochrane System Review examined all the published evidence on omega-3’s for autism. They found no high quality evidence that omega-3 supplementation is effective for ASD. A study published last year did not find a statistically significant improvement.
This website has a good summary of evidence-based interventions for autism It doesn’t even mention omega-3’s.
I am not optimistic about the potential benefit of omega-3’s. On the other hand, a short therapeutic trial probably wouldn’t cause any harm.
Harriet A. Hall is a retired family physician, former U.S. Air Force flight surgeon, and health advocate who writes about alternative medicine and quackery for Skeptic magazine, Skeptical Inquirer and Science-based Medicine.