Live Long and Well with Dr. Bobby
Let's explore how you can Live Long and Well with six evidence based pillars: exercise, good sleep, proper nutrition, mind-body activities, exposure to heat/cold, and social relationships. I am a physician scientist, Ironman Triathlete, and have a passion for helping others achieve their best self.
Live Long and Well with Dr. Bobby
#45 Over Our Skis: Hype Beyond Evidence
Dr. Bobby examines how legitimate medical treatments often get overextended into unproven health claims—why it happens, why it matters, and how to spot it.
Building on last episode’s theme of health hype, this installment digs into examples where therapies with real medical uses (like vitamin C, B12, hyperbaric oxygen, and stem cell therapy) are being promoted far beyond what the evidence supports. Dr. Bobby unpacks the flawed logic of “theory plus anecdote plus expert equals evidence” and explains why even well-intentioned health advice can go too far when it skips the evidence.
You’ll hear about the historical rise and modern misuse of vitamin C—from preventing scurvy to overstated claims of immune boosting. The episode dives into vitamin B12, which has real benefits for those with deficiencies but is often marketed as a cure-all without support. Hyperbaric oxygen therapy, which is FDA-approved for very specific conditions like carbon monoxide poisoning and diabetic ulcers, is another example—now advertised for fatigue, brain fog, and aging without strong data to back it. And stem cell therapy, which truly helps in leukemia and bone marrow failure, is being extended to treat everything from dementia to heart disease—despite the lack of proven efficacy in these areas.
Dr. Bobby then addresses why this happens: patient desperation, the placebo effect, and the sheer momentum of what has been called “Big Wellness”—an industry now worth hundreds of billions. Social media only amplifies these trends, creating fear of missing out and distorting what counts as credible.
To help listeners navigate this landscape, Dr. Bobby shares questions to ask when encountering bold health claims. Has the treatment been proven in your condition? Are there peer-reviewed studies in humans? What are the risks and costs—not just financially, but in delaying evidence-based care? Are the promoters benefiting from those beliefs?
He encourages all of us to remain open-minded skeptics: curious, informed, and protective of both our health and our wallets.
Takeaways:
Ask whether the health claim is backed by solid evidence, not just theory and anecdote.
Don’t assume treatments with real uses are effective for everything they're marketed for.
Before trying the latest therapy, ask: Is this proven for my condition, and what’s the real cost?
You may have heard that vitamin C prevents scurvy, but does that mean it also boosts immunity in healthy people? What about those IV clinics that will replenish your vitamins? Or you may have heard that hyperbaric oxygen heals particular wounds, but can it fix brain fog? Sadly, evidence doesn't support these uses. So why do treatments that effectively work for some uses get promoted for far too many unsupported uses? Let's find out.
Speaker 1:Hi, I'm Dr Bobby Du Bois and welcome to Live Long and Well, a podcast where we will talk about what you can do to live as long as possible and with as much energy and figure that you can shoot. Together we will explore what practical and evidence-supported steps you can take. Come join me on this very important journey and I hope that you feel empowered along the way. I'm a physician, ironman, triathlete and have published several hundred scientific studies. I'm honored to be your guide. Welcome, my dear listeners, to episode 45, over Our Skis hype beyond the evidence. Well, last episode we talked about hype in health more generally and I talked about why there's so many claims for what works in the longevity and wellness space but really little evidence to support most of those claims. We focused on treatments built around a good theory, but a theory like mitochondrial damage or the problem plus anecdote well, john felt better when he did this plus an expert saying it works doesn't equal evidence. So, again, theory plus anecdote plus an expert is not evidence. And we finished with a sort of call to action for all of you to be like me, if you can, to be open-minded skeptics or curious skeptics Listen but question.
Speaker 1:Now, today we're going to continue the theme Now focusing on being over our skis. What do I mean by that? Well, promoting wellness or longevity approaches beyond what the evidence supports. Specifically when experts claim well, this works for this group of patients, but then they broadly hype it to far other uses. Now this is becoming increasingly common, whether it's red light therapy, microbiome treatments, nutritional supplements. There is truth for some uses, but unfortunately, the vast majority of uses there really isn't credible evidence. So why now? Why do I want to talk about this? Well, it's because I care about you. It really, really hurts me when people get excited, they flock to therapies when the evidence doesn't support it and it's almost kind of a religious fervor that folks might have. And this deeply hurts me because I know there's not evidence to support it. And not only is there not evidence. But when people get excited about these ways of solving whatever the problem is, they often waste money, they delay a chance to get real treatments and, in I said, it really hurts me when I see folks chasing the latest shiny longevity object and there are a lot of them and they keep changing and we keep chasing them.
Speaker 1:As I've shared before, my career really focused on what does and doesn't work in healthcare focused on what does and doesn't work in healthcare, and I publish about 180 papers or so on this topic, and so it's been a lifelong passion. My hope is that you, my listeners, can begin to spot these claims and by all means bring some to me. Send them through my website claims and by all means bring some to me. Send them through my website, drbobbylivelongandwellcom. I'd love to hear from you when you do it that way then I can respond to you.
Speaker 1:Also, I listen to a lot of health podcasts. I want to find out what's being said, how it's being said, and it's really frequent that what I hear is the experts will start with areas with some rigor to them and some evidence to support it, but then they quickly push way beyond it or, as the saying goes, over their skis. I want you to be able to see when that occurs and question it. Well, let me add a true confession, which is I did this episode on evidence issues and now I'm doing another one, and, yes, it's an important separate topic, but related. But it's a nerdy area for me and I don't know if it's something you guys are excited about, and as a podcaster, I always fear of boring my audience, losing my audience, and so, just so you know, this is my issue, I'll deal with it, but if you actually enjoy these type of explorations, specifically around evidence and claims about it, let me know what you think.
Speaker 1:Well, our plan for today, part one I'm going to provide some motivation with a bunch of examples that this phenomenon of being over our skis, of sharing ideas about what will help you, when maybe one use has evidence but a whole bunch of them don't that it's pretty darn common. Second, we're going to talk a bit about why does this occur, why does this occur so often? And then, third and very importantly, some action items that might help you combat this. Well, here's one action item. I'm about to do a series on healthcare costs. Everybody knows healthcare can be really expensive in general, for society and for us individually. Let me know what aspects of this issue you might want me to discuss. This has been a part of my career for decades and so it's an area I care passionately about. I just haven't spoken about it with you. So, again, send me a note through my website. Action item number two do continue to tell others about the podcast. It makes me very happy when I see new subscribers.
Speaker 1:All right, let's dive in Part one, some examples, and I'm going to begin with a few historical examples and then bring it to present day. Well, back in the 1600s to about the 1800s, scurvy was a really big deal, especially among sailors, because they had a very restricted amount of food when they were traveling across long distances at sea. And it was found that vitamin C well, they didn't really know it was vitamin C, but that lemons and lime and citrus fruits, which have vitamin C, could stop the problem from happening. Fast forward to the 1970s, nobel Prize winner in chemistry, linus Pauling, promoted the use of vitamin C to prevent colds. So we knew it had a very important use for scurvy. But now we have somebody pushing it for something really different like preventing colds. Oh, by the way, that has been completely debunked. Now today you still hear vitamin C helps our immune system and it may give us a boost of that immune system. So the issues still remain. Okay, a couple of years ago, ivermectin. Ivermectin is an important drug for worm infestations, parasites, and it cures river blindness, which is a huge cause of blindness in third world countries, especially in Africa. But then people started pushing it for COVID and pushing it, and pushing it and pushing it and ultimately it was clear that there wasn't evidence that it actually helped people. Well, here are some current ones that you'll see in the social media when you're driving down the street.
Speaker 1:How about hyperbaric oxygen? These chambers where you go in and they bombard you with high amounts of oxygen under pressure. Now it's absolutely critical. Hyperbaric oxygen chambers are life-saving for carbon monoxide poisoning. If you've been a part of a fire or if you're a scuba diver and you came up too fast and you have the nitrogen bends and it's been f FDA approved and really well studied for hard to heal wounds Like you have a diabetic foot ulcer or radiation induced tissue injury. Studies show hyperbaric oxygen really works for this wound healing under these circumstances and obviously for carbon monoxide poisoning and nitrogen poisoning. That's where there's evidence and the belief is that the hyperbaric oxygen increases oxygen in your tissues and might help the repair process in dothelial cells might do better and that evidence supports that this could work.
Speaker 1:But that's not why hyperbaric chambers are used most of the time. You get all of these claims. Well, they'll help you against aging, it will help your fatigue, it will help your migraine, headache, sports injuries or depression. None of these uses have solid clinical support. There are some risks associated with it. So it's not a completely benign procedure and also it's expensive. Each session in a hyperbaric chamber might be $200 to $1,200 or so and you might need many, many sessions. You might need three sessions, you might need 10 sessions, you might need 20 sessions. That's a lot of money. So that's one Narrow uses, absolutely important. But then people are like well, I got this chamber, maybe there's other uses I can charge for, and that's what you see, okay, well, it's not unique to hyperbaric chambers.
Speaker 1:How about vitamin B12? Well, vitamin B12 deficiency is a real problem. Now, it's not very common nowadays, but it can cause anemia because your blood cells need it to multiply and grow, and if it's really bad, it can cause significant brain issues, cognitive impairment. Now, if you are deficient in B12, taking a supplement will correct that deficit, and if you have one of these uncommon problems, it can reverse it. But, just like hyperbaric treatments, it's over-promoted for unproven uses. You'll hear vitamin B12 can prevent dementia. It can improve your mood and your heart health and enhance athletic performance, none of which has evidence to support it. So, just like the hyperbaric, it's absolutely helpful in some conditions, but those are uncommon. And it's being promoted for a huge number of other things, and you've probably seen these IV therapy clinics that give vitamin B12 and other things.
Speaker 1:Well, there's a local company. I went on internet and looked to see what's being pushed in my local area in Texas. Well, there's one place that has the Myers cocktail. For $335, they'll hook up an IV and if you have a hangover, a cold, a flu, anxiety, fatigue, muscle aches, allergies, headaches, they claim it's perfect for you. Of course, there's no evidence to support that.
Speaker 1:What do these things contain? They contain saline, meaning salt water. They contain vitamin B12 that we just talked about. They contain vitamin C, may contain magnesium or maybe some zinc. They might tout an immune IV package or a health, skin and nail package, or, for an extra $100, you can get NAD plus added. This all sounds healthy.
Speaker 1:These are things that could be good for our body and beneficial, but for somebody who is basically able to eat and drink, there is absolutely no benefit for a typical person with these types of infusions. Frankly, you can absorb all of this if you drink Gatorade and maybe take a multivitamin. There is no evidence to support that. For a typical person with any of those symptoms, giving those things IV is anything other than a complete waste of money. Now, if you're dehydrated, you're taken to the emergency room and your blood pressure is low, Of course IV therapy is important, but again, it just gets promoted way beyond where the evidence takes us. Well, how about a third one? Detox your toxins Sounds good. You got these bad things inside you and I talked about it in episode 29,.
Speaker 1:There are real reasons to do detox treatments If you have heavy metal poisoning like lead or mercury. Now, this is pretty uncommon today, but when it occurs, this can be very damaging, and this is, of course, at high doses of these heavy metals, and you might need chelation agents which attach to these heavy metals and they remove it from your body. Okay, so evidence supports it for these uncommon uses, but it's marketed for so much more. Heart disease, it'll cure your autism in your child cancer. All of this lets detoxify our body, again without proof. So uses for some things uncommonly great evidence. But yet the world of marketing pushes it way beyond that.
Speaker 1:One more example stem cell therapy. Stem cell therapy is a really important modality for certain blood disorders leukemia, lymphoma, other kinds of bone marrow disorders, other kinds of bone marrow disorders. Stem cells then go to the bone marrow, help repopulate the cells there and help solve those diseases along with other therapies that are adjunctive to it. Great, good evidence, really important. There's a little bit of evidence for patients with osteoarthritis injecting it into the knee. Maybe it helps pain. A little bit of evidence for patients with osteoarthritis injecting it into the knee. Maybe it helps pain a little bit, maybe it helps function a little bit. But there's no evidence that it rebuilds your cartilage as people claim. So again, we're starting to push over our skis beyond what's known.
Speaker 1:But you're also seeing claims for stem cells to help dementia or COPD or spinal cord injury. Gosh, I wish it would work there. Maybe in the future it will. Or heart disease. So there may be some early animal studies in some of these areas, but there is no rigorous proof in people. So, once again, stem cells, like these other therapies, great evidence for some uses, but then you see it extrapolated for so many others. Stem cells are expensive. They're about $4,000 per treatment and you may need many of these treatments. So without evidence, spending a lot of money doesn't seem good.
Speaker 1:All right, let's turn to part two. Hopefully, with part one, you realize that this actually happens a lot and that you may be running across these uses beyond what the evidence supports. So why does it happen? Probably, first and foremost, patients want relief. If you have a problem, a pain, fatigue, headaches that regular medicine isn't helping, it's natural to want to find relief anywhere you can find it and there is a power of taking control. Well, I know maybe these IV therapies won't work, but it's something I'm doing on Wednesdays and maybe it will help me. So that's really important to feel you are empowered. And, as we've talked about in a prior episode on placebo, placebos are real. But I'm not sure I want to be spending money and my time if it's really just about placebo, all right.
Speaker 1:Second reason why this occurs financial incentives, absolutely Seems like. Almost everywhere you turn, everyone is selling something. As I said, I listen to a lot of podcasts and almost all of these podcasts have advertisers or the people have financial stakes in the companies that are related to this. I heard a great description We've heard about big pharma and the power they have, or big ag, big agriculture and the power they have. I heard something recently and it really struck me, and they said big wellness, that the wellness and the longevity space has grown into a huge industry with billions and billions and billions and billions of dollars being spent on it 150 billion, 300 billion a tremendous amount and as this happens, people who are making money have power to try to promote it and influence, perhaps, public policy and other kinds of things. So, big wellness interesting way to put it. And the other reason that this has become a big issue is because of social media.
Speaker 1:All of us have, to some extent, fomo, fear of missing out. I have that. I suspect maybe you do too, but when you hear about something on social media. Well, I tried this and I lost weight. I tried this and my headaches, which I'd had for decades, went away. I tried this and my fatigue, which was so problematic, got better, and this is what I did to solve this problem. Might've been a supplement, might have been a red light therapy or something else, and we have a fear of missing out. It's like, oh my God, it helped them, but again, was there evidence to support it?
Speaker 1:Let's now turn to part three. What can we do about all this? Like before, ask yourself, ask the practitioner who's pushing it? Is this really theory or is it based on evidence? And remember to me a theory like allergies are the key to all your problems. You need this supplement or diet or whatever. So a theory of what is wrong plus an anecdote well, sarah did really well plus an expert pushing it does not equal evidence. So keep that in mind.
Speaker 1:So, specifically, some action items here. What questions might you ask when you run across one of these therapies? Not a broad question has this been proven to work? But has it been proven to work in my condition, whatever that is? Or is it primarily an anecdote? Yes, it's been proven for that condition, but has it been proven in my condition? Has there been rigorous studies in people for the exact problem I have? What are the risks associated with doing this? What are the costs associated with doing this? What's the impact if you delay a routine treatment to try these and are the ones promoting this new approach, financially benefiting or benefiting in some other way? And ultimately, like the title of this podcast episode, are the experts over their evidentiary skis. Action item number three for you. Send me examples of what you're seeing around town or in social media. Maybe we can do a follow-up based on your examples.
Speaker 1:Well, we've come to the end, so we need to wrap up. As always, let's try to be open-minded skeptic Not just skeptical of everything, but open-minded, curious skeptics. I always hope you will live long and well, based upon real human evidence, not hype. Until next time, goodbye. Thanks so much for listening to Live Long and Well with Dr Bobby. If you liked this episode, please provide a review on Apple or Spotify or wherever you listen. If you want to continue this journey or want to receive my newsletter on practical and scientific ways to improve your health and longevity, please visit me at drbobbilivelongandwellcom. That's, doctor, as in D-R Bobby. Live long and wellcom.