How Do Veterinarians Die? (McGill OSS)

4 minute read

I wouldn’t blame you for thinking something along the lines of “just like everyone else,” but I’m here to tell you otherwise.

Being a veterinarian is a lot like being a human doctor. Besides the fact that both professions practice medicine, albeit on different subjects, they both require top grades and many years of school. They usually necessitate one to go into debt, to work long hours, to have extreme empathy and to be on call for days at a time.

Given their similarities, we’d expect them to have similar mortality rates and causes of death, but that isn’t the case. Veterinarians are at an extremely elevated risk for suicide.

Studies find that veterinarians are between 4 and 8 times more likely to kill themselves than the general population.  A study of 1,551 American vets from 1966-1977 found a greater than 100% increase in suicides, and a 2012 Canadian Veterinary Medical Association survey found that 19% of respondents had seriously considered suicide, with 9% having made attempts. These risks seem to exist for vets around the world.

But why though? These high rates don’t seem to be mirrored in their human-treating counterparts (though some studies do find the rates of suicide in physicians elevated, but to a lesser extent), and appears to directly oppose the correlation between lowered mortality rates and graduate degrees.

Read the entire article here:

Is Algaecal a Marine Mineral Miracle or Just Another Overhyped Health Product?

7 minute read
Originally posted here:

Every supplement makes flashy claims, but the ones made by AlgaeCal, that it is “the only calcium supplement that increases bone density” is particularly bold. You see, while every other calcium supplement currently on the market can, at best, decrease the rate of loss of bone density, AlgaeCal claims to be able to fully tip the scales in the other direction and make your bones denser with time. So, are the makers of AlgaeCal lying, or is it truly a miracle marine mineral? Does it represent a breakthrough in the way that we treat osteoporosis? Let’s look at the science.

Why do I care how dense my bones are?

Put simply, because bones that are less dense break more easily, and no one likes broken bones.

As we live our day-to-day lives our bones receive micro-damage. To combat this, our bones are in a constant state of remodelling. So constant in fact that up to 10% of our bones may be in the remodelling process at any one time. This remodelling has two main parts: bone resorption, and bone formation. Most of the time these two processes exist in equilibrium, but as we age this equilibrium can shift (for a wide variety of very complicated reasons). The result is osteoporosis. It affects roughly 10% of Canadians aged 40 or older and is characterized by weak and brittle bones that break in situations healthy bones would not, like when bending over to pick something up.

We can put a number on this loss of bone strength by looking at bone mineral (a calcium-containing compound that makes up 70% of the mass of a human bone called carbonated hydroxyapatite) since it is responsible for most of a bone’s strength. The bone mineral density (BMD) is a good predictor of fracture risks and can be easily and painlessly measured using a DEXA test.

As aside: What is a DEXA test?
DEXA stands for dual-energy X-ray absorptiometry, a non-invasive procedure that involves lying on a table for several minutes while two X-ray beams are aimed at your hip, spine, wrist or other bone. As for how this allows doctors to measure your BMD, I’ll let Osteoporosis Canada explain: “Think of the light shining through the curtains of your home on a sunny day. The amount of light that reaches your eye depends on the thickness of the curtains. If your curtains are very thick, very little sunlight passes through them. If, however, you replace them with a thinner fabric, the light coming through to you will increase substantially. Similarly, a bone densitometer uses a detector to measure the transmission of small amounts of X-rays (light) through your bones. The amount of light that passes through the bone is measured, thus providing a radiologist with a picture that indicates how dense (thick or thin) your bones are.”

How well do the existing calcium supplements work?

AlgaeCal costs more than 100 times as much as normal calcium supplements, so it must work much, much better right? Well, to answer that we first have to look at how well traditional calcium supplements work.

A 2007 meta-analysis published in The Lancet found, looked at both studies using fractures or BMD as their endpoint, and found that calcium supplementation was associated with a 12% risk reduction in all fracture types, and a 0.54% reduction in the rate of BMD loss in the hip and a 1.19% in the spine.

Basically, calcium supplements can help mitigate the decrease in BMD and increase in fracture risk that come with osteoporosis.

An aside: Why do we sometimes use fractures and sometimes use bone mineral density as our outcome?
The main negative outcome of osteoporosis is bone fractures. So, when we’re testing treatments for osteoporosis, we would ideally use fractures as our endpoint. Basically, that means that we would test if patients receiving a particular treatment suffer fewer fractures to see if that treatment works. This, however, can be difficult to do. If researchers run studies on osteoporosis treatments only lasting a few years, they may get artificially skewed numbers, as patients could experience no fractures during the study, but suffer one days after it ends, or they could experience two fractures during the study period but never another. Hypothetically, researchers could monitor osteoporotic patients from the time they’re diagnosed with osteoporosis to the time of their death, but the logistics of funding and operating an over-30-year-long study would be monumental. So, our options are to either run studies over only a few years using fractures as an endpoint but with a large number of participants to help account for the inconsistencies or to use bone mineral density as a surrogate clinical endpoint.

While some studies have found that calcium supplementation is not effective unless given with vitamin D, the Lancet meta-analysis found no statistical difference between the risk reductions offered by calcium alone versus calcium + vitamin D. Vitamin D only affected the fracture risk if the patient was deficient in it, and a similar effect was seen with calcium. Essentially, if you’re vitamin D or calcium deficient, it could be affecting your body’s ability to create new bones, but if you’re not, taking a vitamin D supplement likely won’t help you avoid broken bones, and taking calcium supplements will only help a bit.

How is AlgaeCal different from traditional calcium supplements?

What is it about AlgaeCal that allows it to do what other calcium supplements cannot? Well, what is AlgaeCal?

As you may have gathered from the name, AlgaeCal is made from algae. Specifically, a red algae found in the waters near Brazil, South Africa and New South Wales in Australia. The AlgaeCal website explains that the balls of algae are harvested by hand, sun-dried and then milled into a powder. It states that it is “pure whole food,” even though it is very literally not whole but ground up and that AlgaeCal contains “Nutrients. Not Chemicals.” I hate to be the one to tell them, but calcium, the selling point of their supplement, is so much of a chemical that it’s even on the periodic table of the elements!

The website states that AlgaeCal Plus naturally contains “all 13 essential bone supporting minerals: calcium, magnesium, boron, copper, manganese, silicon, nickel, selenium, strontium, phosphorus, potassium, vanadium, and zinc”, as well as vitamins D3 and K2. Unfortunately, they only provide values for six of these minerals, making it impossible to know if the others are present in useful amounts.

Even for the minerals we know the amounts of, the research supporting their effects on BMD is a bit weak. This 2008 study found no relation between boron intake and BMD in the femur or lower spine, and this 2000 studyfound that low vitamin K2 intake was not associated with low BMD.

So, if these minerals don’t matter, is the calcium in AlgaeCal somehow different than traditional calcium supplements?

Well, it claims to contain “pre-digested” or “plant-digested” calcium. Unsure what this meant, even having studied science for many years, I reached out to the company and asked. Unfortunately, their answer didn’t really explain much: “In regards to pre-digested, the algae itself absorbs all 13 bone-building minerals and pre-digests them for you.” I guess what they mean by pre-digested is just one of the great mysteries of the universe, like dark matter and why it’s impossible to eat only one potato chip.

Anyways, whatever pre-digested means, all that really matters is the bioavailability of the calcium or the amount that is absorbed through your digestive tract and into your bloodstream.

Calcium in conventional calcium supplements (or “rock-based” calcium, as AlgaeCal calls it) can be in a variety of salts, which, according to a 2000 review have bioavailabilities ranging from 23-37%. So, this is the number to beat for AlgaeCal.

Too bad we have no idea what the bioavailability of AlgaeCal actually is! While a clinical trial to answer that question was started in 2009 and finished in 2010, no data from it was ever published. Perhaps because it didn’t show the results that AlgaeCal wanted it to.

Nonetheless, the AlgaeCal website claims that there are 4 studies that support their product’s effectiveness. So, let’s take a look at those.

The studies of AlgaeCal

The first one published looked at AlgaeCal’s effects on human bone cells. The researchers treated human osteoblast cells with either AlgaeCal, calcium carbonate or calcium citrate, and found that AlgaeCal-treated cells showed statistically better function than the cells treated with the other calcium compounds. But there are two problems with this study. First, results in Petri dishes rarely translate directly to humans. Second, this study was funded, at least in part, by AlgaeCal. A conflict of interest that throws all of these results into question.

The next two studies (12), both done in 2011, were thankfully done in humans. They compared several “bone-health plans” (see image below) implemented in 176 participants and found that any of the plans were associated with increases in BMD. Not just that they slowed losses but that they increased bone mineral density!

Unfortunately, a few aspects of the designs of these studies prevent us from trusting their results. They weren’t blinded in any fashion, which means the results could be extremely biased, and they were not placebo-controlled. Oh, and also the lead scientist, Dr. Gilbert Kaats, is the CEO of Integrative Health Technologies inc., a company that has invested in AlgaeCal, and funded one of the studies! That’s a conflict of interest if I’ve ever seen one.

The last study on their site, from 2016, is also headed by Dr. Kaats, and funded via a grant provided by AlgaeCal themselves. Like the others, it wasn’t placebo-controlled or blinded in any fashion and, like the others, it showed increases of BMD over a 7-year period.

If we could trust these results, that is to say, if these results were replicated in a double-blind, placebo-controlled study that wasn’t funded by AlgaeCal or led by someone with a conflict of interest, it would be incredible. If we truly could increase the BMD of those with osteoporosis, not just slow their losses, it would literally revolutionize how doctors treat these patients. But when something seems too good to be true, it usually is.

It’s certainly true that new drugs or treatments are sometimes discovered that revolutionize medicine. A quick look at ganciclovir or penicillin proves that. But it doesn’t happen often, and before we start considering AlgaeCal revolutionary, we need an independently performed study.

So, while we don’t know if AlgaeCal is a pseudoscientific product, it sure does market itself like one. Ever since I first googled this product, I have been inundated with ads for AlgaeCal on every platform from Twitter to Buzzfeed. Now, aggressive marketing doesn’t necessarily mean a product isn’t evidence-based. However, when I’ve previously looked into the science behind products that forcefully target me with ads (like BioSilAllerpet or Skinny Magic) the evidence has not been in their favour.

As of right now, it’s hard to say whether AlgaeCal works or not. All we can really say is that there’s no good evidence that it does. Also, it’s expensive. At $2.17 CAD per day, you would save quite a bit of money by instead buying a traditional calcium supplement and throw in a vitamin D supplement too, for $0.14 per day.

Using Imodium as an Opioid

Originally published here:

The drug marketed as Imodium, loperamide, has found a new, unintended use. While traditionally used for relieving diarrhea, some drug users are now turning to loperamide to either relieve the symptoms of opioid withdrawal, or achieve a high. Loperamide is an opioid receptor agonist, meaning it is very effective at activating opioid receptors, but capsules of Imodium contain very little of loperamide. A normal dose for an adult is 2 capsules, or 4 mg of loperamide, with the maximum dose capping out at 8 capsules, or 16 mg. Forums online cite drug users as recommending a minimum of 100 mg, or 50 tablets to achieve the euphoric high they’re searching for, and some users have taken as many as 200 capsules, or 100 mg. Such a high dose is necessary for psychoactive effects because loperamide essentially does not pass the blood brain barrier, which prevents it from affective the central nervous system at low doses. At these high doses though, users are at a high risk for death due to cardiotoxicity– a dysfunction of the electrical systems of the heart, or damage to its muscles. Naloxone, the main emergency drug in opioid overdose, can treat symptoms like decreased respiration function or unconsciousness, but it is unable to reverse the damage to the heart that loperamide may cause. Not to mention that high doses of Imodium will cause an extreme version of its intended effect- lack of bowel movements. Many users of loperamide are actually trying to treat their opioid withdrawal symptoms, in an attempt to eventually get clean, but do not realize the significant risk associated with such high doses of Imodium. Part of the reason loperamide is so dangerous is its wide availability. Any drug, corner or grocery store will carry it, and there is no limit of the number of packages bought, or the age for purchasing it. Indeed, recent reports have called for placing it under restrictions similar to those affective cough medicine in America.

Is There Evidence for Massage as a Medical Treatment?

Originally published here:

Most of us will agree that a massage feels very nice, but does massage therapy actually have any medical effects? A 2004 paper reviewed the research on massage therapy available at the time and found some interesting things. After 1 massage session, massage clients show reduced heart rates, blood pressures, cortisol levels (the main stress hormone) and anxiety, and after several sessions, clients showed remarkable drops in depression levels, on par with the positive effects of psychotherapy.

The same paper found that immediately after massage, clients didn’t report drops in their pain levels, but after several sessions, they reported better pain levels. There are a few theories for why this is, with one of the most popular being that massage lowers stress and anxiety, better-allowing sleep to occur and healing to occur during that sleep. Other theories for why massage can help with pain (short or long term) include the gate control theory, that touch, vibration and pressure signals can block pain signals to neurons, and the theory that massage activates the parasympathetic nervous system, which triggers the release of endorphins and hormones that contribute to feelings of wellness.

Medical effects aside, massages just feel nice, and things that make humans happy tend to trigger hormone reactions that propagate those nice feelings. And we mustn’t forget the possible placebo effects of believing massages help us.

Cissus quadrangularis: the Fever Fighting, Pain Preventing, Diabetes Defeating Supplement?

Originally published here:

Cissus quadrangularisis a plant which belongs in the grape family, has red berries, and green or yellow flowers. Cissus quadrangularisis also the name slapped across a lot of supplements that claim to support ‘optimal joint health’, ‘promote healthy bone structure’, and support ‘healthy weight management’. Add in a few anti-ulcer properties, a pain-killing effect and even type II diabetes support, and this all sounds too good to be true. And it is right?

Well, as per usual, there’s some truth to this plant’s claims, and a lot of overblown and overhyped information.

Cissus quadrangularishas been used for centuries in the traditional medical practices of India. It’s used as a pain reliever, and to heal broken bones. Indeed one of its many names is asthisamharaka, which translates to ‘that which prevents the destruction of bones’.

There are a lot of claims about Cquadrangularis(CQ), but we can broadly divide them into a few different groups, its action as an: analgesic (pain relieving), anti-inflammatory, antioxidant, bone growth supplement and weight loss supplement. Let’s unpack these one at a time.

There have been a few studies looking at the potential pain relieving effects of CQ. A 2010 study looked at the ability of CQ supplements to inhibit pain in rats. They compared 50, 100 and 150 mg/kg bwt (body weight) of CQ with 300 mg/kg bwt of aspirin, and found CQ to be more effective than aspirin at 150 mg/kg bwt. A 2008 studylooked at CQs analgesic effects in albino mice, and found that at doses of 250 or 350 mg/kg bwt CQ worked to inhibit both neurogenic pain (pain from damage to nerves) and inflammatory caused nociceptive pain (pain resulting from injury). The extra 100 mg/kg bwt of CQ caused a ~10% increase in pain tolerance, in both types of pain. A 2008 studyechoed the finding that CQ acts as an analgesic, and suggests ‘the analgesic activity may be due to the presence of carotene, phytosterol substances, calcium, sitosterol, amyrin and amyrone’.

Most analgesics also have some anti-inflammatory action, and it seems that CQ is no different. This 2007 study looked at the supplement’s analgesic, anti-inflammatory and venotonic (increasing venous blood flow) effects, specifically in how they may be used to treat hemorrhoids, and rules positively. The same studythat looked at pain in rats also examined CQ’s ability to act as an anti-inflammatory and an antipyretic. As an anti-inflammatory, 150 mg/kg bwt CQ was more effective than 300 mg/kg bwt aspirin for the first 3 hours after administration. After this time, CQ lagged behind aspirin, but only slightly. As an antipyretic, CQ in the doses tested (50, 100, 150 mg/kg bwt) was less effective than aspirin, but still showed ‘marked’ antipyretic effects.

As far as antioxidant action goes, CQ seems to fair quite well. This 2010 studynotes CQ’s efficacy at lowering lipid levels, improving insulin sensitivity and general antioxidant protection. A 2006 study examined CQ’s potential in treating ulcers caused by NSAIDs (like Advil). In doses of 500 mg/kg bwt, CQ was shown to ‘effectively reduce the extant of gastric lesions’ when used before aspirin treatments. The antioxidants in CQ allow it to enhance ‘defence enzymes in gastric mucosal tissues’. It’s theorized that CQ acts by inhibiting the formation of pro-inflammatory cytokines (substances that tell the body to become inflamed), but no studies that I could find seem sure of the mechanism of CQ’s ulcer defence. They do, however, seem fairly sure that it works.

This 2004 study  noted that CQ supplementation caused an increase in mucous secretion in the stomach, and an increased concentration of mucin, the major protein constituent, in that mucous. It also noted a decreased number of shed cells, and an increase in the DNA per mg of mucous, both of which signal healthier stomach lining. Another 2006 studymirrored the ulcer-healing properties of CQ, and suggested that the high β-carotene content of the plant is responsible for its antioxidative properties.

Speaking of healing things, why not bones too? This 2003 studyfound that treatment with 750 mg/kg bwt CQ per day for 3 months caused a significant increase in osteoblastic (bone cell formation) and decrease in osteoclastic (bone cell re-absorption) activity. It suggests that an unidentified anabolic phytogenic steroid is responsible for CQ’s osteoporosis fighting capability. This 2009 studymimics the preventative effects of CQ on bone loss, and postulate that its effect is due to the steroids interacting with estrogen receptors. A different 2009 studygave perhaps the most in depth analysis of CQ’s method of action. It found that CQ activated and sped up the process of turning bone marrow stem cells into osteoblasts (bone cells).

Now for the claim that seems to be the odd one out, CQ’s effectiveness as a weight loss drug. This 2006 studyfound that at daily doses of 1028 mg for 8 weeks, CQ combined with green tea, soy, B vitamins, selenium and chromium reduced ‘weight, % body fat, BMI and, especially, waist circumference of obese and overweight patients, regardless of calorie-controlled diet’. A 2008 studyconfirmed these results, and specifically found that a combination of CQ and Irvingia gabonensis (African Mango) positively affected patient’s weights and other parameters of metabolic syndrome. 

So how can one plant be having this many effects? Well, that remains to be seen. When researching CQ I found an abundance of studies, without an abundance of answers, and I expect more research to be done in the future. We do knowhowever a lot of the constituents in CQ, such as ‘flavanoids, triterpenoids, Vitamin C, stilbene derivatives, resveratrol, piceatannol, pallidol perthenocissin and phytosterols’. We know that ‘the plant contains ascorbic acid, 479 mg and carotene, 267 mg per 100 g freshly prepared paste, in addition to calcium oxalate’, and that ‘the root powder also contain a rich source of mineral elements (mg/100g dry matter): potassium 67.5, calcium 39.5, zinc 3.0, sodium 22.5, iron 7.5, lead 3.5, cadmium 0.25, copper 0.5 and magnesium 1.15’.

We need to be careful though not to fall into a trap of seeing a long list of chemical names and assuming it’s a new wonder drug. Some of these things are known to be beneficial to humans (like vitamin C), others have more debated effects (like resveratrol), and like every drug, dose matters. It doesn’t matter is CQ has pallidol, if it’s not in relevant amounts. Almost every study that I cited here ends with some variation of ‘further work is necessary to isolate active principles and elucidate the actual mechanism involved in the antioxidant activity of this plant’, meaning that even in the face of these results, these studies know that research is crucial to fully understand this supplements, before we can recommend it for humans. Not to mention that the majority of studies mentioned here were performed on rats or mice, and though they’re good human analogues, they are not perfect replicas.

There is also potentially some behind the scenes meddling at play in these remarkable findings. As this 2010 journal letterpoints out, ’at least 3 recently published studies support the safety and effectiveness of CQ for weight loss but lack financial disclosures or funding sources’. It’s a common practice for studies to mention their funding sources, whether they be McGill University, Government of Canada, or the Liquor Control Board of Ontario. Stating where the money comes from for a study allows readers to know if any involved parties have vested interests, as some CQ study authors seem to. The 3 aforementioned studies have an author in common, who holds the patent for Hydroxycut Advanced, a weight loss supplement using CQ. If that’s not a conflict of interest, then I’m not sure what is.

Looking at the studies of CQ, I’d be hard pressed to deny its potential for use in the treatment of a variety of illnesses, but looking at the state of CQ research right now, I wouldn’t add it to my Amazon cart just yet. 

Under The Microscope: Rose Petals

Originally posted here:

Nowadays roses are mostly used for Bachelorette ceremonies and hipster lattes, but once upon a time roses, and their fruit, rose hips, were widely used as medicines.
Diarrhodon is the name given to herbal treatments containing roses, and there are lots of them, said to treat everything from liver problems to heart problems to digestion issues. Traditional Chinese medicine made use of the China rose for regulating menstruation, pain relief, thyroid problems and diarrhea.
Did any of the rose-based traditional therapies work? Well, at least one could have. As rose-hips are quite high in vitamin C, they would likely have done wonders for sailors afflicted with scurvy.
Today we mostly keep our rose-based products for use in cosmetics, and a few specialty food products like rose hip jam, rose water or syrup that is common in many Indian desserts, or rose flavouring for ice cream, liquor or hipster lattes.
Even though the petals in these photos have been dried for more than 5 years, they still retain a fair amount of pollen, seen as yellow specs on their surface.

BioSil: Can it Really Help Thicken Your Hair and Nails?

Originally published here:

The ads for BioSil look and sound like every other supplement ad. There are bold claims like “promotes unbreakable nails” (I’m pretty sure that’s impossible); references to science like “molecular biologists have pinpointed the key structural protein…” and “your own DNA fingerprint”; and a blond celebrity (Christie Brinkley) smiling while talking about how this product, in particular, has changed her life.

The BioSil website features the familiar refrain “This statement has not been evaluated by the Food and Drug Administration” after every statement about their product, as well as snazzy scientific-looking pictorial representations of what it can do for you.

BioSil is manufactured by Natural Factors. Their site features images of sprawling fields and a cross-section of a grassy patch complete with worms. Everything about it inspires thoughts of nature, because natural is always better, right?

Too bad their site also says “You should not use the information on this site for diagnosis or treatment of any health problem or for prescription of any medication or other treatment.” I would definitely call a supplement for “Rejuvenating your hair, skin, and nails” a treatment, but what do I know?

BioSil’s advertisements, bottles and website make three main claims:

  1. Thickens and strengthens hair
  2. Improves skin elasticity and reduces wrinkles
  3. Strengthens nails

The active ingredient in BioSil is choline-stabilized orthosilicic acid (ch-OSA). Orthosilicic acid is just a silicon atom surrounded by four hydroxide (OH) units, but it is unstable on its own. Enter choline. Choline is an essential nutrient for humans that most of us consume more than enough of every day (it’s found in everything from cauliflower to tofu to chicken to almonds). In BioSil, choline serves to stabilize the orthosilicic acid.

BioSil’s website constantly references clinical trial results, so I read the two trials in question. It’s important to note that we can’t take these studies’ conclusions at face value. Not all studies are created equal. There are a plethora of issues that can hide in a study’s design that could call its conclusions into question. We need to evaluate the design and procedures of a study to know whether we can trust its results. That’s not always an easy task, so let me help.

The first study involved 48 middle-aged, white, healthy women with fine hair (as determined by the study’s hairdresser). 24 of the women were given a placebo, while 24 were given 10 mg of ch-OSA orally for 9 months, during which they did not heat or colour-treat their hair. The 45 women who finished the study had the diameter and tensile strength of their hair measured at the beginning and end of the treatment.

As for the results, well, they’re pretty confusing. I mean look at this:

“the elastic gradient decreased in both groups, but the change was significantly smaller in the ch-OSA group (-4.52%, P = 0.027) compared to the placebo group (-11.9%).”

What does P = 0.027 mean? Let me try to explain.

When a scientist writing a study says that something is significant, it is not the same as when I yell at my TV that the colour of the Monster’s hair on The Masked Singer is significant. Significance in science actually refers to statistical significance, which is measured with something called a p-value.

It’s a controversial way to measure significance but has been something of a standard for a long time (though that is slowly changing). You can click below to read about how p-values work and why they are so confusing, but to evaluate this product all you need to know is that if something is statistically significant, we can say that it is meaningfully different from something else.

For example, we could take a hair sample from someone in the ch-OSA group at the beginning and end of the 9-month period and compare them. A statistically significant result would mean that they are significantly different, i.e. that the thickness of the hair changed in those 9 months.

We could also compare the hair of someone using ch-OSA to the hair of someone using a placebo at the end of the 9 months. A statistically significant result here would mean that whatever happened to the hair with ch-OSA did not also happen with placebo.

Almost every experiment has two hypotheses. Yeah, two. The null hypothesis is the status quo, the prediction that nothing will change. By finding a significant p-value you disprove the null hypothesis. In the Biosil study’s case the null hypothesis is that there was no difference between the effects of the placebo and the ch-OSA. The other hypothesis is the alternate hypothesis, the prediction for the effect your treatment will have. By disproving the null hypothesis, you can conclude that the alternate hypothesis may be confirmed. In this study’s case it’s that the ch-OSA supplement improved hair strength and cross-section more than the placebo

So how do we decide which hypothesis fits with our study results best?

The p-value!

Often times the seemingly magical target to match or surpass is a p-value of 0.05.

That tells us that there is only a 5% chance of obtaining the data we did, or data more extreme than ours if the null hypothesis is true.

In our case a p-value of 0.05 would mean that there was only a 5% chance of getting our data, or data showing even more difference between the placebo and ch-OSA if the placebo and ch-OSA really did have no difference in their effects.

Why 0.05? Because that is what scientists have decided. They could have decided something else, and many others do use a different value. But 0.05 remains the usual p-value threshold of significance.

Looking at the study results we can see that the decrease seen in the elastic gradient of hair was significantly smaller in the ch-OSA group than in the placebo group. This would imply that the ch-OSA helped the hair stay stretchy.

But, we can also look at the yield extension of hair, and see that it was significantly increased for both the placebo group and the ch-OSA group. This would imply that it was not the ch-OSA that caused the improvement in yield extension.

Looking at hair diameter (the literal hair thickness) we can see that the hair of those who took the placebo did not significantly increase, whereas the hair of those who took ch-OSA did. So that is a good mark in ch-OSA’s book, right?

Well, it is not as simple as proving significance. Something of concern in these results is the considerable amount of overlap between the placebo’s effects and the ch-OSA’s effects.

Take a look at the graphs below. I’ve shown the range of results for the ch-OSA group in yellow, and the range of results for the placebo group in blue. Where there is green means that they overlap. 

The majority of each coloured section is green.

This means that there was quite a noteworthy amount of people in the ch-OSA group who experienced the same effects as the placebo group, and vice versa.

Do you really want to pay $25.99 plus tax per month for the chance to be in that little yellow bit?

There is another thing we need to remember when looking at these results: statistical significance does not always equal practical significance.

Those who took the ch-OSA saw a statistically significant increase in their hair diameter, sure, but did they notice it in the mirror, shower or at the hairdressers? Did their hair feel thicker to them? It is possible that the result was statistically significant but that, if asked, participants would say their hair felt no thicker to them, meaning that it was not practically significant.

Do you really want to pay $25.99 plus tax per month for results you can’t even see?

We can evaluate the practical significance of a result through something called the effect size. This measures the magnitude of a phenomenon and would give us an idea not just whether hair thickness improved but also by how much. Sadly, this study does not report an effect size (although judging by the percent increases in diameter of hair, I would guess that it is likely quite small).

So, can ch-OSA make your hair thicker? Maybe. But also, maybe not. And probably not by that much.

As for the other study the product cites, well, I’ll skip explaining the analysis of this one and cut to the chase.

The second study showed that ch-OSA actually decreased skin hydration, although it did very slightly improve skin roughness, nail brittleness and hair brittleness. The problem again is one of effect size. Looking at nail brittleness, participants had the brittleness of their nails ranked from 0 (not brittle) to 3 (severely brittle). With ch-OSA treatment their brittle scores did decrease, but by very little.

So, can ch-OSA help your skin be smoother, your nails be stronger, or your hair be thicker? If you are a middle-aged, healthy, white woman who does not treat her hair, maybe. A teensy bit. But if you are anyone else, we have no evidence to suggest so.