Skip to content



What is the “sick user” effect and why does it screw up science?

It’s all very well Mike Adams (The Health Ranger) getting up in arms about conspiracies and supposed scientific fraud. I admire his enthusiasm and there is certainly plenty of the things he gets angry about going on in the world.

But science is nowhere near as cut and dried as untrained people think. Mike is not a doctor and has never been in a clinical situation or had to figure out fact from fiction in a patient setting.

Not all doctors and scientists who come up with odd answers are crooks, Mike!

As an example, let’s take a published study that investigates the taking of vitamins: it follows a bunch of people who take supplements and concludes that vitamins actually shorten your life. On average, the supplement takers died sooner… That’s obviously a fraudulent study; we know that vitamins help you live longer, right?

Well, no! That’s not necessarily true.

It may be that naughty patients themselves are screwing up the investigation, not the doctors. How so?

It’s a common enough observation among doctors in general that most patients do want to bother getting involved in living a healthy lifestyle. They are too lazy and expect doctors to fix them, after decades of self abuse, when they finally get sick and have to report in.

But when he or she is diagnosed with cancer, the patient suddenly gets very interested in health issues; maybe starts exercising; and taking supplements. It may be too late! In any case, he or she doesn’t do much else; no vigorous lifestyle changes; no heartfelt emotional cleansing. He or she dies on schedule and gets listed as someone on supplements who died prematurely.

It’s called “sick user syndrome” and is often a problem for researchers. People who are already in trouble suddenly jump on the bandwagon and profoundly distort the resulting statistics. It may even look like a therapy causes trouble: but it doesn’t at all, it’s just that “sick users” tend to influence the results.

OK, Mike?

This was noted by a great 11-year EPIC study published recently (EPIC doesn’t mean epic, it stands for European Prospective Investigation into Cancer and Nutrition, a GREAT initiative). They showed overall the powerful benefits of antioxidant vitamin supplement use at the start of the study was associated with a 48 percent reduction in the risk of cancer mortality over 11 years of study. The findings were published in the European Journal of Nutrition.

In addition, the risk of all-cause mortality was reduced by 42 percent in people who were supplement users at the start of the study. That’s the cruncher: if the person was genuinely interested in health and ALREADY taking supplements as part of a lifestyle regime, he or she did exceptionally well (I know of no drug that can achieve that kind of mortality reduction).

So where did the “sick user” result come in?

The EPIC researchers noted that people who started taking supplements AFTER the start of the study were at a higher risk of cancer mortality and so-called all-cause mortality. These were the naught minority who didn’t take any sensible health measures, till diagnosed, and then jumped onto the vitamin game, in the vain hope it would save them…

Nah. Life is cruel like that.


Of course there are those who are not happy with any finding that taking nutrients is good for us. In 2007 an infamous meta-analysis was published by Goran Bjelakovic et al. and from the Copenhagen Trial Unit at the Copenhagen University Hospital in Denmark in the Journal of the American Medical Association (Vol. 297, pp. 842-857).

The meta-analysis “proved” that vitamins A and E, and beta-carotene may increase mortality risk by up to 16 per cent. But in fact the trial was totally bent (as Mike Adams would readily argue): the excluded quality 400 trials, because no deaths occurred!

This was kind of crazy as a study protocol. Many people were not comfortable with it. And in fact, recently, a team of internationally renowned antioxidant scientists, including Prof Blumberg, re-analysed the SAME DATA used by Bjelakovic et al., and arrived at completely the opposite conclusion.

Blumberg et al. found that 36 percent of the trials showed a positive outcome or that the antioxidant supplements were beneficial, 60 percent had a null outcome, while only 4 percent found negative outcome.

The EPIC scientists based their findings on analysis of intakes of 23,943 people, all free of cancer and heart disease at the start of the study.


Most interesting in this study was the definition of “regular use”. The bar was set pretty low (25% of what they were supposed to take) and might easily have missed the resulting benefits: In other words, for 5 doses or one week of use per month when the label states ‘take daily’.

Maybe that was a deliberate attempt to invalidate the results, Mike? If it was, the ruse misfired. Because even with such poor compliance and mediocre levels of vitamin supplementation, the benefits were still dramatically measurable.

As Prof Blumberg added, “If this was a study of a drug and adherence was this poor, a null outcome would be dismissed as meaningless due to non-compliance.”

Source: European Journal of Nutrition?Published online ahead of print, doi: 10.1007/s00394-011-0224-1 ?“Vitamin/mineral supplementation and cancer, cardiovascular, and all-cause mortality in a German prospective cohort (EPIC-Heidelberg)”?Authors: K. Li, R. Kaaks, J. Linseisen, S. Rohrmann

The post What is the “sick user” effect and why does it screw up science? appeared first on Dr. Keith Scott-Mumby.

Older Post
Newer Post
Close (esc)


Use this popup to embed a mailing list sign up form. Alternatively use it as a simple call to action with a link to a product or a page.

Age verification

By clicking enter you are verifying that you are old enough to consume alcohol.


Shopping Cart