Paltrow’s Goop Doctors Keep Quacking Along

It goes without saying (but I’m saying it anyway) that Gwyneth Paltrow is not the person to go to for medical advice. She is not a medical professional. She doesn’t even play one on TV. She is simply a famous person who sells snake oil. But it’s hard to fault her for being a good capitalist. After all, it’s caveat emptor, right?

But the shit she sells and the garbage she writes are harmful to real people. Ask any doctor you know how much time they have to spend refuting bad medical advice when they could be, I don’t know, treating diabetes. As is proper, doctors are trying to limit the damage Paltrow is causing. Part of fighting fake medicine is going after actual doctors who promote the stuff, and going after them hard. My colleague Dr. Jen Gunter (I don’t actually know her, but she’s my colleague because we are both real doctors) had some unkind things to say about Goop, and about the doctors who are quoted on the Goop website. She went a bit easy on them, but they still expressed a great deal of butt-hurt.

Anyway, Dr. Gunter (the good guy in this story) is hilarious, and being a gynecologist was especially critical of the advice about stuffing things in your vagina. Now, that seems pretty uncontroversial to me. There are only a few things that should go in your vagina, and jade eggs and crystals are definitely not on the list. Anyway…

Goop calls their doctors’ response to criticism, “Uncensored: A word from our doctors.” This would seem to imply that someone has censored them. I call this “stupid”. Criticism should not be confused with censorship, unless you’re a thin-skinned quasi-professional who is overly defensive about being called out on your bad medical advice. Because you know better.

The Goop Docs (Steven Gundry and Aviva Romm) defend the indefensible, namely lending their names and degrees to Paltrow’s fake medicine empire. Dr Gundry’s response is frankly embarrassing. In science, it’s evidence that counts, and that evidence has to be able to weather challenge after challenge. Gundry’s particular obsession is “lectins”, a chemical naturally found in a lot of healthy foods. He believes that people should avoid lectins and, well, he sounds like kind of a douche (another thing that shouldn’t go in the vagina) when talking about it:

I bring this up because I am writing this on a plane while returning from giving a paper to the 11th annual World Congress on Polyphenols Applications — on the effect of a lectin-limited diet, supplemented with polyphenols with fish oil, on intravascular markers of inflammation in 467 patients with known coronary disease. I won’t bore you, but when we removed high lectin-containing foods like grains, beans, and, yes, nightshades like your beloved tomatoes, their elevated markers of inflammation returned to normal.

Now I actually looked up Gundry’s research, and some of it was interesting. It doesn’t rise to the level of “fact” yet, but it has potential. It’s a bit technical, but what it comes down to is that his whole lectin idea is not ready to be applied in real life. He has done a small experiment in which his diet was not shown to prevent heart attacks. The study looks for something called “endothelial dysfunction” which, while interesting, is not enough to recommend changing your diet.

Gundry admits to being obsessed with non-proven diets and something called “nutriceuticals”, which basically means untested medicine being sold as supplements. That’s a lucrative gig, so I hope he got a piece of the action.

And then Gundry goes full-on douche (remember, not in the vag) by bragging about his academic appointment and how many of his patients he has “cured” of various problems. I can just imagine him at a party, standing against the door jamb of the kitchen so that he can comment on everyone’s plate from the buffet. See, the thing that makes Gundry a douche is that he tells us we should believe him because he’s a famous doctor. Evidence, not degrees, is what leads us to medical facts.

The other doctor who Dr. Jen made sad was Aviva Romm. She does not strike me douchey, just wrong. Her entire justification for Gooping is that science is sometimes wrong, and you gotta start somewhere, right?

“If women seeking wellness is a trend, I’d say that it’s a positive one, particularly in a country facing diabetes, obesity, chronic disease, and narcotic-related death epidemics of epic proportions. Further, let’s not forget that many common medical practices that were not too long ago considered wellness trends, at best, unscientific bunk, or at worst, dangerous, are now widely incorporated into conventional patient care. Fish oil for heart health, a Mediterranean-style or vegetarian diet for prevention of cardiovascular disease, probiotics for inflammatory bowel disease, or St. John’s wort for depression, are just a few we’re all now familiar with due to “wellness trends.””

OK, I see her point, but she’s still wrong. First, the things she says are now “conventional medical care” aren’t. She’s wrong. Probiotics are not a first-line treatment for inflammatory bowel disease, St. John’s wort is not recommended for depression, and fish oil might, maybe, have a small effect for some heart patients. Maybe.*

Second, the fact that, “ women are desperately hungry for safe alternatives to mainstream practices” does not justify turning them into guinea pigs for Goop products.

Look, I get it. Paltrow needs to make a living, so she sells things to people. And now she’s so rich she can spray silver on her first class plane seat before exposing it to her buttocks. I’m not kidding.

But for doctors to lend their names and degrees to her medicine show, that’s just shameful. They should know better.

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*As usual, these are complex issues. Some probiotics may have some role in some cases of bowel disease, but not much. Fish oil may be helpful in some heart patients, but the evidence is slim and it’s nothing compared the standard therapy we already have. And St. John’s wort is a disaster. It interferes with other medications and has an inconsistent effect on depression.

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