%0 Journal Article
%T Scientific evidence, rather than uncontrolled case studies should be
the basis for patient management
%A Dennis Savaiano
%J Archive of "Therapeutic Advances in Drug Safety".
%D 2018
%R 10.1177/2042098618760924
%X The case study and review article by Mill and colleagues published in this volume of Therapeutic Advances in Drug Safety reaches a potentially dangerous conclusion that puts patient belief ahead of scientific evidence. The authors report on a case study in which the patient was convinced that they require a lactose-free preparation. The authors present a very admirable review of the research literature that demonstrated that lactose-intolerant individuals can easily tolerate the small amounts of lactose found as an excipient in pharmaceutical preparations.1¨C3 In fact, the level of tolerance is likely 30-fold higher than the highest amount of lactose found in a single capsule (12 g of tolerance versus 400 mg).4 Mill and colleagues consider that the nocebo effect (the worsening of symptoms following the administration of a placebo, in this case the small amount of lactose found in the pharmaceutical) might be at work
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166317/