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Would you rather choose a pain remedy based on art or science? How are mixtures of herbal remedies chosen?


Rightful is a mixture of herbal ingredients alleged to relieve pain, improve sleep, and “restore your body to its optimal state”. They say, “Pain-free days are rightfully yours”. They advertise that it was designed by integrative and conventional medical experts, has the best bio-availability on the market, and provides high, clinically effective, scientifically proven precise doses of each component. Tieraona Low Dog is listed as “Rightful co-founder, Chief Innovation Officer and Formulator”. Her name will be familiar to critics of alternative and integrative medicine. She says, “crafting an herbal supplement is an art form.” Maybe; it sure isn’t science. No conventional medical expert is identified in their advertising.

They claim to have tested their formula, but the “testing” was laughable; they gave it to people and recorded their subjective reports of improvement. No control group, no comparison to placebos. All their “testing” did was confirm the effect of suggestion and the placebo response.

They claim to have the best bioavailability, but bioavailability doesn’t necessarily translate to improved clinical outcomes.

“We have consulted the latest clinical research to determine the precise amount of every therapeutic ingredient that’s most effective”. They don’t tell us what research they consulted, and I couldn’t find any such research. After all, why would they need research when they claim to be relying on an art form rather than science?

The ingredients

  • Turmeric rhizome – to help reduce inflammation
  • Corydalis – promotes pain relief and healthy circulation
  • Curcumin – helps inhibit inflammatory responses to physiological stressors
  • Broad-spectrum hemp – promotes healthy function of the central nervous system
  • Ashwagandha – supports the body’s response to stress and inflammation
  • California poppy – promotes restful sleep, relaxation and mental calm
  • Black pepper – enhances the absorption and effectiveness of turmeric and hemp

The evidence for these effects is pretty sketchy. For instance, the Natural Medicines Comprehensive Database rates California Poppy as “Insufficient evidence to rate effectiveness” and it says there is insufficient evidence to establish an appropriate dose.

What happens when you mix ingredients?

It may seem logical that if you mix two ingredients, there will be an additive effect. But that may not be true. The effect may be additive (2 + 2 = 4), may be potentiated (0 + 2 > 2), may be antagonistic (6 + 4 < 10), or may be synergistic (2 + 2 = >>>4, maybe as much as 10 times greater). There’s no way to reliably predict what will happen, so each combination must be tested.

Serendipity

As I was writing this, I received the current issue of The Medical Letter with their evaluation of ashwagandha (volume 63, issue number 1619, dated March 8, 2021). It was a revelation. Rightful claims its ingredients have no serious side effects. While it is true that no major adverse effects have been reported in clinical trials of ashwagandha, there have been many case reports that are very concerning. It has been reported to cause severe diarrhea, skin burning and discoloration, sedation, severe liver injury, heavy metal poisoning, thyrotoxicosis, increased testosterone levels, and miscarriage. The Medical Letter didn’t mince words. Its conclusion reads:

There is no convincing evidence that ashwagandha supplements are effective or safe for any indication; patients should be advised not to take them. FDA-approved drugs are available for treatment of all the conditions for which these herbal supplements are being promoted.

In all the years I have subscribed to The Medical Letter, I don’t remember them ever issuing such a strong condemnation.

Conclusion: This product can’t be recommended

Despite the testimonials, there is no science to back up Rightful’s misleading claims. And considering The Medical Letter’s condemnation of ashgawandha, it should not be included in any herbal mixture.

Reading the advertising for Rightful was not a total loss. I did learn something: now I know how to spell ashgawandha!

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Posted by Harriet Hall

Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.