I got a little jittery when I saw news coverage of Vitamin K for leg cramps

Here's what a closer read revealed

This is my first Substack piece. I’m retired now, after a career of 50 years of health care journalism, capped off by 16 years as founder and publisher of HealthNewsReview.org - a team effort of scrutinizing claims made in major media about health care interventions. (The site is no longer available.) People started calling us a watchdog, which is why I initially used a watchdog logo.

But, upon reflection, I thought that watchdog imagery implied that we were just doing this to watch and criticize. But we were really dedicated to helping people hone their own critical thinking skills in order to become smarter, better informed health care patients and consumers. If we could show people how we critically analyzed claims then maybe they could pick up some of those skills themselves.

After retiring two years ago, I welcomed the break from daily publishing and fundraising. But I’d lost that long form platform to analyze and comment when I wanted to do so. Then this one little Medscape news story got me off the couch and back on the keyboard:

I experience fairly regular nocturnal leg cramps and, at age 73, qualify as an older adult. My primary care doc’s Rx is “hydrate….hydrate…hydrate.” And when I do keep that in mind and drink enough water, I don’t have leg cramps. (Although I do get up in the night to relieve that hydration.) So I had a special interest in this Medscape headline. But Medscape wasn’t alone in seizing my attention.

The Medical Xpress hyped its story with the reminder that this is a “dreaded” condition.

ABC’s Good Morning America program thought enough about the published paper to feature it on the air.

The Daily Mail headlined: Study uncovers surprising way to prevent agonising nighttime leg cramps. “Uncovers”?? How about “suggests, in a short-term study”? After all, the researchers themselves only used that verb - “This trial suggests that vitamin K₂ might be an effective strategy for managing (cramps) in older individuals with good safety profile.” And in the battle for the top of the hype heap, “agonising” (British spelling) tops “dreaded.” But The Daily Mail led with this:

“Eating more meat could help prevent agonising nighttime leg cramps, a study claims.”

Which study claimed that? Not the one that is highlighted in the story!

Here’s what I caught very quickly. Most of the stories I found failed to mention anything about potential conflicts of interest involved in the study. At least Medscape mentioned some of the disclosures made by the Chinese authors of the paper reporting their study results. Emphasis on “some” of the disclosures, but not all. In the published paper, in the peer-reviewed JAMA Internal Medicine, this was mentioned: “nonfinancial support from Sungen Biotech during the conduct of the study.” No explanation was given for “nonfinancial support.” But the paper itself explains that Sungen Biotech’s product was THE product used in the study. It stated: “the study products, (were) custom manufactured by Sungen Biotech.” Right there for anyone who read the paper to see, quite clearly - not hidden, as it was in all media coverage I came across. But, hey, who reads the full journal article anymore before reporting on it?

This is not a trivial issue about the quality of the media coverage. The published paper probably doesn’t really disclose why these researchers chose to do a particular study of a particular product. But because they want a journal to publish their paper, they feel obliged to disclose that one company provided the product they were studying and unexplained “nonfinancial support.” And then they reported a seemingly impressive finding from that study. But you - the consuming public - don’t see how the sausage is being made.

Medscape did include this caveat: “This study did not investigate the quality of life or sleep, which could have provided additional insights into the impact of vitamin K on nocturnal leg cramps. The relatively mild nature of nocturnal leg cramps experienced by the participants may limit the generalizability of the findings to populations with more severe symptoms.” That’s almost a direct lift from the limitations published in the paper. It’s amazing how many stories don’t ever mention any limitations - even though some are almost always listed, depending on the particular journal’s guidelines. And the discussion of “the relatively mild nature” of the study participants’ leg cramps further calls the “dreadful” and “agonising” hype into question.

Without mentioning relevant potential conflicts of interests and without mentioning limitations to the reported findings, everything looks like Candyland.

Always read to the end; at the bottom of the Medscape story is this note:

Some human intelligence is still required to address the grey areas that artificial intelligence misses. It didn’t happen here.

Post note: This might be an important finding. But even the somewhat-flawed Medscape story mentioned limitations that could signal why this may not be an important finding. I’ll wait for more confirming research, done by independent researchers, with full disclosure, and - if you rely on media coverage - better media coverage with some detailed discussion of alternative options for people with nocturnal leg cramps. Meantime, I’m doing what my veteran primary care doc recommends: hydrate, hydrate, hydrate. This kind of media coverage cramps my style.

While this little story in the daily tsunami of health care news wasn’t of monumental importance and the flaws are far from the worst I’ve seen, it was enough to rouse me from retirement to start this Substack and, I hope, build on it from here. What I found doesn’t require a PhD; anyone should be able to sharpen their eye and their scrutiny enough to find what I found…and more…just by applying a little healthy skepticism.

Which is why - from time to time - I’ll chime in on this Substack account with items that catch my eye. Not as often as we did on HealthNewsReview.org for 16 years. But I’ll resurrect the same lessons learned from the 3,000+ media messages we reviewed from 2006-2022. So please come back for more.