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Reasons not to take Lumina's anticavity probiotic

trevorklee.substack.com

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Re: Reasons not to take Lumina's anticavity probiotic

#2
> Taking unapproved drugs is a bad idea

What about off-label medication?

I don't think taking Lumina is smart, more or less for the reasons the author ennumerates. I also think it's unlikely enough to hurt people that FDA approval shouldn't be required. There's a lot of stuff in that category!

Re: Reasons not to take Lumina's anticavity probiotic

#3
post #2

> Taking unapproved drugs is a bad idea What about off-label medication? I don't think taking Lumina is smart, more or less for the reasons the author ennumerates. I also think it's unlikely enough to hurt people that FDA approval shouldn't be required. There's a lot of stuff in that category!

Off-label drugs are still approved by the FDA for their original purpose.

Re: Reasons not to take Lumina's anticavity probiotic

#4
> I’ve also been disappointed for some months to see how many people I respect (and some I don’t respect) have been using it/promoting it. Taking unapproved drugs is a bad idea, no matter what rationalist bloggers with MDs, porn star/escort/sex researchers, Twitter guys, or conservative firebrands who get sick immediately after taking the unapproved drug tell you.

The "rationalist community" has always been quirky and edgy, but iterations in recent years have felt increasingly reactionary and contrarian at all costs. Being anti-FDA has been a meme in the rationalist community for several years, especially since Scott Alexander (Slate Star Codex / Astral Codex Ten) started writing anti-FDA pieces. (Side note: The conservative firebrand they're talking about is a person who was caught using a pseudonym to post extremely biased, racist material, who has somehow remained prominent in the community despite the revelations).

This appears to have primed the community for "FDA bad" takes, which has triggered their contrarian tendencies to assume that anything that goes against the FDA must therefore be good.

A supplement maker publicly defying the FDA and pushing out a miracle treatment without the normal rigor of human trials and safety reviews is the type of behavior that would have triggered skepticism from the rationalist community. Yet because the community has been primed with "FDA bad, anti-FDA good" memes for years and the person pitching this supplement is vaguely connected to the rationalist community, this product has triggered a lot of adoration and praise from the community.

The product also exists in a space that is difficult to disprove: The effects of any anti-cavity product can only really be shown over very long periods of time in controlled settings. Anyone who gets a cavity while using this product will surely be dismissed as having a pre-existing cavity growing, or poor oral hygiene, or being a statistical anomaly, or any other number of excuses. At the same time, I'm sure we're about to hear endless anecdotes from people who have been taking the supplement and haven't had any cavities (while ignoring the fact that most people also don't get cavities in a given year, even without this magic probiotic).

It feels like the perfect storm for a grift, and this company is taking the lead and running with it. It's weird that a blog post advising some caution and skepticism for a supplement pusher making extraordinary claims who has refused to participate in the normally expected clinical trials. It's equally weird to see the self-described rationalist community throwing scientific rigor to the wind and embracing marketer's claims.

I don't entirely understand what's going on here, but I think it's strange that an article advising a modicum of skepticism for supplement pushers is now considered a contrarian take in the rationalist community.

Re: Reasons not to take Lumina's anticavity probiotic

#5
I was hoping for a more thorough explanation for why this particular regimen is dangerous. Instead this is a rather lengthy essay which ultimately relies on the appeal to authority fallacy. Not to say I think people should just put random things into their bodies - It is indeed probably not the best idea.

That said, I'm not sure I learned anything new after reading this.

Re: Reasons not to take Lumina's anticavity probiotic

#6
post #2

> Taking unapproved drugs is a bad idea What about off-label medication? I don't think taking Lumina is smart, more or less for the reasons the author ennumerates. I also think it's unlikely enough to hurt people that FDA approval shouldn't be required. There's a lot of stuff in that category!

>I also think it's unlikely enough to hurt people that FDA approval shouldn't be required.

The author has provided some solid arguments that this is not the case. Why do you think so?

Re: Reasons not to take Lumina's anticavity probiotic

#7
post #2

> Taking unapproved drugs is a bad idea What about off-label medication? I don't think taking Lumina is smart, more or less for the reasons the author ennumerates. I also think it's unlikely enough to hurt people that FDA approval shouldn't be required. There's a lot of stuff in that category!

> What about off-label medication?

Off-label means prescribed for a different purpose than originally indicated, at the prescriber's discretion. The medication must still have past safety testing and have shown efficacy for something.

> I also think it's unlikely enough to hurt people that FDA approval shouldn't be required. There's a lot of stuff in that category!

You can sell a lot of products as-is without FDA approval. However, making substantial claims about that product's medicinal properties is regulated in a different manner.

These people are trying to have the best of both worlds: Making extraordinary claims about preventing a medical condition, while also avoiding any participation in the FDA process or even funding standard trials.

I think the most obvious counter argument is that this could easily be a massively successful drug if it works as well as they claim. The TAM is everyone with teeth who wants to keep them, which is basically everyone. Yet instead they've chosen this weird path of embracing the rationalist community and supplement nuts, which is a much smaller market.

Re: Reasons not to take Lumina's anticavity probiotic

#8
Whenever this topic comes up on HN it strikes me as bizarre that anyone thinks they can genetically modify a bacteria, release it into the wild - and that it'll stay genetically modified? Like the author mentions, bacteria are constantly swapping genes via horizontal gene transfer. Surely the bacteria in our mouths have found the optimal metabolism for their environment? Why wouldn't we expect our genetically modified bacteria to adopt the same strategy?

I imagine that you could, at least on paper, create a Rube Goldberg machine in their genes that, say, killed them if they produced lactic acid, and made it very difficult to delete these genes without destroying their ability to reproduce. But you'll probably also handicap them in the process and make it difficult for them to adapt to competitive adaptations from other bacteria.

Re: Reasons not to take Lumina's anticavity probiotic

#9
post #5

I was hoping for a more thorough explanation for why this particular regimen is dangerous. Instead this is a rather lengthy essay which ultimately relies on the appeal to authority fallacy. Not to say I think people should just put random things into their bodies - It is indeed probably not the best idea. That said, I'm not sure I learned anything new after reading this.

How does the section titled ‘Category 2: the known health risks of BCS3L-1’ problematically appeal to authority? It seems to about as much as appealing to known results that swallowing vast quantities of lead is a bad idea would. (The other sections certainly appeal to authority, although not obviously fallaciously to me, but that would be to go over quite tired ground about medical regulation.)

Re: Reasons not to take Lumina's anticavity probiotic

#10
post #5

I was hoping for a more thorough explanation for why this particular regimen is dangerous. Instead this is a rather lengthy essay which ultimately relies on the appeal to authority fallacy. Not to say I think people should just put random things into their bodies - It is indeed probably not the best idea. That said, I'm not sure I learned anything new after reading this.

What a strange take! Not an expert (or even a beginner) in this area by any means, but I definitely learned a lot, and I thought the author pretty clearly laid out why they think this probiotic may not be good for your body. Did we read the same blog post?
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