1/
Liv 52 - A🧵
➡️ What is it?
➡️ Is it Ayurveda?
➡️What is it used (advertised) for?
➡️What is the evidence?
➡️Research and evaluation?
➡️Is it safe?
➡️Who prescribes it?
➡️Should/ can I use it?
#medtwitter #livertwitter #meded #Ayush #Ayurveda
Liv 52 - A🧵
➡️ What is it?
➡️ Is it Ayurveda?
➡️What is it used (advertised) for?
➡️What is the evidence?
➡️Research and evaluation?
➡️Is it safe?
➡️Who prescribes it?
➡️Should/ can I use it?
#medtwitter #livertwitter #meded #Ayush #Ayurveda
2/
What is Liv 52?
It is a herbal drug manufactured by Himalaya India
Launched in 1955 😐
Named Liv (for liver)
52 (becoz 'researchers' got the 'correct' formulation coded '52' - at 52nd attempt)
docprime.com/liv-52-mddp
himalayaglobalholdings.com/innovation/liv…
Contains ALMOST 20 components...
What is Liv 52?
It is a herbal drug manufactured by Himalaya India
Launched in 1955 😐
Named Liv (for liver)
52 (becoz 'researchers' got the 'correct' formulation coded '52' - at 52nd attempt)
docprime.com/liv-52-mddp
himalayaglobalholdings.com/innovation/liv…
Contains ALMOST 20 components...
3/
...making it multiherbal drug
Is Liv 52 Ayurvedic?
According to the principles that guide an Ayurvedic treatment,
Any classical Ayurvedic drug must act on atleast one of the 3 doshas - Vata/Pitta/Kapha - to 'align' it normally
Action of Liv 52 on doshas isnt mentioned...
...making it multiherbal drug
Is Liv 52 Ayurvedic?
According to the principles that guide an Ayurvedic treatment,
Any classical Ayurvedic drug must act on atleast one of the 3 doshas - Vata/Pitta/Kapha - to 'align' it normally
Action of Liv 52 on doshas isnt mentioned...
4/
…as per classical ayurvedic principles anywhere on the drug manufacturer website himalayawellness.in/products/liv-52
Multiherbal combination specific to Liv 52 isnt
mentioned in ANY classical Ayurvedic texts
Which makes Liv 52 - private company owned herbal dietary supplement...
…as per classical ayurvedic principles anywhere on the drug manufacturer website himalayawellness.in/products/liv-52
Multiherbal combination specific to Liv 52 isnt
mentioned in ANY classical Ayurvedic texts
Which makes Liv 52 - private company owned herbal dietary supplement...
5/
...& nothing more that a proprietary product
1 - they don't know what classical Ayurvedic drug isrvedic drug - for example, Ayurvedic practitioners like @deepadoc, it means 2 things:
1 - they dont know what classical Ayurvedic drug is
2 - they dont know Ayurveda...
...& nothing more that a proprietary product
1 - they don't know what classical Ayurvedic drug isrvedic drug - for example, Ayurvedic practitioners like @deepadoc, it means 2 things:
1 - they dont know what classical Ayurvedic drug is
2 - they dont know Ayurveda...
6/
...so lets drop Ayurveda from the discussion and come to the private company owned proprietary drug
What R (advertised) uses of Liv 52?
Website says Liv 52 "exhibit potent hepatoprotective properties against chemically-induced hepatotoxicity" and then...
(this is best part)
...so lets drop Ayurveda from the discussion and come to the private company owned proprietary drug
What R (advertised) uses of Liv 52?
Website says Liv 52 "exhibit potent hepatoprotective properties against chemically-induced hepatotoxicity" and then...
(this is best part)
7/
...uses lot of science JARGON - oxidative, cell regeneration, membrane stability, antiperoxidase etc....(Pic 1)
....jumps one disease 2 another aftr confusing medical jargon use (lay ppl think its credible, Pic 2)
This is classical pseudoscience fraud
ncbi.nlm.nih.gov/pmc/articles/P…
...uses lot of science JARGON - oxidative, cell regeneration, membrane stability, antiperoxidase etc....(Pic 1)
....jumps one disease 2 another aftr confusing medical jargon use (lay ppl think its credible, Pic 2)
This is classical pseudoscience fraud
ncbi.nlm.nih.gov/pmc/articles/P…
8/
So the actual indication of Liv 52 is chemical hepatitis (alcohol as the website state) - i.e one group of patients
But they want to sell this product MORE!
Look further down at the website
they increase the portfolio to include other vague conditions as well...
So the actual indication of Liv 52 is chemical hepatitis (alcohol as the website state) - i.e one group of patients
But they want to sell this product MORE!
Look further down at the website
they increase the portfolio to include other vague conditions as well...
9/
Loss of appetite - so children, adults, elderly can be prescribed (general practitioners targeted)
Optimal growth - children targeted (pediatricians targeted)
Weight gain - children, young males/females targeted (endocrinologist/general physicians targeted)...
Loss of appetite - so children, adults, elderly can be prescribed (general practitioners targeted)
Optimal growth - children targeted (pediatricians targeted)
Weight gain - children, young males/females targeted (endocrinologist/general physicians targeted)...
10/
...Pregnancy - OBGyn doctors targeted
"daily health supplement" - every PRESCRIBING DOCTOR targeted!
So wat starts off as product 4 alcohol liver disease is suddenly converted 2 product which ANY DOCTOR can prescribe
This is SMART marketing
NO trials 4 these indications!
...Pregnancy - OBGyn doctors targeted
"daily health supplement" - every PRESCRIBING DOCTOR targeted!
So wat starts off as product 4 alcohol liver disease is suddenly converted 2 product which ANY DOCTOR can prescribe
This is SMART marketing
NO trials 4 these indications!
11/
But the advertised uses do not end there
Look at this image for Liv 52 use.
Glaring mistakes
The first is a symptom (jaundice)
Then comes viral liver disease of which - Hep B is a DNA virus and Hep C is RNA virus and A and E are virus infection with self limiting course
But the advertised uses do not end there
Look at this image for Liv 52 use.
Glaring mistakes
The first is a symptom (jaundice)
Then comes viral liver disease of which - Hep B is a DNA virus and Hep C is RNA virus and A and E are virus infection with self limiting course
12/
...which means, these can go away without treatment and with only symptom care
But how does Liv 52 act both on DNA as well as RNA virus? - there has to be two different set of actions right? - but expected, no trials on such effects - only advertised
Becoz Himalaya said...
...which means, these can go away without treatment and with only symptom care
But how does Liv 52 act both on DNA as well as RNA virus? - there has to be two different set of actions right? - but expected, no trials on such effects - only advertised
Becoz Himalaya said...
13/
...INFECTIVE hepatitis - everyone prescribed for every type of infective hepatitis - DNA virus or RNA virus - not bothered --> that is again brilliant marketing tactic!
Like I said - marketed drug, with little evidence...
...which brings us to
What is the Evidence?!
...INFECTIVE hepatitis - everyone prescribed for every type of infective hepatitis - DNA virus or RNA virus - not bothered --> that is again brilliant marketing tactic!
Like I said - marketed drug, with little evidence...
...which brings us to
What is the Evidence?!
14/
Himalaya claims - from 1955 - MORE THAN 300 trials were done on Liv 52 with modern science methods to show case its effectiveness and safety
Let us take a quick look
If you go to Pubmed and type Liv 52
You get 86 articles. Yes. 86 articles.
pubmed.ncbi.nlm.nih.gov/?term=Liv+52
Not 300.
Himalaya claims - from 1955 - MORE THAN 300 trials were done on Liv 52 with modern science methods to show case its effectiveness and safety
Let us take a quick look
If you go to Pubmed and type Liv 52
You get 86 articles. Yes. 86 articles.
pubmed.ncbi.nlm.nih.gov/?term=Liv+52
Not 300.
15/
So what are these 86 articles?
There are ONLY 7 in humans.
Yes. 7 --> pubmed.ncbi.nlm.nih.gov/?term=Liv+52&f…
And of that, one is on LEPROSY - nothing to do with chemical hepatitis or cirrhosis or liver disease
And the last study was in 2005 in a third rate journal which also published...
So what are these 86 articles?
There are ONLY 7 in humans.
Yes. 7 --> pubmed.ncbi.nlm.nih.gov/?term=Liv+52&f…
And of that, one is on LEPROSY - nothing to do with chemical hepatitis or cirrhosis or liver disease
And the last study was in 2005 in a third rate journal which also published...
16/
...Fraud Baba Ramdev's fake CORONIL Covid 19 study
So you can now gauge the quality of Liv 52 studies
Moving on...
So what about other 81 studies?
ALL cells/tissue/rats/mice studies
NO HUMAN CLINICAL OUTCOMES FROM THESE
But what does Himalaya say about these?
...Fraud Baba Ramdev's fake CORONIL Covid 19 study
So you can now gauge the quality of Liv 52 studies
Moving on...
So what about other 81 studies?
ALL cells/tissue/rats/mice studies
NO HUMAN CLINICAL OUTCOMES FROM THESE
But what does Himalaya say about these?
17/
On the website researchpapers.himalayawellness.in/liv52.htm
They mention
total papers - 116
clinical - 24
experimental 92
But show - 33 papers
Where did advertised >300 papers come frm?
Truth is:
Pubmed clinical 7 papers
Pubmed preclinical 79
Quack papers (quackademics) - 300-86 = 214 papers!
On the website researchpapers.himalayawellness.in/liv52.htm
They mention
total papers - 116
clinical - 24
experimental 92
But show - 33 papers
Where did advertised >300 papers come frm?
Truth is:
Pubmed clinical 7 papers
Pubmed preclinical 79
Quack papers (quackademics) - 300-86 = 214 papers!
18/
MOST clinical papers advertised ARE NOT peer reviewed and are actually not CLINICAL
Most are opinionated reviews with details from cell study
For eg Alcoholic hepatitis (Pic below - study cannot be found anywhere AND the journal is a fake one)...
oalib.com/journal/6796/1…
MOST clinical papers advertised ARE NOT peer reviewed and are actually not CLINICAL
Most are opinionated reviews with details from cell study
For eg Alcoholic hepatitis (Pic below - study cannot be found anywhere AND the journal is a fake one)...
oalib.com/journal/6796/1…
19/
Here is another (Pic)
This is not a full paper, is not published and only abstract available in PDF in third party website without links to the original journal (not found)
researchpapers.himalayawellness.in/pdf_files/liv0…
212 more of such papers all over the web on Liv 52!
Paid, company sponsored
Here is another (Pic)
This is not a full paper, is not published and only abstract available in PDF in third party website without links to the original journal (not found)
researchpapers.himalayawellness.in/pdf_files/liv0…
212 more of such papers all over the web on Liv 52!
Paid, company sponsored
20/
Some papers are completely
cooked up
without proper methods
no adequate referencing
fraudlent data
sampling error
no ethics clearance
and probably written by kindergarten kids
It burns your eyes reading it
Like this one researchpapers.himalayawellness.in/pdf_files/liv1…
Some papers are completely
cooked up
without proper methods
no adequate referencing
fraudlent data
sampling error
no ethics clearance
and probably written by kindergarten kids
It burns your eyes reading it
Like this one researchpapers.himalayawellness.in/pdf_files/liv1…
21/
But what about the original pubmed indexed human studies!?
They are of VERY POOR quality, that there are no good meta-analysis of these studies.
If there are multiple well done studies, a metanalysis of all studies gives clarity in evidence
Reminding levels of evidence👇
But what about the original pubmed indexed human studies!?
They are of VERY POOR quality, that there are no good meta-analysis of these studies.
If there are multiple well done studies, a metanalysis of all studies gives clarity in evidence
Reminding levels of evidence👇
22/
So here is the metanalysis link on Liv 52 on pubmed
pubmed.ncbi.nlm.nih.gov/?term=Liv+52&f…
Number found: 0
But wait - I found one metanalysis on Liv 52 and was so happy. Here is more on that!...next tweet...quite something....
So here is the metanalysis link on Liv 52 on pubmed
pubmed.ncbi.nlm.nih.gov/?term=Liv+52&f…
Number found: 0
But wait - I found one metanalysis on Liv 52 and was so happy. Here is more on that!...next tweet...quite something....
23/
This one.
researchpapers.himalayawellness.in/pdf_files/liv2…
Metanalysis of 50 studies of Liv 52 on infective hepatitis ( we saw 7 before right?)
Guess what
Himalaya company did the analysis
I >90% trials arent published
No PRISMA method
It is just like a company sponsored review
Absolute fraud
This one.
researchpapers.himalayawellness.in/pdf_files/liv2…
Metanalysis of 50 studies of Liv 52 on infective hepatitis ( we saw 7 before right?)
Guess what
Himalaya company did the analysis
I >90% trials arent published
No PRISMA method
It is just like a company sponsored review
Absolute fraud
24/
Is it safe?
No.
Fleig et al used Liv 52 and found more death in liver patients
FDA banned Liv 52 in USA
So company was forced to rename it Liver Care and remarket it. Everywhere else, it is Liv 52. Not in the USA
Think abt it
Is it safe?
No.
Fleig et al used Liv 52 and found more death in liver patients
https://twitter.com/drabbyphilips/status/1339083966024798208?s=20
FDA banned Liv 52 in USA
So company was forced to rename it Liver Care and remarket it. Everywhere else, it is Liv 52. Not in the USA
Think abt it
https://twitter.com/drabbyphilips/status/1338545697923112961?s=20
25/
I analysed Liv 52 and found contaminants and adulterants in it 👇
My published data on Liv 52 analysed showed adulteration and liver toxins and death among liver disease patients 👇 (also see supplementary files)
ncbi.nlm.nih.gov/pmc/articles/P…
Summary...
I analysed Liv 52 and found contaminants and adulterants in it 👇
https://twitter.com/drabbyphilips/status/1338512707276828674?s=20
My published data on Liv 52 analysed showed adulteration and liver toxins and death among liver disease patients 👇 (also see supplementary files)
ncbi.nlm.nih.gov/pmc/articles/P…
Summary...
26/
Liv 52
clinical evidence for any condition is very poor
marketing is heavy and taregted
papers are fraud
marketing is heavy/targeted
general practitioners/young Ayurvedics are mostly prescribers becoz THEY ARE DEFRAUDED by the company OR receive benefits under the table
Liv 52
clinical evidence for any condition is very poor
marketing is heavy and taregted
papers are fraud
marketing is heavy/targeted
general practitioners/young Ayurvedics are mostly prescribers becoz THEY ARE DEFRAUDED by the company OR receive benefits under the table
27/
There is no strong evidence for Liv 52 for any clinical condition
This is not an Ayurvedic product, but decades of beautiful marketing and defrauding general public and physicians
I asked Himalaya if they want to do a REAL trial and they kept MUM.
There is no strong evidence for Liv 52 for any clinical condition
This is not an Ayurvedic product, but decades of beautiful marketing and defrauding general public and physicians
I asked Himalaya if they want to do a REAL trial and they kept MUM.
https://twitter.com/drabbyphilips/status/1366955594469437440?s=20
28/28
Oh & be4 I end
Liv 52 trial that says drug can reduce hangover?
They actually used 9 volunteers and got them drunk, without ethical clearance
link.springer.com/article/10.100…
And Liv 52 studies R stil going on!
Even in year 2020
It is still on
RATS
Cheers
bmcpharmacoltoxicol.biomedcentral.com/articles/10.11…
Oh & be4 I end
Liv 52 trial that says drug can reduce hangover?
They actually used 9 volunteers and got them drunk, without ethical clearance
link.springer.com/article/10.100…
And Liv 52 studies R stil going on!
Even in year 2020
It is still on
RATS
Cheers
bmcpharmacoltoxicol.biomedcentral.com/articles/10.11…
5/ correction
...& nothing more that a proprietary product
When Ayurvedic practitioners like @deepadoc, quotes Liv 52 as the poster boy of Ayurvedic practice by modern doctors, it means 2 things:
1 - they dont know what classical Ayurvedic drug is
2 - they dont know Ayurveda..
...& nothing more that a proprietary product
When Ayurvedic practitioners like @deepadoc, quotes Liv 52 as the poster boy of Ayurvedic practice by modern doctors, it means 2 things:
1 - they dont know what classical Ayurvedic drug is
2 - they dont know Ayurveda..
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