Beyond the Hype: Why Good Theories Aren’t Good Medicine

The message of Ending Medical Reversal, the book Vinay Prasad and I published in 2015, is that the only way to know that a medical practice is effective is to show that it improves important clinical outcomes in a robust clinical trial. Just because you want something to work, or because it should work, or because it appears to work, or because you can profit from it, does not mean it works. I could write an article that says this every week.

Fortunately, this week, I don’t have to because Dr. Bobby Dubois wrote such a good one.

Adam Cifu

In today’s wellness world, scientific buzzwords and mechanistic explanations are everywhere. Red light therapy for fatigue. NAD+ infusions to support mitochondrial health. IV drips claiming to “boost immunity.” These interventions are often promoted with an air of scientific credibility. After all, don’t they have biology behind them? Aren’t experts endorsing them?

But the real question isn’t whether something sounds scientific. It’s whether it actually works. As a physician, scientist, and wellness/longevity podcaster, I care deeply about helping people live long and well, but the hype that happens in this space bothers me greatly.

1. The Hype Equation

Here’s the pattern that shows up again and again:

Cool mechanism + Compelling anecdote + Credentialed endorsement ≠ Reliable evidence

Understanding this simple equation can save people thousands of dollars, a lot of wasted time, and in some cases — even potential harm.

Take mitochondrial supplements. It’s true that mitochondria play a critical role in energy production and decline with age. But just because a supplement might boost NAD+ in theory (or even in the lab/yeast/mice) doesn’t mean it improves energy in real people.

Or look at detox cleanses. The idea of “flushing toxins” sounds appealing, and you’ll hear testimonials like, “I followed this 14-day plan and feel amazing.” Add in an expert who says, “This is changing lives,” and it becomes tempting to believe. But when we check for high-quality studies in people—especially randomized controlled trials—those benefits typically don’t hold up.

With the growth of social media and numerous podcast “experts” promoting seductive theories (and selling the solution), the problematic equation cited above becomes very worrisome and all too common.

2. When Biology Doesn’t Equal Benefit

History is full of examples where promising theories fell apart under testing.

• Dietary cholesterol was once blamed for heart disease. The logic made sense—artery plaque contains cholesterol, so eating cholesterol must be harmful. But large-scale studies later showed that for most people, egg consumption has little effect on cardiovascular outcomes.

• Coronary stents were assumed to prevent heart attacks in people with stable chest pain, since a clogged artery can’t be good for you. But when tested in rigorous trials like COURAGE and ORBITA, the procedures didn’t outperform standard treatment.

• Vertebroplasty, a procedure to inject cement into fractured spinal bones, sounded promising. But a 2009 NEJM study found it worked no better than a placebo procedure.

These weren’t fringe ideas. They were widely accepted, grounded in biology, and ultimately proven ineffective.

3. When Science Gets Stretched

It’s not just fringe ideas that get overhyped. Sometimes good science gets carried too far.

Take vitamin C. It absolutely prevents scurvy—something 18th-century sailors learned the hard way. But when Nobel Prize winner Linus Pauling suggested it could prevent colds, the public jumped on board. Yet Cochrane reviews show it doesn’t reduce cold frequency for most people.

Or look at hyperbaric oxygen therapy. There is excellent evidence supporting its use for decompression sickness, carbon monoxide poisoning, and diabetic foot ulcers — including a Cochrane review. But broader claims — like boosting cognition or reversing aging — lack that level of evidence and remain speculative.

We’ve seen similar leaps with stem cells, infrared saunas, and “bioenergetic” devices. Biology may explain how something might work. But that doesn’t prove it does.

4. Why We Fall for Hype

There are good reasons why these claims are so persuasive:

• Unmet needs. Fatigue, brain fog, chronic pain—many people live with symptoms that traditional medicine hasn’t resolved. They seek alternative solutions.

• Placebo power. Just taking action—doing something—can lead to feeling better, even if the treatment itself isn’t effective.

• Marketing money. Wellness is a very large industry globally. Financial gain often fuels bold claims.

• Buzzwords everywhere. “Natural detox.” “Immune support.” “Cellular rejuvenation.” These phrases are catchy but often empty.

5. How to Stay Grounded

Whether you're a health professional or just a curious consumer, here are a few helpful questions to ask when you hear about a new therapy:

1. Has it been tested in humans? Animal and lab studies are great starting points—but they aren’t proof.

2. Who profits? Always ask who stands to gain if people believe it works.

3. Are the claims measurable? Buzzwords like “boost” or “detox” sound good but are rarely defined.

4. Was there a fair comparison? Was the treatment tested against a placebo or best available care?

5. How big is the benefit? Even if there’s a study, was the effect meaningful—or just statistically significant?

6. Could this be placebo? Many symptoms improve naturally or because we expect them to.

7. Is the source honest about uncertainty? Trust people who say “we don’t know yet” over those offering a cure-all.

6. Final Thoughts

It’s easy to get swept up in new wellness trends—especially when the stories are moving and the science sounds right. But whether you’re making decisions for yourself or advising others, what matters most is real-world evidence.

Anecdotes can offer clues. Mechanisms can guide research. But only studies — done in real people, with fair comparisons—can tell us what actually works. Experts who tout a compelling mechanism and are armed with laboratory, mice, or human anecdotal data do not reach the level of actionable evidence.

Keep the hype equation in mind: Cool mechanism + Compelling anecdote + Credentialed endorsement ≠ Reliable evidence

So next time a supplement or therapy seems too good to be true, take a pause.

Be curious. Be open. But stay grounded.

Dr Bobby Dubois is a physician and scientist with 180 peer-reviewed publications on evidence-based medicine, appropriateness of care, and the value of health care interventions. He is also an Ironman Triathlete, a wellness/longevity/health podcaster, and a writer. To hear more health thoughts, listen to his podcast: Live Long and Well With Dr. Bobby, or sign up for his newsletter