A couple of months ago, a regular reader sent me an interesting email. His wife is pregnant with their first child. (Congrats!) Like most expecting mothers, she is dealing with morning sickness. Her doctor told her to suck on Preggie Pops, and if that doesn’t help, to come back for another visit, and she would prescribe her something for the nausea.
After driving all over town looking for Preggie Pops, the couple came home empty-handed. They turned to the internet to order some. It isn’t instant relief, but it is better than nothing. Like all brilliant consumers, they looked to see what the active ingredient is so that they can look for an equivalent generic and save some money. It was then that they discovered that the active ingredient in Preggie Pops was… nothing. There is no active ingredient. He wrote me:
“[They are] an over-priced piece of candy placebo on a stick, marketed to pregnant women! My wife (who is a doctor herself) was more than a little insulted. Ingredients: Sugar, corn-syrup, corn-starch, natural flavors.
To top off his frustration, it was another hour trip to see the doctor for the nausea medicine.
His frustration is understandable, right? No one likes wild-goose chases. It’s a lot of running around for sugar and corn-syrup.
About that Placebo Effect…
Over the last 7 years, I’ve covered in excruciating detail the damage pyramid schemes selling snake oil do. In particular, I cover some of the harm of the placebo effect. It can lead to self-licensing of unhealthy behavior. It also undermines good science and the doctor-patient relationship.
Finally, let’s just say that I’m not a fan of marketers lying to consumers to make a buck. I believe there is a simple word for it, “fraud.”
What Makes Preggie Pops Different?
I had a gut feeling that Preggie Pops weren’t nearly as bad as the pyramid schemes selling snake oil. It took a little thinking to bring my gut feeling into words that I can use to explain it.
The pyramid schemes selling snake oil use a Groupthink and financial bias (through a financial fraud) to coerce its cult-followers that the products work. Preggie Pops do nothing of the sort. No one joins the Preggie Pop cult. When Scarlett is trying Preggie Pops, she’s not thinking “If this works for me I can make money recommending it to Candice”, which would logically increase the placebo effect.
As if avoiding a cult isn’t important enough, there are the other considerations. If your doctor is recommending it, it doesn’t undermine the doctor-patient relationship.
Morning sickness is also a special case. Its very nature is fleeting with the advancement of the pregnancy. No one goes through life with a chronic case of morning sickness.
One of the other problems with placebo is that they can prevent people from getting real medical treatment during which time the condition may worsen. In this case, the condition isn’t likely to worsen.
Finally, until very recently there didn’t exist real medical treatment out. This Reuters article points out that this morning sickness drug is the first the FDA approved in 50 years.
(Interesting side story: It was taken off the market in 1983 after mothers filed a ton of lawsuits claiming it hurt children. It wasn’t that it was shown to cause harm or be ineffective, but the company didn’t have the money for a legal defense. Reminds me a little of the witch-hunt with vaccinations, except they have the money and scientific community.)
According to the Reuters article, this new medication, Diclegis, “consists of two main ingredients: doxylamine succinate, which is contained in several over-the-counter antihistamines; and pyroxidine hydrochloride, also known as vitamin B6.”
We’ll get back to the B6 in a bit.
Understandably, expecting mothers aren’t going to rush to take medication. We are all very, very careful with such little lives. Many of the safest medications specifically state to consult your doctor. My wife, a pharmacist, not only stayed away from every medication known to man, she extended her boycott to anything that she considered a chemical such as high-fructose corn syrup or artificial sweeteners.
Given this, I can understand and appreciate the appeal of a sugar candy to alleviate a temporary symptom.
So Do Preggie Pops Work?
If you want to know if something is clinically effective, you do studies as described here. These studies properly blind patients and researchers to avoid bias as well as take other safeguards to ensure the science is accurate. I couldn’t find any such studies on Preggie Pops.
The closest thing we have to that (which isn’t that close) are the Amazon reviews Preggie Pops. There are currently 139 ratings that average 3.6 out of 5 stars. That’s very underwhelming as far as Amazon reviews go.
The Wall Street Journal reported on the lollipops as well. They bring in gastroenterologist Patricia L. Raymond, an assistant professor of clinical internal medicine at Eastern Virginia Medical School in Norfolk, Va, who said, “there is insufficient proof that any of the candies are effective.”
The article goes a little further to explore the company’s claims. In particular Preggie Pops contain two ingredients that may help with nausea.
The first is ginger. Preggie Pops contain 62mg of ginger according to the article. A Dr. Leung has reviewed studies which seemed to show that 750 to 2,500 milligrams may help with morning sickness. It is dangerous to make conclusions on a few studies and of course, Preggie Pops contain far less of the ingredient than in the research.
I noticed that only one of Preggie Pops flavored were ginger. It wasn’t clear to me if there was ginger in their other flavors. However, these Ginger Tummydrops are better rated than Preggie Pops with a 4.2 rating across 366 reviews. So maybe people’s reviews of Preggie Pops are dependent on the flavor.
The Wall Street Journal also mentioned that a couple of studies showed that 10mg of B6 or more may help with morning sickness. Again, these studies are sparse, but it is worth noting that Preggie Pops do contain 10mg of vitamin B6 and a competing brand has 25mg.
If you remember, one of the two ingredients in the recently approved prescription medicine above was vitamin B6. Again, the research in general appears to be paper thin.
So what about the cost of Preggie Pops
This website is about money, so I need to talk about the money aspect. This might also help people who can’t locate Preggie Pops locally or don’t wish to wait for them to be shipped over the internet.
Preggie Pops and Tummydrops on Amazon cost around 32 to 37 cents a piece. It doesn’t sound like much, but it could be a a buck per day for a couple of months.
This Source Naturals Vitamin B-6, 50mg, 250 Tablets is 3 cents per does, about 1/10th cost… and it has twice as much vitamin B6. If you have a pill splitter handy, you could make that 500 pills of the same amount of B6 in some of the drops or pops. The pills also state that they are used for morning sickness.
What about the Ginger? The Ginger Tummydrops seems to contain 15mg of ginger even less than the Preggie Pops 62mg. However you can get 550mg of Ginger Root for 5 cents a pill. That’s a lot more ginger than you can in drops.
If it’s sucking on sugar that helps, add in a bag of Jolly Ranchers for really cheap for another penny or two.
For a total of around 8 or 9 cents a dose you can get a lot more ginger and B6 than what you’d get with the drops. That’s better than 32 or 37 cents right?
If those two ingredients are really effective, the 7 cents seems like the right way to go, right?
What do you think? Let me know in the comments.
Rebecca @ Stapler Confessions says
Interesting! This last go around, I ate these chewy ginger bombs called gin-gins. Disgusting, but they kept the nausea at bay. I also literally drank a bottle of diet ginger ale a day (don’t let your wife read that, I know aspartame is bad!). All so I didn’t have to take zofran too often, which is another anti-nausea med.
And if there’s one thing I learned about morning sickness, it’s that what works for one person may or may not work for another. So heck, maybe the lollipops help because they give you a dose of easily absorbed vitamin B exactly when you need it, as opposed to taking a pill that takes time to work?
Lazy Man says
Maybe, but the pill seems to have been deemed effective as well. I wonder how much of it is also the placebo effect. If only I knew some pregnant women who were willing to be guinea pigs.
Dustin James says
Dear Lazy Man,
Thank you for writing such a well thought out article. I was hoping to add my expertise about ginger. As a disclaimer, I act as the Vice President of Enteral Health & Nutrition, LLC, the company which makes tummydrops.
When I set out to invent tummydrops for my own patients, I wanted to create a natural product that had sound scientific backing. Numerous studies have shown the ability of ginger to assist with nausea from a variety of causes, but it is impossible to generalize between different products, as ginger is a living and diverse plant, as opposed to a singular chemical.
Science does know that the compounds in ginger that can assist with nausea come from the pungency compounds, as opposed to the volatile parts. In food, the volatile compounds contribute to aroma and taste. In some plants, the beneficial compounds are in the volatile component of a plant, as is the case with peppermint oil.
With ginger, the smell and characteristic taste compounds are in the essential oil. This part of the plant does not contribute to any clinical benefits. In ginger, the part of the plant that assists with nausea comes from the spicy part.
If you review most of the ginger products aimed at assisting with nausea, you will find that they only contain the volatile essential oil. The benefits they create are likely only a placebo effect. This effect is to not be discounted, however, even in clinical settings as it is estimated to be effective in as much as 40% of patients in digestive diseases.
The other complicated part of determining which ginger may have clinical benefits is that there are many ways to process ginger to get the desirable compounds.
For instance, eating pure, raw ginger could assist with nausea, as the pungency compounds have not been degraded. Unfortunately, most of ginger root is water, and the amount someone would have to eat to get benefit is likely too high to tolerate.
Dried, ground ginger, like that commonly found in capsules, removes the water component, but it does nothing to augment the desirable compounds. The pungency compounds may only amount a few percent of the total weight. Special extraction processes can increase the percentage of the desired compounds. For instance, one mg of a special extract may be close to 1000 mg of unprocessed, ground, dried ginger. For tummydrops, it took years for us to develop a special blend of ginger EXTRACT that was enriched in the pungency compounds that prior trials suggested were able to assist nausea.
This variation in ginger products makes it hard to compare on clinical study to another. It is truly a case of comparing apples to oranges. One clear guide, though, is…if a ginger product only contains ginger essential oil (ginger oil), it is unlikely to contain the compounds that science has identified as beneficial to assist with nausea.
In clinical medicine, clinical trials represent the best way to test if a treatment can assist with a problem. They are not without their own flaws though.
For tummydrops, we spent 2 years conducting an open-label prospective clinical trial of tummydrops in subjects with common digestive complaints. The ginger tummydrops were made with 15 mg of our special blend of ginger extract enriched in the pungency, anti-nausea compounds. This 15 mg is more valuable than pounds of ginger products containing only the essential oil or 100 times its weight in dried, ground whole ginger root.
The results showed that they were able to assist with these complaints in most subjects. We do not want to market tummydrops as a product that assists with nausea 100% of the time in 100% of people-there is no such product, be it over-the-counter or a prescription drug. The study was positive, however, and showed that most people did find benefit.
I’ll be the first to admit that a prospective study is not as meaningful as a double blind placebo randomized controlled trial, but it is a start. As our company grows, we are able to conduct more and more research to answer these questions and make our product better.
We hope this helps and please contact me if I can be of any assistance in the future.
Have a great day,
Dustin James, MD
Dustin James said: “Science does know that the compounds in ginger that can assist with nausea come from the pungency compounds”
Well science is very smart isn’t it? What are the names of those “pungency” compounds and at what concentrations/amounts are they present in your product?
Dustin James said: “For tummydrops, we spent 2 years conducting an open-label prospective clinical trial of tummydrops in subjects with common digestive complaints.”
Two years??? Why did it take you so long to conduct an anti-nausea trial? And why would you go through all that effort to do a study without blinding and placebo controls (i.e., an open-label trial)? That seems rather pointless.
Dustin James said: “The results showed that they were able to assist with these complaints in most subjects. We do not want to market tummydrops as a product that assists with nausea 100% of the time in 100% of people-there is no such product, be it over-the-counter or a prescription drug. The study was positive, however, and showed that most people did find benefit.”
Was the study published? If not, it’s essentially worthless. The results you describe are suspiciously vague. Did you not perform proper statistical analyses? It sounds as though you did not. Where is the data? Your comment is threadbare.
Dustin James said: “I’ll be the first to admit that a prospective study is not as meaningful as a double blind placebo randomized controlled trial, but it is a start.”
It sounds like you don’t know the meaning of the term “prospective”. All double-blind randomized controlled trials are prospective. Perhaps you erred and meant retrospective rather than prospective, and if your initial study was retrospective, it’s even more worthless.
I also noticed that you’re marketing these candies for the treatment of medical conditions, and making claims about safety, in contravention to US law. Not cool! Your website states:
“This trial showed that tummydrops assisted a wide variety of tummy symptoms, including pregnancy related nausea (morning sickness), motion sickness, nausea, nervous stomach and bowels, digestive upsets related to gluten, and dyspepsia. It also showed that they were very safe and side effects.”
I’d like to say that you talk a good game, but if I did I’d be lying. Seems that what you’re doing is antithetical to science; snakeoil BS some might even call it.
One other thing I find disturbing about Dustin’s shameless plug for his ginger candies is that they are, allegedly, a concentrated form of various compounds isolated from ginger that are being marketed to pregnant women. However, this product has not undergone proper safety testing, so it’s unknown as to whether they cause adverse effects on the fetus. I’d certainly stay the hell away from them if I was pregnant.
Andrea Tickle says
As a CAM Doctor who’s expecting, I sincerely appreciate all natural attempts to help with symptoms of morning sickness. I noticed that B6 prehistoric pops made my nausea and vomiting worsen, and my guess is it is how my body responds to the sugar spike. Ginger in any form always helps. The research on Tummy drops may not be adequate, but it’s a great start and far from snake oil, as stated above. Thank you for your work, and thanks for this article. I was searching to see if other pregnant women experienced negative reactions to the B6 preform pops too. Gentlemen, until you suffer through morning sickness you haven’t a clue of the desperation we experience for relief. Your efforts are sincerely a appreciated!
What exactly is a “CAM doctor”? I think you meant chiropractor. Dodgy!
Andrea Tickle says
Are you this rude to everybody in real life or just on the internet- or is it just your own website that you belittle?
It’s really interesting that anyone who takes the time to contribute you bash!
To answer your question, I have a double undergrad in Contemplative Psychology of Health and Healing, and in Yoga Education. And Doctorates in Chiropractic and Physical Therapy, with diplomats in prenatal and pediatric care.
How about you?
You’ve certainly never been pregnant, and that should be all it takes to earn credibility enough to comment here with respect!
Please learn to show some manners and kindness if you wish to moderate topics relating to sensitive topics such as human reproduction.
Lazy Man says
To the best of my knowledge, Vogel doesn’t have a website. He didn’t leave one in the area of the comment form where people can state their website.