ANNOUNCER: Funding for HealthWeek is provided by the Howard Heinz Endowment and the Teresa and H. John Heinz III Foundation.

SHARYL ATTKISSON: Today on HealthWeek... Should you get your thyroid checked? Millions of people have a thyroid problem and don't know it.

They're popping up everywhere... from orange juice to antacids. But what do those seals-of-approval from medical groups really mean?

MICHAEL JACOBSON, PhD, CENTER FOR SCIENCE IN THE PUBLIC INTEREST: "These organizations, every time they make an endorsement deal, are losing a little bit of their credibility."

SHARYL ATTKISSON: The whole story behind the "seal" deals.

And ghosts, goblins, and ghouls... why we love scaring ourselves silly.

GINKGO
Hello. I'm Sharyl Attkisson. Welcome to HealthWeek.

Ginkgo Biloba. It's a strange term, but you've probably been hearing a lot of it lately. You can hardly turn on the TV or flip through a magazine without seeing someone singing the praises of this herbal supplement. In our Behind the Headlines segment, we look at what's being done to test the most amazing of those claims: that ginkgo helps people with Alzheimer's disease. This week, researchers released the first major U.S. study on the subject. And the results are generating as many questions as answers. HealthWeek's Marcia Brazda has details.

MARCIA BRAZDA: Wayne Kornblatt can tell you that even before the latest study, ginkgo was one of the hottest movers in his health-food store. Some people swear this product made from the leaves of the ginkgo tree can do everything from fine-tune your memory to jump-start your sex life.

WAYNE KORNBLATT, SPROUTS HEALTH MARKET: "It's been used and known for its ability to increase circulation, oxygenate the brain, the heart, and all the other muscles of the body, helping to not only lower blood pressure, but help in memory, in cognitive memory retention."

MARCIA BRAZDA: Now, there's evidence to back up at least one of those claims. This week's Journal of the American Medical Association includes a study on the effects of a ginkgo extract, known as EGB 761. More than 200 people were studied and all had senile dementia caused by Alzheimer's disease or reduced blood flow to the brain. And six months out, the researchers were pleased with what they saw.

PIERRE LE BARS, MD, PhD, NEW YORK INSTITUTE FOR MEDICAL RESEARCH: "Overall, we had encouraging results with 50 percent of the population taking this drug who showed better performance in their thought process."

MARCIA BRAZDA: Specifically, people who took three ginkgo pills a day, totalling 120 milligrams, scored twice as well on tests that measure thinking as those who took placebo, or "dummy" pills.

WOMAN: "What's the name of this finger? Do you know what this finger is?"

PATIENT: "The thumb."

WOMAN: "And what about this one?"

MARCIA BRAZDA: And that's not all. People caring for patients who took ginkgo were 40 percent more likely to report improvements in day-to-day living.

One brain researcher at the National Institute on Aging... while intrigued by the new findings, is urging caution.

MARCELLE MORRISON-BOGORAD, PhD, NATIONAL INSTITUTE ON AGING: "But it wasn't an all or nothing effect, it really wasn't. It was fairly modest. So that's not what we want from a wonder drug. We're saving 'wonder' for something else."

MARCIA BRAZDA: She also warns the study looked only at whether ginkgo could help people with senile dementia, not those who are healthy.

MARCELLE MORRISON-BOGORAD, PhD: "The bottom line is nothing has been published yet about whether ginkgo prevents the onset of Alzheimer's. So someone taking it in the hope that it would stop them getting it is really on shaky ground."

MARCIA BRAZDA: Still, Wayne Cornblatt and health food owners across the nation are bracing themselves for a new wave of customers, and a new wave of questions.

SHARYL ATTKISSON: Joining us from New York to answer some of those questions is Sarah Masters, news director for Reuters Health Information Services.

This study was funded by a company that actually makes ginkgo extract, so how trustworthy are the results?

SARAH MASTERS, NEWS DIRECTOR: Well, I think they are trustworthy in the sense that the data were all reviewed by health care professionals prior to publication in a prestigious medical journal, the Journal of the American Medical Association. There were, however, some problems with the study. One is that a lot of the enrollees dropped out, particularly those that were taking the placebo, or dummy, pill, and they only studied one dose of Ginkgo Biloba extract. So, that's a problem.

SHARYL ATTKISSON: For those who remained in the study, we did hear a lot about the potential benefits of it. What do we know about the risks?

SARAH MASTERS: Well, today there haven't been too many reports of any major side effects associated with Ginkgo Biloba, if you take it alone. The concern seems to be if you take ginkgo at the same time as you take, for instance, aspirin, vitamin E, the prescription anticoagulants, because all of those are called anti-clotting factors, and they can cause internal bleeding, particularly if they're taken together.

SHARYL ATTKISSON: There are already two FDA approved drugs to treat Alzheimer's. Do we know how the ginkgo extract appears to stack up against those?

SARAH MASTERS: To date, they seem to be fairly equivalent. Those two are Tacrine and Donepezil, and they're recommended for Alzheimer's disease, short-term, moderate improvement. The difference is that those two drugs are regulated by the government and the extract is not.

Therefore, you know how much dose you're getting every time you take one of those two drugs, and you also know that it's not contaminated with anything else. You can't say the same for the ginkgo, because it's not regulated by the government.

SHARYL ATTKISSON: And people will want to know, is the type of the ginkgo extract in the study available right now in the United States? Can people go out to the store and buy it?

SARAH MASTERS: Apparently it is. The investigators are cautioning that anybody who wants to purchase this look for the EGB 761 on the label. That is the same brand that was used in the study.

SHARYL ATTKISSON: All right. Sarah Masters, thank you so much for the information.

SARAH MASTERS: Thank you very much.

HEALTH NOTE
Nuts from the fruit of the ginkgo tree are often used in Chinese and Japanese cooking.

THYROID TESTING
You don't have any energy, your body thermostat is out of whack, and you've put on a few pounds even though you watch what you eat. It might just be a sign that you're getting older. But, for some people, it could be a sign of a more serious problem, one that some doctors think everyone over age 35 should be tested for. HealthWeek's Andrew Holtz in Portland, Oregon has more.

ANDREW HOLTZ: Like a bloom cut from its roots, florist Aretta Christie was wilting. She was tired, swollen, her skin yellowed. Confusion fogged her mind. And her doctor couldn't explain it.

ARETTA CHRISTIE: Basically, I thought I was crazy, and so, I mean at a certain point I just quit going to the doctor, because I thought it was a condition that I just had to accept.

ANDREW HOLTZ: After a year, another doctor suggested testing her thyroid. Results showed it had failed. When at last she was treated with thyroid hormone, she says she got her life back.

ARETTA CHRISTIE: Wow, I could just take this little pill, and suddenly I could think again, and basically I was me again.

ANDREW HOLTZ: The thyroid is a small butterfly-shaped gland just below the Adam's apple. The thyroid gland produces hormones that travel through the blood to every part of the body, telling it how fast to work and use energy.

Among older Americans, as many as one in thirteen may have low levels of thyroid hormone, hypothyroidism, which can cause fatigue, coldness, or even heart or mental problems.

JEPHTA DRACHMAN: They've grown so much! Look at that.

ANDREW HOLTZ: But often there are no clear symptoms. Jephta Drachman says she was feeling perfectly healthy when a routine check-up and then follow-up testing discovered hypothyroidism. She began taking thyroid hormone supplements.

JEPHTA DRACHMAN: I thought this was kind of crazy, I was feeling fine anyway, and then gradually I started to develop more and more energy, and I lost some weight, and I really started to feel as if I could keep going forever.

PAUL LADENSON, MD: "Here's the result of your antithyroid antibody test."

ANDREW HOLTZ: Because mild thyroid problems often remain hidden, some experts, including researchers at Johns Hopkins, argue thyroid screening tests should be routine.

PAUL LADENSON, MD, JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE: Our study found that screening American adults beginning at age 35 every five years with a blood test, the serum TSH, to detect mild hypothyroidism was as effective a preventive medical measure as screening for many other diseases.

ANDREW HOLTZ: But other doctors say that sort of mass screening would go too far, that it would be expensive, unnecessary, and perhaps even harmful.

MARK HELFAND, MD, OREGON HEALTH SCIENCES UNIVERSITY: The controversy is whether you should find people who have signs on lab tests of thyroid failure, but who pretty much are otherwise healthy.

ANDREW HOLTZ, PORTLAND, OREGON: Some doctors worry that widespread screening tests could lead to millions of people being put on life-long thyroid treatment, even if their test results were just borderline, and they say the evidence to justify that kind of widespread treatment just doesn't exist.

For example, the U.S. Preventive Services Task Force, which issues guidelines on a variety of screening tests, calls for thyroid testing only when there is a reason to suspect a problem, not routine screening of healthy people.

ROBERT LAWRENCE, MD, US PREVENTIVE SERVICES TASK FORCE: We found not a single study supporting the benefit of screening as being greater than the potential harms associated with it.

LIGIA MCDONALD: "That's interesting."

ANDREW HOLTZ: Looking back at a college yearbook picture of herself and her future husband, Ligia McDonald wishes she were still that thin and energetic. But three years ago, she suddenly gained 40 pounds and began sleeping up to 14 hours a day. Her doctor ran a thyroid test.

LIGIA MCDONALD: It came back that although my thyroid was normal, it was on the low side of normal, so then that's when he prescribed the thyroid medication.

ANDREW HOLTZ: She says her weight began dropping and her energy returned. But then a follow-up exam found she was getting too much thyroid hormone, which can cause abnormal heart rhythms and accelerate osteoporosis.

LIGIA MCDONALD: It wasn't worth the risk, obviously, so I cut it cold turkey.

ANDREW HOLTZ: Critics of widespread testing worry some doctors might not detect the warning signs of over-treatment, as they did in Ligia's case.

TOM SEGERSON, MD: "Take another sip."

ANDREW HOLTZ: But supporters of more screening say the real problem is the number of people who need thyroid medication and aren't getting it.

TOM SEGERSON, MD, OREGON HEALTH SCIENCES UNIVERSITY: The risk of over-treatment or an unnecessary treatment of people without thyroid disease should not dissuade us from examining more carefully how aggressive we should be at screening the population.

ANDREW HOLTZ: Even the critics of screening say any suspicions of thyroid problems should be checked out. Until more studies can help experts agree on testing people without symptoms, the decisions will have to be made on a case-by-case basis.

MICHAEL MCCLUNG, MD, PROVIDENCE MEDICAL CENTER: Treating the patient and evaluating the patient is what medicine is supposed to be about, rather than treating numbers.

ANDREW HOLTZ: As Aretta Christie knows, successfully discovering and treating thyroid problems can be as difficult, and as rewarding, as tending to an exotic bloom.

SHARYL ATTKISSON: The people we just heard about suffer from hypothyroidism. But there's another thyroid disorder that often goes undetected as well. It's called hyperthyroidism, when the thyroid gland produces too much hormone. Doctor Sheldon Rubenfeld, author of "Could It Be My Thyroid?" tells how to recognize the warning signs for both disorders.

SHELDON RUBENFELD, MD, AUTHOR "COULD IT BE MY THYROID?": Well, people who have hypothyroidism, wherein they're not making enough thyroid hormone, or hyperthyroidism, wherein they're making too much thyroid hormone, can actually have similar symptoms.

Both groups of patients may present fatigue, an extremely common symptom, "I have no energy. I'm very tired, I can't get accomplished everything I want to accomplish." Hair loss, with thyroid disease, both hyper and hypothyroidism, you may lose hair. Once you're treated, the hair will return. People may have memory loss with both hyperthyroidism and hypothyroidism. In hyperthyroidism, their mind is racing.

It's hard to concentrate on things. It's hard to remember things. In hypothyroidism, their mind is somewhat sluggish. It's hard to remember things. People who do not make enough thyroid hormone frequently get cold. Hyperthyroidism causes people to be hot. So you'll notice that people who are hyperthyroid are taking clothes off. They're hot when other people are feeling perfectly fine. Almost all thyroid disorders, fortunately, are treatable. It's unusual to find life-threatening thyroid disorders.

SHARYL ATTKISSON: If you'd like more information about thyroid screening, or any other HealthWeek story, you can call our toll-free number shown at the end of the program.

HEALTHFUL HINTS
NANCY SNYDERMAN, MD: Hello, I'm Doctor Nancy Snyderman with this week's Healthful Hint.

When you step into a hot tub or whirlpool bath, relaxation is usually the main thing on your mind, but you may also want to give your health more than a passing thought. If you're pregnant, or think you might be, stay away from a hot tub. The hot water can hurt your growing fetus. For the rest of you, there's the warm, moist conditions. That can be a problem, because the warm water can encourage the growth of germs that can cause everything from skin rashes to Legionnaire's Disease. As a rule of thumb, the more often your tub is used, the more often you'll have to add disinfectant. One way to cut down on disinfectant use is to get your guests to bathe or shower before jumping in. The cleaner they are, the cleaner your hot tub will stay. Make sure the water temperature doesn't get hotter than 104 degrees, and never drink alcoholic beverages before going in the tub. Not only does alcohol make you feel drowsy, but it makes your body more likely to overheat. Also beware of the drain. Make sure it's covered. Don't sit on it, and if you have long hair, be sure to put it up so it doesn't get caught. Then you can finally sit back and relax. With Healthful Hints, I'm Doctor Nancy Snyderman.

ENDORSEMENTS
SHARYL ATTKISSON: You may have noticed them on something you bought, those little seals of approval from health groups. The American Medical Association recently agreed to put its logo on Sunbeam home health products, products the AMA hadn't even tested, in exchange for millions of dollars in royalties from sales. But the AMA was forced to back out of the deal after many consumer groups and doctors denounced it as unethical. Now, other health seals are facing similar criticism. But as HealthWeek's Dr. Robert Davis found out, not all seals are created equal.

ROBERT DAVIS, PhD: They're everywhere... on orange juice, antacids, cereals, shoe insoles, and toothpastes.

These days, you can't go down a store aisle without spotting some health-related seal of approval. Of course, they're supposed to make us buy the product, and they seem to be working.

WOMAN: "I would probably buy the one with the seal because I would feel that the advertising on it or the informational content is more correct."

MAN: "If I'm making a comparison between one product that doesn't have it and one that does, I might be swayed."

TV COMMERCIAL: Crest with Floristan, so different it's patented, so effective, Crest is the only toothpaste recognized effective against cavities by the American Dental Association.

ROBERT DAVIS, PhD: It was the American Dental Association's seal that helped make Crest the top selling toothpaste in the 1960's. The ADA's approval program, which has been around more than 60 years, is widely considered the gold standard.

GARY RAINWATER, DDS, PRES, AMERICAN DENTAL ASSOC: The consumer, when they walk down that aisle and they look at a product and they see that seal, they know three things: number one that the product works, that it's effective, number two that it's safe, and that it does what it says it does."

ROBERT DAVIS, PhD: To earn the ADA seal, products are subjected to a rigorous review; more than 30% don't make the cut. Once accepted, companies must also submit all their ads for approval and pay a yearly fee.

GARY RAINWATER: That covers one third of the cost of the program. The other two thirds comes out of our pocket and out of our members' dues.

ROBERT DAVIS, PhD: The American Heart Association has a similar program for food. This check mark means the product is low in fat and cholesterol.

NANCY CHAPMAN, AMERICAN HEART ASSOC: This is not an endorsement program. This is really a certification program that states that this has really got the kinds of nutritional profile that will help reduce the risk of heart disease.

ROBERT DAVIS, PhD: But many consumers seem to have a different interpretation.

MAN: "I think they are endorsing the product in the sense that they are saying that this product itself is going to be able to definitely not hurt my heart and it's actually a good product."

WOMAN: "They're letting you know that that is good for you and the other one is not."

ROBERT DAVIS, PhD: But that's not necessarily the case. For example, Kellogg's Raisin Bran has the heart check, but Post Raisin Bran doesn't. Not because the Post cereal is less nutritious, but because it's made by a company that also sells tobacco, and the Heart Association bars such companies from participating in the program.

C. WAYNE CALLAWAY, MD, AMER SOCIETY FOR NUTRITIONAL SCIENCES: The consumer can get very, very confused.

ROBERT DAVIS, PhD: Dr. Wayne Callaway, who's served on the Heart Association's Nutrition Committee, worries seals may give the misleading impression that approved foods are good, and all others bad.

C. WAYNE CALLAWAY, MD: The seals are overly simplistic. It is day-in, day-out, week-in, week-out dietary balance over time plus exercise that improves health. A single food, one way or another, is not going to do it.

ROBERT DAVIS, PhD: In addition to the Heart Check program, the Heart Association has lucrative marketing agreements with various product manufacturers. For example, it's receiving $450,000 from the Florida Department of Citrus for allowing its logo to appear in Florida grapefruit ads.

TV COMMERCIAL: It's naturally fat-free and cholesterol-free.

ROBERT DAVIS, PhD: And the Heart Association is far from alone. The American Cancer Society has a similar arrangement with Florida orange juice, bringing in $1 million a year.

The Cancer Society also has an exclusive partnership with Nicoderm Quit-Smoking Patches, for another 1 million a year.

Meanwhile, the American Lung Association has a deal with a competing product, Nicotrol, for 2.5 million.

And the National Osteoporosis Foundation has teamed up with Tums antacids, to the tune of $2.1 million.

All these groups emphasize they're in no way endorsing products, but instead joining forces with corporations and using their money to help educate the public about important health issues. Many consumer advocates, though, see it as selling out.

MICHAEL JACOBSON, PhD, CENTER FOR SCIENCE IN THE PUBLIC INTEREST: These organizations, every time they make an endorsement deal, are losing a little bit of their credibility. People see these once objective, unbiased health organizations as going commercial, and people know what that means. People know that that means they simply can't be trusted as much as they could if they were strictly non-commercial.

ROBERT DAVIS, PhD: But for now, seals continue to drive sales and the organizations that issue them continue to enjoy strong public trust.

WOMAN: "If that's their way of getting money, then I guess it's okay with me. It doesn't really erode my faith in it because I will look past that."

SHARYL ATTKISSON: If health-group seals leave you confused, what can you do when you're out there shopping? The People's Medical Society offers these tips for comparing products: First, read the labels. Food labels must list fat content, vitamin levels and other important nutrition information, and drugs have to list active ingredients.

Beware of official looking seals that are actually created by manufacturers.

Ignore words like "doctor recommended," they are meaningless advertising slogans.

And, if possible, look for an evaluation of the product by a totally independent source, such as Consumer's Union.

Now for an update on a story we first told you about in July... the dangers of giving children too much Tylenol or other drugs containing acetaminophen. The maker of infant Tylenol recently announced plans to add a warning to the label of the fruit-flavored liquids, which are highly concentrated. The warning will tell parents about the health risks of using more than the recommended amount. Even small overdoses of the drug have been blamed for liver damage and death in young children.

ASK THE DOCTOR
GIRL: "My brother gets nauseous when he rides in a car or a plane for a long time period, and I was wondering if there was any sort of medication or just a remedy to try to help him resolve this problem."

DR. BRUCE DAN: Motion sickness occurs when your eyes tell you that the world is moving rapidly by, but your inner ears say you're sitting still. That situation upsets your brain's nausea center, sending your stomach out of whack. To bring your stomach under control, look far off into the distance where the landscape isn't moving so fast. Or better yet, simply close your eyes, cutting off one of the signals that's confusing your brain. People who often get queasy when they travel may want to try motion-sickness medications, Dramamine, for example. But you have to use the medicine about an hour before the trip begins. For adults, there are also skin patches containing the drug scopolamine that you stick behind your ear. And here's a simple remedy that's often overlooked in this era of air-conditioned cars: try rolling down the window a crack. Sometimes a breath of fresh air may be all the help you need. With "Ask the Doctor," I'm Dr. Bruce Dan.

FEAR
SHARYL ATTKISSON: In just a few short nights, the streets will be full of kids on the prowl for a lot of candy and a really good scare. Most "grown-ups" have outgrown the caramel apples and candy corn. But, for some reason, many of us never lose our taste for the things that send a chill down our spines. HealthWeek's Pat Anson in Los Angeles tells us why.

PAT ANSON: Fear. Perhaps the most dreaded of human emotions... and strangely, one of the most welcome. It's Halloween horror night at Universal Studios, and people are waiting in line for hours, hoping to be scared out of their wits.

GIRL: "It's like fun to be scared because like when the monsters pop out, you just scream and you're like, oh God. It's fun, though."

STUART FISCHOFF, PhD: "We like to be scared in a safe, controlled environment."

PAT ANSON: Stuart Fischoff is an expert on the psychology of film. He says Halloween and horror movies help satisfy a basic human instinct.

STUART FISCHOFF, PhD, CAL STATE LA: "The research shows us pretty consistently that human beings have a need for some kind of excitation. Sometimes it's called an arousal jag. You have to get some really intense kind of experience to kind of cleanse the system and check all the parts that are working."

PAT ANSON: In a civilized, sometimes dangerous society, real horror is something to be avoided. So we turn to our imaginations and create our darkest fears.

MAN: "Life is too ordinary. We need something that like jolts you every once in awhile, that kind of gets the adrenaline flowing."

MAN: "Yah!!!"

PAT ANSON, UNIVERSAL CITY, CA: While most people may go to a haunted house or a horror movie to feel fear, there are others who approach fear from a different perspective -- they like to cause it.

JACK THE RIPPER: "I sort of get a personal pleasure about feeling their fear, if you know what I mean."

PAT ANSON: Notice amid the screams how much laughter there is. It's all part of the experience, what Professor Fischoff calls a "safe high."

STUART FISCHOFF, PhD: "All these kinds of extraordinary experiences people use to test their mettle and to prove that they can cope with stress and cope with life."

PAT ANSON: So the next time you hear a blood curdling scream...

(SCREAM)

PAT ANSON: ...or a seven foot monster sneaks up behind you, try to remember -- it just might be good for you.

SHARYL ATTKISSON: And if you need any more proof that we love to be scared, here's a statistic for you: One survey found that 89% of kids ages 10 to 13 had seen the horror flicks "Friday the Thirteenth" or "Nightmare on Elm Street" at least once, and 62% had seen them at least four times.

That's all for this week. Remember you can visit us throughout the week at our site on the World Wide Web. To reach the HealthWeek home page, go to PBS ONLINE at the internet address on your screen. That address is www.pbs.org Next time on HealthWeek... is testosterone the "miracle drug" that middle-aged men have been waiting for? We'll look at the pros and cons of this new male trend. And if you think your medical records are safe from prying eyes, tune in for our report on medical privacy. What you learn might disturb you. Plus we'll take you on a trip back in time to the dark ages of dentistry. Until then, I'm Sharyl Attkisson. Be well!

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