Before you trust a health article, ask questions about it, and discuss it with your health care provider before you rely on it. You may have found good information, and your provider can tell you whether it is good for you. When a relative forwards an article about a medicine you take, the first questions are about the page, so you can ask them without knowing anything about the drug. If the article counts reports of side effects, start from one fact: reports on a drug in the FDA's database of adverse events do not mean that the drug caused the event.
Checking a page before you read its argument
Before you read a page's argument, find out who runs the site, what it is for and who pays for it. Look on the site's About Us page, where you can usually find most of those answers. If you cannot find out who runs the website, the site may not be trustworthy, and its health information may be unreliable. A site may exist to inform the public, to sell products or services, or to promote the opinions of a person or group. Ads on it should be clearly marked as advertisements; watch for ads designed to look like neutral health information. If a business pays for the site, its health information may favor that business and its products.
The end of the web address can sometimes help identify what kind of organization owns the site:
- .gov, a U.S. government agency
- .edu, an educational institution, such as a school, college or university
- .org, usually a nonprofit, such as a medical or research society or an advocacy group
- .com, a commercial site, such as a business or a pharmaceutical company
As a rule, health websites sponsored by federal government agencies are accurate sources of information. Many commercial websites do provide accurate, useful health information too, and in some cases it can be hard to tell that information apart from marketing and promotional material, so a .com page still needs the rest of these checks. Look also for the date the information was written and last reviewed or updated, which often appears at the bottom of the page.
What a doctor's name at the top tells you
A doctor's name at the top tells you whom the page credits, and whether that person knows this subject is the next thing to check. Pages often, but not always, identify their authors, and when one is named, ask:
- Is the author an expert in the field, a health care professional or scientific researcher with in-depth knowledge of this topic?
- Does the author work for an organization, and if so, what are its goals?
- Is the author's or any other contributor's connection to the website, and any financial stake they have in what it says, made clear?
- If the author is not an expert, has a health care professional or other credentialed specialist reviewed the information?
A physician's byline on a respectable-looking site still needs sources behind it. Dependable health information websites share sources and citations, and content pages should have links or references to where their information comes from. Even if a website links to a trustworthy source, the site does not necessarily have that organization's endorsement or support. When a site seems trustworthy, look for similar health information on other reliable sites too.
Be cautious about testimonials, individual blogs and posts on discussion boards. Personal stories may be helpful and comforting, but not everyone experiences health problems the same way. However accurate a page is, the person to give you specific advice is a health care professional who can thoroughly evaluate your own situation.
Side-effect reports, and what a count of them can show
An adverse event report, which an article may call a side-effect report, is an account of an adverse event sent to the FDA by a drug company, a health care provider or a consumer, and the information in it reflects only the reporter's observations and opinions. A count of them tells you how many reports were filed, and it cannot be used to estimate how often the event occurs. The database they sit in is now named the FDA Adverse Event Monitoring System, or AEMS, and was formerly the FDA Adverse Event Reporting System, or FAERS, so an article may use either name.
The data by themselves are not an indicator of a drug's safety profile, and the reports have these limits:
| Limit | What it means |
|---|---|
| Duplicate and incomplete reports are in the system | There are many duplicate reports, and some reports do not contain all the necessary information. |
| Existence of a report does not establish causation | For any given report, there is no certainty that the suspected drug caused the event. |
| Information in reports has not been verified | Sending a report does not mean its information has been medically confirmed, and it is not an admission by the reporter that the drug caused or contributed to the event. |
| Rates of occurrence cannot be established with reports | Reports cannot be used to estimate the incidence, meaning how often the reported events occur. |
The event in any one report may have been related to the underlying disease being treated, caused by some other drug taken at the same time, or happened for other reasons. A count in the thousands is still a count of accounts like these, none of them verified by being filed, and the count may include duplicates.
Reports are still wanted. Consumers and health care professionals are encouraged to report adverse events, and complete, detailed reports help the agency monitor a product's benefits and risks. You can file one yourself about a side effect you have had, through MedWatch, the FDA's medical product safety reporting program for health professionals, patients and consumers, which receives reports from the public and, when appropriate, publishes safety alerts. Start from the Report a Problem link on the MedWatch page (see Reporting a side effect that has not gone away).
According to the FDA, you should talk to your doctor before you stop a medicine or change how you take it, whatever an article's count says.
Signs that a frightening page is selling something
The plainest sign is something to buy: a page that frightens you about your medicine and then offers a product, a supplement or an "all natural" alternative is promoting something, and good health information does not promote one treatment over another. A health product is fraudulent if it is deceptively promoted as being effective against a disease or health condition, but not scientifically proven safe and effective for that purpose. Watch for these tip-offs to health fraud:
- One product does it all: it claims to cure a wide range of diseases.
- Personal "success" testimonials, which are easy to make up and are not a substitute for scientific evidence; reviews on online marketplaces and social media can be fake.
- Quick fixes. Few diseases or conditions can be treated quickly, even with legitimate products.
- An "all natural" cure or treatment. The words do not necessarily mean safe, and numerous products promoted that way have been found to contain hidden, dangerously high doses of prescription drug ingredients.
- A "miracle cure", or a claim like it, such as "new discovery" or "secret ingredient".
- Conspiracy theories, such as "the cure our government or Big Pharma doesn't want you to know about", used to distract you from obvious, common-sense questions about the product.
Even on a page that sells nothing, beware of dramatic writing, promises of cures and claims that sound too good to be true. Fraudulent health products are not always easy to spot, even with these tips, so if you are tempted to buy an unproven product or one with questionable claims, check with your doctor or another health care professional first. If a page offers to sell you a prescription medicine directly, check the seller before you pay anything (see Is a cheap injection from a private seller safe to buy?).
Handling the next article a relative sends
Run the same checks on the next one before it changes anything you do:
- Find who runs the site, who wrote the page and who pays for it.
- If it counts side-effect reports, read the number as reports filed, not as events the medicine caused.
- Look for anything it sells, and for the tip-offs to health fraud.
- Take it to your doctor before you rely on it, and before you stop a medicine or change how you take it.
The sender's worry is real, and it does not make the article accurate: a post from a friend or colleague is not necessarily accurate, complete or applicable to your health. Check the source of the information and make sure the original author is credible. If you are still unsure whether it is trustworthy, do not pass it on, the same caution that applies to health information seen on social media. If the relative who sent it is frightened for you, tell them you are taking the article to your doctor.
A symptom you have right now is a separate matter from anything an article says. If a person or an unborn baby could die or be permanently disabled, it is an emergency: for problems such as severe chest pain or pressure, severe shortness of breath, or suddenly being weak or drooping on one side of the body, dial 911, or your area's emergency number, so the emergency team comes to you right away. Problems such as a severe allergic reaction with swelling, hives or trouble breathing, sudden confusion, or throwing up or loose stools that do not stop also need emergency care: get to an emergency department, or dial 911 or your area's emergency number. If you are unsure what to do and you have none of these or the other signs of an emergency, call your own doctor's office and describe the symptom; if the office is closed, your call may be forwarded to a nurse or another provider on call.
If NicoCares put you in touch with the physician who prescribes your medicine, post the article's link in Spruce, the service that hosts secure messaging for NicoCares patients and their care team, and ask your care team what in it applies to you. A side effect that is not an emergency can go to them there too: side effects are one of the things your physician stays available for. No NicoCares page says how soon a message is answered, so if you are unsure what to do about a symptom, call your own doctor's office as well. NicoCares does not provide emergency care: if you think you are having a medical emergency, use 911 or an emergency room near you.
