From the psychiatrist who'd never take anti-depressants, to the heart doctor who steers clear of statins, we reveal the medical treatments the experts REFUSE to have themselves

Leading doctors and researchers reveal what they would personally avoid



Many surprising comments go against the established view

Ask your doctor is: 'What would you do?'

When faced with a worrying diagnosis, invasive procedure or risky operation, probably the smartest question you can ask your doctor is: 'What would you do?'

With years of experience, they know better than anyone which treatments and tests are worth having - and which are better avoided.

So here, leading doctors and researchers reveal what they would personally avoid, many of which go against the established view. Their comments may surprise and enlighten you...

Psychiatrist who'd never take anti-depressants

Dr Joanna Moncrieff, senior lecturer in psychiatry at University College London and author of The Myth Of The Chemical Cure.

I've been practising psychiatry for 20 years, and in my experience antidepressants don't do any good at all. I wouldn't take them under any circumstances - not even if I were suicidal.

All the research shows is that, at best, antidepressants make people feel a tiny bit better than a placebo. But this doesn't mean they actually treat depression.



After all these years of brain scanning, we don't even have evidence that depression is related to a chemical imbalance in the brain, so the whole idea that we can treat it chemically is questionable.

I believe depression is an extreme reaction to our circumstances, and the best way to recover from it is to work out the cause.



Sometimes that means talking therapies and sometimes it means changing your circumstances, such as getting a new job or addressing relationship problems.

There are, of course, some people who are depressed for no apparent reason, but there is still no evidence they suffer from a brain disease or that antidepressants can help. It's still better to try and find new things and break the cycle of thoughts and behaviour.



Antidepressants are psychoactive drugs -they alter the mind, like cannabis or alcohol, and I've always thought that were I depressed, I'd want to have all my faculties to get me out of the rut - not be clouded by a drug whose effects we don't really understand.

Weight-loss GP who wouldn't go on a diet

Dr Ian Campbell, GP and founder of Bodylibrium, a weight-loss programme.

'All the evidence is that diets rarely work long term' (posed by model)

All the evidence is that diets rarely work long term.



I've been working with people to help them lose weight for decades and my experience has shown me that the only way to achieve long-term success is through asking: 'Why?' - why do we comfort eat, why do we prefer fatty foods, why do we drink too much alcohol and why do we find physical activity unattractive?

Techniques based on changing behaviour (similar to cognitive behavioural therapy), combined with strategies such as keeping a food diary and setting realistic goals, are what really help people lose weight effectively.



Diets which encourage polarised approaches, such as low-carb, 5:2 diets or any other 'reductionist' approaches, will only ever achieve short-term success - you'll regain the weight you lost.

Heart doctor who refuses to have statins

Professor Kevin Channer, consultant cardiologist at Claremont Hospital, Sheffield.

Statins have had a huge effect in reducing the number of strokes and heart attacks and there's now a movement to give these cholesterol-lowering tablets to everyone.

But I wouldn't take one unless I had proof I was at significant risk.



Whenever you're taking a drug, you've got to think about the risks and the benefits.



Statins reduce your chance of heart attack or stroke by about 30 per cent, so, yes, there's a benefit. But in real terms it's very small.

As a 60-year-old, healthy, non-smoking man, statistically my annual risk of a stroke or heart attack is about 1 per cent - very low. Taking a statin would take it down to 0.7 per cent - still very low. And I've spent my professional life prescribing statins, so I know about the side-effects: muscle aches, general debility and stomach upsets.



Some say statins should be given when the risk is 1.5 per cent, but I personally wouldn't consider taking the drug unless my risk was 3 per cent.



Anyone who's had a stroke or heart attack has a risk of about 3 per cent and for them the pain is definitely worth the gain.



On the other hand, I would - and do - take blood pressure-lowering medication, even though my reading is currently borderline.



That's because, as a cardiologist, I know that as I get older it will only get higher, and studies show that the lower your blood pressure, the longer you live.



Some of the older treatments caused side-effects, but I'm on one of the newer ones called an angiotensin receptor blocker, and I'm not having any problems.

Former GP who says vitamin C is pointless 'Vitamin C probably doesn't cut short colds' George Lewith, professor of health research at the University of Southampton and a former GP. Despite what many patients say, vitamin C probably doesn't cut short colds. It probably won't do you any harm and it won't break the bank, but on the whole the evidence is pretty limited.

There's also no evidence that it staves off colds. If you have a good diet, with plenty of vitamin C from fruit and veg, your immune system will protect you as far as possible. But those supplements containing 500 per cent of your recommended daily amount (RDA) are a waste of time. Echinacea, on the other hand, does have some pretty positive evidence to show it may shorten the

length of a cold. There's also some intriguing evidence around the plant extract perlargonium - that's what I take when I have a cold.

Prostate expert who won't have PSA test

Richard Ablin, professor of pathology at the University of Arizona College of Medicine.

When I discovered the prostate specific antigen (PSA) in 1970, we soon realised it could be hugely helpful to prostate cancer patients.



The protein is specific to the prostate gland - it's not found in any significant amount in any other organ. So if a man with prostate cancer had his prostate removed, our discovery meant we could measure his PSA afterwards to see if there was cancer remaining which hadn't been detected.

However, the PSA test began to be used to diagnose prostate cancer. This was a huge mistake.



The PSA is not cancer-specific - it's simply a protein produced by the prostate, so a high level can just mean a man has prostatitis (an infection) or an enlarged prostate - sometimes troublesome but benign.



Also, 'normal' PSA levels vary dramatically from one man to the next: there's no threshold at which point we can reliably diagnose cancer. The test also cannot differentiate between a slow-growing 'pussycat' prostate cancer and an aggressive 'tiger' cancer. It's about as effective as a coin toss.

Nevertheless, it was taken up as a way to check for prostate cancer and, as a result, millions of men have been overtreated, often with unnecessary, highly debilitating side-effects. I would have a PSA test only after treatment for prostate cancer, or if I was at risk of the disease (for example because of family history), and was using it in combination with other tests, such as digital rectal examination, to diagnose it.

Health professor who says exercising isn't enough

Jack Winkler, public health expert and former professor of nutrition policy at London Metropolitan University.

To lose weight, you need to burn off more calories than you're taking in = reduce the amount you eat

Exercise can prevent you gaining weight if you overeat a bit. But if you're overweight, I'm afraid it won't be nearly enough.



That 300-calorie sandwich you had for lunch? You'd have to swim for more than an hour to compensate.



To lose weight, you need to burn off more calories than you're taking in, and the only way to do that is to reduce the amount you eat - that is the real essential.



Combining this with exercise is a good idea, as there are lots of other benefits to exercise.

Orthopaedic surgeon who'd avoid X-rays

Chris Walker, orthopaedic surgeon at Liverpool Bone and Joint Centre.

Too often, patients see their doctor about stiffness, aches and pains, wanting something to be done. The doctor sends them for an X-ray, which may or may not show a bit of wear and tear, and tells them they have arthritis.



As soon as they get that diagnosis, people tend to lose control and become victims. They take anti-inflammatories (which can have gastrointestinal side-effects), feel frightened to exercise and generally become miserable.

That's why, as long as I didn't have red-flag symptoms of severe arthritis - such as constant pain, or pain that comes on at night - I would avoid an X-ray.



Most of us will have a little wear and tear on the joints as we age, and actually the best thing to do is get out and about and keep moving.



Joints love movement - what does them harm is running and jumping. But anything like walking, swimming and cycling will actually reduce pain and stiffness and slow the onset of the arthritis.

By keeping active, you'll lose weight - which will help enormously - and you won't get depressed because you'll be too busy getting on with life.

'As soon as they get that diagnosis, people tend to lose control and become victims'

Hip specialist who says forget mid-life marathons

Jeremy Latham, orthopaedic surgeon with a special interest in hip surgery, at University Hospital Southampton.

This is partly because I'm bone-idle. But I regularly see patients in their 40s and 50s who have wrecked their joints because they had a mid-life crisis and decided to run a marathon or do a triathlon.

It's an interesting conundrum because on one hand there's good evidence that running can be good for joint health. But if you're going in cold, with no history of previous athleticism, there's a risk you'll accelerate any underlying wear and tear on your knees, ankles and hips.



If you hit middle age and decide you want to lose weight and get fit, I'd suggest walking, swimming or cycling, which are gentler on the joints.



I've got a rowing machine which I use two to three times a week - it's a great workout for the heart and is good for the upper and lower body, without overly stressing the joints.

Dietitian who won't eat reduced-fat food



Helen Bond, dietitian.

I steer clear of foods labelled 'reduced fat' and wouldn't give them to my children either. The label can be really misleading.



A reduced-fat mayonnaise or cheddar, for example, is still going to be pretty high in fat, it's just lower in fat that its previous incarnation.



A 'light' McVitie's chocolate digestive has 78 calories, compared with 86 in the standard version - a difference of only eight calories.

I eat low-fat or fat-free products, such as yoghurt, but with reduced-fat foods it's worth checking the label to see what the fat has been substituted with - often it's sugar to compensate for the loss of flavour.



Asthma professor who wants to cut inhaler use

Mike Thomas, professor of primary care research, specialising in respiratory medicine and asthma care, at the University of Southampton.

A lot of people become overly reliant on their rescue inhalers - using them every day can increase risks

A lot of people become overly reliant on their rescue inhalers, so feel out of control when they don't have them to hand. Using them every day can increase the risk of serious attacks, and side‑effects of high doses of steroids can include bone-thinning, easy bruising and increased risk of diabetes and high blood pressure.

So rather than allowing people to become reliant on their inhalers, I'm currently working on a government study looking at how simple breathing exercises and controlling anxiety can improve asthma control.



Patients find asthma episodes less stressful and so are less likely to reach for their inhaler. If I had asthma, I would learn how to self-manage; it brings patients a better quality of life and can help them reduce the drugs they are taking.

Obstetrician who would not give birth at home

Moneli Golara, obstetrician, Barnet Hospital.

I think your first pregnancy is a 'test', and generally, if you pass it, you know the likelihood of any problems second time round are very low.



There are certain conditions, such as pre-eclampsia (dangerously high blood pressure), that can occur mainly in a first pregnancy, and these may only show themselves during labour.



These are rare, but for this reason, I would never have my first child at home. I'd personally choose to be in a setting where there is access to medical intervention if needed.

Sport scientist who thinks long workouts are pointless

Stuart Phillips, professor of sport and exercise at Loughborough University.



As A young man I played rugby and ice-hockey and went running regularly. I used to be a bit sanctimonious and say that a workout was only worth doing if it was at least an hour long and you were drenched in sweat at the end.



Now if I spend longer than an hour exercising I think it's a waste of time - the data shows that shorter bouts of activity, such as ten minutes of intense exercise, are just as beneficial.



I study both the psychological and physical benefits of exercise and the incremental benefit you gain from going longer than an hour is pretty marginal.



Sleep specialist who won't take sleeping pills Sleeping pills weaken your trust in your own natural ability to drop off Dr Guy Meadows, sleep specialist and founder of The Sleep School. Sleeping pills weaken your trust in your own natural ability to drop off, and can end up causing physical and psychological dependency.

You start to think 'I won't be able to sleep unless I take a pill.' The body then starts to expect the sedative to be in the system. In turn, you run the risk of having rebound insomnia when you're coming off them, which explains why so many people struggle to ditch sleeping pills. Side-effects can include dizziness, headaches, memory loss and feeling groggy. Recent research has also shown that sleeping medication is associated with more than a fourfold risk of death. For me, these greatly outweigh the benefits. Research suggests that sleeping tablets provide as little as 20 or 30 minutes' extra sleep.

And the sleep these drugs do provide is not natural or refreshing. That's because they alter your 'sleep architecture' - limiting the amount of deep, or rapid eye movement, sleep, which we need to wake up feeling refreshed. In certain instances, when people are experiencing excessive sleep deprivation as a result of a serious trauma, sleeping pills can provide that essential release.

But the majority of people aren't in that position, and for them, sleeping pills become an unhelpful prop.

Surgeon who says avoid steroid jabs in your feet



Andy Goldberg, orthopaedic surgeon at the Wellington Hospital, London.

One of the most common reasons people visit their GP is for heel and foot pain, and an often-used treatment is a steroid injection to reduce inflammation.



It's the bane of my professional life. If an injection goes into or near a tendon, it can cause the tendon to rupture, which can lead to weak or flat feet. And if the steroid goes into the wrong place, it can lead to damage to the fat pad under the heel, which normally absorbs the shock when we run and jump.



If the fat pad is damaged then the patient walks on their heel bone without protection. It hurts like hell and there is virtually no treatment.



If a patient comes to see me with this, my heart sinks.



There are, of course, some times when a steroid can be useful, for example for treating inflammation of arthritic joints. But I would have it only if it were done under ultrasound guidance by a trained radiologist.

