Homeopathy

Homeopathy

Naturopathy

Pseudoscience

Quackery

Susan and Henry Samueli College of Health Sciences

Susan Samueli

University of California Irvine

surgery

Categories

https://m.youtube.com/watch?v=fHrvWqN2TkM

Does anyone have access to fitness and exercise advice prescribed by the "integrative" crowd?

I'm ready to bet £5 that it's all about tai-chi, yoga and "be careful not to exert yourself" types of exercise, rather than strength training or anything close to a sport or planned training with measurable performance or objectives.

To be fair, some forms of yoga can be very vigorous. I used to do vinyasa and ashtanga at a studio in Ann Arbor, and it was definitely difficult and good exercise. There are "goals," like being able to attain certain postures or getting better at "easy" ones, holding things for longer, etc.

Sure, we can be a really proficient Yogi in the same way that someone can be a really good golfer, volleyball player or anything else.

My perspective though, is that there are sports and exercise endeavours that are more conducive than others to improving people's fitness in a measurable way.

My anecdotal experience is that alt-med types are keen to praise fitness and food advice but such advice is not even that great.

This:

Is not exactly golf. But whatever.

Sure, we can be a really proficient Yogi in the same way that someone can be a really good golfer, volleyball player or anything else.

Don't confuse the popularized "Swedish gymnastics" version of yoga with that connoted by the yogi/yogini title.

From the course descriptions, it looks like my med school hasn't yet integrated quackery into its curriculum.

It did recently get a huge cash donation, but the only visible consequence as far as I can tell is that they renamed the med school after the donor.

@ The Vodka Diet Guru:

To be truthful, a few woo-meisters** DO provide information about cardiovascular and strength training and advocate their usage - as well as yoga et al -
HOWEVER they often present realistic material in self serving ways or exaggerate its effects on health and longevity
.
They present themselves as examples and hint that their products will allow followers to achieve similar spectacular results to their own. Yep, they're elite athletes/ specimens.

They misrepresent what is indeed even feasible for most people in the real world ( which none of them inhabit)-
e.g. one hour of CV a day and one hour of weights most days plus meditation; doing physical work on a ranch or farm.
All while eating extremely restricted, arcane diets ( vegan, mostly raw or paleo, organic etc).

They promise incredible non-verifiable results like adding 6 years to your life, reversing menopause or eliminating/ curing most serious illnesses. You should remember that most of these guys ( and they are mostly men) sell videos, books and supplements/ superfoods whilst one has a holistic retreat/ spa to hawk.

** Mercola, Null, Adams

Sadly, CAM has been integrated into the nursing curriculum for the entire state of North Carolina community college system via the CIP program in 2007.

How well its been integrated depends on the individual instructor. I wouldn't teach that crap in my classroom. But some of my colleagues did on a regular basis, especially when it came to acupuncture and aromatherapy.

When I was in the psych ward at St. Joe's, they once offered some kind of ridiculous ear acupuncture. I considered doing it just for the chance to get off the locked ward, but instead I said "I don't believe in that stuff" and went and made some coffee or something. (They actually let us have real coffee at the two places I was at in Michigan.)

MSM has a Trojan Horse problem because apparently it f'ed up the "nutrition, physical activity, stress reduction angles" so badly, that it even still exists as a CAM thorn, after 50-80 years of MSM and diatetic failures.

The hostile comments here to discussion on higher dose vitamin D and (IV) vitaman C show how badly various strata of MSM misunderstand some biochemical subjects and mistreat (potential) customers.

Although thin on high cost evidence, there are a number of phenomena not well addressed in MSM recognized by legitimate MDs, PhD and independent thinkering patients with as much horsepower as the average MD or better. It's that simple.

Why do I do on about C and D? Because they are amongst the better described areas historically that an outsider can even begin to technically address various issues independently and their being ignored and misstated all these years have had substantial life and death consequences throughout society.

Fix the real problems or quit bitching and go extinct as "they" occupy and displace, even if part of them create more problems.

@prn

Er, no they're hostile to the fact that people like you say that extra vitamins "Can Cure All Your Ills" and other blather like that, when in fact the only thing you're getting rid of is your money.

PRN: I think part of the hostile reaction you personally are getting is that you act like a porcupine on meth. Asking for proof isn't the same as challenging you to a duel at dawn, but you act like it is.

I'm an alumnus of two prominent medical schools (MD, residency), and it pains me to see that both offer acupuncture, chiropractic, reiki, chinese herbal medicine, and other quackery.

prn: actually, no. Modern medicine has not "f'd" up nutrition. Quacks have co-opted it and sell a load of baloney. Not the same thing.

When you can prove your claims, come back. We've pressed you again and again for EVIDENCE you never provide.

"On the “integration” of quackery into the medical school curriculum"

Do you still teach?

And no...once again, you're wrong. I'm not Travis...

Panacea, #14: the original statement has a few missing words:

Modern medicine has “f’d” up the profitability of the quackery surrounding nutrition.

Hope that helps.

LOL. Conventional "modern medical professionals" are certainly not widely known for their independent thought or creativity. To be fair, the "standard of care" binds them, in order to avoid liability. Lifespans are longer at the moment than they were a century ago, but the quality of that extended life is generally not one that people would consider desirable. And the youngest generations are not predicted to live so long, with children plagued by obesity, arthritis, diabetes, cancer, and other chronic health problems. It doesn't take a rocket scientist to realize better answers must be out there. Kudos to the practitioners who are willing to explore them

LOL. Conventional “modern medical professionals” are certainly not widely known for their independent thought or creativity.

BTW, Honeybunch, you might want to have your freak radio tuned into the 16th.

^ "LOL"

^^ Oh, dear, G-d, I actually again tried sitting through one of Gindo's "Wal Thornhill" videos, which exist because LIGO makes him constipated,* or something. My machine actually crashed immediately after he barfed up the axiomatic nature of Euclidean geometry.

* If anybody has the spare time, there must be a wormhole theory to be had here.

@NWO

Well you're one to talk about "independent thought" and "creativity" when all you antivax snobs parrot out the exact same lame, pathetic excuses as to why you hate science and love to pad your wallets with the money of ill-informed people.

Is it just me or do all of the antivax people here all spout their own tropes over and over ad nauseum?

Okay apparently NWO has emerged from the void to ruin another comment section

@NWO

You're one to talk about a lack of creativity when all you antivax snobs parrot out the same excuses as to why you hate science and love to ruin people's lives.

Narad: "A braver man than I.."

I'd hoped NWO had figured out she's not welcome here, but alas, she's back.

(And no, I'm not going to her site. I just got this machine working again. In case you all have been wondering, I've been using my tablet most of the week.)

As far as creativity goes, I don't think most people want creativity from their doctors. Usually, people go to a doctor because they have a problem they want resolved. And 99% of the time, a relatively straightforward solution can be found.

As long as you're here, Ginny, I still want an answer. Did any European royalty die of smallpox or other diseases? Why isn't Europe full of immortal royalty?

Kudos to the practitioners who are willing to explore them

Some people who call themselves "practitioners" are exploring by selling things to ignorant people. They're exploring, all right-- prospecting for gold.

Other people are exploring by subjecting new ideas to high standards of evidence, and sharing the ones that work with real practitioners.

I know which group of practitioners I prefer: the ones who stick to evidence-supported treatments. Even if they are boring old uncreative fuddy-duddies (which they're not).

Heyy it's NWOR, ready to ruin another post.

Ohhkay sorry for all those dumb posts my stupid computer wasn't showing that they posted and I thought they got lost in the internet void

God this is so embarrassing....

This guy is full of crap - there is hard core FACTUAL EVIDENCE of curing of degenerative diseases - INCLUDONG CANCER - with ALTERNATIVE HEALING METHODS. When did he write this article of QUACKERY? Over the last 20 years - it has been PROVEN over and over again that big pharma, FDA, medical schools and health organizations are all HAND IN HAND keeping the medical industry afloat and in business! If we get CURES for these degenerative diseases without pharmaceuticals - what happens? There is no medical industry! See, there’s no $$ to be made in LIFESTYLE changes, foods that are good for you or in Mother Earth. Why would quacks like this say anything good about what we SHOULD do to be healthy - or how to get rid of or prevent disease? If they did that, they would lose billions! To find out more - read the book POLITICS IN HEALING!!

prn@10: MSM has a Trojan Horse problem because apparently it f’ed up the “nutrition, physical activity, stress reduction angles” so badly, that it even still exists as a CAM thorn, after 50-80 years of MSM and diatetic failures.

The hostile comments here to discussion on higher dose vitamin D and (IV) vitaman C show how badly various strata of MSM misunderstand some

Panacea@14: ...Quacks have co-opted [nutrition] and sell a load of baloney. Not the same thing.

Both parts can be true.

P@14We’ve pressed you again and again for EVIDENCE you never provide
I've provided sources for overviews *of what there is*.
You're greatly biased and (a) behind.

IV vitamin C in acute disease, a subject obstructed by generations of medical biases, is largely summarized in those two books, Levy's Curing the Incurable: Vitamin C, Infectious Diseases, and Toxins- and McCracken's Injectable Vitamin C and the Treatments of Viral and Other Diseases although a few important papers for working hypotheses are missing.

Vitamin D3 is a (re-)emergent area, what's available is largely viewable with vitaminDwiki.com

Oh, so you admit the High Vit C crowd sells baloney? Nice to know.

I said provide evidence, not nonsense.

PRN: See my remarks re:your attitude and maybe, you might see why you're getting a "hostile reaction." It's one thing to present bad facts; its another thing entirely to present bad facts and sneer and snarl while you're doing so. Maybe drop the dukes a little and open up those ears.

PGP: Bad facts are in the eye of the beholder. I'm past trying to "prove" things to those of narrow and very dense, concrete perspectives. The problem I deal with here is to find which facts or concepts are at variance in a certain way. Sometimes I do try inject a little reality or perspective into the conversation, whether its in an FDA approved factoid or not.

Occasionally I get nice useful bits of science or history - e.g. Kerbiozen was the most frequent with his lab based experiences, sometimes Narad has useful original content that I've never seen, even when it's ad homeniem dirt on someone.

@prn

There are no such things as "bad facts", moron. You sound like those idiotic knuckleheads who came up with "alternative facts."

A fact is a fact, and just because you do not like it, or it comes from somebody/thing you do not like, does not diminish its factualness. Arrogant fluff-brain.

Epsilon, you sound like a grammer nazi that has little experience in the real world and with laboratory work. "Facts" can be very slippery things even in various technical environments due to inadequate specification, description or measurement of conditions, context, misuse, abuse, and yes, politics.

People will often quote some basic random error stats in their data when their systematic errors and biases are eating them alive by orders of magnitude larger. In fact this latter point is central to a number of disputes between CAM and MSM, with profound examples from both "sides". Whether these larger errors are merely unknown, unrecognized or (willfully?) unacknowledged is another area that often colors the conversation.

I'll go one further on the oxymoron of "bad facts":
they come in several flavors.

When, pray tell, did I ever try to correct your grammar? Yes, I did state that you were wrong, and I admit I went off a little, but I never even paid attention to your grammar. (But I will correct your spelling here: it's "grammar" not "grammer," doofus)

Another thing I will admit, unlike you, is that no, I do not have experience in medical fields or laboratory workings; I have not reached that part of my life yet.

If you are true, and there are "bad facts," then they are not facts, but lies. Also, you're one to talk about biases, so don't lecture me on them sweetie.

@Suzy

Uhh yeah there's tons of money to be sold in altie medicine. Just look at the overpriced vitamin C supplements prn is probably hawking. Look at how much money it costs to eat healthy, and how much you have to pay to get into altie "cancer treatment" clinics that are just oh-so conveniently out of the country to avoid restriction.

prn: I’m past trying to “prove” things to those of narrow and very dense, concrete perspectives. The problem I deal with here is to find which facts or concepts are at variance in a certain way.

First thing, see that second half of the first sentence? That's exactly what I mean when I was talking about your attitude and the way you come in swinging.

Secondly, you don't have any facts. You've never provided any proof of anything, and haven't managed to provide or find a single citation by anyone reputable. You just assert "these things are fact," and demand that you be taken seriously on your word alone. And you've done this for years.That's just not going to fly.

You really don't know how science works, do you?

There's no such thing as bad facts. A conclusion is either correct, or incorrect.

The sky is blue. It may vary in its shade of blue for a wide variety of factors, but it is still blue. It is not green. It is not red. It is not yellow.

prn makes a grand claim about errors of magnitude but since he NEVER gives verifiable examples of what he means by that, he takes the language of science and turns it into a Star Trek like technobabble that isn't nearly as interesting or enjoyable as Star Trek.

To a Troo Believer™ like prn, a fact is 'bad' when it differs from the imaginings [s]he desires to consider as if it were reality. 'Bad facts' are the equivalent of trump's 'fake news'.

there is hard core FACTUAL EVIDENCE of curing of degenerative diseases – INCLUDONG CANCER – with ALTERNATIVE HEALING METHODS

I'm not sure where it's going to prove useful, but I'm definitely adding it to my vocabulary.

@Narad

Maybe it's a secret term like covfefe or heel. :p

It's a portmanteau, and I've heard it used in Thailand.

@Suzy you are right. Conventional medicine sent me home to die after 20 doctor's and untold number of hospital's could not figure out I had Lyme disease.
That was in 2005. A Chiropractic Physician saved my life and correctly diagnosed my condition on the first visit.
Herbs and homeopathic remedies are true medicine.
RX drugs are just a mask or bandage on the wound.

I'm off all RX drugs and have never looked back.

In all fairness, if you get a broken bone, burst appendix or need open heart surgery then I say go to they specialist. I am not against doctor's. They have their place and are good for certain things.

Marjean: sent you home to die?

What hyperbole.

A false diagnosis of Lyme disease might be good for at least 20 followup visits to the chiro.

"Antibiotics just mask the problem dearie, you need a comprehensive set of adjustments."

Ugh, really? Physical manipulation cured your Lyme?

More like your chiro cured you of the dreaded disease called "wealth".

Worse - it was "physical manipulation" and homeopathy....which equals - "monetary manipulation."

Western Medicine is paramount for people to survive. Naturopathic Medicine is paramount for people to survive with vitality and an overall quality of life.

To negate Integrative medicine is small minded thinking. Yes, Western Medicine is groundbreaking but it’s missing ONE HUGE ingredient in it’s majority of it’s production.
PREVENTATIVE CARE.
This is because Big Pharma runs you guys and if you can’t see that then you’re either feeble minded or simply not willing to look.

So calling Naturopathic Medical Doctor’s a quackery is nothing but a cry out for your own shortcomings.

Let them bring the quality, the complimentary quality to the Western medicine world because we need it as long as you don’t offer it as a standard.

Gee, should I cancel my appointment, in about 2 weeks, for a long visit for preventative care, with a real doctor instead of a Not-a-Doctor? Should I not take the meds I take for the purpose of preventative care, since they were prescribed by a real doctor instead of an ND?
What, oh what, should I do????

Lady, this is a science blog, not the ad section of a tabloid. Go peddle your nasty snake oil elsewhere.

I hear Natural News welcomes your type. You'll love 'em. You both seem to love nature and ignoring decades of research for "treatments" that would make any respectable nurse or doctor facepalm.

Silly me. For years I've been teaching nursing students about the 3 levels of prevention. But I guess I don't know anything about that, according to Elizabeth.

Oh wait! Vaccines are prevention.

I could have sworn that naturopathy was a product of the Occident.

My doctor prescribed an update to my TDaP as a preventative measure today for a burn on my hand.
There’s a lot of skin that needs to heal and I don’t want my grandson to get pertussis!

Elizabeth: Scuse you. I just had a quarter size chunk dug out of me in the name of preventative medicine, because everyone concerned wanted to stop whatever it was cold. And every one of the medical professionals i saw was really serious about preventing any infection. No one pushed any more treatment on me than I needed. (for the record, I'm fine, no malignancy detected.)

Squirrelite: Congrats on the grand kid. We have a nib in the family, and I'm so happy I got my flu shot. (I updated my tdap before nib was born.)

John Weeks accuses Orac of having "blood on his hands" for criticizing the Samuelis' $200 million gift to UC-Irvine. Orac responds.

oracknows — Fri, 29 Sep 2017 05:00:17 +0000

John Weeks accuses Orac of having "blood on his hands" for criticizing the Samuelis' $200 million gift to UC-Irvine. Orac responds.

John Weeks has long been an activist for what is now known as "integrative medicine," earlier known as "complementary and alternative medicine"(CAM). Basically, for many years Mr. Weeks has been at the forefront of encouraging the "integration" of quackery with real medicine and promoting what I like to refer to as "quackademic medicine," a perfect term to describe the increasing encroachment of pseudoscience and quackery in medical academia in the form of—you guessed it—integrative medicine.

Despite his having zero background in scientific research or the design and execution of experiments and clinical trials, for some bizarre reason in May 2016 he was appointed editor of the Journal of Alternative and Complementary Medicine (JACM), even though he has zero background in science or medicine of a type that one would expect in a journal editor. Once there, he wasted little time comparing doctors advocating science-based medicine and opposing pseudoscience in medicine to Donald Trump.

Fast forward a year and a half, when the University of California, Irvine (UCI) accepted a $200 million gift from Susan and Henry Samueli to vastly expand the integrative medicine offerings at UCI (which were already quite extensive) in the form of establishing the Susan and Henry Samueli College of Health Sciences, with the current Susan Samueli Center for Integrative Medicine becoming the Susan Samueli Integrative Health Institute.

Amazingly, it wasn't just skeptics like Steve Novella and myself writing negative articles about this development. Michael Hiltzik of the LA Times wrote an article in which Dr. Novella and I were quoted with a lovely headline, A $200-million donation threatens to tar UC Irvine's medical school as a haven for quacks. Elsewhere, Usha Lee McFarling over at STAT News chimed in with a story with a somewhat less critical but still quite unflattering headline, A $200 million gift promotes alternative therapies at a California medical school — and critics recoil.

Both articles contrasted the claims by Dr. Howard Federoff, CEO of UC Irvine’s health system that the new institute and college will be rigorously evidence-based with the reality of the homeopathy offered by UCI. Hiltzik, amusingly, pointed out how UCI was trying to send references to homeopathy on its website down the memory hole and failing miserably. Meanwhile, Rick Seltzer at Inside Higher Ed quoted Steve Novella as he asked, Does $200 million quack? (My answer: Yes. Very loudly.) I, of course, used this observation to point out that UCI has long embraced homeopathy and that, because all naturopaths are trained in homeopathy, you can't have naturopathy without homeopathy.

Those of us who know how deeply "integrated" (couldn't resist) quackery is in naturopathy couldn't help but point out that Dr. Federoff's claim that UCI's new integrative medicine effort will be rigorously evidence-based is complete and utter bullshit unless UCI gets rid of naturopaths, at least as a start. Also, given that the Samuelis are very much believers in homeopathy, so much so that they mentioned support for research into homeopathy in one of their gift agreements with UCI in 2004, I highly doubt that UCI could dump homeopathy very easily even if Dr. Federoff wanted to.

Indeed, given Dr. Federoff's long history of integrating quackery into medicine at Georgetown, which was his gig before he moved to UCI, I doubt that Dr. Federoff is particularly serious about getting rid of the quackery, anyway. It's now too entrenched. This sort of coverage clearly enraged poor Mr. Weeks, who goes to great lengths to project a facade of civility in comparison to all the "anger" he portrays on "our" side. Indeed, his facade slipped so much that he misspelled Mr. Hiltzik's name alternatively as "Hitzig" and "Tiltzig" in a post published—where else?—that original wretched hive of scum and quackery, The Huffington Post, in the form of an article entitled Shameful Media Response to the Samueli’s Visionary $200-Million Integrative Health Investment at UC Irvine, in which he refers to critics of integrative medicine as "antiscience" and as "having blood on our hands."

You can get a taste from the introduction:

The response of the LA Times, STAT, Medpage, and most media to the visionary $200-million integrative health investment of Susan and Henry Samueli at UC Irvine has been a shameful display of media descent into Trump-like, polarizing tweets. Worse yet, the coverage has been a profoundly anti-science. These media, and others, have chosen to provide platforms to a small handful of individuals who for decades have denied the evidence of acupuncture, chiropractic, mind-body and multiple other integrative approaches.

Mr. Weeks is nothing if not predictable. These days, to him any criticism of integrative medicine is "Trump-like" and "polarizing." This is the schtick he came up with last year, before the election and continuing after it. To this recent but now familiar trope, Mr. Weeks adds a new epithet: "Anti-science." In essence, he is doing exactly what climate science denialisms and anti-vaxxers do: Try to flip the narrative and portray themselves as the true defenders of scientific inquiry and their critics as close-minded dogmatic skeptics who will not consider all the evidence.

This is, of course, nonsense when anti-vaxxers and climate science denialists do it, and it's no less ridiculous when Mr. Weeks does it. Also, note how Mr. Weeks also tries to minimize the criticism by minimizing the critics, referring to us dismissively as a "small handful of individuals," in order to portray us as being a tiny minority who can safely be ignored. Elsewhere in his article, he refers to Medscape "bleating" out a link to McFarling's article in STAT. (Get it? We're sheeple.)

Sadly, Mr. Weeks' tactics are all mind-numbingly obvious, but at this point in his jeremiad, Mr. Weeks turns out to be just getting started. It doesn't take him long to work himself into a fine lather:

From his LA Times podium, Michael Hiltzig first gives voice to David Gorski and then to Steven Novella, long-time colleagues and back-slapping companions as anti-integrative medicine vigilantes. Hiltzig quotes Gorski first, shaping the Samueli’s investment this way: “The only reason ‘integrative medicine’ exists is to integrate quackery into medicine.” Tiltzig immediately turns to Novella to use the Trumpish, name-calling term that Gorski himself favors: “In a blog post, Novella flayed UCI’s establishment of an integrative medicine curriculum as ’quackademic medicine.’”

"Back-slapping companions as anti-integrative medicine vigilantes"? I laughed out loud when I read that line. Maybe I should change the name of the blog from Respectful Insolence to Anti-Integrative Medicine Vigilante. On second thought, "Respectful Insolence" rolls off the tongue much more nicely. The whole "vigilante" charge, though, is meant to further demonize Steve and me, who slap each other on the back like dudebros after each new takedown of integrative medicine. Maybe next he'll portray us as bumping chests and shouting. (Seriously, could Mr. Weeks be any more obvious?) The answer, apparently, is no:

It would be one thing if this were just journalistic laziness. Sure, go ahead and run polarizing copy based on a tweetish view of the universe that makes a story fit for afternoon TV. In fact, however, these media have chosen to trumpet fake news. They promote this polarizing grandstanding rather than honor the emerging scientific consensus that is yet poorly integrated into health professional education and practice - and that utterly backs the Samuelis’ investment and direction at UC Irvine:

He then cites four references that actually show how deeply embedded quackery has become in medicine, thanks to the efforts of people like Mr. Weeks. For instance, he mentions the Joint Commission's 2015 revision of its pain management standard that recommends nonpharmacologic approaches to pain, and mentions acupuncture, chiropractic, and osteopathic manipulation. Now, I've discussed many times before how integrative medicine mavens have latched on to the opioid crisis as an opportunity to expand their influence by rebranding CAM/integrative medicine as "nonpharmacologic approaches to pain." Indeed, the National Center for Complementary and Integrative Medicine (NCCIH) enshrined this in its 2016-2021 strategic plan.

Ever since the opioid crisis inserted itself into the national consciousness, proponents of integrative medicine have seen a golden opportunity to use it to further the integration of quackery into medicine. Only they want to be seen as science-based; so when programs like the one at UCI are caught advertising The One Quackery To Rule Them All, homeopathy, they scramble to hide the evidence of it. Mr. Weeks makes a great show of mentioning guidelines published by the Mayo Clinic, which, if anything, showed that the "complementary" approaches to pain examined do not have an effect greater than placebo.

Truly, it was an awful review article. Predictably, he also mentioned American College of Physicians guidelines for low back pain. I can't help but note that those recommendations characterized evidence base for acupuncture, for example, as low quality evidence, moderate at best, and cited the GERAC Study, which basically showed that acupuncture does not work. Another mixed "electroacupuncture" (which is basically TENS) with acupuncture. Truly this was thin gruel for the ACP. Finally, he referred to the National Academy of Medicine's review on nonpharmacological approaches to pain. I perused it. It misrepresents the evidence base for acupuncture in a far too favorable a fashion, for instance claiming that recent "reviews and meta-analyses examining the effect of acupuncture on musculoskeletal pain (neck and back pain, osteoarthritis, chronic headache and shoulder pain, fibromyalgia) have found that overall, acupuncture is superior to sham and no acupuncture, but with relatively modest differences between true and sham acupuncture."

Yes, the NAM cited the Vickers meta-analysis, which showed that acupuncture doesn't work, with no clinically significant effect on pain, although the conclusion was spun to be the exact opposite. Yes, Mr. Weeks is doing what any "thought leader" in integrative medicine has to do: Exaggerate or even misrepresent the evidence base supporting the quackery that integrative medicine is seeking to add to medicine.

Up until now, Mr. Weeks didn't actually piss me off. Rather, he amused me, as he recycled the same tired, dubious arguments that he's always used, complete with his dismissive comparison of critics of integrative medicine to Donald Trump, which he's now done so often that to me it's a cliché. Indeed, I'm half tempted to make a drinking game out of Mr. Weeks' references to Donald Trump as a means of denigrating his opponents: Take a drink each time he compares our writing to Trump or to Tweets. The only problem is that I'd probably be at risk for alcohol poisoning if I were to play that game.

Here's where Mr. Weeks actually managed to piss me off. It's hard for an apologist for quackery to do, but Mr. Weeks managed it:

The roundhouse, condemnatory, “quackademic” perspectives of Gorski, Novella, Caulfield and their like toward complementary and integrative health and medicine need to be treated and dismissed by the LA Times and others as the anti-science that they are. Sure, discussion can be engaged over specific approaches or therapies. Yet giving a platform to this broad dismissal of the Sameulis’ investment is no different than repeatedly quoting non-believers in climate change at the top of an article about a massive, exciting effort to correct human environmental degradation. And while the scale is different, both forms of science denial have blood on their hands. The residual, reactive, medical ideology of these anti-integrative careerists to which the LA Times and others give a platform is a barrier to potentially lifesaving directions toward which the Joint Commission-Mayo/NIH-American College of Physicians-NAM-Attorneys General jointly urge us - and the Samueli investment would propel us.

Fuck you, Mr. Weeks. Longtime readers know that I pretty much never drop the F-bomb on this blog other than when quoting others, such as Jenny McCarthy's famous quote about the MMR and autism. In this rare case, however, I think an exception to that rule is more than justified. When you accuse Steve Novella, Tim Caulfield, me, and those who make the same arguments as we do of having "blood on our hands," telling you to fuck off is the only appropriate reaction.

We're doctors. Mr. Weeks is not. We save lives. Mr. Weeks does not. I'm a medical researcher. Mr. Weeks is not.

I can deal with his unwarranted attacks on us as "antiscience." I can laugh at them, even. I know we have the data, the science, and reason on our side. Also, contrary to how we are portrayed, we do not dismiss massage, mindfulness, exercise, diet, or other lifestyle aspects of integrative medicine. We merely point out that they are more appropriately a part of science-based medicine and that integrative medicine is "rebranding" them as somehow being "alternative" or "integrative" and then throwing in quackery like acupuncture, reiki, naturopathy, and the like. The purpose, of course, is to legitimize quackery.

That's why I say that there is no reason for integrative medicine to exist other than to provide a vessel through which quackery can be integrated into medicine. As for being an "anti-integrative medicine careerist," I view this as a thinly disguised variant of the "pharma shill" gambit, in which Mr. Weeks insinuates that we must be biased because we've made a career out of being "anti-integrative medicine." Would this sort of thing were even possible! Seriously, though, Mr. Weeks should look at my publication record. Only two of my publications indexed on PubMed can be characterized as even being about integrative medicine. However, Mr. Weeks' little tirade has med me think that maybe I should try much harder to publish more of this in the peer-reviewed scientific literature. The reason I haven't is because I'm not an "anti-integrative medicine careerist." Maybe I should become one, except that I'd call it being a pro-science careerist.

To get an idea of where Mr. Weeks comes from, he repeats a number of anti-medicine tropes. For instance, he does his best to paint critics of integrative medicine as a discipline as not caring about prevention. That's an old chestnut, because integrative medicine proponents have tried very hard to rebrand any sort of interventions to prevent disease as their bailiwick. He also cites a BMJ paper concluding that medical errors result in 251,000 deaths per year and are the third largest cause of death in the US, clearly having selected that particular paper because it has one of the largest numbers of deaths estimated anywhere in the literature. (Über-quacks Mike Adams, Gary Null, and Joe Mercola would be proud.)

As I pointed out when this study was published in 2016, the methodology used to calculate this number was highly questionable, at best, and basically custom-designed to inflate the number of deaths due to medical error, particularly through misattribution of the cause; i.e., mischaracterization of complications that had nothing to do with medical error as being due to error. Mr. Weeks then defends the poor, put-upon Samuelis as being philanthropists of the highest order, listing their charitable donations over the last two decades. No one is denying that the Samuelis have made worthwhile charitable donations over the last 25 years. It is not those particular donations that I and people like Steve Novella and Tim Caulfield have a problem with.

Rather, it is the Samuelis' repeated donations in the cause of furthering integrative medicine that we criticize. Remember, as has been pointed out in multiple articles, the Samuelis are true believers in The One Quackery To Rule Them All, homeopathy. Does Mr. Weeks think that homeopathy is science-based? I'm sorry, but you cannot credibly claim the mantle of science if you believe in homeopathy. Period. You just can't. You can try, but you will be called out, even laughed at—and deservedly so. Homeopathy is quackery based on concepts of vitalism and sympathetic magic.

Mr. Weeks concludes:

Reporters: stop giving a platform to anti-science. Do us all a favor and get serious, and scientific, about your reporting of an investment of the Samuelis at UC Irvine that - despite this apparently necessary stone throwing - may prove to be the most influential philanthropic investment in the substantial course correction that US academic medicine and medical industry need.

Actually, that's what I'm afraid of, that the Samueli investment will be the most influential philanthropic donation in medicine. I agree that reporters should stop giving a platform to antiscience. What that means is not at all what Mr. Weeks thinks it means. As much as he thinks otherwise, it is he who is promoting antiscience. Indeed, the reporting on the Samueli donation represents one of the times that the mainstream press that bothered to pay attention to this story actually got it mostly right about integrative medicine. Mr. Weeks doesn't like this, not one bit. That's why he's lashing out now.

oracknows Fri, 09/29/2017 - 01:00

Categories

https://www.youtube.com/watch?v=hopNAI8Pefg

As a science-based physician who has done research, I will also say "fuck you" to Mr. Weeks for his accusation that you have "blood on your hands" along with all the other anti-science and anti-medicine bullshit he spouts in his Huff-Po screed.

Do quacks bleed when a potential source of revenue is squeezed? If true, you'd have to grab them by the purse to have "blood on your hands".

I, too, will join in the fuck youing.

I am not a doctor or a researcher. I did pass my grade school chemistry class. I still am baffled how anyone else who has taken even the most basic class in chemistry can accept homeopathy as a science.

Orac writes,

We’re doctors. Mr. Weeks is not. We save lives. Mr. Weeks does not. I’m a medical researcher. Mr. Weeks is not. I can deal with his unwarranted attacks on us as “antiscience.” I can laugh at them, even. I know we have the data, the science, and reason on our side.

MJD says,

Q. What do Orac and Col. Nathan R. Jessup have in common.

A. They're a few good men.

Mr. Weeks has a lot of nerve accusing anyone of journalistic laziness when he misspells the name of the journalist he's criticizing not once, but twice. Within the same paragraph, no less.

What idiot made him the editor of a journal? Part of an editor's job is to spot and correct errors like that.

While Orac and Chris are rightly irritated by the "blood on their hands" comment, I would point out Weeks only went there because his argument is otherwise so weak as to be nonexistent. He has to resort to hyperbole to get any traction.

Pathetic.

Mr. Weeks has a lot of nerve accusing anyone of journalistic laziness when he misspells the name of the journalist he’s criticizing not once, but twice. Within the same paragraph, no less.

And with two DIFFERENT misspellings, no less. I mean, I know I make a fair number of typos (you try cranking out 2,000 words a day in your spare time and not making typos), but Weeks is a frikkin' EDITOR.

Also, which may be quite telling, is the fact that Mr. Weeks was the AANP's first "Exective Director", and that may fit well with the observations above regarding what I often term a 'reversal of values.'

After all, it is naturopathy by way of the AANP that still quite falsely terms homeopathy a "medicinal science."

So if you like physics and vectors, if "science" is the actual value, what we have in Mr. Weeks is deviation and indistinction:

"-science".

-r.c.

There is a profound difference between Trump and those criticized by Weeks. Pretty much all available evidence demonstrates that Trump is profoundly ignorant about nearly everything. Orac et al actually know things.

I have a suggestion for a title for a regular "column" by Weeks: Weeks Sauce.

Despite his having zero background in scientific research or the design and execution of experiments and clinical trials

More likely, because, not despite. Their publication couldn't survive a pro-science bias.

Here is an open challenge to this Mr. Weeks:

We will inject you with the rabies virus. You have two choices: 1. Follow the science based cure and get the rabies vaccine or 2. Follow the homeopathy/naturopathy cure method(s).

I can bet which choice you will make. Choice 2 leaves you dead, choice 1 will let you live.

I won't say F/U to you because the time and effort with no pleasure wouldn't be worth it. Crawl back into some dark corner and continue to play with yourself. Unfortunately you are proof that the Peter Principle isn't true, you have raised way beyond your competency.

What does Mr. Weeks say about using alternative medicine for cancer? (If he wants to talk about the effects on saving people's lives).

I'd be very surprised if he speaks up against them. I'll try to run a search after teaching.

They’re a few good men.

Yeah, but you think Vinu is a good person, so it's obvious you don't understand the concept.

Johnny
The Bad One

The misspellings and lack of eighth-grade-level copy editing should have consigned this little rant to the round file. I stopped reading HuffPo years ago when it lost its editorial direction, but this kind of sloppiness is inexcusable in something that still has such a large audience. I'm almost as disappointed that the mainstream press is providing cover for his ridiculous false-balance argument. Who reads his journal? Is it indexed anywhere? Who's paying for it? A supplement manufacturer? A woo peddler? Is anyone asking those questions? There are hundreds/thousands of garbage/front journals. Why give a garbage journal editor any voice at all?

To give Weeks credit, "anti-integrative medicine vigilante" is a bit more creative than "polarization-based medicine bloggers", a term he used in the course of this outpouring of verbal diarrhea:

https://www.integrativepractitioner.com/whats-new/all-news/april-2015-j…

I suspect part of his angst stems from Orac's lack of respect for NDs (Weeks is married to one).

Climate-change denialist? Wait till he calls you a holocaust denialist.

What idiot made him the editor of a journal? Part of an editor’s job is to spot and correct errors like that.

That's not the job of an EIC. I have no idea whether the new SnuffPo has putative comma jockeys (PLOS doesn't), but even copyeditors need copyediting. On the other hand, the misspellings could be deliberate.

. . . On the other hand, the misspellings could be deliberate.

And therefore juvenile, at best.

@ Johnny (#12),

No, I think Vinu is a "great" person based on creativity and effort.

You (Johnny) are also a "great" person based on creativity and effort.

Therefore, you have fallen off the top100 list of Orac's minions:

98) helpmeplease
99) Willtodie
100) David Corcos
101) Johnny

After twenty years of steering clear of the subject, Weeks struggles mightily to keep both buttocks on the middle of the fence when considering "the most sacred of cows in U.S. medicine".
https://www.integrativepractitioner.com/whats-new/all-news/furies-vacci…

Pusillanimous ignorant creep.

@doug #8: LOL. I broke Rule #1.

@Narad: It actually is the EIC's job, the buck stops with him. But I'll grant you, the role has become much more ceremonial than it used to be, which probably explains the declining quality of print publications in general nowadays.

MJD: no one is fooled by your pathetic attempts to suck up.

In other news: Tom Price has resigned...

No loss. Though, at this rate the Orange Cheeto will have to replace his entire cabinet, and he hasn't even been in office a full year yet.

The bonus is, Price is out of Congress for at least a couple of years.

You round-earth fanatics are so polarising with your refusal to even consider the flat-earth evidence. What is wrong with an integrative approach that combines the complementary aspects of both cosmologies?

MJD,

Therefore, you have fallen off the top100 list of Orac’s minions

You actually keep tabs of Orac's minion?!?!

@ herr doktor bimler (#24),

You Schwarzbier fanatics are so polarising with your refusal to consider Dunkel.

Friday night cheers, cosmological friend!

Alain (#25) asks,

You actually keep tabs of Orac’s minion?!?!

MJD says,

I certainly do, the list has grown considerably over the last seven years.

You (Alain) have moved up on the list (#97) due to Johnny's Orac-less disposition lately.

Congratulations Alain!

Pgp, don't be too hard on MJD. His posts help me keep "obsequious" on the tip of my tongue - with "simpering", 'sappy' and other s-words slightly astern. Alas "exsanguinated sequoia" images intrude into my imagination. Irritating.
Don't let his lame litter lead to lament - Rubus replies recommended.

I have a quarter-inch diameter canker sore on my uvula.

In misery, please recommend a science-based treatment.

I've tried hydrogen peroxide and chloraseptic (1.4% phenol) but continue to suffer.

Please advise...

Orac, this article reads as if it were a guest posting by your and our esteemed 'friend', Dr Gorski, rather than by our revered blinky-light box.

So, I did some googling. Weeks is basically self taught, no degree, somehow worked his way to editing an alternative health journal, runs an alternative health blog, and is married to a naturopath? How did he get to the "forefront of encouraging the “integration” of quackery with real medicine?"

This is one of my problems with the alternative health industry - what Dr Offit calls the "false prophets."

UCI, which is my alma mater, will lend respectability to alt health with this donation, Weeks is right. That is a real shame. I wish there was some way for them to turn this down and stick to good science.

What do the Samuelis have that wins such devoted defenders? $200 million to give away! That's all you need to know.

I’ll grant you, the role has become much more ceremonial than it used to be, which probably explains the declining quality of print publications in general nowadays

EICs haven't been proofreaders in nearly half a century. Please don't try to teach your grandmother how to suck eggs.

It's not only $200-million. It's a visionary $200-million investment!
And you can same the same visionary investment in ludicrous high-tech precision medicine. When quackery triumphs, it means that there is no hope for the patient.

sorry, you should read;
you can MAKE the same

For the Washington Post, or JAMA, I'll agree with that.

For small, serious journals with small budgets, nope. The EIC is still involved in the process.

Believe me, I learned this the hard way when I published in a small journal earlier this year. They still managed to leave in errors I told them to correct after I reviewed the galley proofs.

I'm afraid that I do have to agree with Weeks on one thing. Ant-Science screeds should never get the coverage in the media that they do. False balance has done more to harm science education and policy in North America than just about anything else. But if a policy to ban that was put into effect, Weeks would be ranting about censorship.

I really wish our anti-hate laws could be used to keep the NDs from advertising in Dr COS-play dress in Ontario. It does serve to remind me why I don't watch broadcast television.

@28 Doug: You forgot moronic and imbecilic, both highly appropriate when referring to MJD.

Anonymous Pseudonym (#35) writes,

You forgot moronic and imbecilic, both highly appropriate when referring to MJD.

MJD says,

I found some relief from the canker sore on my uvula (comment #29) and it comes from an article in Reader's Digest.

https://www.rd.com/health/wellness/stop-canker-sore-pain/

I thought about going to the doctor but a Google search presented an article with a multiplicity of natural remedies described above in the Reader's Digest article.

I saved a lot of $ by avoiding the doctor and continue to be thankful, in some situations, that there are alternatives to science-based medicine.

Big thanks to Google and artificial intelligence.

Schwartzbier is #FAKEBIER created by liberals.

Schwartzbier is #FAKEBIER created by liberals.

It's no Apex Predator, but I'll take a $4.99 four-pack of Köstritzer happily.

Believe me, I learned this the hard way when I published in a small journal earlier this year. They still managed to leave in errors I told them to correct after I reviewed the galley proofs.

And this demonstrates that the EIC is also the Comma Jockey in Chief how, exactly?

Orac IS an "anti-integrative medicine vigilante", a badge methinks he wears with pride. So what Orac doesn't get into is how much division and contention there is within the rubric of IM. Weeks isn't just an IM propagandist. He's a propagandist for the worst sorts of IM. He's not out to legitimate what Orac calls "quackademic medicine". TPTB there (places like Mayo) don't need him, and probably don't want him either. He's out to legitimate IM as a specialty practiced by autonomous individual providers – in essence re-branding the neighborhood naturo-quack. This is far different from and vastly more expansive than what the "quackademic" programs do – a good number of which limit the CAM to a few 'modalities' employed for pain management and supportive therapy (in which placebos are actually useful), and all that I know of have any CAM providers working under and limited by qualified MDs.

This is NOT what Weeks wants. Or should I say it's not what the grifters he shills for want. He makes his living by representing alt-med companies and interest groups. And for this cabal, IM isn't about helping folks get through chemo or distracting them from musculo-skeletal pain rather than dosing them with opiods. No, it's all about "prevention"! or IOW supplement scams. Weeks being in bed with firms like XYMOGEN which pile a variety of shady business practices on top of manufacturing dubious products to begin with.

I don't buy that he's genuinely outraged and offended by Orac's critique of UCI on principle. His attempt to run a Turdblossom on 'anti-science' is transparently calculated and cynical. My bet is he's trying to use the controversy Orac and Novella have generated for his own agenda and/or his clients' agendas. Maybe he's trying to ingratiate himself with an institution that now has $200 million to spend. Maybe he hopes to pull the new UCI program into an even quackier direction. Maybe he just wants to use the prestige of the UC system to promote legitimacy for his own brand of IM, as if they were the same thing. Which they're not, no matter that Orac may find both unacceptable...

There are two editors for the journal. Both have equal responsibility for all aspects of publication. It's a really small, new journal that publishes once a year. My article came out in Issue 2.

Yes, it's peer reviewed. No, it's not a predatory journal (it's sponsored by my university). But the editors actually have to edit.

Hey, MJD, here’s a poem for your next book -
*Not safe for work*
https://youtu.be/HhGuXCuDb1U

And try as I like, a small crack appears in my diplomacy-dike.
"By definition", I begin,
"Alternative Medicine", I continue,
"Has either not been proved to work, or been proved not to work.
Do you know what they call 'alternative medicine' that's been proved to work?
Medicine."

@Johnny (#44),

When science-based medicine fails, hope is clearly derailed.
When 'alternative medicine' fails, a hope silently prevails.
When all else fails, there is no hope.

The canker sore on my uvula is waning (comment #38), I'm hopeful that the use of natural remedies made a difference.

@ 42 Panacea

But the editors actually have to edit.

Clearly your business model needs some fine tuning.

http://deevybee.blogspot.ca/2017/07/breaking-ice-with-buxom-grapefruits…

I believe the poem MJD provided is by the acclaimed British poet Paula Nancy Millstone Jennings of 37 Wasp Villas, Greenbridge, Essex, GB10 1LL.

@ Johnny (#47),

Allow me to add a condescending enhancement with respectfully-insolent intent:

When science-based medicine fails, hope is clearly derailed.
When ‘alternative medicine’ fails, a hope silently prevails.
When all else fails, there is no hope you DOPE.

Paula N. M. Jennings can't take credit for that, Johnny. :-)

@jrkrideau: I guess I'm having an Aspie moment. I'm not sure what you mean to say with your link.

@49 Panacea

Editors are supposed to charge "page fees" not read the paper!

Title of paper:
[b]Breaking the ice with buxom grapefruits: Pratiques de publication and predatory publishing [/b]

In this case, it does not appear that anyone even read the title. And in this case the "editor" did not even get the cash.

Oh, silly me!

Heaven forfend there actually be any editing.

When science-based medicine fails, hope is clearly derailed.

Something something Jesse Fuller something.

Johnny:Snicker. It's hilarious to me that neither MJD or NWO read books, despite both of them being older than me. Well, supposedly in NWO's case, as I'm not convinced they aren't actually a twelve-year-old.

David Brin, who I find always worth reading even when I don't agree with him (https://davidbrin.blogspot.com/) speaks of there being a war against the fact-using professions, and I think this is just another example of that.
I can't describe it as well as he does, so go read him.

I'm trying to picture the respectable Dr. Gorski and Dr. Novella bumping chests and shouting. I think that would be a perfect way to commemorate next years 10 yr NECSS anniversary! :)

Kat -- D'you think they could get Dr Lance O'Sullivan teach them how to do a haka? That would be awesome.

https://www.youtube.com/watch?v=W235oVNy2bs

May I suggest The rock if Dr O'Su,llivan is not available?

[youtube https://www.youtube.com/watch?v=l7E3Sph45z8?rel=0&w=560&h=315]

Which one gets to wear the pink, Gorski or Novella?

Integrative medicine is trying to hitch a ride on the coattails of actual medicine. I'm reminded of a con artist who wants credit for mixing an occasional truth in with his lies.

MJD,

May I suggest a hydrochloric acid throat gargle. That should get rid of your canker together with your entire uvula, tongue, throat, and the ability to speak. A marked improvement you'd have to agree.

Billyjoe: Careful there. MJD's dumb enough to actually do that.

Actually, since simple canker sores typically heal by themselves in about a week,
https://www.webmd.com/oral-health/guide/canker-sores#1

it's quite likely that any alternative treatment MJD uses will "work".

Acids are not recommended, though.

It's been five days, so how is your sore doing, Michael?

Have you visited your dentist? I'll probably need to see mine soon myself.

You know what you are? You are an anti-integrative medicine careerist and a big pharma shill.

Yawn:
http://scienceblogs.com/insolence/2013/02/14/the-pharma-shill-gambit/

Homeopathy at UC-Irvine: The administration can run but it can't hide from its history of embracing quackery

oracknows — Tue, 26 Sep 2017 04:01:40 +0000

Homeopathy at UC-Irvine: The administration can run but it can't hide from its history of embracing quackery

Last week, the University of California, Irvine (UCI) announced that Susan and Henry Samueli were donating $200 million for it to set up a massive new integrative medicine initiative. The plan would basically transform biomedical sciences and medical education at UCI—and not in a good way.

Remember what "integrative medicine" is. What is being "integrated" into medicine is, of course, quackery. Oh, sure, integrative medicine also emphasizes lifestyle modification, such as diet and exercise, but that is part of "conventional medicine" already.

There is no good scientific or medical rationale for a separate specialty devoted to just that. What integrative medicine does is that it rebrands perfectly science-based modalities, such as diet and exercise, as somehow "alternative" and then "integrates" quackery, like naturopathy, acupuncture, functional medicine, applied kinesiology, homeopathy, and basically any form of quackery you can think of. Without the quackery, there is no integrative medicine.

Worse, the phenomenon has resulted in a most pernicious effect in medical academia, the infiltration of outright quackery into the research and education efforts there, a phenomenon I like to refer to as "quackademic medicine."

Of course, The Very Serious Academics In Very Serious White Coats who have come to believe in integrative medicine to the point of devoting their careers to it would vehemently disagree with my characterization. I'm referring to the sort of doctors who present at conferences of learned academics and write what they claim to be evidence-based care guidelines for breast cancer patients. Perhaps the best thing to mention to rile up serious academic advocates of integrative medicine is homeopathy. Any mention of homeopathy is guaranteed provoke paroxysms of self-righteous denial.

"Oh, no," they'll say, "homeopathy is pseudoscience! It's quackery. Integrative medicine is evidence-based, and we would never do anything that isn't evidence-based!" Sadly, as I've pointed out time and time again, you can't have naturopathy without homeopathy, as homeopathy is an integral part of naturopathy. As long as you have naturopaths, you will have homeopathy. Oddly enough, many of these The Very Serious Academics In Very Serious White Coats are utterly oblivious to this simple fact, even ones who write Very Serious Clinical Guidelines with naturopaths and welcome naturopaths into their Very Serious Medical Society.

ll of this brings me back to UCI, because yesterday there was a story by Michael Hiltzik for the LA Times about this very phenomenon. Well, not exactly. Rather, it's about the relationship between UCI and homeopathy and how UCI seems rather—shall we say?—touchy about the subject:

As of late last week, visitors to the website of UC Irvine Health, that institution’s clinical arm, could learn that among its services to patients was “homeopathy.” That was a problem, because homeopathy is a discredited and thoroughly debunked “alternative medicine.” Even Howard Federoff, UCI’s vice chancellor for health affairs, agreed that the scientific basis for homeopathy was “lacking.” The issue is important because the donors of a $200-million gift to UCI’s medical schools, the billionaire couple Susan and Henry Samueli, are sworn believers in homeopathy and supporters of a raft of other “integrative” health treatments. As I reported, some medical authorities have raised questions about whether the Samuelis’ beliefs and their rare generosity will undermine UCI’s explicit commitment to science-based medicine. So it’s interesting that after I raised questions about the treatment’s listing on the website, it mysteriously disappeared. As of this writing, a UCI spokesman hasn’t gotten back to me with word on when it was removed, or whether its removal means that homeopathy no longer will be offered to patients, or merely that UCI is keeping it quiet. The listing was present as recently as last Wednesday, when I asked Federoff about it in connection with my column about the Samueli gift, which appeared online Friday; its presence can be seen on an archived version of the website dated Sept. 19.

Ah, yes. The light of national attention due to the Samuelis' enormous donation to promote pseudoscience must have rattled UCI. After all, even the most avid proponents of integrative medicine are profoundly uncomfortable with homeopathy, even Dr. David Katz, whose "more fluid concept of evidence" led him to try homeopathy in a patient.

That's because homeopathy is quackery.

Indeed, there's a reason I routinely refer to homeopathy as The One Quackery To Rule Them All. To recap, homeopathy is based on two laws. One states that to treat a symptom you use something that causes that symptom. The other states that a homeopathic remedy becomes stronger with dilution. Neither are based in evidence. Indeed, many homeopathic remedies are 30C or greater in dilution, where C is a 100-fold dilution. Thus 30C means diluting the solution 100-fold thirty times, which results in a dilution of 10^-60.

Given that Avogadro's number is on the order of 6 x 10²³, a 30C dilution is more than 10³⁶-fold greater, which means that it's incredibly unlikely that a single molecule of original remedy remains. Most homeopathic remedies are just water or ethanol diluent. Even the most die-hard advocate of quackademic and integrative medicine has to admit that, which is why even they are so uncomfortable when homeopathy is brought up and so loudly and self-righteously deny that integrative medicine would ever have anything to do with homeopathy.

Amusingly, Hiltzik noted a web page that looked very, very familiar to me, that of Dayna Kowata, ND, LAc. Yes, she's a naturopath and acupuncturist. She also expresses an interest in homeopathy. What's so familiar about Not-a-Dr. Kowata? Well, I used her UCI webpage in talks about quackademic medicine several years ago, and I've even mentioned her on two different occasions on this very blog, albeit not by name. At the time, I didn't know that Susan Samueli is strong believer in homeopathy, but I do now.

I wonder what Ms. Samueli will think if Dr. Federoff actually does eliminate homeopathy from UCI. I rather suspect that she won't be happy. I particularly wonder this based on the original gift agreements between the Samuelis and UCI when the Samuelis first founded the Susan Samueli Center for Integrative Medicine (SSCIM) at UCI. The original gift was $20 million in 1999. Now here's where it gets interesting. In 2003, the board of directors of the Samueli Center was formally founded in the UCI College of Medicine.

You can read the whole thing if you like, but this is the key paragraph:

The proposed Center will build on the considerable knowledge and experience of its faculty to study the efficacy of various therapeutic modalities considered to be part of complementary and alternative medicine, including herbs and homeopathic medicine, as they relate to areas such as cardiovascular, autoimmune and neuromuscular diseases, cancer treatment and prevention; and menopaus and ageing. In addition, the proposed center will foster UCI's emergence as a leader in the area of acupuncture by supporting basic and clinical research into the mechanism of action and the efficacy of acupunctxure as a modality. The proposed Center will encourage and foster multidisciplinary studies that involve appropriate faculty from across the campus as well as from other institutions.

That's right. Homeopathy was baked into the Samueli Center from near the very beginning. I can't help but wonder what would be found in the formal gift agreement for the Samuelis' $200 million donation. Perhaps a Freedom of Information Act request would shed some illumination on this question. On the other hand, I note that homeopathy was only mentioned in one of the gift agreements.

Perhaps then, as now, UCI and the Samuelis learned that homeopathy brought too much embarrassment to the university—and rightly so—and that's why homeopathy hasn't been mentioned in any of the Samuelis' gift agreements since 2003. Alternatively, most of the gift agreements after that had to do with setting up fellowships and endowed chairs and gave UCI administration the latitude to use the gifts for whatever purposes it judged most consistent with the wishes of the donors.

Contrary to what Dr. Federoff claims, quackery is deeply embedded at UCI. It's the raison d'être for the SSCIM. He might be in denial about it, but it's true. That's why I was amused to read Hiltzik's observation:

The on-again-off-again appearance of homeopathy on UCI’s website and among its clinical offerings underscores the difficulties the university may face in navigating the inconsistencies between the world view of its biggest donors and its explicit commitment to rigorous scientific standards in its medical teaching, research, and clinical treatment. The Samuelis, after all, will have their names on UCI’s main on-campus medical building, and their gift will endow up to 15 faculty members, all of whom will have to demonstrate some “expertise in integrative health.” We reported over the weekend that “integrative health” is interpreted by many in the medical profession as code for introducing unproven and debunked nostrums into a curriculum that should be based exclusively on scientific evidence. Although Federoff says science will govern at UCI, that hasn’t necessarily been the case at the Susan Samieli Center, which was established in 2001 with a $5.7-million donation from the couple and will be converted into the Susan Samueli Integrative Health Institute and absorbed into the university’s entire medical complex under the terms of the gift.

I can't help but note that Dr. Federoff came to UCI from Georgetown University. Why is that significant? Georgetown was one of the "pioneers" (if you will) in quackademic medicine. Basically, Georgetown was the first to "integrate" quackery into all phases of medical education beginning in the first year of medical school, with acupuncturists giving lectures in gross anatomy class. I kid you not.

By the time Dr. Federoff left Georgetown in 2015, quackademia reigned supreme at Georgetown, even to the point where Georgetown credulously teaches homeopathy to its medical students. Dr. Federoff was there when it began and took hold. You'll pardon me if I call bullshit on his claims that the SSCIM will be rigorously based in science. It won't. That's not what the donors want, and that's not what the culture at UCI will support.

Thanks to the Samuelis and the credulous culture they have built at UCI and fueled by the enormous $200 million gift given by the Samuelis, quackademic medicine will reign more supreme than ever at UCI and serve as an example for the metastasis of the cancer that is integrative medicine.

oracknows Tue, 09/26/2017 - 00:01

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University of California Irvine

Categories

http://www.webmd.com/balance/tc/homeopathy-topic-overview

I wonder what she will think if Dr. Federoff actually does eliminate homeopathy from UCI.

He's just diluting the curriculum to make it more effective.

I always find it stunning that someone can have a very scientific mind and have invented/patented multiple devices of incredible complexity and then turn around and buy into something as ridiculously stupid as homeopathy. But smart in one area never means smart in all areas.

"smart in one area never means smart in all areas."

Just can't leave Ben Carson alone, huh?

Wait, they're going to use homeopathy to treat heart disease, cancer and autoimmune diseases? That's what they're saying?

Chris Hickie (#2) writes

But smart in one area never means smart in all areas.

MJD says,

But, being creative (i.e., invented/patented) in one area often means creative in other areas.

It appears Henry Samueli is simply being creative with his $ based on the love and affection he has for his wife.

Remember the Taj Mahal?

It was commissioned in 1632 by the Mughal emperor, Shah Jahan (reigned 1628–1658), to house the tomb of his favourite wife, Mumtaz Mahal.

The Taj Mahal didn't change world architecture and, in parallel, UCI's $200 million from Mr. Samueli will not change science-based medicine.

@ Orac,

Stop whining and let it play out.

MJD: The Taj Mahal didn’t change world architecture.

Oh man, every time I think you can't be more wrong, you prove me wrong. Obviously, you've never been to Southeast Asia. Or seen a Russian orthodox church. Or Aladdin.

"UCI’s $200 million from Mr. Samueli will not change science-based medicine."

That's about as ridiculous as saying that Russia has no influence in the US. Do you know where doctors come from? Medical schools. If one medical school is teaching inaccurate and just plain bad medicine, the practice will spread to other medical schools and hospitals. California already has a huge problem with quacks and people who abandoned their medical degrees (see "Dr" Gordon and "Dr" Sears.) So no, Orac can't just let this one 'play out.'

PGP writes,

So no, Orac can’t just let this one ‘play out.’

MJD says,

If Orac wants to confront Dr. Gordon and Dr. Sears that's fair.

But, the billionaire couple Susan and Henry Samueli are NOT medical professionals and can most definitely be appreciated for their charitable contributions to UCI.

@ Orac,

If UCI made a disclaimer that homeopathy is intended to be researched as a supplementary-treatment would you back off?

In the spirit of freedom-of-choice, homeopathic medicine may have a theatrical placebo effect that may improve the quality-of-life for some individuals dealing with science-based medicine.

I wonder if UCI will apply homeopathy methods for teaching their med students. Think how fast you can turn out docs if you dilute each course by 30c. I think they may need to start with a blood sample from a real doctor before they begin their dilutions.

I can just see the RonCo knock-off: Become a MD for only 49.95 but wait if you order right now get the second one for only process and handling.

Wandering in from my respite...

PGP: " Every time I think that you can't be more wrong, you prove me wrong"

Agreed.

Srsly, MJD telling Orac to "stop whining" truly illustrates self unawareness at its most ironic
.
It's like Mike Adams bemoaning the current state of education
or AoA's Managing Editor discussing poor writing or Jake Crosby investigating anything

MJD: But, the billionaire couple Susan and Henry Samueli are NOT medical professionals and can most definitely be appreciated for their charitable contributions to UCI. "

Nope. Still wrong. If they'd donated a no-strings attached gift to UC Irvine, that'd have been fine and no one would find fault with them. Unfortunately their "gift" came with more strings attached than you'd find on the entire Muppet cast of Sesame Street.

What a ridiculous article. Everything is prejudged and makes mockery of basic human knowledge. Pharna lobby seeing a danger to its business is out in the open.

@Ash

Oh, to be blissfuly clothed in the raiments of ignorance.

"If UCI made a disclaimer that homeopathy is intended to be researched as a supplementary-treatment would you back off?"

I hope not - nobody should, since the fact that homeopathy is discredited means there is no evidence that it benefits anyone except the quacks who practice it and pocket the checks. People who understand science and reality understand that. Given your history of comments it's no surprise that you don't understand it.

Ash: "Everything is prejudged and makes mockery of basic human knowledge."

What basic human knowledge? A couple of big pharmaceutical companies are Boiron and Hylands. You may have actually bought some of their special little pills in the tiny bottles. So to save from the tyranny of supporting Big Homeopath Pharm, I present you this way to make your own:

Recipe for Nat Mur or Natrum Mur or Natrium Mur or Natrum muriaticum:

1) Take ½ teaspoon of sea salt and dissolve into 1 cup of distilled water in a bottle.

2) Shake well.

3) This is a 1C solution (ratio 1/100).

4) Take ½ teaspoon of the 1C solution and put it a bottle with 1 cup of distilled water, throw out the 1C solution.

5) Shake well.

6) This is a 2C solution (ratio 1/10000).

7) Take ½ teaspoon of the 2C solution and put it a bottle with 1 cup of distilled water, throw out the 2C solution.

8) Shake well.

9) This is a 3C solution (ratio 1/1000000).

10) Take ½ teaspoon of the 3C solution and put it a bottle with 1 cup of distilled water, throw out the 3C solution.

11) Shake well.

12) This is a 4C solution (ratio 1/100000000).

13) Take ½ teaspoon of the 4C solution and put it a bottle with 1 cup of distilled water, throw out the 4C solution.

14) Shake well.

15) This is a 5C solution (ratio 1/10000000000).

16) Take ½ teaspoon of the 5C solution and put it a bottle with 1 cup of distilled water, throw out the 5C solution.

17) Shake well.

18) This is a 6C solution (ratio 1/1000000000000).

19) Take ½ teaspoon of the 6C solution and put it a bottle with 1 cup of distilled water, throw out the 6C solution.

20) Shake well.

21) This is a 7C solution (ratio 1/100000000000000).

22) Take ½ teaspoon of the 7C solution and put it a bottle with 1 cup of distilled water, throw out the 7C solution.

23) Shake well.

24) This is an 8C solution (ratio 1/10000000000000000).

25) Take ½ teaspoon of the 8C solution and put it a bottle with 1 cup of distilled water, throw out the 8C solution.

26) Shake well.

27) This is a 9C solution (ratio 1/1000000000000000000).

28) Take ½ teaspoon of the 9C solution and put it a bottle with 1 cup of distilled water, throw out the 9C solution.

29) Shake well.

30) This is a 10C solution (ratio 1/100000000000000000000).

31) Take ½ teaspoon of the 10C solution and put it a bottle with 1 cup of distilled water, throw out the 10C solution.

32) Shake well.

33) This is a 11C solution (ratio 1/10000000000000000000000).

34) Take ½ teaspoon of the 11C solution and put it a bottle with 1 cup of distilled water, throw out the 11C solution.

35) Shake well.

36) This is a 12C solution (ratio 1/1000000000000000000000000).

37) Take ½ teaspoon of the 12C solution and put it a bottle with 1 cup of distilled water, throw out the 12C solution.

38) Shake well.

39) This is a 13C solution (ratio 1/100000000000000000000000000).

40) Take ½ teaspoon of the 13C solution and put it a bottle with 1 cup of distilled water, throw out the 13C solution.

41) Shake well.

42) This is a 14C solution (ratio 1/10000000000000000000000000000).

43) Take ½ teaspoon of the 14C solution and put it a bottle with 1 cup of distilled water, throw out the 14C solution.

44) Shake well.

45) This is a 15C solution (ratio 1/1000000000000000000000000000000).

46) Take ½ teaspoon of the 15C solution and put it a bottle with 1 cup of distilled water, throw out the 15C solution.

47) Shake well.

48) This is a 16C solution (ratio 1/100000000000000000000000000000000).

49) Take ½ teaspoon of the 16C solution and put it a bottle with 1 cup of distilled water, throw out the 16C solution.

50) Shake well.

51) This is a 17C solution (ratio 1/10000000000000000000000000000000000).

52) Take ½ teaspoon of the 17C solution and put it a bottle with 1 cup of distilled water, throw out the 17C solution.

53) Shake well.

54) This is an 18C solution (ratio 1/1000000000000000000000000000000000000).

55) Take ½ teaspoon of the 18C solution and put it a bottle with 1 cup of distilled water, throw out the 18C solution.

56) Shake well.

57) This is a 19C solution (ratio 1/100000000000000000000000000000000000000).

58) Take ½ teaspoon of the 19C solution and put it a bottle with 1 cup of distilled water, throw out the 19C solution.

59) Shake well.

60) This is a 20C solution (ratio 1/10000000000000000000000000000000000000000).

61) Take ½ teaspoon of the 20C solution and put it a bottle with 1 cup of distilled water, throw out the 20C solution.

62) Shake well.

63) This is a 21C solution (ratio 1 in 10^42 or 1/1000000000000000000000000000000000000000000).

64) Take ½ teaspoon of the 21C solution and put it a bottle with 1 cup of distilled water, throw out the 21C solution.

65) Shake well.

66) This is a 22C solution (ratio 1 in 10^44 or 1/100000000000000000000000000000000000000000000).

67) Take ½ teaspoon of the 22C solution and put it a bottle with 1 cup of distilled water, throw out the 22C solution.

68) Shake well.

69) This is a 23C solution (ratio 1 in 10^46 or 1/10000000000000000000000000000000000000000000000).

70) Take ½ teaspoon of the 23C solution and put it a bottle with 1 cup of distilled water, throw out the 23C solution.

71) Shake well.

72) This is a 24C solution (ratio 1 in 10^48 or 1/1000000000000000000000000000000000000000000000000).

73) Take ½ teaspoon of the 24C solution and put it a bottle with 1 cup of distilled water, throw out the 24C solution.

74) Shake well.

75) This is a 25C solution (ratio 1 in 10^50 or 1/100000000000000000000000000000000000000000000000000).

76) Take ½ teaspoon of the 25C solution and put it a bottle with 1 cup of distilled water, throw out the 25C solution.

77) Shake well.

78) This is a 26C solution (ratio 1 in 10^52 or 1/10000000000000000000000000000000000000000000000000000).

79) Take ½ teaspoon of the 26C solution and put it a bottle with 1 cup of distilled water, throw out the 26C solution.

80) Shake well.

81) This is a 27C solution (ratio 1 in 10^54 or 1/1000000000000000000000000000000000000000000000000000000).
(the zeros are running off of the page!)

82) Take ½ teaspoon of the 27C solution and put it a bottle with 1 cup of distilled water, throw out the 27C solution.

83) Shake well.

84) This is a 28C solution (ratio 1 in 10^56 or 1/100000000000000000000000000000000000000000000000000000000).

85) Take ½ teaspoon of the 28C solution and put it a bottle with 1 cup of distilled water, throw out the 28C solution.

86) Shake well.

87) This is a 29C solution (ratio 1 in 10^58 or 1/10000000000000000000000000000000000000000000000000000000000).

88) Take ½ teaspoon of the 29C solution and put it a bottle with 1 cup of distilled water, throw out the 29C solution.

89) Shake well.

90) This is a 30C solution (ratio 1 in 10^60 or 1/1000000000000000000000000000000000000000000000000000000000000).

And then you are done! To make the pills, go to baking center of your grocery store and get some plain cake decorating sprinkles. You can try dropping some of the solution on the sprinkles, or just set the bottle next to the solution for it to absorb the energy (which is the typical method used for over the counter homeopathic remedies).

dean (#13) writes,

Given your history of comments it’s no surprise that you don’t understand it.

MJD says,

It is written, "Homeopathy is based on the idea that "like cures like." That is, if a substance causes a symptom in a healthy person, giving the person a very small amount of the same substance may cure the illness. In theory, a homeopathic dose enhances the body's normal healing and self-regulatory processes.

Q. Doesn't allergy shot immunotherapy, which is science-based, falls within the parameters of homeotherapy.

Example, low dose of a natural allergen with repeated exposure to decrease sensitivity to that allergen.

https://www.aaaai.org/conditions-and-treatments/treatments/allergy-shots-(immunotherapy)

In this instance, conventional medicine and integrative medicine overlap.

I don't know how much experience anyone here has with college/university development offices, but those folks are usually glad-handing snakes. Their job is to get as much money from donors first, and then see that the fewest strings are attached to it so the school administrators can use it any damn way they please. In this, they are expert are snowing both the faculty and the donors. They have lots of tricks for this – making it look to the donor like the money will go to one thing when it actually goes to something else, and then forcing the faculty into continuing the ruse through the years...

Which is not to say that $200 million doesn't buy a lot of influence. Just that how much influence and where it lands is a complex negotiation, and PR releases can't be trusted to give a proper indication of how it all will play out. My guess would be that most of the The Susan and Henry Samueli College of Health Sciences will be giving only lip service to IM, and continuing the re-branding of useful stuff they were already doing as "integrative". That is, very little of the $200 million will be going to 'quackery'. But, on the other hand, the old Susan Samueli Center for Integrative Medicine is being upgraded and more firmly anchored institutionally within UCI along with the renaming to the Susan Samueli Integrative Health Institute.

Another way to put it: $200 million buys getting your name on a school, but it's probably not enough to dictate everything that goes on inside, (or even all that much of it...). Academic institutions much smaller than the UCI med school are as easy to turn around as the Titanic, and declarations of 'new cutting edge program!!' are more often than not puffed up with hype while most day-to-day business stays pretty much the same.

That's my experience anyway in my corner of academia, which I admit is far away from health sciences, but it seems pretty common, fwiw. Of course, things could be different at Irvine ("Zot! Zot!"), but of all the news I'll read this week, this is likely to worry me the least.

Spectator @12: Oh, that is brilliant. May I borrow it when the need arises?

#15 Michael J. Dochniak, September 26, 2017

MJD says,
It is written, “Homeopathy is based on the idea that “like cures like.” That is, if a substance causes a symptom in a healthy person, giving the person a very small amount none of the same substance may cure the illness.

FTFY.

Q. Doesn’t allergy shot immunotherapy, which is science-based, falls within the parameters of homeotherapy.
Example, low dose of a natural allergen with repeated exposure to decrease sensitivity to that allergen.

The difference is that the low dose is a low but non-zero dose; where the homœopathetic dose is diluent only, a dose of zero.

The other fallacy of your simile is that the extremely low dose of active ingredient in the anti-allergy treatment is designed to produce a subtle effect, teaching the patient's immune system that the allergen really ain't anything to be askeered of. That's why the dose is small rather than non-zero.

OTOH, the homœopathetic "dose", with no remaining active ingredient, is claimed to produce a profound effect, curing whatever the symptom might be.

The similarity you imagine vanishes upon examination.

What is this zot thing everyone keeps going on about?

PGP, you should look up UC-Irvine's mascot for the answer.

Sadmar: I think you're underestimating the influence donors can have on a school.

Why go to the Susan and Henry Samueli College of Health Sciences when you can be taken for a more enjoyable ride at nearby Disneyland?

Despite the classic Hahnman infinite dilutions theme, historical connection or popular association with herbal, natural or nutritional treatments exists with (some?) homeopathic doctors.

So I'm unclear what percentage of lay persons saying that they want homeopathic treatment are really buying into the infinitely dilute treatments superstition.

Go Eaters! Zot!

Quackademic medicine now reigns supreme at UC-Irvine

oracknows — Tue, 19 Sep 2017 04:55:38 +0000

Quackademic medicine now reigns supreme at UC-Irvine

It's not infrequently that, whenever I complain about the increasing infiltration of quackery and pseudoscience into medicine, I sometimes lament that skeptics and supporters of science-based medicine are massively outgunned, because we are. Thus, we have the continued growth of what I like to refer to as "quackademic medicine," the infiltration of pseudoscience into medical academia in the form of whole divisions, departments, and institutes dedicated to studying fairy dust like acupuncture, naturopathy, and other "unconventional" treatments that are then "integrated" into medicine. It's not for nothing that I refer to "integrative medicine" as integrating quackery with medicine.

Unfortunately, I was reminded yesterday of what an uphill battle it is to counter the increasing pseudoscience in medicine when I learned that wealthy donors Susan and Henry Samueli just donated a whole bunch of money to the University of California, Irvine (UCI) to establish an institute dedicated to pseudoscience:

The University of California, Irvine today announced the largest gift in its history: $200 million from Susan and Henry Samueli, longtime campus supporters, to name a first-of-its-kind College of Health Sciences focused on interdisciplinary integrative health. The far-reaching donation – the seventh-largest to a single public university – positions UCI as a bold, new leader in population health, patient care, education and research. “This gift catalyzes UCI’s belief that human health and well-being requires a science-based approach that engages all disciplines in caring for the whole person and total community,” said Chancellor Howard Gillman. “Susan and Henry Samueli’s dedication, their vision for what is possible and their deep generosity will help UCI set a standard that, over time, other medical centers in the U.S. can follow.”

Thanks to the Samuelis, unfortunately UCI has long been a prominent force in the brave new world of integrative medicine. Now, it appears to be taking this "integration" a step further, by "integrating" the pseudoscience across not just the new institute. Behold:

The Susan and Henry Samueli College of Health Sciences will be the first university-based health sciences enterprise to incorporate integrative health research, teaching and patient care across its schools and programs. Integrative health redefines the relationship between the practitioner and patient by focusing on the whole person and the whole community. It is informed by scientific evidence and makes use of all appropriate preventatives, therapeutic and lifestyle approaches, and healthcare professionals and disciplines to promote optimal health and wellness. The existing Susan Samueli Center for Integrative Medicine will become the Susan Samueli Integrative Health Institute and will focus on improving medical care by supporting multidisciplinary research, education, clinical service and community programs. Faculty and students in computer science, engineering, social sciences, business and other areas will collaborate within the institute to study the future of human health.

Of course, the whole paragraph about integrative health "redefining" the relationship between the practitioner and patient by focusing on the "whole person" is the usual blather that quacks everywhere. As I've said so many times before, it is not necessary to "integrate" pseudoscience into medicine in order to take care of the "whole patient." A good science-based primary care doctor takes care of the "whole patient," with no need to resort to appealing to magic like acupuncture, reiki, reflexology, homeopathy, and the like. And if you don't think this is about all of the forms of quackery I just mentioned, take a look at how the Samuelis became interested in "integrative" medicine:

Susan Samueli caught a cold while visiting France more than three decades ago. Instead of the usual medicines, a friend suggested aconite, a homeopathic remedy derived from a plant in the buttercup family. She was cured — and became a lifelong advocate of homeopathy and other alternative healing methods to complement conventional medicine. Her husband, Henry — the billionaire co-founder of Broadcom, the Irvine semiconductor maker — says he was initially skeptical but found the integrative health approach helped him easily shake off colds and flus and kept their children healthy without antibiotics. Now the couple’s passion for integrative health has led to the largest donation ever made to UC Irvine.

As an origin myth, This is just downright silly. Colds are self-limited, and the homeopathic remedy Mrs. Samueli took almost certainly had no effect on the course of her cold. She just got better, as the vast majority of otherwise healthy adults with colds do. As for Mr. Samueli's apparent belief that homeopathy and other "integrative" approaches helped him shake off colds and flus, the same thing is going on. Colds are self-limited. So is the flu for most people, although what most people call the "flu" isn't really the flu but much milder "flu-like illnesses" caused by other viruses. (The real flu can easily knock you on your posterior for a week or even more.)

Basically, this story is a load of confirmation bias and good old-fashioned regression to the mean being confused with therapeutic effect. Yet, that's all it takes for otherwise intelligent people to become believers. Humans are pattern-forming animals. If we take something and then get better we'll say that what we took caused us to get better, whether it really did or not.

Of course, supporters of "integrative medicine" will no doubt become indignant at my description of their favored new medical specialty. They will point to how diet and exercise are an important part of integrative medicine, how integrative practitioners emphasize prevention and healthy lifestyle. The problem, of course, is that diet, exercise, healthy lifestyles, and prevention are all part of conventional medicine. There is no need for a separate specialty for them, any more than there is a need for a separate specialty in order to take care of the "whole patient."

The reason "integrative medicine" exists is not to promote science-based prevention, lifestyle, and exercise interventions, but rather to provide a vessel into which quackery can be poured and mixed with the science-based care until it becomes difficult to tell which is which. That's the idea, whether physicians who have become integrative medicine practitioners will admit it to themselves (or others) or not. So here's how this next stage of "integration" will go.

The Susan and Henry Samueli College of Health Science will eventually include the existing Samueli Center plus the following schools at UCI:

School of Medicine
Sue & Bill Gross School of Nursing
School of Pharmacy (currently the Department of Pharmaceutical Sciences)
School of Population Health (currently the Program in Public Health)

And here's where the money will go:

The Samuelis’ gift will provide $50 million toward construction of a facility to house the college and $5 million for state-of-the-art technology and labs – forming the foundation of a national showcase for integrative health. It also earmarks $145 million to create an endowment for:

Up to 15 faculty chairs across the medicine, nursing, pharmacy and population health disciplines for senior, midcareer and junior faculty with expertise in integrative health

Integrative health training and mentoring for interested medical school students

Scholarships and fellowships for undergraduate and graduate students planning careers in related fields

Innovative curricular development and campuswide interdisciplinary research projects

Ongoing clinical services, research and education in the Susan Samueli Integrative Health Institute, including investigations of nonconventional interventions as part of medical treatment and educating medical and lay communities about benefits and risks associated with new healthcare approaches

That last bullet point is critical. The whole point of "integrative medicine" is to integrate "nonconventional interventions as part of medical treatment." That means quackery. There is no other reason for integrative medicine. Just think about the evolution of the naming of integrative medicine. First, it was known as alternative medicine. But "alternative" implied that the "nonconventional interventions" weren't medicine (or weren't good medicine, which they weren't).

So the name evolved to "complementary and alternative medicine," or CAM. However, that wasn't good enough either, because the name mean that the quackery was "complementary" to real medicine. It wasn't real medicine itself (or at least it wasn't as effective or important as real medicine). It was just "icing on the cake." So a new name was coined, "integrative medicine," in which all the quackery was (and still is) portrayed as co-equal with conventional medicine and "integrative medicine" as "the best of both worlds." And here we are. A wealthy couple has donated $200 million to a public university to promote their vision of pseudoscience, and the university has eagerly accepted, even though it will utterly reshape its medical school and all its biomedical sciences for decades to come.

I find it helpful to look at what UCI's Samueli Center already offers. I first took note of the school just shy of 10 years ago, when I added the Susan Samueli Center for Integrative Medicine as part of an early version of my Academic Woo Aggregator.Really long time readers of this blog know that for a time I maintained a list of medical schools that had embraced quackademic medicine. I only maintained the list for a relatively brief period of time, not because I didn't think it was a worthwhile endeavor, but rather because there were just too many schools for me to keep track of alone.

Quackademic medicine has become the norm, not an outlier. It's schools like mine, where I'm faculty, that have little or no quackademic medicine that are the outliers. So what does Samueli Center offer? It's basically the same slate of "integrative medicine" that most quackademic "integrative medicine" centers offer:

Acupuncture & traditional Chinese medicine
Ayurvedic therapies
Functional medicine
Massage therapy
Meditation
Mindfulness
Nutritional counseling
Physical medicine & rehabilitation
Preventive cardiology
Sports medicine & osteopathic manipulation
Tai chi
Vitamin infusion therapy
Women's health
Yoga

Of course, traditional Chinese medicine and Ayurvedic medicine are prescientific systems of medicine based on mysticism and vitalism. Functional medicine is a bit of "make it up as you go along" quackery that combines the worst of conventional medicine on steroids (e.g., massive overtesting) with quackery. Vitamin infusion therapy, of course, is also not scientifically supported. As for the rest, Tai Chi and yoga are nothing more than exercise. Massage therapy makes people feel better, but specific therapeutic claims are to be treated with skepticism.

If you want to get an idea of the level of pseudoscience going on here, it's useful to look at what UCI says about various modalities. For instance, "functional medicine" turns out to be all about naturopathy as well:

Functional medicine, which is based on naturopathic principles, takes a more comprehensive approach. At the Susan Samueli Center for Integrative Medicine, our highly trained naturopaths:

Identify and treat the root causes of illness

Harness the healing power of nature

Treat the whole person

Emphasize disease prevention

Encourage self-responsibility for health

Explore alternatives to drugs and surgery

And, based on functional medicine, UCI might offer:

Based on your individual needs, we develop a treatment plan which may include:

Detoxification

Dietary and lifestyle changes

Exercise therapy

Herbs and dietary supplements

Homeopathy

Manipulative therapies

Psychotherapy and counseling

Stress reduction

There you go. "Detoxification" is virtually always the purest of quackery. Then, of course, there's homeopathy, or, as I like to call it, The One Quackery To Rule Them All. If you don't know why that's the case, I refer you to any of a number of my previous posts, like this one. Of course, one aspect of "integrative medicine" is bias. Basically, its adherents don't ask whether it will help patients and result in better outcomes. Rather, they confidently predict that they will be vindicated in their beliefs:

“As a preventive cardiologist and researcher, I cannot stress enough the critical need for society to adopt a truly integrative approach to health, whether we are talking about community health, nutrition, prevention or appropriate medications. It must start with those who provide care and guidance,” said Dr. Shaista Malik, director of the Susan Samueli Center for Integrative Medicine and the endowed chair of integrative medicine. “Through this exciting new college, we will demonstrate to everyone involved in the health system – from patients to providers to policymakers – the value of an integrative approach.”

And:

Fundamental change in thinking about healthcare and how it’s delivered will take time, a steady stream of new evidence and strong academic leadership. The Samuelis’ transformational gift is the first step toward creating an expanded health sciences campus, integrating the affiliated schools and programs of the college as well as new teaching, research and clinical spaces. “Susan and I have supported healthcare research for nearly 20 years, and over that time, we have seen a significant expansion of the scientific evidence demonstrating the value and efficacy of integrative health. This evidence base is critical as UCI – a young, innovative institution – takes this big and influential step,” said Henry Samueli, Ph.D., an engineer and co-founder of Broadcom Corporation. “We are very excited for the UCI College of Health Sciences to become a national model for integrative health. We believe this model will eventually become the standard approach for promoting health and well-being in our society.”

That's right. Adherents of "integrative" medicine "believe" that it will eventually become standard of care. What evidence do they base this belief on? Certainly not on evidence. I do note that advocates of integrative medicine are quite honest about their goals, as you can see from this article in the the LA Times:

The Samuelis said they hope their financial support for research will help build evidence for alternative therapies that would convince insurers to pay for them, thus letting more people benefit. Acupuncture, for instance, has been widely documented to ease migraines, according to Howard Federoff, a specialist in neurodegenerative disorders and UC Irvine’s vice chancellor for health affairs. But not all health plans cover the treatment.

No, acupuncture is nothing more than a theatrical placebo. When I say that skeptics and supporters of science-based medicine are at a profound disadvantage, this development at UCI is exactly what I'm talking about. What we have is a ragtag band of physicians and skeptics alarmed at the infiltration of pseudoscience into medicine versus very wealthy believers like the Samuelis willing to donate far more money than we can imagine.

Sure, we have science on our side, but will it matter? We have to make it matter.

oracknows Tue, 09/19/2017 - 00:55

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University of California Irvine

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https://www.forbes.com/sites/williampbarrett/2016/12/14/the-largest-u-s…

"Quackademic Medicine now reigns supreme at UC-Irvine"

But aren't you an "Assistant Professor" in Michigan?

Oh, Travis, you're several years behind the times. I was promoted to full professor last year and had been an associate professor for several years before that. You must be reading J.B. Handley.

I would like to think there are faculty at the UC Irvine School of Medicine who are upset about this--because if there are not then things are much worse than feared. Why do these faculty not speak out against this pseudoscience? Some of them must be tenured, which should grant the ability to speak openly on such nonsense. Then again when I was doing my residency at the University of Arizona, I never saw anyone openly oppose Andre Weil and his nonsense, which has openly infiltrated many of the residency training programs there since I finished my training.

Shruggies. The vast majority of physicians are shruggies. https://sciencebasedmedicine.org/a-shruggie-awakening/

In a Forbes article titled, "The Largest U.S. Charities for 2016" a quick calculation indicates ~ 7 billion dollars donated to medical organizations that are predominantly science-based.

I'm thankful for their generosity...

It has to be said that to some extent, physicians have nurtured this entire movement--not because they don’t care or are ignorant of what constitutes a healthy lifestyle, but because the truth of these thing just isn’t what people want to hear. I am as guilty of this as anyone else. When I ask my doc about some diet-related thing and she gives me a half page blurry handout on her way out the door, I am grossly offended, but because I know that there is no magic, I accept it. Had she been a naturopath, the interaction would have gone very differently and if I weren’t so steeped in skepticism, I would tend to be much happier with the naturopath, even more so if I were not a skeptic.

It is one thing to acknowledge that “there are problems in medicine” but it is time to offer some real solutions to them instead of bemoaning the success of the quacks in addressing people’s need to interact with their health provider on a more personal level. And don’t say there’s no time because I’ve had providers who achieve a level of care that addresses “the whole person” in the same amount of time that most utterly fail. I accept a level of care that falls short of better experiences because I am an informed skeptic, but most people aren’t and that’s why they respond so well to the woo.

We have done well at outlining the problem, but very little to address it on our own side. My favorite example is that my PCP, a lovely woman who has been my doctor for seven years, has not ONCE asked me how I am--something the dietician (my fave provider) always does. If I bring up mental health (just everyday type of mental health, not serious impairment), she stiffens, mumbles about a psychiatrist or a psychologist (ack!) if I “just need to talk”. This is not an isolated example; I have been through a number of providers at this medical center and it’s all pretty much the same. I’m currently seeking a smaller institution, but that is difficult in my state. My friends find various integrative quacks instead. I used to argue, but I’ve become somewhat of a shruggie these days, given my own state of dissatisfaction with the system. Mind you, I’m not seriously ill or anything, but isn’t that the demographic that is so ripe for the picking by the quacks?

Don’t misunderstand my horror at the goings-on at UCI, but we have to do more than bemoan it. If diet and exercise are “part of medicine”, more needs to be done to make regular people aware of that. Saying “30 minutes a day” or “25 grams a day” and a handout with stick people for back pain are not enough, even though that may be the actual truth of things.

I’m sorry if this comment relies too heavily on personal experience, but I use it to amplify interactions that I have on an almost daily basis over many years. Although I am educated, I don’t travel in academic circles anymore, and as you all know, that is no guarantee anyway that one will not encounter woo--hence today’s sad tale of UCI.

Clearly you need a new primary care doctor. No, I'm serious. The one you have clearly isn't meeting your needs. I haven't had that problem with my last two PCPs; so I'll counter your anecdote with mine.

A bit off topic, please.

I noticed that someone (maybe Mike Adams?) has changed the referenced image in comment #70 of Orac's post titled, "Does the Flu Vaccine cause miscarriages?"

Orac and Mike Adams are matter and antimatter, I appreciate both!

Chris@3: Never mind the faculty, what do the accreditation people think of this? From where I sit, it looks as though UCI is in thrall to a couple of big dollar donors who are encouraging the medical faculty to practice a form of medicine that the donors themselves, let alone the faculty, either know or should know does not work.

I can understand the reluctance of soft money faculty to speak up. They may be dependent on the university for things like bridge funding and lab space, and are therefore not as free to speak their minds as faculty should be. But the accreditation board is designed to be independent of a university's donors. They have no excuse for not pushing back at the first opportunity.

I am a PCP, and have been for 25 years (damn, that is hard to type!) What I have found is that in order to counter this movement you need to be familiar enough with the woo to discuss it with some knowledge. If your patent asks your opinion on massage or chiropractic and you roll your eyes and tell them they are idiots, the interaction will not go well. It does require time spent reading sites that reek of stupid so you know of what they speak, but if you can build a relationship, it is possible to counteract a lot of this. The major drawback is that it takes time, both in reading and talking, and most of us are very pressed for time. Nonetheless, I have a fairly huge antivax population and have been successful at getting the majority of them to get at least some shots. Is that a win? I think so. The latest is everyone needs lip and tongue ties lasered. (!) No clue where this came from, but with research I have talked several down from that ledge. It's all about knowing your patient and your stuff.

"$5 million for state-of-the-art technology and labs" State of what art? And of course they need labs to conduct imaginary tests to produce imaginary results that require imaginary interventions to treat imaginary symptoms, no doubt.

Looking into the accreditation process and registering complaints is a good idea. Also, mingling state and federal funds with these donations should be investigated as well. Contacting your California congress member about your taxes going to support this kind of nonsense if you live in California is a good place to start.

The fact that some science based medicine practitioners are not communicative is not the fault of science based medicine, it is the fault of those practitioners, but yes, we do need to be more proactive towards people that pursue peudo-medical solutions. It won't make you any friends, though. A friend of mine has a little local paid ad service and he regularly allows ads from other friends who advertise the whole spectrum of pseudo-medicine, but he won't allow me to run ads that debunk pseudo-medicine, citing the controversy that would result for him. I think it is mainly because, he too, is a believer. He suggested a juice fasting book to me and said I just didn't want to face the unpleasantness of fasting when I told him it was bull$hit. He's right to an extent, I really don't want to face the unpleasantness of starving myself by consuming just vegetable juice for one or two weeks, especially since it has no positive effects on one's body other than dramatic although temporary weight loss.

@ Eric #9: good point. I have wondered this as well. I suspect the accreditation folk look more at a school meeting the requirements of what they want taught and turn a blind eye to the rest . I don't know if there's a "things you can't teach and get accreditation list" out there, but there ought to be.

What really upsets me is that as the pseudoscience gets embedded over time, the physicians being graduated--unless they have a solid background in science prior to medical school--are going to take all this pseudoscience at the same level of truth as their lectures on anatomy, physiology and pathophysiology. That is not good. Not good at all.

"Is this the shape of medicine to come?"

Can it get much worse than mainstream medical quackery?

Bioinformatics analysis links type 1 diabetes to vaccines contaminated with animal proteins and autoreactive T cells express skin homing receptors consistent with injected vaccines as causal agent
https://www.researchgate.net/publication/319592904_Bioinformatics_analy…

Oddly enough, I just saw an ad here at RI for "relaxation, meditation" as tools in " your arsenal" and clicked it in order to see which woo-fraught institution was advertising its wares and lo! and behold! it was
the AIRFORCE. trying to get health care professionals.

Because I live in an area with money ( mostly) I notice how much regular doctors ( MDs. DOs) as well as DCs advertise all the usual woo ( acupuncture etc) as well as newer ( possibly SB) options like
lasers.
Is this just a way to make potential clients feel that their so-called individual needs will be addressed or a way to earn more?

Heh. Vinu cites an article he wrote himself, that contains references to articles he wrote him self, that contains references to articles he wrote himself, that contains references to articles he wrote himself... and there I grew tired of the exercise, but it's Vinu all the way down.

When you cite your own work more than all other people cite your work, I would think professional help may be indicated.

Funny - the only person he ever cites is himself.....

Oh, come on, Johnny. How is Vinu supposed to gain any credibility unless he's referenced in other articles? So by referencing himself in more articles he's written and then repeating it ad nauseum , the impact factor on his articles goes WAY up...or at least rises above zero.

@Vinu: when no reputable person (outside of yourself, for all I know you are reputable in other parts of your life) references your writings, maybe you should take a look at the reason.

MJD: " In a Forbes article titled, “The Largest U.S. Charities for 2016” a quick calculation indicates ~ 7 billion dollars donated to medical organizations that are predominantly science-based."

And? Why do you care about this? You don't even care about science.

the whole person, the whole person, the whole person... magic, wishful thinking, wooly bullshit... the whole person, the whole person.. blah de bah.. behhhe, sheep noise, behhhe.. gobble, gobble.. grovel, grovel.. GI'Z THE BLOODY MONEY!!!

Is this just a way to make potential clients feel that their so-called individual needs will be addressed or a way to earn more?

These options are not mutually exclusive. It's probably both: a floor topping and a dessert wax.

@ #14 Denice Walter.

I suspect it is both revenue enhancement and virtue signalling of some sort. I first encountered the "revenue enhancement" term in connection to use of certain devices and procedures related to some surgeries I was checking on. The links were to sites directed to hospitals and physicians. Sort of chips away at one's faith in the profession.

PGP (#17) writes,

And? Why do you care about this? You don’t even care about science.

MJD says,

I knew you'd be the first minion to initiate a conversation with a personal question. :-)

For the record, I care about science.

For example, I think vinu arumugham (#13) is a creative and well-respected vaccine-safety-advocate who is science-based.

A bit off-topic but of great concern because of the misleading post above about $7 billion going to science-based medical organizations.

Who says they are science-based? You? The 501 (c) 3 structure for charities in the US is highly porous and has almost no meaningful oversight. I suspect there are many, many fake charities and science-y-sounding front groups set up by supplement manufacturers and vitamin/quackery hustlers who have figured out either how to get phony IRS charity status or qualify for it under even more porous state charity laws as a tax dodge for their profits.

The house organ publications and "research" entities I've seen at some of these quackpot web sites strongly suggest they are gaming the system in some very sophisticated ways to evade financial oversight and confuse the gullible about their wonderfully magnanimous efforts to advance public health and conduct legitimate research--all the way to the bank.

"She was cured — and became a lifelong advocate of homeopathy and other alternative healing methods to complement conventional medicine. Her husband, Henry — the billionaire co-founder of Broadcom, the Irvine semiconductor maker — says he was initially skeptical but found the integrative health approach helped him easily shake off colds and flus and kept their children healthy without antibiotics."

As emphasised, Mrs S was not 'cured' of anything by homeopathy - and neither were their children spared 'antibiotics', which of course have no effect on viruses.

Surely it shouldn't be possible for a billionaire to influence the progress of medicine in the US in this way? Surely he would be laughed out of the consulting room? Whatever next? A billionaire with bizarre ideas as President? Surely not.

Lots of acupuncturist were put in jail before Dr Lok Yee Kung in 1973. It was so unfair . It was an unhill battle fought in Nevada. Finally Dr Lok Yee Kung and his supporters won the decisiive battle. Since than Acupunctuirist recognized. Many states soon follow to open up and recognized Acupuncturists as health professionals. Lots of evidence shows Acupuncture works and it is matter. The patients became their own judge.

"Oh, Travis, you’re several years behind the times."

Wrong again, duck.

Then again, it's not really at all surprising.

"Oh, Travis, you’re several years behind the times."

Wrong again, duck.

Then again, it's not really at all surprising...

"Oh, Travis, you’re several years behind the times"

Wrong person yet again, oh duck. It's really not surprising; not in the least bit.

It must so terrible being such a paranoid quack.

Heads up for Orac: Check the spam filter, and tell other ScienceBloggers to do the same. The disappearing post issue is back.

For the record, I care about science.

For example, I think vinu arumugham (#13) is a creative and well-respected vaccine-safety-advocate who is science-based.

MJD,

That would be your own version of science.

This inquiring mind here want to know how your version of science is in accordance with:

1-: Scientists' definition of science?

2-: Philosophers of science definition of science?

Alain

"Interdisciplinary" in this context also really rubs me wrong. Which disciplines are being combined?

And what will happen if the research shows these other methods don't work?

Perhaps MJD has a point, and I may have been a bit harsh in my response to Vinu.

Vinu was complaining about medical quackery, and, unlike many commenters, offered up a prime example of quackery. He pointed us to a quack paper, written by a quack, full of quack ideas.

I appreciate when people provide examples, references, and citations, and wish to encourage such behavior.

I do disagree, however, that Vinu is 'science based', and believe that MJD's endorsement of those ideas proves PGP's point quite nicely.

I like when universities accept money to promote blatant quackery, otherwise people are unable to judge how corrupt they are.

MJD: "For the record, I care about science.
For example, I think vinu arumugham (#13) is a creative and well-respected vaccine-safety-advocate who is science-based."

How can you not see how contradictory those sentences are? As others have pointed out, Vinu's got nothing. His so-called research is pulled, whole cloth, out of his rear end. So are your 'theories.' You wouldn't know science or writing skills if they BIT you.

I, too, laughed out loud when I read MJD's comment.

Thank you for writing on this. Any ideas on getting my university held accountable for such nonsense?
https://ufhealth.org/integrative-medicine/integrative-medicine-consulta…
http://smallanimal.vethospital.ufl.edu/clinical-services/integrative-me…

PGP (#24) says,

Vinu’s got nothing.

MJD says,

Mathematics was stagnant before the initial conceptualization of zero (e.g., nothing) was discovered.

Therefore, nothing can lead into something amazing.

Keep up the outstanding work Vinu (#13).

What a long article to say UCI got a lot of money and I'm jealous. The Samuelis can do whatever they want with their money

Listen and become one of Orac's minions.

https://www.youtube.com/watch?v=8HqyEHqEYho

The only time mjd seems to care about science is when he needs to look its spelling up in the dictionary. The rest of the time he doesn't think about it.

Mathematics was stagnant before the initial conceptualization of zero (e.g., nothing) was discovered.

Well no, it wasn't. Apparently you are as ignorant of mathematics as you are science. I'd say you should take some of my classes but I wouldn't be able to tolerate your dishonesty.

Obviously, homeopathy is a bunch of bs. However, in the "origin myth" she talks about taking homeopathic aconite for a cold, and mentions that it's related to buttercup. Buttercups are pretty, right? What she took (suggesting there were theoretically any molecules of it in the preparation to begin with) is wolf's bane. It's also known as the queen of poisons. I will never understand how these people can be terrified of vaccine adjudivants, but will willingly take poison.

Mathematics was stagnant before the initial conceptualization of zero (e.g., nothing) was discovered.

Well no, it wasn't. Apparently your denial of science extends to unfamiliarity of mathematics.

MJD,

Zero in math does not equal nothing. Zero is a discreet point on a number line. Because a number line is infinitely long any point maybe considered the zero point.

When we get to real life yes, zero has taken on the meaning of nothing in a material sense.

Not to mention that the ancient Egyptians, who had a concept of zero, would beg to differ. They left us the pyramids as proof.

MJD: Unsurprisingly, you know about as much about math as you do everything else. I hope you didn't pay for that 'education.'

I just want to know what this purported "stagnation" is supposed to comprise. Coordinates are enough of a nuisance as it is.

Therefore, nothing can lead into something amazing.

Um, no.

Add or subtract nothing to something, you don't get anything more or anything less - you aren't lead anywhere.
Start with nothing, multiply or divide it by something, and you lose everything. Despite popular belief, deux fois rien ('twice nothing') is still nothing.
Take something, pull it up to the power of nothing, and you go back to step one.
In the rare case when you start with nothing and put it to the power of nothing, you end up staring at oneself. It's a bit navel-gazing.
Have something, divide it by nothing, and now you are contemplating not infinity, but insanity.
And despite your best wishes, it doesn't get better when nothing is applied to imaginary numbers.

Throughout history the rich have patronized their favorites causes. Sometimes society wins like when Carnegie funded libraries. Unfortunately it can also lead to legitimization of quackery such as this.

Mathematics was stagnant before the initial conceptualization of zero (e.g., nothing) was discovered.

Well no, as others have pointed out, that is not at all true. But I'm not sure whether you mean the concept of zero as (roughly) "no amount" or its use as a place holder for large number. Symbols in cuneiform exist in numerals that play the same role as 0 in our numerals like 640002.

Either way, it's clear you don't have any understanding of the issue, which is consistent with your lack of understanding of science and the related statistical issues. I'd suggest you should study to catch up, but you've shown no interest in learning anything, so that won't work.

And if you subtract something from nothing, you are now either in debt or in the basement.

Perhaps MJD should review Billy Preston's research on the subject.

https://youtu.be/G_DV54ddNHE

I agree more with #6 darwinslapdog. A lot of this reflects MSM failures, often hubristic and massively profitable. Failures to achieve, retain, extend, parse out, or at least accurately explain in many areas, often old. You guys don't even have the vitamin C and D stories remotely correct.

However manifold the faults of various integrative practices, it is the ongoing failures of medicine that largely have brought this about. Perhaps analogous to "those who fail to learn history are doomed to repeat it".

The cynical parts of me certainly worry about the medical versions of Willie Sutton going where the money is, as well as MSM exploitation of charlatans to establish even more repressive Medical Authority and exploitation of the public, again.

Wow, with PRN here, we've got almost the full cadre of armchair, rear-based scientists. I wonder if NWO or Thingy want to chime in.

oh good lord, that is my alma mater. Some anteaters died at this news. Zot. Sigh. I am appalled. Just appalled.

I have to add that this does not surprise me about Orange Co California. There is are a reason Bob Sears has his practice there and that is pretty much antivax central. A lot of OCers are completely ignorant of science and rational thinking. I grew up there. I moved north for a reason!

Turf wars!!! Science have been killing off people for a few decades now. LMFAO. How do you justify that? Moron!!

I misspoke. Evidently we were missing a Fendlesworth chimp.

Kathy: I thought the creators of BC were hard-core rightwingers and allergic to facts.

Have any academic medical centers cashed in yet on health woo for members of the armed forces? Big bucks await those who can take battlefield acupuncture to the next level.

https://www.facebook.com/photo.php?fbid=1433197313382128&set=p.14331973…

dean (#42) writes,

Apparently your denial of science extends to unfamiliarity of mathematics.

MJD says,

Maybe you can add this to your teachings.

https://www.livescience.com/27853-who-invented-zero.html

Provide a brief summary of this article dean and I'll grade it with total objectivity.

Alternative medicine: Deadly for cancer patients

oracknows — Mon, 21 Aug 2017 01:14:20 +0000

Alternative medicine: Deadly for cancer patients

Alternative medicine, by definition, consists of medicine that either has not been shown to work or has been shown not to work. To paraphrase an old adage yet again, medicine that has been shown to work with an acceptable risk-benefit ceases to be "alternative" and becomes simply "medicine."

Unlike the case for many conditions commonly treated with alternative medicine, whether or not a treatment works against cancer is determined by its impact on the hardest of "hard" endpoints: Survival. A patient either survives his cancer or he does not. Even the "softer" endpoints used to assess the effectiveness of cancer treatments tend to be much harder than for most other diseases, such as progression-free survival (the cancer either progresses after treatment or it does not) or recurrence-free survival (a cancer either recurs after treatment eliminates it, or it doesn't). Yes, although there are lots of other aspects of cancer treatment to be assessed, such as quality of life and adverse reactions, at the very heart of evaluating any treatment for a specific cancer are the questions: Does the therapy save the lives of cancer patients? Does it prolong survival, and, if it does, by how much and at what cost?

One might reasonably predict that, for alternative medicine and any given cancer, the answer to both questions will be no. However, the question is much harder to study than one might guess if you don't do cancer research yourself. For one thing, it is unethical to do a randomized, controlled clinical trial of a treatment with no evidence of benefit. So, except for very uncommon situations (e.g., the Gonzalez protocol, which was tested in a clinical trial against pancreatic cancer and failed miserably), leaving Nicholas Gonzalez to make all sorts of excuses, we have to use other methods to investigate the effect of alternative medicine use on survival in cancer patients. Yes, anecdotes like that of Michaela Jakubczyk-Eckert, who died a horrible potentially preventable death from breast cancer because she chose the quackery of Ryke Geerd Hamer’s German New Medicine and stopped her neoadjuvant chemotherapy, which allowed the tumor to grow back bigger and deadlier than ever, are powerful and very likely representative of what happens, but this is science-based medicine. What are the actual numbers. Yes, I've seen at least a dozen women like Ms. Jakubczyk-Eckert through my career, but what is the effect of choosing alternative medicine beyond my clinical experience and in cancers that I personally do not treat?

Such were the thoughts going through my mind as I was made aware through social media of a study published online ahead of print in the Journal of the National Cancer Institute by Skyler et al, entitled "Use of Alternative Medicine for Cancer and Its Impact on Survival." In it, Skyler B. Johnson, Henry S. Park, Cary P. Gross, James B. Yu, all from the Department of Therapeutic Radiation (basically radiation oncology) at Yale, seek to answer the question: What is the effect of choosing alternative medicine as the primary treatment for a potentially curable cancer on a cancer patient's chance of surviving his or her disease?

The newest study showing that alternative medicine kills cancer patients

The latest study, by Skylar et al, is a good demonstration of how difficult it is to study alternative medicine use in cancer patients. I'll show you why in a moment. First, however, the authors introduce why it is so important to study this:

Delay or refusal of conventional cancer treatment (CCT), when done in favor of alternative medicine (AM), may have serious survival implications for cancer patients (1–7). However, there is limited research evaluating the use and effectiveness of AM, partly due to data scarcity or patient hesitance to disclose nonmedical therapy to their providers (8,9). To address this knowledge gap, we used the four most prevalent cancers (breast, prostate, lung, and colorectal) in the United States (10) from the National Cancer Database (NCDB) between 2004 and 2013 to identify the factors associated with AM selection and compared survival outcomes between AM and CCT.

Yes, there is a paucity of studies evaluating the use of alternative medicine in cancer. (I will cite some of the other studies that exist after I discuss this one.) The reason is clear. It's hard, and data are lacking. This brings me to the National Cancer Database.

There are two very large databases in the US that are commonly mined for cancer outcomes. One, of course, is the Surveillance, Epidemiology, and End Results (SEER) database, which is maintained by the National Cancer Institute. The program began in 1973 and consists of cancer registries all over the country that enter data regarding cancer outcomes in a standardized format, which includes patient demographics, primary tumor site, tumor morphology and stage at diagnosis, first course of treatment, and follow-up for vital status. Mortality and patient survival are tracked, with the mortality data coming from the National Center for Health Statistics and population data coming periodically from the Census Bureau. As large as it is, though, because of many gaps in coverage SEER only reports cancer outcomes for 28% of the US population. Still, it is a large database that's been around for 45 years. However, working with it in collaboration in the past, I've found that it has notable oddities and omissions. Often it is behind the times in tracking important variables, such as HER2 status in breast cancer, which SEER didn't begin tracking until 2011 or so, even though HER2 status had been used for at least a decade before that.

That's probably why the authors chose the National Cancer Database, which is a joint project of the American College of Surgeons and the American Cancer Society. It is a clinical oncology database sourced from hospital registry data collected by the more than 1,500 facilities accredited by the American College of Surgeons Commission on Cancer (CoC). Data cover more than 70% of newly diagnosed cancer cases nationwide and are used to develop quality improvement initiatives and set quality standards for cancer care in many hospitals across the US.

Now, imagine that you want to look at the effect of alternative medicine use on cancer mortality, and you had access to a large database like this. How would you go about doing it? There are a lot of things you have to consider. First, you would want to look at potentially curable cancers, because you want to find out if patients with curable cancers who choose alternative medicine die at a much higher rate than those who use conventional therapy. Thus, you have to exclude patients who had metastatic disease at the time of diagnosis. Another important thing you have to do is to choose cancers that have a reasonable rate of cure using conventional therapy. Choosing pancreatic cancer, for instance, wouldn't make much sense, since the vast majority of pancreatic cancer patients, even those without metastatic disease at diagnosis, die of their disease. Even though we know from the Gonzalez trial that patients with pancreatic cancer still do much worse, dying faster and suffering more, than those treated with conventional medicine, such a difference would be unlikely to show up in a database study like this. So the authors chose four common cancers, nonmetastatic breast, prostate, lung, or colorectal cancer.

Similarly, how do you identify patients in the database who underwent alternative medicine treatment rather than conventional therapy? This is a question that is not as easy to answer as it sounds. For one thing, many databases don't include that information. One statewide database with which I worked, for instance, didn't even have a field for alternative medicine (or even "complementary and alternative medicine"), even though it had over 750 elements tracked for each patient. This is almost certainly the reason the SEER database was not used for this study.

Fortunately, the NCDB has data fields that can help:

Patients who underwent AM were identified as those coded as “other-unproven: cancer treatments administered by nonmedical personnel” and who also did not receive CCT, defined as chemotherapy, radiotherapy, surgery, and/or hormone therapy. Patients with metastatic disease at diagnosis, stage IV disease based on the American Joint Commission on Cancer (AJCC) staging system (11), receipt of upfront treatment with palliative intent, and unknown treatment status or clinical or demographic characteristics were excluded.

The authors identified only 280 patients who fit the criteria, and noted that patients in the alternative medicine group were likely to be younger, female, and have a lower Charlson-Deyo Comorbidity Score (CDCS, a measure of preexisting comorbidities or of how "sick" the patient is at the time of diagnosis). In multivariate analyses controlling for clinical and demographic factors, the authors found that patients undergoing alternative cancer treatments were more likely to have breast cancer, higher education, Intermountain West or Pacific regions of residence, stage 2 or 3 disease, and a lower CDCS. All of this jibes with the usual impression that patients who choose alternative cancer cures tend to be of higher socioeconomic status and education, as well as healthier than average.

So what were the results? Not surprisingly, the risk of death was higher for three out of the four cancers. Overall, the hazard ratio (HR) for death was 2.5 (95% confidence interval [CI] 1.88 to 3.27); 5.68 for breast cancer (CI 3.22 to 10.04); 2.17 for lung cancer (CI 1.42 to 3.32); and 4.57 for colorectal cancer (CI 1.66 to 12.61). The differences observed were not significant for prostate cancer, likely because the survival with conventional therapy was so high to begin with. Prostate cancer tends to have a long natural course, and in this study numbers were small and follow-up too short.

As the cliché goes, a picture is worth a thousand words. Here are the survival curves (click to embiggen):

Survival curves for (A) all patients, (B) breast, (C) prostate, (D) lung, and (E) colorectal cancers.

Obviously, this study has a lot of limitations. For one thing, the use of conventional medicine is likely to have been under-ascertained (i.e., undercounted or incompletely identified). After all, as I've discussed with other patients, some of those who choose alternative medicine to treat their cancer ultimately realize that it's not working and come back to conventional medicine. Such patients could also have gone to different institutions that aren't covered by the NCDB. However, if such a bias occurred, it would have tended to make the differences in survival between the alternative medicine group and the conventional treatment group smaller, not larger, meaning that if such a bias occurred in this study the harm caused by choosing alternative medicine is likely to be significantly worse than reported.

Other studies

Obviously, this study by Skyler et al is just one study, and the most recent. There are other studies showing similar results, but unfortunately they are relatively few. For example, the first study I remember encountering after I had started blogging about medicine and alternative medicine that addressed the question of the effect of alternative medicine on cancer survival was published in 2006 in the American Journal of Surgery by Chang et al. This study used a different methodology to study the effect of alternative medicine on breast cancer survival. Specifically, the authors did a chart review of patients who refused or delayed recommended treatment of their breast cancer to pursue alternative therapies and compared their survival to that expected in patients with disease of their type and stage.

Even eleven years later, this study remains interesting to me because it's the first one that I can recall encountering that explicitly looked at the outcomes of patients who chose "alternative" therapies as their primary treatment. There are lots of studies out there looking at alternative medicine use in cancer patients, but these mainly look at patients who use it in addition to conventional therapy (i.e., as "complementary" therapy). This study does have one strength, too, compared to most such studies, in that the patient population comes from a community practice, not an academic medical center. Consequently, it can be viewed as more representative of the "real" world situation than many studies done in academic medical centers, where the patient population may be self-selected as people as either motivated enough to seek out tertiary care centers or sick enough that their community surgeons and oncologists refer them.

One thing that was also rather fascinating about the study was the variety of alternative therapies that the study population opted for, including coral calcium, coenzyme Q₁₀, herbs, dietary therapy, high dose vitamins, mushrooms, chelation therapy, poison hemlock (I'm not kidding), and a variety of unspecified therapies. Because of the sheer variety of therapies used and the low number of patients using each individual therapy, it was not possible to "identify particular alternative modalities that were particularly ineffective," as the authors put it.

Who says scientific papers don't occasionally have sarcasm in them?

Basically, the study identified 47 breast cancer patients who opted for alternative therapy, but follow-up information was only available for 33. These were divided into patients who refused surgical treatment altogether; patients who delayed appropriate surgical treatment to pursue alternative treatments; patients who refused adequate sampling of the lymph nodes; patients who refused procedures to ensure adequate local control (additional surgery and/or radiation therapy); and patients who refused chemotherapy. I'm going to concentrate first on patients who refused or delayed surgery, for the simple reason that surgery is what is curative for breast cancer and differences in survival due to adjuvant therapy can be as low as the single digit percentages, depending upon the stage of the cancer.

Of patients who refused surgery, none of the six patients identified were Stage IV (metastatic disease) at initial diagnosis. However, five out of these six patients who returned to the surgeons doing the study had progressed to stage IV, with a median time of follow-up of 14 months, with one death within a year. That's pretty amazing, given that two of these patients were Stage I upon initial presentation. There were also five patients identified who initially refused surgery in favor of alternative medicine, all of whom were Stage II or III. The median time between diagnosis and surgery was 37 months. All five demonstrated progression of their disease, with three progressing to Stage IV disease and one of these dying of metastatic disease. Thus, 10/11 patients who refused surgery experienced significant disease progression, with 8/11 of these progressing to stage IV disease, which is incurable, and 2/11 dying within the short time frame of the study.

Not surprisingly, patients who declined chemotherapy or hormonal therapy fared better because, as I've explained before, for operable breast cancer, the single most efficacious intervention is surgery, and it is not that uncommon for patients with even fairly large tumors to be "cured" with surgery alone. Indeed, the benefits of chemotherapy are fairly modest in many cases, particularly those with early stage disease. In a small number of patients, it was difficult to quantify the effect of choosing alternative medicine over conventional chemotherapy, but the authors were able to estimate that the relative risk of death in 10 years in those who refused chemotherapy was 1.54; i.e., a 54% higher chance of dying within 10 years compared to those treated with conventional medicine.

A few years later, there was followup study published in the Annals of Surgical Oncology examining the same question, this time with 61 patients to study and ten year follow-ups available. Again, a retrospective chart review was performed, with telephone interviews conducted when possible. Again, authors calculated an estimated expected 10-year survival rate and/or 10-year relapse rate of each patient if they used recommended therapy and compared it to what was actually observed in the alternative medicine group. For patients who delayed surgery, the prognosis at initial presentation was compared with the prognosis based upon return presentation.

The results were just as grim. As before, patients were divided into two groups, those who refused or delayed surgery (n=26) and those who refused adjuvant therapy, such as radiation and chemotherapy (n=35). In the group that refused surgery, 96.2% of patients experienced progression of their cancer, and 50% died of their disease. The mean stage at diagnosis in this group was II. The mean stage when patients in this group re-presented after primary treatment with alternative medicine was IV, which is, again, incurable. In the group refusing adjuvant therapy, progression occurred in 86.2% of those in the ASG, and 20% died of disease. Overall, in the surgery group, the expected mean 10-year survival calculated for those omitting surgery was 69.5%. In comparison the actual observed 10-year survival for these patients was 36.4% at a median follow-up of 33 months. For the patients who delayed surgery to undertake alternative treatments, the figures were 73.6% expected 10-year survival versus a 60% observed 10-year survival.

The authors also noted that, for the patients refusing adjuvant chemotherapy or hormonal therapy, the median tumor size at presentation was 2 cm and that the mean calculated 10-year relapse-free survival at initial presentation was 59.2%. Using a commonly utilized online tool to calculate the benefit of chemotherapy based on aggregated clinical trials, the authors noted that, had recommended adjuvant therapy been followed, relapse-free survival would have improved to 74.3%. However, the observed relapse-free survival was only 13.8%. They also noted that, although the patients' intent was to avoid traditional therapy, ultimately, 6 patients in this group started endocrine therapy to control breast cancer recurrence, and 21 had salvage chemotherapy to attempt to control recurrent disease.

Here's a summary of the patients who refused surgery (AWD = "alive with disease; NED = "no evaluable disease," or basically no detectable disease) [click to embiggen]:

You get the idea. This is far worse than what would be expected in patients undergoing standard treatment. As before, this study shows that refusing surgery results in the worst outcomes, which is something that has been known for a long time. For instance, this 2005 study utilizing data from the Geneva Cancer Registry. This study did not look at alternative treatments but rather at just the refusal of patients to undergo surgery for their breast cancer. The results were very similar to what the other studies I discussed showed (click to embiggen):

Another study, this time published in the World Journal of Surgery in 2012 examined women in the Northern Alberta Health Region who declined recommended primary standard treatments and included 185 women who refused standard treatment, resulting in a median delay in instituting effective treatment of up to 101 months. The survival graphs look depressingly the same (click to embiggen):

Both Scott Gavura and I discussed this study in detail when it was published. Of note, quoth the authors:

Our data showed that almost all the patients who initially refused treatment progressed to a higher stage on later presentation at the cancer center. The majority of the patients (57%) in our series initially chose CAM as the primary treatment instead of surgery. Those who had chosen CAM had disease progression with particularly poor disease-specific survival when compared to those who received standard treatment.

Finally, a recent study from Malaysia found a strong correlation between CAM use and delays in diagnosis and treatment in breast cancer patients, although this study also suggested that the reason many women use alternative medicine is because they don't have good access to high quality medical care.

As an aside, I will note that one tendency in some of these studies that drives me up a wall is the authors' tendency to refer to alternative medicine used as primary treatment for a cancer "CAM." It is not CAM. CAM, by definition (you know, the "complementary" in "complementary and alternative medicine") is not used as primary treatment for cancer or anything else. If an unproven or ineffective treatment "outside the mainstream" is being used to treat a cancer, it's not CAM. It's alternative medicine. I don't like the term "CAM," because it was designed as a means to slip unproven treatments into conventional medicine by adding them to conventional therapy when they are unnecessary, but it is the language we have.

Finally, compare the curves above to this curve, which I use frequently. This is from a famous study from 1962 by Bloom and Richardson that calculated the survival of patients with untreated breast cancer. It was carried out long before mammographic screening became the norm, which means that the cancers were detected by palpation and other clinical signs. The point is that survival in untreated breast cancer is longer than you might guess:

Survival of untreated breast cancer.

The authors compared their data with previous studies from the 1920s and 1930s and found that their curve lined up very closely with previous data on expected survival in a group of women, all comers, with untreated breast cancer. Basically, the median survival was 2.7 years. 18% of the patients survived five years; 3.6% survived 10 years; and 0.8% survived 15 years. Of note, it was 19 years before all 250 patients in the study were dead. Notice how the curves above for women choosing alternative medicine over conventional therapy get closer to resembling the curve from the Bloom-Richardson paper. The don't quite get there because we're in a different era, where breast cancers are usually discovered by mammography and were much smaller at diagnosis than in the patients in that paper.

But what about CAM?

I made a point of expressing annoyance over how some authors throw around the term "CAM" when they mean "alternative medicine." This brings up a question. Does CAM use affect cancer survival? Again, there is a paucity of evidence. We might expect that it probably doesn't, at least when used as the strict, "integrative medicine"-approved definition of unconventional therapies used in addition to conventional medicine is followed. Again, there aren't a lot of studies, and most of those seek to demonstrate that a specific set of CAM involving "mind-body" or psychotherapeutic interventions actually improve survival in cancer patients. Unfortunately, they do not, as has been discussed here before.

Other studies have looked at CAM in cancer patients, with mixed and mostly unfavorable results. For example, a study from Norway found a modest negative effect of CAM use in cancers, with a higher death rate over the study period (79% versus 65%), with a hazard ratio for death of 1.30 that just missed statistical significance, leading the authors to conclude that the use of alternative medicine "seems to predict a shorter survival from cancer" and that "the effect appears predominantly in patients with a good performance status" (i.e., the healthiest patients). In addition, a Korean study of terminally ill cancer patients assessed the use of CAM on survival and health-related quality of life (HRQOL), finding that CAM did not provide a survival benefit but did negatively impact various measures that go into calculating HRQOL.

Finally, a large prospective trial known as the Health Eating, Activity, and Lifestyle (HEAL) Study examined 707 patients with stage I to IIIA breast cancer. No associations between CAM use and breast cancer-specific or total mortality were observed. Another study, a pooled analysis from 2012 of four studies conducted in Hawaii in 1994–2003 and linked to the Hawaii Tumor Registry to obtain long-term follow-up information, also found no overall link between CAM use and breast cancer mortality, but did find links between the use of energy medicine use and death as well as finding that Filipino women who used CAM were at a higher risk of death. Those results might have been spurious, but I note that the data did actually show a trend towards a correlation between overall CAM use and death that just didn't reach statistical significance.

What's probably most problematic about CAM is not so much that using it with conventional medicine harms patients. Rather, it's the mindset that leads to strong associations between CAM use and, for instance, refusing adjuvant chemotherapy, as I have discussed in detail before and noted by way of citing a Malaysian study in which CAM use was associated with delays in diagnosis.

The bottom line: Alternative medicine kills cancer patients

There is a surprising paucity of evidence regarding whether the use of CAM in addition to conventional therapy has an adverse effect on cancer survival, but the evidence that we do have is very clear on at least one thing: CAM does not improve cancer survival. Less clear is whether CAM has an adverse effect on cancer survival. There the evidence is conflicting, but there is plenty of reason to be concerned about the use of CAM in cancer, given correlations between CAM use and delays in diagnosis and refusal of adjuvant chemotherapy.

Regardless of what you think of the phenomenon of "integrative" medicine or CAM, there is one thing that the existing medical literature, as thin as it is, indicates, and it's that alternative medicine kills cancer patients. It is basically no different than refusing treatment altogether and much more expensive and troublesome. Given that there is no good evidence of specific anticancer effects from close to all (if not all) alternative medicines, there was never any reason to suspect that the answer would be otherwise. Moreover, as strongly suggested by the Gonzalez trial, alternative medicine use as a primary therapy for cancer often means that patients aren't receiving effective, science-based supportive care for their cancers, resulting in inadequate (or nonexistent) relief of cancer-related symptoms and unnecessary suffering. Use of alternative medicine alone to treat cancer is likely to be a death sentence, or at least to cause delays that make ultimate cancer treatment with conventional medicine more difficult and less likely to be successful.

oracknows Sun, 08/20/2017 - 21:14

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http://www.radiotimes.com/news/2017-08-20/bbc-comedy-ill-behaviour-has-…

A paper published in a high impact factor journal has proposed active surveillance for low risk breast cancer:
http://www.nejm.org/doi/full/10.1056/NEJMp1703787
Maybe they could go further and propose CAM in the meantime ;-)

Sadly, not an unexpected result. Who knew not treating your cancer leads to it not getting any better? I doubt it's going to convince anyone already into woo, but maybe studies like this could be used to point out how CAM-friendly hospitals are endangering patients.

Also, I think you accidentally put the same graph up twice. The one that comes after "Here’s a summary of the patients who refused surgery" should be a different one, right?

@ J
"you accidentally put the same graph up twice"
One is for breast cancer mortality and the other for overall mortality. Not surprisingly they are very similar.

It's chilling to look at the graphs.

I knew that high socioeconomic class was correlated with increased risk for breast cancer, but not with worse outcomes.

This might be a hard question to answer Orac, but what percentage of cancer quacks do you think truly believe their treatments work versus those who are just in it for the money and prestige?

@ Panacea
I would predict that, in the higher socioeconomic class, you will observe two different groups: women who adhere to mammography screening, with higher breast cancer rates, and CAM users, who don't and have worse prognosis.

Panacea@3: This study is probably not statistically powerful enough to prove a causal mechanism for that, but it's plausible. Bear in mind that most CAM practitioners do not accept insurance, because the insurance companies won't pay for most unproven treatments. So patients who seek out CAM practitioners expect to pay cash. Who has the means to do so? People with high socioeconomic status, of course.

@ Eric Lund
This is the explanation for the use of CAM among rich women, but not for higher incidence of BC.

Maybe they could go further and propose CAM in the meantime ?

Why?

@DC: Certain environmental factors, among them diet, are associated with increased risk of certain cancers. Woo-prone types frequently carry this too far, claiming that you can eliminate your cancer risk by eating certain foods (not true) or even cure your cancer by eating certain foods (most definitely not true). And some of those environmental factors, including diet, are associated with high socioeconomic status.

In the case of breast cancer in particular, the risk increases with age. So part of that correlation is that women of lower socioeconomic status are more likely to die of something else before they get breast cancer.

There's a new BBC miniseries called Ill Behaviour about friends of a cancer patient who try to get him to do chemo rather than homeopathy and coffee enemas.

@ Eric
Usually the incidence are age adjusted.
For higher socioeconomic status, factors likely to increase age-adjusted incidence of BC are delayed pregnancy and mammography screening. For lower economic status, obesity.

@ Science Mom
The problem with CAM is the delay in real treatment, isn't it?

Although I think a lot of AM has poor results, I think this does a disservice to AM that works. To me, "AM that works" solves or helps one or more (fatal) problems, where survival requires a series of multimodal steps.

I would include in AM, nonstandard treatments done by legitimate researchers but typically dismissed by clinicians (of a lesser god).

So there is this dr at MSK who uses Hepatic Arterial Infusion on selected, hopeless mCRC patients. Her "terminal" pts typically encounter oncologists' scorn at the mention of HAI, "disproven" in the 1980s/90s and dismissed as obsolete. She has a fantastic record of saves. Is she an AM quack?

In essence, she solves one problem well by AM.

The thing I notice about most AM and MSM (mainstream) failures, is that they fail to solve or combine a series of fatal problems that have already been solved. Like HAI.

The thing I notice about most AM and MSM (mainstream) failures, is that they fail to solve, utilize or combine solutions, for series of fatal problems that have already been solved. Just like HAI, but more broadly.

So there is this dr at MSK who uses Hepatic Arterial Infusion on selected, hopeless mCRC patients. Her “terminal” pts typically encounter oncologists’ scorn at the mention of HAI, “disproven” in the 1980s/90s and dismissed as obsolete. She has a fantastic record of saves.

How are they 'selected', and define 'fantastic'. What's her win/loss record?

The problem with CAM is the delay in real treatment, isn’t it?

That's a problem, sure, along with the fact that CAM doesn't work, and is often very expensive to vulnerable people. Basically, there is no upside.

prn - is this what you're talking about? How is this CAM???

https://www.ncbi.nlm.nih.gov/pubmed/26830685

AM that works

As mentioned in the OP, this is an oxymoron. "Alternative medicine" protocols that have been shown to actually work cease to be "alternative medicine" protocols, and instead become science-based medicine protocols.

Johnny her patients are largely selected against extrahepatic disease, physical condition, and judgement. She reads extra markers and personalizes decisions. The study appears to be in one of Orac's favorite formats, the observational series with historical patients as controls.

Much like a lot of CAM stuff. Again, largely "disproven" 25 years ago and abandoned.

I would include in AM, nonstandard treatments done by legitimate researchers but typically dismissed by clinicians (of a lesser god).

prn,
Therein lie the root of the issue, we got nothing but your words about dismissal of potentially legitimate treatment. Do you have some evidence, on both side of the coin; namely:

dismissal / acceptance

Either way, I'd love to investigate a bit more but one has to start with some evidence first.

Alain

@ Science Mom
The problem with CAM is the delay in real treatment, isn’t it?

Perhaps I misunderstand but it does not follow that CAM should be recommended for active surveillance of some breast cancers. I couldn't get the full text of your citation so don't know if I'm missing something. It doesn't make sense to me to take the bold step of active surveillance and gob up the results with potentially harmful CAM.

@ Science Mom
Maybe you missed the smiley ;-) at the end of the sentence. You missed the irony toward a reputable journal, which selects very drastically the papers it receives, but publishes a paper proposing to DELAY breast cancer treatment.

@ Eric
I think the term AM is problematic in this sense, because it puts together treatments that cannot work and treatments that will work and are under investigation. Science works in the grey zone of knowledge and there are many CAM treatments that are not in this zone: we simply know they cannot work.

That's exactly what played out in the case of my own mother. She refused adjuvant chemotherapy after having surgery for her breast cancer five years ago and went down the rabbit hole of alternative medicine deep enough that when two years later she eventually conceded defeat and went back to conventional cancer treatment the disease had progressed to Stage IV. She eventually passed away a little over a year ago from septic shock due to an infection that her cancer-weakened immune system could no longer fight off.

Yeah, alternative medicine killed my mother. If I managed to get her to follow through with conventional cancer treatment after surgery she might still be alive today and she might have lived to see her grandson grow to be a young man.

@ Daniel Corcos, thanks for clearing that up. Although I don't see why that study is ironic (again didn't see the full text).

My wife chose conventional all the way to the end, but as a Tony Robbins fanatic, she also embraced alternative, mainly diet and juicing- she thought this would go a long way towards preventing recurrence. I knew otherwise but did not tell her. And did not talk to her about a BC stage 3A diagnosis outcome compared to say, 2A. She just needed to that element of control. But she was smart enough to do conventional and got five good, healthy years.

Alain@21
I'm not sure if you would have to have mCRC liver mets to personally poll the oncologists within a several state radius whether they would refill your HAI pump, to find out.

I doubt the average oncologist will openly take shots at MSK but it is a phenomenon. The majority of patients I know get initial AM type discouragement and no support for filling the pump locally such that they have to travel cross country to NYC everytime.

The majority of patients I know...

How do you know these paiients? Are you a health care professional, and if so, what type? Are you a naturopath?

Jeff@ 27: I'm so sorry to hear about your wife. While I don't agree with taking useless treatments, I understand her need for control perfectly. If that's what she needed, I'm glad she got it.

Johnny: great question. I think prn has tipped his hand.

Informed, proactive mCRC patients and families often discuss things amongst themselves to improve their understanding and chances.

I am on the civilian-patient side of the table with limited direct experience with ND, more alt MD interview time. However, I've read a lot of the nutritional and chemistry related stuff, and know some backstories there. My general technical background was very advanced.

I am on the civilian-patient side of the table with limited direct experience with ND, more alt MD interview time.

Dafuk does that even mean? Anyone have any idea?

Sure, patients and families talk, but why are you privy to their discussions? Who pays you, and for what? What technical training do you have?

"civilian":
Many here signed up for paid positions, "soldiers", in the War on Cancer, at one position, level or another.

I didn't. I never even was interested in medical courses or a career. I once accepted an interview from a large pharma's research group but I wasn't interested despite being a fine trip and tour.

Sure, patients and families talk, but why are you privy to their discussions?
I am "them"

What does "them" mean. Are you saying you have cancer? Or someone in your family? What type?

You didn't answer Johnny's question. What technical training do you have?

I'm glad I'm not the only one frustrated by the non-answers to a coupla very simple questions.

Even 'piss off, it's none of your business' would have been more satisfying.

@prn, #33:

Sure, patients and families talk, but why are you privy to their discussions?

I am “them”

How many "patients and families" do you claim to be, and why?

Hmmm. Interesting.

I for one am certainly glad to have discovered the first true viable "Grand Unified Model" of Tumorgenesis. And I did it after having a small part of my brain respected. God inspired me, He is the ultimate healer. Guard your rogues, all who care to be derisive after reading my comment...I might just not share later and your kid will die from your impudence.

If we all hide, maybe the scary man will go away...

All hail Geoffry's pineal gland!

@Rebecca Fisher: got room in your hiding place for me? I'm not sure *what* Geoffry Feinberg is trying to say, but it's sure weird.

I’m not sure *what* Geoffry Feinberg is trying to say, but it’s sure weird.

This is why we can't have nice things, like a “Grand Unified Model” of Tumorgenesis.

I’m not sure *what* Geoffry Feinberg is trying to say

I think he has been over-using his Tillinghast Resonator.

I wonder if God sent Geoffrey a boat to get him out of Houston.

No, Panacea. He sent Joel Osteen on his yacht to hand him a signed copy of his book. (Snark)

LOL! Funniest thing I've read all day . . . .

Q: What do you get when you cross a spambot with an altie?
A: Geoffry Feinberg.

Although I am rather ashamed to be laughing at hurricane jokes
( but I did)
here's something that's not so funny..

Mike Adams, a self-described Texan, is donating 50%** of all sales made Wednesday and Thursday at his 'store' to various groups who will assist flood victims..

So far he's raised 20 000 USD ( of a 50K goal)

** knowing Mike I'm sure that his markup is so high that this doesn't hurt him at all despite what he may say

So sometimes the issue with complementary actions (in addition to conventional medicine) such as modifying diet is that the proof of effectiveness on disease is not absolute, only indicative or plausible. Significant research has been performed in vitro using cancer cells and in vivo in lab animals to demonstrate the effectiveness of certain nutrients such as curcumin on suppressing cancer cell growth. And one could add population studies too as indicative in some cases. Of course, none of these constitute absolute proof of slowing progression of cancer in humans but they are certainly indicative of the possibility. IMHO ridicule is unwarranted for those making a 'Pascal Wager' based on laboratory indications. A personal choice and In most cases the cost is low and side effects minimal.

Naturopathy: When fake doctors cosplay real doctors

oracknows — Tue, 15 Aug 2017 01:10:38 +0000

Naturopathy: When fake doctors cosplay real doctors

Someone yesterday was not very happy with my attitude towards naturopaths, as evidenced in my post yesterday about the death of a young woman named Jade Erick due to intravenous infusion of curcumin by—you guessed it—a naturopath. Amusingly, that someone going by the 'nym of JR said that he or she didn't "like the tone of this article and it’s complete disregard for naturopaths." Well, JR, you're right. I do have a complete disregard for naturopaths because they are quacks who mix a small amount of good advice about diet and exercise with a whole lot of pure quackery (like homeopathy) and sell it to patients as being somehow "natural."

Basically, naturopaths are fake doctors, but they crave the acceptance of real physicians. Whether it's because they really believe that they are physicians or because, deep down, they know they are fake doctors, I don't know. Maybe it's a little of both. Either way, above all their professional organizations strive for legitimacy in the form of being licensed by all 50 states. They even have a goal of having naturopaths licensed in all states by 2025. But it's more than that. In states where they are already licensed, their goal is to expand their scope of practice to come close to that of real physicians.

So I can't believe that I missed this story that was going around a couple of weeks ago from the Denver CBS affiliate about Naturopathic Doctors Illegally Calling Themselves ‘Physicians’:

I can't resist mentioning here that I think that letting naturopaths refer to themselves as "doctors" or "naturopathic doctors" is bad enough, because most people don't make that big a distinction between "doctor" and "physician." Als, their favored abbreviation for their degree of"ND" looks and sounds and awful lot like a real doctor's degree of MD. Be that as it may, things are a bit different in Colorado than in a lot of states that license naturopaths. For one thing, there is a law specifically stating that naturopaths cannot refer to themselves as "physicians." The law came about this way:

The death of Sean Flanagan in 2003 touched off a storm. Ill with cancer, he received treatment from a man who called himself a naturopathic doctor practicing in Wheat Ridge.

Sean’s father David Flanagan told CBS4’S Rick Sallinger three years later about his dismay.

“We’ve got people like Brian O’Connell who can claim to be a doctor and use the word, put it on his scrubs, wear a stethoscope like he’s somebody important,” he said.

Although Flanagan died from cancer, Brian O’Connell’s actions may have sped up his death.

He was sent to prison and legislation was later passed by the state to register naturopathic doctors. In the law one point was made very clear: naturopaths cannot refer to themselves by a key word: “physician.”

I had never heard about this case (at least, I couldn't remember having heard about it); so I did a little Googling. It turns out that O'Connell ran Mountain Area Naturopathic Associates. Consistent with what David Flanagan said in the interview above, in his office O'Connell displayed numerous degrees and certifications claiming he was doctor and a naturopath. In an investigation, the Colorado Medical Board found that O'Connell had no license to practice medicine in Colorado and was not certified as any kind of health care worker. It also turned out that O'Connell's only medical-related "training" had come from a correspondence school in Arkansas called the Herbal Healer academy. As Naturowatch notes, in 2003 the school's proprietor Marijah McCain agreed to a consent judgment under which she paid $10,000 and was barred from disseminating certificates stating that the holder is an "ND, NMD," or similar designation that would indicate that the holder is a doctor or physician.

Naturowatch also notes:

O'Connell told the family that he personally had "cured" many patients suffering from the same type of cancer he had. He also showed them a plastic bag containing an object he claimed was a cancerous tumor removed from a patient and claimed that he had a black salve that would draw cancerous tumors from the body. Flanagan had failed a course of chemotherapy and his cancer was progressing. Also, black salve is not just quackery, but disfiguring quackery. It's a caustic substance derived from plants that literally burns.
The family paid O'Connell $7,400 for "photoluminescence" treatments in which blood was removed from Sean Flanagan's body, exposed to ultraviolet light, and then returned to the body along with a diluted solution of hydrogen peroxide. Both of these, UV blood irradiation and intravenous hydrogen peroxide, are also quackery. Basically, it's UV blood irradiation combined with hydrogen peroxide therapy.
The boy developed a blood infection because O'Connell's wasn't exactly careful about sterile technique.

Also:

O'Connell also injected this hydrogen peroxide solution into a 17-year-old girl, which caused her to go into cardiac arrest. Another patient of O'Connell's had terminal liver cancer and was told by O'Connell that a "black salve" compound would pull the cancer out of his body. Instead it created open, bleeding wounds that continued until his death, prosecutors said.

In other words, even though he didn't have the "ND" degree, O'Connell was a typical naturoquack. Ultimately, he was convicted. In 2006, he pleaded guilty to theft, perjury, criminally negligent homicide, practicing medicine without a license, and 3rd degree assault. As a result, he was sentenced to 13 years in prison, which was a salutary outcome which is all too rare when quacks are prosecuted.

As a result of this case, when Colorado passed a law registering—not licensing—naturopaths, the law made it very clear that naturopaths are not allowed to refer to themselves as physicians. Now, I'm not exactly clear on the difference between licensure and registration, but apparently registration provides for a much less rigorous degree of scrutiny of naturopaths than licensure would. Basically, according to Colorado law, naturopaths who have gone to the top tier naturopathy quack academies, like Bastyr University, and as a result have the "ND" degree can call themselves "doctor" but not physician. All other naturopaths are forbidden from calling themselves "doctor" or "physician." Of course, one wonders why such naturopaths are even allowed to practice, although I suppose that, despite what "NDs" claim, there really isn't any substantive difference that I've ever been able to find in the level of quackery practiced by NDs or non-ND naturopaths. Basically, licensed naturopaths are no safer than any other naturopath.

Be that as it may, even though the law expressly forbids it, naturopaths gonna naturopath:

Larry Sarner and Linda Rosa of the Colorado Citizens for Science and Medicine conducted a survey of websites and claim most naturopathic doctors violate the Colorado Medical Practices Act and State Statutes.

Sarner said, “It would be almost hard not to believe they are medical doctors given their own discussions of it.”

Some naturopathic doctors claim they are licensed. They can’t be. The state of Colorado says they are simply registered, which carries less scrutiny.

Not surprisingly, Roanne Houck, the president of the Colorado Association of Naturopathic Doctors, makes excuses:

“Well, many of the doctors have moved here from other states such as Oregon or Washington,” she said.

They may be called physicians there, but in Colorado, for naturopaths that’s not allowed.

Naturopathic doctors may now also go by “Registered Naturopathic Doctors” in Colorado after new legislation was passed earlier this year.

That's nice. It's still confusing and potentially deceptive, leading patients to think that naturopaths are actually physicians.

Just for yucks, I looked up Houck's practice website, Gunnison Main Street Clinic. I noticed that it offers the usual naturopathic quackery, such as The One Quackery To Rule Them All (homeopathy), "detoxification," acupuncture and traditional Chinese medicine, and something called Ortho-Bionomy®, which is basically a form of osteopathic manipulation that I'd never heard of before.

Of course, at least Colorado doesn't let naturopaths use the term "physician" to describe themselves. Lots of other states, where naturopaths are licensed and not just registered, do let naturopaths use terms like "naturopathic physician," the favored term of organized naturopathy. Naturopaths continue to push for this, because they know that language feeds impressions. If they can win the legal right to be called "naturopathic physicians," chances are that a lot of people won't know the difference between that and real physicians and that legislators will be more likely to expand their scope of practice to reach their Holy Grail, being considered primary care physicians in all 50 states.

oracknows Mon, 08/14/2017 - 21:10

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http://www.naturopathic.org/content.asp?contentid=59

As I mentioned in another thread, I have some business cards that call me an Applied Nutritionist (If you feed me, I'll comment on the food) but I have had a least one person think it was serious. I made up some silly cards with some left-over business card stock

Give me a white coat (CDN$ 20 ) and a stethoscope, not sure of the price but I think I can get one for under CDN$ 50, and I'm in business.

jrkrideau,

Probably I'd be the one close enough for you to come here in a reasonable timeframe to get feed and comment on my food :)

Alain

most people don’t make that big a distinction between “doctor” and “physician.”

As someone who has earned a Ph.D., I have the right to put "Dr." in front of my name, but I almost never do so, and this is a big reason why. To most people "doctor" means "medical doctor", except in contexts where it might mean dentist, veterinarian, or optometrist. The handful of occasions where I do use the title, or other people address me by that title, are within the context of my field, where it is clear that the Ph.D. is meant.

At least one guy I know, who engages in lots of international travel both work- and family-related, has always been careful to avoid revealing both his Ph.D. and his occupation to the airlines. He is afraid someone will see "Dr. [redacted], research physicist" on a passenger manifest and incorrectly assume that he is a physician.

I can see how a layman would mistake a naturopath for a medical doctor. Naturopaths use a fair amount of medical-sounding jargon and talk about treating patients. You need to know a bit about naturopathy and real medicine to spot the difference between the two. Most people who have no background in either subject don't, and of course it's not in the interest of naturopaths to make the distinction in an honest fashion.

This year, the Colorado legislature was disturbed to learn that many registered naturopaths in the state are illegally calling themselves "physician," along with other misleading terms, such as "primary care provider." A number of them claim to have attended "medical school," or to have the same education as MDs, but with a "specialty in natural medicine."

As a result, the sunset bill has an amendment that requires NDs in Colorado to use the title "Registered Naturopathic Doctor" or "RND" in an attempt to reduce the ND/MD confusion. (As an RN, I'm not all that happy with this, though I applaud it as a partial solution.)

What I find much more disturbing are the dangerous practices being offered by Colorado's RNDs. While the "educated" naturopaths obtained regulatory status in part because of the Flanagan case, it is possible today to find RNDs in the state who use the same insane practices as that "traditional naturopath" who was sent to prison.

Heh--I wouldn’t even bother to credit ND’s with giving decent dietary advice. Their diet advice is as wooish as the rest of their bag of woo. It’s a lot of deprivation, esclusions, and utter stupidity like “fat is good for you!” and “calories aren’t all alike”. They jump on the bandwagon of the latest fad, be it gluten, paleo, or coconut oil. No matter how well you supposedly eat, they still pump you full of supplements as well. I also doubt that their exercise advice is any better. Who needs to pay someone to tell you to take a 30-minute walk most days?

FYI - There are real med schools that are teaching real medical classes and procedures to those who desire to treat patients w/o drugs. They are in med school for 4 years and are highly qualified to treat patients. They are also trained to work along with or refer to a medical doctor, if necessary, since they generally do not prescribe drugs. Please do not generalize all
Nautropaths to be like the ones you have described above. Seeking online certifications and then trying to treat patients.
This is why licensing is necessary; to distinguish between the good and really qualified and those that are not.
Please see the ND program at Bastyr University, I have seen what they teach there and am confident that those who graduate from their program will be fantastic doctors.

So if NDs are bogus then how do you explain my naturopathic doctor fixing 2 health issues I've had in the past when MDsy just wanted to push dangerous medications. How do you explain that?

There really isn’t any substantive difference that I’ve ever been able to find in the level of quackery practiced by NDs or non-ND naturopaths.

I'll excuse Orac from the task, but someone should look harder. While the worst practices of the worst Bastyr-degreed NDs may be as risky as those of diploma mill quacks like Brian O'Connell, that's also true of the worst of licensed MDs who have degrees from respectable med schools. In the aggregate, though, there's no comparison between MDs and correspondence school quacks. As weak or even misdirected as 'education' at Bastyr may be, it's hard to believe it would lead to wacko with the same regularity and intensity as the no-real-training-at all naturos. It also seems like the unlicensed naturos pop up more off in the dramatic cases recounted here. like the death of Fikreta Ibrisevic.

Orac has noted that a lot of well-meaning young people are drawn to naturopathy school, as Britt Hermes was, believing it will lead to career in 'legitimate' health-care. They at least would seem to believe they need a training for that that describes itself as "rigorous", and are trying to learn to be 'good' providers who can help patients with something resembling a 'standard of care' – albeit one that is 'alternative' and weakly defined. It strikes me that this must contrast to the sort of person so confident in their idiosyncratic 'natural' gifts as 'natural healers' that they'd hang out a shingle on the basis of nothing but a mail-order diploma, if even that.

While I have always thought natuopathy licensing is a bad idea, I'm at least willing to entertain that letting unlicensed naturopaths continue to have free run is a worse idea. There may be better answers than licensing 'real' NDs, but I'm not sure they're practical politically. The Colorado example illustrates a couple things. One is that no legal approach matters unless there's adequate enforcement. But another, on the less-dim side, is that regulation can take different forms, and the differences matter. NDs want to have licensing come with increased scope of practice, but that doesn't have to be the case. I don't see the point of 'you can't call yourself a "physician", but you can call yourself a "doctor".' How about prohibiting both?

I believe the naturopathy associations open to all who claim the rubric, not just NDs, are vehemently against licensing. Maybe if they're afraid of it, we might want to take their reasons a bit more serlously.

I’ll excuse Orac from the task, but someone should look harder.

You are naive. I've been looking for years and failing to find a substantive difference. I'd be happy for someone else to give it a try and prove me wrong in my assessment. I suspect I will wait a long time.

But another, on the less-dim side, is that regulation can take different forms, and the differences matter. NDs want to have licensing come with increased scope of practice, but that doesn’t have to be the case. I don’t see the point of ‘you can’t call yourself a “physician”, but you can call yourself a “doctor”.’ How about prohibiting both?

The problem is the degree. The degree is "ND," which stands for "naturopathic doctor" or "doctor of naturopathy." The only way to get NDs to stop calling themselves "doctor" would be to abolish the degree.

"So if NDs are bogus then how do you explain my naturopathic doctor fixing 2 health issues I’ve had in the past when MDsy just wanted to push dangerous medications."

What were these "health issues"?

Give NDs credit, they're pretty good at reducing wallet bloat.

REH: "Please see the ND program at Bastyr University, I have seen what they teach there and am confident that those who graduate from their program will be fantastic doctors."

Last time I looked they still had classes in homeopathy, which is just a whole bunch of nothing. They also do other nonsense like acupuncture, Reiki, etc.

We had a relative who decided the Bastyr educated naturopath was smarter than the actual medical doctor. So she dropped her real meds for the very expensive homeopathic pills the naturopath sold her. They did nothing.

She suffered from chronic pain, and the naturopath actually told her to record every ache and pain. Which is pretty much the worst advice you can give someone with pain:
https://www.nytimes.com/2017/08/01/well/live/the-secret-life-of-pain.ht…

An ND stands for "Not a Doctor."

Pat Vandell: "How do you explain that?"

How do we explain your anecdote? We don't because we have no evidence of anything.

Here is an idea, publish all of your medical records on a website so we can all read them. Then you might get an explanation. The mostly likely reason is something we call "tincture of time."

Also, REH, the guy who killed that poor woman with IV curcumun was a graduate of Bastyr.

#2 Alain
Perhaps around Chrismas when there are lots of tourtières around?

"Basically, naturopaths are fake doctors, but they crave the acceptance of real physicians. "

No, what they crave is the perception of legitimacy in the marketplace so that they can make more money. They don't care a whit about what's real.

REH: Bastyr . . . . what a laugh. They teach homeopathy, and if you teach homeopathy you are teaching people to treat illness with water. If I know nothing else about them, I know enough to know any degree from that school is worthless.

Of course, you're symptomatic of the problem since you refer to their program (of which I suspect you are a graduate) as "med school." What Bastyr offers is not med school. I know more about medicine than any "graduate" of Bastyr, and I'm a nurse, not a physician.

Pat: "So if NDs are bogus then how do you explain my naturopathic doctor fixing 2 health issues I’ve had in the past when MDsy just wanted to push dangerous medications. How do you explain that?"

Well, since you've given me nothing to go on, there really is NOTHING to explain. You don't say what "health issues" you are talking about, which makes me think they're bogus conditions like "chronic Lyme."

sadmar: You've just given us a classic example of a false equivilency. Really, you're better educated than this and you know better.

You cannot make an apples to apples comparison of naturopaths, whose "care" is not based on anything resembling reality to actual physicians who finished medical school, then turn around and try an qualify what you just said to somehow lessen how bad that actually was.

Even an incompetent physician knows more than any naturopath, and at least they can be held accountable in some way for any harm they do, be it before their employer, the Medical Board, or in a court of law.

Licensing naturopaths is a horrible idea. It makes it easy for quacks to fool patients into thinking they are state sanctioned. The naturopath board is like the fox guarding the hen house; they are even worse at disciplining their own that many Medical Boards are.

Eric Lund: re use of Doctor as a PhD. I know what you mean. It is the reason why some physicans oppose doctorally prepared nurse practitioners from using the title "doctor" when seeing patients, even though there's little evidence that patients are confused about who's treating them. Heck, I've had patients call ME "doc" knowing I'm a registered nurse, not an NP or a MD/DO. You correct the patient and move on.

I do have an acquaintance who is a pyschologist; he has a PhD but hasn't passed his licensing boards yet. He tried to insist people address him as "Doctor" in social setting. No one did, and he got a lot of odd looks as he should.

I once knew a dentist who insisted on being addressed as "Doctor" in all settings, and even signed his name as "Dr. Soandso, DDS." Colleagues told me he never got over not getting into medical school, and viewed being a dentist as second best.

I have no doubt that is what drives many naturopaths.

@ Orac

If you had any systematic evidence there was no distinction between the aggregate of NDs and the aggregate of basically self-appointed naturos, wouldn't you cite it in every post? All I've seen here the Tim Caulfield-ian surveys of sketchy treatments listed on web sites, and that's hardly evidence of frequency and degree of harm. I'm certainly not claiming there is a difference, I just don't see that your observations are sufficient proof there isn't one.

I shall ask you, and anyone else, what practical agenda do you advocate to prevent the harms suffered by folks like Sean Flanagan, Fikreta Ibrisevic, and Jade Erick? Let me even grant that the agenda might not be that practical, since there are so many obstacles. Just 'no licensing' doesn't seem to cut it, since clowns like 'Chemo Is For Losers' Gonzalez are running amok now. Give me a plan with any real chance to make things better in terms of these grievous harms and I'll be there for it. I'm not going to sweat too much over the average ND shilling worthless supplements to the worried well, or even chronic pain sufferers like Chris's relative. That sucks, of course, but let's just focus on measures that could curb the worst abuses for a start.

I'm serious. 'What is to be done?'

Easy, if you don't necessarily need practical. Don't license quacks like naturopaths and actually enforce existing laws against practicing medicine without a license. That would be a start.

Sadmar: I shall ask you, and anyone else, what practical agenda do you advocate to prevent the harms suffered by folks like Sean Flanagan, Fikreta Ibrisevic, and Jade Erick? Let me even grant that the agenda might not be that practical, since there are so many obstacles.

Well, to begin with, why SHOULD anyone do anything? Ms. Erickson was an adult, free to do whatever dumb thing she pleased. If she couldn't live with eczema, that's her and her family's problem, not anyone else's.
I think that if getting actual health care was viable (ha-ha, not in the States, ever) we'd see a huge dip in naturopathic business, but there's always a few ding-dongs who will fall for any old lie.
I think that kids shouldn't be treated by naturopaths, and every parent who does that should be watched closely, and if possible arrested, but we should let dumbasses be dumbasses. (I do sympathize with Ms Erikson's family, but come on, eczema isn't life threatening.)

Since there is no naturopathic standard of care, it's hard to distinguish which naturopaths are doing it "right".

By their own definition, naturopathy includes homeopathy.

But when you see what methods they share with each other, it sounds like a Jane Austen village apothecary mixing up this tincture or that potion and hoping the patient will get well in a few days.

That's why I like to think of them as Nineteenth century Doctors.

My challenge for the "good naturopaths" is the following:

1. Provide a citation for your approve methods of treatment (standard of care). Otherwise it's make it up as you go along.

2. What are the three biggest improvements in naturopathic practice in the last 20 years?

3. What three treatments have been generally abandoned and are no longer being taught in naturopathic schools because they were either found to be ineffective, had too many risks, or a better method was found?

My plan for the general medical system would be:
1. taxpayer supported single payer
2. increase reimbursements for most office care so Medicaid patients aren't an assigned expense/semi-pro bono category, and doctors can earn a reasonable living treating them.
3. increase scholarships for medical school so graduates don't come out of school with a huge debt burden.
4. increase general medical research funding
5. put some backbone and teeth in state medical boards so they can weed out at least the worst offenders.

As someone who has earned a Ph.D., I have the right to put “Dr.” in front of my name

"Right"?

Orac,

You have my permission to give my email address to jrkrideau.

jrkrideau, please ask Orac for my email address. In the meantime, I'll get something prepared for December around xmas :)

Alain

Oh btw, everyone who can make it to Montreal, QC, Canucksland is invited (around xmas).

I disagree with your article.As i am able to function today only because of naturopathy.Doctors had no answer to my glandular fever .

I'm not particularly satisfied with what I see/hear for some naturopaths. I, of course, reject "homoeopathy as a placebo effect" as a moment of intellectual bankruptcy in the face of natural chemistry. Historically, homoeopathy simply may have had advantages to the extent it avoided some truly harmful medicines (e.g arsenicals, mercurials and god knows what else) and (heroic) practices; or provided some benefit with herbs, fasting, sunshine, fresh air, or basic medicine (e.g. bone setting).

I see Colorado's statutes as having first amendment issues when someone has a degree or paperwork from another state telling them that are a natural medical doctor or physician. One might get into specific wording of discussions and ads, but the first amendment is an area that needs some rejuvenation in medicine.

Even if one says that ND's are just techs in disguise, they are far better for some subjects than "regular" MDs and the ADA/AND pygmies. I view them more as 2nd generation post apocalypse survivors with stunted educations along with mature MDs, who in their 40s, 50s, 60s realize that they have seen (or read medical literature) some better natural results than "standard". To me, a doctor that can't even get the story on vitamin C and D straight therapeutically is pretty glaringly limited in their knowledge base.

Much of what I see in "evidence based medicine" failures salvaged by natural medicine might be better classed as evidence avoided, -ing medicine.

Traditional medicine in USA is corrupt. People need alternative to be treated. Treatment with herbs thats how traditional medicine strated before it became corrupt with big farma. 3 people died from natural treatment? Did y count how many people dying from traditional treatment daily in U S A? Number is hundreeds if not thousand. You against NDS BECAUSE IT TAKES MONEY away from corrupted traditional medicine.. You dont care about people. My friend just died listening his Md and taken 20 prescription drugs daily. I have cured myself with herbs and alive and well. NATUROPATHIC MEDICINE EXIST. NO MATTER HOW MUCH U WANT TO SUPPRESS IT JUST TO HAVE A MONOPOLY OF CORRUPTED MDS.

@Panacea: when I was practicing as a CNM, a lot of my patients would refer to me as their doctor. They knew the difference between me and the MD in the office, but it was easier for them, I guess. Like you, I'd correct them the first time then move on. If they repeated it, I'd generally ignore it unless it impacted their care (i.e. they wanted me to do something I couldn't legally, so the MD would need to do it).

Not all NDs are crooks, but all NDs are not physicians .

Gouri Goudase: Doctors had no answer to my glandular fever .

Yeah, that's because it's nonexistent. Unless you meant 'hot flash' or 'thyroid inflammation,' which take some time to resolve.

The term ND should be changed to DN: Doctor of Nothing.

Nona, is this the type of evidence you prefer:
http://thesciencepost.com/peer-reviewed-studies-soon-to-be-replaced-by-…

As someone who has earned a Ph.D., I have the right to put “Dr.” in front of my name

On the other hand, as my old man used to say (PhD German Languages/Literature), "I'm not the kind of doctor who does anybody any good."

PGP, "glandular fever" is real enough, and is known in much of the world as infectious mononucleosis. It is caused by a virus, so only anti-viral agents are of "curative" use, and they are rarely employed. A quack can make mono appear to go away, simply because it goes away without treatment in the vast majority of cases.

PGP: "Glandular fever" is the term generally used in the UK and some other countries for mononucleosis.
Gouri Godase: Mononucleosis is a bear to go through, but it is generally self-limiting, lasting for weeks, even months, but gets better in time without specific treatment. Since you tried reality-based medicine first, and more than one provider (You wrote "Doctors", plural.), you probably spent a few weeks seeking help from them. By the time you came to the naturopath and underwent her treatment, the disease had just about run its course in you.
In other words, your body did the work, and the naturopath happened to show up at the right time.

This article in the Journal of the American Medical Association (JAMA) is the best article I have ever seen written in the published literature documenting the tragedy of the traditional medical paradigm.
Doctors Are The Third Leading Cause of Death in the US, Killing 225,000 People Every Year

The author is Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health and she desribes how the US health care system may contribute to poor health.

ALL THESE ARE DEATHS PER YEAR:

12,000 -- unnecessary surgery
7,000 -- medication errors in hospitals
20,000 -- other errors in hospitals
80,000 -- infections in hospitals
106,000 -- non-error, negative effects of drugs
These total to 225,000 deaths per year from iatrogenic causes!!

What does the word iatrogenic mean? This term is defined as induced in a patient by a physician's activity, manner, or therapy. Used especially of a complication of treatment.

Dr. Starfield offers several warnings in interpreting these numbers:

First, most of the data are derived from studies in hospitalized patients.
Second, these estimates are for deaths only and do not include negative effects that are associated with disability or discomfort.
Third, the estimates of death due to error are lower than those in the IOM report.
If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000. In any case, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Even if these figures are overestimated, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebrovascular disease).

Another analysis concluded that between 4% and 18% of consecutive patients experience negative effects in outpatient settings,with:

116 million extra physician visits
77 million extra prescriptions
17 million emergency department visits
8 million hospitalizations
3 million long-term admissions
199,000 additional deaths
$77 billion in extra costs
The high cost of the health care system is considered to be a deficit, but seems to be tolerated under the assumption that better health results from more expensive care.

However, evidence from a few studies indicates that as many as 20% to 30% of patients receive inappropriate care.

An estimated 44,000 to 98,000 among them die each year as a result of medical errors.

This might be tolerated if it resulted in better health, but does it? Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom) for 16 available health indicators. More specifically, the ranking of the US on several indicators was:

13th (last) for low-birth-weight percentages
13th for neonatal mortality and infant mortality overall
11th for postneonatal mortality
13th for years of potential life lost (excluding external causes)
11th for life expectancy at 1 year for females, 12th for males
10th for life expectancy at 15 years for females, 12th for males
10th for life expectancy at 40 years for females, 9th for males
7th for life expectancy at 65 years for females, 7th for males
3rd for life expectancy at 80 years for females, 3rd for males
10th for age-adjusted mortality
The poor performance of the US was recently confirmed by a World Health Organization study, which used different data and ranked the United States as 15th among 25 industrialized countries.

There is a perception that the American public "behaves badly" by smoking, drinking, and perpetrating violence." However the data does not support this assertion.

The proportion of females who smoke ranges from 14% in Japan to 41% in Denmark; in the United States, it is 24% (fifth best). For males, the range is from 26% in Sweden to 61% in Japan; it is 28% in the United States (third best).
The US ranks fifth best for alcoholic beverage consumption.
The US has relatively low consumption of animal fats (fifth lowest in men aged 55-64 years in 20 industrialized countries) and the third lowest mean cholesterol concentrations among men aged 50 to 70 years among 13 industrialized countries.
These estimates of death due to error are lower than those in a recent Institutes of Medicine report, and if the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.

Even at the lower estimate of 225,000 deaths per year, this constitutes the third leading cause of death in the US, following heart disease and cancer.

Lack of technology is certainly not a contributing factor to the US's low ranking.

Among 29 countries, the United States is second only to Japan in the availability of magnetic resonance imaging units and computed tomography scanners per million population. 17
Japan, however, ranks highest on health, whereas the US ranks among the lowest.
It is possible that the high use of technology in Japan is limited to diagnostic technology not matched by high rates of treatment, whereas in the US, high use of diagnostic technology may be linked to more treatment.
Supporting this possibility are data showing that the number of employees per bed (full-time equivalents) in the United States is highest among the countries ranked, whereas they are very low in Japan, far lower than can be accounted for by the common practice of having family members rather than hospital staff provide the amenities of hospital care.
Journal American Medical Association July 26, 2000;284(4):483-5

Folks, this is what they call a "Landmark Article". Only several ones like this are published every year. One of the major reasons it is so huge as that it is published in JAMA which is the largest and one of the most respected medical journals in the entire world.

Doug and ORD: I'd never heard of glandular fever before, so I assumed it was a nonsense diagnosis like 'adrenal fatigue' or 'Chronic Lyme.' I've heard of mono before, as I knew a guy who spent most of a year out of high school with it.

Francesco,

Yawn:
http://scienceblogs.com/insolence/2010/01/08/the-three-musketeers-of-wo…

Claims that there are problems with science based medicine does not prove naturopathy is better. Especially when they still push homeopathy.

Francesco @34: A few comments on your 17 year old paper.
1) Please do no conflate or mistake the way that health care is delivered with the science behind medicine. One of the many reasons why outcomes in the US are worse is lack of access to care due to income, which was much more common in 2000 than it is now (but who knows about the future).

2) Has anything changed in the past 17 years? Do you have data on if the rates of death from these causes have gotten worse, stayed the same or gotten better? Also, can you please convert these to #/100,000 population? That really helps everyone see the scale of the problem.

3) What about continuous quality improvement programs at hospitals? What about the changes to the way Medicare/Medicaid are paid based on patient re-admission?

4) Do you have a viable alternative? What is the victim of a traffic accident, who is bleeding internally, supposed to do? A woman in labor with breech twins? A Type I diabetic? Unless you have a solution that is *at least* as good as the current standard of care, why should anyone switch?

No one denies that there are problems. Scientists and doctors and nurses and tons of other people in health care are working to fix them. But just because airplanes can crash doesn't mean I'm going to try a magic carpet.

Narad: Yes, right. When you're granted a doctoral degree it comes with "all the rights and privileges there pertaining to." You have to do something pretty extreme to get your doctorate rescinded.

prn: basically you're saying homeopathy is better because it didn't have the side effects or toxicity of medications that we no longer use . . . because we have safer alternatives that work better, with fewer side effects.

I would never say ND's are techs in disguise. That gives them way too much credit. A certified medical assistant or a certified nursing assistant has least has valid training in real procedures or care that actually work. I always listen to my CNAs; they may not know why something is wrong, but when something goes wrong they often know it before anyone else does!

Since what you think about vitamin C and Vit D are largely bullshit, you really aren't in a position to complain about what physicians do and do not know.

doug; the thing that scares me about naturopaths and mono is it can have pretty serious sequelae. I'd hate to see a naturopath tell a high school athlete they can go back to a contact sport too early.

When you’re granted a doctoral degree it comes with “all the rights and privileges there pertaining to.”

This phrase is meaningless outside of the granting institution. There is no legal "right" conferred to the use of a regulated title by having a random Ph.D.

prn: basically you’re saying homeopathy is better because it didn’t have the side effects or toxicity of medications that we no longer use
That's only part of it. I cited actual historical interventions like herbs, sunshine and fasting that have a physiological basis.

. . . because we have safer alternatives that work better, with fewer side effects.
Ummm, in a number cases, modern medicine is more self congratulatory than effective or safe.

I would never say ND’s are.. I always listen to my CNAs...Since what you think about vitamin C and Vit D are largely bullshit, you really aren’t in a position to complain about what physicians do and do not know.

Thanks for your opinion. IRL it is important to be aware some of " the cartoon thought bubbles" when we encounter obstruction, interference or assault from less informed medical personnel disconnected from reality.

Narad: Here we go. Look, physicians do not own the title "Doctor." It's an academic title, not a professional one. Anyone who completes a course of study that confers a doctoral degree has every right to use it. You better believe when I earn my DNP, I will use the title Doctor (though mostly with my students, more than likely).

The professional title is physician. MDs and DO's can use it and NO ONE else.

Physicians who think otherwise, just need to get over themselves. And if they can't, then they f***ing need to stop referring to their medical assistants as "nurse."

prn: please cite a peer reviewed source showing that fasting has physiological health benefits (I will concede it has spiritual health benefits in moderation).

I'm aware that sunshine has physiological health benefits in regards to treating mild jaundice of the newborn, and seasonal affective disorder (SAD). Please cite a peer reviewed source showing it has any other medical use.

I'm aware that many modern medications have their basis in plants. Please show me a peer reviewed source that proves to me willow bark tea is safer and more effective than aspirin. Preferences don't count.

"Modern medicine more self congratulatory?" Dude you are alive and healthy because of modern medicine, even if you eschew it. Modern medicine has meant that people who would have died 50 years ago, live, and live better. That medicine isn't perfect, and we sometimes still get bad outcomes is not the fault medical science, though I will agree that how we have allowed our capitalist system to so influence who gets access is a major problem.

As for thought bubbles . . . you realize what you just said applies to you far more than it will ever apply to me, right? Because naturopathy has no basis in any science.

prn: 1 year 7 days ago if I had seen a DN (doctor of nothing), I would be dead. I had a widow maker heart attack, with less than a 6% survival chance. I did even better than just survival because I have no detectable heart muscle damage. This happened because of the care from our ANP (I work in a health center) and everyone else along the way. A DN would have been running circles just trying come up with some weird concoction to try to treat something (he/she would not have the skills or equipment to do things right). They may have enough skill to dial 911 but I am not sure about even that.

Oh by the way, our med department considers me there rock star because I beat the odds so well.

prn: please cite a peer reviewed source showing that fasting has physiological health benefits
I'm aware that there are physiological changes are easy to spot, amongst many fast types and durations. The "proved benefit" game is a partisan operation that a "civilian" might only prefer to wade into when they have substantial skin in the game..

I’m aware that sunshine has physiological health benefits in regards to treating mild jaundice of the newborn, and seasonal affective disorder (SAD).
Did something happen to vitamin D deficiencies.

...proves to me willow bark tea is safer and more effective than aspirin.
It may be more likely that a naturopath asks whether you would benefit more by reducing the salicylates to under 100 mg (0, 40, 81, 100) and adding serrapeptase or another, rather than just going all out with willow instead of Bayer.

“Modern medicine more self congratulatory?” Dude you are alive and healthy because of modern medicine, even if you eschew it. Modern medicine has meant that people who would have died 50 years ago, live, and live better. That medicine isn’t perfect, and we sometimes still get bad outcomes is not the fault medical science, though I will agree that how we have allowed our capitalist system to so influence who gets access is a major problem.

I don't automatically eschew everything medicine sells, I am simply a critical and discerning customer with a strong, independent technical view of the world.

As for thought bubbles . . . you realize what you just said applies to you far more than it will ever apply to me, right?
That's fine, you might learn something...

Because naturopathy has no basis in any science.
You're confused. Naturopathy is a smorgesbord with many treatments originating in the old medical literature. Some of them surviving because of their clear superiority at the ground level, against so many commercially based attacks.

"Some of them surviving because of their clear superiority at the ground level, against so many commercially based attacks."

Name ONE and link to credible research on it.
We'll wait.

prn @43: The sun also causes burns and cancer. So, you know, moderation?

CJTX: "...Name ONE"
Polysaccharide Krestin, aka PSK, a Coriolus versicolor hot extract discovered at home by a Japanese chemical engineer over 50 years ago.

In the US, this is a naturopathic oncology supplement. I've bought it for some years now. It was the leading oncology drug in Japan for over a dozen years and has hundreds of medical and scientific papers on it. MSM oncologists in the US know very little about it and probably wouldn't figure it out to save their lives.

Of course, if they did, they wouldn't be so MSM anymore. Which is roughly how a lot of MSM MDs went natural...

1) You named something but failed to provide links to credible research proving it works. Soooooo, 50% success rate at most?

2) Being forced to google it, most of what I found says there's no evidence to support the claim its effective, much less that it is "clearly superior" as stated in your original comment. I also find no credible mechanism for it to work.

3) I found a few glowing studies - but I have neither the education, skill or experience to evaluate them and will therefore leave that to others.

4) I find no evidence to support that it "was the leading oncology drug in Japan." Assuming it was for the sake of argument, the popularity of its use is not evidence of its efficacy. That's an ad pop fallacy. Also, why "was" it the leading drug, implying it is no longer the leading drug? Perhaps actual drugs came into use?

5) "MSM oncologists in the US know very little about it" Why should they if there's no evidence it works or can work, other than having a hobbyist's interest in mushrooms.

6) " probably wouldn’t figure it out to save their lives." Not sure what this even means? But, see #5.

7) MSM and "natural" are not two sides of the same coin. You know what they call 'natural medicine" that works? Medicine.

#42 Rich Bly
Ocean Shores
August 17, 2017
prn: 1 year 7 days ago if I had seen a DN (doctor of nothing), I would be dead.
a speculative statement

I had a widow maker heart attack, with less than a 6% survival chance. I did even better than just survival because I have no detectable heart muscle damage....They may have enough skill to dial 911 but I am not sure about even that.
The question is whether advanced nutritional methods could have entirely prevented a heart attack by stopping or reversing one or more processes. Even started up to the preceeding days.

I have to admit that my views derive from MDs, but they are often the same guys that might influence techie naturopaths.

Oh by the way, our med department considers me there rock star because I beat the odds so well
...especally if insurance paid all the bills...

PRN: Did something happen to vitamin D deficiencies?

You obviously don't drink milk. Most commercial brands add vitamin d to it. And between that and you know, eating food, people have a lot fewer deficiencies now.

pgp@49:
Partly depends on what you call deficient e.g. under 20 ng/mL or 32 ng/mL, the daily amount needed to achieve that level, and what other problems you're dealing with that might have therapeutic implications at higher levels.

If you need 8000 - 15,000 iu per day to get to 32 ng, that's a lot of milk...and obviously, hitting 60 - 100 ng/mL means more.

I think they were going for the minimum that would prevent rickets in kids. Which is actually fine for most people since they really don't need much more than that. One thing about vitamins is that they don't really stay in the system; if someone has more than they need, the minimum stays and the rest goes. This is why supplementing doesn't really work unless there's a defeciency already present.

Overt rickets is almost a medievally dangerous standard for vitamin D dosing. I wouldn't be surprised if endocrinologists sometimes called such knuckle draggers, "bone heads" in private.

Different vitamins have much varied residence times, that can individually vary with disease condition by orders of magnitude. And although I know you don't want to be listed as a supporter of alt meds on deficiencies, benefit related to deficiency is only "often true", not solely true.

There are immunological and pharmacological phenomena where some pronounced therapeutic effects are not remotely deficiency related, even focally. e.g. vitamin D in the 50,000 - 300,000 iu per day range or high dose IV vitamin C multiple times per day.

PRN: Overt rickets is almost a medievally dangerous standard for vitamin D dosing. I wouldn’t be surprised if endocrinologists sometimes called such knuckle draggers, “bone heads” in private.

That's kind of blamey, prn.
There are plenty of people who have vitamin defiencies who simply don't notice, until it starts interfering in their lives.It's not intentional, most of the time. I have an iron defeciency right now, partly because that's something I'm prone to, partly because my diet has become a bit more vegetarian.
In most cases, a general physician can spot worrying signs before someone develops full-blown rickets or jaundice.

I support supplementing as needed, but it's not a cure all, and in most cases, it simply results in expensive waste products.That's not supporting alternate medicine, it's supporting what works.

The rest of your post is simply your usual gabble, which means you have nothing to say, really. I'd also like to note that IV administration is usually a surgical procedure for a good reason. Do you know what an edema is?
There's a reason most reputable doctors prefer people to take their vitamins orally. Also, poking holes in veins constantly isn't a really good idea.

"I have an iron defeciency right now, partly because that’s something I’m prone to, partly because my diet has become a bit more vegetarian."
My daughter has been a strict vegan for years, and she is deficient in nothing. As a young adult woman, you might expect some degree of iron loss through menses, but instead is a highly capable amateur athlete - she does acroyoga and I have seen her lift and support a man nearly twice her weight. My advice is to do your homework like she does.
PGP, IV placement is only done by surgeons or other trained personnel when a semipermanent IV access needs to be placed into a central vein or a cutdown needs to be done to access a peripheral vein. Otherwise, peripheral lines are put in at bedside by nurses, PAs, nonsurgical MDs, LPNs, IV techs, etc. Actual administration of IV fluids and medications is usually done at bedside by RNs.
prn, I also was saved by modern medicine. I had a mitral prolapse, and even though I took all the precautions, against the odds I had bacterial vegetations on my mitral and aortic valves, and was going into heart failure. My internist's partner took one listen and sent me to a cardiologist to be sent to a hospital for admission. After a few days of tests (cardiac catheterization, transesophageal echocardiogram, and more) I went to the OR and had the two infected valves replaced. I had to take IV antibiotics five hours a day for a month before I was considered out of the woods. I still take a calcium channel blocker for prophylaxis of atrial fibrillation.
By the time I sought help for my extreme fatigabiity, I was in all likelihood days away from the vegetations breaking loose and causing me to stroke out and quite likely to die. I don't know of any so-called alternative medicine modality that would have helped me, and if I believed in any of them I might have delayed effective treatment long enough to die. Can "advanced nutritional methods" keep bacteria that once in the blood will settle down on an abnormally configured heart valve away? If so, I'd like to see the evidence. And how would you know if worked? Even if I hadn't taken the recommended antibiotic premedication the odds of my valves becoming infected were fairly small, and how would you measure what doesn't happen? Any study that withheld the antibiotics would be morally and ethically monstrous, and malpractice to boot.

"Bacterial vegetations" is a delightful term that would not be out of place in a monologue from one of the rustic characters in 'Cold Comfort Farm'.

ORD: I am working on that actually. I've been training in martial arts for years, and I jog and walk regularly. I cook a lot, and I'm tweaking my diet continously.

ORD: IV placement is only done by surgeons or other trained personnel when a semipermanent IV access needs to be placed into a central vein or a cutdown needs to be done to access a peripheral vein. Otherwise, peripheral lines are put in at bedside by nurses, PAs, nonsurgical MDs, LPNs, IV techs, etc. Actual administration of IV fluids and medications is usually done at bedside by RNs.

Yes, I am aware of this, but I don't know if PRN is. He (?) seems to believe having holes poked in him constantly by untrained people is somehow a good thing.

PGP: well, he's trying to defend naturopaths by reclassifying them as technicians when even they don't call themselves that. So yeah, he's basically full of it.

Re #43, prn said regarding fasting: "I’m aware that there are physiological changes are easy to spot, amongst many fast types and durations. The “proved benefit” game is a partisan operation that a “civilian” might only prefer to wade into when they have substantial skin in the game.. "

So you admit there is no evidence of physiological benefit from fasting.

Your "proved benefit" is a dodge. This is science. You either have the data or you don't. And you don't.

Re aspiring: "…proves to me willow bark tea is safer and more effective than aspirin.
It may be more likely that a naturopath asks whether you would benefit more by reducing the salicylates to under 100 mg (0, 40, 81, 100) and adding serrapeptase or another, rather than just going all out with willow instead of Bayer."

My, my. That sounds suspiciously like the practice of medicine. And suggesting anyone add an unproven substance to regular aspirin in my mind is even worse than drinking willow bark tea, since we do know it can be effective if it's prepared properly (it is why we figured out to isolation salicylic acid after all).

Prn said, "I don’t automatically eschew everything medicine sells, I am simply a critical and discerning customer with a strong, independent technical view of the world."

If that were true you wouldn't be advocating unproven treatments.

Prn said, "That’s fine, you might learn something…"

From you? Not a chance. You don't know anything.

prn said, "You’re confused. Naturopathy is a smorgesbord with many treatments originating in the old medical literature. Some of them surviving because of their clear superiority at the ground level, against so many commercially based attacks."

Please. This is science. If there were real, solid evidence anything in this smorgasbord worked, we would know it. The evidence is weak and unconvincing. And given that naturopaths never said their treatments don't work, don't work for everyone, and do say every treatment works for everything, the BS is strong with this one.

As for the allegedly "pronounced therapeutic effects" of high dose vitamin D supplementation:

"...according to a review led by the University of Auckland’s Associate Professor Mark Bolland...published in the latest British Medical Journal that involved research colleagues at the University of Auckland and the University of Aberdeen in Scotland...scientific evidence does not support the use of vitamin D supplements to prevent disease, except in a small group of people at high risk...Bolland and colleagues make the case (based on a comprehensive search of published evidence) that existing clinical trials show vitamin D supplementation does not improve musculoskeletal outcomes."

“There is no high quality evidence to suggest that vitamin D supplementation is beneficial for other conditions such as heart disease, stroke, and some cancers - and ongoing trial results are unlikely to alter these conclusions,” he says."

"The study authors suggest people at high risk should be counselled about sunlight exposure and diet, and low dose vitamin D supplements considered on an individual basis."

“Otherwise we conclude that current evidence does not support the use of vitamin D supplementation to prevent disease,”

https://www.auckland.ac.nz/en/about/news-events-and-notices/news/news-2…

Panacea: well, he’s trying to defend naturopaths by reclassifying them as technicians when even they don’t call themselves that. So yeah, he’s basically full of it.

Agreed. I do kind of wonder how PRN's avoided infection or scarring or embolisms. I don't even like professionals like nurses or phlebotomists drawing blood or giving me shots. But I understand that they are trained and do those procedures often.
Where does a naturopath get training to administer IVs? Do they just poke and hope?

Polysaccharide Krestin, aka PSK, a Coriolus versicolor hot extract discovered at home by a Japanese chemical engineer over 50 years ago.

In the US, this is a naturopathic oncology supplement. I’ve bought it for some years now.

So what are you doing with all this PSK?

PGP: learning to insert a peripheral IV really isn't that difficulty. It just requires practice and use of good technique. I can teach anyone to start an IV, but I can't teach everyone to be a good nurse. Nursing's skill set is cognitive, not tactile. The skills are simply tools.

Anyone can take a course in basic phlebotomy from any community college. That teaches you how to draw blood, and the challenges behind it. It's not a great leap beyond that to learn to advance an angiocath.

There are tons of videos on You Tube.

How naturopaths acquire the skill, I'm not sure. Maybe they get a licensed physician or nurse to train them. But as I said; this skill requires practice to get any good at it.

I have to wonder how many pokes their patients get before they get the line. I also have to wonder what their aseptic technique is like, and how they're priming their lines.

Panacea: well, he’s trying to defend naturopaths by reclassifying them as technicians when even they don’t call themselves that. So yeah, he’s basically full of it.

Yup. I'm just wondering how he's managed to avoid infections, embolisms and scarring. Are naturopaths even trained to put in IVs? Or do they poke and hope?

There's only one formal school of training for naturopaths that I know of; Bastyr. I don't know if they train naturopaths to do IVs, or how they learn. Most other programs are little more than diploma mills so I'm afraid to ask how they learn. Self taught maybe, or take a CC class in phlebotomy. But if you don't use good aseptic technique, there is a risk for infection, infiltration and phlebitis that is not insubstantial. That can lead to venous scarring yes.

I imagine most of their patients are young and healthy. Those are usually "good sticks" easy to get a line.

It would be interesting to try and figure out just how bad they are.

Big news! I have found a homeopathic remedy that really works!
I consulted a homeopath for treatment of a dark substance on my hands. He didn't say anything, he just took a little dirt from a potted plant, and after diluting it to 30C, he poured it over my outstretched hands. The dark stuff was stripped away like magic! It's great! I'm going to do this all the time!
All this time I thought they were full of s**t, but now I'm a convert.
I'm inspired, so much that I have begun experimenting with a homeopathic cure for dehydration. Any number of substances diluted to 30C or more are showing promising results. It's been so simple that I wonder why homeopathic medicine never took this one on.

Do you know what an edema is?

A novel turn of phrase?

Panacea: Eek.

Do you know what an edema is?
A distant relative in The Adams Family? She only appeared in 3 episodes.

There’s only one formal school of training for naturopaths that I know of; Bastyr.

There are a few more, with NCSM perhaps being the heaviest hitter after Bastyr.

^ NCSM SCNM

hdb: I meant embolism, and accidentally typed edema.

I don't understand why the hate against NDs just because they want to try to treat people more naturally and not have the first instinct for every problem be writing a prescription.
Why is this called scienceblogs if you are going to unscientifically bash a profession that gets educated in science.
NDs get science based training the same as MDs and DOs. They can also prescribe actual medication just like other doctors because of the fact that they are real doctors.

The article is mainly citing an individual who was not licensed for anything and using it to condemn all legitimate NDs. Why are you not trashing all MDs? Plenty of them screw up also. Every profession seems to have shady individuals or those who aren't as good as someone else.
Just because you don't agree with all the other subjects the ND has studied doesn't mean they are less entitled to be called a doctor. I don't agree with pharmaceutical reps meeting with MDs trying to encourage them to push more drugs on patients but that doesn't mean the medical doctor is less qualified to be considered a doctor.

Which is what I'm seeing here that people disagree with homeopathy or acupuncture or something else that is less mainstream and they aren't comfortable with it so they are trying to force their negative opinion to be fact.

Mainstream medicine has multiple drugs all capable of treating the same condition because everybody is different. Just because one drug works for one person doesn't mean it will work for somebody else with the same issue.

http://www.naturopathic.org/education

Read the FAQS as well and be informed before just stating negative opinions and being disrespectful to an entire profession.

Guess what? When I went to my MD years ago and was told my blood work showed I had high cholesterol, his first response was to offer a natural solution.
He told me I needed to start eating healthy and exercising. Does that mean that this actual medical doctor is a quack because he offers first common sense instead of medication?
I of course being extremely lazy at the time was honest with my doctor and told him I'd consider trying some healthy food but didn't see myself exercising anytime soon. He then gave me some samples of cholesterol medicine and said if these were working he'd write a prescription and again urged me to consider exercising and eating healthy foods.

I eventually got tired of the side effects from prescription drugs and wanted to do things more naturally and so changed my diet with some occasional exercise thrown in. I still see the same medical doctor when needed and have never seen a naturopathic doctor. Now that I'm more educated that popping pills isn't always the best solution since it only masks the symptoms and doesn't resolve the root cause, I'd definitely consider seeing an ND for their expertise.

Too much of the comments and articles on this website seemed to be fear based. I've seen comments from other articles as well where others present valid opposing arguments and links to other sources to support their viepoint and still so many on here are dismissive and refuse to consider the possibility that they might be wrong.
If people want to try some new age method to solve their issues and they believe it works than why is it problem to anyone else, if no one forces you to do it and you can keep with your same traditional method?.
I'm not saying one is better than the other I just think there needs to be more tolerance and acceptance of others and this website doesn't seem to have much regard for anything that goes outside of the author's opinion.
sometimes I'm disappointed by humanity and so I felt compelled to say something. Example: my employer offered 4 hours paid time to go volunteer for any non-profit during the month of august. They had hoped for a 65% participation, at the end of the month less than 30% actually volunteered.
Just one of many things I guess I'll never understand.

Thanks for reading this comment. Have an awesome day!

@JR,

You seem to be someone who is looking for a friendly discussion, but has a naive or limited understanding of what naturopathy actually is and how naturopaths treat diseases. So I'll offer you my thoughts.

If naturopaths would only "try to treat people more naturally" and also quickly refer their patients to a better trained physician when that doesn't work, we wouldn't be nearly as concerned about them.

But they do things like injecting curcumin, a spice, directly into the bloodstream, injecting stem cells into the spine, sticking pins into the back, and many other things that don't seem very natural.

And using treatments that don't work or can actually harm the patient can delay getting the needed treatment and sometimes lead to the death of the patient. Unnecessary deaths that might have been prevented do upset us.

There are many problems with naturopathy, but a key problem is that there is no standard of care. That means that there are no rules on how to diagnose or treat anything. And that lets the naturopath do pretty much whatever they think will work.

And, their training is a laundry list of various methods that have been abandoned by standard medicine in favor of prescribing medicines that have been tested and found to work.

So I suggest you look for the standard naturopathic treatment for eczema and Hodgkins' lymphoma, and search in Pubmed for a study that shows it is effective.

Also, to be scientific, naturopaths need to keep trying to improve their methods, so can you find any examples of treatments that have been abandoned by naturopaths because they were found to be ineffective or had too many harmful side effects?

Where do you report these fake doctors? "Doctor" Kathia Roberts seems to be a naturopath, although it is difficult to navigate the sea of bizarre "credentials" and achievements on her website. As you can see, she is also wearing a white coat and a stethoscope.(!) She is selling homemade supplements out of her house and charging people $200-300 per consultation. Please check her website below.
http://www.seasonalhealth.com/about/

Dr. Aviva Romm: Distancing herself from Goop after defending it

oracknows — Fri, 28 Jul 2017 01:00:20 +0000

Dr. Aviva Romm: Distancing herself from Goop after defending it

It's been over a month now since I started paying real attention to that wretched celebrity hive of scum and quackery founded by Gwyneth Paltrow known as Goop. It was a long time coming, and I feel a bit guilty for not really paying much attention to the "wellness," "lifestyle," and, of course, expensive quackery being sold by Paltrow and her minions through Goop. It began when Goop caught flack for selling pricey magic energy healing stickers. Well, it wasn't so much for that as much as for the amusing intervention of NASA, which slapped down Goop's claims that these stickers were made with a carbon compound that was developed for use in spacesuits used by astronauts.

Then it was a mere three weeks later that Goop decided to strike back against Dr. Jen Gunter, one of its most persistent and effective critics. Basically, Goop's editors published a tag-team article introduced by an unnamed editor and then featuring "rebuttals" by two of Goop's doctors, Dr. Steven Gundry and Dr. Aviva Romm. While Dr. Gundry's response was condescending as hell and full of tone trolling and appeals to his alleged authority based on his history (like Dr. Mehmet Oz, he was once a respected academic cardiothoracic surgeon before he turned to woo), Dr. Romm's response was a bit more low key. Unlike Dr. Gundry, in her defense of Goop she didn't directly attack Dr. Gunter, and, to be honest, she basically admitted that a lot of what Goop publishes isn't based in science but invoked this excuse:

In a time when women are desperately hungry for safe alternatives to mainstream practices that too often fall short of helpful for chronic symptoms, and in the setting of a medical system that is continually falling short of providing lasting solutions to the chronic disease problems we’re facing: I prefer, rather than ridiculing vehicles that are actually highly effective at reaching large numbers of women who want to be well, to seek to understand what women are looking for, what the maintstream isn’t providing; and how we can work together to support those vehicles in elevating their content so that women are receiving the meaningful, and evidence-based answers, they want and deserve, whenever possible.

This would have been well and good if Goop ere actually producing evidence-based answers to anything. In any case, I bring this up because yesterday an interview with Dr. Romm by Megan Thielking was published by STATNews, entitled Goop promoted her as one of ‘our doctors.’ But Dr. Aviva Romm is concerned the site is becoming a caricature. When I saw the title, I couldn't help but wonder if maybe, just maybe, Dr. Romm is figuring out that Goop has gone so far down the rabbit hole of quackery that it might just be rubbing off on her. Her statements sure read that way, but they also read as a doctor who is trying to have it both ways. Clearly Dr. Romm is trying to put some distance between her and the unsavory expensive pseudoscience being peddled by Goop and Paltrow while not alienating Goopies (my new name for Goop fans who are happy to hand Paltrow their money for such ridiculous nonsense.). Hilariously, Dr. Romm claims that she doesn't even read Goop, that she's shocked—shocked, I say!—that there's quackery being sold there:

But one of those physicians, Dr. Aviva Romm, told STAT that she doesn’t see herself as Goop’s doctor at all. She hasn’t read most of the content on the site (which promotes things like goat’s milk cleanses, energy healing stickers, and “brain dust” to “align you with the mighty cosmic flow”). She can’t give it a scientific stamp of approval. And she’s wary of anyone who automatically endorses products or therapies simply because they’re branded as “natural.”

In fact, she said she’s advised Goop that if it wants to be more than a “caricature of everything alternative health for women,” the editors need to do an audit of all their content, in consultation with physicians.

“I don’t think everything in there is necessarily evidence-based or effective,” said Romm, who lives in Massachusetts and runs a small practice in New York City.

She added: “I’m not one of these integrative doctors who basically just because it’s alternative thinks it’s safe and good. I try to keep my doctor thinking cap on as well.”

I laughed out loud when I read one statement there. "I don’t think everything in there is necessarily evidence-based or effective"? Ya think? What was your first clue, Dr. Romm? In fact, I was chuckling heartily throughout large swaths of this interview. For one thing, Dr. Romm is correct to characterize Goop as a caricature of everything alternative health for medicine. No, wait, on second thought, no she isn't. This is what "alternative health," be it for men or women, is. It's some uncontroversial advice on diet and exercise, with a whole lot of woo, quackery, pseudoscience, and mysticism slathered on liberally. Goop isn't a caricature. It's the epitome of "alternative health," and Dr. Romm helped make it that way.

Particularly amusing was her claim that she's an integrative doctor who tries to keep her "doctor thinking cap on as well." She really, really could have fooled me. Remember. I perused her website. Remember how I not infrequently say that a very good indication that you're dealing with a quack is if that doctor advocates "detoxing." Well, Dr. Romm's blog is full of articles with titles like How to Detox Every Day: Top Ten Foods & Herbs, Detox Immunity, The Easiest, Most Effective Spring Detox Ever, and Detoxing Before Pregnancy. (That last one sounds like a really, really bad idea to me.)

Here's a taste of what I'm talking about:

So you can imagine by the time you hit your 20s and beyond, our bodies have been steeped in environmental chemicals!

These chemicals come from herbicides, pesticides, antibiotics, hormones, and artificial ingredients in our foods. They exist as pollutants in our air, water, cosmetics, medications, vaccinations, household cleaners, furnishings, cars – there are literally tens of thousands of them.

Not only that, we create toxic chemicals in our bodies from the process of breaking down the hormones and stress chemicals that our own bodies produce.

This is nothing more than a variant of a very old idea that isn't science-based, namely autointoxication. The idea behind autointoxication is that the colon is leeching "toxins" into our body that must be purged for optimal health. Of course, as I've pointed out before, by the time a colon becomes "toxic" because of what's in it, it's called toxic megacolon, and it's a surgical emergency, usually associated with sepsis. No, the colon is quite capable of eliminating all the "toxins" thrown at it, as is the liver. Dr. Romm has just changed the source of the "autointoxication" from teh colon to the body "breaking down hormones and stress chemicals." This is just as nonsensical an idea as the idea that "death begins in the colon" because the poo in it is slowly poisoning us.

At some level, Dr. Romm even appears to realize this:

The good news is that your body is amazingly equipped with detoxification systems that have been evolving and improving over millions of years. Most of these are in your liver, but also require that you keep your bowels moving well each day to “take out the garbage” that the liver has processed. Your body has the mechanisms in place to keep you healthy – vibrant, in fact.

The bad news is that never before in the history of humanity have we been exposed to so many different individual and combinations of chemicals at once. You know how you can feel overwhelmed by life sometimes? Well, our bodies are overwhelmed by toxic loads and need some extra daily detox help.

How do I know this? As a Yale-trained MD and an environmental health scientist, one of my key areas of research is women’s and children’s health and environmental toxicity.

Oops. I spoke too soon. She did indeed invoke a more direct variant of the old idea of autointoxication. Of course, it's utter nonsense that never before in history have we been exposed to so many different individual and combinations of chemicals at once. Anyone who studies history and understands how much more polluted our world was throughout the industrial revolution will realize that. Indeed, if anything, the environment we live in is almost certainly much cleaner, with many fewer environmental threats than even 50 years ago, although Donald Trump is sure enough trying to take us back to the bad old days. (If you're a Trump supporter and don't like me injecting politics here, guess what? I don't care!)

I also love Dr. Romm's invocation of her authority. She's not just an MD. Oh, no. She's a Yale-trained MD. Well, Yale is, unfortunately, a bastion of quackademic medicine. Remember Dr. David Katz and his more "fluid concept of evidence"? I sure do, and Dr. Romm strikes me as the epitome of what Dr. Katz was talking about someone so open-minded that her brains fell out. As for Dr. Romm being an "environmental health scientist," I searched Medline for her publications resulting from environmental research. To my surprise, I found one article in the New England Journal of Medicine. Actually, it wasn't an article. It was a letter to the editor questioning an article about prepubertal gynecomastia linked to lavender and tea tree oils. (Gynecomastia is abnormal breast growth in males.) The letter is ten years old, and the only thing I could find in the peer-reviewed literature by Dr. Romm on environmental determinants of health or "environmental toxicity" in children. There's also an "ask the experts" article in Explore, which, as you might know, is one of the more "out there" alternative medicine publications.

And I haven't even gotten into Dr. Romm's embrace of functional medicine, which basically combines the worst aspects of conventional medicine with the quackery of alternative medicine, her "adrenal thyroid revolution," which basically posits that Epstein-Bar Virus is the cause of Hashimoto's thyroiditis, and also the cause of...just about every chronic health problem. Then there's her flirtation with antivaccine ideas, which, as far as I know, she has not rejected.

So we've established that Dr. Romm is not nearly so evidence-based as she claims to be, which is a reason why her proposal that Goop institute a medical advisory board made up of physicians cracks me up. There's no reason to expect that such a board would make any difference, not if it's made up of Goop physicians like Dr. Romm and her fellow Goop doctors.

Of course, Dr. Romm can't be too critical of Goop. After all, she got involved with Goop when her publicist thought that writing for Goop would help her "expand her audience" (translation: sell more books, supplements, and stuff), which is probably why she was willing to do it for free, while claiming she has no idea what's published there. (I really do call BS on that last part, but maybe she really doesn't read anything in Goop except for her stuff.)

Here's how she came to write part of the response to Dr. Gunter:

Romm got roped into the Goop fight after Dr. Jen Gunter — a longtime critic of the site — lambasted the lack of scientific evidence behind Goop’s recommendations in a widely shared post on her blog in May.

“When the Goop hit the fan, let’s say, with the Jen Gunter piece, it was just kind of in the early stages of my writing for them,” she said.

Goop asked her to submit a quote addressing the criticism. She responded that she couldn’t endorse the site, but she could share her thoughts on women’s wellness. That’s how she came to write the open letter which Goop later published as “A word from our doctors.”

If Dr. Romm wasn't comfortable writing the response to Dr. Gunter, then she should have politely declined. However, she knows what side her bread is buttered on; so she didn't. And she's still defending Goop:

But, Romm said, it’s not just celebrities and alternative medicine providers who are making money off patients. She pointed to the billions drug companies spend on TV ads.

“Let’s not be misled here,” she said. “Those drug company commercials are making lots of people millions. So it’s not just one isolated situation with Goop.”

I love the smell of pharma mongering in the morning. It smells like...false equivalence! Yes, pharmaceutical companies make lots of money selling drugs. The difference, of course, between pharmaceutical companies and Goop is that pharmaceutical companies have to do the scientific and clinical studies to show their products work before they can market them. As a result, most drugs do what their manufacturers say they do. In contrast, Goop (and, truth be told, Dr. Romm) can make any claim they want to sell their product—and they do. I'd also wonder if Dr. Romm really wants to compare Goop to pharmaceutical companies. As I'm sure she'd agree, pharmaceutical companies have done some bad things over the years, and she basically defended Goop by comparing it to pharmaceutical companies.

One wondes how much longer she'll be writing for Goop. Or maybe she's just part of Goop's pivoting.

oracknows Thu, 07/27/2017 - 21:00

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Antivaccine nonsense

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http://www.cityam.com/269234/walkie-talkie-has-been-sold-13bn-herbal-me…

Like 99.9% of quacks Dr. Romm as likely to be found commanding a nuclear submarine as she is to be in a hospital treating sick people. What does that say about her? But she is happy to shill her products to strangers and patients alike. The quote below is from her website:

At Thrive you are not paying a premium on lab tests or supplements, which can save you literally thousands of dollars in office and monthly costs. In fact, with Thrive Health you will receive:

All lab testing at direct labs costs – not the typical expensive functional medicine lab prices you’ll find in many practices.

20% off of all retail prices on any supplements in my patient supplement store

Oh my god...here's the end all be all response to "big pharm" accusations.

Making money does not automatically mean sinister motives or dishonesty!

It's called effin' capitalism, and without a profit motivation most companies would stop trying to make cancer drugs, AIDS medications etc and would instead focus on hair loss and erectile disfunction with all available resources.

From the bottom of the Romm web site:

Copyright 2012-2017 Aviva Romm All material provided on this website is provided for informational or educational purposes only, and is not intended as a substitute for the advice provided by your healthcare professional or physician

I remain amazed at how people will ask me about nonsense peddled by quacks like Romm during office visits and then seem flabbergasted when I state bluntly that what they've read online is bunk (and yes, I will refute point by point after stating that). At least they ran it by me, but I can always tell very quickly whether they will go for the flashy web site or the "advice provided by their healthcare professional". Sadly, the flashy web sites win about 2/3 of the time.

On the subject of "Pharma makes a lot of money", I would like to point this out from recent news:

In short: LKK Health Products Group spent £1.3Bn to acquire a large office building in the City of London, where all large finance companies like to have their HQ.

LKK is a "herbal medicines" company from Hong Kong.
http://www.lkkhpg.com/en-us/

From the press release:
"This is the largest-ever office complex property transaction in the United Kingdom for a stand-alone office building. 20 Fenchurch Street is an iconic building prominently situated in London's financial district, with uninterrupted 360° views across Central London. [...] The acquisition enables the Group to not only achieve a reasonable return from rental income, but also extend its property portfolio to a major overseas financial center for sustainable and stable capital appreciation. As such, the property will be held by the Group as a long-term investment."

What does LKK sell?
"In 1992, LKKHPG established the brand “Infinitus”. With the mission of “advocating the premium Chinese health regimen and nurturing healthier lives with balance, affluence and harmony”, Infinitus is devoted to providing the public with high-quality Chinese herbal health products and services."
----

I'll take Big Pharma over Big Woo everyday.

Shouldn't pick on Dr. Romm.

She offers discounts at her online supplement store (betcha Orac doesn't do that), has lots of nice white teeth and likes begonias.

Maybe it's time to slow down medical pseudoscience.

Q. Would a true flat-rate tax be useful.

In the short term, tax deductions allow life-style organizations like Goop to metastasize.

Companies (e.g., pharmaceutical) that provide health & wellness products that have FDA approval would be exempt from the true flat-rate tax system.

@Chris H
That quack Miranda is the only thing needed to tell you to run away. Quickly.

Sadly, most site visitors ignore it. 20% off!!!!!!

The bad news is that never before in the history of humanity have we been exposed to so many different individual and combinations of chemicals at once. You know how you can feel overwhelmed by life sometimes? Well, our bodies are overwhelmed by toxic loads and need some extra daily detox help.

Dr. Romm, sure knows little about how ancient humans (my first B.S. is Anthropology) lived. The types of chemicals used may have changed somewhat but in reality the dose levels now are much lower than in the past. One theory of why Caligula was so insane was lead poisoning from lead wine goblets. Bacterial loads of foods has decreased just by how food is preserved.

The myth that a cannibal from a 1000 years ago would die from eating a modern human is just that a myth.

Rich Bly (#8) writes,

(my first B.S. is Anthropology)

MJD says,

In a Wikipedia profile for Gwyneth Paltrow it is written, "Later, she briefly studied anthropology at the University of California, Santa Barbara, before dropping out to act."

https://en.wikipedia.org/wiki/Gwyneth_Paltrow

I wonder how many anthropology college-credits the GP in GOOP received?

Although, she gave a great performance in the movie "Proof" showing that she is a very special actress.

Thrive???

Isn’t that Arianna Huffington’s new gig?

Yesterday, in Montana, I picked up a couple of backpackers (it was 99 degrees) who almost immediately announced that they didn’t use fluoride toothpaste because “it’s toxic to your pineal gland” and then one asked if we could stop for “smokes”--oh, the dissonance, it hurts!. I threw them out after two (futile) attempts at reason. Oh yes, they are “anarchists” and have no need for cars--but they don’t mind me having one. o_o

CAM has developed a certain 'buzz' within popular culture, resulting in the proliferation of a number of buzzwords – which is to say terms that have a certain cache despite having no fixed meaning or maybe no real meaning at all. 'Integrative Medicine' is one of these, and 'detox' surely seems to be another, as it gets used for approaches as disparate as weird and possibly dangerous enemas to what amounts to potentially sensible dietary advice. Based on the above, Romm seems to be closer to the later end.

We might refer to some of these 'detox diets' as figurative quackery. The definitions of 'toxin' and 'detox' are so loose as to be more metaphoric than literal: no cures for real illnesses are promised, just some elevation of "wellness", and the diet guidelines proffered are not in and of themselves harmful. Basically, then, we have your basic standard popular diet book wrapped up in a superficial gloss of CAM 'detox' hype. Which helps boost sales, generate TV appearances for the author, possibly up to genuine celebrity status.

But as Kurt Vonnegut said, 'We are what we pretend to be, so we must be careful about what we pretend to be.' Whether or not Dr. Romm is a true quack, or just another diet doctor wrapping herself in a faux-quack cloak, she winds up feeding the detox hype as much as she feeds off it, and it's no surprise then that she finds herself traveling alongside the goat’s milk cleanses, energy healing stickers, and “brain dust to align you with the mighty cosmic flow”.

So now Dr. Romm may eliminate the goop from her diet of professional associations and activities, but I doubt that will be enough to return her to medical wellness. I think the whole discourse of "detox" she's been promoting is toxic, and she could use a good thorough cleanse.

"In a time when women are desperately hungry for safe alternatives to mainstream practices..."
I was in the line at the local grocery and Macleans magazine had an article defending goop and Gwyneth saying basically that it is no wonder that women look for alternatives to the male dominated (and centric) women-hating health professions. Quote: Gwyneth should be praised for figuring out how to take care of herself.
Macleans has run some good articles on Paltrow-based quackery, too bad they had to run this one.
http://www.macleans.ca/tag/gwyneth-paltrow/

'Goopies'. I love it

I bandied the idea out to my nineteen year old stepdaughter who has a strong interest in medicine. She thought the whole thing was bullshit. So there is hope that the coming generation will be as sceptical as we are.

I wonder how much people come to believe their own BS, and apparently the answer is: Quite a lot, but not without some conflict

I might be late to call them "Goopies." I see on the website that sometimes Goop uses "Goopy" as an adjective to describe its fans and, at other times, various interventions.

Speaking of Celebrity Quackery, did you catch the one earlier this week where Angelina Jolie claimed to have successfully beaten her Bell's Palsy with acupuncture?

I threw them out after two (futile) attempts at reason.

I think the Fabulous Furry Freak Brothers had a panel on this topic. Anyway, while I'm free-associating after dozing off at the library,

But as Kurt Vonnegut said, ‘We are what we pretend to be, so we must be careful about what we pretend to be.’

"[T]he lesson I see in his experience for myself and most others is 'the same old one': MAKE UP A GOOD STORY ABOUT YOURSELF, OR NONE AT ALL."

@ Richard Bly:

Unfortunately, even legit anthropology can be co-opted by woo-meisters...
IN FACT today Mercola ( see Mercola articles) features an article about the fabulously diverse microbiome of hunter gathers. An anthropologist eats with indigenous people and his microbiome improves etc.
So suppose that porcupine and baobab will be featured next at hip natural food joints.

Mr Woo recently did a cleanse (a website assured him this specific cleanse would cure T2 diabetes by allowing his liver to eliminate his excess visceral fat). I keep waiting for him to have as much skepticism for woo as he seems to have for reality. When there is no logical mechanism of action, how in the world does someone even fall for this stuff?

I might be late to call them “Goopies.”

"The Gooped"?

Denice, do not eat porcupine. Porcupine is the worst tasting meat that I have ever tried. Remember they eat the inner bark of pine trees. If you have smelled turpentine; that is exactly what the meat tastes like. I guess it would be a great woo food item.

not the typical expensive functional medicine lab prices

"Functional-medicine lab tests are a worthless stupidity tax. Come to my practice, get your functional-medicine lab tests without the mark-up!"

Porcupine is the worst tasting meat that I have ever tried.

Someone must like eating them or they wouldn't need ALL THOSE PRICKLY BITS.

If you have smelled turpentine

Have you ever smelled moth balls??

Yes??

How did you get their little legs spread apart????

Rich, no worry about me eating porcupines.

Interestingly, woo-meisters seem to either totally despise meat
( vegans) or relish exotic, natural choices ( Paleos- which Mercola is/ Adams like natural grass fed or suchlike,meat ).

I wonder how far the Paleos go towards what some older cultures do- ie. do they go as far as grubs or only grasshoppers?

If you have smelled turpentine; that is exactly what the meat tastes like.

So, don't pair it with retsina?

Someone must like eating them or they wouldn’t need ALL THOSE PRICKLY BITS.

Some dogs. The local bartender[1] had a dog who had a fixation on porcupine and never learned.

close to two decades ago, I was living at an uncle's place and one of the dogs managed to catch a skunk and HOLD on to it to bring it back home...The skunk, still alive and angry.

I never knew if the dog was ever allowed to get back in the house. Ever.

[1] == and yup, even though I did alcohol rehab, I still go to my local bar because according to a number of specialists, alcohol was never my problem. Me? maybe, maybe not but I'm figuring it out.

Yesterday, in Montana, I picked up a couple of backpackers (it was 99 degrees) who almost immediately announced that they didn’t use fluoride toothpaste because “it’s toxic to your pineal gland”...

If you had actually read about fluoride and the pineal gland, you wouldn't have put scare quotes around that.

viggen: I saw it. I read stuff like that and despair for journalism. You know they could simply have reported on the Bell's Palsy and left out the woo, or pointed out that it's usually a self limiting disease anyway.

When it comes to cognitive dissoance, I can think of no better example than this. Here's a woman who had a double mastectomy and oophorectomy because she has the BRCA1 gene, which could very well have been a smart decision considering her mother's health history. And this same woman turns to accupuncture for a disease that's typically self limiting.

Oy.

Lentz: lots of things accumulate in the pineal gland besides flouride, so his use of "scare quotes" was quite appropriate.

Panacea: Oh, the pineal gland's an actual thing? I assumed it was made up by the hippy-dippy crowd, just like oxytocin was made up and then used as a hammer by the right wing.

@ # 20 et al

. . . do not eat porcupine. Porcupine is the worst tasting meat that I have ever tried. . . .

Having grown up in a rural area and time of not wasting potential edibles, even acquired via pest control measures, I can join in that advice. Despite my mother's skills in cooking game animals, even young groundhogs soaked in buttermilk were too strong a taste. We normally passed groundhogs to neighbors or farm workers who liked or were more willing to eat the meat. Porcupine had been sampled by some of these stalwarts, resulting in warnings to anyone who cared to listen in language not to be repeated even by drunken sailors or sober drill instructors.

Something is wrong with your website. New postings are occurring in bursts, usually a few days late. I clear my cache and reload, but I don't see new stuff until later. Somehow, other posters are able to see them a day or more before I do. I don't know what the problem is, but it didn't used to be like this.

PGP: Yes, it's a real thing. It's a tiny little gland in the brain that doesn't get a lot of attention. It produces melatonin and probably has a role in sleep regulation. Possibly in sexual development as well. There's a lot we don't know about this gland.

However, it is highly vascular and accumulates a lot of deposits, including fluoride and calcium. Some woo inclined call it "the third eye". The anti flouride crowd hang their hats on the flouride deposits as proof that flouride is toxic. There's no evidence that's the case, but they keep trying.

Totally OT: I cannot read this blog if there's a Teavanna ad running (video). The page keeps scrolling up to where the ad is. It doesn't happen with any other product ad. Anyone have a suggestion for me? And sorry for the OT question.

Cognitive dissonance....

An Australian quote on FB that soy was a cancer causing food from hell (slight exaggeration on my part). The Japanese eat the stuff morning, noon and night and have a lower cancer rate (in general) than both the UK, USA and Australia. Its not even hard to look up.

Lentz: lots of things accumulate in the pineal gland besides flouride, so his use of “scare quotes” was quite appropriate.

I would be more inclined to believe you if you had spelled fluoride correctly.

Some woo inclined call it “the third eye”.

Comparative anatomists call it a "third eye". It's called an "eye" because, like the eye" it is a photoreceptive organ. It is also similar in biochemistry: " The pineal
cells of the chicken and fishes contain a series of components found in the retinal phototransduction pathway, such as opsins, transducin (12–14), cGMP phosphodiesterase (15), cGMP-gated cation channel (16) and interphotoreceptor retinoid-binding protein (14,17). These observations suggest that the pineal photoreceptor cells share a similar phototransduction mechanism with the retinal photoreceptor cells (18). This fact supports the idea that the mammalian pinealocytes have evolved from photoreceptor cells (Fig. 1), although the physiological relevance of the remnant expression of these genes remains unclear." –Dr. Mano

Many lizards have a "third eye" between their two primary eyes which is visible. This is called a parietal eye, and is analogous to the pineal.

You sound like an evolution-denier. Do you think "god" placed a photoreceptive endocrine organ in our heads as a joke? Or do you think that it is an evolutionary vestige of the reptilian parietal eye like most scientists?

The anti flouride crowd hang their hats on the flouride deposits as proof that flouride is toxic.

They have much better evidence for that than pineal calcification. This does occur however, as the blood that supplies the pineal lies outside the BBB.

There’s no evidence that’s the case, but they keep trying.

I see you haven't even bothered to do a Google Scholar search. The pineal hydroxyapatite ("brain sand") has actually been measured for fluoride concentration (via electrode). The concentration is much greater than in bone and increases with age, making the pineal gland the single organ with the highest concentration of fluoride (as hydroxy-fluorapatite).

" By old age, the pineal gland has readily accumulated F and its F/Ca ratio is higher than bone." –Dr. Luke

Fluoride Deposition in the Aged Human Pineal Gland
Caries Research

Ellie: If you have adblocker software, turn it on. Or switch to a different browser.

Panacea: Oh, thanks for clearing that up.

Alain: My grandpa trapped skunks for a while and claimed to be possibly the only man who had ever been sprayed by all three North American species of skunk in a 24 hour period. I suspect he spent the rest of the week sleeping in the yard.

Now I wonder how platypus tastes. I suspect not great, even if one manages to avoid the spurs.

sirhton: I had squirrel once, and that was pretty awful. Rodents were not meant for human consumption. I've heard cavy is good, but I kept guinea pigs as pets for years, so I could never eat it.

And, on cue, one live hippie-dippie shows up.

Something is wrong with your website.

It's been like that for at least a couple months now. I *think* it may have to do with 'load balancing' and the comments being spread out amongst different servers which take a while to filter down.

The strange thing is I can reload the site from bookmarks and see that I and others have made a comment only to click it and have it not be there.

Reloading by clicking on ORAC acts more like you describe.
==============================

TIL that certain people still think oxytocine is a right wing conspiracy. I'll remember that the next time I knock a girl up and the doctor wants to give petocine to induce labor.

Dr Luke's work was on a small number of cadavers, & claims such as Lentze's conveniently ignome the fact that the pineal calcifies with age; fluoride follows.

The parietal eye of some reptiles is not analogous to the pineal gland as they have that too. It appears to play a role in circadian rhythms.

If you had actually read about fluoride and the pineal gland, you wouldn’t have put scare quotes around that.

Don't worry, there's always the Schumann resonances to fall back on for defense.

"Then you'd notice about six huge hairy tits swelling up on your back."

I see you haven’t even bothered to do a Google Scholar search.

Heh.

Lentz: when the woo inclined call it the third eye, they erroneously mean it is the "seat of the soul", and attribute all kinds of mystical BS powers to it. And you knew what I meant, but you just had to go all off half cocked.

Thank you for your argumentum ad nauseum. It's so much better than my simple misspelling. It makes me understand why Orac hates pedantry so much.

Lentz: when the woo inclined call it the third eye, they erroneously mean it is the “seat of the soul”, and attribute all kinds of mystical BS powers to it.

That doesn't mean that darwinslapdog's backpacker's were imbibed with such woo.

Melatonin is very important and there is tons of research on that. By converting serotonin to melatonin, the pineal effectively lowers blood pressure during the PM and early AM hours. This increases brain perfusion allowing CSF to cleanse the brain.

People with cardiovascular disease and Alzheimer's Disease have been shown to have reduced melatonin levels.

Perhaps the backpackers were merely thinking about melatonin production. There is no reason to beat them with the "woo stick" for avoiding fluoride toothpaste. There are many good reasons to avoid avoid sodium fluoride, it's toxicity is well established (although, admittedly, it's effect on the pineal outside of its effect on mineral composition is less well-studied. The best evidence in this seems to be from a 297-page PhD dissertation from the University of Surrey.)

A closing quote from "Mechanisms of Fluoride Neurotoxicity A quick guide to the literature."

Fluoride is a developmental neurotoxin that has been linked to human brain damage since the 1920s when Fluoride induced cretinism was investigated and confirmed with animal studies. With advances in imaging, chemical analytical techniques including proteomics, detailed molecular mechanisms of Fluoride damage to the brain, spinal cord and nerve networks have been investigated with ever increasing levels of detail. The current peer-reviewed scientific publication rate regarding Fluoride neurotoxicity is about one paper per week. This literature guide provides a snapshot of the science as easily obtained in early 2017, to help inform those interested in the depth of knowledge and where the ongoing studies are directed.

Come on, most intelligent people know this stuff. How many people here actually use fluoridated toothpaste?

"Allowing CSF to cleanse the brain"?

Dr Luke’s work was on a small number of cadavers, & claims such as Lentze’s conveniently ignome [sic] the fact that the pineal calcifies with age; fluoride follows.

I don't usually ignome things.

Lentz: "I would be more inclined to believe you if you had spelled fluoride correctly."
Lentz: "ignome" (sic)
Lentz: "There are many good reasons to avoid avoid sodium fluoride, it’s toxicity is well established"

Yes, kiddies, another example of Gaudere's Law in action (those who point out spelling and/or grammar mistakes in others' posts invariably are guilty of spelling and/or grammar mistakes themselves).

I actually use fluoridated toothpaste and I've got the biggest, most bodacious pineal gland in the county.

Fucklesworth, that you?

PGP, thank you for the browser suggestion.

“Allowing CSF to cleanse the brain”?

Yeah. Search for the article called "Sleep Drives Metabolite Clearance from the Adult Brain" and read it.

Yet despite its high metabolic rate and the fragility of neurons to toxic waste products, the brain lacks a conventional lymphatic system. Instead, cerebrospinal fluid (CSF) recirculates through the brain, interchanging with interstitial fluid (ISF) and removing interstitial proteins,
including amyloid β (12, 13).

We used in vivo two-photon imaging to compare
CSF influx into the cortex of awake, anesthetized, and sleeping mice. The fluorescent tracers were infused into the subarachnoid CSF via a cannula implanted in the cisterna magna for real-time assessment of CSF tracer movement.
Electrocorticography (ECoG) and electromyography (EMG) were recorded in order to continuously monitor the state of brain activity (Fig. 1A and fig. S1).

Our analysis indicates that the cortical interstitial space increases by more than 60% during sleep, resulting in efficient convective clearance of Aβ and other compounds (Figs. 2 and 3).

The blood pressure raising effects of serotonin are well known, and its very name derives from this action.

Tim: It's pitocin, and you, like most of Reddit, are unlikely to ever be that close to a woman. Now go back to your snake pit, and let the adults talk.

Lentz: Or do you think that it is an evolutionary vestige of the reptilian parietal eye like most scientists?

A lot of vestigial organs are common throughout genomes. Doesn't mean they serve any purpose. When was the last time anyone's appendix did anything for them? Go back to your John Birch meeting, bub.

Ellie: You're welcome, glad I could help. I've learned that certain sites do not play well with certain browsers. Disqus in particular gives my Mozilla browser hiccups. (I have Explorer too, speaking of vestigial organs, which doesn't work with anything at all.)

Much of the time, quotation marks are used to indicate an actual quote. It's only in odd corners of the Internet that italics are preferred for that purpose, perhaps in reaction to people using quotes for emphasis, a use where italics would be more appropriate.

I'd recommend the Pale Moon browser (a Mozilla fork) with the Adblock Lattitude addon -- It really works a treat.

PgPig (#49) asks,

When was the last time anyone’s appendix did anything for them?

MJD says,

John Floyd was the only member of the Lewis and Clark expedition that lost his life, probably from appendicitis.

The expedition named the location Floyd's Bluff in his honor.

https://en.wikipedia.org/wiki/Charles_Floyd_(explorer)

Hope this answers your question, PgPig.

Doltchik: Point went whoosh over your head as usual. Why do we consider the pineal gland as a double-plus good when it hardly does any thing at all?

Lives in Stockbridge, Massachusetts and has a small practice on 40th street in NYC?

That's not really an easy commute, 2:30, so she must not be there much. She must have some deep-pocketed woo customers in NYC to support the expense of an office there.

For example, wisdom teeth and the appendix aren't a double plus good, so why is the pineal gland, a leftover like the rest , worshipped?

Jon H,

I do wonder if there's any monthly passes for that train: https://www.amtrak.com/acela-express-train

Still require some rich clients but that would be my choice of transportation to ease the pain.

PgPig (#56) asks,

...why is the pineal gland, a leftover like the rest , worshipped?

MJD says,

Propagation of the species?

The pineal gland produces melatonin, which helps maintain circadian rhythm and regulate reproductive hormones.

For many reasons, humans often worship reproduction.

Above melatonine, the pineal gland produces Dimethyltryptamine -- involved in religious experiences and dreaming.
=====================
It has been postulated that the appendix acts as a storehouse for gut flora in the event that the supply is wiped out; from, say, diarreah or antibiotics.

Doltchik: For many reasons, humans often worship reproduction.

Another example of humans being stupid. Have you really not noticed how all your fellow travelers in the Autism-is-a-plague group hate their kids? Why have kids in the first place if they're never going to be good enough to love?

Tim: The world would be a better place if there were no religion. God is just an excuse to wreck everything and be a bully- just take a look at Congress!

If you overstimulate the pineal gland, things can get weird with that third eye:
https://youtu.be/5kENuvJ2MIA

"Please don't eat those, they will make you very sick."

https://www.youtube.com/watch?v=H0FgsIkg2dM

Yes, a mind is a terrible thing to taste.

Tim:It has been postulated that the appendix acts as a storehouse for gut flora in the event that the supply is wiped out; from, say, diarreah or antibiotics.

It's not doing a very good job then if it gets infected so often that most adults have to have it removed. Or you know, if it keeps killing people. Also diarhea doesn't work that way.

Elie, your suffering may soon be over.
Yesterday,I read in Newsday that Starbucks is closing all 379 Teavana stores.
From what I can see in a short search, it will continue online and Teavana-branded products will be available in Starbucks locations, so I wouldn't get too excited over it just yet.

Sadmar: "If you overstimulate the pineal gland, things can get weird with that third eye:"
Racists, of which H.P. Lovecraft was one, often believe a lot of other crap beside their particular racial views.

There's still a lot we don't know about the pineal gland, like why it's outside of the blood brain barrier. Speculating that it has or has not an essential use is pretty pointless since we can't resolve the issue on a blog. Ditto the appendix, which may serve a use and most people go through their entire lives never having it removed.

But to claim the pineal gland is harmed by fluoride requires a little more evidence than the development of brain sand, since no one has ever shown it actually does anyone any harm.

And yes, Lentz, I brush with fluoridated toothpaste every day, and it's a good thing too since years of taking Depakote as migraine prophylaxis softened my teeth to the point where I now have five crowns. I haven't broken a tooth since I quit taking Depakote, and fluoride is likely why. We give it to people to harden their teeth and prevent cavities.

Tim: re Dimethyltryptamine. Citation needed.

Certainly, Panacea; but with the caveat that I only point out that the various flavors of the alkaloid are endogenous:

https://scholar.google.com/scholar?q=endogenous+Dimethyltryptamine+dmt&…

In 2013 researchers first reported DMT in the pineal gland microdialysate of rodents.

A study published in 2014 reported the biosynthesis of N,N-dimethyltryptamine (DMT) in the human melanoma cell line SK-Mel-147 including details on its metabolism by peroxidases.

In a 2014 paper a group first demonstrated the immunomodulatory potential of DMT and 5-MeO-DMT through the Sigma-1 receptor of human immune cells. This immunomodulatory activity may contribute to significant anti-inflammatory effects and tissue regeneration.

https://en.wikipedia.org/wiki/N,N-Dimethyltryptamine#Chemistry

@ PGP:

If I may venture a guess about
why woo-meisters and their compadres/madres have focused onto the pineal gland:
- there's not as much SBM being written about it**
- there's some mystery about its fxs**
- Cartesian myths about the soul etc
- it isn't represented on both sides of the brain so hey man it must some kind of unifier
- third eye myths

** So they have a somewhat blanker place to project their fantastical notions
although they also make up stories about things we do know much about.
-
-

the pineal calcifies with age; fluoride follows

Obviously it's the body's reservoir of calcium and emergency back-up halogens.

@Denice Walter #68: The third eye of Eastern traditions is nothing more than the mind's 'eye' or the ability of visualization.

@ ORD

I've never read Lovecraft, and have no interest in his schtick. I just know the 80's 'cult' film From Beyond, which is a hoot. I doubt the filmmakers took Lovecraft seriously, or considered the pineal gland anything besides a MacGuffin on which to hang "a funny, horrific grossout" (G. Siskel), with "gross sexual excess" that apparently displeased "hardcore Lovecraft fans" (Wikipedia).

Dr. Katherine McMichaels: If there is a statistical correlation between schizophrenia and the pineal gland, they may be feeling or seeing what we saw.
Bubbae: Well, what about the hard on I got? Is there a statistical correlation for that too?

BTW: Tim knows the movie is a joke, and as usual I think, he's gently yanking the chains of minions who take what he writes too seriously.

I doubt the filmmakers took Lovecraft seriously
Next you'll be telling me that Reanimator is not a documentary.

[The appendix is] not doing a very good job then if it gets infected so often that most adults have to have it removed.

From Wikipedia:

About 327,000 appendectomies were performed during U.S. hospital stays in 2011, a rate of 10.5 procedures per 10,000 population. Appendectomies accounted for 2.1% of all operating-room procedures in 2011.

Doesn't sound like "most adults" to me.

Since the thread has once again devolved into discussing films, I need to ask a question.
Valerian and the City of a thousand planets is in cinemas. The reviews have been scathing, but one found the film to be unintentional comedy, i.e. "so bad it's good". Has anyone seen it? And if so, should I go and watch it?

About 327,000 appendectomies were performed during U.S. hospital stays in 2011, …
Doesn’t sound like “most adults” to me.

I had one of those 327K appendectomies in 2011, for my seventieth birthday. Are you trying to tell me I'm not "most adults"? ;~Þ

@Lentz: I've used fluoride toothpaste all my life, and grew up with fluoridated water. My children have, also. We all have really good teeth, and as far as I can tell, my pineal gland is working just fine. Like most "antis" you don't seem to understand the dose makes the poison so fluoride, in the doses I've been getting it in my 50+ years isn't neurotoxic.

OT
@ Julian Frost 74

Valerian and the City of a thousand planets

I'm French and a fan of the comics version, so my own opinion is highly biased...

On the minus side:
I haven't seen the movie yet, just the trailers, and I developed strong misgivings. It seems too far away from the comics. I was already disappointed by the TV cartoon adaptation, back in the 90's, so maybe I'm just giving up.
Also, the author of Schlock Mercenary, whose movie opinions I tend the value, wrote an abysmally negative review about one week ago. He confirmed my suspicions about the movie.

On the plus side
Colleagues saw the movie this week-end. A bit long, especially the romance bit, but plenty of nice special effects.

Judging by the relatively good critics in French news, I feel like, if you are looking for an American sci-fi movie (or for a French movie), you will be disappointed.
If you are looking for an American movie done by a French, you may be alright.

Uh, sorry I cannot be more helpful...

Next you’ll be telling me that Reanimator is not a documentary.

No. I might try to convince ORD of that, but I know you know better.

Julian Frost: That few? I was under the impression appendectomies were much more common than that. Next you'll be telling me most adults still have their tonsils.

JF: I'd go and see it. The Fifth Element got fairly scathing reviews, but it was such a pretty movie. I think this one will be the same, so if you want to get the full advantage of the visuals, see it in theaters.
(Also, if you haven't seen it, Midnight Special, speaking of gorgeous movies. Who-a.)

Lentz @43: "Come on, most intelligent people know this stuff. How many people here actually use fluoridated toothpaste?"
::raises hand::
I used to be rabidly anti-fluoride, ever since the 1970s or so. I used all kinds of herbal-based and 'natural' toothpaste. When I did use toothpaste, that is; I reasoned that brushing your teeth wasn't really natural (truth be told, I was just to lazy to brush regularly). I never bothered to really examine the fluouride contreversy, just accepted the "it isn't natural!" argument.
Then, about three years ago, I found myself at the dentists having a mouthful of horribly rotten teeth attended to. At the end of six sessions of removals and fillings, the dentist handed me a prescription for double-strength fluoride toothpaste, with instructions to use it twice a day until it ran out, then use normal fluouride toothpaste twice a day from then on. When I looked doubtful, she promptly launched into a mini-lecture explaining in some detail how fluouride reminaralises worn-down tooth enamel - and the enamel on my remaining teeth was *very* thin, as simply looking in the mirror showed.
I went on the internet when I got home and checked what she'd told me, had the "Why didn't I bother to find this out before??!!?" revelation, been using fuoridated toothpaste ever since. Never had any more dental/gum problems, teeth are now quite sparkly and fit to show!
And that's my story.

re the film, Valerian....

I suppose I am so steeped in woo/ herbalism that as soon as I saw the title** I thought about the herb's sedating qualities so you can insert your own snark about the film..

** I wasn't aware of previous sources like comics

@PGP #79, I'm not sure if you're being sarcastic or not. South Africa has the highest number of tonsillectomies performed (1 888 per 100 000 people under the age of 19) in the world. Most adults have their tonsils.
Over the last 30 years, the number of tonsillectomies worldwide has fallen significantly.

Re Valerian: when it comes to movie adaptations of novels or comic book, I remind myself that film is a completely different medium, and adjust my expectations accordingly.

From what I saw of the trailers, I wasn't impressed by what the story seemed to be about. I have never read the comic.

But the landscape visuals are gorgeous, and I may go see it for that and no other reason . . . . to appreciate visual artistry on the big screen, and see if the score is any good (if it is, I'll get it; plenty of bad movies have great scores)

And who knows. I may even enjoy the ride if I don't get my expectations too high.

I hated the 5th Element when it first came out, and I saw it in theatres. Thought it was awful. But I do like Gary Olman (not his best role), and the film is worth watching for Ruby Rod and the Diva alone. So maybe I'll get lucky and there's a character like that in Valerian that'll make the film worth the bucks.

But I'll see a matinee.

Julian: 50% sarcasm, 50% honest query. I will say that 'do you have your tonsils/ appendix' is not something I've ever asked my friends, though one did mention her tonsillectomy at one point. Due to the high prevalence of both in the media I assumed that their rate of occurance was much greater than it appears to be.
Though pericarditis, apologies for the spelling, is in fact probably as rare as I thought it was

Lentz, this is kinda late in the day, but as I’m traveling, I haven’t checked in that much, but for what it’s worth at this point, the “scare quotes” weren’t that at all-- they were there to quote the hitchhikers exact words. Isn’t that what “...” are actually for?

Secondly, the hitchhiker was definitely deep into the woo, or I wouldn’t have bothered to relate any of the experience.

I was curious about Bell’s Palsy after reading through these comments so went to what I usually consider a respectable source. Disturbingly I found this under “How Is It Treated”:

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sh…

Maybe Ms Jolie also tried to find reliable information?

We are losing the battle bigly.

Lentz,
I use prescription fluoridated toothpaste, because I didn't get enough as a kid (non-fluoridated water), and now my enamel is soft and fragile.

But no one is forcing you to use it, so please feel free to skip it. Just know that not having your own teeth takes years off your life expectancy.

Re: Valerian: the reviews I read were not good, but several friends said they enjoyed it, so maybe it's more fun than good?

Re Romm and Yale - Yale Med School may offer some form of so called "integrative" classes as part of their overall curriculum but last time I looked Yale was considerably more highly rated in the US "league" of med schools than Case Western, and remains considerably harder to gain admission to. I'd like to see how many of the numbskull commentators here would succeed in getting into top schools like Yale/Harvard/Stanford/Johns Hopkins etc after all the highly credentialled (and highly opinionated) Orac did not make it to a top ten school, while his own (rated 77/100) alma mater is also offering "quackademia". Logical criticsm is one thing, below the belt insolence is arguably disrespectful and smacks of sour grapes. Like the old joke - what do you call a doctor who came bottom of the class? Doctor.

Actually, I graduated from the University of Michigan Medical School, silly, ?

Of course, other than in selecting residents, nobody cares what medical school you went to. Seriously, within a couple of years of graduation, no one cares any more.

I had steroids and an anti-viral course. I suppose massage might help, but I chose not to do that. (Also, do not EVER mix puerh or dark tea with steroids. I spent about thirty minutes thinking I was gonna die, my heart was going so fast.)

Just know that not having your own teeth takes years off your life expectancy.

Looks like someone is setting-up a false dichotomy.

There are recorded cases in which fluoride has actually decreased longevity, substantially.

Acute Fluoride Toxicity from Ingesting Home-use Dental Products in Children, Birth to 6 Years of Age
Journal of Public Health Dentistry
Jay Shulman, DMD

Sara: Well, if you're a child and you EAT toothpaste, or drink a rinse with fluoride in it, toxicity can happen. The dose makes the poison.

You're talking about an acute episode. You have to drink or eat a lot of fluoride to get there.

However, we know that poor oral hygiene is directly related to endocarditis. And that we know takes years off your life expectancy. It's why people with high blood pressure must have it controlled before dental work. It's why people with really bad teeth have to take antibiotics before dental work.

jonno: Wow. The appeal to authority fallacy. Sort of. Where you went to school isn't a direct reflection of your expertise. It's how you get your foot in the door. What you do after that is all on you.

That's why Orac said that literally no one cares after a few years. No one does.

But you do remind me of an ER physician I used to work with who used to brag about how he graduated from Stanford. It got so annoying I told him one day, "I graduated from nursing school before you even started at Stanford."

Surprisingly, it shut him up. At least, when I was in the room.

"Acute Fluoride Toxicity from Ingesting Home-use Dental Products in Children"

Recommendations from that report: "Dentists and other health care providers should educate parents and child care providers about the importance of keeping fluoride products out of reach of children. Manufacturers should be encouraged by the ADA and the FDA to use child-resistant packaging for all fluoride products intended for use in the home."

Wow, what controversial ideas. :)

I suspect there's a risk of toxicity when kids get into lots of different sorts of drugs and supplements. Maybe even vitamins?

Yep.

http://www.emedicinehealth.com/iron_poisoning/article_em.htm

Guess we should ban vitamin pills.

Confession: My medical school was not a top tier institution. I use snark to make up for my feelings of mediocrity. :(

I’d like to see how many of the numbskull commentators here would succeed in getting into top schools like Yale/Harvard/Stanford/Johns Hopkins etc

Just out of curiosity, "jonno," where are your postsecondary degrees from?

Sara: Well, if you’re a child and you EAT toothpaste, or drink a rinse with fluoride in it, toxicity can happen.

You misspelled "Fucklesworth," BTW.

Valerian -totally lame and cliched. Trailers better than movie.very disappointed..

Jonno - you dumba$$ - many people go to the medical school or university they can afford. Like, local, live at home, minimal debts, etc.

Welcome to the real world.

Jonno, I graduated in about the middle of the pack of a Guggenheim School of Aeronautics. My class started with seventy students, and about half of that graduated. I was in the middle of the pack.

One of the graduate who graduated a bit higher than me was actually fired by a large aerospace company. Something that rarely happened there. Usually they reduced head count by lay offs. The difference with being "fired" is that they will never hire them again.

It turned out that he cheated through out the program. I always wondered why he made sure to sit next a certain student. Apparently he copied what that guy wrote.

A really nice guy who drew fantastic artwork on the black boards, who came from a working class family and was very modest about his achievements. He had to convince his parents that he was not throwing his life away by going to community college instead of going directly to the factory floor as a mechanic. He was featured a few years ago on a company publication as a brilliant technology fellow.*

So apparently the other guy who was fired from the same company could not find anyone to cheat off of when he was employed.

By the way, I am old enough to have worked with women who became engineers after being human calculators. You can read about them in Rise of the Rocket Girls: The Women Who Propelled Us, from Missiles to the Moon to Mars and Hidden Figures: The American Dream and the Untold Story of the Black Women Mathematicians Who Helped Win the Space Race. Both are good reads. (My favorite anecdote from the first book is that one the women who did not finish her college degree was downgraded from "engineer" to "technician"... which meant in rules of employment for JPL/NASA that she had to be paid overtime for any week over 40 hours of work, that turned out to be very expensive, so she was reclassified as an "engineer" ;-) )

So, yeah. Don't rely on college/department rankings for much after a few years past graduation.

*
Oh, crud... I did not delete the asterisk. I was going to mention that he and I were in the same discipline (structural dynamics and loads), but in different company divisions.

If I had a choice I would have loved to work in his group. He was, and I assume, still a cool guy.

Jonno: You do know that a lot of people who get into Yale or Harvard do not get in on their own merits, right? Even the medical programs are susceptible. (Really, I haven't taken Yale seriously since 2000.)

Valerian and the City of a thousand planets
I’m French and a fan of the comics version, so my own opinion is highly biased…

Heavy Metal printed a couple of the story-lines, many decades ago. I remember them as being rather fun.

@ Panacea:

Interestingly, alties/ woo-meisters often trumpet either the schools they attended or the degrees they attained EVEN when they studied an area totally unrelated to what they discuss ( Mike Adams, Louise Kuo Habakus, Mark Blaxill, Heckenlively, other anti-vaxxers like the MIT computer maven or the Thinking Moms) or when their degree is unrelated to reality ( mail order or worse).

HOWEVER they often criticise universities and academic standards as being corrupted by outside influences and money. I find it hilarious when a web woo-meister talks about reforming educational systems because students' abilities are so abysmal.

You can't have it both ways.

Someone else for Orac to respectfully insolate:
http://americanloons.blogspot.com/2017/08/1878-caroline-leaf.html

Denice: good point. Very often when people attack academic standards, it's code for "schools aren't teaching students my point of view."

Nowhere is this more obvious than in the creationist movement. But you see it in conservative attacks on "liberal" college campuses (my students have a wide spectrum of political views), attacks which came fast and furious long before someone told Milo he wasn't welcome at Berkeley and he got all butthurt about it.

When the experts don't tell you what you want to hear, attack the experts. A lesson Michael Mann learned the hard way.

@Orac #89 Apologies for the misattribution. I guess you are right to some extent about the receding importance of one’s original school and its hard to “top” an onc.surgical residency/ fellowship AND PhD in cell biology for relevance to the critical project of your blog. In a way, all the more reason for you to uphold the “respectful” part of your “insolence” - some of the commentators on this blog remind me of Trump supporters at an election rally - smearing Romm because Yale has (sadly along with most upper echelon med schools) has an “integrative”dept is the kind of logical sleight of hand that you are usually quick to identify and take down when employed by others. Many of your readers comments here are rather less nuanced than they might be. (welcome to the internets:)

I share your dim view of so called “integrative” medicine and I guess that even the better schools feel obliged to offer such because the mindset of the top percentile of today’s MCAT scorers is nonetheless befuddled enough to think it a relevant factor in deciding where to get their medical training…its as much about marketing as anything else.

Finally, FWIW, Dr Romm, along with for example Dr Tieraona Low Dog, are fairly rare examples of individuals who were deeply involved with herbal medicine for many years prior to their MD training - which they presumably undertook because of the medical shortcomings of "herbal medicine”. I would suggest this is “transdisciplinary” rather than integrative, but if more “alt-med” types knuckled down to learn real clinical medicine we would perhaps be dealing with less pervasive woo/alt BS .

Transdisciplinary is just another buzzword for alt med, integretive medicine, or CAM. If it doesn't work, it's quackery.

My beef with Dr. Romm is not where she went to school. It's what she's doing with her training. I don't care if she was involved in herbal medicine "before" going to med school. Do you really think it makes it better to think she went to med school because of the "medical shortcomings of herbal medicine?" To think she got an MD to benefit from the imprimatur of that training would be the rankest form of cynicism in terms of her motivations.

I prefer to think she just got stars in her eyes over the money.

It turned out that he cheated through out the program. I always wondered why he made sure to sit next a certain student. Apparently he copied what that guy wrote.

Wow. I'm glad he got fired.

@panacea #105. Confounding the issues I think. On semantics - using herbals that may “work” for certain indications is neither herbal medicine nor biomedicine these days. E.g. ginger root can be (and is) regarded/classified variously as a food, a dietary supplement, a traditional herbal medicine, or a prescripton medicine depending who prescribes or recommends it for what. Context is key and this is all enshrined in regulatory terms. If a licensed provider suggests a patient try ginger for N&V of pregnancy ( a supported indication) you can of course “pretend” that is an rx drug because it “works” per trial data - i’d prefer to use a descriptor that reflects the multifaceted multi-context uses of such a material. Of course it either will either help or not, but ginger was being used in herbal medicine for centuries before trial data became available to support its potential rx by modern day licensed healthcare professionals.

You are pretty much exemplifying what I referred to as “lack of nuance”with the simple smear “its quackery” if it does not “work". The discussion of what “works” is too involved for commentaries in other people’s blogs, but again, its actually a fairly complex subject that can be addressed at various levels - if one is so inclined. The Science Blog staffers have touched on several aspects of this over the years. The point here is what do you call it if it does “work”? Ideally I suppose nothing :) but we seem to need to name & classify stuff. Give me an alternative that works for you.

The question is what are we discussing and why? If you are happy with your soundbytes - that’s your right of course. If a cancer patient experiencing chemo induced N&V asked if ginger might help I would say try it, it might. Zofran is hardly a panacea after all and can actually make those sx worse in some instances. What would you say? Quackery because there is no trial support for ginger in CINV? Maybe these questions do not come up in your world, but things are rarely conveniently black and white….

As for Romm, I frankly have no idea what she typically recommends, (although she appears now to not recommend goopdom) but I hesitate to presume that its solely financially motivated; finances necessarily affect the majority of medical practice in our culture. And It was not my point re Orac’s post.

I just ran across a woomeister who makes Dr. Romm look like a sober and rational practitioner.

Dr. Karen Kan bills herself as an "Earth Angel Starseed" physician. According to her website: "Her empathic specialty is sensing and clearing Dark Spirit influences from her patients and clients from all timelines and dimensions and helping people navigate the Ascension with greater ease."

Dr. Kan sells a bunch of nifty supplements and other products on her site, including a line of audios and videos of which the following is my favorite:

"Ascension 1 All-in-One: Removes negative energy including curses, entities, negative cords, energy weapons, implants from all time lines and dimensions at the speed that is perfect for you or the person/place/thing you target. It also downloads the Universal shield to protect you from negative energy."

http://karenkan.com

Dr. Kan (who has a radio show) is also an "award-winning" acupuncturist and an antivaxer. Who'da thunk it?

I'm sure Dr. Kan won't mind a little snickering at her brand of bizarre woo, since she no doubt has a Universal shield deployed to protect her from negative energy.

Sara: "Wow. I’m glad he got fired."

Oh, so was I. He was an insufferable twit. The polar opposite of the dude he copied off of... a guy that I would have gladly worked for.

jonno: " Ideally I suppose nothing ? but we seem to need to name & classify stuff. Give me an alternative that works for you. "

What do you call "alternative medicine that works"? We call it "medicine." See this:
https://www.youtube.com/watch?v=HhGuXCuDb1U

By the way, the most recent cancer breakthroughs are way over in the fringes of the imagination. Some actually work. So there is actual value in real scientific research.

Because the "fringes of the imagination" are only in the minds of those who do not actually understand the science. This is what we in the autism community find when several genetic sequences have been found to cause the behaviors, but the "vaccines cause autism" and "this will cure it" folks refuse acknowledge that research.

All I say to them is to get their family as participants of https://sparkforautism.org ... become part of the solution, and stop being part of the problem.

@jonno: your examples of ginger aren't really good ones. Most people - physicians as well as lay - know that ginger *may* help with mild nausea and vomiting. However, if you try to tell someone who is vomiting uncontrollably to try ginger instead of Zofran, you'll probably get laughed out of the room (or vomited on). I love ginger and use it for mild nausea. However, since I tend to vomit uncontrollably after anesthesia, I make sure any doctor is aware of that and get Zofran instead of ginger ale.

Also - you have to understand drug interactions. If the ginger is going to react negatively with a patient's medication, then maybe you DON'T want them using it.

If the ginger is going to react negatively...

Gingers are negative about everything, with the sole exception of this guy.

"helping people navigate the Ascension with greater ease"

I prefer GPS.

Dangerous Bacon:Wow. all the woo in one handy package. I am so tempted to submit her site to a podcast I know of.

"Her empathic specialty is sensing and clearing Dark Spirit influences from her patients and clients from all timelines and dimensions"

I'd really like to meet some patients from other timelines and dimensions.

While driving home from work today I was treated to an ad for "Juice Beauty" cosmetics featuring Gwyneth Paltrow. Checking into one type of goop this company recommends applying around your eyes, I was shocked to see the following ingredients:

"sodium benzoate, potassium sorbate, ethylhexylglycerin, panthenol, magnesium ascorbyl phosphate, tocopherol, sodium hyaluronate, stearic acid, butyrospermum parkii, allantoin."

Those are CHEMICALS!* And as the Food Babe has told us, there is no safe level of any chemical in our bodies. Also, many people can't pronounce those words, so they must be especially dangerous chemicals. Shame, Gwyneth.

*malic acid, citric acid, stearic acid and tartaric acid are also listed components of Juice Beauty's products. ACIDS to put on your skin, and (shudder) around your eyes? What was she thinking?
**even more shockingly, one of the company's anti-wrinkle "eye care" concoctions contains "fruit stem cells". What if these are absorbed into the bloodstream and become differentiated fruit cells in your body, causing you to start budding, leafing and fruiting? This could be worse than anything Monsanto has done. :(

It is sad to see quality adhesives like Shoe Goo and Gorilla Glue suffer guilt by association with these profoundly goofy patent medicines and the carnies that hawk them.

It is sad to see quality adhesives like Shoe Goo and Gorilla Glue suffer guilt by association with these profoundly goofy patent medicines and the carnies that hawk them.

My thoughts exactly!!! (Ahemm...I sold-short Goop™ hand cleaner a few weeks ago and I'm making a killing.)

Thought I'd leave this here: https://www.theguardian.com/fashion/2017/aug/07/colette-welcome-gwyneth…

Are Gwyneth Paltrow and Goop winning against skeptics?

oracknows — Fri, 21 Jul 2017 01:41:54 +0000

Are Gwyneth Paltrow and Goop winning against skeptics?

One of the problems we as skeptics and advocates for science-based medicine face is that quackery and pseudoscience are legion. They are everywhere. Worse, in many cases, they can be a good business model. For example, back when Oprah Winfrey was peddling The Secret, the magical mystical belief that if you only want something badly enough, the universe will somehow provide it, and promoting Jenny McCarthy's antivaccine beliefs, skeptics were all over her. Many were the refutations of the nonsense that she promoted published in a wide variety of blogs, websites, and magazines; yet her brand wasn't based on what skeptics thought. Criticism had little effect. Her brand was selling a fluffy, gauzy, "positive" attitude and lifestyle, and when she ended her long-running show it was on her terms, not because she was driven from the air by low ratings. A more recent example was, unsurprisingly, spawned by Oprah. I'm referring, of course, to "America's Doctor" (whom I like to refer to as "America's Quack"), Dr. Mehmet Oz. Many are the times I and others have documented the rank quackery and fear mongering he's promoted on his show, be it homeopathy or the lie that carrying a cell phone in the bra causes breast cancer. Oz was even dragged before a Senate committee and humiliated, not having realized that he was a major target. It all seems to have had little effect on his brand. Indeed, when a group of physicians associated with an industry-aligned "science" group attacked Oz, it backfired miserably. Dr. Oz's show is still around, still a "strong performer," and was recently renewed through the 2018-2019 season.

Such were the thoughts roiling through my brain as I came across an article by Julia Belluz entitled Is Gwyneth Paltrow’s pseudoscience winning? Writing in the aftermath of recent incident in which the editors of Gwyneth Paltrow's goop, that wretched hive of scum and quackery catering to affluent, woo-prone women by selling them jade eggs to stuff up their vaginas, magic energy stickers for health, and, of course, homeopathy and the usual assortment of alternative medicine, counterattacked against skeptics criticizing it by singling out one of its most persistent and vocal critics, Dr. Jen Gunter, Belluz wonders if skeptics are having any effect:

As the Goop website has emerged as a reliably laughable source of pseudoscience, a small army of journalists (myself included), doctors, researchers, and bloggers has evolved to pounce on Goop’s claptrap as soon as it’s out. We explain why jade eggs for vaginas, $30 sex “dust,” and body stickers that “promote healing” are misleading drivel. In the best cases, we use Goop’s bunk to teach people about how actual science works. It’s practically a parasitic relationship.

Recently, though, I’ve been asking myself what impact all this debunking is having.

Noting that she's been criticizing Goop and Paltrow since 2013 and rattling off a list of examples of her work and that of others deconstructing the rank quackery peddled by goop on a daily basis, Belluz notes:

In the time we’ve been debunking Paltrow, the stories and books pointing out the absurdity and potential harms of Goop’s claims have certainly been read and bought. And it’s clear they resonate with certain readers.

But the Goop empire has also grown and expanded in influence. So I set about to understand why — and what impact, if any, critics have had on the brand.

She then notes that, despite the debunking Goop appears than ever. Even though it's not a public company, which means that we don't know how much money it's making, Belluz notes that Goop raised $15 to $20 million in venture capital last year. Of course, compared to the Oprah and Oz juggernauts, that's not particularly impressive, but it's definitely nothing to sneeze at, either. Just last month, Paltrow held the first inaugural Goop Summit, which garnered extensive news coverage, some good to neutral, some mocking, but, as they say, any publicity is good publicity. One thing the publicity did reveal is just how much about the money Paltrow is:

This is Paltrow’s peculiar gift — or grift — and it was on full display at “In Goop Health,” her day-long event meant to bring her website’s “most requested and shared wellness content to life.” By last week, all 500 tickets, ranging from $500 to $1,500, had sold out; another event is planned for New York City in January.

Attendees were told via email to arrive at 9 a.m. The summit wouldn’t actually begin for another hour, which allowed enough time to shop inside a cavernous industrial space for Goop-branded products such as water bottles ($35), hoodies ($100) and a “G.”-branded flight pack consisting of four thin nesting canvas bags containing some magnesium packets, a sleep mask, earbuds and moisturizer ($198).

It was the physical manifestation of the day to come: For those willing to spend so much on so little, Paltrow will happily take your money.

The conference itself, of course, was chock full of every quackery imaginable, all peddled by celebrities and celebrity doctors. The dubious health modalities ranged from "leech facials" to aura photographs—"Holy quackery, Batman! Kirlian photography!"—to IV drips to earthing to crystal therapy (of course!) to the lectin avoidance diet, which was touted by Dr. Steve Gundry in his counterattack against Dr. Gunter. Indeed, going back to read about it now, I can't believe that I only started to pay real attention to Goop within the last month. It's been around since 2008, and Paltrow's company's been peddling utter nonsense a long time. I have a lot of catching up to do.

On the other hand, Belluz makes a good point. When I noted that the article by Dr. Steve Gundry and Dr. Aviva Romm was represented as being the first in a series of articles responding to Goop critics, my first reaction was, "Bring it!" It still is. However, my first enthusiastic reaction is now tempered by this realization:

Harvard Business School brand analyst Jill Avery told me this response may have been a calculated move to strengthen their brand and draw their customers closer. “The segment of consumers who engage with Goop are interested in alternative, homeopathic remedies,” Avery said. “So, when Dr. Gunter challenges Goop, she challenges the ideological foundation of its consumers as well.”

What’s more, Avery said, the Goop response evokes “themes from feminism, Eastern medicines and philosophies, and anti-establishment politics to incite [Paltrow’s] consumers to action: to make them feel as if they are under attack, to reassure them that their ideology will be supported by Goop, and to arm them with arguments to help them defend themselves.”

And:

Still, wouldn’t the negative press surrounding Goop’s health claims have made some dent in their business? Avery doesn’t think so. “The old adage ‘no news is bad news’ comes to mind here,” she said.

I also posed this question to Larry Light, author of Six Rules for Brand Revitalization and the chief executive of the brand consulting company Arcature. “You can’t attack a belief with facts,” he said. He agreed the Goop debunking would only galvanize its fans and thought that Paltrow’s new summits and magazine would further expand the Goop cult and deepen its members’ beliefs.

This is, of course, always the danger whenever skeptics go after a cult-like group like Goop acolytes. I also suspect that all the negative press last month mocking the Goop Wellness Summit struck a nerve, leading to this counterattack. Given the timing (not long after a whole lot of negative press about credulous, wealthy women spending ridiculous sums of money to imbibe the quackery being promoted by Goop and buy lots of Goop product), it's also quite possible, likely even, that this attack on Dr. Gunter was an intentional business strategy to do exactly what is described above: Rally Goop's fans and provide them with enemies who can be caricatured and attacked. Dr. Jen was a convenient first target because she fought fire with fire. When Paltrow attacked her critics by saying "If you want to fuck with me, bring your A game," Gunter fired back by saying Dear Gwyneth Paltrow we’re not f**king with you we’re correcting you, XOXO Science. Yet, Goop used her use of the F-word as an excuse to paint her as somehow uncouth and crude compared to its "respected" doctors. Indeed, Dr. Gundry's simultaneously pearl-clutching, mansplaining misogyny was indeed something to behold.

It wouldn't surprise me if the next subject of Goop's attacks is Tim Caulfield, who's even written a book criticizing Gwyneth Paltrow and Goop. Then I could easily see Julia Belluz and other frequent critics of Goop finding their way onto the list of people attacked in regular counterattacks. The reason they weren't first on the list is because Jen's use of the F-bomb gave the editors an opening that the other targets didn't provide. Never mind that it was only in response to Goop's Dear Leader's firing first. Indeed, Paltrow herself is a canny businesswoman who knows that there's no such thing as bad publicity:

But really, the fact that Goop has survived – and is seemingly thriving – despite the endless mockery is because Paltrow, as a former darling of Hollywood, is all too aware of the power of the press. As she told Linkedin, “When you have an e-commerce business, no press is bad press". Even in 2013 the scorn was beginning to fade, as Bloomberg’s Joel Stein admitted: “after a while you stop laughing at those $935 leather-and-gunmetal pants from Rag & Bone—instead, you want to own them”.

So does this mean that skeptics are wasting their time deconstructing Goop's quackery? It's not as though the website slowed down after this little dustup. It's still peddling homeopathy and writing about how to "detoxify" yourself from "hidden mold." There's little reason to suspect that Goop will stop. Like many quacks, it's basically immune to criticism. That doesn't mean criticism isn't worthwhile.

Belluz rightly points out that we "need to think about how to prevent Goopshit from taking off." We do. We definitely do. She points out that we need to teach people how to think critically from a very early age. However, that's not to say that "debunking" is worthless. If I thought that, I wouldn't do it.

Think of it this way; liken it to the antivaccine movement. Goop basically peddles misinformation and nonsense on par with the pseudoscience and misinformation peddled by antivaxers. When I debunk antivaxers, I realize that I'm not going to change the minds of hardcore antivaxers. They're too far down the rabbithole, and it's incredibly hard to change the mind of a person like that. In fact, it's damned near impossible. They have to be predisposed by other things in their life to change their mind before deconstructions of their beliefs might have an effect. No, I aim my efforts at those who might be on the fence, who might be susceptible to the pseudoscience of the antivaccine movement but are reachable in such a way that good information, entertainingly (I hope) presented, has a chance of beating back the bad.

It's the same with Goop. I don't expect to change a Goop editor's mind. I don't expect to change Gwyneth Paltrow's mind in the unlikely event she were ever to read one of my posts. I don't expect to change Dr. Gundry's or Dr. Romm's mind. I don't expect to change the mind of someone buried deep into the Goop lifestyle. However, there are a lot of women who might see the rhetoric of female "empowerment," coupled with the star power of Paltrow and her minions, and not have the background knowledge to know why what she's peddling is bullshit. Skeptics can provide the knowledge, facts, and science to help them evaluate the products Goop sells. There's value to that. There's power to that. In fact, that's real empowerment.

oracknows Thu, 07/20/2017 - 21:41

Tags

Antivaccine nonsense

http://real-psychiatry.blogspot.ca/2017/02/remission-before-discharge-u…

leech facials

I am disappointed by the lack of enthusiasm in alt-med circles for my own proposed modality of hagfish-slime facials with lamprey dermabrasian.

I know this can never be proven, but I do think that this debunking is having an effect. I think quacks who rose to extreme heights- like Dr. Oz- got a pass until it was too late. Same thing with Food Babe. Their imitators won't be impoverished, but if skeptics keep doing their job, their success will have a ceiling it previously did not. Also, teaching the public to recognize these frauds takes time. The "psychic hotlines" that scammed people in the 1980s and 1990s seem to have vanished and earn the scorn and derision of most today. Other quack fads have come and gone. Hopefully we'll look back at goop 20 years from now like we now look at Miss Cleo.

Goop just reminds me of Reginald Perrins "Grot" shop.

YouTube - Grot

At least old Reggie was honest, but the customers inexplicably came anyway.

Unfortunately, a pleasant sounding lie is always going to sound better then an ugly truth. Pseudoscience is perpetually the pleasant lie.

On a side note. It's irritating to see things like this: http://www.cbc.ca/news/canada/saskatchewan/saskatchewan-cancer-patient-… Basically we've hit the point of encouraging people to use BS treatments, and doctors must still provide follow-up care while the patient is going against medical advice.

HDB: I realize you jest, but that does explain this:
http://www.bbc.com/news/av/world-us-canada-40609528/truck-full-of-hagfi…

Orac: It’s been around since 2008, and Paltrow’s company’s been peddling utter nonsense from the very beginning. I have a lot of catching up to do.

Maybe not that much. As I understand it, up until her divorce from that guy from Coldplay, Paltrow was mostly running it as a side gig, basically a supersized version of an Etsy shop of some corporate CEO's wife. It wasn't until after the divorce (2014 or so) that she really doubled down on it.

@2: The Psychic Readers Network (the one Miss Cleo worked for) wasn't shut down because of debunkers, though; it was shut down by an FTC lawsuit for deceptive advertising, billing, and collection practices. Deceptive advertising not for the psychic claims, but for misrepresenting the cost of the service. And it was the organization that did most all of the TV advertising. Phone psychics didn't go away because of debunking, they went away because of illegal business practices.

Er, not an FTC lawsuit obviously, FTC prosecution. Was confusing it with the civil suits that were brought around the same time for the same reason.

As a high school science teacher I sadly must agree that sCAM is winning. When a town of 11K has almost as many chiropractors as family doctors, then sCAM is winning. When I hear colleagues who are sick or injured say "I went to my chiropractor...", then sCAM is winning. When I see students covered like mummies in kinesiotape, then sCAM is winning. When the busiest store in your mall is GNC, then sCAM is winning. Skepticism is hard an offers no easy answers - that is a difficult sell many people (a hard pill to swallow if you will).

HDB: That's because it's all about marketing, baby.

Bill it as "ancient naturally based oceanic facial with natural tubular dermabrasian" and they'll line up around the block, the suckers.

No, I aim my efforts at those who might be on the fence, who might be susceptible to the pseudoscience of the antivaccine movement but are reachable in such a way that good information, entertainingly (I hope) presented, has a chance of beating back the bad.

That you do, Orac, in a way that I admire and appreciate so much. Thank you.

This site and SBM broke the gravitational pull towards woo for me and I'm grateful.

Belluz is out of her element in trying to parse the growth of Goop and the effect of critique. She winds up conflating the problem of any attack – 'all publicity is good publicity' – with the specific problems of a skeptic debunking – sober explications of scientific fact are weak persuasion to general audiences. She also over-rates her own potential influence. So Goop has continued to grow in the four years she's been debunking it. Well, what did she expect? She's just one voice, and she doesn't have anything resembling Paltrow's megaphone. Maybe Goop would have grown more without her efforts. And while she may have been dogging Goop since 2013, Goop has really only entered the pop culture stage as a subject of ridicule recently, with John Oliver's takedown and "all the negative press last month mocking the Goop Wellness Summit." Belluz should probably be taking a bow on behalf of the early-adopter Goop-critics, as if they hadn't labored in their own limited channels, there probably wouldn't have been anything to leak out into the more popular media streams, no place for the newer critics to get the quick concise background material they need.

There's a big difference between factual debunking and mockery. Mockery will create a backlash, but if it's done well (easier said than done) it can be deadly over time. If Goop becomes a stock punch-line for late night TV comics (somebody get Kimmel on this) let's see how well it's doing a year after that.

One fairly obvious problem is Belluz's worry about the growth of Goop in general. She takes this as evidence of some broad increase in woo acceptance, but that's not necessarily the case. Goop may well be just stealing market share from other Veblen-Good-slinging 'lifestyle' brands and other pseudoscience scams. And, for that matter, she may over-rate the role of the more woo-ey Goop products in the success and growth of the brand, compared to the role of what appear to be the core products displayed on the Goop website: Clothing, Shoes, Bags, Jewelry, Accessories, Fragrance, Skincare, Beauty...

Methinks even the wellness woo is more 'lifestyle' than dangerous alt-med. In that, I have to say I think Orac is way overboard in comparing Goop to antivax. Anti-vax is anti-science as religious zealotry, Goop is pseudoscience as fashion. Fashion is all essentially 'bullshit', which is to say it's all about aesthetics over pragmatics. Of course, aesthetics aren't really BS, they're a pretty fundamental aspect of being human. But we don't treat our aesthetic objects literally; their function is figurative. And the aesthetics of fashion are always more surface than substance, and most importantly, constantly in faddish flux. How different are Vagina Jade Eggs from Pet Rocks? If wearing Energy Healing Body Stickers is hip in 2017, it will probably be passe by 2018, and gauche by 2019. And if we understand Goop-woo as fashion, we may be somewhat reassured that a large part of it's appeal are gratifications that have nothing to do with serious deviation from sensible medicine, in those senses that fashion is fundamentally un-serious, a game of "let's pretend", a form of having fun.

There's a great used book store in Niantic, CT, near where I used to live that has a section in the front of the store labeled "Atheists, Skeptics and other killjoys". The guy who wrote that was a friend of mine, so I knew it was double-edged irony, and appreciated the thought, acknowledging that I can indeed be a killjoy sometimes. For example, I f-ing hate 'Star Wars'. Part of that is that (with the exception of TESB, and Rogue One) the movies are just cinematic pablum. But another part is that I think the whole mythos is ideologically insidious in the ways its anti-science and privileges magical thinking. But to attack 'Star Wars' is to attack fun, and that's not without it's problems. It's hard to say where make-believe stops being just make-believe, and just where, how, and how much escapist "fun" bleeds over into more serious realities...

And if we understand Goop-woo as fashion, we may be somewhat reassured that a large part of it’s appeal are gratifications that have nothing to do with serious deviation from sensible medicine, in those senses that fashion is fundamentally un-serious, a game of “let’s pretend”, a form of having fun.

Perhaps, but Goop also promotes homeopathy, colon cleanses, fad diets that can be harmful, "detox" regimens (which can also be quite harmful), and bad health advice. It's all a package. You can't easily separate the "fashion woo" like "energy healing stickers" from the harmful quackery. Therein lies a major flaw in your analysis.

( I see I'm not the only one who remembers Reginald Perrin)

At any rate, goop isn't only about fashion- it's about woo. The fashion angle is accessible in other better ways and I doubt that people go to goop primarily for a fashion report- there are lots other of those, print and net.

People go to goop to emulate GP and her sister/ fellow travelers- clothes are part of the deal but the altie/ hippie/ cool gir/ knowitalll vibe is primary.
AND you can't do that without woo ( which rhymes with woo)

That should be WHICH RHYMES WITH GOO

Why women are susceptible to sh*t like GOOP.
Dear Dr. G,
With all due respect, I think you are trying to educate the wrong audience. It's doctors that need to be educated.
As a women, my biggest pet peeve is the dismissive way doctors treat women's health concerns. I can't tell you how many times I've been in a group of women and one or another complains about some health issue and all the other women start saying, "it's stress." Women learn this language from their doctors. I can't tell you how many doctors have dismissed my health concerns as stress. For some reason, as soon as I hit 30 and had some legitimate health concerns, doctors tried to convince me that I had suddenly become unable to handle the demands of my busy life. . And the older I got, the more condescending the doctors became..
In my mid 30s I developed a series of symptoms that clearly, obviously pointed to one diagnosis. I will list them and see if you can figure it out.
Symptoms: a little weight gain, fatigue, dry skin, hair loss. Every year, for 8 years I went to the doctor (different doctors too) and was diagnosed with "stress". Finally at 42, I went to the doctor and complained I was falling asleep mid conversation at 6 pm every night., and this doctor sent me to an endocrinologist. Not surprisingly I have hypothyroidism.
I can't tell you how many friends have come back from doctor's appointments and like me, were told to work on their "stress". Is it any wonder women look to magic for help?
And if you think I'm a doctoraholic, constantly complaining about mysterious illnesses, I go to the doctor once or twice a year and I take one daily medication.
I am also flabbergasted that doctors are so frequently upset at patients who are knowledgeable. When my husband was first sick, I went to his appointments. I was pretty convinced my husband had cancer-not because I'm negative or anxious, but because I'm smart and I know my husband.. My husband had unexplained weight loss, consistent side and back pain, early satiety, and severe sob. I didn't suggest that my husband had cancer, but I asked his doctor for a CT scan and got "now, now dear, let's not overreact," He told me that my husband had, gerd, COPD, (he did a chest x-ray and ruled out lc haha), back strain, and high cholesterol. He sent him to a pulmonologist for the COPD and as a parting shot to me said, "I ordered a CT of his abdomen to make you happy," The pulmonologist found the lung cancer on his abdominal CT (it had metastasized to his liver and spine). And I won't even tell you the story about the time a doctor assumed I was 'drug-seeking and interrogated me for using the word, "musculoskeletal".
And although, I shouldn't have to defend myself, unfortunately most people reading this will think I'm some brash, pushy, hysterical woman (in itself, so sad that that's the assumption and sad that I have to make sure I behave within some weird social gender norms boundaries to deserve respect), I'm a boring mom, teacher, nice lady you meet at the park walking her big puffy dog.
I'm not really susceptible to woo, but a lot of my friends are and I get it.

Polly

In other news...

Suzanne Somers appears to be going strong with the lower rent crowd ( see her eponymous website)

Aura photography isn't necessarily Kirlian photography, though it can be. Probably more common are "aura cameras" which take a normal photograph and superimpose upon it an out-of-focus image of colored LEDs. Which LEDs are turned on and how brightly is determined by software from input from a set of electrodes you place your hand on which measures electrical resistances between them.

@ 15 I guessed your ailment before you finished your sentence.
My "stress" turned out to be lumbar stenosis. A friend's "stress" was discovered to be fibroid tumors. Still, when it's all said and done, the only one to really blame for turning to the Woo, is oneself.

No, don't blame the victim. That's like saying the victims of Ponzi scams have only themselves to blame. Would you have been able to discern that Bernie Madoff was running a Ponzi in 1999?

@21, if you are addressing me, I'd say that was comparing apples and rocks.

Could be that the better way to attack things like Goop would be to praise their business model, for example, "by peddling thrift store trinkets and penny a pound supplements for Park Avenue prices with a hefty helping of health "wisdom" straight out of a 1970s issue of the National Enquirer, Paltrow has shrewdly crafted a business empire out of the gullibility of her followers. Investors would be wise to get in on the ground floor of this modern day Rasputin."

@ Orac #14

It seems the strength of qualification I intended by the "somewhat" before "reassured" didn't cross the great Internet divide. My points are:
1) We don't know how successful Goop is in promoting health woo like colon cleansing and other "detox" nonsense. Belluz assumes the popularity of Goop generally applies to those things equally as to all the other merchandise, and it well may not. That doesn't mean Goop's success isn't a bad sign, just probably not as bad as Belluz seems to think.
2) There's good reason to think that in the form of upscale life-style 'fashion' culture health woo will have a different sort of investment among those Goopers who get into it via that venue than health woo has within the 'mainstream' of Alt-Med (if you'll excuse the oxymoron). We would expect the Goopers to be more likely to dabble superficially, and be less likely to stay with it over time. Again, that doesn't make the Goop-woo not-a-problem – it might be a sort of 'gateway' to more 'hardcore' Alt-Med, for example – just "somewhat" less worrisome than other cultural frames for cleanses, detox, etc., etc.

But these dynamics always work both ways, so it's also possible that women who might otherwise be drawn into a deeper, more serious woo will have their impulses in that direction satisfied and then burned-off by a more superficial and short lived infatuation with Goop's faddish woo-lite.

I'm sure plenty of Goop customers do separate the “fashion woo” like “energy healing stickers” from the harmful quackery, just as others separate the clothes, jewelry, and dinnerware from all the woo.* But at the very least, I'd argue you can't just assume the “fashion woo” inevitably connects to harmful quackery without evidence. Popularization and commodification always weaken and hollow out subcultures as they spread salable versions thereof. If you're revolted by punk, alt-rock, and nu-metal, you hate Hot Topic for spreading those styles to otherwise innocent mallrats. If you're a devoted fan of punk, alt-rock or nu-metal, you hate Hot Topic for shilling ersatz versions of your passions to tennybopper poser mallrats...
––––––
But, these are actually secondary points to what I set out to express in my earlier comment, which was that Belluz is being too pessimistic in feeling she's losing some fight to Gwynneth Paltrow. I did get a bit sidetracked from that in the second half of the post. Maybe her voice is relatively weak, and Goop has continued to grow. But she's not giving herself enough credit, and not looking at the big picture beyond Goop. Other voices are now picking up her critique, and some of those, like John Oliver, are far more skillful at presenting it effectively. These things take time, and while Goop may continue to grow for awhile, today's critiques could be the peas-under-the-mattress that eventually make the whole wellness-woo wing of the operation crash. More importantly, Goop's silliness and Paltrow's precious pretentiousness might backfire and have negative consequences for woo as a whole.

So, basically, I'm saying that if Belluz (or anyone else) thinks Goop is a problem, they should keep criticizing it, not throw up their hands in defeat. Which is not to say they can't improve their messaging: If factual debunking seems not to be working that may be because it just doesn't work very well as either a lone or central persuasion strategy. So sure, self-reflection and self-critique are warranted when your tack seems not-to-work. But it's better to check your confirmation biases about what you would find convincing and what sort of rhetoric you want to be effective, and step into the mocassins of your intended audience and figure out what will move them, realizing it's always a long haul and a complicated bit of business one way or the other.
–––––––
For that matter, I can't imagine that anything but a minority of folks who buy supplements from NN share Mike Adams' lunatic perspectives. When I'm in central PA, I always buy a box of Miller's pretzels. Miller's is a small regional company, apparently run by a very religious clan, as there are proselytizing Bible verses printed in large type on the side of each box. I just disregard that BS, because I really like the pretzels.

I think there are a few things to take into consideration when thinking about goop's success and the impact of skepticism.
The first is that Gwyneth Paltrow is a full-on A-list celebrity and movie star. She could be selling literally *anything* and people would buy it just because she is selling it. So that will overwhelm a lot of the pushback. There are probably people who buy her tote bags but laugh themselves sick at the energy stickers.

The other is like Orac said; we're not going to reach (probably) the people buying the stickers, but we may convince the people buying the tote bag to not buy the detox tea.

And I'd like to share two stories to remind us that we can and do reach people who seem lost on the path to woo.
1) A nurse friend posted to FB a link about flu shots being worthless. In 5 minutes her dad (non-medical, non-scientist) had replied with a citation of why that link was wrong, and she changed her mind about getting her flu shot. Win!

2) A cousin is a yoga instructor and pretty hippie and conspiracy inclined. She posted to FB that microwaves are terrible (in a conversation about cooking for yourself) and were invented by Nazis (among other things). I gently pointed out the less judgmental errors (when microwave ovens were invented, how they work) and she changed her mind!

So we can make incremental progress.

sadmar @13 and 23
You've hit the nail on the head with "lifestyle" woo. That is what all successful celebrities sell: their lifestyle. Buy my clothes/bags/jewelry/makeup/hair products, follow my (insane) diet, follow my (equally nuts) exercise plan, read my books, etc, and you'll be just like me, thin and pretty and successful!

In the world of celebrity, is as it ever was.

The thing that is different about goop is that it has branched out from the standard celebrity woo - weight loss. The intersection of fashion, celebrity and potentially dangerous diets/ exercise plans/ cleanses/ serious woo is enough for a thousand doctoral theses and has been the source of many, many books. Lots of celebrities do this. What's different about goop is that it's moved into other areas of health, and that's where more skeptics have come in.

On some level its surprising that it takes woo beyond weight loss to get skeptics to pay attention to the risks, given the very real dangers of some of those "cleanses", but maybe those have become accepted, where magnesium for sepsis isn't.

Good to see you using the 'bullshit' word. It is, as we Ivy leaguers know, often quite accurate

Polly@17 --

most people reading this will think I’m some brash, pushy, hysterical woman (in itself, so sad that that’s the assumption and sad that I have to make sure I behave within some weird social gender norms boundaries to deserve respect),

I may be fooling myself, but I like to think that Orac's readers are several cuts above this.

I really hope you and your husband are both OK.

None of you seem to get it. You don't convince people out of woo with facts and logic. It's all about persuasion. I've learned so much reading Scott Adams's blog (the Dilbert cartoonist). In 2015, he predicted Trump would win the Republican nomination and then win the Presidency. Why? Because Trump is a master of the techniques of persuasion.

Hillary's problem was she seemed to think it was all about facts and logic. That's not why people vote for a candidate. They vote for a candidate because they want to. It's an emotional decision. Once they make the emotional decision, they analyze all the facts and logic through that lens. That's called cognitive bias. You accept the facts that fit with your emotional decision and reject the ones against it.

You want to convince somebody out of their favorite woo? Telling them they're wrong, the science says you're wrong, the people who sell the woo are frauds is the wrong approach. Fact-based and logic-based approaches are the least effective. Gwyneth Paltrow is Trump and you are Clinton. Loser!

Adams explains what does work. You don't start by confronting them, but by agreeing with them on something. Let them know you're on their side. You're their friend. That's called pacing. Then you gradually introduce new ideas. That's called leading.

Orac is a really smart guy. He's an MD and a surgeon at a major medical center. I'll bet he's never tried blue-green algae from Upper Klamath Lake in Oregon, but if he did I'm sure he'd really like it. He'd probably recommend it for all of his patients.

I’ll bet he’s never tried blue-green algae from Upper Klamath Lake in Oregon, but if he did I’m sure he’d really like it.

Quite.

During a heart attack, the muscle is still trying to pump. There’s carbon dioxide but no oxygen. We wondered if there were any way to use plant cells and put them next to heart cells to produce oxygen from the carbon dioxide.”

Ooopsy:
http://www.futurity.org/heart-disease-photosynthesic-bacteria-1460572/

@palindrom
Thank you. Sadly my husband passed away two years ago after 20 quality months of living. I feel I owe something special to this blog. After his diagnosis, I faced constant judgement for encouraging my husband to do chemo. (One person actually asked why I would allow big pharma to poison my husband!) This article in particle gave me the courage/knowledge to stand up. Ihttp://scienceblogs.com/insolence/2009/05/20/chemotherapy-versus-death-…
I now advocate as much as I can against the lung cancer stigma and for lung cancer research. (lung cancer kills more than the four most common cancers combined!)
@sadmar
I agree with you that with GOOP there's an element to what you call 'lifestyle woo" but disagree that it's not dangerous. I live in so cal and I think anti-vaxxing is viewed as a lifestyle choice by some. It's dangerous.
@Mark Thorson
I think that there's an element of persuasion to any good grift, I would argue you need a receptive audience. Women who seek out help for legitimate health concerns (weight, anxiety, fatrigue, etc...) are routinely dismissed and told their illnesses are in their head. Chronic Fatigue Syndrome and Fibromyalgia are two examples I can think of off the top of my head that were first called made up illnesses. I can't help but wonder how they'd be treated if they were more common in men. But I've also know women who were first told their allergies, heart attack, arthritis, heavy periods, acne, IBS, were initially 'stress'. ( and obviously there are amazing doctors who respect and listen to women but I think we need more.) So as women, we learn not to bother the doctor with our trivial pain and common health problems-and that opens the door for the Dr. Oz's and Gwenyth Paltrows of the world.

WHAT WE SAY: A study in the New England Journal of Medicine indicates this product is not merely ineffectual, it actually causes the condition it purports to treat. The FDA has issued a warning letter demanding destruction of all inventory within 30 days. Quackwatch reports company executives charged in the deaths of three people. Gwyneth Paltrow says "This is really great for my skin!"

WHAT THEY HEAR: A study blah blah blah blah blah blah blah blah blah. FDA blah blah blah blah blah blah blah blah blah. Quackwatch blah blah blah blah blah blah blah blah blah. Gwyneth Paltrow says "This is really great for my skin!"

Polly does hit on a real problem in health care, and its the reason why nurse practitioners are so well liked by the public.

It's not that physicians can't have good bedside manner . . . many do. But enough don't, and worse have terrible bedside manner, that it taints everyone else in the profession. I have a male friend who is like this. He's had a couple enounters with physicians that were just awful; the physicians didn't listen and were dismissive of his concerns. So he thinks all physicians are that way by default.

We both shared an excellent physician who retired a few years ago. My friend referred to him as the unicorn. That doc had excellent bedside manner and listened to his patients. So he rarely got the diagnosis wrong, and if he did, it wasn't because he dismissed the patient's concerns. When you went to his office, you knew he'd liklely be late, but you also knew he'd take the time he needed to talk to you.

Physicians often block appointment times in 10 minute increments. They have to, to bring in enough money to keep the doors open. Nurse practitioners are often salaried. My peds preceptor, a PNP, blocked 20 minute appointments.

You can build a trusting relationship in 10 minutes, but you better have mad communication skills to do it.

@ JustaTech:

I think you're right about the most serious problem in lifestyle woo being the diets, and that this is just kind of accepted and normalized, and that's a skeptic fault.

I have the feeling that the sort of woo unique so far to Goop is there because it's unique so far to Goop, rather than because there's a great demand for it, or large direct profit in it. That is, I expect it's fundamentally a branding strategy, and there's some appeal in the 'holistic' image that works even for the customers who don't go in for the woo, and are just there for the clothes etc. This may seem counter-intuitive, but marketing often is. I won't try to unpack it in detail here, but just suggest the woo operates figuratively for these customers, helping Paltrow position herself as something like Paltrow as renaissance woman who cares about the right things... There's also something "upscale" about Goop's take on "wellness" that distinguishes it from more plebian celebrity endorsed fad diets and such...

@ Mark Thorson

Dude, Trump is hardly a master of persuasion technique, especially the sort of standard approach to public speaking Adams appears to be proffering (establish common ground first, etc.). His appeal is complicated, and rooted in celebrity and the image of power, wealth and control. And HRC ran what was largely a one-note campaign that extremely emotion based – trying to get suburban moderate Republican women to cross-over and vote for her out of fear of Trump – in that, her messaging included a lot of what you call "leading". it's just that she was pitching the wrong emotion to the wrong audience.

Trump had as many 'facts' as HRC did, too. They were just all wrong/lies.

Polly @32 -- I'm so sorry to hear that.

Good for you for sticking with real treatment in the face of such peer pressure.

Panacea @34 -- The anecdotal evidence I hear from my nurse-practioner spouse suggests you're right about nurse-practioners. I can't imagine anyone could be more sensitive and respectful to patients than she is (and I hasten to add that she's a very well-regarded clinician as well. You can be as sensitive and respectful as all get out, but if you don't know your stuff it's not going to do that much good.)

Polly does hit on a real problem in health care, and its the reason why nurse practitioners are so well liked by the public.

I much preferred the NP I saw at the agency I go to over the psychiatrist I see now through Skype (or some similar thing). She actually took the time to talk through everything and wasn't dismissive, and unlike the shrinks I had had in the psych ward, she didn't just throw a million prescriptions at the wall to see what would stick.

The last appointment I had with the psychiatrist was after I had the Celexa doubled (because I had been chronically suicidally depressed) and he was like "any better?" and I was like "no, not really," and he was like, "well, let's give it some time and I'll see you in three months" and I was out the door.

Which is... fine, I guess. But...

I get you JP.

About 10 years ago I was in a major depression. I have borderline ADHD and my psychiatrist was worried about "amping me up" on Wellbutrin. So she put me on all kinds of things to "balance the uplift" from the anti depressants.

One of them was Geodon, an atypical antipsychotic. Problem: I've never had symptoms of psychosis. But it says something about how depressed I was that I didn't challenge her pharmaceutical tinkering . . . until the Geodon had me spinning in circles from the panic it induced. I had to take Ativan to calm me down until it wore off.

A psychologist friend got me in with a much better psychiatrist, who set me up for CBT with a very good therapist, and took me off everything but the Wellbutrin. A year later I was off everything and have been fine ever since.

Depression is a b****. I hope you've got a good therapist. I don't think medication works without therapy. But I'm probably biased.

@Panacea:

Yeah, polypharmacy seems to be really rife in psychiatry. One thing I do like about my current shrink is that he's pretty conservative when it comes to adding meds or upping dosages or whatever. He even took me off of the antipsychotic I'm on, although he said "Keep some on hand and start taking it again if you start getting psychotic" and I just felt like bwaaahahaha, how am I supposed to know if I'm delusional? Like, dude, you're a shrink, I think you're supposed to know about anosognosia and the fact that I have a history of it; it's in my records.

One of them was Geodon, an atypical antipsychotic. Problem: I’ve never had symptoms of psychosis. But it says something about how depressed I was that I didn’t challenge her pharmaceutical tinkering . . . until the Geodon had me spinning in circles from the panic it induced. I had to take Ativan to calm me down until it wore off.

I've been on Geodon before; my shrink back in Michigan started me on when I was batsh!t crazy back in the winter of 2015-2016 and I tolerated it pretty well. It also seemed to help eventually (once I actually started taking it properly.)

But then, in the psych ward this summer they had me on more than one antipsychotic; I was on risperidol for a while at one point, then one of the better shrinks took me off of both Geodon and the Risperdal and prescribed Abilify. Ugh... I was on other stuff, too. Lamictal seems to work okay, and I was on it before I was in the psych ward this summer... but then they tried to make me take Lithium anyway (redundant) and I was like "yeah, sorry, hell no," b/c I have tiny veins and blood draws are difficult and painful to the point of being practically traumatic.

And re: Ativan; I was doped up on benzos a lot of the time too, to make me "calm down" or something, because I would obsessively pace and couldn't sit still. (This summer, that is. When I was manic I would get combative.) Aaaaand I still have a boatload of Ambien, which is (I've been told) related to benzos, but not one itself, from last summer when I couldn't sleep at all. I might start using it again. It's really pretty great (short term) except it makes you a little groggy in the morning.

So yep, meds, been there, done that. I should go get a degree in psychopharmacology or something, I'm like halfway there.

(Oh, and yes, I have an excellent therapist. I took an assessment yesterday and it turns out I have barely sub-clinical PTSD (I've been diagnosed with it before, actually) and she wants me to do a structured 12 week therapy thingy to help with it.)

Welp, that was long.

Panacea: You can build a trusting relationship in 10 minutes, but you better have mad communication skills to do it.

Yup. The two best doctors I've had were urgent care doctors. First time was for Bell's Palsy, second time was for stitches. In both cases I was in and out in a half hour or so and much calmer than I was before.
Both times, the doctors explained to me exactly what I had to do, and in one case, the doctor got me kicked upstairs to neurology the next morning, just to make sure I did in fact have Bell's Palsy, because it's really rare in the under-30 population.

Mark Thorsen: I'm not sure Adams knows anything about communication. He's cheerfully alienated about half or more of his potential audience, and he hasn't been funny in years. All Adams and Trump know to do is shout at people until they either agree or go away.
Adams should also just give up the whole cartoonist gig already. He's just taking up space in the paper that could go to someone more talented and who isn't a scuzzbucket.

So, the good brand is basically a tax on insufferable stuck up rich twits. Unfortunately the tax is being collected by an exceedingly insufferable rich twit. Maybe we can drop her off in Palmyra to imbibe some ancient Syrian wisdom.

JP,

you would like that psychiatrist:

Alain

you would like that psychiatrist:

I liked the article and found it interesting, although I had a hard time parsing one of the paragraphs.

I was definitely dangerous for the entire time of every time I was hospitalized, in at least one way. (When I was manic I couldn't care for myself (ask my friends in Michigan) and when I was super depressed I was definitely acutely suicidal.)

The slightly bitter and annoyed (if that's the word) psychiatric patient in me still resents being court ordered to be in the psych ward for so long last summer (over a month, with a few days in between the hospitalizations when I was talking blatantly about killing myself to friends - I had lied and faked my way out of the psych ward after a couple of weeks.) But I was certainly dangerous in the legal/psychiatric sense of the word. Hell, I still wanted to kill myself when they eventually let me out and sent me to the group home; my provider ("Dr. Joseph") said as much as "nobody doubts that you're suicidal." But my favorite psychiatrist there (Dr. Muse, he was from somewhere in Latin America and a lovely person) convinced the "treatment team" that locking me up in the Eastern State Hospital for months would do more harm than good, delusional or not.

So a "short stay" was not a problem in that particular episode. (It was, though, during my manic episodes; I would pretend to sleep and pretend to be better to get let out - because I hate being locked up - and I remember when St. Joe's let me out and I was still messed up, my friend Eugene (who was more or less my guardian at that time and place) was furious.)

Lord, I miss my psychiatrist from back in Michigan. I mean, we still keep in close touch - we are both very attached to each other*, I guess - but I wish he were my treating psychiatrist. He's brilliant, he's kinds, he listens, and he actually cares about people. I remember how guilty he seemed to feel about having me involuntarily admitted to St. Joe's - "I think you've been traumatized by that whole experience." "Well, I'm pretty f*cking resilient," I said, and ran off to another city.

*Plus his undergrad degree is in English literature from UC Berkeley and he likes Frank Herbert's Dune; what more can you ask for?

I remember once, in a rather promiscuous manic phase, I mentioned to him that I had spent the night with a very nice young man who was originally from Alaska. "Oh, we just stayed up all night talking and smoking and I played Tom Waits," I said. (There was rather more to it than that.**) "Be careful with Tom Waits," he said. "He can lead to dangerous things... like marriage." *meaningful look.*

** I did learn pretty much his whole history that night, for example, though I won't divulge it here. Among other things.

Alain: great article. Thanks for sharing it. The author hit several nails on the head.

When I was still working ER in California, we had a number of MH patients who were frequent fliers for 5150's--mental health holds. They'd come in suicidal, obviously unable to care for themselves, we'd keep them up to 12 hours trying to find an inpatient bed, and in about 24-48 hours after we sent them out, it would be lather rinse repeat.

The psych facilities were so over loaded these patients were being kept less than 24 hours in many cases.

Until we're willing to stop viewing mental illness as a character flaw, and to fund and treat it appropriately, we're going to continue playing round robin with people who could be helped . . . and some of them will die because of that.

Panacea:
Until we’re willing to stop viewing mental illness as a character flaw, and to fund and treat it appropriately, we’re going to continue playing round robin with people who could be helped . . . and some of them will die because of that.

I think one of the major problems is that right now ANY health problem is treated as a character flaw. Mental health is just an extra flaw for people to judge you for. At this point, I'm out and out lying about my depression and ADD on intake forms so as to not lose my insurance. It'd be nice to not have to worry about stuff like that, but apparently health care makes Jesus sad. Or something.

MT: Maybe you should improve your communication skills. Start by disregarding everything Scott Adams ever said.

PGP: Agreed. My aunt died because my grandmother viewed schizophrenia as a character flaw, and didn't tell anyone that my aunt had visited the cliff she threw herself from 2 days before she killed herself. Grandma always tried to pretend my aunt wasn't sick. Sadly, my aunt confided in her, and Grandma didn't act because to act was to admit there was something wrong.

Polly - you are right about some of the problems in medicine, and I am sorry for your experience.

Are you in the USA? In Australia, anyone presenting to their GP complaining of feeling tired gets basic bloods including thyroid function, it's really inexcusable for such a common condition to take so long to be diagnosed - and it sounds like your presentation was pretty textbook.

As a female GP, I do find that people just expect that I will spend time listening to them, in a way they don't expect of men. And I have had female patients who I have referred to (male) specialists only to have their real problems dismissed as 'anxiety'. I avenge these women by in future referring only the most painful of patients to those specialists.

It is part of why NP clinics are more attractive, but the same part is what makes sCAM practitioners more attractive, and neither are the answer. While NPs are obviously trained in real medicine, they aren't doctors and don't have the depth of understanding of the same topics. In Australia, trials of NP clinics to take pressure off EDs have actually had the opposite effect, costing more and seeing an increase in ED attendances referred by the NP clinic.

I'm not saying I know what the answer is, but it seems to me that giving health consumers the time and the environment in which to be heard and to feel heard (by an appropriately qualified person) is a big part of it.

GPG, Panacea, you reminded me how, back in the day when I was 19 and ended up hospitalised after a suicide attempt, my parents' only worry was what would people say. If they expressed some concern, it was in a rather accusatory way, as in What did you do to us.

There are so many facets of mental illnesses and their sufferers not being taken seriously. I got all colours of Tough it out and It's just in your head. I got my pneumonia or GERD described as It's just nerves, get some more meds for your anxiety or learn to relax more. I had a shrink who apparently didn't believe that someone with depression and anxiety can manage one's own life and started planning for me when I should get pregnant.

At least I'm living in Socialist Evil Europe and my insurance pays for my treatment.... sigh, poor Americans.

Stress certainly does cause a number of health problems. Or it makes some health problems worse. So we shouldn't ignore stress as a causative factor.

But we can't default to stress just because we can't find any other reason for the symptoms, and because we're reluctant to say, "I can't find a physical cause for what's happening to you."

Sure, pyschiatric symptoms can and do cause real physical pain. But at the very least we need to reassure patients their pain is real. Psychosomatic pain is real pain.

It's rare that people fake pain. Even if they're drug seeking they have pain of sorts that they're trying to treat.

It's true that the art of persuasion is a separate thing from the art of reasoned argument, as the related skill of rhetoric. The problem is that some messages lend themselves well to rhetoric and others do not. Good messages for rhetoric are simple, appeal to common knowledge, and appeal to common emotions. So telling people that crime is out of control (common emotion/ common knowledge) and that immigrants are to blame (simple/ common emotion) works well rhetorically. Saying that despite public perception crime is generally down, and despite anecdotal evidence immigrants commit fewer crimes per capita, is complex, goes against what people think they know, and thus is not persuasive.

Same thing with healthcare: complex, counter-intuitive and thus not persuasive: problems persist in healthcare because it is a big, complicated system that is hard to fix, Obamacare was necessarily jury-rigged and hobbled by political compromise, and could not fix everything, and any solution in healthcare will hurt some people even if it helps most; nonetheless, this far this has benefitted more people than it has harmed, and could be improved through gradual alteration.

Simple, persuasive argument: problems persist because Obamacare sucks, and removing it will solve those problems.

Now we're seeing what happens when somebody gets elected on the power of persuasion rather than reason: getting rid of Obamacare without a new solution would be a catastrophe, and coming up with a good alternative is complicated messy work that nobody is even trying to do. It's like we've gone on a date with a serial killer because we liked his shiny car.

More importantly: hagfish are practically the only thing keeping some fishing communities going. They are used for food, research, and making "eelskin" wallets. The fishermen I spoke to know them as "slime eels."

Psalmanazzar said: It’s like we’ve gone on a date with a serial killer because we liked his shiny car.

This. So this.

The real problem is now, how do we survive this?

If anyone needs a laugh... :)

https://www.mcsweeneys.net/articles/attention-goop-employees-were-pivot…

@53, LOL.

Psalmanazzar: Now we’re seeing what happens when somebody gets elected on the power of persuasion rather than reason: getting rid of Obamacare without a new solution would be a catastrophe, and coming up with a good alternative is complicated messy work that nobody is even trying to do. It’s like we’ve gone on a date with a serial killer because we liked his shiny car.

There are a lot of factors, I think. First of all, we have a substantial amount of the population that is allergic to facts (most of Kansas, just about every state south of the Mason Dixon line). Secondly, people hate every facet of health care. They hate doctors (too educated and snobby), vaccines, and exercise and nutrition. Finally, people really like being racist and sexist, and the virus can spread really easily to even unlikely people. It doesn't help that Trump appeals to the serial killer in everyone.
Speaking of unlikely people, I'm no longer talking to one of my uncles because he started spouting anti-Democrat conspiracy theories last summer. And this was a guy who worked in the Peace Corps, hated Scott Walker like poison, and previously liked fishing and parks.
I can only conclude that either living in a fact-free state in a small town finally got to him, or he's actually secretly hated women and minorities all his life. I'd think it was Alzheimer's, but that doesn't run in that side of the family.

Looking for some diversion from Vac Pap? Try this:
Edmonton Goop-debunker buoyed by renewed attack on Gwyneth Paltrow's wellness brand

You can't have naturopathy without antivax

oracknows — Mon, 26 Jun 2017 04:10:16 +0000

You can't have naturopathy without antivax

Orac gets fan mail. Yes, as hard as it is to believe, my blog sometimes ticks certain people off, and sometimes I even hear from them. For instance, last week a reader wrote me. The subject header read, "Why do you hate naturopathic physicians so much?" and the letter went something like this (OK, exactly like this other than the name of the reader, which I've withheld, and to whom I will refer as "T"):

Having stumbled across one of your diatribes against licensed naturopathic doctors, I can't help but wonder what that profession has done to hurt you? If you have examined the evidence, meticulously collected by insurance companies in several states, you will see that the outcomes for patients who are treated by naturopathic doctors are very good, and cheaper, and result in fewer hospitalizations. There are, no doubt, bad doctors of all types. But, why do you find it necessary to attack an entire profession? Without them, I would probably be dead now. And, there are many others like me who are VERY grateful for the option. So, your damaging words may be preventing others from getting the help that they need.

First off, T has part of it wrong. She really does. I don't hate naturopaths, licensed or otherwise. Rather, I consider them a danger to patients and oppose the very existence of their profession. That's a very different thing, and I've discussed my reasons more times than I can remember. For instance, you can't have naturopathy without homeopathy because homeopathy is an integral part of naturopathic training and is featured on the NPLEX, the examination that naturopaths seeking licensure in any of the states that have made the profound error of passing naturopathic licensing laws must pass. Even naturopaths who have their doubts about homeopathy make excuses for it and never completely disavow it.

However, if T wants to know why I detest naturopathy as a profession so much, an example popped up just this week. It's from Timothy Caulfield, Canada Research Chair in Health Law and Policy at the University of Alberta and a Trudeau Fellow, who summarized a recent study he published in The Globe and Mail in an article entitled Stop those naturopaths who spread anti-vaxxer myths. The study, by Tim Caulfield, Alessandro R Marcon, and Blake Murdoch, appeared in the Journal of Law and the Biosciences. We'll start with the summary, and then I'll dig into the study itself.

Caulfield first notes growing concern about vaccination rates in Canada (join the club) and how more people are falling prey to concerns based on antivaccine misinformation and tells how he decided to look into one potential source of this, naturopaths:

Unfortunately, much of this science-free vaccination noise comes from health-care practitioners, especially those in the complementary and alternative medicine (CAM) community. Not every complementary and alternative practitioner pushes an anti-vaccine perspective. But, let’s face it, many do. This must stop.

"Many" is putting it mildly. I'd say that most "pure" practitioners of alternative medicine are antivaccine. Certainly, we know that naturopaths, for example, imbibe quite a bit of antivaccine misinformation in their "education."

Onward:

Working with my colleagues, Sandro Marcon and Blake Murdoch, we examined more than 300 websites for naturopaths and naturopathic clinics in Alberta and British Columbia. In this study, which was recently published in the Journal of Law and the Biosciences, we identified 53 websites that had vaccination-hesitant language and/or suggested a vaccination alternative. In other words, a significant number of naturopaths – that is, members of a provincially regulated health profession – are explicitly and publicly spreading nonsense about vaccination. And this ignoble list doesn’t include the clinics (and there are many) that make baseless claims about how to naturally “boost” your immune system.

Some of the clinics offer warnings about how vaccines contain mercury and/or reference the frequently debunked myth that vaccines are linked to autism. Many websites provide specific recommendations regarding alternatives to vaccination. For example, one clinic suggests that “as an alternative to the flu shot, you can choose a homeopathic prophylactic injection instead” and another claims that “homeopathy flu injections” are a “safe and effective alternative to the regular flu shot.”

When I read the study itself, as well as some of the accompanying news coverage of it, one thing that surprised me is that Caulfield et al only found 53/330 (16%) naturopath websites with "vaccine-hesitant" language in them or that suggested alternatives to vaccination. I would have guessed a far higher percentage. Of course, if there's one thing I've learned about naturopath websites over the years, it's that they frequently rely on vagueness about "natural" treatments and don't always mention explicitly all of their services, at least not in detail. Also, Caulfield et al weren't doing a comprehensive survey and were rather stringent in their criteria for flagging a website, requiring the following: "(1) discourse of vaccine hesitancy (text or links to text which demonstrate explicit anti-vaccination views or which raise issues surrounding the harms/risks of vaccination) and (2) services offered or text descriptions of alternatives to vaccinations or the flu shot." They didn't include websites offering natural solutions to ‘boost immunity' or to prepare one for the flu season. If there's one thing experience has taught me, it's that such claims are usually a pretty darned good indicator of antivaccine views.

Caulfield et al note that the statements ranged from the obviously antivaccine, like this one:

Vaccines given to children and adults contain mercury and aluminum. Babies are especially susceptible to small amounts of mercury injected directly into their tiny bodies. It is now suspected that the increase in autism and Asperger Syndrome is related to the mercury in childhood vaccinations.

Or this one:

…children are now being given increasing numbers of vaccinations containing potentially harmful derivatives and substances such as mercury, thimerisol [sic], aluminum and formaldehydes. These harmful derivatives can become trapped in our tissues, clogging our filters and diminishing one's ability of further toxins out.

To less blatantly antivaccine statements like this one:

The bugs in question (on the Canadian Vaccine List) can enter our systems and depending on our bodies, our histories, and mostly the bugs' propensity, they can cause serious harm. There are certainly questionable ingredients in vaccines that have the potential to do the same.

Not surprisingly, given how you can't have naturopathy without homeopathy, most of the vaccine alternatives, particularly flu vaccine alternatives, involve " homeopathic prophylactic immune injection" and "immune-boosting homeopathics." Anyone who is sufficiently familiar with naturopathy would have been able to predict this particular result. Of course, given that homeopathic remedies over around 12C are so diluted that it's unlikely that a single molecule of the original compound remains, what these websites are, in essence, doing is suggesting that you can prevent influenza and other potentially deadly diseases with water or sugar pills infused with water.

Now here comes the part where I describe why I detest even licensed naturopaths—no, especially licensed naturopaths. Caulfield et al point out that naturopaths present themselves as "evidence-based" and that governments that license naturopaths have basically accepted their claim of being evidence-based. Basically, in most provinces (and states in the US) where naturopaths are licensed, they are, like physicians, self-regulating. In British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario, for example, naturopaths create provincial colleges of naturopathy that are responsible for setting practice standards and enforcing them among their members. Here's a bit from the Ontario Naturopathy Act's Professional Misconduct Regulation:

The Ontario Naturopathy Act's Professional Misconduct Regulation, for example, states that it is an act of professional misconduct to recommend or provide a treatment ‘the member knows or ought to know is unnecessary or ineffective'. Further listed acts of professional misconduct include ‘making a claim respecting a drug, substance, remedy, treatment, device or procedure other than a claim that can be supported as reasonable professional opinion', and ‘permitting the advertising of the member or his or her practice in a manner that is false or misleading or that includes statements that are not factual or verifiable'.

I had to laugh at this passage, given that probably 90% of what naturopaths claim about health is not "factual or verifiable." Caulfield notes that since Alberta legislated self-regulation in 2012 for naturopaths, the provincial college has carried out only one investigation of misconduct by a member. This was the death of Ezekiel Stephan, a child who died of meningitis, which I've discussed multiple times here before. Of note, the parents of the child are outspoken antivaxers and represented their prosecution for medical neglect as a plot to imposed forced vaccination.

Caulfield et al also call out naturopathic regulatory bodies for promoting at the very least a vaccine-hesitant approach:

The regulatory bodies that govern and represent the profession have, to date, largely been silent or have taken remarkably soft positions on vaccination. For example, of all the naturopath college websites in Canada, only the College of Naturopaths of Ontario site contains content that speaks directly to homeopathic vaccines and vaccines in a way that restricts allowable claims to those that are scientifically proven. In this case, Health Canada's position is merely reiterated.

Conversely, the British Columbia Naturopathic Association has published a position paper on vaccination that supports a vaccine-hesitant approach. The document is an excellent example of the ambiguous attitude of the naturopathic community to vaccines. It purports to explain the advantages and disadvantages of vaccination, at one point implying that the risks are equivalent to the benefits. The document notes that vaccine preventable ‘diseases can cause injury or death in a less than robustly healthy infant or child', then states that ‘[i]t's of equal importance to note that all of the vaccines for these diseases can also cause injury or death in a less than robustly healthy infant or child, and this is where most of the parental concerns arise'. It contains a list of unsubstantiated concerns such as the alleged presence of toxic preservatives and the unnatural route of entry of vaccines. The document suggests that vaccines are helpful only because without them ‘parents run the risk of their child encountering a virile disease agent at a time when their child's immune system may be compromised by stressors such as injury and poor nutrition'. The implication seems to be that one can build up the immune system ‘naturally' to prevent serious vaccine-preventable diseases, which is scientifically inaccurate.

This is no different from naturopaths in the US, either. For example, the American Association of Naturopathic Physicians (AANP) published a position paper on immunizations that provides at best grudging support for vaccination, noting that naturopaths, "as primary care providers, are morally obliged and legally mandated to uphold and carry out the public health mandates and should be authorized to administer immunizations in all jurisdictions where naturopathic regulation to do so exists." In other words, vaccinate if the law tells you you have to vaccinate, but note that it "is documented that some of the current and past immunizing agents have been associated with significant morbidity and are of variable efficacy and varying necessity."

As ex-naturopath Britt Hermes noted, the AANP position paper does not advocate the administration of routine childhood vaccines. Nor does it mention any vaccine schedule specifically or recommend a standard of care. She also noted a couple of years ago that a draft position on immunizations was leaked and appeared to be a lot more pro-vaccine. It even made the hilariously disingenuous claim that families "fired" from conventional pediatric practices for refusing vaccines often seek out naturopaths, placing "naturopathic physicians in an opportune position to provide information and vaccine coverage to those patients who might otherwise receive no vaccines at all."

I'm sorry. I probably should have warned those of you who just spewed liquid all over your laptop or mobile device to put down your drink before reading that. In any case, I tend to agree with Britt that this was almost certainly leaked for political reasons, to make naturopaths seem more pro-vaccine than they really are. As she noted, only around 3% of naturopaths support the full CDC vaccine schedule. Indeed, pro-vaccine naturopaths are quite rare. I've searched for them and only ever found one or two. Even then, one such naturopath who presented herself as "not antivaccine" still expressed what were clearly what Caulfield would characterize as "vaccine-hesitant" views and cites execrably bad research by "scientists" associated with the antivaccine movement. I've also pointed out that, when they think no one's listening, naturopaths routinely spew antivaccine pseudoscience amongst themselves. Indeed, there's one of these antivaccine naturopaths in my neck of the woods named Doug Cutler. Here's a taste:

Absolutely shameful that the biggest medical fraud (perpetuated by Big Pharma) continues to indoctrinate the public (“milk does a body good”) that vaccines are safe and effective. As you stated, we still don’t know the longterm vaccine safety so hoping that they are safe and effective for the “greater good” is unacceptable and completely immoral until we fully know.

You are right though, we need to question our personal “dogma/bias”. I fully believed in vaccines until my intimate association with hundreds of mothers that had vaccine injured children, changed that entire belief set completely around. The same amazing mothers that knew more about vaccines than any doctor or scientist out there, hands down. Then with my training and knowledge of environmental toxins, just analyzing the actual ingredients of each vaccine, one by one – I could never in good conscience justify those known toxic ingredients to have a free pass directly (no detox roadblocks) to a baby’s brain.

And:

My disclosure, I am opposed to all sources of toxins therefore I am against vaccines whose one size approach fails to account nutritional statuses, toxic burden of mom/child and genetic polymorphisms that are at epidemic levels. 10 vaccines from birth to 6 years in 1983 and 36-38 vaccines from birth to 6 years in 2010. Insane.

I'll conclude by saying to T that I don't hate naturopaths. I'm sure some of them are perfectly nice, albeit deluded, people. I oppose naturopathy because it is quackery that endangers patients. One reason is that you can't have naturopathy without antivax. The high prevalence of antivaccine views and very low support for vaccination show that. Antivaccine views are baked into naturopathic education and philosophy. That cannot be escaped.

oracknows Mon, 06/26/2017 - 00:10

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Antivaccine nonsense

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http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-7531201700…

Are you going to tackle T's claim that:

If you have examined the evidence, meticulously collected by insurance companies in several states, you will see that the outcomes for patients who are treated by naturopathic doctors are very good, and cheaper, and result in fewer hospitalizations.

?
I'm quite sure it's false.

The 16% figure for "vaccine-hesitant"/alternative naturopath websites is probably also way low, considering that many if not most likely are hiding their views and wait until patients come in to lobby for them.

I'd also be interested to know what proportion of naturopath websites explicitly endorse vaccination and urge parents to have their children complete the recommended schedule. Bet that's considerably lower than 16%.

"The Textbook of Natural Medicine", which I've heard is required at most schools of naturoquackery (having been authored by the founders of Bastyr school of naturoquackery) is full of anti-vaccine statements (easily viewed thanks to Amazon's "Look Inside" feature online). You won't find anti-vax BS in allopathic textbooks.

Caulfield notes that since Alberta legislated self-regulation in 2012 for naturopaths, the provincial college has carried out only one investigation of misconduct by a member. This was the death of Ezekiel Stephan, a child who died of meningitis, which I’ve discussed multiple times here before.

It's hard to violate the standard of care when there is no standard.

I'm not surprised to hear that anti-vax views are common among naturopaths. Crank magnetism strikes again. The homeopathic option that some of them recommend is absurd on its face, but no more so than anything else involved with homeopathy.

Q. Can a mother's intuition affect their homeopathy/antivax tendencies.

In a recent article published by Rev Cubana Pediatr. (2017) titled, Autoserum skin tests in allergic patients, and in autistic patients and their mothers, it is written that the a positive correlation had been found with the results of autistic patients and their mothers.

It's understandable that mothers with atopy may gravitate towards homopathy/antivax tendencies in an effort to maintain their child's health.

@Orac,

How can medical science convince atopic mothers that their children are safe when exposed to vaccine contaminants (i.e., foodstuff proteins and allergens)?

I find the claim that "we still don’t know the longterm vaccine safety" to be quite enjoyable. It's been, what, 125, 150 years since the introduction of the smallpox vaccine? We don't have data on long term safety? Really? Maybe it's just that everyone who ever received a smallpox vaccine died eventually of something?

I have to say that I am getting really fed up with the BS. It's the first thing I would go after if I were in charge.

@Julian Frost

I find it interesting when people make claims like T saying that if Orac did a proper amount of research etc then do not actually offer up any of that evidence. Oh, and perhaps naturopaths lead to fewer hospitalizations because more of their patients refuse to go to hospitals out of irrational fear of science or just simply die as a result of mismanaged care.

@Zach-You wrote "perhaps naturopaths lead to fewer hospitalizations because more of their patients refuse to go to hospitals out of irrational fear of science or just simply die as a result of mismanaged care."

That's possible, but another possibility is that most people with serious illnesses realize that they need real medical care, not quackery, and that most of the people who see naturopaths are "the worried well" and/or people with minor health conditions that would be unlikely to require hospitalization.

And another possibility (probably the most likely), is that T's claim that patients who go to naturopaths have fewer hospitalizations is simply false.

@MJD-I am so sick of hearing people say stuff like "a mother knows what's best for her child, not doctors".

While a parent may KNOW their child better than their child's doctor, that does NOT mean that they know WHAT IS BEST for their child's health. The doctor has medical training, they do not. Mother's "intuition" (combined with anti-vax propaganda spread by people like Andrew Wakefield) is the reason why 78 people, mostly Somali children, have contracted measles in Minnesota this year.

And regarding allergies specifically, the risk of a severe allergic reaction to a vaccine is exceptionally low.

I have a friend who is the queen of woo. Despite claiming that if you go to a real doctor, they will find things wrong with you "because that's what they do" when she and her SO broke bones they both went to medical doctors "because they're good for that." I foolishly refrained from asking why she didn't wave her magic Reiki hands above the break. I still regret it.

@MJD-You write-"It’s understandable that mothers with atopy may gravitate towards homopathy/antivax tendencies in an effort to maintain their child’s health."

I don't think that is "understandable". The reason you do is because you are already anti-vaccine, and are convinced an allergic reaction caused your son's autism.

The bottom line is that unless a parent is already vaccine-hesitant, I really don't see why having a kid with allergies/eczema/asthma would make one avoid vaccines.

MJD - I skimmed the article which cites Wakefield - how pathetic can you get?

Good luck buying your camel milk.

Jonas -- another possibility is that the naturopaths seldom find out if any of their patients later have to go to the hospital. How would they even know? There's no mechanism for consistent follow-up. This is even a problem in mainstream medicine; it's gotta be considerably worse in naturopathy, which eschews anything to do with mainstream medicine.

I don't know why Orac uses the sentence form "You can't have naturopathy without [X]" since its meaning is ambiguous, and in most senses it's obviously wrong. The sense in which it is true is where "you" is a government, and "have naturopathy" is some permitting legislation that allows natuopaths to practice medicine despite lacking conventional credentials (MD, DO, APRN, PA) and either without regulation or with self-regulation. Of course, in that sense, you can't have MDs without anti-vax and homeopathy either, since 'renegade' doctors go those woos, and state boards and physicians' organizations just shrug.

Allow me to suggest it would be simpler and less confusing to frame the problem directly, rather than as an abstract principle. I'll also suggest doing so with equanimity by starting with an acknowledgment that even conventional practitioners have shown no ability or willingness to police their own profession effectively. 'Self-regulation of MDs is a joke, but self-regulation of naturopaths is a sick joke.' It's not that there aren't 'bad doctors' and 'good naturopaths' on homeopathy and/or vaccines, but an issue of relative numbers – which the OP above documents rather convincingly.

Orac is surprised that only 16% of the naturopathy websites Caulfield surveyed betrayed anti-vax sentiments. But that's A LOT! You wouldn't expect any casual or routine views on vaccines at a given health services clinic to show up on a website. That it does indicates it's a point of emphasis. Even at 16%, that is very disturbing. It would have helped if Caulfield (who has to fail in un-impressing me) had provided some bases of comparison, e.g. the frequency with which other points of emphasis, dubious and/or laudatory, show up on the range of websites surveyed. Just in knowing how most small-business websites get constructed and what they contain – that is, without imagining some wide intent to cover up anything – I'd imagine that anything that shows up prominently in 16% of websites is but the out-front tip of an iceberg of more casual, routine less-vocal practices and attitudes. IOW, I'd say the out-front 16% antivax correlates well with Britt Hermes' report that only 3% of naturopaths will admit to supporting the full CDC schedule...

... and yes, the overall picture there is alarming to say the least.

Considering allopathy kills an estimated 250,000 people a year due to medical errors, there is no reason to blindly subscribe to the witch hunt against naturopaths, homeopaths, or any other unlicensed natural healer. Enough said.

I foolishly refrained from asking why she didn’t wave her magic Reiki hands above the break.

How do you know that she didn't try that, and decided to see a real doctor when that didn't work?

Call me an optimist, but maybe your friend learned something about the limitations of woo. If so, that can only be a good thing.

if you go to a real doctor, they will find things wrong with you “because that’s what they do”

I mostly get the idea that is a speciality of quacks.

@Jonathan, #15
Your reasoning is fatally flawed. Even if medical errors kill so many people, then the solution most definitely is not to lower the quality of medicine quite a bit further by allowing utter nitwits to sell placebos to the gullible -- something which will inevitably lead to more patient deaths.
The solution in other words is to fix the problem with real medicine, not to aggravate it by tolerating pretend medicine as well.

Your solution is more fatally flawed. There is no such thing as real medicine. Herbs, medications, and supplements alike kill in incorrect dosages. Medicine is simply the more palatable method of treatments for Americans which requires medications and surgery as its agent of perceived efficacy. I prefer that neither side attack the other. Medicine is way more deadly than naturopathy or any opposition to medicine.

"I prefer that neither side attack the other. Medicine is way more deadly than naturopathy or any opposition to medicine."

Wow. You violated your own prescription in the very next sentence. And still nothing presented to support your extreme claims. Medicine has a standard of care; NDs have a PR cheat sheet.

You probably need to see a doctor to get your head examined if you really believe that. I don't need a million dollar study to understand common sense. You just keep shoveling dollars into their pockets.

Eric - you're an optimist. An incurable optimist

Now she believes that diet can cure cancer. Sigh.

@Jonathan-The fact is that the "treatments" offered by naturopaths either have never been proven to have efficacy, have been studied and found to be useless, or are biologically implausible and thus CANNOT POSSIBLY have efficacy.

Furthermore, while the "treatments" offered by naturopaths are ineffective, they are not harmless. Homeopathy is (of course, indirectly, it is, since people often use it instead of real medicine, but I'm talking about direct harm), but some of the supplements promoted by naturopaths can be dangerous. Certain herbs are well-known to have the potential to cause liver failure.

And, when you wrote "Medicine is way more deadly than naturopathy", you ignored the fact that naturopathic treatments have NEVER saved anyone's life, whereas real medicine has saved countless lives. It's estimated that the MMR vaccine ALONE saved 17 million lives between 2000 and 2015.

@Jonathan (#21) You write "You just keep shoveling dollars into their pockets."

Kind of like how people like you keep paying naturopaths for supplements and homeopathic remedies that don't work (and are sometimes recommended by naturopaths for "diseases" that don't even exist, like "adrenal fatigue")?

I don’t know why Orac uses the sentence form “You can’t have naturopathy without [X]” since its meaning is ambiguous, and in most senses it’s obviously wrong. The sense in which it is true is where “you” is a government, and “have naturopathy” is some permitting legislation that allows natuopaths to practice medicine despite lacking conventional credentials (MD, DO, APRN, PA) and either without regulation or with self-regulation. Of course, in that sense, you can’t have MDs without anti-vax and homeopathy either, since ‘renegade’ doctors go those woos, and state boards and physicians’ organizations just shrug.

There are two sorts of comments I hate more than any other: Grammar or style flames and pedantry. You've combined both. I mean, bloody hell, WTF? I'll frame my point any damned way I feel like it.

Orac is surprised that only 16% of the naturopathy websites Caulfield surveyed betrayed anti-vax sentiments. But that’s A LOT! You wouldn’t expect any casual or routine views on vaccines at a given health services clinic to show up on a website. That it does indicates it’s a point of emphasis. Even at 16%, that is very disturbing. It would have helped if Caulfield (who has to fail in un-impressing me) had provided some bases of comparison, e.g. the frequency with which other points of emphasis, dubious and/or laudatory, show up on the range of websites surveyed. Just in knowing how most small-business websites get constructed and what they contain – that is, without imagining some wide intent to cover up anything – I’d imagine that anything that shows up prominently in 16% of websites is but the out-front tip of an iceberg of more casual, routine less-vocal practices and attitudes. IOW, I’d say the out-front 16% antivax correlates well with Britt Hermes’ report that only 3% of naturopaths will admit to supporting the full CDC schedule…

… and yes, the overall picture there is alarming to say the least.

Point taken, although vaccines are a point of emphasis in naturopathy, so much so (and more, I suspect, than you realize) that I still remain surprised that it was only 16%.

@Jane Ostentatious (#12)-Let's hope MJD doesn't start giving his son raw camel's milk in an attempt to cure his autism. Raw cow's milk is dangerous enough (unpasteurized dairy products thus cause 840 times more illnesses and 45 times more illness requiring hospitalizations than pasteurized milk, per a study published earlier this year in Emerging Infectious Diseases)...I can't even imagine how dangerous raw camel's milk would be.

Maybe MJD should read this article on the detection of MERS-CoV in camel's milk. http://www.sciencemag.org/news/2014/06/mers-virus-found-camel-milk

Jonas,
I can agree with all of your statements, in part. You cannot say that naturopathy has not saved lives when it has impacted people's lives in countless ways; ways that you cannot measure with a study. And vaccines were created using the homeopathic literature at the time. I won't even argue with you about adrenal fatigue because you couldn't understand the biochemistry of it. You don't think allopathy thinks up crazy labels and gives it to a set of symptoms? Ever heard of Complex regional pain syndrome? Yup. A medical term.

@Jonathan-"Vaccines were created using homeopathic literature"?
On what planet and according to whom?! Homeopathy is biologically implausible AND randomized controlled trials (which, in view of it's lack of plausibility, were never even necessary to begin with) have found it to be worthless!

But hey, if you are so sure that homeopathy works, prove it and collect the $1 million prize that James Randi has offered to anyone who can prove it is effective!

I'll get right on that, Jonas. Where do you think Jenner got the idea for the cowpox vaccine?

@Jonathan (#27)-Naturopathy and homeopathy have impacted many people's lives-for the worse! Just ask the families of the cancer patients who have died after refusing to undergo chemotherapy because they believed that naturopathic "treatment" and/or homeopathy would cure it (and that's not even mentioning the amount of $$ that the "worried well" waste on naturopathic or homeopathic "treatment, or the potentially life-threatening adverse effects that some herbs and supplements can have)

There was a terrible case in Australia about 15 years ago in which a woman with rectal cancer was convinced by a homeopath that homeopathy could cure her cancer and she did not need to undergo surgery and chemotherapy. The woman's cancer progressed and she developed a bowel obstruction, at which point she would have died within a day or two without emergency surgery-and even then the homeopath attempted to dissuade her from having surgery. She finally underwent surgery at that point, but by then the cancer had metastasized, and it was too late-she died 2 years of metastatic rectal cancer. Just look up "Penelope Dingle" and you will see what I am referring to.

And there are many other similar cases of cancer patients choosing quackery over real medicine-and they all have the same sad ending-the patient dies of untreated cancer.

Jonathan @ 27:

And vaccines were created using the homeopathic literature at the time

That'd be pretty impressive, considering homeopathy is younger than vaccination. Seriously. Hahnemann was born in 1795, and Jenner published his first paper about vaccination in 1796.

I won’t even argue with you about adrenal fatigue because you couldn’t understand the biochemistry of it.

Are you sure that's why you won't argue with him about it? Is it that he can't understand, or because you can't explain it well enough for anyone to understand? If you want to prove it's the former, give it a try. Tell us what you think adrenal fatigue is, and why you think it's a real thing and not just something to allow naturpaths to create more customers.

Sure thing, Calli. I'm going to get right on trying to prove something to you that you don't have the symptoms of. Let me throw in some biochemistry in there for you.

You're basing the whole homeopathic modality against ONE case in Australia of all places. People die with or without medical or naturopathic treatment. However, the fools who were tricked by either side are the loudest.

Where do you think Jenner got the idea for the cowpox vaccine?

Not from homeopathy, anyway, unless a time machine was involved.

vaccines were created using the homeopathic literature at the time

I find this unlikely, because Edward Jenner developed the first smallpox vaccine in 1796, the same year that Samuel Hahnemann created homeopathy. (Wikipedia is my source for both dates.) There would not have been an existing body of homeopathic literature to which Jenner could refer.

By the time other vaccines were being developed, Avogadro's number was well known. That's the number that tells most people why homeopathy cannot possibly work: it calls for dilutions to the point where the expected number of molecules of the alleged active ingredient in the remedy is much smaller than 1. Vaccines for viral diseases may contain dead or attenuated viruses, but they do contain detectable amounts of actual virus.

@Jonathan (#31) No, I'm basing my view of homeopathy on the fact it is scientifically impossible for homeopathy to have any effect on any illness. The same is true for acupuncture, reiki, etc-there is no plausible mechanism through which they could possibly work.

To be blunt, anyone who believes in homeopathy is either out of touch with reality or has absolutely zero understanding of basic science.

I think the Chinese with their 2000+ year old modality of acupuncture would disagree. Basic science is not an explanation for every argument. My undergrad minor is in biology. I'm not saying that homeopathy is a cure-all but it is not snake oil or an agent of death as most medicines are when used improperly.

ONE case in Australia of all places
I never thought I'd be defending Australia, but really it's not as bad as you might think from those Mad Max documentaries.

the fools who were tricked by either side

Holy false equivalence, Batman!

Science-based medicine is aware of its limitations. There are some diseases for which cures have not yet been found. Late stage cancers are among them.

Alt-med types are frequently unaware of their limitations. Which is how Ezekiel Stephan, mentioned in the OP, had his case of meningitis turn fatal: by the time it was made clear to his parents that Ezekiel had to get to a hospital pronto, it was too late. And which is why alt-med practitioners almost always fail to cure their patients of cancer (the overwhelming majority of "success stories" do not withstand scrutiny).

@Jonathan (#29)-Jenner was not even the first one to observe the infection with Cowpox conferred immunity to Smallpox. It was actually Dr John Fewster who made that observation, in 1768, and Benjamin Jesty, a farmer, inoculated his wife and two of his sons with cowpox in 1774, so Jenner wasn't even the first one to use cowpox to protect against Smallpox.

I will note that the above proves that your claim that "vaccines were created using the homeopathic literature at the time." is false, since homeopathy DID NOT EXIST in 1774.

Eric. Science nor alt-meds can cure late-stage cancer. I hope there are not alt-meds out there who state that they can. They're fighting the good fight along side doctors who think they know everything. Disease processes are complex and contain elements that we do not yet understand; we may never understand them completely. This bickering over who's right and who's scientifically correct is what urks me.

@Jonathan (#34)-First and foremost, acupuncture is based on prescientific myths (e.g., the belief in " qi"), number two, acupuncture as practiced hundreds of years ago bears little resemblance to acupuncture today, with the acupuncture needles being far thicker and the wounds that the insertion of these needles caused often becoming infected.

Also, I bet you didn't know that by the end of the Song dynasty acupuncture had fallen out of favor in China, and that in 1822, Chinese Emperor signed a decree BANNING the practice of acupuncture at the Imperial Medical Institute.

@Jonathan-You write that homeopathy is not "an agent of death"-for once, I agree with you-homeopathic remedies are not "agents" of anything because they are no different than a placebo!

And there are things you will never admit to because you are too sure of yourself. Qi exists alright. Call it what you will.

Jonathan, to bricker about who is scientifically correct, you first have to use science. Since, homeopathy, naturopathy etc, etc do not use any science what so ever they have no place to argue or bricker about who is right.

an aside on the case of the death of Ezekiel Stephan:

Still no verdict in the Stephans' appeal of their convictions for failure to provide the necessaries of life. The appeal was heard in February, and the judges promised to be prompt (I don't recall the exact words). Ha!

I suspect that there is a dissenting opinion among the three judges, resulting in all of them going back to look at more case law.

I'll leave you to your science, Rich.

@Jonathan (#40)-Well, it doesn't, but it's very obvious that nobody here is going to be able to make you see that...

I am interested to see how you try to explain away the fact that a 2008 study found that sham acupuncture was at least as "effective" as "real" acupuncture (thus proving that any "effect" of acupuncture is nothing but the placebo effect), though (read my next comment).

Jonathan, how do you explain this?
"OBJECTIVE:
To compare true and sham acupuncture in their abilities to relieve arm pain and improve arm function in individuals with arm pain due to repetitive use.
METHODS:
Participants with persistent arm pain (N=123) were randomly assigned to true or sham acupuncture groups and received 8 treatments over 4 weeks. The primary outcome was intensity of pain (10-point scale) and secondary outcomes were arm symptoms, arm function, and grip strength. Outcomes were measured during treatment (at 2 and 4 wk) and 1 month after treatment ended.
RESULTS:
Arm pain scores improved in both groups during the treatment period, but improvements were significantly greater in the sham group than in the true acupuncture group. This difference disappeared by 1 month after treatment ended. The true acupuncture group experienced more side effects, predominantly mild pain at time of treatments.
DISCUSSION:
Sham acupuncture reduced arm pain more than true acupuncture during treatment, but the difference did not persist after 1 month. Mild side effects from true acupuncture may have blunted any positive treatment effects. Overall, this study did not find evidence to support the effectiveness of true acupuncture in treatment of persistent arm pain due to repetitive use."

Source:
Goldman, R.H., Stason, W.B., Park, S.K., Kim, R., Schnyer, R.N., Davis, R.B., Legedza, A.T., Kaptchuk, T.J. (2008). Acupuncture for Treatment of Persistent Arm Pain Due to Repetitive Use: A Randomized Controlled Clinical Trial. Clin J. Pain, 24(3), 211-218.

Jonas. Don't take one study and try to prove you're the king of England. It's not becoming of such a delegate.

Also from Canada this morning: recommending a crackdown on 'natural health products'

http://www.cbc.ca/news/canada/toronto/medical-journal-takes-aim-at-natu…

Needless to say, naturopaths aren't happy.

The last paragraph really sets it out:

Health Canada is currently reviewing the regulations that govern the sale of self-care products, including naturopathic remedies. At a recent stop in Toronto, Manon Bombardier, Health Canada's director general of natural and nonprescription health products, said under the current rules, she has no authority to remove from shelves a natural remedy that proves to be harming people.

"We need to change that," she said. "Health Canada has the power to recall a bag of chips, but does not have the power to to recall an unsafe natural health product."

"You’re basing the whole homeopathic modality against ONE case in Australia of all places."

http://whatstheharm.net/homeopathy.html

Jonathan -- Jonas cited one study, fortunately there are plenty more out there demonstrating (sometimes inadvertently) the useless of acupuncture as an effective treatment for anything but fat walletitis.

http://www.dcscience.net/2013/05/30/acupuncture-is-a-theatrical-placebo…

And doctors don't get paid exorbitant amounts for doing nothing more than recording height/weight and blood pressure readings. Acupuncture isn't going anywhere, neither is homeopathy or naturopathy. As long as there are doctors who cannot help people with their symptoms, there will be alternative practitioners who can. So if you can call up the medical establishment and ask them to cure everything and provide a scientific explanation for everything else, I'll ignore the studies who profit off of demeaning the competition.

@41 "This bickering over who’s right and who’s scientifically correct is what urks me."

Seriously? Really? I would think THAT'S THE WHOLE POINT.
I want the treatment that's scientifically accurate, thank you very much.

As long as there are doctors who cannot help people with their symptoms, there will be alternative practitioners ...

If you'd stopped there, you would have been accurate. There are always going to be people willing to profit off the desperate.

I'm urked by all the brickering.

And a mite confused.

No, I don't hate naturopaths, I pity the fools, for they will destroy everyone who goes under their care!

@ Orac #25:

My point is that showing up on 16% of websites is exactly evidence of a strong point of emphasis. Websites don't have that much info, and there's good reason to expect naturos who might volunteer anti-vax options in the exam room if they gauge their clients might be receptive would avoid trumpeting such a hot-button topic in their advertising. AV is a word-of-mouth thing anyway. My experience in/with advertising PR etc. suggests that if you took any known common 'controversial' position within groups-who-advertise-to-the-general-public – like Mitt Romney's 40% for a non-naturo example – you'd find mentions of that below 10% in public forums. I don't deny that 16% of anything seems small, but that's why I would have liked Caulfield et al to frame the number within some context of comparison.

Side note: I'll do brief scans of right-wing talk radio when I'm in the car and the sports stations are in commercial or just dumb or boring, and when Trump left the Paris accords one of the popular nationally syndicated hosts said carbon emissions were nothing to be concerned about because carbon dioxide constitutes such a small percentage of the gasses in the atmosphere. Really. It's still only 400 parts per million, nothing to worry about...

Having been an actual professional language/communication pedant/pedagogue, and a damn good one, I'll comment on efforts that strike me as unproductive when the mood strikes me. Fwiw, that wasn't a flame and had nothing to do with grammar. I just literally don't understand why you insist on framing this stuff in ways that can be easily mis-interpreted, taken as more extremist than you actually are, and cause your credibility to suffer.

I was actually trying to help you out by pointing out the way in which "you can't have naturopathy without {X}" is true, since I suspect most folks new to the blog would take the claim as applying at the level of individual naturopaths, and blanch at that, thinking some practitioners somewhere may indeed choose to support the CDC schedule (3% is a 'can have') or eschew prescribing the homeopathic remedies they learned about at school. (As if anyone practices everything they 'learned' in college. I taught college kids for over 30 years, so I know better.) That is, "you can't have naturopathy without {X}" sounds like a universal, global, unqualified claim, and such claims about anything are just rhetorical malpractice. on all three parts of Aristole's breakdown of logos, pathos, and ethos.

These matters hardly pedantic trivia, especially in terms of the last senetence you excerpted, noting that it's not hard to find renegade MDs whole promote homeopathy (comically, in the case of Bill Gray) and cater to anti-vax (not so comically, like the Drs. Sears). It really is a question of relative numbers, and without that, the argument fails as logos. And without an acknowledgement that self-regulation by MDs does nothing to stop the woo-slingers, deriding self-regulation for naturopaths is going to risk appearing as credibility-damaging hypocrisy, and pathos alienating smugness.

I do know, believe me, that you'll frame your points any damned way you feel like. There's a reason the original comment isn't addressed to you. It's not about you personally, but about the general principle, of which you just happened to provide an example. And it's not for you, either, but for anyone who happens by and might care to think about how best to make an effective case against naturopathy to an audience that hasn't already taken sides and dug in.

Qi exists

Prove it. Demonstrate that it has observable effects that cannot be explained by other means.

That last sentence is important. We don't yet know what dark matter is, but we do observe the effects it has on the Universe, we see that the observed effects are exactly what theory predicts, and that no alternative explanation fits all of the observed facts. That is what distinguished dark matter from qi. Not only do we not know what qi is, the explanations of what it allegedly does are not consistent from one practitioner to another. It amounts to what physicists call handwaving (I don't know whether medical doctors use that term similarly).

Cut your arm off. That phantom feeling where your arm used your be....yea...that's Qi. Proof enough for me. Call it quantum resonance for all I care. You just want a label and a study to help you sleep better at night. I use Ambien when needed.

No, no that's not it at all.
Those are your nerves and brain.

https://en.wikipedia.org/wiki/Phantom_limb

(Seriously, I did a science fair project on this in middle school, are you kidding me right now?)

Tell you what, Jonathan. Produce something that works like this:
http://dragonball.wikia.com/wiki/Scouter

Then we'll believe that qi exists.

You and your Wikipedia references...qi is synonymous with energy. Last time I checked, your brain and nervous system run on energy. I'm going to use some qi to roll my eyes right now.

So, can qi be measured, quantified, and altered with electricity and medications like nerves, muscles, and the brain?

Show me on my last MRI where the qi is?

Or are you just admitting that what you call qi is what real scientists and doctors call electrical impulses? Cause that would be progress.

This argument makes no damn sense WHATSOEVER.

No, CJTX. These guys just want to discredit thousands of years of Asian history and you just want a label that credits a scientific term to help you better understand it. There's no argument. You're just trying to stress yourself out.

"These guys just want to discredit thousands of years of Asian history"

Citation needed. For both parts of that.

"and you just want a label that credits a scientific term to help you better understand it."
That's kinda how science works. And progress and civilization. Also qi has never been proven to exist. If someone you care about was ever to get Alzheimers or Parkinsons, would you believe poking a needle in their foot would treat it?

"There’s no argument."
Clearly not. Denialism is strong with this one.

"You’re just trying to stress yourself out."
???
What does that even mean?

Yes. I'd rather stick a needle in a family member in lieu of a drug.
Taken from http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1247-acu…
"
Researchers find that acupuncture may help Alzheimer’s disease patients. Laboratory findings show that acupuncture reduces plaques in the brain that cause dementia. The researchers note that their findings suggest that acupuncture improves memory and prevents degradation of brain tissue. They note “that EA (electroacupuncture) may be a promising treatment for AD (Alzheimer’s disease)” and “may improve cognitive function.”

Well then, we have absolutely nothing to talk about. You might as well cast a spell, sacrifice a chicken, or pray.

Oh wait, this'll be fun:
"Study" sponsored by:
"About HealthCMi
The Healthcare Medicine Institute provides acupuncture CEU continuing education credit for licensed acupuncturists with anytime online courses and live webinars. The HealthCMi news division provides up-to-date research and acupuncture continuing education news."
Might as well ask the petro companies what they think about climate change.

"The researchers note that their findings suggest that acupuncture improves memory and prevents degradation of brain tissue."
Oh really? Real doctors, scientists, and researchers would ask, "how?" - but I'm not one so I'll skip to the logical gaps (assuming all data is actually true and not pulled out of one's hiney)

"The findings are a result of a controlled laboratory experiment on cognitively impaired mice with AD."
Ahhh, mice. High standard that.

Also, not to be discriminatory, but it looks like all the studies cited are chinese - where it's a known fact they manipulate data to achieve a result per the direction of the chinese government.

After that, it gets too sciency for me - but I bet the fine people would have a field day with it.

At any rate, let's have that whole thing get reproduced in a serious, RCT, shall we?

Cut your arm off. That phantom feeling where your arm used your be….yea…that’s Qi. Proof enough for me.

Sounds risky. A lot of amputees never experience a phantom limb effect. Sometimes it develops, but years later. maybe they didn't have any Qi?

Qi. Proof enough for me. Call it quantum resonance for all I care.

Or I could call it 'wibble'. Or 'calenture fritillary hatstand'. I'd be making as much sense.

@Jonathan, #19

There is no such thing as real medicine.

Yes there is, at least as opposed to quackery. Real medicine consist of treatments that have proven efficacy, i.e. they do more than pure placebo treatments (a.k.a. quackery or "pretend medicine").
And even if those generally proven treatments have drawbacks and risks, and its practitioners sometimes make mistakes, that does not mean that we should tolerate pure placebo treatments, especially when patients are conned into believing that these treatments have proven efficacy.

As I said, accepting those fake treatments means a very serious lowering of medical standards, apart from the fact that these fake treatments also cost money -- and that real medicine is supposed to clean up the mess when it turns out that a fake treatment didn't help a patient after all.

In my opinion, naturopaths, homeopaths and other quacks are just parasites: their 'successes' have nothing to do with their interventions, and everything with natural processes, and often even the success of real medicine -- just look at all those cancer patients who attribute their healing to 'alternative' treatments, when in reality they received real and proven effective treatments as well. I therefore think that 'parasitic medicine' is a good general term for naturopathy and other forms of quackery: it lives off real patients with real ailments, without providing any real benefits in return.

If denying Qi as a scientific concept is discrediting thousands of years of Asian history (as if Asia were a monolith and not many distinct cultures), then what do you call the rejection of the humours theory of disease? Perhaps you have an excess of yellow bile, which can cause people to become argumentative.

When your level of consciousness and awareness reaches your higher self you will read your words and wonder where you were! That is if you ever get to finish reading your above article... Wishing you a peaceful sleep, those that are awake will try to be as quite as possible so as to not disturb you! It's quite common hearing people rant with no substance if tried to waken before they're ready... Sleep tight Authur ☺️

Here is an easy test to see if homeopathy actually works. Homeopathy states that water has a memory factor that allows it to work. If you own a gas powered lawn mower empty the fuel tank. Buy 2 one gallon gas cans, fill one with gas. Now pour all but a small amount of the full gas can into the empty one. Now add water (of your choice) to now mostly empty gas can. Shake well. Now fill fuel tank of lawn mower. If mower starts and run homeopathy works, if it doesn't start and run homeopathy is at best a farce.

@Rich Bly, #74
Countless tests have been devised for this 'water memory'. All have failed so far.
Besides, if what homeopaths claim is true (i.e. the water retains a sort of persistent 'imprint' of the original tincture by diluting and shaking), then the water must not only have a memory, but intelligence as well. Because around dilution step 3-4 (C or K scale, so 1:100 per step), there are as many molecules of the original substance as there are contaminants: carbon dioxide and dust particles from the air, all sorts of salt ions and even metals such as lead and arsenic, leaching from the glass in tiny but traceable amounts. Yet somehow the water doesn't remember an 'imprint' of any of those unwanted substances, it only remembers what the homeopath wants it to remember. That's some smart water!

Richard,

I only put that up to show some of the less informed readers how easy it is to disprove homeopathy. I forgot to mention if you run this experiment, you will at least have an expensive bill to repair to the mower.

I only put that up to show some of the less informed readers...

Yeah, I know, and perhaps I should have included some tongue-in-cheek hint in my reply as well -- homeopathy is so utterly ludicrous in so many respects, that I'm always surprised that there are actually people (including homeopaths) who take it seriously.
It keeps reminding me of a bunch of seven-year-old girls who play witches, much like my stepdaughter used to do when she was that age: "OK, we have mud, and grass, and stinging nettles, and a dead beetle and one match head. Now if we put some more water in and shake it ten times, we will have a real magic potion!"
And also eerily similar to homeopaths, when asked what it was that this magic potion was supposed to do, they made things up on the spot -- although of course there was a generous dose of 'stinging' and 'crawling' and 'fire' and other imaginary properties derived straight from the ingredients. And in fact their potion might actually do something, quite contrary to 'real' homeopathic stuff. So all considered, homeopathy is even sillier than little girls' make-believe witch play :-)

Jonathan: Researchers find that acupuncture may help Alzheimer’s disease patients.

A lot of things 'help' with Alzheimers. Cats, personal contact. But nothing, including acupuncture, has cured Alzheimers. Also, why would you want to torment an Alzheimers patient with needles?
I've done acupuncture, ok? Mostly it's relaxing, but sometimes, the acupuncturist misses their mark.(For the record, it didn't actually help with anything but my sleeping habits.) My grandmother had dementia, and trust me, all holy hell would've broken loose if we'd been fool enough to try acupuncture.
Also, why are you taking ambien? Shouldn't you just meditate or look in the mirror and feel smug for an hour? Seems kinda hypocritical of you to run your mouth about Western medicine and then pop in an Ambien, a product of said Western medicine.

Jonathan @ 32:

Sure thing, Calli. I’m going to get right on trying to prove something to you that you don’t have the symptoms of. Let me throw in some biochemistry in there for you.

So, is that an admission you do not understand "adrenal fatigue" well enough to explain it? There are actual biochemists here; if you think one needs to be a biochemist to understand that, there should be nothing stopping you. Nothing, that is, unless you have nothing to say.

I do notice you did not respond to me pointing out that vaccination predates homeopathy, and therefore cannot have been inspired by it. This seems to be a pattern for you -- ignore what you cannot explain. Do you imagine that impresses people?

Researchers find that acupuncture may help Alzheimer’s disease patients. Laboratory findings show that acupuncture reduces plaques in the brain that cause dementia. The researchers note that their findings suggest that acupuncture improves memory and prevents degradation of brain tissue.

Really? Simply by sticking thin needles and twizzling them, like the Chinese have been doing for thousands of months?

They note “that EA (electroacupuncture) may be a promising treatment for AD (Alzheimer’s disease)” and “may improve cognitive function.”

Oh, that's disappointing. They've taken a standard medical device (transcutaneous electrical nerve stimulation), based on two thousand years of Western medicine, and called it acupuncture simply because you can use needles as electrodes. Note that TENS has been demonstrated in clinical trials to do many of the things claimed in the link. Scholarly articles

Shocking the lengths these so-caled TCM practitioners will go to. And here you had me all amped up. Guess I'll have to rely on meditation.

Ohmmmmmmmmmmmm....

Jonathan -
"Australia of all places" - what the f@ck is that supposed to mean, mate?

Plenty of people here have medical and science backgrounds. Please, please explain adrenal fatigue to us. Should I not be able to understand, explain, diagnose or treat any condition I've never experienced? I hope the ridiculousness of that assertion is obvious. Otherwise I'd be a pretty useless doctor limited to treating hay fever, tonsilitis and mild period pain.

You ought o be embarrassed by your anti-science, quack-apologist ravings. You don't deserve Ambien.

I wonder if Harry Nilsson was thinking of a naturopath when he wrote this song?

https://www.youtube.com/watch?v=Tbgv8PkO9eo

@ #41: "Science nor alt-meds can cure late-stage cancer. I hope there are not alt-meds out there who state that they can."

*cough* Burzynski *cough*. Or anyone promoting Gerson 'therapy', for that matter.

Jonathan, here is a little reading about what is happening with real science:
https://spectrumnews.org/features/special-reports/the-genetics-of-autis…

And if you have tired of paying top price for magical sugar pills I have this for you:

Recipe for Nat Mur or Natrum Mur or Natrium Mur or Natrum muriaticum:

1) Take ½ teaspoon of sea salt and dissolve into 1 cup of distilled water in a bottle.

2) Shake well.

3) This is a 1C solution (ratio 1/100).

4) Take ½ teaspoon of the 1C solution and put it a bottle with 1 cup of distilled water, throw out the 1C solution.

5) Shake well.

6) This is a 2C solution (ratio 1/10000).

7) Take ½ teaspoon of the 2C solution and put it a bottle with 1 cup of distilled water, throw out the 2C solution.

8) Shake well.

9) This is a 3C solution (ratio 1/1000000).

10) Take ½ teaspoon of the 3C solution and put it a bottle with 1 cup of distilled water, throw out the 3C solution.

11) Shake well.

12) This is a 4C solution (ratio 1/100000000).

13) Take ½ teaspoon of the 4C solution and put it a bottle with 1 cup of distilled water, throw out the 4C solution.

14) Shake well.

15) This is a 5C solution (ratio 1/10000000000).

16) Take ½ teaspoon of the 5C solution and put it a bottle with 1 cup of distilled water, throw out the 5C solution.

17) Shake well.

18) This is a 6C solution (ratio 1/1000000000000).

19) Take ½ teaspoon of the 6C solution and put it a bottle with 1 cup of distilled water, throw out the 6C solution.

20) Shake well.

21) This is a 7C solution (ratio 1/100000000000000).

22) Take ½ teaspoon of the 7C solution and put it a bottle with 1 cup of distilled water, throw out the 7C solution.

23) Shake well.

24) This is an 8C solution (ratio 1/10000000000000000).

25) Take ½ teaspoon of the 8C solution and put it a bottle with 1 cup of distilled water, throw out the 8C solution.

26) Shake well.

27) This is a 9C solution (ratio 1/1000000000000000000).

28) Take ½ teaspoon of the 9C solution and put it a bottle with 1 cup of distilled water, throw out the 9C solution.

29) Shake well.

30) This is a 10C solution (ratio 1/100000000000000000000).

31) Take ½ teaspoon of the 10C solution and put it a bottle with 1 cup of distilled water, throw out the 10C solution.

32) Shake well.

33) This is a 11C solution (ratio 1/10000000000000000000000).

34) Take ½ teaspoon of the 11C solution and put it a bottle with 1 cup of distilled water, throw out the 11C solution.

35) Shake well.

36) This is a 12C solution (ratio 1/1000000000000000000000000).

37) Take ½ teaspoon of the 12C solution and put it a bottle with 1 cup of distilled water, throw out the 12C solution.

38) Shake well.

39) This is a 13C solution (ratio 1/100000000000000000000000000).

40) Take ½ teaspoon of the 13C solution and put it a bottle with 1 cup of distilled water, throw out the 13C solution.

41) Shake well.

42) This is a 14C solution (ratio 1/10000000000000000000000000000).

43) Take ½ teaspoon of the 14C solution and put it a bottle with 1 cup of distilled water, throw out the 14C solution.

44) Shake well.

45) This is a 15C solution (ratio 1/1000000000000000000000000000000).

46) Take ½ teaspoon of the 15C solution and put it a bottle with 1 cup of distilled water, throw out the 15C solution.

47) Shake well.

48) This is a 16C solution (ratio 1/100000000000000000000000000000000).

49) Take ½ teaspoon of the 16C solution and put it a bottle with 1 cup of distilled water, throw out the 16C solution.

50) Shake well.

51) This is a 17C solution (ratio 1/10000000000000000000000000000000000).

52) Take ½ teaspoon of the 17C solution and put it a bottle with 1 cup of distilled water, throw out the 17C solution.

53) Shake well.

54) This is an 18C solution (ratio 1/1000000000000000000000000000000000000).

55) Take ½ teaspoon of the 18C solution and put it a bottle with 1 cup of distilled water, throw out the 18C solution.

56) Shake well.

57) This is a 19C solution (ratio 1/100000000000000000000000000000000000000).

58) Take ½ teaspoon of the 19C solution and put it a bottle with 1 cup of distilled water, throw out the 19C solution.

59) Shake well.

60) This is a 20C solution (ratio 1/10000000000000000000000000000000000000000).

61) Take ½ teaspoon of the 20C solution and put it a bottle with 1 cup of distilled water, throw out the 20C solution.

62) Shake well.

63) This is a 21C solution (ratio 1 in 10^42 or 1/1000000000000000000000000000000000000000000).

64) Take ½ teaspoon of the 21C solution and put it a bottle with 1 cup of distilled water, throw out the 21C solution.

65) Shake well.

66) This is a 22C solution (ratio 1 in 10^44 or 1/100000000000000000000000000000000000000000000).

67) Take ½ teaspoon of the 22C solution and put it a bottle with 1 cup of distilled water, throw out the 22C solution.

68) Shake well.

69) This is a 23C solution (ratio 1 in 10^46 or 1/10000000000000000000000000000000000000000000000).

70) Take ½ teaspoon of the 23C solution and put it a bottle with 1 cup of distilled water, throw out the 23C solution.

71) Shake well.

72) This is a 24C solution (ratio 1 in 10^48 or 1/1000000000000000000000000000000000000000000000000).

73) Take ½ teaspoon of the 24C solution and put it a bottle with 1 cup of distilled water, throw out the 24C solution.

74) Shake well.

75) This is a 25C solution (ratio 1 in 10^50 or 1/100000000000000000000000000000000000000000000000000).

76) Take ½ teaspoon of the 25C solution and put it a bottle with 1 cup of distilled water, throw out the 25C solution.

77) Shake well.

78) This is a 26C solution (ratio 1 in 10^52 or 1/10000000000000000000000000000000000000000000000000000).

79) Take ½ teaspoon of the 26C solution and put it a bottle with 1 cup of distilled water, throw out the 26C solution.

80) Shake well.

81) This is a 27C solution (ratio 1 in 10^54 or 1/1000000000000000000000000000000000000000000000000000000).
(the zeros are running off of the page!)

82) Take ½ teaspoon of the 27C solution and put it a bottle with 1 cup of distilled water, throw out the 27C solution.

83) Shake well.

84) This is a 28C solution (ratio 1 in 10^56 or 1/100000000000000000000000000000000000000000000000000000000).

85) Take ½ teaspoon of the 28C solution and put it a bottle with 1 cup of distilled water, throw out the 28C solution.

86) Shake well.

87) This is a 29C solution (ratio 1 in 10^58 or 1/10000000000000000000000000000000000000000000000000000000000).

88) Take ½ teaspoon of the 29C solution and put it a bottle with 1 cup of distilled water, throw out the 29C solution.

89) Shake well.

90) This is a 30C solution (ratio 1 in 10^60 or 1/1000000000000000000000000000000000000000000000000000000000000).

You can make up other remedies by knowing what the mother tincture is… For instance “Nux Vomica” (or Nux Vom) is from the Nux Vomica plant which contains the poison strychnine, Nux Sulph uses sulpher, and the stuff advertised on the radio for colds, Oscillococcinum is from duck bits.

Why am I not allowed to upvote Chris' posts?

Because sometimes this is a silly site. ;-)

(Also I have to post with an alternative email address because of silly sockpuppet stuff)

Avogadro's number, number of units in one mole of any substance (defined as its molecular weight in grams), equal to 6.022140857 × 10 23.
A 12C solution has been diluted 1 * 100 a total of 12 times. It is a dilution of 1 * 10 24.
By that point, the odds that there is even a single atom/molecule of the "medicinal" substance remaining in the solution are very low. By 30C, or 1 * 10 60, the odds are 1 * 10 36.
Homeopathy is hogwash.

I guess the [sup] tags don't work here.

I'm still waiting for the wunnerful "biochemistry" proving adrenal fatigue is real, which no-one, apparently, on a site mostly populated by medics, nurses, scientists of various stripes and the like, will understand.

How come in all the gazillion blood tests I've had in the last 3 months no-one has looked at this? And how come the MRI I had this week didn't show any "qi"?

Damn, but North East England must be backwards!

Julian Frost, June 29, 2017, #89:

I guess the [sup] tags don’t work here.

Why would scienceblogs want anyone able to write science here, anyway?

In lieu of <sub> and <sup< tags, I've been known to use the raised and lowered Unicode glyphs that I find at wikipedia under Unicode_subscripts_and_superscripts. Since the pages here seem to use UTF-8 encoding, one should be able to use any old Unicode character, subject only to the reader's browser and selection of font. Let's try 6.022140857 × 10²³ and see what happens.

Crikey, if someone discovered the cure for all cancers, brought about world peace, figured out how to avoid climate change, and found the God particle, yet had some trepidation regarding the CDC vaccine schedule Orac would label them a crank. Talk about a one song singer. Orac missed his true calling as a vaccine sales rep.

If this miracle worker that you imagine tried to abuse his fame to endanger the population with VPDs, of course many of us would call him on it. Being right in some things does not make him right in all, and doesn't give him immunity from correction when he is wrong.

@Se Habla Espol: give Mustapha Mond a little credit, though. At least he seems to understand that "cancer" is not a single entity, unlike most alties. And, he doesn't apparently know what Dunning-Kruger is.

@Mustapha Mond: Orac doesn't have time to be a medical sales rep. He's very busy as a breast cancer surgeon and researcher. However, since he does care for women in (often) immunosuppressed states, he is very pro-vaccine.

"he is very pro-vaccine."

Pathologically obsessed with vaccines you mean. I'm quite sure there is a DSM-V diagnosis for that. There may even be a medication that could help. No vaccine available I'm afraid though.

Hmmm, there must be a DSM-V diagnosis for someone who thinks he can diagnose "obsession" by what a blogger writes? He is a medical blogger, and this just one aspect that he blogs about.

Man, Jonathan is the very definition of a troll. Someone should have been able to do away with him in more efficient fashion though. I guess the problem is where to begin!?

"He is a medical blogger, and this just one aspect that he blogs about."

Riiiiiight.... That's why the vast majority of entries are on vaccines, as anyone with eyes and a brain can easily check by looking at the last 10 entries and their content.

Clearly you are an Orac sycophant if you are willing to submit this obviously wrong comment for all to see. What kind of doctor/blogger requires their own band of salivating sycophants? Usually that's reserved for emperor/clothing type territory.

That’s why the vast majority of entries are on vaccines, as anyone with eyes and a brain can easily check by looking at the last 10 entries and their content.

assuming your faulty sampling turns out to be correct and they do compose "the vast majority of entries", it makes sense given vaccinations are probably the greatest public health success in the history of man AND seem to be the #1 target by woo-meisters.

Did you know that between 1941 and 1946 the vast majority of stories in american newspapers were about WWII?

Obviously, they were obsessed!

Also, the reason for so much on vaccines lately is because it's what's been interesting me lately. It's summer, and there hasn't been a lot of other news that caught my attention. I'm sure that will change. :-)

If you don't like what he writes, then don't read it. Or just start your own blog. Because who just doesn't love someone who whines about what a blogger writes?

That’s why the vast majority of entries are on vaccines, as anyone with eyes and a brain can easily check by looking at the last 10 entries and their content.

One of these things is not like the others.

,Narad, I doubt you will see that much intellectual rigor from someone who thinks a string of insults is a valid substitute for evidence, or even civil discussion. Especially since he seemed to not know how the category cloud on the right hand side of the page works.

All you sycophants always sing in complete unison. How about some harmony once in a while, or God forbid, dissonance? Must you all echo the exact same thing, all the time? Science is not a popularity contest.

Must you all echo the exact same thing, all the time? Science is not a popularity contest.

There is but one objective reality, so there is unison in science. There's lots of dissension in the various religions, since each one is based on a particular collection plate/woo/conspiracy. The agreement you see here reflects the common value we place on reality vs unsupported opinion—disagreement is seen on matters of values, of course, since values are subjective. These values also come up on matters where the scientific understanding isn't settled: the validity of naturopatheticism isn't one of those unsettled areas..

Of course, there is this thing too:

"Yeah, that happened to me last night. I had wanted to move on from writing about antivaccine nonsense, as it seems that that’s all I’ve been writing about for the last several days (probably because it almost is)"

Let the cognitive dissonance begin!

What cognitive dissonance might you be imagining?

There is but one objective reality

Please note that I reject ontology wholesale.

^ Oh, and that phraseology implies plural minds, which implies dualism. I don't see it as a useful approach to anything.

Watch out, Narad: Mustapha Mond has ordered us not to disagree or even discuss with each other, since we're all Orac's sycophants.

Watch out, Narad

Sheer cussedness is a marker of a good day for me at this point.

Wow, this is hilarious. Poor little Mustapha is reduced to repeating random insults, and is left without a single cogent response.

Actually I see dissonance enough, not only from those anti-vaccionists, but as well from people who might agree on vaccins, but aren't agreeing at other things. If you want some dissonance, read discussions between Political Guinea Pig and others on this blog.

"we’re all Orac’s sycophants"

What?? I thought that I'd finally succeeded at becoming a minion. With a few more years hard work I hope to reach the elevated stratum of shill.

Deaths and complications due to treating the fake disease known as "chronic Lyme disease"

oracknows — Wed, 21 Jun 2017 01:26:27 +0000

Deaths and complications due to treating the fake disease known as "chronic Lyme disease"

In pseudomedicine, fake diseases predominate. Basically, fake diseases are diseases that do not exist in conventional medicine as diagnostic entities because there does not exist sufficient sufficient evidence to support them as one or there exists compelling evidence that they are not. Naturopaths, for instance, like to diagnose people with "adrenal fatigue," which is one of the prototypical "fake diseases." Basically, it involves a constellation of vague symptoms that may include a combination of several of the following: fatigue, inability to handle stress, cravings for salty foods, difficulty getting up in the morning, and more. Basically, the idea is that the adrenal glands have become "fatigued" and thereby unable to produce adequate quantities of hormones, primarily the glucocorticoid cortisol, due to chronic stress or infections. Of course, there is no such thing as "adrenal fatigue." It is not an accepted medical diagnosis. That hasn't stopped a veritable industry devoted to selling "adrenal supplements" and other quackery to treat this nonexistent condition from cropping up.

Chronic lyme disease is another prototypical fake medical diagnosis. This should be contrasted to Lyme disease, which is a real diagnosis and a real disease caused by the tick-borne bacterium Borrelia burgdorferi. Lyme disease symptoms include fever, headache, and fatigue, and it's characterized by a skin rash known as erythema migrans. The diagnosis of Lyme disease is based o nits symptoms, physical findings (e.g., the characteristic skin rash, which looks like a bull's eye), and a history of being in an area where exposure to ticks is possible. Laboratory testing can be helpful if appropriate tests are used appropriately. In the case of Lyme disease, that usually includes a two-step process to test the blood for the presence of antibodies against the bacteria that causes Lyme disease, the first step being an enzyme immunoassay, which, if negative rules out Lyme disease. If the first step is positive or indeterminate, then an immunoblot test (Western blot) is performed, and results are considered positive only if both tests are positive. If not treated, Lyme disease can spread to cause meningitis, carditis, neuropathy, or arthritis. The usual treatment for Lyme disease is 2-4 weeks of antibiotics, which is highly effective.

Alternative medicine practitioners claim that Lyme infection can become chronic and attribute a vague constellation of symptoms not unlike the vague constellation of symptoms attributed to adrenal fatigue to chronic Lyme infection, a condition they commonly refer to as chronic Lyme disease. It's not all just alternative medicine practitioners, though. A group of physicians who like to refer to themselves as "Lyme literate" physicians describe patients whom they believe have persistent B. burgdorferi infection, claiming that the condition requires long-term antibiotic treatment.

Now, there is a condition known as posttreatment Lyme disease syndrome, which is the proper term for patients with a verified previous B. burgdorferi infection who experience fatigue, arthralgias, or other symptoms six months or more after antibiotic treatment when all other conditions have been ruled out. However, there is no evidence that this syndrome is caused by chronic B. burgdorferi infection, nor is there any good evidence that prolonged treatment with antibiotics benefits patients with persistent symptoms after treatment for Lyme disease—quite the contrary, actually. At least five five randomized, placebo-controlled studies have shown that prolonged courses of IV antibiotics do not improve long-term outcome for patients with a diagnosis of chronic Lyme disease (e.g., this one). The evidence is about as solid as evidence gets in science-based medicine that prolonged courses of antibiotics do not help these patients and in fact harm them. Yet these "Lyme literate" physicians and a coterie of naturopaths treat patients with symptoms after Lyme disease for weeks, months, or even years of antibiotics, and there are many known complications to long term antibiotic treatment.

These potential complications have been illustrated in a recent article in the CDC's Morbidity and Mortality Weekly Report (MMWR), Serious Bacterial Infections Acquired During Treatment of Patients Given a Diagnosis of Chronic Lyme Disease. The report begins:

The term “chronic Lyme disease” is used by some health care providers as a diagnosis for various constitutional, musculoskeletal, and neuropsychiatric symptoms (1,2). Patients with a diagnosis of chronic Lyme disease have been provided a wide range of medications as treatment, including long courses of intravenous (IV) antibiotics (3,4). Studies have not shown that such treatments lead to substantial long-term improvement for patients, and they can be harmful (1,5). This report describes cases of septic shock, osteomyelitis, Clostridium difficile colitis, and paraspinal abscess resulting from treatments for chronic Lyme disease. Patients, clinicians, and public health practitioners should be aware that treatments for chronic Lyme disease can carry serious risks.

Noting:

Chronic Lyme disease, on the other hand, is a diagnosis that some health care providers use to describe patients with a variety of conditions such as fatigue, generalized pain, and neurologic disorders. Many of these patients have experienced significant debilitation from their symptoms and have not found relief after consultation with conventional medical practitioners. As a result, some seek treatment from practitioners who might identify themselves as Lyme disease specialists (“Lyme literate” doctors) or from complementary and alternative medicine clinics, where they receive a diagnosis of chronic Lyme disease (3,7).

A diagnosis of chronic Lyme disease might be based solely on clinical judgment and without laboratory evidence of B. burgdorferi infection, objective signs of infection, or a history of possible tick exposure in an area with endemic Lyme disease (1,7). There is a belief among persons who support the diagnosis and treatment of chronic Lyme disease that B. burgdorferi can cause disabling symptoms even when standard testing is negative, despite evidence that the recommended two-tiered serologic testing is actually more sensitive the longer B. burgdorferi infection has been present (6). Some practitioners use tests or testing criteria that have not been validated for the diagnosis of Lyme disease (1). A significant concern is that after the diagnosis of chronic Lyme disease is made, the actual cause of a patient’s symptoms might remain undiagnosed and untreated (3,8).

This is how pretty much every fake disease is diagnosed, particularly the part about "specialty" laboratories using non-validated testing methods and diagnostic criteria. (Again, echoes of adrenal fatigue.) The consequences of such diseases can be dire. Indeed. I remember an article last year about a woman with multiple sclerosis who sought out a Lyme-literate doctor and was given a diagnosis of chronic Lyme disease. She never went back to her conventional doctor and instead continued to be treated for chronic Lyme disease. Not surprisingly, she continues to have symptoms of multiple sclerosis, because her disease is untreated. Who knows how many patients out there with real medical conditions that are hard to diagnose and treat (like MS) are on long term antibiotics for chronic Lyme disease?

Some even die from complications related to their "therapy":

A woman in her late 30s with fatigue and joint pain received a diagnosis of chronic Lyme disease, babesiosis, and Bartonella infection by a local physician. Despite multiple courses of oral antibiotics, her symptoms worsened, and a peripherally inserted central catheter (PICC) was placed for initiation of IV antibiotic treatment. After 3 weeks of treatment with IV ceftriaxone and cefotaxime, the patient’s joint pain continued, and she developed fever and rash. She became hypotensive and tachycardic and was hospitalized in an intensive care unit, where she was treated with broad spectrum IV antibiotics and required mechanical ventilation and vasopressors. Despite maximal medical support, she continued to worsen and eventually died. The patient’s death was attributed to septic shock related to central venous catheter–associated bacteremia.

That's right. "Lyme literate" doctors sometimes place long-term intravenous access in order to administer antibiotics. Yet long-term indwelling intravenous catheters have complications. They clot. They become infected. Sometimes those catheter-associated infections result in fatal sepsis, as in the case above. Infections are less common than clotting problems (and pretty uncommon in PICC lines), but when the benefit of the treatment is zero, as it is for long term antibiotics for chronic Lyme disease, then what we're dealing with is all risk, no benefit, and even if they don't die of their infection, the sequelae can be very serious, as this other case described in the MMWR report, an adolescent girl who received several months of oral and IV antibiotics and suffered an infection of her PICC line:

One week after antibiotics had been discontinued, the patient developed pallor, chills, and fever to 102.9°F (39.4°C); after consultation with the alternative medicine clinic, she was given another dose of ceftriaxone through the PICC. Later that day she was evaluated in an emergency department with fever to 105.3°F (40.7°C), hypotension, and tachycardia consistent with septic shock. Blood and PICC tip cultures grew Acinetobacter spp. She was hospitalized in an intensive care unit and required vasopressors as well as broad-spectrum antibiotics to treat the infection. The PICC was removed, and the patient was eventually discharged after several weeks of hospitalization.

Yes, seven weeks in the hospital, much of it in the ICU. It never ceases to amaze me how alternative practitioners castigate conventional medicine for administering treatments that have side effects and then think nothing of co-opting such treatments, even placing indwelling catheters that can become infected, in order to administer the products of big pharma unnecessarily, as most of the cases discussed in the MMWR report show. One of these patients developed osteomyelitis and a paraspinal abscess that required surgical drainage.

However, catheter-associated infections are not the only risk of long-term antibiotics, although they are one of the most potentially deadly. "Lyme-literate" doctors might claim that the complications above were due more to the catheter than to the long term antibiotics, but long term antibiotics generally require the placement of an indwelling catheter, be it a PICC line, a Hickman, a Broviac, or a subcutaneous reservoir like a Mediport. One complication that is straight up due to antibiotics is Clostridium difficile colitis. C. difficile colitis is a complication that can occur from nearly any antibiotics, although it is more common with clindamycin, and it can occur after oral antibiotics, no IV antibiotics necessary.

Consider this tragic case:

A woman in her 50s developed progressive weakness, swelling, and tingling in her extremities and received a tentative diagnosis of chronic inflammatory demyelinating polyneuropathy. Despite various treatments over a 5-year period, her symptoms did not substantially improve, and a diagnosis of amyotrophic lateral sclerosis was made.

The patient was subsequently evaluated by another physician and was told she had chronic Lyme disease, babesiosis, and Rocky Mountain spotted fever. Initial treatment with herbs and homeopathic remedies had no effect. She was treated with IV ceftriaxone and oral trimethoprim-sulfamethoxazole, acyclovir, fluconazole, and tinidazole. After 7 months of intensive antimicrobial treatment, her pain improved, but the weakness worsened. She discontinued treatment after developing C. difficile colitis that caused severe abdominal cramps and diarrhea. The C. difficile infection became intractable, and her symptoms persisted for over 2 years, requiring prolonged treatment. The patient subsequently died from complications of amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disease affecting motor neurons. There is no cure, and there are only two FDA-approved drugs that I am aware of that slow the progression of the disease. Neither prolong life that long, and the one that was recently approved, Radicava, costs $145,524 a year and has not yet been shown to prolong survival. Reading between the lines, one can imagine that this woman might have been in denial over her diagnosis, given that ALS is a relentless and terminal disease with no good treatment that arrests the progress of the disease, leaving supportive care as the only option. One might imagine that the diagnosis of chronic Lyme disease gave this woman hope that maybe she didn't have an invariably fatal disease after all. Instead of the hoped-for result, she continued to deteriorate and had to deal with chronic C. difficile colitis for the rest of her unfortunately short life, decreasing the quality of her remaining life significantly. One can only imagine dealing with the abdominal pain, diarrhea, and fevers associated with C. difficile as one becomes progressively weaker and less able to control one's muscles.

Skeptics like to point to homeopathy as the ultimate quackery. I even like to refer to it as "The One Quackery To Rule Them All." However, most homeopathic remedies other than the ones contaminated with other substances or drugs are basically water. They don't help, but they usually don't cause significant harm themselves, other than being ineffective. (Their ineffectiveness allows whatever disease is being treated to progress.) The treatment of chronic Lyme disease is different and much worse. It involves not only serious problems like the selection of antibiotic-resistant bacteria, but injuries related to unnecessariy procedures, sepsis due to bacteremia, vein clots, and missed opportunities to diagnose and treat actual underlying diseases and conditions. The MMWR report notes that number of people who undergo treatments for chronic Lyme disease is unknown, as is the number of complications that result from such treatments, noting that systematic investigations "would be useful to understand the scope and consequences of adverse effects resulting from treatment of persons with a diagnosis of chronic Lyme disease." Unfortunately, belief in the entity known as chronic Lyme disease is very cult-like. No matter how large the number of people undergoing unnecessary and prolonged antibiotic treatment, no matter how many people suffer complications of that treatment, ranging from minor to severe to death, I doubt that it will stop the quacks who call themselves "Lyme literate physicians."

oracknows Tue, 06/20/2017 - 21:26

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