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A Misguided Apology

A new book by Thomas Schneider, MD, offers A Physician’s Apology. The subtitle asks, “Are WE making you sick?” I was eager to read it, because I could think of many things doctors might be apologizing for: overdiagnosis, overtreatment, ordering unnecessary tests, pathologizing the vicissitudes of everyday life, offering misleading low-fat diet advice, misrepresenting inadequately tested treatments, not putting enough emphasis on prevention, prescribing medication before giving lifestyle changes a chance, etc. I was disappointed: his basic apology was “Truth is extremely hard to find in medicine and science, and I’m sorry,” which is true but is hardly his fault. Then he promises to “tell you a number of medical and scientific facts that are different from what many have always been told.” He blames commercials, creative marketing, and clueless doctors. Then he offers his own “truths” and his personal recipe for wellness. Some of these “truths” are questionable, and some are frankly wrong.

a-physicians-apology

The author’s personal story

As a fighter pilot in Viet Nam, he was shot down and “landed in Agent Orange” which he believes causes all sorts of metabolic and physiologic abnormalities. (It does, or rather the dioxin contaminant does, but the effects are dose-related, and some veterans with minimal exposure have blamed it for everything from birth defects to diabetes. According to the American Diabetes Association, the evidence for a link with diabetes is modest. Schneider doesn’t provide any information that would help us assess his degree of exposure.) After his military service he went to medical school; but instead of implementing what he learned there about a healthy lifestyle, he smoked, drank, ate too much, didn’t get adequate sleep, and led a stressful life. He developed a number of health issues and eventually started a “wellness” program. He stopped smoking and drinking, ran triathlons, and dropped his weight from 294 to 180 pounds. It didn’t keep him well: he developed diabetes, coronary artery disease requiring bypass surgery, went on dialysis when medications destroyed his kidney function, developed joint pain for which he took medication that perforated his intestine and put him in the ICU for 3 months, developed cancer that was surgically removed, and continued to experience a series of other medical disasters including gout, hypertension, impotence, and a worsening of his diabetes requiring insulin treatment.

He concluded that his “wellness” program was not working. (My conclusion is that it couldn’t very well work to reverse all the damage that was already done.) In frustration, he collaborated with other doctors to develop a program to evaluate patients holistically and encourage a healthy lifestyle. He says much of this new medical path has not been published yet, that most physicians don’t know about it, but that it is the truth. He claims that

…the information we are given is often just plain wrong (or, at best, is unsupported by scientific evidence.

He offers the truth, but many of his truths commit the very sin he accuses mainstream doctors of: they are unsupported by scientific evidence. He doesn’t even give us any reason to believe his own health has objectively improved from (belatedly) following his own advice.

Good advice

He provides a lot of good advice for a healthy lifestyle: nutritious diet, exercise, smoking cessation, weight control, adequate sleep, stress avoidance, limiting alcohol intake. No one can argue with any of that, but it’s nothing new; it’s what mainstream doctors have always recommended.

Questionable advice

Much of what he says is not supported by any published studies showing credible evidence of clinical benefit and it contradicts consensus recommendations like those of the US Preventive Services Task Force (USPSTF). Here are a few examples:

  • If you don’t get adequate sleep, you won’t be able to lose weight. Take melatonin or magnesium for restful sleep. Magnesium is pretty much good for everything and everyone.
  • Drink 8 glasses of water a day. (This is a medical myth that even Snopes.com has declared is FALSE.)
  • Cholesterol should be managed without statins. You shouldn’t take statins if your doctor can’t guarantee that they won’t hurt you and will prolong your life. (There are no guarantees, but statins have been shown to decrease all-cause mortality.)
  • A wellness evaluation should include measurement of your neurotransmitters (serotonin, GABA, dopamine, glutamate), a free T3 level, a free testosterone level, hemoglobin A1C, insulin level, homocysteine, hsCRP, arachidonic-to-EPA ratio. He even recommends routine carotid ultrasound testing. (These are simply not indicated as routine screening tests. I wonder if he is related to the doctor I wrote about recently who ordered $3,700 worth of unnecessary lab tests on a healthy 21-year-old.)
  • These supplements have been “clearly related” to increased brain function: omega-3, CoQ10, multivitamins, melatonin, arginine, acetyl L-carnitine, carnosine, d-ribose, nitric oxide, chromium, and water. Low cholesterol impairs brain function.
  • Hormones should be “balanced” by measuring their levels and prescribing testosterone, thyroid (both T4 and T3), and bio-identical female hormones. No one should be taking Premarin because it is not “natural” but is made from pregnant horse urine. (Not true. The company website says it “contains a mixture of conjugated estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine.” Anyway, one could argue that horse urine is a “natural” substance.)

It’s unfortunate that he mixes a wealth of excellent science-based health advice with non-evidence-based opinions. As in the case of Dr. Oz, this misleads laymen who can’t tell them apart. It even confuses doctors who wonder, “Why does he say that?” and waste time trying to find his (nonexistent) sources in the literature.

Non-recommended sources

He recommends functional medicine (criticized here and elsewhere on SBM) and anti-aging websites like A4M, which has received a Silver Fleece Award for quackery. He recommends books like Mark Hyman’s The UltraMind Solution: Fix Your Broken Brain by Healing Your Body First (listed as nonrecommended by Quackwatch).

Conclusion

Dr. Schneider’s book is misleading. Offering an “apology” is a clever ploy to engage readers and make them more receptive to his impassioned approach to wellness, much of which is simply not supported by credible evidence.

In my opinion, that’s what he should be apologizing for!

Posted in: Book & movie reviews

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98 thoughts on “A Misguided Apology

  1. Cervantes says:

    It would be worthwhile for a physician to write a book offering the legitimate apologies you propose. One difficulty in reducing overdiagnosis and overtreatment is that patients generally want it — people think that imaging and other tests can only benefit them, they want to do something about their low back pain or whatever it may be and feel abandoned if the doc says let’s just wait and see, they demand antibiotics for URTIs . .. I could go on and on. Convincing people that less is often more is a big challenge.

    1. WilliamLawrenceUtridge says:

      Gilbert Welch did this with Overdiagnosed. Jerome Groopman tried to do this as well, with much less success in my opinion, with How Doctors Think.

  2. stanmrak says:

    Truth doesn’t need scientific evidence to exist, an idea that I’m sure baffles most of you here.

    1. EBMOD says:

      What you are missing is that without evidence . . . how are we to know the difference? How do you KNOW what is truth and what isn’t without evidence? In your case, its pretty clear that you pull your truth out of your backside, especially when it provides you with a nice profit from your dubious supplements. Basing one’s worldview on endless unfalsifiable arguments is a pretty sure way to end up highly misled…

      1. EBMOD says:

        And I should add I see you continue to dodge my question about your websites’ claims regarding astaxanthin and glaucoma. As an eye doc, it is highly offensive that you are preying on people with this disease. If even one person listens to your opinion and goes off their glaucoma meds for astaxanthin, they are risking permanent blindness. To put it another way, if I stopped Rx’ing the standard of care and followed your guidelines for glaucoma, I would be sued into oblivion for malpractice and likely lose my license. Yet, since you are operating in a completely unregulated market where the only guiding principle is your profit, you have no problem harming people for your own gain. In other words, you are acting just like the ‘big pharma’ you supposedly oppose. Hypocrisy at its most blatant.

      2. stanmrak says:

        How do you know the difference between good science and fraudulent science? Anyone who trusts that “Monsanto science” is good science hasn’t really looked at it very hard. It’s manipulated to make it look good, but it’s not.

        Repeatedly throughout history, ‘good’ science has been discovered to be bad somewhere down the road. How much of the science we trust today will be revealed to be false tomorrow? No one knows. Stop acting like it reflects the ‘truth’ any more than anything else does.

        1. Harriet Hall says:

          “How do you know the difference between good science and fraudulent science?”

          There are ways. We try to explain them on this blog.
          Science does a whole lot better at reflecting the “truth” than anything else does.
          Stop acting like you can know what the “truth” is without evidence.

          1. stanmrak says:

            “A whole lot better” is not the same as being ” the truth.” I have no argument that science isn’t useful, but it’s not infallible, and scientists are fooled all the time. Arrogance will prevent you from realizing that. The science you’re getting on GMOs is being manipulated, that should be obvious.

            1. Harriet Hall says:

              “I have no argument that science isn’t useful, but it’s not infallible, and scientists are fooled all the time. Arrogance will prevent you from realizing that”

              Straw man. We do realize that. That’s exactly what this blog is all about.

              “The science you’re getting on GMOs is being manipulated, that should be obvious.”
              Some of the science may be manipulated, but some is not. How can we tell the difference? In the first place, we can avoid knee-jerk rejections of anything that doesn’t support our preconceived biases. And we can use common sense and our knowledge of how biology works.

            2. WilliamLawrenceUtridge says:

              You approach “the truth” as if you already had it though, and you resist not only changing your mind, but have a cognitive strategy you implement consciously to avoid even seeing dissenting information. I’m talking about your “all research is funded by Monsanto” gambit, even though it’s not.

              It’s arrogant to assume you already have the answer without even understanding the topic at hand. Your beliefs about GMOs bear no relation to the evidence and your excuse for why this is the case is just you being lazy and engaging in information bias.

              You claim the science is “obviously” being manipulated. How is it that the AAAS, the AMA, the WHO, the EU and basically all major scientific bodies who aren’t predicated on criticizing GMOs have consistently found there is a lack of evidence to support their harms?

              Further – how can GMOs even harm us? What is the mechanism by which glyphosate resistance, to pick a bugbear, can harm us? Or antifreeze molecules found in a fish we already eat?

              You’re invoking the precautionary principle to avoid even looking at the evidence. That’s not a logical or rational approach, that’s purely your emotional disgust at corporations overwhelming your ability to think or understand reality.

            3. Frederick says:

              Yes you are right, some of the study on GMO were manipulated. In fact, Gille-éric Séralini did manipulated his study WAY out of proportions. It was ridiculous, Even if Mosanto or Pioneer would wanted to manipulated a GMO study, they would not even by able to be as noob as Séralini was. And Séralini was totally finance by anti-gmo group and the 2 biggest anti-gmo groceries store chain in France, all those peoples had financial and ideological interest in building their own evidence, not caring about reality. That is NOT a independent study. So yes you are totally right, The only problem is that a lot of the manipulations in science are, in reality, not happening in the direction you are saying. So you close you mind and your eyes, and let you brain biases. Truth is not want you want it to be, it is just what it is, and only objective, rigorous and open investigation can reveal it.

              And for all those truths that can’t be reach with science, we have Philosophy for that, and funny thing is, a lot of philosopher think science is a good thing and a lot of them work WITH science. But of course, all this truth is sliding on your mind like water on the back of a duck.

            4. Chris says:

              “I have no argument that science isn’t useful, but it’s not infallible, and scientists are fooled all the time. ”

              Well it beats making it up out of thin air, which is often what you do.

            5. You are gittn under their skin!!

              1. WilliamLawrenceUtridge says:

                No he’s not, there’s merely a standing necessity to rebut spurious nonsense that is superficially convincing if you are underinformed or don’t understand the science.

        2. WilliamLawrenceUtridge says:

          How do you know the difference between good science and fraudulent science?

          How do you? Do you examine the control groups, compare the results to other comparable experiments? Review the histology of tissue samples? Check the statistics? Or do you just look at the authors and play “six degrees of separation from Monsanto”? Like, “oh, this person is a professor at the University of Ohio, the University of Ohio is in Ohio, the Ohio State Representative was funded by Monsanto in 1997, BOOM! Conflict of interest.”

          Is that a fair summary of your reasoning?

          The thing is, you never, ever show any signs of having actually read the studies, you never point to problems with the methodology, sampling or analysis, you merely say “MONSANTO!” as if it were an argument. Well, Monsanto isn’t the only entity to fund GMO. Golden rice was developed using only the patent ideas from private funders, is it somehow horrible? Further, there are few biological reasons to even expect GMOs to present unique risks. Merely saying “MONSANTO” isn’t an argument, it’s you saying you’re too lazy and too uninformed to do any of the hard work of actually educating or reasoning out why GMOs even could present unique harms not found as part of conventional breeding.

          Repeatedly throughout history, ‘good’ science has been discovered to be bad somewhere down the road. How much of the science we trust today will be revealed to be false tomorrow? No one knows. Stop acting like it reflects the ‘truth’ any more than anything else does.

          I think you mean “technology”, science accumulates knowledge which can be turned into technology. How has the theory of relativity been turned bad? How has our understanding turned bad, aside from allowing you to communicate your ignorance throughout the world? How has understanding what a vitamin is and how the molecule is used in the body bad? How is understanding the immune system and germ theory of disease bad? And don’t say vaccines are bad, because they aren’t, and they’re the reason you don’t have to worry about smallpox.

          Also, so what, we should just revert to a level of technology before the development of science? How do you feel about never leaving your village? That was the reality before the invention of trains, cars and busses. How do you feel about eating the same thing every day of your life? That was the reality before the development of shipping containers and the discovery of cross-breeding for new climates. How do you feel about finding out the king has died two weeks’ after the fact? Because you’d be stuck with a king, and news travels slow. Dying of gangrene after cutting your toe on a rock? Your relatives being sucked into a tornado because you can’t predict the weather?

          How much of the science we trust today will be revealed to be false tomorrow? No one knows. Stop acting like it reflects the ‘truth’ any more than anything else does.

          You spew such crap. Since the development of empirical observations, the history of science has been a history of increasing refinement of ideas. Very, very rarely does a previously-held fact get overturned as completely wrong, but it does get modified. There are of course exceptions for blatant fraud, but they are vanishingly rare because unreplicable studies are generally ignored studies. How much has the electromagnetic theory changed since the 19th century? Has the theory of evolution substantially changed in its three main beliefs of natural selection, descent with modification and random mutations? Was the Newtonian theory of physics discarded or merely modified at extremes by Einstein?

          Science represents an increasingly precise understanding of the world, and it’s far superior to your apparent alternative of “what I know is true is true, and I don’t need any evidence”.

        3. EBMOD says:

          You keep responding to my comments with arguments about Monsanto. Please address the astaxanthin/glaucoma question. I’m highly curious how you discovered this ‘truth’.

        4. Calli Arcale says:

          stanmrak — a good question, how do you tell what is good science. But I notice that it doesn’t answer the question that was put to you — you wish to eschew science in favor of THE TRUTH, yet you will not tell us how you decide what is the truth and what is not.

          From where I’m sitting, it looks like you haven’t the foggiest idea what is the truth. You just pick whatever looks appealing and then seek justification of it. If you are ever espousing the truth, it is by chance alone and you yourself would never know it.

          Science at least has a record; we can read the studies and look for deficiencies and oversights and even outright fraud. But you? We have only your word. That doesn’t make you as untrustworthy as Monsanto. Honestly, it makes you even *less* trustworthy, since you give us less to judge by.

          1. Dan McPeek says:

            As a devoted visitor but non-commenter, who is this stanmrak person?
            Is he a supplement pusher; a magic health food store, pill advocate for every affliction?

            1. n brownlee says:

              Yes, he is all that, and more… so much more.

            2. Thor says:

              Just another run-of-the-mill woo-pusher, one among thousands, who base their world-view on pseudo-science and unfounded claims, and peddle accordingly. As EBMOD pointed out, he has a website hawking supplements, but I, personally, won’t go there to even give him the time of day.

            3. Chris says:

              He is this dude. Apparently a marketing guy who thinks he knows science. Except most of the time it is stuff he just makes up out of thin air.

          2. NO, your description is not science it describes data and information.

            1. WilliamLawrenceUtridge says:

              Steve, you’ve never been able to successfully describe science, and your continued insistence that your personal experience matters more than the 3,000+ controlled trials shows that you dont’ understand it.

    2. MTDoc says:

      Neither does falsehood.

    3. WilliamLawrenceUtridge says:

      Distinguishing between truth and “making shit up” (also known as the prescientific method”) generally does require scientific evidence.

      You denigrate science because it challenges your prejudices, never coming up with a reason why it doesn’t or can’t work. The best you can manage is “Big Pharma!!!!” ignoring the billions of dollars of research funding provided by governments, and ignoring the fact that Big Pharma is not omnipotent.

      You’re lazy stan. Lazy and ignorant. And specifically here, completely ignoring the fact that if something is “true” then science can be used to confirm that truth.

      1. stanmrak says:

        Money buys more way more lies than it does truth. If you think that your government is more concerned about your welfare than they are about Monsanto’s, I have bad news for you. Our government is completely in bed with them. Our food safety “czar”, the head of the USDA, several members of the supreme court, a bevy of senators and congressman, are all on, or have been on the Monsanto payroll. The rule is not to bite the hand that feeds you.

        1. WilliamLawrenceUtridge says:

          Money buys more way more lies than it does truth. If you think that your government is more concerned about your welfare than they are about Monsanto’s, I have bad news for you. Our government is completely in bed with them. Our food safety “czar”, the head of the USDA, several members of the supreme court, a bevy of senators and congressman, are all on, or have been on the Monsanto payroll. The rule is not to bite the hand that feeds you.

          Sure, that’s why non-US and non-Monsanto-funded agencies like the WHO, AMA, AAAS and European Union have all concluded that GMOs have no risks.

          Stan, a question for you – why are you worried about GMOs. Not who told you to be worried, but why. What specific health problem do you think they can inflict upon you, and what do you think the mechanism is.

          Also, you sell supplements. By your own rational, since you are too ignorant of the scientific research on the topic to give a reasonable accounting, how could we ever trust your opinion? Unlike most of the head of the USDA, members of the Supreme Court, senators and congresspeople who were once on Monsanto’s payroll (source?) you currently sell vitamins and directly profit by portraying food as dangerous and supplements as safe. Why should we trust you?

        2. Stan
          You are good! Be careful these guys will try to kill you.

          1. WilliamLawrenceUtridge says:

            If by “kill” you mean “point out how you are incorrect in your assumptions and facts”, then yes – we are going to kill him. Of course, a reasonable person might note that pointing out someone is wrong isn’t actually killing them.

            And why would you agree with someone who prates about his expertise despite being actually, startlingly ignorant about the topic he claims expertise in?

            Actually, don’t answer – I already know why. Because you recognize a kindred spirit.

            1. Windriven says:

              I suspect that by ‘kill’ he is referring to Andrey having filed a complaint against him with the Texas board.

          2. Windriven says:

            @Steve Rodrigues

            “Stan – You are good!”

            So Steve, can you tell us what Stan said that you imagine to be ‘good’? His comment was nothing more than the outline of a conspiracy theory supported by nothing but his own febrile imagination. What is it that he wrote that was so good?

            I hope you will think about this and think about how the things that you say, say things about you.

            Stan said nothing more meaningful or sensible than ‘the Illuminati killed JFK’ or ‘Martians are controlling you through radio waves sent through the amalgam fillings in your teeth.’

    1. Harriet Hall says:

      Confirmation bias strikes again!

    2. WilliamLawrenceUtridge says:

      Stan, there exist enough independent, long-term and multi-generational feeding studies to undertake multiple meta-analyses of the topic at hand.

      So – industry-sponsored studies show no harms. Independent, non-industry sponsored studies show no harms. Two individual studies with inadequate numbers of subject in each group show equivocal results based on unblinded “meh, that looks different” eyeballing of lab subjects based on groups ideologically committed to organic farming and opposing GMOs, one of which was funded by CRIIGEN which is also ideologically committed to GMOs, those show possible harms if you ignore much of the data even within the studies themselves. But those you trust?

      Science. You do not get it.

  3. stanmrak says:

    Gee, for the last 3 decades, the best “science” that money could buy told us that saturated fat caused heart disease and polyunsaturated fats would prevent it. Now, they say… oops!

    “Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.”

    http://annals.org/article.aspx?articleid=1846638#tab10Div

    1. EBMOD says:

      So, if rigorous scientific standards can still be wrong a decent amount of the time, why do you think that a decidedly unscientific approach would be wrong less? Seems to me you are shooting yourself in the foot with this argument. Showing that science isn’t infallible doesn’t automatically validate your alternative. If anything, it shows that less rigorous methods should be trusted even less. As has been said here before, critiques of airplane design is not evidence for the existence of flying carpets…

      1. Calli Arcale says:

        I always wonder why it is that people think that a form of medicine which admits to having been wrong is inferior to one that never admits to anything.

        1. EBMOD says:

          Lol, indeed.

          “Your science, which does its best to control for biases is often wrong, thus we must embrace the method which doesn’t control for ANY biases and relies on rumor and hearsay!!”

      2. KayMarie says:

        Science is not infallible, it has methods and procedures for correcting errors over time.

        Many other ways people intuit the Truth have no systematic way of finding errors and correcting them. But then if you have no way to find out if you are wrong I guess that means you are always right.

    2. WilliamLawrenceUtridge says:

      Gee, for the last 3 decades, the best “science” that money could buy told us that saturated fat caused heart disease and polyunsaturated fats would prevent it. Now, they say… oops!

      And who are you quoting for this authoritative and confident statement?

      A FUCKING SCIENTIFIC ARTICLE. Hypocrite.

      I’m sure equivalent articles could be found to justify the opposite of yours, because the area is complicated, incredibly so, with multiple confounds.

      Also, the science supported a link between monounsaturated fats, not poly, and there is still evidence linking saturated fats to increased risk of heart disease. Further, the use of trans fats was the result of saturated fats being considered unhealthy and the industry responding with trans fats – not because of recommendations to use trans fats instead. Current research still supports the reduction of saturated fat and increase of monounsaturated fats, and above all not replacing the missing calories from fats with calories from refined sugars.

      It’s complicated, and you don’t get to pretend that you predicted all scientific breakthroughs because the dietary recommendations have evolved. The recommendation is still, and has been for decades, to consume predominantly fruits and vegetables with limited proteins and fats.

  4. stanmrak says:

    When you spout Monsanto studies, why is that NOT confirmation bias?

    1. KayMarie says:

      You do know there are studies that are not Monsanto studies. They are not the only people in all the world allowed to do research on GMO.

    2. WilliamLawrenceUtridge says:

      I don’t cite “Monsanto” articles. In fact, I have linked above to an article that discusses multiple meta-analyses of non-industry funded publications.

      You don’t get to discard outright studies that refute your biases merely because you don’t like them. Unless they are examples of outright fraud, which is very rare, the studies merely need to be interpreted with caution within the context of all studies on the subject and the general consensus. Which I have pointed out here is that GMOs offer no unique risks and show no indication of being inherently harmful.

  5. Peter S says:

    “A wellness evaluation should include measurement of your neurotransmitters (serotonin, GABA, dopamine, glutamate), ”

    Is there a test that RELIABLY measures neurotransmitter levels? From what I can tell urinary neurotransmitter levels – which I assume he is referring to — are essentially meaningless.

    1. MTDoc says:

      Even if you could measure it in the CSF it wouldn’t tell you how much is the right amount at the synapse, or how the brain is using it. Totally useless, especially in the wrong hands; dangerous in Stan’s.

      1. EBMOD says:

        Clearly, we must perform deep brain stimulation on all patients to ensure proper health . . .

        1. simba says:

          Open-skull Indian Head Massage. Safe and totally effective*!

          *In patients who follow an entirely organic, all-whole grain, no grains, vegan, fruitarian, no-fruit diet, are not exposed to pollution, do not engage in ritual impurities, don’t think obscene thoughts, have never seen the colour yellow… Of course, if you’ve done any of these things you accept it is entirely your own fault if anything bad happens to you. Even if you do not remember doing any of these things, you must have done them and forgotten them if the IHM doesn’t work or has side-effects.

      2. Peter S says:

        It always amuses me when the same CAM people who criticize claims that antidepressants correct neurotransmitter imbalances are quick to embrace the same trope when advocating supplements.

        1. n brownlee says:

          Or grass.

  6. stanmrak says:

    No Scientific Consensus on Safety of Genetically Modified Organisms

    There is no scientific consensus on the safety of genetically modified foods and crops, according to a statement released by an international group of more than 90 scientists, academics and physicians.

    “Such claims may place human and environmental health at undue risk and create an atmosphere of complacency,” states Dr. Angelika Hilbeck, chairperson of the European Network of Scientists for Social and Environmental Responsibility (ENSSER) and one of the signatories. “The ENSSER statement draws attention to the diversity of opinion over GMOs in the scientific community and the often contradictory or inconclusive findings of studies on GMO safety. These include toxic effects on laboratory animals fed GM foods, increased pesticide use from GM crop cultivation, and the unexpected impacts of Bt insecticidal crops on beneficial and non-target organisms,” Dr Hilbeck continues.

    The statement comes in response to recent claims from the GM industry and some scientists, journalists, and commentators that there is a “scientific consensus” that GM foods and crops were generally found safe for human and animal health and the environment. The statement calls these claims “misleading”, adding, “This claimed consensus on GMO safety does not exist.”

    http://www.independentsciencenews.org/news/no-scientific-consensus-on-safety-of-genetically-modified-organisms/

    1. Thor says:

      This is an anti-GMO lobby group which works in coordination with Greenpeace and the Green party in Europe. Hardly unbiased. Any organization can use the argument from authority fallacy to promote their particular view.
      Heck, even creationists pull out a list of all the scientists who support their view that the earth is six thousand years old.
      Using ENSSER to make the point that there is no scientific consensus is specious.
      What about the conclusions of numerous reputable science, food safety, and health organizations who contradict what ENSSER says with 600 studies showing the safety of GMOs? I think you conveniently failed to mention this.
      Quit cherry-picking. Try being a bit balanced, objective.

    2. WilliamLawrenceUtridge says:

      Safety of GMOs are asserted by the independent bodies of the AMA, AAAS, WHO, NAS and EU scientists. Your news story cites ninety scientists. The citations are a circle-jerk of press releases by the The European Network of Scientists for Social and Environmental Responsibility whose main goal is environmental protection, not science. Their beliefs are ideological, not factual. They’re now up to apparently 300 scientists, but much like the “dissenters from Darwin” list that prompted Project Steve, this is a pitiable selection of scientists compared to the number of scientific societies who have reviewed the evidence and concluded GMO is safe. Their signatories include professors of geography, laywers, anthropology, geochemistry, doctors, nuclear phsycists, astronomers, mathematics, vets (a lot of vets actually), etc. It includes such luminaries as John Fagan and Vandana “Who Cares if Poor Children Go Blind” Shiva, who are distinguished solely for opposing GMOs, not for proving they are harmful.

      So yeah, your cute little press release printed verbatim by Independent Science News is about as convincing to us as a Monsanto press release would be to you. Note how I try to cite scientific consensus statements rather than press releases from Monsanto.

  7. Seth Katzman says:

    Don’t engage him. I can see fish coming out of some of your cheeks.

    1. Seth Katzman says:

      (Fish hooks.)

      1. Thor says:

        It’s for the record, and for the fence-sitters. And not to let rubbish stand un-countered. And, as WLU once said, for one’s own satisfaction and amusement.

        1. EBMOD says:

          Yes, this. I find a perverse amusement out of seeing such blatant displays of cognitive dissonance and hypocrisy, though it is paired with an equal sense of sadness that some are so incapable of rational thought…

          1. Thor says:

            Indeed, sometimes the sadness is inescapable. Also, anger and irritable impatience. Most of us here plainly see the negative repercussions in the world (affecting us all) of such thinking, not only in our current time, but going back throughout human history. One can only imagine what a world this would be today if this wasn’t the case.

            1. EBMOD says:

              I graduated recently with my OD, and during my externships, I was located at an Indian Health Services hospital. Unfortunately, vaccination rates were abysmal on this reservation, and during my time there we had a large whooping cough outbreak. My daughter was 4 months old at this time. Even though I am vaccinated, never showed any symptoms, and was washing my hands constantly, I found myself worried that I might pass the pathogen on to my daughter who was too young at the time for the vaccine to confer immunity, considering my routine exposure to it. Pretty enraging when the apathy/ignorance of others is putting me and my family at risk…

              I went to school near Portland, OR (which has poor vaccination rates due to the haven of alt/med OR is) where my wife worked as a pediatric RN and they had a 7 month old patient of theirs die of whooping cough. Such a senseless loss, so easily preventable…

              1. Thor says:

                Exactly. Thus, the necessary “fight” so many of us are partaking in. Appeasement can never be an option.

      2. Calli Arcale says:

        I do hear the putt-putt-putt of a trolling motor, indeed. But one can amuse oneself by tugging on the lines and placing seaweed on the hooks. ;-)

        1. EBMOD says:

          That, and I think Stan truly believes his schtick. He isn’t a run of the mill troll, he actively makes a living from sales of his alt med snake oils. For him to grasp reality he would be required to view his products for what they are. Its obvious (at least to me) that he carries a pretty large burden of cognitive dissonance. I base this on the fact that he refuses to answer specific questions posed to him, in conjunction with the fact he just repeats his mantra over and over. I think SBM is an avenue for him to self-reinforce. This mindless repetition is likely more for his sake than ours…

          1. WilliamLawrenceUtridge says:

            It’s much like masturbation in that regard.

  8. Kiiri says:

    Wow stan has one horse and he’s beating it. Stan, the horse is dead man, it’s never going to ride. Great article as usual Dr. Hall. I shall now sit back and watch stan’s search for ‘truth’ which seems to only be about proving to us all how GMO’s are bad. IMHO when someone starts batting around the word ‘truth’ it is merely a proxy for ‘believe this with all of your heart but don’t ask me to prove it’. It isn’t truth, it is essentially religion. You are arguing that your view, with nothing to support it, should be believed because it is ‘truth’. That is religion, not science. If you want religion go to a church but back out of the science sphere because you’re just embarrassing yourself.

    1. WilliamLawrenceUtridge says:

      A good rule of thumb is, any website with truth in the url, any user with truth as part of their name, can be safely ignored as a quack.

  9. Natasha says:

    As the author indicates, there is much that is unknown in medicine/healthcare. This becomes worthy of apology when it is not acknowledged by doctors to their patients, and treatments/screenings are recommended without adequately informing patients of the chance of benefit, chance of harm, and state of the evidence (or lack thereof) supporting that assessment. For example, patients should be clearly informed whether a treatment or screening is being recommended on the basis of anecdotes/tradition/observational case studies, or well-designed randomized controlled trials with adequate sample sizes and long-term mortality figures, and they should be informed of the NNT. Failing to disclose the state of the evidence denies patients the opportunity to give truly informed informed consent, which is at the crux of what is exploitative and unethical, and worthy of apology in healthcare. On the other hand, if the patient is fully informed that a treatment or screening has only weak evidence and chooses to consent anyway, then that is their prerogative.

  10. Frederick says:

    Some Docs sure should apologize in believing into WOO,( Wizard of OZ being number 0 on that list) and letting all the freaking woo, barely regulated product, other dishonest doctors. roam free. Some medical board are such bunch of wusses. And how many time I heard people saying their Doc recommend Chiro, Some stupid woo or supplement. This doctor probably just wanted a nice retirement, any book with a MD saying “truths” , it’s guaranteed to generate revenue, just wait until The Wizard of OZ invite him over in his emerald castle, The sales will start right up. Show me the money!

    And SBM.org should apologize for being so interesting and sucking up so much of my time! hehe Great review Harriet once again short and pertinent

  11. goodnightirene says:

    Has Windriven been lost at sea?

    1. Thor says:

      Was wondering the same thing. No daily post is complete without at least one witty, incisive comment from Windriven, huh?

      1. Chris says:

        The sun has returned to our typically soggy part of the world. Let him have some fun in the sun. He deserves it!

        1. goodnightirene says:

          I would give a lot to return permanently to your “soggy” part of the world. I hope WD has his sunscreen handy if he’s playing in the sun. :-)

  12. Beth says:

    Premarin = PREgnant MARe urINe.
    As per http://labeling.pfizer.com/showlabeling.aspx?id=131
    “PREMARIN® (conjugated estrogens tablets, USP) for oral administration contains a mixture of conjugated estrogens obtained exclusively from natural sources, occurring as the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine.”

    Being made of pregnant mare urine, while kind of squicky, isn’t the issue.

    The issue is that it’s an incredibly abusive manufacturing system that relies on pregnant mares having concentrated urine (via dehydration), inhumane collection methods that prevent the animal from free movement or lying down, and finally the mass production of poor quality foals on a regular basis and massive scale, the VAST majority of whom go directly to slaughter, often for human consumption.

    There are safe and effective pharmaceutical alternatives; there is no good reason to continue industrialized animal abuse.

    You know, fyi and stuff.

    1. Calli Arcale says:

      And that, I feel, is an entirely sensible reason to be against Premarin. Arguing that it’s less natural than phytoestrogens, though, is frankly nuts. It’s far more “bioidentical” than stuff made by a soybean plant, since of course horses are mammals and use the hormone for exactly the same purposes as we do. Plants . . . don’t.

      I’m all in favor of synthetic estrogen, myself, or one manufactured by GMO yeast, like how medical-grade insulin is made. More accurate, and much more ethical. Phytoestrogens seem like a shortcut to a more ethical product that compromises quality, and I suspect if there weren’t a market for a vegan form of estrogen, they wouldn’t be in the news at all since obviously a horse product is gonna be closer.

      1. WilliamLawrenceUtridge says:

        Bioidentical is a nonsense marketing term anyway, sometimes you don’t want bioidentical estrogen because it has mixed effects.

        Also, I read an editorial a while back by a doctor in…Menopause? Or some similar journal whose scope encompassed hormone replacement therapy. He made the point that when premarin is consumed, the GI track (or liver?) modifies the molecule to become identical to human estrogen anyway.

        What you swallow doesn’t matter, it’s what acts on the receptor that is important.

        1. Calli Arcale says:

          Oh I agree that what you swallow isn’t the important thing. It just sort of puzzles me that phytoestrogens are touted as “bioidentical” as some sort of contrast to Premarin, which they want you to think is . . . less bioidentical? Or something? I don’t really get it. Maybe I’m not their target market. ;-)

          1. WilliamLawrenceUtridge says:

            It’s beause you are attempting to be logical and rigorous. Pretend you’re stan, and it’s all about the marketing. Bioidentical is a branding term used to establish some sort of warm, happy, fuzzy feelings to a product that is identical to things you can buy from Big Pharma for a lot cheaper.

            1. MadisonMD says:

              Pretend you’re stan, and it’s all about the marketing.

              Plantz is gud and natural. pharma bad.

              How’d I do?

              1. simba says:

                It’s like that weird thing where they try and convince you that tablets are ‘food’, often because the ‘active ingredient’ is extracted from food.

                So it’s a pill, it comes in a bottle, but it’s totally ‘food’ so it gets around the fact that sensible nutritionists, those who aren’t trying to sell a pill for every ill, tell you to get your vitamins from food.

              2. WilliamLawrenceUtridge says:

                You’re looking for outside feedback to validate your previously-held ideas, so you’re still a little off. Real stan would never ask whether he was right.

            2. mouse says:

              I don’t think that’s entirely it, WLU. I think women want the hormones because menopause sucks and comes with serious health risks. But, they DON’T want the proven health risks of the hormones that have been tested. The bioidentical name comes with a storyline that the hormones are SAFER because they are more identical than the ones tested. There are M.D.s who are prescribing these bioidenticals claiming they are better/safer. The question is whether that claim is true or not. Many people don’t have the background to discern for themselves.

              If the proponents of the bioidenticals are making untrue claims, one should reprimand THEM for it. You seem to be focused on deriding the people who are fooled by the lie.

              Sorry for the caps, pretend they are italics, because, apparently, I can’t use html tags.

              1. Thor says:

                You make valid points. Most of the women I know who took bio-identical hormones did so because of misinformation, mainly promulgated by MDs like John Lee. It was his mission in life to promote these substances.

                http://www.johnleemd.com

              2. MadisonMD says:

                I had a patient once who called me after her Gyn recommended bioidentical hormones from an over-priced local compounding pharmacy that specializes in this. The one recommended was estriol cream, because estriol is short-lived. The gyn had told her it was safe because it had such a short half life. I asked her why the gyn believed it would improve symptoms given its short halflife.

              3. mouse says:

                Thor “Most of the women I know who took bio-identical hormones did so because of misinformation, mainly promulgated by MDs like John Lee.”

                I wonder if those are the books that a neighboring artist told me about. I was having hot flashes working an art fair and I joked about it with my neighbor, expecting a dose of the typical “ain’t that a drag” camaraderie. Instead she told me “Oh you should take progesterone, lots of women are progesterone deficient. I read about it…” Looks like John Lee was a big progesterone advocate.

                Turns out a minor adjustment of my thyroid replacement eliminated most of the hot flashes.

                I find all those hormones very confusing. Now a days, from what my sister tells me, hormone “cocktails”, mixtures from compounding pharmacies, are the thing. I don’t know, it’s hard to separate the good from the bad.

              4. mouse says:

                MadisonMD “The one recommended was estriol cream, because estriol is short-lived. The gyn had told her it was safe because it had such a short half life. I asked her why the gyn believed it would improve symptoms given its short halflife.”

                How long is a short half life?

              5. MadisonMD says:

                How long is a short half life?

                Not a lot of details are available, since estriol is not FDA approved for any indication. So, I cannot look it up in standard pharmacology references. However, this study shows systemic levels after vaginal application increase to 42 pg/ml and then reach around 12 pg/ml in 2 h and undetectable (<5pg/ml) in 1h. So estimated systemic halflife, without knowing kinetics of absorption, is clearly much less than 1h. This study suggests a multi-exponential model of clearance after intravenous estrone with halflives of 3.6 and 64 min.

                Although it is impossible to discern the local halflife of estrone with vaginal application, it is clearly subpar in efficacy: the standard an estradiol-releasing ring (estring) beats estriol pessaries. Vaginal estriol cream, which is popular with the bioidentical crowd, is expected to be more short-lived than a pessary.

              6. MadisonMD says:

                I wrote estrone but meant estriol.

              7. mouse says:

                Oh! So not something that’s just a temporary measure, like astroglide, viagra or tasteful porn.

                Doh- I’m just an idiot on this topic. I think fade away inconspicuously.

              8. MadisonMD says:

                Ha! Yes, astroglide would be a the best choice for short term mitigation of dryness.

                The purpose of vaginal estrogen is to reduce risk of atrophy, chronic dryness, pelvic relaxation and associated incontinence. The same benefits can be had with systemic estrogen (e.g. premarin) with additional benefits of reducing hot flashes and maintaining bone density, but incurs the small increased risk breast cancer and cardiovascular events*. Of course systemic estrogen can also increase risk of uterine cancer slightly, although this risk is easily mitigated by also taking a progestin if the uterus is intact.

                There is no reason to believe that “bioidentical hormones” are any different, since they hit the same receptors, except for differences in pharmacology, absorption, and the money that can be had by compounding pharmacies and labs running useless hormone tests on saliva.

                ————–
                *Of course, before 2003, it was thought that hormone replacement therapy reduced cardiovascular risk based on observational data. However, the WHI RCT revealed that it actually increases cardiovascular risk slightly and previous observations likely reflected the better underlying health of women who chose replacement.

              9. WilliamLawrenceUtridge says:

                Hm…either you’re reading into my comment, or I didn’t do a good job of explaining myself. I completely and totally blame the unethical and/or credulous promoters of bioidentical hormones, not the patients. As I’ve said many times, in many previous comments, the background to understand the specifics is quite extensive, which is why doctors should be recognized as experts (and the quacks strongly controlled). Trying to inform patients always struck me as a losing proposition, unfortunately, because to really grasp the issues you need a substantial body of knowledge about cognitive fallacies, the scientific method, and basic biology, and then you need to get into the specific actions of individual hormones and hormone variants. I think a rigorous oversight and enforcement mechanism is a far stronger public health protection tool than education, particularly once you get into the weeds of a specific scientific and medical area.

                The only time I really “blame” the patients is when they consistently and persistently keep repeating the talking points spoon-fed to them by the shilling practitioners and never, ever seem to grasp or even try to engage with why they are wrong.

                For hormone replacement therapy, what needs to be emphasized to patients is that hormones are hormones, and always carry risks. There are no magical, risk-free drugs, and hormone supplements are very much drugs.

                It’s the quacks and shills who brand bioidenticals, not patients.

              10. WilliamLawrenceUtridge says:

                BTW, compounding is one of the added dangers of bioidentical hormone replacement therapy. They aren’t actually the same thing, but BHRT is often accompanied by compounding as a way of “personalizing” the dosing (and as a way for compounding pharmacists and prescribing doctors to provide a boutique service that increases their income stream). It adds danger by lacking proper quality control that you get with Big Pharma (they’re evil, but they do a good job of producing a standardized product) and as a result you can get concentration swings on the order of 30% or more in either direction. When you’re adding a picogram of hormone to 250ml of topical gel (quantities are arbitrary, I can’t be arsed to look it up) it’s very easy to screw it up if you’re using equipment that’s not research-lab grade. The FDA did a series of tests and found that most of the samples they selected from compounding bioidentical pharmacists were off to a sometimes dangerous degree.

                The wikipedia page is lengthy and strongly-sourced. I recommend it. Nudge, wink.

              11. mouse says:

                WLU “Hm…either you’re reading into my comment, or I didn’t do a good job of explaining myself. ”

                Sorry for the misunderstanding and thanks for clarifying. That’s why it’s great to have these exchanges. Sometime different perspectives results in confusion.

                I’ll have to check out the wiki article.

                @MadisonMD – thanks for the excellent summary! My mom died of uterine cancer. I have heard different recommendations hormone therapy and how or whether it increases the risk of uterine cancer, but not about adding progesterone. Maybe that is a newer development or just one that hasn’t been mentioned to me.

          2. mouse says:

            Premarin is pregnant mare urine? Hmm, I’ve already tried the post-menopausal nun urine* and it didn’t agree with me. I think I may say away from Premarin.

            *http://drugtopics.modernmedicine.com/drug-topics/news/infertility-agent-targets-profound-lh-deficiency?page=full

  13. Yolanda says:

    Thank you Harriet for this helpful review. There is so much junk science (if it even deserves to be called that) it’s difficult to keep track of what to follow sometimes. For example, the first questionable piece of advice you mention about one not being able to lose weight if one doesn’t sleep enough is one I’ve heard and seen over and over again. I think even the nutritionist I used to see told me that one. Thanks again. Please continue the great work.

  14. Cute, this is the pot calling the kettle black.

    Yea, I know, just bored and looking for ideas on how to debate with people who do not care to understand your ideas, evidence and experiences.

    1. Windriven says:

      ” just bored and looking for ideas on how to debate with people who do not care to understand your ideas, evidence and experiences.”

      Your ideas are barely juvenile, you wouldn’t know evidence if it was naked in your bed, which leaves only your experiences which you experience through rose colored glasses and a mist of wishful thinking and delusion. So yeah, I understand why you’re boring.

    2. WilliamLawrenceUtridge says:

      Yea, I know, just bored and looking for ideas on how to debate with people who do not care to understand your ideas, evidence and experiences.

      That’s a bit rich, considering you never actually debate. You show up, assert you are correct and everyone else is wrong, ignore the substantive replies you receive, on occassion dump in a massive list of totally irrelevant references, and proclaim conspiracy, meanness or any other irrelevant tangent to avoid the fact that you’re not actually debating.

      If you are bored, take up bowling.

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