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HPV Vaccine for Boys

A recent announcement is likely to generate a lot of controversy. The Advisory Committee on Immunization Practices of the CDC has recommended that boys and young men be vaccinated against human papillomavirus (HPV). Previously the guidelines said boys “could” be given the HPV vaccine. Now they have recommended that boys age 11 to 12 “should” be vaccinated, as well as boys age 13 to 21 who have not already had the full series of 3 shots. The vaccine can also be given to boys as young as 9 and to young men age 22 to 26.

The vaccine was originally promoted as a way to prevent cervical cancer. Boys don’t have a cervix, so why should they be subjected to a “girl’s” vaccine? There are some good science-based reasons:

  • Boys can transmit the virus to female sex partners later in life, leading to cervical cancer in women.
  • More importantly, boys themselves can also be directly harmed by the virus. It can cause genital warts, cancer of the head and neck (tongue, tonsils and throat), anal and penile cancer, respiratory papillomatosis, and giant condyloma of Buschke and Lowenstein. In rare cases, immunocompromised patients can develop epidermodysplasia verruciformis.
  • There are other unconfirmed concerns: HPV has been associated with cardiovascular disease in one study.

Some of these conditions are not common, and the most common one, genital warts, may sound trivial. But “a picture is worth a thousand words,” so here is a link to a picture of a giant condyloma of Buschke and Lowenstein as an example of what HPV can do to the unvaccinated. The picture is not pleasant. If you are squeamish, you may not want to look at it. If you can’t even stand to look at it, imagine how devastating it would be to have it appear on your own body, and how nice it would be to be vaccinated against it.

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Posted in: Cancer, Vaccines

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Lessons Learned

I just returned from a trip to Montreal where I spoke at the Lorne Trottier Public Science Symposium, an annual event that David Gorski spoke at a year ago. My topic was “Puncturing the Acupuncture Myth” and the other speakers were Paul Offit, Edzard Ernst, and Bob Park. I was honored to be in such august company; and we were wined, dined, and cossetted: overall, an experience that will count among the high points of my career. In addition to speaking at the Symposium, I was interviewed on the radio; participated in a roundtable discussion with other doctors, scientists and journalists; and was invited to speak to a large freshman chemistry class at McGill University. I told the students a bit about how I came to be the SkepDoc and some of the things I’ve written about, with “Vitamin O” as an example, and I provided 3 “lessons I have learned” from my investigations that are general principles applicable to other fields:

  • Roosters don’t make the sun come up.
  • Never believe one study.
  • The SkepDoc’s Rule of Thumb: when encountering a new or questionable claim, always try to find out who disagrees and why.

My presentation was recorded and is available as a webcast. Scroll down to “2011/11/08 HallOffit” near the bottom and click on the appropriate symbol to the far right. That saves me having to write a post this week. I think SBM readers will find it pertinent to all we discuss here.

Posted in: Science and Medicine

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Weight Loss Customers Are Being Hoodia-Winked

I first wrote about Hoodia in my “SkepDoc” column in Skeptic magazine (Vol. 13, No. 1, 2007).  The following is adapted from that column with an update from new research revealing that it doesn’t work and that it causes worrisome side effects.

I first heard of Hoodia in 2006, when a radio ad informed me that it was the new miracle weight loss pill. Shortly after that, I started seeing ads for Hoodia everywhere. Anna Nicole Smith took it. It was featured on Oprah.  Lesley Stahl went to Africa to taste the plant on 60 Minutes. There are nearly 40 competing brands of pills, a patch version, and even a Hoodia lollipop. It seems to have taken the world by storm; but it’s not new.

Hoodia gordonii is a cactus that grows in the deserts of southern Africa, and the San people have traditionally used it as an appetite suppressant, thirst quencher and to treat severe abdominal cramps, hemorrhoids, tuberculosis, indigestion, hypertension and diabetes. The claim is that it banishes hunger and thirst. What is the evidence? At this point it’s strictly anecdotal. Skinny Bushmen report it relieves hunger pangs in starvation conditions on long hunts; we don’t know what happens if it’s used by lazy fat people with access to food. Before the new study, there hadn’t been a single published study in humans. (more…)

Posted in: Clinical Trials, Herbs & Supplements

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Steven Fowkes (Part 2 of 2): Nutrients for Better Mental Performance

Last week, in part 1, I covered Steven Fowkes’ “cures” for Alzheimer’s and herpes. In part 2, I will cover a video where he goes further afield. It is titled “Nutrients for Better Mental Performance,” but he also discusses sleep, depression, hangovers, and a lot of other topics.

Some of what he says are simple truisms: mental performance is affected by everything related to health such as sleep, food, vitamins, minerals, detoxification, nutrients, amino acids, hormone replacement, pharmaceuticals and herbs. Metabolism is the key to brain function: 3% of the body uses 20% of the energy. Macronutrients, micronutrients, exercise, water, and breathing are important too.

We knew that.

Which nutrients promote optimal brain function? All of them: any deficiency will affect the brain. Fowkes goes beyond the evidence to claim that some nutrients are needed at super-physiological levels; Mother Nature is not optimal. Some supplements appear to work but the effects are not sustainable. It’s not about parts, but about how things work together. (more…)

Posted in: Neuroscience/Mental Health, Nutrition

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Steven Fowkes (Part 1 of 2): How to Cure Alzheimer’s and Herpes

A correspondent asked me to review a video presentation by Steven Fowkes, “Nutrients for Better Mental Performance,” one segment of a 9-part series on preventing and curing Alzheimer’s that was mentioned recently by an SBM commenter. Fowkes is an organic chemist without a PhD; he says this means:

I am not institutionalized [This begs for a joke, but I will refrain.] and see the world differently. Everything I know I learned outside the system.

He is associated with CERI, the Cognitive Enhancement Research Institute and has written extensively on nutrition and health. I’ll comment on his claims for Alzheimer’s and herpes first, and then return to the “Nutrients for Better Mental Performance” video next week.

Alzheimer’s

He says he can prevent Alzheimer’s disease and cure it in the early stages, although later damage will not be reversible. And yet he doesn’t actually specify the details of how he accomplishes that miracle: apparently it’s complicated (I would imagine so) and varies with the individual. Science doesn’t know what causes Alzheimer’s, but Fowkes does. The current thinking of scientists is that it is due to genetic factors interacting with environmental factors, and it might be a natural consequence of the aging process that would eventually affect anyone who lives long enough. Fowkes says it involves a complicated domino cascade of effects, but the cause boils down to loss of glutathione cycling and failure of sulfhydryl enzymes, which  interferes with the detoxification of mercury in the brains of Alzheimer’s patients. (more…)

Posted in: Herbs & Supplements, Neuroscience/Mental Health

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Birth Control

From a message posted on Facebook:

 Is the pill safe? The International Agency for Research on Cancer in a 2007 study made by 21 scientists reported that the pill causes cancer, giving it the highest level of carcinogenicity, the same as cigarettes and asbestos. It also causes stroke, and significantly increases the risk of heart attacks. Several scientific journals have stated that the natural way of regulating births through the Billings Ovulation Method has no side-effects, and is 99.5 % effective.

The Billings Ovulation Method (BOM) is a method of natural family planning where women are taught to recognize when they have ovulated by examining their cervical mucus, allowing them to avoid intercourse during fertile periods or conversely, to have intercourse during fertile periods when pregnancy is desired. We used to call people who used the rhythm method “parents,” but BOM is more reliable than older abstinence methods.

I’m a big fan of oral contraceptives. They contributed to women’s liberation by giving us a reliable method of planning, delaying, or avoiding pregnancy.  They also have medical uses that go beyond contraception. Birth control pills (BCPs) have had such an important impact that they are known as simply “The Pill.” We have always known they were not 100% risk free; but we also know they are less risky than pregnancy itself. There are other methods of birth control; but they are generally less effective and less convenient.  For those who want permanent solutions, tubal ligation and vasectomy are available; but even they have occasional failures. What does science tell us about the effectiveness and safety of BCPs as compared to other methods?  (more…)

Posted in: Obstetrics & gynecology, Pharmaceuticals

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Pursued by Protandim Proselytizers

I’m fed up! In August 2009 I wrote about Protandim, pointing out that it’s not supported by good evidence. I thought I had made myself clear; but apparently I had only made myself a target. True believers have deluged the Internet with attacks on my article, calling it mere “opinion,” ignoring its main points, and denigrating me personally. I have ignored the Internet attacks, but I’m beginning to feel personally harassed: I have lost count of the e-mails I have received from Protandim enthusiasts trying to convince me that it works and that I should change my mind. I’ve spent hours trying to explain my reasoning in e-mails, and it’s becoming a repetitive chore, so I am writing this so that next time I get an e-mail inquiry I can simply forward this link.

What Is In It?

Protandim is a mixture of milk thistle, bacopa extract, ashwagandha, green tea extract, and turmeric extract (all of which, incidentally, can be purchased individually at much lower cost).

What Do They Claim It Does?

As described on Wikipedia:

The manufacturers of Protandim claim the product can indirectly increase antioxidant activity by up-regulating endogenous antioxidant factors such as the enzymes superoxide dismutase (SOD) and catalase, as well as the tripeptide glutathione, and by activation of theNrf2 pathway.

Nrf2 is a transcription factor that upregulates the expression of various genes that may regulate oxidative stress. Drugs to target that pathway might have benefits for diseases that are caused or exacerbated by oxidative stress. Such drugs are investigational at this point, but the makers of Protandim have skipped the investigational stage and are marketing a product that they think is effective for almost every ailment known to man and that they are promoting as an anti-aging supplement.

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Posted in: Herbs & Supplements

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Artificial Sweeteners: Is Aspartame Safe?

Note: This was originally published as a “SkepDoc” column in Skeptic magazine under the title “Aspartame: Safe Sweetener or Perilous Poison?” and is reprinted here with the kind permission of Michael Shermer. There are other artificial sweeteners not specifically addressed here, but as far as I know there are no convincing health concerns about any of them, just this same kind of hype and fearmongering based on animal studies and speculation with no validation from human clinical studies.


Aspartame is a low calorie sugar substitute marketed under brand names like Equal and Nutrasweet. It is a combination of two amino acids: L-aspartic acid and L-phenylalanine. It is available as individual packets for adding to foods and it is a component of many diet soft drinks and other reduced-calorie foods. Depending on who you listen to, it is either a safe aid to weight loss and diabetes control or it is evil incarnate, a deadly poison that is devastating the health of consumers.

A reader sent me an ad from his local newspaper that recommended using stevia instead of aspartame and made these startling claims about aspartame:

  1. It is derived from the excrement of genetically modified E. coli bacteria
  2. Upon ingestion, it breaks down into aspartic acid, phenylalanine, methanol, formaldehyde, and formic acid.
  3. It accounts for over 75% of the adverse reactions to food additives reported to the FDA each year including seizures, migraines, dizzinesss, nausea, muscle spasms, weight gain, depression, fatigue, irritability, heart palpitations, breathing difficulties, anxiety, tinnitus, schizophrenia and death.

Let’s look at those claims one by one.
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Posted in: Herbs & Supplements, Nutrition

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Benedetti on Placebos

There has been an ongoing debate about placebos on SBM, both in the articles and in the comments. What does it mean that a treatment has been shown to be “no better than placebo?”  If our goal is for patients to feel better and they feel better with placebos, why not prescribe them? Do placebos actually do anything useful? What can science tell us about why a patient might report diminished pain after taking an inert sugar pill? The subject is complex and prone to misconceptions. A recent podcast interview offers a breakthrough in understanding.

On her Brain Science Podcast Dr. Ginger Campbell interviewed Dr. Fabrizio Benedetti, a physician and clinical neurophysiologist who is one of the world’s leading researchers on the neurobiology of placebos. A transcript of the interview [PDF] is available on her website for those who prefer reading to listening. The information Dr. Benedetti presents and the expanded remarks by Dr. Campbell after the interview go a long way towards explaining the placebo phenomenon and its consequences for clinical medicine. Dr. Campbell also includes a handy list of references. I’ll try to provide a summary of the main points, but I recommend reading or listening to the original.

A common misconception is that the response to placebos is a purely subjective psychological response involving only the cortical level of the brain; but evidence is accumulating that real, measurable, objective subcortical neurophysiologic phenomena are involved. One of the first hints was a 1978 study showing that the placebo response to pain could be blocked by naloxone, a narcotic antagonist drug, indicating that the placebo must have actually caused an increase in endogenous opioids. (more…)

Posted in: Basic Science, Neuroscience/Mental Health

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Scientific American Mind Is Not So Scientific

When Scientific American first announced that they would publish Scientific American Mind, I hurried to subscribe, thinking it would keep me informed about new developments in a field I am passionately interested in. I have enjoyed the magazine, particularly the regular columns, the news items about research findings, the reviews that alert me to books I will want to read, the “Ask the Brains” Q and A, the challenging “Head Games” quiz, and the presentation of many intriguing ideas. The board of advisers is impressive, and the columns by Christof Koch, Scott Lilienfeld, Hal Arkowitz, the Ramachandrans and others have been consistently excellent. Unfortunately, some of the other articles have descended into pop psychology, speculation, poor science and even pseudoscience. Contributing editor Robert Epstein’s articles have particularly raised my blood pressure.

Love-Building Exercises

In December 2009 I was annoyed enough to write this letter to the editor:

After reading Robert Epstein’s article in the last issue, I had to go back to the cover and verify that the word “scientific” was indeed part of the title of your magazine. The Love Building Exercises he recommends are more appropriate to a magazine of fantasy and science fiction.

Two as One — feeling that the two of you have merged?
Soul Gazing — looking into the very core of your beings?
A Mind-Reading Game — wordlessly trying to broadcast a thought to another person?
Love Aura — feeling “eerie kinds of sparks” when your palm is close to another’s?

Thought transfer? Auras? Come on! Shame on you for publishing such metaphysical pseudoscientific psychobabble!

They published my letter to the editor with the heading “Hating ‘Love’.” There was no response from the author.

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Posted in: Neuroscience/Mental Health, Science and the Media

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