Articles

Archive for Herbs & Supplements

dōTERRA: Multilevel Marketing of Essential Oils

A stay-at-home mom recently e-mailed me. She is a former CAM user who once treated her infant’s colic with homeopathy but has since seen the light and is now thinking skeptically. She asked that I look into the dōTERRA company, seller of essential oils: concentrated extracts distilled from plants, containing the “essence” or distinctive odor of the plant. She said:

…moms, well educated and seemingly rational moms, will believe anything. This isn’t a big deal if we are talking about sugar pills trying to cure crying that has no cause. However, I recently attended a dōTERRA “talk” (aka pressure to buy) about how essential oils can cure everything and anything, including one woman’s mother’s skin cancer. I didn’t want to offend this mom by calling her a quack, so I walked away spending 60 bucks on oils to be polite (this was the least amount I could spend and I used these oils to make my home smell nice, even though they were intended to solve all sorts of skin and digestive problems. I didn’t want to use them without knowing if they actually worked).

Instead of stressing the aromas, the focus was on the need to spend hundreds of dollars on these products to keep your family healthy. A handout showed how you could replace everything in your medicine cabinet with an essential oil alternative.  She said:

The reps talked about how conventional medicine failed them and how they never go to the doctor anymore because the oils are a better cure.

(more…)

Posted in: Herbs & Supplements

Leave a Comment (101) →

Dr. Oz Doubles Down on Green Coffee Bean with a Made-for-TV Clinical Trial

“One of the most important discoveries I believe we’ve made that will help you burn fat – green coffee bean extract” – Dr. Oz, September 10, 2012, Episode “The Fat Burner that Works”

Dr. Mehmet Oz may be biggest purveyor of health pseudoscience on television today. How he came to earn this title is a bit baffling, if you look at his history. Oz is a bona fide heart surgeon,  (still operating 100 times per year), an academic, and a research scientist, with 300+ or 400+ (depending on the source) publications to his name. It’s an impressive CV, even before the television fame. He gained widespread recognition as the resident “health expert” on Oprah, and went on to launch his own show in 2009. Today “The Dr. Oz Show” is a worldwide hit, with distribution in 118 countries, a massive pulpit from which he offers daily health advice to over 3 million viewers in the USA alone. For proof of his power to motivate, just look at the “Transformation Nation Million Dollar You” program he launched in 2011, enrolling an amazing 1.25 million participants. Regrettably, what Oz chooses to do with this platform is often disappointing.  While he can offer some sensible, pragmatic health advice, his show’s content seems more focused on TV ratings than medical accuracy, and it’s a regular venue for questionable health advice (his own, or provided by guests) and poorly substantiated “quick fixes” for health issues. (And I won’t even touch Oz’s guests like psychic mediums.) One need only look at the number of times the term “miracle” is used on the show as a marker of the undeserved hyperbole. Just this week, Julia Belluz and Stephen J Hoffman, writing in Slate, itemized some of the dubious advice that Oz has offered on his show, with a reality check against what the scientific evidence says. It’s not pretty. (more…)

Posted in: Clinical Trials, Herbs & Supplements, Medical Ethics

Leave a Comment (41) →

An Alternative “Truth” About Flu Shots

Vaccines, and flu shots in particular, have been covered ad nauseum on this blog; but the anti-vaccine propaganda never stops, so forgive me for bringing it up again. A correspondent inquired about a podcast by Steve Wright on Revolution Health Radio entitled “The Truth About Flu Shots (and What to do Instead).” You can either listen or read the transcript. It’s just too funny to pass up. That is, it would be funny if it weren’t endangering our public health by spreading misinformation.   (more…)

Posted in: Herbs & Supplements, Vaccines

Leave a Comment (42) →

The CAM Docket: Boiron III, et al.

Oh, the irony of it all! Quackery continues its increasingly successful assault on the citadel of medicine, viz: quackademic medicine, integrative medicine, credulous medical journal articles, shruggies, medical society support for CAM provider licensing. Will that nemesis of medical doctors, plaintiffs personal injury attorneys, turn out to be the last defenders of science in a world of health care fraught with so-called alternative medicine?

Maybe not. But the thought did occur to me while reading the Final Judgment and Order entered in Gallucci v. Boiron, the class action accusing the world’s largest manufacturer of homeopathic products of consumer fraud.

(more…)

Posted in: Health Fraud, Herbs & Supplements, Homeopathy, Legal, Politics and Regulation

Leave a Comment (15) →

Isagenix Study Is Not Convincing

Isagenix is a wellness system sold by multilevel marketing. It consists of a suite of products to be used in various combinations for “nutritional cleansing,” detoxification, and supplementation to aid in weight loss, improve energy and performance, and support healthy aging. It allegedly burns fat while supporting lean muscle, maintains healthy cholesterol levels, supports telomeres, improves resistance to illness, reduces cravings, improves body composition, and slows the aging process. And makes millions for distributors who got on the bandwagon early and are high on the pyramid.

I have written about it before and have been roundly criticized by its proponents.   It generated my all-time favorite insult: “Dr Harriet Hall is a refrigerator with a head.”

My biggest concern with Isagenix was that it had not been clinically tested. They claimed that clinical tests were in progress (funded by Isagenix).  An e-mail correspondent recently told me I should take another look at Isagenix, since a clinical study had been completed. It had not yet been published, and I asked her to get back to me when it was. Ask and you shall receive (but you may be sorry!). She contacted me when the study by Kroeger et al. was published in the journal Nutrition and Metabolism.   The full study is available online and I urge readers to click on the link and look at Table 2, which I will be referring to later. The journal is peer-reviewed but, as will become painfully obvious, the peer reviewers did not do a competent job. It is an open-access online journal with a low impact factor. The authors had to pay to get their article published: it cost them $1805.

(more…)

Posted in: Clinical Trials, Herbs & Supplements

Leave a Comment (17) →

Down the Virtual Rabbit Hole

The interwebs are more than a series of tubes, it has the power of endless distraction and tangents, a series of clickable rabbit holes that can drag you deeper and deeper into the alternative universes that are parallel with our own. One moment you can be on Science Based Medicine, grounded on the terra firma of reality, and then with a click of the mouse you can lose your way in the electronic warren.

It started as an advertisement on a skeptical website, perhaps SBM, perhaps not. The entrances to rabbit holes are Hogwartian in nature, never being in the same place twice. It is how I remember it.

Google serves up ads based on what their algorithm perceives as the content of the website. The algorithm lacks a certain, shall we say, nuance, and fails to understand that advertisements suggesting training in homeopathy or the promoting the practice of chiropractic may not have a close relationship to the content of Science Based Medicine. Still the ad did intrigue me, as it mentioned that the practitioner was Oregon’s only MD Acupuncturist. So I clicked. (more…)

Posted in: Energy Medicine, Herbs & Supplements, Humor

Leave a Comment (24) →

Fan Mail from an ASEA Supporter

We have an active comments section on our blog, but for some reason some people prefer not to comment there, but to send personal e-mails to authors when they disagree. Some of them make me laugh. Some of them make me despair. We can carry on our struggle better if we know what we are fighting; and in that spirit, I want to describe a recent e-mail exchange.

If an e-mail is filled with angry CAPITALS and abusive language, I know there is no point in responding. But I still get suckered in by the ones that start out sounding as if a productive dialog might be possible; unfortunately, discussions almost always degenerate. In this case, it started with a polite request for my opinion about a specific study. (more…)

Posted in: Herbs & Supplements

Leave a Comment (603) →

Andrew Weil/AAFP Article Rejected by Slate

I was asked to write an article for Slate, the on-line magazine, about Andrew Weil’s selection as the keynote speaker for the 2012 AAFP annual scientific assembly. The science and health editor, Laura Helmuth, was initially enthusiastic about what I wrote, but eventually decided not to publish it. Here is the initial draft of my article. My comments follow.

Original Draft of Article for Slate

The American Academy of Family Physicians picked Andrew Weil to be the keynote speaker at its annual scientific assembly October 16-20 in Philadelphia. What were they thinking? That’s like having an astrologer give the keynote speech at an astronomy meeting.

The AAFP stands for the best in conventional medicine, for the standard of care as determined by physicians and scientists. Weil doesn’t. The AAFP stands for evidence-based medicine. Weil doesn’t. (more…)

Posted in: Herbs & Supplements, Science and Medicine

Leave a Comment (94) →

More Boosting

Topics, as I noted a fortnight ago in my uniquely misspelled and ungrammatical way, never die**. Or even fade away. There are popular ideas that persist in the world that have little to do with reality. In the reality based world of medicine there are concepts that refuse to die. Atelectasis causing fever or the need to ‘double cover’ Pseudomonas. Neither are true, yet every year medical students tell me that is what they have been taught. It is said the only way new ideas take hold is for those that hold the old ideas to die off. So maybe 50 years from now those medical myths will be gone.

Popular culture also its myths. Take the immune system. Please. It is not a bicep that can be made stronger with a little exercise. It is a complex network of cells and proteins. There are antibodies (IgG (with five subtypes, IgM, IgA, IgE),the complement pathway, polymorphonuclear cells, monocytes, lymphocytes in a profusion that rivals beetles. God, I think, has an inordinate fondness for lymphocytes. There is the Toll system, the cytokines and lymphokines, the non-specific defenses like cilia and mannose binding lectin and on and on and on.

I have a journeyman’s understanding of the immune system, what is needed to understand why a given patient has an infection, although there is little I can do to reverse the immunologic defects: abnormal antibodies from Waldenström’s or low mannose binding lectin levels from liver disease are not amenable to clinical intervention. (more…)

Posted in: Herbs & Supplements, Humor, Science and Medicine, Vaccines

Leave a Comment (38) →

Don’t call CAM “cost-effective” unless it’s actually effective

Your health insurance plan probably covers anti-inflammatory drugs. But does it cover acupuncture treatments? Should it? Which health services deliver good value for money? Lest you think the debate is limited to the United States (which is an outlier when it comes to health spending), even countries with publicly-run healthcare systems are scrutinizing spending. Devoting dollars to one area (say, hospitals) is effectively a decision not to spend on something else, (perhaps public health programs). All systems, be they public or private, allocate funds in ways to spend money in the most efficient way possible. Thoughtful decisions require a consideration of both benefits and costs.

One of the consistent positions put forward by contributors to this blog is that all health interventions should be evaluated based on the same evidence standard. From this perspective, there is no distinct basket of products and services which are labelled “alternative”, “complementary” or more recently “integrative”. There are only treatments and interventions which have been evaluated to be effective, and those that have not. The idea that these two categories should both be considered valid approaches is a testament to promoters of complementary and alternative medicine (CAM), who, unable to meet the scientific standard, have argued (largely successfully) for different standards and special consideration — be it product regulation (e.g., supplements) or practitioner regulation.

Yet promoters of CAM seek the imprimatur of legitimacy conferred by the tools of science. And in an environment of economic restraint in health spending, they further recognize that showing economic value of CAM is important. Consequently they use the tools of economics to argue a perspective, rather than answer a question. And that’s the case with a recent paper I noticed was being touted by alternative medicine practitioners. Entitled, Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations, it attempts to summarize economic evaluations conducted on CAM treatments. Why a systematic review? One of the more effective tools for evaluating health outcomes, a systematic review seeks to analyze all published (and unpublished) information on a focused question, using a standardized, transparent approach to evidence analysis. When done well, systematic reviews can sift through thousands of clinical trials to answer focused questions in ways that are less biased than cherry-picking individual studies. The Cochrane Review’s systematic reviews form one of the more respected sources of objective information (with some caveats) on the efficacy of different health interventions. So there’s been interest in applying the techniques of systematic reviews to questions of economics, where both costs and effects must be measured. Economic evaluations at their core seek to measure the “bang for the buck” of different health interventions. The most accurate economic analyses are built into prospective clinical trials. These studies collect real-world costs and patient consequences, and then allow an accurate evaluation of value-for-money. These types of analyses are rare, however. Most economic evaluations involve modelling (a little to a lot) where health effects and related costs are estimated, to arrive at a calculation of value. Then there’s a discussion of whether that value calculation is “cost-effective”. It’s little wonder that many health professionals look suspiciously at economic analyses: the models are complicated and involve so many variables with subjective inputs that it can be difficult to sort out what the real effects are. Not surprisingly, most economic analyses suggest treatments are cost-effective. Before diving into the study, let’s consider the approach:

(more…)

Posted in: Acupuncture, Chiropractic, Energy Medicine, Herbs & Supplements, Homeopathy, Naturopathy, Science and Medicine

Leave a Comment (7) →
Page 7 of 24 «...56789...»