Articles

Naturopathy for allergies

Naturopathy is an unusual chimera.  It is basically a collection of old fashioned medical superstitions presented under a veneer of highly speculative, quasi-scientific assertions.  But given its popularity, it is important, from time to time, to evaluate specific claims made by this particular non-science-based belief system.

A reader informed me that he was advised to seek the advice of a naturopath for treatment of his seasonal allergies.  Since naturopaths claim to be “doctors plus”, I was curious what they would recommend.  Would it be standard allergy treatment with antihistimines and other proven medications along with some sort of vitalistic mumbo-jumbo? It turns out I was half-right.

A visit to a national (US) naturopathic association website is a painful lesson in how naturopathic believers view health and disease.  No unfounded assertion would be complete without a good straw man.  Regarding the difference between real medicine and naturopathy, they say of allergies:

It’s a yearly ordeal for many people, and many others struggle with these symptoms year-round due to molds, dust, and pet dander. Pharmaceutical commercials offer a promise of living clear, but is a life of pills and side effects the only solution?
Far from it, say naturopathic physicians! Allergic symptoms are your immune system’s extreme reaction to substances that are normally found, harmlessly, in your everyday environment. Very often, simple changes of diet, nutritional supplements, and homeopathic remedies can relieve this extreme reaction and the resulting inflammation that triggers most allergy symptoms.

In fact, it’s a bit more complicated than that.  The pathophysiology of environmental allergies is pretty well understood.  Normally harmless antigens are taken in, processed, and presented to the immune system.  Plasma cells then crank out allergen-specific IgE which coats basophils and mast cells.  On re-exposure to the allergen, basophils and mast cells release a soup of mediators of allergic reactions, including substances such as histamine.  After this immediate (and unpleasant) reaction, a later reaction involving other inflammatory mediators kicks in.

The best way to fight allergies is to avoid the offending allergen, but for many of us, this isn’t possible.  Treatments are based on the underlying pathophysiology.  Antihistamines help fight the unpleasant effects of histamine release, including sneezing, itching, and runny nose and eyes.  Unfortunately, they do little to prevent the release of histamine in the first place and some have significant side-effects.  The oldest anti-histamines, such as diphenhydramine (Benadryl) can cause sedation and dry mouth.  Newer antihistamines cause very little sedation and are quite effective.

There are also medications to help prevent degranulation of mast cells, preventing the histamine from being released in the first place.  These “mast cell stabilizers” can be very effective in preventing allergy symptoms, as long as you take it regularly.  Steroids sprayed in the nose can help with many of the symptoms, usually without side effects, and leukotriene inhibitors can also help blunt the immune response and improve symptoms.  These medications are very well-tolerated, safe, effective, and are based on what we know about the pathology of allergies.

The naturopaths offer something else entirely.

Red meat contains a substance called arachadonic acid, which helps to produce the cytokines and leukotrines that cause your immune system to react with allergic inflammation. While you need a small amount of arachadonic acid for your immune system to function, your body can produce this amount naturally. Simply eliminating red meat from your diet can reduce the level of this acid, thus lessening your allergic reactions.

This speculative assertion has no data supporting it.  It is an interesting supposition, but implausible and unproved.  It is unlikely that any dietary modification could reduce a substrate of allergic reactions enough to give relief of allergies.

They also recommend omega-3 fatty acids.  There is very little clinical literature on the topic.  A recent review of the use of omega fatty acids in allergy prevention found that despite some promising in vitro studies, there was no significant clinical benefit.   They also recommend turmeric, papaya, and pineapple, none of which have been shown to be effective treatments for allergies.

There next piece of advice is to toss money away:

For Best Results – Supplement!
A healthy organic diet low in Omega-6 fatty acids and high in vitamin E, Omega-3 fatty acids, and natural anti-inflammatory foods can help to reduce your allergy symptoms. However, your best bet is to supplement your diet with concentrated doses of anti-allergic nutrients such as those listed below:

  • Vitamin C (up to 10 grams/day) is a natural anti-histamine;
  • Vitamin B5 (up to 800 mg/day);
  • Zinc picolinate (up to 150 mg/day); and
  • Cod Liver Oil or other cold-water fish oil (look at the label and use a high quality fish oil product containing from 1000 – 2000 mg of the essential fatty acids EPA + DHA per day).

Once again, none of these assertions is backed up by evidence.  Most of it isn’t even promising enough to bother with.  But they really hit it out of the park with their final recommendations.

Homeopathic remedies involve taking an extremely diluted form of selected allergens in liquid or sugar-pill form sublingually (under the tongue). These miniscule doses serve somewhat like a vaccination, stimulating your immune system to an effective rather than extreme response.

Vaccination is to homeopathy as horseback riding is to unicorn wrangling.  First of all, vaccination, while sometimes used as immunotherapy and immunoprophylaxis, is not used to treat type I hypersenstivity, the cause of seasonal allergies.  Immune desensitization is used.  Desensitization uses small but measurable amounts of allergen to induce tolerance and prevent an allergic reaction.  There is nothing homeopathic about it.

They go on to mention liver detoxification, gut flora “balancing”, and chiropractic as useful treatments for allergies.

Naturopaths, it would seem, are not “medicine plus”, but “everything but.”  Since they do not use proven, effective therapies, the throw unproved, implausible therapies at their patients perhaps hoping that when the allergies relent as a natural course of the disease, they might finally claim credit.  That’s what all the best shamans do.

Posted in: Science and Medicine

Leave a Comment (185) ↓

185 thoughts on “Naturopathy for allergies

  1. KB says:

    It seems like, if you actually managed to limit your intake of arachidonic acid (as well as precursors linoleate and linolenate acid) enough to decrease your allergy response, you’d be in big trouble. Big trouble.

  2. WilliamLawrenceUtridge says:

    I had thought that vitamin C had an antihistamine action, and this was where it was useful in suppressing the sniffling/nasal congestion symptoms of the common cold (far from preventing or treating it, vitamin C merely suppresses the symptoms – like, you know, a medicine). I’m not saying it’s magical or a cure, but I believe there is evidence to support at least that one treatment:
    * http://books.google.ca/books?id=Vi1_QobIY6IC&pg=PA189#v=onepage&q&f=false

    Plus, there’s an argument that it’s simply not worth the time or money; one day of suffering less per year:
    * http://www.bcm.edu/medpeds/articles/TreatmentofURI.pdf

    Educate me comments section!

  3. Enkidu says:

    I like how they say, “but is a life of pills and side effects the only solution? Far from it, say naturopathic physicians!” and then go on to recommend, uh, sugar pills and pill supplements. I guess only Big Pharma pills are bad?

  4. Scott says:

    I like how they say, “but is a life of pills and side effects the only solution? Far from it, say naturopathic physicians!” and then go on to recommend, uh, sugar pills and pill supplements. I guess only Big Pharma pills are bad?

    Absolutely! It’s always hilarious how quacks yell and scream about how pills are evil, then proceed to sell you enough of them to choke an elephant.

  5. whhaymd says:

    Mr. Utridge,

    While the information on Vitamin C and allergies establishes a theoretical basis why it might work, the scientific literature is a grave yard for theories that look promising. Actual studies of the effects of vitamin C on allergy symptoms would be needed (0r did I miss these?).

    As to your second reference, it was about vitamin C and infections and so is not relevant to this discussion.

  6. Doctor Jay says:

    If you can’t dazzle them with brilliance then baffle them with bullshit!
    It makes them sound smart to the non-medical community.

  7. kumarei says:

    Man, how I wish that not eating red meat would cure allergies. I’ve been a vegetarian for the last four years, and my allergies are just as bad as ever.

  8. Molly, NYC says:

    “Medicine plus” is rather perverse. These guys’ best work is the stuff that real practitioners do that isn’t medicine. Great at hand-holding. Lovely bedside manners. But they do all that minus medicine.

  9. I second kumarei’s point. I know plenty of vegetarian’s and non-red meat eaters with allergies.

    To me SCAM does not seem particularly well suited to allergies. Maybe there are some very mild/vague symptoms that come and go, but many of my symptoms are very distinct and I don’t think I get any placebo effect relief at all.

    One symptom is chronic sinusitis facial pain that will stick around over a month without treatment. Benedryl-doesn’t help. Claritin-doesn’t help. Rhinocort-doesn’t help. Saline rinses a little relief. Aleve alone a little relief. The only thing that really works is a Zyrtec/Aleve combo.

    So perhaps it can only convince people who don’t really have allergies or really want to be convinced and don’t mind being miserable.

  10. kestrel says:

    I love the general theory behind naturopathy – cure deficiencies, eliminate aggravating substances from your body, maybe a little supplementation here and there to tip the balance, and BAM healthy body without direct modulation of histamines, receptors etc. ala most pharmaceuticals.

    Too bad it’s hit or miss.. mostly miss (yes i believe some of this stuff works) and often the misses leave you broke and perhaps less healthy than before.

    Here’s a little anecdote for you all, friends (i know you all love anecdotes, especially when it involves a miniscule sample group… aka 1). A colleague of mine who works in the same small office recently made a “lifestyle change”, as advised by an AM doc. About a month into it, he ceased his incessant sniffling, sneezing, hacking etc… all is quiet. I listened to him sniffle, sneeze, hack and ahem for the last year.. even the littlest bit of dust set him off. He commented on his allergies being “all but gone”. I thought it was interesting.

  11. Bogeymama says:

    Thanks for another article on the quackery of naturopaths and allergy treatments. Any chance you could do one or two on the methods that they use to diagnose and treat food allergies? Naturopaths are begging in some areas to be allowed to conduct oral challenges, and I am frightened at the prospect.

    Also, I really feel that naturopath’s “diagnosing” food allergies in kids with behavioural issues is really muddying the waters. Kids are showing up at schools with a laundry list of allergies, NONE of which require Epipens. Teachers are starting to consider allergies less of an issue, and I fear that those of us who have “true” allergies are going to have a much more difficult time getting people to take us seriously.

    Seems that “milk-free, wheat-free” diets are more than an autism diet – it’s becoming a trendy lifestyle choice, and these people walk around telling people they’ve been allergic all this time. Sorry, but behaviour and digestive problems are not symtpoms of food allergies last time I checked. Difficulty breathing, sneezing, rashes, vomiting, facialy swelling … those are the things that I have seen! (You know, REAL allergy symptoms).

    Thanks again!

  12. Joe says:

    Thanks for this (and M Crislip for his most recent) post. It is really hard to face a naturo and prove they are not educated in health care. They have little literature and make vague claims (always coated with plausible deniabilty). It is nice to see their ignorance on display.

  13. GinaPera says:

    Oh dear. Such certitude. Such arrogance. Such ignorance.

    I’m sorry to be so blunt, but intellectually incurious attitudes such as this are the reason so many people have started avoiding “mainstream” physicians and flocking to “naturopaths.” It’s also the reason so many people have grown skeptical of the “pop a pill” mentality in allopathic medicine: Because too many physicians do not understand basic physiological processes and treatment strategies that can heal their patients on a more foundational level.

    The result? When people actually do need a pill, they do not trust physicians. I see this fallout every day in the ADHD community, where stimulant medications can actually help children and adults to lead healthier lives but people have grown skeptical of “pill-pushers” who cast aspersions on their questions about diet. As if what we put in out bodies could never affect our brains. No wonder so many people try “alternatives” for ADHD and shun medication, because their physicians often cannot help them from a dietary standpoint.

    After years of suffering allergies and allergists giving me shots (useless) and pills (who wants to take a pill 24/7 for three seasons each year?), I found myself in the middle of a severe cat allergy and had no antihistamines.

    A nutritionist at this event mixed for me a drink of juice, magnesium, and B vitamins. Not wanting to be impolite, I drank it, fully expecting to keep sneezing convulsively. To my surprise, the allergic reaction stopped immediately.

    Do most physicians even know why magnesium offers some allergic people this benefit? No, but the good ones do. That’s because they actually understand basic physiology, including the role of minerals and vitamins, and can apply it to their patients’ various conditions. They don’t rely solely on double-blind studies and drug reps for all of their knowledge and thus they can integrate treatment.

    Frankly, I’m shocked at what you’re calling “science-based medicine” here. There are some huge gaps in your “science.”

  14. Harriet Hall says:

    GinaPera,

    I’m intrigued. I found support on PubMed and in the Natural Medicines Comprehensive Database for using magnesium to treat asthma, but I couldn’t find anything about using it for allergic rhinitis. How did the nutritionist know to try it? Do you have any references?

  15. BillyJoe says:

    GinaPera,

    “I’m shocked at what you’re calling “science-based medicine” here.”

    Well, Gina, I’m shocked that you don’t understand that anecdote is not science-based medicine.

  16. Nescio says:

    Another anecdote, for what it’s worth. I used to have a cat allergy; if I was in a home with a cat my eyes would redden, I would sneeze and feel moderately miserable, and if I stroked one and then touched my eyes I was extremely miserable. I had suffered from this allergy for over ten years. This became more of a problem when I started living with someone who owned cats.

    One day I was reading a book about self-hypnosis that claimed it could help some allergies, so I followed the procedure in the book, not expecting much. The technique used ideomotor signals to communicate with the “unconscious part of me” (whatever that means) that was causing me the allergic symptoms, I was to explain to it that I understood it was trying to protect me, but that it was making a mistake, and ask it nicely to stop giving me the symptoms. It sounded like hokum, but I suspended my disbelief and gave it a try.

    To my astonishment the allergy disappeared instantly and completely, and never came back. After finishing the procedure I stroked a kitten and then deliberately rubbed my eyes, and nothing happened. That was over twenty years ago, and I have since spent a couple of years in a cat-free home, and the past few years living with two cats (so it can’t be some sort of antigen suppression).

    Even stranger, at the time I had a friend who also had a cat allergy, worse than mine had been. He used to phone us ahead of time to ask that we put my partner’s cats out of the house before he visited. After a conversation with him in which I explained in detail what I had done, his allergy also spontaneously disappeared. Oddly he didn’t even notice until I pointed it out several months later. Coincidence? Perhaps.

    So, purely on this personal anecdotal evidence, I strongly suspect that some allergies have a psychogenic element to them. Perhaps at least some allergies are amenable to psychotherapeutic approaches. This may explain the success that unconventional and implausible treatments have in some cases.

    Before you dismiss this as utterly implausible, take a look at these studies that might support my anecdotes.

    Pavlovian conditioning of rat mucosal mast cells to secrete rat mast cell protease II http://www.ncbi.nlm.nih.gov/pubmed/2911721

    Pavlovian conditioning of nasal tryptase release in human subjects with allergic rhinitis http://www.ncbi.nlm.nih.gov/pubmed/8022900

    Behavioral conditioning of antihistamine effects in patients with allergic rhinitis
    http://www.ncbi.nlm.nih.gov/pubmed/18418029

    These are small studies, and perhaps the design could be improved, but they are interesting I think. I have also wondered if the sedative effect of most antihistamines, the worsening of my seasonal allergies when I am tired or anxious, and the disappearance of allergies during sleep and deep relaxation might be connected. Just wondering…

  17. Versus says:

    GinaPera,
    With your superior knowledge of human physiology, did it not strike you as odd when the nutritionist’s potion worked “immediately,” thereby bypassing your digestive system and all the other physiological phenomena required to get the active ingredients in this drink to the right places in your body to stop your allergic reaction? Perhaps someone just put the cat out.

  18. sarkeizen says:

    “Oh dear. Such certitude. Such arrogance. Such ignorance.”

    Are you talking about the quotes from Natruopaths? I assume so but you are pretty unclear. For example, the way I use the term “arrogant” is a statement of “distance” between the certianty of what is said and the evidence supporting it. Unless you can point me to epidemlogical data. I’m reasonably comfortable with the assertion that none has been done and published in a peer-reviwed journal based both on my belief that Peter is capable of doing a PubMed search as well as a few checks I did on my own.

    “I’m sorry to be so blunt, but intellectually incurious attitudes such as this are the reason so many people have started avoiding “mainstream” physicians and flocking to “naturopaths.””

    Perhaps you are attempting to be artful or something but personally I don’t want my body to be treated as an object of my physicians “curiosity” (also is there some kind of “physical curiosity”? Otherwise “intellectually” is redundant). Considering that I’m not really convinced that there is any significant change in peoples habits with regard to moving to naturopaths. Even if there were, there are a myriad of reasons that could happen that are entirely independent of “curiosity” or even results. For example one study on diabetes patients using CAM http://www.ncbi.nlm.nih.gov/pubmed/16828133 The most common reason (86.8%) was the perception for “quick and additional relief” even though MOST (53.6%) people percieved no benefit at all.

    Point being, that people can “flock” for social reasons. One of which, as is often mentioned by GP’s I’ve met is that ND’s can afford to spend more time
    per patient. Clearly people want to be heard and understood, not just treated and shuffled off but when faced with the choice

    “physiological processes and treatment strategies that can heal their patients on a more foundational level.”

    I always find this claim kind of interesting. How does one define “more foundational”? Not to mention that isn’t that claim far more arrogant than some of the simple claims that were made

    “A nutritionist at this event mixed for me a drink of juice, magnesium, and B vitamins. Not wanting to be impolite, I drank it, fully expecting to keep sneezing convulsively. To my surprise, the allergic reaction stopped immediately.”

    Immediately after oral delivery? Doesn’t that mean faster than you would have been able to metabolize anything at all in that drink to any useful level? Perhaps I’m looking at this the wrong way but any immediate effect makes me infinitely more skeptical that my actions are doing anything on a physiological level. Analgesics, Anti-histamines, etc… I have trouble coming up with an oral delivery that acts as fast as you are implying.

    “They don’t rely solely on double-blind studies and drug reps for all of their knowledge and thus they can integrate treatment.”

    Drug reps aside. Again I’m always interested in the idea that people level some criticism at the double-blind study. I mean if there *WAS* a double-blind study showing the efficacy of Mg in alergic attacks. Then it would be medicine, if there were a double-blind study showing no real success why would you trust your own ideas over that?

    “Frankly, I’m shocked at what you’re calling “science-based medicine” here. There are some huge gaps in your “science.””

    All science has gaps. Especially, as demonstrated here Naturopathy – considering how easy it is to find ND literature advising something that has never been studied in a controlled way.

    But let me ask you this, and this is a question I pose to a number of people: Can you have science without a quantified error-bound? In other words (and this is a rare case here I’m at odds with Feynman on scientific method). In other words if you can’t give a figure that indicates how likely your results are to be correct. Do you really think you have any right to call that science. Because, if not – try asking your ND’s for that kind of information (P-values, R values, CI, CL’s) and I’m willing to bet you get a blank stare faster than a Radio Shack employee.

  19. sarkeizen says:

    Hmmm didn’t finish that paragraph:

    “Point being, that people can “flock” for social reasons. One of which, as is often mentioned by GP’s I’ve met is that ND’s can afford to spend more time per patient. Clearly people want to be heard and understood, not just treated and shuffled off but when faced with the choice. I understand why a GP will prioritize time for diagnosis and treatment over making the person feel better (emotionally)”.

  20. sarkeizen says:

    Geez…another one…

    “I always find this claim kind of interesting. How does one define “more foundational”? Not to mention that isn’t that claim far more arrogant than some of the simple claims that were made by Peter”

    i.e. “This speculative assertion has no data supporting it. It is an interesting supposition, but implausible and unproved. It is unlikely that any dietary modification could reduce a substrate of allergic reactions enough to give relief of allergies.”

    Ok here we have Peter saying a specific assertion has no data supporting it. Recognizing that it might be interesting but stating significant doubts.

    And we have you…echoing something I hear from various sources in and about Naturopathy. That ND’s, somehow have a generally deeper understanding of therapy and physiology than all medical science combined?

    Sorry who was being arrogant again?

  21. Scott says:

    intellectually incurious attitudes such as this are the reason so many people have started avoiding “mainstream” physicians and flocking to “naturopaths.”

    The irony here is breathtaking. After all, it’s naturopaths who have absolutely not intellectual curiosity – indeed, they actively AVOID information. Whereas scientists have been intellectually curious enough to test the quackery and determine that it doesn’t work.

  22. Scott says:

    Oh, and by the way:

    A nutritionist at this event mixed for me a drink of juice, magnesium, and B vitamins. Not wanting to be impolite, I drank it, fully expecting to keep sneezing convulsively. To my surprise, the allergic reaction stopped immediately.

    I call faulty memory. Other than the purely mechanical effect of washing things down, “a drink of juice, magnesium, and B vitamins” cannot have any “immediate” effect. Even IF juice, magnesium, and vitamins were an effective treatment, they would have to be absorbed and travel to the involved site before they could have any effect.

    Odds are overwhelming that what really happened was something along these lines:

    1. You drink the drink.
    2. Some minutes later, the symptoms resolve as normal.
    3. Via a post hoc ergo propter hoc fallacy, the symptom relief is attributed to the drink.
    4. After some time, the usual faults of human memory forget about the time lapse.

  23. tariqata says:

    Very interesting post!

    One thing I’m curious about – is there any evidence that it’s harder to treat multiple allergies?

    Last year, I lived in an older apartment that almost certainly had a significant mould problem (lots of visible mould in inaccessible spots in the bathroom, plus a lot of water damage). I was using nasal spray and Claritin almost constantly for the entire year, and my seasonal allergy symptoms were really severe; I felt like my sinuses never really cleared at all. This year I moved into a building that’s been maintained much better and has had some major renovations done as well, and although I definitely notice allergy symptoms when I go outside (itchy, runny eyes, stuff nose, consistent with the seasonal allergies I’ve had all my life), it’s been much less severe and persistent and I haven’t needed to treat them to feel like I can breathe comfortably. It could just be that there’s less pollen floating around this spring (though that seems doubtful), but I’m curious about whether being able to avoid *some* allergens is having an effect on the severity of response to others.

    That said, I haven’t eaten red meat in 13 years and I suffered miserably every spring up until now, so I don’t think I’ll be trusting any naturopath’s advice. Also, 1 – 2 pills daily plus a squirt of nasal spray beats multiple pills plus cod liver oil, hands down.

  24. GinaPera says:

    Gee, there seems to be reading comprehension challenges with some of the posters. Most of you missed my points entirely.

    The cognitive dissonance and selective perception seems to be so overwhelming you cannot comprehend what I actually wrote.

    As for this:
    “I mean if there *WAS* a double-blind study showing the efficacy of Mg in alergic attacks. Then it would be medicine, if there were a double-blind study showing no real success why would you trust your own ideas over that?”

    This is exactly one of the problems. Many physicians are simply rote-learners. Proceduralists. They are not scientists. They do not understand physiologic systems and the basic sciences involved. They do not know how to read about the properties of magnesium and its effect on physiologic systems and extrapolate as to how it can sometimes alleviate certain conditions. Just because a double-blind study does not exist doesn’t mean these physiologic processes don’t exist.

    In short, this type of physician is simply acting like a robot, regurgitating studies (though not always parsing them accurately) and understanding little else. And that’s why we have a healthcare crisis in this country that Congress cannot even begin to reform.

  25. GinaPera says:

    “physiological processes and treatment strategies that can heal their patients on a more foundational level.”
    I always find this claim kind of interesting. How does one define “more foundational”? Not to mention that isn’t that claim far more arrogant than some of the simple claims that were made
    ———

    Seemed a straightforward statement to me.

    To treat the causes of illnesses, when possible, instead of adding more pills.

  26. GinaPera says:

    Scott, I will assume you are an oppositionally defiant troll and not actually seeking answers.

  27. GinaPera says:

    To Harriet — the only responder who both uses her real name (I assume) and asks a legitimate question (could there be causation or association?)

    You ask:,
    I’m intrigued. I found support on PubMed and in the Natural Medicines Comprehensive Database for using magnesium to treat asthma, but I couldn’t find anything about using it for allergic rhinitis. How did the nutritionist know to try it? Do you have any references?

    —-
    Yes, there is plenty of research on using magnesium to treat asthma as well as other conditions.

    One helpful source for you regarding magnesium and allergies might be magnesium researcher Mildred Seelig’s work posted online here:
    http://www.mgwater.com/clmd.shtml

    There can be no blanket guidelines about magnesium dosage, etc. For one thing, its effect will depend on if the person is deficient. But we do know that most Americans are deficient in this key mineral.

    From http://ods.od.nih.gov/factsheets/magnesium.asp

    Magnesium is needed for more than 300 biochemical reactions in the body. It helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and keeps bones strong. Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis [2-3]. There is an increased interest in the role of magnesium in preventing and managing disorders such as hypertension, cardiovascular disease, and diabetes. …

    Data from the 1999-2000 National Health and Nutrition Examination Survey suggest that substantial numbers of adults in the United States (US) fail to get recommended amounts of magnesium in their diets. Among adult men and women, the diets of Caucasians have significantly more magnesium than do those of African-Americans. Magnesium intake is lower among older adults in every racial and ethnic group. Among African-American men and Caucasian men and women who take dietary supplements, the intake of magnesium is significantly higher than in those who do not

  28. When I have a sneezing fit, a cold acidic drink typically slows it down almost instantly. Cold orange juice, cold coke, even cold beer. Cold water doesn’t help as much.

    I think the effect is real, but I don’t think it’s due to any magic nutrients in a diet soda. I think it’s due to local effects on my throat and sinuses. So I would hold off on the skepticism over the “immediately,” because there are other plausible mechanisms besides B-vitamins and magnesium being absorbed and travelling to the involved site.

    If magnesium actually does ease asthma, specifically atopic asthma, I see no reason to think that relief of atopic rhinitis is inherently implausible. Of course that doesn’t mean it works; it might. Just as LDN might relieve MS.

    So a drink of cold orange juice with magnesium probably has an immediate effect on sneezing just because it’s cold and acidic (I can’t be the only person this works for) and possibly also has a medium-term effect due to the Mg. Or maybe it just has an immediate effect.

    Back in the eighties when AIDS and treatment were new, I knew of an MD who, lacking better data, looked at a case series (his patients) and wrote down what other things people were doing to look after themselves than whatever he was telling them to do. After a while a pattern stood out: the ones who were seeing Naturopath X were doing better. He met with Naturopath X, who was probably prescribing a whole lot of silly things but was also doing something the doctor thought was plausible: prescribing B vitamins so that B vitamins would not be a limiting factor for the liver in processing the heavy load of drugs these patients were taking. The doctor invited Naturopath X to partner with him in his practice and seemed quite pleased with the arrangement.

    These are anecdotes. They are plausible, not silly, but that doesn’t make naturopathy science-based as a practice: it’s clearly not. But laughing at people for thinking there might be something to some of the treatments proposed doesn’t make sense either.

    I’m not saying that naturopathy has credibility. I’m saying that ridiculing people who believe they have had relief from something that is actually plausible makes no sense.

  29. Scott says:

    As for this:
    “I mean if there *WAS* a double-blind study showing the efficacy of Mg in alergic attacks. Then it would be medicine, if there were a double-blind study showing no real success why would you trust your own ideas over that?”
    This is exactly one of the problems. Many physicians are simply rote-learners. Proceduralists. They are not scientists. They do not understand physiologic systems and the basic sciences involved. They do not know how to read about the properties of magnesium and its effect on physiologic systems and extrapolate as to how it can sometimes alleviate certain conditions. Just because a double-blind study does not exist doesn’t mean these physiologic processes don’t exist.

    No, it just means that you can’t know what effect a treatment intended to affect those physiologic processes actually has. The human body is FAR too complex for the kind of first-principles deduction you’re advocating. Anyone who tells you that they can deduce from biochemistry and physiology that magnesium is an effective allergy treatment doesn’t actually understand the biochemistry and physiology.

    Scott, I will assume you are an oppositionally defiant troll and not actually seeking answers.

    In other words, you can’t actually refute any of my points so you fall back on an ad hominem.

  30. GinaPera says:

    Thank you, Alison:

    “These are anecdotes. They are plausible, not silly, but that doesn’t make naturopathy science-based as a practice: it’s clearly not. But laughing at people for thinking there might be something to some of the treatments proposed doesn’t make sense either.
    I’m not saying that naturopathy has credibility. I’m saying that ridiculing people who believe they have had relief from something that is actually plausible makes no sense.”
    —–

    Anecdotes that illustrate basic science are worthwhile.

    And I never ascribed credibility to naturopathy, either; I only pointed out their appeal to people who are frustrated by physicians who are blind to basic principles of health.

    As for magnesium, that’s interesting that cold drinks have that effect on your allergic reactions. In the past, growing up in the south amid abundant tree and grass pollen, I would often place a cold compress on my itchy eyes and running nose; it helped a bit, along with an antihistamine. But mostly I was miserable.

    The rest of my “anecdote”: If I’d been smart, I would have researched magnesium when that nutritionist stopped my cat allergy on a dime. But back then, 1983 or so, I was seldom around cats, so the “avoidance” strategy worked for me. Plus, I was relying on the allergists. (Talk about a profession with bogus claims.)

    Only 15 years later did I learn that chronic magnesium deficiency had adversely affected my health in so many ways. When I finally found a smart physician — after running through many rheumatologists, allergist, orthopedic physicians, etc. — she was disgusted that no physician had suggested magnesium and B vitamins. Basic stuff. But always overlooked by physicians who don’t understand the basics.

  31. GinaPera says:

    I can refute your points, Scott, but I choose not to waste my time on someone who only wants to attack and belittle.

    You seem unable to consider ideas that don’t fit your ossified schema.

  32. Scott says:

    I can refute your points, Scott, but I choose not to waste my time on someone who only wants to attack and belittle.

    Then refute! There’s not a single thing I’ve said that could credibly be interpreted as “attack and belittle,” so I honestly can’t reach any other conclusion than that you have no actual answers.

    You seem unable to consider ideas that don’t fit your ossified schema.

    No, you mean that I don’t unquestioningly accept any foolishness someone feels like spouting.

  33. Harriet Hall says:

    GinaPera,

    You didn’t really answer my question. You didn’t provide any evidence that magnesium is effective for allergic rhinitis or any clear rationale as to why a naturopath would choose it over other treatments.

    You said that “They do not know how to read about the properties of magnesium and its effect on physiologic systems and extrapolate as to how it can sometimes alleviate certain conditions.”

    It seems that you think extrapolation and speculation are appropriate guides to choosing a treatment. They are notoriously unreliable, and that’s why we have to do science. For every case where extrapolation and speculation led to success, there are hundreds of cases where they misled practitioners and failed to help patients or even harmed them. Your comments make me wonder if you truly understand the scientific method and the need to put ideas to the test.

  34. KB says:

    “You seem unable to consider ideas that don’t fit your ossified schema.”

    Magnesium can increase your calcium loss in the kidneys, so can you really blame us for being more ossified?

    (I’m sorry, I know only at high levels… but the joke was there, and I had to take it.)

  35. Professor Tom says:

    GinaPera,

    When you make a statement like this one, assuming you are being serious, it boggles the mind: “…treat the causes of illnesses, when possible, instead of adding more pills.”

    Lots of us have careers in science where every day of our lives we investigate the fundamental biology of life and what goes out of whack in a diseased individual. We are looking for cures, and yes hopefully those will be pills that precisely treat the exact causes of the illness. If we are not treating the fundamental causes, hopefully the treatments will make the symptoms more tolerable.

    I have been in research for 20 years and meet lots of dedicated people working to find cures for diseases, and you seem to paint us as pill-pushing shysters.

    I assume that your intentions are good and maybe you were a little defensive.

    In short, a reasonable goal to to ask people to prove that something works in a controlled study before giving people advice on a matter as important as what substances they could ingest to improve their health. After all, the world is full of toxins, the vast majority of which are “all natural” and could even be labeled “organic”. The question is always, toxic at what dose? Salt, sugar, oxygen, and everything else (including magnesium) is toxic at SOME dose.

    I’m glad that your Mg intake (that apparently doesn’t involve a pill of any type?) has helped your health. I would caution endorsing it to the masses until there is a controlled and doubly-blinded study showing that it does some good. I would ask the same for hypnosis, or a new cancer drug coming out of my lab.

  36. Peter Lipson says:

    I can refute your points, Scott, but I choose not to waste my time on someone who only wants to attack and belittle.

    HAHAHA!!!

    Second-funniest thing I’ve read all day.

  37. zed says:

    @Peter Lipson

    What was the most funny thing you read today?

    —-

    I love people who complain about “science” and then try to make it seem that their favorite unproven treatment is enough science for them! As always, the plural of Anecdote is not Data.

  38. GinaPera says:

    Harriet wrote:

    “It seems that you think extrapolation and speculation are appropriate guides to choosing a treatment. They are notoriously unreliable, and that’s why we have to do science. For every case where extrapolation and speculation led to success, there are hundreds of cases where they misled practitioners and failed to help patients or even harmed them. Your comments make me wonder if you truly understand the scientific method and the need to put ideas to the test.”

    Yes, I understand the scientific method. I also understand common sense.

    And when you have a mineral deficiency that is epidemic, when supplementing that mineral causes no harm (except with kidney patients and select others with contraindications), and when there is a scientific reason to think that it might help, why not try it?

    Why wait for the impossible double-blind study that will be the one-size-fits-all answer to allergic rhinitis while people suffer? Real medicine doesn’t work that way. Each person must be assessed individually.

    I’ve sincerely offered solid, even life-changing and life-saving information. I’ve pointed to resources. To those who don’t want to learn more, who prefer to be spoon-fed false surety by a pharma rep, that’s your right. But that won’t make you smarter, more discerning, or more scientific than I am.

  39. GinaPera says:

    Professor Tom, you seem sincere but, sincerely, you miss the point.

    How about you read up on magnesium science and get back to us.

    Double-blind controlled studies are important. Of course. But you can’t possibly imagine they are the answer to every human ill? That is impossible! The sheer range of human physio-chemistries alone confounds such cookie-cutter approaches, not to mention the influence of diet and other lifestyle factors.

    I can only re-state my point that what’s wrong with healthcare in this country cannot be fixed by congress. It can only be fixed by smarter physicians.

  40. Peter Lipson says:

    @zed

    It was this.

    And Gina’s response should be struck as “non-responsive”.

  41. GinaPera says:

    Professor Tom wrote: I have been in research for 20 years and meet lots of dedicated people working to find cures for diseases, and you seem to paint us as pill-pushing shysters.

    —-

    I suggested nothing of the sort. Please go back and carefully read what I did write.

  42. overshoot says:

    Sorry, but behaviour and digestive problems are not symtpoms of food allergies last time I checked. Difficulty breathing, sneezing, rashes, vomiting, facialy swelling … those are the things that I have seen!

    Of course digestive problems can result from food allergies. As for behavioral, here’s another worthless anecdote:

    About 20 years ago I was successful enough with cutting back on red meat that I got refused for blood donation. Low iron reserves are fine up to a point but that was my point, so I went about correcting it. $MD prescribed chromagen, which I dutifully took as prescribed.

    That summer I was taking a CE class in artificial intelligence (hold the jokes) and something was making me miserable. Not only did I have a chronic headache, but my ability to concentrate was totally shot. As in, the mental equivalent of trying to wade through cement. Try this, try that — it turned out that elimination the chromagen did the trick, and a challenge confirmed it. By which time the class was over. Hardest I’ve ever worked for an A in my life.

    Now, it’s one thing to have something like that happen to a 40yo adult. Imagine a kid with a similar chronic condition, who has no idea that it’s not normal. So, yeah, food allergies can screw up your thinking and behavior. The thing to remember is that “possible” isn’t the same as “always.”

  43. GinaPera says:

    Peter, to be so young and so sure, even when there are huge gaps in your medical knowledge.

    A little humility about things you might not yet understand — and a little effort to understand them — would best serve your patients.

  44. GinaPera on sincerity:
    “I’ve sincerely offered solid, even life-changing and life-saving information.”

    Gina, it may or may not be solid but you have no idea whether it’s solid or not. You don’t have a way of telling. There is nothing impossible about a randomized double-blind controlled study of magnesium for allergic rhinitis.

    “Individualization” is often used as a reason that alternative remedies can’t be studied, but this excuse falls down in two places.

    1) Medicine looks at the patient, looks at the evidence, and tries to make a match. Alternative practice always makes a match to the same thing. If you are an acupuncturist or a homeopath or a naturopath, then you always use acupuncture or homeopathy or vitamins to treat whatever it is. There is less individualization in alternative medicine, not more.

    2) It’s perfectly possible to test individualized treatments. Homeopathy is supposed to be individualized, so one study followed children being treated for asthma at an outpatient clinic. Half the children were randomized to homeopaths who treated them individually with homeopathy in addition to the care they were receiving at the clinic. The other half just got the standard of care. The homeopathically treated children were much better in a year and could reduce their use of medication significantly. So could the non-homeopathically treated children. The standard of care was effective; children also grew out of the condition to a certain degree. Individualized homeopathic treatments added nothing.

    On the popularity of ineffective remedies:
    http://arstechnica.com/science/2009/04/why-snake-oil-sells.ars

    On the use of the scientific method (hard science is easy; soft science is hard):
    http://www.skepticstoolbox.org/hall/

  45. Scott says:

    And when you have a mineral deficiency that is epidemic, when supplementing that mineral causes no harm (except with kidney patients and select others with contraindications), and when there is a scientific reason to think that it might help, why not try it?

    That’s not what anybody here is objecting to. I think everyone would agree that if a deficiency is identified (preferably lab-confirmed) and cannot be readily corrected with proper diet, supplementation is often appropriate.

    What we’re objecting to is your entirely unsupported attribution that this will result in miracle cures of allergies (or anything else). And ESPECIALLY the claim you appear to be making that magnesium will cure allergies in general.

  46. Scott says:

    Spell check fail, apologies. That should be “entirely unsupported assertion“.

  47. GinaPera says:

    Alison, what are you not understanding here?

    And please — one study on, of all things, homeopathy??? What were the controls on homeopath-patient interaction? That must be figured in.

    To the larger point, there are many potential reasons for allergic rhinitis. Magnesium deficiency is just one of many.

    And how will you gather the groups necessary for such a study? How will you determine who is magnesium-deficient and by what degree? There is no way to measure this, no standard for all humans. The amount of magnesium one needs, the ability to uptake it, etc. is all highly individual.

    Perhaps someone will design such a study and pull it off, at least on some minute point. But I’m not holding my breath, and neither should physicians.

    Smart physicians aren’t waiting for the proof in this area they know can never be definitive for each patient. They have to use the existing data, the hard science, their own common sense, and the feedback from their patients.

  48. overshoot on allergies I:
    “Of course digestive problems can result from food allergies.”

    See http://www.medscape.com/viewarticle/708187

    Box 2. Classification of food allergy in the gastrointestinal tract.
    IgE-mediated
    Type I hypersensitivity.
    Rapid onset.
    Positive skin-prick test and/or in vitro radioallergosorbent test.
    Symptoms: itching of lips, angioedema, vomiting and abdominal cramps with or without symptoms in other targets (urticaria, rash, wheezing and anaphylaxis).

    Non-IgE mediated
    Type IV hypersensitivity (cell mediated).
    Late onset.
    Negative skin-prick test and radioallergosorbent test.
    Symptoms are usually confined to the gut: vomiting, diarrhea, abdominal pain or colic and failure to gain weight.

    Mixed IgE & non-IgE-mediated (allergic eosinophilic gastropathies)
    Variable onset.
    Peripheral eosinophil count, skin-prick test and serum results are inconclusive.
    Symptoms are confined to the gut and vary according to the site of eosinophilic inflammation.

    overshoot on allergies II:
    “$MD prescribed chromagen, which I dutifully took as prescribed. … [S]omething was making me miserable. Not only did I have a chronic headache, but my ability to concentrate was totally shot. … Try this, try that — it turned out that elimination the chromagen did the trick, and a challenge confirmed it.”

    ??? And this is relevant to food allergy how???

  49. Scott says:

    And how will you gather the groups necessary for such a study? How will you determine who is magnesium-deficient and by what degree? There is no way to measure this, no standard for all humans. The amount of magnesium one needs, the ability to uptake it, etc. is all highly individual.

    Appropriate subjects would be selected however you propose to determine who should get magnesium for their allergies.

    Perhaps someone will design such a study and pull it off, at least on some minute point. But I’m not holding my breath, and neither should physicians.

    There is absolutely no difficulty in the study that does not at least equally defeat the “treatment.”

    Smart physicians aren’t waiting for the proof in this area they know can never be definitive for each patient. They have to use the existing data, the hard science, their own common sense, and the feedback from their patients.

    SMART physicians know that common sense, first principles, and feedback from their patients are not reliable. If there’s “existing data” and “hard science” demonstrating that magnesium is an effective allergy treatment, you should have no difficulty presenting it.

  50. GinaPera says:

    Scott, you obviously don’t need medication. You are quite expert at “self-medicating” with opposition and provocation. How fortunate for you.

    Meanwhile, I’m heading to a Tea Party meeting. There’s more reasoned discourse there, I’m hoping.

  51. Scott says:

    And again, faced with entirely reasonable and polite arguments, GinaPera responds with ad hominem attacks.

    This is almost invariably a single of someone who has no actual support for their claims.

  52. Professor Tom says:

    I guess GinaPera wants us to trust her, because she simply knows what’s best and “feels” it. Us silly scientists, always looking for EVIDENCE. We should just rely upon her wealth of anecdotal life experiences. /rolleyes

    As long as she sticks to allergy sufferers, I guess the harm is controlled. It’s an area with a HUGE placebo effect, so many people will be happy, even if she is wrong, and none of them should be much worse off. I hope that she doesn’t branch out into other areas, though, such as homeopathic cures for cancers.

    Some arguments can’t be won… I try to get my wife to stop spending extra money on the boutique shampoos that tout their ability to “energize your scalp with moisturizing molecules and envigorate your hair with nature’s ions”. I have checked their labels, and the ingredient list looks pretty much like the bottle of Suave selling for 10% of the price.

  53. overshoot says:

    ??? And this is relevant to food allergy how???

    Look up chromagen and you’ll see.

  54. GinaPera says:

    Still haven’t checked out the research, eh, Tom? Easier to disparage me in your attempts to remain superior. Not the stuff of good science, methinks.

  55. Scott says:

    The stuff of good science is to present the evidence when you make the claim, rather than demanding that your audience go do your work for you.

  56. Professor Tom says:

    Yes, Gina, I have checked out the research. Scifinder lists two relevant references when keyword searching on magnesium deficiency and allergic rhinitis. One is a review paper with no primary data, from India in 1995 entitled “Clinical approach to primary chronic marginal magnesium deficiency.”

    The only paper with data is a 1993 study from Germany entitled “Magnesium supplementation in allergic diseases (rhinitis)” This reference is an abstract of a report from a “magenesium conference”

    Not exactly hard-hitting stuff. It seems like the studies never apperaed in any reputable journal, or really any journal at all, reputable or not.

    But I’m sure that you have some nice glossy pamphlets.

  57. GinaPera says:

    Tom, your reading comprehension is shocking in an alleged researcher. Please go back and read what I’ve written — twice, thrice, as many times as it takes — to understand the gray area here.

    Ah, but I suspect a cognitive inability to navigate gray area is the problem here. With virtually each responder. Wearisome. And a total waste of my time.

  58. Bogeymama says:

    Overshoot,

    You walked right into the trap. What you are describing is an intolerance, which is very different from an allergy. That is my whole point!!! And I should have expanded on my definition of “digestive problems”. Of course, allergies can cause acute GI symptoms. Notice the use of the word “acute”. I’ve been puked on enough times to know this. Chronic GI symptoms are a result of intolerances, which are a chemical reaction in the gut – not a result of an IgE-mediated allergy. Bothersome, yes. Dangerous, no. That’s what makes this distinction so important.

    I have discussed this point with numerous allergists, and not one of them agrees that chronic behavioural issues in kids are caused by true allergies. A few even rolled their eyes.

    Go ahead, blame kids’ bad behaviour on the food they eat (it’s never the parents fault, is it??) And I’m sure you can find many naturopaths who will listen, wave a magic wand, and PRESTO – determine that the child is allergic to milk and wheat. Then they will charge you tons of money for this magical diagnosis, make you spend even more money on useless supplements, and tell you that real doctors would never have figured this all out.

    Just DON’T call it an allergy. Accidentally taking a bite of something with milk in it won’t harm those children. It has killed others (I know of 3 – all teenagers who died from their milk allergies here in Canada just in the past 5 years).

  59. overshoot on food allergy:
    “Look up chromagen and you’ll see.”

    I looked up chromagen:
    http://www.drugs.com/cdi/chromagen.html
    Iron/Succinic Acid/Vitamin C/Vitamin B12/Desiccated Stomach Substance

    I’m not seeing anything. Are you saying you have an IgE-mediated hypersensitivity to meat or vitamin C?

    From wikipedia.org:

    Allergy is one of four forms of hypersensitivity and is called type I (or immediate) hypersensitivity. It is characterized by excessive activation of certain white blood cells called mast cells and basophils by a type of antibody known as IgE, resulting in an extreme inflammatory response. Common allergic reactions include eczema, hives, hay fever, asthma attacks, food allergies, and reactions to the venom of stinging insects such as wasps and bees.

    Really… not seeing anything.

  60. Peter Lipson says:

    As written above, allergic rhinitis and food allergies are examples of type I (immediate) hypersensitivity.

    Food intolerances are not IgE-mediated responses. Sometimes they are specific metabolic problems (relative lactase deficiency), sometimes autoimmune (celiac disease), and sometimes simply multifactorial or subjective.

  61. GinaPera on people who know a heck of a lot more about both the theory and practice of medicine than she does:
    “Oh dear. Such certitude. Such arrogance. Such ignorance.”

    On what basis do you think that the doctors here know less about how to interpret medical research than you do? Am I to assume that you have completed medical school and residency and therefore know exactly what is taught there? The things you think doctors and researchers don’t know are just silly. How do you know what it is that they know and don’t know?

    You might be interested in this article:
    http://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect
    “The Dunning–Kruger effect is a cognitive bias in which “people reach erroneous conclusions and make unfortunate choices but their incompetence robs them of the metacognitive ability to realize it.” The unskilled therefore suffer from illusory superiority, rating their own ability as above average, much higher than in actuality; by contrast, the highly skilled underrate their abilities, suffering from illusory inferiority. This leads to a perverse result where less competent people will rate their own ability higher than more competent people. It also explains why actual competence may weaken self-confidence because competent individuals falsely assume that others have an equivalent understanding. “Thus, the miscalibration of the incompetent stems from an error about the self, whereas the miscalibration of the highly competent stems from an error about others.””

    (Incompetent people don’t realize how much there is to know, therefore they think they know a substantial amount of it and conclude that the other person must be wrong. Competent people think that if they can be competent then anyone could be competent, including the person who disagrees with them, and conclude that they themselves could be wrong.)

    It’s not enough to assert that you know better than someone, or to conclude from the fact that you disagree with someone that they must be wrong.

    You also need to explain how you came by more knowledge than they have. For instance, perhaps you are an MD/PhD and combine both theory and practice, whereas most poor mortals have settled for one or the other. Or perhaps you are just, you know, know. Kind of like making it up.

  62. GinaPera on the superiority of naturopathy to science:
    “To the larger point, there are many potential reasons for allergic rhinitis. Magnesium deficiency is just one of many.

    And how will you gather the groups necessary for such a study? How will you determine who is magnesium-deficient and by what degree? There is no way to measure this, no standard for all humans. The amount of magnesium one needs, the ability to uptake it, etc. is all highly individual.”

    1) It is simply not true that the effects of magnesium supplemenation on symptoms of allergic rhinitis are impossible to study. It’s actually quite easy to study. I don’t know why you would think it’s hard.

    2) But let’s say it is true that it’s impossible to know anything about whether someone might benefit or has benefited from magnesium supplementation. How can naturopaths know it then? Magic?

  63. GinaPera says:

    With all due respect, Alison, I’ve explained all I need to explain to those who can actually parse information and have critical-thinking skills.

    To the rest, there’s obviously something else going on here, and I’ll refrain from speculating on the nature of the problems.

  64. kscrimgeour says:

    Ah the debate continues. I think the question of science needs to be broadened. I feel science is a 1.group of people with similar training to start with(and this does not have to be a phd.)
    2. They do similar methods
    3. They make observations
    4.They record and discuss observations
    5.They make conclusions.
    That is science, that is the scientific method in a nutshell.

    Can we all agree on this.

  65. But we do know that most Americans are deficient in this key mineral.

    Uh, no, we don’t know that, and the reference that you cited doesn’t say that. It says:

    Data from the 1999-2000 National Health and Nutrition Examination Survey suggest that substantial numbers of adults in the United States (US) fail to get recommended amounts of magnesium in their diets.

    Substantial numbers could be thousands or even millions or tens of millions and still be a small minority of the population. The reference also says:

    Among African-American men and Caucasian men and women who take dietary supplements, the intake of magnesium is significantly higher than in those who do not.

    Funny thing: the site that these statements come from is the Office of Dietary Supplements, established by the Dietary Supplement Health and Education Act of 1994—a government handout to BigSup.

    The truth of the matter—the ‘hard science’—is that Mg++ is a ubiquitous ion in biology, as are Na+, K+, Cl-, Ca++, and a few others, and as such is ubiquitous in, well, foods—as is also shown in the reference that you cited. People who are truly deficient in it are those with predictable reasons to be deficient: those on some diuretics, those with some kidney diseases, infirmed people with very poor diets in general, and a few others.

    It is possible, but unlikely (because, like other ions crucial to biochemistry, Mg++ tends to be tightly controlled), that taking more Mg++ than usual will do something useful. The only way to find out is to study it.

    KA

  66. Chris says:

    And to think all of my allergies are due to lack of magnesium?

    Does that include my fairly severe nickel allergy? My hand have finally healed after I seemed to have touched something with nickel a couple of weeks ago.

  67. Alison quoted “This leads to a perverse result where less competent people will rate their own ability higher than more competent people. It also explains why actual competence may weaken self-confidence because competent individuals falsely assume that others have an equivalent understanding.”

    Are you screwing with me? If I think I know something I probably don’t. If I think I don’t know something, I probably do? These kind of things kill me. It’s a paradox, enigma, etc pasty (the kind that involves dough, not tassels).

    I won’t be able to have an opinion for a week…well, maybe five minutes at least.:)

  68. GinaPera says:

    Kimball, it’s not my job to educate physicians on each and every point of magnesium research and epidemiology.

    As they say about horses, you can lead them to water…..

  69. Harriet Hall says:

    GinaPera said “it’s not my job to educate physicians on each and every point of magnesium research and epidemiology”

    No, but if you present us with a claim, it’s your job to present the evidence to support that claim.

  70. GinaPera says:

    Harriet, I’m sorry but it’s really not my fault if you don’t know how to read the information at the links I’ve provided and then go on to learn more yourself.

    It’s funny….. I’m detecting some strong undercurrents of autistic-like thinking in many of these comments, a failure to make connections and a rigid insistence to have everything spoon fed in irrefutable little bite-size pieces.

    It might work that way in engineering, but not in medicine. The science-based kind, anyway.

  71. Bogeymama says:

    Gina, why won’t you explain it? You’ve been fairly rebutted, but then throw up a wall of superiority when challenged. Why don’t you tell us what makes you able to interpret the information better than a physician? I don’t see an MD behind your name. You obviously don’t think like a scientist. You think like a journalist, and someone with an axe to grind.

  72. GinaPera says:

    LOLOLOL! Yes, my “ax to grind” is medical incompetence cloaked in superiority. Always been a bane to the profession.

    I obviously DO think like a scientist. Good scientists have much in common with good journalists: Strong intellect, a perseverative nature, and a passion for understanding how things work with no love of arrogant sacred cows.

  73. pmoran says:

    Ginapera, before you leave, do try and answer Alison’s question: “But let’s say it is true that it’s impossible to know anything about whether someone might benefit or has benefited from magnesium supplementation. How can naturopaths know it then? Magic?. ”

    It is obvious to me that anything that made clinical studies prohibitively complicated would generate at least equal opportunity for error if practitioners try to adjudicate on treatment results on a patient by patient basis. Fter all, scientific studies apply the exact same logic, merely adding a variety of measures to eliminate sources of error, such as allergies coming and going of their own accord, or responding to placebos.

    This is why the Naturopath Association has such a vast array of somewhat unlikely treatments for allergy, none of which, apparently, stand out over any other. The methodology is clearly unable differentiate between sometimes effective and ineffective treatments.

    Of course, the trial and error approach might uncover a useful treatment if it had dramatic and consistent effects, but why would clinical studies have any difficulty in detecting that? Gina’s “physico-chemical differences” are a weak attempt to prop up an untenable, somewhat circular, argument.

    Of course, any kind of medical care generates powerful illusions of treatment efficacy in the practitioner as well as probably helping some patients through non-specific influences. Whether any treatments used have intrinsic efficacy is a question that has to be addressed in isolation from some of the quirks of medical practice.

  74. overshoot says:

    I have discussed this point with numerous allergists, and not one of them agrees that chronic behavioural issues in kids are caused by true allergies. A few even rolled their eyes.

    There is a difference between “behavioral issues are caused by …” (the Feingold hypothesis) and “behavioral issues can be caused by …”

    Research has proven the Feingold hypothesis and found it sadly wanting. On the other hand, if you ask any pediatric ENT about the effects of chronic sinusitis on children you’ll get a laundry list of effects on learning, behavior, etc.

    Go ahead, blame kids’ bad behaviour on the food they eat (it’s never the parents fault, is it??)

    Ax grinding aside, I have a daughter who had a chronic fungal sinusitis (colonized by a fungus she’s allergic to) from about the age of seven to the age of twelve. It seriously screwed with her hearing, ability to concentrate, etc. None of the above is speculative; we have radiology, tissue samples, antibody titers, audiometric tests, etc.

    As for chromagen, I tolerate iron sulphate, ascorbic acid, and B vitamins just fine. That “dessicated stomach” on the other hand apparently does something fierce to my system which results in some pretty impressive effects a long way from the GI tract and which are hard to distinguish from the worst ragweed season ever.

  75. Bogeymama says:

    Chronic fungal sinusitis does not sound like a food allergy. I was talking about behavioural issues being blamed on food allergies, largely coming from naturopaths. I don’t disagree about the effects that chronic sinusitis may have on kids.

    My “axe” to grind is clearly laid out in my original post – that it’s becoming trendy to blame behavioural issues on food allergies, some people are doing it by choice alone and calling it allergies – and it’s muddying the waters when it comes to the general public’s understanding of allergies, and potentially putting the kids with potential for anaphylaxis in danger. If it’s an intolerance, call it an intolerance.

  76. Composer99 says:

    GinaPera,

    You say to Harriet:

    But that won’t make you smarter, more discerning, or more scientific than I am.

    Since you apparently insist on accepting anecdote as clinical data and lazily dismissing people who have been at this for years (decades), this casual observer can only conclude that Harriet is more likely to be the smarter, more discerning, and more scientific of the two of you.

    Your style of writing reminds me greatly of a columnist for one of the major daily newspapers where I live. This is not meant as a compliment.

    Finally, regarding your comment about how a good scientist is like a ‘good journalist’: I would suggest that you check the ‘Science and the Media’ category to see the rather more typical behaviour of journalists; even ones who might otherwise be accounted to be good.

  77. On Chronic Allergies and Chronic Behavior problems.

    I’m not really sure why an allergist would rule out chronic behavior problems as a symptoms of chronic allergies. Or why they would diagnose a child they haven’t seen.

    Firstly, when my allergies act up I feel like *^%$. I know when my kids feel bad (sick) they act up, alot.

    Secondly chronic allergies often cause otitis media with effusion in children (somethings adults) which can mild hearing loss. One of the documented effects of mild hearing loss in children is behavior problems.

    Thirdly chronic allergies can cause poor sleep and sometimes even sleep apnea, which research is starting to show can cause inattention and behavior issues in children.

    Bogeymama – while I genuinely sympathize with your desire and right to have school personal take your child’s severe allergy seriously, I feel the need to underscore the fact that even though an allergy or intolerence may not be life threatening, the children still need preventative measures taken by the school. They may not be the extreme measures needed with a child with severe allergies, but no child should have frequent bouts of diarrhea, just because the milks not going to kill him, nor should a child with a mild allergy to strawberries be repeatly given strawberries just because they don’t need an epi-pen.

    Regardless of the fact that some parents incorrectly claim their child has an allergy when they in fact have an intolerance or that some children are misdiagnosed, I believe you will often find that the general population is quite unaware of the consequences of a severe allergic reaction.

    I find that many people routinely under estimate the severity of any illness in children unless it is highly visible or cancer. If you feel they are not taking things seriously, perhaps a clearly worded information sheet with precautions and risks that each of your child’s teacher and teacher’s aid must sign would be a helpful educational tool.

  78. GinaPera says:

    Gina’s “physico-chemical differences” are a weak attempt to prop up an untenable, somewhat circular, argument.

    —–
    LOLOL!! More brave talk from an anonymous poster who knows as much about science as Glenn Beck does about, well, anything.

    It’s not enough that I’m dressed down by, gasp, “Bogeymama,” now it’s the esteemed “Pmoran.”

    I just hope few of you are actually physicians. That is a depressing thought. It’s depressing enough to witness the poor reading comprehension and critical-thinking skills in this thread.

  79. Bogeymama says:

    Thanks micheleinmichigan. My child’s situation is well-known and taken care of, but I am a certified regional allergy / asthma educator, and it is a huge problem everywhere I go. Again, I don’t dismiss that seasonal allergies and pet allergies can lead to behavioural issues because the sufferers feel like crap. I am only talking about food allergies. Like I said, I deal with many allergists. The situation I am referring to is naturopath or self-diagnosed “allergies” to food because of the child’s behaviour IN THE ABSENCE of usual allergy symptoms. In other words, you will not see hyperactive or distracted behaviour as the only symptom, which is typically what the parents report. These children have no runny noses, no sneezing, no hives, no swelling, no acute vomiting, no bronchospasm, no eczema-type rashes etc when they consume a food that the naturopath has told them they are allergic to. It’s a diagnosis of convenience, and it’s becoming very trendy. It may very well be an intolerance – milk and wheat are more difficult proteins to digest than others (along with corn – eliminating those 3 foods from the diet temporarily is a common treatment for IBS), but eliminating them from the diet usually makes anyone feel better, so it’s easy to say that it worked.

    Allergy vs intolerance is one of the main teaching points that I discuss in my presentations, and it would be nice if I didn’t have to spend as much time on it as I do so I could focus more on what to do in an emergency.

  80. Bogeymama says:

    “It’s not enough that I’m dressed down by, gasp, “Bogeymama,” now it’s the esteemed “Pmoran.””

    Some of us can’t spend time writing blogs. We actually spend our time working in health care, treating real patients, attending countless conferences and educational symposia in our specialty areas. Guess that doesn’t make as much of an authority as a journalist.

  81. sarkeizen says:

    “The cognitive dissonance and selective perception seems to be so overwhelming you cannot comprehend what I actually wrote.”

    …or maybe you just lack the ability to detect irony.

    Anyway I find blanket responses pretty amusing. Not like you couldn’t have – like many of us are doing. Pointed out exactly how and where people have misunderstood you. That would be almost rational.

    “This is exactly one of the problems. Many physicians are simply rote-learners. Proceduralists. They are not scientists. They do not understand physiologic systems and the basic sciences involved. They do not know how to read about the properties of magnesium and its effect on physiologic systems and extrapolate as to how it can sometimes alleviate certain conditions. Just because a double-blind study does not exist doesn’t mean these physiologic processes don’t exist.”

    Argument by special definition for “science” aside. “Don’t know how to read?” is a weird argument. Someone who can read an “regurgitate” a study on X can read and regurgitate information on Mg. Which is all you’re doing – minus the information part.

    Seriously though: one has to ask “What makes us think these ‘physiologic’ process” are there to begin with. How was that information attained?

    On top of that why do we think this ‘physiologic’ process is generally effective. There are scads of treatments with huge amounts of biochemistry behind them – which failed utterly in people. Sometimes it’s cracking the delivery system, sometimes it’s just that we don’t understand the chemistry as well as we think we do. There are a myriad of reasons that something that is plausible is actually ineffective. Why is Mg any less susceptible to these limitations than any other therapy?

    So that leaves us with the question: “How do we figure out what actually has clinical effect. I’ll give you a hint it’s initials are: Double-blind placebo controlled studies.

    “Seemed a straightforward statement to me.”

    Everything is obvious to the uncritical eye.

    “To treat the causes of illnesses, when possible, instead of adding more pills.”

    Define “causes of illnesses”.

    I notice that you dodged my question…so I’ll ask it again:

    Can you have science without a quantified error-bound?

  82. Harriet Hall says:

    GinaPera,

    You have been hostile and insulting from your very first comment. I was polite and asked reasonable questions. Instead of answering and providing your evidence, you gave me links that didn’t answer the questions. Then you accused me of poor reading comprehension and proceeded to personally attack me and others. That is not appropriate. I think you can do better than that. Please try to be more polite and to contribute to a productive discussion instead of offering insults.

    Let’s try again:
    (1) Do you have any evidence (actual evidence, not just speculation, rationales, anecdotes, and the fact that a lot of people are magnesium deficient) that magnesium is effective for allergic rhinitis – either in people who are magnesium deficient or who are not? Any controlled studies such as the ones I found for magnesium and asthma?
    (2) How did the nutritionist know to try it? especially in combination with juice and B vitamins? Was it just her intuition based on what she knows about physiology, or was there something more?
    (3) A nutritionist who understands physiology, and someone as “smart, discerning and scientific” as you are surely knows how long it takes for magnesium and B vitamins to be absorbed and to reach a therapeutic blood level after oral ingestion: how do you and she account for the observed “immediate” effect?

  83. Chris says:

    GinaPera, I am allergic to both nickel and chromium. Yes, they are both metals. But they cause a painful skin reaction (itchy hives). It is genetic, my dad has the same problem. My sister is allergic to wool.

    What if someone was allergic to magnesium?

    (okay, they are no where near each other on the periodic table, and the allergy is related to the reaction with ones one persperation… but it is a valid question)

  84. GinaPera says:

    Harriet, I don’t know why you persist.

    I can only assume, once again, that you are having trouble reading very straightforward language and cannot research this topic on your own.

    I never offered evidence that magnesium is effective for allergic rhinitis. I did, however, refer you to the work of magnesium researcher Mildred Seelig, who explains how this might work. Did you read it? Obviously not. Why didn’t you read it, Harriet?

    What kind of question is that, asking me to imagine decades after the fact, what the nutritionist was thinking? You can’t be serious. If you are curious, why don’t you look into the matter yourself?

    Good grief. I never intended for this to be a symposium on magnesium. I offered it as one example of key “blind spot” of many physicians.

    If the responses here are indicative of physicians in general (I suspect it’s not, as most competent, in-demand physicians don’t hang out on blogs reading nonsense), I have new understanding of why my scientist friends who teach med students often get so frustrated.

  85. sarkeizen says:

    “I have new understanding of why my scientist friends who teach med students often get so frustrated.”

    So you talk regularly with scientists? Then perhaps, you can answer the question I’ve now asked three times (and you have avoided twice).

    “Can you have science without a quantified error-bound?”

  86. GinaPera says:

    Bogey — if you’re so qualified, why don’t you use your real name so that can be verified? We should just….. trust you?

  87. GinaPera says:

    Sark — the answer has to be NO.

  88. GinaPera says:

    Sark wrote:
    And we have you…echoing something I hear from various sources in and about Naturopathy. That ND’s, somehow have a generally deeper understanding of therapy and physiology than all medical science combined?
    Sorry who was being arrogant again?

    —–
    Another example of reading-comprehension challenges. Can you please show me where I have defended naturopaths? I’m confident you won’t find it.

  89. sarkeizen says:

    GinaPera,

    Interesting, then provide the error bound and its cite for the alleged clinical effect of Mg on allergy sufferers. Please do not resort to some of the other dodge tactics you have employed with others. Such as making it sound like this is an onerous task – although I don’t necessarily expect you to have the number at hand – it’s reasonable to expect you can find it.

  90. squirrelelite says:

    I’m jumping into this a bit late, so please forgive me if I repeat something already covered. It’s been a busy day.

    @GenaPera (12:29 pm),

    I read your earlier comments, but thought I would start with this one.

    I looked up Mildred Seelig’s reference that you cited as a “helpful source for you regarding magnesium and allergies”. It looked like a summary article about a book she had written about chronic fatigue syndrome and magnesium. It talked mostly about CFS and a few other conditions but didn’t seem to mention asthma or allergies.

    I also looked up the NIH fact sheet on magnesium. I copied it into a word processor and did a word search for “allerg” which should cover allergy, allergies, allergens, etc. No hits.

    What was that about “reading comprehension challenges with some of the posters”?

    I also went to PubMed and did a search on magnesium and allergies and got 528 references. One was from “Medical Hypotheses”! Several referred to using intravenous magnesium sulfate to avoid having to stick a tube down the patient’s throat to get air into the lungs or perhaps cutting open the trachea (which I think Dr Ray referred to having done once in an emergency situation on last night’s CSI.).

    This Greek study was the first such reference, but there were others. That obviously is not what your nutritionist did when she offered you a juice cocktail.
    http://www.ncbi.nlm.nih.gov/pubmed/19911854

    Another was this Bastyr study, which sounds vaguely familiar. (Has it been discussed elsewhere in this blog?)
    http://www.ncbi.nlm.nih.gov/pubmed/20100026

    They looked at 55 subjects who “were randomly assigned to consume 340 mg(170 mg twice a day) of Mg or a placebo for 6.5 months.” There was no mention in the short abstract of blinding or controlling to ensure the two groups were medically equivalent. They reported significant improvement in “Subjective validated questionnaires on asthma quality of life(AQLQ) and control(ACQ)” but didn’t say how much improvement was “significant”.

    They also noted that “Despite these improvements, there were no significant changes in any of the markers of Mg status.” So, it is difficult to tell if magnesium status had anything to do with the improvement.

    And, this was a study on a possible preventive or mitigating effect of magnesium, not a one dose treatment for an acute event.

    You also stated that “There can be no blanket guidelines about magnesium dosage, etc.”

    Curious! Your NIH reference in table 2 gives “Recommended Dietary Allowances for magnesium for children and adults “. Of course that’s only a dietary allowance, not a medical treatment dosage, but it does sound like a blanket guideline.

    You also said “But we do know that most Americans are deficient in this key mineral.”

    The results you referred to from the “1999-2000 National Health and Nutrition Examination Survey suggest that substantial numbers of adults in the United States (US) fail to get recommended amounts of magnesium in their diets”.

    It also notes that “symptoms of magnesium deficiency are rarely seen in the US”. Since RDA’s are aimed at avoiding effects of nutritional deficiencies, not providing medical therapy for specific conditions, we don’t seem to be doing too badly. But, since seizures are one of the symptoms mentioned and I am taking medication to control seizures, perhaps I will discuss it with my neurologist in a few months. Since my current control is pretty good, I would be surprised if I really have that problem. But, I may try to eat a few more peanut butter sandwiches on whole wheat bread (2 good sources of magnesium).

    But, more importantly, “substantial” is not the same as “most”. If only 10% of Americans had magnesium deficiency, that would be about 30 million people which I certainly consider substantial. However it would take 5 times that many people plus 1 to get to most.

    What was that about “reading comprehension challenges”?

    I also looked up magnesium and allergic rhinitis. There was a very small study (15 subjects) on “intranasal hypertonic dead sea saline spray and intranasal aqueous triamcinolone spray in seasonal allergic rhinitis”, which showed that “improvements were seen in both active-treatment groups; as expected, the corticosteroid spray was the more effective of the two treatments.” This was published in 2005 and there doesn’t seem to be a lot since.

    Finally, you mentioned being asked “I mean if there *WAS* a double-blind study showing the efficacy of Mg in allergic attacks. Then it would be medicine, if there were a double-blind study showing no real success why would you trust your own ideas over that?”

    I didn’t see where you answered that question.

    Dr Hall asked “I couldn’t find anything about using it for allergic rhinitis. How did the nutritionist know to try it? Do you have any references?” I didn’t see anything more about the nutritionist, but you did give some references which I have reviewed. But, they don’t discuss allergic rhinitis which seems to be what you were suffering from, so again no answer.

    Instead of answering why you would trust your own experience in one incident over a randomized double-blinded controlled study, you stated
    “This is exactly one of the problems. Many physicians are simply rote-learners. Proceduralists. They are not scientists. They do not understand physiologic systems and the basic sciences involved.”

    Yes, most working physicians are not working as scientists doing scientific research. Except perhaps for monitoring patients participating in a controlled study, most physicians are too occupied with their real work which is treating and, hopefully, curing their patients.

    Becoming a medical doctor requires a lot of rote learning. There are a lot of facts, relationships and biochemical processes to cram in, memorize, and internalize before they can get on to the real hands-on work of learning to become a good doctor. Which is why medical doctors get a lot more academic and residential education than naturopaths and even more so than nutritionists. I wouldn’t be too quick to belittle that knowledge.

    Being a proceduralist can be a very good thing. Following proper procedures can go a long way to minimize bad results. Just read Mark Crislip’s blog today for some examples.
    http://www.sciencebasedmedicine.org/?p=5273

    But when you state that “They do not know how to read about the properties of magnesium and its effect on physiologic systems and extrapolate as to how it can sometimes alleviate certain conditions”, it sounds like you are talking about education in a medieval university 500 years ago. They did a lot of reading about properties from documents handed down from antiquity and using logic and philosophy to extrapolate to develop further ideas. But then we made a major breakthrough. We discovered how to take those ideas and look at them in the real world and do tests, experiments and studies to see if they were true or not. Fundamentally, that is what science is all about. And, we discovered that a lot of those ideas and extrapolations were wrong.

    And, we discovered that one described incident (an anecdote) can sometimes give us a clue to how nature really works. But, it takes a lot of carefully set up, carried out and described incidents to figure out if our extrapolations are true or not. That is the difference between an anecdote and a study.

    Unless you show some understanding of that difference, I think as you said, “I choose not to waste my time”.

    And, thanks to all of you who have the fortitude to actually read all the way through this comment!

  91. sarkeizen says:

    “Another example of reading-comprehension challenges. Can you please show me where I have defended naturopaths? I’m confident you won’t find it.”

    Ta da…

    “I’m sorry to be so blunt, but intellectually incurious attitudes such as this are the reason so many people have started avoiding “mainstream” physicians and flocking to “naturopaths.”””

  92. sarkeizen says:

    (Note: You may well appeal that you are not ‘defending’ them. However that’s irrelevant to my original argument)

  93. Bogeymama says:

    “Bogey — if you’re so qualified, why don’t you use your real name so that can be verified? We should just….. trust you?”

    Because I have no blog to promote, and no book to sell. And no, you don’t have to trust me. But thousands of patients do, and that’s all I care about.

  94. GinaPera says:

    Nah, Bogey….bullies always attack best when they are cloaked. They feel safer that way.

    For your information, I’ve been an unpaid advocate for ten years, helping people to navigate around clueless physicians and find legitimate medical help. And anyone who thinks writing a book is a path to making money is sadly clueless.

    Your attack, I’m afraid, apparently speaks more to your own dark nature than to my own.

  95. squirrelelite says:

    I have a long comment in moderation. It’ll show up some time.

    In fact, when I read all the rest of the comments and scrolled over it, I was even surprised at how long it was. Almost long enough for Dr Gorski’s “friend”.

    To Scott, Professor Tom, Dr Hall, Alison, Michelle, pmoran, Chris, sarkeizen and several others who beat me to the punch, thanks for fighting the good fight.

    In retrospect, it was interesting how much of what I had written proved to be germane to the discussion.

    @GinaPera,

    You asked “if you’re so qualified, why don’t you use your real name so that can be verified? We should just….. trust you?”

    Q1, perhaps you should ask Dr Offit that one. When people will stalk and threaten your children because they disagree with your statements, using a pseudonym as I do can be a reasonable precaution.

    Q2, actually no, you should not just trust me. As I told my children many years ago, nothing is true just because I say it (except as an expression of personal opinion). If what I say is true, it is because it is supported by the references I give to relevant scientific studies and because my conclusions follow from the logic of my arguments which, I hope, are free from fallacies. You don’t need to know who I am to judge those things. You merely need to read them.

    And, if you don’t understand or disagree, you may ask a direct question and I will try to give you a direct and, as best I may, correct answer.

  96. GinaPera says:

    Scott, could you please site where exactly I wrote this? Is it a reading-comprehension issue or willful distortion? It’s one or the other.

    “What we’re objecting to is your entirely unsupported attribution that this will result in miracle cures of allergies (or anything else). And ESPECIALLY the claim you appear to be making that magnesium will cure allergies in general.”

  97. GinaPera says:

    Chris wrote: GinaPera, I am allergic to both nickel and chromium. Yes, they are both metals. But they cause a painful skin reaction (itchy hives). It is genetic, my dad has the same problem. My sister is allergic to wool.
    What if someone was allergic to magnesium?
    (okay, they are no where near each other on the periodic table, and the allergy is related to the reaction with ones one persperation… but it is a valid question)

    Sorry Chris. I have no idea. Perhaps you should ask a nickel or chromium scientist — or a metallurgist.

  98. GinaPera says:

    ta da blah blah, Sark. Keep reading that paragraph. Taking points out of context like that is reserved for Fox TV bloviators.

  99. GinaPera says:

    “Q1, perhaps you should ask Dr Offit that one. When people will stalk and threaten your children because they disagree with your statements, using a pseudonym as I do can be a reasonable precaution.”
    —–

    Been there. Done that. Educating about the validity of ADHD as a medical diagnosis is a risky endeavor.

    I didn’t resort to anonymity. And if I did, I wouldn’t expect people to take me seriously.

  100. GinaPera says:

    Squirrel wrote:
    You don’t need to know who I am to judge those things. You merely need to read them.

    ——
    Precisely. Which is why it’s so amusing to be taking to task by anonymous bullies who demand to know why I could ever presume to know more than (or as much as) an MD.

    Waving the “I’m an MD” flag is proof of nothing. Except perhaps narcissism.

Comments are closed.