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Naturopathy vs. Science: Allergy Edition

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I glanced at my pharmacy license recently, and noticed I became a licensed pharmacist almost exactly twenty years ago. Two decades seems like a long time to do pretty much anything, yet I can still vividly recall some of the patients I encountered early in my career, working evenings in a retail pharmacy that drew heavily on the alternative medicine crowd. It was the first pharmacy I’d ever seen that sold products like homeopathy, detox kits, salt lamps, ear candles, and magnetic foot pads. And the customers were just as unorthodox. There were some that told me they manipulated their own pH, and others that insisted any prescription drug was designed to kill. And there was a huge clientele that relied on the pharmacy for their “bioidentical” hormones. It was an instructive learning experience, as it was as far from the science of pharmacy school as you could expect to find in a place that still called itself a pharmacy. One of the really interesting aspects of that pharmacy was the enormous supply of vitamins and supplements for sale. It stretched over multiple aisles and even back into where the drugs were kept, as there were some brands kept behind the counter. This wasn’t for any regulatory reason – it was because these were the “naturopathic” supply, the brands often recommended by naturopaths. In order for this pharmacy to sell them they had to keep the products behind the counter, presumably to grant these supplements a veneer of medical legitimacy. After all, they were “special”, and had the prices to prove it.

It was in this setting that I began to understand the practice of the naturopath. Toronto is home to one of the handful of naturopathy schools in North America, so there are a lot of naturopaths in Toronto. At the time I didn’t know much about naturopathy other than it was some sort of alternative-to-medicine, and their recommendations tended to involve a lot of supplements – and when I say a lot, I mean hundreds-of-dollars-per-month habits for some customers. All of this was good for sales, and for the pharmacy, but it left me perplexed about the medical merits of these products and of naturopaths, especially since I’d never heard of diagnoses like candida overgrowth, detox, adrenal “fatigue”, hormone “depletion”, and widespread nutritional depletion in my pharmacy education.

I started researching naturopathy, and what I learned concerned me. Regular readers to the blog will be familiar with naturopathy, but depending on where you live, the likelihood that you may encounter a naturopath (or someone that consults one) may vary. Naturopathy has been described at SBM as a chimera, something that’s imagined, but in reality is illusory or impossible to achieve. That’s an apt description for naturopathy, as the practice is a strange assortment of unorthodox, discarded, and disparate alternative health practices, linked by a philosophy based on pre-scientific ideas of medicine. The central belief, vitalism, posits that living beings have a “life force” not found in inanimate objects. Vitalism as a hypothesis in medicine was reasonable 200 years ago, but despite being disproved by Wöhler in 1828, it continues to thrive in naturopathy. Naturopathic treatment ideas are grounded in the idea of restoring this “energy”, rather than being based on objective science. It is perhaps unsurprising that disparate practices like homeopathy, acupuncture and herbalism are all part of naturopathy, yet don’t cause any cognitive dissonance for its practitioners. Given there’s no need to justify or rationalize practices in scientific terms, pretty much anything goes, as long as it aligns with this belief system. To be fair, not all naturopath advice is bunk. Some can be sound. Unfortunately this isn’t because there is good scientific evidence to support that practice, but rather that the beliefs and philosophy of naturopathy happen to align with science:

I love being able to look at new approaches that may come along and to ask myself, “Is this within the bounds of the philosophy I so embrace?” And if not, to let it go.

– Amy Rothenberg, Naturopath

With philosophy rather than objective evidence guiding what a naturopath decides to promote, it should not be surprising that there are serious concerns about the standard of care offered. A letter published a few years ago in Allergy, Asthma, & Clinical Immunology documents the concerns about naturopathy in Canada and any naturopathic alignment to science-based methodologies. Timothy Caulfield and Christen Rachul found that the most widely advertised practices in Alberta and British Columbia lacked a sound evidence base. They concluded:

A review of the therapies advertised on the websites of clinics offering naturopathic treatments does not support the proposition that naturopathic medicine is a science and evidence-based practice.

Among the interventions promoted by naturopaths were (no surprise) homeopathy, chelation, acupuncture and hydrotherapy. And among the top conditions naturopaths claimed to treat were allergies. People suffering with allergies are a target market for naturopaths – which is concerning, because potentially life-threatening conditions are no place for pseudoscience. About five years ago, a coalition of seven Canadian allergy organizations wrote a letter (PDF) to the British Columbia Minister of Health, protesting the plan to allow naturopaths to perform allergy testing and treatment. They identified multiple concerns about the ability of naturopaths to treat allergies, given their diagnostic and treatment methods are not based on scientific standards. Since that letter was written, some of their cautions have already come to pass. I’ve already described how Canadian naturopaths (working with pharmacies, sadly) have turned unvalidated IgG blood testing into a lucrative market to diagnose fake food “intolerances” with the secondary market of selling supplements to correct for all the new dietary restrictions that are recommended.

I was reminded of allergies again this week when a colleague passed on a post from a naturopath about seasonal allergies. Before we go into that post, it’s worth reviewing the scientific evidence on seasonal allergies. The medical term is allergic rhinitis and you’re probably familiar with the symptoms: itchy watery eyes, sneezing, runny nose and nasal congestion, cough, and fatigue are all typical. It’s common, affecting 10-30% of the population, and while it’s not life threatening, can be quite debilitating. Seasonal allergies are usually caused by pollen, and you can often tell what you’re allergic to by checking the pollen counts. Trees, grasses and weeds can all cause seasonal allergies. Pollen exposure causes reactive individual to product antibodies, which bind to mast cells in the nasal mucosa and basophils in the blood. Subsequent exposure to the same allergen causes mast cell activation and the typical cascade of symptoms. The diagnosis is based on a clinical examination, but many people diagnose themselves – they take an antihistamine and see if they feel better. (Not a strategy I recommend.) The ideal treatment is avoidance, but that’s difficult, so many rely on drug therapy. The main categories of treatments are the inhaled steroids (e.g., Flonase) which reduce the allergy cascade by direct action in the nasal passages, and the oral antihistamines, which centrally reduce histamine activity. For most, these products are effective and well-tolerated. Medical consultation is always advisable to ensure the diagnosis is clear, and referrals to allergists are warranted for complex cases. There are several other forms of treatments, with allergy shots generally reserved for the most refractory situations.

Naturopaths consider themselves to be primary care providers comparable to medical doctors, so their advice can justifiably be compared against the same standard. Naturopath Shawna Darou’s bio notes she “graduated from the Canadian College of Naturopathic Medicine (www.ccnm.edu ) at the top of her class and was the recipient of the prestigious Governor’s Medal of Excellence” so presumably her advice is representative of what you should expect from a naturopath. Here’s what she advises to “prepare your immune system” in her column on seasonal allergies:

A liver-focused cleanse before the start of your allergy season. This often makes a great impact on your allergy susceptibility. If you have severe allergies all summer, then a second cleanse mid-summer is also recommended. Most people schedule a 10-20 day cleanse in late March or early April.

Not a good start. Cleansing is pure pseudoscientific quackery, and there is no evidence that “cleansing” even occurs, or that has any effect on seasonal allergies. Your liver doesn’t need any cleansing, allergies or not, and your susceptibility to an allergen has nothing to do with a fictitious treatment. Allergies can wax and wane season to season based on pollen levels and even individual responses, and that variation can occur regardless of any “cleanse”.

Testing for food sensitivities. Chronic, long-term food sensitivities cause significant stress on the immune system and prime your body to react to seasonal allergens. If you reduce overall immune system stress by removing food intolerances from your diet, seasonal allergy symptoms will be minimized. If you haven’t already had a food intolerance test, please ask about one.

Naturopaths regularly promote unvalidated and clinically useless IgG blood testing to diagnose imagined food intolerances, in part because it’s a primer to sell unnecessary supplements. What’s never disclosed is the fact that IgG blood testing hasn’t been clinically validated to diagnose intolerance to a single food product, yet naturopaths claim to test for hundreds of these food “sensitivities”. Allergy organizations explicitly warn against this testing:

The Canadian Society of Allergy and Clinical Immunology (CSACI) is very concerned about the increased marketing of food-specific immunoglobulin G (IgG) testing towards the general public over the past few years, supposedly as a simple means by which to identify “food sensitivity”, food intolerance or food allergies. In the past, this unvalidated form of testing was usually offered by alternative or complementary health providers, but has now become more widely available with direct-to-consumer marketing through a nationwide chain of pharmacies. There is no body of research that supports the use of this test to diagnose adverse reactions to food or to predict future adverse reactions.

Continuing on through the advice:

Purchase a neti pot or a saline nasal spray, which are methods for clearing out the sinuses. Using this daily (1-2x) during allergy season will flush the allergenic pollens out of your nasal passages which will also help to minimize your symptoms.

Irrigating the nasal passages with saline or a neti pot is reasonable advice, is incorporated into conventional treatment guidelines, and is widely recommended by family physicians. It’s an example of where the naturopathic philosophy happens to align with the actual evidence. Neti pots and nasal rinses are generally low risk, but users must ensure they use distilled or previously-boiled water, as plain tap water may have a brain-eating amoeba that can kill.

Watch your stress levels: high stress hormones (cortisol especially) can worsen allergies or make you more susceptible to them. Find methods to lower your stress such as: yoga, exercise, breathing exercises, guided imagery or meditation. If you need further support to lower stress hormones, certain supplements can help to lower cortisol while you work on the external factors.

Neuroimmunology is a real science examining the relationships between the nervous system and the immune system. This advice, however, is unproven speculation. There is no published evidence to suggest you can meaningfully manipulate your allergy symptoms by will alone. Having said that, none of this is likely to be harmful – with the possible exception of supplements, which are unnecessary. With the exception of real medical conditions like adrenal insufficiency, your cortisol levels are not something you need to concern yourself with.

Mold alert: In the past few summers, there were high counts of mold spores circulating. Symptoms most commonly observed are around the eyes – swelling, itching, watering, rashes. In general, people who are sensitive to external molds often have an internal yeast imbalance which makes the immune system more sensitive to external moulds [sic]. If this applies to you, please ask about a ‘yeast-cleanse’ to prevent mold allergies this summer.

Molds can cause allergic rhinitis, so this is an opportunity to promote a made-up disease – candida (yeast) overgrowth. Yeast cleanses are just another variation of the detoxification myth that naturopaths believe, despite the lack of any scientific justification or evidence of effectiveness. People with seasonal allergies don’t have a yeast imbalance, and they don’t need a yeast cleanse: they need to prevent and control histamine release. There’s no fake disease that needs to be invoked.

If you are still getting allergies, even after these recommendations, there are also some natural alternatives to antihistamines that can be used that have no side-effects. Examples include: vitamin C, quercitin, various herbal combinations, homeopathic nasal sprays and specific homeopathic remedies.

Instead of recommending demonstrably effective treatments, like antihistamines, there’s the recommendation for unproven and ineffective treatments. There’s no persuasive evidence that vitamin C, quercitin or any herbal medicines have any meaningful effects comparable to drug therapies, or are backed by adequate scientific evidence to support their use. And herbal remedies are not innocuous. Some, like echinacea, feverfew, and chamomile are members of the ragweed family and could aggravate, rather than relieve, allergies.

Homeopathic nasal sprays are simply saline nasal sprays – there are no active ingredients, yet you’re charged even more for the memory of some substance that was diluted out of existence. Homeopathy is a placebo system, and the “remedies” are usually pure sugar pills – completely inert and without medicinal effects. There’s no scientific justification for homeopathy in the management of seasonal allergies – or for any medical condition, for that matter.

Conclusion

Naturopaths purport to be science-based primary care providers and claim to have the training equivalent to medical doctors. Surveys of naturopathic practices suggest naturopaths do not offer treatments that are science-based, a finding that is consistent with the recommendations examined from a Canadian naturopath. While they claim to treat the “root cause” of disease, their recommendations suggest they lack (or reject) objective evidence about the scientific nature of conditions like seasonal allergies. With a practice that prioritizes philosophy over science, naturopaths are tilting at medical windmills.

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

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66 thoughts on “Naturopathy vs. Science: Allergy Edition

  1. goodnightirene says:

    How I WISH the naturopaths knew something my allergist doesn’t–As I sit here recovering from a nasty bout of allergic asthma resulting from something accumulated in my house (most likely “dust”) during this very nasty winter which has wreaked havoc with my allergies. I long for spring and the relatively milder hay fever it brings.

    Today’s and yesterday’s posts intersected for me at my Pharmacy yesterday. I was waiting for a prescription and while picking through the sale bin, I came across a preparation (not sure it was meant to be homeopathic or just “herbal”) of “pediatric nose drops” branded as “Dr. Sears”. It was a tiny bottle on sale for $14! It contained various herbs including belladonna, so I presume it was homeopathic. This is a pharmacy affiliated with a major HMO organization, not some chain–at least the stuff was in the clearance bin.

    Ugh.

    1. Kasey Chang says:

      Dr. Sears? Is that the guy on “The Doctors”?

      I always thought Belladonna was poisonous… :)

      1. Young CC Prof says:

        It is. It’s also a popular ingredient in homeopathic remedies for children. I sincerely hope they are all properly diluted down to one molecule per bottle or less.

        1. Thor says:

          Don’t mean to alarm you, but at the lower potencies more often used for acute symptoms, there could actually be one molecule of substance for every 1,000,000 of solution. Or if you really want a low potency 1:10,000.
          Sounds dangerous. (And weird that the higher the dilution the more potent it is.)

      2. Elizabeth says:

        Holy shit, not being a naturopath myself, I only buy medicines that are FDA approved or uhhh prescribed…
        I had never heard of Belladonna. I am neither a chemist, scientist or doctor of any sort. I am just a regular mom. I looked it up and read on it after seeing it here and was like “WHAT IN THE FUUU??” People give their kids this stuff?

        SMH.

        I am kind of stupid compared to everyone here so all I do is lurk and cheer on the smart people. Sorry for interruption. This is completely bizarre to me.

        1. WilliamLawrenceUtridge says:

          It is homeopathic belladonna, which is to say – there’s no actual belladonna n it. So while your concern might be about someone poisoning their children, this is extremely unlikely – the manufacturer would have to produce exactly not a homeopathic product to do so. Of course, since there is no testing of the products, since you can’t differentiate between a homeopathic preparation and a simple lactose ball, the whole thing seems rather moot.

          Elizabeth, if you are really interested in homeopathic products, I recommend Jay Shelton’s Homeopathy: How it really works. A very good book, quite readable, and lays out just how stupid they are.

  2. tw says:

    Having had sinus surgery after years of misdiagnosis (most symptoms a byproduct of structural nose and sinus issues) by Dr.s and thousands in drugs to address the symptoms like: acid reflux, asthma symptoms, a number of different infections.

    These virtually disappeared after surgery…..when some science based medicine was actually applied. Part of this was clearly due to an improvement in immune function due to the relief of constant assault provided by the surgical procedure.

    I endorse the scientific approach, but it would be nice if practitioners were a little more thorough in their investigation at times.

    The biggest impact on seasonal allergies for me: dropping wheat. Although it is unscientific, it is the cheapest, non invasive, no downside thing to try.

    I fully endorse nasal rinsing which is used extensively after sinus surgery, and seems to be effective when you find your sinuses infected, although a trip to the Dr, who has a track record of science based medicine, for some antibiotics may also be advisable in this instance.

    1. WilliamLawrenceUtridge says:

      The biggest impact on seasonal allergies for me: dropping wheat. Although it is unscientific, it is the cheapest, non invasive, no downside thing to try.

      I beg to differ. Breads, pastries, cakes, muffins, cookies, these are all delicious. My life would be materially worse for their absence.

      1. stanmrak says:

        It’s amazing how many people with multiple chronic health complaints feel significantly better when they stop eating wheat entirely. Why wait until science “proves” that wheat is bad for you? You can find out for yourself.
        Wheat is especially hard to give up, tho; it has relatively high concentrations of known addictive properties.
        Wheat contains the following opioid peptides, known as gluten exorphins, alongside which are listed their amino acid structure:
        Gluten exorphin A5: H-Gly-Tyr-Tyr-Pro-Thr-OH
        Gluten exorphin B4: H-Tyr-Gly-Gly-Trp-OH
        Gluten exorphin B5: H-Tyr-Gly-Gly-Trp-Leu-OH
        Gluten exorphin C: H-Tyr-Pro-Ile-Ser-Leu-OH
        Gliadorphin: Tyr-Pro-Gln-Pro-Gln-Pro-Phe

        http://www.greenmedinfo.com/blog/do-hidden-opiates-our-food-explain-food-addictions

        1. Fergus says:

          You obviously missed the point of the whole article…a plea to ignore quackery. You know nothing, absolutely nothing, about the effects of those compounds you listed, they have been in wheat for thousands of years and we did ok eating it. What nonsense. As for putting the word “proves” in inverted commas, you have “proven” you’re the type of gullible idiot these fraudsters thrive on.

          1. WilliamLawrenceUtridge says:

            Not just “thrive on”, Stan is a participant, an active seller of anti-aging quackery! He thinks unprocessed foods and supplements can prevent all degenerative diseases, and by proxy that highly-penetrative genes don’t exist, and that people in the past didn’t ever get sick, obese, become diabetic, develop arthritis, etc. And in many cases this is true, because they died of infectious disease, malnutrition, spear through the belly, etc.

            He’s also got a lot of experience in marketing, which explains his emphasis on the form of the message over its accuracy, quality and truthfulness.

        2. WilliamLawrenceUtridge says:

          It’s amazing how many people with multiple chronic health complaints feel significantly better when they stop eating wheat entirely.

          What’s amazing is how there is little to no scientific evidence that this actually happens in the absence of frank allergy. If this is true, why doesn’t it show up in controlled trials?

          Please commence handwaving and conspiracy theories. IT’S BIG WHEAT MAN, THEY’VE GOT YOU BY THE PANCREAS AND YOU DON’T EVEN KNOW IT!!!!!

          What’s amazing is what it takes to convince you.

          Why wait until science “proves” that wheat is bad for you?

          1) It may never “prove” it

          2) Wheat is a valuable source of macronutrients for large portions of the world that would otherwise be underfed

          3) Whole wheat is a valuable source of nutrients for the parts of the world that do get enough macronutrients

          4) Wheat is an incredibly flexible food that can be used to produce a vast variety of food products, most of which are delicious – bread, breading, muffins, cakes, cookies, gravy, pasta, etc.

          Somehow, despite eating all of these without any real thought, I manage to a) not be addicted (I will go whole weeks without eating any wheat because my meals for the week don’t include any) and b) not be fat (my BMI registers as obese, mostly because much of it is muscle and bone from all the exercise; when I put on weight every year at Christmas, it gradually drops off without any real thought or effort over the course of months).

          Question – in your world, does the stomach not break proteins down into amino acids?

          Why limit a tremendous source of gustatory pleasure merely so some quack can sell you diet books, or some organic food processor can sell you unpalatable gluten-free products?

        3. Thor says:

          It’s even more amazing that so many people with chronic multiple health problems don’t improve their condition by abstaining from eating wheat. You’re right, anyone can easily find out for themselves. But, it must be determined by isolating the wheat because what gets completely overlooked is that the touted benefits of not eating wheat has more to do with ingestion of the final product containing wheat, not the wheat per se., namely, sugar and fats, ie. high-density caloric foods. Who wouldn’t feel better eating a bit less cookies, pancakes, muffins (these can contain 700 calories, a full third of daily allotment—check out the calorie counts on Starbucks muffins, for example), cakes, etc?

          So simple-minded to choose a food substance like wheat as one of the root
          causes for (most) disease or health issues. CAM excels in this kind of thinking—boiling down complex biochemical issues into a nice and easy simpleton answer.

          And that’s certainly not to discount the very real phenomenon of food allergy or autoimmune disease, but these are rare, indeed. The gluten-free craze is strictly for the worried-well.

          1. stanmrak says:

            The responses to my suggestion reflect everything that’s wrong about so-called ‘science-based medicine.’ Apparently, it doesn’t matter how many people improve their health dramatically by abstaining from wheat, it couldn’t possibly work because there aren’t any studies that prove it! And no true science-minded thinker is even going to try something that isn’t proven by science.

            Just because we’ve been eating wheat for thousands of years doesn’t mean it’s safe. Thousands of years only reflect a tiny percentage of the time man has been in existence. In addition, modern wheat bears no resemblance to wheat of just 60 years ago.

            We’ve also been eating sugar for a long time. Ok, go ahead, defend sugar.

            1. windriven says:

              Stan, you can’t be as big a nitwit as you pretend. If you feel better by not eating wheat there isn’t anyone here who is going to force you to eat it. But when you suggest that others eschew wheat, a common dietary grain in many cultures for millennia, without meaningful evidence to support your claims, you are indulging in blatant quackery. Drink acai juice, have coffee colonics, have IV H2O2 infusions – all these claims have proponents just as eager as you. But that doesn’t make them useful therapies.

            2. Thor says:

              Who said anything about studies? Your whole reply is as if you didn’t even read my comment. It’s so off the mark.

              One can reliably bank on your knee-jerk reactions, though, repeating like a tape loop.
              “Science-based medicine BAD. Me know better than science.
              ME always right”.

            3. MadisonMD says:

              Just because we’ve been eating wheat for thousands of years doesn’t mean it’s safe.

              Well we’re not extinct. Anyway, Stan reminds me of the lifestyle nutritionists.

            4. WilliamLawrenceUtridge says:

              Apparently, it doesn’t matter how many people improve their health dramatically by abstaining from wheat, it couldn’t possibly work because there aren’t any studies that prove it!

              No, what matters is that there is no proof to ascribe improvements to gluten, rather than say, weight loss by avoiding high calorie foods, or dedication to a new and healthier lifestyle. I concede that gluten might explain it, but you can’t know it explains their health improvements (assuming they exist, and aren’t merely re-interpretations of what they feel anyway).

              Just because we’ve been eating wheat for thousands of years doesn’t mean it’s safe. Thousands of years only reflect a tiny percentage of the time man has been in existence. In addition, modern wheat bears no resemblance to wheat of just 60 years ago

              Most circulating infectious diseases can have dramatic effects in mere centuries. For instance, all descendants of the original Native Americans are genotypically and immunologically different from their ancestors. Regarding food, the gene for prolonged lactose tolerance evolved in several locations independently and spread in a very short time to dominate much of the population. Incidentally, have you heard about what’s happening to elephant tusks? They’re getting shorter, within the lifespan of individual humans.

              Evolution isn’t always slow.

              Further, wheat is still fundamentally food. Want to see an addictive drug? Opium can be eaten to produce euphoria. Do you get a high when you eat wheat? If you’re not sure, have some opium. If that’s what you feel like when you eat a slice of bread – yes, wheat is addictive and euphoric.

              We’ve also been eating sugar for a long time. Ok, go ahead, defend sugar.

              What do brains run on?

              Sugar is omnipresent in pretty much all foods. It’s found in large amounts, both simple and complex, in many grains, fruits and vegetables. Without some sugar, we die. Our bodies are designed to crave sugar because it is a concentrated source of calories. Current economics have allowed us to easily access large volumes of sugar cheaply, which means people are less likely to starve to death but more likely to become obese.

              So…what exactly am I defending? Consuming massive amounts of refined sugar is a good thing? It’s not. Nobody thinks that. So why do you bring it up?

              1. Dr Robert Peers MBBS [UniMelb] says:

                SNAP! At last, William and I agree on something. He is RIGHT ON THE NAIL with his proposal that weight loss etc., seen on low-gluten diets is better explained by other dietary changes like calorie reduction.

                My late father used to grow 1000s of tons of the Golden Grain–high-protein bread wheat, rich in gluten. I was born in Pinnaroo, South Australia–settled in 1910 by pioneering WHEAT farmers [many of them German].

                Only 20 years before my birth, in a district dubbed The Land of Promise, bagged wheat was still being carted on wagons drawn by Clydesdale horses, to the Pinnaroo rail yards, and stored in huge wheat stacks–right opposite the Golden Grain Hotel, with its large stables and regular horse markets.

                I worked in my home town, 20 minutes away, in 1972-73, as a solo doc, and often stayed up late stargazing [very clear, black skies]. Often, the smoke from the wood-fired bakery oven would obscure my view of rising stars to the East, so I would stroll down the sandy back lane to chat to the baker, who drilled me on the art of baking.

                One day, he brought out some GLUTEN powder, which he added, sometimes, to make the bread more stretchy. He wet it and showed me how it became stretchy.

                I did a bread run for him, once, 40 miles down the line, with hi-top loaves, sandwich loaves, viennas and finger buns stacked all over the seats and back shelf of his big red Ford Falcon GT V8.

                He took me to Adelaide one time, to buy flour at Charlick’s big flour mill–where a friendly guy showed us all over the place, explaining the milling process. He gave us some freshly milled wheat bran–still warm off the rollers.

                I get email news letters from our Grains and Legumes Nutrition Council–the latest has a report on GLOBAL WHEAT BASHING, with a link to cereal expert Dr Jill [or Jennie] JONES. Google J JONES WHEAT BELLY –a complete demolition job on wheat paranoia and gluten-free delusions.

                And guess what? Folks with a sweet tooth may like to consider that the anxiety disorder underling this addiction responds to a glucose isomer–yep, a SUGAR–called myo-inositol, found in WHEAT!!!!

                While you are on Google, check our MURTOASTICKSHED–the largest rustic-built structure in the world, in Western Victoria–longer than most cathedrals, held up by 560 Mountain Ash poles. Used to hold 200, 000 tons of wheat.

                I am hoping to establish in this small town a National Centre for Grains and Health, that will hold health festivals and conferences in the shed. First theme will be BIG SHED–BIG IDEA. Olives and legumes are grown in the vicinity–and premium malting barley, and even wine grapes and champagne–we’re gonna have us one good menu!

                WHEAT BELLY and GRAIN BRAIN cranks are welcome to come along, to sample the local produce, and to get their minds right.

        4. Andrés says:

          First, a personal disclosure. I only eat/drink gluten containing items occasionally. My father and my daughters still eat bread, pasta and biscuits. For me the big impact of gluten avoidance is the great appetite control it gives to us (my other half and me). I still eat white potatoes and white rice. I suffered adult acne well into my 40s but since I did a lot of changes at the same time I have no idea what drove its demise.

          I have only located one random control trial on wheat avoidance and it was conducted on irritable bowel syndrome patients with positive results. I am not aware of any RCT on allergies, osteoarthritis or anything else.

          I am perfectly aware that Dr. Davis has first arrived to the conclusion driven by his clinical practice and afterwards he searched for confirming evidence. It seems that he didn’t do it so well.

          It seems logical to wait for RCTs to be conducted before exposing oneself to some potentially dangerous intervention. Gluten avoidance is certainly not one of them, though. With help of somebody else it even could be checked with a blinded gluten/placebo challenge. Gluten can be perfectly isolated. No external RCT needed.

          As for the digestion of proteins, it seems that proline and glutamine may give us problems to reach the amino acid level in the gluten case (via Julianne Taylor.

          So count me quack on this (giving a chance to wheat avoidance without waiting for any added evidence) too.

          1. WilliamLawrenceUtridge says:

            I’ll fight you tooth and nail for nearly everything you say, but I give you mad props for this statement:

            I suffered adult acne well into my 40s but since I did a lot of changes at the same time I have no idea what drove its demise.

            —-

            So count me quack on this (giving a chance to wheat avoidance without waiting for any added evidence) too.

            Meh, you’re far more of a quack for your vitamin fetish. I mean, you say you’re primarily avoiding gluten for reasons of appetite control, and that’s reasonable. And I doubt you’re all self-righteous about it.

          2. MadisonMD says:

            Yeh, Andres is a fairly reasonable voice…. but the vitafetishes, oh my.

            I liked this:

            I am perfectly aware that Dr. Davis has first arrived to the conclusion driven by his clinical practice and afterwards he searched for confirming evidence.

            It shows that Andres is quite aware of the danger of making a conclusion first and then looking for confirmation.

            Anyway, Andres. Please stay. It is nice to have a dissenting voice that actually is reasonable and provides citations. Makes me think.

            1. WilliamLawrenceUtridge says:

              Agreed.

        5. Angora Rabbit says:

          Stan, only the first and last sequences are wheat sequences. A simple Blast search reveals that none of these have the slightest homology to human peptides, let alone an opioid or anything remotely neuroactive.

          Your tin hat has sprung a leak.

          1. WilliamLawrenceUtridge says:

            Well foil hats never were the most durable of head coverings.

  3. Jann Bellamy says:

    This post really hits home for me. My son has life-long allergies and asthma, which are pretty well-controlled by prescription medications. Do we both wish he didn’t have to take them? Of course. But he does if he doesn’t want to be constantly sniffing and sneezing, or, with asthma, worse. Surgery to repair a severely deviated septum also helped relieve his allergy symptoms. I feel so sorry for the children of parents who follow the advice of naturopaths in treating their allergies and asthma. (I looked at some of their recommended treatments for asthma too: It consists of the same sort of “load up on supplements,” food “sensitivities,” etc. advice. It also suggested – falsely – a connection between asthma and various vaccinations.) These children must suffer terribly for lack of effective treatment. I would think that naturopathic management of allergies would actually increase the cost of care, as not only is the parent paying for ineffective treatment, but also for the complications that can arise when allergies are left untreated. And I don’t even want to imagine the untreated asthma. It is incomprehensible to me that someone who wants to call himself, or herself, a “primary care physician” could watch the suffering of these patients and not question his actions. To me, it is immoral.

    Yet naturopathy may be coming soon to yet another state in the U.S. The Maryland House just passed a naturopathic licensing bill and the bill is now before the Senate.
    http://mgaleg.maryland.gov/2014RS/bills/hb/hb0402t.pdf Fortunately, if it passes in its current form, naturopaths will be under the jurisdiction of the medical board, must have a collaborative relationship with a physician, won’t be able to use colonic irrigation, can’t do office procedures, and won’t be able to shoot their patients up with IV vitamin “cocktails.” In other words, their practices would be a far cry from the “primary care physicians” they claim to be. Still, it is bad enough to allow them to practice at all.

    1. Thor says:

      And let’s not forget the costs. A local MD turned naturopath charges $500 for the initial session. Then, add on the invariable long list of supplements prescribed and on offer, of course, at the in-house pharmacy, which oftentimes needs to be replenished. This easily adds on hundreds of more dollars. Then, there’s the requisite battery of tests ordered (none from a conventional lab, of course), which can add on several hundred more. Then factor in follow-up visits. The final tally on a visit to a naturopath is skyrocket high! Nature is very expensive. And insurance usually pays for none of this. In this light, naturopathy is for the well to do only. And many times for the worried well to do.

    2. Thor says:

      My comment was placed wrong (as usual): it was a general comment on the post, not a reply to you, Jann.

    3. Hal says:

      I had no idea this was up in Maryland. I just sent off a quick note to my local state Senator, but since she’s one of the bill’s cosponsors, I’m doubtful it will do any good. The House bill passed unanimously; not a positive sign.

  4. Greg says:

    As a child I had bad hayfever, which resulted in pink-eye a few times. My parents took me to an allergist for a number of years – shots didn’t seem to help much. I found that as I have gotten older the symptoms are much less severe, however I never take anything for them. I don’t believe allergy testing is all that accurate – at least not for me – I was supposedly very allergic to chocolate, but it has never had any effect on me – I eat dark chocolate every day. I was diagnosed with several other food allergies but just ignored the diagnosis. Only pollen seems to bother me, particularly ragweed. I guess one of the reasons I avoided using any meds for allergies was I did not want to become dependent on them. A childhood friend used nasal spray a lot and he seemed to be almost addicted to the stuff. Economics was another factor – my parents couldn’t afford OTC meds for my hayfever, nor were they ever recommended by our family physician or allergist.

    1. Young CC Prof says:

      Afrin (a decongestant nose spray) can cause dependency and rebound symptoms. The steroid nasal sprays are used once per day and do not cause dependency.

      Allergy blood tests are, well, kinda accurate. About half of positive test results are false positives. They are good for narrowing down possibilities when someone is experiencing food allergies and can’t identify the cause, especially if a history of anaphylaxis makes trial-and-error too dangerous, but positive results need to be confirmed with a direct challenge.

  5. Echinacea, etc., are not members of the ragweed family — they are members of a family to which ragweed also belongs, Asteraceae. Along with the asters, chrysanthemums, black-eyed susans, and many other plants. I believe it overstates the case to make it sound like ragweed is the parent, rather than a sibling, in the family.

    But otherwise — great article.

  6. MTDoc says:

    Can’t help getting a kick out of the liver cleansing concept. Sort of like changing the oil filter on your car. Would love to sit in on a physiology class at one of these ND “colleges”. As for “cortisol” being responsible for allergic symptoms, it has never occurred to them that we use steroids to treat serious allergic reactions? Where is Flexner when you need him.

    1. Kasey Chang says:

      No, MT Doc… it’s “flush out the oil filter”, not changing the oil filter…

      Really reminds me of the Click and Clack (Cartalk) advice about the “mud chiggers” (real episode)

      http://www.cartalk.com/content/1202-mud-chiggers-fuel-line

      1. MTDocw says:

        Late reply. Took me a while to navigate the site, being old and senile. However, thanks for the link, I always loved those guys and lost track of them when we moved into an an area without NPR coverage. For us its either trees or radio, and we did find a spot for a satellite antenna. Only problem now its 95 cents to listen to an old episode, but I know the guys need it to maintain their boats and ex-wives. Thanks again for the link.

        1. windriven says:

          @MTDoc

          “Only problem now its 95 cents to listen to an old episode, but I know the guys need it to maintain their boats and ex-wives.”

          All the episodes are available as podcasts – free for nuthin’. I am rarely at a radio on weekend mornings when my local NPR station broadcasts Car Talk, but I listen on an iPod when I’m riding my stationary bike (when the weather is nasty I still ride an aging AirDyne and swear it’s the best thing since sliced bread).

    2. Preston Garrison says:

      “has never occurred to them that we use steroids to treat serious allergic reactions?”

      Exactly my thought. It’s incredible that they remain ignorant of the fact that their ideas are completely backwards. I spent 2 years in med school back in the ’70s before going off to get a Ph.D. in Biochem. My recollection is that every other day we were hearing about using steroids to turn down down immune responses, and I had occasion years later ,when I had a really severe attack of allergies to find out just how potent a cortisol shot can be. Turned the attack off like a switch.

    3. Dr Robert Peers MBBS [UniMelb] says:

      Hi MT Doc,

      Flexner never knew this: cortisol is TRICKY. A big sudden treatment dose is strongly anti-inflammatory. And so is the prompt cortisol response to a serious infection, that comes from inflammatory cytokines reaching the hypothalamus, and activating the HPA stress axis.

      What the body is not ready for, however, in Anxiety Disorder, in which chronic cortisol overactivity may actually PROMOTE inflammation: and it’s a weird mechanism.

      Fatty maternal diets cause offspring anxiety [S Bilbo; E Sullivan], and the associated CRF and cortisol hyper activate the key enzyme GSK3beta. And this, in turn–sayeth Richard Jope in Alabama–promotes immune cell interleukin-6 secretion, that is a key driver of T helper 17 cells [which are apparently very pro-inflammatory].

      The effect may be small, but it is a potential cause of lifelong low-grade tissue inflammation in anxious folks [a third of Americans--K Merikangas].

      Stacy Bilbo saw the same thing in mouse pups from fat-fed moms–anxiety, plus hair-trigger proneness to aggravated inflammation.

      In addition, Sheldon Cohen [stress man in Pittsburgh] claims that long-term “stress” can lead to cortisol RESISTANCE, that would independently cause inflammation. Inflammation scientist John Marwick, in Scotland, sees similar resistance developing to inhaled steroids in progressive asthma.

      Finally, Ronald Glaser–another stress man–has found that stress aggravates allergy. Many years ago, a Yale professor commented “Shyness and asthma are on the same chromosome;”

      Except there is no evidence that anxiety is inherited [latest GWA studies]. So cortisol–long term, low level–in anxiety may promote a predisposing inflammatory state that aggravates allergic inflammation; it may lose any anti-inflammatory effect if corticosteroid receptor resistance develops; the chronic inflammation and tissue-wasting effects appear to weaken mucosal integrity [letting allergens penetrate]; and the other stress hormone, noradrenaline, is known to activate T helper 2 lymphocytes, that promote allergy via interleukins 4 and 5.

      Reversing anxiety with my much-maligned serotonin 2A receptor blocker, myo-inositol, corrects stress axis activation [and sympathetic activation], and I have seen promising allergy reduction in a few test cases with anxiety plus hay fever, or plus allergic asthma.

      The big rise in childhood allergies in the last 20 years may well be due to more young moms eating more fat [my guess] in pregnancy–chocolate, ice-cream, butter, bakery fat, and chicken that is far fattier than years ago. Prof Susan Prescott, in Perth, is interested in this explanation, and may do a study.

  7. Kasey Chang says:

    It seems “naturopath” is basically “non-medical-path”, isn’t it? None of their advice refers to medicine even though medicine would have provided proven relief of allergy symptoms (albeit with some side effects).

    In a certain way, it’s a bit like a self-sealing conspiracy… Any evidence you give against it is turned into some sort of evidence for “big pharma”, and any evidence you gave for “Big Pharma” is dismissed with “it’s Big Pharma and not natural”.

  8. jag says:

    Naturopathy: Tilting at windmills with the lance of nonsense from the back of a hobby horse.

  9. Kathy says:

    “A liver-focused cleanse before the start of your allergy season … then a second cleanse mid-summer”
    “If you haven’t already had a food intolerance test, please ask about one.”
    “Purchase a neti pot or a saline nasal spray”
    “Find methods to lower your stress such as: yoga, exercise, breathing exercises, guided imagery or meditation … certain supplements can help to lower cortisol”
    “please ask about a ‘yeast-cleanse’ ”
    “If you are still getting allergies, even after these recommendations … vitamin C, quercitin, various herbal combinations, homeopathic nasal sprays and specific homeopathic remedies.”

    After all these recommendations, if you are still solvent, you might try some plain old anti-histamines. But that may not be necessary as it will likely be winter again by then.

    I guess what caught my attention most in this article, was the cool statement in the last recommendation, “If you are still getting allergies, even after these recommendations …” What brass-faced cheek!

  10. Frederick says:

    “Toronto is home to one of the handful of naturopathy schools in North America, so there are a lot of naturopaths in Toronto”

    It’s like Here In my town of Trois-Rivières, We have the Only Chiropractic university campus in Quebec. (it is at the “université du Québec a Trois-rivieres) When they built it, it was the only university that accepted them. A small town, smaller university, they needed the money i guess. Funny thing now it that the Université de Montréal now have a Medicine Campus now the associated with the UQTR. So there is a lot of Chiropractors , I even know one.
    We even have a Vet who do Acupunture for animal and homeopathy! THAT’S cruel, choose some crappy non-working stuff for yourself fine. But the put you pets at risk, you enforce you belief of them. Seriously it is criminal. Science-base Vet-medicine FTW :-).

    1. WilliamLawrenceUtridge says:

      Somewhere out there is a presentation for “horse acupuncture” including a needling point for the gallbladder (or some other organ). The amusing thing being, horses don’t actually have said organ.

    2. CHotel says:

      I’ve always meant to ask you where in Quebec you’re from, but every time I wrote it it seemed borderline creepy to ask a stranger where he lives just because he’s a fellow Canadian.

      I’m a little jealous, I’ve heard it’s a beautiful city. Plus you’re only like a half hour drive away from watching a Cataractes game in Shawinigan. Even if they did suck this year.

  11. mjkbk says:

    I’ve been noticing that naturopaths these days are bragging about their “clairvoyant training” at psychic “institutes”. Is this so that patients don’t have to describe their symptoms–the naturopath simply uses ESP to divine them?

    My local pharmacy chain has been phasing out some of its supplies of actual, efficacious OTC drugs in favor of homeopathic remedies. I’ve seen the same thing happening at places like Costco. What is the MATTER with these people?

    Whacko, science-illiterate customers shouldn’t be able to drive the retail reduction of proven remedies, preventing those of us who are SANE from buying reasonable treatments.

  12. G. Vazquez MD says:

    After reading the past two posts on Science based Medicine . I am more certain than ever that the blame for the propagation of CAM therapies lies squarely on the shoulder of allopathic pharmacists and physicians.
    The evidence is there. I myself am a member of The American Academy of Pediatrics. The academy knows about decreasing immunization rates in the US and the rise of pertussis and measles. I can’t imagine that they are not aware that the same groups of patients that use CAM modalities are the same group that distrusts pharmaceutical companies and the products that they produce. Among those products are vaccines.
    You would think that in the face of decreasing immunization rates the AAP would make an effort to combat pseudo science and increase public trust in evidence based medicine, but you would be wrong. Instead they have opted to embrace CAM modalities and were seriously contemplating a fellowship in CAM.
    Then there are the many hospitals and even university centers that have jumped on the greed bandwagon and offer CAM therapies to patients.
    If the majority of allopathic pharmacists, physicians and hospitals can’t get together and offer a complete repudiation of pseudoscience how can we expect the American people to trust us with their healthcare. I think it needs to be spelled out: CAM therapies do not work; those who offer them are doing it for profit.

    1. windriven says:

      Well said, doctor. I couldn’t agree more. There has been a shocking abrogation of the physician-patient contract by some of the foremost organizations and institutions best-suited to protect that relationship. It is, in my opinion, nothing less than scandalous. It would seem that a misplaced sense of collegiality prevents many otherwise thoughtful physicians from objecting.

    2. Sawyer says:

      Thanks for the input Dr. Vasquez. What I find truly bizarre is that so many supposedly scientific literate doctors are still clinging to the middle ground approach with CAM. This strategy has completely backfired on every level, and yet somehow if we are even more friendly to crackpots they will go away? Not surprisingly, all those university departments looking into CAM are going to be a lot harder to dissolve than they were to create, especially with support from enthusiastic consumers.

      Hope you’ll stick around.

      1. Dr Robert Peers MBBS [UniMelb] says:

        The Mouth from The South–that’s me!!–says DownUnderLand is far ahead of the US, in ridding this scourge from our universities. Emeritus Prof John Dwyer has set up Friends of Science in Medicine [find the web site], and has ALREADY launched a blitzkrieg attack on errant Deans, demanding the removal of WOO courses all over the country. One Dean confessed that they needed the money [from teaching WOO], and there was a big demand for WOO courses, etc., but he quickly gave in when Dwyer kept the heat on.

        We still have some serious fountains of WOO to dry up–see our National Institute of Integrative Medicine [Prof Avni Sali], and the Australian College of Nutritional and Environmental Medicine [ACNEM]. Last year, I called the President of the Royal Aust. College of General Practitioners, Dr Liz Marles, to warn her not to let ACNEM infiltrate their training course and continuing education/credit points set-up. She was already aware of the threat, and promised to reject anything that had no evidence base. Hooray.

        Any GP can be caring, take time with patients etc., and satisfy the public’s demand for NEW STUFF, without jumping the fence into idiocy–like the confused rural doc from Idaho, now spreading BIG WOO at U of Wisconsin’s Family Medicine Dept, in beautiful downtown Madison [the home of major nutritional discoveries many years ago, by the way].

        My own strategy, to fight the WOO tide, and enhance family practice, is to persuade our GP College to push an aggressive Mediterranean diet, for prevention and therapy of chronic disease: EVERY DOCTOR A DIETITIAN.

        I wear the two hats myself–Medicine and Nutrition–have done so for 25 years, and my patients love it, and spread the word.

        I also hope to start my own Australian College of Health Practitioners, to train ex-nurses, mental health nurses, and intelligent community-minded recruits, in scientific diet for disease prevention and health enhancement etc.. I have rural roots, and was once a solo “bush doctor”–in my own home town, in the wheat-belt–so my first priority is to set up an Institute of Health in each regional town and city, staffed by locally-recruited and trained “HPs”.

        GP numbers are falling in regional Australia, so these HPs can fill the vacuum, and do a power of preventive good, both independently, and in co-operation with the remaining GPs and government sickness services. If we get the results that I expect, I will send a report to Dr Andrew Weil, saying IF YOU WANT TO BE NICE TO YOUR PATIENTS, AND REFORM THE HEALTH CARE SYSTEM TOO, DROP THE WOO AND DO IT PROPERLY.

  13. JR says:

    Slightly OT comment, but maybe not really: I have, over the last few years, been having the “amazing” and almost unique experience, in the Western World, of watcing someone die from untreated Type 2 diabetes. Why? Because he refuses, absolutely refuses, any “allopathic” remedies or to visit an allopathic doctor and instead relies entirely on herbal “remedies”, naturopathy, supplements, homeopathy, etc. He has spent up to and beyond $500 a month on these remedies and deluded himself into believing – as they promise – he is reversing not only his diabetes and the internal damage it has now done to him, but that he is actually growing younger and will live to be at least 150 years old. He calls me and everyone who visits a real doctor a “deluded sheep”. He is obsessed with the idea that his food is full of oxalates and carbs, so he eats almost nothing.
    He can barely walk due to severe neuropathy and looks 30 years older than his age. He is almost completely incontinent, falls down frequently, and cannot get up without assistance. He feet swell and have sores that don’t heal. He refuses ambulance help if one is called after a public fall and injury and he is coherent enough that paramedics have to let him sign an AMA and go away again. So there seems no way to fix this. I assume he is going to die and am in fact amazed he has lasted this long. What amazes and maddens me most is that people still listen to him preach online about vitamins and nutrition even though he is fairly honest about his health issues, down to disgusting, stomach-turning detail.
    I don’t know how to talk to him. I think there is no way to talk to him. He asks for money to buy more supplements because he is too poor to work now and I refuse because I won’t give one penny to him to be funneled toward these charlatans. And if I try talking about this to his friends – who are still sending him supplements! – they just politely change the subject, like I’m the crazy one.

    1. WilliamLawrenceUtridge says:

      Have you heard of whatstheharm.net?

      I’m not sure what the requirements are to submit a case, possibly an existing news article that can be linked to. If that’s the case, depending on where you live, you might try contacting the press or a health/science reporter as a human interest story.

  14. David Dressler, BA, RMT says:

    This is the first time I have been to this “place” and am impressed at the sneering bias I see here. In my response, I am not going to argue the case for the naturopath, homeopath, massage therapist, or other so-called alternative practitioner. Rather, I am going to state the facts about conventional medicine. True believers may be shocked. I will also cite my primary reference although I can provide numerous others. Here goes:

    My thesis is that conventional medicine is only 10-15% proven to do more good than harm. That means 85-90% of medical procedures (drugs and surgery) is of unknown safety and efficacy.

    This statement, word for word, comes from the “father” of evidence-based medicine (EBM), Dr. Kerr White, speaking to me from the bedside of his dying wife in 1999 when I called him during an investigative report I was doing on a British Columbia medical group.

    For the record, Dr. White was the teacher of Dr. Archie Cochrane of the now famous Cochrane Collaboration.

    I asked Dr. White what conventional medicine was based on prior to the mid-1960s when EBM started. “Opinion”, he said. Shocked, I asked him what it was based on in 1999. “Opinion”, he repeated.

    To check on his statement, I researched the efficacy and safety of medicine as found in several countries and the results were closely similar to Dr. White’s 10-15%.

    At that time, in 1999, the British Columbia College of Physicians and Surgeons and British Columbia Medical Association were telling their doctors not to refer to “alternative therapies” because, they said, they did not have evidence for their safety and efficacy and that only conventional medicine did. According to Dr. White, the originator of EBM, this statement about medicine was patently false.

    In my investigative report, I noted that 110,000 people died every year in the US alone due to “correctly applied” drugs and surgeries, not counting malpractice. The number is rising. Drugs are taken off the market every year because of side effects and deaths. The reasons have to do with side effects and inadequate testing as well as deliberately skewed research intended to generate profit.

    In the year I did my expose I also talked to the Dean of the University of British Columbia School of Medicine. I asked her if graduates were qualified to evaluate research done by either mainstream or alternative medicine. She had one word for an answer: “No.”

    I rest my case.

    1. WilliamLawrenceUtridge says:

      This is the first time I have been to this “place” and am impressed at the sneering bias I see here.

      Well, sneering bias is what we do best.

      In my response, I am not going to argue the case for the naturopath, homeopath, massage therapist, or other so-called alternative practitioner. Rather, I am going to state the facts about conventional medicine. True believers may be shocked. I will also cite my primary reference although I can provide numerous others.

      Why bother? We know that real medicine comes with harms. In most cases those harms are systematically tracked, studied, and practice changes to reflect them. The harms and travails of real medicine say things about real medicine, they are totally unrelated to the harms and travails of pseudomedicine.

      A lot, probably most, CAM promoters, like to wave the “real medicine kills people!!!!” flag quite vigorously as if it justified reiki, homeopathy, acupuncture or whatever their favoured woo. This is stupid for two reasons:
      1) It’s irrelevant to the efficacy of fake medicine; reiki, homeopathy, acupuncture and other types of woo still don’t work (or are at best unproven).
      2) CAM kills people too. It can kill directly, as when someone taking laetrile dies of cyanide poisoning, or when someone’s kidney dies due to Aristolochia consumption (or any other herb with adverse effects) or indirectly when someone tries to treat their cancer through diet rather than surgical excision. This doesn’t excuse real medicine, of course, it just points out that people are hypocrites when they criticize real medicine for causing harm.

      My thesis is that conventional medicine is only 10-15% proven to do more good than harm. That means 85-90% of medical procedures (drugs and surgery) is of unknown safety and efficacy.
      This statement, word for word, comes from the “father” of evidence-based medicine (EBM), Dr. Kerr White, speaking to me from the bedside of his dying wife in 1999 when I called him during an investigative report I was doing on a British Columbia medical group.

      So…that was 15 years ago, while someone watched his spouse die. Did you get his references for this, or do you consider deathbed vigils to be a form of evidence superior to the double-blind randomized controlled trial and meta-analysis? You know…Darwin recanted on his deathbed, as did Pasteur. I guess that means neither evolution nor the germ theory of disease are valid.

      To check on his statement, I researched the efficacy and safety of medicine as found in several countries and the results were closely similar to Dr. White’s 10-15%.

      How amazing! So, did you find, like, a single article discussing all medicine, or did you have to look up a couple JAMA reviews? Have you updated them since 1999?

      In my investigative report, I noted that 110,000 people died every year in the US alone due to “correctly applied” drugs and surgeries, not counting malpractice. The number is rising. Drugs are taken off the market every year because of side effects and deaths. The reasons have to do with side effects and inadequate testing as well as deliberately skewed research intended to generate profit.

      Three points:
      1) How many would die without treatment? Please feel free to extrapolate from “number needed to treat” figures and adverse effects of individual medications.
      2) Don’t you think the fact that drugs are taken off the market every year rather works against your point that drug companies are all-powerful, all-corrupting, and maintain inadequate testing? Don’t you think this is rather evidence that a recognized, important and enshrined part of drug monitoring, postmarketing surveillance, works? I mean, even in well-controlled, independent trials, you’re only talking about a couple thousand, perhaps as much as 10,000 patients. That won’t catch adverse effects that appear in the per-100,000 range. So…should we force Big Pharma to increase the size of their trials until they are so unwieldy that new drugs are simply too expensive to ever produce? Don’t you think that doing this would encourage more greed and lies since the return on investment has to be that much higher?
      3) So…what you appear to be saying is nobody can criticize CAM until medicine is perfect and causes no accidental deaths? That’s an extraordinary bar, are you sure we’re not better off restricting access to cyanide-containing “herbal medicine” now, since there’s no proof it cures cancer but definite proof it kills people?

      In the year I did my expose I also talked to the Dean of the University of British Columbia School of Medicine. I asked her if graduates were qualified to evaluate research done by either mainstream or alternative medicine. She had one word for an answer: “No.”

      Oh. Well then. I suppose the opinion of a single dean of a single institution is enough to proclaim all of medicine not worth it. Let’s go back to herbs, stone needles and child mortality figures in the double-digits then.

      I rest my case.

      That’s great and all, but if you go back to your apparent original conclusion, apparently that CAM shouldn’t be criticized because real medicine isn’t perfect, you’ll find that your case is rather undercut by a severe problem with your main premise – that CAM’s success somehow rests on the flaws of real medicine. CAM treatments are either safe, or not, either work, or don’t, and the failings of real medicine have nothing to do with the safety or efficacy of CAM.

      If your original conclusion was “real medicine is flawed”, congratulations! You are in agreement with tens of thousands of physicians, policy makers, hospital administrators, lawyers, researchers and patients. Thank goodness medicine has an inherent, robust and while imperfect, at least reasonably effective form of self-criticism and self-improvement that is built to ensure ineffective and dangerous practices are dropped, and effective ones are made safer. Of course, this is inherent in your little stories above – since the people you interviewed were all mainstream practitioners. I note that you haven’t identified a single journal article by or interview with a CAM practitioner. If they bother to cite any literature at all – it is usually medicine’s criticism of itself. Sounds like CAM is parasitic on real medicine, and worse – incapable of defining or defending itself on the merit of its own practices.

      1. Sawyer says:

        If your original conclusion was “real medicine is flawed”, congratulations! You are in agreement with tens of thousands of physicians, policy makers, hospital administrators, lawyers, researchers and patients.

        I don’t think I’ll ever get over these Arrogance of Ignorance arguments coming from the pro-CAM / anti-Western medicine crowd. It doesn’t even occur to them that this conversation has already happened literally hundreds of times on this site, and that everyone else has a far better grasp on the problems they are highlighting than they do.

        If David wanted to have an actual debate, maybe he could try proposing an actual solution to the problems he claims to understand so well.

        1. David Dressler, BA, RMT says:

          Sawyer, the first step to a “solution” is to stop doing the problem. If you know something doesn’t work or, worse, creates more problems, then you start with not doing that. “First do no harm.” Surely you are aware of the flawed nature of drug research, flawed because of the need of drug companies to profit. They are not going to stop producing dangerous, unproven drugs. So you can’t ask them to “first do no harm.” Doctors unfortunately are compromised because they get lectures by drug company reps in medical school and medical schools get endowments by drug companies. So, can’t ask the schools to “teach no harm.” Practicing physicians are given a few minutes of prep on the latest drugs by the itinerant drug reps. Not much time to check what they are being told. Can’t be too confident about the doctor’s Rx. “Rx no harm.” A year later the Rx’ed drug is being recalled. Too many adverse incidents. Oops. I call this health scare, not health care.

          As I wrote, medical school graduates (at least at the prestigious University of British Columbia and, I would wager, elsewhere) are not qualified to evaluate medical research, according to the Dean of the UBC Medical School. That means conclusions doctors draw from medical research about the quality of that research, and therefore the conclusions of that same research, may be unreliable. “Trust the doctor”. I don’t think so.

          Is this an argument FOR CAM? Is the 85-90% figure representing the unknown safety and efficacy of conventional medicine as a whole an argument to drop the doc? No. Not for emergencies. For any condition that is not life-threatening? Yes. Why? Because so much of conventional medicine IS life-threatening at worst and ineffective at best.

      2. David Dressler, BA, RMT says:

        In my expose in which I talked with Dr. Kerr White, the acknowledged “father” of evidence-based medicine, I researched investigations into the safety and efficacy in several countries in Europe, US, and Canada. The statistics were very similar, and they were not merely quoting or citing Dr. White’s research.

        In the meantime, if you track the statistics for doctor-caused deaths in America, you will see that, since 1999 (when I wrote my article and cited that statistic), the figure has gone up by thousands more deaths.

        Only yesterday, a neurologist confided to me–in one of the most honest conversations I have ever had with a doctor–that predicting the outcome of any spinal surgery (which was the topic) was pretty much an “educated guess”. He added that medicine is really more of an “art” than a science and there is not good evidence for much of what it does. This is precisely what I and Dr. White are saying.

        I never said my case for CAM is resting on the flaws of medicine. I never said I interviewed CAM practitioners. I specifically said the flaws of medicine are based on the research medicine has done on itself. I specifically said I interviewed or researched medical doctors. I think you can’t read!

    2. Harriet Hall says:

      @David Dressler,

      The 15% figure is wrong. It comes from a a 50-year-old British study that was designed to study a different problem entirely. The majority of what conventional medicine offers is based on good quality evidence. See http://www.veterinarywatch.com/CTiM.htm and
      http://theness.com/neurologicablog/index.php/how-much-modern-medicine-is-evidence-based/

      The “Death by Medicine” gambit is a fallacy. See http://www.sciencebasedmedicine.org/death-by-medicine/

      I agree with you that most medical graduates are not qualified to evaluate research. That’s why so many doctors have adopted questionable CAM treatments and why quackademic medicine is gaining ground. Thank goodness some of us have learned (AFTER medical school) to evaluate research and can differentiate good science from bad. That’s what this blog is all about.

      1. David Dressler, BA, RMT says:

        No, Harriet, that is not where my figure comes from. I said who my source was. This the ORIGINAL source of that statistic. In fact, for your information, that is what is taught in medical school, unfortunately. And, as I also said, I verified that figure across the world in several countries and spanning years. These were independent studies, not retrospective studies.

    3. windriven says:

      “I rest my case.”

      You have missed the point, not by a centimeter but by a kilometer. The point of SBM and of the “sneering bias” you claim, is not to celebrate the perfection of medicine but to advance the practice of medicine a bit closer to perfection each day.

      Medicine is marked by great voids in knowledge and understanding, defaced by hoary practices based on little but inertia, narrowed by the stenosis of tradition. It is only an image of beauty when placed next to the graffiti that is “alternative medicine,” a static melange of fantasies, delusions, and frauds masquereding as profundity.

      Medicine has all of the shortcomings that you mention though we may quibble about the exact percentages. But we know about these shortcomings for the precise reason that medical science is highly self-critical. The labor of medical science is to push back the shroud of darkness and misapprehension little by little, piece by piece, day by day.

      Who do you think comes up with these numbers about practice and evidence? Who do you think examines practice against proof? Do you think this is done by some naturopath in her spare time between colon cleanses?

      Your comment betrays an ignorance, a stupidity even, of astonishing vacuity. If that seems sneering, well, take it as you will.

      1. David Dressler, BA, RMT says:

        Windriven, your prose is poetry. You wax translucent in the shimmer of a brain that reflects its own light and yet obscures the beams of brightness from a not-so-distant star. I applaud your poetic innocence but do not agree with your crackling conclusion that would wound rather than elucidate. Alas, fair one, I bid thee ado!

        1. Windriven says:

          “Alas, fair one, I bid thee ado!”

          Don’t go away mad ;-)

  15. weing says:

    “I asked Dr. White what conventional medicine was based on prior to the mid-1960s when EBM started. “Opinion”, he said.”

    Interesting. He gave you his opinion.

    “In the year I did my expose I also talked to the Dean of the University of British Columbia School of Medicine. I asked her if graduates were qualified to evaluate research done by either mainstream or alternative medicine.”

    Again, you received an opinion. Which, if true, should prompt the graduates to get their money back.

    Therefore, your case is based on “opinion”.

    “In my investigative report, I noted that 110,000 people died every year in the US alone due to “correctly applied” drugs and surgeries, not counting malpractice. The number is rising.”

    Knowing how lousy reporters are, please cite your source.

    Here is my “opinion”. Medicine is not perfect. A lot of what we have has been grandfathered in. I am all for testing and abandoning these practices if evidence doesn’t back them up, just as drugs become abandoned because of new evidence. These practices and drugs then become part of “alternative medicine”.

    1. David Dressler, BA, RMT says:

      Weing, this was not Dr. White’s “opinion.” The figure of 10-15% is in his research. As I also said, I cross-checked his figures in published research in several countries and they were the same or very close in the percentages. The Dean of UBC School of Medicine oversees the curriculum; she knows what the medical students study. She also said that only a graduate who went on to become a PhD in medical research has the knowledge capable of analyzing research. Again, this is not opinion; it is curriculum and acquired knowledge. The 110,000 deaths by doctors per year was not a reporter’s opinion. As I also stated, it is the Fraser Institute. I have read the same or worse figures elsewhere since then, all by research groups. Again, not personal opinion. As for abandoning drugs and them becoming part of alternative medicine, that is certainly false and just nonsense.

      1. AdamG says:

        As I also stated, it is the Fraser Institute.

        The same Fraser Institute that just released the heinous report downplaying obesity in Canada? The one that also released reports funded by tobacco companies claiming little to no risk from secondhand smoke exposure? Color me unimpressed. They’re like the Canadian Cato Institute.

        I have read the same or worse figures elsewhere since then, all by research groups.

        So you’d be happy to cite these sources then, right?

      2. Dave says:

        You’re obviously a newcomer to the site. If you look back even a few weeks you will see all these issues raised and argued innumerable times.

        Any drug that is powerful enough to have an effect will have side effects. Sometimes these will be severe. Any treatment runs the risk of harm. So does the risk of not treating. Doing a risk-benefit analysis before any treatment is a key to medical practice. I quoted a paragraph about this from the first chapter of Harrison’s textbook of internal medicine a few weeks ago. A prime example is the use of thrombolytics for stroke patients. In the proper candidates thrombolytics have a 6.4% chance of causing an intracranial hemorrhage which, if it occurs, has a 50% mortality rate. Patients who do not get tpa have the same mortality as those who do get it, however, as more of them die of the stroke itself. Those patients who get tpa have a better functional status post-stroke, a better chance of returning home and less chance of winding up in a nursing home. So here we have a medication that can prevent some patients from winding up in a nursing home, does not affect total mortality, but is definitely responsible for some deaths. Current standard of care is to have an informed consent with patients who are a candidate for it (there is a long list of exclusion criteria) and to administer it if they want it and agree to the risks. There will be some who wind up in your “killed by medicine” category. Similar risk/benefit analyses take place with every treatment. When I was in medical school in the early 1970′s I was told that the treatment for Hodgkin’s disease or for some potentially curable leukemias would kill 10% of the patients who received it (we now have GCSF and better support methods to get people through chemo which we didn’t have then). Given that the diseases were 100% fatal, very few patients refused the treatment. A Whipples procedure for pancreatic cancer back then had about a 5% chance of cure with a significant ( much higher than 5% )mortality from the surgery itself. Given that the alternative was a 100% chance of dying, the surgery was offerred to those who were candidates. “Number needed to treat” and “number needed to harm” are terms used frequently on this site.

        Anyhow, you can pore through numerous old posts here but your comments are not new and the problems with modern medicine are rehashed frequently on this site. The basic premise to this site is to discuss the evidence for treatments and tests – not just CAM therapies, but things like mammograms, vaccines, statins etc. If you’ve got evidence that a particular mainstream medicine kills more people than the disease it is given for, have at it. We’re all aware of the dangers of therapy, you just have to counterbalance that with the dangers of the condition you’re treating. A quote from one of my professors: “Drastic diseases sometimes require drastic therapies.”

        Also, if you have issues with the validity of a particular study, have at it (but please, not statins, that’s been beaten to death). Wakefield’s report in Lancet on MMR vaccines has been a particular target here.

        1. Windriven says:

          Nicely done.

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