Vaccination is arguably medicine’s greatest success. It has eradicated smallpox and has saved millions from death and suffering from a growing list of preventable diseases. It’s surprising that it has so many critics. Most of them are either not educated in medical science (like Jenny McCarthy) or are educated but prefer to reject science in favor of anecdotal experience (like Jay Gordon). Their arguments have been examined ad nauseum on this blog and elsewhere, and are easy to dismiss. But when I learned that an immunologist had written a book rejecting the whole idea of vaccination, I couldn’t dismiss it so easily. An expert in the field obviously knows more than I do about the relevant science; and if nothing else, she might have some valid criticisms of vaccines that I had overlooked. In 2012 Tetyana Obukhanych, PhD, published a short (53 page) book that is available in a Kindle edition: Vaccine Illusion: How Vaccination Compromises Our Natural Immunity and What We Can Do To Regain Our Health. I read the book hoping to learn something, and I did learn some things, but not anything that would make me question the current vaccine recommendations. I tried valiantly to understand her message; I think I succeeded. I’ll try to summarize what she is saying and explain why I think she got it wrong.
Four weeks ago, I wrote a post in which I explained why wearing a bra does not cause breast cancer. After I had finished the post, it occurred to me that I should have saved that post for now, given that October is Breast Cancer Awareness Month. The reason is that, like clockwork, pretty much every year around this time articles touting various myths about breast cancer will go viral, circulating on social media like Facebook, Twitter, Pinterest, and Tumblr like so many giant spider-microbes on the moon on Saturday. Sometimes, they’re new articles. Sometimes they’re old articles that, like the killer at the end of a slasher film, seem to have died but always come back for another attack, if not immediately, then when the next movie comes out.
So I thought that this October I should take at least a couple of them on, although I can’t guarantee that I’ll stick to the topic of breast cancer myths for the whole month. After all, our “atavistic oncology” crank (you remember him, don’t you?) is agitating in the comments and e-mailing his latest “challenge” to my dean, other universities, and me. It was almost enough for me to put this post on hold for a week and respond to our insistent little friend’s latest “evidence,” but for now I’ll just tell Dr. Frank Arguello, “Be very careful what you ask for. You might just get it.” Maybe next week. Or maybe on my not-so-super-secret other blog. Or maybe never. Because Dr. Arguello has officially begun to bore me.
In the meantime, I’m going to stick with the original plan, at least for now.
So, first up this week is a myth that I can’t believe that I haven’t covered in depth sometime during the nearly seven years of this blog’s existence, other than in passing a couple of times, even though it’s a topic that deserves its own post. I’m referring to the claim that antiperspirants cause breast cancer. I bet you’ve seen articles like this oldie but not so goodie from über-quack Joe Mercola entitled “Are Aluminum-Containing Antiperspirants Contributing To Breast Cancer In Women?” or this older and even moldier article from seven years ago entitled “Why women should avoid using anti-perspirants that could cause breast cancer” or this one from last year entitled “Attention Deodorant Users: New Studies Link Aluminum To Breast Cancer“. Surprisingly, I haven’t found that many from this year yet. (Maybe the Ebola scare is distracting the usual suspects and diverting their efforts.) The same ones, however, keep reappearing every year, and they’re all based on the same sorts of claims and the same studies. So let’s dig in, shall we? (more…)
I receive a monthly newsletter from my medical board. Among other issues discussed are the results of disciplinary actions for physicians. Occasionally a physician who has boundary issues is required to have a chaperone present when doing exams.
I was thinking that the concept of a chaperone could be more widely applicable. Consider “You Docs: Amazing acupuncture,” the latest from Drs Oz and Roizen. Both are professors at their respective institutions. Professors. To judge from the ability to read and interpret the medical literature, both should not be allowed near a journal without a chaperone to remind them about cognitive biases, logical fallacies and what constitutes a good clinical study. Looking at their recent review of acupuncture suggests they lack an understanding of all three.
They start with the argument from antiquity, which is not only wrong as a logical fallacy, it is wrong historically when they say:
acupuncture has been a go-to therapy for 5,000 years.
Off by a factor of about 500. They are unaware that acupuncture as currently practiced is relatively new, having been a form of bloodletting until recently when the modern version with steel needlesbecame popular under Mao.
However, in the early 1930s a Chinese pediatrician by the name of Cheng Dan’an (承淡安, 1899-1957) proposed that needling therapy should be resurrected because its actions could potentially be explained by neurology. He therefore repositioned the points towards nerve pathways and away from blood vessels-where they were previously used for bloodletting.
They explain the mechanism of action as stimulating
points in the body that affect chi or qi, the life energy.
without noting that chi or qi is a fantasy. No life energy has ever been measured and virtually every point on the body is an acupoint in one of the multiplicity of styles that are acupunctures. Except, as mentioned in the past, the genitals.
Yahoo News appears to have confused NaturalNews with actual news. It’s not. NaturalNews is the in-house propaganda organ for Mike Adams, whom I’ll introduce in a minute (although he needs no introduction for most readers here). A couple of recent examples:
A recycled story, over a year old, from NaturalNews, appearing on Yahoo News last week. It starts out as a fairly straightforward report of the Japanese’s governments suspending its recommendation if favor of the HPV vaccine pending further research, although government health officials were still standing by the vaccine’s safety. Actually, Medscape reported that the actual rate was 12.8 serious adverse side effects reported per 1 million doses, a fact not revealed in the NaturalNews story. These effects were correlated with the vaccine; there is no evidence of causation.
After this rather tame start, NaturalNews cranks it up to 11 and beyond, as David Gorski would say. Governments which still recommend HPV vaccinations “remain under the thumb of Merck’s vaccinations spell” even though Merck is “an organization of murderers and thieves.” A scary list of adverse events are described as “side effects of Guardasil” even though causation has not been shown.
Two days ago there was an “ongoing debate”? There is no ongoing debate about “whether or not vaccines cause autism” because there never was any credible evidence that vaccines cause autism and there still isn’t.
In April 2013 President Obama announced the BRAIN initiative – Brain Research through Advancing Innovative Neurotechnologies – committing 100 million dollars to brain research. The goal of this initiative is to accomplish with the brain what the Human Genome Project accomplished with the human genome.
The BRAIN project came after a similar, and larger, initiative in Europe – the European Union’s Human Brain Project (HBP), which was given 1.3 billion dollars in funding. The HBP came under some controversy this summer when neuroscientists complained about how the money was being awarded.
The serious commitment to brain research on both sides of the Atlantic reflects the general recognition that the brain is an important and complex organ (arguably the most complex thing we know about in the universe) and there is tremendous opportunity to reap benefits from new research.
The comparison to the Human Genome Project is quite deliberate. The HGP is generally perceived to have been incredibly successful, the biological equivalent of announcing that we will send people to the moon by the end of the decade, then doing it.
Science is complicated. Simple concepts that appear at first to be obviously true or untrue usually turn out to be more nuanced than we thought. Newtonian physics was taken as “the truth” until we learned in the 20th century that it didn’t apply on cosmological or subatomic scales. Medicine and human physiology are more complicated than most people realize or want to believe. A case in point is the recent realization that vitamin K is not a single chemical compound, but a whole family of them, and that vitamin K2 has unique properties that vitamin K1 lacks.
Recently, there has been some interesting preclinical research on K2 that warrants further study to tease out its implications for human health, diet, and supplementation. There has also been a lot of hype that warrants taking its claims not with a grain but with a large bolus of salt. According to Canadian naturopath Kate Rhéaume-Bleue, author of Vitamin K2 and the Calcium Paradox:
- It could save your life
- It is missing from the modern diet
- It is the most important anti-aging nutrient for fighting wrinkles, Alzheimer’s, heart disease, osteoporosis and more
- It promotes straight, cavity-free teeth
- It is needed to get the benefits from calcium and vitamin D supplements; without it, those nutrients will increase the risk of heart attack and stroke
- It is the only vitamin known to prevent and reverse atherosclerosis
The old adage is still true: if something sounds too good to be true, it probably is. There is only weak evidence behind these strong claims. (more…)
Quackademia update: The Cleveland Clinic, George Washington University, and the continued infiltration of quackery into medical academia
Quackery has been steadily infiltrating academic medicine for at least two decades now in the form of what was once called “complementary and alternative medicine” but is now more commonly referred to as “integrative medicine.” Of course, as I’ve written many times before, what “integrative medicine” really means is the “integration” of quackery with science- and evidence-based medicine, to the detriment of SBM. As my good bud Mark Crislip once put it, “integrating” cow pie with apple pie does not improve the apple pie. Yet that is what’s going on in medical academia these days—with a vengeance. It’s a phenomenon that I like to call quackademic medicine, something that’s fast turning medical academia into medical quackademia. It is not, as its proponents claim, the “best of both worlds.”
In fact, it was my two recent publications bemoaning the infiltration of quackademic medicine into medical academia, one in Nature Reviews Cancer and one with Steve Novella in Trends in Molecular Medicine, that got me thinking again about this phenomenon. Actually, it was more my learning of yet another step deeper into quackademia by a once well-respected academic medical institution, occurring so soon after having just published two articles bemoaning that very tendency, that served as a harsh reminder of just what we’re up against. So I decided to greatly expand a post that I did for my not-so-super-secret other blog recently beyond a focus on just one institution, in order to try to demonstrate for you a bit more how and why quackery has found a comfortable place in medical academia and how, just when I thought things can’t get worse, they do. There is also room for hope in that I also found evidence that our criticisms are at least starting to be noticed. I begin with the sad tale of the Cleveland Clinic Foundation, which has gone one step beyond its previous embrace of traditional Chinese medicine. I’ll then discuss another unfortunate example, after which I’ll look a bit at the pushback and marketing of “integrative” medicine.
nOne of the most common questions I get in the newborn nursery, especially from first time parents, involves hiccups. Babies hiccup in the womb and most, if not all of them, will have periodic bouts of hiccups in the neonatal period. But many new parents are surprised by their baby’s first spasmodic contractions of the diaphragm. When brought up, it is often to simply acknowledge that their baby had a run of a few hiccups, usually associated with a feed, with some parents expressing surprise and others nervousness. Regardless of their assumed motivation, I always provide reassurance that hiccups are a normal experience for babies, as they are across the entire spectrum of age.
The medical term for hiccups, which I admit I only learned while researching this topic, is “singultus.” We doctors like to use our own peculiar language as much as possible in order to maintain a sense of superiority when dealing with today’s internet savvy customers, I mean patients, and their families. The rumbling of your stomach, that’s actually borborygmus. You don’t have a unibrow above your nose, that’s a synophrys. It isn’t abdominal or pelvic discomfort associated with ovulation that keeps annoying you midway through your menstrual cycle, it’s mittelschmerz. But since this is a forum meant for general public consumption, I’ll use the rather pedestrian and philistine “hiccup” for the duration of the post. (more…)
The supplement industry wants you to buy their products, and they’re not above using a little parental guilt to make you into a customer. In the photo above, the promoter is my local pharmacy, where the large window display caught my eye:
Give your Child The Tools to SUCCEED in School!
Who doesn’t want their child to succeed? And if you knew a supplement could give you or your child a learning edge, would you consider it? I’d imagine many do. Supplements have a remarkable health halo. As a pharmacist myself, I’ve noticed this when speaking with patients – few consumers identify any potential risk or downsides to supplement use. Some don’t even think of them as medicine at all. The marketing has resonated: Supplements are perceived as “safe”, “natural” and “effective”. But whether you’re giving your child a prescription medicine to treat attention deficit hyperactivity disorder, or you’re giving a supplement to “improve focus and brain function”, you’re still administering a chemical substance to a child with the intent of changing brain function. We’d probably think twice before pouring an unknown substance in our car’s gas tank, especially one claimed to boost performance. We’d probably ask for some evidence that it works, and some assurance it wouldn’t harm our vehicle. A decision to use a drug or supplement in a child deserves just as much consideration of benefits and risks. (more…)
It looks like we can file this one under “here we go again.” A small town in Colombia, El Carmen de Bolivar, has seen more than 200 girls hospitalized with a mysterious illness since May of this year. The symptoms include dizziness, headaches, and fainting. So far, all of the girls hospitalized have been found to be healthy and were quickly released from the hospital without discovering any specific disease or pathology.
Unfortunately I have to depend on news outlets to provide information about this case, and most are skimpy on details. However, taking what is being reported, the case has all the features of mass psychogenic illness. Specifically, the cases are clustering in a small community, which is typical for typical for episodes of mass delusions. The symptoms being reported are all subjective and the kinds of symptoms that can result entirely from psychological stress. I have seen no reports of objective clinical findings, such as fever, rash, abnormal laboratory findings, strange lesions, or objective findings on exam.
Doctors who have examined the patient feel that the presentation is consistent with psychogenic illness. I have discussed this at length previously. A psychogenic illness results from the physical manifestation of psychological stress. This is always partly a diagnosis of exclusion, meaning that other causes of the presenting symptoms need to be ruled out. However, it is more than just a diagnosis of exclusion, as there are sometimes clinical features that can be positively demonstrated to be psychological rather than physical. The ultimate test of the psychogenic diagnosis is that patients should improve with support and encouragement.