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Naturopathy vs. Science: Allergy Edition

snakeoil

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. (more…)

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

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Medical Conspiracies

Anyone publicly writing about issues of science and medicine from a pro-science perspective likely gets many e-mails similar to the ones I see every week. Here’s just one recent example:

Im sorry the medical community has become decadent and lazy as most that follow your stance could care less to study the real truth. I have also seen it much more deviant as many professionals know the risks and harm vaccination cause but continue to push it through there practices because of pure greed. Many are also scared of loosing there practices for not following the corrupt industry. Im sorry but the medical industry has become drug pushing decadent slobs that only care about there bottom line.

The e-mailer clearly has a particular narrative that he is following (in addition to the amusingly common poor grammar and spelling). He even writes at one point in our exchange, “the details really don’t matter at this point what matters is what the bigger picture…” He is certain of his big picture conspiracy narrative. The details are unimportant.

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Posted in: Science and Medicine

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Nature vs. Technology

For those who dismiss advocates of the “natural” as ignorant of science and deluded by the logical fallacy that natural = best, Nathanael Johnson’s new book is an eye-opener: All Natural: A Skeptic’s Quest to Discover if the Natural Approach to Diet, Childbirth, Healing, and the Environment Really Keeps Us Healthier and Happier. If nothing else, it is a testament to the ability of the human mind to overcome childhood indoctrination in a belief system, to think independently, and to embrace science and reason.

Nathanael Johnson was brought up by hippie parents who subscribed to every “natural” belief and fad. His mother nearly died of a postpartum hemorrhage when he was born at home (he weighed 11 pounds!). His parents didn’t report his birth, and he didn’t have a birth certificate. He co-slept with his parents, never wore diapers (imagine the clean-up!), was allowed to play in the dirt and chew on the snails he found there, was fed a Paleolithic diet, was never allowed any form of sugar, didn’t know there was such a thing as an Oreo cookie, was home-schooled, and did not know that public nudity was taboo until he and his brother shocked the folks at a church picnic by stripping naked to go swimming in the lake. Nudity was customary in his home, and he was encouraged to “let his balls breathe.”

As he grew up, he started to question some of the dogmas he had learned from his parents. He had been taught that good health resulted from forming connections with nature, but he found that nature “generally wanted to eat me.” Now an adult and a journalist, he understands science and how to do research. He tried to read the scientific literature with an unbiased mindset, asking questions about the subjects in his book’s title rather than looking for evidence to support any prior beliefs, and he arrived at pretty much the same conclusions we science-based medicine folks did. But he still appreciates that a natural approach has value, and he seeks to reconcile nature with technology. He calls his book a comfortable refuge from people who are driven to extremes. (more…)

Posted in: Book & movie reviews, Nutrition, Obstetrics & gynecology

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A bit of shameless self-promotion: Dr. Gorski interviewed by Point of Inquiry about Stanislaw Burzynski

Every so often, I or one of my fellow SBM bloggers, is interviewed somewhere. This time, it’s my turn, and this time I was interviewed by Lindsay Beyerstein over at Point of Inquiry. In these days when credulous reporters still, in essence, do Burzynski’s bidding with respect to the message he wants to get out, while Burzynski takes advantage of the desperation of patients with incurable cancers, every little bit helps to counter that message.

Hopefully that’s what I’ve done. Please check out the interview.

Posted in: Cancer

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A tale of quackademic medicine at the University of Arizona Cancer Center

Quackademic medicine.

I love that term, because it succinctly describes the infiltration of pseudoscientific medicine into medical academia. As I’ve said many times, I wish I had been the one to coin the phrase, but I wasn’t. To the best of my ability to determine, I first picked it up from Dr. R. W. Donnell back in 2008 and haven’t been able to find an earlier use of the term. As much as I try to give credit where credit is due, I have, however, appropriated the term “quackademic medicine” (not to mention its variants, like “quackademia”), used it, and tried my best to popularize it among supporters of science-based medicine. Indeed, one of my earliest posts on this blog was about how quackery has infiltrated the hallowed halls of medical academia, complete with links to medical schools that have “integrative medicine” programs and even medical schools that promoted the purely magic-based medical modalities known as reiki and homeopathy. It’s been a recurrent topic on this blog ever since, leading to a number posts on the unethical clinical trials of treatments with zero or minimal pre-trial plausibility, the degradation of the scientific basis of medicine, and the acceptance of magical thinking as a means of treating patients in all too many medical centers.

One strong candidate for quackademic ground zero, if there can be such a thing for the phenomenon like quackademic medicine, which is creeping up like so much kudzu in the cracks of the edifice of science-based medicine (SBM), is the University of Arizona. U. of A. is, of course, the home of one of the originators of the concept of quackademic medicine and one of its most famous and tireless promoters, Dr. Andrew Weil. Dr. Weil, as you might recall, has even been the driving force for creating a highly dubious “board certification” in integrative medicine. Sadly, apparently this new board certification has been so popular among physicians wanting to “integrate” a little quackery into their practices, that its first examination has been delayed from May to November 2014, so that the American Board of Physician Specialties can figure out how to accommodate the unexpectedly large number of applicants.

So what happens when a patient arrives at U. of A. for treatment? I found out last week when I received an e-mail, which led to a fairly long e-mail exchange, with a man whose son was diagnosed with leukemia and is being treated at the University of Arizona Cancer Center (UACC). Although this man gave me permission to use his name, I am going to decline to do so because there is a child involved, although anyone involved in his case at U. of A. will likely quickly be able to identify who the man is. It turns out that he is a professor at U. of A. in a humanities department (which is why I’ll refer to him henceforth as the Professor), and, even though he is not a scientist, he clearly knows how to think (which would not be surprising if you knew what department he was in). In his e-mail, he told me how appalled he was at the sorts of treatments being offered to his son:
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Posted in: Acupuncture, Cancer, Chiropractic, Energy Medicine, Medical Academia, Religion

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Nightmares, Night Terrors and Potential Implications for Pediatric Mental Health…..

Earlier this month, the typical media outlets were abuzz (“Childhood nightmares may point to looming health issues“) with the results of a newly published study linking early childhood nightmares and night terrors with future psychotic experiences. Expressing little in the way of skepticism, most reports simply regurgitated the University of Warwick press release. The research, published in the quite legitimate journal Sleep, is interesting but I’m not sure it tell us anything that we don’t already know. And it certainly doesn’t support any causal relationship between sleep disorders of any variety and “delusions, hallucinations, and thought interference”. But before we delve into the specifics of the paper, I believe a quick review of sleep, and sleep problems, in children is in order.

What is sleep?

To the outside observer, sleep appears as an altered level of consciousness where response to our environment and voluntary movements are noticeably decreased. But, with a certain degree of variability, the line between sleep and wakefulness is pretty thin. This distinguishes it from the increasing stimulation required to reverse other states of altered consciousness such as lethargy, obtundation, stupor and ultimately coma, which is not acutely reversible. I don’t plan on getting too technical, but there is obviously much more to sleep than that. Physiologically our metabolic demands drop a bit, and we enter a generalized anabolic or “growth” state during which a number of beneficial processes take place, predominantly, we think, involving the brain.

Sleep is a vital aspect of human life that has appears to have both physiological and psychological purpose, and is essentially universal in the animal kingdom. All you need to do is observe a cat for more than five minutes to see that we aren’t the only animal species that both needs and seemingly enjoys sleep. In fact, if you could talk to a nematode, it would likely go on for hours about how much it enjoys sleeping in on Sundays. Humans spend roughly a third of their lives asleep, but the percentage of each day devoted to sleep is significantly higher during infancy and early childhood.

We don’t know why the need to sleep became part of the blueprint for life so early on in our evolutionary history, and researchers certainly haven’t worked out all of the nuances of why humans and other animal species continue to be so dependent on it throughout the lifespan. It is likely that its purpose has broadened over time as species branched out into new environments. There are a number of leading hypotheses, however. And barring some amazing technological or medical advance, we appear to be stuck with sleep.
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Posted in: Neuroscience/Mental Health

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When healing turns into killing: religious and philosophical exemptions from parental accountability

Parents have a fundamental right to guide the upbringing of their children protected under the Due Process Clause of the U.S. Constitution. This includes the choice of medical care for the child. They also have a First Amendment right to the free exercise of their religious beliefs, including the right to care for their children in accordance with the tenets of their religion. In a better world, these rights would be exercised in a manner that is consistent with a reasoned selection of medical care among choices supported by the best available scientific evidence. If, for example, deeply religious parents choose to forego a treatment that had only a minimal chance of extending their child’s life and terrible side effects in favor of palliative care because they believe that their child would be better off in heaven we could all agree that their choice is constitutionally protected.

Unfortunately, that is not the case. Religious believers and those whose “philosophy” favors pseudoscience in child medical care (surveys bloviating about the popularity of CAM to the contrary) are in fact a tiny minority of the American population who influence public policy in a manner that far exceeds their actual numbers. This influence allows these special interest groups to cause needless suffering and death among children and their families. As well, their actions siphon off medical and legal resources that could more properly be directed toward the common good when states and medical institutions are put in the position of having to go to court to protect children from their parents. And, by giving parents false choices between a belief in magic and standard medical care, unnecessary complications are introduced into what are already difficult and heart-wrenching decisions by parents who truly want to act in the best interests of their children. (more…)

Posted in: Cancer, Epidemiology, Legal, Medical Ethics, Politics and Regulation, Religion, Vaccines

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Oil Pulling Your Leg

Oil pulling is a traditional Ayurveda method of oral care. It involves swishing sesame oil or a similar oil, perhaps mixed with other substances, in the mouth for 10-20 minutes as a means of preventing caries (cavities), reducing bacteria, and promoting healthy gums. In our internet-fueled age of misinformation, oil pulling has seen a surge in popularity as it makes the rounds on Facebook and other popular social media sites.

The proliferation of unscientific medical advice also essentially assured that oil pulling would be updated to incorporate the latest marketing memes in the alternative marketplace. It is therefore not surprising that this technique is being presented as a cure-all, treating all sorts of systemic diseases by allegedly pulling toxins from the mouth. The Wellness Mama (the first hit on Google) proclaims:

Oil pulling is an age-old remedy that uses natural substances to clean and detoxify teeth and gums. It has the added effect of whitening teeth naturally and evidence even shows that it is beneficial in improving gums and removing harmful bacteria!

Food Matters also gushes:

It is believed that these oils help the lymphatic system of the body as harmful bacteria are removed and beneficial microflora are given with [sic] a healthy environment to flourish. Because of this holistic perspective, oil pulling has been used as a preventative health measure for many other conditions.

This is followed by a long list of conditions from migraines to bronchitis. (more…)

Posted in: Dentistry, Herbs & Supplements

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Accused of Lying about ASEA: Not Guilty

I wrote about ASEA in August, 2012. To quote the company’s website, “ASEA is trillions of stable, perfectly balanced Redox Signaling Molecules suspended in a pristine saline solution—the same molecules that exist in the cells of the human body.” Molecules that supposedly have all kinds of antioxidant benefits for health and for athletic performance through “redox signalling.” They claim it is “a mixture of 16 chemically recombined products of salt and water with completely new chemical properties.” But they never specify exactly which molecules those are, what they mean by balanced, or how they can determine that they remain stable. The product label only lists salt and water. If those 16 recombined molecules are really in the product, the FDA can and should act against them for false labeling.

An ASEA distributor (part of the company’s multi-level marketing cadre) recently wrote an e-mail, not to me, and not to the editors of SBM, but to an assistant editor, to demand that my article be taken down, or that at least the comments for that article be re-opened. Since the e-mail was not sent to me, and I don’t have the writer’s permission, I won’t name him or quote him directly but will paraphrase what he said. He said my article had prevented thousands of people from benefitting from the health effects of ASEA. Thousands? I don’t think I’m that influential; I only wish I were! Anyway, it has not been established that ASEA offers any health benefits. He complains that I don’t have any evidence that ASEA doesn’t work, and of course I don’t. The burden of proof is not on me to prove it doesn’t work, but on those making the claims to prove it does.

He says there is real scientific evidence showing that it does work. My article said there was nothing about ASEA listed in PubMed, and he countered that there are 102 mentions. I was skeptical, so I checked for myself. What I found left me rolling on the floor in paroxysms of laughter. (more…)

Posted in: Herbs & Supplements

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Has science-based medicine already lost to pseudoscience?

After writing Saturday’s 5,000-word magnum opus about misguided “right to try” bills that are proliferating in state legislatures like so much kudzu, I thought I’d try something a bit different—and more concise. Fear not. This doesn’t mean that I’m going to become Harriet Hall as a writer, because no one does concise and insightful as well as she does, but I do on occasion want to try my hand being less logorrheic. I’ll probably fail, but at least I can pat myself on the back for trying. If I succeed, though, it’ll only make me better. I hope. I also realize that I just made it harder by blathering on for a whole paragraph before getting to the point, a habit of mine that infuriates some readers and amuses others who find my way of winding towards the point at least somewhat entertaining.

Thus endeth the nauseatingly—but briefer than usual!—self-deprecating navel gazing and beginneth the post.

The opportunity appeared to me in the form of an article that popped up in my feed on Medscape entitled, Do Clinicians Base CAM Recommendations to Patients on Evidence of Efficacy? Since “complementary and alternative medicine” (CAM) is, by and large, mostly made up of a collection of modalities either based on prescientific thinking and possessing little, if any, plausibility on a scientific basis, my first reaction was to note that health care practitioners do recommend CAM to some patients, meaning that the answer must be, “No,” and then to move on. However, I wanted to see what Dr. Désirée A. Lie, the author, said and to see what the reasons are for whatever answer she came up with. So I read on.

The article starts with a case study:
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Posted in: Science and the Media

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