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Another Negative Study of Vitamins

Perhaps one of the most common questions I receive from those who wish to utilize science-based medicine for their own health is what I think about vitamins. Even among hard-nosed skeptics, this question is often perplexing. On the one hand, vitamins themselves were discovered by medical and biological science, they play a vital role (by definition) in the healthy functioning of our bodies, and deficiencies of vitamins can cause disease. So they seem perfectly legitimate. On the other hand the market is full of exaggerated and even magical claims about the cure-all power of vitamins.

It’s difficult for people to come to a bottom-line conclusion – should they take vitamin supplements or not. Is it woo or not woo?

Well – it’s complicated. But there is large body of research to help inform our decisions about vitamins. Now, the largest study to date has been published (Multivitamin Use and Risk of Cancer and Cardiovascular Disease in the Women’s Health Initiative Cohorts) looking at 161,808 post-menopausal women over 8 years and finding no benefit for heart disease, cancer risk, or overall survival. This study comes on the heels of other recent studies showing no benefit from routine supplementation.

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Posted in: Nutrition

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Chiropractic’s Pathetic Response to Stroke Concerns

The chiropractic industry must be feeling the pressure. Billboards, signs on the sides of buses, chiropractic victims’ organizations, and lawsuits are telling the world that chiropractic neck adjustments can cause strokes. The risk is very small, but it is very real. We have addressed the subject before on this blog here, here, and here.

Chiropractors are in denial and are trying to shift the blame elsewhere. A correspondent sent me copies of a pamphlet and a “distribution kit” that the FCER (Foundation for Chiropractic Education and Research) is selling to chiropractors so they can inform the public about cervical artery dissection (CAD). It is advertised as a campaign to help the public recognize warning signs of stroke; but in my opinion, it amounts to a cynical, self-serving ploy to divert attention away from neck manipulation and to spread biased information about the recent study in Spine by Cassidy et al. (more…)

Posted in: Chiropractic

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More evidence that CAM/IM advocates see health care reform as an opportunity to claim legitimacy

Four weeks ago (was it really that long?), I wrote one of my usual lengthy essays for this blog in which I analyzed two editorials published by some very famous advocates of “complementary and alternative medicine” (CAM)/”integrative medicine” (IM). They included one in that credulous repository of all things antivaccine The Huffington Post (no, this isn’t about vaccines, but I can’t resist pointing out at every turn the antivaccine slant of that rather famous political blog) and in the Wall Street Journal. The first, published in HuffPo and written by Deepak Chopra, Andrew Weil, and Rustum Roy, was entitled Leaving the Sinking Ship, while the second added Dean Ornish to its team, switched from the highly liberal venue of hte previous article to the conservative WSJ, and was entitled “Alternative” Medicine Is Mainstream: The evidence is mounting that diet and lifestyle are the best cures for our worst afflictions. In doing so, advocates of unscientific and even pseudoscientific faith-based medical treatments seemingly covered the entire span of political thought, from highly liberal to highly conservative, with their message.

That message, as I have argued, along with Wally Sampson, Kimball Atwood, Val Jones, and Peter Lipson, is, to boil it down to its essence, this: The new Obama Administration has promised to make health care reform one of its top priorities, and CAM/IM advocates want to take advantage of this movement for reform as the “foot in the door” behind which they try to muscle their way in to be treated by the government as co-equal with established, science- and evidence-based medicine. How do they plan on doing this? As I have discussed before, they plan on doing this by coopting disease “prevention” strategies as being CAM/IM and using them as a Trojan horse. When the government brings the giant wooden horse into the fortress of government health care, along with the bona fide prevention strategies of diet and exercise a whole lot of woo will jump out of the belly of that horse and open the fortress doors to let in its comrades. Indeed, the same strategy can be seen in how CAM/IM advocates have coopted the Institute of Medicine with a joint conference.

In other words, because CAM/IM advocates have succeeded so well in tying the perfectly acceptable science- and evidence-based modalities of diet and exercise, as well as ghettoizing the respected pharmacology discipline of pharmacognosy by associating it with herbalism and, in essence, bringing it under the CAM umbrella, where it became unfairly and incorrectly tainted with its association with all the other woo that falls under the CAM/IM mantle, they expect that renewing an emphasis on diet and exercise by their definition and on their terms will lead to the opening of the door into the promised land of having their modalities be funded by the government. It’s a very conscious strategy, which is why Chopra et al’s articles so clearly tried to convince readers that diet and exercise are CAM/IM. Unfortunately, that they are able to do this with such success is in part because science- and evidence-based practitioners arguably underemphasize such health prevention strategies.

I learned of another salvo fired off by CAM/IM advocates through my somehow finding myself on the mailing list for The Mary Ann Liebert, Inc. family of medical journals. Unfortunately, one of the journals published by the Liebert group is the Journal of Alternative and Complementary Medicine. This particular e-mail was advertising an editorial written by a chiropractor named Daniel Redwood that spells out in the most detailed manner exactly how CAM/IM advocates plan on hijacking any health care reform that the Obama Administration might come up in order to persuade the government to fund what Wally frequently terms “sectarian medicine” and I simply like to call unscientific. The editorial is freely available to all (unlike the contents of JACM) and entitled Alternative and Complementary Medicine Should Have Role in New Era of Health Care Reform. It’s about as blatant a description of the goals of the CAM/IM movement as I have ever seen.
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Posted in: Politics and Regulation, Public Health, Science and Medicine

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Antivaccine hero Andrew Wakefield: Scientific fraud?

Pity poor Andrew Wakefield.

Actually, on second thought, Wakefield deserves no pity at all. After all, he is the man who almost single-handedly launched the scare over the MMR vaccine in Britain when he published his infamous Lancet paper in 1998 in which he claimed to have linked the MMR vaccine to regressive autism and inflammation of the colon, a study that was followed up four years later with a paper that claimed to have found the strain of attenuated measles virus in the MMR in the colons of autistic children by polymerase chain reaction (PCR). It would be one thing if these studies were sound science. If that were the case, then Wakefield’s work would have been very important and would have correctly cast doubt on the safety of the MMR. Unfortunately, they were not, and, indeed, most of the authors of the 1998 Lancet paper later withdrew their names from it.

Over the next decade, aided and abetted by useful idiots in the media, by British newspapers and other media that sensationalized the story, and the antivaccine movement, which hailed Wakefield as a hero, Wakefield managed to drive MMR vaccination rates in the U.K. below the level of herd immunity, from 93% to 75% (and as low as 50% in some parts of London). As a result Wakefield has been frequently sarcastically “thanked” for his leadership role in bringing the measles back to the U.K. to the point where, fourteen years after measles had been declared under control in the U.K., it was in 2008 declared endemic again.

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Posted in: Science and the Media, Vaccines

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Yes We Can! We Can Abolish the NCCAM! Part III

A Reminder…

…of why we keep harping on this. A couple of days ago The Scientist reported that the “economic stimulus package” may include a windfall for the NIH:

Senate OKs big NIH bump

Posted by Bob Grant

[Entry posted at 4th February 2009 04:12 PM GMT]

The US Senate, which is furiously debating the details of the economic stimulus package making its way through Congress, passed an amendment yesterday (Feb. 3) to add $6.5 billion in National Institutes of Health funding on top of the $3.5 billion already allotted to the agency in the bill…

Exactly how an NIH funding increase will be spent remains to be determined.

You can bet that if this happens, the NCCAM will be licking its chops for some of that lettuce. Let’s continue to explore why it shouldn’t get any…

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Posted in: Medical Academia, Medical Ethics, Politics and Regulation, Science and Medicine

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The Anniversary

I received a surprising morning call several weeks ago

“Wally?”

“This is he.”

“This is Judy V…. I just wanted to call and thank you again for what you did for me. It’s the 35th anniversary of my cancer…“

Judy V. is a physician’s widow. Her husband, a surgical specialist died in his 40s, 20plus years ago.   She had a Stage II breast cancer; the surgeon had done a modified radical, and I was consulted for possible adjuvant chemotherapy.

Thirty-five years ago the standard was simpler. Same for our knowledge of staging and biological behavior. Genomics was not a word yet. Targeted therapy was not a concept. Tamoxifen was the ony estrogen agonist and had just been introduced.  The standard adjuvant therapy was single agent melphalan or its equivalent. But even then, patients had choices. The surgery had probably cured her, but then… Chemo or none.
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Posted in: Cancer, Health Fraud, Herbs & Supplements, Nutrition, Pharmaceuticals, Politics and Regulation

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Where Does Sanjay Gupta Register On The Quackometer?

Four weeks ago I wrote a blog post about Sanjay Gupta’s nomination by the Obama administration as our potential new Surgeon General. Many of you voiced concerns about Sanjay’s nomination, specifically because of his poor handling of the Raelians’ Clonaid fiasco, his inability to counter Michael Moore’s health statistics as presented in Sicko and his relationship to the pharmaceutical industry.

As I wondered about what Sanjay Gupta might be like as Surgeon General – and specifically how he might assist in “restoring science to its rightful place” – I decided to educate myself about his thought processes by purchasing his recent book “Chasing Life.” The question I sought to answer was, “is Sanjay Gupta a crank?”

The short answer is: I’m not sure.  Although I wouldn’t go so far as to say that he is a crank, I think he’s more likely to be a shruggie. For those of you who haven’t read my post on shruggies, here’s the definition:

Shruggie (noun): a person who doesn’t care about the science versus pseudoscience debate. When presented with descriptions of exaggerated or fraudulent health claims or practices, their response is to shrug. Shruggies are fairly inert, they will not argue the merits (or lack thereof) of complementary and alternative medicine (CAM) or pseudoscience in general. They simply aren’t all that interested in the discussion, and are somewhat puzzled by those who are.

The longer answer involves an exploration of Gupta’s disturbing insistence on flirting with cranks, if it gets him publicity. The back cover of Chasing Life caries an endorsement from Deepak Chopra – and the inside page a favorable review from Andrew Weil. Normally, I would assume that the author of any book endorsed by those two would contain an intolerable blend of science and pseudoscience and refuse to read it. But for the sake of the readers of Science Based Medicine, I stifled my gag reflex and purchased the book. I hope that my sacrifice will benefit you all.
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Posted in: Book & movie reviews, Public Health, Science and the Media

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Some Good News on the Academic Front

There is a recent trend in UK Universities to close programs offering science degrees for various forms of so-called alternative medicine (CAM), such as homeopathy, crystal healing, and traditional Chinese medicine. This occurs amid growing scientific criticism of these programs.

This is a very good thing, and something I would like to see replicated in the US. The scientific community is appropriately concerned about such programs for a number of reasons. We have also been highly critical of them here at SBM – for example take a look as Wallace Sampson’s excellent analysis of academic medicine here and here, and David Gorski’s summary of Medical Academic Woo here.

Academic institutions have an implied contract with society – they are given resources (donations, scholarships), power (the ability to grant recognized degrees), and respect (the institutions and their members are often given the assumption of credibility and knowledge), and in exchange they agree to follow a code of professional ethics.  This contract is similar to many professions, like physicians or lawyers.

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Posted in: Medical Academia

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University of the Sciences in Philadelphia Justification for Scientific Honor of Homeopathic Leader, John A. Borneman, III

To update readers, I posted last week that my alma mater was to offer a Doctor(ate) of Science degree at our Founders’ Day celebration to Mr. John A. Borneman, III, pharmacist graduate (1952),  founder of the Board Member, Homeopathic Pharmacopoeia Convention of the United States, Southeastern, PA, and Chairman, Standard Homeopathic Company, Bryn Mawr, PA

The university, known prior to 1998 as the Philadelphia College of Pharmacy and Science (PCP&S), has been led by Dr. Philip Gerbino, a gentleman whom I hold in highest regard for his leadership and dedication to pharmacy practice. As I increasingly appreciate the time demands on a university administrator, I was grateful to receive a very prompt response from Dr. Gerbino following the public posting here of my letter of objection last week:

Dear Dr. Kroll,

I would like to thank you for e-mailing myself and our provost, Dr. Russell DiGate, on Jan. 26 with your concerns regarding our Founders’ Day honoree. We most certainly respect your opinion and thoughtful correspondence.

We had no intention of eroding the honorific nature of science with our selection of John A. Borneman, III, P’52, RPh. Instead our objective was to honor a man who is a founder, innovator, and successful entrepreneur.  His selection for the Honorary Doctorate of Science degree is not about the rigors of science, nor the appropriate applications of science to homeopathic and alternative medicines, but about a founder who possesses remarkable leadership qualities and who is willing to share some of those with our students.  

Mr. Borneman’s selection as our Founders’ Day degree recipient provided a source of considerable discussion internally. I can say that in the end, it was decided that since one of our missions is to provide our students with academic and personal development through intellectual, cultural, and ethical understanding and awareness, Mr. Borneman’s honor would ultimately benefit them on their own paths to becoming future leaders and innovators. As point of emphasis, and in this context, we honor founding, not the field of homeopathic medicine. We honor a founder with entrepreneurial spirit.

Again, we appreciate your interest and comments and value your opinion. This letter is not intended to change your mind. It is provided to offer a better understanding of our decision. A good criticism is healthy and often inspiring. While it is not always necessary that we all agree, the basis of academia is to provide an environment of inquiry, debate, and critical thought where all opinions are respected.

Sincerely.

Philip P. Gerbino, PharmD

President

Again, readers, please keep in mind that I hold Dr. Gerbino in my highest regard.  He has been a university leader since I conducted my very first research project at PCP&S in 1984. Knowing what I know of him personally, even considering the unrecognized challenges of being a lead university administrator, I am led to register an even stronger objection to this honor of Mr. Borneman.

At first, I thought it might be more appropriate to acknowledge Mr. Borneman with an honorary MBA from the university.  However, even this recognition would honor leadership and entrepreneurship in the absence of ethics by promoting the sale of products with no medicinal value under the guise of health remedies.

Not to be melodramatic, but if I were to collect lawn clippings from my yard and sell them as a cure for cancer with 30% of patients claiming they were helped, would I be worthy of an Honorary Doctorate of Science from my alma mater?

And I also submit that Mr. Borneman’s grandfather, John P. Borneman (1907) was a PCP graduate and promoter of both botanical medicines *and* homeopathics at a time when dose-response pharmacology was first being realized in the United States.

My most serious point is that one cannot, as Dr. Gerbino proposes, separate the business leadership and success of Mr. Borneman from the fact that the business is one of deceptive products marketed in the name of medicine.

Whatever Mr. Borneman offers to my alma mater in terms of business acumen and leadership training, I find his honor highly deficient in ethics and an affront to the principles of authenticity and scientific rigor put forth by the founders of the Philadelphia College of Pharmacy.

Unfortunately, my compatriots are graduates of a small college with a small alumni organization. I was graduate number 17,346 since 1821 and the school has only had between 900 and 2,500 students per year in the last 20 years. I doubt seriously that a significant public objection can be mounted against the honoring of Mr. Borneman.  I’m sure he is a fine gentleman personally, and I hope to meet him at some point to discuss these issues, but I am disgusted by the imprimatur about to be given to him by the same institution whose academic endorsement hangs above my desk.

 

Posted in: Homeopathy

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Amish Home Burn Treatment: B&W Salve and Burdock Leaves

People in the Amish community have been using “The New Concept in Treating Burns” and their experience is recounted in a little booklet by that title. It is a compilation of articles, testimonials, and letters to the editor of a monthly newspaper Plain Interests, published in Millersburg PA.

The treatment, involving B&W ointment and dressings of scalded burdock leaves, was developed by John Keim, an Amish farmer and natural healer. The Amish have a tradition of taking care of their own, and they try to avoid hospitals whenever possible. In the booklet, they even recommend treating hip fractures at home without surgery. (Which, after all, is what we did before we had hospitals and surgery).

They claim that with the B&W burn treatment:

  • Painful burns are rendered non-painful.
  • Healing is faster.
  • Painful debridement is not necessary.
  • Skin grafting is not necessary.
  • Scarring seldom occurs.
  • Iatrogenic harm from hospitals is avoided.
  • Patients can be treated at home at much less expense. (more…)

Posted in: Herbs & Supplements

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