Articles

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

Leave a Comment (148) →

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

Leave a Comment (61) →

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:
(more…)

Posted in: Science and the Media

Leave a Comment (284) →

“Right to try” laws and Dallas Buyers’ Club: Great movie, terrible for patients and terrible policy

One of my favorite shows right now is True Detective, an HBO show in which two cops pursue a serial killer over the course of over 17 years. Starring Woody Harrelson and Matthew McConaughey, it’s an amazingly creepy show, and McConaughey is amazing at playing his character, Rustin Cohle. I’m sad that the show will be ending tomorrow, but I really do want to see how it ends.

Unfortunately, as much as I like Matthew McConaughey as an actor, he is in part responsible for re-inspiring a movement that has the potential to do profound harm to patients and cancer research. That’s because his other big role over the last year has been in an Oscar-nominated movie, Dallas Buyers Club, where he plays Ron Woodroof, an early AIDS patient who in the 1980s smuggled unapproved pharmaceutical drugs into Texas when he thought he found them effective at alleviating his symptoms, distributing them to fellow sufferers by establishing the “Dallas Buyers Club” while battling the FDA. I haven’t seen the movie, and I really don’t want to, given that, from everything I’ve heard about it, it’s basically the story of a “brave maverick” who bucks the FDA, complete with all the tropes about indifferent bureaucrats who don’t care if these brave patients die. That might not be so bad if it weren’t also riddled with inaccuracies and misinterpretations of the AIDS crisis in the 1980s. Worse, the real Woodruff rejected the one truly promising drug at the time, AZT, as hopelessly toxic and instead smuggled drugs like Peptide T, which never panned out. Basically, what Woodruff appears to have smuggled as part of his activities for the “Dallas Buyers Club” was a mixture of useless supplements, experimental drugs that were never approved, and a handful of experimental drugs that showed promise. Meanwhile, the movie portrays the FDA as the implacable enemy of these sorts of activities, jackbooted thugs not unlike the stereotype promoted by “health freedom” quacks who don’t like the FDA preventing them from selling their quackery. As far as I can tell without actually seeing the movie, the overall message is a typical uplifting story of an underdog who fights the power and in doing so finds redemption. (more…)

Posted in: Cancer, Clinical Trials, Politics and Regulation, Public Health

Leave a Comment (57) →

Acupuncture Vignettes

I seem to be writing a lot about acupuncture of late. As perhaps the most popular pseudo-medicine, there seems to be more published on the topic. I have a lot of internet searches set up to automatically feed me new information on various SCAMs. Interestingly, all the chiropractic updates seem to be published on chiropractic economics sites, not from scientific sources. Go figure.

Here is a hodgepodge of articles, mostly from the scientific literature, I have read concerning acupuncture and TCM. (more…)

Posted in: Acupuncture, Clinical Trials

Leave a Comment (115) →

The illusions of “right to try” laws

There is nothing like a touching anecdote to spur a politician into action. And those who want to try investigational drugs outside the FDA’s clinical trial process have touching anecdotes in spades. If I, or a loved one, had a terminal cancer, I’d probably be right there with them, telling my story and hoping to get my hands on an investigational drug, no matter how slim the chance for improvement it offered. But a less emotion-driven analysis of so-called “Right to Try” bills currently before several state legislatures reveals some sobering truths about the false promises behind these bills, promises which in some cases appear to be driven more by political ideology than genuine concern for patients.

“Right to Try” bills are pending before four state legislatures: Colorado, Louisiana, Arizona and Missouri. We’ll get to the details of these in a bit. Legislators in other states have expressed an interest in filing similar bills. On February 26th, a Missouri legislative committee “heard emotional debate from supporters of a bill that would allow makers of investigational drugs, biological products or devices to make them available to eligible terminal patients.” Among those testifying were the parents of a young girl with a brain tumor and the father, a physician, of a patient with metastatic colon cancer. These stories are hard to hear and make it hard to say no.

The Right to Try bill has been christened with another catchy name (Warning! Link to credulous media report!) – the Dallas Buyer’s Club bill after the terrific movie which just won Matthew McConaughey and Jared Leto Academy Awards for best actor and best supporting actor, and deservedly so. It depicts a macho, homophobic, HIV-infected cowboy (McConaughey) who saves the day battling the evil, bureaucratic FDA and the medical establishment. He skirts the law to bring life-saving drugs to AIDS patients at a time when AIDS was pretty much a death sentence. The plot even includes a delicensed American doctor who supplies the unapproved drugs from his Mexican clinic. And dietary supplements, of course. (You’d be tempted to suspect Stanislaw Burzynski, Hulda Clark and a naturopath co-authored the script.) But no matter its merits as a movie, it is just that, a movie. It is based on a true story but its interpretation of events has been called into question. (Orac also deconstructs the factual inaccuracies on Respectful Insolence today.) Nevertheless, it is a public relations boon to the Right to Try promoters, although, considering their decidedly right-leaning political inclinations, there has to be a certain amount of squeamishness in associating their cause with a movie featuring raunchy, sexually-explicit scenes, lots and lots of cussing, and a colorfully dressed trans-gender person (Leto) as its most sympathetic character. (more…)

Posted in: Cancer, Clinical Trials, Legal, Politics and Regulation, Science and Medicine

Leave a Comment (62) →

Messaging and Public Health

Affecting public health has a few components. It includes providing a safe environment at home, at work, and in public spaces. It involves protecting the food and water supply from pathogens and toxins. Perhaps the most challenging component, however, is affecting people’s behaviors. Humans are complex psychological animals, and simply providing information to facilitate a rational decision may not always have the intended effect.

Those in power wishing to protect the public from themselves can simply pass laws that coerce people into safer behavior, such as seat belt laws and helmet laws. This approach amounts to outlawing certain unhealthy choices. There is also the “nudge” approach where the unhealthy choice is not outlawed, but the healthier choice is facilitated or made the default choice so that people have to work harder if they still wish to make the unhealthier choice for themselves.

Short of passing laws to force or nudge people in the right direction, the default approach to improving healthy behaviors is to provide information via either public service announcements or warning labels. How effective, however, are such measures? (more…)

Posted in: Public Health

Leave a Comment (74) →

Different Strokes for Different Folks: Assessing Risk in Women

You may have noticed that men and women are different. I hope you have noticed. As the French say, vive la différence! It’s not just that one has dangly bits and the other has bumpy chests. Or that one has to shave a beard and doesn’t like to ask for directions while the other has menstrual periods and likes to discuss feelings. There are differences in physiology and in the incidence of various diseases. For instance, normal lab values for hemoglobin are higher for men than for women, and autism is more prevalent in males while multiple sclerosis is more prevalent in females.

In the past, women have been underrepresented in clinical studies; when the first studies of aspirin for cardiovascular prevention came out, we knew it was effective for men, but we didn’t have enough evidence to recommend it for women. This is changing; researchers today are more aware of the need to include women in their studies. Now the American Heart Association/American Stroke Association (AHA/ASA) has issued the first evidence-based guidelines for reducing the risk of stroke in women. (more…)

Posted in: Public Health, Science and Medicine

Leave a Comment (17) →

Antivaccine happenings ten years time ago

pagehappening

This is about antivaccine happenings ten years’ time ago. Unfortunately, it’s also about antivaccine happenings now. The reason, and what links the two, is that antivaccine happenings, particularly myths, never seem to die. They just keep coming back over and over again. One myth that’s been recycled since at least 2005 is the one that claims that there’s been a study that has vindicated Andrew Wakefield. Stories pop up every so often that look for all the world as though they’re new claiming that the results of Andrew Wakefield’s original Lancet case series has been replicated. Sadly for Wakefield (and happily for the rest of the world), it’s just not true. I have a Google Alert for vaccines set up, so I see these stories when they pop up periodically. Sometimes they even make an appearance on Facebook and/or Twitter as antivaccine memes.

This time around, what’s happening is not exactly the same thing. The “Wakefield was right” news stories appear to arise organically every so often. I have no idea why. This particular story is one that’s being desperately pushed by antivaccine mavens—again. It’s one that has been desperately promoted dating back to a decade ago, as you will see. Unfortunately, like Jason or Michael Myers in a classic slasher flick, just when you think it’s dead is the time to be vigilant because it’s not. I’m referring to a myth that I’ve been covering on and off for nearly a decade that the Centers for Disease Control (the CDC) has been “hiding evidence” that mercury in vaccines is a major cause of the “autism epidemic.” It’s not true, of course. Indeed, my very first post for this blog lo these six years ago referred to the hypothesis that mercury in the thimerosal preservative that used to be used in childhood vaccines as a failed hypothesis. And so it is—and remains.
(more…)

Posted in: Vaccines

Leave a Comment (44) →

Measles gets a helping hand

In a recent post I shared a bit of my personal, near-death experience with measles during the US epidemic of 1989-1991. As I describe in that post, I contracted a very serious measles infection at the end of medical school, and was highly infectious when I interviewed for a residency position at Seattle Children’s Hospital. Like others my age who received an ineffective, killed measles vaccine between 1963 and 1967, I had not been adequately protected. The MMR vaccine was not yet available, and no boosters were recommended at the time. Unfortunately, though my measles titers (a test of immunity to measles) were checked when I entered medical school, the school’s student health department failed to notice or respond to the results – I was not immune and did not receive a booster dose at that time, as I should have. That mistake was huge, and could have cost me my life. It also caused me to potentially sicken many vulnerable children during my tour of the hospital, as well as others I may have inadvertently exposed during the window of communicability as I walked the streets of Seattle. The Department of Health had to be called to trace all of my steps and attempt to track down and protect any potential contacts.
(more…)

Posted in: Epidemiology, Medical Ethics, Politics and Regulation, Public Health, Science and Medicine, Vaccines

Leave a Comment (67) →
Page 4 of 197 «...23456...»