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Lactobacillus acidophilus

Some apparently rather useless Lactobacillus acidophilus

I always cringe when I see an acupuncture headline with ‘needle’ or ‘point’ in the title. Can’t the writer avoid the clichéd pun? I had an editor who commented that the titles of my essays are often obtuse. Probably true. In going back over my essays on SBM I often can’t tell from the title what I have written about until I read the article. It is a fine line between (what I think) is a clever title and obscurity. So gut check it is.

Time flies when you are having fun. I wrote about probiotics back in 2009.

My conclusion at the time:

Probiotics are useful for the prevention of antibiotic-associated diarrhea. Probiotics may be helpful in preventing other overgrowth syndromes or diseases associated, and perhaps with perturbations of the gut microbial flora such as IBS and colic.

Probiotics are foreign bacteria that are not a normal part of your GI tract; they do not enhance your immune system and, in normal people do not promote the nebulous bowel health.

If you are a normal human, with a normal diet, save your money. Probiotics have nothing to offer but an increased cost.

Medicine is not static and there have been interesting advances in the understanding of the human microbiome in health and disease since 2009, so for SBM and my own medical understanding, I thought it would be a good opportunity to review the topic. Although with over 12,000 references on the PubMeds, I will only touch on a smattering of the papers. My ID attending in medical school always referred to reading the medical literature as drinking from a fire hose. Indeed. (more…)

Posted in: Herbs & Supplements

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Are skin-lightening glutathione injections safe and effective?

A Toronto naturopath’s advertisements were recently criticized on social media for insensitivity and racism:

Glutathione Advertisement TTC Jean-Jacqques Dugoua

Picture used with permission of @emilyknits

Naturopath Jean-Jacqques Dugoua sells glutathione injections, claiming it will give “brighter, lighter and glowing skin”. His URL, lightnaturalskin.com seems to imply that lighter skin is more natural, and he claims the following:

After over 3 years of treating patients for skin concerns, Dr. JJ has developed the Skin Brightening IV, which includes glutathione, vitamin C and other vitamins/minerals. Not only is this treatment effective for most people, it is also safe. The Skin Brightening IV glutathione is a good alternative to skin bleaching creams, which can damage, scar, inflame, discolour or irritate the skin, or microderm abrasion, which is painful and may also irritate the skin and sometimes worsen hyper-pigmentation.

This safe and natural treatment involves principally the use of intravenous (IV) vitamins (excluding vitamin A), minerals and amino acids, including glutathione. All ingredients are regulated by Health Canada and obtained from pharmacies or pharmaceutical companies in Canada or the United States. The treatment is performed in compliance with licensure in Ontario.

(more…)

Posted in: Science and Medicine

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Unfalsifiable Beliefs

sisyphus

As we search for a logo for SBM or the SfSBM, Mark Crislip has been a strong advocate of using an image of Sisyphus, endlessly pushing a boulder up a hill only to have it roll back down again. It’s a bit too self-defeating to be enthusiastic about that suggestion, but it does reflect a common feeling among all of us here at SBM – promoting science can be a frustrating endeavor.

Our frustration reflects a broader phenomenon, that it is difficult to persuade people with facts and logic alone. People tend to prefer narrative, ideology, and emotion to facts. The high degree of scientific illiteracy in the culture presents another barrier.

In recent years psychologists have demonstrated experimentally what we have come to understand through personal experience, that people engage in a host of cognitive defense mechanisms to protect their beliefs from the facts. We jealously guard our world view and are endlessly creative in shielding it from refutation.

A recent series of experiments published by Friesen, Campbell, and Kay in the Journal of Personality and Social Psychology demonstrates that one strategy commonly used to protect our beliefs is to render them unfalsifiable, or at least incorporate unfalsifiable elements. (more…)

Posted in: Critical Thinking

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Shedding Light on Unreasonable Decisions

BloodPressure2

One of the biggest frustrations for a doctor is when a patient refuses to take science-based medical advice. We would like to believe that giving a patient accurate information will lead him to make good decisions that will improve his health or save his life. But that’s not how it works. Patients reject life-saving surgery and chemotherapy, patients on essential medications are non-compliant, parents reject vaccines for their children…what are these people thinking? Why would anyone in their right mind knowingly reject a treatment that has been proven to increase their chances for survival and health? What could their reasons possibly be?

This ties into a subject we have debated over and over: why do people choose alternative medicine? Many reasons have been suggested: cost and accessibility, the need for control, dissatisfaction with mainstream medicine, the peer pressure of a popular fad, “belonging” to a group of like-minded people, a need for answers, autonomy, health freedom, ideology, rebellion against authority, a need for hope even if it is false hope, giving more importance to stories than to studies, the post hoc ergo propter hoc fallacy, scientific illiteracy, misinformation, superstition, magical thinking…the list goes on. Studies have been done, but we can’t be sure the reasons people give to researchers are the real reasons. There is a problem with the search for reasons: these decisions are not made on the basis of reason. Physician Lisa Rosenbaum has written a beautiful essay in The New England Journal of Medicine entitled “Beyond Belief — How People Feel about Taking Medications for Heart Disease“, that sheds a penetrating light on what is really going on. It made me think of the subject in a whole new way. (more…)

Posted in: Critical Thinking

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The Disneyland measles outbreak: “Dr. Bob” Sears says measles isn’t that bad, and an antivaccine activist invokes the Brady Bunch fallacy

Editor’s note: There is an extra special bonus guest post today in addition to my regular post. It’s by Paul Knoepfler, a stem cell biologist, and it’s about unregulated stem cell clinics. Be sure to check it out!


BradyBunch

Last week, I wrote about a rather impressive measles outbreak at the “happiest place on earth,” a.k.a. Disneyland. At the time I wrote that post, the outbreak, which had reached several states, had spread to 17 people. As I sat down to write this, I wasn’t actually sure that this topic needed another post, but then I saw this:

As the number of measles cases continues to rise in Southern California following an outbreak at Disneyland last month, about two dozen unvaccinated students at one Orange County high school have been forced to stay home after a classmate contracted the disease.

In a message to students and parents at Huntington Beach High School on Thursday, Pamela Kahn, health and wellness coordinator at the Orange County Department of Education, said that students “who do not have any documented [measles, mumps and rubella] immunizations will be excluded from attending school until January 29.”

Also, the number of confirmed measles cases has climbed to 52, 46 of them in southern California. In Orange County itself, there were 16 cases as of Friday, ten of them linked to Disneyland, the rest not, a finding that’s led health officials to conclude that “measles has become more widespread throughout the county.” Not surprisingly, health officials in Californian are warning that the number is likely to go higher still. In fact, it’s already happening as “satellite” outbreaks are being reported as children infected at Disneyland come home and infect others.
(more…)

Posted in: Science and the Media, Vaccines

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Stem cell clinics and unapproved, for-profit human experimentation

Editor’s note: I met Dr. Paul Knoepfler online in the wake of my two posts on Gordie Howe and his stem cell treatment for stroke. I was impressed by his posts on the topic and what I saw at his own blog. Given that he’s a stem cell researcher, I wanted him to write a post on stem cell clinics like the one that treated Gordie Howe, and, I’m happy to say, he accepted my invitation and agreed to write this post. I hope to persuade him to write more for us in the future, even though he has his own blog.


When I started blogging in 2010 the stem cell arena was a very different place.

Back then the hot topic was the battle over the legality of federal funding of embryonic stem cell research. That battle is over, or at least in hibernation, with a 2013 federal court ruling allowing such funding to continue. The stem cell debate of today, which in its own way is just as fierce as the old one, is focused on how best to regulate the clinical translation and commercialization of innovative stem cell technologies.

The stakes in this new stem cell battle on the regulatory front are very high both for the stem cell field and for patients. Too little regulation could lead to harm to patients and damage to the stem cell field at a crucial juncture in its history, while too much regulation could stifle stem cell and regenerative medicine innovations.

Stem cell clinics should be better-regulated than a Starbucks

Stem cell clinics should be better-regulated than a Starbucks

The goal of stem cell advocates, including myself, is to find a regulatory sweet spot where science-based, innovative stem cell medicine can advance expeditiously. On the other side we have largely physicians and lawyers along with some patients arguing for drastically-reduced regulation and acceleration of for-profit stem cell interventions to patients, even without concrete data supporting safety or efficacy.

The latter group is a key part of a rapidly-proliferating stem cell clinic industry in the US. It consists of for-profit stem cell clinics that collectively have already conducted stem cell transplants on potentially thousands of patients without federal regulatory approval. These clinics have in effect thrown down the gauntlet to the US Food and Drug Administration (FDA) with their use of non-FDA approved stem cell products on patients. (more…)

Posted in: Legal, Medical Ethics, Politics and Regulation, Science and the Media

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SfSBM at NECSS. Update and More

Screen Shot 2015-01-09 at 1.35.26 PM

A day of Science-Based Medicine, a weekend of science and skepticism

Registration for NECSS, the North-East Conference on Science and Skepticism, is now open. Included in the program will be a day of Science-Based Medicine.

Speakers will be Harriet Hall, Jann Bellamy, David Gorski, Steve Novella and Mark Crislip.

NECSS will be held April 9th–12th, 2015, in New York City at the Fashion Institute of Technology. The SfSBM part of the program will be Friday, April 10 and you can attend one or more of the days. $95 for one day or $195 for the entire conference.

A preliminary program, subject to change

Time Speaker Topic
10:00 Steve and David Introductions and Welcome.
10:10 Steve TBA
10:40 Harriet Chiropractic
11:10 David Integrative Oncology
11:40 Mark Acupuncture
12:10 A buffer because we will run over
12:30 Lunch
1:00 Lunch
2:00 Jann Legislative alchemy
2:30 Panel Topic pending
3:15 Question and answer Questions from the twitter and audience
4:15 Break
4:00 Crislip MC, Jann, David, Jeopardy
Steve and Harriet Compete
5:00 Wrap up
5:15 SfSBM business meeting
5:45 End

For more information and to register, go to NECSS or this registration page.

The Society for Science-Based Medicine is a co-sponsor of NECSS and paid SfSBM members can get a 15% discount using the code SFSBM2015.

This would be a good time to consider joining or renewing a membership in the Society for Science-Based Medicine.

But wait! There’s more.

A self-aggrandizing moment.

You may not know this, but for a year I blogged on my own on the topic of infectious diseases.

I had self-published those early essays in a volume and readers gave it good reviews: 4.5 Stars on Amazon and a 3.89 on Goodreads, but they complained about the lack of copy editing. Go figure.

Screen Shot 2015-01-17 at 8.54.52 AMNo longer. Bitingduck press is my publisher and has collected, edited, and organized the first year’s Rubor, Dolor, Calor, Tumor blog entries, now available on Kindle for a mere $5.99. Other versions, including a paperback, to follow in about 10 days. It should be 99% typo free.

Puswhisperer: A year in the life of an Infectious Disease Doctor.

The perfect gift for the pus lover in your life.

Posted in: Announcements

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Does a Common Treatment for Childhood Constipation Cause Autism?

constipatedkid

Last week an article published by the New York Times entitled “Scrutiny for Laxatives as a Childhood Remedy” made the rounds. The article raised the question of a possible link between the use of a popular over-the-counter laxative, PEG (polyethylene glycol) 3350, and neurological or psychiatric problems in children. This wasn’t the first time this particular journalist wrote a piece on this topic, however. In 2012, she wrote about the popularity of the treatment among pediatricians despite a lack of FDA approval for use by children, a fact which applies to many if not most of the drugs commonly prescribed by pediatricians. (more…)

Posted in: Science and Medicine

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New FDA regulatory role threatens bogus diagnostic tests

lab test
The FDA regulates in vitro diagnostic devices (IVDs) as medical devices. IVDs analyze human samples, such as blood, saliva, tissue and urine. However, in the past, the agency did not use its authority to regulate what are known as “laboratory-developed tests” (LDTs), tests developed and performed at a single laboratory, with all samples sent to that particular lab for testing. Instead, it focused on commercial tests kits, which are broadly marketed to laboratories or the public. These tests had to undergo the same pre-market approval process as other medical devices regulated by the FDA, including, in some cases, clinical studies demonstrating that the device is safe and effective for its intended use.

Historically, LDTs were developed by hospitals, researchers and academic medical centers for their own use. That is no longer true. In the past 15 years or so, there has been an explosion in the use of LDTs by commercial labs and biotechnology companies. The FDA now estimates that there are about 11,000 LDTs offered by 2,000 laboratories. One estimate is that the results of clinical lab tests (although not exclusively LDTs) influence 70% of health care decisions. (See the Congressional Research Service Report’s exhaustive analysis of FDA regulation of IVDs and inclusion of LDTs for more on the history and current use of LDTs.)

Do you have any idea whether the IVDs that have poked around in your blood or tissues are FDA-approved or unapproved LDTs? (Does your physician?) Do you know what evidence (if any) there is standing behind these tests? No? Me either. That’s because there is no requirement that anyone give you this information. (more…)

Posted in: Diagnostic tests & procedures, Legal, Medical devices, Naturopathy, Politics and Regulation

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Acupuncture, Organic Food, and Other Questions

Acupuncture-koreanSBM frequently receives questions from readers asking for more information or even challenging our position on various topics. We make extensive efforts to answer such questions, since engaging with the public is one of the primary purposes of this blog. In fact, I specifically chose the blog format because of its interactive nature and the ability to rapidly respond to items in the news or being discussed publicly.

Sometimes it’s helpful to provide answers to questions in the form of its own post. I do this when the questions are common or explore some new or interesting angle of a topic. I am also more likely to engage when the questions are polite and genuine.

We recently received the following e-mail which meets all these criteria, so here is my response. I will reprint the e-mail in sections as I address each question.

Organic pesticides

I have the utmost respect for the scientific method, and we subscribe to the Skeptical Inquirer. I respect much of what your organization does, and I do not believe that Reiki or Therapeutic Touch is effective, unless the person receiving these therapies believe they work. However, your organization seems to go out of its way to disprove things like the benefit of organic produce which has less pesticides than conventional produce. You claim that natural pesticides could be just as harmful. Here are some examples of these natural pesticides: apply 1 tablespoon of canola oil and a few drops of ivory soap to the leaves of plants and vegetables to repel insects. Also, apply 2 TBSPS of hot pepper sauce with a few drops of ivory soap to leaves, use baking soda and water or pureed onions to repel insects. How can you claim that these innocuous substances are as harmful as conventional pesticides?

(more…)

Posted in: Acupuncture, Herbs & Supplements, Nutrition

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