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Naturopathic Medicine Week 2013, or: Quackery Week 2013

[Ed. Note: This is an extra "bonus" post from Dr. Gorski's not-so-super-secret other blog. He thought the topic would be of interest to SBM readers as well. Fear not. There will be a post on Monday, as usual.]

The vast majority of ideas and treatments that make up the “complementary and alternative medicine” (CAM) specialty known as naturopathy are quackery. There, I said it. No doubt I will be castigated for being too “blunt,” “dismissive,” or “insulting,” but I don’t care. It is my opinion based on science, and I’m sticking to it.

The problem with naturopathy, of course, is that it is so diffuse and encompasses so many different forms of quackery that it’s hard to categorize. Basically, it’s anything that can be portrayed as “natural,” be it traditional Chinese medicine, homeopathy (which is an integral component of naturopathy, something that should tell you all you need to know about naturopathy), herbalism, energy healing, Ayurvedic medicine, the four humors, or whatever. Add to that a number of bogus diagnostic modalities, such as applied kinesiology, live blood cell analysis, iridology, tests for imaginary “food allergies” and “nutrient deficiencies” that conventional medicine doesn’t recognize, plus an overwhelming emphasis on purging the body of “toxins,” unnamed and named but all unvalidated by science, and it rapidly becomes apparent that naturopathy is a veritable cornucopia of pseudoscience and quackery. Seemingly, there is no quackery that naturopathy does not credulously embrace, which is why the success of recent efforts of naturopaths to achieve licensure in several states and even obtain limited privileges to prescribe real pharmaceutical drugs is so alarming, as are their efforts to become recognized as primary care providers under the Affordable Care Act. Basically, naturopathy is a hodge-podge of quackery mixed with science-based modalities magically “rebranded” as “alternative” and “natural.” In that, naturopathy is the ultimate in “integrative medicine,” in which quackery is “integrated” with science-based medicine. As I’ve pointed out many times before, integrating quackery and pseudoscience with real medicine does not elevate the quackery and pseudoscience, but it does contaminate the real medicine with quackery to no good benefit. Unfortunately, it’s insinuating itself into the law.

With that introduction in mind, did you know that the week of October 7 through 13 is Quackery Week in the U.S.? No, seriously, it is. The Senate just passed a resolution declaring that this is so. Oh, it’s true that the Senate didn’t actually call it that. Instead, the resolution (S.Res. 221) was passed, and it declares the week of October 7 to 13, 2013 to be Naturopathic Medicine Week, which is the same thing as declaring it Quackery Week:

S.Res.221 – A resolution designating the week of October 7 through October 13, 2013, as “Naturopathic Medicine Week” to recognize the value of naturopathic medicine in providing safe, effective, and affordable health care.

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Posted in: Homeopathy, Naturopathy, Science and the Media

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Homeopathy First Aid Kits

Homeopathy first aid kit

I don’t know how I missed them, but somehow homeopathic first aid kits had not registered on my radar. They’re readily available. Even Amazon.com sells them, for $54.99. They contain 18 vials of tiny sugar pills, all with potencies of 200C, guaranteed by Avogadro not to contain a single molecule of the active ingredient. (For those of you who may not know, Avogadro was the Italian scientist who discovered the Avogadro constant, the number of atoms needed such that the number of grams of a substance equals the atomic mass of the substance.

If that paralyzes your brain, never mind. Just take my word for it that Avogadro’s discovery allows us to calculate that a 13C dilution (a 1 in 100 to the 13th power dilution), is the equivalent of diluting 1/3 of a drop of the original substance in all the water on earth, and to reach a 200C potency you would have to continue to dilute it by 1 to 100 a total of 187 more times.)

What’s in the kits?

On homeopathy websites you can buy special first aid kits for the car, for hiking and camping, for horses, for pets, for pregnancy, for childbirth, and for travel. One website sells a first aid kit that “contains all the major homeopathic first aid remedies which work so amazingly well particularly when given immediately after an accident or injury.” Only $99.95, but you’re also advised to buy a book to explain its use, for an additional $18.95. It contains 15 remedies in a 30C potency:
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Posted in: Homeopathy

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The deceptive rebranding of aspects of science-based medicine as “alternative” by naturopaths continues apace

That naturopathy is a veritable cornucopia of quackery mixed with the odd sensible, science-based suggestion here and there is not in doubt, at least not to supporters of science-based medicine (SBM). However, what naturopaths are very good at doing is representing their pseudoscience as somehow being scientific and thus on par with conventional SBM. So how do they accomplish this? Certainly, it’s not through the validation of any of the cornucopia of pseudoscience and quackery that naturopaths apply to their patients as though picking “one from column A and one from column B” from a proverbial Chinese menu of woo. Naturopaths’ favored modalities include homeopathy (which remains to this day an integral part of naturopathy that all naturopaths are taught), acupuncture and traditional Chinese medicine (TCM), “detoxification” practices (a key precept of a lot of naturopathy) such as juicing, enemas, and chelation therapy, and the various other quack modalities that make up the practice of naturopathy. Treatments like these (especially homeopathy, whose precepts would require a massive rewriting of the laws of physics and chemistry for it to work) have not been and almost certainly cannot ever be scientifically validated with an evidence base of the quality and quantity supporting SBM.

So, instead naturopaths play a very clever game. In all fairness, naturopaths are not the only practitioners of so-called “complementary and alternative medicine” (CAM) or “integrative medicine” who play this game, but from my observations they appear to be the most talented at it. Their skill at obfuscating the line between SBM and naturopathy is evidenced by the success they have had in state legislatures in expanding their scope of practice, most recently in Colorado, where, if there is not a groundswell of support urging the Governor to veto SB-215 (or, as Jann Bellamy aptly called it, the quack full employment act), consumer protections against quackery in Colorado will be laid waste. At the same time, there is a naturopath licensing act (HB-1111) sitting on the Governor’s desk as well that would license naturopaths and give them the path to mandatory reimbursement from insurance companies. Instructions to write to the Governor opposing both bills can be found here and here; they would be disastrous for efforts to keep full vaccination in Colorado. A direct link to write the Governor can be found here.
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Posted in: Clinical Trials, Homeopathy, Naturopathy, Nutrition, Science and the Media

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More shameless self-promotion that is, I hope, at least entertaining

Three weeks ago, I gave a talk to the National Capital Area Skeptics at the National Science Foundation in Arlington, VA. The topic was one near and dear to my heart, namely quackademic medicine.

I was informed the other day that the video had finally been posted. Unfortunately, there were some problems with the sound in a couple of places, which our intrepid NCAS video editor did his best to fix. Overall, however, the sound quality seems decent. The video even includes the Q&A session. In case you’re interested, the guy who asks the question about mercury in vaccines and autism is Paul Offit’s very own stalker Jake Crosby. I feel honored to think that Jake now apparently lumps me in the same category as Paul Offit, whom I admire greatly. Enjoy.

Posted in: Clinical Trials, Energy Medicine, Homeopathy, Medical Academia, Science and Medicine

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An open letter to Penn & Teller about their appearance on The Dr. Oz Show

An open letter to Penn & Teller about their appearance on <em>The Dr. Oz Show</em>
OzPT

 

Dear Penn & Teller,

I really don’t want to say this, but I feel obligated to. I’m afraid you screwed up. Big time. (Of course, if this weren’t a generally family-friendly blog, where we rarely go beyond PG-13 language, I’d use a term more like one that Penn would use to describe a massive fail, which, as you might guess, also starts with the letter “f”; I think he’d appreciate that.)

I’m referring, of course, to your appearance on The Dr. Oz Show one week ago (video: part 1, part 2, part 3, part 4). Before I begin the criticism, let me just take care of the obligatory but honest statement that I am a fan. I’ve been a fan for a long time. Indeed, I remember seeing you guys perform in Chicago back in the late 1990s when I was doing my fellowship at the University of Chicago. I’ve also seen you in Las Vegas a couple of times, most recently a couple of years ago (see pictures below) at TAM. The two of you have become skeptical icons, through your association with James Randi and over the last several years through your Showtime series Bullshit!, which is advertised with the tagline, “Sacred cows get slaughtered here.” And so they did for the eight seasons Bullshit! was on TV. When you guys were on, it was a thing of beauty to behold, both from the standpoint of entertainment and skepticism.
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Posted in: Faith Healing & Spirituality, Homeopathy, Public Health, Science and the Media

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A truly homeopathic defense of homeopathy

I realize that I’ve said it many times before, but it bears repeating. Homeopathy is the perfect quackery. The reason that homeopathy is so perfect as a form of quackery is because it is quite literally nothing. On second thought, I suppose that it’s not exactly nothing. It is, after all, water or whatever other diluent that homeopaths use (usually ethanol). However, thanks to some basic laws of physics and chemistry and a little thing known as Avogadro’s number, any homeopathic dilution greater than 12C (twelve serial 100-fold dilutions) is incredibly unlikely to contain even a single molecule of starting compound. That unlikeliness reaches truly astonishing levels as we reach the common homeopathic dilution of 30C, which is the equivalent of a 1060-fold dilution. Given that that little thing known as Avogadro’s number, which describes how many molecules of a compound are in a mole, is only approximately 6 x 1023, a 30C dilution is on the order of 1036- to 1037-fold higher than Avogadro’s number. Even assuming that a homeopath started with a mole of remedy before diluting (unlikely, given the high molecular weight of most of the organic compounds that can serve as homeopathic remedies), the odds that a single molecule could remain behind after the serial dilution and succussion process is infinitesimal. Appropriately enough, the “law” in homeopathy that states that diluting a remedy will make it stronger is the law of infinitesimals.

It is also the reason that homeopathy is nothing.

Homeopaths have known these facts for many decades. Anyone who is any sort of a scientist or has an understanding of science, when confronted with these simple, well-established physical laws, might—just might—start to rethink his belief in something that is so utterly implausible from a scientific standpoint. Indeed, homeopathy is about as close to impossible as anything I can imagine, because for it to “work” multiple well-established laws of physics and chemistry would have to be not just wrong, but spectacularly wrong. Yet, as Richard Dawkins famously put it, undeterred, homeopaths bravely paddle up the river of pseudoscience and invent explanations to “explain” how homeopathy could work, the most famous of which is the so-called “memory of water,” in which the water in the homeopathic remedy remembers all the good bits meant to heal but, as Tim Minchin so famously put it, somehow forgets all the poo that’s been in it. Homeopathy is truly magical thinking, which is why I love to use it as an illustrative example of quackery. Not only is it magical thinking, but because it is nothing but water, it’s a very useful educational example for placebo effects and the general types of fallacious arguments quacks and pseudoscientists make. Apparently it’s time for another one.
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Posted in: Basic Science, Homeopathy

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Getting NCCAM’s money’s worth: Some results of NCCAM-funded studies of homeopathy

As hard as it is to believe, the Science-Based Medicine blog that you’re so eagerly reading is fast approaching its fifth anniversary of existence. The very first post here was a statement of purpose by Steve Novella on January 1, 2008, and my very first post was a somewhat rambling introduction that in retrospect is mildly embarrassing to me. It is what it is, however. The reason I mention this is because I want to take a trip down memory lane in order to follow up on one of my earliest posts for SBM, which was entitled The National Center for Complementary and Alternative Medicine (NCCAM): Your tax dollars hard at work. Specifically, I want to follow up on one specific study I mentioned that was funded by NCCAM.

Even though I not-so-humbly think that, even nearly five years later, my original post is worth reading in its entirety (weighing in at only 3,394 words, it’s even rather short—for me, at least), I’ll spare you that and cut straight to the chase, the better to discuss the study. It is a study of homeopathy. Yes, in contrast to the protestations of Dr. Josephine Briggs, the current director of NCCAM, that NCCAM doesn’t fund studies of such pure pseudoscience as homeopathy anymore (although she does apparently meet with homeopaths for “balance”), prior to Dr. Briggs’ tenure NCCAM actually did fund studies of the magic water with mystical memory known as homeopathy. Two grants in particular I singled out for scorn. The principal investigator for both grants was Iris Bell, who is faculty at Andrew Weil’s center of woo at the University of Arizona. The first was an R21 grant for a project entitled Polysomnography in homeopathic remedy effects (NIH grant 1 R21 AT000388).
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Posted in: Basic Science, Clinical Trials, Homeopathy

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No, sugar pills won’t repel insects, and other consequences of regulating nonsense

As a group blog, Science-Based Medicine brings a variety of perspectives to issues of science in medicine. However we align around a few core principles which define what science-based medicine is, and how it should be practiced. One principle we emphasize is the importance of subjecting the evaluation of all health interventions and treatments to a single, science-based standard. One of the biggest successes of the alternative medicine industry, worldwide, has been the embedding of different regulatory standards for the evaluation and approval of so-called “non-drug” products such as supplements, herbal products, and non-scientific treatment systems like homeopathy or traditional Chinese medicine (TCM). The implications cannot be overstated: this different and lower standard is now so firmly entrenched in most health systems that few seem to question its rationale, or consider the consequences. As a practicing pharmacist I spent the first decade of my career working within this regulatory framework without ever stepping back to question why we regulate some products differently. I started reading, took the red pill, and here I am today. (more…)

Posted in: Homeopathy, Science and Medicine

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Update: Homeopathy in Brazilian Scientific American

Last week I wrote about a regrettable piece on homeopathy that was published in Scientific American Brasil.  There have been gratifying developments. Within hours, the editor in chief of Scientific American, Mariette DiChristina, appeared in the Comments. She said that Scientific American does not condone the pseudoscience of homeopathy, that the piece clearly should not have been published, that it would never have been published if Scientific American had been consulted beforehand, and that she had complained to the responsible parties. I was very grateful for her response to my article, for her intervention, and for her willingness to speak out in support of good science.

An Apology

Lo and behold, two days later Ms. DiChristina reported that the editor of Scientific American Brasil had written a letter of apology and had published it on the website. Here is a full translation:

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Posted in: Homeopathy, Science and the Media

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Scientific American Declares Homeopathy Indispensable to Planet and Human Health

I recently received an e-mail from one of SBM’s readers in Brazil, Felipe Nogueira Barbara de Oliveira, a PhD candidate in Medical Science who holds an MS in Computer Science and is who is trying to promote critical thinking and scientific medicine in his country. He sent me a jpeg copy of a short piece that was published (in Portuguese) in the April, 2012 issue of Scientific American Brasil. He was appalled that this appeared under the aegis of Scientific American, and so was I.  He provided the translation which follows.

Warning: this is painful.

The Questioned Effectiveness of Homeopathy

Application of this technique in agriculture shows recuperation of plants and environment.

Homeopathy is known as an alternative treatment for human beings, but few people know about its utilization on animals, plants, soils, and water. This technique is the target of critiques regarding results and efficacy.  One of them is about the “placebo effect” of its remedies, which do not contain any trace of the raw material used in its preparation. To answer this criticism, a clarification is necessary: homeopathy is not related to chemistry, but to quantum physics, because it works with energy, not with chemical compounds that can be qualified and quantified. (more…)

Posted in: Homeopathy, Science and the Media

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