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Posts Tagged Naturopathy

Selling “integrative oncology” as a monograph in JNCI

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Sometimes, it’s hard not to get the feeling that my fellow bloggers at Science-Based Medicine and I are trying to hold back the tide in terms the infiltration of pseudoscience and quackery into conventional medicine, a term I like to refer to as quackademic medicine. In most cases, this infiltration occurs under the rubric of “complementary and alternative medicine” (CAM), which these days is increasingly referred to as “integrative medicine,” the better to banish any impression of inferior status implied by the name “CAM” and replace it with the implication of a happy, harmonious “integration” of the “best of both worlds.” (As I like to point out, analogies to another “best of both worlds” are hard to resist.) Of course, as my good buddy Mark Crislip has put it, the passionate protestations of CAM advocates otherwise notwithstanding, integrating cow pie with apple pie doesn’t make the cow pie better. Rather, it makes the apple pie worse.

In any case, over the last three months, Steve Novella and I published a solid commentary in Trends in Molecular Medicine decrying the testing in randomized clinical trials of, in essence, magic, while I managed to score a commentary in Nature Reviews Cancer criticizing “integrative oncology.” Pretty good, right? What do I see this month in the Journal of the National Cancer Institute (or JNCI, as we like to call it)? An entire monograph devoted to a the topic, “The Role of Integrative Oncology for Cancer Survivorship”, touting integrative oncology, of course. And where did I find out about this monograph? I found out about it from Josephine Briggs, the director of the National Center for Complementary and Alternative Medicine (NCCAM) herself, on the NCCAM blog in a post entitled “The Evidence Base for Integrative Approaches to Cancer Care“, in which she touts her perspective piece in the JNCI issue entitled “Building the Evidence Base for Integrative Approaches to Care of Cancer Survivors.” In an introductory article, Jun J. Mao and Lorenzo Cohen of the Department of Family Medicine and Community Health, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania and the University of Texas M.D. Anderson Cancer Center, respectively, line up this monograph thusly:
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Posted in: Cancer, Clinical Trials, Medical Academia

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Naturopathy vs. Science: Autism

asperger's autism

Just when I thought I was out, they pull me back in. My blogging plan was to take a break from my series of naturopathy versus science posts, where I’ve been contrasting the advice from naturopaths against the scientific evidence. From a blogging perspective, naturopathy is a fascinating subject to scrutinize as there is seemingly no end of conditions for which naturopaths offer advice that is at odds with the scientific evidence. From a health care perspective, however, reading the advice of naturopaths is troubling. Naturopaths promote themselves as health professionals capable of providing primary care, just like medical doctors. And they’re increasingly seeking (and obtaining) physician-like privileges from governments. Naturopathy seems to be getting an easy ride from regulators, despite a lack of evidence that shows naturopathy offers anything distinctly useful or incrementally superior to science-based medicine.

Defining the scope of “naturopathic” treatment is difficult. Naturopaths offer an array of disparate health practices like homeopathy, acupuncture and herbalism that are only linked by the (now discarded) belief in vitalism – the idea we have a “life force”. From this philosophy can sometimes emerge reasonable health advice, but that has little to do with the science or the evidence. As long as it’s congruent with the naturopathic belief system, it’s acceptably “naturopathic”. In past posts I’ve looked at the naturopathic perspectives on fake diseases, infertility, prenatal vitamins, vaccinations, allergies and even scientific facts themselves. An advertisement passed to me this week promoted a naturopath who claims to treat pediatric conditions like ADHD and learning disabilities: (more…)

Posted in: Herbs & Supplements, Naturopathy, Vaccines

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Naturopathy vs. Science: Fake Diseases

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Low body temperature! Do you have Wilson’s Temperature Syndrome?

This is another in an irregular series of posts that puts the statements of naturopaths up against the scientific evidence

How are you feeling today? Tired? Lethargic? Chilled? Lacking energy? Is it the nature of life – or is it something more serious? If you consult with a naturopath, you could walk out diagnosed with something called Wilson’s Temperature Syndrome. But the naturopath would be wrong, because Wilson’s Temperature Syndrome is a fake disease.

One of the hallmarks of alternative medicine is the “fake disease”. Fake diseases don’t actually exist – they are invented without any objective evidence showing that they are real. Fake diseases tend to emerge from vague symptoms which can’t be attributed to a specific medical diagnosis. This is not to say what patients are experiencing isn’t real – the issue is the diagnosis, and the practitioner making the call. As has been pointed out by other SBM contributors, it’s understandable to want reasons and answers when you have debilitating symptoms. But symptoms need to be studied in rational and objective ways in order to understand the underlying illness – call it the “root cause” if you prefer. The diagnosis guides the treatment plan, so getting a diagnosis right is essential. While a group of vague symptoms might lead a medical doctor to run tests to rule out serious illness, alternative medicine providers already know the underlying problem. It’s your Chi. Your energy fields. Your diet. Whatever it is, it’s usually your fault. Adrenal fatigue is a fake disease. So is multiple chemical sensitivity, and Morgellons (delusional parsitosis). “Chronic” Lyme disease is another fake disease. Rather than offer a guide to proper care, a fake disease is a distraction from the truth. (more…)

Posted in: Health Fraud, Naturopathy, Science and Medicine

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What naturopaths say to each other when they think no one’s listening

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The true test of a man’s character is what he does when no one is watching.

— John Wooden

 

Regular readers might have gathered from reading this blog that we are not particularly fond of naturopaths. Actually, naturopaths themselves might be perfectly nice people; rather it’s naturopathy we don’t like, mainly because it is a cornucopia of quackery based on prescientific vitalism mixed with a Chinese restaurant menu “one from column A, two from column B” approach to picking quackery and pseudoscience to apply to patients. Indeed, Scott Gavura features as an excellent recurring series “Naturopathy vs. Science,” which has included editions such as the Facts Edition, Prenatal Vitamins, Vaccination Edition, Allergy Edition, and, of course, the Infertility Edition. Of course, as I’ve pointed out, any “discipline” that counts homeopathy as an integral part of it, as naturopathy does to the point of requiring many hours of homeopathy instruction in naturopathy school and including it as part of its licensing examination, cannot ever be considered to be science-based, and this blog is, after all, Science-based Medicine. Not surprisingly, we oppose any licensing or expansion of the scope of practice of naturopaths, because, as we’ve explained time and time again, naturopathy is pseudoscience and quackery.

A couple of weeks ago, over at my not-so-super-secret other blog, I was “celebrating” (if you will) Naturopathy Week. During that week, one of my readers brought to my attention something that, more than anything else, shows the truth of the quote with which I started this post and another similar quote by J.C. Watts that goes, “Character is doing the right thing when nobody’s looking.” I’m referring to the contents of a subreddit posted by a user going by the ‘nym “Naturowhat,” Read what naturopaths say to one another. Conclusion: manipulative, poorly trained, and a threat to public health. Now, I’m not a big fan of Reddit, largely because I can’t figure out how to find things easily, and I hate the sheer ugly and user hostile format of it. However, beggars can’t be choosers; so Reddit it was to examine what naturopaths say to each other when they think no one is looking. I hadn’t planned to comment on this again, but Jann Bellamy thought that our readers would be interested, and who am I to question Jann’s judgment, particularly on a weekend when I was deep into grant writing?
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Posted in: Naturopathy, Vaccines

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Naturopathy vs. Science: Facts edition

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This is another post in the naturopathy versus science series, where a naturopath’s advice is assessed against the scientific literature.

When you think medicine, your first thought may be “physician”. But the practice of medicine today is a collaboration, as few health professionals, even physicians, can deliver health care completely independently. As a pharmacist I’ve worked closely with physicians, nurses, and other health professionals my entire career. Collaboration starts early, and the setting is usually the teaching or academic hospital, which is always crawling with students, interns, and residents from all professions. Teamwork and trust are essential. In order for different professions to work effectively together, there has to be a common foundation. For medicine, that foundation is science. From basic science principles through a common understanding of fields like biochemistry and physiology, health professionals all work from the same basic understanding about how the body works and what the principles of medicine actually are. If I give a recommendation to a physician or a nurse, I’m basing that assessment on an evidence base that we both rely on. It’s not “pharmacist evidence” versus “physician evidence”, it’s “medical evidence”. This is reality-based healthcare. (more…)

Posted in: Naturopathy

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Naturopathy vs. Science: Prenatal Vitamins

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This is another post in the naturopathy versus science series, where a naturopath’s medical advice is assessed against the scientific evidence. Today’s topic is brought to you by Toronto naturopath Shawna Darou, who recently published her evaluation of prenatal vitamins.

Vitamin supplementation is unnecessary for the vast majority of people. You wouldn’t know this walking through a drug store, where you’ll usually find an entire aisle packed with supplements. Alternative health providers like naturopaths tend to be strong supporters of supplementation, but this advice seems to be based mainly on the belief that “vitamins are magic” rather than good science. The best research hasn’t established a strong evidence base for taking  supplements. We definitely need vitamins in our diet to live. But that’s where we should be getting those vitamins – from our food, instead of from pills. If you eat a reasonable and balanced diet, and have no medical conditions that require special consideration, vitamin supplementation won’t offer meaningful health benefits. In the absence of any deficiency, vitamin supplements seem to be useless at best and harmful at worst. (more…)

Posted in: Naturopathy

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Naturopathy vs. Science: Vaccination Edition

evil-mr-vaccine

We saw it coming. The re-emergence of vaccine-preventable disease should surprise no-one that’s been following the anti-vaccine movement.

Rebutting anti-vaccine rhetoric feels like a Sisyphean struggle. Steven Novella likened it to a game of whack-a-mole, where the moles are the same old tropes that keep popping up, no matter how often they are refuted with facts. Vaccines are a remarkable success of modern medicine: They are health interventions that are both demonstrably effective and remarkably cost-effective. Vaccination has likely prevented more deaths in the past 50 years than any other health intervention. Smallpox was a ruthless killer that took 300 million lives, just in the 20th century alone. Today it’s gone – eliminated forever. And now there are now over two dozen diseases that are vaccine-preventable. They should be an easy sell, and to most people, they are. But the control of vaccine-preventable disease relies in part on herd immunity – sufficient immunization to stop the spread of infection (no vaccine offers 100% protection) and protect those that cannot be immunized. Even a modest number of unvaccinated individuals can lead to reemergence of disease. None of this matters to antivaccinationists, to whom vaccines are bad. Viewing anti-vaccine websites for only five to ten minutes can increase the perception of risk of vaccination, and decrease the perceived risk of omitting vaccines. It also lowers vaccination intentions. By changing perceptions of safety, the willingness to vaccinate decreases. Now imagine that someone you believe to be a health professional openly questioned the efficacy and safety of vaccines – would it reduce your willingness to vaccinate? The evidence says it does. And that’s why the modern practice of naturopathy or “naturopathic medicine” is so concerning. Naturopaths have opposed vaccinations since the invention of naturopathy – starting with smallpox: (more…)

Posted in: Naturopathy, Vaccines

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Maryland legislature passes naturopathic licensing bill, but with damage control

It looks like Maryland is about to become the 18th state licensing (or registering) naturopaths unless the governor vetoes this legislation. That is unlikely to happen because the licensing bills passed overwhelmingly in the House and Senate. But becoming licensed in Maryland may turn out to be something of a pyrrhic victory.

The companion House (HB 402) and Senate (SB 314) bills moved through the General Assembly with lightning speed, suggesting the legislative wheels were well-greased behind the scenes. The lubricant was compromise by all parties: the NDs, the Maryland Board of Physicians, and Med Chi, the state’s medical association. The result seems to be the product of the legislature giving everyone some of what they want, but no one got it all. The baby got split, and that is never good for the baby’s health.

The warhorse parade

The bills originally introduced were obviously drafted by the naturopaths. It gave them their own governing board. They would be able to perform minor office procedures, use colon hydrotherapy, dispense therapeutic devices for barrier contraception, and durable medical equipment. They could administer homeopathic remedies, nutritional “medicine,” vitamins, minerals and so forth via intradermal, subcutaneous and intravenous routes. And they could practice independently, free of any supervision by a physician. Basically, they would be primary care physicians, which is what they claim they are.

Fortunately, all of that is gone in the version that passed. Unfortunately, there is still plenty to be concerned about. We’ll get to those features in a minute.

I listened to recordings of a couple of hours of testimony before two committees, one House, one Senate. (You’re welcome.) But the groundwork for licensing was laid last year, with a report from the Maryland Board of Physicians based on “Practitioner Workgroup” meetings that included representatives from state government and medical, chiropractic, acupuncture, occupational therapy, naturopathic and “chain drug store” (go figure) organizations, a law/lobbying firm (can’t tell who they represented), and Dr. Linda Lee, the Director of the Center for Integrative Medicine at Johns Hopkins. These “stakeholders” decided to try to iron out their differences rather than duke out all the issues in front of the legislature.

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Posted in: Naturopathy, Politics and Regulation

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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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pH Miracle Living “Dr.” Robert O. Young is finally arrested, but will it stop him?

pH Miracle Living “Dr.” Robert O. Young is finally arrested, but will it stop him?

Being a cancer surgeon and researcher, naturally I tend to write about cancer a lot more than other areas of medicine and science. It’s what I know best. Also, cancer is a very common area for unscientific practices to insinuate themselves, something that’s been true for a very long time. The ideas don’t change very rapidly, either. Drop a cancer quack from 2014 into 1979, and he would probably be right at home. Of course, part of the reason is because the “elder statesmen” of cancer quackery today were getting their starts in 1979. Still, the same ideas keep recurring even as far back as a century ago and even older, and if you broaden your criteria, these ideas exist on a continuum, either having descended directly from various ancient ideas such as vitalism, miasmas, or humoral theory or branched off somewhere along the way. Others branch off from the progress of science, taking a germ of a seemingly reasonable idea and turning it into quackery. It is the latter with which I plan on concerning myself today, the reason being that over the weekend I heard some truly awesome news. One of the most egregiously practicing non-physicians who claim to be able to cure cancer that I’ve ever encountered was arrested—yes, arrested!—and arraigned on criminal charges. I’m referring to “Dr. Alkaline” himself, he of the pH Miracle Living program and his Articles of Health blog, “Dr.” Robert O. Young. Behold:
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Posted in: Cancer, Naturopathy, Politics and Regulation

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