Author Archive

Chiropractic Gynecologist Offers Dangerous Treatments and Misinformation


Yes, you can have a chiropractor for a gynecologist, but it’s not a good idea.

Over a year ago I wrote about escharotic treatments for cervical dysplasia. It is offered not by MD gynecologists but by chiropractors and naturopaths, along with inconsistent and unproven diet recommendations and supplements. A corrosive agent similar to “black salve” is applied repeatedly to the cervix; it works by destroying tissue. There are no controlled studies evaluating it for safety and effectiveness. One major drawback is that there is no surgical specimen to submit to pathology to determine if there is invasive cancer. I urge you to read my first article for further details. Escharotic treatment is decidedly not a good idea.

In that article I focused on the treatment itself. I recently revisited the website of the chiropractor I mentioned in that article, Nick LeRoy, and I want to comment on some other issues raised by this individual who is offering the treatment.

Who is Nick LeRoy?

On one website he is listed as a Chicago holistic medicine physician and primary care physician for an HMO, Alternative Medicine Incorporated, which he says is underwritten by Blue Cross/Blue Shield. When I googled for Alternative Medicine Incorporated, I found a company in England, but none in America with that name. On his other website he claims to have “post-doctoral medical training in gynecology and internal medicine and to be a credentialed primary care physician (PCP) for Blue Cross of IL.” I phoned Blue Cross of Illinois, and they told me he was not listed as a provider in their records. They suggested I contact him directly to ask for clarification. I did, by email. He didn’t answer.

He has taken courses in acupuncture and Traditional Chinese Medicine, and got “private breast thermography training.” It’s not clear how much training he has in gynecology. On one page of his website he says his “integrative medicine training included gynecology, internal medicine, acupuncture, chiropractic, and nutrition.” In a video, he says he has been specializing in gastrointestinal disorders for twenty years, and he describes how he does unconventional food allergy testing for 154 different foods.

He lists himself as “DC, MS, AcT,” but he calls himself “doctor” and readers are likely to assume he is an MD. The testimonials all refer to “Dr. LeRoy.” He sells his books and supplements through his “doctor’s supplement store.” (more…)

Posted in: Cancer, Chiropractic, Obstetrics & gynecology

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Dr. Richard Rawlins Reveals the Real Secrets of Alternative Medicine

Dr. Richard Rawlins reveals the secrets of alternative medicine in a new book

Dr. Richard Rawlins

Dr. Richard Rawlins, an orthopedic surgeon in the UK who is also a magician and member of the Magic Circle, has written an exhaustive review of alternative medicine, Real Secrets of Alternative Medicine: An Exposé.

“A conversation with Mrs. Smith”

A conversation with Mrs. Smith bookends the text. She comes to Dr. Rawlins for hip replacement surgery and asks if there is any alternative medicine she could try first. He tells her some patients say they have benefited, but personal experience is no substitute for critical analysis of evidence. He explains that there is no evidence to support those alternatives but that if she wants to try them, she can go ahead and try. Then she asks which one is most likely to help her. He tells her he can’t recommend one because he has not studied them in any detail. She says perhaps he should study them, and then write a book. So he does.

At the end of the book, he tells Mrs. Smith what he has learned: that complementary and alternative medicine (CAM) “works” but only as a placebo; it does not affect disease outcomes and can sometimes do harm. He quotes cancer researcher David Grimes:

By clinging to delusion, belief in alternative medicine denigrates the very wonder of science and medicine and the massive strides we as a species have made over the last century or so in understanding the world around us, and how our bodies work.

Rawlins ends the book by telling Mrs. Smith “Conventional practitioners care more than you may think. That is the real secret.”

In between those conversations is a 370-page tour de force that covers the entire history of medicine and CAM, stresses the importance of scientific evidence, reviews how good the brain is at deluding itself, explains the placebo effect and the attractions of CAM, and argues that society should not pay for it. (more…)

Posted in: Book & movie reviews

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A Credible Placebo Control for Chiropractic Research

D.D. Palmer, the father of chiropractic, died in 1913. Over a century later, his ideas have never been properly tested with placebo controls - until now.

D.D. Palmer, the father of chiropractic, died in 1913. Over a century later, his ideas have never been properly tested with placebo controls – until now.

The research on chiropractic has been far from rigorous. One of the problems is that studies of spinal manipulation therapy (SMT) can’t be double blinded, and it is very difficult to even do single blinding. So most studies resort to non-manipulation control groups like “usual care” or “wait list” or “pain medication.” Those studies are practically guaranteed to lead to false positive conclusions: they make SMT look more effective than it would look if you could provide a control that patients couldn’t distinguish from real SMT.

In a study just published in the European Journal of Neurology, Chaibi et al. successfully used a credible placebo manipulation on patients with migraine. It showed that SMT doesn’t work for migraine, but that’s not news. The news is that it showed how to improve the methodology of SMT studies to get more reliable results. (more…)

Posted in: Chiropractic, Clinical Trials

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Plavinol and Other Natural Remedies for Diabetes: “Condimentary Medicine”?

Is this an effective medicine or a condiment?

Is this an effective medicine or a condiment?

We don’t yet have a cure for diabetes, but we have insulin; it controls the disease and allows Type 1 diabetics to lead a relatively normal life instead of suffering and quickly dying as they all did in the pre-insulin era. We know to counsel Type 2 diabetics about weight loss, diet, and exercise; and when those measures are not enough, we have prescription medications that work very well to control symptoms and help prevent complications.

For some people, that’s not good enough. They want to find “natural” remedies to supplement or replace conventional treatments. In a recent article on SBM, Scott Gavura quoted a pharmacy customer who said “I don’t want to take any drugs. Do you have something natural I can use to cut my blood sugar?” Scott went on to cover the questionable evidence for cinnamon in that article. Many other “natural” remedies have been proposed. Here’s an alphabetical list: acetyl L-carnitine, aloe, alpha-lipoic acid, banaba leaf (not banana!), basil, berberine, bilberry, biotin, bitter melon, cinnamon, chromium, coQ10, crepe myrtle, fenugreek, fish oil, fructo-oligosaccharides, green tea, ginseng, glucomannan, gymnema, hibiscus, Indian kino tree extract, magnesium, mistletoe, olive leaf, onion, psyllium, purslane, resveratrol, starch blockers, thiamine, vanadium, and vitamins. I compiled that list from just three websites; I’m sure there are many more natural remedies that I missed. These natural remedies have been recommended on the basis of rather shaky preliminary evidence that they lower blood sugar, usually by only a small amount. Even the CAM-friendly National Center for Complementary and Integrative Health (NCCIH) concluded:

There is not enough scientific evidence to suggest that any dietary supplements can help prevent or manage type 2 diabetes.

They also warn that “Some dietary supplements may have side effects, including interacting with your diabetes treatment or increasing your risk of kidney problems.” (more…)

Posted in: Herbs & Supplements

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Studying Chiropractic with Imaging: Another Dead Salmon?

The Activator: a spring-loaded thumper. Is this "chiropractic"? Does it really balance the alignment of the lumbar spine and sacrum?

The Activator: a spring-loaded thumper. Is this “chiropractic”? Does it really “balance the alignment of the lumbar spine and sacrum”?

Researchers in Japan have done a study evaluating the effects of chiropractic treatment using MRI and PET scans. It was published in the 2009 report of the Cyclotron and Radioisotope Center (CYRIC) of Tokohu University.

Their rationale for doing the study

Ray Hyman‘s categorical imperative is “Do not try to explain something until you are sure there is something to be explained.” These researchers believe there is something to be explained. They think chiropractic has proven clinical benefits and they are trying to find the underlying physiological mechanisms. They think they have found something with their advanced imaging procedures, but the dead salmon study and Satel and Lilienfeld’s book Brainwashed have taught us that neuroimaging studies can be misleading and must be interpreted with great caution.

Posted in: Chiropractic

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Parkinson’s Disease: A Detective Story

I didn’t intend to review Jon Palfreman’s book Brain Storms: The Race to Unlock the Mysteries of Parkinson’s Disease, but after reading it I decided it was too good not to share. Palfreman is an award-winning science journalist who has Parkinson’s himself. He has done a bang-up job of describing Parkinson’s disease, its impact on patients, and how science is working to understand and treat it.

The disease

Parkinson first described the disease in 1817. It is characterized by shaking, rigidity, slowness of movement, and difficulty with walking. There is a decrease in dopamine in the basal ganglia in the brain. One million Americans have Parkinson’s disease. The incidence increases with age; by age 80 one in fifty people are affected.

Some very strange phenomena have been observed. Parkinson’s disease is less common among smokers and coffee drinkers. When a patient becomes frozen and unable to take the next step, if you draw a line on the floor they will step over the line and walk on. Patients who can’t walk can run, ride a bike, or ice-skate. Some patients appear to have strong responses to placebos, with reversal of symptoms for long periods. Exposure to vibration seems to decrease symptoms; in the late 1800s patients were treated with vibrating chairs until controlled studies showed they didn’t work. (more…)

Posted in: Basic Science, Book & movie reviews, Neuroscience/Mental Health

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“Glyconutrients,” Mannatech, and Ambrotose: Marketing, Not Science

This doctor (Ben Carson) believes “glyconutrients” cured his prostate cancer. Researchers in the field of glycobiology think he is wrong. They don’t even accept the term “glyconutrients.”

It has been a long time since I first became aware of Mannatech, the multilevel marketing company that sells “glyconutrient” dietary supplements. After its claims were debunked and it lost a court case, it had dropped off my radar; but last month it came roaring back in the form of an email from a reader in South Africa. He said his in-laws had recently become Mannatech Sales Associates. Although the company can’t legally claim that their products cure any ailments, they continue to imply that their products give your body the tools it needs to cure itself. Company representatives and other advocates continue to claim in seminars and on the Internet that Ambrotose helps with a variety of conditions including MS, AIDS, cancer, lupus, colitis, diabetes, fibromyalgia, cystic fibrosis, ADHD, neuralgia, wound healing, and much more. There are even claims that it “cures” Down syndrome and even changes its characteristic facial features. My correspondent had done his own research and had concluded that Mannatech was marketing modern day snake oil with outrageous claims. But he was shocked that there was so little impartial information available about “glyconutrients.”

He is right: much of the available information about “glyconutrients” is from people who are trying to sell products; there isn’t much unbiased information available. Science-Based Medicine has not previously addressed “glyconutrients” or Mannatech except when Dr. Gorski recently wrote about presidential candidate Ben Carson, MD, shilling for Mannatech and claiming that Mannatech products had cured his prostate cancer. Let’s take a closer look at the science behind the claims for “glyconutrients.” (more…)

Posted in: Herbs & Supplements

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Alternative Medicine Is Infiltrating Veterinary Continuing Education

We want the veterinarians who care for our animals to continue their education and keep up to date by learning about new developments in science. A new proposal for veterinary continuing education would encourage them to learn to use questionable treatments based on pseudoscience and fantasy.

We want the veterinarians who care for our animals to continue their education and keep up to date by learning about new developments in science. A new proposal for veterinary continuing education would encourage them to learn to use questionable treatments based on pseudoscience and fantasy.

My friend Carmen Czachor is a science-based veterinarian practicing in Port Angeles, Washington. She has alerted me to a disturbing development that she fears will “put veterinary medicine back in the dark ages.” The Washington State Department of Health is contemplating a rule change in the regulations requiring continuing education for veterinarians. Current requirements are for 30 hours of continuing education every 3 years; the only restriction is that no more than 10 hours can be earned in practice management courses. The Veterinary Board of Governors had observed an increase in the volume of continuing education courses related to CAVM (complementary and alternative veterinary medicine) and they wanted to provide some guidance. They explain:

The board originally proposed a ten hour limit on the number of veterinary CAVM CE hours that can be earned in any three year reporting period. After stakeholder feedback from multiple veterinary practitioners who practice solely in CAVM, the board decided to revisit the proposal. The board now proposes to establish a twenty hour limit on CAVM continuing education and add a ten hour minimum requirement for conventional medicine. The board finds that doing so would not result in a reduction in the quality of care provided and supports the consumer’s choices about what kind of care they seek.

Note: “stakeholder feedback from multiple veterinary practitioners who practice solely in CAVM.” I find this alarming. Veterinarians are licensed to practice veterinary medicine, not CAVM. Alternative medicine is called “alternative” because it is not supported by the kind of evidence that would earn it a place in conventional medicine. What does it mean that veterinarians are “practicing solely in CAVM”? Does that mean they have abandoned the conventional veterinary medicine that they were licensed to practice?

And how on earth did they determine that the proposal “would not result in a reduction in the quality of care provided”? They just made that up because they wanted to believe it and because they believe alternative medicine constitutes quality care. (more…)

Posted in: Politics and Regulation, Veterinary medicine

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Efforts to Encourage Breastfeeding Like the Baby-Friendly Hospital Initiative (BFHI) May Have Unintended Consequences

A brand-new newborn. According to BFHI rules, he must maintain continuous skin contact with Mom and start breastfeeding with in the first half hour.

A brand-new newborn. According to BFHI rules, he must maintain continuous skin contact with Mom and start breastfeeding within the first half hour.

“Breast is best,” but current efforts to increase the rate of breastfeeding may be misguided. A recent article in JAMA Pediatrics by pediatricians Joel Bass, Tina Gartley, and Ronald Kleinman is titled “Unintended Consequences of Current Breastfeeding Initiatives.” They criticize the Baby-Friendly Hospital Initiative (BFHI), saying “there is now emerging evidence that full compliance…may inadvertently be promoting potentially hazardous practices and/or having counterproductive outcomes.”


The Baby-Friendly Hospital Initiative was launched by WHO and UNICEF in 1991 and has been adopted in 152 countries. In the US it has been promoted as the standard of care by government agencies like the CDC and the Joint Commission, and has been implemented by a growing number of hospitals. The criteria for a hospital’s Baby Friendly accreditation include:

  1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
  2. Train all health care staff in skills necessary to implement this policy.
  3. Inform all pregnant women about the benefits and management of breastfeeding.
  4. Help mothers initiate breastfeeding within one half-hour of birth.
  5. Show mothers how to breastfeed and maintain lactation, even if they should be separated from their infants.
  6. Give newborn infants no food or drink other than breastmilk, not even sips of water, unless medically indicated.
  7. Practice rooming in – that is, allow mothers and infants to remain together 24 hours a day.
  8. Encourage breastfeeding on demand.
  9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants
  10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.


Posted in: Obstetrics & gynecology

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Genetic Testing: Does Knowing Risk of Disease Make a Difference?

Genetic variants may provide information you'd rather ignore

Genetic variants may provide information you’d rather ignore

The complete sequencing of the human genome by the Human Genome Project was a remarkable accomplishment and a cause for celebration. Several companies including 23andMe, Navigenics, and deCODE have capitalized on that scientific achievement by offering genomic testing directly to the public. They promise more than they can deliver, and consumers don’t understand the limitations of the test results. The subject has been covered in several SBM articles.

One of the expected benefits of genomic testing is that if people knew they were at high risk of a disease, they would take preventive steps to reduce their risk. That seems plausible; but a recent study, a systematic review in the BMJ (formerly the British Medical Journal) calls that assumption into question. It found that communicating DNA-based disease risk estimates did not increase risk-reducing health behaviors or motivation to engage in such behaviors.


Posted in: Diagnostic tests & procedures

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