Author Archive

Australian review finds no benefit to 17 natural therapies


Health care systems around the world are being pressured to “do more and spend less”, to make healthcare more cost effective. Owing to aging populations and the growing cost of providing health services, there’s more scrutiny than ever on the value of different health treatments, with the goal of reducing the use of treatments that don’t help. The Choosing Wisely initiative was establishing expressly for this purpose. Regrettably, while well-intentioned, Choosing Wisely hasn’t had as much of an effect as you might expect. Medicine can be slow to change, as David Gorski discussed earlier this week. Unless we ruthlessly scrutinize what we do for effectiveness, and are willing to act on what we learn, self-driven change is unlikely. One way that governments (and insurers) can dramatically reduce the use of a health service or treatment is to simply stop offering it, or paying for it. Yet stopping funding is something that is relatively uncommon in health care. It seems to be much more difficult to stop a practice, possibly owing to inertia, a reluctance to change, and the sometimes-vociferous protests that can emerge from patients or physicians that may feel that their preferred therapy is effective. The formidable challenge of stopping health care funding, once it has started, is one reason why this blog has been very critical of the expanding scope of practice being granted to alternative medicine purveyors – the legislative alchemy that is the first step towards insurance coverage. Because once that’s in place, it will be far more difficult to stop it. So it’s essential to understand the evidence. (more…)

Posted in: Acupuncture, Chiropractic, Herbs & Supplements, Homeopathy, Naturopathy, Traditional Chinese Medicine

Leave a Comment (0) →

The horrible consequences of seeking “natural” immunity: Naturopathy and Whooping Cough

Whooping cough isn't pretty

This is what whooping cough looks like. It sounds even worse.

If there’s one area of “alternative” medicine that saddens (and angers) me, it’s the antivaccine movement. Most alternative medicine only risks harm to the user. But antivaccinationists threaten public health. Their actions can harm the most vulnerable in our society – often children, and others who depend on the herd immunity that vaccination provides. After my last few naturopathy vs. science posts I thought I’d take a bit of a break with another subject. However, last week ex-naturopath (and friend of the blog) Britt Hermes flagged a post from a naturopath that stunned me. Here was antivaccinationism and naturopathy, all rolled into a blog post about three children with a parent that doesn’t vaccinate. Heather Dexter, who claims to be a “Board Certified Naturopathic Doctor” in Michigan, blogs at She recently used her blog to describe, in astonishing, horrific, gut-wrenching detail, how she let three of her children suffer with whooping cough without seeking proper medical attention. The post was pulled down after a few days, but has recently reappeared with some modifications. (The original post, which I am quoting from below, has been archived and can be found here or here). I strongly encourage you to read the entire post in its entirety. Because amazingly, not only did Heather Dexter let her three children suffer through weeks of pain with whooping cough, she also subjected them repeatedly to invasive (and useless) alternative medicine. Yet she claims to have no regrets. (more…)

Posted in: Naturopathy, Vaccines

Leave a Comment (0) →

Naturopathy vs. Science: Diabetes Edition

Diabetes Mellitus
Does naturopathy offer something special or uniquely effective for the treatment of diabetes? Naturopaths are alternative medicine practitioners who claim to provide primary care, like medical doctors. Among naturopaths and their supporters, it’s regularly claimed that naturopathy offers something that “conventional” medicine does not: Naturopaths are described as “doctors plus”, using unconventional approaches to coax the body to “heal itself” with methods that are claimed to be safer and more effective than conventional drugs and medical interventions. The superiority of naturopathy over conventional medicine is an argument that showed up in the comments to my last post, when I pointed out that this year’s Nobel Prize in Physiology or Medicine failed to validate either naturopathy or herbalism. Here’s one example:

Someone diagnosed with pre-Type 2 diabetes could visit a Naturopathic Doctor and stop the disease in its tracks. The doctor would recommended a simple diet change to a high-fat, low-carb, zero refined sugar diet, maybe some supplements, and exercise. Bye, bye, Type 2 diabetes. The same person could visit an MD, and before you know it would be taking insulin and Metformin (and other horrible drugs) for the rest of his or her life. An added bonus with the insulin is weight gain. Notice that the diabetes commercials feature overweight actors and actresses? Yes, there are natural cures. Is this is a site promoting good health, or is it a front for the pharmaceutical companies?

You can follow the comment thread for the discussion that followed. The same commenter continued in Mark Crislip’s post on Friday about the difference between naturopathy and conventional medicine:

Allopath – you will be taking insulin, Metformin and other drugs for the rest of your life. Your diabetes will be managed, but there will be a slow deterioration in the quality of your life.

Naturopath – we can reverse this with a change in your diet, along with exercise.

Naturopath wins.

Now this individual never claimed to be a naturopath – but testimonials like these are not surprising. I’ve written several posts in the past about the claims made by naturopaths, and how they stack up against the scientific evidence. Naturopaths offer an array of disparate health practices like homeopathy, acupuncture and herbalism that are linked by the (now discarded) belief in vitalism – the idea we have a “life force”. From this philosophy can sometimes emerge sensible health advice, but not because naturopaths are following the evidence. As long as a treatment is viewed as being congruent with the naturopathic belief system, it’s acceptably “naturopathic”. In past posts I’ve looked at the naturopathic perspectives on fake diseases, infertility, autism, prenatal vitamins, vaccinations, allergies, and even scientific facts themselves. Britt Hermes is a former naturopath and has written extensively about naturopathy from the perspective of an insider, and her evaluation is scathing: There are no naturopathic standards of care, naturopathic training is much different than what naturopaths purport, and the accreditation of naturopathic schools is questionable. Now, diabetes is a widely prevalent chronic disease. It causes a huge burden of illness on society. And while we have a fair understanding of its causes and how to treat it, there are still far too many people suffering from complications of the disease. Diabetes already requires care from multiple medical professionals, including physicians, nurses, dietitians, and pharmacists. Should naturopathy be included? Is there any evidence that demonstrates that naturopathy can “stop” diabetes? And how does advice from a naturopath differ from “conventional” medical advice? (more…)

Posted in: Naturopathy, Science and Medicine

Leave a Comment (0) →

No, the Nobel Prize does not validate naturopathy or herbalism

Herbal medicine
The 2015 Nobel Prize in Physiology or Medicine was awarded Monday, acknowledging the developers behind two drugs used to treat parasite infections. In a shared award, William C. Campbell and Satoshi Ōmura won for the discovery of avermectin, and Youyou Tu won for the discovery of artemisinin. Given both of these products are derived from natural substances, and “natural” remedies are used in different alternative medicine philosophies, it is perhaps not surprising that advocates claimed that this somehow validates practices like Traditional Chinese Medicine (TCM) and naturopathy. The Association of Accredited Naturopathic Medical Colleges (AANMC) made the following announcement on their Facebook page:
aanmc announcement
Which if you follow the link to the CNN story and actually read it, is surprising. It doesn’t mention naturopathy at all. In fact, when you look closer at the two drugs and their development, this year’s Nobel Prize is actually an excellent case study that illustrates the inherent limitations and weaknesses in alternative medicine systems like naturopathy, herbalism or TCM, while reinforcing just what science-based medicine is capable of delivering. (more…)

Posted in: Basic Science, Herbs & Supplements, Naturopathy

Leave a Comment (0) →

An aspirin a day to prevent heart attacks, strokes, and cancer?

Low dose aspirin is now recommended to prevent heart disease and cancer.

Low dose aspirin is now recommended to prevent heart disease and cancer.

Despite the remarkable advances in medicine over the past 20 years, cardiovascular disease and cancer will still kill half of us. Beyond the deaths, millions survive heart attacks, strokes and cancer, but many are left with disability and a reduced quality of life. While lifestyle changes can improve our odds of avoiding these diseases, they do not eliminate our risk. Finding ways to medically prevent these diseases before they occur, a term called “primary prevention”, is a holy grail in medicine. Primary prevention can be a tough sell, personally and medically. It means taking medicine (which may cause side effects) when you’re well, with the hope of preventing a disease before it occurs.

The US Preventative Services Task Force (USPSTF) released draft guidelines on the primary prevention of cardiovascular disease and colorectal cancer last week. The USPSTF is now recommending daily aspirin in some age groups who have at least a 10% risk of cardiovascular disease in the next 10 years. This isn’t the first guideline that’s recommended aspirin for primary prevention of cardiovascular disease, but it is the first major guideline to endorse aspirin to prevent colorectal cancer. Given these recommendations will apply to millions of people, they have attracted considerable controversy. Is this strategy going to reduce deaths and disability? Or are we about to start “medicalizing” healthy people inappropriately? (more…)

Posted in: Public Health, Science and Medicine

Leave a Comment (0) →

Are guidelines for calcium and vitamin D rooted in evidence, or vested interests?

B0003853 Osteoporotic bone - fully focused image Credit: Professor Alan Boyde. Wellcome Images Scanning electron micrograph of osteoporotic bone. This sample shows the 4th lumbar vertebra of an 89 year old woman with osteoporosis showing very thin, and some fractured trabeculae. This SEM image has been reconstructed from a series of images in different focal planes to give a completely focused picture of the bone. This enables a much clearer picture to be gained of the osteoclast resorption activity within the bone. The field of view is 2.7mm wide. Scanning electron micrograph Published:  -   Copyrighted work available under Creative Commons by-nc-nd 2.0 UK, see

Osteoporotic bone. Are the mainstay treatments for osteoporosis prevention, calcium and vitamin D, truly useless?

Do osteoporosis guidelines overstate the benefits of calcium and vitamin D supplements? And is their continued presence due to vested interests and conflicts of interest? That’s the provocative argument made by Andrew Grey and Marc Bolland, two endocrinologists who recently detailed their analysis in The BMJ, in a paper entitled “Web of industry, advocacy, and academia in the management of osteoporosis” [PDF]. They introduce their case by noting:

For many years, recommendations for prevention and treatment of osteoporosis have included increasing calcium intake (by diet or supplements) and use of vitamin D supplements. Since the average dietary calcium intake in most countries is much less than that recommended by guidelines, many older people are advised to take calcium supplements to prevent osteoporosis. The recommendations have been implemented successfully: over half of older Americans take calcium and vitamin D supplements, either prescribed or over the counter, and bone health is the most common specific motivation for use of nutritional supplements. However, this behaviour does not reflect evidence that has emerged since 2002 that such supplements do not reduce the risk of fracture and may result in harm. Guideline bodies also continue to recommend calcium and vitamin D supplements. Here, we argue that change is made difficult by a complex web of interactions between industry, advocacy organisations, and academia.

Osteoporosis is a medical condition for which supplements have been considered an accepted part of conventional medicine for some time. Are conflicts of interest trumping good science? And are calcium and vitamin D supplements truly useless? Like many clinical questions, there is evidence to  support a range of opinions, and it’s very  difficult to state, with certainty, that one position is the correct one. Despite this, that’s the case that Grey and Bolland make in their analysis. (more…)

Posted in: Herbs & Supplements, Science and Medicine

Leave a Comment (0) →

Is there a natural treatment for tinnitus?

Ear Tone is a supplement claimed to help tinnitus. Does it work?

Ear Tone is a supplement claimed to help tinnitus. Does it work?

“Why do you bother blogging?” asked a colleague. “You take hours of your personal time to write, and you do it for free. You’re not even getting any citations for all that work.” I admit I found the questions a bit surprising. True, you won’t find SBM posts abstracted in PubMed. But I’m writing for an entirely different audience. I blog for the same reason that I became a pharmacist: to help people use medicines more effectively. Practicing as a pharmacist is one way to do that. In that setting, you’re helping one patient at a time. And seeing how your advice and support can enhance someone’s care is tremendously gratifying.

I see blogging as another form of pharmacy practice, hopefully with similar effects. Yes I do get regular hate mail, and the occasional legal threat, but there’s also gratitude for a post that resonated with someone, or helped them make better decisions about their health. When Google searches don’t give answers, I get questions — too many to answer. Today’s post is based on a request for help from someone seeking advice on natural supplements to treat ringing in their ears. They have tinnitus, and they’re frustrated at the limits of what their physician (and medicine) can do. They sent me an advertisement for a supplement called Ear Tone, a natural health product which is advertised (and approved) to provide tinnitus relief. Can natural supplements do what conventional medicine cannot? (more…)

Posted in: Herbs & Supplements

Leave a Comment (0) →

A homeopathic win for consumers

Homeopathy – not medicine

Do you believe in magic? It might surprise you to learn that some people believe sugar pills have healing properties. This belief system, called homeopathy, is a multi-billion dollar industry worldwide, and it’s growing. While there is no convincing evidence to demonstrate that homeopathic treatments are more effective than a placebo, many consumers and even some health professionals accept homeopathy as a legitimate health treatment, and its providers as legitimate health professionals. Responding to the perceived consumer demand for these products, government regulators have had a difficult decision to make: They could ignore homeopathy as a health practice, treating it like we might think of astrology: firmly outside of medicine. Or they could choose some form of regulation, targeting the providers (homeopaths) or the product (homeopathy), possibly with the goal of managing its use, or perhaps limiting harms to consumers. The risk of regulating nonsense, as has been described before, is the perceived legitimacy that recognition and regulation implies. Regrettably, regulation in many countries has had that exact effect. What’s worse, regulation often seems to have prioritized the commercial interests of homeopaths over the public interest, leaving consumers with little understanding that homeopathy lacks scientific credibility as a health practice. Consequently, homeopathy has attracted regular criticism from SBM’s bloggers, science and health journalists, and other science advocates over the years. It appears this advocacy is finally having an effect. Regular readers will recall several posts over the past few weeks, describing the possibility of new regulation of homeopathy by the US Food and Drug Administration (FDA). And just recently, Health Canada announced two important changes to its homeopathy regulation, which may signal a new direction. Are we witnessing the beginning of more sensible regulation of this prescientific practice? (more…)

Posted in: Homeopathy, Politics and Regulation, Science and Medicine, Vaccines

Leave a Comment (0) →

Rehydrating with an appeal to nature

Ski faster with coconut water?

Ski faster with coconut water?

I don’t tend to worry too much about hydration, except when I exercise. I’ve been running regularly for over 15 years, and since I started I’ve usually carried water, or for longer runs, I drink old-school Gatorade. The formulation is basic: sugar, salt, and potassium. There are hundreds of electrolyte products marketed for athletics, but I’ve been faithful to the original: It’s cheap, I don’t mind the taste (even when it’s warm), you can buy it nearly anywhere, and it’s the usual liquid (besides water) offered at races. After exercise, I rehydrate with plain water, preferring to get my electrolytes and carbohydrates from food, rather than a specialty beverage, some of which are “designed” to support rehydration after exercise. The science of sports and hydration is constantly evolving, and so is the marketing. I’m apparently an outlier by still running with Gatorade. New hydration products criticize Gatorade for being artificial and inferior, arguing that natural sources of hydration are better. There’s been an explosion of rehydration beverages, marketed both for everyday hydration and sport purposes. Coconut water was the first natural product to find fairly wide popularity as a sports-oriented beverage. Now you can find maple water, cactus water, watermelon juice and even artichoke water. Is “natural” hydration better that substitutes, including plain old water? (more…)

Posted in: Nutrition, Science and Medicine

Leave a Comment (0) →

The evolving story of the harms of anti-inflammatory drugs

Advil (ibuprofen)

Owing to summer vacation, today’s post updates a 2011 post and a 2013 post with some new information.

Anti-inflammatory drugs are among the most well-loved products in the modern medicine cabinet. They can provide good pain control, reduce inflammation, and eliminate fever. We give non-steroidal anti-inflammatory drugs (NSAIDs) in infancy, continuing through childhood and then adulthood for the aches and pains of modern living. It’s the later stages of life where NSAIDs are used most frequently, usually in the treatment of joint disease like osteoarthritis, which eventually affects pretty much everyone. Over 17 million Americans use NSAIDs on a daily basis, and this number will grow as the population ages. While they’re widely used, they also have a long list of side effects. Not only can they cause stomach ulcers and bleeding by damaging the lining of the gastrointestinal tract, cardiovascular risks are also significant.

It was the arrival (and withdrawal) of the drugs Bextra (valdecoxib) and Vioxx (rofecoxib) that led to a much better understanding of the potential for these drugs to increase the risks of heart attacks and strokes. And it’s now well-documented that these effects are not limited to the “COX-2″ drugs – almost all NSAIDs, including the old standbys we have used for years, raise the risk of heart attacks and strokes. (more…)

Posted in: Clinical Trials, Politics and Regulation, Science and the Media

Leave a Comment (0) →
Page 1 of 15 12345...»