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Deconstructing the Conspiracy of Deliberate Poisoning of US Municipal Water

Mass spectrometer

It takes more than a mass spectrometer, more than even a mass spectrometer and an ISO certification, to make you a scientist. Honesty helps too!

Heavy metals here, there, everywhere…

One of the key narratives among the supporters and practitioners of complementary and alternative medicine (CAM), particularly those with a conspiratorial world-view, is the claim that vast portions of the US general populous is being deliberately poisoned by certain corporations, special-interest groups, invested individuals, and the US government. Some of these supporters and practitioners go as far as to claim that this conspiracy is global in scope and not restricted solely to the USA. Among the supposed vectors of this poisoning is the claim of elevated and/or toxic levels of heavy-metals in such items as foods, vaccines, as well as municipal drinking water supplies; I will address the latter in this article.

One prolific web-based publication supporting this narrative is Natural News. Many of its writers, including its editor-in-chief Mr. Mike Adams (The Health Ranger), have added outspoken support to these claims of…someone…deliberately poisoning the drinking water. A brief search on Google using the appropriate keywords produces a large number of hits, with many of these hits being found on the Natural News website, and many have heavy-metal “detoxing” as a central theme. Titles of these Natural News articles include: (more…)

Posted in: Basic Science, Public Health

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Acupuncture and Endorphins: Not all that Impressive

Acupuncture needling

Pictured: A great way to get a staph infection, not a great way to get an endorphin rush.  Try jogging.  Or heroin.*

I was reading, and deconstructing, a particularly awful bit of advice for acupuncture by Consumer Reports. It was the same old same old, but it was the source that made it particularly awful. I expect more from Consumer Reports than the uncritical regurgitation of the standard mythical acupuncture narrative. The report included the quote

One possible reason for the benefits of acupuncture: Studies show that it causes us to release feel-good hormones, called endorphins, that suppress pain.

I have never bothered to go back and see what the original literature was to support endorphins as a potential mechanism for a beneficial effect of acupuncture on pain.

That endorphins are released as a result of a noxious stimulus didn’t surprise me; that is what endorphins are for. And endorphins are unlikely to be the mechanism for all the other diseases for which the WHO suggests acupuncture benefits.

To my surprise, my brief search that day came up with very little information on the endorphins and acupuncture.

What I wanted to know was the evidence behind the universal meme that acupuncture releases feel-good hormones. If Consumer Reports says it is so, it must be true, right? So I plugged ‘acupuncture endorphin’ into PubMed and went to work. (more…)

Posted in: Acupuncture, Basic Science, Clinical Trials, Traditional Chinese Medicine

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The Gene: An Intimate History

A superb writer, Siddhartha Mukherjee's books are easier to read than his name is to spell

A superb writer, Siddhartha Mukherjee’s books are easier to read than his name is to spell

Six years ago I reviewed Siddhartha Mukherjee’s book The Emperor of All Maladies: A Biography of Cancer. It was hands-down one of the best books I have ever read on a medical topic. Now he’s done it again. His new book is titled The Gene: An Intimate History.

Mukherjee is a superb writer. Much of what I said about his first book applies equally to his second, so I will quote myself:

It is a unique combination of insightful history, cutting edge science reporting, and vivid stories about the individuals involved: the scientists, the activists, the doctors, and the patients. It is also the story of science itself: how the scientific method works…

Beautifully written and informative

Reads like a detective story with an exciting plot.

He links this second book to his first by pointing out that cancer is an ultimate perversion of genetics, and that studying cancer means also studying its obverse: normalcy. He gives the subject a human face by interspersing anecdotes from his own family’s struggles with mental illness and its connection to inherited genes. He sets out to tell the story of the birth, growth, and future of one of the most powerful and dangerous ideas in the history of science: the gene. He says it is one of three destabilizing ideas that have transformed science: the concept that irreducible units underlie matter (the atom), digitized information (the byte or bit), and biological information (the gene). He explains how the consequences of these ideas have transformed our thinking, our language, our culture, politics, and society. (more…)

Posted in: Basic Science, Book & movie reviews, History, Medical devices

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The Primo Vascular System: The N-rays of Acupuncture?

Is this a PVS structure or something else?

Is this a PVS structure or something else?

Acupuncture meridians and acupoints are imaginary until proven otherwise. Anatomists have never been able to detect them by microscopy or autopsy, and they are not mentioned in anatomy textbooks. For decades, acupuncturists have been trying to prove that their pre-scientific belief system is grounded in scientific reality. Now they are telling us that acupuncture meridians and acupoints have been discovered in the form of the Primo vascular system (PVS). A typical website trumpets “Science Finally Proves Meridians Exist.”

The available information is confusing.

Primo vessels were supposedly missed by anatomists because they are so small. They are reported to only be visible by electron microscopy, yet researchers have used dye to show them under a regular microscope. There has been speculation about their involvement in cancer metastasis: one paper provides images of a putative PVS cancer metastasis thread afloat in a lymph duct.  PVS vessels are said to be too tiny to study by the usual methods of science, but some researchers say they have somehow learned that they are characterized by high resistance and low capacitance. They are allegedly studded with electrically charged nodes that attract nutrients, oxygen, and regulatory hormones. They allegedly transmit energy to organs and integrate the features of the cardiovascular, nervous, immune, and hormonal systems and serve as the physical substrate for acupuncture points and meridians. (more…)

Posted in: Acupuncture, Basic Science

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Is there a reproducibility “crisis” in biomedical science? No, but there is a reproducibility problem

NOTE: Anyone who has seen several derogatory articles about me on the web and is curious about what the real story is, please read this and this.

Journal of Irreproducible ResultsMost scientists I know get a chuckle out of the Journal of Irreproducible Results (JIR), a humor journal that often parodies scientific papers. Back in the day, we used to chuckle at articles like “Any Eye for an Eye for an Arm and a Leg: Applied Dysfunctional Measurement” and “A Double Blind Efficacy Trial of Placebos, Extra Strength Placebos and Generic Placebos.” Unfortunately, these days, reporting on science is giving the impression that the JIR is a little too close to the truth, at least when it comes to reproduciblity, so much so that the issue even has its own name and Wikipedia entry: Replication (or reproducibility) crisis. It’s a topic I had been meaning to write about again for a while. Fortunately, A recent survey published in Nature under the somewhat clickbaity title “1,500 scientists lift the lid on reproducibility” finally prodded me to look into this question again. Before I get to the survey itself, though, I can’t help but do my usual pontificating to provide a bit of background.
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Posted in: Basic Science, Pharmaceuticals, Politics and Regulation, Science and Medicine

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“Integrative” medicine versus “alternative” medicine

“Integrative” medicine versus “alternative” medicine

I’ve written a lot about the language issue with respect to alternative medicine. As I like to put it (at least in shortened form), first there was quackery. Quacks did not like that name at all, and thus was born alternative medicine. And the quacks did think it good—for a while. There was a problem, however. “Alternative” medicine implied (correctly, of course) that what was being discussed was not real medicine, and the quacks could not abide that. Thus was born “complementary and alternative medicine” (CAM).

And the quacks thought this very good indeed.

Unfortunately, it was not long before the problem with the term CAM became apparent. It had the word “complementary” in it. The implication of that word, of course, is that what they were doing was still somehow not real medicine. It was complementary to real medicine, the icing on the cake, if you will. Real medicine could do without it, and having that implication in the very name that their evolving specialty had taken on was offensive to the quacks.

So they changed it.
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Posted in: Basic Science, Critical Thinking, Science and the Media

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Vaginal Seeding. Ew. That’s nuts. Hmmm, interesting.

A breakdown of bacterial species from your skin's microbiome. As a favor to

A breakdown of bacterial species from your skin’s microbiome. As a favor to pregnant women expectant fathers teenage boys on the internet everyone, this is the image I went with. Click to macrolaarggen (Ikean for embiggen).

Sometimes a headline will cause me to run through a series of reactions in rapid sequence. For example “Mothers facing C-sections look to vaginal ‘seeding’ to boost their babies’ health”:

Early studies show that swabbing a mother’s vagina and transferring it to her baby’s mouth, eyes and skin may stimulate microbiome development similarly to babies born naturally – and protect it from health issues later in life

I mean ick.

But take a step back. Not really. I tend to think of people like “Pig Pen” in Charlie Brown, shedding skin and bacteria into the environment. If we were to really think about each other’s microbiome, we might not have intimate contact with our significant other. Or any other animal. I always point out, when someone lets their dog lick them, that they (the dog) had probably just licked its rear, AKA dog-ass seeding. And no, a dog’s mouth is not cleaner than a human’s, unless your dog brushes and flosses with greater frequency than you. (more…)

Posted in: Basic Science, Evolution, Faith Healing & Spirituality, Humor, Nutrition

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Sharks Get Cancer, Mole Rats Don’t: Clues to Understanding Cancer

sharks
We think of cancer as caused by mutations. Mutations are necessary, but not sufficient, to cause cancer. New research indicates that it’s the body’s response to mutant cells that determines whether cancer will develop. James S. Welsh, MD, a radiation oncologist and researcher, has written a book on the immunology of cancer, Sharks Get Cancer, Mole Rats Don’t: How Animals Could Hold the Key to Unlocking Cancer Immunity in Humans. In it, he pieces together clues from animals, pregnancy, Ebola virus, infections, organ transplantation, parasites, and human cancer patients, weaving a web of insights that point to a better understanding of cancer biology and treatment.

Sharks do get cancer

Shark with cancer

Shark with cancer

The first book claiming that sharks don’t get cancer came out in 1992. It persuaded so many people to take shark cartilage that the world market exceeded $30 million and shark populations decreased by as much as 80%. Sharks do get cancer, as you can see in this picture.

Ironically, sharks can even get cancer of the cartilage! And of course shark cartilage supplements don’t prevent cancer in humans. Welsh explains how that myth got started. It was magical thinking based on extrapolation from a legitimate scientific study on angiogenesis where tumor growth in lab animals was suppressed by placing rabbit cartilage next to the tumors.
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Posted in: Basic Science, Cancer

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NCCIH Strategic Plan 2016-2021, or: Let’s try to do some real science for a change

NCCIH
It’s no secret that we at Science-Based Medicine (SBM) are not particularly fond of the National Center for Complementary and Integrative Health (NCCIH). Formerly known as the National Center for Complementary and Alternative Medicine (NCCAM) and before that the Office of Alternative Medicine, NCCIH has been the foremost government agency funding research into quackery for the last 24 years, and, of course, that’s the reason we at SBM have been harshly critical of NCCIH since SBM’s inception. Basically, NCCIH not only funds studies of dubious “alternative” therapies, but it also promotes quackery by funding “fellowships” at various institutions to teach “integrative medicine,” or, as we like to call it, “integrating” quackery with real medicine.

Indeed, back in 2009, when President Barack Obama first took office, Steve Novella and I both suggested that the time was ripe for NCCIH to be defunded and its functions allowed to revert back to the already existing Institutes and Centers of the National Institutes of Health. We were under no illusions that this would happen, given that NCCIH always had a powerful protector in the man who was arguably more responsible for creating NCCIH and guarding it against all attempts at defunding or, even worse, forcing it to do more rigorous science, woo-loving Senator Tom Harkin (D-IA). Harkin is no longer in the Senate, having retired at the end of 2014, but NCCIH is still with us, and the nature of government makes it very much that, unless someone with power is willing to expend serious political capital to eliminate it, NCCIH will be with us always, no matter how much it tries to change its name to eliminate anything implying pseudoscience.

So those of us who recognize that NCCIH was created to promote the “integration” of “outside of the mainstream” or “unconventional” treatments (the vast majority of which are quackery) into real medicine have to learn to live with NCCIH and, as much as it might gall us, to try make lemonade out of the lemon by prodding it to doing some actual rigorous science on “complementary and alternative medicine” that have at least a modicum of biological plausibility and avoid wasting taxpayer money on fairy dust treatments whose precepts either violate the laws of physics (e.g., reiki, homeopathy, and other “energy” medicine) or depend on nonexistent anatomy or physiology (e.g., reflexology, craniosacral, traditional Chinese medicine tongue diagnosis).

This brings me to something I saw on the NCCIH Director’s Blog late last week, a post by the director Josephine Briggs, Requesting Comments on NCCIH’s Draft Strategic Plan. Patriotic US citizen and advocate of SBM that I am, how could I turn down such a request? Kimball Atwood didn’t shirk from such a request back when Dr. Briggs was asking for comments on the NCCAM 2011-2015 strategic plan, nor did I.

In fact, you, too, can comment as well. The deadline is April 15.
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Posted in: Basic Science, Clinical Trials, Politics and Regulation

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The hijacking of evidence-based medicine

One of our heroes at SBM: John Ioannidis.

One of our heroes at SBM: John Ioannidis.

It’s no secret that I’m a fan of John Ioannidis. So, I daresay, are pretty much all of the editors and regular contributors to this blog. (If you don’t believe me, just type Ioannidis’ name into the blog search box and see how many posts you find.) Over the last couple of decades, Ioannidis has arguably done more to reveal the shortcomings of the medical research enterprise that undergirds our treatments, revealing the weaknesses in the evidence base and how easily clinical trials can mislead, than any other researcher. Indeed, after reading what is Ioannidis’ most famous article, “Why Most Published Research Findings Are False“, back in 2005, I was hooked. I even used it for our surgical oncology journal club at the cancer center where I was faculty back then. This was long before I appreciated the difference between science-based medicine (SBM) and evidence-based medicine (EBM). So it was with much interest that I read an article by him published last week and framed as an open letter to David Sackett, the father of evidence-based medicine, entitled “Evidence-based medicine has been hijacked: a report to David Sackett.” Ioannidis is also quoted in a follow-up interview with Retraction Watch.

Before I get to Ioannidis’ latest, I can’t help but point out that, not surprisingly, quacks and proponents of pseudoscientific and unscientific medicine often latch on to Ioannidis’ work to support their quackery and pseudoscience. They’ve been doing it for years. Certainly, they’re already latching on to this article as vindication of their beliefs. After all, their reasoning—if you can call it that—seems to boil down to: If “conventional” medicine is built on such shaky science, then their pseudoscience isn’t wrong after all, given that the same scientific enterprise upon which conventional medicine is based produces the findings that reject their dubious claims and treatments. Of course, whenever I hear this line of argument, I’m reminded of Ben Goldacre’s famous adage, seen in one form on Twitter here:

The adage can be generalized to all EBM and SBM as well. Just because big pharma misbehaves, EBM has flaws, and conventional medicine practitioners don’t always use the most rigorous evidence does not mean that, for example, homeopathy, acupuncture, or energy medicine works.

Still, when Ioannidis publishes an article with a title provocatively declaring that EBM has been “hijacked,” we at SBM take notice. (more…)

Posted in: Basic Science, Clinical Trials, Medical Academia, Pharmaceuticals, Politics and Regulation

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