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:
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…)
Archive for Herbs & Supplements
You read that headline correctly.
Stephanie Seneff first came to skeptical attention when she published a study claiming that vaccines were linked to autism. She trolled through the VAERS database and, as David Gorski noted, “tortured the data until it confessed.” Last year she published a paper in which she claimed glyphosate caused autism, claims which I addressed almost a year ago. Gorski also deconstructed this paper, noting, “In fact, if you look at the slides for Seneff’s talks (e.g., this one, available at her MIT web page), you’ll find a tour de force of confusing correlation with causation…”
Seneff is a computer scientist who apparently is anti-vaccine and anti-GMO. In a stunning example of the Dunning-Kruger effect, she feels she can take her computer expertise and export it to biology. She nicely demonstrates that expertise is not so easily transferable.
From autism to concussions
Last year she also published a paper, which escaped my attention until it was recently pointed out to me, claiming that glyphosate, GMOs, and other modern lifestyle factors are responsible for the recent increase in concussions. Her co-author on the paper is Wendy Morely, who is a “Registered Holistic Nutritionist” specializing in the nutrition of concussion. Neither author has any neuroscience background.
As a pediatrician working in a relatively sCAM-inclined region, it is not uncommon to find myself taking care of patients who are also being followed by so-called alternative medicine practitioners. This often creates a major obstacle to providing appropriate care and establishing an atmosphere of mutual trust in the provider-patient/parent relationship. It usually makes me feel like I’m battling invisible serpents in a sea of sCAM.
While these double-dipping parents utilize a variety of sCAM providers, including naturopaths, homeopaths, chiropractors, and a smattering of “holistic healers”, most are taking their children to one of a few “wellness” centers near my practice where they are seen by actual medical doctors practicing so-called “integrative medicine”. Many of these children have vague, chronic, usually non-specific complaints that are difficult to explain and thus to treat. Some have behavioral and mental health problems, or neurodevelopmental conditions such as autism for which parents are seeking explanations and treatments.
What I find to be a common theme with these patients is that they and their parents are summarily taken advantage of by their alternative care providers when they are given a fictitious diagnosis and treated with a variety of useless potions, elixers, and false hopes. Often, parents bring their children to these providers because they are frustrated by their child’s chronic complaints of fatigue, pain, or other somatic issues that have eluded a satisfactory diagnosis or treatment. Invariably, the diagnosis that has remained so elusive to me is quickly found and treated by these much more “holistic” and open-minded providers. In fact, I have never seen a consultation note from one of these providers indicating any uncertainty as to diagnosis or treatment regimen. Typically a large battery of expensive, inappropriate, and sometimes outright fraudulent lab tests is ordered, often from equally questionable laboratories. Again, there are invariably interesting findings prompting tailored and bizarre treatments. In typical red-flag sCAM fashion, some of these providers have their own supplement store, available online only to their patients, prominently displayed on their website. These providers are perceived as being more holistically informed about health and wellness then “conventional” doctors like myself, as if there are two distinct ways of treating illness and maintaining health…as if there is truly such a thing as alternative medicine.
It can be very difficult to manage patients who are being simultaneously “treated” by such providers. Sometimes the treatments complicate or confuse the picture, but it always indicates a failure of trust in the “conventional” method of practice, which is science and evidence based, and in science itself.
Below are a few examples of patients cared for by my practice and simultaneously followed by alternative medicine practitioners. They provide a good picture of just how problematic these co-practitioners can be. No names or identifying information are revealed. (more…)
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…)
“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…)
When I first started writing about the claims made for medical marijuana and the cannabis oil derived from it, it didn’t take long for me to characterize medical claims for cannabis as the “new herbalism,” as opposed to pharmacognosy, the branch of pharmacology devoted to the study of natural products. The reason is simple. Although I support legalization of marijuana for recreational use, when I look at how medical marijuana has been promoted as a “foot-in-the-door” prelude to legalization, I see testimonials and flimsy evidence ruling over all. I see all the hallmarks of alternative medicine herbalism and none of the hallmarks of pharmacology. Here’s what I mean. Pharmacognosy examines an herb, plant, or other natural product and seeks to identify the chemicals within it that have pharmacological activity against a condition or a disease, the better to purify and isolate those chemicals and turn them into drugs. Herbalism, on the other hand, emphasizes the use of whole plants or extracts from plants, rather than the isolation of the most active compounds. Thus, herbal remedies often contain hundreds, or even thousands, of different compounds, of which only one or a few are active. Even extracts, such as cannabis oil, contain many compounds.
In contrast to pharmacognosy, herbalists make the claim that whole herbs and plant components possess a synergy that is missing from the purified active constituents and/or that the mixture is safer than the pure components because one compound can reduce the side effects of another without reducing therapeutic efficacy. When looked at closely neither claim stands up to scrutiny. Synergism between plant constituents is rare and very difficult to demonstrate, for example. In essence, herbalism turns back the clock 200 years to a time before scientists had developed the techniques and abilities to isolate active ingredients with pharmaceutical activity. Moreover, herbalism, in contrast to pharmacognosy, emphasizes anecdotes over scientific evidence.
Indeed, in my previous posts in this series on medical marijuana, one theme has emerged, which is that cannabis—specifically, a class of active chemicals in marijuana known as cannabinoids—has potential for some diseases but is not the panacea claimed by its proponents. It does not cure cancer, for instance, contrary to glowing testimonials promoted by people like Rick Simpson. For other conditions, the evidence is either not particularly compelling or only mildly promising.
So I reacted with considerable dismay on Friday night when I saw this news report on the 11 o’clock news, “Michigan panel recommends allowing marijuana for autism“:
I got an e-mail from a woman who had read my article on ASEA, a multilevel marketing diet supplement that I characterized as an expensive way to buy water. She had not tried ASEA products but was applying for a position as an accountant with the company, and she chastised me for not doing my due diligence and researching the new science of ORMUS.
First she dismissed science, saying “science as we know it is no longer valid and quantum physics clearly shows this.” Then she claimed there was valid science that would support ASEA’s claims. She had personally done a sea salt cleanse with good results. If ASEA is only salt water, that doesn’t negate its validity, since ORMUS material is from sea salt and when minerals are rearranged they no longer register as the original element. Alchemy is not a myth, and the “quantum non-mainstream sciences” prove it is real. Quantum physics “explains that particles can interact without actually being on contact, this is a form or property of superconductivity.” She thinks ORMUS material is superconductive and constitutes a percentage of the human brain mass, allowing transmission of thoughts to others who tune in to these superconductive energy transmissions.
But wait, there’s more! She went on to tell me about an experiment where a dog’s entire blood volume was replaced by seawater. She shared her belief that the power of the mind can heal all disease, and she explained that she relies on a natural knowing within herself and only uses outside evidence to confirm her beliefs. She has been studying subjects like sacred geometry, Vedic mathematics, the golden ratio, quantum physics, and extraterrestrials.
Orbitally Rearranged Monoatomic Elements
This woman is obviously misguided and misinformed, but what is this ORMUS she’s talking about? I’d never heard of it, so I started with Rational Wiki:
ORMUS, also called ORMEs (Orbitally Rearranged Monoatomic Elements) and m-state materials, is a fictitious group of substances exhibiting many miraculous properties, such as healing powers and superconductivity at room temperature. They were supposedly discovered in 1975 by David Hudson, a cotton farmer from Arizona.
Practicing a licensed health care profession, such as medicine, without a license used to be a felony in Nevada. Not any more. As of July 1, quacks and charlatans are free to ply their trades unencumbered by the threat that they might have to answer to the regulatory authorities for their misdeeds, as long as they follow a few simple rules.
This new law, passed overwhelmingly in the Legislature and signed by the Governor, is yet another success of the “health care freedom” movement. It was shepherded through the legislative process by Alexis Miller, a lobbyist for the Sunshine Health Freedom Foundation (Sunshine), which is affiliated with the National Health Freedom Coalition. It’s Director of Law and Public Policy, Diane Miller, also spoke in favor of the bill. We’ll get back to these groups and their comrades in arms in a moment.
First, let’s take a look at what the new law does. A person who provides “wellness services” is protected from prosecution as long has he doesn’t practice medicine, podiatry, chiropractic, homeopathy (homeopaths are licensed in Nevada) or another licensed profession. Some forbidden services are listed in the law, including surgery, setting fractures, prescribing or administering x-rays or prescription drugs, or providing mental health services in the exclusive domain of psychiatrists and psychologists. Of course, while there is certainly danger in untrained persons doing any of these things, they aren’t generally on your average quack’s list of services, nor are they likely interested in them in the first place. (more…)
If there’s one thing that unites all countries and cultures, it’s our love of caffeine. Whether it’s coffee, tea or other foods, caffeine is the most widely consumed drug in the world — more than alcohol, and more than tobacco: 90% of adults worldwide consume caffeine daily. At doses found in food and beverages, the effects are predictable and the side effects are slight. But natural or not, caffeine is a drug; isolate the pure substance, and the risks change. It would be difficult for most people to drink 16 cups of coffee in a row, but that’s the equivalent of just one teaspoon of caffeine powder. If that doesn’t hospitalize you, a tablespoon of the powder will probably kill you. Yet despite the risks, there are no restrictions on the sale of caffeine powder. You can buy a 1kg bag for $35, which provides the caffeine of about 5,000 cups of coffee. Caffeine powder is freely available to buy because regulators treat it differently – not because of its inherent properties, but because it’s “natural” and sold as a dietary supplement rather than a drug. This is a regulatory double-standard that harms consumers. It’s leaving a body count. And it needs to change: (more…)
The FDA recently announced it would send field staff out to collect samples of commercially-manufactured raw dog and cat food. The samples will be analyzed for Salmonella, Listeria monocytogenes and E. coli, all of which have been found in raw pet food, in the animals who eat it, in their feces, on their bodies after eating it, in the areas they inhabit, and on their owner’s bodies. Not surprisingly, this has led to both pet and human infection and illness. If the FDA finds pathogens, it could result in a recall, a press release and Reportable Food Registry Submission. The next day, the CDC joined the effort to curb illness caused by pathogens in raw pet food by posting information on safe handling.
Because of the risk to public health, and the lack of any proven benefit of raw pet food diets, the FDA does not recommend them.
However, we understand that some people prefer to feed these types of diets to their pets.
And why is that? For some of the same reasons humans follow absurd diet fads: the “lone genius” discovery, it’s “natural,” anecdotal evidence, appeal to antiquity, anti-corporate sentiment, and “holistic” practitioner recommendations.