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An Update on FDA Concerns Over Homeopathic Teething Products


Steven Novella recently wrote a post discussing an FDA warning against the use of homeopathic teething products over safety concerns related to the possibility of toxic amounts of belladonna. He goes into the hypocrisy of the FDA regulation of homeopathic products, a topic covered numerous times here on Science-Based Medicine, as well as the misleading initial response from Hyland’s, producers of the most popular homeopathic teething remedies in the United States and Canada. There have been some updates over the past two weeks that I’ll cover in this post. (more…)

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Stem Cell Tourism for Eye Disease: No Passport Required


Stem cell clinics outside the United States, and outside the jurisdiction of the U.S. regulations, have flourished and the pursuit of treatment at these centers has been called “stem cell tourism.” Seekers of unproven stem cell therapies no longer need to look outside the U.S. Paul Knoepfler, a stem cell researcher and leading advocate for the responsible use of stem cell technology, wrote an SBM post on the regulatory aspects of stem cell treatment, a highly recommended read. He also coauthored an article highlighting the direct-to-consumer stem cell industry in the United States. For now, the article is behind a paywall. Fortunately, David Gorski summarized the article here. The authors found a shocking 351 businesses advertising stem cell treatment at 570 locations in the U.S. The problem is that the proliferation of for-profit facilities far outpaces the science on stem cell therapies. Most of these facilities are selling treatments without proven value and with mostly unknown safety.

Clearly, there is no shortage of “experts” prepared to sell you expensive, unproven stem cell treatments for a multitude of diseases. So who can you trust? If I wanted a source of reliable information about stem cell treatment, I might be tempted to seek out the world’s leading homeopathic ophthalmologist!

Introducing: the World’s Leading Homeopathic Ophthalmologist

How do I know Dr. Edward Kondrot is the world’s leading homeopathic ophthalmologist? It says so, right on his website. But it would be an injustice to simply characterize Dr. Kondrot as a homeopathic ophthalmologist. Dr. Kondrot is a Renaissance man of alternative medicine. He is a Board Certified Ophthalmologist, author, radio show host, Fellow of the College of Syntronics, Research Chairman for the College of Syntronics, Adjunct Professor Department of Research at Southwest College of Naturopathic Medicine, President of the Arizona Integrative and Homeopathic Medical Association and member American Academy of Ozonotherapy, just to name a few of the credentials listed on his bio. If you Google Dr. Kondrot’s name you will find he has quite a presence on the internet. I find this video to be particularly endearing. (more…)

Posted in: Basic Science, Science and Medicine

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R&D and the High Cost of Drugs

Would I lie to you?

Would I lie to you?

Until a year ago very few people had ever heard of Martin Shkreli. In 2015 the then-32-year-old CEO of Turing Pharmaceuticals LLC became the poster boy for Big Pharma eXXXcesses when Turing acquired rights to Daraprim, an antiparasitic drug used widely to treat toxoplasmosis. The acquisition itself wasn’t particularly controversial. Raising the price of Daraprim from $13.50 per pill to $750 per pill was.

And so another round of hand-wringing and teeth-gnashing over health care costs began. There was a Congressional hearing where Shkreli preened and smirked and refused to answer questions, later asserting that he had been subpoenaed “unethically” and that it is, “hard to accept that these imbeciles represent the people in our government.” Benjamin Brafman, Shkreli’s attorney, clarified afterward that, “he meant no disrespect…” He wouldn’t want to leave the wrong impression. (more…)

Posted in: Ethics, Pharmaceuticals, Science and Medicine

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Pulp Fiction

I'm sorry, did I break your concentration?

I’m sorry, did I break your concentration?

As so often happens at Science Based Medicine, the inspiration for today’s post comes from a reader of the blog, seeking evidence-based advice and references after receiving conflicting (and perhaps even contradictory) information from other sources. On one hand, it saddens me when people get bad advice from health care professionals or elsewhere, whether it’s from their “regular” doctor, an “alternative” practitioner, or from Dr. Google; on the other hand, the fact that well-meaning patients are seeking out science-based recommendations through Science Based Medicine is encouraging and emphasizes the important role this blog serves.

The email that was referred my way was written by a man who is considering having a tooth extracted in the hopes that it will alleviate some general health issues he is having. He writes:

May I request that you write an article refuting the claims made in the book “Toxic Tooth — How a Root Canal Could Be Making You Sick”?

The purpose of my request is that I am considering getting a root canal pulled out.

After an initial back and forth where I told him that I’d look into it and to meanwhile not do anything hasty, he related his general symptoms (all correspondence reprinted with permission):

My personal information is I am a ** year old male, and I have a lot of fatigue. MDs are not able to tell me why. I have a TSH of 12. MDs are not able to tell me the root cause. I have Monocytes of 13, normal range is 4-13, this means I have an infection. This makes me wonder if maybe that root canal is the cause of that infection.

To translate (very superficially and simplistically): His TSH (Thyroid Stimulating Hormone) level is elevated. TSH is a hormone released from the pituitary gland and helps regulate the thyroid hormones which are involved in the body’s cellular metabolism. Normal values are in the 0.3–3.0 µIU/mL in an adult, and an elevated TSH usually means that the patient has an underactive thyroid (hypothyroidism). On rare occasions, it can indicate the presence of a thyroid tumor or other uncommon issues. His monocyte level is a bit elevated as well, which could mean the presence of a chronic infection or perhaps an auto-immune disease, but that lab value alone is not enough to make that call. But I’m just a dentist; what do I know? (more…)

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Another way ibuprofen can kill us?

Does ibuprofen really raise your risk of heart failure by 83%? No.

Does ibuprofen really raise your risk of heart failure by 83%? No.

Do you ever take ibuprofen? Naproxen? Cold medication with an anti-inflammatory ingredient? The non-steroidal anti-inflammatory drugs (NSAIDs) are among our most well-loved medications. We start giving them in infancy, for fever, and continue use through to adulthood for everyday aches and pains. But it’s our later stages of life when we really ramp up the use, and daily consumption becomes common for conditions like arthritis. While they may be easily accessible and included as ingredients in thousands of consumer products, NSAIDs have a long list of potentially serious side effects. Not only can they cause stomach ulcers and bleeding by damaging the lining of the gastrointestinal tract, they can also increase the risk of fatal cardiovascular disease. Now there’s new research that looks at the relationship between NSAIDs and heart failure, a condition where the heart cannot pump adequately and appropriately. The study, “Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study” resulted in some fairly dramatic, alarming headlines:
daily mirror headline NSAIDS ibuprofen heart failure

Headlines like this suggest that NSAIDs are killing us indiscriminately, which may make you wonder how so many of us manage to have lived this long. And while The Daily Mirror got the facts wrong, they quoted from a well-conducted study. There is a real risk of heart failure from NSAIDs. But context is everything. (more…)

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Infectious Diseases and Cancer


Dr. William Coley. Not a brain surgeon.

With apologies to my colleagues, but infectious diseases really is the most interesting specialty in medicine. There are innumerable interesting associations and interactions of infectious diseases in medicine, history, art, science, and, well, life, the universe and everything. ID is so 42.

A recent email led me to wander the numerous interactions between infections and cancer.

There are the cancers that are caused by infection. HPV and cervical and throat cancer. EBV and lymphoma. HHV8 and Kaposi’s Sarcoma. I certainly hope I am not reincarnated as a Tasmanian Devil. (more…)

Posted in: Basic Science, Cancer, Clinical Trials, Epidemiology, Science and Medicine, Vaccines

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American Academy of Pediatrics Calls for End to Pediatric Codeine Use…Again

So, pretty please...with sugar on top. Stop prescribing codeine to kids.

So, pretty please…with sugar on top. Stop prescribing codeine for children.

The safe and effective management of subjective symptoms in the pediatric population, in particular pain, has always been difficult. Young patients, even premature infants at the limit of viability, experience pain, a fact that sadly was not widely accepted until the late last century. But even with full recognition of pain as a potential concern in all pediatric patients, undertreatment of pain remains a system wide issue.

Pediatric pain management is especially challenging for a variety of reasons. Overall there are fewer pediatric friendly pharmaceutical options to choose from and limited data on available pain medications for children, leaving pediatric providers fitting square pegs in the round hole of adult medicine. Further complicating the situation is the fact that kids can have significantly different absorption and metabolism of drugs compared to adults. Finally, young children are more likely to be undertreated because of the reluctance to prescribe, or to consent to the use of, opioid medications by providers and caregivers respectively.

As if things weren’t difficult enough, the AAP Section on Anesthesiology and Pain Medicine has published a clinical report in the September Pediatrics that aims to remind providers that it is “time to say no” to one of the our most popular pain medications: codeine. Sadly, the authors are not raising new concerns. Instead, they are once again pointing out serious problems with this drug, problems we have known about for over a decade that have resulted in deaths and inadequately treated pain.

Posted in: Science and Medicine

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Belly Button Healing: Science plus Magic for Only $99?


The patient doesn’t choose the Healing Life Wand. The Healing Life Wand chooses the patient.

If you wanted to design and market an ineffective treatment with the best chance of successfully fooling consumers, it would have to include a certain set of key components in order to maximize profit. A connection to nature is extremely important, the more emotional the better. Although trickier to pull off, your product would need to call upon ancient wisdom while also being associated with cutting edge science. But keep the association vague and let the consumers connect the dots. A hint of conspiracy, where the consumer believes that they are being let in on a secret or suppressed cure helps too.

The mechanism of action should be unclear in order to avoid easy refutation, and should preferably involve concepts such as removing toxins and balancing energy or hormones. Again, it’s important to combine science with your magic, so include things like lymphatic drainage or increased blood flow. The ailments your treatment would remedy need to be subjective and likely to respond to numerous placebo effects. And the treatment should be simple, even a bit fun, in both concept and execution. Finally, throw in a catchy slogan or two and you’ll be rolling around on a pile of hundreds in no time at all.

Posted in: Science and Medicine

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Oxygen water? You can’t breathe through your stomach

Unless you have gills, this won't make you a strong, faster athlete.

Unless you have gills, this won’t make you a stronger, faster athlete.

My exercise of choice is running. Despite the heat I’ve been having a great summer, training for the Chicago marathon. I’ve followed the training schedule fanatically since June. But it all came crashing down in one run last week when I moved from the ranks of “marathoner in training” to “injured runner”.

With the sudden onset of very sharp, radiating back pain, I was struggling to walk. My marathon plans seemed to evaporate. And in that moment of weakness, I became prey. Prey to pseudoscience, and prey to anyone offering a quick fix. (more…)

Posted in: Herbs & Supplements, Nutrition, Science and Medicine

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An Unexpected Miscellany of Medical Malarkey



I had originally intended a focused discussion of a single topic, but life circumstances have conspired to prevent me from doing so.  In the place of my intended post, please enjoy the following collection of hastily assembled pseudomedical odds and ends brought to my attention over the past few weeks. (more…)

Posted in: Acupuncture, Science and Medicine

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