Archive for Science and Medicine

“Magic Socks?” Alternative Medicine’s Obsession With Your Feet.


Inappropriate earthing technique?

I recently received an email from none other than Jann Bellamy pointing out a particular flavor of naturopathic nonsense that I had missed up until this point: “magic socks.” A quick search revealed that our own Scott Gavura had briefly mentioned this remedy in a 2013 post, but I plan on going into much greater detail. The claim contained in the newsletter attached to Jann’s email involved the use of said magic socks to “alleviate congestion.” Three links were thoughtfully provided for more information and I took the bait. Thanks Jann.

That’s right, magic socks!

The first link took me to the website of Bastyr University, where Britt Hermes matriculated to the tune of $300,000 and a leader in “innovation in natural health education” that offers numerous degrees in “science-based natural medicine.” According to the experts at Bastyr, wet sock treatment, apparently synonymous with “magic socks”, is “a natural method of stimulating the immune system and zapping a cold or flu” that involves forcing a child to don ice-cold socks overnight. They even admit that this is a treatment approach recommended regularly by the naturopathic physicians at Bastyr Center for Natural Health.

According to the chief medical officer at BCNH (seems like there should be an asterisk there or something), we shouldn’t be thrown by how much this sounds like complete and utter nonsense, because it works. He reassures us that magic socks “rally the body’s defenses” using the healing power of nature. And it’s free! All you need is water, socks, a freezer, and some electricity. Okay, so it isn’t free but it’s pretty darn cheap. (more…)

Posted in: Naturopathy, Science and Medicine

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Tobinick Lawsuit Update – Justice Has Prevailed


On September 30, the U.S. District Court for the Southern District of Florida granted Dr. Novella’s motion for summary judgment, ending the lawsuit against him by Dr. Edward Tobinick and two of his companies. Earlier in the case, all of the other defendants had filed successful motions to dismiss or for summary judgment and were no longer parties to the case.

That he won the remaining issues in the case on a motion for summary judgment is highly significant. Summary judgment motions are granted sparingly by the courts. In granting his motion, the judge was required by law to view the facts in the light most favorable to Tobinick and the other plaintiffs and draw all reasonable inferences from those facts in their favor.  Dr. Novella had to convince the judge that there was no dispute as to any of the relevant facts and that those undisputed facts entitled him to prevail. Because of this ruling, the case will not go to trial.

For a quick background, Tobinick filed a suit against Dr. Novella, the Society for Science-Based Medicine (SFSBM), Yale University and SGU Productions. The subject of his suit was an article Dr. Novella wrote here critical of his claims that perispinal etanercept can treat a variety of neurological conditions, as well as a second article, posted after suit was filed.


Posted in: Announcements, Science and Medicine

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Antivaccine activists fund a study to show vaccines cause autism. It backfires spectacularly.

You want to inject me with vaccines and then dissect my brain? Why? We already know vaccines don't cause autism!

You want to inject me with vaccines and then dissect my brain? Why? We already know vaccines don’t cause autism!

Having written about pseudoscience and quackery continuously for over a decade and having engaged in conversations about it online for over 15 years, I’ve come to recognize a number of traits that are virtually the sine qua non of quacks and pseudoscientists and their believers. Obviously, one of them is a severe case of the Dunning-Kruger effect, a tendency of those with low expertise in a topic to overestimate their expertise and express far more confidence in their conclusions than warranted while those with high expertise know enough to know how much they don’t know about a topic and thus tend to express more uncertainty and caveats. Basically, the Dunning-Kruger effect describes how unskilled individuals express an illusory superiority, mistakenly believing their knowledge, competence, and ability to be much higher than it really is.

As a result of the Dunning-Kruger effect, coupled with other cognitive shortcomings suffered by all human beings (but seemingly amplified in believers in quackery and pseudoscience) that lead them to believe in pseudoscience, such as confusing correlation with causation, motivated reasoning, and the like, believers in pseudoscience are often so absolutely rock-solid in their beliefs that they are virtually impossible to reason with. It is incredibly difficult to change their minds, and disconfirming evidence often causes them to dig in all the more deeply to defend their beliefs. Not uncommonly, this leads them to commission studies designed to support their beliefs. But what happens when such a study does not actually support their belief? What happens when such a study backfires spectacularly and not only fails to support their belief, but emphatically so? Skeptics were re-treated to just such a spectacle last week when SafeMinds and other antivaccinationists were burned by a study they funded (subscription required):

Between 2003 and 2013, SafeMinds provided scientists from the University of Texas Southwestern School of Medicine, the University of Washington, the Johnson Center for Child Health & Development and other research institutions with approximately $250,000 to conduct a long-term investigation evaluating behavioral and brain changes of baby rhesus macaques that were administered a standard course of childhood vaccines. (The National Autism Association, another organization that has questioned vaccine safety, also provided financial support for this research.) The latest paper in the multiyear project was published Monday in the Proceedings of the National Academy of Sciences (PNAS). In it, the researchers concluded that vaccines did not cause any brain or behavioral changes in the primates.

Astute readers will recognize that I’ve written about similar papers before reporting that pediatric vaccines cause changes in behavior and/or brain structure in macaque monkeys. Specifically, way back in 2008, I noted the initial report of this ongoing study, first when preliminary results were reported as a poster presentation and then later another publication from the same group published in 2009. Steve Novella and a certain well-known friend of the blog have also described how poor experiments published from these studies in 2010 were, the latter of whom cited several other major criticisms of the study, not the least of which was some reporting of changes in the size of a part of the brain known as the amygdala that were…hard to believe. There were also a lot of issues with the control group chosen.

Basically, these abstracts and papers reported the results of an ongoing study looking at infant vaccines in macaque monkeys to see if there was an effect on socialization or changes in brain anatomy, the key hypothesis seeming to be that thimerosal-containing vaccines cause autism. (The investigators even added thimerosal to some of the vaccines because they weren’t being made with thimerosal anymore!) You can read the links I cited just now if you want the gory details; suffice to say that these were not good studies and not particularly good evidence that vaccines cause autism, as shown by the fact that homeopaths loved the study, and ultimately the paper examining hepatitis B specifically was withdrawn. Yet these reports were flogged for quite a while by the antivaccine movement as proof positive primate data that vaccines are Evil.

Fast forward to 2015. Now we have a much larger, much better study. It’s even by the same people. And guess what? It’s as negative as negative can be. No wonder SafeMinds and other antivaccinationists are unhappy. Let’s take a look. (more…)

Posted in: Science and Medicine

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Open vs Blinded Peer-Review


The overall goal of science-based medicine is to maintain and improve the standard of science in the practice of medicine at every level. At the heart of the scientific basis of medical knowledge and practice is a process known as peer-review. We have occasionally written about peer-review on SBM, and once again the process is under the microscope over a specific question – should peer review be open or blinded?

What is peer review

The term peer-review refers to a pre-publication process in which a journal editor will send a submitted manuscript to 2-3 experts in a field relevant to the paper to carefully examine every aspect of the paper. They then provide a detailed analysis of the paper: is the research question relevant and appropriate, did the study design properly address the question, were the methods rigorous, was the statistical analysis appropriate, was the data presented fairly, are the conclusions supported by the data, did the authors account for other publications addressing the same issue, and did they address every possible question or objection?

The reviewers’ reports will make specific recommendations for changes that would be necessary to improve the paper, and also make their bottom-line recommendation: accept as is, accept with revisions, or deny. The journal editor(s) then rely upon those reviews, plus their own assessment, to make a final decision.


Posted in: Medical Academia, Science and Medicine

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The Enigma of Chiropractic: A Brief Review with a Perspective on Chiropractic as a Specialty

 Subluxation-based chiropractic care is sustained more by faith than by facts.

Subluxation-based chiropractic care is sustained more by faith than by facts

Much of what is discussed in this article has been said before in previous articles I have written for Science-Based Medicine. But since the audience for SBM has greatly increased over the past few years, some subject matter should be repeated for the new readers and researchers coming to this site for reliable information on health care.

Many consumers now search SBM for articles dealing with controversial alternative treatment methods that have been shown to be ineffective or to be loaded with fraud and quackery. Chiropractic in particular continues to be problematic for its failure to renounce the scientifically indefensible, nonfalsifiable subluxation theory that defines the profession as a whole. A review of chiropractic web sites reveals that many chiropractors continue to base their treatment methods on subluxation theory, encompassing a broad scope of health problems. Some chiropractors are now including use of “functional medicine” which uses “natural tools” to treat diabetes, thyroid disease, neuropathy, and other diseases best treated by conventional medical care. Most alarming of all is the treatment of infants and children by “pediatric chiropractors.” Chiropractors are being certified in 10 different specialties, including a diplomate in Diagnosis and Internal Disorders.

As long as chiropractic is licensed as a health-care profession based on subluxation theory or some other unscientific approach, it will continue to be subjected to scrutiny and criticism by the science-based community. It is, in fact, the moral and ethical responsibility of science-based practitioners to oppose any form of unscientific health care, wherever it might exist, separating sense from nonsense without being influenced by politics, special interest, pseudoscience, or belief systems.


Posted in: Chiropractic, Science and Medicine

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A “Natural Cure” for Eczema Leaves a Young Child in Agony…..


“I swear I had nothing to do with this!”

A short post today, for me at least, but an important one to file away for the next time somebody asks “What’s the harm?” during a discussion on the use of irregular medicine in the care of pediatric (or any) patients.

The case

The September 2015 issue of Pediatrics in Review, the official American Academy of Pediatrics source for continuing medical education, contains a case report that should be of particular interest to readers of Science-Based Medicine. The authors, pediatricians at Children’s Hospital at Albany Medical Center, describe the ordeal of a six-year-old boy, previously healthy except for eczema, suffering with lower extremity pain to the point of crying with attempts to walk or to even bear weight. For those of you who don’t have experience with children of this age, it takes a considerable amount of discomfort or disability to interfere with their determination to remain in a near constant state of motion. Refusal to bear weight is a red flag that we take very seriously as the cause in a young child is often serious, ranging from traumatic injuries and severe infections of the bones or joints to diagnostic dilemmas such as leukemia and juvenile rheumatoid arthritis. (more…)

Posted in: Science and Medicine

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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

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Here be Dragons: Caring for Children in a Dangerous Sea of sCAM

Here be dragons large map

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…)

Posted in: Diagnostic tests & procedures, Herbs & Supplements, Naturopathy, Pharmaceuticals, Science and Medicine

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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

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The price of a naturopathic education

Editor’s Note: I’m on vacation in London and won’t be doing my regular Monday post this week. In its place, here’s another guest post from Britt Hermes of, about her extraordinary student debt from her abandoned naturopathy career. If you’re in London, join me at the London Skeptics’ Skeptics in the Pub on Monday night at The Monarch Bar at 7:30 PM! I won’t be giving a talk (I am, after all, on vacation), but after being in contact with some London skeptics I decided that this was the best way for me to meet as many SBM readers as possible without disrupting our vacation to the point where my wife would start to become irritated with me. :-) ~ Dr. David Gorski

Dr. Nick of Hollywood Upstairs Medical College

Dr. Nick graduated from Hollywood Upstairs Medical College

This morning, I checked my student loan balance from earning a doctorate in naturopathic medicine from Bastyr University. I owe a little over $333,000. Since graduation, my loans have accumulated interest while I deferred payments during my naturopathic residency and again after I quit practicing naturopathy.

To call this amount daunting or depressing is an understatement.

Since I thought an ND degree meant I’d have job prospects as a real primary care physician, I assumed I’d have no problem paying back my student loans, just like most medical doctors. I also thought I’d be eligible for federal loan repayment programs. I quickly learned, as have my former colleagues, that naturopathic doctors have dismal job prospects and earnings.

The average naturopathic doctor makes $60,000 a year in private practice. To put this in perspective, the average primary care physician income is about $186,000. Despite Bastyr insisting that naturopaths are trained as primary care physicians, their income certainly does not reflect it. (Nor does their training.)


Posted in: Science and Medicine

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