Where’s the sauna detox?
It is no secret that we at SBM are not particularly fond of the National Center for Complementary and Integrative Medicine (NCCIH; formerly, the National Center for Complementary and Alternative Medicine). We’ve lamented NCCIH’s use of limited public funds for researching implausible treatments, the unwarranted luster NIH/NCCIH funding bestows on quack institutions, the lack of useful research it has produced, and its failure to shoot straight with the public when discussing alternative/ complementary/ integrative medicine. Nor does NCCIH’s research appear to affect CAM practice. Lack of evidence of safety or effectiveness is no impediment to use among CAM practitioners or “integrative” physicians.
So I shouldn’t have been surprised (NCCIH’s promise to “do some real science for a change” notwithstanding) when, a few days ago, I ran across a study of which I was previously unaware (for good reason, as you’ll see) on clinicaltrials.gov:
Sauna Detoxification Study: Pilot Feasibility
The goal of this study is to assess the feasibility of the approach, conduct a dose-finding investigation, and obtain pilot data on hyperthermia via sauna to apply in follow-up trials in the assessment of human chemical body burden reduction, for general wellness, detoxification, and pain reduction.
The investigators wish to determine if a hyperthermia-based detoxification protocol is feasible to conduct: including assessment of recruitment, enrollment, retention, protocol adherence, adverse events, and changes in serum polychlorinated biphenyls (PCBs).
Complementary and Alternative Medicine Sauna Detoxification Study: Phase I
The purpose of this study is to determine the impact of sauna use on polychlorinated biphenyls (PCB) in the blood of healthy human adults, as well as to assess safety, feasibility, and tolerability, and effects on quality of life and wellness. We hope to determine if there is a link between lower PCB levels in blood and sauna use.
A recent New York Times article about how the sugar industry manipulated research starting in 1965 is getting some attention. The article is largely based on a recent JAMA Internal Medicine article that reviews historical documents revealing how the Sugar Research Foundation (SRF) (based largely on revealed internal documents) put their thumb on the scale of diet research starting in 1965 in an attempt to shift the blame for heart disease from sugar onto fat.
The diet wars
I think this latest round of information can only be understood in the context of the longstanding diet wars. Heart disease has become the number one cause of death, as life expectancy has increased and we have reduced many other causes of mortality.
Overweight and obesity are also diseases of modern civilization which is characterized by abundance and an increasingly sedentary lifestyle. Further, the food industry is driven by market forces which favor tasty foods, which often means being high in fat and/or sugar.
This doctor (Ben Carson) believes “glyconutrients” cured his prostate cancer. Researchers in the field of glycobiology think he is wrong. They don’t even accept the term “glyconutrients.”
It has been a long time since I first became aware of Mannatech, the multilevel marketing company that sells “glyconutrient” dietary supplements. After its claims were debunked and it lost a court case, it had dropped off my radar; but last month it came roaring back in the form of an email from a reader in South Africa. He said his in-laws had recently become Mannatech Sales Associates. Although the company can’t legally claim that their products cure any ailments, they continue to imply that their products give your body the tools it needs to cure itself. Company representatives and other advocates continue to claim in seminars and on the Internet that Ambrotose helps with a variety of conditions including MS, AIDS, cancer, lupus, colitis, diabetes, fibromyalgia, cystic fibrosis, ADHD, neuralgia, wound healing, and much more. There are even claims that it “cures” Down syndrome and even changes its characteristic facial features. My correspondent had done his own research and had concluded that Mannatech was marketing modern day snake oil with outrageous claims. But he was shocked that there was so little impartial information available about “glyconutrients.”
He is right: much of the available information about “glyconutrients” is from people who are trying to sell products; there isn’t much unbiased information available. Science-Based Medicine has not previously addressed “glyconutrients” or Mannatech except when Dr. Gorski recently wrote about presidential candidate Ben Carson, MD, shilling for Mannatech and claiming that Mannatech products had cured his prostate cancer. Let’s take a closer look at the science behind the claims for “glyconutrients.” (more…)
Joe Biden promotes the Cancer Moonshot initiative.
The Cancer Moonshot. It’s a topic that I’ve been meaning to address ever since President Barack Obama announced it in his State of the Union address this year and tasked Vice President Joe Biden to head up the initiative. Biden, you’ll recall, lost his son to a brain tumor. Yet here it is, nearly eight months later, and somehow I still haven’t gotten around to it. The goal of the initiative is to “eliminate cancer as we know it,” and to that end, with $195 million invested immediately in new cancer activities at the National Institutes of Health and $755 million proposed for FY 2017. My first thought at the time was that that wasn’t nearly enough money to achieve the ambitious goals set out by the President. That has now become particularly clear now that the National Cancer Institute has released the report from the initiative’s blue ribbon panel suggesting ten ways to speed up progress against cancer.
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.
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…)
Using stem cells to treat disease or improve recovery is an exciting area of research. The potential is undeniably great – these are cells that have the potential to differentiate into mature cells of a specific type. They can be used to replace damaged cells or improve the environment for cell function and recovery. Ideally stem cells can be developed from cells harvested from the patient themselves, so there is no issue of rejection.
Stem cell technology, however, is tricky and currently in its infancy. One challenging hurdle is to prevent transplanted stem cells from turning into tumors. We also need the cells to do what we want and to survive long enough to be useful. Research is progressing, but the potential for stem cells has not yet been realized.
Quackery in the gap
Into this gap between the hype and potential of stem cells and the current reality of the research there is a space where dubious stem cell clinics can thrive. I first wrote about dubious stem cell clinics debuting in China nine years ago. Despite various regulatory efforts these clinics continue to thrive.
We want the veterinarians who care for our animals to continue their education and keep up to date by learning about new developments in science. A new proposal for veterinary continuing education would encourage them to learn to use questionable treatments based on pseudoscience and fantasy.
My friend Carmen Czachor is a science-based veterinarian practicing in Port Angeles, Washington. She has alerted me to a disturbing development that she fears will “put veterinary medicine back in the dark ages.” The Washington State Department of Health is contemplating a rule change in the regulations requiring continuing education for veterinarians. Current requirements are for 30 hours of continuing education every 3 years; the only restriction is that no more than 10 hours can be earned in practice management courses. The Veterinary Board of Governors had observed an increase in the volume of continuing education courses related to CAVM (complementary and alternative veterinary medicine) and they wanted to provide some guidance. They explain:
The board originally proposed a ten hour limit on the number of veterinary CAVM CE hours that can be earned in any three year reporting period. After stakeholder feedback from multiple veterinary practitioners who practice solely in CAVM, the board decided to revisit the proposal. The board now proposes to establish a twenty hour limit on CAVM continuing education and add a ten hour minimum requirement for conventional medicine. The board finds that doing so would not result in a reduction in the quality of care provided and supports the consumer’s choices about what kind of care they seek.
Note: “stakeholder feedback from multiple veterinary practitioners who practice solely in CAVM.” I find this alarming. Veterinarians are licensed to practice veterinary medicine, not CAVM. Alternative medicine is called “alternative” because it is not supported by the kind of evidence that would earn it a place in conventional medicine. What does it mean that veterinarians are “practicing solely in CAVM”? Does that mean they have abandoned the conventional veterinary medicine that they were licensed to practice?
And how on earth did they determine that the proposal “would not result in a reduction in the quality of care provided”? They just made that up because they wanted to believe it and because they believe alternative medicine constitutes quality care. (more…)
I’ve had the Monday spot on this blog for quite a long time now. While there are many advantages to posting on Monday, not the least of which is having more time to put a post together (although that is also a disadvantage because it incentivizes my taking more time than I sometimes should), one distinct disadvantage is that all the Monday holidays are mine. That leaves me a choice on, for example, Memorial Day and Labor Day every year. It’s a choice with three options: The first is: Don’t post. (Do stop laughing, please. I know it’s me.) The second is: Use a guest post. I thought about this, and there are guest posts in the pipeline, but I don’t like to use a guest post just because I’m feeling lazy. It strikes me as an abuse of being the managing editor. Finally, I could post, which is what I decided to do.
I mainly decided to do a post because late last week there was something to blog about that was pretty important and interesting, courtesy of the National Center for Complementary and Integrative Health (NCCIH), which was formerly known as the National Center for Complementary and Alternative Medicine (NCCAM). Basically, on September 1, the NCCIH published a press release, “Review Examines Clinical Trial Evidence on Complementary Approaches for Five Painful Conditions.” Elsewhere, NCCIH Lead Epidemiologist and first author of the review, Richard Nahin, PhD, MPH, bragged on the NCCIH blog, “New Review Offers Providers and Researchers Evidence-Based Information on Complementary Health Approaches for Pain.” It didn’t take long for headlines to start appearing that said things like:
Imagine this Leach attached to your knee.
Medicine can be aggravatingly slow to change and it can take years for new diagnostic or therapeutic interventions to percolate through the medical community. It can take equally long for old practices to fade. I have tried to follow the dictum of “be neither the first to try nor the last to abandon a therapy.”
But nothing in the real world rivals that of the pseudo-medical world, who follow the dictum “be the first to try and the last to abandon a therapy.”
New, often preliminary, findings are spun into grand diagnostic and treatment plans, especially in the world of naturopathy, where there is a fondness for innumerable one cause of all disease.
And the old is never abandoned, although there is a weird propensity for various pseudo-medicines to combine to produce a new mutant strain of pseudo-medicine. But leeches?
Who knew that leeches were still a thing? (more…)