MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

commercial interests

Acupuncture seems to be as popular as never before – many conventional pain clinics now employ acupuncturists, for instance. It is probably true to say that acupuncture is one of the best-known types of all alternative therapies. Yet, experts are still divided in their views about this treatment – some proclaim that acupuncture is the best thing since sliced bread, while others insist that it is no more than a theatrical placebo. Consumers, I imagine, are often left helpless in the middle of these debates. Here are 7 important bits of factual information that might help you make up your mind, in case you are tempted to try acupuncture.

  1. Acupuncture is ancient; some enthusiast thus claim that it has ‘stood the test of time’, i. e. that its long history proves its efficacy and safety beyond reasonable doubt and certainly more conclusively than any scientific test. Whenever you hear such arguments, remind yourself that the ‘argumentum ad traditionem’ is nothing but a classic fallacy. A long history of usage proves very little – think of how long blood letting was used, even though it killed millions.
  2. We often think of acupuncture as being one single treatment, but there are many different forms of this therapy. According to believers in acupuncture, acupuncture points can be stimulated not just by inserting needles (the most common way) but also with heat, electrical currents, ultrasound, pressure, etc. Then there is body acupuncture, ear acupuncture and even tongue acupuncture. Finally, some clinicians employ the traditional Chinese approach based on the assumption that two life forces are out of balance and need to be re-balanced, while so-called ‘Western’ acupuncturists adhere to the concepts of conventional medicine and claim that acupuncture works via scientifically explainable mechanisms that are unrelated to ancient Chinese philosophies.
  3. Traditional Chinese acupuncturists have not normally studied medicine and base their practice on the Taoist philosophy of the balance between yin and yang which has no basis in science. This explains why acupuncture is seen by traditional acupuncturists as a ‘cure all’ . In contrast, medical acupuncturists tend to cite neurophysiological explanations as to how acupuncture might work. However, it is important to note that, even though they may appear plausible, these explanations are currently just theories and constitute no proof for the validity of acupuncture as a medical intervention.
  4. The therapeutic claims made for acupuncture are legion. According to the traditional view, acupuncture is useful for virtually every condition affecting mankind; according to the more modern view, it is effective for a relatively small range of conditions only. On closer examination, the vast majority of these claims can be disclosed to be based on either no or very flimsy evidence. Once we examine the data from reliable clinical trials (today several thousand studies of acupuncture are available – see below), we realise that acupuncture is associated with a powerful placebo effect, and that it works better than a placebo only for very few (some say for no) conditions.
  5. The interpretation of the trial evidence is far from straight forward: most of the clinical trials of acupuncture originate from China, and several investigations have shown that very close to 100% of them are positive. This means that the results of these studies have to be taken with more than a small pinch of salt. In order to control for patient-expectations, clinical trials can be done with sham needles which do not penetrate the skin but collapse like miniature stage-daggers. This method does, however, not control for acupuncturists’ expectations; blinding of the therapists is difficult and therefore truly double (patient and therapist)-blind trials of acupuncture do hardly exist. This means that even the most rigorous studies of acupuncture are usually burdened with residual bias.
  6. Few acupuncturists warn their patients of possible adverse effects; this may be because the side-effects of acupuncture (they occur in about 10% of all patients) are mostly mild. However, it is important to know that very serious complications of acupuncture are on record as well: acupuncture needles can injure vital organs like the lungs or the heart, and they can introduce infections into the body, e. g. hepatitis. About 100 fatalities after acupuncture have been reported in the medical literature – a figure which, due to lack of a monitoring system, may disclose just the tip of an iceberg.
  7. Given that, for the vast majority of conditions, there is no good evidence that acupuncture works beyond a placebo response, and that acupuncture is associated with finite risks, it seems to follow that, in most situations, the risk/benefit balance for acupuncture fails to be convincingly positive.

The volume of medical research, as listed on Medline, is huge and increases steadily each year. This phenomenon can easily be observed with simple Medline searches. If we use search terms related to conventional medicine, we find near linear increases in the number of articles (here I do not make a distinction between types of articles) published in each area over time, invariably with a peak in 2013, the last year for which Medline listing is currently complete. Three examples will suffice:

PHARMACOTHERAPY        117 414 articles in 2013

PHARMACOLOGY               210 228 articles in 2013

ADVERSE EFFECTS              86 067 articles in 2013

Some of the above subjects are obviously heavily industry-dependent and thus perhaps not typical of the volume of research in health care generally. Let’s therefore look up three fields where there is no such powerful industry to support research:

PSYCHOTHERAPY              7 208 articles in 2013

PHYSIOTHERAPY                7 713 articles in 2013

SURGERY                           154 417 articles in 2013

Now, if we conduct similar searches for topics related to alternative medicine, the picture changes in at least three remarkable ways: 1) there is no linear increase of the volume per year; instead the curves look flat and shapeless (the only exception is ‘herbal medicine’ where the increase even looks exponential). 2) The absolute volume does not necessarily peak in 2013 (exceptions are ‘acupuncture’ and ‘herbal medicine’). 3) The number of articles in the year with the most articles (as listed below) is small or even tiny:

ACUPUNCTURE                    1 491 articles in 2013

CHIROPRACTIC                      283 articles in 2011

HERBAL MEDICINE           2 503 articles in 2013

HOMEOPATHY                        233 articles in 2005

NATUROPATHY                         69 articles in 2010

You may think: so what? But I find these figures intriguing. They demonstrate that the research output in alternative medicine is minimal compared to that in conventional medicine.  Moreover, they imply that this output is not only not increasing steadily, as it is in conventional medicine, but in the case of chiropractic, homeopathy and naturopathy, it has recently been decreasing.

To put this into context, we need to know that:

  1. there is a plethora of journals dedicated to alternative medicine which are keen to publish all sorts of articles,
  2. the peer-review process of most of these journals seems farcically poor,
  3. as a result, the quality of the research into alternative medicine is often dismal, as regularly disclosed on this blog,
  4. enthusiasts of alternative medicine often see rigorous research into their subject as a dangerous threat: it might disprove their prior beliefs.

In their defence, proponents of alternative medicine would probably claim that the low volume of research is due to a severe and unfair lack of funding. However, I fail to see how this can be the sole or even the main explanation: areas of conventional medicine that do not have industry support seem to manage a much higher output than alternative medicine (and I should stress that I have chosen 5 sections within alternative medicine that are associated with the highest number of articles per year). Research in these areas is usually sponsored by charitable and government sources, and it needs to be stressed that these are open to any researcher who submits good science.

What follows, I think, is simple: in general, alternative medicine advocates have little interest in research and even less expertise to conduct it.

While the previous post was about seeing a traditional herbalist (who prescribe their own herbal mixtures, tailor-made for each individual patient), this post provides essential information for those consumers who are tempted to take a commercially available herbal remedy available in pharmacies, health food shops, over the Internet etc. These remedies are usually bought by consumers and then be self-administered, or (less frequently) they might be prescribed/recommended/sold by a clinician such as a doctor, naturopath, chiropractor etc. Typically, they contain just one (or relatively few) herbal extracts and are used under similar assumptions as conventional medicines: one (hopefully well-tested) remedy is employed for treating a defined condition, diagnosed according to validated and generally accepted criteria (for instance, St John’s Wort for depression or Devil’s claw for back pain). This approach is sometimes referred to as ‘rational phytotherapy’ – it is certainly more rational than the traditional herbalism referred to in my previous post. The manufacture, promotion and sale of commercial herbal remedies (in many countries marketed as ‘dietary supplements’) has grown into a multi-billion dollar industry.

Here are a few essentials you ought to know before you decide to take such an herbal remedy:

  1. Many people claim that herbal medicine is effective because many of our modern drugs are based on plants. The latter part of this claim is true, of course, but this does not necessarily mean that herbal remedies are effective. The drugs derived from plants contain one single, well-defined, extensively researched molecule (by definition, this makes them conventional drugs and not herbal remedies), while herbal remedies are based on entire (parts of) plants; thus they contain many pharmacologically active molecules. This often means that it is difficult or impossible to tell what dose of which ingredient is being administered and what pharmacological actions can be expected.
  2. Even though national regulations differ greatly, herbal remedies generally do not have to be supported by evidence for efficacy in order to be legally available. This means that a given remedy might or might not have been tested in clinical trials to determine whether it works for the condition advertised. In fact, only very few (less than 30, I estimate) herbal remedies are supported by sound evidence for efficacy; thousands do not meet this criterion.
  3. The extremely wide-spread notion that herbal remedies are by definition natural and therefore safe is nothing but a promotional myth. Plants contain many chemicals which can have pharmacological activity. This means they might be therapeutic, but it also means that they might be toxic (traditionally the most powerful poisons originated from the plant kingdom). If anyone uses the ‘natural = safe fallacy’ remind him/her of hemlock, poison ivy etc.
  4. In addition to potential toxicity of an herbal ingredient, there are other important safety issues to be considered. Most importantly, herbal remedies can interact with prescribed medicines. For instance, St John’s Wort (one of the best-studied herbal remedies in this respect) powerfully interacts with about 50% of all prescription drugs – in fact, it lowers their level in the blood which means that a patient on anti-coagulants would lose her anti-coagulant protection and might suffer from a (potentially fatal) blood clot.
  5. In many countries, including the US, the regulation of herbal remedies is so lax, that there is no guarantee that an herbal remedy which is being legally sold is safe. The regulators are only allowed to intervene once there are reports of adverse effects. This means that the burden of proof of safety is effectively reversed which obviously exposes consumers to incalculable risks.
  6. The quality of the herbal product is equally poorly regulated in most countries. A plethora of investigations in the US, for instance, has shown that the dose of the herbal ingredient printed on the label of a commercial product can range virtually from 0 – 100%. Similarly there is little safe-guard that the ingredients listed on the label correspond to the ones in the preparation. This means that it is worth purchasing not just well-researched herbal remedies but also those marketed by high quality manufacturers via respectable outlets.
  7. Any regulation of herbal remedies, even the European one that is often praised as protecting consumers adequately, is null and void once consumers go on the Internet and purchase their herbal remedies from one of the many dubious sources found there in truly alarming profusion. Bogus claims, inferior quality and even outright dangerous products abound, and it is often impossible to tell the acceptable from the fraudulent product.

Here I am not writing about herbal medicine in general – parts of which are supported by some encouraging evidence (I will therefore post more than one ‘seven things to remember…’ article on this subject) – here I am writing about the risks and benefits of consulting a traditional herbal practitioner. Herbalists come in numerous guises depending what tradition they belong to: Chinese herbalist, traditional European herbalist, Ayurvedic practitioner, Kampo practitioner etc. If you consult such a therapist, you should be aware of the following issues.

  1. Worldwide, the treatment by traditional herbal practitioners is by far the most common form of herbal medicine; it is more common than to use specific, well-tested herbs to treat specific conventionally diagnosed conditions (an approach that might best be called ‘rational phytotherapy’).
  2. Herbalists often use their very own diagnostic methods (think, for instance, of ‘tongue and pulse diagnoses’ used by Chinese herbalists) and reject (or are untrained to use) conventional diagnostic methods. The traditional diagnostic techniques of herbalists have either not been validated at all or they have been tested and found to be not valid.
  3. Herbalists usually do not recognise conventional disease categories. Instead they arrive at a diagnosis according to their specific philosophy which has no grounding in reality (for instance, energy imbalance in traditional Chinese herbalism).
  4. Herbalists individualise their treatments, meaning that 10 patients suffering from depression, for instance, might receive 10 different, tailor-made prescriptions according to their individual characteristics (and none of the 10 patients might receive St John’s Wort, the only herbal remedy that actually is proven to work for depression).
  5. Typically, such prescriptions contain not one herbal ingredient, but are mixtures of many – up to 10 or 20 – herbs or herbal extracts.
  6. Even though the efficacy of the individualised herbal approach can, of course, be tested in rigorous trials, and even though about a dozen such studies are available today, there is currently no good evidence to show that it is effective.
  7. The risk of harm through these individualised herbal mixtures can be considerable: the more ingredients, the higher the likelihood that one of them has toxic effects or that one interacts with a prescription medicine. Essentially, this means that there is no good evidence that individualised herbal treatments as used by so many herbal practitioners across the globe generates more good than harm.

Some of the recent comments on this blog have been rather emotional, a few even irrational, and several were, I am afraid, outright insulting (I usually omit to post the worst excesses). Moreover, I could not avoid the impression that some commentators have little understanding of what the aim of this blog really is. I tried to point this out in the very first paragraph of my very first post:

Why another blog offering critical analyses of the weird and wonderful stuff that is going on in the world of alternative medicine? The answer is simple: compared to the plethora of uncritical misinformation on this topic, the few blogs that do try to convey more reflected, sceptical views are much needed; and the more we have of them, the better.

My foremost aim with his blog is to inform consumers through critical analysis and, in this way, I hope to prevent harm from patients in the realm of alternative medicine. What follows, are a few simple yet important points about this blog which I try to spell out here as clearly as I can:

  • I am not normally commenting on issues related to conventional medicine – not because I feel there is nothing to criticise in mainstream medicine, but because my expertise has long been in alternative medicine. So commentators might as well forget about arguments like “more people die because of drugs than alternative treatments”; they are firstly fallacious and secondly not relevant to this blog.
  • I have researched alternative medicine for many years (~ 40 clinical studies, > 300 systematic reviews etc.) and my readers can be confident that I know what I am talking about. Thus comments like ‘he does not know anything about the subject’ are usually not well placed and just show the ignorance of those who post them.
  • I am not in the pocket of anyone. I do not receive payments for doing this blog, nor did I, as an academic, receive any financial or other inducements for researching alternative medicine (on the contrary, I have often been given to understand that my life could be made much easier, if I adopted a more promotional stance towards my alternative medicine). I also do not belong to any organisation that is financed by BIG PHARMA or similar power houses. So my critics might as well abandon their conspiracy theories and  focus on a more promising avenue of criticism.
  • My allegiance is not with any interest group in (or outside) the field of alternative medicine. For instance, I do not see it as my job to help chiropractors, homeopaths etc. getting their act together. My task here is to point out the deficits in chiropractic (or any other area of alternative medicine) so that consumers are better protected. (I should think, however, that this also creates pressure on professions to become more evidence-based – but I see this as a mere welcome side-effect.)
  • If some commentators seem to find my arguments alarmist or see it as venomous scare-mongering, I suggest they re-examine their own position and learn to think a little more (self-) critically. I furthermore suggest that, instead of claiming such nonsense, they point out where they think I have gone wrong and provide evidence for their views.
  • Some people seem convinced that I have an axe to grind, that I have been personally injured by some alternative practitioner, or had some other unpleasant or traumatic experience. To those who think so, I have to say very clearly that none of this has ever happened. I recommend they inform themselves of the nature of critical analysis and its benefits.
  • This is a blog, not a scientific journal. I try to reach as many lay people as I can and therefore I tend to use simple language and sometimes aim to be entertaining. Those who feel that this renders my blog more journalistic than scientific are probably correct. If they want science, I recommend they look for my scientific articles in the medical literature; I can assure them that they will find plenty.
  • I very much invite an open and out-spoken debate. But ad hominem attacks are usually highly counterproductive – they only demonstrate that the author has no rational arguments left, or had none in the first place. Authors of insults also risks being banned from this blog.
  • Finally, I fear that some readers of my blog might sometimes get confused in the arguments and counter-arguments, and end up uncertain which side is right and which is wrong. To those who have this problem, I recommend a simple method for deciding where the truth is usually more likely to be found: ask yourself who might be merely defending his/her self-interest and who might be free of such conflicts of interest and thus more objective. For example, in my endless disputes with chiropractors, one could well ask: do the chiropractors have an interest in defending their livelihood, and what interest do I have in questioning whether chiropractors do generate more good than harm?

The chiropractic profession have been reminded time and times again that their claim to be able to effectively treat paediatric conditions is bogus. Many experts have asked them to produce some compelling evidence or stop this dangerous nonsense. Yet most of them seem to remain in denial, famously documented by the British Chiropractic Association suing Simon Singh for libel after he disclosed that they happily promote bogus treatments.

Some chiropractors now say that things have changed and that chiropractors are finally getting their act together. If that is true, progress must be painfully slow – so slow, in fact, that it is hard to see it at all. There are still far too many chiropractors who carry on just as before. There are hundreds, if not thousands of articles promoting chiropractic for childhood conditions; a very basic Google search for ‘chiropractic for children’ returns more than 7 million hits many of which advertise this sort of approach. Take this website, for instance; it makes its bogus claims entirely unabashed:

Even as an infant your child may have spinal nerve stress, known as subluxations. Although subluxations may not be painful, they can pose serious threats to your child’s development. If your baby was in a difficult position in the womb, or experienced a traumatic birth they may have developed subluxations. A common condition attributed to subluxations in children is known as Blocked Atlantal Nerve Syndrome. This condition may be the primary cause of ear and upper respiratory infections, and chronic tonsillitis.

Even regular childhood activities such as tumbles taken while learning to walk and run, bike riding, and participation in sports can also cause stress on your child’s body. Emotional stress and trauma may also be a cause of subluxations. Unless they are corrected they can affect future nerve function and the development of your child’s nervous system. They can also cause problems as your child grows and develops into adulthood.

With regular chiropractic care your child may be at less risk for common childhood disease such as colds and fevers. Some children show a marked improvement in asthma symptoms with regular chiropractic care and nutritional counselling. While chiropractors do no treat disease or sickness, they can identify and remove subluxations which interfere with your child’s natural ability to heal. By removing this stress from your child’s spinal system their immune system may function more efficiently and your child may have a better defense to disease. Their overall health may improve as their natural healing power is released. Children who receive regular chiropractic care may also be able to handle emotional and physical stress better and this care may contribute to their natural development.

Your child is never too young to start chiropractic care. Well-child care starts are early as the first month of life. Doctors use a very gentle pressure to treat children (no more pressure than picking up a tomato in the grocery store) and their treatments are very soothing to your child. After their first visit it is recommended that they receive treatments every three months up to age three, and then every six to 12 month after that. You may also want to visit your chiropractor after major milestones in your child’s life such as learning to sit up, crawl, and walk. They should also be seen if they experience any falls or trauma, and if you notice any balance issues they may be experiencing. These may include head tilting and limping.

Pediatric chiropractic care has many benefits. Children as young as infants may see an improvement in their development and overall health with regular care. Doctors of chiropractic take a proactive approach to health by striving to return and maintain your body’s natural balance. If you are looking for an alternative or supplement to traditional medical care, look into chiropractic care for your entire family.

Just a few rotten apples!… the apologists would probably say. But this is clearly not true. I find it even hard to locate the non-rotten apples in this decomposing and disgusting mess. More importantly, if it were true that things were now changing, one would expect that the progressive sections of the chiropractic profession protest regularly, sharply and effectively to shame the many charlatans amongst their midst. Crucially, one would expect the chiropractic professional organisations  to oust their bogus members systematically and swiftly.

The sad truth, however, is that none of this is really happening – certainly not in the US or the UK. On the contrary, organisations like THE INTERNATIONAL PEDIATRIC ASSOCIATION, books entitled CHIROPRACTIC PEDIATRICS, and periodicals like the JOURNAL OF PEDIATRIC, MATERNAL AND FAMILY CHIROPRACTIC remain popular and respected within the chiropractic profession. A few lip-services here and there, yes. But truly effective action? No!

The tolerance of quackery, I would argue, must be one of the most important hallmarks of a quack profession.

After yesterday’s post mentioning ‘biopuncture’, I am sure you are all dying to know what this mysterious treatment might be. A website promoting biopuncture tells us (almost) all we need to know:

Biopuncture is a therapy whereby specific locations are injected with biological products. The majority of the products are derived from plants. Most of these injections are given into the skin or into muscles. Products commonly used in Biopuncture are, for example, arnica, echinacea, nux vomica and chamomile. Arnica is used for muscle pain, nux vomica is injected for digestive problems, echinacea is used to increase the natural defense system of the body. Biopuncturists always inject cocktails of natural products. Lymphomyosot is used for lymphatic drainage, Traumeel for inflammations and sports injuries, Spascupreel for muscular cramps. Injections with antiflogistics, hyaluronic acid, blood platelets, blood, procaine, ozon, cortisone or vitamin B are not considered as Biopuncture…

How can such a small dose influence your body and stimulate healing? Scientists don’t have the final proof yet, but they postulate that these injections are working through the stimulation of the immune system (which is in fact your defense system). Let’s compare it with a vaccination. When you receive a tetanus vaccination, only small amounts of a particular product are necessary to stimulate the immune system against lockjaw. In other words, just a few injections can protect your body for years…

An important issue in Biopuncture is the detoxification of the body. It literally means “cleaning the body” from all the toxins that have accumulated: for example from the environment (air pollution, smoking), from bad nutrition, or from medication (e.g., antibiotics and steroids you’ve taken). These toxins can block your defense system. Some injections work specifically on the liver and others on the kidneys. Cleaning up the lymphatic system with Lymphomyosot is considered very important in Biopuncture. It is like taking the leaves out of the gutter. The down side of such an approach is that old symptoms (which have been suppressed earlier on) may come to the surface again. But that is sometimes part of the healing strategy of the body…

That sounds strange, to say the least. But remember: strange treatments might still work! The question is therefore: IS BIOPUNCTURE AN EFFECTIVE THERAPY? If you ask it to Dr Oz, the answer would be a resounding YES – but let’s not ask Oz, let’s try to find some reliable evidence instead. In my quest to locate such evidence, I came across claims like these.

Examples of some acute conditions we treat with biopuncture: 

  • Knee and ankle sprains
  • Muscle sprains- quadriceps, hamstring, adductors, rotator cuff
  • Whiplash 

Examples of some chronic conditions we treat with biopuncture: 

  • Headaches
  • Achilles tendinitis
  • Tennis elbow
  • Chronic arthritis of the knee, hip, shoulder
  • Back pain
  • Myofascial pains
  • Irritable bowel syndrome
  • TMJ syndrome

Somehow I had the feeling that this was more than a little too optimistic, and I decided to conduct a rudimentary Medline search. The results were sobering indeed: not a single clinical trial seems to be available that supports any of the claims that are being made for biopuncture.

So, what should we conclude? I don’t know about you, but to me it seems that biopuncture is quackery at its purest.

The question that I hear with unfailing regularity when talking about alternative medicine is WHY IS IT SO POPULAR? I always struggle to find a simple answer – mainly because there is no simple answer. The reasons for patients and consumers to use alternative medicine are complex and multiple. They range from dissatisfaction with conventional medicine to clinging to the last straw. However, one factor is very clearly always involved: the often bafflingly uncritical promotion of quackery by the daily papers – and that even includes those with a reputation for being respectable.

Yesterday’s article in THE TELEGRAPH is as good an example as any. In the following section, I quote excerpts from it and add my own comments in bold. 

It is perhaps easier to list what the naturopath Katrin Hempel doesn’t offer her clients than what she does. Bioresonance and live blood analysis, acupuncture, biopuncture, infusion therapy, oxyvenation…”

Katrin Hempel, B.H.Sc.,ND, Dipl.Ac. describes herself on her website as an energetic, enthusiastic and experienced natural therapist with a great passion and commitment to the health and well-being of her patients. She calls herself a ‘naturopathic doctor’. I am not sure what this actually is but I am fairly sure she has not studied medicine. I do not doubt her enthusiasm, but I do doubt that most of the methods listed above are anything else but pure quackery.

“Germany has a long tradition of natural medicine, so it’s more common to find conventional doctors who have also studied natural medicine and use these modalities. Here we are at least 20 years behind.” That is true only, if one regards the integration of quackery as progress.

“Every cell in the body puts out a certain electromagnetic frequency, that can be measured – a healthy stomach cell sounds different to a healthy brain cell – and the machine can put the right resonance back in, to trigger deep healing.”) This is pure pseudoscience; neither live blood analysis nor bioresonance are supported by good evidence (and don’t even ask about ‘biopuncture’).

The article goes on misleading the reader in the most scandalous way by promoting pure nonsense. To provide a flavour, I will merely cite a few quotes from the ‘naturopathic doctor’:

  • “If your digestion isn’t working properly there is a malabsorption of nutrients”
  • “Bioresonance can pick up a condition before it manifests as a disease.”
  • “Bioresonance measures the electromagnetic output of every cell in the body. If there’s any discrepancy with the healthy frequency for that kind of cell that gives a diagnosis.”
  • “Whatever the problem, at root it will be an imbalance in the cells.”

At no point in this article is there an attempt to challenge or critically analyse this bonanza in quackery; THE TELEGRAPH promotion of dangerous nonsense ends with the cheerful footnote informing the reader that one hour with the ‘naturopathic doctor’ will cost from £100. THE TELEGRAPH does not even shy away to print an address for booking a consultation with the ‘naturopathic doctor’.

But is it really all quackery? Yes it is! The article promotes so many unproven methods that I find it hard to choose one for demonstrating how irresponsible it really is. Let’s take life blood analysis (LBA), for instance; here is what I published about LBA some time ago:

The principle of LBA is fairly simple: a drop of blood is taken from your fingertip, put on a glass plate and viewed via a microscope on a video screen. Despite the claims made for it, LBA is by no means new; using his lately developed microscope, Antony van Leeuwenhoek observed in 1686 that living blood cells changed shape during circulation. Ever since, doctors, scientists and others have studied blood samples in this and other ways.

What is new, however, is what today’s “holistic practitioners” claim to be able to do with LBA. Proponents believe that the method provides information “about the state of the immune system, possible vitamin deficiencies, amount of toxicity, pH and mineral imbalance, areas of concern and weaknesses, fungus and yeast”, as another website puts it.

Others dare to be much more concrete and claim that they can “spot cancer and other degenerative immune system diseases up to two years before they would otherwise be detectable”; or say they can diagnose “lack of oxygen in the blood, low trace minerals, lack of exercise, too much alcohol or yeast, weak kidneys, bladder or spleen”. All this would amount to a remarkable discovery if it were true. But it’s not.

No credible scientific studies have demonstrated the reliability of LBA for detecting any of the above conditions. In what was, to the best of my knowledge, the first attempt to assess the value of this method, a practitioner with several years of experience in LBA tested the samples of 110 patients. Twelve had cancer and the task was to identify their samples without knowing further details. The results could hardly have been more disconcerting – just three of the 12 with confirmed cancer were detected, and the authors concluded that the method “does not seem to reliably detect cancer. Clinical use of the method can therefore not be recommended.”

And, in case you do not trust me, here is a recent Advertising Standards Authority ruling on LBA:

London Natural Therapies is in breach of the UK Advertising Standards Code for making unproven claims on its website about Live Blood Analysis. The CAP Compliance team has contacted London Natural Therapies several times about removing claims implying that Live Blood Analysis could be beneficial for Gastro Intestinal Tract Disorders, Allergies and Hormonal Imbalances after the ASA previously ruled that Live Blood Analysis was not effective in detecting/diagnosing those conditions. Despite repeated requests to remove the problem claims, London Natural Therapies continues to feature them on its website, www.londonnaturaltherapies.co.uk. Because of London Natural Therapies continued non-compliance we took the decision to place its details on this section of the ASA website on 26 June 2012. These details shall remain in place until such time as London Natural Therapies has removed or appropriately amended the claims on its website to ensure compliance with the CAP Code.

This is but one of many examples of truly shoddy journalism published in a daily paper that most people would call ‘respectable’. If anyone cares to look at the less respectable end to the journalistic spectrum, the picture gets even more horrific. The points I am trying to make are simple and, I think, important:

  1. Journalists and editors have a responsibility which, in the realm of alternative medicine, they often disregard most scandalously.
  2. Such poorly researched, unbalanced and uncritical articles can cause very serious harm.
  3. The promotion of quackery may be good for selling copy, but it can also quickly ruin the reputation of a paper.

If you have diabetes, chances are that you need life-long treatment. Before effective anti-diabetic medications became available, diabetes amounted to a death sentence. Fortunately, these times are long gone.

…unless, of course, you decide to listen to the promises of alternative practitioners many of whom offer a cure for diabetes. Here is just one website of hundreds that does just that. The following is an abbreviated quote where I have changed nothing, not even the numerous spelling mistakes:

Modern medicine has no  permanent cure for diabetes but alternative medicines like yoga ,mudra,ayurveda is very useful to control and even cure diabetes.Ayurveda is an alternative medicine to cure diabetes.

Alternative medicine like ayurveda is a best to cure diabetes naturally.
A serious disorder of the glands,of pancreas to be exact,is diabetes,or madhumeha as described in ayurveda.It is one of the most insidious disorders of the metabolism and,if left undiagnosed or untreated,it may lead to rapid emaciation and ultimately death…
Ayurveda medicines to cure diabetes
In ayurveda the following medicines have been recommended for this disease
Shiljita ————————–240 mg
Nyagrodadhi churna ———3 gm
These should be given twice after meals with decoction of arni.
Vasantakusumakara rasa —120 mg
Shudha Shilajit ————–240 mg
Nag Bhasma —————–120 mg
Haldi ————————–500 mg
Amlaki Churna ————-500 mg
Twice daily with powder of rose-apple stones.Twice daily with honey.
Chadraprabha  Vati ——– 500 mg
Mudra the alternative treatment to cure diabetes naturally
Mudra is a non medical and no cost treatment to cure diabetes.You can perform mudras at any time or any position.It is an effective way of treatment you can get better result if you practice it regularly .

It goes without saying that none of these treatments would cure diabetes. A Cochrane review concluded that there is insufficient evidence at present to recommend the use of these interventions in routine clinical practice. It also goes without saying that not many patients would fall for the nonsense proclaimed on this or so many other websites. But even just one single patient dying because of some charlatan promising a cure for life-threatening diseases is one patient too many.

Some people are their worst enemies, and it seems as though chiropractors are no strangers to this strange phenomenon.

On this blog, I frequently criticise chiropractic; my main concerns are that

  1. chiropractors make far too many bogus claims far too often,
  2. there is precious little evidence that their hallmark treatment, spinal manipulation, generates more good than harm.

I repeatedly voice those concerns because I feel strongly that consumers have the right to unbiased information for making evidence-based therapeutic decisions. When I do this, I get invariably attacked by some chiropractors who disagree with me. Frequently, these chiropractors are not interested to discuss the issues I raised with me; instead they insult me in the most primitive way imaginable.

This happens far too often to write about each time, but occasionally things are so extraordinary that I do blog about them. A case in point is the email I recently received out of the blue from “Dr” Brian Moravec, a chiropractor who believes in subluxation and claims that new-born babies should have spinal adjustments. My last post quotes his astonishing views in full; he believes I am a self proclaimed “expert” on alternative medicine, promoting so much misinformation with regard to chiropractic care.  Unfortunately he failed to tell me which of my statements he considers to be misleading and he continued: fortunately you look old.  and soon will be gone. 

Rejoicing at the (hopefully not so) imminent demise of a fellow human being is perhaps not what one might expect from a health care professional. Yet it does fit into the behaviour of chiropractors which tends to turn outright self-destructive when challenged. The comments by chiropractors that followed my post seem to confirm this tendency. They show that the demolition of chiropractic’s reputation by chiropractors is relentless.

One chiropractor claimed Moravec’s opinion could “have been better put”… and “come over as a somewhat personal attack” while quickly changing the subject by starting a discussion on the evidence-base of chiropractic. This ended abruptly in him agreeing with me to disagree. Other chiropractors seemed to concur.

At that stage, one chiropractor noted that Moeavec’s email is doing no favours to the reputation of chiropractic, a ray of light which quickly was instantly overshadowed by a further chiropractor’s comments. This man – or perhaps woman (hiding behind a pseudonym) – is a regular commentator on my blog. He felt that Moravec’s comments were rather polite an opinion which he justified as follows: Dr. Moravec thinks you are old because of your unflattering (IMO) photo. The shiny, bald look adds years to a person’s looks, especially in photos. It is the old glass half-empty or half-full debate. IOW, have you lost hair or have you gained face? The mustache is so fifties, too. The perpetual scowl, however, does suit you rather well. Just sayin’.  

At this point, I cannot help but laugh out loud. Someone asked how I can bear those vicious attacks. The answer is that I merely cringe at the stupidity on display.  Are these guys really so limited as to not realise what they are doing to their own reputation? Do they not notice that this amounts to a relentless and general demolition of chiropractic’s reputation?

All of this would, of course, be rather trivial fun, if it were a single occurrence – but it is most definitely not!

As I already pointed out, such things happen to me all the time. More remarkably, chiropractors have repeatedly tried to get me fired. Much more importantly, chiropractors have behaved in this way when they decided to sue Simon Singh for libel. Each time, they ended up with plenty of egg on their faces.

Isn’t it time that they learn a lesson? Isn’t it time that they learn to consider criticism seriously? Isn’t it time the more rational one amongst them do something about the many cranks in their midst? Isn’t it time they got their act together?

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