MD, PhD, FMedSci, FSB, FRCP, FRCPEd

evidence

Wellness?

Yes, it’s a new buzz-word in the realm of alternative medicine – actually, not so new; it’s been around for years and seems to attract charlatans of all imaginable types.

But what precisely is it?

The authors of this paper explain: “While the concept of wellness is still evolving, it is generally recognized that wellness is a holistic concept best represented as a continuum, with sickness, premature death, disability, and reactive approaches to health on one side and high-level wellness, enhanced health, and proactive approaches to health and well-being on the other. It is further acknowledged that wellness is multidimensional and includes physiologic, psychological, social, ecologic, and economic dimensions. These multiple dimensions make wellness difficult to accurately assess as multiple subjective and objective measures are required to account for the different dimensions. Thus, the assessment of wellness in individuals may include a variety of factors, including assessment of physiologic functioning, anthropometry, happiness, depression, anxiety, mood, sleep, health symptoms, toxic load, neurocognitive function, socioeconomic status, social connectivity, and perceived self-efficacy.”

Sounds a bit woolly?

I agree! It sounds like a gimmick for getting at the cash of the gullible public.

Is there money to be made with ‘wellness’?

Sure! Lots!

For instance, with so-called ‘wellness retreats’.

Wellness retreats are all the rage. They use all sorts of bogus therapies within luxurious holiday settings for the ‘well to do’ end of our societies.

But is there any science behind this approach?

Few studies have evaluated the effect of retreat experiences, and no published studies have reported health outcomes. The objective of this new study therefore was to assess the effect of a week-long wellness-retreat experience in wellness tourists. The study was designed as a longitudinal observational study without a control group. Outcomes were assessed upon arrival and departure and 6 weeks after the retreat. The intervention was a ‘holistic, 1-week, residential, retreat experience that included many educational, therapeutic, and leisure activities and an organic, mostly plant-based diet’.

The outcome measures included anthropometric measures, urinary pesticide metabolites, a food and health symptom questionnaire, the Five Factor Wellness Inventory, the General Self Efficacy questionnaire, the Pittsburgh Insomnia Rating Scale, the Depression Anxiety Stress Scale, the Profile of Mood States, and the Cogstate cognitive function test battery.

Statistically significant improvements were seen in almost all measures after 1 week. Many of these improvements were also sustained at 6 weeks. There were statistically significant improvements in all anthropometric measures after 1 week, with reductions in abdominal girth, weight, and average systolic and diastolic pressure. Statistically significant improvements were also noted in psychological and health symptom measures. Urinary pesticide metabolites were detected in pooled urine samples before the retreat and were undetectable after the retreat.

The authors concluded that “the retreat experiences can lead to substantial improvements in multiple dimensions of health and well-being that are maintained for 6 weeks. Further research that includes objective biomarkers and economic measures in different populations is required to determine the mechanisms of these effects and assess the value and relevance of retreat experiences to clinicians and health insurers.”

IS THIS GOOD OR BAD RESEARCH?

Let’s apply my checklist from the previous post:

  • published in one of the many dodgy CAM journals? YES
  • single author? NO
  • authors are known to be proponents of the treatment tested? YES
  • author has previously published only positive studies of the therapy in question? YES
  • lack of plausible rationale for the study? YES
  • lack of plausible rationale for the therapy that is being tested? YES
  • stated aim of the study is ‘to demonstrate the effectiveness of…’ ? NO
  • stated aim ‘to establish the effectiveness AND SAFETY of…’? NO
  • text full of mistakes, e. g. spelling, grammar, etc.? NO
  • sample size is tiny? YES
  • pilot study reporting anything other than the feasibility of a definitive trial? NO
  • methods not described in sufficient detail? YES
  • mismatch between aim, method, and conclusions of the study? YES
  • results presented only as a graph? NO
  • statistical approach inadequate or not sufficiently detailed? NO
  • discussion without critical input? NO
  • lack of disclosures of ethics, funding or conflicts of interest? NO
  • conclusions which are not based on the results? YES

To me, this rough and ready assessment indicates that there are too many warning signals for characterising this as a rigorous study. It looks a lot like pseudo-science, I fear.

But these are at best formal markers. More important is the fact that the whole idea of measuring the effects of a ‘wellness retreat’ makes little sense, particularly in the absence of a control group. If we take a few people out of their usual, stressful work-environment and put them into a nice and luxurious holiday atmosphere where they get papered, eat better food, exercise more, sleep better and relax a lot – what would we expect after one week?

Yes, precisely! We would expect that almost anything measurable has changed for the better!

In fact, this result is so predictable that it is hardly worth documenting. Crucially, the outcome has very little to do with wellness, holism, or alternative medicine.

My conclusion: wellness not only attracts charlatans, entrepreneurs and windbags, it also is firmly steeped in pseudoscience.

 

 

 

One of the questions I hear frequently is ‘HOW CAN I BE SURE THIS STUDY IS SOUND’? Even though I have spent much of my professional life on this issue, I am invariably struggling to provide an answer. Firstly, because a comprehensive reply must inevitably have the size of a book, perhaps even several books. And secondly, to most lay people, the reply would be intensely boring, I am afraid.

Yet many readers of this blog evidently search for some guidance – so, let me try to provide a few indicators – indicators, not more!!! – as to what might signify a good and a poor clinical trial (other types of research would need different criteria).

INDICATORS SUGGESTIVE OF A GOOD CLINICAL TRIAL

  • Author from a respected institution.
  • Article published in a respected journal.
  • A clear research question.
  • Full description of the methods used such that an independent researcher could repeat the study.
  • Randomisation of study participants into experimental and control groups.
  • Use of a placebo in the control group where possible.
  • Blinding of patients.
  • Blinding of investigators, including clinicians administering the treatments.
  • Clear definition of a primary outcome measure.
  • Sufficiently large sample size demonstrated with a power calculation.
  • Adequate statistical analyses.
  • Clear presentation of the data such that an independent assessor can check them.
  • Understandable write-up of the entire study.
  • A discussion that puts the study into the context of all the important previous work in this area.
  • Self-critical analysis of the study design, conduct and interpretation of the results.
  • Cautious conclusion which are strictly based on the data presented.
  • Full disclosure of ethics approval and informed consent,
  • Full disclosure of funding sources.
  • Full disclosure of conflicts of interest.
  • List of references is up-to-date and includes also studies that contradict the authors’ findings.

I told you this would be boring! Not only that, but each bullet point is far too short to make real sense, and any full explanation would be even more boring to a lay person, I am sure.

What might be a little more fun is to list features of a clinical trial that might signify a poor study. So, let’s try that.

WARNIG SIGNALS INDICATING A POOR CLINICAL TRIAL

  • published in one of the many dodgy CAM journals (or in a book, blog or similar),
  • single author,
  • authors are known to be proponents of the treatment tested,
  • author has previously published only positive studies of the therapy in question (or member of my ‘ALT MED HALL OF FAME’),
  • lack of plausible rationale for the study,
  • lack of plausible rationale for the therapy that is being tested,
  • stated aim of the study is ‘to demonstrate the effectiveness of…’ (clinical trials are for testing, not demonstrating effectiveness or efficacy),
  • stated aim ‘to establish the effectiveness AND SAFETY of…’ (even large trials are usually far too small for establishing the safety of an intervention),
  • text full of mistakes, e. g. spelling, grammar, etc.
  • sample size is tiny,
  • pilot study reporting anything other than the feasibility of a definitive trial,
  • methods not described in sufficient detail,
  • mismatch between aim, method, and conclusions of the study,
  • results presented only as a graph (rather than figures which others can re-calculate),
  • statistical approach inadequate or not sufficiently detailed,
  • discussion without critical input,
  • lack of disclosures of ethics, funding or conflicts of interest,
  • conclusions which are not based on the results.

The problem here (as above) is that one would need to write at least an entire chapter on each point to render it comprehensible. Without further detailed explanations, the issues raised remain rather abstract or nebulous. Another problem is that both of the above lists are, of course, far from complete; they are merely an expression of my own experience in assessing clinical trials.

Despite these caveats, I hope that those readers who are not complete novices to the critical evaluation of clinical trials might be able to use my ‘warning signals’ as a form of check list that helps them to tell the chaff from the wheat.

First she promoted vaginal steam baths and now Gwyneth Paltrow claims that putting a ball of jade (which you can order from her online-business, if you happen to have the cash) in their vaginas is good for women.

Yes, I kid you not; this is what she states on her website:

The strictly guarded secret of Chinese royalty in antiquity—queens and concubines used them to stay in shape for emperors—jade eggs harness the power of energy work, crystal healing, and a Kegel-like physical practice. Fans say regular use increases chi, orgasms, vaginal muscle tone, hormonal balance, and feminine energy in general. Shiva Rose has been practicing with them for about seven years, and raves about the results; we tried them, too, and were so convinced we put them into the goop shop. Jade eggs’ power to cleanse and clear make them ideal for detox…

But if you think that Gwyneth is somehow fixated on her feminine parts, you are probably mistaken. She is much more versatile than that and seems to employ her vagina merely for drumming up publicity for her business. If you browse her site, you find no end of baffling, vagina-unrelated wonders and purchasable products from the world of alternative medicine.

Here are just two further examples.

Flower  remedies

A flower essence is a bioenergetic preparation. Through the use of sunlight and water, we are able to capture the energy of a flower and use it for healing purposes: A freshly harvested flower is placed on the surface of water for a specific length of time and exposed to sunlight, resulting in the vibrational imprint of the flower in water. The flower essence is then used as an energetic remedy, with each flower having its own range of unique therapeutic benefits.

Vibrational imprint?

Unique therapeutic benefit?

Pull the other one! The truth about (Bach) flower remedies is much simpler: they are expensive placebos.

A method for getting rid of the parasites we allegedly all suffer from

…an eight-day, mono-diet goat-milk cleanse—accompanied by a specific vermifuge made of anti-parasitic herbs—is the most successful treatment. Parasites primarily live in the mucus lining of the gut system, where they feed on nutrients before they enter the body. Think of the goat milk as bait—parasites come out of the gut lining to drink the milk, which they love, but they also consume the vermifuge, which will eventually eradicate them. On top of being highly effective, this method is a much more gentle medicine than bombarding them—and your body—with a harsh drug.

Are they for real?

This is pure and potentially very dangerous, unethical nonsense!

Oh sorry – I forgot: we now must call it differently now: we are obviously dealing with Gwyeneth’s ‘alternative facts’.

Why has homeopathy such a bad name?

Why have the most ardent defenders of homeopathy become the laughing stock of the science community?

Why is there, after >200 years., still no proof of homeopathy’s efficacy?

Why is there not more research into homeopathy?

Why is there not more money in homeopathy?

Why is there so much opposition to homeopathy?

Nothing to do, of course, with the fact that highly diluted homeopathic remedies are pure placebos. No, no, no! It is because BIG PHARMA is doing everything they can to supress homeopathy!!! They have no choice: if the good news about homeopathy would go any further, they would go bankrupt.

On this blog, we have heard such ludicrous notions regularly. Homeopaths seem to believe that, according homeopathy’s ‘like cures like’ principle, their ‘alternative facts’ can be converted into real facts.

The homeopathic industry tries very hard to keep the image of the poor little victim, while, in fact, it is not really much different from the pharmaceutical industry. This is, of course, what we have been pointing out repeatedly on this blog; yet somehow the message does not seem to get across to many homeopaths. Perhaps this excellent comment by Thomas Mohr (I don’t know who he is) might be more successful:

“…homeopathic companies work exactly like any other pharmaceutical company to the point that homeopathic companies can patent homeopathic drugs and do that. The reason why this is not extensively used in the field of homeopathy is not the impossibility, but the necessity to provide at least feasible examples of efficacy with the patent application – which fails in most cases.

If one looks at the balance of Boiron, one of the largest manufacturers of homeopathic drugs one notes that the profit is comparable, if not higher than any pharmaceutical company (e.g. Pfitzer, etc.) but research costs are one tenth. That means that homeopathic companies have a far lower risk to benefit ratio while yielding the same profit. The same time pharmaceutical companies have a high failure rate (e.g. substances screened to drugs marketable) whereas the failure rate of homeopathic companies is almost zero. I.o.W. investing into homeopathic companies is far safer than into pharmaceutical companies. No company would try to destroy a low risk : benefit concurrent. A company would try to purchase it. Why is that not done with homeopathic companies ? Because the market is very limited due to the ineffectiveness of the drugs.

The comment was prompted by an article of Dana Ullman entitled “Extreme Bias in FTC’s Ruling on Homeopathic Medicine” where he, yet again, displays his well-known biases and ignorance. There you can, if you want, read all the misconceptions and stupidities about homeopathy you ever need to know about. They include the firm anti-vaccination stance of deluded homeopaths, and the fact that Dana can never resist claiming that ‘the Swiss government’s “Health Technology Assessment” on homeopathic medicine is much more comprehensive than any previous governmental report written on this subject to date’ and – how could it be otherwise? – is sufficient proof that homeopathy works.

Personally, I also find certain temptations too difficult to resist – like citing the intriguing evidence on Ullman being called as an expert witness in a class action against a homeopathy vendor for misleading marketing claims. On this occasion, the judge stated:

The Defendant presented the testimony of Gregory Dana Ullman who is a homeopathic practitioner. He outlined the theory of homeopathic treatment and presented his opinion as to the value and effectiveness of homeopathic remedies. The Court found Mr. Ullman’s testimony to be not credible. Mr. Ullman’s bias in favor of homeopathy and against conventional medicine was readily apparent from his testimony. He admitted that he was not an impartial expert but rather is a passionate advocate of homeopathy. He posted on Twitter that he views conventional medicine as witchcraft. He opined that conventional medical science cannot be trusted.
[…]
Mr. Ullman’s testimony was unhelpful in understanding the purported efficacy of the ingredients of SnoreStop to reduce the symptoms of snoring. Although he is familiar with the theory of homeopathic treatment, his opinions regarding its effectiveness was unsupported and biased. The Court gave no weight to his testimony.(Rosendez v. Green Pharmaceuticals)

Ullman is a rich source of ‘alternative facts’. For the ral facts about homeopathy, however, I should direct you elsewhere (for instance, here) and, if I may, to my latest book.

 

 

*** another thing I cannot not resist is to use this new term (recently coined by the Trump team) to describe outright lies.

We all know that alternative medicine is currently popular, and much of the evidence suggested that this is mostly because mostly people in the midst of their lives are using it. This may be so, but it is about to change; it stands to reason that these ‘baby boomers’ are getting older, and therefore the typical user of alternative medicine is or will soon be an elderly person. In addition, the ‘oldies’ (I am one of them) are likely to be multi-morbid and therefore have more reason to try everything that is on offer.

Not convinced? But that is roughly is what this website seems to suggest:

START OF QUOTE

Geriatric population is more susceptible to chronic diseases such as heart problems, joint disorders and others. Therefore, this population group needs regular use of the medicines to prevent the disease conditions. The use of complementary and alternative medicines is increasing among the geriatric population globally due to the fact that CAMs decreases the risk of adverse reactions and drug interactions.

Complementary and alternative medicines include products such as dietary medicine and herbal medicine products. These medicines can be used for the management of both communicable (i.e. tuberculosis, hantavirus and others) and non communicable diseases (i.e. chronic kidney disease, cardiovascular and others) in geriatric population. These medicines (i.e. CAM) treat the patients by healing therapies which is not based on principles of conventional medicine.

Geographically, North America is considered as the largest market of geriatric complementary and alternative medicines owing to high use of CAMs in this region. For example, Health and Retirement Study conducted one survey which concluded that around 85% of the geriatric population in North America reported the use of complementary and alternative medicines. Thus, high use of CAM modalities will establish healthy platform to develop the growth of geriatric complementary and alternative medicines market.

Europe is the second largest market of geriatric complementary and alternative medicines. The growth is mainly attributed to the increasing aging population coupled with rising use of complementary and alternative medicines in Europe. According to European Commission (Eurostat) report published in 2013, around 17.8% of the European population were aged 65 years and above. The organization has also stated that aging population is expected to increase at high rate in coming year in Europe. In addition, Asia-Pacific is the emerging market for geriatric complementary and alternative medicines market because of rising interest of key companies to expand their presence in Asia Pacific.

Key companies operating in the market for geriatric complementary and alternative medicines include Geriatric & Medical Companies, Inc., Merck Sharp & Dohme Corporation. Geri-Care pharmaceuticals, UAS Laboratories.

END OF QUOTE

I know, this text includes several glaring errors. But the main claim that alternative medicine is fast becoming a thing for the elderly might well be true. This, of course, has implications for marketing, research, etc. For us on this blog it means that we need to find better ways to get through to people who are no spring chickens any longer.

The elderly have special needs and can be vulnerable in several ways. When they are ill, they need efficacious treatments. By and large, this excludes alternative therapies. The elderly may also be more susceptible to the risks of alternative medicine. Moreover, they are often not that affluent and might need to watch their expenses. Making them spend large amounts of cash on treatments that are ineffective is therefore a particularly unethical.

I think that messages like these might convince some elderly people to stop putting unreasonable hope in, and wasting their time/money on bogus therapies. But I am very keen to hear from my readers about further ideas how to curb the boom of alternative medicine in this age group.

The Committees of Advertising Practice (CAP) write and maintain the UK Advertising Codes, which are administered by the Advertising Standards Authority. On their website, the CAP recently published an updated advertising code for naturopathy. As we have regularly discussed the fact that the public is being frequently misled in this area, I consider the code important in the context of this blog. I therefore take the liberty of repeating it here – not least in the hope that this helps preventing misinformation in the future [the numbers in square brackets refer to me footnotes below].

START OF QUOTE

What is Naturopathy?

Naturopathy is a holistic [1] approach to healthcare that uses a combination of one or more different disciplines (for example herbal medicine or hydrotherapy) and a healthy lifestyle [2] in order to gain and maintain a healthy body [3].

What claims are likely to be acceptable?

The promotion of a healthy [4] lifestyle is likely to acceptable as are claims that go no further than those commonly accepted for healthy [4] eating, sleeping well, taking exercise and the like.

What claims are likely to be problematic?

The ASA and CAP have not yet been provided with evidence which demonstrates that Naturopathy can be used to treat medical conditions (Rule 12.1).  Therefore, any claims that go beyond accepted claims for a healthy [4] lifestyle are likely to be problematic [5] unless they are supported by a robust body of evidence.  In 2013, the ASA ruled against claims on a marketer’s website which said that Naturopathy could be used to treat acute and chronic illness and disease because the marketer had not provided any evidence in support of their claims (CNM The College of Naturopathic Medicine Ltd, 13 March 2013).

What about serious medical conditions?

Claims to offer treatment on conditions for which medical supervision should be sought [6] are likely to be considered to discourage essential treatment unless that treatment is carried out under the supervision of a suitably qualified health professional (Rule 12.2).

END OF QUOTE

Naturopathy has been the subject of my posts before – see for instance here, here, here, here and here. Naturopathy can be dangerous to the point where it can kill the patient – see for instance here and here. Therefore it is important that advertising gets regulated. To make it very clear: the above statement by the CAP is, in my view, a step in the right direction, and I encourage alternative practitioners to look up the equivalent CAP documents for their specific therapy.

Having said that, I still feel the need to make a few comments:

  1. It is misleading to call naturopathy ‘holistic’. This is often factually incorrect and also gives the impression that conventional medicine is not holistic – see also here.
  2. Are we sure that all lifestyles promoted by naturopaths are, in fact, healthy?
  3. Maintaining a healthy body is naturopathy speak for DISEASE PREVENTION. Who decides what is effective prevention? On what evidence? How come many naturopaths are against the most effective means of prevention of all times – vaccination?
  4. Who decides what is ‘healthy’? On what evidence?
  5. Why ‘problematic’? Are they not wrong or bogus or false or fraudulent or criminal?
  6. Are there conditions for which medical supervision should not be sought? Which are they?

Whenever a level-headed person discloses that a specific alternative therapy is not based on good evidence, you can bet your last shirt that a proponent of the said treatment responds by claiming that conventional medicine is not much better.

There are several variations to this theme. Today I want to focus on just one of them, namely the counter-claim that, only a short while ago, conventional medicine was not much better than the said alternative therapy (the implication is that it must be unfair to demand evidence from alternative medicine, while accepting a similar state of affairs in conventional medicine). The argument has recently been formulated by one commentator on this blog as follows:

“Trepanation, leeches for UTI’s, and bloodletting are all historical treatments of medical doctors…It’s hypocritical… to impute mainstream chiropractice to the profession’s beginnings and yet not admit that medicine’s founding and evolution was inbued with consistently scientific rigor.”

Sadly, some people seem to be convinced by such words, and this is why they are being repeated ad nauseam by interested parties. Yet the argument is fallacious for a range of reasons.

  • Firstly, it is based on the classical ‘tu quoque’ fallacy (appeal to hypocrisy).
  • Secondly – unless we happen to be historians – it is not the healthcare of the past that is relevant to our discussions. The question cannot be what this or that group of clinicians used to do; the question is HOW DO THEY TREAT THEIR PATIENTS TODAY?

As soon as we focus on this issue, it is impossible to deny that conventional medicine has made lots of progress and moved light years away from treatments such as trepanation, leeches, bloodletting and many others.

Why?

Why did we make such huge progress?

Because research showed that many of the traditional treatments were ineffective, unsafe and/or implausible (thus demonstrating that hundreds of years of experience – which alternative therapists rate so very highly – is of more than dubious value), and because we consequently developed and tested new therapies and subsequently used those treatments that passed these tests and were proven to do more good than harm.

By contrast, in the last decades, centuries and millennia, homeopathy, chiropractic, acupuncture, paranormal healing etc. did make no (or very little) progress. So much so that Hahnemann, for instance, would pass any exam for  homeopathy today. (If you disagree with this statement, please post a list of those treatments that have been given up by alternative therapists in the last 100 years or so.) Come to think of it, it is a hallmark of alternative medicine that it does not progress in the way conventional medicine does. It is almost completely static, a fact, that renders it akin to a dogma or a cult.

But why? Why is there no real progress in alternative medicine?

Don’t tell me that there is no research, research funding, etc. There are now hundreds of studies of homeopathy or chiropractic, thousands of acupuncture, and dozens of paranormal healing, for instance. The trouble is not the paucity of such research but its findings! The totality of the evidence in each of these areas fails to show that the therapy in question is efficacious.

And there we have, I think, another hallmark of alternative medicine: it is an area where research is only acted upon, if its findings are in line with the preconceptions and aspirations of its proponents.

I find this interesting!

It means, amongst other things, that research into alternative medicine tends not to be used for finding the truth or establishing new knowledge; it is mainly employed for the promotion of the therapy in question, regardless of what the truth about it might be (this would disqualify this exercise from being research and qualify it as PSEUDO-RESEARCH). If the research findings are such that they cannot be used for promotion, they are simply ignored or defamed as inadequate.

Originally, I had meant this blog to discuss all types of alternative therapies – well, perhaps not all (there are simply too many of them), but at least the most popular ones. And so far, I have omitted one that seems certainly quite wide-spread: CRYSTAL HEALING.

What the Dickens is crystal healing, you ask? It is the attempt to bring about healing with the power of crystals, of course. And how is it supposed to work? This is where things get quite nebulous; this website, for instance tells us that the repeating chemical structure of crystals is said to invest them with a kind of memory. This means that crystals have the power to hold energies. You may hold a quartz crystal with the intention of filling it with your love. This is what is meant by programming a crystal. You do not need any wires or a special connection with God – all you need is intention and focus. The crystal will remember your love, which will then permeate any environment in which the crystal is placed. Crystals can remember negative as well as positive energies and so will sometimes need to be cleansed. For instance, an amethyst will actually help to cleanse a room of negative energies (eg. anger) but this means that the amethyst, which will retain an element of that negative energy, will itself occasionally require cleansing.

Most crystal healers make fairly specific claims about the healing power of specific crystals. This website explains it in some detail. The following text is an extract of several key (only marginally altered) passages from much longer instructions about the use of different crystals for healing purposes:

Crystal healing specialists generally agree that garnet promotes rapid general healing and regeneration in users. Garnet also has a positive effect on disorders such as acid reflux, blood-related illnesses, and physical strength.

Rose quartz is considered, by practitioners of alternative medicine, to be the stone of love—in this case, love of the self, in the form of self-esteem and self-worth. Rose quartz is simply brimming with happiness, and is a very positive stone that can help bring out forgiveness, compassion, and tolerance in users.

Fluorite is of mental order and clarity, and can be used to help alleviate instability, paving the way for a more balanced view of life. Feeling tossed about on a sea of restless emotions? Try carrying fluorite with you throughout the day—it helps cleanse and detoxify the centers of emotion. Fluorite is also the stone of learning, and can improve concentration and focus, while simultaneously reducing the anxiety that can sometimes make retaining information difficult. If you’re a student, learning a new instrument, or facing a complex new job, fluorite may be the stone you’ll want to keep on your person.

Lapis lazuli is beneficial to the throat, vocal cords, and larynx, and can help to regulate endocrine and thyroid issues. This is one of the most effective stones to meditate with, as lapis lazuli is the stone of higher awareness, able to bring information to the mind in images rather than words. This is an especially great boon to those who have creative jobs, as their next big inspiration can come from this.

If you suffer from anxiety, hematite is for you. A heavy, calming stone, hematite is very grounding—it leaves the user feeling comfortable and “in the moment,” rather than being lost in memory or worry. This disconnection from the present—which many of us suffer from—is the cause of much discomfort. But by practicing mindfulness through meditation with hematite, you can reconnect with what’s currently going on in your life.

Alternative medicine practitioners consider jade to be the stone of the heart, and as such, affects this organ in a positive way, promoting heart health. Not only does jade promote physical heart health, but heals emotionally, as well. Focusing energies on the emotional heart, jade helps regulate what we embrace and what we resist, giving us better self-control, as well as a better picture of our own wants and needs.

Turquoise is powerful, giving peace to the spirit and well-being to the body. This stone induces a sense of serenity, keeping physically harmful stress and inflammation at bay. Holding turquoise can bring back focus and restore vitality. Turquoise is also a stabilizer, and can calm the nerves when working on a difficult problem, or when performing or speaking in public. It is known for its effectiveness in alleviating the fear of flying.

Obsidian is a protective stone, able to remove and guard against negativity. If you are trying to release issues from your past, including emotions such as anger, resentment, and fear, handling obsidian can help by allowing you to see them for what they are so that they can be dealt with. Physically, obsidian is said to benefit good health in muscle tissue and the digestive system, and can help rid the body of infection. It helps to reduce the pain of arthritis, joint problems, and cramps.

Citrine holds the power of granting energy and stamina and supporting proper metabolism. Especially beneficial for those suffering from chronic fatigue syndrome, this stone can bring back some much-needed vitality, and can even alleviate nausea and vomiting for those suffering from morning sickness. This gem also aids in keeping the nails, skin, and hair healthy, and is effective in relieving skin irritation of any kind. Emotionally, citrine is the gem of joy, helping the subconscious mind to accept happiness in life, releasing anger and negativity. This is the most effective gem for those suffering from depression—combined with the skills of a trained counselor, meditation with citrine can help channel happiness through you, imbuing you with real joy.

Whether you believe in the healing power of crystals or not, they are worth trying alongside your normal health regimen. At best, you’ll find a spiritual support for your physical and mental health goals. And at worst? You’ll be in possession of a few beautiful stones that make great meditative focal points. So do a little research and go try out a few of your favorite stones!

END OF QUOTES

Recently, I promised to be more respectful in my criticism of quackery, but when it comes to things like crystal healing this is a difficult task indeed. It goes almost without saying that there is not a jot of evidence for any of the therapeutic claims made in the above quotes or other promotional texts on crystal healing.

Who publishes this sort of nonsense? The above excerpts come from ‘BELIEFNET‘, the “leading lifestyle site dedicated to faith and inspiration. Beliefnet helps people find and walk a spiritual path that instills comfort, hope, strength and happiness. It is through this discovery that our readers are empowered to live a more meaningful life.”

Say no more!

At a recent conference in Montréal (October 2016), the WFC (World Federation of Chiropractic) and the ACC (Association of Chiropractic Colleges) reached a consensus on education. Consequently, recommendations were produced that offer 12 key ‘take away messages’. I take the liberty of reproducing these statements entitled ‘Training Tomorrow’s Spine Care Experts’ (the square brackets were inserted by me and refer to brief comments I made below).

START OF QUOTE

1. Chiropractic educational institutions have a  responsibility to equip students with the skills and  attributes necessary to become future spinal health care experts. This includes a commitment to astute diagnostic ability, a comprehensive knowledge of spine-related disorders [1], appreciation for the contributions of other health professionals and a commitment to collaborative, patient-centered and evidence-informed care [2].

2. Technological advances [3] provide an opportunity for the chiropractic profession to enhance, evolve and standardize core education and practice. This is relevant to the teaching of chiropractic skills, sharing of learning resources and assessment of performance. Emerging technologies that support the development of clinically-competent practitioners should be embedded within chiropractic programs.

3. The teaching and learning of specialized manual assessment and treatment skills should remain a key distinguishing element of chiropractic curricula.

4. Surveys of the public have a demonstrated a desire for consistency in the provision of chiropractic services. Such consistency need not compromise the identities of individual institutions but will cultivate public trust and cultural authority [4].

5. Globally consistent educational and practice standards will facilitate international portability [5] and promote greater health equity in the delivery of spine care.

6. Chiropractic programs should espouse innovation and leadership in the context of ethical [6], sustainable business [7] practices.

7. Chiropractic educational curricula should reflect current evidence [8] and high quality guidelines [9], and be subjected to regular review to ensure that students are prepared to work in collaborative health care environments.

8. The training of tomorrow’ s spine care experts should incorporate current best practices in education.

9. Interdisciplinary collaboration and strategic partnerships present opportunities to position chiropractors as leaders [10] and integral team players in global spine care.

10. Chiropractic educational institutions should champion the integration of evidence informed clinical practice [11], including clinical practice guidelines, in order to optimize patient outcomes. This will in turn foster principles of lifelong learning and willingness to adapt practice methods in the light of emerging evidence [12].

11. Students, faculty, staff and administrators must all contribute to a learning environment that fosters cultural diversity, critical thinking [13], academic responsibility and scholarly activity.

12. Resources should be dedicated to embed and promote educational research activity in all chiropractic institutions.

END OF QUOTE

And here are my brief comments:

[1] Some chiropractors believe that all or most human conditions are ‘spine-related disorders’. We would need a clear statement here whether the WFC/ACC do support or reject this notion and what conditions we are actually talking about.

[2] ‘Evidence-informed’??? I have come across this term before; it is used more and more by quacks of all types. It is clearly not synonymous with ‘evidence-based’, but aims at providing a veneer of respectability by creation an association with EBM. In concrete terms, asthma, for instance, might, in the eyes of some chiropractors, be an evidence-informed indication for chiropractic. In other words, ‘evidence-informed’ is merely a card blanch for promoting all sorts of nonsense.

[3] It would be good to know which technical advances they are thinking of.

[4] Public trust is best cultivated by demonstrating that chiropractic is doing more good than harm; by itself, this point sounds a bit like PR for maximising income. Sorry, I am not sure what they mean by ‘cultural authority’ – chiropractic as a cult?

[5] ‘International portability’ – nice term, but what does it mean?

[6] I get the impression that many chiropractors do not know what is meant by the term ‘ethics’.

[7] But they certainly know much about business!

[8] That is, I think, the most relevant statement in the entire text – see below.

[9] Like those by NICE which no longer recommend chiropractic for back pain? No? They are not ‘high quality’? I see, only those that recommend chiropractic fulfil this criterion!

[10] Chiropractors as leaders? Really? With their (largely ineffective) manipulations as the main contribution to the field? You have to be a chiropractor to find this realistic, I guess.

[11] Again ‘evidence-informed’ instead of ‘evidence-based’ – who are they trying to kid?

[12] The evidence that has been emerging since many years is that chiropractic manipulations fail to generate more good than harm.

[13] In the past, I got the impression that critical thinking and chiropractic are a bit like fire and water.

MY CONCLUSION FROM ALL THIS

What we have here is, in my view, little more than a mixture between politically correct drivel and wishful thinking. If chiropractors truly want chiropractic educational curricula to “reflect current evidence”, they need to teach the following main tenets:

  • Chiropractic manipulations have not been shown to be effective for any of the conditions they are currently used for.
  • Other forms of treatment are invariably preferable.
  • Subluxation, as defined by chiropractors, is a myth.
  • Spine-related disorders, as taught in many chiropractic colleges, are a myth.
  • ‘Evidence-informed’ is a term that has no meaning; the proper word is ‘evidence-based’ – and evidence-based chiropractic is a contradiction in terms.

Finally, chiropractors need to be aware of the fact that any curriculum for future clinicians must include the core elements of critical assessment and medical ethics. The two combined would automatically discontinue the worst excesses of chiropractic abuse, such as the promotion of bogus claims or the financial exploitation of the public.

But, of course, none of this is ever going to happen! Why? Because it would mean teaching students that they need to find a different profession. And this is why I feel that statements like the above are politically correct drivel which can serve only one purpose: to distract everyone from the fundamental problems in that profession.

The WDDTY is not my favourite journal – far from it. The reason for my dislike is simple: far too many of its articles are utterly misleading and a danger to public health. Take this recent one entitled ‘Paleo-type diet reversing Crohn’s and ulcerative colitis’, for instance:

START OF QUOTE
Crohn’s disease and ulcerative colitis are being reversed solely by diet—essentially a Paleo diet. The non-drug approach has been successful in 80 per cent of children who’ve been put on the special diet.

The diet—called the specific carbohydrate diet (SCD)—has been pioneered by Dr David Suskind, a gastroenterologist at Seattle Children’s Hospital. The diet excludes grains, dairy, processed foods and sugars, other than honey, and promotes natural, nutrient-rich foods, including vegetables, fruits, meats and nuts.

Children are going into complete remission after just 12 weeks on the diet, a new study has discovered. Ten children with inflammatory bowel disease (IBD)—an umbrella term for Crohn’s and ulcerative colitis—were put on the diet, and eight were completely symptom-free by the end of the study. Suskind started exploring a dietary approach to IBD because he became convinced that the standard medical treatment of steroids or other medication was inadequate. “For decades, medicine has said diet doesn’t matter, that it doesn’t impact disease. Now we know that diet does have an impact, a strong impact. It works, and now there’s evidence,” he said.

END OF QUOTE

“For decades, medicine has said diet doesn’t matter, that it doesn’t impact disease”.

Really?

In this case, I must have studied an entirely different subject all these years ago at university – I had been told it was medicine but perhaps…???…!!!

It took me some time to find the original paper – they cited a wrong reference (2017 instead of 2016). But eventually I located it. Here is its abstract:

GOAL:

To determine the effect of the specific carbohydrate diet (SCD) on active inflammatory bowel disease (IBD).

BACKGROUND:

IBD is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Diet is a potential therapeutic option for IBD based on the hypothesis that changing the fecal dysbiosis could decrease intestinal inflammation.

STUDY:

Pediatric patients with mild to moderate IBD defined by pediatric Crohn’s disease activity index (PCDAI 10-45) or pediatric ulcerative colitis activity index (PUCAI 10-65) were enrolled into a prospective study of the SCD. Patients started SCD with follow-up evaluations at 2, 4, 8, and 12 weeks. PCDAI/PUCAI, laboratory studies were assessed.

RESULTS:

Twelve patients, ages 10 to 17 years, were enrolled. Mean PCDAI decreased from 28.1±8.8 to 4.6±10.3 at 12 weeks. Mean PUCAI decreased from 28.3±23.1 to 6.7±11.6 at 12 weeks. Dietary therapy was ineffective for 2 patients while 2 individuals were unable to maintain the diet. Mean C-reactive protein decreased from 24.1±22.3 to 7.1±0.4 mg/L at 12 weeks in Seattle Cohort (nL<8.0 mg/L) and decreased from 20.7±10.9 to 4.8±4.5 mg/L at 12 weeks in Atlanta Cohort (nL<4.9 mg/L). Stool microbiome analysis showed a distinctive dysbiosis for each individual in most prediet microbiomes with significant changes in microbial composition after dietary change.

CONCLUSIONS:

SCD therapy in IBD is associated with clinical and laboratory improvements as well as concomitant changes in the fecal microbiome. Further prospective studies are required to fully assess the safety and efficacy of dietary therapy in patients with IBD.

What does this mean?

The WDDTY report bears very little resemblance to the journal article (let alone with the title of their article or any other published research by David Suskind).

How come?

I cannot be sure, but I would not be surprised to hear that the latter was ‘egged up’ to make the former appear more interesting.

If that is so, WDDTY are (once again) guilty of misleading the public to the point of endangering lives of vulnerable patients.

SHAME ON EVERY OUTLET THAT SELLS WDDTY, I’d say.

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