MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

gullible consumer

I have often remarked on the fact that, in alternative medicine, more surveys get published than in any other medical field. Typically these surveys are not just useless but overtly counter-productive:

  • they tend to be of very poor quality;
  • their results are not generalizable and thus meaningless;
  • they show that a sizable proportion of the population uses alternative therapies, pay out of their own pocket for them, and are satisfied with them;
  • the authors then state that it must be unfair that only the affluent can benefit from alternative medicine;
  • eventually, the conclusion is reached that alternative medicine should be paid for by the healthcare system and be free for all at the point of usage.

Therefore, I find that it is a waste of time to even read surveys of alternative medicine usage. But every now and then, one does come along that is worth discussing – like this one, for instance.

The survey evaluated dietary supplements (DS) usage by US adults aged ≥60 y to characterize the use of DSs, determine the motivations for use, and examine the associations between the use of DSs and selected demographic, lifestyle, and health characteristics. Data from 3469 older adults aged ≥60 y from the 2011-2014 NHANES were analyzed. DSs used in the past 30 d were ascertained via an interviewer-administered questionnaire in participants’ homes. The prevalence of overall DS use and specific types of DSs were estimated. The number of DSs reported and the frequency, duration, and motivation(s) for use were assessed. Logistic regression models were constructed to examine the association between DS use and selected characteristics.

Seventy percent of older adults reported using ≥1 DS in the past 30 d; 54% of users took 1 or 2 products, and 29% reported taking ≥4 products. The most frequently reported products were multivitamin or mineral (MVM) (39%), vitamin D only (26%), and omega-3 fatty acids (22%). Women used DSs almost twice as often as men. Those not reporting prescription medications were less likely to take a DS than those reporting ≥3 prescription medications. The most frequently reported motivation for DS use was to improve overall health (41%).

The authors concluded that the use of DSs among older adults continues to be high in the United States, with 29% of users regularly taking ≥4 DSs, and there is a high concurrent usage of them with prescription medications.

I find these data impressive – but not in a positive sense, I hasten to add.

The level of DS use in the US is staggering. Considering that 90% (my estimate) of the supplements are completely useless, the amount of money that is being wasted is huge. Even more concerning is the frequency of drug interactions that are being provoked by DS-intake.

And what’s the solution?

Obviously, it is better information for consumers (which is easier said than done – but I am trying my best!).

We have repeatedly discussed on this blog the fact that many alternative practitioners are advising their patients against vaccinations, e. g.:

There is little doubt that this phenomenon contributes to low immunisation rates. This, in turn, is a contributing factor to outbreaks of measles and other infectious diseases. The website of the European Centre for Disease Prevention and Control has recently published data on measles outbreaks in Europe:

Bulgaria: There is an increase by three cases since 21 July 2017. Since the beginning of 2017 and as of 16 July, Bulgaria reported 166 cases. During the same time period in 2016 Bulgaria reported one case.

France: On 27 July 2017 media quoting the French Minister of Health reported the death of a 16-year-old unvaccinated girl. She had fallen sick in Nice and died on 27 June 2017 in Marseille.

Germany: There is an increase by four cases since the last report on 21 July 2017. Since the beginning of 2017 and as of 26 July, Germany reported 801 cases. During the same time period in 2016 Germany reported 187 cases.

Italy: There is an increase by 170 cases since 21 July 2017. Since the beginning of 2017 and as of 25 July, Italy reported 3 842 cases, including three deaths. Among the cases, 271 are healthcare workers. The median age is 27 years, 89% of the cases were not vaccinated and 6% received only one dose of vaccine.

Romania: There is an increase by 229 cases, including one additional death, since 21 July 2017. Since 1 January 2016 and as of 21 July 2017, Romania reported 8 246 cases, including 32 deaths. Cases are either laboratory-confirmed or have an epidemiological link to a laboratory-confirmed case. Infants and young children are the most affected groups. Timis, in the western part of the country closest to the border with Serbia, is the most affected district with 1 215 cases. Vaccination activities are ongoing in order to cover communities with suboptimal vaccination coverage.

Spain: There is an increase by seven cases since 14 July 2017. Since the beginning of 2017 and as of 25 July, Spain reported 145  measles cases.

United Kingdom: Public Health Wales reported two additional cases related to the outbreak in Newport and Torfaen, bringing the total to ten cases related to this outbreak. In England and Wales there is an increase by 76 cases since 21 July 2017. Since the beginning of 2017 and as of 23 July 2017, England and Wales reported 922 cases. In the same time period in 2016, they reported 946 cases.

In addition to the updates listed above ECDC produces a monthly measles and rubella monitoring report with surveillance data provided by the member states through TESSy. The last report was published on 11 July 2017 with data up to 31 May 2017.

Measles outbreaks continue to occur in EU/EEA countries. There is a risk of spread and sustained transmission in areas with susceptible populations. The national vaccination coverage remains less than 95% for the second dose of MMR in the majority of EU/EEA countries. The progress towards elimination of measles in the WHO European Region is assessed by the European Regional Verification Commission for Measles and Rubella Elimination (RVC). Member States of the WHO European Region are making steady progress towards the elimination of measles. At the fifth meeting of the RVC for Measles and Rubella in October 2016, of 53 countries in the WHO European Region, 24 (15 of which are in the EU/EEA) were declared to have reached the elimination goal for measles, and 13 countries (nine in the EU/EEA) were deemed to have interrupted endemic transmission for between 12 and 36 months, meaning they are on their way to achieving the elimination goal. However, six EU/EEA countries were judged to still have endemic transmission: Belgium, France, Germany, Italy, Poland and Romania. More information on strain sequences would allow further insight into the epidemiological investigation.

All EU/EEA countries report measles cases on a monthly basis to ECDC and these data are published every month. Since 10 March 2017, ECDC has been reporting measles outbreaks in Europe on a weekly basis and monitoring worldwide outbreaks on a monthly basis through epidemic intelligence activities. ECDC published a rapid risk assessment on 6 March.

END OF QUOTE

Personally, I believe that it is high time to stop the rhetoric and actions of the anti-vaccination movements. This includes educating alternative practitioners and their patients. If necessary, we need regulation that prohibits their dangerous and unethical activities.

An article by Rabbi Yair Hoffman for the Five Towns Jewish Times caught my eye. Here are a few excerpts:

“I am sorry, Mrs. Ploni, but the muscle testing we performed on you indicates that your compatibility with your spouse is a 1 out of a possible 10 on the scale.”

“Your son being around his father is bad for his energy levels. You should seek to minimize it.”

“Your husband was born normal, but something happened to his energy levels on account of the vaccinations he received as a child. It is not really his fault, but he is not good for you.”

Welcome to the world of Applied Kinesiology (AK) or health Kinesiology… Incredibly, there are people who now base most of their life decisions on something called “muscle testing.” Practitioners believe or state that the body’s energy levels can reveal remarkable information, from when a bride should get married to whether the next Kinesiology appointment should be in one week or two weeks. Prices for a 45 minute appointment can range from $125 to $250 a session. One doctor who is familiar with people who engage in such pursuits remarked, “You have no idea how many inroads this craziness has made in our community.”

… AK (applied kinesiology) is system that evaluates structural, chemical, and mental aspects of health by using “manual muscle testing (MMT)” along with other conventional diagnostic methods. The belief of AK adherents is that every organ dysfunction is accompanied by a weakness in a specific corresponding muscle… Treatments include joint manipulation and mobilization, myofascial, cranial and meridian therapies, clinical nutrition, and dietary counselling. A manual muscle test is conducted by having the patient resist using the target muscle or muscle group while the practitioner applies force the other way. A smooth response is called a “strong muscle” and a response that was not appropriate is called a “weak response.” Like some Ouiji board out of the 1970’s, Applied Kinesiology is used to ask “Yes or No” questions about issues ranging from what type of Parnassa courses one should be taking, to what Torah music tapes one should listen to, to whether a therapist is worthwhile to see or not.

“They take everything with such seriousness – they look at it as if it is Torah from Sinai,” remarked one person familiar with such patients. One spouse of an AK patient was shocked to hear that a diagnosis was made concerning himself through the muscle testing of his wife – without the practitioner having ever met him… And the lines at the office of the AK practitioner are long. One husband holds a crying baby for three hours, while his wife attends a 45 minute session. Why so long? The AK practitioner let other patients ahead – because of emergency needs…

END OF EXCERPTS

The article  is a reminder how much nonsense happens in the name of alternative medicine. AK is one of the modalities that is exemplary:

  • it is utterly implausible;
  • there is no good evidence that it works.

The only systematic review of AK was published in 2008 by a team known to be strongly in favour of alternative medicine. It included 22 relevant studies. Their methodology was poor. The authors concluded that there is insufficient evidence for diagnostic accuracy within kinesiology, the validity of muscle response and the effectiveness of kinesiology for any condition. 

Some AK fans might now say: absence of evidence is not evidence of absence!!! There is no evidence that AK does not work, and therefore we should give it the benefit of the doubt and use it.

This, of course, is absolute BS! Firstly, the onus is on those who claim that AK works to prove their assumption. Secondly, in responsible healthcare, we are obliged to employ those modalities for which the evidence is positive, while avoiding those for which the evidence fails to be positive.

 

Isn’t it wonderful when your long-held views are confirmed by someone with influence?

This, of course, is a rhetorical question – I can tell you: it is wonderful!

Matthew Stanbrook, MD PhD recently published an editorial in CMAJ which I find delightful; let me present you a few quotes from it:

The multibillion-dollar market for “natural” health products has flourished under lax government regulations. These regulations have enabled manufacturers to exploit the public’s difficulty in distinguishing nonprescription drugs, with scientifically proven therapeutic benefits, from herbal or homeopathic preparations and supplements that often make similar health claims with little or no evidence and are frequently grounded in unscientific belief systems about health and disease…

In pharmacies, supermarkets and convenience stores, natural health products are displayed side by side with nonprescription drugs. Both tout their approval by Health Canada as an implicit endorsement of efficacy and safety on package labels that make similar health claims. However, although nonprescription drugs and their therapeutic claims require scientific evidence that is carefully scrutinized by Health Canada, natural health products have a separate regulatory system that typically imposes such minimal requirements that it is effectively a rubber stamp. Unlike nonprescription drugs, if a problem arises with a natural health product, Health Canada has little or no authority to compel any changes to its manufacture, labelling or sale.

…Risk is often difficult to perceive accurately without direct evidence. For example, under the proposed framework, Health Canada would continue to classify most homeopathic preparations as low-risk products and, thus, exempt from scientific review. Recently, a homeopathic product sold in the United States that claimed to relieve teething pain in infants and supposedly contained a very dilute extract from the belladonna plant was associated with several deaths of infants who manifested classic signs of anticholinergic poisoning…

…If consumers are unable to separate products with no scientific proof behind them from products supported by evidence, then we need to separate them in stores. Natural health products should be pulled from the shelves where they are mixed with nonprescription drug products and confined to their own separate section, away from any signage implying a therapeutic use.

The double standard perpetuated by both regulators and retailers that enables the deception of unsuspecting Canadians must end. Alternative medicines with claims based on alternative facts do not deserve an alternative, easy regulatory road to market — at the very least, they need to be moved to an alternative shelf.

END OF QUOTES

This, of course, is Canada. But elsewhere progress is also being made.The Australian reported about plans in Australia whereby pharmacies would be banned from selling useless and possibly dangerous homoeopathic remedies. The Australian last year ­revealed a review of pharmacy regulation, headed by Stephen King from the Productivity ­Commission, identified a potential conflict of interest in pharmacists selling vitamins, for example, that may not have a significant ­evidence base, alongside more stringently regulated and government-subsidised medicines. In its interim report, the review panel was “concerned that the sale of complementary medicines alongside other medicines may mislead consumers”. It therefore concludes that “complementary medicines should be held in a separate area within community pharmacies, where customers can easily access a pharmacist for appropriate advice.”

“To avoid potential harm, or the confusion between the efficacies of different types of medicines, pharmacists need to be easily ­accessible to give needed advice when consumers choose a complementary or pharmacy-only medicine,” the review panel said. It was scathing of homo­eopathy and the perception of legitimacy given to those so-called remedies sold in pharmacies. “The only defence put to the panel regarding homoeopathy was that it was harmless and able to be used as a placebo in certain circumstances,” the review panel noted. “The panel does not believe that this argument is sufficient to justify the continued sale of these products in pharmacies …”

AUSTRALIAN JOURNAL OF PHARMACY (AJP) noted that the interim report of the Review of Pharmacy Remuneration and Regulation states that “there are unacceptable risks where community pharmacies are allowed to sell homeopathic products”.

In 2015 Pharmaceutical Society of Australia (PSA) said it did not support the sale of homeopathy in pharmacy. “Our position is that pharmacists must use their professional judgement to prevent the supply of products with evidence of no effect,” PSA president Joe Demarte said at the time. Ian Carr, of Saxby’s Pharmacy in Taree, NSW, and Friends of Science in Medicine member, told the AJP that “in terms of homeopathic products being recommended not to be sold by PBS-approved pharmacies, I one hundred per cent heartily agree with that finding. “I love saying that I believe homeopathy works. But it has never been shown to work better than placebo. There are many things that will work as well as placebo, but it’s not ethical to be selling them as a cure or treatment for something. I would have a bit more time for it if there was a plausible theory behind it, but its basis is entirely implausible – it pushes all the buttons for being a pseudoscience, so I agree it has no place in Australian pharmacy. However, I am at a bit of a loss to understand why they haven’t carried some of that logic over into the comments on complementary medicines generally.”

Mr Carr also told the AJP that “If one conceives of complementary medicines as being vitamins and minerals, that’s one thing. But the marketing of those items has become so diffuse and so wide that on most of these CM shelves we have traditional medicines, we’ve got herbal medicines, we’ve got items that are basically just marketing formulas for certain conditions. The evidence behind most of these things is very very slim, and we still have the possibility of health fraudsters just marching in and taking advantage of the lack of regulation in the industry.”

So, Canada and Australia are making progress in protecting consumers from bogus healthcare products and from pharmacists selling them.

Hurray!!!

When, I ask myself, are the UK, the US and other countries following suit?

 

The title of the article actually was ‘SIX REASONS TO TRY A WEATGRASS COLONIC’. I will only repeat parts of the introduction, but please do take the time to read the full text, particularly if you feel sad or depressed – it is hilarious!

START OF QUOTE

If you’ve ever had a colonoscopy, then you may be familiar with colonics. Colon cleansing is normally used to prepare for medical procedures. However, some alternative medicine practitioners might offer colon cleansing for other reasons, such as detoxification. During a colon cleanse, large amounts of water are flushed through the colon, along with other ingredients, such as herbs, teas, juice or coffee. This takes place with a tube that’s inserted into the rectum. In some cases, and depending on the colonic, smaller amounts of water along with other substances are left in the colon for about 30 minutes before being removed.

Wheatgrass is a humble weed that has a wide variety of health benefits for the body due to high concentrations of chlorophyll, active enzymes, vitamins and other nutrients. According to Israeli research on wheatgrass, lab studies suggest that it may have anticancer potential. In animal experiments, wheatgrass demonstrated possible benefits in cancer prevention and as an aid to cancer treatment — particularly chemotherapy. In clinical trials wheatgrass was found to improve chemotherapy and decrease chemotherapy-related side effects.

Wheatgrass has also been found to support the immune system and help repair damaged cells. It’s also shown promise for conditions such as:

  • Rheumatoid arthritis
  • Ulcerative colitis
  • Hematological diseases
  • Diabetes
  • Obesity
  • Oxidative stress (the body’s ability to repair damage)

Wheatgrass colonics cleanse and nourish the colon, according to digestive wellness center Vitallife. And effects are felt almost immediately. This is attributed to wheatgrass’s dense nutrient profile, which contains over 90 minerals, and the high absorption rate of the colon. Both factors allow for easy and fast entry into the bloodstream.

END OF QUOTE

The article motivated me to come up with my SIX REASONS TO AVOID A WHEATGRASS COLONIC. Here they are:

  1. The treatment is not effective.
  2. It is uncomfortable.
  3. It is not safe.
  4. It costs money.
  5. It has no plausibility.
  6. There are better therapeutic options for whatever condition you want to treat.

I know, some of my reasons are not entirely scientific or fully evidence-based. But, if you read the article which inspired me to write this post, you will discover, I am sure, that my version is a whole dimension better than the original.

In 2006, the World Health Organization and UNICEF created the ‘Global Immunization Vision and Strategy’, a 10-year strategy with 4 main goals:

  1. to immunize more people against more diseases,
  2. to introduce a range of newly available vaccines and technologies,
  3. to integrate other critical health interventions with immunization,
  4. to manage vaccination programmes within the context of global interdependence.

More than a decade later, we have to realise that this vision has been frustrated, not least by fans of alternative medicine (FAMs). They are almost by definition more negative about the value and achievements of conventional medicine and science. This shows in all sorts of ways; the clearest this phenomenon is documented must be the FAMs’ attitude towards immunisations. Few rational thinkers would doubt that vaccinations are amongst the most important achievement in the history of medicine.

Vaccination is a miracle of modern medicine. In the past 50 years, it’s saved more lives worldwide than any other medical product or procedure.”

Yet FAMs are not impressed by such statements and often refuse to have their kids vaccinated according to the recommended schedule. This trend has significantly contributed to vaccination rates that, in some parts of the world, are now dropping so low that our ‘herd immunity’ is jeopardised.

One such place is Germany, and the German government is now making a controversial move against parents who choose to refrain from vaccinating their children. Germany is presently passing a law that will force kindergartens to inform the authorities, if parents don’t provide evidence that they have gotten advice from their doctor on vaccinations for their children.

Yes, the festive season is upon us and therefore it is high time to discuss detox (yet again). As many of us are filling their fridges to the brim, most of us prepare for some serious over-indulgence. Following alt med logic, this must prompt some counter-measures, called detox.

The range of treatments advocated by detox-fans is weird and wide (see also below):

  • various alternative diets,
  • herbal, vitamins, minerals and other ‘natural’ supplements,
  • various forms of chelation therapy,
  • electromagnetic devices,
  • colonic irrigation and enemas,
  • various forms of skin bruising,
  • cupping,
  • sauna and other means of inducing extensive sweating,
  • homeopathy,
  • ear candles,
  • foot-baths,
  • etc., etc.

I suppose it was to be expected that detox often goes with other crazy beliefs. This website, for instance, shows that it is even associated with anti-vaxx:

START OF QUOTE

Whether you believe vaccines to be harmful or not, one has to admit that all the ingredients added to vaccines cannot be good for anyone, especially children.

As David Wolfe has discussed, vaccines contain the following: sucrose, fructose, dextrose, potassium phosphate, aluminum potassium sulfate, peptone, bovine extract, formaldehyde, FD&C Yellow #6, aluminum lake dye, fetal bovine serum, sodium bicarbonate, monosodium glutamate, aluminum hydroxide, benzethonium chloride, lactose thimerosal, ammonium sulfate, formaldehyde, glutaraldehyde, bovine extract), calf serum, aluminum phosphate, aluminum hydroxyphosphate sulfate, and ethanol.

That is a long scary list and many of these things will not leave the body naturally. Thus, a gentle detox is necessary.

Detoxification Bath

Living Traditionally suggests a detoxification bath with both Zendocrine and epsom salt. Zendocrine is an essential oil mixture made up of tangerine, rosemary, geranium, juniper berry, and cilantro. Rosemary, juniper berry, and cilantro are good choices for detoxification and tangerine and geranium are purifiers.

Garlic

Garlic has been scientifically proven to treat heavy metal poisoning. Organic Lifestyle Magazine suggests consuming three cloves a day to help remove toxins.

Silica

Silica is also good for a heavy metal detox. Natural News states, “Aluminum (Al) is passed out through the urine when one supplements silica. It seems there’s little danger of taking too much, as long as adequate water is consumed and vitamin B1 and potassium levels are maintained.”

One of the best ways to get silica in your system is with the horsetail herb, rye, barley, oats, wheat, and alfalfa sprouts nuts.

Chlorella

Chlorella is one of the best detoxifying substances available. According to Dr. Mercola, “Chlorella is uniquely designed to not bind to the minerals your body naturally needs to function optimally. It does not bind to beneficial minerals like calcium, magnesium, or zinc. It’s almost as if chlorella knows which metals belong in your body and which chemicals need to be removed. Supplementing with chlorella is like unleashing a tiny army inside your body to fight the battle of removing toxins from your tissues and ushering them back outside your body where they belong.”
You can take it in supplement form or add a powdered version to your smoothie.

Probiotics

Probiotics are what is needed to put good bacteria system to rights when it has been thrown off by toxins. “They can provide assistance by decreasing the number of bad bacteria while helping to restore balance between good and bad bacteria in the gut and to keep your body functioning properly.” (LiveStrong)

Some probiotic foods include: organic yogurt, kefir, sauerkraut, kombucha, and fermented vegetables.

Omega-3

Omega 3 oils are especially good for cell repair and keeping your brain healthy. This is because of their high fat content is similar to the fats that are naturally part of cell and brain systems. (Daily Mail)

A teaspoon daily should be enough or you could take a supplement.

Cilantro

According to Natural Society, cilantro is a very gentle detoxification tool. It is also effective for removing heavy metals from the brain.
For 2-3 weeks, add a teaspoon of cilantro to your food, smoothie, or just eat it up. You can also substitute with 6-7 drops of cilantro essential oil by adding it to your bath.

END OF QUOTE

Don’t you just adore the sources quoted by the author as evidence for his/her statements?

As I said, the therapies recommended for detox are diverse. Yet, they have one important feature in co<span style=”color: #668a1d;”>mmon: they are not based on anything remotely resembling good evidence. As I stressed in my article of 2012:

The common characteristics of all of these approaches are that they are unproved. Even experts who are sympathetic to alternative medicine and AD admit: ‘while there are hundreds of randomized controlled trials on drug and alcohol detox, there are no such trials of detox programs focusing on environmental toxins … at present, “detox” is certainly more of a sales pitch than a science’. The ‘studies’ of AD that have been published are of such poor methodological quality that no conclusions can be drawn from them.

While there is a total absence of sound evidence for benefit, some of these treatments have been associated with risks which depend on the nature of the treatment and can be particularly serious with diets (malnutrition), supplements (hepatoxicity), chelation (electrolyte depletion) and colonic irrigation (perforation of the colon).

Yet detox is big business’. A recent survey, for instance, suggested that 92% of US naturopaths use some form of detox. To lay people, its principles seem to make sense and, in many of us, the desire to ‘purify’ ourselves is deep rooted. Thus detox-entrepreneurs (including Prince Charles who, several years ago, launched a ‘Detox-Tincture’ via his firm Duchy Originals) are able to exploit a gullible public.

Proponents of detox are keen to point out that ‘a modern science of ‘detoxicology’ seems to be emerging’. If there is such a thing, it should address the following, fundamental questions:

  • What are the toxins and toxicants?
  • What evidence exists that they damage our health?
  • How do we quantify them?
  • How do we diagnose that a patient requires detox?
  • Which treatments are effective in eliminating which toxins?

Currently, there is insufficient evidence to answer any of these questions. Until this situation changes, I do not think a ‘science of detox’ exists at all.

The boom of alternative medicine in the US – and consequently in the rest of the developed world – is intimately connected with a NHI centre now called NCCIH (National Center for Complementary and Integrative Health). It was founded in the early 1990s because some politicians were bent on promoting quackery. Initially the institution had modest funding but, after more political interference, it had ample cash to pursue all sorts of activities, including sponsoring research into alternative therapies at US universities. A most interesting video summarising the history of the NCCIH can be seen here.

No other institution in the world had more funds for research into alternative medicine than the NCCIH, and it soon became the envy of alt med researchers globally. I have been invited by the NCCHI on several occasions and invariably was impressed by their apparent affluence. While we Europeans usually had to do our research on a shoe-string, our American colleagues seemed to be ‘rolling in it’.

I was often far less impressed with the research they sponsored. Not only it was invariably eye-wateringly expensive, but also its quality seemed often dismal. Sometimes, I even got the impression that research was used as a means of mainstreaming quackery for the unsuspecting American – and consequently world-wide – public.

An example of this mainstreaming is an article in JAMA published yesterday. Here is a short but telling excerpt:

Researchers led by Richard L. Nahin, PhD, MPH, lead epidemiologist at the NIH’s National Center for Complementary and Integrative Health (NCCIH), examined efficacy and safety evidence in 105 randomized controlled trials (RCTs) conducted between January 1966 and March 2016. The review—geared toward primary care physicians as part of the journal’s Symposium on Pain Medicine—focused on popular complementary approaches to common pain conditions.

Unlike a typical systematic review that assigns quality values to the studies, the investigators conducted a narrative review, in which they simply looked at the number of positive and negative trials. “If there were more positives than negatives then we generally felt the approach had some value,” Nahin explained. “If there were more negatives, we generally felt the approach had less value.” Trials that were conducted outside of the United States were excluded from the review.

Based on a “preponderance” of positive vs negative trials, complementary approaches that may offer pain relief include acupuncture and yoga for back pain; acupuncture and tai chi for osteoarthritis of the knee; massage therapy for neck pain; and relaxation techniques for severe headaches and migraine. Several other techniques had weaker evidence, according to the qualitative assessments, for specific pain conditions (see “Selected Complementary Health Approaches for Pain”). The treatments were generally safe, with no serious adverse events reported.

To me, this looks that NCCIH has now managed to persuade even the editors of JAMA to white-wash their dodgy science. The review referred to here is a paper we discussed some time ago on this blog. I then stated about it the following:

Reading the article carefully, it is impossible not to get troubled. Here are a few points that concern me most:

  • the safety of a therapy cannot be evaluated on the basis of data from RCTs (particularly as it has been shown repeatedly that trials of alternative therapies often fail to report adverse effects); much larger samples are needed for that; any statements about safety in the aims of the paper are therefore misplaced;
  • the authors talk about efficacy but seem to mean effectiveness;
  • the authors only included RCTs from the US which must result in a skewed and incomplete picture;
  • the article is from the National Center for Complementary and Integrative Health which is part of the NIH but which has been criticised repeatedly for being biased in favour of alternative medicine;
  • not all of the authors seem to be NIH staff, and I cannot find a declaration of conflicts of interest;
  • the discussion of the paper totally lacks any critical thinking;
  • there is no assessment of the quality of the trials included in this review.

My last point is by far the most important. A summary of this nature that fails to take into account the numerous limitations of the primary data is, I think, as good as worthless. As I know most of the RCTs included in the analyses, I predict that the overall picture generated by this review would have changed substantially, if the risks of bias in the primary studies had been accounted for.

I find it puzzling that the ‘lead epidemiologist at the NIH’s National Center for Complementary and Integrative Health’ would publish such dubious research. Why does he do it? If you have watched the video mentioned above, you are inclined to think that it might be because of political interference.

However, I suggest another, in a way much more damming reason or contributing factor: the NCCIH has so long indulged in such poor science that even its top people have forgotten what good science looks like. I know this is a bold hypothesis; so, let me try to support it with some data.

Several years ago, my team together with several other researches have looked at the NCCIH-sponsored research systematically according to 4 different subject areas. Here are the conclusions of our articles reporting the findings:

ACUPUNCTURE

Seven RCTs had a low risk of bias. Numerous methodological shortcomings were identified. Many NCCAM-funded RCTs of acupuncture have important limitations. These findings might improve future studies of acupuncture and could be considered in the ongoing debate regarding NCCAM-funding. [Focus on Alternative and Complementary Therapies Volume 17(1) March 2012 15–21]

HERBAL MEDICINE

This independent assessment revealed a plethora of serious concerns related to NCCAM studies of herbal medicine. [Perfusion 2011; 24: 89-102]

ENERGY MEDICINE

In conclusion, the NCCAM-funded RCTs of energy medicine are prime examples of misguided investments into research. In our opinion, NCCAM should not be funding poor-quality studies of implausible practices. The impact of any future studies of energy medicine would be negligible or even detrimental. [Focus on Alternative and Complementary Therapies Volume 16(2) June 2011 106–109 ]

CHIROPRACTIC

In conclusion, our review demonstrates that several RCTs of chiropractic have been funded by the NCCAM. It raises numerous concerns in relation to these studies; in particular, it suggests that many of these studies are seriously flawed. [https://www.ncbi.nlm.nih.gov/pubmed/21207089]

I think I can rest my case and urge you to watch the video mentioned above.

On this blog, we have repeatedly discussed the issues around para-normal or spiritual healing practices. In one of these posts I concluded that these treatments are:

  1. utterly implausible
  2. not supported by good clinical evidence.

What follows seems as simple as it is indisputable: energy healing is nonsense and does not merit further research.

Yet both research and – more importantly – the practice of spiritual healing continue, not only in the developed world but even more so in poor and under-developed countries.

Traditional healers, known in Rwanda as Abarangi or Abacwezi claim to use their spiritual powers to heal sick patients. Recently, they urged their government to acknowledge them through proper regulation. Jean-Bosco Kajongi, the leader of the healers in Rwanda, said Abahereza are like doctors who have been selected by angels. “Umuhereza is someone who gets power from God to treat different diseases but particularly demonic possession such as ‘Amahembe’ and ‘Imandwa’. Sometimes, doctors detect something in the body, do surgery but find nothing. But Abarangi can identify the disease beforehand and heal it. Thus, we want to have legal personality and work with modern doctors because what we cure, they cannot even see it. Therefore, mortality rate would decrease.”

Abahereza claim to have God-given powers to heal any disease, provided that the patient has belief in their powers. Claudine Uwamahoro, a resident of Rulindo district is one of them. “Last year, I was transferred to Kanombe Military Hospital to have my leg cut off after they diagnosed me with cancer. Abarangi told me it was not cancer but rather ‘Imandwa.’ They treated me but I didn’t get healed immediately because I had not yet heeded God’s commandment because they do not use any medicines but only requires you to obey God and respect his commandments.  Now my leg has been healed… Like Jesus came to save us so that we don’t perish, Umurangi also came so that we do not die of diseases that normal medicines cannot treat.”

Another patient agrees: “In 1983, I played football but later, Imandwa disabled me and my legs were paralyzed. I went to various hospitals and was given an assortment of medicines but they could not help. I always had fever; Doctors treated me but could not identify what kind of disease it really was. I even went to traditional healers but they didn’t have a solution. Pastors and priests prayed for me but in vain. Sorcerers also tried but failed. I was possessed by Imandwa and I was cured by Umurangi from Kirehe District. I believe that they have the power from God and when you respect their conditions, they treat and cure you completely.”

According to Alexia Mukahirwa, another witness, Umurangi is very powerful. “I was sick for 16 years. I went to different places and met many doctors. Some told me I had blood infection, others said it was stomach and intestinal infections. I consumed numberless medicines that never helped until I saw the power of Abarangi and believed them. Some people said that I had HIV/AIDS but it was not true. I only weighed 42 kilograms but now I have 68. Abarangi are powerful and may God bless them.”

James Mugabo, who is an “Umuhereza” or priest, said: “Before colonialism, people had their way of treating illness. But we have abandoned everything yet we should not.” The Director General of clinical services in the Ministry of Health responded by stating: “The law and policy are being drafted and will help us to know who does what kind of medicine and their identity. From that, we will know where to localize Abarangi in traditional or alternative.”

Hearing such things, we might smile and think ‘that’s Rwanda – this would not happen in developed countries’. But sadly, it does! These things happen everywhere. I know of healing ceremonies in the UK and the US that are embarrassingly similar to the ones in Rwanda – remember, for instance, the scenes seen on TV where Donald Trump was blessed by some evangelicals to receive the ability to win the election? And now they will probably claim that it worked!

Nothing to do with alternative medicine, you say? Perhaps this website on ‘spiritual homeopathy’ is more relevant then:

START OF QUOTE

What is spiritual homeopathy? It is based on the principle that “like cures like” and “wounds heal wounds” — the underlying wisdom of support groups. A Biblical story which illustrates this principle takes place on the ancient shepherding people’s journey through the desert. When they grew impatient and complained bitterly to Moses, God sent venomous snakes to bite the people. Many died. When the people confessed their sin, God told Moses to put a bronze snake on a pole. Those who were bitten and focused on the bronze snake did not die; they looked and lived.

Many years later Jesus said of his mission, “As Moses lifted up the serpent in the desert, so the Chosen One must be lifted up, so that everyone who believes on the Chosen One might have eternal life.” Jesus’ disciple Peter wrote, “By Christ’s wounds you are healed.” In “The Angel that Troubled the Waters,” Thornton Wilder wrote: “Without your wound where would your power be? … In love’s service only the wounded can serve.”

As the Thanksgiving and Christmas season approaches, spiritual homeopathy offers healing to all – because the Babe in the Manger is also the Wounded Healer

END OF QUOTE

I think I rest my case.

 

 

Homeopathic remedies are being marketed and sold as though they are medicines, yet highly diluted preparations contain nothing and do nothing. This means consumers are constantly mislead into believing that they are drugs. This situation seems to be changing dramatically in the US, and hopefully – led by the American example – elsewhere as well.

It has been reported that the US Federal Trade Commission issued a statement which said that, in future, homeopathic remedies have to be held to the same standard as other medicinal products. In other words, American companies must now have reliable scientific evidence for health-related claims that their products can treat specific conditions and illnesses.

The ‘Enforcement Policy Statement on Marketing Claims for Over-the-Counter (OTC) Homeopathic Drugs’ makes it clear that “the case for efficacy is based solely on traditional homeopathic theories and there are no valid studies using current scientific methods showing the product’s efficacy.”

However, an [over-the-counter] homeopathic drug claim that is not substantiated by competent and reliable scientific evidence might not be deceptive if the advertisement or label where it appears effectively communicates that: 1) there is no scientific evidence that the product works; and 2) the product’s claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts. In other words, if no evidence for efficacy exists, companies must advertise this fact clearly on their labelling, and also disclose that claims are today rejected by the majority of the scientific community. Failure to do this will be considered a violation of the FTC Act.

“This is a real victory for reason, science, and the health of the American people,” said Michael De Dora, public policy director for The Center for Inquiry in a statement issued in response to the new act. “The FTC has made the right decision to hold manufacturers accountable for the absolutely baseless assertions they make about homeopathic products.”

The new regulation will make sure that customers are informed explicitly about whether the product they purchase at a pharmacy has any scientific basis. This is important because homeopathic remedies aren’t just ineffective, but they can be dangerous too. The FDA is currently investigating the deaths of 10 babies who were given homeopathic teething tablets that contained deadly nightshade.

“Consumers can’t help but be confused when snake oil is placed on the same pharmacy shelves as real science-based medicine, and they throw away billions of dollars every year on homeopathy based on its false promises,” said De Dora. “The dangers of homeopathy are very real, for when people choose these deceptive, useless products over proven, effective medicine, they risk their health and the health of their families.”

These are clear words indeed; the new regulation is bound to make a dramatic change for homeopathy in the US. The winner will undoubtedly the consumer who can no longer be so openly and shamelessly misled as before. The FTC has set an example for other national regulators who will hopefully follow suit.

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