Edzard Ernst

MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

US Republican Senator Hatch from Utah (born March 22, 1934) has announced that he is retiring after having been a Senator since 1977When he leaves, the Senate “will lose its most ardent supporter of alternative medicine“. His decision comes after ‘The Salt Lake Tribune’ published a Christmas Day editorial calling on him to do so. The editorial stated that he has an “utter lack of integrity” that comes from “his unquenchable thirst for power.”

 

For advocates of alternative medicine, Hatch’s retirement comes as a blow: for decades, the senator has been one of the most powerful defender of quackery. As a young man, Orrin Hatch sold vitamins and supplements. As an old man, he takes them every day—including. “I really believe in them. I use them daily. They make me feel better, as they make millions of Americans feel better. And I hope they give me that little added edge as we work around here”, he was quoted stating.

And his love was returned: Between 1989 and 1994 Herbalife International gave Hatch $49,250; MetaboLife, $31,500; and Rexall Sundown, Nu Skin International, and Starlight International a total of $88,550. In addition, according to his financial disclosures for 2003, Hatch owned 35,621 shares of Pharmics, a Utah-based nutritional supplement company. In the early 1990s, Hatch’s son Scott began working for lobbying groups representing vitamin and supplement makers. Kevin McGuiness, Hatch’s former chief of staff, was also a lobbyist for the industry.

The NYT reported in 2011 that Hatch “was the chief author of a federal law enacted … that allows companies to make general health claims about their products, but exempts them from federal reviews of their safety or effectiveness before they go to market. During the Obama administration, Mr. Hatch has repeatedly intervened with his colleagues in Congress and federal regulators in Washington to fight proposed rules that industry officials consider objectionable…

“Mr. Hatch has been rewarded with hundreds of thousands of dollars in campaign contributions, political loyalty and corporate sponsorship of his favorite causes back home.

“His family and friends have benefited, too, from links to the supplement industry. His son Scott Hatch, is a longtime industry lobbyist in Washington, as are at least five of the senator’s former aides. Mr. Hatch’s grandson and son-in-law increase revenue at their chiropractic clinic near here by selling herbal and nutritional treatments, including $35 “thyroid dysfunction” injections and a weight-loss product, “Slim and Sassy Metabolic Blend.” And Mr. Hatch’s former law partner owns Pharmics, a small nutritional supplement company in Salt Lake City…”

Image result for hatch with trump

Further information is provided by Wikipedia:

Hatch’s son Scott Hatch is a partner and registered lobbyist at Walker, Martin & Hatch LLC, a Washington lobbying firm. The firm was formed in 2001 with Jack Martin, a staff aide to Hatch for six years, and H. Laird Walker, described as a close associate of the senator. In March 2003, the Los Angeles Times reported that the firm was formed with Hatch’s personal encouragement and that he saw no conflict of interest in working on issues that involved his son’s clients. In 2009, the Washington Times reported that Hatch said “My son, Scott, does not lobby me or anyone in my office”.

In March 2009, the Washington Times reported that the pharmaceutical industry, which has benefited from Hatch’s legislative efforts, had previously unreported connections to Hatch. In 2007, five pharmaceutical companies and the industry’s main trade association, Pharmaceutical Research and Manufacturers of America (PhRMA), donated $172,500 to the Utah Families Foundation—a charitable foundation which Hatch helped start in the 1990s and has continued to support since. Walker, Martin & Hatch LLC was paid $120,000 by PhRMA in 2007 to lobby Congress on pending U.S. Food and Drug Administration legislation.

And finally:

Donald J. Trump‏Verified account @realDonaldTrump Jan 2

Congratulations to Senator Orrin Hatch on an absolutely incredible career. He has been a tremendous supporter, and I will never forget the (beyond kind) statements he has made about me as President. He is my friend and he will be greatly missed in the U.S. Senate!

We should not have to repeat this! But, as it is currently topical and certainly true, let me tell you again:

DETOX IS BUNK!

After the season of gluttony, it seems that half the population has fallen victim to the legion of alternative practitioners and entrepreneurs who claim that their particular form of quackery is ideally suited for detoxifying the body – and, sure enough, rid their clients of money instead of poisons. I have pointed out again and again why detox, as promoted in alternative medicine. is bogus and occasionally even harmful – see for instance here, here and here. And years ago, I published a review of the evidence on ‘alternative detox’ (AD); it concluded that “the principles of AD make no sense from a scientific perspective and there is no clinical evidence to support them. The promotion of AD treatments provides income for some entrepreneurs but has the potential to cause harm to patients and consumers. In alternative medicine, simplistic but incorrect concepts such as AD abound. All therapeutic claims should be scientifically tested before being advertised-and AD cannot be an exception.”

But I have, of course, many readers who do not trust a word I am putting on paper. So, please don’t take it from me, take it from others; read for example this recent article: 

Detox diets are popular dieting strategies that claim to facilitate toxin elimination and weight loss, thereby promoting health and well-being. The present review examines whether detox diets are necessary, what they involve, whether they are effective and whether they present any dangers. Although the detox industry is booming, there is very little clinical evidence to support the use of these diets. A handful of clinical studies have shown that commercial detox diets enhance liver detoxification and eliminate persistent organic pollutants from the body, although these studies are hampered by flawed methodologies and small sample sizes. There is preliminary evidence to suggest that certain foods such as coriander, nori and olestra have detoxification properties, although the majority of these studies have been performed in animals. To the best of our knowledge, no randomised controlled trials have been conducted to assess the effectiveness of commercial detox diets in humans. This is an area that deserves attention so that consumers can be informed of the potential benefits and risks of detox programmes.

To the best of our knowledge, no randomised controlled trials have been conducted to assess the effectiveness of commercial detox diets in humans. I think that says enough; and it applies not just to detox diets, it applies to all detox methods promoted in alternative medicine.

DETOX IS BUNK!

Save your hard-earned money for stuff that is proven to work.

In 2017, Medline listed just over 1800 articles on ‘complementary alternative medicine’. If you find this number impressively high, consider that, for ‘surgery’ (a subject that has often been branded as less that active in conducting research), there were almost 18 000 Medline-listed papers.

So, the research activity in CAM is relatively small. Vis a vis the plethora of open questions, this inactivity is perhaps lamentable. What I find much more regrettable, however, is the near total lack of investigations into the ethical issues in CAM. In 2017, there were just 11 articles on Medline on ‘ethics and CAM’ (24393 articles on ‘ethics and surgery’).

One of the 11 papers that tackled the ethics directly and that was (in my opinion) one of the best is this article. Here is its concluding paragraph:

When we encounter patients who use or consider the use of complementary and/or alternative medicine, we should respect their autonomy while also fulfilling our obligations of beneficence and nonmaleficence. Physicians should become more knowledgeable about research on CAM therapies and approach discussions in an open, nonjudgmental manner to enhance patient trust. In situations where there is little risk of harm and the possibility of benefit, supporting a patient in their interest in complementary therapies can strengthen the patient-physician relationship. However, when a patient’s desire to utilize alternative therapies poses a health risk, physicians have the ethical obligation to skillfully counsel the patient toward those therapies that are medically appropriate.

I have had a long-lasting and keen interest in the ethics of CAM which resulted in the publication of many papers. Here is a selection:

Problems with ethical approval and how to fix them: lessons from three trials in rheumatoid arthritis.

‘Complementary & Alternative Medicine’ (CAM): Ethical And Policy Issues.

Pharmacists and homeopathic remedies.

No obligation to report adverse effects in British complementary and alternative medicine: evidence for double standards.

Homeopathy, a “helpful placebo” or an unethical intervention?

Advice offered by practitioners of complementary/ alternative medicine: an important ethical issue.

The ethics of British professional homoeopaths.

Evidence-based practice in British complementary and alternative medicine: double standards?

Ethics of complementary medicine: practical issues.

The ethics of chiropractic.

Reporting of ethical standards: differences between complementary and orthodox medicine journals?

Informed consent: a potential dilemma for complementary medicine.

Ethical problems arising in evidence based complementary and alternative medicine.

Complementary medicine: implications for informed consent in general practice.

Ethics and complementary and alternative medicine.

Research ethics questioned in Qigong study.

Informed consent in complementary and alternative medicine.

The ethics of complementary medicine.

For most of the time conducting this research, I felt that I was almost alone in realising the importance of this topic. And all this time, I was convinced that the subject needed more attention and recognition. Therefore, I teamed up with with the excellent ethicist Kevin Smith from the University of Dundee, and together we spent the best part of 2017 writing about it.

Our book is entitled ‘MORE HARM THAN GOOD? THE MORAL MAZE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE’ and will be published shortly by Springer.

Product Details

It is an attempt to highlight some of the most important topics in this broad and under-researched area. While working on it, I was continually struck by the fact that most of the issues we have been struggling with on this blog are, in the final analysis, ethical by nature.

My hope is that, in 2018, we will see many more high quality papers filling the almost total void of ethical perspectives on CAM. In my view, it is unquestionably an area that needs to be addressed with some urgency.

At this time of the year it is customary to look back and highlight some remarkable things that occurred during the last 12 months. Here I will try to identify for each month the most important event. My choice is entirely subjective, and I invite everybody to disagree with it and add other happenings.

JANUARY

The U.S. Food and Drug Administration announced today that its laboratory analysis found inconsistent amounts of belladonna, a toxic substance, in certain homeopathic teething tablets, sometimes far exceeding the amount claimed on the label. The agency is warning consumers that homeopathic teething tablets containing belladonna pose an unnecessary risk to infants and children and urges consumers not to use these products.

FEBRUARY

It has just been reported that the Russian Academy of Sciences (RAS) has labelled homeopathic medicine a health hazard. The organization is now petitioning Russia’s Ministry of Health to abandon the use of homeopathic medicine in the country’s state hospitals, the RBC news outlet reported Monday.

A RAS committee warns that some patients were rejecting standard medicine for serious conditions in favour of homeopathic remedies, a move that almost inevitably puts their lives in danger. The committee also noted that, because of sloppy quality control during the manufacturing processes, some unlicensed homeopathic remedies contain toxic substances which harm patients in a direct fashion.

“The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available,” the committee stated in its report.

MARCH

George Lewith has died on 17 March, aged 67. He was one of the most productive researchers of alternative medicine in the UK; specifically he was interested in acupuncture. If you search this blog, you find several posts that mention him or are entirely dedicated to his work. Undeniably, my own views and research were often very much at odds with those of Lewith.

APRIL

A new review of the risks of spinal manipulative therapy (SMT) concluded that it is currently not possible to provide an overall conclusion about the safety of SMT; however, the types of SAEs reported can indeed be significant, sustaining that some risk is present. High quality research and consistent reporting of AEs and SAEs are needed.

MAY

My favourite journal has succumbed to BS. A review that is ‘state of the art’ must fulfil certain criteria; foremost it should be informative, unbiased and correct. The paper I am discussing here has, I think, neither of these qualities. It is entitled ‘Management of chronic pain using complementary and integrative medicine’, and here is its abstract:

Complementary and integrative medicine (CIM) encompasses both Western-style medicine and complementary health approaches as a new combined approach to treat a variety of clinical conditions. Chronic pain is the leading indication for use of CIM, and about 33% of adults and 12% of children in the US have used it in this context. Although advances have been made in treatments for chronic pain, it remains inadequately controlled for many people. Adverse effects and complications of analgesic drugs, such as addiction, kidney failure, and gastrointestinal bleeding, also limit their use. CIM offers a multimodality treatment approach that can tackle the multidimensional nature of pain with fewer or no serious adverse effects. This review focuses on the use of CIM in three conditions with a high incidence of chronic pain: back pain, neck pain, and rheumatoid arthritis. It summarizes research on the mechanisms of action and clinical studies on the efficacy of commonly used CIM modalities such as acupuncture, mind-body system, dietary interventions and fasting, and herbal medicine and nutrients.

JUNE

Scientology seems to have started an aggressive campaign in the UK to promote its cult.

JULY

The NHS seems to be edging towards banning homeopathy.

AUGUST

A group of German experts published a document pointing out that the ‘Heilpraktiker’ has introduced two hugely different quality standards into the German healthcare system. In the interest of the patient and of good healthcare, this double standard must be addressed. We are demanding the profession of the Heilpraktiker either is completely abolished, or is reformed such that it no longer poses a threat to public health in Germany. Our document makes concrete suggestions for such reforms.

SEPTEMBER

It has been announced that Susan and Henry Samueli have given US$ 200 million to medical research at the University of California, Irvine (UCI). Surely this is a generous and most laudable gift! How could anyone doubt it?

OCTOBER

I feel deeply honoured to have received the Ockham Award. It is a generous appreciation of our small efforts in decreasing the ignorance and stupidity that seems to be all around us today – sadly not just in the realm of alternative medicine (but that would be the subject of another blog). I thank everyone who contributed to our blog’s success and hope you keep the comments coming.

NOVEMBER

The RCVS publishes a position paper on alternative medicine for animals: “Homeopathy exists without a recognised body of evidence for its use. Furthermore, it is not based on sound scientific principles. In order to protect animal welfare, we regard such treatments as being complementary rather than alternative to treatments for which there is a recognised evidence base or which are based in sound scientific principles. It is vital to protect the welfare of animals committed to the care of the veterinary profession and the public’s confidence in the profession that any treatments not underpinned by a recognised evidence base or sound scientific principles do not delay or replace those that do.”

DECEMBER

The US Food and Drug Administration proposed a new, risk-based enforcement approach to drug products labeled as homeopathic. To protect consumers who choose to use homeopathic products, this proposed new approach would update the FDA’s existing policy to better address situations where homeopathic treatments are being marketed for serious diseases and/or conditions but where the products have not been shown to offer clinical benefits. It also covers situations where products labeled as homeopathic contain potentially harmful ingredients or do not meet current good manufacturing practices…

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This time of the year is also a good moment for thanking those who made writing this blog an exercise that is fun and hopefully constructive. Happy New Year to all of you.

How often have we heard the claim from proponents of alternative medicine that one strength of their approach is disease prevention (see for instance my previous post or this, this and this) and that conventional medicine neglects prevention almost completely? Such claims annoy me because they are demonstrably false.

I know, to some readers, this may seem like a bold statement; let me therefore try to justify it.

  1. So far, I have seen no good evidence that any alternative therapy might be effective in preventing any disease.
  2. Practically everything we know today about disease prevention originates from conventional medicine and science.
  3. There are thousands of papers that address prevention and, as far as I can see, they all originate from the realm of conventional medicine. Below is a list of just 7 recent reviews on the subject.

This paper is an update of the evidence for exercise as a prevention of heart failure. It concluded that exercise provides protective benefit in preventing HF (primary prevention). With HF present: exercise improvement with training provides benefits in HF (secondary prevention). The prediction of future in HF patients: exercise impairment, as a leading characteristic of HF, is used as a prognostic factor.

The aim of this review was to update evidence for the US Preventive Services Task Force on the benefits and harms of hormone therapy in reducing risks for chronic conditions. The authors found that hormone therapy for the primary prevention of chronic conditions in menopausal women is associated with some beneficial effects but also with a substantial increase of risks for harms. The available evidence regarding benefits and harms of early initiation of hormone therapy is inconclusive.

This paper reviewed the evidence for Implantable Cardiac Defibrillators (ICDs). The authors stated that individuals with stable ischemic heart disease (no recent myocardial infarction), especially those with inducible arrhythmias, seem to derive the highest mortality benefit from prophylactic ICD use.

These authors investigated whether neuromuscular and proprioceptive training is effective in preventing knee and anterior cruciate ligament (ACL) injuries. They concluded that neuromuscular and proprioceptive training appeared to decrease the incidence of injury to the knee and specifically the AC.

Other researchers summarized current evidence about real-world studies on apixaban for stroke prevention in atrial fibrillation. They concluded that the use of apixaban in real-life is associated with an overall similar effectiveness in reducing stroke and any thromboembolic events when compared with warfarin. A better safety profile was found with apixaban compared with warfarin, dabigatran, and rivaroxaban.

Finally, a review assessed the evidence of blood pressure (BP) lowering treatments as a means of reducing cardiovascular morbidity and mortality. The authors concluded that primary preventive BP lowering is associated with reduced risk for death and CVD if baseline SBP is 140 mm Hg or higher. At lower BP levels, treatment is not associated with any benefit in primary prevention but might offer additional protection in patients with CHD.

Testing preventative treatments is, of course, far from easy. Ideally, one would want to do an RCT, but often this is not possible, for instance, because the sample size would need to be prohibitively huge and the observation period prohibitively long (think of cholesterol-lowering for reducing cardiovascular risks, or smoking cessation for preventing cancer). Thus we rely frequently on other types of investigations such as epidemiological studies. This type of research is, however, rarely undertaken in alternative medicine, and when it does cover subjects related to this area, it is almost never done by proponents of alternative medicine.

The long and short of all this is depressingly simple: the often-heard claim that alternative medicine is strong on prevention is quite simply false. Proponents of alternative medicine like to talk about prevention (presumably because it is good for business), but when it comes to applying prevention and showing that their preventative interventions are effective, all this talk turns out to be little more than hot air.

I am sure – even hope – that some readers will disagree, and I look forward to their evidence proving me wrong.

 

On this blog, we are all fond of what homeopathy-guru DUllman tells us (see for instance here, here and here). It seems only fair, therefore, to show you an excerpt of his latest article, particularly as it is on the highly topical subject of the flu:

Scientific Evidence That Homeopathy Works for the Flu

There are several scientific studies published in peer-reviewed medical journals that have confirmed Oscillococcinum’s efficacy. One large study of 487 patients found that almost twice as many patients who were given Oscillococcinum recovered from the flu within 48 hours as those given a placebo (17 percent versus 10 percent).10

A different group of researchers conducted a randomized, double-blind study involving 372 patients (188 treated with Oscillococcinum and 187 with placebo) of both sexes, ranging in age from 12 to 60, who presented rectal temperature ≥ 100.4 F, muscle pains, headache, or at least one of the following symptoms: shivering, chest pain, spine pain, coughing, irritation of nasal mucosa or feeling of malaise.12

Patients received three tubes of Oscillococcinum or placebo each day (morning, noon and night) for three days. The results of this trial show a highly statistically significant difference between the two groups, for what concerns disappearance of symptoms after 48 hours (19.2 percent in the Oscillococcinum group versus 17.1 percent in the placebo group) and improvement in symptoms (43.7 percent vs 38.6 percent for placebo) ) (p = 0.0028).

Moreover, the frequency of use of concomitant medicines was slightly higher for the placebo group, as was also the use of multiple medicines. Only 13.8 percent of the Oscillococcinum group used two or three drugs (analgesics and antirheumatics), against 19.6 percent in the placebo group.

Another parameter considered was the percentage of patients able to return to work, which was higher in the Oscillococcinum group, both two days after the onset of the illness (16.3 percent against 9.3 percent) and after four days, with highly significant differences.

Homeopathic Treatment Reduced Length of Influenza Illness

The Cochrane Collaboration is an internationally respected group of researchers who evaluate scientific studies. In 2004, they reviewed seven studies using Oscillococcinum in the treatment or prevention of influenza.13 Four treatment trials (n = 1,194) and three prevention trials (n = 2,265) were evaluated.

Only two studies had sufficient information to complete data extraction fully, and both of these studies only evaluated the use of this medicine in the treatment of influenza or influenza-like conditions (the two studies mentioned above were the two studies that were evaluated).

Oscillococcinum treatment reduced length of influenza illness by 0.28 days (95 percent confidence interval 0.50 to 0.06). Oscillococcinum also increased the chance of a patient considering treatment effective (relative risk 1.08; 95 percent CI 1.17, 1). This review also concluded that the number of days needed to return to work were significantly reduced by 0.49 days (95 percent CI 0.89-0.08) compared to the control (average of 4.1 days).

The relative risk from treatment was 0.60 (0.37-0.98), meaning that the proportion of patients treated with Oscillococcinum who considered the treatment to be useless was 0.6, relative to 1.0 for the placebo (a significant difference of 40 percent). The authors of this research review considered these results “promising,” though not strong enough to warrant a general recommendation to use Oscillococcinum for “first-line” treatment of influenza or influenza-like syndromes.

As for the use of Oscillococcinum in the prevention of the flu, the researchers concluded that it was not effective. However, it should be highlighted that the company that makes Oscillococcinum does not market this medicine for “prevention” of the flu, only for the treatment of it (and for “influenza-like” syndrome).

In 2012, a new analysis of research on Oscillococcinum in the treatment of influenza was conducted by the Cochrane Collaboration, and their conclusion was more conservative than previous analyses by this organization.14

The 2012 analysis concluded, “Although the results from four other clinical trials (total of 1196 participants) suggested that Oscillococcinum relieved flu symptoms at 48 hours, this might be due to bias in the trial methods.” In other words, even though two of these studies were double-blind, randomized and placebo controlled, these studies did not achieve the higher caliber of standards of research, thereby enabling the possibility of bias in the results….

END OF QUOTE

It is perhaps not unusual for DUllman to fail noticing that Vickers review [ref 13] has long been withdrawn. It is, however, highly unusual for DUllman not to accuse the authors of the current Cochrane review of bias. After all, they concede that the effect might be an artefact due to bias! In fact, their published conclusions (in both the 2012 and 2015 reviews; the latter was not mentioned by DUllman at all) are quite different from DUllman’s interpretation:

There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum(®) in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum(®) could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling. There was no evidence of clinically important harms due to Oscillococcinum(®).

The reason why DUllman is so unusually restrained seems obvious: the authors of the review are some of the most vociferous promoters of homeopathy who he knows well and they are pals: Fisher, Frye, Robert Mathie.

[For those who are interested, their COI statements (which might explain the rather off conclusion ‘Our findings do not rule out the possibility that Oscillococcinum(®) could have a clinically useful treatment effect…’) are here:

Robert T Mathie: Dr Mathie is Research Development Adviser, British Homeopathic Association. He was a member of the International Scientific Committee on Homeopathic Investigations, which ceased its committee activities in July 2013.

Joyce Frye: Dr. Frye received partial salary support from Standard Homeopathic Company, which terminated June 2013 and honoraria from the International Scientific Committee on Homeopathic Investigations, which was dissolved in July 2013.

Peter Fisher: I am Expert Adviser on Complementary and Alternative Medicine to the National Institute for Health and Clinical Excellence (NICE), which may take an interest in the evidence in this review. I am Editor in Chief of an international, peer-reviewed journal dedicated to homeopathy. All payments and reimbursements for lectures have been from universities or professional or learned societies. None of these lectures has been dedicated to the subject of this review. Some meetings have been supported by grants from commercial interests, including the manufacturer of the product that is the subject of the review.]

Moreover, DUllman does not mention how dismal the quality of the RCTs really is. Here is the quality rating by Mathie et al:

Figure 1. ‘Risk of bias’ summary: review authors’ judgements about each risk of bias item for each included study.

And here is the crucial quote from the review: The standard of trial reporting was poor or very poor.

But this might just be nit-picking. What is much more important in my view is this:

  1. Even at the most optimistic interpretation of the findings, these results are clinically meaningless. Their effect size is minute and therefore not relevant.
  2. If we consider the prior probability of less than one molecule of duck liver per universe (more on Oscillococcinum here) having any effect at all, the results (which DUllman calls ‘highly significant’) are not statistically significant at all.

My conclusions are simple:

  1. Oscillococcinum is a placebo (a fact that has been affirmed by several US judges).
  2. DUllman is great fun but not a great scientist (also confirmed by a US judge):…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… 

What better to give to you for the holidays than your very own CHRISTMAS SURVIVAL KIT? This article by Eileen Scullion, Registered Homeopath LicISH ISHom with the Irish Society of Homeopaths explains. Sadly, its recommendations lack sections detailing the evidence for the claims made. Therefore, I have taken the liberty of adding my short scientific assessments (IN BOLD CAPITAL LETTERS):

START OF QUOTE

1. Over indulgence

Nux Vomica – For symptoms that arise after over indulgence and excess in food, alcohol, tobacco and coffee. The person suffers from headaches, indigestion, nausea and irritability and symptoms are worse in the morning or after eating.

Arsenicum – For symptoms of diarrhea, vomiting, cramps where you suspect food poisoning.

ZERO PLAUSIBILITY, NO EVIDENCE FOR EFFECTIVENESS.

2. Stress & Anxiety

Argentum Nitricum – Anxiety from worry that it won’t work out – What if the turkey burns? What if the electric goes out? What if the gifts don’t arrive on time? There is a great sense of urgency, hurriedness and worrying about everything with sleepless nights of tossing and turning.

ZERO PLAUSIBILITY, NO EVIDENCE FOR EFFECTIVENESS.

3. Sleep problems

Coffea – Sleeplessness from excitement. For the kids who just can’t sleep in anticipation of Santa’s arrival.

ZERO PLAUSIBILITY, NO EVIDENCE FOR EFFECTIVENESS.

4. Anger and resentment

Staphysagria – If you are feeling angry and resentful and are suffering in silence, or have difficulty in saying no but feel walked over, then this is an excellent remedy to help verbalise things or process your emotions.   Pent up emotions can also be accompanied with urinary tract infections where this remedy fits the symptoms.

ZERO PLAUSIBILITY, NO EVIDENCE FOR EFFECTIVENESS.

5. Colds

Aconite – If caught at the early stage, nip those colds in the bud that come on suddenly after exposure to cold dry winds or getting chilled.

ZERO PLAUSIBILITY, NO EVIDENCE FOR EFFECTIVENESS.

END OF QUOTE

As the ‘survival kit’ turns out to be pure speculation, fantasy and wishful thinking, let’s join into the seasonal fun and add some equally evidence-based homeopathic treatments of our own.

1. World peace

We all live in dangerous times, but the way to world peace could be guaranteed by this homeopathic remedy: Donald Trump C30. It is manufactured by exposing a glass of distilled water to a picture of the US president for about 30 minutes and then potentising the mother tincture 30 times in the time-tested way of homeopathy.

2. Fuzzy head

After all the booze and laziness over the holidays, one is bound to feel oddly fuzzy, incoherent and unfocussed. My homeopathic remedy for this complaint is HRH C200. You can make it yourself: take a vial of distilled water to a public library, find Prince Charles’ book ‘Harmony‘ (do not buy this book! it is expensive and not worth it), put the vial between its pages and shake vigorously. Subsequently return the book to its shelve and potentise your mother tincture 200 times.

3. Poverty

Yes, Christmas is expensive! If your bank account is now empty, don’t worry: homeopathy can help. Take your last fiver, cut a tiny bit off, grind it down in some sugar, put the mixture in distilled water, and your mother tincture is ready. You can then potentise it in the usual way; if you want to become a millionaire use the £ C30 potency; if you prefer to be a billionaire, I recommend the £ C200 dilution.

I must stop myself here, because I hope you, the reader of this post, will now chip in. If you are suffering from any symptom at all, please use your imagination and, based on the ‘like cures like’ principle, design your very own homeopathic cure.

Yes, that’s my Christmas challenge.

Have fun!

On their  website, the US Food and Drug Administration (FDA) has recently published a statement on homeopathy which, I think, is important enough to get cited extensively:

… Food and Drug Administration proposed a new, risk-based enforcement approach to drug products labeled as homeopathic. To protect consumers who choose to use homeopathic products, this proposed new approach would update the FDA’s existing policy to better address situations where homeopathic treatments are being marketed for serious diseases and/or conditions but where the products have not been shown to offer clinical benefits. It also covers situations where products labeled as homeopathic contain potentially harmful ingredients or do not meet current good manufacturing practices…

The FDA’s proposed approach prioritizes enforcement and regulatory actions involving unapproved drug products labeled as homeopathic that have the greatest potential to cause risk to patients…  The FDA intends to focus its enforcement authorities on the following kinds of products:

  • products with reported safety concerns;
  • products that contain or claim to contain ingredients associated with potentially significant safety concerns;
  • products for routes of administration other than oral and topical;
  • products intended to be used for the prevention or treatment of serious and/or life-threatening diseases and conditions;
  • products for vulnerable populations; and
  • products that do not meet standards of quality, strength or purity as required under the law.

Examples of products that may be subject to the enforcement priorities in the draft guidance are infant and children’s products labeled to contain ingredients associated with potentially significant safety concerns, such as belladonna and nux vomica; and products marketed for serious conditions, such as cancer and heart disease.

While the FDA considers comments to the draft guidance, the FDA intends to examine how the agency is implementing its current compliance policy. Given the concerns about the proliferation of potentially ineffective and harmful products labeled as homeopathic, the FDA will consider taking additional enforcement and/or regulatory actions, consistent with the current enforcement policies, which also align with the risk-based categories described in the draft guidance, in the interest of protecting the public…

Until relatively recently, homeopathy was a small market for specialized products. Over the last decade, the homeopathic drug market has grown exponentially, resulting in a nearly $3 billion industry that exposes more patients to potential risks associated with the proliferation of unproven, untested products and unsubstantiated health claims. During this time, the FDA has seen a corresponding increase in safety concerns, including serious adverse events, associated with drug products labeled as homeopathic. In addition, the agency has also found an increasing number of poorly manufactured products that contain potentially dangerous amounts of active ingredients that can create additional risks.

In September 2016, the FDA warned against the use of homeopathic teething tablets and gels containing belladonna, a toxic substance that has an unpredictable response in children under two years of age, after the products were associated with serious adverse events, including seizures and deaths, in infants and children. An FDA lab analysis later confirmed that certain homeopathic teething tablets contained elevated and inconsistent levels of belladonna. A similar issue occurred in 2010 when Hyland’s Teething Tablets were found to contain varying amounts of belladonna. An FDA inspection of that product’s manufacturing facility indicated substandard control of the product’s manufacturing.

The FDA has issued warnings related to a number of other homeopathic drug products over the past several years. These include certain homeopathic zinc-containing intranasal products that may cause a loss of sense of smell, homeopathic asthma products that have not been shown to be effective in treating asthma and various homeopathic drug products labeled to contain potentially toxic ingredients, like nux vomica, which contains strychnine (a highly toxic, well-studied poison often used to kill rodents).

“Homeopathic products have not been approved by the FDA for any use and may not meet modern standards for safety, effectiveness and quality,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “The draft guidance is an important step forward in the agency’s work to protect patients from unproven and potentially dangerous products.”…

The FDA is not alone in reexamining its approach to homeopathy. In November 2016, the Federal Trade Commission (FTC) announced a new enforcement policy explaining that they will hold efficacy and safety claims for over-the-counter homeopathic drugs to the same standard as other products making similar health claims. Notably, the FTC said that companies must have competent and reliable scientific evidence for health-related claims, including claims that a product can treat specific conditions…

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US homeopaths were quick to respond, as reported here:

The National Center for Homeopathy’s board of directors stated:

The National Center for Homeopathy supports the FDA’s efforts to ensure safety and good manufacturing practices in the industry. We are committed to working with industry partners to protect consumer access to homeopathic medicines, and we are hopeful that this action will not impede access. Homeopathic medicines are safe, gentle and effective when products are manufactured in accordance with HPUS (Homoeopathic Pharmacopoeia of the United States) guidelines under CGMPs (Current Good Manufacturing Practices). We welcome the opportunity to educate consumers and healthcare professionals about the unique aspects of homeopathic medicine.

Of course, the unique aspect of homeopathic medicines undoubtedly is that they usually contain no active molecules and therefore do not work. But somehow, I doubt that the NCH was thinking of telling consumers the truth.

The NCH statement is tame in comparison with the NCH’s response to the FDA’s actions during the homeopathic teething investigation last year. Prior to the recall, the FDA issued a warning to consumers, which the NCH dubbed as “arbitrary and capricious.” The NCH went on to say that the FDA’s warning led to “exaggerated fear mongering” in the media and a “public scare” that threatened access to homeopathic products. “[G]roups interested in seeing homeopathy destroyed continue to hammer away at the system—making exaggerated claims that create misunderstandings about and limit consumer access,” the NCH wrote [emphasis theirs].

And this response is tame compared to what a prominent US homeopaths claimed at the time:

“It’s time to hold these people accountable. There are laws in every country against officials taking bribes and malfeasance in office. Write to your legislators and demand that they investigate and bring these criminals to justice. Send them the links to hundreds of homeopathy studies, including disease prevention with homeopathy, at the end of this article.   Tell them that the regulatory agencies are protecting Pharma profits, not the public.

Meanwhile, let us insist that pharmaceutical drugs be labeled honestly, like this:

“This drug was tested by the same company that profits from it, and which company has been fined millions of dollars in the past for lying about test results. This drug does not cure any medical condition, but only suppresses symptoms which may ultimately make the patient sicker. This drug has already  killed or injured X  number of people.”

The outrage is understandable for two reasons, I think:

  1. even homeopaths cannot deny that the days of unchecked claims are counted;
  2. against rage of this sort homeopathic remedies are obviously not working.

Electrohomeopathy is a version of homeopathy few people know about. Allow me to explain:

Cesare Mattei (1809–1896), an Italian count, was interested in homeopathy. Mattei believed that fermented plants gave off ‘electrical’ energy that could be used to cure illness. He also believed that every illness had a cure provided in the vegetable kingdom by God. He began to develop his system from 1849. The large bottles are labelled ”Red”, ”Green”, “White”, “Yellow” and “Blue” so the actual ingredients remained a secret. Ointments were made up with ingredients from the small and large bottles. The vial labelled “Canceroso 5” was used for bruises, cancers, chilblains, hair loss, skin diseases and varicose veins, among other conditions. Although dismissed by the medical profession as quackery, Mattei’s system was popular. It formed part of the treatment at St Saviour’s Cancer Hospital in London from 1873.

Wikipedia offers more informing us that:

“… Mattei, a nobleman living in a castle in the vicinity of Bologna studied natural science, anatomy, physiology, pathology, chemistry and botany. He ultimately focused on the supposed therapeutic power of “electricity” in botanical extracts. Mattei made bold, unsupported claims for the efficacy of his treatments, including the claim that his treatments offered a nonsurgical alternative to cancer. His treatment regimens were met with scepticism by mainstream medicine:

The electrohomeopathic system is an invention of Count Mattei who prates of “red”, “blue”, and “green” electricity, a theory that, in spite of its utter idiocy, has attracted a considerable following and earned a large fortune for its chief promoter.

Notwithstanding criticisms, including a challenge by the British medical establishment to the claimed success of his cancer treatments,  electrohomeopathy (or Matteism, as it was sometimes known at the time) had adherents in Germany, France, the USA and the UK by the beginning of the 20th century; electrohomeopathy had been the subject of approximately 100 publications and there were three journals dedicated to it.

Remedies are derived from what are said to be the active micro nutrients or mineral salts of certain plants. One contemporary account of the process of producing electrohomeopathic remedies was as follows:

As to the nature of his remedies we learn … that … they are manufactured from certain herbs, and that the directions for the preparation of the necessary dilutions are given in the ordinary jargon of homeopathy. The globules and liquids, however, are “instinct with a potent, vital, electrical force, which enables them to work wonders”. This process of “fixing the electrical principle” is carried on in the secret central chamber of a Neo-Moorish castle which Count Mattei has built for himself in the Bolognese Apennines… The “red electricity” and “white electricity” supposed to be “fixed” in these “vegetable compounds” are in their very nomenclature and suggestion poor and miserable fictions.

According to Mattei’s own ideas however, every disease originates in the change of blood or of the lymphatic system or both, and remedies can therefore be mainly divided into two broad categories to be used in response to the dominant affected system. Mattei wrote that having obtained plant extracts, he was “able to determine in the liquid vegetable electricity”. Allied to his theories and therapies were elements of Chinese medicine, of medical humours, of apparent Brownianism, as well as modified versions of Samuel Hahnemann‘s homeopathic principles. Electrohomeopathy has some associations with Spagyric medicine, a holistic medical philosophy claimed to be the practical application of alchemy in medical treatment, so that the principle of modern electrohomeopathy is that disease is typically multi-organic in cause or effect and therefore requires holistic treatment that is at once both complex and natural.”

END OF QUOTE

If one would assume that electrohomeopathy is nothing more than a bizarre and long-forgotten chapter in the colourful history of homeopathy, one would be mistaken; it is still used and promoted by enthusiasts who continue to make bold claims. This article, for instance, informs us that:

  • Electro Homeopathic remedies tone up the brain and the nerves through which overall body processes are controlled and strengthen the digestion process.
  • The tablets provide food for the red blood cells and provide nourishment for the white corpuscles of the lymph and the blood.
  • They provide the useful elements to the plasma of the blood and provide required nutrients for the cells of which tissues are made.
  • They enhance the eviction through the skin and other modes and unnecessary substances which disturb the function and health of the body.
  • They cure the diseases and are helpful to the patients who use them.
  • They are curative as well as palliatives.
  • They are helpful in curing the serious diseases whether it is acute or chronic, non-surgical or surgical, for women, men, and children. They provide 100 percent cure.
  • They cure diseases such as tuberculosis, cancer, fistula, and cancer. They can cure these diseases without operation.
  • They cure all type of infectious diseases with certainty and are also helpful in prophylactics in the epidemics.

This article also provides even more specific claims:

Here are the 5 best Electro Homeopathic medicines for curing kidney stones –

  • Berberis Vulgaris – is the best medicine for left-sided kidney stones
  • Cantharis Vesicatoria– is one of the best medicine for kidney stones with burning in urine
  • Lycopodium – is the best remedy for right-sided kidney stones
  • Sarsaparilla – is the best medicine for kidney stones with white sand in urine
  • Benzoic Acid – is best homeopathic medicine for renal calculi…

The aforesaid homeopathic medicines for kidney stones have been found to be very effective in getting these stones out of the system. It does not mean that only these medicines are used.

What all of this highlights yet again is this, I think:

  • There are many seriously deluded people out there who are totally ignorant of medicine, healthcare and science.
  • To a desperate patient, these quacks can seem reasonable in their pretence of medical competence.
  • Loons make very specific health claims (even about very serious conditions), thus endangering the lives of the many gullible people who believe them.
  • Even though this has been known and well-documented for many years, t here seems to be nobody stopping the deluded pretenders in their tracks; the public therefore remains largely unprotected from their fraudulent and harmful acts.
  • In particular, the allegedly more reasonable end of the ‘alt med community’ does nothing to limit the harm done by such charlatans – on the contrary, whether knowingly or not, groups such as doctors of ‘integrative medicine’ lend significant support to them.

Placentophagy is the act of eating the placenta after childbirth. It seems to be advocated widely. But why would anyone even think of doing such a weird thing?

According to Wikipedia, the placenta contains high levels of prostaglandin. Prostaglandin stimulates involution (an inward curvature or penetration, or, a shrinking or return to a former size) of the uterus. The placenta also contains small amounts of oxytocin which eases birth stress and causes the smooth muscles around the mammary cells to contract and eject milk.

Wiki also tells us that human placenta has also been an ingredient in some traditional Chinese medicines, including using dried human placenta, known as “Ziheche” (simplified Chinese: 紫河车; traditional Chinese: 紫河車; pinyin: Zǐhéchē), to treat wasting diseases, infertility, impotence and other conditions. Most recently, the Center for Disease Control published a report of a newborn infected with Group B Streptococcus (GBS) bacteria likely after the mother ingested placenta capsules. Consequently, the CDC said that placenta capsule ingestion should be avoided and to educate mothers interested in placenta encapsulation about the potential risks. A recent publication advised that physicians should discourage placentophagy because it is potentially harmful with no documented benefit.

The benefits of placentophagy are, according to many proponents of this therapy, considerable. This website, for instance, claims the following effects:

START OF QUOTE

BALANCE HORMONES
When  a woman births the placenta, she loses the many useful hormones contained in it that were produced during pregnancy.  It can take months for the body to balance these hormones again. Taking placenta pills helps reintroduce these hormones into the mother’s body  in small doses, until her body resumes its natural hormonal balance.

DECREASE THE INCIDENCE OF POSTPARTUM DEPRESSION
Iron-deficiency in postpartum women can lead to fatigue, and may be a contributing factor to depressive symptoms. The placenta is extremely rich in natural iron and can be a valuable and natural resource to replenish the mother’s lost iron supply.  It is also rich in naturally-produced B6 which is often used to combat depression.  Many mothers find the combination of these substances in placenta encapsulation to be helpful in improving their post-birth emotional experience.

INCREASE ENERGY & FACILITATE FASTER HEALING
The placenta contains hormones and nutrients that have been found to increase energy and promote healing.  It is also rich in naturally-produced iron and protein, which can help replenish the mother’s nutrients following childbirth.

LESSEN POSTPARTUM BLEEDING
Historically, midwives have utilized a small portion of the placenta to control postpartum bleeding during and after childbirth.  Placenta pills contain these same hormones and can lessen bleeding and help promote uterine healing.

PROMOTE HEALTHY BREAST MILK PRODUCTION
The  placenta contains Human Placental Lactogen and Prolactin, which help prepare the mammary glands and stimulate milk production.  These are often beneficial in successful breastfeeding of a new infant.

END OF QUOTE

As we all know, bogus claims abound in alternative medicine; the question, as always is: are they true?

There have been no studies of whether placentophagy provides hormonal effects in humans, Wiki claims. But this last statement is no longer true. The first human trial of placentophagy has just been published. The objective of this study was to investigate whether salivary hormone concentrations of women ingesting their own encapsulated placenta during the early postpartum differed from those of women consuming a placebo.

Randomly assigned participants (N=27) were given a supplement containing either their dehydrated and homogenized placenta (n=12), or placebo (n=15). Saliva samples were collected during late pregnancy and early postpartum. Samples of participants’ processed placenta, and the encapsulated placebo, were also collected. Hormone analyses were conducted on all samples utilizing liquid chromatography-tandem mass spectrometry.

The results show that there were no significant differences in salivary hormone concentrations between the placenta and placebo groups post-supplementation that did not exist pre-supplementation. There were, however, significant dose-response relationships between the concentration of all 15 detected hormones in the placenta capsules and corresponding salivary hormone measures in placenta group participants not seen in the placebo group. The higher salivary concentrations of these hormones in the placenta group reflects the higher concentrations of these hormones in the placenta supplements, compared to the placebo.

In a second paper on the same trial, the authors assessed the maternal mood, bonding, and fatigue via validated scales across 4 time points during late pregnancy and early postpartum.

The results show no significant main effects related to maternal mood, bonding, or fatigue between placenta and placebo group participants. However, examination of individual time points suggested that some measures had specific time-related differences between placenta and placebo groups that may warrant future exploration. Though statistical significance should not be interpreted in these cases, the authors did find some evidence of a decrease in depressive symptoms within the placenta group but not the placebo group, and reduced fatigue in placenta group participants at the end of the study compared to the placebo group.

The authors concluded that no robust differences in postpartum maternal mood, bonding, or fatigue were detected between the placenta and placebo groups. This finding may be especially important for women considering maternal placentophagy as a ‘natural’ (i.e., non-pharmacological) means of preventing or treating blues/depression. Given the study limitations, these findings should be interpreted as preliminary. Small, time-related improvements in maternal mood and lower fatigue post-supplementation among placenta group participants may warrant further research.

Will this largely negative evidence stop enthusiasts of placentophagy making therapeutic claims?

I very much doubt it!

 

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