Edzard Ernst

MD, PhD, MAE, FMedSci, FRCP, FRCPEd.

The Journal of Evidence Based Homeopathy (JEBH)?

Yes, it does exist!

It was launched in 2023 by Willmar Schwabe India, as a twice yearly publication that presents itself as a peer-reviewed outlet for research, clinical trials, case studies, reviews, and theoretical pieces about homeopathy. Its own site describes it as a “groundbreaking” journal meant to promote the “evidence-based practice and understanding of homeopathy,” and lists the editor-in-chief as Dr. Ramachandran Valavan who seems to be on the payroll of Schwabe India. As far as I can see, the editorial board consist exclusively of Indian homeopathy supporters.

The publisher is Dr. Willmar Schwabe India Pvt. Ltd., with a Noida/Ghaziabad address in Uttar Pradesh, India. The firm is a branch of the well-known German manufacturer of homeopathic products. JEBH is a specialty homeopathy journal rather than a mainstream medical journal. Its language is strongly promotional, emphasizing “rigorous investigation,” “scientific exploration,” and “solid evidence,” but those claims are made by the journal itself rather than independently demonstrated in the material available here.

JEBH claims it is peer-reviewed. However, its articles often read like advocacy: they present homeopathy as being refined by “modern scientific exploration” and “real-world data,” and frequently treat positive case reports or reviews as confirmation of homeopathy’s validity. That style is, of course, not unusual in homeopathy publications, but from an evidence-based medicine perspective it is a ridiculous substitute for reproducible controlled data.

To give you a taster, here is the first section of a recent editorial published in the JEMH:

The Journal of Evidence-Based Homeopathy (JEBH) continues to strengthen its mission of uniting classical homeopathy with modern scientific exploration. This issue exemplifies how research, provings, and clinical observations converge to validate and refine homeopathic practice. The original articles section presents a diverse set of contributions from clinical case management to digital tools aiding repertorization. The featured case on Natrum muriaticum exemplifies the precision of individualized prescribing in addressing emotional and mental health concerns , while an insightful review on repertory software underscores the evolving integration of technology in clinical decision-making …

I wonder: does anyone know of another so-called “evidence-based” medical journal that is fully controlled, financed and run by a BIG PHARMA firm?

I don’t!

The JEBH confirms what we all suspected:

HOMEOPATHY IS UNIQUE.

 

The Nazi relic of the German Heilpraktiker – alternative health practitioner, who practise so-called alternative medicine (SCAM)) – is a topic that I wrote about repeatedly, e.g.:

The path to becoming a Heilpraktiker is as unique as it is scandelously unregulated. By law, the profession requires no mandatory curriculum, no accredited school attendance, and no state-regulated university degree. Technically, anyone over the age of 25 holding a basic middle-school education (Hauptschulabschluss) can sit for the exam (the Heilpraktikerüberprüfung), even without any education or training at all. While some candidates choose to prepare by voluntarily attending a private and expensive school (a Heilpraktikerschule) for one to three years, the lack of standardized educational oversight leaves massive gaps in crucial medical and professional subjects.

Chief among these neglected subjects is, in my view, medical ethics. For those who do attend a school, average ethics instruction ranges from minimal to non-existent. Because private institutes design their own proprietary curricula, ethics is rarely taught as a standalone subject. Instead, it is briefly touched within broader modules concerning Berufs- und Gesetzeskunde (Professional and Legal Studies).

This systemic omission is directly tied to the narrow scope of the state licensing exam. Conducted by local health departments (Gesundheitsamt), the examination is explicitly designed around Gefahrenabwehr, i.e. the prevention of immediate danger to public health. The state’s priority is ensuring that applicants know what they are legally forbidden to do, such as managing highly infectious diseases, prescribing prescription-only medications, or practicing dentistry.

Consequently, broader ethical education is completely sidelined. Vital topics like the biomedical principles of patient autonomy, managing clinical conflicts of interest, and the complexities of informed consent are virtually absent. While some voluntary professional associations have established a code of conduct (Berufsordnung für Heilpraktiker), learning and understanding these ethical guidelines is entirely voluntary and self-guided.

Beyond ethics, maany other critical subjects are severely neglected in the Heilpraktiker schools, e.g.:

  • Evidence-Based Medicine (EBM) and Scientific Literacy: students are rarely taught how to critically appraise clinical research, differentiate between correlation and causation, or recognize the cognitive biases inherent in anecdotal “success stories.”
  • Pharmacology and Interaction Risks: While forbidden from prescribing prescription drugs, practitioners heavily utilize herbs and other dietary supplements. The study of how these substances interact with each other and a patient’s conventional pharmaceutical regimens is usually overlooked.
  • Emergency Medicine and Differential Diagnosis: Because training lacks mandatory, standardized clinical rotations, practical competency in identifying red flags, such as atypical cardiac symptoms or early-stage oncological presentations, is dangerously variable.

The Heilpraktiker system offers unparalleled freedom of practice. At the same time, there is a near total lack of rigorous educational standards. This huge and dangerous imbalance leaves practitioners ill-equipped and put the public at unacceptable risks. Here are some examples of what can thus happen:

  • The Klaus Ross / 3-Bromopyruvat (3-BP) Tragedy (2016): In one of Germany’s most notorious SCAM scandals, a Heilpraktiker operating a “Biological Cancer Center” in Brüggen treated terminally ill cancer patients with 3-Bromopyruvat, an unapproved, highly experimental chemical compound. Using an inaccurate kitchen scale to mix the powder himself, he administered massive overdoses via intravenous infusions. At least three patients died within days of the treatment, leading to his conviction for negligent homicide.
  • The “BG-Mun” Fake Cancer Cure Scandal (Schrobenhausen): A Heilpraktiker, working alongside a businessman, defrauded desperately ill cancer patients by selling a fake “miracle serum” called BG-Mun for up to €5,900 per package. The practitioner explicitly pressured patients to abandon their conventional oncological treatments (like chemotherapy), promising that the serum would reverse tumor growth. Chemical testing later revealed the expensive liquid was nothing but worthless dilutions of glucose and basic amino acids. Multiple patients, including a 52-year-old esophagus cancer patient who went public with the story, died after their cancers metastasized following their cessation of proper medical care.
  • Severe Complications from Autologous Blood Therapy (Eigenbluttherapie): A widespread SCAM among Heilpraktiker involves drawing a patient’s blood, mixing it with ozone, oxygen, or homeopathic remedies, and reinjecting it back into the muscle or vein to “stimulate the immune system.” Due to insufficient training in strict clinical hygiene, numerous documented cases have occurred where patients suffered from sepsis, internal abscesses, and systemic bacterial infections requiring emergency ICU hospitalizations.
  • Misdiagnosis of Life-Threatening Emergencies: Because the Heilpraktiker exam does not mandate clinical training, practitioners have no clinical experience and frequently miss time-critical medical diagnoses. Documented cases include patients presenting with atypical chest pain being treated with acupuncture for “energy blockages” rather than being immediately referred to a hospital for an evolving myocardial infarction. Similarly, early-stage, highly curable melanomas or other malignancies have been misidentified as benign skin lesions or metabolic imbalances, delaying life-saving surgeries until the diseases reached terminal stages.
  • Ineffective SCAMs for Acute Psychiatric Crises: Some Heilpraktiker choose to specialize in psychotherapy (Heilpraktiker für Psychotherapie). Scandals have arisen where patients suffering from severe clinical depression or acute psychotic episodes were treated solely with Bach flower remedies, St. John’s wort, or talking therapy rooted in esoteric ideas. The rejection of conventional psychiatric intervention and pharmaceutical stabilization in these acute phases has directly led to preventable self-harm and suicides.

So, why does Germany put up with the Heilpraktiker?

Despite repeated and fierce criticism, the German Heilpraktiker is sustained by a combination of law, politics, and tradition. The primary legal shield is Article 12 of the German Basic Law, which guarantees freedom of occupation (Berufsfreiheit). Because the state’s entry exam pretends to screen for immediate public danger (Gefahrenabwehr), courts pretend the system is legally sufficient; completely banning the profession would trigger severe constitutional challenges.

Furthermore, as often discussed on this blog, SCAM enjoys immense public popularity in Germany. Millions of Germans value the Heilpraktiker for the long and empathetic consultations that the overburdened conventional insurance system rarely permits. This widespread voter support, coupled with a highly organised political lobby, makes outright abolition a political non-starter.

Thus Germany continues to have a two-tier health system. This paradox exposes a profound cultural contradiction in the German psyche, which is famously stereotyped as risk-averse, highly bureaucratized, and obsessed with systemic order. While Germany tends to regulate everything from highway speeds to the exact composition of its beer, its tolerance of the Heilpraktiker system represents a massive, hazardous blind spot.

By clinging to an outdated Nazi-law out of political convenience and romanticized cultural traditions, the state has allowed this two-tier medical landscape to persist – one built on rigorous science, and another shielded by a legal loophole. In trying to uphold the constitutional freedom of occupation, the German legislative framework inadvertently compromises a far more fundamental duty: the protection of the public from dangerous quacks. This leaves a nation known for “playing it safe” in the ironic position of legally sanctioning pseudo-scientific nonsense within its healthcare system.

A fuller analysis of the Heilpraktiker can be found in my book “Vorsicht Heilpraktiker” [in German].

Because homeopathic remedies are usually diluted to the point where none of the original substance remains (often beyond Avogadro’s number), the ethical concerns with this treatment must focus on veracity (truth-telling), patient autonomy, beneficence, and justice. Here are some of the problems that ensue**:

Violations of Veracity and Informed Consent

Informed consent is an essential element of medical ethics and dictates that a patient must be given full, accurate, and evidence-based information regarding a treatment’s nature, mechanisms, risks, and efficacy to make an autonomous decision.

Homeopathy operates on two main principles: “like cures like” (Law of Similars) and the “law of minimum dose” (the more diluted a substance, the more potent it becomes). Scientifically, these principles contradict established kowledge of chemistry, physics, and pharmacology. Presenting these concepts nevertheless as scientifically valid violates veracity.

When a practitioner administers or sells a homeopathic remedy without explicitly stating that it contains no active ingredients and performs no better than a placebo in clinical trials, the patient’s autonomy is compromised. In other words, patients are making a healthcare choice based on deception or omission.

Maleficence 

While homeopathics are physically inert and thus unlikely to cause direct harm, homeopathy poses a severe threat via indirect harm.

The most critical ethical issue occurs when patients use homeopathy for severe, progressive, or life-threatening conditions (such as cancer, severe infections, or chronic diseases like diabetes). Delaying or entirely replacing evidence-based medicine with placebo treatments (i.e. homeopathy) violates the duty of non-maleficence (do no harm). It can lead to preventable suffering, worsening of the condition, or even death in extreme cases.

Homeopathic “Vaccines” (Homeoprophylaxis) is an apt example. Some homeopaths offer all sorts of homeopathic vaccinations as alternatives to standard immunizations. Marketing these as effective protection against potentially deadly diseases like measles, polio, or pertussis erodes public herd immunity, leaves individuals entirely unprotected, and can endanger us all. This is a massive failure of both individual and public health ethics.

Beneficence

Beneficence requires healthcare providers to act in the best interest of the patient by offering treatments that provide a tangible, therapeutic benefit.

While the empathetic, unhurried nature of a homeopathic consultation can provide psychological comfort, homeopaths cannot ethically justify charging high fees for what is essentially a placebo wrapped in pseudo-medicine. Relying on a mechanism that depends on the patient remaining ignorant of the treatment’s true nature is fundamentally paternalistic and violates modern standards of beneficence.

Justice and the Exploitation of Vulnerability

The ethical principle of justice involves fairness, equity, and the responsible distribution of healthcare resources. It is regularly violated in the realm of homeopathy.

Homeopathic remedies are cheap to manufacture, yet they are marketed at unjustifiably inflated prices. Targeting vulnerable populations, such as the chronically ill, parents anxious about medication side effects in their children, or low-income individuals seeking cheap alternatives, is an ethical violation of justice.

When public the health insurance programs of certain countries, or mainstream pharmacies fund or promote homeopathic products alongside effective medicines, they misallocate resources and mislead the public. In other words, they give a false stamp of authority to quackery, draining resources that could support evidence-based public health initiatives.

So, how unethical is homeopathy? My short answer is: VERY!

** for a more detailed discussion, please have a look at our book.

I was reminded of a paper that I published a long time ago – 23 years to be precise. It is entitled THE LECTURE FROM HELL.  As it is not available online, let me give you a slightly revised version of it here:

When it comes to giving lectures, I have certainly made every mistake there is, and therefore I consider myself qualified to write this personal account on how to deliver THE LECTURE FROM HELL. I do this in the hope that others might learn from my imperfections.

In preparing for a lecture, it is best to be cool and leave things to the last minute. You are so gifted and competent that a few scribbles made on the way to the venue will easily suffice for fascinating your audience. Don’t bother enquiring who they are; what you have to say will capture the attention of a lay audience as much as that of a highly specialised one.

The kind people who have invited you will certainly have suggested a topic. Don’t get irritated by that; you know best what you can and want to talk about and, after all, it is always best to stick to what you know. If your subject is palliative cancer care, for instance, it should not be too difficult, after a few introductory sentences, to shift the attention to the most revealing survey you conducted on 10 back pain patients 25 years ago – cancer patients suffer from back pain too!

From the outset, you need to show the audience that you are better than they are. A good way of achieving this aim is to display your knowledge of as many acronyms as possible. Making abundant use of abbreviations has the added advantage that it could hide a few glitches in your arguments (or spelling). People might even think you are talking about palliative care after all.

Another golden rule is never produce evidence for your statements. Some people use visual aids to produce the evidence, but this is both tiring and confusing (and it would, of course, require much more preparation than you allowed for). If you want to use visual aids, use photographs of your kids (pets if you are childless) or your last holiday in Corfu. This will add the personal touch that people crave. Surely, if they had wanted evidence they would have gone to a library, not to your lecture.

It is advisable to spend as much time as possible with lengthy preliminaries, particularly if you are not really covering the subject as printed in the programme. Mention that you first met Cathy (who just introduced you) when you were both in nursery and give a full and colourful account of your relationship since then. If you haven’t actually been to nursery with Cathy, perhaps you could talk about the car accident you saw en route and what it made you think of. Or you could take the holistic approach, ask everyone to stand up, do a few relaxation exercises and feel the flow of energy in the body, room or universe. The obvious aim is to leave as little time as possible for the proper lecture. Thus, you can pretend to know much more about your subject than you had time to disclose and you can end your unfinished lecture with the upbeat exclamation ‘‘yeah! perhaps another time’’.

Most lecturers find the ensuing discussion period the most challenging part of their task. Not you! First, you have wisely ensured that there is no time left. Thus, the discussion slot will either be completely cancelled or it will be refreshingly brief. When the first difficult question comes your way, remember the important principle: you are so much cleverer than anyone else in this room! Make sure you show it. Arrogance has always been a perfect shield for hiding incompetence.

Another good strategy is to ridicule the person who dared ask the awkward question. Thus, they end up with egg on their face instead of you. If all else fails and you really don’t know how to answer, the best approach is to say: ‘‘this is a bit too complex right now; perhaps I could explain this to you later over coffee’’. Just ensure that you are safely on the way home when the coffee break starts.

Generally speaking, the overriding principles of a truly diabolically bad talk are quite simple. Lectures are neither the time nor place for transmitting knowledge to those who came to listen. Their predominant purpose is to massage the lecturer’s ego and increase their income. If you keep this in mind, you will stop worrying about things like evidence, structure and delivery and simply enjoy the outing.

I was reminded of this article because I saw the title of a recently published paper: HOW TO GIVE A BAD TALK. It starts as follows: “It is crucial to know how to communicate your work by delivering an effective talk, but our training for doing so is limited, so it is a skill often learned by watching others — who sometimes do it badly”.

Sadly, I could not read on; the journal asked almost 30 Euros for the privilege! So, I will never know what else I can do to give a truly poor lecture. Yet, I did learn something important: the knowledge of how to give a bad talk does not always come cheap!

I recently coined a new term: Chutzpah-Based Medicine (CBM). It requires a bit of an explanation which I herewith try to deliver. Medical decisions should rely on a rational hierarchy: systematic reviews at the top, followed by randomised clinical trials, observational studies, and way down at the bottom we anecdotal experience and opinion. The new paradigm of “Chutzpah-Based Medicine” (CBM) turns this pyramid upside down.

In CBM, double-blind trials are replaced by double-down charisma. Why wait 10 years for evidence when you can assert a medical breakthrough in 15 seconds on video with dynamic lighting, an unbuttoned linen shirt, and absolute, unshakable certainty? Here is an overview of the core tenets and leading luminaries of this revolutionary field.

The Dogmas of CBM

  • The Confidence-to-Evidence Ratio: The validity of any health claim is directly proportional to the volume, velocity, and eye contact with which it is delivered.
  • The “Big Pharma Secret” Axiom: If a treatment worked and had evidence, it would evidently be mainstream. Therefore, the total absence of evidence is the ultimate proof that “They” are trying to suppress it.
  • Quantum Syllogism: If you insert the word “quantum” before anything, biology no longer applies, and anything becomes possible.

Four Ambassadors of CBM

  1. Gwyneth Paltrow

The undisputed pioneer of High-End CBM. Paltrow proved that with enough aesthetic minimalism and raw audacity, one can sell jade eggs, vaginal steaming, and “psychic vampire repellent” as essential wellness routines. Scientific consensus is but a sign of unrefined taste. See also previous posts, e.g.:

  1. Dr. Mehmet Oz

Before entering politics, Dr. Oz laid the groundwork for CBM. He demonstrated that a cardiothoracic surgeon could look directly into a camera and declare green coffee bean extract a “miracle burn in a bottle” without blinking. “Magic” is, according to Oz, a valid clinical outcome. See also previous posts, e.g.:

  1. Dr. Joseph Mercola

He is a true titan of digital CBM mastering the art of building a multi-million-dollar supplement empire by warning millions that modern medicine is a toxic conspiracy, while conveniently offering his own unapproved tanners, liposomal vitamins, and other SCAMs as the sole salvation. See also previous posts, e.g.:

  1. Deepak Chopra

Chopra brought profound philosophical chutzpah to CBM by blending endocrinology with poetic quantum bollox. By asserting that human bodies are “localized energy fields” capable of “quantum healing,” he elevated clinical vagueness into a high-margin spiritual enterprise. See also previous posts, e.g.:

While Evidence-Based Medicine requires years of arduous testing, CBM offers immediate answers, simple villains, and premium-priced remedies. Why let a clinical trial get in the way of an excellent means of getting rich quickly?

Mikhaila Peterson? I must admit, I never heard of her. As it turns out, she is the daughter of Canadian psychologist Jordan Peterson and rose to fame not through peer-reviewed research but by declaring that red meat and salt cured her juvenile arthritis, depression, and other ailments. Her formal qualifications consist of a bachelor’s degree in Biological and Biomedical Sciences, some study in psychology and classics and (because every self-styled medical revolutionary needs a touch of glamour) a diploma in beauty and editorial makeup artistry.

Armed with this impressive background, Peterson has reinvented herself as a podcaster, CEO of multiple ventures (Peterson Academy, Fuller Health, the Lion Diet), and “researcher” of biotoxins. Her outstanding contribution to medicine is the “Lion Diet”, a plant-free, ruminant-meat-only regimen that she claims has put tens of thousands into remission from autoimmune and psychiatric disorders – never mind that it flies in the face of basic nutritional plausibility; and never mind that the actual clinical evidence amounts to close to zero.

When the beef-only version of her innovative diet failed to keep her symptom-free, she deftly pivoted first to lamb and bison, then to mould toxicity, and most recently to mitochondrial dysfunction, each time attaching her brand to a new fringe theory and selling supplements, testing kits, or subscriptions to the gullible public.

Peterson’s expertise in nutrition appears to be inversely proportional to her confidence (or is that chutzpa?). She dismisses evidence-based dietary guidance, promotes IgG-based mould tests are meaningless, and treats correlations between mould and disease as settled causation. Her podcast, which features “opposing views” but mostly amplifies like-minded voices, serves as a platform for monetising anecdote and speculation rather than evidence.

Mikhaila Peterson, it seems to me, is a savvy entrepreneur and influencer with a biology degree and a knack for rebranding pure quackery as medical breakthroughs, reinventing medicine badly and absolving herself of the inconvenient requirement of evidence for health claaims. In a word, she is a high-profile ambassador for CBM – Chutzpa-based Medicine.

The various forms of fasting have many, mostly positive health effects. The most obvious is that of losing weight and body fat. The aim of this study was to investigate the feasibility of measuring the effects of a 14-day Periodic Fasting (PF) intervention (<200 cal) on multi-organs of primary interest (liver, visceral/subcutaneous/bone marrow fat, muscle) using non-invasive advanced magnetic resonance spectroscopic (MRS) and imaging (MRI) methods.

One subject participated in a 14-day PF under daily supervision of nurses and specialized physicians, ingesting a highly reduced intake: 200 Kcal/day coupled with active walking and drinking at least 3 L of liquids/day. The fasting was preceded by a 7-day pre-fasting vegetarian period and followed by 14 days of stepwise reintroduction of food. The longitudinal study collected imaging and biological data before the fast, at peak fasting, and 7 days, 1 month, and 4 months after re-feeding. Body fat mass in the trunk, abdomen, and thigh, liver and muscle mass, were respectively computed using advanced MRI and MRS signal modeling. Fat fraction, MRI relativity index T2* and susceptibility (Chi), as well as Fatty acid composition, were calculated at all-time points.

A decrease in body weight (BW: −9.5%), quadriceps muscle volume (−3.2%), Subcutaneous and Visceral Adipose Tissue (SAT −34.4%; VAT −20.8%), liver fat fraction (PDFF = 1.4 vs. 2.6 % at baseline) but increase in Spine Bone Marrow adipose tissue (BMAT) associated with a 10% increase in global adiposity fraction (PDFF: 54.4 vs. 50.9%) was observed. Femoral BMAT showed minimal changes compared to spinal level, with a slight decrease (−3.1%). Interestingly, fatty acid (FA) pattern changes differed depending on the AT locations. In muscle, all lipids increased after fasting, with a greater increase of intramyocellular lipid (IMCL: from 2.7 to 6.3 mmol/kg) after fasting compared to extramyocellular lipid (EMCL: from 6.2 to 9.5 mmol/kg) as well as Carnosine (6.9 to 8.1 mmol/kg). Heterogenous and reverse changes were also observed after re-feeding depending on the organ.

These results suggest that investigating the effects of a 14-day PF intervention using advanced MRI and MRS is feasible. Quantitative MR indexes are a crucial adjunct to further understanding the effective changes in multiple crucial organs especially liver, spin, and muscle, differences between adipose tissue composition and the interplay that occurs during periodic fasting.

This interesting and well-reported study supports the idea that fasting does not just “burn fat” uniformly; it shifts energy stores differently across organs and fat depots. Visceral fat appears more responsive and more durable in its reduction than subcutaneous fat, which is relevant because visceral fat is more strongly linked to cardiometabolic risk. Because this was a case report with one participant, the findings are best viewed as hypothesis-generating rather than definitive.

The long-standing consensus surrounding moderate alcohol consumption has recently been disrupted by a landmark review. Initiated under a US congressional mandate to evaluate the evidence base for the US Dietary Guidelines for Americans, the study—convened by the National Academies of Sciences, Engineering, and Medicine (NASEM) alongside the Department of Health and Human Services (HHS)—concluded that even a single alcoholic beverage per day significantly elevates the risks of serious chronic illness and premature death. After unexplained bureaucratic delays, the release of this taxpayer-funded research delivers a sobering truth: there is no net health benefit derived from alcohol consumption at any level.

For decades, public perception was shaped by data suggesting that a daily glass of wine or beer could act as a cardiovascular shield. This new review systematically dismantles that notion by identifying significant methodological biases in the previous evidence. Chief among these is the “sick quitter” effect, wherein baseline categories of non-drinkers inadvertently included individuals who had abstained precisely because of pre-existing, severe health conditions. By correcting for these distortions, the review demonstrated that health risks accumulate linearly. Alcohol acts as a dose-dependent toxin with no safe lower threshold, and even minimal daily intake accelerates linear risk trajectories for:

  • liver cirrhosis,
  • severe hypertension,
  • various malignancies, including esophageal, colorectal, and breast cancers.

Beyond chronic pathology, low-level consumption also:

  • impairs cognitive architecture,
  • accelerating brain aging,
  • elevates the immediate probability of physical injury.

The friction surrounding the report’s delayed release has exposed systemic vulnerabilities at the intersection of federal policy and corporate lobbying. Historically, US dietary guidelines defined moderate drinking as up to two drinks per day for men and one for women. The new scientific consensus exposes these thresholds as dangerously obsolete, highlighting a stark disconnect between federal health advice and contemporary medical data.

This friction might underscore the impact of the commercial determinants of health, exposing how multi-billion-dollar alcohol conglomerates employ aggressive public relations campaigns and sophisticated scientific interference to preserve market shares. By aggressively marketing alcohol as a benign staple of a healthy lifestyle, the industry had successfully obscured its intrinsic risks. The new evidence shifts the conversation from personal indulgence to an important public health issue.

Update (July 2026): a US government–commissioned analysis of alcohol-related risk was published. Here is its abstract:

The purpose of this study was to estimate the lifetime risk of alcohol-attributable mortality and morbidity in the United States based on a person’s average lifetime weekly alcohol consumption to assess the impact of per-occasion alcohol consumption on health.

Lifetime risks were estimated using a cause-specific modeling approach that combined exposure data from national health surveys, relative risks, population data from the U.S. Census Bureau, mortality data from the Centers for Disease Control and Prevention, and morbidity data from the Institute for Health Metrics and Evaluation. A narrative review assessed the health impact of per-occasion alcohol consumption on health.

At low levels of consumption, no protective net effect of alcohol consumption on health was observed. Elevated mortality and morbidity risks were associated with alcohol consumption starting at relatively low levels. Males consuming >6.5 (95% CI [<1, 13.5]) and females consuming >7.0 (95% CI [<1, 11.5]) drinks per week had life-time alcohol-attributable mortality risks >1:1,000. At >8.5 (95% CI [2.5, 13]) drinks per week for both males and females, these risks increased to >1:100. At 14 drinks per week for males (the upper limit of the former Dietary Guidelines for males), the risk of an alcohol-caused death was 1:25 (4%). Drinking patterns also impacted risk. Above 1 drink per occasion, higher consumption was associated with progressively increased risks of breast cancer, cardiovascular disease, and injury.

Alcohol consumption, including at what may be perceived as “moderate” levels, is associated with increased mortality and morbidity risks. These results support tightening alcohol use guidance in the United States, for both males and females, to no more than 1 drink per day.

Public health significance statement: The Alcohol Intake and Health Study shows that for Americans, even what is socially considered “moderate drinking” increases the risk of dying or developing health problems, helping people better understand the net health impact of alcohol. Furthermore, by identifying the levels of alcohol use that raise the risk of cancer, cardiovascular disease, and injury, these findings can guide individuals, families, and communities in making safer choices about drinking patterns. The results also support changing the U.S. Dietary Guidelines on alcohol to recommend that current adult drinkers consume 1 drink or less in a day.

Authors and independent observers have described the report as having been sidelined during the Trump administration, citing conflicts with industry interests and existing “moderate drinking is safe” messaging.

This double-blind, three-arm randomised trial evaluated the efficacy of homeopathic medication in patients with seasonal allergic rhinitis (SAR). Patients at eleven outpatient clinics and two medical centres were randomised to receive:

  • (1) individualised homeopathic case taking (IHCT) and standardised homeopathic medication with Galphimia Glauca (GG),
  • (2) IHCT and individualised homeopathic treatment (IHG),
  • (3) IHCT and placebo (PG).

The primary outcome was disease-specific quality of life, assessed using the Rhinitis Quality of Life Questionnaire (RQLQ) after three and four weeks. Secondary outcomes included response rate (≥0.5-point change in RQLQ), rescue medication use, and total nasal and non-nasal symptom scores (TNSS, TNNSS).

Sixty-two SAR patients (mean age ± SD: 46.9 ± 14.9; 43.5% female) were recruited, approximately 25% of the planned sample size. After weeks three and four, there were no significant differences in RQLQ (p=0.244) between GG (adjusted mean, 1.2, 95% CI 0.7-1.7), IHG (1.7, 1.2-2.3), and PG (1.4, 0.8-2.0). High response rates were observed (GG: 86.4%, IHG: 66.7%, PG: 81.3%), while RM use was 21.7%, 55.6%, and 29.4%, respectively. There were no relevant differences in RM score, TNSS and TNNSS between the three groups. Eight adverse events but no serious adverse events were reported.

The authors concluded that standardised and individualised homeopathic drugs were not superior compared to placebo suggesting that treatment response was not based on study medication. The validity of the study and its conclusions are limited by the fact that the recruitment target was not achieved.

Multicentre studies like this one are useful for recruiting large numbers of patients. SAR is a common condition; the recruitment of a large sample should therefore have been fairly straight forward. So, why was this study so woefully under-powered? An average of 6 patients per centre is dismal, to put it mildly!

This leaves us with a failed study of a failed (implausible) hypothesis; its negative findings cannot be properly interpreted (other than showing the incompetence of the trialists).

Why publish such a waste of resorces at all?

Search me!

Exercise is recommended for managing pain, yet the consistency, magnitude, and certainty of effects across different pain conditions and exercises remain unclear. This umbrella review aimed to synthesize the best available evidence on the analgesic effects of exercise by examining systematic reviews and meta-analyses of randomized controlled trials (RCTs).
Eleven databases were systematically searched from inception to August 2024. Eligible studies included systematic reviews with meta-analyses of RCTs comparing exercise to control conditions, with pain as a primary or secondary outcome. Reviews without meta-analyses, those not involving RCTs, or those primarily focused on experimentally induced or laboratory pain were excluded. Two reviewers independently extracted data and assessed methodological quality using AMSTAR-2. Standardized mean differences in pain were synthesized using random-effects meta-meta-analysis. Certainty of evidence was evaluated using GRADE, with subgroup and sensitivity analyses.
A total of 157 systematic reviews comprising 2,736 RCTs and 221,279 participants were included. Exercise significantly reduced pain compared with controls (pooled standardized mean differences = −0.59; 95% CI, −0.65 to −0.53; P < 0.001). Effects were observed across both chronic and acute pain conditions, encompassing musculoskeletal, neurological, inflammatory, and cancer populations. Aerobic, resistance, yoga, Pilates, and tai chi were effective. Greater effects were observed in lower-intensity, shorter-duration (<12 weeks) programs. Sensitivity analyses supported the robustness of findings, and the overall GRADE certainty was moderate.
The authors concluded that this umbrella review provides robust evidence supporting the effectiveness of exercise for managing a wide range of pain conditions. Our findings suggest that relatively brief, low-intensity programs, often perceived as more achievable by people living with chronic pain, are associated with greater pain reductions on average. However, these patterns reflect trends across diverse studies and should not be interpreted as prescriptive. Rather, they underscore the importance of starting with accessible, lower-dose programs that can be adjusted based on individual needs, preferences, and progression. Given the consistent benefits observed across exercise types and populations, clinicians are encouraged to integrate exercise as a core component of multimodal pain care. These findings reinforce the role of exercise as a safe, adaptable, and patient-centred option, particularly valuable in addressing the limitations of pharmacological pain management. Future research should focus on how to best individualise, deliver, and sustain effective exercise interventions in real-world clinical settings..
This is an excellent paper that provides a wealth of data relevant to both clinicians and patients. The authors report that significant, large reductions in pain were observed for various modes of exercise, including aerobic, aquatic, dance, HIIT, mind body (various), mixed-mode, Pilates, resistance, tai chi, telehealth, exergames and VR, and yoga. The largest reduction in pain was observed for dance, Pilates, and tai chi. It occurs to me that these three forms of exercise are normally all performed in groups and thus have a strong sociaal element to them. Could it be that this is an additional factor in their analgesic benefit?
While these exercises seem particularly effective, the most remarkable finding is, in my view, that practically ALL types of excercise work for practically ALL types of pain. This means, I think, that it might be best to let the patient decide which type of excercise he or she prefers; this might be one way to increase compliance. Because compliance might in many cases a significant problem. If you have severe pain, you are not usually motivated to do excercise!
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