Edzard Ernst

MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

The HOMEOPATHY RESEARCH INSTITUTE (HRI) – yes we did discuss its activities before – has just published an ‘update’ on clinical trials of homeopathy. Let me show it to you:

We are pleased to share the results of a recent collaboration with Dr Robert Mathie to update his analysis of randomised controlled trials of homeopathy.

The findings from the 5-year update from 2014-2019 are as follows:

Total number of randomised controlled trials

2014: 189 trials of homeopathic treatment for 100 medical conditions
2019: 221 trials of homeopathic treatment for 115 medical conditions

Placebo-controlled trials only

2014: 104 trials on 63 medical conditions
2019: 129 trials on 77 medical conditions

When considering the balance of positive, negative and inconclusive studies, it is interesting to observe the following shifts in the evidence base for homeopathy over this 5 year period:

Positive trials                Up from 41% to 45%
Negative trials              Down from 5% to 4%
Inconclusive trials        Down from 54% to 51%

__________________________________________________

Impressed?

Me too (but only about the profound ignorance of the HRI)!

One could now point out that the ‘pee counting’ method of reviewing clinical trial evidence is nonsense and leads almost invariably to irrelevant findings. All the positive trials could, for instance, be methodologically invalid, while the negative are rigorous. But this is not even necessary. The triumphant update can be invalidated much more easily.

All we need to do is to remind ourselves of what clinical trials are.

Simply put, they are experiments that test a hypothesis, to be precise, they test the ‘null-hypothesis’: the experimental therapy generates results that are not different from those in the control group. Depending on the data, the null-hypothesis must then be either rejected or accepted by the results of the clinical trial. If it is rejected, the therapy seems to be better than placebo. If it is accepted, the therapy seems to perform just like a placebo.

THERE IS NO SUCH THING AS NEITHER REJECTING NOR ACCEPTING!

The results can not say: “We like the null-hypothesis just as much as we dislike it.” Clinical trials always give a YES or NO answer.

This means the category of ‘inconclusive trials’ is entirely an invention of homeopaths and similar wishful thinkers. In their interpretation, it covers those trials where the null-hypothesis was accepted, while the ‘negative trials’ are studies where the control group had better results than the patients treated homeopathically. But trials that accept the null-hypothesis are negative!

So, what does the HRI’s ‘pee-counting’ update really show?

It reveals that, of the 221 RCTs of homeopathy, 45% are positive, i.e. they suggest that homeopathy was better than the control intervention. That is a sizable percentage, but we might ask how reliable these studies were, what control treatments they employed, and whether they all truly used homeopathy (I know, some used isopathy and some employ homotoxicology, for instance).

The majority of the 221 RCTs, however, are trials where the null-hypothesis had to be accepted. These are the studies failing to show that homeopathy works. In other words, the HRI’s triumphant ‘pee-counting’ update confirms what we have pointed out as nauseam for years:

THE MAJORITY OF THE EVIDENCE ON HOMEOPATHY IS NEGATIVE.

The spread of misinformation has accompanied the coronavirus pandemic, including topics such as immune boosting to prevent COVID-19. This study explores how immune boosting is portrayed on the internet during the COVID-19 pandemic. The researchers compiled a dataset of 227 webpages from Google searches in Canada and the USA using the phrase ‘boost immunity’ AND ‘coronavirus’ on 1 April 2020. They coded webpages for typology and portrayal of immune boosting and supplements. They recorded mentions of microbiome, whether the webpage was selling or advertising an immune boosting product or service, and suggested strategies for boosting immunity.

No significant differences were found between webpages that appeared in the searches in Canada and the USA. The most common types of webpages were from:

  • news (40.5%),
  • commercial (24.7%) websites.

The concept of immune boosting was portrayed as beneficial for avoiding COVID-19 in 85.5% of webpages and supplements were portrayed as beneficial in 40% of the webpages, but commercial sites were more likely to have these portrayals. The top immune boosting strategies were:

  • vitamin C (34.8%),
  • diet (34.4%),
  • sleep (34.4%),
  • exercise (30.8%),
  • zinc (26.9%).

Less than 10% of the webpages provide any critique of the concept of immune boosting.

The authors concluded that pairing evidence-based advice for maintaining one’s health (eg, healthy diet, exercise, sleep) with the phrase immune boosting and strategies lacking in evidence may inadvertently help to legitimise the concept, making it a powerful marketing tool. Results demonstrate how the spread of misinformation is complex and often more subtle than blatant fraudulent claims.

The authors did not search for evidence to check whether any of the named interventions have any influence on the immune system. As reported previously, this review did just that. Its authors aimed to evaluate evidence from clinical trials that studied nutrition-based interventions for viral diseases (with special emphasis on respiratory infections). Studies were considered eligible if they were controlled trials in humans, measuring immunological parameters, on viral and respiratory infections. Clinical trials on vitamins, minerals, nutraceuticals and probiotics were included.

A total 43 studies met the inclusion criteria:

  • vitamins: 13;
  • minerals: 8;
  • nutraceuticals: 18
  • probiotics: 4

Among vitamins, A and D showed a potential benefit, especially in deficient populations. Among trace elements, selenium and zinc have also shown favourable immune-modulatory effects in viral respiratory infections. Several nutraceuticals and probiotics may also have some role in enhancing immune functions. Micronutrients may be beneficial in nutritionally depleted elderly population.

There were 15 studies with a high score for methodological quality. Here is what their results showed:

  1. No significant difference in incidence of winter-time upper respiratory tract infection in children with high versus low dose vitamin D.
  2. Significantly less acute respiratory infections in elderly individuals with vitamin D versus placebo.
  3. Higher TGFbeta plasma level in response to influenza vaccination but no improved antibody response in elderly, vitamin D-deficient individuals with vitamin D versus placebo.
  4. No effect on lower respiratory tract infections; however, a protective effect was noted on upper respiratory tract infections in elderly individuals with vitamin E versus placebo.
  5. Neither daily multivitamin + mineral supplementation at physiological dose nor 200 mg of vitamin E showed a favourable effect on incidence and severity of acute respiratory tract infections in well-nourished, non- institutionalized elderly individuals.
  6. Better improvement in the clinical status, respiratory rate and oxygen saturation in children suffering from pneumonia with zinc sulphate versus placebo.
  7. Selenium-yeast increased Tctx-antibody-dependent cellular cytotoxicity cell counts in blood before flu vaccination + dose-dependent increase in T cell proliferation, IL-8 and IL-10 secretion after in vivo flu challenge in healthy volunteers.
  8. Frequency and duration of acute respiratory infections during the first two months was unaffected in healthy elderly with ginseng versus placebo.
  9. Broccoli sprout homogenate favourably affected immunological variables in healthy volunteers.
  10. The incidence of illness was not reduced, however significantly fewer symptoms were reported and the proliferation index of gd-T cells in culture was almost five times higher after 10 weeks of cranberry polyphenol supplements versus placebo.
  11. Higher antibody titres against all 3 strains contained in the seasonal influenza virus vaccine than the placebo in healthy elderly individuals with a sea-weed extract versus placebo.
  12. Non-inferiority was demonstrated for Echinacea compared to oseltamivir in early treatment of clinically diagnosed and virologically confirmed influenza virus infections.
  13. Significant reduction of cold duration and severity in air travellers with elderberry supplement versus placebo.
  14. Increased NK cell activity with probiotics versus placebo in tube-fed elderly patients.
  15. Titres against the influenza B strain increased significantly more with probiotics compared to placebo in healthy elderly individuals.

 

THE WORLD FOUNDATION OF SCIENCE had been unknown to me, I must admit (I came across it when googling ‘Schuessler salts’). The name does, I suspect, attract many people who search for reliable, science-based information. Its website contains all sorts of amazing articles, for instance:

On the subject of Schuessler salts (also called Tissue salts), their website informs us that:

… Dr. Schüßler found out that functional organ disorders are often caused by a lack of one or more minerals. To treat the disorder, these minerals are supplied in homeopathic potency to stimulate the body to improve the absorption and transport of the mineral in question. In the treatment of colds or to strengthen the immune system, very good results can be achieved with Schuessler salts.

Colds

On the first signs:
Schuessler Salt no. 3 Ferrum phosphoricum D12

For coughs, colds, hoarseness, sore throat, earache:
Schuessler Salt No. 4 Potassium chloratum D6

For persistent colds with yellowish secretions:
Schuessler Salt No. 6 Potassium sulfuricum D6
Schuessler Salt No. 12 Calcium sulfuricum D6

With a fever below 39 degrees Celsius/102.2 degrees Fahrenheit:
Schuessler Salt No. 3 Ferrum phosphoricum D12

With a fever of more than 39 degrees Celsius/102.0 degrees Fahrenheit:
Schuessler Salt No. 5 Potassium phosphoricum D6…

 

I wonder how many patients with persistent cough have followed their advice and taken Schuessler Salt No. 6 Potassium sulfuricum D6 and/or Schuessler Salt No. 12 Calcium sulfuricum D6.

And why not?

I’ll tell you why not: persistent cough can be a sign for corona-virus or other serious infections. And if it’s not due to an infection, it might be due to cancer.

IF YOU HAVE A PERSISTENT COUGH, PLEASE SEE YOUR DOCTOR!

Back to Schuessler salts (I have written about them before here and here). They are a derivative of homeopathy in the sense that they are highly diluted (Schuessler was a German homeopath). But they do not follow the ‘like cures like’ assumption. Many homeopaths are thus indignant, if Schuessler salts get confused with homeopathics. Yet, they shouldn’t be: both Schuessler salts and homeopathics have one important feature in common: they are ineffective.

Some years ago, I published a systematic review of all clinical studies of Schuessler salts (sorry, I cannot find the reference at the moment). That was an easy task, because there are none (one ought to ask why there is not a single trial of Schuessler salts. I suspect the manufacturers do not want one, because they already know the result). This renders the recommendation of the THE WORLD FOUNDATION OF SCIENCE all the more enraging.

I think I will therefore rename this organisation; I shall call it

THE WORLD FOUNDATION OF ANTI-SCIENCE.

Low-level laser therapy has been used clinically to treat musculoskeletal pain; however, there is limited evidence available to support its use. The current Cochrance review fails to be positive: there are insufficient data to draw firm conclusions on the clinical effect of LLLT for low‐back pain. So, perhaps studies on animals generate clearer answers?

The objective of this study was to evaluate the clinical effectiveness of low-level laser therapy and chiropractic care in treating thoracolumbar pain in competitive western performance horses. The subjects included 61 Quarter Horses actively involved in national western performance competitions judged to have back pain. A randomized, clinical trial was conducted by assigning affected horses to either:

  • laser therapy,
  • chiropractic,
  • or combined laser and chiropractic treatment groups.

Low-level laser therapy was applied topically to local sites of back pain. The laser probe contained four 810-nm laser diodes spaced 15-mm apart in a square array that produced a total optical output power of 3 watts. Chiropractic treatment was applied to areas of pain and stiffness within the thoracolumbar and sacral regions. A single application of a high velocity, low-amplitude (HVLA) manual thrust was applied to affected vertebral segments using a reinforced hypothenar contact and a body-centered, body-drop technique. The HVLA thrusts were directed dorsolateral to ventromedial (at a 45° angle to the horizontal plane) with a segmental contact near the spinous process with the goal of increasing extension and lateral bending within the adjacent vertebral segments. If horses did not tolerate the applied chiropractic treatment, then truncal stretching, spinal mobilization, and the use of a springloaded, mechanical-force instrument were used as more conservative forms of manual therapy in these acute back pain patients.

Outcome parameters included a visual analog scale (VAS) of perceived back pain and dysfunction and detailed spinal examinations evaluating pain, muscle tone, and stiffness. Mechanical nociceptive thresholds were measured along the dorsal trunk and values were compared before and after treatment. Repeated measures with post-hoc analysis were used to assess treatment group differences.

Low-level laser therapy, as applied in this study, produced significant reductions in back pain, epaxial muscle hypertonicity, and trunk stiffness. Combined laser therapy and chiropractic care produced similar reductions, with additional significant decreases in the severity of epaxial muscle hypertonicity and trunk stiffness. Chiropractic treatment by itself did not produce any significant changes in back pain, muscle hypertonicity, or trunk stiffness; however, there were improvements in trunk and pelvic flexion reflexes.

The authors concluded that the combination of laser therapy and chiropractic care seemed to provide additive effects in treating back pain and trunk stiffness that were not present with chiropractic treatment alone. The results of this study support the concept that a multimodal approach of laser therapy and chiropractic care is beneficial in treating back pain in horses involved in active competition.

Let me play the devil’s advocate and offer a different conclusion:

These results show that horses are not that different from humans when it comes to responding to treatments. One placebo has a small effect; two placebos generate a little more effects.

The objective of this study was to carry out a patent survey of homeopathic products and processes. A free and international patent database, Espacenet, was used. The search was carried out using the keyword homeop*, with two approaches:

  1. no date restrictions for the search,
  2. a date limit for the publication years 2008 to 2018.

The patents from the limited period were organized as depositor countries, ownerships and groups, including homeopathic formulations, equipment, packaging, production procedures, and analytical methods.

Without date restriction, 601 patents were identified in the survey. Of these, 174 were related to homeopathy and published in the period 2008 to 2018. Technologies come mainly from the following countries:

  • United States (55 patents),
  • Russia (24),
  • Germany (15),
  • France (13),
  • India (12),
  • Ukraine (11),
  • Brazil (6),
  • China (6).

Among the ownerships,

  • 69% of patent applications were by independent depositors,
  • 23% by companies,
  • 7.5% by universities,
  • 0.5% by company/university partnerships.

New formulations represented 75.9% of technologies, whilst the others comprised 14.3% for equipment, 3.8% for drugs packaging, 3.8% for production procedures, and 2.2% for analytical methods.

The authors concluded that the present review helps visualize the homeopathy-related patents published in recent years, as well as the main countries and researchers investing in the field of homeopathy.

It is not often that I find anything interesting published in the journal HOMEOPATHY these days. But this paper is fascinating, I thought. The main reason for this is the fact that we hear so often arguments which go something like this:

HOMEOPATHY CANNOT BE PATENTED —> NO COMMERCIAL INTEREST —> NO MONEY TO BE MADE —> NO FUNDS FOR RESEARCH —> NO LARGE AND RIGOROUS CLINICAL TRIALS.

And here we learn that there are about 17 patents per year. Sure this is not a lot but it squarely defeats the argument that homeopathic formulations cannot be patented.

Even more fascinating is the question which homeopathic formulation one might want to get patented. I have recently alluded to the weird and wonderful stuff that is already on offer (see here, here, here and here). Here I persent to you a few more:

We see very clearly that, in homeopathy, imagination knows no bounds. So, let me ask you, my readers and avid fans of homeopathy

WHICH FORMULATION WOULD YOU WANT TO PATENT?

(only serious answers, of course)

I was alerted to an article entitled ‘Energy Medicine: Current Status and Future Perspectives‘ by Christina L Ross, Wake Forest Center for Integrative Medicine, Medical Center Boulevard, Winston-Salem, USA. Dr Ross’ paper , she tells us, was supported by the Wake Forest Center for Integrative Medicine. The Center for Integrative Medicine at Wake Forest School of Medicine aims to expand knowledge of integrative medicine through research and educational opportunities.

The article in question is lengthy yet intriguing. Here, I will present just two short excerpts.

In the abstract, the author concisely explains the nature of energy medicine:

Quantum physics teaches us there is no difference between energy and matter. All systems in the human being, from the atomic to the molecular level, are constantly in motion-creating resonance. This resonance is important to understanding how subtle energy directs and maintains health and wellness in the human being. Energy medicine (EM), whether human touch or device-based, is the use of known subtle energy fields to therapeutically assess and treat energetic imbalances, bringing the body’s systems back to homeostasis (balance).

In the paper itself, the author explains what this means in relation to various SCAM modalities, such as acupuncture:

Acupuncture can be considered an electromagnetic phenomenon due to the ionic charge between 2 acupuncture points. This has been demonstrated by Mussat and others. Acupuncture needles with 1 metal (copper, silver, bronze, or an alloy) for the shaft and another metal for the handle, form tiny batteries. Some acupuncture therapies use additional electrical stimulation (2–4 Hz) applied to the needles. From this electrical perspective, each organ in the body is like a battery housed in a sac of electrolytes, with a positive potential on the surface of the sac that is the aggregate result of electrical processes in the tissues of the organs. The positive potential at the needle tip attracts negatively charged ions from the interstitial medium until a saturation equilibrium is achieved. The normal functions of an organ tend to generate stronger and more harmonic ionic effects than organs with trauma or disease. Acupuncture is considered a wiring system in the body, as is the analog perineural nervous system, and ion transfer within blood plasma. It is difficult to use a voltmeter to measure the voltage in organs because voltages pulse in the body. It is common to use an ohm meter to measure the voltage and convert ohms to volts using Ohm’s law (voltage = ohms × amps).

Table 1 shows frequencies that correspond to organ function. Assuming amperage is constant, then ohms = voltage.

Frequencies Associated With Normal Organ Function.

Organ Frequency (MHz)
Brain 70–78
Thyroid 62–68
Lungs 58–65
Thymus 65–68
Heart 67–70
Spleen 60–80
Liver 55–60
Stomach 58–65
Colon 70–78

______________________________

Is that what the Wake Forest School of Medicine considers to be ‘expanding knowledge … through research and educational opportunities’ ? Where is the actual research that backs up any of the weird claims made above? Is it truly knowledge that is being expanded here … or is it perhaps total, utter BS?

There are many others who are much better placed to write about Randi who passed away on 20 October 2020. I only met him a few times and therefore cannot claim that I knew him well. Yet, I admired him, and he was one of my heroes. In that, I am certainly not alone; sceptics all over the world worshipped James Randi.

I will not attempt to do justice to his incredible legacy. I will merely try to offer my personal respects to a truly great man. I heard of JR first when he was recruited by the editor of Nature, John Maddox, to check out Benveniste’s lab and try to reproduce his surprising results on an in-vitro model of homeopathy. At the time, I thought this was a weird idea, but when I read up about JR’s background, it seemed a smart move. When he then identified the error in Benveniste’s work, I was not surprised. Randi had the gift of a sharp intellect, a detective and a arch sceptic.

Many years later, in 2008, I decided to edit a multi-author book entitled HEALING, HYPE OR HARM, and I invited JR to contribute a chapter. I felt honoured when he accepted the offer and sent me his chapter ‘AN AMATEUR’S VIEW OF THE SCAM SCENE’. In classical JR-style, it opened with the sentence: At the outset, let me make one thing perfectly clear: my qualifications concerning this subject, alternative/complementary medicine, here referred to as CAM, consist mostly of common sense, a wide-ranging experience of flimflam, and extensive exposure to a great variety of scam artists. After that, I received Christmas cards from him every year.

Eventually, I did meet JR in person. This was around 2010 on the occasion of sceptics meetings in New Orleans and Berlin. I introduced myself to him, he looked at me intensely, shook my hand and said: “Ahh, that’s you!”, and we had a little chat. By that time JR had become quite frail; his health was visibly in decline. This, however, did not stop him to remain active, influecial and inspirational; it seemed that JR was unstoppable.

His decades of achievements are perhaps best summarised by the hist of honours and awards bestowed on him. The list below is from his Wiki page:

Year Award or honor
1977 Visiting Magician of the Year, Academy of Magical Arts & Sciences at the Magic Castle in Hollywood.[158]
1978 Garden State Magicians’ award.[158]
1981 Asteroid 3163 Randi was named after James Randi,[159] who had always been an active amateur observer. His friend Carl Sagan encouraged his interest.[18]
Certificate of appreciation at the MIT Club of Boston.[158]
Designated Grand Master of Magic by Hocus Pocus Magazine.[158]
1983 Blackstone Cup, International Platform Association as Outstanding Speaker (won again in 1987).[158]
1984 Honorary membership, Bay Surgical Society of Los Angeles.[158]
1986 A $273,000 MacArthur Foundation Fellowship was awarded to James Randi for his investigations of the claims of Uri Geller and TV “faith healers[160]
Honorary membership, Israeli Society for Promoting the Art of Magic.[158]
1987 Special fellowship, Academy of Magical Arts & Sciences in Los Angeles.[158]
Certificate of Appreciation, Ring 254 of the International Brotherhood of Magicians.[158]
Award of Merit, Assembly 22 of the Society of American Magicians.[158]
1988 National Consumer Service Award, National Council Against Health Fraud.[158]
International Ambassador of Magic, Society of American Magicians.[158]
1989 Joseph A. Burton Forum Award, American Physical Society.[161]
Gold Medal, University of Ghent.[158]
1990 Humanist Distinguished Service Award, American Humanist Association.[158]
Thomas Paine Award, Baton Rouge Proponents of Rational Inquiry & Scientific Methods.[158]
1992 Commemorative Medal with Golden Wreath, Hungarian Society for the Dissemination of Scientific Knowledge.[158]
1996 Distinguished Skeptic Award, Committee for Skeptical Inquiry (CSICOP).[158][162]
1997 Lifetime Achievement Award, International Brotherhood of Magicians.[158]
“One of the 100 Best People in the World, people who make our lives richer or larger or happier,” Esquire magazine.[158]
Award, Science & Engineering Society of the National Security Agency.[158]
1999 “In Defense of Reason” Special Lifetime Achievement Award, Comitato Italiano per il Controllo dell Affermazioni sui Paranormale.[158]
2000 Distinguished Lecturer Award, Nova Southeastern University.[158]
2002 Presidential Citation, International Brotherhood of Magicians.[158]
2003 First Richard Dawkins Award.[30]
2007 Philip J. Klass Award.[163]
2008 Lifetime Achievement Award, Independent Investigations Group (IIG). Previous recipients Carl Sagan and Harry Houdini.[158][164]
2009 In Praise of Reason Award, Committee for Skeptical Inquiry.[158]
2010 Elected a Committee for Skeptical Inquiry Fellow.[165]
2012 Lifetime Achievement Fellowship, Academy of Magical Arts.[166]
Lifetime Achievement Award, American Humanist Association.[167]
2016 Heinz Oberhummer Award, 2016[168]
Lifetime Achievement Award, Humanist Association of Canada.[169]
James Randi is one of very few members of the UK Magic Circle to be granted their highest order: Member of the Inner Magic Circle With Gold Star (MIMC).

Randi finished the book chapter in my book with the following remark: … several aquaintances have described my work as being anti-Darwinian, in that it interfers with the natural selection process with which we are so familiar. I will leave you to ponder on that matter.

Now he has left us, and sceptics around the world will miss him dearly.

The new kid on the SCAM block seems to be hydrogen-rich water (HRW). It is pure water infused with hydrogen molecules and can be purchased in pouches and cans or made at home using special, commercially available devices. Health writers and entrepreneurs have been everything but timid in publishing claims about HRW. This is from one of thousands of sites promoting it:

1. Antioxidant And Anti-inflammatory Properties

Studies show that consuming hydrogen-rich water for a few weeks at a time can reduce reactive oxygen metabolites (ROMs) in the bloodstream, which can damage cells while sustaining blood oxidation levels needed to ensure health. The result is a reduction in and inflammation, which effectively reduces cell damage and leads to an improved quality of life. Decreased oxidative stress is also a valuable factor which helps prevent metabolic syndrome and soften the impact of neurodegenerative disease. Hydrogen-rich water, through its power to combat oxidative stress, is a promising remedy for these and other diseases. Its anti-inflammatory properties are already used to treat rheumatoid arthritis, one of the most prominent and debilitating conditions caused by high levels of inflammation in the body.

2. May Treat And Prevent Metabolic Syndrome

Metabolic syndrome, which includes obesity, high cholesterol, high blood pressure, and often causes a range of cardiovascular illnesses, is a rapidly growing problem among American adults. Early studies show that hydrogen-rich water health benefits include staving off metabolic syndrome and reversing negative metabolic symptoms because of its ability to reverse the effects of oxidative stress on the body. In fact, studies have shown that consuming hydrogen-rich water decreases the “bad” cholesterol, also known as serum-LDL cholesterol while improving HDL function — the “good” cholesterol.  This effect, in turn, prevents against the development of a number of debilitating cardiovascular issues.

3. Slows The Development Of Neurodegenerative Diseases

By fighting in important brain tissues, hydrogen-rich water fights a key cause of conditions like Parkinson’s disease and , both of which feature cognitive and behavioral impairment and decline. Because it consumes a high level of oxygen, the brain is prone to oxidative stress. Hydrogen-rich water elicits effects in the brain that counter the ability of oxidative stress to kill dopamine cells and damage proteins that maintain cognitive functioning. When used daily by patients of Alzheimer’s, hydrogen-rich water has been shown to restore neural proliferation, thereby inhibiting cognitive decline. Especially promising is the demonstrated ability of H2-rich water consumption to combat cognitive impairment even in its latest stages and to alleviate the harm of brain injury — again, because of its ability to ameliorate oxidative stress on brain tissue. In fact, some researchers recommend daily consumption of hydrogen-rich water as a long-term preventative treatment against dementia and neurodegenerative disease and as a part of a recovery program for brain injury from stroke or surgery.

4. May Treat And Prevent Insulin Resistance And Type 2 Diabetes

Recent studies demonstrate that hydrogen-rich water health benefits include having a normalizing effect on glucose in the body. In combination with powerful antioxidant properties, hydrogen-rich water improves insulin circulation and sensitivity, while also increasing levels of certain compounds that build insulin resistance. The end product is improved glucose metabolism, which can both prevent and slow the development of Type 2 Diabetes Mellitus and insulin resistance.

5. Improves Dental Health

As shown above, oxidative stress causes a number of ailments. One of the most common is dental decay. Fortunately, consuming hydrogen-rich water has been proven to treat conditions associated with dental deterioration, such as periodontal disease, because of its ability to fight oxidative stress, in addition to its effective anti-inflammatory properties. Drinking water containing molecular hydrogen targets periodontal disease at the source by suppressing inflammation in the oral tissue.  Hydrogen-rich water also prevents age-related oxidative damage to oral tissue, thereby offsetting dental decay.

6. Combats Muscle Fatigue

One compelling study of male soccer players found that, by consuming hydrogen-rich water before exercise, these athletes could reduce blood lactate levels and improve muscle function during exercise. After exercise, these athletes experienced lower levels of muscle fatigue and were able to recover faster. Because it also treats exercise-induced dehydration, hydrogen-rich water is a promising remedy for athletes. According to Biethan, “more and more athletes are picking up on it” to improve their athletic performance and recovery.

And how does HRW work? What is its mode of action? Nobody seems to know! During the last months, there have been several controlled clinical trials of HRW. Regardless of what condition they address, they all arrived at positive conclusions:

  1. In conclusion, these results suggest that supplementation with hydrogen-rich water may have a beneficial role in prevention of T2DM and insulin resistance.
  2. HRW significantly attenuates oxidative stress in CHB patients, but further study with long-term treatment is required to confirm the effect of HRW on liver function and HBV DNA level.
  3. Two weeks of HRW intake may help to maintain PPO in repetitive sprints to exhaustion over 30 minutes.
  4. Thus, hydrogen-rich water appeared to alleviate the mFOLFOX6-related liver injury.
  5. appears that orally administered H2 as a blend of hydrogen-generating minerals might be a beneficial agent in the management of body composition and insulin resistance in obesity.
  6. Although preliminary, the results of this trial perhaps nominate HRW as an adjuvant treatment for mild-to-moderate NAFLD. These observations provide a rationale for further clinical trials to establish safety and efficacy of molecular hydrogen in NAFLD.
  7. To conclude, acute pre-exercise supplementation with HRW reduced blood lactate at higher exercise intensities, improved exercise-induced perception of effort, and ventilatory efficiency.

Aprart from producing uniformly positive results, these studies have another common feature: they are methodologically flimsy. Probably the most rigorous trial of HRW was published earlier this year. Perhaps it is worth having a look at it:

An international team of researchers conducted a randomized, double-blinded, placebo-controlled trial in 60 subjects (30 men and 30 women) with metabolic syndrome. An initial observation period of one week was used to acquire baseline clinical data followed by randomization to either placebo or high-concentration HRW (> 5.5 millimoles of H2 per day) for 24 weeks.

High-concentration HRW was prepared via hydrogen-producing tablets (HRW Natural Health Products Inc., New Westminster BC, Canada) while the placebo was prepared as a placebo drink similar in taste, dissolution, and appearance to HRW. Placebo capsules, also donated by HRW Natural Health Products Inc. (New Westminster, BC, Canada), contained identical ingredients to the hydrogen supplement, but instead of metallic magnesium the placebo contained various forms of magnesium salts (i.e. tartrate, malate, chloride) and similar organic acids to prevent any pH buffering effect from the conjugate bases of the alkaline salts.

The participants consumed 1 tablet 3 x daily in 250 mL of 12-18°C water. They were advised to drink the product in one gulp as soon as the tablet finished dissolving on an empty stomach/morning. This method of H2 administration would provide >5.5 millimoles H2/day.

Supplementation with high-concentration HRW significantly reduced blood cholesterol and glucose levels, attenuated serum haemoglobin A1c, and improved biomarkers of inflammation and redox homeostasis as compared to placebo. Furthermore, H2 tended to promote a mild reduction in body mass index and waist-to-hip ratio.

The authors concluded that the results from our study suggest that supplementation with high-concentration HRW produced via H2-producing tablets improves body composition, favorably modulates fatty acid and glucose metabolism, and improves inflammation and redox homeostasis in subjects with metabolic syndrome. Therefore, long-term treatment with high-concentration hydrogen-rich water may be used as an adjuvant therapy to decrease the features of metabolic syndrome. However, a larger prospective clinical trial is warranted to further determine the biological effects of HRW in this subject population.

The authors of this study, which was conducted in Moradabad India and supported by Slovak Research and Development Agency; Scientific grant agency of the Ministry of Education of the Slovak Republic, and by HRW Natural Health Products Inc., have the following affiliations:

  • Centre of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, Bratislava, Slovak Republic.
  • Molecular Hydrogen Institute, Enoch, UT, USA.
  • Hospital and Research Institute, Moradabad, India.
  • Era Medical College, Lucknow, India.
  • Applied Bioenergetics Lab, Faculty of Sport and PE, University of Novi Sad, Novi Sad, Serbia.
  • Faculty of Health Sciences, University of Pécs, Pécs, Hungary.
  • Medical Faculty, Pharmacobiochemical Laboratory of 3rd Medical Department, Comenius University Bratislava, Bratislava, Slovakia.
  • Laboratory of Pathophysiology, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan.
  • Third Internal Clinic, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
  • Center of Nutrition Research, International College of Nutrition, Moradabad, India.

In the last two years, the 1st author of this new trial has published over a dozen expeimental papers on HRW; all of them report positive findings. Whenever I see a treatment that never fails to produce positive results, regardless of the conditions it is applied to, I start asking myself, are these findings not too good to be true?

Am I the only one to smell a rat?

A study from the US found that belief in conspiracy theories is rife in health care. The investigators presented people with 6 different conspiracy theories, and the one that was most widely believed was the following:

THE FOOD AND DRUG ADMINISTRATION IS DELIBERATELY PREVENTING THE PUBLIC FROM GETTING NATURAL CURES FOR CANCER AND OTHER DISEASES BECAUSE OF PRESSURE FROM DRUG COMPANIES.

A total of 37% agreed with this statement, 31% had no opinion on the matter, and just 32% disagreed. What is more, the belief in this particular conspiracy correlated positively with the usage of alternative medicine.

The current popularity of so-called alternative medicine (SCAM) is at least partly driven by the conviction that there is a sinister plot by the FDA or more generally speaking ‘the establishment’ that prevents people from benefitting from the wonders of SCAM.

But where do those conspiracy theories come from?

How do they evolve?

A new article investigates these questions. Here is its abstract:

Although conspiracy theories are endorsed by about half the population and occasionally turn out to be true, they are more typically false beliefs that, by definition, have a paranoid theme. Consequently, psychological research to date has focused on determining whether there are traits that account for belief in conspiracy theories (BCT) within a deficit model. Alternatively, a two-component, socio-epistemic model of BCT is proposed that seeks to account for the ubiquity of conspiracy theories, their variance along a continuum, and the inconsistency of research findings likening them to psychopathology. Within this model, epistemic mistrust is the core component underlying conspiracist ideation that manifests as the rejection of authoritative information, focuses the specificity of conspiracy theory beliefs, and can sometimes be understood as a sociocultural response to breaches of trust, inequities of power, and existing racial prejudices. Once voices of authority are negated due to mistrust, the resulting epistemic vacuum can send individuals “down the rabbit hole” looking for answers where they are vulnerable to the biased processing of information and misinformation within an increasingly “post-truth” world. The two-component, socio-epistemic model of BCT argues for mitigation strategies that address both mistrust and misinformation processing, with interventions for individuals, institutions of authority, and society as a whole.

This makes a lot of sense to me, and it seems to apply well to the BCT in SCAM.

To mitigate BCT, the authors advocate asking:

  • Who do you trust or mistrust and why?
  • How do you decide what to believe?

Effective mitigation strategies, they state, may necessitate wholescale approaches that:

  1. confer resistance against BCT by utilizing inoculation strategies that counter misinformation where it occurs (e.g. online),
  2. teach analytic thinking within educational systems at an early age,
  3. restructure or otherwise impose restrictions on the digital architectures that distribute information in order to label or curb misinformation and promote “technocognition”.

These are no small challenges, and I am proud to say that, in the realm of SCAM, I am doing what I can to tackle them.

THE FIRST WORLDWIDE MANIFESTO AGAINST PSEUDOSCIENCE

2750 signatories from 44 countries have signed it [I was number 11] and today is its official launch. I am delighted to present to you the full text of the English version:

 

Let’s be clear: pseudoscience kills. And they are being used with total impunity thanks to European
laws that protect them.
They kill thousands of people, with names and families. People such as Francesco Bonifaz, a 7-yearold boy whose doctor prescribed homeopathy instead of antibiotics. He died in Italy [1]. People like Mario Rodríguez, who was 21 years old and was told to use vitamins to treat his cancer. He died in Spain [2]. People like Jacqueline Alderslade, a 55-year-old woman whose homeopath told her to stop taking her asthma medication. She died in Ireland [3]. People like Cameron Ayres, a 6-month-old baby, whose parents did not want to give their child “scientific medicine”. He died in England [4]. People like Victoria Waymouth, a 57-year-old woman who was prescribed a homeopathic medication to treat her heart problem. She died in France [5]. People like Sofia Balyaykina, a 25-year-old woman, who had a cancer that was curable with chemotherapy but was recommended an “alternative treatment”, a mosquito bite treatment. She died in Russia [6]. People like Erling Møllehave, a 71-year-old man whose acupuncturist pierced and damaged his lung with a needle. He died in Denmark [7]. People like Michaela Jakubczyk-Eckert, a 40-year-old-woman whose therapist recommended the German NewMedicine to treat her breast cancer. She died in Germany [8]. People like Sylvia Millecam, a 45-year-old woman whose New Age healer promised to cure her cancer. She died in the Netherlands [9].

European directive 2001/83/CE has made –and still makes— possible the daily deception of thousands of hundreds of European citizens [10]. Influential lobbyists have been given the opportunity to redefine what a medicine is, and now they are selling sugar to sick people and making them believe it can cure them or improve their health. This has caused deaths and will continue to do so until Europe admits an undeniable truth: scientific knowledge cannot yield to economic interests, especially when it means deceiving patients and violating their rights.

Europe is facing very serious problems regarding public health. Overmedication, multi-resistant bacteria and the financial issues of the public systems are already grave enough, without the additional problem of gurus, fake doctors or even qualified doctors claiming they can cure any disease by manipulating chakras, making people eat sugar or using “quantic frequencies”. Europe must not only stop the promotion of homeopathy but also actively fight to eradicate public health scams. More than 150 pseudo-therapies have been identified as being in use throughout Europe. Thousands of citizens lives depend on this being prevented. In fact, according to a recent research, 25.9 % of Europeans have used pseudo-therapies last year. In other words, 192 million patients have been deceived [11].

Some believe there is a conflict between freedom of choice for a treatment and the removal of pseudo-therapies, but this is not true. According to article 25 of the Universal Declaration of Human Rights, every person has a right to medical care. Lying to patients in order to sell them useless products that could kill them breaks their right to correct information about their health. This way, even if a citizen has a right to refuse medical treatment when he or she is properly informed, it is also true that nobody has the right to lie to obtain profit at the expense of someone else’s life. Only in a world in which lying to a sick person would be considered ethical, could homeopathy —or any other pseudo-therapy— be allowed to continue to be sold to citizens.

Effective treatments being replaced by false ones is not the only danger of pseudo-therapies. Obvious delays in therapeutic care occur when a person gets false products instead of medication at the early stages of a disease. Many times, it is then too late by the time they get treated with proper medicine. Moreover, several of these practices have serious effects on their own and may cause damage or even death because of their side effects.

Many pseudo-therapists argue that “the other medicine” comes with side effects as well, which is indeed true. However, the difference resides in that pseudo-therapies cannot cure a disease or improve your health, and because of that patients assume risks in exchange of promises that are a scam, according to the full weight of the scientific evidence available. Lying to a sick person is not another type of medicine, it is simply lying to a sick person.
Every country has to face the pseudo-therapies issue in its own ways. Yet it is not acceptable that European laws protect the distortion of scientific facts so that thousands of citizens can be deceived or even lead to their deaths.

We, the signatories of this manifest, therefore declare that:

1. Scientific knowledge is incompatible with what pseudo-therapies postulate, as in the case
of homeopathy.
2. European laws that protect homeopathy are not acceptable in a scientific and technological
society that respects the right of the patients not to be deceived.
3. Homeopathy is the best known pseudo-therapy, but it is not the only one nor the most
dangerous one. Others, such as acupuncture, reiki, German New Medicine, iridology,
biomagnetism, orthomolecular therapy and many more, are gaining ground and causing
victims.
4. Measures must be taken to stop pseudo-therapies, since they are harmful and result in
thousands of people being adversely affected.
5. Europe needs to work towards creating legislation that will help stop this problem.

Europe being concerned about the misinformation phenomena but at the same time protecting one the most dangerous types of it, health misinformation, is just not coherent. This is why the people signing this manifesto urge the governments of European countries to end a problem in which the name of science is being used falsely and which has already cost too many lives.

 

[1] Homeopathy boy died of encephalitis. Redazione ANSA, 2017.
http://www.ansa.it/english/news/general_news/2017/05/29/homeopathy-boy-died-of-encephalitis-3_13e02493-
4e62-4787-9162-12d831121ef6.html
[2] Grieving dad sues over ‘cure cancer with vitamins’ therapy, The local. Emma Anderson, 2016.
https://www.thelocal.es/20160412/grieving-father-sues-naturopath-over-son-cure-cancer-vitamins-leukaemia
[3] Asthmatic ‘told to give up drugs’. The Irish News, 2001.
https://www.independent.ie/irish-news/asthmatic-told-to-give-up-drugs-26063764.html
[4] Homeopaths warn of further tragèdies. BBC News, 2000.
http://news.bbc.co.uk/2/hi/health/702699.stm
[5] Alternative cure doctor suspended. BBC News, 2007.
http://news.bbc.co.uk/2/hi/uk_news/england/london/6255356.stm
[6] Футболист рассказал трагичную историю жены. Она умерла от рака в 25 лет. Sport24, 2018.
https://sport24.ru/news/football/2018-08-28-futbolist-rasskazal-tragichnuyu-istoriyu-zheny-ona-umerla-ot-raka-v-25-let
[7] Mand døde efter akupunktur – enke vil nu lægge sag an mod behandleren, TV2, 2018.
http://nyheder.tv2.dk/samfund/2018-01-23-mand-doede-efter-akupunktur-enke-vil-nu-laegge-sag-an-modbehandleren

[8] The price of refusing science-based medical and surgical therapy in breast càncer, Science Blogs, 2012.
https://scienceblogs.com/insolence/2012/08/30/the-price-of-refusing-science-based-medical-and-surgical-therapy-inbreast-cancer
[9] Psychic ‘misled actress to hopeless cancer death’. Expatica. 2004.
http://web.archive.org/web/20070208144309/http://www.expatica.com/actual/article.asp?subchannel_i
d=19&story_id=4821
[10] Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001.
https://ec.europa.eu/health/sites/health/files/files/eudralex/vol1/dir_2001_83_consol_2012/dir_2001_83_cons_2012_en.pdf
[11] Use of complementary and alternative medicine in Europe: Health-related and sociodemographic
determinants. Scandinavian Journal of Public Health. Laura M. Kemppainen et al. 2018.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989251/

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