I regularly used to ask alternative practitioners what diseases they are good at treating. In fact, we once ran an entire research project dedicated to this question and found that their own impressions were generally based on wishful thinking rather than on evidence. The libel case of the BCA versus Simon Singh then brought this issue into the focus of the public eye, and consequently several professional organisations of alternative practitioners seem to have advised their members to be cautious about making unsubstantiated therapeutic claims. This could have been an important step into the right direction – unless, of course, a clever trick had not been devised to bypass the need for evidence. Today, when I ask alternative practitioners ‘what do you treat effectively?’ I tend to get answers like:
- Alternative practitioners, unlike conventional clinicians, do not treat diseases.
- I treat the whole person, not just the disease.
- I treat people and their specific set of signs and symptoms, rather than disease labels (this actually is a quote from the comments section of one of my recent posts).
- I focus on the totality of the symptoms; disease labels are irrelevant in the realm of my therapy.
- Chiropractors adjust subluxations which are the root cause for most diseases.
- Acupuncturists re-balance life energies which is a precondition for healing to commence irrespective of the disease.
- Homeopaths treat the totality of symptoms so that the patient’s vital force can do the healing.
- etc. etc.
All of these statements are deeply rooted in the long obsolete notions of vitalism, i.e. the assumption that a vital energy flows in all living organisms and is responsible for our health irrespective of the disease we happen to suffer from. But what do the answers to my question ‘what do you treat?’ really mean? If we analyse the above responses critically, they seem to imply that:
- Conventional clinicians do not treat patients but merely disease labels.
- Alternative practitioners can successfully treat any disease or condition.
Ad 1 In my view, it is arrogant and grossly unfair to claim that alternative practitioners work holistically, while conventional health care professionals do not. I have pointed out repeatedly that any good medicine always has been and always will be holistic. High-jacking holism as a specific characteristic for alternative medicine is misleading and an insult to all conventional clinicians who do their best to practice good medicine.
Ad 2 By claiming that they treat the whole person irrespective of her disease, alternative practitioners effectively try to give themselves a ‘carte blanche’ for treating any disease or any condition or any symptom. If a child has asthma, a chiropractor will find a subluxation, adjust it with spinal manipulation, and claim that the child’s condition will improve as a consequence of his treatment – NEVER MIND THE EVIDENCE. If a person wants to give up smoking, an acupuncturist will use acupuncture to re-balance her yin and yang claiming that this intervention will make smoking cessation more successful – NEVER MIND THE EVIDENCE. If a patient suffers from cancer, a homeopath might find a remedy that promotes her vital energy claiming that the cancer will subsequently be cured – NEVER MIND THE EVIDENCE which in all of the three cases is negative.
The claim of alternative practitioners to not treat disease labels but the whole patient is doubtlessly attractive to consumers and it is also extremely good for business. On closer inspection, however, it turns out to be a distraction from the fact that alternative practitioners treat everything and anything, usually without the slightest evidence that their interventions generates more good than harm. It allows alternative practitioners to live in a fool’s paradise of quackery where they believe themselves to be protected from any challenges and demands for evidence.
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A new article on Huffington Post demonstrates this fallacy well. I wrote a response to it, but HuffPo won’t let me post a comment without linking with Facebook and giving HuffPo access to all my personal data. It’s called “Is Acupuncture a Deception” http://www.huffingtonpost.com/dr-jingduan-yang/acupuncture_b_3908855.html
The author writes: “Acupuncture influences human energy through manipulating the meridians of the human body that are connected energetically with internal organs and systems. In TCM, it is the energetic level of any disorder that is considered the primary factor in mental and physical illnesses. Whereas acupuncture treats the root cause of the problem at an energetic level so that the body does not continue to suffer, pharmaceuticals only treat symptoms. They don’t cure anything.”
My (unposted) response to his article:
Comparing acupuncture meridians to oxygen shows a huge gap in your scientific literacy. Many, many experiments have verified the existence and properties of oxygen. Unfortunately for acupuncturists, the traditional meridian maps are an astrology-based fantasy and have failed to be verified despite thousands of experiments. The Vickers (JAMA) study was controversial in its methods and conclusions, but even taking it at face value, the average pre-treatment pain level was 6 and the post-treatment for ‘real’ acupuncture was 3 and for ‘sham’ acupuncture was 3.5. This small difference is likely due to bias and poor blinding in some of the included studies.
Pain and nausea are the most likely symptoms to respond to placebo treatments. Yet the acupuncture literature is full of claims that certain points can treat virtually any disease, from schizophrenia to beri-beri. The most carefully designed experiments show no difference between ‘real’ acupuncture and fake acupuncture which doesn’t even involve penetrating the skin. To spin this into support for ‘real’ acupuncture takes religious dedication.
You wrote: “Whereas acupuncture treats the root cause of the problem at an energetic level so that the body does not continue to suffer, pharmaceuticals only treat symptoms. They don’t cure anything.” This shows great hubris on your part, and is an example of why science-based doctors often brand TCM as harmful quackery. Acupuncture has never been shown to actually treat the root cause of any disease, whereas pharmaceuticals are often prescribed to do just that. Of course, this takes a belief in infection as a cause of disease, rather than the pre-scientific notions of ‘heat’ and ‘wind’ TCM proposes.
The sad truth is that the vast majority of acupuncture research which has been done in China in the past 50 years has been of such poor quality and shows such high bias as to be useless to those actually interested in the truth: Traditional Chinese Medicine’s acupuncture is a disproven vitalistic pseudoscience which offers a strong placebo effect for subjective symptoms. Acupuncturists often take credit for curing conditions which would have gotten better on their own. There are no special points related to ‘fire, water, wood, earth, or metal’ which have special functions if the needle is twirled clockwise or counterclockwise (TCM theory states each direction twirled has opposite effect).
Your post ends “And, it is irresponsible, unethical and unprofessional for someone who lacks training and knowledge to misinform and mislead the general public in this very specialized medical area.” This, I agree with. You clearly lack knowledge about good scientific research methodology, and are misinforming and misleading by promoting TCM acupuncture as supported by science. I’ve read Dr. Offit’s book, and recommend it along with “Snake Oil Science” by R. Barker Bausell and “Trick or Treatment” by Edzard Ernst and Simon Singh.
By the way, I was trained as an acupuncturist and TCM herbalist and practiced for 20 years before giving it up after extensive research and personal reflection. I know of several other acupuncturists who have likewise moved on to more productive pursuits and feel deceived by the TCM promoters and apologists. If good research actually did show acupuncture to be more than a theatrical placebo, I’d be glad to do it again. It paid well and many of my patients were happy with it. However, once I understood what actual good research is what it says about acupuncture, I couldn’t ethically continue such a deceptive practice.
Well, I’m honoured to have apparently inspired a whole blog post!
Ex-acupuncturist, would you mind providing a link to your favourite well-designed study that shows real acupuncture no more effective than non-insertion placebo for pain, so I can offer my perspective?
don’t fool yourself: repeating nonsense does not inspire me;
Well, some of the opinions you constantly repeat do inspire me to present alternative perspectives. Being interested in lively debate rather than vitriol, I won’t stoop to calling your opinions nonsense.
So acupuncture cures disease and medicine doesn’t? So how come syphilis was an incurable chronic disease prior to the discovery of antibiotics, and diabetics in China died just as quickly as diabetics anywhere else prior to the discovery of insulin?
Oh, wait, I know why: the claim is bollocks.
Guy, I’m not sure if your comment was directed at me, but if so I didn’t say that Western medicine doesn’t cure disease, nor did I say it doesn’t have great strengths. Both paradigms have a lot to offer in my opinion.
Why stop with insulin, which is a replacement therapy (might be called symptomatic)?
More than 90% of diabetes today is of type2 (T2DM), which results from insulin resistance (IR). IR causes a clulster of disorders, called IRSyndrome (G. Reaven, Stanford): increased blood sugar, increased blood pressure…
In 1994 Magnusson et al. from Iceland published a study with tables showing that those signs of IR were associated with indices of increased iron storage:
http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=8281634
We all know that association does not prove causation. We could remove iron from the body and see if IR / the IRS is alleviated. Such a study was published by Bofill et al. from Spain in the same year:
http://www.ncbi.nlm.nih.gov/pubmed/8177050
They observed the change of several metabolic parameters after obtaining preoperatively blood for autologous transfusions. “Bleeding produced a significant decrease in serum glucose, cholesterol, triglyceride, and apoprotein B concentration in diabetic patients. Except for glucose, this effect was not observed in controls. ”
Meanwhile a lot of such studies have been performed, all supporting a causal role of “surplus iron” in the body for IR / the IR Syndrome (as far as I am aware). The most impressive study was that of Francesco S. Facchini and Kami L. Saylor, published 2002, more than a decade ago – but completely ignored by diabetologists and “mainstream medicine”:
http://www.ncbi.nlm.nih.gov/pubmed/12079862
From this study it can be concluded that simple depletion of stored iron (on average 1,5g) by a series of phlebotomies (analogous to blood donations) can “cure” early T2DM. Which of course is FAR superior to insulin.
Actually practitioners of Chinese medicine (CM) who say that CM treats the patient, not the disease, are misinformed. CM has categorised diseases since its very earliest days, and a significant part of treatment strategy in both acupuncture and herbal medicine is directed towards treating the disease. What is different – and perhaps uniquely sophisticated in CM – is that it recognises that patients with the same disease may differ in significant ways, and treats them by additionally adapting the treatment to take account of those important differences. From that perspective it is more advanced than biomedicine, although with ideas such gene tailored treatments, biomedicine is catching up.
However the idea that interventions can modify the human organism as a whole is self-evident. One of the reasons that the powerful benefits of exercise or dietary modification or emotional regulation have puzzled researchers is exactly because they are not specific. I would say that acupuncture in particular has strong non-specific effects (in addition to specific effects).
Well said. Note I said I didn’t treat disease labels, not that I didn’t treat diseases. In other words, when confronted with a disease label I try to interpret it in the context of the individual situation (I left an example of this on the other thread), and vary my treatment accordingly. WM is not very good at this, and tends to lump people with the same disease label together rather crudely. Take chemotherapy for example – if drugs were selected more subtly based on patient constitution etc. I imagine tolerance and success rates would improve.
“I would say that acupuncture in particular has strong non-specific effects…” — I totally agree with you: death and severe complications are indeed two examples of its strong and non-specific effects.
What utter nonsense. First of all, the methods of CM in diagnosing anything are somewhat crude to say the least. One might rather call them imaginary. Besides, CM does not have any concept whatever of transmittable diseases of any Kind. Bacteria and virusses? Never heard of in CM. Not the slightest idea what they could be. Which somewhat renders all categorization of diseases rather pointless in the modern world.
And what on earth makes you say that medicine does not adapt Treatment according to how patients differ from one another? Matter of fact, that happens all the time. Remedies are perscribed according to medical history, weight, Age (albeit not enough) other preexisting conditions etc. etc. Sex admittedly is not taken into consideration enough it seems as there are some indications that some medicines affect women differently from men and a lot of research is being performed in that direction.
Edzard, Amen! Great article. Keep them coming.
The non-penetrating Streitberger acupuncture needle is relatively new, but here are a few studies which used it and found no difference from penetrating acupuncture on pain conditions:
http://www.ncbi.nlm.nih.gov/pubmed/22738796
“Attitude towards acupuncture and partial unblinding did not affect the results. We conclude that acupuncture on predefined points has a minor effect on experimental pain in healthy subjects.”
http://www.ncbi.nlm.nih.gov/pubmed/22405683
“CONCLUSIONS:
To our knowledge, this study is the first randomized, placebo-controlled, double-blinded prospective study of traditional acupuncture for CTS. Both the treatment and placebo groups demonstrated improvements from baseline. Acupuncture was not shown to be superior to placebo acupuncture when used in conjunction with bracing for patients with mild to moderate CTS.”
http://www.ncbi.nlm.nih.gov/pubmed/22169359
” Improvements occurred from baseline, but acupuncture has no specific efficacy over either placebo. The individual practitioner and the patient’s belief had a significant effect on outcome. The 2 placebos were equally as effective and credible as acupuncture. Needle and nonneedle placebos are equivalent.”
http://www.ncbi.nlm.nih.gov/pubmed/21760827
“Acupuncture needling at low pain stimulus intensity showed a small analgesic effect which did not significantly differ from placebo response and was significantly less than a DNIC-like effect of a painful noninvasive stimulus.”
Here’s a study showing the needling sensation “De Qi” doesn’t matter for pain relief from acupuncture:
http://www.ncbi.nlm.nih.gov/pubmed/20964256
“CONCLUSION:
These data suggest that the presence and intensity of de qi has no effect on the pain relief obtained for patients with OA. This result may have implications for both acupuncture treatment and for future trial methodology.”
The German GERAC trials used shallow acupuncture on non-traditional points with no needle stimulation, and found it to be as good as “real” acupuncture on TCM points with stimulation to get De Qi: http://en.wikipedia.org/wiki/German_Acupuncture_Trials
Then there is the “toothpick” study: http://www.ncbi.nlm.nih.gov/pubmed/19433697
“CONCLUSIONS:
Although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient and penetration of the skin appear to be unimportant in eliciting therapeutic benefits. These findings raise questions about acupuncture’s purported mechanisms of action. It remains unclear whether acupuncture or our simulated method of acupuncture provide physiologically important stimulation or represent placebo or nonspecific effects.”
You may criticize these studies (probably best on your own blog, but post a link here if you do that, please), but even better would be to provide references to better studies which show specific effects of acupuncture (or acupuncture points) which aren’t replicated by sham acupuncture. For example, there is a “lower blood pressure” point on the top of the ear. Are there any studies which show it actually does lower blood pressure, ideally more than a point done on the bottom of the ear? Hot flashes–doesn’t work. Drug addiction–doesn’t work. Biggest variable: practitioner attitude and communication (i.e. con(fidence) game).
Since doing very shallow needling at random points with a good bedside manner is as effective as doing deeper needling with stimulation to get needling sensations at “carefully selected” TCM points, ethics and honesty would recommend the safer, simpler approach to be superior. Here is where deception comes in. Self-deception for the faith-based acupuncturist who rejects scientific findings and patient deception when telling them that specific acupuncture points have specific effects on actual diseases.
Peter Deadman, co-author of A Manual of Acupuncture (a text used in acupuncture schools), here are a few questions for you. One example of point functions in your book is:
“Bl-10 (Bladder 10) is further indicated for mental disorders characterised by mania and incessant talking, as well as for disorders characterised in the classical texts as seeing or ‘communicating with ghosts’ and therefore attributed to some form of demonic possession. In terms of modern medicine these indications refer to various forms of severe mental disorder including schizophrenia.” (p 263, http://www.amazon.com/Manual-Acupuncture-Peter-Deadman/dp/0951054651)
Is there any research which backs up this point as having those properties?
Does any such research compare needling the point to non-insertion placebo?
Does any research compare using this point (and telling the patient about its traditional properties) with doing another point and saying the same? Or doing this point *without* telling the patient those traditional functions?
Can you see any harm that may come from telling a schizophrenic person in a mania that you are doing a treatment traditionally used to exorcise demons and that it should help them?
Most TCM textbooks have no references at all for such claims–they are often just translations and conglomerations of earlier TCM books, and usually don’t even directly footnote them. There are often no references to actual studies, or in the case of Bensky’s herb book, sometimes Chinese animal studies are mentioned without reference to a journal, researcher, etc.
The most realistic explanation of acupuncture is that it is a theatrical placebo treatment based on expectation and cultural myths. The best research that I’m aware of supports this conclusion. That is why I stopped doing acupuncture. I am more concerned with medical ethics (informed consent, patient autonomy) and scientific facts than promoting the pseudoscientific religion which is TCM. There is a narrow window for TCM proponents to win me back over to the other side, and that window is only open for good quality actual research.
To ex-acupuncturist
Since you directed a question to me I am happy to answer it. The textbook I co-wrote is a presentation of a roughly two thousand year tradition. The core principle behind it is that since Chinese acupuncture has a very long textually transmitted history, it is useful for any development of acupuncture outside China to have an accessible record of that history before moving onwards. When we say that an acupuncture point is indicated for a symptom/disorder, that is simply stating a fact. It does not suggest that we think the point is necessarily effective in treating that symptom/disorder, simply that the tradition suggests that it was thought to do so. As far as schizophrenia is concerned, acupuncture was certainly used to treat it when I visited in-patients in a Chinese hospital in 1981, but on the basis of a single visit I was unable to form an opinion as to whether it was helpful or not – only that the doctors there thought it was. Whether acupuncture is still used in that way, I can’t say.
@Peter Deadman
Your tired, old argument to antiquity that Acupuncture is a two thousand year tradition is rather amusing seeing as massive evidence points to the fact that modern day acupuncture is not even a century old. The real acupuncture tradition was quite another practice, very related to the blood-letting tradition elsewhere in the world.
The words of a missionary doctor can serve as a telling example:
From the book “Thirty years in Moukden”, 1883-1913
By Dugald Christie, a Scottish Doctor :
Is this the tradition that you present in your textbook Mr. Deadman?
You have obviously chosen to not listen to the other side of the flow of information.
Now, it would be interesting to hear, Mr. Deadman, how (or if) you choose to explain away the well researched work of Ben Kavoussi that he summarizes in these words: “Acupuncture with fine needles, Chinese or Japanese, cannot be ancient. The “Nine Needles” described in the Yellow Emperor’s Inner Classic, are a set of pins and lancets that necessary cause bleeding. What we know today as acupuncture is a 20th Century practice that is based on an ancient myth.”
I suggest you start with reading this:
http://www.sciencebasedmedicine.org/astrology-with-needles/
From there it should be easy for you to google your way towards more of the blood, gore and violence in the REAL story of the tradition of acupuncture.
After writing the above it struck me that one might be able to obtain an electronic copy of the above mentioned book by the good Dr. Christie. And lo and behold, there it was, for all and anyone to load down at leisure from the internet archive at the Library of Congress. Thank you modern science for the wonders of the internet!
Here is the link to the book.
http://archive.org/details/thirtyyearsinman00chri
You can, in the box on the left, choose between many different file formats. I prefer PDF’s but there’s a Kindle version and more
The citation I gave in my post above is on page 33.
Please be warned that further reading on that page is not for the faint hearted and sensitive. Dr. Christie elaborates further on his own observations of the art and practice of traditional (as opposed to modern) “acu-puncture”. He tells, among other accounts, about the case of a little girl killed at the hands of a what we today might call “a practitioner of TCM” who found it necessary to puncture the girls abdomen in several places with his traditional instruments.
Or, Mr. Deadman. You can perhaps tell us whether the practice of sticking needles under the nails of sick children is part of the two thousand year old tradition presented in the textbook you co-authored?
Peter Deadman, co-author of A Manual of Acupuncture, wrote, “It does not suggest that we think the point is necessarily effective in treating that symptom/disorder, simply that the tradition suggests that it was thought to do so.” His text is used in schools which train acupuncturists to become medical practitioners. This reveals a huge problem in the field: Many people are just reporting what “the tradition” and “previous texts” have stated, with little concern regarding actual clinical efficacy. When an author of a text such as this backs out of his printed indications for the therapy by saying what is clearly printed “does not suggest” that “we think the point is necessarily effective” it brings everything else in the text into question. Is it just written as a historical piece? What does Deadman really believe acupuncture is effective for?
Searching his book for the word “effective” there are many claims, such as: “The proposition that the jing-river points are effective for treating cough and dyspnoea derives from the status of the jing-river points of the yin channels as metal points (the Lung pertains to metal)…” (page 35). The Five Phases/Elements associations are clearly based on astrology and esoteric correspondences, and have, as far as I know, failed to show any effect over placebo needling. The idea that there are specific effects of these points on the Lungs is very testable, though no references to studies are given here.
Further down on the same page there are more indications for specific points for psychiatric conditions with mania as a component:
Yangxi LI-5: manic raving, propensity to laughter.
Jiexi St-41: Stomach heat with raving.
Jianshi P-5: loss of voice, halting speech, manic raving as if seeing ghosts.
With Deadman’s above clarification, the reader (including prospective patients and acupuncturists-in-training) are supposed to note that the author may not think these treatments are actually effective.
The practice of sticking needles under the fingernails of children still exists in the slightly modified treatment of bleeding the point Shao Shang, Lung-11, just 1 mm away from the bottom radial corner of the thumbnail. This is usually very painful, but is spoken of as a certain treatment for sore throats in the acupuncture world. I personally have experienced this and found it ineffective and painful. Here is how Deadman’s Manual encourages this tradition to continue, despite no supportive research (page 90):
“…Actions: Revives consciousness, Clears heat and benefits the throat
Indications:
Loss of consciousness from windstroke, loss of consciousness, cold inversion, hot inversion.
Sore throat, throat painful obstruction, childhood throat moth, mumps, lotus flower tongue, nosebleed, dry lips with desire to drink, febrile disease with cold shivering.
Agitation (of the Heart) with cough and dyspnoea, fullness of the Heart with sweating, fullness below the Heart, mania, childhood fright wind, malaria, vomiting.
…
As the terminal point of the Lung channel, Shaoshang Lu-11 has a particularly strong action on the opposite end of the channel and may be needled or pricked to bleed in all acute disorders of the throat and surrounding tissues due to excess heat and fire poison. As well as simple sore throat due to attack by exterior wind-heat, Shaoshang Lu-11 is indicated for mumps and ‘childhood throat moth’, a traditional disease category more or less corresponding to tonsilitis. To induce bleeding more easily from Shaoshang LU-11, the thumb and index fingers of one hand are used to grasp and encorge the patient’s thumb, whilst using the other hand to prick the point… Its ability to treat stasis and heat in the Heart is further reflected by its indications for mania and agitation of the Heart. For this reason it was included under its alternative name of Gui-xin (Ghost Faith) among Sun Si-miao’s ‘thirteen ghost points’ for the treatment of mania disorder and epilepsy.”
If that weren’t enough, a combination is given including this point for treating ‘dementia.’
It certainly appears that this text recommends bloodletting from near the fingernails of children for tonsilitis and mumps, and additionally recommends it for psychiatric conditions and epilepsy. For the author to say that the reader should not assume he intends to promote these practices in a modern clinic, and that one shouldn’t conclude that the text of his book suggests he actually believes in the efficacy of what he has written is disingenuous. The entire field of acupuncture is filled with misleading materials, and virtually all acupuncturists have been mislead to believe that these treatments are actually effective. Many acupuncturists, when they fail to get the clinical results claimed by their texts, doubt themselves, not the system, and jump from style to style, seminar to seminar, seeking the “masters” who can teach them the right points to select for virtually any disease, from schizophrenia to mumps to dementia.
Searching this text on Amazon for “effective” leads to so many implausible claims that it could fill its own large post. But for now, I’ll conclude with this statement from page 161:
“In conclusion, such is the range of actions and indications of this singular point, that it barely seems an exaggeration to state, as did Qin Cheng-zu nearly a thousand years ago, that by the use of Zusanli St-36 [a point on the outer leg, a few inches below the knee] “all diseases can be treated.”
Really impressive… – the effort to DISPROVE claims of quacks. But Prof. Ernst said it was his goal to help: how about using at least some of your time and effort to find “alternative” therapies that work / help?
An example: W. Zidek et al. in 1985 published results of a (low quality) study showing 15/15 patients with uncontrollable hypertension becoming treatable after a few phlebotomies (without explanation of mode of action):
http://www.ncbi.nlm.nih.gov/pubmed/4046500
Facchini & Saylor (2002) demonstrated that depletion of stored iron by serial phlebotomies (analogous to blood donations) practically cures the insulin resistance syndrome (including high blood pressure), often termed “metabolic syndrome” (X):
http://www.ncbi.nlm.nih.gov/pubmed/12079862
Hypertension is a strong risk for stroke, but also for dementia, including Alzheimer’s: Why are there no studies to confirm and expand the effects of depletion of stored iron already demonstrated? Because Prof. Ernst (and others) warn against plebotomies!?
He should explain WHY he does (now). Because in his earlier years he did studies quite similar to the one of Zidek et al., but of better quality, i.e.:
http://www.ncbi.nlm.nih.gov/pubmed/2885450
However, not plasma viscosity is the central parameter of importance, but iron, i.e.
http://www.ncbi.nlm.nih.gov/pubmed/22071209
“… The odds of existing CVD for subjects in the upper third of catalytic iron were 10 times that of subjects with lower catalytic iron in unadjusted analyses. … ” Impressive. Why has S.V. Shah (nephrology professor in Little Rock USA) to go to India to do such studies, i.e. on the effect of iron chelators on nephropathies? (Role of “ethics” committees?)
http://www.ncbi.nlm.nih.gov/pubmed/22978744
Prof. Ernst started at Exeter in 1993. A year earlier Randall B. Lauffer published (as editor) “Iron and Human Disease”: Why has Prof. Ernst opposed the progress in research on what was known in 1993 already on the detrimental effects of stored iron by his verdict: phlebotomies do “not work” and are dangerous? Cui bono?
Come on, Edzard, prove that your primary goal is health, not endless fight with quacks!
Come on, people, help improve public health. “Epidemic” increase of (type 2) diabetes has alarmed the WHO, i.e. “St.Vincent Declaration” of 1989, almost a quarter of a century ago.
Prof. Sudhir V. Shah (Little Rock, USA) has been stressing the central role of iron in the aetiology of T2DM and complications, notably nephropathy, i.e.:
http://care.diabetesjournals.org/content/30/7/1926.long
“… The role of iron in the pathogenesis of diabetes is suggested by 1) an increased incidence of type 2 diabetes in diverse causes of iron overload and 2) reversal or improvement in diabetes (glycemic control) with a reduction in iron load achieved using either phlebotomy or iron chelation therapy. Recently, a link has been established between increased dietary iron intake, particularly eating red meat and increased body iron stores, and the development of diabetes. A causative link with iron overload is suggested by of the improvement in insulin sensitivity and insulin secretion with frequent blood donation and decreased iron stores (3,4). … ”
(“Overload” starts at values above those of healthy children, with young women being borderline. Serum ferritin below ca. 25 ng/ml is optimal – with 50 ng/ml insulin resistance is common, blood pressure rises…)
All that has been known for many years (i.e. Facchini & Saylor 2002, 2003), but is ignored.
What is urgently needed are clinical studies confirming what already is known. (Example: in the FeAST phlebotomy study of Leo Zacharski et al. it turned out that removal of iron from the body reduces cancer risk – no surprise to those knowledgeable in the field. But that was not the “intention to treat”, therefore more studies should be done…)
“Blood letting” has to be lifted from “alternative therapy” to first line preventive therapy for all sorts of diseases of affluece, which depend on age (iron accumulation normally is a slow process) and typically develop earlier in men.
Depletion of iron by serieal phlebotomies could have become “mainstream” therapy for insulin resistance and T2DM more than 10 years ago without opposition to this simple and cheap appproach from a large network of people warning against it.
Everyone can be mistaken – but we have the possibility to correct our mistakes. The least that can be expected from scientists is willingness to discuss controversial topics, and this blog is a good example – my congratulations.
But why is there no discussion about the pros and cons of phlebotomies?
this blog is about alternative medicine; I do not consider blood letting, hemodilution or related treatments to fall under this umbrella. I will therefore not post any further comments on this subject.