Monthly Archives: October 2015
I am probably more used to nonsensical statements by promoters of alternative medicine than the average person. But the ‘ALTERNATIVE MEDICINE ZONE’ just broke my BS-meter. Here are a few samples from their most remarkable website, all relating to homeopathy:
There has always been a debate whether allopathic treatment methods of the modern age are more beneficial or are the natural homeopathic treatment ways more reliable. The goal of healing the sick is the same in both these groups of treatment, but there is a strong contrast in the methods use, the ideology behind the treatment and the detailed theories. The following is a detailed comparison between homeopathy and Allopathy for those who wish to pick between the two:
Beliefs
Allopathic practitioners aim to target that part of the body that has been affected by a problem or disease and they do so by identifying the causing agent. On the other hand, in Homeopathy, doctors believe that emotional stress or psychological reasons make the body more susceptible to diseases and use more of a holistic approach of treatment.
Medicines
Allopathic doctors make use of those medications which are produced by pharma companies or are man-made. On the other hand, Homeopathy uses natural supplements and cures such as herbs, dietary changes and other such ways to cure a disease. Allopathic doctors use an aggressive approach whereas homeopathic doctors consider one dose enough to treat a disease.
Surgeries
While on one hand, allopathic doctors consider surgeries to be very important for removal of tumors etc. or correcting problems inside the body, Homeopathic doctors almost never use surgery as a treatment method. Only when certain tissue in the body has become seriously damaged they practice this technique.
Allopathic surgeons heavily rely on surgical procedures in case of serious diseases which cannot be cured by medicines or any other approach. Homeopathic doctors try to treat each and every condition with a natural method or by recommending strong dietary changes.
Origins
Homeopathy is basically based on beliefs of German Physician Samuel Hahnemann whereas Allopathic system of treatment or cure of diseases is based on the principles of the ancient Greeks, for example Hippocrates. Allopathic is considered to be regular medicine in many countries such as US but Homeopathy is argued to be a natural and holistic way of cure.
Controversy
Both these schools of medicine consider the other to be non-beneficial. Homeopathy thinks that allopathic medicines tend to make people even sicker in the long run whereas Allopathy doctors believe that Homeopathy only uses Placebo as its mechanism to cure people. Supporters of both schools are often seen defending their preferred method of treatment.
The ‘ALTERNATIVE MEDICINE ZONE’ also does not shy away from giving concrete medical advice on their website. Two examples will have to suffice:
HOMEOPATHY FOR SHINGLES
Compare to anti-viral medicines, homeopathy has proved more effective for shingles and chicken pox. It offers rapid and successful approach in treating this infection. People with weak immune system are more prone to get shingles. Homeopathy medicines influence the immune system efficiently from within and improve body’s healing capacity. The homeopathy medicines are also capable of defusing pain, discomfort in body due to shingle. It also refrain shingles from spreading.
HOMEOPATHY FOR PILES
The homeopathic treatment is considered much better than surgery because it corrects the problem from the root which is not the case in surgery. Homeopathy is considered very useful in the early cases of piles and can help in complete healing. However as the problem becomes complex, it can only help in the healing of the symptoms.
Both articles finish by giving a list of homeopathic remedies that are recommended for the two conditions.
So there we have it!
My BS-meter has just broken.
Who can I sue?
On this blog, we have already discussed the good news that the US Federal Trade Commission (FTC) is considering whether advertisements for homeopathic products have any evidence to back the numerous claims that are being made for them. A meeting took place on 21 September, and now the first details are emerging.
Michelle Rusk, senior staff attorney in the FTC advertising practices division, said in this public hearing on over-the-counter homeopathic products that advertisements lauding the health benefits of medical products need to be based on competent, reliable, and rigorous scientific support.
“As a general rule, for treatment claims, we expect randomized, double-blind, placebo-controlled human clinical studies—not in vitro studies, not animal studies, not anecdotal evidence, no matter how compelling it is,” she said. “Second, we expect the studies to be internally valid. That means well-designed, reliably conducted, using procedures accepted in the field of research. It also means that results are not just statistically significant but also strong enough to be clinically meaningful. Third, the evidence has to match the product and the specific claim.”
In the context of any form of health care, such statements would amount to mere platitudes: the fact that we cannot possibly tolerate double standards in medicine is almost too obvious to mention. In the realm of homeopathy, however, these words amount to a revolution!
Could it be that the days of bogus claims for homeopathic products are counted?
Could it be that consumers might soon be protected from unscrupulous entrepreneurs exploiting the vulnerable?
Could it be that, one day, we will have one standard only?
Bach flower remedies (BFR) are amazingly popular. They have been the subject of posts on this blog before (see here and here, for instance). They are as dilute as most homeopathic remedies and just as implausible. All the rigorous trials that have tested BFR have so far been squarely negative. Here is a truly surprising new study where BFR was administered externally which would seem to make an effect not more but less likely.
A randomized, placebo-controlled clinical trial was conducted with the aim of evaluating the effectiveness of a cream based on BFR for symptoms of carpal tunnel syndrome. Forty-three patients with mild to moderate carpal tunnel syndrome during their “waiting” time for surgical option were randomized into 3 parallel groups: Placebo (n = 14), blinded BFR (n = 16), and non-blinded BFR (n = 13). These groups were treated during 21 days with topical placebo or a cream based on BFR.
Significant improvements were observed on self-reported symptom severity and pain intensity favorable to BFR groups with large effect sizes. In addition, all signs observed during the clinical exam showed significant improvements among the groups as well as symptoms of pain, night pain, and tingling, also with large effect sizes (φ > 0.5). Finally, there were significant differences between the blinded and non-blinded BFR groups for signs and pain registered in clinical exam but not in self-reports.
The Cuban authors of this study concluded that the proposed BFR cream could be an effective intervention in the management of mild and moderate carpal tunnel syndrome, reducing the severity symptoms and providing pain relief.
This is truly amazing, not least because there is not much that we can offer such patients except for surgery which usually is very successful. The current Cochrane review of non-surgical interventions for carpal tunnel syndrome shows significant short-term benefit from oral steroids, splinting, ultrasound, yoga and carpal bone mobilisation. Other non-surgical treatments do not produce significant benefit. More trials are needed to compare treatments and ascertain the duration of benefit.
What then should we make of the new study?
I have to admit, I am not sure. It was published in one of the worst journals I know which has attracted our attention on this blog before. It was published by authors from Cuba who I know nothing about. More importantly, its findings sound far too good to be true.
If I had been the editor in charge, I would have asked for the original data and had them re-analysed by an independent statistician. As we cannot do that, our only option is to apply common sense and wait for an independent replication before conceding that BFR are effective.
Having been in contact with homeopaths most of my life, I had almost come to the conclusion that they tend to be more than a little short of a sense of humour. Well, I was wrong! I first realised my error when I came across this website. Under the heading ‘WHY USE HOMEOPATHICS?’, it lists 6 reasons which are undeniably full of humour, satire and irony. Here they are:
- Homeopathy is extremely effective. When the correct remedy is taken, results can be rapid, complete and permanent.
- Homeopathy is completely safe. Even babies and pregnant women can use Homeopathy without the danger of side effects. Homeopathic remedies can also be taken alongside other medication without producing unwanted side effects.
- Homeopathy is natural. Homeopathic remedies are normally based on natural ingredients.
- Homeopathy works in harmony with your immune system, unlike some conventional medicines which suppress the immune system. (For example, cough medicines suppress the cough reflex, which is your body’s attempt to clear the lungs)
- Homeopathic remedies are not addictive – once relief is felt, you should stop taking them. If no relief is felt, you are probably taking the wrong homeopathic remedy.
- Homeopathy is holistic. It treats all the symptoms as one, which in practical terms means that it addresses the cause, not the symptoms. This often means that symptoms tackled with Homeopathy do not recur.
This is hilarious, but perhaps not as funny as this website of the ‘British Homeopathic Dental Association’ (yes, you read correctly: there are dentists who use homeopathy!) providing ‘six good reasons why you should visit a homeopathic dentist’:
- Because they treat patients holistically
- Homeopathic remedies are effective and have no unpleasant side effects
- There are remedies which stop swelling and pain after injections and extractions
- There are remedies which reduce the pain and swelling of dental abscesses
- There are remedies which alleviate toothache
- There are remedies which which cure ulcers and cold sores and many more
You might think that these are isolated cases of humour. If so, I recommend you go on the internet and find what else homeopathy offer for our amusement. There is more laughter hidden in the homeopathic websites that you can possibly imagine. Here is another example: on his homepage, a homeopath clearly states that the following list of conditions are curable/treatable with homeopathy:
- Abscess (Boils)
- Acne
- Acromegaly
- Acne Rosacea
- Adenoids
- ADHD
- AIDS and HIV
- Allergy
- Alopecia Areata
- Alzheimer’s disease
- Ankylosing Spondylitis
- Anxiety disorders, Anxiety Neurosis
- Aplastic Anemia
- Appendicitis (Acute, Chronic)
- Asthma in adults
- Asthma in children
- Ataxia
- Atherosclerosis
- Atopic Dermatitis
- Attention Deficit Hyperactivity Disorder
- Autism
- Backache (pain)
- Bells Palsy
- Bipolar Mood Disorder
- Boils (Recurrent)
- Bowen’s disease
- Bronchitis
- Breast Cancer
- Calcaneal Spur
- Callosities (corns)
- Cancer
- Candidiasis (Thrush)
- Carbuncle
- Cardiac (Heart) diseases
- Carpal Tunnel Syndrome
- Cellulitis
- Cervical Spondylitis
- Chalazion
- Cheilitis
- Chronic Fatigue Syndrome
- Chyluria
- Coeliac Disease
- Conjunctivitis
- COPD
- Chronic Constipation
- Corns (Callosities)
- Crohn’s Disease
- Cystitis
- Dandruff
- Dengue
- Depression
- Dermatomyositis
- Diabetes Type I
- Diabetes Type II
- Dry Eye
- Dyslexia
- Dysmenorrhea (Painful menses)
- Eczema
- Elephantiasis
- Endometriosis
- Enteric fever (Typhoid)
- Epidermolysis Bullosa
- Epilepsy
- Epiphora
- Erectile Dysfunction
- Fatty Liver
- Fibroadenoma (Breast tumor)
- Fibromyalgia
- Fissure-in-ano
- Frequent Colds
- Fungal Infection
- G6PD Deficiency
- Gall bladder Stones
- Ganglion
- Gastritis
- GERD (Gastro-esophageal reflux disease)
- Glaucoma
- Gout
- Granulomatous Rosacea
- Granuloma Annulare
- Guillain Barre Syndrome
- Gynecomastia
- Hailey Hailey Disease
- Hair loss
- Hallervorden Spatz Disease
- Heart Diseases
- Hematuria
- Hemiplegia (limb paralysis)
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Herpes
- Herpes Zoster
- HIV and AIDS
- Hives
- Hot Flashes
- H-Pylori
- Hydradenitis Suppurativa
- Hypertension
- Hyperthyroidism
- Hypothyroidism (Under active thyroid
- Ichthyosis
- Idiopathic Thrombocytopenic Purpura (ITP)
- Ingrowing Toenails
- Interstitial Cystitis (Painful bladder syndrome)
- Irritable Bowel Syndrome
- Keloid
- Kidney Stones
- Lichen Nitidus
- Lichen Planus
- Lichen Planus Pigmentosa
- Lichen Planopilaris
- Lichen Sclerosus
- Lipoma
- Liver Cirrhosis
- Loss of Libido (Low sex drive)
- Lumbar Spondylitis
- Mastoiditis
- Meniere’s disease
- Migraine
- Molluscum contagiosum
- Motor Neuron Disease
- Mouth Ulcers (Apthous Ulcers)
- Multiple Myeloma
- Multiple Sclerosis
- Multiple System Atrophy
- Muscular Dystrophy
- Myasthenia Gravis
- Myopia
- Nasal Polyps
- Nekam’s Disease
- Nephrotic Syndrome
- Neurofibromatosis
- Non-healing ulcers
- Nutritional Anemia
- Obesity
- Obsessive Compulsive Neurosis (OCN – OCD)
- Onychomycosis
- Optic Neuritis
- Osteoarthritis (OA)
- Parkinson’s Disease (PD)
- PCOD (Polycystic Ovarian Disease)
- Pemphigus Vulgaris
- Peptic ulcer
- Pernicious anemia
- Photodermatitis (Photosensitivity)
- Piebaldism
- Piles
- Pityriasis Alba
- Pityriasis Corporis
- Pityriasis Rosea
- Pityriasis Versicolor
- Plantar Fasciitis
- Post Herpetic Neuralgia
- Polymyositis
- Premenstrual Syndrome
- Prostate Cancer
- Prostate Enlargement
- Prostatitis
- Prurigo Nodularis
- Psoriasis
- Psoriasitic Arthritis
- Pulmonary Renal Syndrome
- Pulmonary Tuberculosis
- Raynauds Disease
- Reactive perforating collagenosis
- Restless Leg Syndrome
- Retinal Detachment
- Rheumatoid Arthritis (RA)
- Rubella
- Salivary gland stones
- SARS
- Schizophrenia
- Sciatica
- Scleroderma
- Seborrhoeic Dermatitis
- Sexual disorders
- Sinusitis
- Sleep Apnea Syndrome (SAS)
- sleeplessness
- Steven Johnson Syndrome
- Swine Flu
- Thalassemia
- Thrush (Candidiasis)
- Tinea alba
- Tinea Corporis
- Tennis Elbow
- Tinea Rosea
- Tinea Versicolor
- Tinnitus
- Trachoma
- Tonsillitis
- Trigeminal Neuralgia
- Tumor (Bone)
- Turner Syndrome
- Typhoid (Enteric fever)
- Ulcerative Colitis
- Under-active Thyroid
- Urinary Tract Infections
- Urticaria
- Urticaria Pigmentosa
- Uterine fibroid
- Uveitis
- Varicose veins
- Vertigo
- Verruca Plana
- Vitiligo
- Vocal Nodules
- Warts
- Writer’s Cramp
You have to admit, this is funny! No?
Perhaps this website will make you giggle:
The online procedure for homeopathic treatment is straightforward, and only requires four simple steps. Please note that your second Follow Up Consultation is absolutely free.
- First, please send me some basic information about yourself, so that I can analyse your case. In my reply I will inform you if Homeopathic treatment can be successful personally for you. This step is absolutely FREE.
- After receiving my reply, you may decide whether you wish to continue with treatment. You can then make a payment and you will be sent a First Consultation Form, to complete via email, which you should fill in carefully and send back. This will be a detailed questionnaire.
- Please allow two days for me to read your form, from which I will be able to work out your case. I will then send you a reply, with written report regarding your general state of health, pointing possible weaknesses and a Homeopathic prescription for Homeopathic remedies with full explanation of how to use them and the reason why they are prescribed.
- After your initial period of using homeopathic medication is over / usually 4-5 weeks/, you will then be asked to fill in a Follow Up Consultation Form, which will be sent to you. This is to see how you have got on with the treatment.
From here, the fourth step is repeated until you are treated. As stated above, your second Follow Up Consultation is absolutely free. This is to encourage you to stay on your course of treatment, as often (not always), you will need some patience to see lasting results. Your health is my first priority.
You will also have phone and email support from me at any time while you are using this service.
I am only ever a phone-call away if you have any queries and I do not charge for this service.
There you are, I am certain that nobody can deny it: THIS IS COMIC GOLD!!!
Good humour carries a strong element of satire aimed at “the absurdity of everyday life”. And surely these homeopaths are spot on.
If you ever receive an email from ‘[email protected]’, please be aware that it is not from me. It comes from some clown who seems to want to pretend to be me.
How do I know? I received a short email from that very person. Here is its full text in all its beauty:
“You are the most bullshit person i know who claim to be a good doctor by putting other professions down. you are a killer because of your false information.”
What does that tell us about the identity of the author?
- He does not seem to be an admirer of my work.
- He feels strongly about something.
- He does not mince his words.
- He does not write very good English.
- He is not very well-informed [I do not think that I ever claimed to be a ‘good doctor’].
- He is factually wrong [I have not ever killed anyone for any reason].
What he presumably wants to express is that, in his view, the information I publish on this blog and perhaps elsewhere has the potential to kill patients. This is a somewhat disturbing assumption because the opposite is truly my intention.
It is a great pity that the author of these lines did not manage to be a little more specific.
- Does he [somehow, I presume the author is male] think that, by warning readers of all sorts of quackery and outright health fraud, I might kill someone?
- Does he believe that my repeated warnings about the lack of good evidence for alternative medicine drive patients into the arms of even more dangerous clinicians?
- Or is he just an unfortunate sufferer of a serious mental condition such as paranoia?
As I am totally in the dark here and cannot even begin to answer these questions, I will leave it to you, the readers of this post, to decide.
Or perhaps the author of this charming email wants to enlighten us?
Alternative medicine (AM) use has become popular among patients with cancer. I find this very easy to understand: faced with such a grave diagnosis, who would not be tempted to try everything that is being promoted as being helpful. And, by Jove, promoted it is! But does it do any good?
The evidence clearly shows that no form of AM is capable of changing the natural history of any form of cancer. This means the millions of websites that imply otherwise are criminally wrong and frightfully dangerous.
But some AMs might still be useful, namely for improving symptoms, well-being and quality of life (QOL) as supportive or palliative therapies. Unfortunately the evidence for this assumption is less sound than AM fans try to make us believe. Before this background, better research is needed and more trials would be welcome. A brand-new paper might tell us more.
The purposes of this study were to compare the QOL in CAM users and non-CAM users and to determine whether AM use influences QOL among breast cancer patients during chemotherapy.
A cross-sectional survey was conducted at two outpatient chemotherapy centers. A total of 546 patients completed the questionnaires on AM use. QOL was evaluated based on the European Organization for Research and Treatment of Cancer (EORTC) core quality of life (QLQ-C30) and breast cancer-specific quality of life (QLQ-BR23) questionnaires.
A total of 70.7% of patients were identified as AM users. There was no significant difference in global health status scores and in all 5 subscales of the QLQ C30 functional scales between AM users and non-AM users. On the QLQ-C30 symptom scales, AM users (44.96±3.89) had significantly (p = 0.01) higher mean scores for financial difficulties than non-AM users (36.29±4.81). On the QLQ-BR23 functional scales, AM users reported significantly higher mean scores for sexual enjoyment (6.01±12.84 vs. 4.64±12.76, p = 0.04) than non-AM users. On the QLQ-BR23 symptom scales, AM users reported higher systemic therapy side effects (41.34±2.01 vs. 37.22±2.48, p = 0.04) and breast symptoms (15.76±2.13 vs. 11.08±2.62, p = 0.02) than non-AM users. Multivariate logistic regression analysis indicated that the use of CAM modality was not significantly associated with higher global health status scores (p = 0.71).
The authors drew the following conclusions: While the findings indicated that there was no significant difference between users and non-users of AM in terms of QOL, AM may be used by health professionals as a surrogate to monitor patients with higher systemic therapy side effects and breast symptoms. Furthermore, given that AM users reported higher financial burdens (which may have contributed to increased distress), patients should be encouraged to discuss the potential benefits and/or disadvantages of using AM with their healthcare providers.
One needs to caution, of course, that this was not an RCT, and therefore cause and effect cannot be taken for granted. Nevertheless, I believe, that these findings should make us think critically about the wide-spread notion that the supportive and palliative use of AM leads to an improvement of QOL in cancer patients.
The ‘INTERNATIONAL CHIROPRACTIC PEDIATRIC ASSOCIATION’ (ICPA) is, according to their website, ‘a nonprofit organization whose mission is to advance chiropractic by establishing evidence informed practice, supporting excellence in professional skills and delivering educational resources to the public. It fulfills this mission by engaging and serving family chiropractors worldwide through research, training and public education.’
It fulfils its mission by, amongst other things, tweeting links to other pro-chiropractic activities. It is via such a tweet that I recently found the Pathways to Family Wellness (PFW). This is a quarterly print and digital magazine whose mission is to support you and your family’s quest for wellness.
This sounds exciting, I thought, and decided to have a closer look. I found that, according to its website, the magazine ‘collaborates with consciousness leaders, cutting-edge scientists and researchers, families on their conscious path, holistic practitioners and dynamic non-profit organizations to bring the most current insights into wellness to our readers.’
The Executive Editor and Publisher of PFW is Dr. Jeanne Ohm. She has ‘practiced family wellness care since 1981 with her husband, Dr. Tom. They have six children who were all born at home and are living the chiropractic family wellness lifestyle. Ohm is an instructor, author, and innovator. Her passion is: training DC’s with specific techniques for care in pregnancy, birth & infancy, forming national alliances for chiropractors with like-minded perinatal practitioners, empowering mothers to make informed choices, and offering pertinent patient educational materials.’
My suspicion that this is an outlet of chiropractic nonsense is confirmed as I read an article by Bobby Doscher, D.C., N.D. on the subject of chiropractic treatment for children with neurological problems. The article itself is merely promotional and therefore largely irrelevant. But one short passage is interesting nevertheless, I thought:
Chiropractic Based on Scientific Fact
Since its beginning, chiropractic has been based on the scientific fact that the nervous system controls the function of every cell, tissue, organ and system of your body. While the brain is protected by the skull, the spinal cord is more vulnerable, covered by 24 moving vertebrae. When these bones lose their normal motion or position, they can irritate the nervous system. This disrupts the function of the tissues or organs these nerves control; this is called vertebral subluxation complex.
I thought this was as revealing as it was hilarious. Since such nonsensical notions are ubiquitous in the chiropractic literature, I am tempted to conclude that most chiropractors believe this sort of thing themselves. This makes them perhaps more honest but also more of a threat: sincere conviction renders a quack not less but more dangerous.
Don’t get me wrong, I have nothing against systematic reviews. Quite to the contrary, I am sure they are an important source of information for patients, doctors, scientists, policy makers and others – after all, I have published more than 300 of such papers!
Having said that, I do dislike a certain type of systematic review, namely systematic reviews by Chinese authors evaluating TCM therapies and arriving at misleading conclusions. Such papers are currently swamping the marked.
At first glance, they look fine. On closer scrutiny, however, most turn out to be stereotypically useless, boring and promotional. The type of article I mean starts by stating its objective which usually is to evaluate the evidence for a traditional Chinese therapy as a treatment of a condition which few people in their right mind would treat with any form of TCM. It continues with details about the methodologies employed and then, in the results section, informs the reader that x studies were included in the review which mostly reported encouraging results but were wide open to bias. And then comes the crucial bit: THE CONCLUSIONS.
They are as predictable as they are misleading. let me give you two examples only published in the last few days.
The first review drew the following conclusions: This systematic review suggests that Chinese Herbal Medicine as an adjunctive therapy can improve cognitive impairment and enhance immediate response and quality of life in Senile Vascular Dementia patients. However, because of limitations of methodological quality in the included studies, further research of rigorous design is needed.
The second review concluded that the evidence that external application of traditional Chinese medicine is an effective treatment for venous ulcers is encouraging, but not conclusive due to the low methodological quality of the RCTs. Therefore, more high-quality RCTs with larger sample sizes are required.
Why does that sort of thing frustrate me so much? Because it is utterly meaningless and potentially harmful:
- I don’t know what treatments the authors are talking about.
- Even if I managed to dig deeper, I cannot get the information because practically all the primary studies are published in obscure journals in Chinese language.
- Even if I did read Chinese, I do not feel motivated to assess the primary studies because we know they are all of very poor quality – too flimsy to bother.
- Even if they were formally of good quality, I would have my doubts about their reliability; remember: 100% of these trials report positive findings!
- Most crucially, I am frustrated because conclusions of this nature are deeply misleading and potentially harmful. They give the impression that there might be ‘something in it’, and that it (whatever ‘it’ might be) could be well worth trying. This may give false hope to patients and can send the rest of us on a wild goose chase.
So, to ease the task of future authors of such papers, I decided give them a text for a proper EVIDENCE-BASED conclusion which they can adapt to fit every review. This will save them time and, more importantly perhaps, it will save everyone who might be tempted to read such futile articles the effort to study them in detail. Here is my suggestion for a conclusion soundly based on the evidence, not matter what TCM subject the review is about:
OUR SYSTEMATIC REVIEW HAS SHOWN THAT THERAPY ‘X’ AS A TREATMENT OF CONDITION ‘Y’ IS CURRENTLY NOT SUPPORTED BY SOUND EVIDENCE.
The search for an effective treatment of obesity is understandably intense. Many scientists are looking in the plant kingdom for a solution, but so far none has been forthcoming – as we have already discussed on this blog before (e. g. here, and here). One herbal slimming aid is currently becoming popular: Yerba Mate also called Ilex paraguariensis, a plant many of us know from teas and other beverages. Our review concluded that the evidence for it was unconvincing but that it merited further study. This was 10 years ago, and meanwhile the evidence has moved on.
The aim of a recent study was to investigate the efficacy of Yerba Mate supplementation in subjects with obesity. For this purpose, a randomized, double-blind, placebo-controlled trial was conducted. Korean subjects with obesity (body mass index (BMI) ≥ 25 but < 35 kg/m(2) and waist-hip ratio (WHR) ≥ 0.90 for men and ≥ 0.85 for women) were given oral supplements of Yerba Mate capsules (n = 15) or placebos (n = 15) for 12 weeks. They took three capsules per each meal, total three times in a day (3 g/day). Outcome measures were efficacy (abdominal fat distribution, anthropometric parameters and blood lipid profiles) and safety (adverse events, laboratory test results and vital signs).
During 12 weeks of Yerba Mate supplementation, statistically significant decreases in body fat mass and percent body fat compared to the placebo group were noted significant. The WHR was significantly also decreased in the Yerba Mate group compared to the placebo group. No clinically significant changes in any safety parameters were observed.
The authors concluded that Yerba Mate supplementation decreased body fat mass, percent body fat and WHR. Yerba Mate was a potent anti-obesity reagent that did not produce significant adverse effects. These results suggested that Yerba Mate supplementation may be effective for treating obese individuals.
These are encouraging results, but the conclusions go way too far, for my taste. The study was tiny and does therefore not lend itself to far-reaching generalisations. What would be helpful, is a review of other evidence. As it happens, such a paper has just become available. Its authors evaluated the impact of yerba maté on obesity and obesity-related inflammation and demonstrate that yerba maté suppresses adipocyte differentiation as well as triglyceride accumulation and reduces inflammation. Animal studies show that yerba maté modulates signaling pathways that regulate adipogenesis, antioxidant, anti-inflammatory and insulin signaling responses.
The review authors concluded that the use of yerba maté might be useful against obesity, improving the lipid parameters in humans and animal models. In addition, yerba maté modulates the expression of genes that are changed in the obese state and restores them to more normal levels of expression. In doing so, it addresses several of the abnormal and disease-causing factors associated with obesity. Protective and ameliorative effects on insulin resistance were also observed… it seems that yerba maté beverages and supplements might be helpful in the battle against obesity.
I am still not fully convinced that this dietary supplement is the solution to the current obesity epidemic. But the evidence is encouraging – more so than for most of the many other ‘natural’ slimming aids that are presently being promoted for this condition by gurus like Dr Oz.
What we needed now is not the ill-informed, self-interested voice of charlatans; what we need is well-designed research to define efficacy, effect size and risks.
On the website of the Bristol University Hospital, it was just revealed that UK homeopathy seems to have suffered another blow:
“Homeopathic medicine has been available in Bristol since 1852, when Dr Black first started dispensing from premises in the Triangle. During the next 69 years the service developed and expanded culminating in the commissioning in 1921 of a new hospital in the grounds of Cotham House. The Bristol Homeopathic Hospital continued to provide a full range of services until 1986 when the in-patient facilities were transferred to the Bristol Eye Hospital, where they continue to be provided, and outpatient services were moved to the ground floor of the Cotham Hill site. In 1994, following the sale of the main building to the University by the Bristol and District Health Authority, a new purpose built Department was provided in the Annexe buildings of the main building, adjoining the original Cotham House. The NHS Homeopathic Service is now being delivered on behalf of University Hospital Bristol by the Portland Centre for Integrative Medicine (PCIM), a Community Interest Company.”
The Portland Centre for Integrative Medicine has joined Litfield House offering medical homeopathy with Dr Elizabeth Thompson. And this is how the new service is described [I have added references in the following unabridged quote in bold which refer to my comments below]:
Medical Homeopathy is a holistic [1] approach delivered by registered health care professionals that uses a low dose of an activated [2] natural [3] substance [4] to stimulate a self-healing response in the body [5]. At the first appointment the doctor will take time to understand problem symptoms that might be physical, emotional or psychological and then a treatment plan will be discussed between the patient and the doctor [6], with homeopathic medicines chosen for you or your child on an individual basis.
WHAT CONDITIONS ARE SUITABLE FOR MEDICAL HOMEOPATHY?
Homeopathy can be safely [7] used to improve symptoms and well-being across a wide range of long term conditions: from childhood eczema [8] and ADHD [9]; to adults with medically unexplained conditions [10]; inflammatory bowel disease [11], cancer [12] or chronic fatigue syndrome [13]; and other medical conditions, including obesity [14] and depression [15]. Some people use homeopathy to stay well [16] and others use it to help difficult symptoms and/ or the side effects of conventional treatments [17].
This looks like a fairly bland and innocent little advertisement at first glance. If we analyse it closer, however, we find plenty of misleading claims. Here are the ones that caught my eye:
- Homeopaths claim that their approach is holistic and thus aim at differentiating it from conventional health care. This is misleading because ALL good medicine is by definition holistic.
- Nothing is ‘activated’; homeopaths believe that succession releases the ‘vital force’ in a remedy – but this is little more than hocus-pocus from the dark ages of medicine.
- Nothing is natural about endlessly diluting and shaking a medicine, while pretending that this ritual renders it more active and effective. And nothing is natural about remedies such as ‘Berlin Wall’.
- It is misleading to speak about ‘substance’ in relation to homeopathic remedies, because they can be manufactured also from non-material stuff too; examples are remedies such as X-ray, sol [sun light] or lunar [moonlight].
- The claim that homeopathic remedies stimulate the self-healing properties of the body is pure phantasy.
- “The doctor will take time to understand problem symptoms that might be physical, emotional or psychological and then a treatment plan will be discussed between the patient and the doctor” – this also applies to any consultation with any health care practitioner.
- Homeopathy is not as safe as homeopaths try to make us believe; several posts on this blog have dealt with this issue.
- There is no good evidence to support this claim.
- There is no good evidence to support this claim.
- There is no good evidence to support this claim.
- There is no good evidence to support this claim.
- There is no good evidence to support this claim.
- There is no good evidence to support this claim.
- There is no good evidence to support this claim.
- There is no good evidence to support this claim.
- True, some people use anything for anything; but there is no sound evidence to show that homeopathy is an effective prophylactic intervention for any disease.
- Nor is there good evidence that it is effective to “help difficult symptoms and/ or the side effects of conventional treatments”.
So, what we have here is a short paragraph which, on closer inspection, turns out to be full of misleading statements, bogus claims and dangerous lies. Not a good start for a new episode in the life of the now dramatically down-sized homeopathic clinic in Bristol, I’d say. And neither is it a publication of which the Bristol University Hospital can be proud. I suggest they correct it as a matter of urgency; otherwise they risk a barrage of complaints to the appropriate regulators by people who treasure the truth a little more than they seem to do themselves.
