Monthly Archives: January 2020
Today is a momentous and desperately sad day. Allow me therefore to deviate from my usual subject and write a very personal post (I promise, it won’t happen often).
This post is not about SCAM but about something that is even closer to my heart.
I first moved to the UK in 1979. The reason was simple, I had fallen in love with Danielle, the woman who now is my wife. I only stayed for about 3 years. However, as luck would have it, this short time would become the most formative period of my life, both privately and professionally. After a brief and unhappy stint as a doctor in a psychiatric hospital, I got a job under John Dormandy who opened my eyes to the wonderous world of science.
I nonetheless went back to Germany because I felt I had to complete my clinical training. In 1987, became a professor first in Hannover and then in Vienna. Even though the Vienna post was grand (to say the least), I soon became unhappy with it (no need to go into details here; if you need to know, read this or this). I thus started looking for other opportunities, ideally in the UK.
Why the UK?
It wasn’t because of the weather.
It also was not because of the food.
Nor was it because of the huge salary (the move roughly halved my previous income).
It was because of the beautiful memories. And it was because of my deep appreciation of the people. I had grown to admire their humour, their tolerance, their openness, their way of life, their way of dealing with problems, their politeness, their understatement, their honesty, their fair play.
Much has been written about my time at Exeter. Not everything was smelling of roses. But, on the whole and despite all the problems encountered, I had a really good time – mainly because my initial judgement of the people was being confirmed over and over again. I began to feel British and, in 2000, I became British. All my life, I had felt the burden of the recent German past weighing heavily on my shoulders. I had never managed to be proud of being a German. Now I was proud to be British, and I had a passport to prove it!
When Cameron announced the ‘in/out referendum’, I was baffled by the sheer stupidity of the move. How could anyone want to get out of the EU? It never made sense to me. The EU had given us peace for decades and was a guarantor that we Europeans would never again start killing each other. Why was that not pointed out in the run-up to the referendum? Most families had lost sons in the last two European wars. Why did hardly anyone use such arguments? Why was the remain campaign fought so half-heartedly? The other side was campaigning with (mostly vile and primitive) emotions; why did we not use positive and ethical ones?
I remember being in tears when I heard the results of the vote.
I remember fighting tears when acquaintances asked my wife (she is French and has, like I, a British passport) and me: ‘are you now going to go home?‘
Since the referendum, I have observed in utter horror and bewilderment how the county that I now call my home has changed.
What happened to the tolerance that I so admired?
What happened to the openness of the people?
What about honesty and fair play?
What happened even to humour?
During our 8 years in Germany, my wife and I had to witness our fair share of xenophobia. I despised my fellow Germans for it. Now I see it in Britain, and I feel nauseous.
What is happening to the county I love?
I have recently reported that some homeopaths recommend homeopathics against the corona virus. Since I wrote last about this subject, numerous further sites have sprung up where homeopaths try to make a fast buck on the increasing panic of large sections of the population. Here is an apt example:
We all know that in homeopathy we treat patients according to the symptoms. According to these symptoms, the homeopathic medicine influenzam 30 drug can prove to be very effective. If you want to protect yourself from the corona virus, then you can take this medicine two to three drops three to four times a day. You can also get this medicine online at home.
And if you read French, you might want to read this hair-raising nonsense under the title ‘Quelques conseils pour s’armer contre le coronavirus et autres virus de l’hiver‘:
L’un des piliers de la défense antivirale est la thymuline. Elle permet aux cellules thymiques de communiquer entre elles, et en particulier aux cellules mères d’initier les cellules jeunes et immatures. Elle est toujours conseillée en homéopathie, en 9 CH, seule dilution homologuée par les travaux du professeur Madeleine Bastide. Vous pouvez donc, quels que soient votre âge ou votre poids, prendre quatre granules de thymuline 9 CH le matin (idem pour un nourrisson de quelques semaines) pour renforcer vos défenses immunitaires.
As though this is not bad enough, now the Indian government has followed suit. The Indian ‘AYUSH’ ministry has issued recommendations that homeopathic and Unani medicines could be effective in the prevention of novel coronavirus (nCoV) infections. The advisory was issued following a meeting of the scientific advisory board of the Central Council for Research in Homoeopathy (CCRH) under the Ministry of AYUSH to discuss ways and means for prevention of the nCoV infection through homoeopathy, the ministry said in a statement. The original press-release from the ministry beggars belief; it can be viewed here.
The ministry recommended that homoeopathic medicine Arsenicum album 30 could be taken on an empty stomach daily for three days as a prophylactic medicine against the infection. The dose should be repeated after one month by following the same schedule in case the nCoV infection prevails in the community, the advisory said, adding that the same has also been advised for prevention of influenza-like illness. It also suggests some Ayurvedic medicines, Unani decoctions and home remedies which can be useful in symptomatic management of nCoV infections. The advisory also recommended prophylactic measures/ immunomodulatory drugs as per Ayurvedic practices and taking measures to strengthen the immune system through a healthy diet and lifestyle practices.
Regular readers of this blog will, of course, understand what homeopathy is. But what is Unani, some might ask. This excerpt from my book explains:
Unani (or Yunani) is an Islamic healing philosophy that combines elements of ancient Greek medicine with those of Ayurvedic medicine. In the course of the current boom in alternative medicine, Unani has become popular also in the West.
- Unani means “Greek” in Arabic. Ancient Greek medicine was based on the erroneous concept of four elements: earth, fire, water, air, corresponding to four humours: Phlegm (balgham), Blood (dam), Yellow bile (safra) and Black bile (sauda).
- Unani is popular in the Middle East, India, Pakistan and their neighbouring countries.
- It is based mainly on Ibn Sina’s The Canon of Medicine from the 11th century. Ibn Sina (or Avicenna) is regarded as one of the most significant physicians, astronomers, thinkers and writers of the Islamic Golden Age.
- According to proponents of Unani, the health of the human body is maintained by the harmonious arrangement of al-umoor al-tabiyah, the seven basic physiological principles of the Unani doctrine. These principles include (1) arkan, or elements, (2) mizaj, or temperament, (3) akhlat, or bodily humours, (4) aaza, or organs and systems, (5) arwah, or vital spirit, (6) quwa, or faculties or powers, and (7) afaal, or functions. Interacting with each other, these seven natural components maintain the balance in the natural constitution of the human body. Each individual’s constitution has a self-regulating capacity or power, called tabiyat (or mudabbira-e-badan; vis medicatrix naturae in Latin), or to keep the seven components in equilibrium.
- Unani treatments can consist of diet, massage, exercise, blood-letting, leeching, and medication.
- There are very few rigorous clinical trials of Unani. Their results vary and depend on the modality tested.,
- Unani remedies can include substances or products, including herbs, minerals, that are not safe for human consumption. The risks may therefore be considerable.
And what do Unani and homeopathy have in common?
Not a lot!
But one thing is for sure: neither of the two approaches are supported even by a shred of evidence to suggest that they might help against the corona virus pandemic. And another thing is almost equally sure: the above advice is not just governmental, it is mental!
What is pseudoscience and how can it be differentiated from science? This ‘demarcation problem’ has occupied many of our best minds and which nevertheless is largely unresolved. Two brave academics have recently published a paper aimed at providing organisations within the justice system with an overview of:
a) what science is and is not;
b) what constitutes an empirically driven, theoretically founded, peer-reviewed approach;
c) how to distinguish science from pseudoscience.
In it, they demonstrate that not all information which is presented as comprehensively evaluated is methodologically reliable for use in the justice system. Even though it does not really solve the old demarcation problem, I found their article important and informative and therefore take the liberty of quoting a brief excerpt here:
Organisations within the justice system do use empirically and theoretically supported approaches. However, some implemented approaches lack empirical evidence. In more perturbing cases, police officers, lawyers and judges may resort to pseudoscience – that is, bodies of information that may appear to be scientific but, in reality, lack the characteristics of scientific knowledge. … if members of the justice community are not advised about the publishing process then pseudoscientists can be fairly proficient at providing counterarguments. In addition, pseudoscientists can use several other fallacious arguments to achieve maximum support for their approaches.
For example, pseudoscientists might argue that their approaches are supported by a select number of articles, theses or books, and that they are reliable due to their acceptance by important organisations. However, if upon reading such literature it becomes apparent that there is no empirical or theoretical support, or that the steps leading to the conclusions are not thoroughly justified (be this methodologically or through evaluation), the implementation of their approaches remains merely destitute of vision. In addition, such reference to important organisations – often known as ‘name-dropping’–is detrimental by nature; doing so lends support to the notion that one might be unable to distinguish pseudoscience from science and may not understand the role that science plays in developing better professional practice.
Fallacious arguments from pseudoscientists can also address negative comments in a way that attempts to discourage further criticism from members of the scientific community. They can engage in legal threats and ad hominem attacks – that is, opposition to an argument ‘by questioning the personal circumstances or personal trustworthiness of the arguer who advanced it’. For example, if academics raise concerns regarding a particular pseudoscience without having attended its associated seminars, pseudoscientists might assert that the academics do not have the required understanding and that, as such, their criticism is of no value. If the academics had indeed attended the seminars, the pseudoscientists might instead suggest that their concerns are raised out of obscure or malicious reasons. Pseudoscientists might even state that they are criticised due to their revolutionary approach and refer to a quote dubiously attributed to the German philosopher Arthur Schopenhauer: ‘All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as self-evident’. However, as Sagan rightly points out,
the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright brothers. But they also laughed at Bozo the Clown.
Last week I was in Prague for a lecture which was great fun. On this occasion, I was interviewed by 5 different journalist. One of them asked a question that I had not often heard before: ‘how do they react to criticism?’
What he was inquiring about was the responses I get after publishing results, articles, interviews or blog posts that do not live up to the expectations of proponents of so-called alternative medicine (SCAM). I think the journalist was taken aback by the detail of my response:
- They denounce tell lies about me. I have written about some of such lies on my blog. But this was just the tip of the iceberg; if you go on the internet, you could find much, much more. Here is a nice example: Prof. Ernst has published little original primary research. His clinical trials have nearly all encountered severe methodological criticism and have often been published in low impact journals.
- They claim that I falsified my qualifications.
- They state that I am a killer.
- They say that my research was sub-standard: the reviews and evaluations he publishes have often met with substantial methodological criticism. In situations where reviews were conducted simultaneously by other research groups, other scientists frequently came to entirely different, and usually more positive, conclusions.
- They claim that I am not adequately qualified to do what I do and unqualified or unwilling to judge the evidence fairly.
- They write that I am dishonest and fabricate data.
- They claim that I have violated medical research ethics (more details here).
- They specifically claim that I do not have a clue about the homeopathy of Hahnemann.
- They sue me and people who work with me. The BCA famously sued Simon Singh. I have also had numerous legal actions against me from various SCAM advocates/entrepreneurs.
- They file complaints with my university. I remember about a dozen such actions but, as I failed to keep a record, there could have been even more.
- They try to get me struck off the medical register. That happened thankfully only once, yet it was one of the most unpleasant experiences of them all.
- They claim that I am paid by ‘Big Pharma’ almost on a daily basis.
- They stop inviting me to their conferences. Since the publication of TRICK OR TREATMENT, I have rarely been invited to SCAM conferences (before, this used to be almost my ‘daily bread’).
- They send me hate-mail. On this blog, I have written about the many ‘love letters’ I receive (see for instance here and here).
- They threaten me with physical violence or death. At one stage we had to call the police because there were threats of letter bombs coming my way (more details here).
- Some have even used their influence to close my department. Yes, I almost forgot Prince Charles in this long list of opprobrium.
So, how do they react to criticism?
In a word: badly!
In the Republic of Ireland, chiropractors are not regulated and there is no legislation governing the profession. That means anyone who feels like it can call him/herself a chiropractor and start treating or advising patients regardless of what condition they may be suffering from. The ‘CHIROPRACTIC ASSOCIATION OF IRELAND‘ (CAI) is the professional organisation that represents chiropractors in the country. The purpose of the CAI is to maintain professional standards, liaise with various government and health bodies, and to be a professional voice for Chiropractic.
Recently, the CAI has warned that a proposed law banning practitioners of so-called alternative medicine (SCAM) from claiming they can treat cancer without any medical evidence could have “unintended and unforeseen” consequences for its members. The CAI wrote to health minister Simon Harris claiming that a lack of “clarity” in the bill could have serious implications for chiropractic patients and chiropractors.
I am inclined to agree: the bill would reduce the cash-flow of many charlatans trying to make a fast buck on the desperation of cancer patients. But most probably, Tony Accardi, the president of the CAI, did not have this in mind when he said that, if patients with cancer inform a medical practitioner they are seeing a chiropractor, it may be construed that the chiropractor is “attempting to treat the cancer even though [it] may be for neck/back pain or overall wellbeing”.
As the evidence is hardly convincing that chiropractic is effective for neck/back pain or wellbeing (see numerous previous posts on this blog), we might well ask what else chiropractors have to offer for cancer patients. This website, for instance, is one of many that makes concrete claims:
Chiropractic treatment can benefit cancer patients in many ways. It can reduce stress, increase mobility, and optimize function, and generally improve quality of life.
By easing headaches and nausea, and relieving muscle tightness and neuropathy pain, chiropractic can help patients follow through with their treatment plans, which may even help extend their lives.
Chiropractors treating cancer patients approach patient care in much the same way as other primary care providers by:
- Gathering a comprehensive health history
- Conducting a thorough physical exam
- Ordering necessary diagnostic tests
- Deciding on an appropriate treatment plan
The chiropractic course of treatment often includes spinal manipulation and adjustments that provide patients with pain relief as well as overall improvement in function.
Chiropractic care can also be a viable alternative to pain medication for cancer patients. Although the use of medication is common in the management of a patient’s pain, it’s estimated that at least half of all cancer patients do not receive tolerable relief from their pain. Chiropractic care can address this issue, potentially even decreasing a cancer patient’s dependence on pain medication.
Cancer treatment has historically been focused on treating the disease itself. While doctors of chiropractic don’t treat cancer directly, they function very effectively as part of an integrated care plan to help the patient obtain the best treatment results possible.
The CHIROPRACTIC CANCER FOUNDATION FOR CHILDREN go even further:
Dr. Garvey has a strong belief in the human body’s innate ability to combat cancer cells and other diseases. He has first-hand experience with cancer since Dr. Garvey, himself, was diagnosed with Leukemia at the age of eleven. Stress and poor circulation can undermine the body’s natural healing powers and interfere with the central nervous systems’s ability to communicate effectively. At the foundation, we believe that chiropractic adjustments and other natural healing techniques can mitigate or reverse stresses that lead to poor health and even life threatening diseases such as cancer.
The claims can thus be summarised as follows:
- reduce the stress suffered by cancer patients,
- increase their mobility,
- optimize their function,
- improve their quality of life,
- alleviate cancer pain,
- serve as an alternative to pain medication,
- decrease cancer patients’ dependence on pain medication,
- the ‘innate’ (vital force which, according to DD Palmer is stimulated by chiropractic adjustments of spinal subluxations) can combat cancer.
Considering the above-mentioned dispute, it is only fair to ask: where is the evidence that chiropractic achieves the above (or indeed anything else)? I have to admit, I don’t find any sound evidence for any of these claims. But, of course, I might be biased or blind.
So, if anybody knows of compelling evidence to support the above claims, it would be helpful to let me have it. Meanwhile, it might be an excellent idea for the Irish government to go ahead with their plan of banning practitioners of so-called alternative medicine (SCAM) from claiming they can treat cancer without any medical evidence, don’t you think?
To make it clear from the outset: do not watch Gwyneth Paltrow’s 6-part Netflix series. It’s not worth it!
I could have guessed that too, of course. But the BBC had asked me to watch some of it and, wanting to help, I agreed and then joined a small group of scientists to discuss what we had seen (here is link to the broadcast).
The 6 episodes follow a similar pattern; two ‘experts’ (often decorated with a PhD, DC, DO, or similar title) are talking to well-groomed middle-aged women (including Gwyneth) and reveal their insights into different topics including anti-ageing, sex, psychedelic drugs, cryotherapy, energy healing, clairvoyance, etc. Normally, one would expect the two ‘experts’ to come from different perspectives, disagree on certain issues and discuss them productively. Not so here!
On the contrary, one ‘expert’ tends to be more outrageous than the other, and the two support each other in producing the most embarrassing nonsense (just one exception: the episode on sex). The amount of utter bullshit is completely overwhelming; so much so that even a sceptical listener is bound to fall silent with embarrassment. I find it futile to do another fact check, as others have published one in addition to ours on the BBC (see above).
In no time at all, the ‘experts’ then manage to re-write the laws of nature and throw almost everything we know about health and disease out the window. Gwyneth is often the focus of the camera looking pretty, and exclaiming ‘so cool’, ‘how the fuck does that work’ or similarly profound comments. The other ladies can be seen nodding obediently.
‘Science is just one way of knowing; intuition is another’, the ‘experts’ explain. Yet, in nearly every second sentence, they proudly impress the audience with their cutting edge ‘science’. At closer inspection, this ‘science’ turns out to be a mixture of platitudes and the worst pseudoscience imaginable. To any informed listener, this can only be cringingly embarrassing; to the lay audience, however, it might even look impressive.
The videos involves many volunteers who receive this or that form of quackery and usually start crying as soon as the camera catches them. They are clearly impressed with the idea to be on a Netflix video together with a film diva. Several volunteers stress that, in fact, they approached all this as sceptics – only to display minutes later the exact opposite of scepticism.
On returning from the BBC, got more and more depressed about these Netflix videos and our post-truth society. The misinformation promoted in the videos is as dangerous as any other fake news, I felt. So, what can be done about it?
There are several options, as far as I can see:
- We can ignore it. That would have been my preferred choice, but sadly this is hardly possible. The news about Paltrow’s Netflix foray is all over the place. To pretend it does not exist is to give way to her attempts to mislead the public.
- We can approve of it. I fear that this is exactly what millions will do. Sadly, this will increase the harm such misleading information does – not just in terms of healthcare, but more importantly in undermining rational thinking in our society.
- We can oppose and publish what we think. That’s what I did (and I did not mince my words; the BBC might even edit much of what I said). But will it have the desired effect? My fear is that the comments of the small troop of critical thinkers assembled by the BBC will, in the end, merely help Miss Paltrow and her fellow charlatans to get even richer by defrauding the gullible public.
- We can ridicule it. I have recently tried this as well. But I am perhaps not best suited to do this. It would be good if comedians would pick up this theme. I suspect that this could be the most effective way of making progress in preventing harm to the public.
It’s not (yet) a global emergency, the WHO have announced. But 26 fatalities have today been reported, and soon we will have thousands of people infected with the new coronavirus, experts predict. A vaccine will take at least a year to become available, and experts are alarmed.
But there is no need for panic!
Let’s just ask our homeopaths for help. They are excellent with curing viral infections!
You don’t believe me? But it must be true; take this website, for instance; its message could not be clearer :
… Homeopathic remedies can help you in fighting viral infections effectively… Homeopathy can be effective for viral infections including influenza-like symptoms, viral coughs and serious viral infections like herpes cold sores and genital herpes… The most common oral homeopathic remedy for herpes outbreaks is Rhus Toxicodendron (Rhus Tox in short), which is an extremely diluted form of poison ivy…
Another website offers more detail:
Conventional drugs do not offer comprehensive treatments for viral infections. Certain viruses like Influenza, HIV, etc. have tendencies to mutate (change) very rapidly, thereby lowering the effectiveness of such medicines. Additionally, viruses quickly develop resistance to these drugs, making the development of preventive medicine somewhat challenging. Conventional medications therefore only provide supportive management and suppression of the symptoms.
Homeopathic treatment for viral infections helps ease the symptoms and also enables the body to heal naturally.
Homeopathy treatment for viral infections is steadily gaining popularity as a natural way to deal with viral infections. These medicines help reduce the frequency and intensity of acute symptoms like weakness, fever, body pain, etc. These help with quick recovery. In some cases, they reduce the chances of further complications. Homeopathy treatment for viral infections treats the symptoms not by suppressing them, but by strengthening the immune system. It activates the body’s natural restorative properties by producing symptoms similar to the ones experienced by the patients. This method helps settle underlying internal disturbances in the body. Homeopathy treatment for viral infections also minimizes the weakness and fatigue commonly encountered as an aftermath of the infection.
Viral infections are highly communicable and spread rapidly from one person to another. Homeopathy treatment for viral infections is also preventative and helps reduce the chances of contracting the infection.
Yet another website is equally clear:
For viral ailments with symptoms that are fast and violent, use the following homeopathic remedies: Aconitum and Belladonna.
Aconitum – also known as Devil’s helmet or Queen of All Poisons – is a flowering plant that belongs to the family Ranunculacea. The flowers of this plant are harvested and then processed to treat various ailments, including viral infections.
Belladonna – also known as Deadly Nightshade – is a perennial herbaceous plant – prized for its medicinal benefits. It’s used as a muscle relaxant and pain reliever. The plant contains potent anti-inflammatory properties too. It’s an excellent remedy for viral infections.
What, you are still not convinced? In this case, have a look at what a Devon homeopaths stated only yesterday about the current epidemic:
Panic and anger in Wuhan as China orders city into lockdown.
A Coronavirus is a common virus that causes an infection in your nose, sinuses, or upper throat. Most corona viruses are not dangerous, they can in fact just cause symptoms which look like a mild cold. Earlier this month though, the World Health Organization identified a new type (2019-nCoV) in China and to date there have been over 500 confirmed cases of this Corona virus with 17 fatalities reported so far this month. The Media seems to be covering its progress with great relish, causing a lot of panic.
The virus starts with a fever, followed by a dry cough, and then after a week or so this leads to shortness of breath when some patients are hospitalised. Pneumonia is one complication that can be caused by the virus. Most of the information spread about the virus is gained from these severe cases in hospital.
To protect yourself from any virus, you should boost your own immune symptom with a healthy diet and supplements if necessary. I recommend the best vitamin C & D supplements you can get. I also love Fermented Cod Liver Oil and a good Magnesium supplement. Having homeopathic constitutional treatment is also proven to boost your immune system.
Homeopathic remedies can address every symptom caused by this virus so having an inexpensive homeopathy kit at home is an excellent resource. I love the First Aid Kit by Helios Pharmacy which also comes with a booklet to guide you on which remedy to choose. If you have remedies but feel you’re not equipped to use them, get in touch with me and I will send you a free PDF first aid booklet.
Here are a few homeopathic remedies which will be useful to treat viruses such as this one. If you are confident the remedy is well indicated you need to repeat often in a 30C or 200C until it no longer helps, then move onto another if necessary:
Ferrum-phos: give this at the very first sign of symptoms. Useful when you just don’t feel well, tired. Red inflamed eyes, chill with shivering and fever. Hot, burning eyes. Worse cold, better rest.
Gelsemium: This is for when your symptoms start to feel more severe, especially if they have come on gradually. You will feel dull, sluggish, heavy, often with a headache at the back of the neck. Shivering up and down the spine, aching muscles, burning throat. Worse cold, better after urination.
Pulsatilla: You will feel Chilly, even in a warm room. Nose blocked up, bland and thick mucous. Dry mouth with no thirst. Changing, shifting symptoms, weepy and sorry for oneself. You may often have a sore throat or ear ache with viruses. Worse in a warm room, better in the open air.
Camphora: You will feel very cold, and may have laborious, asthmatic breathing with an accumulation of phlegm in the air tubes, cold, dry skin. Total exhaustion, with coldness and shivering. Weak pulse, irritability. Worse cold.
Phosphorous: For any virus which affects your lungs. You may have bloody sputum and crave cold drinks. Burning, pressure and constriction in the chest; worse lying on the left side or painful side. Better in company, needing reassurance.
Bryonia: Excellent in pneumonia or pleurisy, especially when the right side is affected. There is dryness everywhere, dry tongue, with generally a white coating. There may be pain when breathing or coughing where the patient wants to hold steady as any movement hurts. Irritable and thirsty. Better rest, pressure. Worse excitement, bright lights, noise, touch, movement.
This is outrageous, you claim? You insist that homeopathy is bunk, that homeopaths behave irrationally and their remedies are pure placebos? Placebos are no good for life-threatening infections! Anyone who says otherwise is deluded and irresponsible, you suggest.
I see, you might have a point.
Think of the time when homeopaths travelled to Liberia to cure Ebola. That was a homeopathic disaster, if there ever was one. Have homeopaths learnt their lesson since then? Clearly not: there are still hundreds of websites and books promoting homeopathy even for the most serious viral diseases. Do homeopaths provide sound evidence for their claims? I can see none.
Maybe that’s why nobody asks homeopaths to help with medical emergencies.
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They recently conducted independent lab tests on the purity of 33 samples of essential ois from well-known names in the essential oil industry to see what was really inside each bottle. Their report raises lots of concerns, in my view. The team that wrote the report kindly sent me a summary and asked me to publish it here which I now do without any alteration, abbreviation or further comment:
Everybody’s talking about essential oils. More importantly, everybody’s using them. The global demand for these fragrant chemical compounds reached an extraordinary 226.9 kilotons in 2018 and further growth is projected by the marketing people who measure such things. The proliferation of essential oil users is tied to growth in the food and beverage, personal care and aromatherapy industries.
It’s not surprising that the scientific study of essential oils has also increased with demand for the products. The best essential oil brands invest in quality testing but don’t necessarily follow scientific protocol or make detailed testing results available to consumers. So the literature is still limited— and the jury is still out on whether these compounds are effective in treating medical conditions.
Essential oils are extracted from plants. In their pure form, they are highly concentrated—and sometimes toxic. To make them practical to use, essential oils are typically mixed with diluting carrier oils. Methods of extraction include cold-pressing, steam and water distillation, and the use of chemical solvents. Evaluating individual products made with essential oils is challenging because there are thousands of brands on the market. Neither the extraction methods used or the potency of the products—let alone, testing methods—are standardized. Manufacturers’ ambitious marketing claims, which often rely on ambiguous language, further obscure consumers’ ability to judge for themselves which oils are best suited to their purposes. The list of problems some products purport to solve can run the gamut from an itchy scalp to menopause symptoms.
What’s more, few essential oil manufacturers educate consumers on proper dosage or contraindications, which can lead to accidental misuse and illness. Children are particularly sensitive to many oils and yet most manufacturers fail to warn against applying oils to children’s skin. Pregnant women are usually advised not to use essential oils during their first trimesters, though some studies have suggested they can help alleviate pain during childbirth. Some essential oils should never be used during pregnancy. Essential oils can interact or interfere with prescription medicines and nutritional supplements. But unlike prescription drugs, they don’t come with warning labels about these potential interactions.
Genuinely scientific, peer-reviewed studies of essential oils have primarily focused on using aromatherapy as an adjunct to conventional medical treatment. Science has confirmed that when inhaled, essential oil molecules travel quickly to the brain—specifically the limbic region, which controls pulse, respiration, sexual arousal, and other autonomic functions. Emotional responses like fear and motivation originate in the limbic system. The most promising applications of aromatherapy appear to be in diminishing stress and offering pain relief. But actual clinical trials into such topics as reducing nausea in by chemotherapy patients, relieving anxiety during childbirth, alleviating headaches, and improving sleep have been inconclusive.
Other studies have focused on the subject of inflammation, which is known to contribute to a wide range of medical problems. Essential oils derived from the thyme, clove, rose, eucalyptus, fennel, and bergamot have been demonstrated through one study to activate chemicals in the body which suppress inflammation and suppress chemicals that activate it.
Researchers are also exploring the potential of essential oils as antibacterial agents. Parts of the juniper, cumin, coriander and lavender plants may be effective in battling E coli, while cinnamon may prove useful in treating strep throat and pneumonia.
As ancient and traditional as their use may be in certain cultures, the scientific reality is it’s too early to tell how effective essential oils are in treating the wide range of conditions they are theorized (and now, commonly advertised) to treat.
But that’s not to say you shouldn’t use them, according to recommendations from your doctor. When considering the efficacy of essential oils, bear in mind that the act of self-care can be therapeutic in and of itself. We all know that treating ourselves to a hot bath—or an ice cream cone for that matter—can give us a temporary sense of well-being. For the time being, short-term selfsoothing may be all we can count on from essential oils. But there’s something to be said for even temporary relief. An entire industry of over-the-counter medicines has been founded upon it.
Ever since the government in Bavaria has been misguided enough to agree to a research programme testing whether homeopathy has a role in curtailing the over-use of anti-biotics, the subject of homeopathics as a replacement of antibiotics has been revived.
In this paper, homeopaths describe four female cases with recurrent urinary tract infections. The patients were treated successfully with the homeopathic strategy after several conventional approaches revealed no improvement. The follow-up period was a minimum of 3 years and the frequency of episodes with urinary tract infection as well as of antibiotic treatment was documented. Additionally, the patients were asked to assess the treatment outcome retrospectively in a validated questionnaire.
The treatment resulted in a reduction of urinary tract infections and the need for antibiotics from monthly to less than 3 times a year. Three of the four women had no cystitis and related intake of antibiotics for more than 1.5 years. A relapse of symptoms could be treated efficiently with a repetition of the homeopathic remedy. All subjective outcome assessments resulted positive.
The authors concluded that this case series suggests a possible benefit of individualized homeopathic treatment for female patients with recurrent urinary tract infections. Larger observational studies and controlled investigations are warranted.
Such articles make me quite angry! They have the potential to mislead many patients and, in extreme cases, might even cost lives.
The ‘possible benefit’ of any treatment cannot be demonstrated with such flimsy case series. It has to be shown in properly controlled clinical trials. The findings of case series are confounded by dozens of variables and tell us next to nothing about cause and effect.
Case series make sense when they explore possible new therapeutic avenues. Homeopathy does certainly not fall into this category. The notion that homeopathics might be an alternative to antibiotics has been tested many times before in different settings, in animals, in humans, it vivo and in vitro. This has never generated convincingly positive findings. To re-address it by reporting uncontrolled cases is not just a nonsense; in my view, it is an unethical attempt to mislead us.
About 85% of German children are treated with herbal remedies. Yet, little is known about the effects of such interventions. A new study might tell us more.
This analysis accessed 2063 datasets from the paediatric population in the PhytoVIS data base, screening for information on indication, gender, treatment, co-medication and tolerability. The results suggest that the majority of patients was treated with herbal medicine for the following conditions:
- common cold,
- digestive complaints,
- skin diseases,
- sleep disturbances
The perceived effect of the therapy was rated in 84% of the patients as very good or good without adverse events.
The authors concluded that the results confirm the good clinical effects and safety of herbal medicinal products in this patient population and show that they are widely used in Germany.
If you are a fan of herbal medicine, you will be jubilant. If, on the other hand, you are a critical thinker or a responsible healthcare professional, you might wonder what this database is, why it was set up and how exactly these findings were produced. Here are some details:
The data were collected by means of a retrospective, anonymous, one-off survey consisting of 20 questions on the user’s experience with herbal remedies. The questions included complaints/ disease, information on drug use, concomitant factors/diseases as well as basic patient data. Trained interviewers performed the interviews in pharmacies and doctor’s offices. Data were collected in the Western Part of Germany between April 2014 and December 2016. The only inclusion criterion was the intake of herbal drugs in the last 8 weeks before the individual interview. The primary endpoint was the effect and tolerability of the products according to the user.
And who participated in this survey? If I understand it correctly, the survey is based on a convenience sample of parents using herbal remedies. This means that those parents who had a positive experience tended to volunteer, while those with a negative experience were absent or tended to refuse. (Thus the survey is not far from the scenario I often use where people in a hamburger restaurant are questioned whether they like hamburgers.)
So, there are two very obvious factors other than the effectiveness of herbal remedies determining the results:
- selection bias,
- lack of objective outcome measure.
This means that conclusions about the clinical effects of herbal remedies in paediatric patients are quite simply not possible on the basis of this survey. So, why do the authors nevertheless draw such conclusions (without a critical discussion of the limitations of their survey)?
Could it have something to do with the sponsor of the research?
The PhytoVIS study was funded by the Kooperation Phytopharmaka GbR Bonn, Germany.
Or could it have something to do with the affiliations of the paper’s authors:
1 Institute of Pharmacy, University of Leipzig, Brüderstr. 34, 04103, Leipzig, Germny. firstname.lastname@example.org.
2 Kooperation Phytopharmaka GbR, Plittersdorfer Str. 218, 573, Bonn, Germany. email@example.com.
3 Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
4 ClinNovis GmbH, Genter Str. 7, 50672, Cologne, Germany.
5 Bayer Consumer Health, Research & Development, Phytomedicines Supply and Development Center, Steigerwald Arzneimittelwerk GmbH, Havelstr. 5, 64295, Darmstadt, Germany.
6 Kooperation Phytopharmaka GbR, Plittersdorfer Str. 218, 53173, Bonn, Germany.
7 Institute of Pharmaceutical Biology, Goethe University Frankfurt, Max-von-Laue-Str. 9, 60438, Frankfurt, Germany.
8 Chair of Naturopathy, University Medicine Rostock, Ernst-Heydemann Str. 6, 18057, Rostock, Germany.
WHAT DO YOU THINK?