Monthly Archives: January 2021
Trump and his lamentable influence on so-called alternative medicine (SCAM) have been the subject of several of my posts (see for instance here, here, and here). Now they are a thing of the past, and one may well ask how Biden and his new administration might influence the SCAM boom in the US and the rest of the world.
Joe Biden has chosen former Food and Drug Administration (FDA) commissioner, Dr. David Kessler, to lead Operation Warp Speed — the U.S. government’s program for accelerating the Covid-19 vaccine and treatments rollout. The Alliance for Natural Health seemed to think that was bad news:
Dr. David Kessler, an anti-supplement crusader, drug industry adviser, and former FDA Commissioner, has been named to Biden’s COVID-19 task force. We must push back. Action Alert!
… During that time, Kessler demonstrated his hostility towards the dietary supplement industry. The last thing we need is someone who is diametrically opposed to natural medicine in a position of power, particularly concerning how our country deals with a virus against which natural medicines like zinc, potassium, and vitamin D have demonstrated efficacy.
The record on Dr. Kessler is clear. In 1993, he took aim at the supplement industry by trying to limit the health claims supplements could make under the Nutrition Labeling and Education Act of 1990. This law gave the FDA the authority to approve disease-prevention claims for food, including supplements (for example, “adequate calcium throughout life may reduce the risk of osteoporosis”)—but Dr. Kessler said the FDA would not approve any of the proposed claims for supplements. He stood before Congress that same year and compared the supplement industry to “snake oil salesmen.”…
Dr. Kessler also serves as board chair for the Center for Science in the Public Interest’s (CSPI) Board of Directors. It is a fitting post for Dr. Kessler, as CSPI shares his negative views on dietary supplements. In particular, CSPI worked to eliminate legal structure/function claims for dietary supplements. (A structure/function claim describes the role of a nutrient on the structure or function of the body, such as “calcium builds strong bones,” or “antioxidants maintain cell integrity.”)
There is also speculation that Dr. Kessler is being considered for a more prominent role in government, such as heading up the Health and Human Services Department.
Dr. Kessler’s appointment to the COVID-19 task force is therefore particularly concerning. We are already dealing with federal agencies trying to gag doctors to prevent them from disseminating basic information about the benefits of supplements for COVID-19—supplements that were part of President Trump’s own treatment regimen. There is clear evidence to suggest many natural medicines to help prevent and treat COVID…
To me, this shows foremost that the ‘Alliance for Natural Health’ is an irresponsible lobby group for SCAM that does not hesitate to put public health at risk in order to boost the already enormous profits of the SCAM industry. If these lobbyists are unhappy, it should be good news.
Right now, Joe Biden has certainly other things on his mind than SCAM. But the appointment of Kessler is one of several indications that he intends to take much more of a pro-science, pro-public health course than his predecessor. The fact that the ‘Alliance for Natural Health’ is up in arms might be a sign that he is not likely to take SCAM fools lightly.
Personally, I am relieved that Trump is gone and I wish the new administration and the American people only the very best.
The state of acupuncture research has long puzzled me. The first thing that would strike who looks at it is its phenomenal increase:
- Until around the year 2000, Medline listed about 200 papers per year on the subject.
- From 2005, there was a steep, near-linear increase.
- It peaked in 2020 when we had a record-breaking 20515 acupuncture papers currently listed in Medline.
Which this amount of research, one would expect to get somewhere. In particular, one would hope to slowly know whether acupuncture works and, if so, for which conditions. But this is not the case.
On the contrary, the acupuncture literature is a complete mess in which it gets more and more difficult to differentiate the reliable from the unreliable, the useful from the redundant, and the truth from the lies. Because of this profound confusion, acupuncture fans are able to claim that their pet-therapy is demonstrably effective for a wide range of conditions, while skeptics insist it is a theatrical placebo. The consumer might listen in bewilderment.
Yesterday (18/1/2021), I had a quick (actually, it was not that quick after all) look into what Medline currently lists in terms of new acupuncture research published in 2021 and found a few other things that are remarkable:
- There were already 100 papers dated 2021 (today, there were even 118); that corresponds to about 5 new articles per day and makes acupuncture one of the most research-active areas of so-called alternative medicine (SCAM).
- Of these 100 papers, only 7 were clinical trials (CTs). In my view, clinical trials would be more important than any other type of research on acupuncture. To see that they amount to just 7% of the total is therefore disappointing.
- Twelve papers were systematic reviews (SRs). It is odd, I find, to see almost twice the amount of SRs than CTs.
- Eighteen papers referred to protocols of studies of SRs. In particular protocols of SRs are useless in my view. It seems to me that the explanation for this plethora of published protocols might be the fact that Chinese researchers are extremely keen to get papers into Western journals; it is an essential boost to their careers.
- Seven papers were surveys. This multitude of survey research is typical for all types of SCAM.
- Twenty-four articles were on basic research. I find basic research into an ancient therapy of questionable clinical use more than a bit strange.
- The rest of the articles were other types of publications and a few were misclassified.
- The vast majority (n = 81) of the 100 papers were authored exclusively by Chinese researchers (and a few Korean). In view of the fact that it has been shown repeatedly that practically all acupuncture studies from China report positive results and that data fabrication seems rife in China, this dominance of China could be concerning indeed.
Yes, I find all this quite concerning. I feel that we are swamped with plenty of pseudo-research on acupuncture that is of doubtful (in many cases very doubtful) reliability. Eventually, this will create an overall picture for the public that is misleading to the extreme (to check the validity of the original research is a monster task and way beyond what even an interested layperson can do).
And what might be the solution? I am not sure I have one. But for starters, I think, that journal editors should get a lot more discerning when it comes to article submissions from (Chinese) acupuncture researchers. My advice to them and everyone else:
if it sounds too good to be true, it probably is!
The aim of this study was to evaluate the effect of reflexology and homeopathy as adjunctive therapies in asthma. In a single centre, randomised, investigator blinded, controlled study, 86 asthma patients were enrolled. They were assigned to one of three study groups:
- conventional treatment alone,
- conventional treatment with homeopathy
- conventional treatment with reflexology
All patients received their asthma treatment during the study and were followed as usual by their general practitioner. The clinical assessors were blinded to group allocations. The primary outcome was the change in the asthma quality of life questionnaire (AQLQ) scores after 26 weeks. Secondary outcomes included asthma control questionnaire, EuroQol, forced expiratory volume in 1 sec, morning and evening peak expiratory flow, asthma symptoms, rescue medication use, and total medication score.
Minor improvements in the AQLQ score were observed in all three groups. However, no statistically significant changes in AQLQ scores were seen within or between groups. Likewise, secondary outcomes did not differ between groups.
The authors concluded that, in this study, the addition of homeopathy or reflexology to conventional treatment did not result in improved quality of life in asthma.
This study has several flaws. For instance, its sample size is too small to allow firm conclusions and it follows the ‘A+B versus B’ design. Therefore, we need to ask whether the findings are perhaps not reliable. The best answer to this question might be found by looking up the current Cochrane review. It concludes that there is not enough evidence to reliably assess the possible role of homeopathy in asthma. In other (and clearer) words, there is no good reason to assume that homeopathy is effective for asthma; in the present study, it did not even convey a placebo effect. This, I think, suggests that the conclusion of this new trial might be correct:
HOMEOPATHY DOES NOTHING FOR ASTHMA PATIENTS.
Professor Andreas Michalsen is the clinical director of the department of naturopathy in a Berlin hospital. He seems most keen to represent the scientific side of so-called alternative medicine in Germany. He has published several (fairly uncritical) books on SCAM and numerous papers in the medical literature. I had a look at those papers and hope you agree that Michalsen should join the other extraordinary experts in THE ALTERNATIVE MEDICINE HALL OF FAME:
- Jennifer Jacobs (homeopath, US)
- Jenise Pellow (homeopath, South Africa)
- Adrian White (acupuncturist, UK)
- Michael Frass (homeopath, Austria)
- Jens Behnke (research officer, Germany)
- John Weeks (editor of JCAM, US)
- Deepak Chopra (entrepreneur, Us)
- Cheryl Hawk (US chiropractor)
- David Peters (osteopathy, homeopathy, UK)
- Nicola Robinson (TCM, UK)
- Peter Fisher (homeopathy, UK)
- Simon Mills (herbal medicine, UK)
- Gustav Dobos (various, Germany)
- Claudia Witt (homeopathy, Germany and Switzerland)
- George Lewith (acupuncture, UK)
- John Licciardone (osteopathy, US)
My Medline search on 10/1/2021 for ‘Michalsen A, clinical trial’, generated 69 hits. Below I list the key conclusions of the 47 SCAM studies that were published in English by Andreas Michalsen et al:
- In this explorative pilot trial, an increase of HRV (more parasympathetic dominance and overall higher HRV) after ten weeks of yoga in school in comparison to regular school sports was demonstrated, showing an improved self-regulation of the autonomic nervous system. (pilot)
- Results showed a contrast between the high agreement of the consented final diagnosis and disagreement on certain diagnostic details.
- A single session of leech therapy is more effective over the short term in lowering the intensity of pain over the short term and in improving physical function and quality of life over the intermediate term.
- Short term fasting during chemotherapy is well tolerated and appears to improve QOL and fatigue during chemotherapy. Larger studies should prove the effect of STF as an adjunct to chemotherapy. (pilot)
- Administering verum (a complex homeopathic drug) resulted in a statistically significantly greater improvement of the Cough Assessment Score than the placebo. The tolerability was good and not inferior to that of the placebo.
- Ayurvedic treatment is beneficial in reducing knee OA symptoms.
- We did not find any clinically relevant differences between groups in this controlled clinical pilot trial of 8 wk of intermittent fasting in healthy volunteers.
- We found positive effects for both groups, which however were more pronounced in the Ayurvedic group. The conversational and counseling techniques in the Ayurvedic group offered more opportunities for problem description by patients as well as patient-centered practice and resource-oriented recommendations by the physician.
- Results of this study suggest that prolonged fasting is feasible and might have beneficial clinical effects. (pilot)
- This clinical trial indicates comparable efficacy of the herbal combination and antibiotic, although non-inferiority was not proved. However, the results and lessons learned are important for the planning of future trials.
- Thus, cycles of a 5-day fasting-mimiking diet are safe, feasible, and effective in reducing markers/risk factors for aging and age-related diseases.
- Ayurvedic external treatment is effective for pain-relief in chronic low back pain in the short term.
- Focused meditation and self-care exercise lead to comparable, symptomatic improvements in patients with chronic low back pain.
- This randomized trial found no effects of yoga on health-related quality of life in patients with colorectal cancer. Given the high attrition rate and low intervention adherence, no definite conclusions can be drawn from this trial.
- The Alexander Technique was not superior to local heat application in treating chronic non-specific neck pain.
- In conclusion, meditation may support chronic pain patients in pain reduction and pain coping.
- The herbal preparation of myrrh, chamomile extract and coffee charcoal is well tolerated and shows a good safety profile. We found first evidence for a potential efficacy non-inferior to the gold standard therapy mesalazine, which merits further study of its clinical usefulness in maintenance therapy of patients with ulcerative colitis.
- Yoga was more effective in relieving chronic nonspecific neck pain than a home-based exercise program. Yoga reduced neck pain intensity and disability and improved health-related quality of life. Moreover, yoga seems to influence the functional status of neck muscles, as indicated by improvement of physiological measures of neck pain.
- In this preliminary trial, yoga appears to be an effective treatment in chronic neck pain with possible additional effects on psychological well-being and QOL. (pilot)
- These results suggest that Gua Sha may be an effective treatment for patients with chronic neck and low back pain.
- The data indicate that during needle insertion high dose acupuncture stimulation leads to a higher increase of sympathetic nerve activity than low dose stimulation independent of personality. After needle insertion subjects who tend to augment incoming stimuli might show a lack of psychological relaxation when receiving high dose stimulation.
- In patients with METS, phlebotomy, with consecutive reduction of body iron stores, lowered BP and resulted in improvements in markers of cardiovascular risk and glycemic control.
- The present study gives preliminary evidence that healing clay jojoba oil facial masks can be effective treatment for lesioned skin and mild acne vulgaris.
- In a laboratory setting, an electroacupuncture procedure was as effective as a single dose of an orally administered opiate in reducing experimentally induced ischaemic pain.
- In the presence of modern treatments, complementary prescription of comprehensive lifestyle modification has no impact on coronary artery calcium progression but sustainable benefit for blood pressure, heart rate and the need of anti-ischemic medication is demonstrated.
- A single course of leech therapy was effective in relieving pain in the short-term and improved disability in intermediate-term. Leeches might be considered as an additional option in the therapeutic approach to lateral epicondylitis.
- Gua sha has beneficial short-term effects on pain and functional status in patients with chronic neck pain.
- Alterations in short-chain fatty acids were found in terms of significant changes to increased acetate levels in the fasting group.
- In this first study on the efficacy of cantharidin blisters, a clinically relevant pain-relieving short-term effect on lumbar spinal stenosis was observed.
- We conclude that cupping therapy may be effective in relieving the pain and other symptoms related to CTS.
- A single course of leech therapy is effective in relieving pain, improving disability and QoL for at least 2 months.
- The high effect sizes indicate that repeated rhythmic embrocation with Solum Oil may improve mood, pain perception (sensory PPS), and the ability to cope with pain (affective PPS) in patients with chronic low back pain.
- The data indicate, that verum acupuncture and sham acupuncture might have a beneficial influence on the autonomic nervous system in migraineurs with a reduction of the LF power of HRV related to the clinical effect. This might be due to a reduction of sympathetic nerve activity. VA and SA induce different effects on the high-frequency component of HRV, which seem, however, not to be relevant for the clinical outcome in migraine.
- Gua Sha increases microcirculation local to a treated area, and that increase in circulation may play a role in local and distal decrease in myalgia. Decrease in myalgia at sites distal to a treated area is not due to distal increase in microcirculation. There is an unidentified pain-relieving biomechanism associated with Gua Sha.
- These results are consistent with possible short-term benefits of a comprehensive lifestyle modification program on some aspects of quality-of-life and emotional well-being, but no effects were discernable 12 months after completion of therapy.
- In the presence of modern treatments, comprehensive lifestyle modification provides no additional benefits on progression of atherosclerosis but improves autonomic function, angina, and QOL with concomitant reduced need of medication. These responses are more pronounced in GNB3*825T allele carriers.
- Neither Mediterranean diet nor fasting treatments affect the microbiologically assessed intestinal flora and sIgA levels in patients with RA and FM.
- Women suffering from mental distress participating in a 3-month Iyengar yoga class show significant improvements on measures of stress and psychological outcomes.
- Adoption of a Mediterranean diet by patients with medically treated CAD has no effect on markers of inflammation and metabolic risk factors.
- A comprehensive lifestyle modification and stress management program did not improve psychological outcomes in medically stable CAD patients. The program did appear to confer psychological benefits for women but not men. Further trials should investigate gender-related differences in coronary patient responses to behavioral interventions.
- Mind-body therapy may improve quality of life in patients with UC in remission, while no effects of therapy on clinical or physiological parameters were found, which may at least in part be related to selective patient recruitment.
- Leech therapy helps relieve symptoms in patients with osteoarthritis of the knee.
- A home-based hydrotherapeutic thermal treatment program improves quality of life, heart-failure-related symptoms and heart rate response to exercise in patients with mild chronic heart failure. The results of this investigation suggest a beneficial adaptive response to repeated brief cold stimuli in addition to enhanced peripheral perfusion due to thermal hydrotherapy in patients with chronic heart failure.
- This open pilot study demonstrates that along with a decrease in sleep arousals a 1-week fasting period promotes the quality of sleep and daytime performance in non-obese subjects.
- Periarticular application of 4 leeches led to rapid relief of pain with sustained improvement after 4 weeks in the absence of major complications.
- Short-term fasting in inpatients with pain and stress syndromes is safe and well tolerated, concomitant mineral supplements have no additive benefit.
- The results suggest that the cardiovascular response during whole-body infrared-A irradiation is accompanied by significant changes in autonomic cardiac regulation: A significant decrease of low-frequency power corresponding to depressed vagal activity results in an increase of Iow/high-frequency ratio. During serial hyperthermias the acute response is diminished suggesting an adaption of the autonomic response to hyperthermia.
This list is impressive in several ways: very few SCAM researchers managed to publish 47 Medline-listed clinical studies, and nobody I know has ever conducted clinical trials of so many different SCAMs in so many different medical conditions. They include:
- Acupuncture
- Alexander technique
- Ayrurvedic medicine
- Blood letting
- Cupping
- Diet
- Embrocation
- Fasting
- Gua cha
- Herbal medicine
- Homeopathy
- Hydrotherapy
- Hyperthermia
- Meditation
- Mind/body therapies
- Leeching
- Life style modification
- Yoga
While this is astounding, another fact is even more baffling: with just 2 or 3 exceptions, all these studies yield postive results. Whatever Michalsen touches turns to gold! And if it doesn’t, he spins the findings such that the conclusions are at least partly positive; see for instance No 14, 33, 36, 40 or 41 in the above list.
WELCOME TO THE ALTERNATIVE MEDICINE HALL OF FAME PROFESSOR MICHALSEN!
Turmeric is certainly a plant with fascinating properties; we have therefore discussed it before. Reseach into turmeric continues to be active, and I will continue to report about new studies.
This study was aimed at estimating the effect of turmeric supplementation on quality of life (QoL) and haematological parameters in breast cancer patients who were on Paclitaxel chemotherapy. In this case series with 60 participants, QoL was assessed using a standard questionnaire and haematological parameters were recorded from the patients’ hospital records.
Turmeric supplementation for 21 days resulted in clinically relevant and statistically significant improvement in global health status, symptom scores (fatigue, nausea, vomiting, pain, appetite loss, insomnia), and haematological parameters.
The authors concluded that turmeric supplementation improved QoL, brought about symptom palliation and increased hematological parameters in breast cancer patients.
Really?
The way the conclusions are phrased, they clearly imply that turmeric caused the observed outcomes. How certain can we be that this is true?
On a scale of 0 -10, I would say 0.
Why?
Because there are important other determinants of the outcomes:
- placebo,
- concommittant treatments,
- natural history,
- etc., etc.
Why does this matter?
- Because such unwarranted conclusions mislead patients, healthcare professionals and carers.
- Because such bad science gives a bad name to clinical research.
- Because this type of nonsense might deter meaningful research into a promising subject.
- Because no ‘scientific’ journal should be permitted to publish such nonsense.
- Because it is unethical of ‘scientists’ to make false claims.
But maybe the Indian authors are just a few well-meaning and naive practitioners who merely were doing their unexperienced best? Sadly not! The authors of this paper give the following affiliations:
- Clinical Pharmacology, Pfizer Healthcare Private Limited, Chennai, Tamil Nadu, India.
- Department of Radiation Oncology, Faculty of Medicine, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
- Process Development, HCL Technologies, Chennai, Tamil Nadu, India.
- Department of Pharmacognosy, Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India.
Yes, they really should know better!
So-called alternative medicine (SCAM) is, as we all know, an umbrella term. Under this umbrella, we find hundreds of different modalities that have little in common with each other. Here I often focus on:
- homeopathy,
- chiropractic,
- acupuncture,
- herbal medicine.
There are uncounted others, and in my recent book, I published critical evaluations 150 of them. But for the moment, let’s keep to the 4 SCAMs listed above.
What strikes me regularly is that many SCAM enthusiasts do seem to appreciate my critical assessments of SCAM; for instance:
- When I point out that the assumptions of homeopathy fly in the face of science, most SCAM enthusiasts agree.
- When I point out that chiropractic spinal manipulations might not be safe, most SCAM enthusiasts agree.
- When I point out that acupuncture is not a panacea, most SCAM enthusiasts agree.
- When I point out that herbal remedies can interact with prescribed drugs, most SCAM enthusiasts agree.
Most but not all!
- Those who find my criticism of homeopathy unfair are the homeopaths and their proponents.
- Those who find my criticism of chiropractic unfair are the chiropractors and their proponents.
- Those who find my criticism of acupuncture unfair are the acupuncturists and their proponents.
- Those who find my criticism of herbal medicine unfair are the herbalists and their proponents.
Hardly ever does a herbalist defend homeopathy’s weird assumptions; rarely does an acupuncturist tell me that I am too harsh with the chiropractors; never have I heard a chiropractor complain that my criticism of acupuncture is unjustified.
Entirely obvious?
Perhaps!
But I find it nevertheless curious, because my critical stance is always the same. I do not change it for this or that form of SCAM (I would also not change it for conventional medicine, but I leave it to those who have more specific expertise to do the criticising). I have no axe to grind against any particular SCAM. All I do is point out flaws in their logic, limitations in their studies, gaps in the evidence. All I do is provide my honest interpretation of the evidence.
It really seems to me that everyone appreciates my honesty, until I start being honest with them.
And this is why I find it curious. Homeopaths, chiropractors, acupuncturists, herbalists and all the other types of SCAM practitioners like to be seen on the side of science, evidence, critical thinking and progress. This, I suppose, is good for the (self) image; it might even help the delusion that they are all evidence-based. But as soon as someone applies science, evidence, critical thinking and progress to their very own little niche within SCAM, they stop liking it and start aggressing the critic.
I suppose this is entirely obvious as well?
Perhaps!
But it also exposes the double standard that is so deeply ingrained in SCAM.
We live in truly grim times! Let me therefore try to cheer you up a little. Here is a story that might make you smile.
In 1981, I moved back from London to Munich. While still in London, I had written an article on garlic for a German medical journal. It was published just as we arrived in our new home. Here is it’s English abstract:
Garlic has had a firm place in folk medicine since ancient times. More recent results are summarized here which show that extracts of the plant have an antimicrobial action, they are capable of lowering blood cholesterol and of reducing secondary vascular changes. They raise fibrinolytic activity and inhibit thrombocyte aggregation. Therefore the plant contains highly active therapeutic principles which appear to be particularly suitable for prophylaxis of arteriosclerosis.
Yes, you are quite right, this paper is nothing to write home about. So, why do I consider it ‘most consequential‘? Here is what happened:
My wife and I had barely arrived in our new home, when a man phoned (he had gone to a lot of trouble to find my number) and said: “I know you are the leading expert on garlic; I urgently need to talk to you”. Never correct a man’s mistake, if it’s in your favour, I thought, and we made an appointment for a meeting at the Munich train station hotel.
When I met him a few days later, he ordered me a coffee (which later I had to pay for) and explained that he had worked his whole life (he was about 50, I guessed) for the pharmaceutical industry and had now decided that this was enough. He thus planned to set up his own pharmaceutical company. He already had a photocopy machine in his basement, he proudly told me, and a wife who was willing to work as hard as he was. Specifically, his plan was to launch a garlic pill, and for that he needed my advice. I told him what he wanted to know, and we parted after about two hours promising to stay in contact.
The man’s name was Kuno Lichtwer.
During the weeks that followed, he often phoned me to pick my brain. One day, he told me that he had everything in place: he had found a supplier of the materials, a manufacturer to produce the pills and even registered a name for it:
KWAI
Then he popped the question that was foremost on his mind: ‘What do you think, Dr Ernst, should I risk it and go ahead with this or not?’. I had started to like that man; he was going to lose all his savings on a crazy idea, I felt. So, I told him: ‘If I were you, I would not do it. There are already plenty of garlic pills on the market. You are risking to lose everything.’ Then there was a long pause; eventually, he thanked me for my honest advice and hung up.
Weeks later he phoned again to tell me that he had truly appreciated my brutally direct advice, thought long and hard about it, but went ahead with his plan anyway. Would I now accept the position of ‘medical advisor’ to Lichwer Pharma? I was surprised, but accepted this new post. Thereafter, I advised him the best I could. We even conducted and published the very first clinical trial with his product. It was a rather flimsy study (we had no funds at all), but did suggest a positive result.
Each time Mr Lichtwer called me, he was elated; things were not just going well, they were booming! He was evidently hugely gifted in promoting KWAI. Then he invited me several times to come to Berlin where Lichtwer Pharma was based for business meetings. Proudly, he showed me that meanwhile his firm had moved out of his basement into a proper building. The next I knew was that he had a dozen employees. Lichtwer seemed unstoppable. This went on for 2 or 3 years, if I remember correctly.
During all this time, we had never talked about money, and my work for him had always been unpaid – that is, until one day just before Christmas he phoned and explained that he had moved his firm to yet a bigger building and hired yet more staff. He also realised that I deserved some renumeration for my advice; therefore, he had put a cheque in the post. When I told my wife about it, we both celebrated in anticipation of the substantial windfall. Two days later, his letter arrived. He very kindly thanked me for years of work and included a cheque of 500 DM (about 150 DM per year of work). A few months later, his firm had grown so big that a full time medical and research director was badly needed. He informed me that he had found a highly experienced expert and invited me to meet the new man, Prof Schulz.
No, I did not feel hard done by! On the contrary, I was happy that my prediction had been grossly wrong and that my friend Kuno was doing so well. In addition, I was also relieved, because my research at the University did not give me nearly enough time to look adequately after the now substantial firm of Lichtwer Pharma.
Thereafter, Lichtwer’s garlic pill went from strength to strength. Several larger studies confirmed our initial results that garlic positively influenced blood lipids (in 2000, our systematic review concluded: The available data suggest that garlic is superior to placebo in reducing total cholesterol levels. However, the size of the effect is modest, and the robustness of the effect is debatable. The use of garlic for hypercholesterolemia is therefore of questionable value). One day, I read somewhere that KWAI had become the most consumed pill in Germany (even beating Aspirin). Then Lichtwer Pharma went international and added several further herbal products to its portfolio. In 1991, Lichtwer Pharma was estimated to be worth 100 Million DM. Several years later, the firm had almost 400 employees and a yearly turnover of 353 Million DM.
To his credit, Kuno Lichtwer never entirely forgot me. When I had moved to the UK, he even came to Exeter, was entertained by my University, and made a donation of £100 000 towards a ‘Lichtwer Research Fellowship’ for my department. I am not sure whether Kuno Lichtwer is still alive. If he is, he would probably agree that, had I offered him 10 000 DM of my savings during our 1st meeting in 1981 (he did hint at that possibility), he would have gladly made me a partner in his enterprise.
But, as they say: money is not everything.
And a good story to tell is also not bad.
Dr Jennifer Jacobs is a homeopaths from the US. She is a family physician and a clinical assistant professor in epidemiology at the University of Washington School of Public Health and Community Medicine. She received her MD degree from Wayne State University and a Masters in Public Health from the University of Washington.
Jennifer is foremost famous for the homeopathic childhood diarhoea studies, but does that justify her joining THE ALTERNATIVE MEDICINE HALL OF FAME with its 15 current members who managed the impossible feast of never publishing a negative conclusion about their pet SCAM:
- Jenise Pellow (homeopath, South Africa)
- Adrian White (acupuncturist, UK)
- Michael Frass (homeopath, Austria)
- Jens Behnke (research officer, Germany)
- John Weeks (editor of JCAM, US)
- Deepak Chopra (entrepreneur, Us)
- Cheryl Hawk (US chiropractor)
- David Peters (osteopathy, homeopathy, UK)
- Nicola Robinson (TCM, UK)
- Peter Fisher (homeopathy, UK)
- Simon Mills (herbal medicine, UK)
- Gustav Dobos (various, Germany)
- Claudia Witt (homeopathy, Germany and Switzerland)
- George Lewith (acupuncture, UK)
- John Licciardone (osteopathy, US)
A Medline search generated 25 papers of hers on homeopathy. Here are the key findings of the … that report original data on the effectiveness of homeopathy (clinical trials or reviews):
- If and when conventional medicine runs out of options for treating epidemic diseases, homeopathy could be seen as an attractive alternative, but only if there is viable experimental evidence of its success.
- The homeopathic syrup appeared to be effective in reducing the severity of cold symptoms in the first day after beginning treatment.
- …the medicines prescribed in individualised homeopathy may have small, specific, treatment effects.
- Homeopathic ear drops may be effective in reducing the use of antibiotics in children with AOM managed with a delayed antibiotic approach.
- This study suggests that homeopathic ear drops were moderately effective in treating otalgia in children with AOM and may be most effective in the early period after a diagnosis of AOM. Pediatricians and other primary health care providers should consider homeopathic ear drops a useful adjunct to standard therapy.
- The homeopathic combination therapy tested in this study did not significantly reduce the duration or severity of acute diarrhea in Honduran children. Further study is needed to develop affordable and effective methods of using homeopathy to reduce the global burden of childhood diarrhea.
- This pilot study provides no evidence to support a therapeutic effect of individually selected homeopathic remedies in children with ADHD. A therapeutic effect of the homeopathic encounter is suggested and warrants further evaluation.
- Small sample size precludes definitive answers, but results from this preliminary trial suggest that homeopathy may be of value in the treatment of menopausal symptoms and improving quality of life, especially in those women not on tamoxifen.
- The results from these studies confirm that individualized homeopathic treatment decreases the duration of acute childhood diarrhea and suggest that larger sample sizes be used in future homeopathic research to ensure adequate statistical power. Homeopathy should be considered for use as an adjunct to oral rehydration for this illness.
- These results suggest that a positive treatment effect of homeopathy when compared with placebo in acute otitis media cannot be excluded and that a larger study is justified.
- These results are consistent with the finding from the previous study that individualized homeopathic treatment decreases the duration of diarrhea and number of stools in children with acute childhood diarrhea.
- The statistically significant decrease in the duration of diarrhea in the treatment group suggests that homeopathic treatment might be useful in acute childhood diarrhea. Further study of this treatment deserves consideration.
Next to Claudia Witt, Jennifer might be the researcher who has published the most clinical trials of homeopathy with positive conclusions (don’t be jealous Michael Frass, you might be in third place!). Attentive readers have probably noticed, she also published a negative trial with a negative conclusion (No 6) and a negative trial with a not so negative conclusion (No 7). The negative study almost cost her the place in the HALL OF FAME. But let’s be generous, and let’s consider the TRUSTWORTHINESS INDEX which, in her case, is still well and safely in the untrustworthy region. Therefore, I hope we all agree: Jenifer does deserve a place in THE ALTERNATIVE MEDICINE HALL OF FAME.
WELCOME JENNIFER!
The UK Professional Standards Authority has just made this announcement:
The Professional Standards Authority has suspended the accreditation of the Society of Homeopaths (SoH) following its failure to meet Conditions set by the Authority during 2020. The suspension is effective from today.
Under the Accredited Registers programme, organisations can apply for accreditation of registers they hold of unregulated healthcare practitioners and must meet Standards set by the Authority. The SoH was first accredited in 2014. In February 2020 accreditation was renewed, subject to a Condition that included making its position statements clear that registrants must not practise CEASE, practise or advertise adjunctive therapies, or provide advice on vaccination.
Accreditation of registers is renewed annually, however where there are serious concerns, we conduct an in-year review. We undertook an in-year review of the SoH during the summer of 2020, after concerns were raised in relation to the appointment of a key official. As set out in the outcome of our in-year review three further Conditions were issued, the first two of which were due in October 2020. In December 2020, a Panel met to consider whether these had been met.
We found the Conditions were not met and that the SoH did not fully meet a number of our Standards. In view of the recurrent nature of the concerns, and that several Conditions had already been imposed on the SoH since February 2020, we decided to suspend accreditation.
The suspension will be reviewed after 12 months. To be lifted the SoH will need to demonstrate that it prioritises public protection over professional interests in its handling of complaints and governance processes. If the SoH can demonstrate that this is achieved through fulfilment of the Conditions and Standards earlier than 12 months then we will consider lifting the suspension sooner.
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For background information, the following posts might be helpful:
The UK Society of Homeopaths, a hub of anti-vaccination activists? (edzardernst.com)
Hesperidin is a flavonoid found in citrus fruits, especially orange and grapefruit. It is said to have antioxidant and anti-inflammatory effects. Research into hesperidin began in the 1940s but only recently interest turned buoyant, and all sorts of benefits have been suggested. Here are just three recent clinical studies:
- This study investigated the effects of chronic intake of an orange extract (2S-hesperidin) or placebo on non-oxidative/glycolytic and oxidative metabolism markers and performance markers in amateur cyclists. A double-blind, randomized, placebo-controlled trial was carried out between late September and December 2018. Forty amateur cyclists were randomized into two groups: one taking 500 mg/day 2S-hesperidin and the other taking 500 mg/day placebo (microcellulose) for eight weeks. All participants completed the study. An incremental test was used to evaluate performance, and a step test was used to measure oxygen consumption, carbon dioxide, efficiency and oxidation of carbohydrates and fat by indirect calorimetry. The anaerobic power (non-oxidative) was determined using Wingate tests (30 s). After eight weeks supplementation, there was an increase in the incremental test in estimated functional threshold power (FTP) (3.2%; p ≤ 0.05) and maximum power (2.7%; p ≤ 0.05) with 2S-hesperdin compared to placebo. In the step test, there was a decrease in VO2 (L/min) (-8.3%; p ≤ 0.01) and VO2R (mL/kg/min) (-8.9%; p ≤ 0.01) at VT2 in placebo. However, there were no differences between groups. In the Wingate test, there was a significant increase (p ≤ 0.05) in peak and relative power in both groups, but without differences between groups. Supplementation with an orange extract (2S-hesperdin) 500 mg/day improves estimated FTP and maximum power performance in amateur cyclists.
- In this clinical trial with a parallel-group design, 49 patients with MetS received either 500-mg hesperidin or placebo, twice daily, for 12 weeks. Number of participants with treated MetS was considered as a primary end point. Anthropometric parameters, dietary intake, physical activity, lipid profile, glucose homeostasis parameter, tumor necrosis factor alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP) were assessed at the beginning and at the end of the study. Compared with the placebo group, hesperidin decreased fasting glucose level (- 6.07 vs. – 13.32 mg/dL, P = 0.043), triglyceride (- 8.83 vs. – 49.09 mg/dL, P = 0.049), systolic blood pressure (- 0.58 vs. – 2.68 mmHg, P = 0.048) and TNF-α (- 1.29 vs. – 4.44 pg/mL, P = 0.009). Based on the within-group analysis, hesperidin led to significant decrease in serum levels of glucose, insulin, triglyceride, total cholesterol, low density lipoprotein cholesterol, TNF-α and hs-CRP, while in control group only glucose and insulin significantly decreased. The results indicate that hesperidin supplementation can improve metabolic abnormalities and inflammatory status in patients with MetS.
- In this study, 64 patients were randomly allocated to receive 500 mg/day hesperidin or placebo capsules for 6 weeks. Data on systolic blood pressure (SBP), diastolic blood pressure, serum total antioxidant capacity (TAC), tumor necrosis factor alpha, interleukin 6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) were collected at the baseline and at the end of the study. In the hesperidin group, SBP (122.7 ± 8.5 vs. 119.0 ± 7.4; p = .005), mean arterial blood pressure (94.2 ± 5.5 vs. 91.8 ± 5.5; p = .009), IL-6 (8.3 ± 2.1 vs. 7.4 ± 1.8; p = .001), and hs-CRP (1.9 ± 1.2 vs. 1.1 ± 0.9; p < .000) decreased whereas TAC increased (0.74 ± 0.1 vs. 0.82 ± 0.1; p < .000) in comparison to the baseline values. There was a significant difference in mean percent change of SBP, diastolic blood pressure, mean arterial blood pressure, serum TAC, and inflammatory markers (tumor necrosis factor alpha, IL-6, and hs-CRP) between hesperidin and control groups following intervention in adjusted models (p < .05). These results suggest that hesperidin may have antihypertensive and anti-inflammatory effects in type 2 diabetes.
The latest suggestion for Hesperidin is – how could be be otherwise? – that it helps against COVID-19: Hesperidin can block coronavirus from entering host cells through ACE2 receptors which can prevent the infection. Anti-viral activity of hesperidin might constitute a treatment option for COVID-19 through improving host cellular immunity against infection and its good anti-inflammatory activity may help in controlling cytokine storm. Hesperidin mixture with diosmin co-administrated with heparin protect against venous thromboembolism which may prevent disease progression. Based on that, hesperidin might be used as a meaningful prophylactic agent and a promising adjuvant treatment option against SARS-CoV-2 infection.
According to one source, Hesperidin can cause several problems:
- abdominal pain,
- diarrhea,
- contact dermatitis,
- nausea,
- interactions with medications (including anticoagulants, blood pressure drugs, and calcium channel blockers),
- increased risk of bleeding.
No doubt, Hesperidin is an interesting substance. Yet, I feel that much more research is needed until we can be reasonably sure that it is clinically effective for any condition, particularly COVID-19.
