Monthly Archives: September 2023
The COVID-19 pandemic has been notable for the widespread dissemination of misinformation regarding the virus and appropriate treatment. The objective of this study was to quantify the prevalence of non–evidence-based treatment for COVID-19 in the US and the association between such treatment and endorsement of misinformation as well as lack of trust in physicians and scientists.
This single-wave, population-based, nonprobability internet survey study was conducted between December 22, 2022, and January 16, 2023, in US residents 18 years or older who reported prior COVID-19 infection.
Self-reported use of ivermectin or hydroxychloroquine, endorsing false statements related to COVID-19 vaccination, self-reported trust in various institutions, conspiratorial thinking measured by the American Conspiracy Thinking Scale, and news sources.
A total of 13 438 individuals (mean [SD] age, 42.7 [16.1] years; 9150 [68.1%] female and 4288 [31.9%] male) who reported prior COVID-19 infection were included in this study. In this cohort, 799 (5.9%) reported prior use of hydroxychloroquine (527 [3.9%]) or ivermectin (440 [3.3%]). In regression models including sociodemographic features as well as political affiliation, those who endorsed at least 1 item of COVID-19 vaccine misinformation were more likely to receive non–evidence-based medication (adjusted odds ratio [OR], 2.86; 95% CI, 2.28-3.58). Those reporting trust in physicians and hospitals (adjusted OR, 0.74; 95% CI, 0.56-0.98) and in scientists (adjusted OR, 0.63; 95% CI, 0.51-0.79) were less likely to receive non–evidence-based medication. Respondents reporting trust in social media (adjusted OR, 2.39; 95% CI, 2.00-2.87) and in Donald Trump (adjusted OR, 2.97; 95% CI, 2.34-3.78) were more likely to have taken non–evidence-based medication. Individuals with greater scores on the American Conspiracy Thinking Scale were more likely to have received non–evidence-based medications (unadjusted OR, 1.09; 95% CI, 1.06-1.11; adjusted OR, 1.10; 95% CI, 1.07-1.13).
The authors concluded that, in this survey study of US adults, endorsement of misinformation about the COVID-19 pandemic, lack of trust in physicians or scientists, conspiracy-mindedness, and the nature of news sources were associated with receiving non–evidence-based treatment for COVID-19. These results suggest that the potential harms of misinformation may extend to the use of ineffective and potentially toxic treatments in addition to avoidance of health-promoting behaviors.
This study made me wonder to what extend a lack of trust in physicians or scientists, and conspiracy-mindedness are also linked to the use of so-called alternative medicine (SCAM) for treatning COVID infections. As I have often discussed, such associations have been reported regularly, e.g.:
- Homeopathy as an Adjuvant to Standard Care in Moderate and Severe Cases of COVID-19
- Arrests in Germany of healthcare professionals who issued fake COVID certificates
- Classical homeopathy worsens the prognosis of patients infected with COVID-19.
- “No jabby-jabby for me! Praise GOD!” But now this antivaxer has died of COVID-related pneumonia
- Homeopathy for COVID: opinions expressed on Twitter
- Efficacy of Persian barley water on clinical outcomes of hospitalized moderate-severity COVID-19 patients
- Effectiveness of Homeopathic Arsenicum album 30C in the Prevention of COVID-19
- Homoeopathy in the Prophylaxis and Symptomatic Management of COVID-19
- Is aromatherapy the answer to long-COVID? I fear not!
- Anthroposophical hospital defies COVID-19 regulations
- An Ayurvedic medication is effective for patients suffering from mild to moderate COVID-19 – true or false?
- Homeopathy for COVID-19: A randomized, double-blind, placebo-controlled trial shows that it does not work
- Micronutrient supplements for patients with COVID-19 infection
- A new trial of homeopathy for preventing COVID-19 infections
- Homeopathy and other SCAMs for long-COVID: WHERE IS THE EVIDENCE?
- Upper Bavaria is struggling with COVID-19, not least due to so-called alternative medicine
- And again: is vitamin C the solution for COVID-19 infections?
- Parents’ Willingness to Vaccinate with a COVID-19 Vaccine: strongly influenced by homeopathy
- A new study of homeopathy for the prevention of COVID-19 infections
- Homeopathic Treatment for COVID-19: a case of scientific misconduct and/or irresponsible behavior?
- The ‘AYUSH COVID-19 Helpline’: have they gone bonkers?
- Adjunctive homeopathic treatment of hospitalized COVID-19 patients. A case study of homeopathic delusion
- US Chiropractor in court for making false claims related to COVID-19
- Chinese Herbal Medicine for COVID-19? The evidence remains unconvincing
- Vitamin C and/or zinc for managing COVID patients?
- An RCT on the efficacy of ayurvedic treatment on asymptomatic COVID-19 patients
- Herbal solutions to the COVID-19 pandemic?
The authors point out that the endorsement of misinformation related to COVID-19 has been shown to decrease the intention to vaccinate against COVID-19, to decrease the belief that it is required for herd immunity, and to correlate with forgoing various COVID-19 prevention behaviors. Such false information is largely spread online and often originates as disinformation intentionally spread by political actors and media sources, as well as illicit actors who profit from touting supposed cures for COVID-19. A substantial minority of the public endorses false information related to COVID-19, although certain subgroups are more likely to do so, including those who are more religious, who distrust scientists, and who hold stronger political affiliations. Cultivating and maintaining trust is a crucial factor in encouraging the public to engage in prosocial health behaviors. The extent to which addressing conspiratorial thinking could represent a strategy to address obstacles to public health merits further investigation.
When the media does not adhere to reporting guidelines regarding so-called alternative medicine (SCAM), this may deceive or mislead consumers about the safety and efficacy of these practices. A team of researchers analyzed whether Serbian online media adheres to reporting guidelines and described dominant psychological appeals used to promote TM/CAM.
They conducted a content analysis of 182 articles from six news and six magazine websites, published July–December 2021. Biologically based treatments – predominantly herbal products – were the most common (205/289 practices). SCAM practices were claimed to:
- improve general health (71/386 claims),
- alleviate respiratory problems,
- boost the immunity,
- and detox the body.
The tone was overwhelmingly positive, with most of the positive articles (145/176) neglecting to disclose the potential harms of SCAM. Few articles provided a recommendation to speak with a healthcare provider (24/176). Articles tended to appeal to SCAM’s long tradition of use (115/176), naturalness (80/176), and convenience (72/176). They used vague pseudoscientific jargon (105/176) and failed to cite sources for the claims that SCAM use is supported by science (39/176).
The authors concluded that given that SCAM use may lead to harmful outcomes (such as adverse events, avoidance of official treatment or interaction with it), Serbian online media reports on SCAM are inadequate to assist consumers’ decision-making. Our findings highlight issues that need to be addressed towards ensuring more critical health reporting, and, ultimately, better informed SCAM consumption choices.
A long time agao, in 2000, we did a similar survey. We compared what UK newspapers published about SCAM and conventional medicine to what German papers did. We found that the proportion of articles about SCAM seems to be considerably larger in the UK (15% v 5%), and, in contrast to articles on medical matters in general, reporting on SCAM in the UK was overwhelmingly positive. I wonder whether, 23 years later, the situation has changed.
Blood electrification? If you had not heard about it, you are in good company. What is it? The Internet has many columns on it. Here is an article that I abbreviated a bit for the purpose of this blog:
Dr. Robert C. Beck is the inventor of blood electrification, which can be traced back to the work of Dr. Hulda Clark and Dr. Robert J. Thiel. The method is based on the assumption that parasites, bacteria, viruses and fungi are paralyzed by a low current pulse of 50 to 100 microamperes. As a result, the pathogens are no longer able to infect the body and the immune system can readily eliminate.
Dr. Beck found that the current flow, i.e., blood electrification, is more important than the frequency. Unlike previous ‘zappers’, the “Beck-Zapper” works only with a frequency of 3.920 Hz. Beck believes that the lower the frequency, the greater the current absorption, i.e. the more effective the therapy. Moreover, the Beck zapper is in harmony with the body’s own rhythm and is therefore not a stress trigger. Since the Beck zapper works with a higher voltage (27 volts) than the Clark zapper (9 volts), it is attached directly to the pulse vein and not held in the hands. Here’s how the Beckzapper works:
- The “enemy in the blood,” as Beck called parasites, viruses and bacteria, is fought with mild electricity between 50 and 100 microamperes at half the Schumann frequency of 3.92 Hz, he said.
- During blood electrification, colloidal silver is added to prevent secondary infection. Colloidal silver is extremely small silver particles dissolved in water, which are held in suspension by the water molecules. Although collodial silver enjoyed great importance in medicine hundreds of years ago, it fell into oblivion due to the introduction of antiobiotics and has only been gradually rediscovered in recent years.
- Powerful magnetic pulses are said to carry pathogens from the lymphatic system back into the bloodstream, where they can then be eliminated by the immune system.
Beck was able to prove that his patients became virus-free and symptom-free after the exact application of the blood electrification device. However, he also found that some of his patients became ill again with the same virus after a few months. After further study, he realized that the repeated infections were due to lingering viruses in the lymph fluid. Starting from the lymph fluid, the viruses returned to the bloodstream, where they re-infected cells and multiplied, causing the repeated symptoms of the disease. Beck then invented another device, the so-called magnetic pulser.
This generated an electrical flow by means of a magnetic pulse, which triggered contractions in the lymphatic channels. This forced movement of the lymph, causing the microbes to be forced back into the bloodstream where they could be electrified. Beck applied the Magnetpluser to some patients in combination with the blood electrifier and obtained surprisingly positive results.
Dr. Beck assumed that parasites were responsible for the development of diseases. Beck also believed that parasites in the blood would limit human life expectancy to 70 to 80 years. Dr. Beck himself was convinced of the effectiveness of his zapper and lost 60 kg through it. He explained this weight loss by the fact that the parasites had previously consumed a large part of the nutrients, causing him to experience constant ravenous hunger. In addition, Beck’s blood pressure dropped significantly, as did his blood sugar. He also regained a full head of hair as an almost 70-year-old bald man. Beck attributed all these benefits to his zapper, which he was able to prove after a three-week treatment by means of a blood test using the dark field method: His blood count was perfect.
The blood zapper also helps with herpes diseases, AIDS, chicken pox, lung ulcers, leukemia and other types of cancer, as well as chronic fatigue syndrome, diabetes, flu-like infections, asthma and gastritis. In short, the blood zapper has been able to treat many diseases that are usually considered incurable.
Beck recommends performing blood electrification for two hours daily for 3 to 6 weeks, or longer if necessary.
- The Beckzapper can be carried in the breast pocket or on the belt.
- The cathode and anode are to be placed where on the one hand the blood flows and on the other hand the pulse beat can be felt.
- This can be, for example, on the wrist or feet.
- For the greatest possible freedom of movement during treatment, the “miniZAP” is recommended.
- This is a matchbox-sized zapper that can be worn comfortably on the wrist.
- The method of blood electrification can be performed by anyone. There are no known side effects when using the blood zapper.
Dr. Alfons Weber has presented research according to which most cancers are caused by excessive microbial infestation of blood cells. According to the findings of Prof. Pappa, this circumstance, in turn, can be attributed to a too low energy status. The use of electrotherapy can therefore achieve considerable success in the treatment of parasitic and energy-related cancers in particular.
- The use of the Beckzapper in cancer patients should be continuous
- According to Dr. Weber, the carcinoma protozoa are located in the blood cells and eat the hemoglobin here.
- The carcinoma protozoa located in the blood cells are first hardly affected by the increased current flow in the blood plasma.
- Only when the respective blood cell has been eaten empty do the carcinoma protozoa leave the blood cell in search of a new one.
- Once the carcinoma protozoa are outside the plasma, they can be eliminated by the continuous surge of the Beckzapper.
- In this way, new blood cells cannot be attacked in the first place.
The continuous application of the Beckzapper, possibly in combination with a magnetic pulse generator with collodial silver, can significantly reduce the number of protozoa.
Vis a vis so much nonsense, I am almost speechless. I did try to find any credible publications that might back up the multityde of claims made above. Neddless to say, I was not successful.
And what makes that anyone who promotes ‘blood electrification’ as a cure of anything?
The answer is easy:
A DANGEROUS CHARLATAN
The Skeptic reported that a cardiologist and one of the UK’s most influential critics of the COVID-19 vaccine, Dr Aseem Malhotra, has been named the 2023 recipient of the “Rusty Razor” award, the prize given by The Skeptic to the year’s worst promoters of pseudoscience.
Dr Malhotra has made a name for himself over the last decade as a cardiologist who advocates strongly against the broad use of statins. He has described the drugs as a multi-billion dollar “con” by the pharmaceutical industry, saying that his critics have “received millions in research funding from the pharmaceutical industry”. He has described the link between heart disease and saturated fat as a “myth”, drawing criticism from the British Heart Foundation.
In 2017, his book The Pioppi Diet put forward a diet that he claimed could prevent 20 million deaths per year from cardiovascular disease. The book was named by the British Dietetic Association as one of the celebrity diets to most avoid – with the BDA highlighting his apparently Mediterranean diet excluded pasta and bread, but included coconuts.
Throughout the COVID-19 pandemic, Dr Malhotra has been a prolific and powerful voice spreading narratives that run contrary to the best available evidence. In 2021, his book The 21-Day Immunity Plan included a diet claimed to improve the immune system and help fight off infections – claims that drew criticism from medical professionals.
In 2022, Dr Malhotra released a paper claiming that COVID-19 mRNA vaccines posed a serious risk to cardiovascular health and that the vaccines were “at best a reckless gamble”. The paper was published in the Journal of Insulin Resistance – where Dr Malhotra sits on the editorial board.
Dr Malhotra and his campaign against the COVID-19 vaccine was subsequently praised in Parliament by Andrew Bridgen MP as part of the reasoning behind his ongoing anti-vaccine crusade. In January of this year, Dr Malhotra used a BBC interview about statins to claim that deaths from coronary artery disease were actually complications from the vaccine, prompting a slew of complaints, and an apology from the broadcaster.
The Skeptic Editor Michael Marshall said: “In our opinion, Dr Malhotra has been an incredibly prolific promoter of pseudoscience throughout the pandemic, including spreading the false notion that vaccines are responsible for thousands of excess deaths.
“Dr Malhotra’s media career has given him a very large platform, from which he spreads misinformation that undermines confidence in a health intervention that has saved the lives of countless people across the world. In doing so, he stokes the flames of conspiracy, paranoia and mistrust of medical consensus.
“For anyone with so large a platform to do this would be concerning enough, but Dr Malhotra shares these pseudoscientific messages as a registered medical professional whose opinions have influenced at least one current member of parliament.
“All of this, we feel, makes Dr Aseem Malhotra a highly deserving winner of the 2023 Rusty Razor award”
The ‘Rusty Razor’ award was announced as part of The Skeptic’s annual Ockham Awards at a ceremony that took place during Saturday’s QED conference on science and skepticism, in Manchester. Also recognised during the event was the Knowledge Fight podcast, who won the 2023 award for Skeptical Activism.
I agree, Malhortra is a deserverd winner. The prize raises, in my view, an important question:
WHAT ON EARTH IS THE GENERAL MEDICIN COUNCIL (GMC) DOING ABOUT THIS GUY?
Malhotra’s activities have been compared to the case of Andrew Wakefield who falsely claimed that the MMR vaccine was linked to autism. While Wakefield was ultimately struck off by the GMC in 2010, the regulator has so far rebuffed repeated pleas to investigate Dr Malhotra.
The BMJ recently reported that Dr. Matt Kneale, who had previously complained to the GMC about the conduct of Aseem Malhotra, was told that the GMC would not be investigating Malhotra because his statements were not sufficiently “egregious” to merit action and he had a right to “freedom of speech.” Kneale’s appeal against this decision in 2023 was also turned down.
Kneale has now filed a claim with the High Court, arguing that the GMC should consider not only whether a doctor’s behaviour could harm individual patients but also whether their actions undermined public trust in medicine. He said that this was particularly important when examining statements relating to vaccines, where doctors with a high profile on social media could potentially cause great harm.
This case report aims to describe the effects of craniosacral therapy and acupuncture in a patient with chronic migraine.
A 33-year-old man with chronic migraine was treated with 20 sessions of craniosacral therapy and acupuncture for 8 weeks. The number of migraine and headache days were monitored every month. The pain intensity of headache was measured on the visual analog scale (VAS). Korean Headache Impact Test-6 (HIT-6) and Migraine Specific Quality of Life (MSQoL) were also used.
The number of headache days per month reduced from 28 to 7 after 8 weeks of treatment and to 3 after 3 months of treatment. The pain intensity of headache based on VAS reduced from 7.5 to 3 after 8 weeks and further to < 1 after 3 months of treatment. Furthermore, the patient’s HIT-6 and MSQoL scores improved during the treatment period, which was maintained or further improved at the 3 month follow-up. No side effects were observed during or after the treatment.
The authors concluded that this case indicates that craniosacral therapy and acupuncture could be effective treatments for chronic
migraine. Further studies are required to validate the efficacy of craniosacral therapy for chronic migraine.
So, was the treatment period 8 weeks long or was it 3 months?
No, I am not discussing this article merely for making a fairly petty point. The reason I mention it is diffteren. I think it is time to discuss the relevance of case reports.
What is the purpose of a case report in medicine/healthcare. Here is the abstract of an article entitled “The Importance of Writing and Publishing Case Reports During Medical Training“:
Case reports are valuable resources of unusual information that may lead to new research and advances in clinical practice. Many journals and medical databases recognize the time-honored importance of case reports as a valuable source of new ideas and information in clinical medicine. There are published editorials available on the continued importance of open-access case reports in our modern information-flowing world. Writing case reports is an academic duty with an artistic element.
An article in the BMJ is, I think, more informative:
It is common practice in medicine that when we come across an interesting case with an unusual presentation or a surprise twist, we must tell the rest of the medical world. This is how we continue our lifelong learning and aid faster diagnosis and treatment for patients.
It usually falls to the junior to write up the case, so here are a few simple tips to get you started.
First steps
Begin by sitting down with your medical team to discuss the interesting aspects of the case and the learning points to highlight. Ideally, a registrar or middle grade will mentor you and give you guidance. Another junior doctor or medical student may also be keen to be involved. Allocate jobs to split the workload, set a deadline and work timeframe, and discuss the order in which the authors will be listed. All listed authors should contribute substantially, with the person doing most of the work put first and the guarantor (usually the most senior team member) at the end.
Getting consent
Gain permission and written consent to write up the case from the patient or parents, if your patient is a child, and keep a copy because you will need it later for submission to journals.
Information gathering
Gather all the information from the medical notes and the hospital’s electronic systems, including copies of blood results and imaging, as medical notes often disappear when the patient is discharged and are notoriously difficult to find again. Remember to anonymise the data according to your local hospital policy.
Writing up
Write up the case emphasising the interesting points of the presentation, investigations leading to diagnosis, and management of the disease/pathology. Get input on the case from all members of the team, highlighting their involvement. Also include the prognosis of the patient, if known, as the reader will want to know the outcome.
Coming up with a title
Discuss a title with your supervisor and other members of the team, as this provides the focus for your article. The title should be concise and interesting but should also enable people to find it in medical literature search engines. Also think about how you will present your case study—for example, a poster presentation or scientific paper—and consider potential journals or conferences, as you may need to write in a particular style or format.
Background research
Research the disease/pathology that is the focus of your article and write a background paragraph or two, highlighting the relevance of your case report in relation to this. If you are struggling, seek the opinion of a specialist who may know of relevant articles or texts. Another good resource is your hospital library, where staff are often more than happy to help with literature searches.
How your case is different
Move on to explore how the case presented differently to the admitting team. Alternatively, if your report is focused on management, explore the difficulties the team came across and alternative options for treatment.
Conclusion
Finish by explaining why your case report adds to the medical literature and highlight any learning points.
Writing an abstract
The abstract should be no longer than 100-200 words and should highlight all your key points concisely. This can be harder than writing the full article and needs special care as it will be used to judge whether your case is accepted for presentation or publication.
What next
Discuss with your supervisor or team about options for presenting or publishing your case report. At the very least, you should present your article locally within a departmental or team meeting or at a hospital grand round. Well done!
Both papers agree that case reports can be important. They may provide valuable resources of unusual information that may lead to new research and advances in clinical practice and should offer an interesting case with an unusual presentation or a surprise twist.
I agree!
But perhaps it is more constructive to consider what a case report cannot do.
It cannot provide evidence about the effectiveness of a therapy. To publish something like:
- I had a patient with the common condition xy;
- I treated her with therapy yz;
- this was followed by patient feeling better;
is totally bonkers – even more so if the outcome was subjective and the therapy consisted of more than one intervention, as in the article above. We have no means of telling whether it was treatment A, or treatment B, or a placebo effect, or the regression towards the mean, or the natural history of the condition that caused the outcome. The authors might just as well just have reported:
WE RECENTLY TREATED A PATIENT WHO GOT BETTER
full stop.
Sadly – and this is the reason why I spend some time on this subject – this sort of thing happens very often in the realm of SCAM.
Case reports are particularly valuable if they enable and stimulate others to do more research on a defined and under-researched issue (e.g. an adverse effect of a therapy). Case reports like the one above do not do this. They are a waste of space and tend to be abused as some sort of indication that the treatments in question might be valuable.
The current BMJ has an article entitled UK could have averted 240 000 deaths in 2010s if it matched other European nations. Here is its staring passage:
The UK has fallen far behind its international peers on a range of health outcomes and major policy reforms are required to reverse this, a report1 has concluded.
Analysts from the Institute for Public Policy Research (IPPR) calculated that there would have been 240 000 fewer deaths in the UK between 2010 and 2020 if the UK matched average avoidable mortality in comparable European nations.
The report says the UK’s poor outcomes are partly down to people’s inability to access healthcare in a timely manner, a problem that has intensified since the pandemic.
To tackle this, the progressive think tank has put forward a 10 point plan to shift the NHS from a sickness service to a prevention service. It says primary care should be placed at the heart of a “prevention first” NHS with a nationwide rollout of neighbourhood health hubs to deliver integrated health and care services in every local area…
INTEGRATED HEALTH?
Isn’t that the nonsense Charles III, Michael Dixon, THE COLLEGE OF MEDICINE AND INTEGRATED HEALTH and many others promote? The integrated health we discussed so often before, e.g.:
- Prince Charles becomes patron of the ‘College of Medicine and Integrated Health’
- The ‘All-Party Parliamentary Group for Integrated Healthcare (PGIH) have just published a new report – and it’s full of surprises
- Eurocam press release in favor of integrated medicine
- A new definition of ‘INTEGRATED MEDICINE’
- Integrative medicine: one of the most colossal deceptions in healthcare today
- INTEGRATED MEDICINE: a disservice to patients?
- Integrated/integrative medicine: a paradise for charlatans?
The UK ‘Integrated Medicine Alliance’ offers information sheets on all of the following treatments: Acupuncture, Alexander Technique, Aromatherapy, Herbal Medicine, Homeopathy, Hypnotherapy, Massage, ,Naturopathy, Reflexology, Reiki, Tai Chi, Yoga Therapy. The one on homeopathy, for example, tells us that “homeopathy … can be used for almost any condition either alone or in a complementary manner.” Is the BMJ thus promoting homeopathy and similar dubious treatments?
The answer is, of course, NO!
The BMJ supports INTEGRATED HEALTH as defined not by quacks but by real experts: “Integrated care, also known as integrated health, coordinated care, comprehensive care, seamless care, or transmural care, is a worldwide trend in health care reforms and new organizational arrangements focusing on more coordinated and integrated forms of care provision. Integrated care may be seen as a response to the fragmented delivery of health and social services being an acknowledged problem in many health systems.”
I have often wondered why quacks use established terms, give it a different meaning and use it for confusing the public. I suppose the answer is embarrassingly simple: they thrive on confusion, want to hide the fact that they have no convincing arguments of their own, and like to use the established terminology of others in order to push their agenda and maximize their benefits.
The US ‘Public Citizen‘ is an American non-profit, progressive consumer rights advocacy group, and think tank based in Washington, D.C. They recently published an article entitled “FDA Guidance on Homeopathic Drugs: An Ongoing Public Health Failure“. Here are a few excerpts:
In December 2022, the U.S. Food and Drug Administration (FDA) issued new guidance on homeopathic drug products. The guidance states that the agency now “intends to apply a risk-based enforcement approach to the manufacturing, distribution and marketing of homeopathic drug products.”
Under this new risk-based approach, the agency plans to target its enforcement actions against homeopathic drug products marketed without FDA approval that fall within the following limited categories:
- products with reports of injury that, after evaluation, raise potential safety concerns
- products containing or purportedly containing ingredients associated with potentially significant safety concerns (for example, infectious agents or controlled substances)
- products that are not administered orally or topically (for example, injectable drug products and ophthalmic drug products)
- products intended to be used to prevent or treat serious or life-threatening diseases
- products for vulnerable populations, such as immunocompromised individuals, infants and the elderly
- products with significant quality issues (for example, products that are contaminated with foreign materials or objectionable microorganisms)
But this new FDA guidance fails to adequately address the public health threat posed by the agency’s decades-long permissive approach to these illegal drug products.
Under FDA regulations, prescription and over-the-counter (OTC) homeopathic products are considered drugs and are supposed to be subject to the same review and approval requirements as all other prescription and OTC medications. However, under a flawed enforcement policy issued in 1988, the FDA has allowed these drug products to be marketed in the U.S. without agency review or approval. Thus, all products labeled as homeopathic are being marketed without the FDA having evaluated their safety, effectiveness or quality…
… there is no plausible physiologic or medical basis to support the theory underlying homeopathy, nor is there evidence from well-designed, rigorous clinical trials showing that homeopathic drugs are safe and effective.
The FDA should declare unequivocally that all unapproved homeopathic drug products are illegal and direct all manufacturers to immediately remove such products from the market. In the meantime, as we have recommended for many years, consumers should not use homeopathic products. At best, the products are a waste of money, given the lack of any evidence that they are effective. At worst, they could cause serious harm because of the lack of FDA oversight to ensure safety.
_____________________
I fully agree with these sentiments. The harm caused by homeopathy is considerable and multi-facetted. Many previous posts have discudded these problems, e.g.:
- Nine cases of severe homeopathy-induced liver injuries
- Another death by homeopathy
- HOMEOPATHY – “It is not just irresponsible, it’s downright dangerous.”
- Adverse effects of homeopathy and aggravations at NAFKAM
- Homeopathy: it’s time to stop the double standards
- Homeopathy can cause serious harm – and finally, the NHS England has realised it
- Vidatox, homeopathy’s answer to cancer or outright fraud?
- Another child has died because of homeopathy
- Doctor homeopaths violate fundamental rules of ethics when practising homeopathy
- ‘Best homeopathy doctor in Delhi’ offers treatment for HIV/AIDS
- DIY-Homeopathy: how to kill your entire family
- The risks of homeopathy?
- The FDA has warned 4 manufacturers of unapproved injectable homeopathic drugs
- Is this the crown of the Corona-idiocy? Nosodes In Prevention And Management Of COVID -19
- The FDA has sent more warning letters to homeopathic manufacturers
- Walmart is being sued for selling homeopathic products
- Homoeopathic remedies may be safe, but do all homeopaths merit this attribute?
- Recommending homeoprophylaxis is unethical, irresponsible and possibly even criminal
- FDA: homeopathic teething remedies were toxic
- “Homeoprophylaxis, the homeopathic vaccine alternative, prevents disease through nosodes.”
- A truly dangerous homeopath
- The scandalous attitude of some homeopaths and their supporters towards immunisations
- Oh yes, let’s have homeopaths as primary care practitioners! But only in a parallel universe,please.
Having warned about the dangers of homeopathy for decades, I feel it is high time for regulators across the world to take appropriate action.
So-called alternative medicine (SCAM) is widely used in Saudi Arabia. One of the common practices is the use of camel urine alone or mixed with camel milk for the treatment of cancer, which is often supported by religious beliefs.
This study observed cancer patients who insisted on using camel urine, and to offer some clinically relevant recommendations. The authors observed 20 cancer patients (15 male, 5 female) from September 2020 to January 2022 who insisted on using camel urine for treatment. They documented the demographics of each patient, the method of administering the urine, reasons for refusing conventional treatment, period of follow-up, and the outcome and side effects.
All the patients had radiological investigations before and after their treatment with camel urine. All of them used a combination of camel urine and camel milk, and their treatment ranged from a few days to 6 months. They consumed an average of 60 ml urine/milk per day. No clinical benefit was observed after the treatment; 2 patients developed brucellosis. Eleven patients changed their mind and accepted conventional antineoplastic treatment and 7 were too weak to receive further treatment; they died from the disease.
The authors concluded that camel urine had no clinical benefits for any of the cancer patients, it may even have caused zoonotic infection. The promotion of camel urine as a traditional medicine should be stopped because there is no scientific evidence to support it.
If you suspected that this was a hoax, you were wrong!
Here is a recent paper on the ‘therapeutic potentials of camel urine’:
Camel urine has traditionally been used to treat multiple human diseases and possesses the most beneficial effects amongst the urine of other animals. However, scientific review evaluating the anticancer, antiplatelet, gastroprotective and hepatoprotective effects of camel urine is still scarce. Thus, this scoping review aimed to provide scientific evidence on the therapeutic potentials of camel urine. Three databases were searched to identify relevant articles (Web of Science, PubMed and Scopus) up to September 2020. Original articles published in English that investigated the effects of camel urine in various diseases were included. The literature search identified six potential articles that met all the inclusion criteria. Three articles showed that camel urine possesses cytotoxic activities against different types of cancer cells. Two studies revealed camel urine’s protective effects against liver toxicity and gastric ulcers, whilst another study showed the role of camel urine as an antiplatelet agent. All studies demonstrated significant positive effects with different effective dosages. Thus, camel urine shows promising therapeutic potential in treating human diseases, especially cancer. However, the standardised dosage and potential side effects should be determined before camel urine could be offered as an alternative treatment.
I have often asked myself the question whether some SCAMs are too absurd to merit scientific study. Over the years, I changed my mind on it; while initially I tended to answer it in the negative, I now think that YES: some ideas – even those that are ancient and, as Charles Windsor would argue, have thus stood the ‘test of time’ – are not worth the effort. Camel urine as a therapy might well be one of them.
This systematic review and meta-analysis was aimed at analyzing the effectiveness of craniosacral therapy in improving pain and disability among patients with headache disorders.
PubMed, Physiotherapy Evidence Database, Scopus, Cochrane Library, Web of Science, and Osteopathic Medicine Digital Library databases were searched in March 2023. Two independent reviewers searched the databases and extracted data from randomized clinical trials comparing craniosacral therapy with control or sham interventions. The same reviewers assessed the methodological quality and the risk of bias using the PEDro scale and the Cochrane Collaboration tool, respectively. Grading of recommendations, assessment, development, and evaluations was used to rate the certainty of the evidence. Meta-analyses were conducted using random effects models using RevMan 5.4 software.
The searches retrieved 735 papers, and 4 studies were finally included. The craniosacral therapy provided statistically significant but clinically unimportant change on pain intensity (Mean difference = –1.10; 95% CI: –1.85, –0.35; I2: 44%), and no change on disability or headache effect (Standardized Mean Difference = –0.34; 95% CI –0.70, 0.01; I2: 26%). The certainty of the evidence was downgraded to very low.
The authors concluded that very low certainty of evidence suggests that craniosacral therapy produces clinically unimportant effects on pain intensity, whereas no significant effects were observed in disability or headache effect.
I find it strange that researchers seem so frequently unable to formulate their conclusions clearly. Is it political correctness? Or are they somehow favorably inclined (i.e. biased) towards the treatment that they pretend to critically evaluate?
Let’s look at the facts related to this review:
- Craniosacral therapy (CST) is utterly implausible.
- Only 4 RCTs were found.
- They were of poor quality.
- They were published mostly by people who want to promote CST.
- Therefore the overall statistically significant effect is most likely a false-positive result.
- This means that the conclusion should be much more straight forward.
I suggest something along the following lines:
A critical evaluation of the existing RCTs failed to find convincing evidence that CST is an effective treatment for headache disorders.
Charles III is about to pay his first visit to France, his second visit to any state. Earlier this year, he has already visited Germany. Originally, France had been first on his list but the event was cancelled in view of the violent protests that rocked the country at the time. Now he is definitely expected and the French are exited. I am currently in France and have been asked to give several interviews on the king’s love affair with so-called alternative medicine (SCAM).
The French have long been fascinated by our royal family which seems a bit odd considering what they did to their own. Now that Charles and Camilla are about to appear with an entourage of about 50 servants between them, the press is full with slightly bemused reports and comments:
Since childhood, Charles has been accustomed to a luxurious, gilded life, which is reproduced on every trip outside the royal palaces, to ensure maximum service, comfort and security… The new king always travels with his private secretary, Sir Clive Alderton, his press advisor, his steward, his doctor, his personal valets, his security guards, and his private chauffeur, Tim Williams… And, of course, his regular osteopath to relieve his lower back. Since he’s had a lot of falls playing polo, Charles regularly suffers from back pain…”.
Really, just an osteopath?
What about all the other SCAM-practitioners whose businesses Charles so regularly supported in the past:
- · Acupuncture
- · Aromatherapy
- · Ayurveda
- · Chiropractic
- · Detox
- · Gerson therapy
- · Herbal medicine
- · Homeopathy
- · Iridology
- · Marma massage
- · Massage therapy
- · Pulse diagnosis
- · Reflexology
- · Tongue diagnosis
- · Traditional Chinese Medicine
- · Yoga
Will they not be disappointed?
I do wonder who Charles’ osteopath and doctor are. Are they competent? I am sure they both must be well-informed and evidence-based experts. If that is the case, they will have, of course, told Charles that osteopathy is hardly an optimal solution for an injured back.
In any case, now I am concerned about the royal back and therefore urgently recommend that HIS MAJESTY reads some of my previous posts on the subject, e.g.:
- Manual therapy (mainly chiropractic and osteopathy) does not have clinically relevant effects on back pain compared with sham treatment
- Spinal manipulative therapy for older adults with chronic low back pain fails to generate convincing results
- NICE no longer recommends acupuncture, chiropractic or osteopathy for low back pain
- The Effects of Yoga, Naturopathy, and Conventional Medical Treatment in Managing Low Back Pain
- Chronic non-specific low back pain: comparing cognitive functional therapy and movement system impairment (MSI)-based treatment
- Cognitive functional therapy for chronic low back pain
- Meditation for Chronic Low Back Pain Management?
Let’s hope all goes well here in France, and please let’s not be so akward as to ask about the environmental aspects – we all know how worried Charles truly is about not just his health but also the health of the planet – of moving such an entourage for a two-day visit.
PS
Charles flew in a private jet from London to Paris and took his Bentley with him.
