MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

case report

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This shocking paper presents 5 cases of patients with moderate to severe COVID-19 infections, 2 of them hospitalized in the intensive care unit, who were successfully treated with homeopathy. All 5 patients responded to homeopathic treatment in an unexpectedly short time span (in fact, it took up to 8 days), improving both physically and mentally.

The authors concluded that the present case series emphasizes the rapidity of response among moderate to severely ill patients to homeopathic treatment, when conventional medical options have been unable to relieve or shorten the disease. The observations described should encourage use of homeopathy in treating patients with COVID-19 during the acute phase of the disease.

If I hear about patients suffering from a cold, or tennis elbow, or otitis, or back pain, or allergy who responded to homeopathic treatment in an unexpectedly short time span, I tend to giggle and usually consider it a waste of time to explain that the observed outcome most likely is not a RESPONSE to homeopathic treatment but a non-causally related by-product. Correlation is not causation! What caused the outcome was, in fact, the natural history of the condition which would have improved even without homeopathy. To make this even clearer, I sometimes ask the homeopath: HOW DO YOU KNOW THAT THE PATIENT WOULD NOT HAVE IMPROVED EVEN FASTER IF YOU HAD NOT GIVEN HIM THE HOMEOPATHIC REMEDY? This question sometimes (sadly not always) leads to the realization that homeopathy may not have caused the outcome.

But when, in the middle of a pandemic during which millions of people died and continue to die, someone writes in a medical journal that 5 COVID patients responded to homeopathic treatment in an unexpectedly short time span, I feel compelled to disclose the statement as pure, unethical, irresponsible, and dangerous quackery.

The 5 patients with COVID-19 were hospitalized at a tertiary medical center in Jerusalem for moderate to severe
COVID-19-related symptoms. Each of them requested homeopathic treatment in addition to conventional therapy from the hospital’s ‘Center for Integrative Complementary Medicine’. All 5 patients were over 18 years old and had confirmed COVID-19 infection at the time of admission. They received their homeopathic medications as small round pills (globules); no further information about the homeopathic treatment was provided. Similarly, we also do not learn whether some patients who did not receive homeopathy recovered just as quickly (I am sure that worldwide thousands did), or whether some patients who did get homeopathic remedies failed to recover.

To make matters worse, the authors of this paper state this:

Several conclusions are evident from the cases presented:
1 homeopathy’s effect may be expected within minutes or, at most, hours;
2 contrary to classical homeopathic consultations, which may extend over an hour, correct medications for patients with acute COVID-19 symptoms may be determined in minutes;
3 there were no observable adverse effects to homeopathic treatment of COVID-19;
4 therapy can be administered via telehealth services, increasing safety of treating patients with active infection;
5 patient satisfaction was high; scoring their experience of homeopathic therapy on a 7-point scale, ranging
from “It greatly improved my condition” to “It greatly aggravated my condition,” all 5 patients indicated it
had greatly improved their condition.

The possibility that the outcomes are not causally related to the homeopathic treatment seems to have escaped the authors. The harm that can be done by such an article seems obvious: fans of homeopathy might be misled into assuming that homeopathy is an effective therapy for COVID infections and other serious conditions. It is not hard to imagine that this error would cost many lives.

The authors state in their article that, to the best of their knowledge, this is the first time that a tertiary medical center has permitted homeopathic therapy of patients under treatment for COVID-19-related illness.

I sincerely hope that it is also the last time!

Last week, a naturopath who has been practicing naturopathy for more than three years, appeared in the Paris High Court. He is accused of “illegal practice of medicine” and of “usurpation of the title of doctor” after two of his cancer patients died.

Charles B. was diagnosed with testicular cancer in 2016 but wanted to avoid traditional medicine. In March 2017, he consulted the naturopath, Miguel B., who studied for fourteen years in the United States and has a degree in biochemistry and a doctorate in molecular medicine. He knew that his qualifications did not allow him to practice in France and presented himself as a naturopath. Knowing about his client’s cancer, Miguel B. drew up a health plan for him that included numerous fasts and purges to detox his body.

In the following months, the cancer spreads to the lungs and brain. Charles B. wrote to his naturopath in early February: “Great pain, don’t know what to do”. The naturopath continued his advice: “You should go on a diet, rest and purge in the evening. In court, Charles B.’s father recalled a conversation between his son and Miguel B. during which the latter had said to Charles B.: “It would be a pity if you were to undergo this chemotherapy.” On 22 February 2018, now weighing only 59 kg, Charles B. finally decided to start chemotherapy. But it was already too late, and he died on 18 December 2018, at the age of 41, of a cancer from which more than 98% of patients usually recover. Charles B.’s wife stated that the naturopath had told her husband that he would not need chemotherapy. She believes that the defendant is “responsible and even guilty” of her husband’s death.

The family of another patient of Miguel B. has also joined the case. Catherine F., who had been suffering from cervical cancer, died at the age of 39. She had followed, among other treatments, a fast recommended by the naturopath and was one of 149 further patients whose list was found on a USB stick belonging to the defendant.

 

 

It has recently been reported that a Canadian naturopath claims he can treat autism with fecal transplants at a clinic in Mexico.  The College of Naturopathic Physicians of B.C. has thus barred him stating that it has taken “extraordinary action” against Jason Klop in response to a complaint from a whistle-blowing former employee, who alleges that he manufactured these products in a “household lab” in B.C. without standard procedures or quality control.

While the complaint is under investigation, Klop cannot manufacture, advertise or sell fecal microbiota transplants (FMT). He’ll also be subject to random on-site audits to make sure he’s not violating his conditions.

This is the first public sign of concrete action by the college since CBC News reported on Klop’s business in January 2020 — nearly 20 months ago. Klop has been charging about $15,000 US for autistic children as young as two years old to have FMT treatment at a clinic near Tijuana. The process isn’t approved as a treatment of autism and carries serious risks of infection.

An illustration shows how fecal microbiota transplants are produced. (Vancouver Island Health Authority)

In a promotional video posted in January, Klop says he believes that “precision manipulation of the gut microbiome will solve every single chronic disease.” He also issued an affidavit boasting that he has a new lab that “produces the best and safest FMT materials in the world” and described the former employee who complained as “manifestly unreliable.” Klop argued that “lives are at stake” if he were to stop what he’s doing and described his therapy as a “life-saving measure.”

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Is there any evidence at all for FMT as a treatment of autism? A recent systematic review drew this conclusion: evidence from human studies suggesting beneficial effects of probiotic, prebiotic, and combination thereof, as well as fecal transplants in autism spectrum disorder, is limited and inconclusive.

 

 

We have covered urine therapy several times already (see for instance here, and here). Essentially it is ineffective but harmless …

except…

CTV reported that a mother in Canada has temporarily lost her right to unsupervised parenting over allegations she made her young son drink his own urine as part of a controversial so-called alternative medicine (SCAM). Specifically, she had fed the eight-year-old boy smoothies made with his own urine.

Apparently, the mother began pursuing a fringe “natural and holistic” lifestyle about three years ago. “It has created significant distrust by the (father) as to the respondent’s judgment in ensuring that the child is safe in her care, which came to a head when the allegation that she was imposing urine therapy on the child arose,” the judge wrote.

The mom’s interest in alternative medicine previously resulted in her seeking unsupported remedies such as homeopathy to treat her breast cancer – all of which failed, ultimately leaving her with no choice but to undergo surgery. Eventually, that inclination also brought her to urine therapy, described in the decision as “a centuries-old practice of drinking one’s own urine and massaging it into one’s skin.”

The mother admitted in court that she started drinking her own urine last January, and even that she appeared on an obscure podcast called “Healing Powers of Urine Therapy,” but denied forcing her son to take part in the practice. The father recounted an after-school incident in which the child approached him looking confused and guilty and said, “I have a secret, you have to promise me not to tell mom. Mom made me pee in a jar, then she put the pee into my fruit smoothie.” The boy later repeated the allegations during an appointment alone with their family doctor. The child said he “didn’t want to do it, told his mom he didn’t want to but she encouraged him to.”

There were also concerns raised about the mother’s fasting, which the father said went on for days on end and left her physically incapable of caring for their son. The judge wasn’t convinced that foregoing food left the mom unable to parent, but ultimately said she agreed with the father’s assessment that, while his former partner loves their son, her “judgment and health are questionable at this time.” The judge ruled that the mother can have parenting time from Sunday mornings to Wednesday evenings, but only with supervision from a professional or a third party agreed upon by both parents.

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The case shows that, once a gullible consumer falls under the influence of the SCAM cult and goes ‘off the rails’, there are no limits. This woman started by treating her cancer with homeopathy and, even though this was not successful, she continued to slide down the slippery SCAM slope until, finally, she experimented with urine therapy on her own son. This indicates to me that we might have to add another risk to the many dangers of homeopathy: it can serve as a gateway drug for all sorts of other SCAMs.

The General Chiropractic Council (GCC) regulates chiropractors in the UK, Isle of Man, and Gibraltar to ensure the safety of patients undergoing chiropractic treatment. The GCC sets the standards of chiropractic practice and professional conduct that all chiropractors must meet.

By providing a lengthy ruling in the case of the late John Lawler and his chiropractor, Arlene Scholten, the GCC has recently established new standards for chiropractors working in the UK, Isle of Man, and Gibraltar (see also today’s article in The Daily Mail). If I interpret the GCC’s ruling correctly, a UK chiropractor is henceforth allowed to do all of the following things without fearing to get reprimanded, as long as he or she produces evidence that the deeds were done not with malicious intentions but in a state of confusion and panic:

  • Treat a patient with treatments that are contraindicated.
  • Fail to obtain informed consent.
  • Pose as a real doctor without informing the patient that the practitioner is just a chiropractor who has never been near a medical school.
  • Cause the death of a patient by treatment to the neck.
  • Administer first aid in a way that makes matters worse.
  • Tell lies to the ambulance men who consequently failed to employ a method of transport that would save the patient’s life.
  • Keep inaccurate patient records that conceal what treatments were administered.

In previous years, the job of a chiropractor had turned out to be demanding, difficult, and stressful. This was due not least to the GCC’s professional standards which UK chiropractors were obliged to observe. The code of the GCC stated prominently that “our overall purpose is to protect the public.

All this is now a thing of the past.

The new ruling changed everything. Now, UK chiropractors can relax and can happily pursue their true devotion, namely to keep their bank manager happy, while not worrying too much about the welfare and health of their patients.

In the name of all UK chiropractors, I herewith express my thanks to the GCC for unashamedly protecting first and foremost the interests of their members, while tacitly discarding medical ethics and evidently not protecting the public.

MAKE CHIROPRACTIC GREAT AGAIN!

Acupuncture is usually promoted as a safe therapy. This may be good marketing but, sadly, it is not the truth. About 10% of all patients experience mild to moderate adverse effects such as pain or bleeding. In addition, there are well-documented complications, for instance:

However, there have been few reports of deaths due to pneumothorax after acupuncture treatment, especially focused on electroacupuncture.

Japanese authors recently reported an autopsy case of a man in his 60s who went into cardiopulmonary arrest and died immediately after receiving electroacupuncture. Postmortem computed tomography (PMCT) showed bilateral pneumothoraces, as well as the presence of numerous gold threads embedded subcutaneously. An autopsy revealed two ecchymoses in the right thoracic cavity and a pinhole injury on the lower lobe of the right lung, suggesting that the needles had penetrated the lung. There were marked emphysematous changes in the lung, suggesting that rupture of bullae might also have contributed to bilateral pneumothoraces and fatal outcomes. The acupuncture needles may have been drawn deeper into the body than at the time of insertion due to electrical pulses and muscle contraction, indicating the need for careful determination of treatment indications and technical safety measures, such as fail-safe mechanisms.

This is the first case report of fatal bilateral pneumothoraces after electroacupuncture reported in the English literature. This case sheds light on the safety of electroacupuncture and the need for special care when administering it to patients with pulmonary disease who may be at a higher risk of pneumothorax. This is also the first report of three-dimensional reconstructed PMCT images showing the whole-body distribution of embedded gold acupuncture threads, which is unusual.

One-sided pneumothoraxes are common events after acupuncture. Several hundred cases have been published and the vast majority of such incidents remain unpublished or even unnoticed. These events are not normally life-threatening. If ‘only’ one lung is punctured, the patient may experience breathing difficulties, but in many cases these are temporary and the patient soon recovers.

Yet a bilateral pneumothorax is an entirely different affair. If both lungs malfunction, the patient’s chances of survival are slim unless he/she is close to an intensive care unit.

You might think that it needs an especially ungifted acupuncturist to manage to puncture both lungs simultaneously. I might agree, but we need to consider that acupuncture needles are often inserted in a symmetrical fashion into the patient’s body. This means that, if the therapist puts a needle at one point of the thorax that is close to a lung, he is not unlikely to do the same on the other side.

And how does one prevent such disasters?

Easy:

  • train acupuncturists properly,
  • avoid needles on the upper thorax,
  • or refuse acupuncture altogether.

 

 

During the last few days, we were entertained by one of the more fanatical specimen of the lunatic fringe. From the outset, ‘ASTRO’ was out to provoke, insult, and foremost state utter nonsense. Within just a few hours ‘ASTRO’ posted dozens of comments, one more hilarious than the next.

As always, I let it pass for a while because this sort of thing usually is very amusing and mildly instructive. Then, when my fun was over, I told him or her that my conversation with him or her was finished, thereafter I sent ‘ASTRO’ my usual hint to indicate that my patience was wearing thin (an overdose of nonsense, fun, and hilarity might be toxic) and now I have blocked ‘ASTRO’.

This little incident is a mere triviality, of course. Yet, it is also a most welcome reminder to demonstrate what is needed to get blocked by me. Here are a few selected ‘bon mots’ posted by ‘ASTRO’ which all contributed to his or her dismissal from this blog:

  • Lenny is an intellectual terrorist
  • you manipulate data
  • you are nobody in the scientific world
  • I’m very sorry for your lack of education
  • I don’t hate you for lying, I pity you
  • With all sincerity, and seeing that you don’t have a single scientific publication, I recommend that mounts a business for atheists resentful and sell cheap products with the face of Carl Sagan or James Randi in a coffe cup or pins, I assure you that the media will make of your business, earn some money and you’ll be able to publish a book trash like Ben Goldacre, with his “Bad science” or the Steven Novella. Poor quality is a typical sign of skeptical pseudoscientists.
  • your “letter to the editor” is based on manipulating data and making false accusations, everything
  • you only have an opinion based on your belief and denial that may well be a projection of your lack of knowledge
  • I’m disappointed that you have very superficial knowledge, no wonder Mathie will ignore you
  • Your comments again reflect that you haven’t the slightest idea
  • your lack of reading comprehension is evident
  • You are very ignorant
  • your aggressiveness and lack of empathy tell a lot about your profile of atheist resentful of life
  •  these” verdicts ” that Ernst quotes in his pamphlets are at best a fraud
  • in reality you, Grams and the team of the anti-homeopathy propaganda network have no idea what you’re talking about
  • Ernst,” friend, ” you’re still pretty aggressive, maybe you need some joy in your life. Now I understand why the pseudoscientific skeptical atheist community is so childish and so toxic
  • anyone who questions Edzar’s sacred dogmas is a troll
  • Thank you for confirming that you are a sectarian
  • your obsessive behavior borders on harassment
  • Magazines like Skepter are very popular with immature gentlemen who believe they are the world or with teenagers who are just out of college who believe that science is done with whims
  • don’t be like Lenny and try to grow up
  • real science is in the objective pursuit and not in harassment campaigns orchestrated by a few clowns who believe James Randi is unquestionable
  • every time I read your entries I feel sorry that your level of logic is so low and lousy
  •  Your naivety and superficial knowledge in philosophy of science (and that of most of those who follow you) is very pitiful
  • you are the example of a pseudo-sceptic, a rude and cowardly skeptic who can’t tolerate criticism
  • your friends are a sect, possibly a group based on coertion
  • it doesn’t look like “Lenny” has a single scientific article published, not to mention your colleagues in the “About” section that the few who look like scientists are mediocre in their fields, the rest are small-time activists. No wonder, so much envy, so much anger, so much hatred, that’s what leaves fanatical atheism. They’re talibans of science, not scientists
  • you with your age presume a lot and I only see you being interviewed by mainstream media that talk nonsense against homeopathy
  • You had to control that aggressiveness, you feel more nervous and angry, maybe you’re a relative of the troll Lenny
  • The obsessive behavior of Aust trying to refute Frass already looks like that of a stalker, similar of the journalist Christian Kreil who invented a whole string of nonsense in a German public media trying to link Frass to a questionable company, the media does not even mention Frass’s refutation to Kreil

One thing we cannot accuse ‘ASTRO’ of is that he or she was not industrious. You might ask why I did not stop his aggressive stupidity earlier after it had stopped being funny. Perhaps I should have – but, to be honest, these trolls do amuse me a great deal. More importantly, they might teach us important lessons:

  • The fun one can have with fanatics is usually short-lasted.
  • Some weirdos are very well misinformed, i.e. they read a lot and misunderstand even more.
  • The minds of heavily deluded people are beyond productive discussions.
  • Any hope to educate them will be disappointed.
  • If we allow them to, they swiftly make themselves ridiculous.
  • Their pseudo-arguments are strikingly similar.
  • Their aggressiveness can be considerable.

And finally, the little ‘ASTRO’ interlude tells you something else:

It really does need a lot to get banned from my blog.

A case report was published of a 35-year-old Chinese man with no risk factors for stroke. He presented with a 2-day history of expressive dysphasia and a 1-day history of right-sided weakness. The symptoms were preceded by multiple sessions of the neck, shoulder girdle, and upper back massage for pain relief in the prior 2 weeks. A CT-scan of the brain demonstrated an acute left middle cerebral artery infarct and left internal carotid artery dissection. The MRI cerebral angiogram confirmed left carotid arterial dissection and intimal oedema of bilateral vertebral arteries. In the absence of other vascular comorbidities and risk factors, massage-induced internal carotid arterial dissection was deemed to be the most likely cause of the near-fatal cerebrovascular event.

INSIDER reported further details of the case: the patient told the doctors who treated him that he had seen the chiropractor for two weeks before he experienced trouble reading, writing and talking. After experiencing those symptoms for two days and one day of pain on his right side, a friend convinced the patient to consult a neurologist. This led to the hospital admission, the above-named tests, and diagnosis. After three months of therapy and rehab, the patient showed “significant improvement,” according to the doctors.

What remains unclear is the exact nature of the neck treatment that is believed to have caused the arterial dissection. A massage is mentioned but massages have rarely been associated with such problems. Neck manipulations, on the other hand, are the hallmark therapy of chiropractors and have, as I have pointed out regularly, often been reported to cause arterial dissections.

Chiropractors usually deny this fact; alternatively, they claim that only poorly trained practitioners cause these adverse events or that their frequency is exceedingly small. However, without a proper post-marketing surveillance system, this argument is hardly convincing.

Former chiropractor Malcolm Hooper, 61, and hyperbaric oxygen therapy provider Oxymed Pty Ltd have been fined following the death of a customer in 2016. They were each convicted of three work safety-related charges, all of failing to ensure a workplace is safe and without risks to health. Hooper was fined $176,750, while the company was fined $550,000. Oxymed was trading as HyperMed at its South Yarra premises in April 2016 when a long-term client with multiple sclerosis and a history of life-threatening seizures came in for treatment. He was later found unconscious in a single-person hyperbaric chamber, taken to hospital, and placed on life support, but died five days later.

The County Court heard that both the company and Hooper had an inadequate system in place for assessing the risks oxygen therapy could pose to clients, and an inadequate system too for developing plans to eliminate or reduce those risks. In her judgment, County Court judge Amanda Fox said HyperMed wasn’t a hospital nor a medical practice and had been described as an “alternative health facility”. Hooper had already been deregistered in 2013 by the national board for chiropractors for misleading and deceptive advertising about the benefits of hyperbaric treatment.

Hyperbaric oxygen therapy involves administering pure oxygen in a pressurised environment, with the heightened air pressure allowing a patients’ lungs to gather much more oxygen than would be possible under normal conditions. The therapy is not based on strong data. A systematic review failed to find good evidence for hyperbaric oxygen therapy as a treatment of multiple sclerosis:

Multiple sclerosis (MS) is a chronic, inflammatory, and degenerative neurological illness with no cure. It has been suggested that Hyperbaric Oxygen Therapy (HBO(2)T) may slow or reverse the progress of the disease. This article summarizes the clinical evidence for the use of HBO(2)T in the treatment of MS. We conducted a literature review focused on the interaction of hyperbaric oxygenation and MS. In particular, we appraised the clinical data regarding treatment and performed a meta-analysis of the randomized evidence using the methodology of the Cochrane Collaboration. We found 12 randomized studies in the area, all of which were performed between 1983 and 1987. A meta-analysis of this evidence suggests there is no clinically significant benefit from the administration of HBO(2)T. The great majority of randomized trials investigated a course of 20 treatments at pressures between 1.75ATA and 2.5ATA daily for 60-120 min over 4 weeks against a placebo regimen. None have tested the efficacy of HBO(2)T against alternative current best practice. No plausible benefit of HBO(2)T on the clinical course of MS was identified in this review. It remains possible that HBO(2)T is effective in a subgroup of individuals not clearly identified in the trials to date, but any benefit is unlikely to be of great clinical significance. There is some case for further human trials in selected subgroups and for prolonged courses of HBO(2)T at modest pressures, but the case is not strong. At this time, the routine treatment of MS with HBO(2)T is not recommended.

The case reminds me of that of John Lawler. Mr. Lawlwer’s chiropractor also used a therapy that was not indicated, broke his neck (to put it crudely), and subsequently proved herself more than inept in saving his life. It suggests to me that some chiros may not be trained adequately to deal with emergencies. If that is true, they should perhaps focus less on practice-building courses and more on first aid instructions.

This retrospective electronic medical record data analysis compared the characteristics and outcomes of drug-induced liver injury (DILI) caused by paracetamol and non-paracetamol medications, particularly herbal and dietary supplements. Adults admitted with DILI to the Gastroenterology and Liver Centre at the Royal Prince Alfred Hospital, Sydney (a quaternary referral liver transplantation centre), 2009-2020 were included. The 90-day transplant-free survival and the drugs implicated as causal agents in DILI were extracted from the records.

A total of 115 patients with paracetamol-related DILI and 69 with non-paracetamol DILI were admitted to our centre. The most frequently implicated non-paracetamol medications were:

  • antibiotics (19, 28%),
  • herbal and dietary supplements (15, 22%),
  • anti-tuberculosis medications (6, 9%),
  • anti-cancer medications (5, 7%).

The number of non-paracetamol DILI admissions was similar across the study period, but the proportion linked with herbal and dietary supplements increased from 2 of 11 (15%) during 2009-11 to 10 of 19 (47%) during 2018-20 (linear trend: P = 0.011). Despite higher median baseline model for end-stage liver disease (MELD) scores, 90-day transplant-free survival for patients with paracetamol-related DILI was higher than for patients with non-paracetamol DILI (86%; 95% CI, 79-93% v 71%; 95% CI, 60-82%) and herbal and dietary supplement-related cases (59%; 95% CI, 34-85%). MELD score was an independent predictor of poorer 90-day transplant-free survival in both paracetamol-related (per point increase: adjusted hazard ratio [aHR], 1.19; 95% CI, 1.09-3.74) and non-paracetamol DILI (aHR, 1.24; 95% CI, 1.14-1.36).

The authors concluded that, in our single centre study, the proportion of cases of people hospitalised with DILI linked with herbal and dietary supplements has increased since 2009. Ninety-day transplant-free survival for patients with non-paracetamol DILI, especially those with supplement-related DILI, is poorer than for those with paracetamol-related DILI.

A co-author of the paper, specialist transplant hepatologist Dr Ken Liu, was quoted in the Guardian saying he felt compelled to conduct the study because he was noticing more patients with liver injuries from drugs not typically associated with liver harm. “I was starting to see injury in patients admitted with liver injury after using bodybuilding supplements for males or weight loss supplements in females,” he said. “I just decided I better do a study on it to see if my hunch that more of these substances were causing these injuries was true.”

Liu and his colleagues said there needed to be more rigorous regulatory oversight for supplements and other alternative and natural therapies. They also noticed almost half the patients with supplement-induced severe liver injury had non-European ethnic backgrounds. Liu said more culturally appropriate community education about the risks of supplements was needed.

Dr Ken Harvey, public health physician and president of Friends of Science in Medicine, said it was important to note that Liu’s study only examined the most severe cases of supplement-induced liver harm and that the actual rate of harm was likely much higher. “The study only examines severe cases admitted to a specialised liver unit; they cannot be extrapolated to the overall incidence of complementary medicine associated liver injury in Australia,” Harvey said.

The Royal Australian College of General Practitioners, Choice, Friends of Science in Medicine and others have called for an educational statement on the pack and promotional material of medicines making traditional claims, for example saying “This product is based on traditional beliefs and not modern scientific evidence”.

“This was opposed by industry and the TGA,” Harvey said. “But is still needed.”

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