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

charlatan

I received an email – a round robin, actually – from my ex-friend Wayne Jonas and was amazed to read the following passage:

My new book, “Healing and Cancer,” co-written with Alyssa McManamon, MD, is now available! Whole person care in oncology centers the person with cancer – their history, intuition, and understanding of what constitutes a good life and, eventually, a dignified end …

For those who don’t know him, here is what Wiki has to say about Wayne:

Wayne B. Jonas is an American family physician, retired army medical officer,[1] and alternative medicine researcher. He is the former president and CEO of the Samueli Institute.[2][3] The institute does research into the efficacy of alternative medicine, such as on the effects of prayer on treating disease, use of homeopathy to fight bioterrorism, and use of magnetic healing devices on orthopedic injuries, with Jonas commenting on these research programs, “There is a good case for looking at these things scientifically, because we don’t know a lot about them”.[3] He is professor of family medicine at Georgetown University and an adjunct professor at Uniformed Services University of the Health Sciences.[2]

Jonas received his medical degree from Wake Forest University School of Medicine.[2]

Jonas began his career as the Director of the Medical Research Fellowship at the Walter Reed Army Institute of Research.[2] From 1995 to 1998, Jonas was the director of the Office of Alternative Medicine (since renamed the National Center for Complementary and Integrative Health), a branch of the National Institutes of Health.[2] In 2001, the Samueli Institute was founded. Jonas has served as its president and CEO ever since.[3].

Some of my regular readers might also know Wayne, as he is a member of my ALTERNATIVE MEDICINE HALL OF FAME. But back to his recent email. I was not sure whether to laugh or cry when I read the above-cited passage:

  1. I honestly don’t know what it means ‘to center the person with cancer’. It sounds very much like new age BS to me, I’m afraid. What I do know, however, is this: almost all cancer patients have formost one wish, and that is to get rid of their cancer. I have never met one who wants to be “centered” with the disease.
  2. I am also sure that cancer patients would want even less to be centered with their cancer, if they knew that this approach eventually entails a ‘dignified end‘. All of us want to live – and cancer patients are certainly no exceptions.

Perhaps it is just Wayne’s clumsy way of trying to express something very profound. Or perhaps it is my mistake for misunderstanding his new age phraseology. In any case, ‘whole person’ cancer care sounds all very attractive – untill you get the diagnosis, that is. Then, you are desperately looking towards a cure, and not towards a ‘dignified end‘. The cure, of that I am quite sure, cannot come from holistic BS, but must come from the best treatments conventional oncology has to offer.

In a nutshell:

if I had the choice between ‘whole person’ care followed by a ‘dignified end’ or conventional oncology followed by survival, I would chose the latter.

 

This study aims to appraise the utility, accuracy, and quality of information available on YouTube on acupuncture for chronic pain treatment. Using search terms such as “acupuncture for chronic pain” and “acupuncture pain relief”, the top 54 videos by view count were selected. Videos were included if they were:

  • > 1 minute duration,
  • contained audio in English,
  • had > 7000 views,
  • related to acupuncture.

Each video was categorised as either:

  • useful,
  • misleading,
  • or neither.

Another primary outcome of interest was the quality and reliability of each video using validated instruments, including the modified DISCERN (mDISCERN) tool and the Global Quality Scale (GQS). The means were calculated for the video production characteristics, production sources, and mDISCERN and GQS scores. Continuous and categorical outcomes were compared using Student’s t-test and chi-square test, respectively.

The results show that, of the 54 videos,

  • 57.4% were categorized as useful,
  • 14.8% were misleading,
  • and 27.8% were neither.

Useful videos had a mean GQS and mDISCERN score of 3.77± 0.67 and 3.48± 0.63, respectively, while misleading videos had mean GQS and mDISCERN score of 2.50± 0.53 and 2.38± 0.52, respectively. 41.8% of the useful videos were produced by a healthcare institution while none of the misleading videos were produced by a healthcare institution. However, 87.5% of the misleading videos were produced by health media compared to only 25.8% of useful videos from health media.

The authors concluded that their analysis of the highest viewed acupuncture videos for chronic pain reveals only about half provide useful information, indicating a significant misinformation challenge for viewers. This underscores the urgent need for more high-quality, unbiased videos from healthcare institutions and physicians on complementary health practices like acupuncture.

This new analysis confirms what we and others have shown numerous times before: information about so-called alternative medicine (SCAM), which is abundantly available on the Internet, needs to be taken with a healthy pinch of salt. Whenever we studied the issue, our conclusions were even less optimistic than those of the present authors. In fact, most of the time we concluded that following such advice is a risk factor to our health.

In the previous two parts of this series (see here and here), we discussed the following SCAM diagnoses:

  • adrenal fatigue,
  • candidiasis hypersensitivity,
  • chronic intoxications,
  • chronic Lyme disease,
  • electromagnetic hypersensitivity,
  • homosexuality.

Today, I will add three further fake diagnoses to the list.

Leaky gut syndrome

Leaky gut syndrome is allegedly caused by the passage of harmful substances from the gut wall into the body. SCAM proponents claim it is the origin of many conditions, including multiple sclerosis and autism. However, there is no evidence to show that these claims are true. SCAM practitioners nevertheless recommend many types of SCAM to treat the non-existing entity, e.g. SCAM diets, supplements, etc. It goes without saying that none of them have been shown to be effective.

Multiple chemical sensitivity

Multiple chemical sensitivity is allegedly caused by a hypersensitivity to commonly used chemicals. The symptoms are vague such as headache, dizziness, fatigue. Even those who believe that the condition exist are unable to offer a generally accepted definition of the syndrome.

The SCAMs recommended include:

  • Nutritional supplements
  • Digestive aids
  • Hormone balancing
  • Detoxification
  • Desensitization
  • Eliminating occult infections
  • Oxygen
  • Immune stimulation

Naturally, none of them is supported by sound evidence.

Neurasthenia

In 1869, physician George Miller Beard developed a diagnostic profile for a mental disorder that appeared to be common in the US. Neurasthenia was allegedly characterised by migraines, fatigue, depression, and digestive problems.

The cure, according to Beard, was to flee the city – because it was the stresses of city life that caused the condition. Women were encouraged to rest, while men were asked to engage in outdoor activities. By the early 20th century, this mental disorder had become a status symbol, and it soon spread to other parts of the world. But this pandemic was short-lived: by 1930, neurasthenia had virtually disappeared from conventional medicine.

In SCAM, however, neurasthenia is still a well-establisged money earner. SCAM practitioners do not hesitate to recomment virually every SCAM under the sun for it. They all have one thing in common: they do not work.

 

It has been reported that a former model almost died trying to cure her cancer with a juice diet. Medics tried to get Irena Stoynova to use conventional cancer treatments after she was diagnosed with non-Hodgkin lymphoma in June 2021, but she ‘shut them out’. Instead of chemotherapy, she sought out so-called alternative medicine (SCAM) online and took the advice of a social media influencer who claims the body can ‘heal itself’ with help of a radical lifestyle and diet changes.

Ms Stoynova thus followed various diets and holistic therapies for two-and-a-half years, which left her emaciated and with fluid on her lungs.

Doctors said she was on the verge of death when she was taken to Frimley Park Hospital by ambulance in May last year. She was told by Dr Clare Rees that she would likely die without treatment for her stage three cancer. But Ms Stoynova continued to refuse for a number of days before finally agreeing to receive chemotherapy. Ms Stoynova then spent 50 days in the hospital’s acute dependency unit.

She said when she was first diagnosed that she decided against traditional treatments after ‘reading about and watching many doctors and professors talk about the success rate of alternative therapies online’. The 39-year-old, who now works in sales, said she did a juice diet for two-and-a-half years, but also tried a raw diet, intermittent fasting, boiling herbs and special teas.

Speaking about her diagnosis, she said: ‘I was devastated, the whole world just closed around me and I felt really alone.’ She said that she was advised to start chemotherapy, but instead turned to the internet to find alternative advice. ‘I found an American guy who has millions of followers who promoted holistic treatment,’ she said. ‘He had a podcast where he interviewed very knowledgeable doctors and professors who are talking about holistic treatment and they called standard treatment “outrageous”. ‘They said that people who had chemotherapy are “lazy” and don’t want to put in the hard work of holistic treatment.’ Ms Stoynova continued: ‘The guy has three or four books on how to heal cancer holistically – how to make salads, use different herbs, juicing, intermittent fasting – there were so many testimonials, so many people that did it. ‘I spent £2,000 on juicers – one for smoothies, one for carrots, one for citrus and one for everything else. I spent two to three hours a day making juice for the next day.

_________________________

The ‘juice diet’ seems to have been the Gerson therapy or a variation of it. We have discussed this particular SCAM several times before, e.g.:

I just wish Irena Stoynova had read my blog instead of following the criminal quackery of the ‘American guy’.

My conclusion:

reading this blog and telling others about it can saave lives

This Phase IV randomized, double-blind, placebo-controlled clinical trial was “designed to demonstrate the efficacy and safety of the product Neurodoron (Kalium phosporicum comp., KPC) in patients with neurasthenia”.

The study was conducted in an outpatient German trial site. Women and men aged 18 and above were randomized to receive either KPC or placebo if they reported typical symptoms of neurasthenia and a severe psychiatric disorder could be excluded. The primary objectives were a reduction in characteristic symptoms of nervous exhaustion and perceived stress as well as improvement in general health status after 6 weeks of treatment.

In total, 204 patients underwent screening, 78 were randomized in each treatment group, and 77 patients each received treatment (intention-to-treat (ITT) population = 154 patients). For none of the primary efficacy variables, an advantage in favor of KPC could be demonstrated in the pre-specified analysis (p-values between 0.505-0.773, Student’s t-test). In a post-hoc analysis of intra-individual differences after 6 weeks treatment, a significant advantage of KPC vs. placebo was shown for characteristic symptoms of nervous exhaustion (irritability (p = 0.020); nervousness (p = 0.045), Student’s t-test). Adverse event (AE) rates were similar between treatment groups, in both groups six AEs were assessed as causally related to treatment (severity mild or moderate). No AE resulted in discontinuation of treatment.

The authors concluded that the trial treatment was well tolerated with only a few and minor AEs reported, confirming the markedly good safety of KPC. A significant improvement of neurasthenia was seen for the total study population at the end of the treatment period. Superiority of KPC vs. placebo could not be demonstrated with the pre-specified analysis with regards to a sum score of 12 typical symptoms, perceived stress, or general health status. However, the explorative post-hoc analysis revealed that KPC is superior to placebo in the characteristic symptoms irritability and nervousness. KPC could therefore be a beneficial treatment option for symptomatic relief of neurasthenia.

The very first thing one notices is the aim of the study. According to its authors, it was “designed to demonstrate the efficacy and safety of the product Neurodoron (Kalium phosporicum comp., KPC) in patients with neurasthenia“. Any group of researchers that is unaware of the fact that clinical trials are for TESTING and not for DEMONSTRATING should, in my view, be sent straight back to school. And while they are at it, they might as well take with them the editor of the journal as well as the peer-reviewers of the paper.

As it happens, I have published a post about Neurodoron before. Here is a short section from it:

Stress is associated with a multitude of physical and psychological health impairments. To tackle these health disorders, over-the-counter (OTC) products like Neurodoron® are popular since they are considered safe and tolerable. One tablet of this anthroposophic remedy contains the following active ingredients:

83.3 mg Aurum metallicum praeparatum trituration (trit.) D10,

83.3 mg Kalium phosphoricicum trit. D6,

8.3 mg Ferrum-Quarz trit. D2.

Experience reports and first studies indicate that Neurodoron® is efficient in the treatment of stress-associated health symptoms…

Apart from its above-mentioned aim, the new study is remarkable in one further aspect: in its conclusion, it makes a big deal out of the ‘good news’ that Neurodoron safe. As the trial was not designed to test safety, this can only be seen as an attempt to hide (as well as possible) the fact that the remedy turned out to be ineffective.

Why would researchers try to distract the reader from the main message of their work? The answer might lie in the affiliation of two of the authors: Clinical Research, Weleda AG, Schwäbisch Gmünd, Germany.

The BBC stands for reliable information, at least that’s what I used to believe. After reading a recent article published on the BBC website, I have my doubts, however. See for yourself; here are a few excerpts:

On a holiday to Kerala on India’s south-western Malabar Coast, Shilpa Iyer decided to visit Kotakkal, a town that became famous after the establishment of Arya Vaidya Sala, Kerala’s best-known centre for the practice of Ayurveda, in 1902. Seven days later, she left the historical treatment centre after completeing panchakarma, a cleansing and rejuvenating programme for the body, mind and consciousness.

“There was nothing really wrong, but I was always busy with the demands of modern life and plagued with continual aches and pains. So, I decided to focus on my own health,” Iyer says.

Panchakarma, a holistic Ayurvedic therapy, involves a series of detoxifying procedures. It integrates herbal medicines, cleansing therapies, personalised diet plans and wellness activities to eliminate the root cause of disease, revive and rejuvenate the body, and ensure health and longevity.

Iyer says she left “feeling lighter, healthier and better than ever before”. She isn’t the only one who signed up for an Ayurvedic treatment in Kerala; the holistic system of medicine is a way of life in this coastal paradise.

… Ayurveda translates to “knowledge of life” and originated in India more than 3,000 years ago. It is based on the ideology that health and wellness depend on a delicate balance between the mind, body, spirit and environment, and places great emphasis on preventive strategies rather than curative ones. The ancient system of medicine is centred on the idea of universal interconnectedness between prakriti (the body’s constitution) and doshas (life forces). Varied combinations of the five elements — aakash (sky), jal (water), prithvi (earth), agni (fire) and vayu (air) – create the three doshas.

Kerala Tourism Ayurveda places great emphasis on preventive strategies rather than curative ones (Credit: Kerala Tourism)

Dr Gaurang Paneri, an Ayurveda practitioner, explains every person has the three doshas, vatapitta and kapha, in varying strength and magnitude. “The predominant dosha determines their prakriti. Diseases arise when doshas are affected because of an external or internal stimulus (typically linked to eating habits, lifestyle or physical exercise). Ayurveda works to ensure harmony between the three,” he says…

The small state has more than 100 Ayurvedic government-run hospitals, 800 Ayurvedic pharmaceutical factories and 800 Ayurvedic medicine dispensaries. As many as 120 holiday resorts and private wellness centres offer specialised treatments such as kasti vvasti, an oil-based treatment for back pain and inflammation in the lumbosacral region; elakkizhi, a treatment with heated herbal poultices to tackles aches, pains and muskoskeletal trauma; njavara kizhi, a massage therapy for arthritis or chronic musculoskeletal discomfort; and shirodhara, a restorative therapy to ease stress and anxiety and that involves pouring warm, medicated oil over the forehead.

Most treatment centres offer therapies and treatments for a range of health issues, including immunity, mental health, anxiety, pain management, weight loss, skin and health care, sleep issues, psoriasis, eczema, eye care, arthritis, sciatica, gastric problems and paralysis. The treatments typically include dietary changes, herbal medicines, massage therapies, poultices, meditation and breath exercises…

___________________________

I find such advertisements disguised as journalism disturbing:

  • No mention that the treatments in question lack conclusive evidence of effectiveness.
  • Not a word about the fact that many can be outright dangerous.
  • No mention of the often exorbitant fees visitors are asked to pay.

Please do better next time you report about health matters, BBC!

I am not in the habit of publishing emails that I receive – even though I did occasionally post and discuss some of the most spectacular insults that came my way, e.g.:

Today, however, I feel like being a trifle indiscrete. The reason is an email I received yesterday from a German homeopath who calls him/herself ‘M. Magic’. After reading an article about homeopathy (I am not sure which one), he/she felt compelled to write to me. Here is (my translation of) the second half of this email which I find simply too funny to keep it to myself:

… I can explain WHY homeopathy works and can even tell you your personal so-called constitutional remedy.
I don’t do that. But I can tell you who you are based on the fact that I know your remedy:

You have no self-confidence. You may be competent in your field … even the best, but deep down you have been moulded in a counterproductive way. A parent has always made you feel like you can’t do anything right or well! This has undermined your self-confidence forever or most of your life, no matter how capable you may be!
You tend to despise women and/or think you are weak and incapable. A projection of your unconscious self-belief.
A typical symptom of your personality type is digestive problems! The background to this is that you do not allow and process feelings. This is reflected in a digestive weakness.

This in a nutshell … the correctly chosen remedy would give you a healthy self-confidence, which may have stabilised to some extent in the meantime. I could also explain to you why this is the case … I am analytically inclined and can determine any background. You are probably also ANALYTICAL … absolute head person and proud of it, right? There’s no reason for that, but fine … It shows how little idea you have of how humans really work and what they could use to cure themselves of everything … and what effect that has …
You clueless people … all of you!

Greetings, M. Magic

_____________________

I replied thanking the author, mainly because I had not laughed so heartily for a long time. My response was followed by an instant secone email:

… a SO typical response for your constitutiona type.
You want to show me that you’re above it and ridicule me … (you’re not, of course; either).
Apparently I hit the nail on the head. (no, I’m not surprised; I know my trade)
And YOU are really a professor?
But nothing surprises me anymore! The blind leading the blind …

__________________________

I did not send a further reply.

 

If you google ‘chiropractic’ you might get the impression that an unusual number of US chiros are outright perverts. Here are four current cases that I found instantly without any in-depth seraching:

Case No 1

A “Christian chiropractor” is facing several criminal charges after at least eight former clients have accused him of rape and sexual assault. Roc Byrd, 61, of Danville, who worked as a chiropractor for Cornerstone Chiropractic in Avon, is facing one felony count of rape, five felony counts of sexual battery and four misdemeanor counts of battery. He is accused of raping a client, touching clients inappropriately over and under their clothes during appointments without consent and pressing his genitals up against multiple patients. Byrd identified himself as a practicing Christian and reportedly began each of his chiropractic appointments by praying with clients.

Case No 2

A Warren chiropractor faces significant legal problems and a criminal investigation into how he allegedly treated one of his patients. Officials say he sells himself as one of only a handful of Michigan “Chiropractic Neurologists,” but the former patient claims he is a sexual predator and offers video as apparent proof. The case involves Dr. John Pispidikis of the Spinal Recovery Center. The complaint was filed Friday (April 19) morning, which surprised the doctor. The patient involved remains unnamed in the civil court documents, but she claims the doctor groped her during a physical exam last February. But she had no proof, so she claims she went out and got some.

Case No 3

The Oklahoma Board of Chiropractic Examiners (OBCE) has ordered the Back Stop’s only chiropractor, Mark Kimble to surrender his license by next Monday after several sexual impropriety allegations against him have surfaced. Oklahoma Board of Chiropractic Examiners confirmed with KFOR that there are seven alleged victims of Kimble’s who have come forward.

Case No 4

The Los Angeles County Sheriff’s Department is looking for possible victims of a chiropractor accused of sexual assault. Richard Carnow, 65, was arrested by authorities on March 13 on four felony counts of sexual battery. Carnow is a chiropractor in San Dimas in the San Gabriel Valley, the Sheriff’s Department says. He’s accused of sexually assaulting multiple adult women between June 2023 and August 2023. Officials did not say if his alleged victims were current or former patients. Investigators say the nature of the alleged crimes have led them to believe there may be additional victims and they are asking for the public’s help to find them.

Yes, I know, these are (according to chiros’ assurances) regrettable, isolated cases – nothing to worry about!

But perhaps these assertions are wrong and there is a problem after all?

I am reminded of my post from 2021; let me refresh your memory:

Two chiropractors conducted a retrospective review of publicly available data from the California Board of Chiropractic Examiners. Their aim was to determine categories of offense, experience, and gender of disciplined doctors of chiropractic (DC) in California and compare them with disciplined medical physicians in California. The DC disciplinary categories, in descending order, were

  • fraud (44%),
  • sexual boundary issues (22%),
  • other offences (13%),
  • abuse of alcohol or drugs (10%),
  • negligence or incompetence (6%),
  • poor supervision (2%),
  • mental impairment (.3%).

The authors concluded that the professions differ in the major reasons for disciplinary actions. Two thirds (67%) of the doctors of chiropractic were disciplined for fraud and sexual boundary issues, compared with 59% for negligence and substance misuse for medical physicians. Additional study in each profession may reveal methods to identify causes and possible intervention for those who are at high risk.

The abstract of the paper does not provide comparisons to with the medical profession. Here they are; relative to doctors, chiropractors are:

  • 2 x more likely to be involved in malpractice,
  • 9 x more likely to commit  fraud,
  • 2 x more likely to transgress sexual boundaries.

________________________

Could it be, I askmyself, that there is something deeply wrong with the chiropractic profession? Could it perhaps be that chiro schools do not have a good hand when it comes to student recruitment? Could it be that chiro schools teach too little medical ethics, or none at all?

Few of us are aware of the fact that there are such things as alternative diagnoses, i.e. diagnoses used by practitioners of so-called alternative medicine (SCAM) that have no basis in science. They are nonetheless popular with some SCAM practitioners and usually cause a wide range of non-specific symptoms.

In part 1 of this series of posts, I dealt with:

  • adrenal fatigue,
  • candidiasis hypersensitivity,
  • chronic intoxications.

Today I will briefly discuss three further alternative diagnoses.

Chronic Lyme Disease

Lyme disease exists, of course; it is a bacterial infection attained via the bite of a tick. By contrast chronic lyme disease is pure fantasy. It is often used to explain persistent pain, fatigue, and neurocognitive symptoms in patients without any evidence of previous acute lyme disease.

Once this diagnosis is given, prolonged treatment with multiple antimicrobial agents as well as a multitude of SCAMs are advocated. The range includes intravenous infusions of hydrogen peroxide, electromagnetic frequency treatments, garlic supplements, even stem cell transplants.

Unsurprisingly, none of them has been shown to work for chronic lyme disease.

Electromagnetic hypersensitivity 

Electromagnetic hypersensitivity (EHS) is a condition where individuals report symptoms attributed to exposure to electromagnetic fields. It is not a recognized medical diagnosis.

Symptoms of EHS include headache, fatigue, stress, sleep disturbances, skin prickling, burning sensations and rashes, pain, psychological distress and many other health problems. The true case seems psychosomatic and unrelated to electromagnetic fields.

Practitioners nevertheless recommend all sorts of SCAMs including chelation, detox, diets, tocopherols , carotenoids, vitamin C, curcumin, resveratrol, flavonoids, sauna, blue light therapy none of which have been shown to be effective.

Homosexuality

Yes, it’s true: some SCAM practitioners offer treatments for homosexuality which must mean that they consider it to be a disease.

As reported in a previous blog post, the German ‘Association of Catholic Doctors’, Bund Katholischer Ärzte, claims that homeopathic remedies can cure homosexuality. On their website, they advise that ‘…the working group HOMEOPATHY of the Association notes homeopathic therapy options for homosexual tendencies…repertories contain special rubrics pointing to characteristic signs of homosexual behaviour, including sexual peculiarities such as anal intercourse.

Say no more!

 

Acute tonsillitis, which includes tonsillopharyngitis, is a common condition, particularly in childhood. It is mostly caused by a viral infection. Symptomatic treatment is of high importance. But which treatment is effective and which isn’t?

For this expert consensus, 53 physicians from Germany, Spain, Netherlands, Switzerland, Austria, and Hungary with at least one year of experience in anthroposophic paediatric medicine were invited to participate in an online Delphi process. The process comprised 5 survey rounds starting with open-ended questions and ending with final statements, which need 75% agreement of experts to reach consensus. Expert answers were evaluated by two independent reviewers using MAXQDA and Excel.

Response rate was between 28% and 45%. The developed recommendation included 15 subtopics. These covered clinical, diagnostic, therapeutic and psychosocial aspects of acute tonsillitis. Six subtopics achieved a high consensus (>90%) and nine subtopics achieved consensus (75-90%). The panel felt that AM was an adequate therapy for acute tonsillitis.

The authors of this paper concluded that the clinical recommendation for acute tonsillitis in children aims to simplify everyday patient care and provide decision-making support when considering and prescribing anthroposophic therapies. Moreover, the recommendation makes AM more transparent for physicians, parents, and maybe political stakeholders as well.

I found it hard to decide whether to cry or to laugh while reading this paper.

Experience in anthroposophic paediatric medicine does not make anyone an expert in anything other than BS.

Expert consensus and clinical guidelines are not conducted by assembling a few people who all are in favour of a certain therapy while ignoring the scientific evidence.

AM for acute tonsillitis in children is nonsense, whatever these pseudo-experts claim.

Imagine we run a Delphi process with a few long-standing members of ‘the flat earth society’ and ask them to tell us about the shape of the earth …

…I rest my case.

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