clinical trial
I have long felt that Cureus is a very strange journal:
- It publishes an incredilby high volume of papers: ~50,000 in 2025.
- An unusual high percentage of these articles are on so-called alternative medicine (SCAM).
- Its article retraction rate seems one dimension higher than the average.
- It charges hefty fees for submissions needing language, formatting, or reference corrections.
- Estimates of its profits vary hugely: $3.5M revenue (Growjo), $1.4M (SignalHire), or $25-50M (Cience).
Now RETRACTION WATCH (RW) have reported that Clarivate has removed Cureus from its Master Journal List. The move means Cureus will no longer be indexed in Web of Science or receive an impact factor. Thus, researchers are less likely to submit to the journal.
Clarivate put indexing for the journal on hold last September for concerns about article quality, which the journal has been criticized for in the past. Cureus has retracted about 125 papers since Springer Nature acquired the title in late 2022. Last year, the journal closed six of its academic channels critics described as dressed-up paper mills, and has had to repeatedly retract plagiarized articles, as we’ve previously reported.
In August, Cureus eliminated author suggestions for peer reviewers in an attempt to decrease potential conflicts of interest. The journal has had authorship issues in the past, as RW previously reported. In 2021, a medical resident in New Jersey invited his wife to review his papers without disclosing their relationship, resulting in five retractions. In 2019, another author faked reviewer accounts for two well-known neurosurgeons and was discovered only after a routine editorial audit.
Rebecca Krahenbuhl, a communications manager at Clarivate, told RW a journal is removed from the Master Journals List when it “no longer meets” 24 quality criteria. These criteria include appropriate citations, adequate and effective peer review, and primarily original scholarly content, according to the company’s website. Krahenbuhl also told RW journals are typically on hold for an average of around six weeks, but in cases where publishers “engage” with Clarivate, the company allows journals to remain on hold for longer “to allow time for publishers to conduct their own investigations and take corrective action should they decide to do so.”
Graham Parker-Finger, the publishing director at Cureus, told us the journal was “very disappointed” in Clarivate’s decision and noted the journal would continue “to offer fast, affordable, trusted and quality-assured publishing for the global medical community.”
This study was aimed at determining whether four weeks of Rhodiola rosea (RHO) supplementation improves intermittent exercise performance, post-exercise blood lactate concentrations, and decision-making under fatigue in competitive football players. Twenty-four male competitive football players completed a randomised, double-blind, placebo-controlled 4-week intervention (RHO vs. placebo). Outcomes included Yo-Yo IR2, repeated-sprint ability (RSA), post-RSA blood lactate (0, 3, 5 min), football-specific technical tests (passing and shooting), a video-based decision-making task (reaction time and accuracy), GPS-derived match running metrics, countermovement jump (CMJ), foot tapping (TAP), and haematological markers.
Yo-Yo IR2 performance significantly improved in the RHO group (p = 0.012) and was superior to the placebo group (p = 0.046). For RSA, mean sprint time improved significantly from pre- to post-intervention in the RHO group (p = 0.017), whereas no significant change was observed in the placebo group. Post-intervention, mean sprint time was significantly better in RHO than placebo (p = 0.041), with no between-group difference observed at baseline. Best sprint time showed no between-group difference (p = 0.723). Post-exercise blood lactate concentrations were significantly lower in RHO than placebo at 0, 3, and 5 min (all p < 0.05). Under fatigue, the RHO group demonstrated faster reaction time (p = 0.042) and higher decision accuracy (p = 0.049) than placebo. Additionally, the RHO group showed significant pre- to post-intervention improvements in passing and shooting performance (p < 0.05), with between-group differences observed only for short-pass performance. Match total and high-speed running distances were higher in RHO, accompanied by increases in haemoglobin and haematocrit (p < 0.05).
The authors concluded that four weeks of Rhodiola rosea supplementation enhanced high-intensity intermittent performance and decision-making under fatigue, with findings suggesting improved performance maintenance rather than increased peak sprint capacity.
Rhodiola rosea is a perennial flowering plant that grows in cold, high-altitude regions of Europe and Asia. It allegedly functions as an adaptogen—a natural substance that helps the body “adapt” to stressors. The plant contains bioactive compounds like rosavins and salidrosides. These are thought to modulate the body’s stress response system and increase the efficiency of energy production in the mitochondria. Rhodiola is also believed to prevent the breakdown of neurotransmitters like dopamine and serotonin, helping athletes keep their “head in the game” even when their legs are tired.
As we will soon see the start of the World Cup, some will ask whether professional players can legally use this method to enhance their performance. As of the 2026 WADA Prohibited List (which governs FIFA and the World Cup), Rhodiola rosea is not a banned substance. It is categorized as a dietary supplement or herbal aid. Yet, even though it is legal, elite players should be careful for two reasons:
- Cross-Contamination: Many herbal supplements are manufactured in facilities that also handle banned stimulants. If a “legal” Rhodiola pill is contaminated with a trace amount of a banned substance, the player still faces a ban.
- The “Monitoring Program”: WADA often puts substances on a “Monitoring Program” list before banning them. While Rhodiola isn’t currently there, caffeine (which was once banned) is a reminder that the rules for natural stimulants can shift over time.
So, would I advise World Cup footballers to take Rhodiola rosea?
No – not so much because of the reasons just mentioned, but because the findings of the above-quoted tiny study obviously require independent replication before we can take them seriously.
Debates on researching SCAM frequently hinge on the tension between theoretical plausibility and empirical testing. The central question is this: should interventions that contradict well-established scientific principles nonetheless be subjected to clinical trials? This issue raises fundamental concerns about the allocation of research resources, the epistemology of medical science, and the boundary between scientific openness and credulity.
In medical research, plausibility refers to the compatibility of a treatment’s purported mechanism of action with established biochemical and physiological knowledge. Treatments such as homeopathy, reiki, bioresonance, etc., etc. are typically judged to be implausible because their mechanisms violate basic physical principles (Ernst, 2010; Offit, 2013). One could argue that conducting randomized clinical trials (RCTs) on such interventions is methodologically and ethically questionable, as the prior probability of efficacy is exceedingly low (Goodman, 1999) and the probability of a positive result obtained with a rigorous trial approaches zero. Framed in Bayesian terms, if a hypothesis begins with a negligible prior probability, even seemingly positive trial outcomes are unlikely to meaningfully change its posterior credibility (Spiegelhalter, 2019).
But insisting that only theoretically plausible hypotheses merit empirical testing risks scientific conservatism. Medical history includes numerous examples – such as the discovery of the antipyretic and antithrombotic effects of aspirin – where therapeutic value was demonstrated before mechanisms were fully understood (Vane, 2000). Advocates of broader testing argue that empirical methods should retain the capacity to surprise theory and that excluding “implausible” ideas a priori risks reinforcing disciplinary dogma (Ioannidis, 2012). This appeal to epistemic humility emphasizes observation as a safeguard against the overreach of theoretical reasoning.
However, defenders of plausibility-based research prioritization contend that such humility must be balanced against the always finite resources for research and the ethical responsibility of researchers. Health research funding is limited, and prioritizing the study of implausible treatments may divert attention from interventions with rational mechanistic foundations and higher expected utility (Sampson, 2005). Additionally, the evidentiary record of clinical trials in SCAM demonstrates a consistent pattern: small, underpowered studies occasionally produce marginally positive results that fail replication, while systematic reviews of rigorous studies yield null or inconclusive conclusions (Shang et al., 2005; Ernst et al., 2011). In such cases, further testing is more likely to perpetuate public misunderstanding than to advance medical knowledge.
So, what is the solution? An epistemologically coherent approach, frequently advocated in evidence-based medicine, is to calibrate evidential standards to plausibility. Highly improbable claims should first demonstrate compelling preclinical signals – biochemical, mechanistic, or reproducible physiological effects – before human trials are considered (Goodman, 1999; Howick, 2011). This proportionality upholds methodological rigor without foreclosing the possibility of genuine empirical discovery. It respects Bayesian reasoning: extraordinary claims require extraordinary evidence.
Science must remain open to the unexpected yet disciplined in method and theory. Medical research is usually at its most productive when it operates between the two extremes—dogmatism that refuses to test unconventional claims, and indiscriminate empiricism that tests everything without theoretical guidance. The prudent path lies in aligning the scope of empirical investigation with scientific plausibility, ensuring openness tempered by rational constraint.
References
- Ernst, E. (2010). “A systematic review of systematic reviews of homeopathy.” British Journal of Clinical Pharmacology, 69(5), 577–582.
- Ernst, E., Pittler, M. H., Wider, B., & Boddy, K. (2011). The Desktop Guide to Complementary and Alternative Medicine. Elsevier.
- Goodman, S. N. (1999). “Toward evidence-based medical statistics. 1: The P value fallacy.” Annals of Internal Medicine, 130(12), 995–1004.
- Howick, J. (2011). The Philosophy of Evidence-Based Medicine. Oxford University Press.
- Ioannidis, J. P. A. (2012). “Scientific inbreeding and same-team replication: Type D personality as an example.” Journal of Psychosomatic Research, 72(6), 408–410.
- Offit, P. A. (2013). Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine. HarperCollins.
- Sampson, W. (2005). “Antiscience trends in the rise of the ‘alternative medicine’ movement.” Annals of the New York Academy of Sciences, 775(1), 188–197.
- Shang, A., et al. (2005). “Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy.” The Lancet, 366(9487), 726–732.
- Spiegelhalter, D. (2019). The Art of Statistics. Pelican Books.
In recent decades, acupuncture has attracted extensive research spanning an astonishingly wide array of medical conditions, from chronic pain and neurological disorders to infectious diseases and psychiatric ailments. However, the proposed mechanisms of action—ranging from peripheral sensory stimulation to central nervous system modulation—fail to provide a coherent, biologically plausible explanation for efficacy across this disparate spectrum (Zhao et al., 2022; WHO, 2003).
The aim of this post is to examine the breadth of published acupuncture trials, delineate the leading scientific hypotheses for its mode of action, and outline the profound implausibility of these mechanisms universally applying to such varied pathologies, ultimately framing acupuncture as non-specific rather than a specific therapeutic modality (Meissner et al., 2019; Ernst, 2018).
Acupuncture has been subjected to thousands of randomized clinical trials (RCTs) and systematic reviews across virtually every medical specialty. A comprehensive 2022 evidence map published in BMJ Open synthesized 120 systematic reviews, encompassing 1,402 individual RCTs and addressing 77 distinct conditions within 12 broad therapeutic categories (Zhao et al., 2022). These categories include neurological disorders, musculoskeletal conditions, cardiovascular diseases, and beyond, reflecting a research enthusiasm that transcends conventional biomedical boundaries.
Neurological applications dominate, with trials targeting stroke sequelae such as hemiplegia and aphasia, vascular dementia symptoms, migraines, tension headaches, and facial nerve palsies like Bell’s palsy (Li et al., 2022; Zhao et al., 2022; WHO, 2003). Musculoskeletal trials are equally prolific, examining low back pain, knee osteoarthritis, fibromyalgia, tennis elbow (lateral epicondylitis), sciatica, shoulder periarthritis, rheumatoid arthritis, and even gouty arthritis (Li et al., 2022; Zhao et al., 2022; Choi et al., 2019; Lam et al., 2020; WHO, 2003). Cardiovascular research has probed essential hypertension, primary hypotension, and pain from thromboangiitis obliterans (Shanghai Medical Clinic, 2025; WHO, 2003). Gynecological and obstetric domains feature prominently, including dysmenorrhea, labor induction, breech presentation correction, pregnancy-related nausea and vomiting, and fertility enhancement (e.g., improved clinical pregnancy rates in IVF protocols) (Zhao et al., 2022; Shanghai Medical Clinic, 2025; Smith et al., 2021; Carr, 2022; WHO, 2003).
Acupuncture trials also extend to psychiatric conditions like generalized anxiety disorder (especially in perimenopause), depression, and other mental disturbances (Zhao et al., 2022; Zhang et al., 2025; WHO, 2003); respiratory issues such as allergic rhinitis and hay fever (Li et al., 2022; Shanghai Medical Clinic, 2025; WHO, 2003); gastrointestinal disorders including acute and chronic gastritis, biliary colic, and postoperative nausea/vomiting (Zhao et al., 2022; Shanghai Medical Clinic, 2025; WHO, 2003); urogenital and nephrological problems like renal colic and radiation-induced leucopenia (often in renal contexts) (Shanghai Medical Clinic, 2025; WHO, 2003); infectious diseases such as acute bacillary dysentery, pertussis (whooping cough), and epidemic hemorrhagic fever (WHO, 2003); pediatric applications, albeit more limited, for post-extubation pain relief and whooping cough (ClinicalTrials.gov, 2013; WHO, 2003); and oncology support for cancer-related fatigue and chemotherapy/radiation side effects (Zhao et al., 2022; Shanghai Medical Clinic, 2025). Additional niches include ear-nose-throat conditions (e.g., rhinitis), eye disorders, connective tissue diseases, metabolic/nutritional imbalances, and skin pathologies (Zhao et al., 2022; WHO, 2003).
This extraordinarily wide spectrum, drawn from seminal analyses like the World Health Organization’s (WHO) 2003 review of controlled clinical trials (WHO, 2003) and Cochrane overviews on pain (Choi et al., 2019; Lee et al., 2011), clearly demonstrates that acupuncture is considered by its proponents to be a ‘cure all’. This begs the question whether such an assumption can be reasonable. The effect sizes are typically modest, and true acupuncture is often no different from sham interventions (e.g., superficial needling at non-acupoints), suggesting limited specific efficacy (Lee et al., 2011).
The scientific literature proposes a constellation of mechanisms to explain how acupuncture might work, integrating peripheral, spinal, supraspinal, and systemic processes. These are often conceptualized through the “Neural Acupuncture Unit” (NAU) model, which posits low-threshold mechanosensitive afferents (Aδ and C fibers) at acupoints converging with brain networks to elicit bidirectional signaling (Zhang et al., 2012).
- Peripheral and Local Mechanisms. Needle manipulation is claimed to induce immediate tissue responses: adenosine triphosphate (ATP) breakdown to adenosine activates A1 receptors, dampening nociceptor firing (Kelly & Suckley, 2016); axonal reflexes release neuropeptides like substance P and calcitonin gene-related peptide (CGRP), modulating local inflammation; and stromal cells exhibit cytoskeleton remodeling, with collagen fibers “wrapping” around needles to propagate mechanical signals (Kelly & Suckley, 2016; Zhang et al., 2012; Li et al., 2025). The characteristic deqi sensation (aching, soreness) correlates with these events, potentially amplifying sensory input (Staud & Price, 2014).
- Spinal Cord Level. Ascending afferents are said to activate the gate control system, presynaptic inhibition, and diffuse noxious inhibitory controls (DNIC), releasing endogenous opioids (β-endorphin, enkephalins, dynorphins), serotonin, norepinephrine, and acetylcholine to suppress nociceptive transmission in the dorsal horn (Kelly & Suckley, 2016; Zhang et al., 2012; Staud & Price, 2014). This underpins analgesia and autonomic regulation, such as reduced sympathetic outflow (Kelly & Suckley, 2016).
- Central Nervous System Modulation. Functional neuroimaging (fMRI, PET) reveals deactivated limbic hyperactivity (amygdala, anterior cingulate), normalized hypothalamic-pituitary-adrenal (HPA) axis activity, and enhanced prefrontal connectivity, particularly in pain, stress, and mood disorders (Kelly & Suckley, 2016; Zhang et al., 2012; Wang et al., 2025). Top-down expectancy modulates descending inhibitory pathways, integrating with reward and mirror neuron systems (Zhang et al., 2012).
- Systemic and Humoral Effects. Acupuncture is also thought to influence immune homeostasis by shifting cytokine profiles (e.g., ↑IL-10, ↓TNF-α, ↓IL-6), autonomic balance (vagal enhancement), and endocrine axes, providing a basis for visceral, metabolic, and inflammatory conditions (Kelly & Suckley, 2016; Li et al., 2025). Recent integrative studies emphasize network pharmacology, where multi-point stimulation perturbs interconnected pathways (Li et al., 2025).
These potential mechanisms have been empirically observed in animal models and/or human imaging studies. They might offer a partial rationale, primarily for analgesia and stress-related syndromes (Kelly & Suckley, 2016; Zhang et al., 2012). The question, however, is whethr they can provide a full explanation for acupuncture’s efficacy in all the above-named conditions.
No synthesis of these mechanisms plausibly accounts for acupuncture’s claimed benefits across unrelated conditions, exposing a core scientific paradox. Musculoskeletal pain might align with local adenosine/opioid effects and spinal gating (Kelly & Suckley, 2016), but how do these explain microbial clearance in bacillary dysentery, hypertensive vascular remodeling, or synaptic imbalances in major depression? (Meissner et al., 2019; Ernst, 2018). Gynecological infertility involves ovarian endocrinology, distant from needle-evoked sensory cues; infectious pertussis implicates Bordetella immunity, not HPA modulation (WHO, 2003; Meissner et al., 2019). This biological implausibility echoes homeopathy critiques: a single intervention cannot verifiably target such heterogeneous pathophysiologies without invoking non-specific forces (Fabrizio et al., 2010).
Trial data reinforce these doubts: meta-analyses consistently show that verum acupuncture is hardly different from sham acupuncture, and sham elicit up to 80% of verum’s effects (Kelly & Suckley, 2016; Meissner et al., 2019; Fabrizio et al., 2010; Kaptchuk et al., 2013). Such considerations implicate patient and therapist expectations, therapeutic ritual, and patient-practitioner alliance as the true mechanism behing the observed outcomes (Meissner et al., 2019; Kaptchuk et al., 2013). Neuroimaging effects often mirror expectancy manipulations in non-needling studies, suggesting top-down confounds (Fabrizio et al., 2010). Lab phenomena (e.g., adenosine release) occur but yield trivial clinical effects, dwarfed by psychosocial amplification (Fabrizio et al., 2010).
Acupuncture’s elaborate ritual maximizes contextual healing, outperforming inert pills but lacking disease-modifying specificity (Meissner et al., 2019; Ernst, 2018). Paradoxes abound—positive preclinical signals evaporate in blinded RCTs; cultural bias inflates Asian trial positives; poor sham penetration and blinding failures perpetuate illusions (Fabrizio et al., 2010; Ernst, 2018). For non-pain conditions, evidence thins further, with publication bias and flexible outcome reporting inflating apparent successes (Fabrizio et al., 2010).
Acupuncture carries risks including minor issues like bleeding, needle site pain, vegetative reactions (e.g., dizziness or nausea), and symptom aggravation, alongside rarer serious events such as pneumothorax, infections, or organ injury. Overall, at least one adverse event in 9.31% of patients undergoing a treatment series or 7.57% of treatments, with half of these being mild local reactions. Serious adverse events seem to be uncommon. Reliable prevalence figures do not exist because there is no adequate surveillance system in place (Ernst 2006).
Acupuncture’s trial proliferation signals cultural and patient-driven demand rather than mechanistic or evidential triumph. Its broad therapeutic claims by far overreach evidence (Staud & Price, 2014). Rigorous advancement would require objective biomarkers (e.g., cytokine assays, EEG), dose-response optimization, adaptive sham designs, and large pragmatic trials stratifying contextual from specific effects (Zhang et al., 2012; Fabrizio et al., 2010). Until compelling evidence exists, acupuncture remains a testament to human suggestibility’s power, but not a biomedical panacea.
References
- Carr, D. (2022). Acupuncture as Treatment for Female Infertility. Medical Acupuncture, 34(1), 12-21.
- Choi, D., et al. (2019). Cochrane reviews on acupuncture therapy for pain: a snapshot of the current evidence. Systematic Reviews, 8, 231.
- ClinicalTrials.gov. (2013). Pediatric Laser Acupuncture and Renal Biopsy (NCT01879826).
- Ernst, E. (2006). Acupuncture–a critical analysis. J Intern Med, 259(2):125-37.
- Ernst, E. (2018). Acupuncture Research: The Problem. Pain Medicine, 19(6), 1287-1288.
- Fabrizio, P., et al. (2010). Paradoxes in Acupuncture Research: Strategies for Moving Forward. Explore (NY), 6(4), 231-239.
- Kaptchuk, T. J., et al. (2013). Are All Placebo Effects Equal? Placebo Pills, Sham Acupuncture, or Placebo Needle in Irritable Bowel Syndrome. PLoS ONE, 8(7), e67485.
- Kelly, R., & Suckley, S. (2016). Mechanisms of acupuncture. European Journal of Integrative Medicine, 20, 1-11.
- Lam, M., et al. (2020). Acupuncture and Chronic Musculoskeletal Pain. Medical Acupuncture, 32(6), 357-366.
- Lee, M. S., et al. (2011). Acupuncture for pain: an overview of Cochrane reviews. Chinese Journal of Integrative Medicine, 17(3), 187-189.
- Li, T., et al. (2022). Evidence on acupuncture therapies is underused in clinical practice. Frontiers in Medicine.
- Li, Y., et al. (2025). Integrative research on the mechanisms of acupuncture. Neural Regeneration Research.
- Meissner, K., et al. (2019). Acupuncture for the Treatment of Pain – A Mega-Placebo? Frontiers in Neuroscience, 13, 1119.
- Shanghai Medical Clinic. (2025). WHO Approved Acupuncture List of Conditions.
- Smith, C. A., et al. (2021). An Overview of Systematic Reviews of Acupuncture for Respiratory Diseases. Frontiers in Public Health.
- Staud, R., & Price, D. D. (2014). Acupuncture therapy: mechanism of action, efficacy, and safety. International Review of Neurobiology, 111, 171-189.
- Wang, L., et al. (2025). Possible antidepressant mechanism of acupuncture. Frontiers in Neuroscience, 19, 1512073.
- WHO. (2003). Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials.
- Zhang, R., et al. (2012). Neural Acupuncture Unit: A New Concept for Interpreting Effects and Mechanisms of Acupuncture. Evidence-Based Complementary and Alternative Medicine, 2012, 429412.
- Zhang, Y., et al. (2025). Patient-reported outcome tools of acupuncture clinical trials. Journal of Pain Research.
- Zhao, C., et al. (2022). Evidence mapping and overview of systematic reviews of the effects of acupuncture therapies. BMJ Open, 12(6), e056803.
The attitude of Robert F. Kennedy Jr. (RFKJr.) on science and evidence-based medicine has long been a source for concern, particularly if we consider his total lack of expertise combined with his immense power to influence public health of the US and beyond. Here are several key quotes and recurring themes that define his perspective:
- “The CDC is a subsidiary of the pharmaceutical industry. The agency’s advisory committee is essentially a front for the vaccine manufacturers.”
- “Tony Fauci’s career has been a long-running effort to prioritize the interests of Big Pharma over public health.”
- “The FDA, the NIH, the CDC—all these agencies have become the sock puppets of the industries they are supposed to regulate.”
- “The scientists who are supposed to be the guardians of our children’s health are instead taking money from the companies that are poisoning them.”
- “We are living in an era where ‘evidence-based medicine’ has been replaced by ‘reimbursement-based medicine.’ The data is cooked to favour the product.”
- “I am not anti-vaccine. I am pro-science and pro-safety. I want the same kind of rigorous, double-blind, placebo-controlled testing for vaccines that we require for every other medication.”
- “When people say ‘follow the science,’ they usually mean ‘follow the decree of the person in power.’ Science is a process of constant questioning, not a set of holy commandments.”
- “Consensus is the enemy of science. Science is about dissent; it’s about looking at the outliers and the data that doesn’t fit the narrative.”
- “The minute you say ‘the science is settled,’ you are no longer talking about science; you are talking about religion and totalitarianism.”
- “Public health policy is no longer based on the best available evidence; it’s based on the best available lobbyists.”
- “I don’t necessarily believe all the scientists, because I can read science myself. That’s what I do for a living. I read science critically.”
- “I spent 40 years cross-examining experts… I know how to tell when someone is lying to me about the data.”
- “I am pro-science. I’ve spent my life fighting for science-based policies. What I am against is ‘captured’ science that serves a corporate bottom line.”
- “I advise parents: do your own research… don’t take my word for it, and don’t take the government’s word for it.”
- “I don’t think people should be taking medical advice from me… I think what we’re going to try to do is to lay out the pros and cons… with replicable studies.”
- “People should be skeptical of any medical advice. They need to look at the primary sources, not the summaries provided by the pharmaceutical industry.”
- “Trusting the experts is not a feature of democracy and it’s not a feature of science. It’s a feature of religion and totalitarianism.”
- “We train physicians to wield the latest surgical tools, but not to guide patients on how to stay out of the operating room in the first place.”
- “The science [on nutrition] is indisputable, and the void [in medical training] is clear… future physicians must graduate prepared to prevent disease.”
- “I’m not scared of a germ. I used to snort cocaine off of toilet seats.”
- “One of the worst parts of addiction was my total incapacity to keep contracts with myself. I didn’t want to be someone who woke up every morning thinking about drugs.”
- “All of us have kind of a God-sized hole in us that we’re trying to fill. And addicts… try to fill that hole inside of you with things that change the way you feel about yourself.”
- “You can’t live off the laurels of the spiritual awakening. You have to renew it every day. You have to wake up every day and say ‘reporting for duty sir,’ and give up control every day.”
- “I had a dark spot on my brain scans… doctors concluded I had a tumor. I was scheduled for an operation by the same surgeon who operated on my uncle.”
- “The abnormality was caused by a worm that got into my brain and ate a portion of it and then died.”
- “I probably got it in South Asia… I was traveling in a lot of places where you can get those kinds of parasites.”
- “I have cognitive problems, clearly. I have short-term memory loss, and I have longer-term memory loss that affects me.”
- “It didn’t require treatment. The worm died on its own, and the symptoms cleared up over time.”
- “I recovered from the memory loss and mental fogginess… I have no aftereffects from the parasite.”
- “Questioning my health is a hilarious suggestion, given the competition.”
RFKJr., as U.S. HHS Secretary since early 2025, was tasked by Trump with restoring trust in healthcare agencies. However, polls show trust has further eroded under his leadership, with KFF data indicating widespread disapproval – nearly 60% of adults – and drops in confidence for CDC, FDA, and vaccine info sources. His tenure involved firing CDC vaccine advisors, slashing HHS staff by 25%, revising childhood vaccine schedules (e.g., dropping hep B at birth), and canceling research grants, sparking measles outbreaks and expert backlash. Public health leaders cite these as science-defying moves worsening distrust across parties. Only 37% trust RFK Jr. as a health info source (KFF Jan 2026). Major health organizations, like the WHO and the American Academy of Pediatrics, point to decades of peer-reviewed, large-scale epidemiological studies that contradict the plethora of demonstrably wrong assertions of RFKJr.
One could almost pity RFKJr. for his naive stupidity – I say ‘almost’ because his stance is not just pitiful and embarrassing, it is evidently dangerous. If a chap having a beer in your local pub came out with such nonsense, you would laugh; if RFKJr. does it and then – horror of horrors – tries to act on it, it gets frightfully dangerous for us all.
Conclusion:
Even Trump cannot be as mean as to allow RFKJr. continue the destruction of public health!
He must be replaced before it is too late!
Ita Wegman (22 February 1876 – 4 March 1943) was born 150 years ago today. Together with Rudolf Steiner, she was a central figure in the development of anthroposophic medicine, an approach that interprets illness through spiritual–cosmological concepts. In 1921, Wegman founded the Klinisch-Therapeutisches Institut in Arlesheim, Switzerland—today the Ita Wegman Clinic—the first hospital dedicated to anthroposophic medicine. Practices developed there included rhythmical massage, a gentle bodywork technique intended to “harmonize” physiological rhythms, and mistletoe-based cancer therapy derived from Viscum album, later marketed as Iscador, as well as many other remedies influences by homeopathy. Wegman also co-founded Weleda, which remains a major producer of anthroposophic remedies and cosmetics.
Despite its continued use in parts of Europe, mistletoe therapy (including Iscador) has not demonstrated reliable clinical efficacy in improving cancer survival or tumor outcomes in well-controlled trials. Major systematic reviews conclude that evidence for benefit is inconsistent, methodologically weak, and often biased, with any reported improvements largely limited to subjective quality-of-life measures. It is therefore regarded by mainstream oncology as an unproven therapy rather than an evidence-based treatment. For Wegman’s other therapeutic innovations the evidence is even less convincing.
Her collaboration with Steiner was both professionally formative and personally intense. They met in the early 1900s, and Wegman later credited Steiner with inspiring her decision to pursue medicine relatively late, enrolling at the University of Zurich. From 1919 onward, their cooperation deepened: Steiner supplied esoteric frameworks derived from anthroposophy, while Wegman sought to translate these ideas into clinical practice. Their collaboration culminated in the book “Fundamentals of Therapy” (1925), published shortly after Steiner’s death.
Speculation about a romantic relationship between Wegman and Steiner has persisted for decades. Purported “love letters” dated to 1924 describe expressions of affection, but most scholars regard them as forgeries, citing factual errors, the absence of originals from Steiner archives, and stylistic inconsistencies with Steiner’s documented correspondence. Steiner himself described their bond in karmic terms, claiming a debt from a past incarnation that explained their closeness despite his marriage to Marie von Sivers. Historian Peter Selg and others interpret the relationship as an intense spiritual and intellectual partnership rather than a conventional affair, though contemporaries did circulate rumors.
Steiner died on March 30, 1925, after a prolonged illness. The exact cause remains uncertain and not definitively confirmed as stomach cancer. Wegman provided Steiner’s main care from September 1924 until his death, leaving her clinic to nurse him in his studio at the Goetheanum in Dornach, Switzerland. She is said to have employed anthroposophic approaches, but specific treatments remain sparsely documented in available accounts.
Following Steiner’s death, Wegman’s authority within the movement became increasingly contested. In 1935 she was expelled from the Anthroposophical Society amid internal power struggles and accusations of doctrinal deviation; this expulsion was formally reversed in 2018. Wegman’s political stance during the Nazi period remains controversial. While anthroposophy as a movement was partially suppressed in Nazi Germany, several leading anthroposophists – including Wegman – sought accommodation rather than resistance. Wegman expressed hopes in the early 1930s that National Socialism might support a spiritual renewal of society and did not publicly oppose the regime. Although she was not a member of the Nazi Party and later faced restrictions, her posture is best described as opportunistic accommodation and ideological ambiguity.
Wegman’s collaboration with Steiner created the foundations of anthroposophic medicine. It also generated enduring scientific, ethical, and political controversies – particularly regarding the medical validity of its treatments and its leaders’ responses to authoritarian power after Steiner’s death.
Homeopathy rests on two main axioms: “like cures like,” where a substance causing symptoms in healthy individuals treats similar symptoms in the sick, and potentization through serial dilution and succussion, often to dilutions so extreme that no original molecules remain. Both axioms fly in the face of science. Yet, homeopaths have put forward a range of theories to explain how their remedies might exert effects on the human body.
Water memory
An early theory posits water memory, suggesting that the solvent – typically water and alcohol – retains a structural imprint of the original solute even after dilutions surpass Avogadro’s number. Proponents of this notion argue that vigorous shaking during succussion organizes water molecules into stable clusters or gels, encoding remedy-specific information that can interact with biological systems. This idea gained notoriety from Jacques Benveniste’s 1988 experiments, which claimed diluted antibodies retained biological activity, though subsequent attempts to replicate them failed under better controlled conditions. Extensions of the concept invoke hydrogen-bonded networks or fractal patterns in water, purportedly persisting long enough to influence cellular hydration and signalling. Homeopathic remedies often come as globuli, i.e. water-free, which is just one of many reasons why the water theory does not hold water.
Nanoparticles
The nanoparticle hypothesis proposes that trace particles of the source material or silica from glass containers persist through preparation. These nanostructures, detected in some studies via electron microscopy, allegedly act as catalytic templates, adsorbing original molecules epitaxially and triggering nonlinear responses in cells at ultralow doses. This mechanism aligns with observations of metal oxides in succussed remedies, suggesting they enhance bioavailability and elicit adaptive physiological shifts without relying on bulk pharmacology. There are many reasons why this theory is more than doubtful. How would it, for instance, explain the action of the many homeopathic remedies that are not based on materials at all, e.g. X-ray, vaccuum, or light?
Electromagnetic signalling
Electromagnetic signalling offers another biophysical explanation, contending that succussion generates low-frequency electromagnetic fields or photon emissions from the remedy, which water or DNA can store and transmit. Nobel laureate Luc Montagnier reportedly captured such signals from diluted bacterial DNA, even digitizing them for remote replication. Quantum electrodynamics models further claim remedies restore coherence to disrupted electromagnetic fields in diseased organisms, with influences like MHz resonances exciting enzyme complexes or quantum tunnelling facilitating information transfer beyond molecular proximity.
This theory also fails the basic scientific test of empirical validation. Homeopathic remedies beyond typical dilutions (e.g., 12C or higher) contain no original molecules, so any claimed signals from succussion must be imprinted solely in water. The structure of water randomizes in femtoseconds via Brownian motion and hydrogen bond breakage, erasing any stable “memory” or electromagnetic imprint from trivial mechanical shaking. Moreover, Luc Montagnier’s DNA signal experiments, central to this theory, have not been independently replicated despite years of scrutiny.
Hormesis
Hormesis and allostasis describe how minute stimuli provoke beneficial adaptive responses, inverting the conventional dose-response curve into a biphasic pattern where low doses stimulate resilience. Homeopathic remedies purportedly modulate interconnected immune, endocrine, and neural networks, leveraging time-dependent sensitization to reverse maladaptive patterns and foster systemic homeostasis, akin to complexity theory’s emphasis on small perturbations rebalancing chaotic systems. Yet, hormesis requires measurable material doses of environmental stressors to trigger specific biphasic responses, unlike homeopathic remedies typically diluted beyond
Molecular imprinting
Molecular imprinting extends the logic of similitude, envisioning potentized solvents forming three-dimensional “imprints” complementary to pathogenic molecules, binding and neutralizing them much like antibodies. This restores a putative vital force, echoing Hahnemann’s holistic vitalism, while additional ideas invoke reactive oxygen species leaving bioenergetic signatures, exclusion zone structured water amplifying information in cells, or thermodynamic shifts reducing molecular crowding to boost reactivity.
Numerous arguments are against this theory, e.g.:
- Water’s hydrogen bonds rearrange randomly in picoseconds due to thermal motion, preventing stable 3D “imprints” from dilution-succussion that could mimic antibody binding.
- High potencies exceed Avogadro’s limit, leaving no template molecules to form such structures, unlike lab molecularly imprinted polymers requiring persistent chemicals.
- Tests using molecularly imprinted chromatography failed to detect differences between homeopathic remedies and plain solvent, undermining claims of functional imprints.
- NMR studies similarly find no spectral changes in potentized solutions versus controls.
- Even if fleeting imprints existed, they could not neutralize pathogens systemically or restore “vital force,” as meta-analyses confirm homeopathy equals placebo across conditions. ROS signatures or exclusion zone water remain speculative without measurable impacts in blinded trials.
Placebo
Despite their apparent ingenuity, none of these theories (which interconnect – nanoparticles emitting signals via quantum effects, for instance) are accepted outside homeopathy as the true explanation for homeopathy’s reported effects. As discussed repeatedly on this blog, the true explanation for the outcomes observed after homeopathic treatments lies in the placebo response and other non-specific effects such as the therapeutic encounter. Rigorous studies find outcomes indistinguishable from placebos in blinded trials, with benefits arising from patient expectations, therapeutic ritual, and contextual healing rather than any specific remedy action. This psychological mechanism, well-documented across medicine, underscores why homeopathy persists culturally despite lacking empirical support for its dilutions.
References
- Bellavite, P. (2015). Hypotheses and findings on the action mechanism(s) of homeopathy: Progress in the last 20 years. World Homeopathy Summit Conference Proceedings. Retrieved from http://paolobellavite.it/files/285_2015_WorldHomeoSummitConference.pdf
- Benveniste, J. (1988). Molecular memory of water. Nature, 333(6176), 816–818. (Original claim; see also Nature Editorial, 1988, 334, 287–290 for retraction context).
- Calabrese, E. J. (2008). Hormesis: Why it is important to biphasic dose responses. Critical Reviews in Toxicology, 38(2), 249–252.
- Chikramane, P. S., et al. (2010). Extreme homeopathic dilutions retain diagnostic molecules: A nanoparticulate perspective. Homeopathy, 99(4), 231–242.
- Del Giudice, E., et al. (2010). Water dynamics at the root of metamorphosis in living matter. Electromagnetic Biology and Medicine, 29(1), 28–46.
- Del Giudice, E., & Vitiello, G. (2016). Role of the electromagnetic field in the water coherence of living systems. Electromagnetic Biology and Medicine, 35(3), 165–178.
- Ernst, E. (2002). A systematic review of systematic reviews of homeopathy. British Journal of Clinical Pharmacology, 54(6), 577–582.
- Ernst, E. (2012). Proposed mechanisms for homeopathy are physically impossible. Focus on Alternative and Complementary Therapies, 17(3), 149–150.
- Hahnemann, S. (1810). Organon of Medicine (6th ed., 1921 trans. by W. Boericke).
- Josephson, B. D., & Pallieri, G. (2012). Quantum processes in biology and the prospects for homeopathy. Journal of Alternative and Complementary Medicine, 18(6), A1–A2 (abstract).
- Konovalov, A. I., & Ryzhkina, I. S. (2012). A model for homeopathic remedy effects: Low dose nanoparticles induce hormesis and allostasis. PMC, PMC3570304. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC3570304/
- Mathie, R. T., et al. (2014). Method for appraising model validity of randomised controlled trials of homeopathic treatment: Multi-rater concordance study. BMC Medical Research Methodology, 14, 102.
- Montagnier, L., et al. (2011). Electromagnetic signals are produced by aqueous nanostructures derived from bacterial DNA sequences. Interdisciplinary Sciences: Computational Life Sciences, 1(2), 81–90.
- National Health and Medical Research Council (NHMRC). (2015). Statement on homeopathy. Australian Government.
- Pollack, G. H. (2013). The fourth phase of water: Beyond solid, liquid, and vapor. Ebner & Sons.
- Roy, R., et al. (2005). The structure of liquid water and aqueous systems: A tentative model. Materials Research Innovations, 9(4), 577–608.
- Samal, S., & Geckeler, K. E. (2001). Unexpected clustering of fullerenes in aqueous solutions. Chemistry: A European Journal, 7(19), 4284–4288.
- Walach, H. (2000). Magic of signs: A non-local interpretation of homeopathy. British Homeopathic Journal, 89(3), 127–131.
This article recounts the 5-year long odyssee of a few concerned and fiercely determined individuals [including myself] to get a published paper retracted that clearly was riddled with scientific misconduct and thus detrimental to science and dangerous to vulnerable patients. Here is the abstract of our just-published paper:
Scientifc misconduct threatens patient safety, progress, and trust in medicine. On October 3, 2020, Frass and colleagues published a randomized, placebo-controlled, double-blind trial in The Oncologist (published by Wiley at the time) claiming that add-on homeopathy signifcantly prolonged survival in advanced non-small-cell lung cancer. Since homeopathy contradicts established scientifc principles, doubts about the trial’s validity quickly emerged. Concerns were frst published in October 2020, followed in 2021 by a detailed analysis alleging scientifc misconduct. This prompted the Medical University of Vienna, the afliation of the study’s lead author, to request an investigation by the Austrian Agency for Research Integrity (OeAWI). After conducting an in-depth review, OeAWI concluded in September 2022 with a clear recommendation for retraction. However, The Oncologist issued only an ‘Expression of Concern’ at the time, despite fve co-authors formally requesting the withdrawal of their authorship— a demand that remained unaddressed as of November 2025. Repeated inquiries to the journal and its publisher, Oxford University Press (OUP), yielded only vague assurances that the matter was“under review,” with multiple deadlines passing without resolution. Finally, by November 24, 2025, The Oncologist retracted the paper. However, the retraction notice fails to address the specifc concerns raised about the study’s results and conclusions, nor does it provide a clear rationale for the retraction itself. Meanwhile, the paper has been cited more than 60 times (according to Google Scholar) and is widely circulated online as“proof” that homeopathy benefts cancer patients. This highlights the harmful consequences of delayed editorial action. According to COPE guidelines, misconduct must be dealt with swiftly and transparently. Our case reveals the opposite: incomplete corrections, prolonged inaction, and even the defense of implausible claims. Against the backdrop of increasing organized scientifc fraud, this experience underscores the urgent responsibility of journals and publishers to protect the scientifc record and prevent harm to patients.
Our paper details the highly unethical behaviour of the editors of THE ONCOLOGIST who put many lives at risk through their incomprehensible inaction. In my view, this was nothing short of a scandal. I do encourage you all the read the full paper which is freely available to everyone.
The aim of this study was to determine the effectiveness of spinal manipulation and clinician-supported biopsychosocial self-management vs medical care for adults with increased risk of chronic disabling LBP.
This 2 × 2 factorial randomized clinical trial enrolled participants in 3 research clinics at the Universities of Minnesota and Pittsburgh from November 2018 to May 2023; final follow-up was in June 2024. Adults with acute or subacute LBP at moderate to high risk of chronicity based on the STarT Back tool were randomized to 1 of 4 groups, with interventions lasting up to 8 weeks. Statistical analysis was conducted from November 2024 to June 2025.
These interventions were:
- Spinal manipulation therapy (n = 201),
- supported self-management (n = 305),
- combined supported self-management with spinal manipulation (n = 193),
- guideline-based medical care (n = 301).
Physical therapists and chiropractors provided spinal manipulation and supported self-management.
The 2 primary outcomes averaged over a follow-up of 1 year were monthly low back disability (Roland-Morris Disability Questionnaire) and weekly pain intensity (numerical rating scale). Secondary analysis examined the proportion of participants achieving a 50% or higher reduction in the primary outcome measures.
Among the 1000 participants randomized (mean [SD] age, 47 [16] years; 58% female), 93% completed the trial. The omnibus test for differences across the 4 treatment groups was statistically significant for disability (P = .001; supported self-management, 4.7; spinal manipulation, 5.5; combined supported self-management with spinal manipulation, 4.8; medical care, 5.9) but not pain intensity (P = .16; supported self-management, 2.8; spinal manipulation, 3.0; combined supported self-management with spinal manipulation, 2.8; medical care, 3.0). Averaged over 12 months, LBP disability was significantly lower compared with medical care for supported self-management (mean difference, −1.2 [95% CI, −1.9 to −0.5]) and supported self-management with spinal manipulation (mean difference, −1.1 [95% CI, −1.9 to −0.3]) but not spinal manipulation alone (mean difference, −0.4 [95% CI, −1.2 to 0.4]). Group differences in pain intensity were not statistically significant; point estimates ranged from −0.2 to 0. Both supported self-management groups had higher proportions of patients achieving a 50% or greater reduction in disability (supported self-management, 67%; spinal manipulation, 54%; combined supported self-management with spinal manipulation, 65%; medical care, 54%).
The authors concluded that for patients with acute or subacute LBP at increased risk of chronic disabling LBP, clinician-supported biopsychosocial self-management showed statistically significant but small reductions in disability, but not pain, vs medical care over 1-year follow-up, and spinal manipulation alone showed no significant difference for either outcome.
These findings are very bad news for chiropractors (the profession that uses spinal manipulations more than any other): spinal manipulation does not generate effects that are in the least convincing. This is particularly remarkable, since the study was not blinded. It means that, even the undoubtedly powerful placebo effect associated with spinal manipulation did not render the outcome more favourable.
I said it many times, and I will say it again: For LBP, many therapies generate similarly marginally positive effects but no treatment is truly convincing. In this situation, we should choose one that is at least inexpensive and free of severe adverse effects. And that evidently cannot be spinal manipulation!
On this blog, some people insist that homeopathy goes from strength to strength. Here I counter this notion by pointing out that several contries have stopped reimbursing homeopathy and that loss of trust in homeopathy has grown significantly.
Several converging factors explain the erosion of confidence:
- Lack of evidence of effectiveness: Large reviews by national and international bodies (for example the Australian NHMRC and the European Academies’ Science Advisory Council) concluded there is no reliable evidence that homeopathic remedies are effective for any health condition beyond placebo.
- Scientific implausibility: Homeopathy’s principles (high dilutions, “water memory”) conflict with established chemistry and physics, which weakens its credibility among scientists and the informed publics.
- Placebo and expectation effects: Empirical work suggests any benefits are best explained by non-sepecific effects such as placebo responses, contextual care, and patient expectations rather than pharmacological action of the remedies.
- Health literacy: Studies indicate that higher health literacy is associated with greater perceived credibility of conventional medicine and relatively lower credibility of homeopathy, which means better-informed patients tend to trust it less.
- Safety and opportunity costs: Critics emphasize that relying on ineffective remedies can delay effective treatment, prolong illness, and in some cases contribute to preventable harm or death.
A range of actors has shaped this loss of trust:
- Scientific bodies and advisory councils: Organizations such as the NHMRC in Australia and EASAC in Europe have issued high‑profile reports stating that homeopathy lacks robust evidence of efficacy and should not be claimed to treat health conditions.
- National health systems and regulators: NHS England, for instance, has advised against prescribing homeopathy, describing it as unsafe or ineffective where better, cost‑effective options exist, and warning that giving it institutional endorsement risks misleading patients.
- Skeptical and consumer‑protection movements: Skeptics’ groups and consumer advocates have campaigned against public funding of homeopathy and organized public “overdose” demonstrations to highlight the extreme dilutions and question the idea that the products contain active ingredients.
- Critical scientists and physicians: Numerous clinicians and researchers have published analyses arguing that homeopathy violates basic scientific and ethical principles, has no explanatory power, and undermines science‑based medicine.
The loss of trust has produced several consequences across healthcare systems and societies:
- Several public health systems have reduced or eliminated reimbursement and institutional support for homeopathy, reallocating funds towards treatments backed by compelleing evidence.
- Market contraction and repositioning: Declining official endorsement and critical media coverage have contributed to shrinking markets in some countries.
- Manufacturers and practitioners increasingly market homeopathy as “wellness” or “complementary” rather than curative medicine, a notion that would make Hahnemann turn in his grave.
- Homeopathy has become a touchstone in broader debates about scientific literacy, misinformation, and the role of the state in regulating ineffective therapies.
Taken together, these dynamics show how rigorous research, scientific critique, regulatory action, and changing public expectations will gradually strip a once‑popular therapy of its medical legitimacy. Or, to put it bluntly: in medicine, evidence will aways win against belief, even if it takes several decades.
