critical thinking
We have discussed the use of bleach, MMS, and related products as a so-called alternative medicine (SCAM) several times before. This regularly prompts advocates of this approach to claim that they are effective and safe. A recent case report seems to suggest otherwise. 
A 9-year-old boy presented with his brother after they accidentally ingested a small amount of undiluted 22.4% sodium chlorite. Symptoms included nausea, vomiting, diarrhea, and dyspnea. Oxygen saturation remained 71% despite supplemental oxygen (15L/min). The patient was noted to have dark chocolate-appearing blood, minimal urine output, diffuse pallor, and cyanosis. He developed methemoglobinemia, renal failure requiring renal replacement therapy, and hemolysis requiring blood transfusion. The authors reveal that these are the 7th and 8th reported cases of sodium chlorite toxicity by ingestion and the second and third in children.
The authors conclude that Miracle Mineral Solution is a commonly purchased potentially lethal compound that can cause methemoglobinemia with respiratory failure, hemolytic anemia requiring transfusion, and renal failure requiring dialysis.
Despite such cases, MMS continues to be promoted for viral and many other diseases, including cancer. Anyone truthfully stating that it is ineffective and dangerous is branded as a pharma shill who is biased against MMS. Would the ‘bleach boys’ claim the same about an agency like the UK Food Standards Authority?
Let’s see!
This is what the FSA says about MMS:
… Sodium chlorite products vary in concentration, specific dosage and method of ingestion.
With products of weaker strength, any health impact from consuming these products is likely to be gastrointestinal irritation.
For stronger products, the effects can be severe nausea, vomiting and diarrhoea, potentially leading to dehydration and reduced blood pressure.
If the solution is diluted less than instructed, it could cause damage to the gut and red blood cells, potentially resulting in respiratory failure.
There are a range of alleged health benefits related to these products and all are unlikely to be authorised. Only nutrition claims listed in the GB NHC Register (Opens in a new window)may be used in Great Britain.
Health and nutrition claims are required to be authorised under retained Regulation 1924/2006 (Opens in a new window), as amended by The Nutrition (Amendment etc.) (EU Exit) Regulations 2019 (Opens in a new window)and The Nutrition (Amendment etc.) (EU Exit) Regulations 2020 (Opens in a new window). As well as being authorised and recorded on the GB NHC Register, the claim must not be ‘false, ambiguous or misleading’.
Some health claims about this product that relate to the treatment of cancer may also be in contravention of the Cancer Act 1939.
Claims range from generic statements about ‘purifying’ the body to more specific ones around cancer and autistic spectrum disorders…
Recently, there has been a flurry of research interest in mindfulness – one could almost call it hype! Not that this is reflected in loads of rigorous trials, rather it manifests itself by an unprecedented amount of systematic reviews on mindfulness being published.
I conducted a Medline search on 8/2/2022 for meta-analyses of mindfulness. It resulted in no less than 9 such papers. Here are their conclusions:
- This meta-analysis suggests that SOF is a moderately effective evidence-based practice for reducing disruptive behavior.
- In conclusion, both mindfulness interventions showed robust evidence on anxiety symptoms in pretest-posttest periods compared to control groups. Few studies and lack of evidence of follow-up periods were the main limitations found.
- Memory specificity did not significantly differ from baseline to post-treatment for either MBCT and Control interventions.
- Although this review was limited by search strategies and most of the included studies were of low quality, it still provided some tentative support for PSIs for the treatment of TOPFA women.
- Meta-regression results showed that some heterogeneity in effect size could be accounted for by intervention dosage, study population, and study design. Our findings quantify MBIs’ potential for improving immune function and thus impacting somatic disorders.
- Mindfulness interventions somewhat improved depression in emerging adults. Because primary researchers did not report the adverse effects, mindfulness interventions should be used with caution. Future researchers might study the adverse effects of mindfulness interventions as well as the long-term effects.
- The effect of MBIs on pain in cancer patients was demonstrated in our analysis, albeit with small effect sizes. High-quality RCTs are needed to verify the efficacy of MBIs on cancer patients or survivors with pain complaints. Future trials should take into account the specific pain outcome measures (pain intensity or pain interference), the approach of intervention provision (clinic-based or remote MBI, group or individual practice), the duration and frequency of interventions and the comparators (passive or active control arms).
- This meta-analysis found that MBIs had beneficial effects on mental health such as psychological distress and wellbeing in nurses.
- Because MBIs show promise across some PICOS, future RCTs and meta-analyses should build on identified strengths and limitations of this literature.
This amounts to about two systematic reviews/meta-analyses per week!
And what do these papers tell us?
If you are an advocate of mindfulness, you probably conclude that your pet therapy is supported by reasonably sound evidence. If, however, you think a little more critically, you would probably see that the evidence is far from strong. The effect size is usually small and of doubtful clinical relevance. This is, I think, important because clinical trials of mindfulness cannot easily control for placebo effects (there is no adequate placebo that would allow patients to be blinded). Therefore, the small effects that do emerge in systematic reviews/meta-analyses are most likely the result of a placebo response and not due to mindfulness per se.
My conclusion is therefore not nearly as positive as that of fans of mindfulness: the collective evidence suggests to me that the success of mindfulness relies mostly or even entirely on the placebo effect. And this means that even dozens of further systematic reviews are not going to advance our knowledge significantly. What is needed, I think, is a few truly rigorous studies aimed at determining whether the effects of mindfulness are specific or non-specific in nature. My prediction is that, once we have this evidence, the current hype around mindfulness will calm down.
The purpose of this recent investigation was to evaluate the association between chiropractic utilization and use of prescription opioids among older adults with spinal pain … at least this is what the abstract says. The actual paper tells us something a little different: The objective of this investigation was to evaluate the impact of chiropractic utilization upon the use of prescription opioids among Medicare beneficiaries aged 65 plus. That sounds to me much more like trying to find a CAUSAL relationship than an association.
Anyway, the authors conducted a retrospective observational study in which they examined a nationally representative multi-year sample of Medicare claims data, 2012–2016. The study sample included 55,949 Medicare beneficiaries diagnosed with spinal pain, of whom 9,356 were recipients of chiropractic care and 46,593 were non-recipients. They measured the adjusted risk of filling a prescription for an opioid analgesic for up to 365 days following the diagnosis of spinal pain. Using Cox proportional hazards modeling and inverse weighted propensity scoring to account for selection bias, they compared recipients of both primary care and chiropractic to recipients of primary care alone regarding the risk of filling a prescription.
The adjusted risk of filling an opioid prescription within 365 days of initial visit was 56% lower among recipients of chiropractic care as compared to non-recipients (hazard ratio 0.44; 95% confidence interval 0.40–0.49).
The authors concluded that, among older Medicare beneficiaries with spinal pain, use of chiropractic care is associated with significantly lower risk of filling an opioid prescription.
The way this conclusion is formulated is well in accordance with the data. However, throughout the paper, the authors imply that chiropractic care is the cause of fewer opioid prescriptions. For instance: The observed advantage of early chiropractic care mirrors the results of a prior study on a population of adults aged 18–84. The suggestion is that chiropractic saves patients from taking opioids.
It does not need a lot of fantasy to guess why some people might want to create this impression. I am sure that chiropractors would be delighted if the US public felt that their manipulations were the solution to the opioid crisis. For many months, they have been trying hard enough to pretend this is true. Yet, I know of no convincing data to demonstrate it.
The new investigation thus turns out to be a lamentable piece of pseudo research. Retrospective case-control studies can obviously not establish cause and effect, particularly if they do not even account for the severity of the symptoms or the outcomes of the treatment.
I have studied so-called alternative medicine for decades, and yet, I have to admit that I am learning every day. There is so much I did not know. Take this statement, for instance:
All alternative healing methods work specifically on a certain level, they are a part of the zero point energy/tachyon energy and therefore optimal to combine. For example, very good experiences have been made with homeopathy, plant extracts, Bach flowers, aura soma, bodywork, oxygen and gemstone therapy by doctors and alternative practitioners. Here, zero-point energy products were used together with other forms of therapy. Sometimes the applied remedies (e.g. Bach flowers, homeopathy) were combined with a zero-point energy product. This is done by simply placing the remedy on e.g. a zero point energy cork plate. Very good results were achieved when an applied remedy was directly converted into a zero-point energy antenna. Silica, healing earth, herbal teas and extracts, and especially water are particularly suitable for this.
The statement comes from a manufacturer that sells no end of fascinating products. This advertisement (my translation) does not hold back, for example:
Through the rediscovery of “old” Atlantic knowledge, it is now possible to use this directly for everyone.
This also includes the Atlantic energy grid. It consists of copper wire, is tuned exactly according to the sacred geometry and connected to form a grid.
In connection with a healing generator, which among other things consists of a large natural rock crystal, this copper grid has a very balancing effect on one’s own energy balance. Measurements with the Prognos measuring method (meridian skin zone measuring device) have already been carried out with success.
This therapy device has also been converted into a zero-point energy antenna. Thus the energy buffet is enlarged, the strong Atlantic energies are harmonised and the body can elegantly help itself to the energies. More detailed descriptions of the energy grid are difficult to formulate in words. Here we recommend simply testing the energy grid and feeling into it. One’s own experiences convey more than words.
All users who have used it so far are simply thrilled.
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In case you find the price for the ‘Atlantic Energy Grid’ of 5.500 Euro unconvincingly low, I recommend another product from the same manufacturer. Here is what they say about it: 
Our T 33, the Torus Tesla coil, has been newly designed and specially developed to harmonise the problems of microwave radiation, especially 5G. The combination of the Torus energy with a Tesla coil has the possibility to additionally connect a frequency generator.
The cells align themselves energetically again according to their origin, the polarity in the cells is readjusted. A true fountain of youth!
Introductory price of 7890 € is valid until all test results are available.
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Gadgets like this never fail to remind me of a post I published 10 years ago entitled How to become a charlatan. I cannot help thinking that the entrepreneurs who market them have studied my advice thoroughly and followed every word I said.
:
People often say WHAT’S THE HARM?
Why not let Prince Charles promote any nonsense he likes?
Let him be!
He means well!
He is not harming anyone!
I think this attitude is not correct. Charles’s advocacy of quackery is by no means harmless. This is one of the points I have been trying to make repeatedly, most recently in my biography of Charles.
And there are plenty of examples for this; just think of the Gerson therapy (a whole chapter in the said book). Another, less obvious example is homeopathy. Charles has promoted homeopathy during all his adult life. When he fell ill with COVID in the early phase of the pandemic, the realm of homeopathy predictably decided that he recovered so well because he homeopathic treatment. A report dated 7 April 2020, for example, is quite clear about it:
British Crown Prince Charles has been “101 per cent” cured of COVID-19 using Ayurveda and Homeopathy treatment, Union Minister of State for AYUSH Shripad Naik … “I am proud that the Ministry which I head, managed to cure such a great man, there is no greater credit than this. He may have some problem (admitting to it) because the system in his country does not give recognition to Ayurveda. He may have felt he would violate rules, that is why his refusal to admit is obvious,” Naik told a local cable news channel in an interview late on Monday. “I believe 101 per cent, that he has been cured (using Ayurveda and Homeopathy),” Naik also said.
On April 2, Naik had told a press conference in Goa, that Prince Charles had been cured of COVID-19 after seeking treatment from a Bengaluru-based alternative treatment resort, SOUKYA International Holistic Health Centre’ run by a doctor Isaac Mathai. A day after his statement, Clarence House, the official residence of Prince Charles had said that the claim was incorrect and that the royal “followed the medical advice of the National Health Service in the UK and nothing more”. The royal had been diagnosed COVID-19 positive last month.
Naik in the cable TV interview on Monday continued to insist that Ayurveda and Homeopathy had indeed cured the Prince and that it was a “victory” for Indian traditional medicine systems. Naik also said that there was no need to disbelieve the doctor Isaac Mathai, who cured Prince Charles. “The man (Dr. Mathai) himself is saying this. He is a doctor, an owner of a resort, he is trustworthy, when he says this, it is a victory of our Indian system,” Naik said.
The royal denial had little effect; Indian officials had persuaded themselves and key decision-makers that Charles’s case was proof for homeopathy’s effectiveness against COVID. Consequently, homeopathy was widely used for that purpose. As a result, millions of Indians deemed themselves sufficiently protected (possibly not taking other measures seriously). And the rest is history: in the summer of 2020, about 1000 Indians per day were reported to have died of COVID (the number of unreported deaths was estimated to be even higher).
The point I am trying to make is this: the promotion of quackery by a ‘VIP’ can have dramatic unforeseen consequences, even if (like in Charles’s case) a direct cause-effect relationship is impossible to prove.
Fish and omega-3 polyunsaturated fatty acids (PUFA) have been suggested to play a role in improving cancer prognosis. However, results from epidemiological studies remain inconsistent. A new systematic review was aimed at creating clarity by assessing the association between dietary fish and/or omega-3 PUFAs intake and cancer prognosis. For this purpose, the authors conducted a meta-analysis of observational studies.
A systematic search of related publications was performed using PubMed and Web of Science databases. Hazard ratios (HR) and 95% confidence intervals (CI) were extracted and then pooled using a random-effect model. Potential linear and non-linear dose-response relationships were explored using generalized least squares estimation and restricted cubic splines.
As a result, 21 cohort studies were included in the analysis. Compared to the lowest category, the highest category of fish intake was associated with a significant lower mortality in patients with ovarian cancer (n = 1, HR = 0.74, 95% CI: 0.57-0.95) and overall cancer (n = 12, HR = 0.87, 95% CI: 0.81-0.94). Marine omega-3 PUFAs intake rather than total omega-3 PUFAs intake showed significant protective effects on survival of overall cancer (n = 8, HR = 0.81, 95% CI: 0.71-0.94), in particular prostate cancer (n = 2, HR = 0.62, 95% CI: 0.46-0.82).
Yes, correlation is not causation, I know. This is all the more important, as the mechanism of action of PUFAs in relation to cancer seems speculative at present. On the other hand, causality is rendered more likely by a dose-response meta-analysis. It indicated a nonlinear and a linear relationship between fish intake, as well as marine omega-3 PUFAs intake, and overall cancer survival, respectively.
Thus I feel that the conclusion drawn by the authors is reasonable: our analysis demonstrated a protective effect of dietary fish and marine omega-3 PUFAs consumption on cancer survival.
Three days ago, I reported a new study of homeopathy. At the time, I had not seen the full paper. Now, thanks to a kind reader sending it to me, I can report more details.
To recap:
In this double-blind, cluster-randomized, placebo-controlled, four parallel arms, community-based, clinical trial, a 20,000-person sample of the population residing in Ward Number 57 of the Tangra area, Kolkata, was randomized in a 1:1:1:1 ratio of clusters to receive one of three homeopathic medicines:
- Bryonia alba 30cH,
- Gelsemium sempervirens 30cH,
- Phosphorus 30cH,
- or an identical-looking placebo.
The treatment period lasted for 3 (children) or 6 (adults) days. All the participants, who were aged 5 to 75 years, received ascorbic acid (vitamin C) tablets of 500 mg, once per day for 6 days. In addition, instructions on a healthy diet and general hygienic measures, including handwashing, social distancing, and proper use of facemasks and gloves, were given to all the participants.
No new confirmed COVID-19 cases were diagnosed in the target population during the follow-up timeframe of 1 month-December 20, 2020 to January 19, 2021-thus making the trial inconclusive.
The Phosphorus group had the least exposure to COVID-19 compared with the other groups. In comparison with placebo, the occurrence of unconfirmed COVID-19 cases was significantly less in the Phosphorus group (week 1: odds ratio [OR], 0.1; 95% confidence interval [CI], 0.06 to 0.16; week 2: OR, 0.004; 95% CI, 0.0002 to 0.06; week 3: OR, 0.007; 95% CI, 0.0004 to 0.11; week 4: OR, 0.009; 95% CI, 0.0006 to 0.14), but not in the Bryonia or Gelsemium groups.
The authors concluded that the trial was inconclusive. The possible effect exerted by Phosphorus necessitates further investigation.
When I first blogged about this, I commented with this question: If you conduct a COVID prevention trial, would you not make sure that rigorous testing for COVID of all participants is implemented? Having seen the full paper, The question remains unanswered. Here is all that the authors write about the outcome measures:
(a) Primary outcome—Occurrence of newly diagnosed (confirmed by detection of the SARS-CoV-2 RNA in nasopharyngeal swab by real-time reverse transcription polymerase chain reaction (RT-PCR) or rapid antigen test) COVID-19 infections as per Government of India records.
(b) Secondary outcome—Occurrence of unconfirmed COVID19 cases as assessed clinically during home visits. It was defined as abrupt onset (within the last 10 days) of fever (100.4°F or 38°C body temperature) with two or more of the following: loss of taste or smell, dry cough, shortness of breath, sore throat, congestion or runny nose, headache, malaise, fatigue, myalgia, limb or joint pain, chest pain or pressure, conjunctivitis, diarrhea, nausea or vomiting, skin rashes, discoloration of fingers or toes.
The timeline was up to 30 days after completing the recommended dosage or once the person reported COVID-19 positive, whichever was earlier. Data were collected weekly by teams of homeopaths from home visits and/or via telephone, whenever required.
I am not entirely sure what this means but I think “as per Government of India records” indicates that they did not bother to systematically measure the primary endpoint of their study. Instead, they relied on the data from occasional unsystematic testing. My suspicion is further confirmed by the authors’ statement in their discussion section: “a manual search of the Government records during the trial phase could not identify a single confirmed COVID-19 positive case belonging to the study population … Enhanced numbers of testing could have changed the outcome of the trial“.
If my suspicion is true, the study is a joke – and not a good one at that. It would mean that considerable funds and efforts have been wasted. It would also mean that the conclusion drawn by the authors “the trial was inconclusive” is inaccurate. It was not inconclusive but it was fatally flawed from its outset.
Yes, today is WORLD CANCER DAY. A good time to remind us that SCAM providers are often a serious risk to cancer patients. Here is a very recent case in point:
It has been reported that a naturopath from Laval in Quebec who describes herself as a “cancer specialist” notably by offering coffee enemas, has been found guilty of the illegal practice of medicine. The Court of Quebec ruled that Annie Juneau, owner of the Vitacru Group, led people to believe that she had “medical knowledge and [that she was] was able to diagnose a health deficiency”. The fine for the offense can vary between $2,500 and $62,000 and which remains to be determined.
The College of Physicians of Quebec (CMQ) conducted an investigation where an agent claiming to be looking for information on colon therapy under an assumed name consulted the therapist. The naturopath charged a little over $300 for the visit and the purchase of prescribed natural products. During the consultation, the naturopath, Annie Juneau, claimed that “we are brainwashed by the medical community”. She introduced herself as a “cancer specialist” and explained that she could even treat patients suffering from advanced stage 4 cancer.
The website of the naturopath praised the merits of the coffee enema, a practice believed to date back to ancient Egypt, stating that “cancer patients deprived of its benefits are unable to detoxify at the speed that optimal healing requires.” ON the Internet and in person, Annie Juneau illegally led a reasonable person to believe that she could perform acts reserved for doctors, the court ruled. In her defense, the naturopath argued that her website contained disclaimers stating that she does not offer medical advice and that she clearly identifies herself as a naturopath. However, the court ruled that such disclaimers are not sufficient protection of the public.
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This case is the latest in a long row of naturopaths (and other SCAM practitioners) risking the lives of cancer patients. Here are a few recent ones that we have discussed on this blog:
The Foundation for Vertebral Subluxation has a ‘clinical practice guideline/best practices project’ that would search, gather, compile and review the scientific literature going as far back as January 1998. Their new Chapter on the chiropractic care of children was peer-reviewed and approved by 196 chiropractors from several countries and included chiropractors specializing in pediatric and maternal care such as Diplomates and others certified in such care. The Best Practices document, developed through the Foundation’s Best Practices Initiative includes a Recommendation statement as follows:
Since vertebral subluxation may affect individuals at any age, chiropractic care may be indicated at any time after birth. As with any age group, however, care must be taken to select adjustment methods most appropriate to the patient’s stage of development and overall spinal integrity. Parental education by the chiropractor concerning the importance of evaluating children for the presence of vertebral subluxation is encouraged as are public health initiatives geared toward screening of children for vertebral subluxation beginning at birth.
I am afraid there may be some errors in the new document. Allow me therefore to post a corrected version:
Since vertebral subluxations do not exist, they cannot affect individuals regardless of age. Chiropractic adjustments are thus not indicated at any time after birth. Parental education by the chiropractor concerning the importance of evaluating children for the presence of vertebral subluxation is discouraged as are public health initiatives geared toward screening of children for vertebral subluxation beginning at birth.
Or, as an American neurologist once put it so much more succinctly:
Don’t let the buggers touch your neck!
A few weeks ago, I blogged about a pilot study of homeopathy to prevent COVID infections. Now a similar trial has been published – also in the journal ‘HOMEOPATHY’.
In this double-blind, cluster-randomized, placebo-controlled, four parallel arms, community-based, clinical trial, a 20,000-person sample of the population residing in Ward Number 57 of the Tangra area, Kolkata, was randomized in a 1:1:1:1 ratio of clusters to receive one of three homeopathic medicines:
- Bryonia alba 30cH,
- Gelsemium sempervirens 30cH,
- Phosphorus 30cH,
- or an identical-looking placebo.
The treatment period lasted for 3 (children) or 6 (adults) days. All the participants, who were aged 5 to 75 years, received ascorbic acid (vitamin C) tablets of 500 mg, once per day for 6 days. In addition, instructions on a healthy diet and general hygienic measures, including handwashing, social distancing, and proper use of facemasks and gloves, were given to all the participants.
No new confirmed COVID-19 cases were diagnosed in the target population during the follow-up timeframe of 1 month-December 20, 2020 to January 19, 2021-thus making the trial inconclusive.
The Phosphorus group had the least exposure to COVID-19 compared with the other groups. In comparison with placebo, the occurrence of unconfirmed COVID-19 cases was significantly less in the Phosphorus group (week 1: odds ratio [OR], 0.1; 95% confidence interval [CI], 0.06 to 0.16; week 2: OR, 0.004; 95% CI, 0.0002 to 0.06; week 3: OR, 0.007; 95% CI, 0.0004 to 0.11; week 4: OR, 0.009; 95% CI, 0.0006 to 0.14), but not in the Bryonia or Gelsemium groups.
The authors concluded that the trial was inconclusive. The possible effect exerted by Phosphorus necessitates further investigation.
How can this be?
If you conduct a COVID prevention trial, would you not make sure that rigorous testing for COVID of all participants is implemented?
Unfortunately, I cannot access the full article – if someone can, please send it to me. From reading just the abstract I cannot help feeling that there is something very wrong here. And from looking at the list of authors’ affiliations I am not convinced that the authors are all that objective about the potential of homeopathy:
- Department of Community Medicine, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 2Department of Organon of Medicine and Homoeopathic Philosophy, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 3Department of Pathology & Microbiology, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 4Department of Forensic Medicine & Toxicology, DN.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 5Department of Materia Medica, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 6Department of Repertory, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 7Department of Practice of Medicine, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 8Department of Surgery, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 9Department of Homoeopathic Pharmacy, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 10Department of Physiology, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 11Department of Anatomy, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
- 12Department of Obstetrics & Gynecology, D.N.De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
