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

diet

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This prospective cohort study examined the effects of fish oil supplements on the clinical course of cardiovascular disease, from a healthy state to atrial fibrillation, major adverse cardiovascular events, and subsequently death.

The analysis is based on the UK Biobank study (1 January 2006 to 31 December 2010, with follow-up to 31 March 2021 (median follow-up 11.9 years)) including 415 737 participants, aged 40-69 years. Incident cases of atrial fibrillation, major adverse cardiovascular events, and death, identified by linkage to hospital inpatient records and death registries. Role of fish oil supplements in different progressive stages of cardiovascular diseases, from healthy status (primary stage), to atrial fibrillation (secondary stage), major adverse cardiovascular events (tertiary stage), and death (end stage).

Among 415 737 participants free of cardiovascular diseases, 18 367 patients with incident atrial fibrillation, 22 636 with major adverse cardiovascular events, and 22 140 deaths during follow-up were identified. Regular use of fish oil supplements had different roles in the transitions from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death:

  • For people without cardiovascular disease, hazard ratios were 1.13 (95% confidence interval 1.10 to 1.17) for the transition from healthy status to atrial fibrillation and 1.05 (1.00 to 1.11) from healthy status to stroke.
  • For participants with a diagnosis of a known cardiovascular disease, regular use of fish oil supplements was beneficial for transitions from atrial fibrillation to major adverse cardiovascular events (hazard ratio 0.92, 0.87 to 0.98), atrial fibrillation to myocardial infarction (0.85, 0.76 to 0.96), and heart failure to death (0.91, 0.84 to 0.99).

The authors concluded that regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for progression of cardiovascular disease from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements.

I must admit that I am slightly puzzled by this study and its findings. The authors clearly speak of the ‘role’ regular use of fish oil supplements has. This language implies a casual impact. Yet, what we have here are associations, and every 1st year medical student knows that

correlation is not causation.

Other things to note are that:

  • the associations are only very weak;
  • they go in opposite directions depending on the subpopulation that is examined,
  • there is no plausible mechanism of action to explain all this.

Collectively, these facts suggest to me that we are indeed more likely dealing here with a non-causal association and not a causal link. All the more surprising then that the (UK) press took up this paper in a major and occasionally alarmist fashion (the headline in THE TELEGRAPH was Revealed: How cod liver oil could be bad for your health). I learned of it by listening to the BBC headline news.

 

In the previous 3 parts of this series (see here, here and here), we have discussed 9 fake diagnoses of so-called alternative medicine (SCAM):

  • adrenal fatigue,
  • candidiasis hypersensitivity,
  • chronic intoxications,
  • chronic Lyme disease,
  • electromagnetic hypersensitivity,
  • homosexuality,
  • leaky gut syndrome,
  • multiple chemical sensitivity,
  • neurasthenia.

Today I will briefly discuss three further fake diagnoses and list the treatments that SCAM practitioners might recommend for them.

Vaccine overload

Vaccine overload is a term for the notion that giving many vaccines at once may overwhelm or weaken a patient’s immune system which, in turn, is alleged to lead to adverse effects. Because children have an immature immune system, they are claimed to be afflicted most frequently.

There is no evidence that vaccine overload exists nor that it can lead to illness. This does not stop SCAM practitioners to apply or recommend all sorts of SCAMs for the imagined condition. Particular favourites are all sorts of detox diets, homeopathy and a wide range of dietary supplements. Such diets and supplements can be tricky for younger children. In this case, SCAM practitioners recommend, amongst many other things, smoothies or adding turmeric, ginger, and small amounts of Shillington’s adult supplements to the child’s food.

None of these recommendations are supported by anything resembling sound evidence, of course.

Vertebral subluxation

On this blog, we have discussed vertebral subluxations more often than I care to remember. Chiropractors claim that these figments of their imagination impair the flow of innate which, in turn, makes us ill. Straight chiros, those who adhere to the gospel of their guru DD Palmer, diagnose subluxations in 100% of their patients. They are undeterred by the fact that vertebral subluxations do not exist.

I can understand why! If they did aknowledge that the diagnosis is fake, they would have no reason to treat patients with spinal manipulations, and they would quickly go out of business.

Yin/Yang imbalance

According to the assumptions of practitioners of Traditional Chinese Medicine (TCM), all health problems arise from an imbalaance of the two life forces , yin and yang. To restore the balance, they employ a range of therapies such as acupuncture, herbal mixtures, massages, etc.

But these life forces do not exist. Thus they cannot be out of balance, and consequently the imbalance cannot cause illness. TCM practitioners don’t want to hear any of this. Why not? You guessed it: if they aknowledged these facts, they would need to stop practising.

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Fake diagnoses are the life-line of many SCAM practitioners:

  • they tell you that something is wrong with you (despite the fact that you are entirely healthy);
  • they make sure that this is a reason for serious concern;
  • they claim they can put the alleged abnormality right again;
  • they administer a lengthy series of treatments and/or sell you plenty of remedies;
  • when they have earned enough money treating you, they give you the good news: you are back to narmal;
  • gullible consumers are impressed by the unfailing competence of the SCAM practitioners.

My conclusion:

there is nothing easier and more profitably to heal that a condition that did not exist  in the first place.

 

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.

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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

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…

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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!

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!

 

It has been reported that King Charles’ charity, formerly the Prince’s Foundation, is compelled to return £110,000 to the Indian government. The funds were earmarked for an NHS alternative medicine clinic championed by Charles, which never materialised. The proposed clinic was aimed at integrating Indian traditional medicine into the UK’s healthcare system.

But why did the plan fail?

The answer is simple: the National Health Service (NHS) did not approve it.

The history of the UK ‘Ayurvedic Centre of Excellence’ goes back several years. Here is an excerpt of my book ‘CHARLES, THE ALTERNATIVE KING‘ where I discuss it as one of Charles’ many pipe dreams in the realm of so-called alternative medicine (SCAM):

In 2018, India’s prime minister Narendra Modi paid a visit to the Science Museum in London where he inspected the ‘5000 Years of Science and Innovation’ exhibition. The event was hosted by Charles and included the announcement of new ‘Ayurvedic Centres of Excellence’, allegedly a ‘first-of-its-kind’ global network for evidence-based research on yoga and Ayurveda. The first centre was said to open in 2018 in London. Funding was to come partly from the Indian government and partly from private donors. The central remit of the new initiative was reported to be researching the effects of Ayurvedic medicine.

Dr Michael Dixon (yes, you may have met him several times before, e.g. here, here, or here) commented: “This is going to be the first Ayurvedic centre of excellence in the UK. We will be providing, on the NHS, patients with yoga, with demonstrations and education on healthy eating, Ayurvedic diets, and massage including reflexology and Indian head massage. And all this will be subject to a research project led by Westminster University, to find out whether the English population will take to yoga and these sorts of treatments. Whether they will be helped by it and finally whether it will reduce the call on NHS resources leading to less GP consultations, hospital admissions and operations.”

 On its website, the College of Medicine and Integrated Health announced that a memorandum of understanding with India’s Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) had been signed “to create centres of excellence in the UK … Dr Michael Dixon agreed the joint venture to provide the UK centres, which will offer and research traditional Indian medicine… The Indian government will match private UK donations to fund the AYUSH centres in the UK”. In November 2019, the following press release by the president of India offered more details:

The Prince of Wales called on the President of India, Shri Ram Nath Kovind, at Rashtrapati Bhavan today (November 13, 2019).

Welcoming the Prince to India, the President congratulated him on his election as the head of the Commonwealth. He said that India considers the Commonwealth as an important grouping that voices the concerns of a large number of countries, including the Small Island Developing States.

The President said that India and the United Kingdom are natural partners bound by historical ties and shared values of democracy, rule of law and respect for multi-cultural society. As the world’s pre-eminent democracies, our two countries have much to contribute together to effectively address the many challenges faced by the world today.

The Prince planted a Champa sapling – plant native to the subcontinent which has several uses in Ayurveda – in the Herbal Garden of Rashtrapati Bhavan. He was taken around the garden and shown different plants that have medicinal properties. The Prince showed a keen interest in India’s alternative model of healthcare.

The President thanked the Prince of Wales for his support for Ayurveda research. The Prince of Wales Charitable Foundation and the All India Institute of Ayurveda signed an MOU during the visit of Prime Minister Narendra Modi to the UK in April 2018. Under the MOU, the All India Institute of Ayurveda and the College of Medicine, UK will be conducting clinical research on Depression, Anxiety and Fibromyalgia. They will also be undertaking training programme for the development of Standard Operating Protocol on “AYURYOGA” for UK Health professionals.

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END OF EXCERPT

Charles’ initiative, encompassing Ayurveda, yoga, naturopathy, and homeopathy, was intended to be a landmark project, with the Indian government contributing £110,000 to the King’s Foundation for its implementation. However, the NHS, responsible for St Charles Hospital, never endorsed the project. Despite initial talks, the proposed collaboration did not progress, and the clinic failed to materialise. According to the west London clinical commissioning group (CCG), which oversaw the hospital at the time, there was no official involvement, and discussions ceased in 2020.

Under charity law, funds designated for a specific project cannot be diverted without donor permission and regulatory approval. The King’s Foundation has acknowledged the need to return the remaining budget to the Indian government but has not disclosed when this decision was made or why the funds were not promptly returned.

The initiative faced opposition from the NHS, as a year before the clinic’s launch, NHS England’s CEO Simon Stevens had issued guidance discouraging the prescription of homeopathy and herbal remedies, citing their limited efficacy and misuse of NHS funds.

Despite the failed project, connections between key figures persist. Dr Michael Dixon played a significant role in finalising agreements with the Indian government. The King’s Foundation defended its actions, stating that due to the Covid-19 pandemic, the project shifted online, resulting in reduced costs. They claim to have contacted the Indian government for the return of unused funds, emphasising that the money remains in a restricted account.

As the controversy unfolds, questions arise about the intersections between alternative medicine advocacy, royal endorsements, and international collaborations within the context of public healthcare.

An article in the Daily Mail reported that the original plan proposed that Ayush treatments would be provided to patients, who would be referred by local GPs, at St Charles Hospital in Kensington. Isaac Mathai, who runs Soukya, a homeopathic yoga retreat in Bangalore which Charles and Camilla have visited, was an adviser to the project at St Charles Hospital.

The Indian government made a payment from the budget of the Ayush Ministry, which Mr Modi has used as a tool of diplomacy to promote Indian medicine and culture worldwide, to the King’s Foundation. It was proposed the charity would use its expertise to help set up the clinic. But the NHS at no point agreed to the plans.

A spokesman of the west London clinical commissioning group (CCG), which administered St Charles Hospital at the time, said: ‘Provision of homeopathy and herbal treatments were not considered as part of the project by the CCG. The aim of the project was to test the use of yoga and massage to support the overall health and wellbeing of patients with long-term conditions.’ A King’s Foundation spokesman added that the initial intention had been to deliver Indian traditional medicine at St Charles Hospital.

TOXIN BUILDUP CAN CAUSE:

  • Brain Fog
  • Irritability
  • Exhaustion
  • Stress Induced Muscle Aches
  • Inability to Concentrate
  • Tiredness
  • Restlessness
  • And Many More Problems

At least this is what we are being told on the Nuunu website which appeared in my emails recently (how did they know that I am full of toxins?). Here is some more of the infinite wisdom promoted by Nuubu:

Improve your body and mind with a natural Asian solution!

  • Traditional Wisdom: Nuubu was inspired by Centuries-old traditional Asian knowledge, passed on by generations. True trust is earned by passing a test of time. Nuubu is made of natural herbs and herbal extracts. Forget about harmful, toxic chemicals and embrace the soothing power of nature!
  • Detox Through Sweat: Nuubu is a revolutionary detox foot patch that can greatly increase your sense of wellbeing. Nuubu supports the body’s natural way of removing toxins through activated sweat glands.
  • Holistic Approach: Tackle the cause, not the symptoms – your body is riddled by toxic elements, which may harm your wellbeing and increase stress. Using sweat detox and vitamin infusion Nuubu helps you to strengthen your mind, body and soul!

Natural Body Toxin Removal:
Amazing
New Way to Improve Your Life

  • A Secret to a Stress-Free Living

    Tired? Stressed? Fatigued? You are not alone – our lifestyles are extremely taxing on our bodies and minds alike. Headaches, bad sleep and stress are the unfortunate hallmarks of fast-moving modern life. Active ingredients that are found in the Nuubu foot patch are known for their ability to remove accumulating harmful elements from your body, which can greatly improve your sense of wellbeing!*

  • Traditional Medicine gets Modern Upgrade

    According to Japanese traditional knowledge, the human body has over 360 acupuncture points, with more than 60 points found on the soles of the foot. Nuubu combines tried-and-true Asian techniques with a sleek and modern approach – attach the herbal-remedy based patches to your feet and wait a few hours for the toxin removal through your sweat glands. It has never been that easy!

  • Natural Approach

    Are you tired of hazardous man-made chemicals being used in every aspect of your life? There is a better way to harmonize your lifestyle! Nuubu foot patches are made using natural herbs similar to ones found in the remote East-Asian mountainsides. Forget the harmful toxicity and side effects!

Traditional Wisdom

Traditional Asian wisdom that has been passed down through the ages is what inspired the Nuubu Patches. The test of time is what allows us to provide you with a product that you can trust. Forget about hazardous, dangerous drugs and enjoy nature’s calming influence instead.

Only the most natural herbs and herbal extracts are used to make the Nuubu Patches. We have blended together ancient herbal therapies to create the ultimate in cleansing wellness.

The soothing herbal aroma of Mother Nature’s finest plants and botanicals allow you to know that the Nuubu Patches are doing their job and providing you with optimal wellness.

______________________

I hope you are as impressed as I am!

So, I searched for the evidence?

Does detox work? Specifically, does the Nuubu reduce my:

  • Brain Fog
  • Irritability
  • Exhaustion
  • Stress Induced Muscle Aches
  • Inability to Concentrate
  • Tiredness
  • Restlessness
  • And Many More Problems

No matter how hard I searched, I did not find any evidence. Eventually, I had to conclude that the patch does not work.

Hold on!

The website might be correct with one claim: it helps you to strengthen your mind

… to such an extend that you will

never fall for the lies of detox entrepreneurs!

The NZZ recently published a long and horrific report about a natural health clinic and its doctors. Here is a  version translated and shortened by me; perhaps it makes a few people think twice before they waste their money and risk their health:

It is a narrow mountain road that they are racing down on this spring evening. Over the green Appenzell hills, towards Herisau hospital. Kathrin Pfister* is fighting for her life in the car. At the wheel is Thomas Rau, internationally renowned practitioner of so-called alternative medicine (SCAM) and director of his own luxury clinic, the Biomed Centre Sonnenberg. Three days later, Kathrin Pfister is dead. The most likely finding according to the experts: Pfister was injected with a drug that was not authorised in Switzerland at the time, the side effects of which killed her.

Pfister is not the only woman to have lost her life following treatment at the Sonnenberg. Other experts accuse Rau of serious breaches of duty that led to the death of a patient. Rau and another doctor are thus being investigated for involuntary manslaughter.

The events remained hidden from the public for over two years. It’s not just about one doctor, not just about one clinic. The events are politically explosive for Appenzell Ausserrhoden. The canton is the centre of alternative medicine in Switzerland. SCAM doctors are an important economic factor in Ausserrhoden. Wealthy people from all over the world fly here for therapies that most conventional doctors just shake their heads at. Treatments lasting several weeks with a hotel stay cost five-figure sums.

The 73-year-old Dr Rau is the star among Swiss alternative medicine practitioners.He describes himself as the “Mozart of medicine”. The Biomed Centre Sonnenberg is “Mozart’s” last big project. The clinic has a hotel and gluten-free vegan restaurant from the Tibits chain. Even the feather pillows are replaced with bamboo ones. All for the “detox” that Rau praises.

Kathrin Pfister’s case began in mid-April 2021, just four months after the Sonnenberg centre opened. She is actually healthy and comes to the clinic anyway; because of some digestive problems and headaches. The hospital records show that Pfister received infusions. Initially only those containing vitamin C and homeopathic remedies. Then one with artesunate, a preparation against malaria. And finally, on a Friday, Pfister was injected with a solution of alpha-lipoic acid into his bloodstream. The infusion is used in Germany for long-term diabetics with nerve damage. It was not authorised as a medicinal product in Switzerland at the time. According to the forensic experts, it was this substance that was “ultimately causally linked to the death”.

A few hours later, Pfister had severe abdominal cramps. Then pain throughout the body. The number of platelets in her blood drops dramatically. Anxiety sets in at the clinic. The intensive care doctors in Herisau and later at the cantonal hospital in St. Gallen can do nothing more. Pfister had a massive blood clotting disorder. Her liver and kidneys were no longer functioning.

Mary Anne Hawrylak meets Thomas Rau by chance at the clinic that weekend. She too is a patient, recently flown in from the USA. Hawrylak had massive side effects after infusions that Friday. “When I told him about it, he turned white as a sheet, like a ghost,” says Hawrylak. “Doctor Rau told me in horror that I had received the same infusions as ‘Kathrin’ and that he had to test my blood.” The tests showed that her blood platelet count had also dropped, says Hawrylak.

The forensic experts point to a central fact: Alpha lipoic acid can cause blood clotting disorders.  They come to the conclusion that this is “most likely a lethal side effect of a drug”. The use of drugs that are not authorised in Switzerland is legal if they are authorised in a country with a comparable procedure. However, there is no real reason to inject this medication into the bloodstream of healthy people. It was authorised in Germany for diabetes patients with nerve damage. So, Pfister did not have this authorisation.

Experts refer to such applications as “off-label use”.  Off-label treatments should only be carried out “on the basis of valid guidelines, generally recognised recommendations or scientific literature”. The guidelines also require that patients are given comprehensive information about off-label use. This counselling session should be documented in writing. None of this can be found in the clinic’s files. No written consent, no documented risk-benefit assessment, no reference to the risk of blood clotting disorders. The forensic experts state: “The scant documentation from the Sonnenberg Biomed Centre does not contain any corresponding information document.” The question arises as to “whether the medical treatment at the Sonnenberg Biomed Centre was carried out with the necessary medical care”.

Patient Hawrylak also says: “I was not told exactly what was in the infusions. I was never told that the medication was not authorised in Switzerland or that its use was off-label. I spoke to Dr Rau about what had happened to ‘Kathrin’ because I was worried about myself,” says Hawrylak. “He said to me: ‘I don’t think it was the infusions. I think it was the Covid vaccinations.” He only justified this with his “intuition”.

The Pfister case triggered an investigation by the public prosecutor’s office. But what hardly anyone knew at the time was that it was not the first questionable death at the clinic – not even the first in a month. Ruth Schmid*, a 77-year-old Swiss woman, had died just three weeks earlier. In this case, the forensic pathologists accused Rau: He had made mistakes that not even a medical student should have made, thus causing Schmid’s death.

Schmid was also in the clinic for a kind of cure. When she was about to leave, she began to tremble violently and had extreme stomach pains. She screamed “like an animal”, her partner said during the interrogation. Ultrasound examinations were carried out at the clinic and Rau gave Schmid painkillers, including morphine. According to the partner’s statement to the public prosecutor’s office, he asked Rau whether Schmid needed to be taken to hospital. Rau said no. Schmid stayed in the hotel room overnight. The next day – according to Rau, she had been feeling better since the previous evening – she travelled home. According to Rau’s confiscated notes, “she was to report closely” and return in four days. At home, Ruth Schmid fell into a coma-like state overnight. Admitted to Zurich University Hospital in an emergency, Schmid died there of cardiovascular failure due to septic shock.

The Zurich forensic pathologists performed an autopsy on Schmid’s body. Their findings: Schmid had suffered from intestinal paralysis. As a result, bacteria entered her body and poisoned her blood, leading to a heart attack. “From a forensic medical point of view, it is incomprehensible why the attending physician, Dr Thomas Rau, did not carry out appropriate diagnostics.” The irritation of the forensic experts is evident in almost every line. There had been several warning signs of intestinal paralysis. The forensic experts wrote: “This knowledge is taught in medical school and is considered basic knowledge in human medicine.” Rau’s behaviour was “a breach of the doctor’s duty of care”. With timely treatment, the prognosis for intestinal paralysis is excellent. The sad conclusion: Ruth Schmid did not have to die.

During questioning by the public prosecutor’s office, Rau denied any guilt. Schmid had left in “good condition”. There was no causality between what happened in the clinic and the death. The findings and conclusions of the Zurich forensic pathologists were wrong. Schmid did not have intestinal paralysis or septicaemia. He had been able to rule out intestinal paralysis because intestinal noises had been audible in the morning. The dose of morphine had been very small, so that it had had no effect. There were no indications of a serious condition. Rau testified that he had acted professionally, as would be expected of an internal medicine doctor.

In the Kathrin Pfister case, the doctors treating her also deny any culpability and question the forensic medical report. The doctor’s lawyer writes that the criminal investigation will show that there was no breach of the doctor’s duty to provide information. Alpha-lipoic acid was not responsible for the death. The expert opinion is not convincing in terms of method or content: “When analysed in depth, it contains no justification that the use of alpha-lipoic acid was in any way causal for the patient’s death.”

During the hearing on the Pfister case, Rau said that restricting the use of alpha-lipoic acid to diabetics was “a joke” and far too narrowly defined. He claimed that Pfister had polyneuropathy, a complex nerve disease. However, there is no mention of this in the files of Rau’s clinic.

The criminal investigation is ongoing in both cases. But did more happen on the Sonnenberg? A former hospital employee, who independently reported to the police, told the public prosecutor about other hair-raising incidents. During the interrogation, she testified that she had seen a young woman being carried out of the clinic extremely weak after an infusion. Days later, she had overheard parts of a telephone conversation between Rau and the patient’s angry husband which made it clear that the woman had died. The former employee also recounted a conversation with Rau’s wife, who is a trained nurse. She said that she had driven a patient to a hospital in Zurich in a private car with Rau because Rau was determined to take her to a particular specialist. The patient was so unwell that she was afraid the woman would die on the way. If this is true, Rau would have travelled past several hospitals with a seriously ill patient.

Hawrylak has one last memory of Appenzell etched in his memory. The departure. She was just leaving the clinic when Rau wished her good luck: “I could only say to him: I wish you good luck too, Doctor Rau. I think you’re really going to need it.”

*Names were altered.

Mushrooms are somewhat neglected in medical research, I often feel. This systematic review focused on clinical studies testing the effectiveness of mushrooms in cancer care. A total of 39 met the authors’ inclusion criteria. The studies included 12 different mushroom preparations. Some of the findings were encouraging:

  • A survival benefit was reported using Huaier granules (Trametes robiniophila Murr) in 2 hepatocellular carcinoma studies and 1 breast cancer study.
  • A survival benefit was also found in 4 gastric cancer studies using polysaccharide-K (polysaccharide-Kureha; PSK) as an adjuvant therapy.
  • Eleven studies reported a positive immunological response.
  • Quality-of-life (QoL) improvement and/or reduced symptom burden was reported in 14 studies using various mushroom supplements.
  • Most studies reported adverse effects of grade 2 or lower, mainly nausea, vomiting, diarrhea, and muscle pain.

The authors caution that limitations included small sample size and not using randomized controlled trial design. Many of the reviewed studies were observational. Most showed favorable effects of mushroom supplements in reducing the toxicity of chemotherapy, improving QoL, favorable cytokine response, and possibly better clinical outcomes.

The authors concluded that the evidence is inconclusive to recommend the routine use of mushrooms for cancer patients. More trials are needed to explore mushroom use during and after cancer treatment.

The use of mushrooms for medicinal purposes has a long history in many cultures. Some mushrooms are known to be highly poisonous, some have hallucinogenic effects, and some are assumed to have pharmacological effects that have therapeutic potential. Some mushrooms possess pharmacologic properties such as anti-tumour, immunomodulating, antioxidant, cardiovascular, anti-hypercholesterolemic, anti-viral, anti-bacterial, anti-parasitic, anti-fungal, detoxification, hepatoprotective, and anti-diabetic effects.

Many modern medicines were derived from fungi. The best-known example is penicillin; others include several cancer drugs, statins and immunosuppressants. In Traditional Chinese Medicine, numerous herbal mixtures contain mushrooms; examples are reishi, maitake and shiitake which are all assumed to have anti-cancer properties.

As the review authors point out, there is a paucity of clinical trials testing the effectiveness of mushrooms, and the existing studies tend to be of poor quality. At present, most of our knowledge comes from traditional use or test-tube studies. The adverse effects depend on the specific mushroom in question and, can in some instances, be serious.

Considering the potential and the complexity of mycomedicine, I find it surprising to not see much more research into this subject.

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