EBM
A long article on chiropractic casts doubt that chiropractic is useful. Here is an abbreviated version of it:
The chemistry and biology graduate from the University of Georgia, 28-year-old Caitlin Jensen, visited a chiropractor to sort out her lower back pain. During the session, the therapist performed an adjustment. It severed four arteries in her neck. She collapsed shortly after, unable to speak or move. The injury had caused her to suffer a series of strokes. Today, she has regained some movement in her head, legs and arms but she is still unable to speak, is partially blind and relies on a wheelchair.
- One 66-year-old grandmother said a visit to a chiropractor to treat her sore shoulder left her covered in bruises, hearing ringing in her ears and with a splitting pain in her jaw. She was later diagnosed by doctors with trigeminal neuralgia – a chronic pain disorder caused by a trapped or irritated nerve in the neck that causes sudden, electric shock-like pain in the face. She believes the condition – which, three years later, still sometimes leaves her unable to open her mouth wide enough to speak to her grandchildren – was triggered by a chiropractic adjustment of her neck.
- A 55-year-old woman was left with chronic neck and shoulder pain after visiting a chiropractor for a sore back. The pain was so bad she once spent 72 hours immobile and unable to sleep despite taking a concoction of painkillers.
- And a 66-year-old man says his back went into spasm as he was leaving his first chiropractor appointment – which left him hospitalised and bedbound for weeks. The intense treatment, he later learned, had pushed one of the discs of his spine out of place, causing him to lose feeling in his right leg for ever.
The aim of this recent review was to investigate the efficacy of non-surgical and non-interventional treatments for adults with low back pain compared with placebo. It included all randomised controlled trials evaluating non-surgical and non-interventional treatments compared with placebo or sham in adults (≥18 years) suffering from non-specific low back pain.
Random effects meta-analysis was used to estimate pooled effects and corresponding 95% confidence intervals on outcome pain intensity (0 to 100 scale) at first assessment post-treatment for each treatment type and by duration of low back pain—(sub)acute (<12 weeks) and chronic (≥12 weeks). Certainty of the evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach.
A total of 301 trials (377 comparisons) provided data on 56 different treatments or treatment combinations. One treatment for acute low back pain: (non-steroidal anti-inflammatory drugs (NSAIDs)), and five treatments for chronic low back pain:
- exercise,
- spinal manipulative therapy,
- taping,
- antidepressants,
- transient receptor potential vanilloid 1 (TRPV1) agonists)
were found to be efficacious. However, effect sizes were small and of moderate certainty. Three treatments for acute low back pain (exercise, glucocorticoid injections, paracetamol), and two treatments for chronic low back pain (antibiotics, anaesthetics) were not efficacious and are unlikely to be suitable treatment options; moderate certainty evidence. Evidence is inconclusive for remaining treatments due to small samples, imprecision, or low and very low certainty evidence.
The authors concluded that the current evidence shows that one in 10 non-surgical and non-interventional treatments for low back pain are efficacious, providing only small analgesic effects beyond placebo. The efficacy for the majority of treatments is uncertain due to the limited number of randomised participants and poor study quality. Further high-quality, placebo-controlled trials are warranted to address the remaining uncertainty in treatment efficacy along with greater consideration for placebo-control design of non-surgical and non-interventional treatments.
This is an important analysis, not least because of the fact that the research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The methodology is sound and the results thus seem reliable.
The findings are in keeping with what we have been discussing at nauseam here: no treatment works really well for back pain. For acute symptoms no so-called alternative medicine (SCAM) at all is efficacious. For chronic pain, spinal manipulation therapy (SMT) have small effects. As SMT is neither cheap nor free of risks, excercise is much preferable.
Considering that most SCAMs are heavily promoted for low back pain (e.g. acupuncture, Alexander technique, cupping, Gua Sha, herbal medicine, homeopathy, massage, mind-body therapies, reflexology, Reiki, yoga), this verdict is sobering indeed!
The US Health Secretary Robert F Kennedy (JFKJr) famously claimed that vitamin A could work “as a prophylaxis” of measles infection. That claim is not just wrong, it also is dangerous. Overuse of vitamin A can have serious health consequences. As a result of JFKJr yet again promoting dangerous nonsense, doctors treating patients during the measles outbreak in Texas and New Mexico are now facing the problem of vitamin A toxicity.
At Covenant Children’s Hospital in Lubbock, near the outbreak’s epicenter, several patients have been found to have abnormal liver function on routine lab tests, a probable sign that they’ve taken too much of the vitamin, according to Dr. Lara Johnson, pediatric hospitalist and chief medical officer for Covenant Health-Lubbock Service Area.
Vitamin A is fat-soluble. It therefore accumulate in organs like the liver when over-doesed. Excess vitamin A can cause dry skin and eyes, blurry vision, bone thinning, skin irritation, liver damage and other serious issues. In pregnant women, it can even lead to birth defects. Recovery for patients with acute toxicity is normally rapid, if the vitamin is discontinued. But the more serious problems with vitamin A toxicity are not always reversible.
The Council for Responsible Nutrition, a trade association for dietary supplement and functional food manufacturers, issued a statement warning parents against using high doses of vitamin A to try to keep their children from getting measles. “While vitamin A plays an important role in supporting overall immune function, research hasn’t established its effectiveness in preventing measles infection. CRN is concerned about reports of high-dose vitamin A being used inappropriately, especially in children,” the statement says.
JFKJr made his remarks in an interview with Fox News medical correspondent Dr. Marc Siegel. Snippets of the interview were featured in four Fox News or Fox Business segments airing on March 4. “They have treated most of the patients, actually, over 108 patients in the last 48 hours. And they’re getting very, very good results, they report from budesonide, which is a steroid, it’s a 30-year-old steroid,” Kennedy said in the longest of the segments. “And clarithromycin [an antibiotic] and also cod liver oil, which has high concentrations of vitamin A and vitamin D. We need to look at those therapies and other therapies,” he said in another segment. “We need to really do a good job of talking to the front-line doctors and see what is working on the ground, because those therapeutics have really been ignored by the agency for a long, long time.”
Local doctors are increasingly concerned about the growing popularity of unproven remedies for preventing and treating measles. They fear that they are causing people to delay critical medical treatment and to reject vaccination, the only proven way to prevent a measles infection.
The measles outbreak has now affected at least 379 people across Texas, New Mexico and Oklahoma. Kansas has reported 23 measles cases, and officials said that they may also be linked to the outbreak. The best measure to get to grips with the outbreak, I think, would be to make JFKJr shut up and let those who understans the issues get on with it.
Robert F. Kennedy Jr. (RFK Jr.), America’s anti-vaxer in-chief, famously claimed his brain has been eaten by a worm. While this assumption is as ridiculous as the man himself, the actions and delusions of RFK Jr. seem almost to confirm that something fundamental must be wrong with his intellectual abilities.
Recently he said that he will be working to get cell phones out of schools. “Cell phones produce electric magnetic radiation, which has been shown to do neurological damage to kids when it’s around them all day … It’s also been shown to cause cellular damage and even cancer … Cell phone use and social media use on the cell phone has been directly connected with depression, poor performance in schools, suicidal ideation, and substance abuse … The states that are doing this have found that it is a much healthier environment when kids are not using cell phones in schools.”
There are two separate issues here:
- Limiting children’s use of cell phones might be – for several (not health-related) reasons – a reasonable idea.
- The assumption that cell phones cause the type of damage that RFK Jr. claimed is nonsense.
There is plenty of evidence on the subject, some more reliable than others. The most reliable data do not support what RFK Jr. claims. Here are a few systematic reviews on the subject:
A recent systematic review included 63 aetiological articles, published between 1994 and 2022, with participants from 22 countries, reporting on 119 different E-O pairs. RF-EMF exposure from mobile phones (ever or regular use vs no or non-regular use) was not associated with an increased risk of glioma [meta-estimate of the relative risk (mRR) = 1.01, 95 % CI = 0.89-1.13), meningioma (mRR = 0.92, 95 % CI = 0.82-1.02), acoustic neuroma (mRR = 1.03, 95 % CI = 0.85-1.24), pituitary tumours (mRR = 0.81, 95 % CI = 0.61-1.06), salivary gland tumours (mRR = 0.91, 95 % CI = 0.78-1.06), or paediatric (children, adolescents and young adults) brain tumours (mRR = 1.06, 95 % CI = 0.74-1.51), with variable degree of across-study heterogeneity (I2 = 0 %-62 %). There was no observable increase in mRRs for the most investigated neoplasms (glioma, meningioma, and acoustic neuroma) with increasing time since start (TSS) use of mobile phones, cumulative call time (CCT), or cumulative number of calls (CNC). Cordless phone use was not significantly associated with risks of glioma [mRR = 1.04, 95 % CI = 0.74-1.46; I2 = 74 %) meningioma, (mRR = 0.91, 95 % CI = 0.70-1.18; I2 = 59 %), or acoustic neuroma (mRR = 1.16; 95 % CI = 0.83-1.61; I2 = 63 %). Exposure from fixed-site transmitters (broadcasting antennas or base stations) was not associated with childhood leukaemia or paediatric brain tumour risks, independently of the level of the modelled RF exposure. Glioma risk was not significantly increased following occupational RF exposure (ever vs never), and no differences were detected between increasing categories of modelled cumulative exposure levels.
Another recent systematic review included 5 studies that reported analyses of data from 4 cohorts with 4639 participants consisting of 2808 adults and 1831 children across three countries (Australia, Singapore and Switzerland) conducted between 2006 and 2017. The main source of RF-EMF exposure was mobile (cell) phone use measured as calls per week or minutes per day. For mobile phone use in children, two studies (615 participants) that compared an increase in mobile phone use to a decrease or no change were included in meta-analyses. Learning and memory. There was little effect on accuracy (mean difference, MD -0.03; 95% CI -0.07 to 0.02) or response time (MD -0.01; 95% CI -0.04 to 0.02) on the one-back memory task; and accuracy (MD -0.02; 95%CI -0.04 to 0.00) or response time (MD -0.01; 95%CI -0.04 to 0.03) on the one card learning task (low certainty evidence for all outcomes). Executive function. There was little to no effect on the Stroop test for the time ratio ((B-A)/A) response (MD 0.02; 95% CI -0.01 to 0.04, very low certainty) or the time ratio ((D-C)/C) response (MD 0.00; 95% CI -0.06 to 0.05, very low certainty), with both tests measuring susceptibility to interference effects. Complex attention. There was little to no effect on detection task accuracy (MD 0.02; 95% CI -0.04 to 0.08), or response time (MD 0.02;95% CI 0.01 to 0.03), and little to no effect on identification task accuracy (MD 0.00; 95% CI -0.04 to 0.05) or response time (MD 0.00;95% CI -0.01 to 0.02) (low certainty evidence for all outcomes). No other cognitive domains were investigated in children. A single study among elderly people provided very low certainty evidence that more frequent mobile phone use may have little to no effect on the odds of a decline in global cognitive function (odds ratio, OR 0.81; 95% CI 0.42 to 1.58, 649 participants) or a decline in executive function (OR 1.07; 95% CI 0.37 to 3.05, 146 participants), and may lead to a small, probably unimportant, reduction in the odds of a decline in complex attention (OR 0.67;95%CI 0.27 to 1.68, 159 participants) and a decline in learning and memory (OR 0.75; 95% CI 0.29 to 1.99, 159 participants). An exposure-response relationship was not identified for any of the cognitive outcomes.
A 2022 systematic review concluded that the body of evidence allows no final conclusion on the question whether exposure to RF EMF from mobile communication devices poses a particular risk to children and adolescents.
That RFK Jr. spouts BS almost every time he opens his mouth should be an embarrassment to all US citizens. For the rest of the world, it is more than that. In fact, it is fast becoming a serious concern: sooner or later, his insane delusions will affect public health on a global scale!
I don’t know whether you noticed but everyone seems to be going on about the new wonder SCAM (so-called alternative medicine) ‘BLACK SEED OIL’ (BSO). If you go on the Internet, you’ll find all sorts of health claims for it, e.g.:
- -Reduces Inflammation
- -High in Antioxidants
- -Can Lower Cholesterol
- -Helps to Fight Cancer
- -Can Kill Off Bacteria
- -Balances Blood Sugar
- -Helps to Lower Blood Pressure
Interesting?
I am – as always – doutful. Nonetheless, I had a look at BSO to find out more.
BSO (also known as black caraway, black cumin or kalonji oil) is derived from the tiny black seeds of Nigella sativa (N. sativa) that grows in hot areas like Eastern Europe, Northern African, and Southwestern Asia, etc. The Wikipedia entry states that “despite considerable use of N. sativa in traditional medicine practices in Africa and Asia, there is insufficient high-quality clinical evidence to indicate that consuming the seeds or oil can be used to treat human diseases”.
But Wiki is often not up-to-date, and I therefore looked into Medline. To my surprise, I found research to be extraordinarily active.
Nigella sativa contains several phytochemical compounds, such as thymoquinone, p-cymene, α-thujene, longifolene, β-pinene, α-pinene, and carvacrol. They confer an antioxidant effect to the seeds, leading to a potent anti-inflammatory effect. Particularly, thymoquinone increases the levels of antioxidant enzymes that counter oxidative stress in the liver. Additionally, the essential oil in N. sativa seeds effectively inhibits intestinal parasites and shows moderate activity against some bacteria, including Bacillus subtilis and Staphylococcus aureus. Thymoquinone exhibits minimum inhibitory concentrations (MICs) of 8-16 μg/mL against methicillin-resistant Staphylococcus aureus (MRSA) and exhibits MIC 0.25 µg/mL against drug-resistant mycobacteria. Similarly, quercetin shows a MIC of 2 mg/mL against oral pathogens, such as Streptococcus mutans and Lactobacillus acidophilus. Furthermore, endophytic fungi isolated from N. sativa have demonstrated antibacterial activity. Further mechanisms involve inducing apoptosis, and inhibiting migration and invasion. N Sativa supplementation significantly decreases serum C-reactive protein, tumor necrosis factor-alpha, and malondialdehyde levels. It also improves total antioxidant capacity and superoxide dismutase levels.
But these effects do not neccessarily mean that BSO is clinically effective for any condition, particularly in view of its low bioavailability. So, what does the clinical evidence tell us? Here are just 9 of the most recent studies and reviews:
- This study aimed to investigate the possible beneficial cardioprotective effect of Nigella sativa in pediatric patients with type 1 diabetes mellitus. Sixty children and adolescents with type 1 diabetes were randomized into two groups: group I (n = 30) who received Nigella sativa seed oil 450 mg twice daily after meals for 3 months in addition to insulin, and group II (n = 30) who received insulin alone. Echocardiographic examinations were performed before and after the treatment. The lipid profile, malondialdehyde, nitric oxide, tumor necrosis factor-α, transforming growth factor-β, and troponin I were also measured before and after Nigella sativa treatment. After 3 months of Nigella sativa administration, group I had significantly lower cholesterol and low-density lipoprotein-cholesterol, malondialdehyde, nitric oxide, tumor necrosis factor-α, transforming growth factor-β, and troponin I levels compared with their pretreatment levels and compared with group II. In addition, group I had a significantly higher left ventricular E’/A’ ratio and two-dimensional left ventricular global longitudinal strain (2D-LV GLS) compared with baseline values and compared with group II after treatment. Conclusions: Nigella sativa can improve subclinical left ventricular dysfunction in pediatric patients with type 1 diabetes mellitus.
- This study evaluated the effects of Nigella sativa L. extract on glycemia among adolescents with PCOS. This secondary analysis used data from a randomized controlled trial conducted between March 2022 and March 2023. One hundred sixteen adolescent girls aged 12-18 years with PCOS were randomized into two groups. The intervention group received 1000 mg/day of Nigella sativa extract for 16 weeks, while the control group received 10 mg/day of medroxyprogesterone for 10 days per menstrual cycle over the same period. Fasting plasma glucose (FPG) and one- and two-hour post-prandial glucose levels were measured at baseline and after the intervention. 103 completed the study (50 in the Nigella sativa group and 53 in the control group). At baseline, there were no significant differences in FPG (p = 0.294), though the control group had higher one-hour (p = 0.002) and two-hour (p = 0.006) post-prandial glucose levels. Post-intervention, significant interaction effects were observed for FPG (p = 0.004) and two-hour post-prandial glucose (p = 0.023), indicating more significant reductions in the Nigella sativa group compared to the control group. Conclusions: Considering the observed effect of Nigella sativa supplementation on FPG and two-hour post-prandial glucose, it may offer a complementary approach to managing glycemia in adolescent PCOS. However, further research is warranted.
- This systematic review and meta-analysis of randomized controlled trials (RCTs) sought to evaluate the effects of Nigella sativa (N. sativa) consumption on glycemic index in adults. A systematic literature search up to December 2023 was completed in PubMed, Scopus, and Web of Science, to identify eligible RCTs. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as weighted mean differences with a 95 % confidence interval. Finally, a total of 30 studies were found to be eligible for this meta-analysis. The pooled results using random effects model indicated that N. sativa supplementation significantly reduced FBS (SMD: -1.71; 95 % CI: -2.11, -1.31, p <0.001; I2= 92.7 %, p-heterogeneity <0.001) and HA1c levels (SMD: -2.16; 95 % CI: -3.04, -1.29, p <0.001; I2= 95.7 %, p-heterogeneity <0.001) but not effect on insulin (SMD = 0.48; 95 % CI: -0.53, 1.48, P = 0.353; I2= 96.1 %, p-heterogeneity <0.001), and HOMA-IR (SMD: -0.56; 95 % CI: -1.47, 0.35, p=0.229; I2= 95.0 %, p-heterogeneity <0.001). Conclusion: the evidence supports the consumption of N. sativa to reduce FBS and HA1c levels. Additional research, featuring extended durations and robust study designs, is necessary to determine the ideal dosage and duration of N. sativa supplementation for achieving a positive impact on glycemic markers.
- In this systematic review, the objective is to assess the effects of Nigella Sativa on parameters that reflect metabolic syndromes, such as lipid profile, blood pressure, blood glucose, and anthropometry indices. Six out of 8 randomised controlled trials (n:776) demonstrated a significant improvement in lipid profile (p <0.05), 5 out of 7 trials (n:701) showed a significant reduction in glycaemic indices (p <0.05), 1 out of 5 trials (n:551) demonstrated significant improvements in blood pressure (p <0.05), and 2 out of 7 trials (n:705) showed a significant reduction in anthropometric measurements (p <0.05). Conclusion: Nigella Sativa has proved to have a significant positive effect on lipid profile and glycaemic index. The results showed in the parameters of blood pressure and anthropometric indices are less convincing, as results were inconsistent across studies. Nigella Sativa can therefore be recommended as an adjunct therapy for metabolic syndrome.
- This study was designed to investigate the effect of Nigella sativa supplementation on polycystic ovary syndrome (PCOS) symptoms and their severity in adolescents. The current randomized clinical trial was conducted on 114 adolescents with PCOS who were referred to gynecologist offices and clinics in Gonabad, Iran from March 2022 to March 2023. Participants were randomly allocated to the intervention (Nigella sativa 1000 mg/day) and control (10 mg/day medroxyprogesterone from the 14th day of the cycle for 10 nights) groups. The study duration was 16 weeks. Ovarian volume (measured by ultrasound), anthropometric and blood pressure; serum testosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), luteinizing hormone (LH), hirsutism severity (Ferriman-Gallwey score) levels were evaluated before and after the study. Data from 103 participants (control group = 53, intervention group = 50) were analyzed. The mean age of participants was 17.0 (Interquartile range [IQR]:2.0). The mean difference in hirsutism score changes (p < 0.001), right (p = 0.002), and left (p = 0.010) ovarian volume, serum LH (p < 0.001) and testosterone (p = 0.001) were significantly higher in the intervention group compared to the control group. The frequency of oligomenorrhea, menometrorrhagia, and amenorrhea, were significantly reduced after the study in the intervention group compared to the control group (ps < 0.001). Conclusions: Short-term Nigella sativa supplementation may be effective in reducing ovarian volume and improving hormonal balance, and menstrual irregularities in adolescents with PCOS. Further research and long-term studies are warranted to validate the potential therapeutic effects of Nigella sativa in adolescents with PCOS.
- This study evaluates the efficacy of a novel mucoadhesive patch containing Nigella sativa 10% extract compared to triamcinolone 0.1% in alleviating symptoms and reducing lesion severity in patients with erosive-atrophic oral lichen planus. A pilot study comprising two groups, each with 10 patients, was conducted. The intervention group received mucoadhesive patches containing N. sativa 10% extract, while the control group received triamcinolone acetonide 0.1% patches. Pain and burning intensity, measured through visual analog scale, and lesion severity based on the Thongprasom scale were assessed weekly for 4 weeks. Descriptive records were kept for side effects and patient satisfaction. Pain and burning intensity decreased in both groups throughout the sessions, with the N. sativa group showing a greater reduction than the triamcinolone group. The reduction in burning intensity within each group was significant (p < .001), and there was a significant difference between groups only in the second session (p = .045). The overall difference between groups was not significant (p > .05). Lesion severity also decreased significantly in both groups (p < .001), with a significant difference between groups observed in the third session (p = .043) and overall throughout the study (p = .006). Conclusion: The use of N. sativa extract in mucoadhesive patches was as effective as corticosteroids in reducing pain, burning, and lesion severity in patients with oral lichen planus, with N. sativa showing superior results in some sessions. Notably, no significant complications were observed with N. sativa use, making it a promising treatment option for lichen planus.
- This study aimed to explore the impact of N. sativa supplementation on the lipid profile of adult participants. We searched Scopus, Web of Science, PubMed, Cochrane, and Web of Science databases until December 2022. Random effects models were used, and pooled data were determined as standardized mean differences with a 95% confidence interval. The findings of 34 studies with 2278 participants revealed that N. sativa supplementation significantly reduced total cholesterol (TC) (SMD: -1.78; 95% CI: -2.20, -1.37, p < 0.001), triglycerides (TG) (SMD: -1.2725; 95% CI: -1.67, -0.83, p < 0.001), and low-density lipoprotein cholesterol (LDL-C) (SMD: -2.45; 95% CI: -3.06, -1.85; p < 0.001) compared to control groups. However, a significant increase was found in high-density lipoprotein cholesterol (HDL-C) (SMD: 0.79; 95% CI: 0.38, 1.20, p < 0.001). Conclusion: N. sativa has improved effects on TG, LDL-C, TC, and HDL-C levels. Overall, N. sativa may be suggested as an adjuvant anti-hyperlipidemic agent.
- In this double-blind clinical trial, 70 nulliparous pregnant women referred to Hajar Hospital and Imam Ali clinics of Shahrekord and had missed abortion before the 12-week gestational age were selected and randomly divided into two interventions and control groups. The intervention group received 5 g of Nigella sativa oil alone daily for up to 3 days and the control group received a placebo. In case of nonresponse, 3 days after the last dose of medication or placebo, 800 μg of misoprostol (vaginal) were used. Data were analyzed by SPSS software. The chi-square test, Fisher’s exact test, independent t-test and paired t-test were used for analytical statistics. According to the results, 18 cases (51.4%) in the intervention group and seven cases (20%) in the control group showed complete evacuation of uterine contents which had a significant difference (p < 0.05). The frequency of vagina physical examination and type of hemorrhage did not show any significant difference between the two groups before and after the intervention. After the intervention, human chorionic gonadotropin (HCG) was significantly decreased in the intervention group but did not change in the control group (p < 0.05). The frequency of adverse events in the intervention group was three (8.6%) and in the control group was one (2.9%) which had no significant difference. Conclusion: Nigella sativa improves the outcome of missed abortion by reducing HCG and facilitating cervix dilatation and delivery of uterine contents.
- This systemaatic review evaluated the role of Nigella spp in managing allergic rhinitis (AR), a comprehensive review through systematic reviews and meta-analyses was conducted. To carry out a meta-analysis of clinical trials that used Nigella spp in treating AR based on current data. A meta-analysis of randomized controlled trials (RCTs) was performed. Various databases, including PubMed, Web of Science, Embase, Science Direct, Springer Link and the Cochrane Library, were searched until October 2023 to obtain RCTs assessing impact of Nigella spp in the control of AR. The current meta-analysis was carried out with a random-effects model. There were 8 studies enrolled, and our meta-analysis findings revealed that, relative to the control group, observation group exhibited the markedly increased total effective rate for allergic rhinitis treatment (odds ratio [OR] = 4.24, 95% confidence interval [CI] (2.57, 7.27), and p < 0.00001); three studies showed that the effect of Nigella spp for nasal symptoms treatment among patients with allergic rhinitis was superior in observation group to control group [mean difference = -2.60, 95% CI (-2.82, -2.38), p < 0.00001]; adverse effects occurred in five studies, all of which were transient, did not require medical intervention, and were not statistically significant between the two groups [OR = 1.01, 95% CI (0.59, 1.73), p = 0.98]. Conclusion: The observation group demonstrated relative safety and had an enhanced effect on allergic rhinitis treatment and total nasal symptom improvement than the control group. The inclusion of fewer studies and the lower quality of trial design might affect the stability of the results. However, the evidence-based findings that Nigella spp for allergic rhinitis treatment is more accurate should be validated in future large-scale, multicenter, and well-designed RCTs.
Yes, I know: the evidence is not perfect for any of the indications. In addition, there is a problem with low bioavailability. And I am suspicious of any SCAM that seems to be effective for an incredibly long list of conditions.
At the same time, I have to admit that, collectively, the research on BSO is impressive. As BSO has been used for centuries (as a spice etc.), serious adverse effects seem unlikely. The evidence regarding its effectiveness might not be fully convincing but, in my book, it is encouraging.
Thanks to Trump and his administration, US science is descending into chaos. Federal grants are being frozen, Scientists are getting fired and are leaving the US in droves, the NIH is under threat, crucial meetings are being postponed indefinitely and anti-science increasingly dominates the agenda of the White House.
US Universities are forced to cut back offers of admission for graduate students. Many have stopped hiring as the Trump administration threatens to take away federal money over their handling of a wide range of issues. Meanwhile, JD Vance does not miss an occasion to insult Europeans and to lecture us about free speach. The whole scenario is so utterly bizarre that it seems to originate from a 3rd class science fiction film.
Back in July 2024, when JD Vance first launched his attack on universities, I pointed out that fascist movements are known to be notoriously anti-intellectual and anti-science. Adolf Hitler said he regretted that his regime still had some need for its “intellectual classes,” otherwise, “one day we could, I don’t know, exterminate them or something.” And the ‘bon mot’, “when I hear the word culture, I reach for my gun”, is attributed even to several of the top Nazis of the Third Reich.
At the time, my comparison to fascist regimes may have seemed exaggerated to some. Now it is fairly obvious to all but the most deluded that it was spot on. Those who are not afraid of what Trump and his sycophants are doing to science are simply not listening!
In response to the multiple threats to science, ‘Stand Up for Science‘ organized demonstrations of scientific communities throughout the US. The central event took place in Washington, D.C. on March 7, 2025, with approximately 2,000 participants in attendance. Parallel demonstrations occurred in more than 30 additional U.S. cities, with international solidarity events reported in several countries, including over 30 locations in France.
Several universities in Europe and elsewhere have also reacted; they are busy putting programmes in place to receive scientists who are fleeing the US. The consequence will inevitably be a significant ‘brain drain’ that will haunt the US for decades to come.
This study investigated the impact of spirituality and SCAM (so-called alternative medicine) use on perceptions of vaccine harmfulness, with a focus on COVID-19 and mandatory childhood vaccinations. Additionally, it examined whether spirituality indirectly influences vaccine hesitancy through SCAM use and beliefs in conspiracies.
A cross-sectional probability-based survey was conducted with over 1300 participants from South Tyrol, Italy, in 2023, using the GrAw-7 (Gratitude/Awe) scale as a measure of the experiential aspect of non-religious spirituality. Statistical analysis encompassed Spearman’s correlation and linear regression to assess the associations between spirituality and vaccine perceptions. A mediation model was applied to evaluate the role of spirituality in shaping attitudes towards vaccination.
The results show that higher experiential spirituality was associated with increased perceived harmfulness of COVID-19 and mandatory childhood vaccinations. Spirituality as well as perceived harmfulness of COVID-19 vaccination and mandatory childhood vaccination were correlated with age, increased SCAM utilisation and conspiracy ideation, while institutional distrust was solely associated with vaccine scepticism but not with spirituality; well-being and altruism were only associated with spirituality. Mediation analysis revealed that experiential spirituality accounted for a modest but significant portion of the influence of SCAM use and conspiracy thinking on vaccine perceptions.
The authors concluded that their study underscores the association between experiential spirituality and vaccine perceptions, particularly among individuals with a predisposition towards SCAM and those who exhibit conspiracy-related beliefs, highlighting the intricate relationships without implying causation. While spirituality does not appear to directly hinder vaccine uptake, it correlates with heightened perceptions of vaccine risks, particularly within contexts where alternative health practices and distrust in mainstream medical authorities are prevalent. This relationship emphasises that people who score high on spiritual awareness may be indirectly influenced to differ from others with respect to vaccination attitudes by promoting scepticism towards vaccine safety and efficacy. Even if we cannot change the spirituality of people, we know now that we can address information campaigns not only by attempting to build trust but also by addressing information to people preferring SCAM use and being spiritual at once. We think that this result is an important insight when focusing vaccine campaigns on vaccine-hesitant persons. These findings emphasise the importance of incorporating spiritual awareness, convictions, and beliefs into public health communication strategies. To address vaccine hesitancy within spiritually inclined populations, public health campaigns could explore framing vaccination in ways that resonate with values such as community care, personal responsibility, or altruism while ensuring that these messages are tailored to the diverse beliefs and perspectives of these groups. Moreover, collaboration with spiritual and community leaders could serve as a strategy to strengthen vaccine acceptance in populations that perceive health through a spiritual perspective. Future research should further explore the interactions between spirituality, SCAM use, and beliefs in conspiracies, with an emphasis on understanding how spirituality mediates health behaviours in culturally and religiously diverse contexts. Longitudinal studies and analyses across broader demographic groups are necessary to generalise these findings and refine public health interventions aimed at addressing spirituality-linked vaccine hesitancy.
My interpretation of these findings is that they confirm what we have repeatedly discussed here: There is a link between SCAM use and vaccination hesitance. It most likely is due to a cross-correlation: a certain mindset (that includes spirituality and several other phenomena) influences the distrust in vaccinations as well as the use of SCAM (and other things like, for instance, the belief in conspiracy theories).
Measles had been declared eliminated from the US in 2000. Now the disease is back with a vengeance. In February, an unvaccinated Texan child became the first person in a decade to die from measles in the US. Another death occurred in New Mexico.
The reason for the outbreak is simple: the uptake of the measles vaccine dropped below the 95% rate that is necessary for herd immunity. In the region where the current outbreak began, only 82% of the kids were vaccinated. This triggered the outbreak and, in turn, might mean that the US will lose its ‘measles elimination status’.
Only days after his appointment, Trump pledged to withdraw the United States from the World Health Organization and to drastically cut the US Agency for International Development. Both moves are likely to cause more cases of measles and similarly vaccine-preventable diseases in the US and around the world. To make matters worse, Trump administration has fired hundreds of workers from the US Centers for Disease Control and Prevention (CDC).
And to make matters even worse, Trump appointed Robert F. Kennedy Jr., one of the US most deluded antivaxer. Since being appointed, Kennedy has downplayed the importance of the current measles outbreak, postponed a meeting of the CDC vaccine advisers, made statements like “vaccinations are over-rated” and claimed that good nutrition and treatment with vitamin A as ways to reduce measles severity. He even praised the benefits of cod liver oil as a measure against measles. “There are adverse events from the vaccine,” Kennedy said in a March 11 interview. “It does cause deaths every year. It causes all the illnesses that measles itself causes, encephalitis and blindness, et cetera. And so people ought to be able to make that choice for themselves.” Further confirming his cluelessness Kennedy also stated: “When you and I were kids, everybody got measles, and measles gave you … lifetime protection against measles infection. The vaccine doesn’t do that… The vaccine wanes 4.5% per year.”
But Kennedy does not just propagate BS in interviews, he also plans to investigate whether vaccines cause autism — an assumption that has been discredited ad nauseam. A spokesperson for the US Department of Health and Human Services (DHHS) said: “The rate of autism in American children has skyrocketed. CDC will leave no stone unturned in its mission to figure out what exactly is happening.”
Meanwhile in Texas, some parents, who evidently believe Kennedy’s deluded nonsense, are giving unvaccinated children vitamin A, which, of course, is toxic at high doses.
This study was aimed at investigating how Spanish media reinforce a positive image of dietary supplements in the treatment of children, potentially leading to harmful health attitudes and behaviors.
The researchers conducted a quantitative content analysis of 912 news articles published between 2015 and 2021 in Spanish media outlets discussing dietary supplements for children. They used a frequency analysis and a proportion comparison to analyze variables such as the reach of news, tone of news, mentions of health professional consultation, association with natural products, media specialization, intertextuality, and headline mentions.
The study found a 60% increase in publications discussing dietary supplements for children during the study period. The content analysis indicates that these articles predominantly present dietary supplements in a positive light, often without robust scientific evidence. Furthermore, many do not emphasize the need for medical consultation, which may contribute to unsupervised consumption of supplements, particularly among minors. This highlights the critical importance of professional guidance when considering dietary supplements for children. Additionally, the frequent emphasis on the “natural” attributes of these products raises concerns regarding consumer perceptions and potential safety risks.
The authors concluded that their study reveals a problem regarding the portrayal of dietary supplements for children in Spanish media. The overly optimistic image, lack of scientific basis, and failure to recommend medical supervision may contribute to unsupervised consumption among minors, risking their health due to misinformed decisions influenced by media portrayal.
I would add that this problem exists not just for children and not just in Spain. It has long been noted to put consumers of all ages and from all countries at risk. The authors kindly cite our own study from 2006 that concluded: “UK national newspapers frequently publish articles on CATs for cancer. Much of this information seems to be uncritical with a potential for misleading patients.”
Even several years before that, my late friend Thomas Weimayr and I published this study in the BMJ:
The media strongly influences the public’s view of medical matters.1 Thus, we sought to determine the frequency and tone of reporting on medical topics in daily newspapers in the United Kingdom and Germany. The following eight newspapers were scanned for medical articles on eight randomly chosen working days in the summer of 1999: the Times, the Independent, the Daily Telegraph, and the Guardian in the United Kingdom, and Frankfurter Allgemeine Zeitung, Süddeutsche Zeitung, Frankfurter Rundschau, and Die Welt in Germany. All articles relating to medical topics were extracted and categorised according to subject, length, and tone of article (critical, positive, or neutral).
A total of 256 newspaper articles were evaluated. The results of our analysis are summarised in the table. We identified 80 articles in the German newspapers and 176 in the British; thus, British newspapers seem to report on medical topics more than twice as often as German broadsheets. Articles in German papers are on average considerably longer and take a positive attitude more often than British ones. Drug treatment was the medical topic most frequently discussed in both countries (51 articles (64%) in German newspapers and 97 (55%) in British). Surgery was the second most commonly discussed medical topic in the UK newspapers (32 articles; 18%). In Germany professional politics was the second most commonly discussed topic (11 articles; 14%); this category included articles about the standing of the medical profession, health care, and social and economic systems—that is, issues not strictly about treating patients.
Because our particular interest is in complementary medicine, we also calculated the number of articles on this subject. We identified four articles in the German newspapers and 26 in the UK newspapers. In the United Kingdom the tone of these articles was unanimously positive (100%) whereas most (3; 75%) of the German articles on complementary medicine were critical.
This analysis is, of course, limited by its small sample size, the short observation period, and the subjectivity of some of the end points. Yet it does suggest that, compared with German newspapers, British newspapers report more frequently on medical matters and generally have a more critical attitude (table). German newspapers frequently discuss medical professional politics, a subject that is almost totally absent from newspapers in the United Kingdom.
The proportion of articles about complementary medicine seems to be considerably larger in the United Kingdom (15% v 5%), and, in contrast to articles on medical matters in general, reporting on complementary medicine in the United Kingdom is overwhelmingly positive. In view of the fact that both healthcare professionals and the general public gain their knowledge of complementary medicine predominantly from the media, these findings may be important.2,3
25 years later, the call on journalists to behave more responsibly when reporting about so-called alternative medicine (SCAM) is as loud and clear as it is neglected and ignored.
There are many interesting and complex interrelationships between religion ond so-called alternative medicine (SCAM). Some of them were discussed here:
- ‘The power of all religions’ is being tested in a study with severely ill corona-virus patients
- Alternative medicine = ‘Ersatz’ religion?
- The ‘Healing Power of God’: a religious group was found guilty of manslaughter of a diabetic girl
- UK politician dabbles in faith healing
- The spiritual healers who sexually harass, molest, and rape female patients
- A ‘Christian Checklist’ for so-called alternative medicine
- Biblical Naturopathy, another SCAM that is new to me
- The ‘WORST PAPER OF 2022’ COMPETITION. Entry No 3: Effects of an Islamic-Based Intervention on Depression and Anxiety
- Daily prayer against severe COVID – an update of a study started two years ago
- Reincarnation therapy “can change your life”
- Does religiosity influence post-operative survival?
- Scientology and chiropractic: is there a link?
- he real danger of yoga!
The list might need to be up-dated with ‘Prophetic Medicine’. This term, I must admit, was new to me. So, I studied the paper and was enlightened. Here is its abstract:
Integrative medicine (IM) aims to create a comprehensive healthcare system by combining conventional medicine with complementary and alternative approaches. This model prioritizes patients, emphasizing the importance of the doctor–patient relationship. By integrating the most beneficial elements of both conventional and complementary medicine, patients can benefit from enhanced therapeutic outcomes while minimizing risks associated with their combination. Given this complexity, patients need access to qualified IM practitioners who can provide guidance on the potential benefits and drawbacks of these combined approaches. One notable complementary approach is prophetic medicine (PM), particularly prevalent in Muslim communities. This practice offers preventive and curative treatments based on the teachings and practices of Prophet Muhammad. Its global recognition is on the rise, attracting increasing interest from scientists regarding its potential benefits. For instance, cupping therapy, a technique employed in PM, has been shown to offer advantages over conventional medications for various ailments, including pain management and blood conditions, such as thalassemia, offering potentially superior outcomes. A precise delineation of the scope of PM practices is crucial for a comprehensive understanding of the methodologies employed, their potential integration into contemporary healthcare systems, and the multifaceted factors influencing patient outcomes. By combining conventional medical practices with the principles of PM, IM can provide a more holistic approach to patient care. Hence, this paper explores this new model, its diverse applications, and its potential impact on IM.
The author’s lengthy conclusion in the article itself is as follows:
IM is gaining traction as it aims to improve patient care and alleviate suffering. Unlike merely combining CAM, IM emphasizes the holistic healing of the mind, body, and spirit. IM can be offered through consultations, standalone clinics, or even as a primary service. Many therapies rooted in PM can be particularly beneficial for patients facing challenging illnesses. However, the successful implementation of PM within an IM framework may be constrained by certain limitations. The most significant challenge is adapting cultural and religious beliefs to modern healthcare practices. To overcome these challenges, it is essential to establish clear, comprehensive, and universally applicable definitions and frameworks for IM. These frameworks should be comprehensive, well-developed, and consider historical roots, religious influences, and modern applications. Moreover, studies indicate that PM therapies are widely used around the world, yet there is a pressing need for a clear definition that encompasses these factors. Defining the scope of PM practices will facilitate a better understanding of the common methods, how they can be integrated into healthcare systems, and the various factors that influence patient care. Furthermore, PM practitioners require enhanced education and training to improve their understanding of traditional remedies and their effective application. Ultimately, addressing these challenges will likely lead to an improved IM model.
Who writes such remarkable nonsense?
The author of the paper is Saud Alsanad, an Associate Professor of Complementary and Alternative Medicine (CAM) in the College of Medicine at the University of Imam Mohammad Ibn Saud Islamic University (IMSIU), Kingdome of Saudi Arabia. He is a founding member and the former CEO of the Saudi National Centre for Complementary and Alternative Medicine, Riyadh, Kingdome of Saudi Arabia. Dr Alsanad is a registered pharmacist at the Saudi Commission for Health Specialists. He completed his PhD in Complementary and Alternative Medicine at the Reading School of Pharmacy, University of Reading, UK, under the supervision of Professor Elizabeth M Williamson.
Alsanad defines PM as medicine “based on the teachings and practices of Prophet Muhammad”. It includes a weird mix of modalities (for instance: spiritual and religious therapy as well as cupping). Would it not be reasonable to demand that each modality of whatever medicine must meet the accepted standards of effectiveness and safety that are applied in conventional medicine? If a therapy demonstrably generates more good than harm, we might consider it for integration into routine care. If not we shouldn’t even be called ‘medicine’!
Most of the treatments listed under the PM-umbrella fall into the second category. Therefore PM is arguably not medicine at all. Whether or not a therapy was mentioned by a this or that prophet is utterly immaterial and should really not matter in the age of evidence-based medicine.
