fatigue
- mind-body medicine (32.0%),
- massage (16.1%),
- chiropractic (14.4%),
- acupuncture (3.4%),
- naturopathy (2.2%),
- art and/or music therapy (2.1%).
Reporting post-COVID-19 was associated with an increased likelihood of using any SCAM in the last 12 months (AOR = 1.18, 95% CI [1.03, 1.34], p = 0.014) and specifically to visit an art and/or music therapist (AOR = 2.56, 95% CI [1.58, 4.41], p < 0.001). The overall use of any SCAM was more likely among post-COVID-19 respondents under 65 years old, females, those with an ethnical background other than Hispanic, African-American, Asian or Non-Hispanic Whites, having a higher educational level, living in large metropolitan areas and having a private health insurance.
I only just came across the announcements for two conferences that made me almost speachless:
No 1 Homeopathy in Cancer Care – Aug. 29, 2024
Hosted by the newly formed Special Interest Group (SIG) on Research in Homeopathy in Cancer Care, this webinar aims to shed light on the role of homeopathy in cancer care, focusing on both its research status and practical applications in supportive treatment.
Supportive and palliative care are pivotal components of cancer treatment, offering avenues to enhance quality of life and potentially extend survival rates. Homeopathy emerges as a prominent integrative modality embraced by patients worldwide, notably in Europe, India, and Latin America. Despite varying perspectives on its efficacy, homeopathy’s emphasis on empathic listening and its unique approach to symptom management garner significant attention.
In the United States, homeopathy’s popularity surged during the 1990s, with over 5 million people reported to have used it by 2015. While some attribute its effects to a placebo response, clinical studies suggest tangible benefits in cancer care, particularly in alleviating symptoms like fatigue, anxiety, and hot flashes. Homeopathy is one of the leading integrative oncology modalities in Europe. Observations from France reveal that homeopathy supplements conventional treatments in about 30% of cancer patients, yielding notable improvements in symptomatology. Homeopathy was the most commonly used integrative therapy in cancer care in Belgium and in the top five in six other countries Turkey, Czech Republic, Sweden, Italy, Spain, and Greece. (Molassiotis 2005)
The speakers are:
Dr. Moshe Frenkel is a clinical associate professor at the University of Texas and founder of the Integrative Medicine Clinic, at The University of Texas M. D. Anderson Cancer Center, Houston Texas where he served as a full faculty until he returned to Israel in 2010. Up to 2014 Dr Frenkel was chairing the clinical practice committee of The Society of Integrative Oncology and was acting as the chair of The Israeli Society of Complementary Medicine (A section of The Israel Medical Association) until 2016. Currently, Dr Frenkel is the medical director of the Integrative Oncology Service in RAMBAM Medical Center Oncology Department, a comprehensive oncology center and the largest in Northern Israel, as well as leading a feasibility study in homeopathy in cancer care.
Elio Rossi, MD will provide a brief overview of his practice and discuss symptom management, particularly focusing on radio dermatitis and leading homeopathic remedies that he utilizes. Director of the homeopathy outpatient clinic at the Campo di Marte public hospital in Lucca Italy, was established in 1998 and to date more than 7,500 patients have been consecutively examined. Of these 1100 are cancer patients who required an ‘integrated’ homeopathic treatment to reduce the adverse effects of anti-cancer therapies and improve their quality of life. Works as a homeopathic doctor and expert in integrative medicine, collaborating with a local oncologist. Collaborated as Co-Chair, in the organization of many national and international congresses on Integrative Oncology (2017, 2019), specific sessions within other congresses organized in Italy (ECIM 2012 Florence, WCIMH 2023 Rome) and regional workshops, which have been attended by hundreds of CIM experts and oncologists.
Jean Lionel Bagot, MD will share insights from his practice, focusing on homeopathic remedies for fatigue and potential remedies for skin afflictions. A specialist in integrative cancer supportive care treatments in private practice as well as coordinating doctor of the Outpatients Department for Integrative Care in Groupe Hospitalier Saint Vincent Strasbourg, France; President of the International Homeopathic Society of Supportive Care in Oncology (SHISSO); Scientific officer of the French Society for Integrative Oncology (SFOI); Associated Member of the University College of Integrative and Complementary Medicine (CUMIC); Lecturer in the Medicine and Pharmacy Faculty in Strasbourg University.
Elizabeth Thompson, MD will have the opportunity to briefly describe her previous NHS practice and discuss symptom management, specifically addressing hot flushes and leading homeopathic remedies. Homeopathic Physician in NHS, NCIM Founder, CEO & Integrative Medicine Doctor, National Centre for Integrative Medicine (NCIM) www.ncim.org.uk, Chair, Integrative and Personalized Medicine Congress, London, June 2022. Past President ECIM 2021 and Board Member European Society Integrative Medicine, Council Member British Society of Integrative Oncology, Council Member College of Medicine.
No 2: “Pushing the Boundaries” Yes to Life Annual Conference 2024, 28th September
Integrative Medicine is a living, rapidly expanding science, with new understandings and potential being unveiled on a daily basis. This year’s conferences – one online in the Summer, and one in-person in the Autumn – share the title ‘Pushing the Boundaries’, as we have decided to devote them both to looking at the latest developments in Integrative Medicine, across the board. So that includes new techniques, new scientific understandings, and new applications for existing therapies, and you’ll be hearing fresh insights from some of your most trusted clinicians and scientists, and led into unfamiliar territory by pioneering speakers who may be as yet unfamiliar. The conferences are being co-created by Patricia Peat from Cancer Options and the Peat Institute and Yes to Life, with the aim of sending our audiences home with a wealth of resources on which to be able to draw for their own needs. Both events will be priced for accessibility, and the in-person Autumn Conference will include an extensive Exhibition that will offer yet more knowledge and resources to delegates.
The speakers are:
- Dr Penny Kechagioglou MBBS (Honours), MRCP, CCT (Clin Onc), MPH, MBA Clinical oncologist
- Dr Britt Cordi PhD
- Dr Robert Verkerk MSc DIC PhD FACN
- Robin Daly Yes to Life Founder and Chairman
- Patricia Peat Founder of Cancer Options
- Mark Sean Taylor Patient Led Oncology Founder
_____________________________
Yes, you remembered correctly: some of the speakers have in the past featured on this blog, e.g.:
- Dr Elizabeth Thompson, NCIM Holistic Doctor & Clinical Lead, says she has had the coronavirus and recommends homeopathy
- When orthodox medicine has nothing more to offer
- Homeopathy in Bristol: from bad to dismal
- Robert Verkerk (Alliance for Natural Health) at his finest
- Corona pandemic: What Quacks Don’t Tell You
Crucially, we have encountered the YES TO LIFE charity:
- Survive cancer, but not thanks to this charity called ‘SURVIVE CANCER’
- Is the promotion of dubious therapies a charitable activity? The Charity Commission wants to know
- Uncharitable charities? The example of ‘YES TO LIFE’
But please do not let me spoil your enthusiasm of attending these meetings!
I do mean it: can someone please attend?
I offter a guest post to any critical thinker who wants to write up his/her experience.
GOOD LUCK
The American Society of Clinical Oncology (ASCO) and the Society for Integrative Oncology have collaborated to develop guidelines for the application of integrative approaches in the management of:
- anxiety,
- depression,
- fatigue,
- use of cannabinoids and cannabis in patients with cancer.
These guidelines provide evidence-based recommendations to improve outcomes and quality of life by enhancing conventional cancer treatment with integrative modalities.
All studies that informed the guideline recommendations were reviewed by an Expert Panel which was made up of a patient advocate, an ASCO methodologist, oncology providers, and integrative medicine experts. Panel members reviewed each trial for quality of evidence, determined a grade quality assessment label, and concluded strength of recommendations.
The findings show:
- Strong recommendations for management of cancer fatigue during treatment were given to both in-person or web-based mindfulness-based stress reduction, mindfulness-based cognitive therapy, and tai chi or qigong.
- Strong recommendations for management of cancer fatigue after cancer treatment were given to mindfulness-based programs.
- Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial.
- The recommended modalities for managing anxiety included Mindfulness-Based Interventions (MBIs), yoga, hypnosis, relaxation therapies, music therapy, reflexology, acupuncture, tai chi, and lavender essential oils.
- The strongest recommendation in the guideline is that MBIs should be offered to people with cancer, both during active treatment and post-treatment, to address depression.
The authors concluded that the evidence for integrative interventions in cancer care is growing, with research now supporting benefits of integrative interventions across the cancer care continuum.
I am sorry, but I find these guidelines of poor quality and totally inadequate for the purpose of providing responsible guidance to cancer patients and carers. Here are some of my reasons:
- I know that this is a petty point, particularly for me as a non-native English speaker, but what on earth is an INTEGRATIVE THERAPY? I know integrative care or integrative medicine, but what could possibly be integrative with a therapy?
- I can vouch for the fact that the assertion “all studies that informed the guideline recommendations were reviewed” is NOT true. The authors seem to have selected the studies they wanted. Crucially, they do not reveal their selection criteria. I have the impression that they selected positive studies and omitted those that were negative.
- The panel of experts conducting the research should be mentioned; one can put together a panel to show just about anything simply by choosing the right individuals.
- The authors claim that they assessed the quality of the evidence, yet they fail to tell us what it was. I know that many of the trials are of low quality and their results therefore less than reliable. And guidance based on poor-quality studies is misguidance.
- The guidelines say nothing about the risks of the various treatments. In my view, this would be essential for any decent guideline. I know that some of the mentioned therapies are not free of adverse effects.
- They also say nothing about the absolute and relative effect sizes of the treatments they recommend. Such information would ne necessary for making informed decisions about the optimal therapeutic choices.
- The entire guideline is bar any critical thinking.
Overall, these guidelines provide more an exercise in promotion of dubious therapies than a reliable guide for cancer patients and their carers. The ASCO and the Society for Integrative Oncology should be ashamed to have given their names to such a poor-quality document.
The aim of this study was to assess the effectiveness of different forms of walking in reducing symptoms of depression and anxiety. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted assessing the effects of walking on depressive and anxiety symptoms. MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Allied and Complementary Medicine Database (AMED), CINAHL, and Web of Science were searched on April 5, 2022. Two authors independently screened the studies and extracted the data. Random-effects meta-analysis was used to synthesize the data. Results were summarized as standardized mean differences (SMDs) with 95% CIs in forest plots. The risk of bias was assessed by using the Cochrane Risk of Bias tool.
This review included 75 RCTs with 8636 participants; 68 studies reported depressive symptoms, 39 reported anxiety symptoms, and 32 reported both as the outcomes. One study reported the results for adolescents and was not included in the meta-analysis. The pooled results for adults indicated that walking could significantly reduce depressive symptoms (RCTs: n=44; SMD −0.591, 95% CI −0.778 to −0.403; I2=84.8%; τ2=0.3008; P<.001) and anxiety symptoms (RCTs: n=26; SMD −0.446, 95% CI −0.628 to −0.265; I2=81.1%; τ2=0.1530; P<.001) when compared with the inactive controls. Walking could significantly reduce depressive or anxiety symptoms in most subgroups, including different walking frequency, duration, location (indoor or outdoor), and format (group or individual) subgroups (all P values were <.05). Adult participants who were depressed (RCTs: n=5; SMD −1.863, 95% CI −2.764 to −0.962; I2=86.4%; τ2=0.8929) and those who were not depressed (RCTs: n=39; SMD −0.442, 95% CI −0.604 to −0.280; I2=77.5%; τ2=0.1742) could benefit from walking effects on their depressive symptoms, and participants who were depressed could benefit more (P=.002). In addition, there was no significant difference between walking and active controls in reducing depressive symptoms (RCTs: n=17; SMD −0.126, 95% CI −0.343 to 0.092; I2=58%; τ2=0.1058; P=.26) and anxiety symptoms (14 RCTs, SMD −0.053, 95% CI −0.311 to 0.206, I2=67.7%, τ2=0.1421; P=.69).
The authors concluded that various forms of walking can be effective in reducing symptoms of depression and anxiety, and the effects of walking are comparable to active controls. Walking can be adopted as an evidence-based intervention for reducing depression and anxiety. More evidence on the effect of low-intensity walking is needed in the future.
Clinical trials of walking are encounter considerable methodological difficulties: there is no adequate placebo, for instance. Thus, such studies are often conducted against no treatment or against ‘active control’ which means that the control group receives a therapy of known effectiveness.
The former comparison is not very meaningful because it does not allow us to tell whether the effects are truly caused by walking or by some non-specific effect. The latter comparison is more rigorous but also not perfect because the patients cannot be blinded.
This means we have to accept a degree of uncertainty in estimating the benefit of walking. As walking is not expensive, not hazardous, and has many other health benefits, this caveat seems truly minor. In other words, the findings reported here are encouraging and should be accepted in clinical practice.
Yet, there is still one ‘hair in the soup’: depressed people find it often very hard to motivate themselves to do activities such as walking. Thus, compliance with this treatment might often be less than satisfactory. It might be worth researching how this obstacle can be best overcome.
Of all the many forms of so-called alternative medicine (SCAM), Reiki is perhaps the one that has the least plausibility. It assumes that a Reiki healer can send healing energy into the body of a patient which, in turn, stimulates the self-healing ability of the body and thus cures illness. Neither the source of the energy, its nature, or its effects have ever been convincingly demonstrated. These facts, however, do not stop enthusiasts to conduct clinical trials of Reiki.
The aim of this randomised clinical trial was to investigate the effect of the application of Reiki on fatigue and sleep quality in people with MS. A total of 60 people (control group = 30, intervention group = 30) participated in this study. Personal Information Form, Piper Fatigue Scale (PFS) and Pittsburg Sleep Quality Index (PSQI) were used as endpoints.
It was found that the PFS and PSQI total and subcomponent scores of the intervention group decreased after Reiki compared to the control group and this was statistically significant (p<0.05). The study showed that Reiki was significantly effective in improving fatigue and sleep quality in people with MS.
The authors concluded that, as Reiki is a simple, inexpensive and accessible method, it was suggested that its use in the management of MS should be encouraged and maintained in nursing practice.
In the introduction, the authors state this:
Reiki is a non-invasive, low-cost, easy-to-apply practice with no side effects and no negative effects on the existing treatment, and prevents acute and chronic conditions. It is frequently preferred in rehabilitation centres, emergency care units, nursing homes, elderly care centres, paediatrics, psychiatry, obstetrics and gynaecology clinics. Reiki can be applied by trained practitioners such as health professionals who have received first level reiki training in hospitals and clinics, caregivers or patients themselves. Reiki can be administered from with the patient or remotely when the patient and practitioner are in separate locations. Both types of Reiki are based on the premise of a universal source of healing energy that the Reiki practitioner can channel through intention.
For me, this begs the questions:
- If all of this were true, why do we need a study?
- If anyone believes such BS, are they the ideal people to conduct a study of Reiki?
Anyway, we should ask why this study generated a positive result. The most plausible explanation is that, as the study was not blind, the Reiki healers managed to maximise patient expectation. This, in turn, has generated a placebo respose which affected the subjective outcome measures. In other words, Reiki has no specific effect but patients tend to improve because of non-specific effects.
We have discussed the LIGHTNING PROCESS before:
- The ‘Lightning Process’: implausible, unproven, hyped and expensive
- The ‘Lightning Process’ (LP), an effective therapy for ME?
Now, the BBC reports that it is promoted as a treatment of Long-COVID. Oonagh Cousins was offered a free place on a course run by the Lightning Process, which teaches people they can rewire their brains to stop or improve long Covid symptoms quickly. Ms Cousins, who contracted Covid in March 2020, said it “exploits” people.
Ms Cousins had reached a career goal many athletes can only dream of – being selected for the Olympics – when she developed long Covid. By the time the cancelled 2020 Olympic Games in Tokyo were rescheduled for 2021, Ms Cousins was too ill to take part. When she went public with her struggles, she was approached by the Lightning Process. It offered her a free place on a three-day course, which usually costs around £1,000.
“They were trying to suggest that I could think my way out of the symptoms, basically. And I disputed that entirely,” the former rower said. “I had a very clearly physical illness. And I felt that they were blaming my negative thought processes for why I was ill.” She added: “They tried to point out that I had depression or anxiety. And I said ‘I’m not, I’m just very sick’.
In secret recordings by the BBC, coaches can be heard telling patients that almost anyone can recover from long Covid by changing their thoughts, language and actions. Over three days on Zoom, the course taught the ritual that forms the basis of the programme. Every time you experience a symptom or negative thought, you say the word “stop”, make a choice to avoid these symptoms and then do a positive visualisation of a time you felt well. You do this while walking around a piece of paper printed with symbols – a ritual the BBC was told to do as many as 50 times a day.
In some cases the Lightning Process has encouraged participants to increase their activity levels without medical supervision, against official advice – which could make some more unwell, according to NHS guidelines. Lightning Process founder, Dr Phil Parker, who’s not a medical doctor but has a PhD in psychology of health, told us his course was “not a mindset or positive thinking approach,” but one that uses “the brain to influence physiological changes”, backed by peer-reviewed evidence. The coach on the course the BBC attended said “thoughts about your symptoms, your worry about whether it’s ever going to go – that’s what keeps the neurology going. Being in those kind of thoughts is what’s maintaining your symptoms. They’re not caused by a physical thing any more.”
___________________
As I pointed out previously, The Lightning Process (LP) is a therapy based on ideas from osteopathy, life coaching, and neuro-linguistic programming. LP is claimed to work by teaching people to use their brains to “stimulate health-promoting neural pathways”.
LP teaches individuals to recognize when they are stimulating or triggering unhelpful physiological responses and to avoid these, using a set of standardized questions, new language patterns, and physical movements with the aim of improving a more appropriate response to situations.
Proponents of the ‘LP’ in Norway claim that 90% of all ME patients get better after trying it. However, such claims seem to be more than questionable.
- In the Norwegian ME association’s user survey from 2012 with 1,096 participants, 164 ME patients stated that they had tried LP. 21% of these patients experienced improvement or great improvement and 48% got worse or much worse.
- In Norway’s National Research Center in Complementary and Alternative Medicine, NAFKAM’s survey from 2015 amongst 76 patients 8 had a positive effect and 5 got worse or much worse.
- A survey by the Norwegian research foundation, published in the journal Psykologisk, with 660 participants, showed that 62 patients had tried LP, and 5 were very or fairly satisfied with the results.
Such figures reflect the natural history of the condition and are no evidence that the LP works.
Is there any evidence supporting the LP specifically for long COVID?
My Medline search retrieved just one single paper. Here is the abstract:
As a result of the COVID-19 pandemic, Long COVID (LC) is now prevalent in many countries. Little evidence exists regarding how this chronic condition should be treated, but guidelines suggest for most people it can be managed symptomatically in primary care. The Lightning Process is a trademarked positive psychology focused self-management programme which has shown to be effective in reducing fatigue and accompanying symptoms in other chronic conditions including Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. Here we outline its novel application to two patients with LC who both reported improvements in fatigue and a range of physical and emotional symptoms post-treatment and at 3 months follow-up.
Well, that surely convinced everyone! Except me and, of course, anyone else who can think critically.
So, I look further and find this on the company’s website:
Do you know how it feels to…
- …be exhausted and tired no matter how much rest you get?
- …be stuck with re-occurring pain, health symptoms and issues?
- …get so stressed by almost everything?
- …feel low and upset much of the time?
- …want a better life and health but just can’t find anything that works?
If any, or all, of these sound familiar then the Lightning Process, designed by Phil Parker, PhD, could be the answer that you’re looking for. There are lots of ways you can find out more about the suitability of the Lightning Process for you, have a look through below…
___________________________
Let me try to summarise:
- The LP is promoted as a cure for long-Covid.
- There is no evidence that LP is effective for it.
- The claim is that it has been shown to work for ME.
- There is no evidence that LP is effective for it.
- A 3-day course costs £1 000.
- Their website claims it is good for practically everyone.
Does anyone think that LP or its promoters are remotely serious?
We all have heard of so-called alternative therapies but few of us are aware of the fact that there are also alternative diagnoses. These are diagnoses used regularly by practitioners of so-called alternative medicine (SCAM) that have no basis on science, or – to put it simply – that do not exist. They are nonetheless popular with SCAM practitioners and allegedly cause a wide range of non-specific symptoms such as:
- anxiety,
- brain fog,
- constipation,
- depression,
- dizziness,
- fatigue,
- headaches,
- heart palpitations,
- insomnia,
- irritability,
- muscle and joint pain,
- loss of appetite,
- loss of libido,
- weight gain.
In this series of posts, I will briefly discuss some of these diagnoses and list the treatments that SCAM practitioners might recommend for them.
Adrenal Fatigue
Adrenal fatigue is not the same as adrenal insufficiency or Addison’s disease; it is a term coined by a chiropractor who claimed that the stresses of modern life tire out the adrenal glands. In turn, this phenomenon allegedly leads to generalised weariness.
There is not evidence that this is true, nor that adrenal fatigue even exists. A systematic review of the evidence concluded that “there is no substantiation that adrenal fatigue is an actual medical condition.”
Yet, SCAM practitioners advise to cure adrenal fatigue with a range of dietary supplements (e.g. fish oil, ashwagandha, rhodiola rosea, schisandra and holy basil, licorice, magnesium, various vitamins), special diets, lifestyle adjustments, stress management and many other SCAMs. They all have in common that their effectiveness is not supported by convincing evidence from rigorous clinical trials.
Candidiasis hypersensitivity
Most of us are infected by the fungus Candida albicans without being affected by it in any way. Yet, many SCAM practitioners claim that candidiasis hypersensitivity is a condition that causes symptoms like fatigue, premenstrual tension, gastrointestinal symptoms, and depression and therefore needs treating.
But, candidiasis hypersensitivity does not exist. An RCT concluded that, “in women with presumed candidiasis hypersensitivity syndrome, nystatin does not reduce systemic or psychological symptoms significantly more than placebo.”
This, however, does not stop SCAM practitioners to recommend numerous forms of SCAM to treat the condition, e.g.: dietary supplements containing probiotics, milk thistle, red thyme, barberry, garlic, or external applications of coconut oil, essential oils of peppermint oil, lavender oil, oregano oil, and tea tree. No sound evidence exists to show that ant of these SCAMs can successfully treat the condition.
Chronic intoxications
Chronic intoxications do ecist, of course. But in the realm of SCAM, they are diagosed for the sole putpose of selling their various ‘detox’ treatments. The alleged rationale is that our bodies are overloaded with all sorts ot harmful substances, for instance, from the environment, from our food, from modern drugs, or from our own metabolism.
To eliminate them, we need to ‘detox’. For that purpose, SCAM practitioners recommend a very wide range of SCAMs; in fact, it is hardly possible to identify a single form of SCAM that is not said to detoxify our bodies. Yet, for none of them is there compelling evidence that it eliminates toxins from our body. Some of the most popular detox regimen include:
- acupuncture;
- CEASE therapy;
- chelation therapy;
- crystal healing;
- cupping;
- detox diets;
- detox supplements;
- gua sha;
- homeopathy;
- homotoxicology;
- Kombucha;
- oil pulling;
- vaginal steaming.
Interim conclusion: non-existing diagnoses are perfect opportunities for SCAM practitioners to rip off gullible patients.
The aim of this systematic review and network meta-analysis was to identify the optimal dose and modality of exercise for treating major depressive disorder, compared with psychotherapy, antidepressants, and control conditions.
The screening, data extraction, coding, and risk of bias assessment were performed independently and in duplicate. Bayesian arm based, multilevel network meta-analyses were performed for the primary analyses. Quality of the evidence for each arm was graded using the confidence in network meta-analysis (CINeMA) online tool. All randomised trials with exercise arms for participants meeting clinical cut-offs for major depression were included.
A total of 218 unique studies with a total of 495 arms and 14 170 participants were included. Compared with active controls (eg, usual care, placebo tablet), moderate reductions in depression were found for
- walking or jogging,
- strength training,
- mixed aerobic exercises,
- and tai chi or qigong.
The effects of exercise were proportional to the intensity prescribed. Strength training and yoga appeared to be the most acceptable modalities. Results appeared robust to publication bias, but only one study met the Cochrane criteria for low risk of bias. As a result, confidence in accordance with CINeMA was low for walking or jogging and very low for other treatments.
The authors concluded that exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments. Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression. To mitigate expectancy effects, future studies could aim to blind participants and staff. These forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression.
As far as I can see, there are two main problems with these findings:
- Because too many of the studies are less than rigorous, the results are not quite as certain as the conclusions would seem to imply.
- Patients suffering from a major depressive disorder are often unable (too fatigued, demotivated, etc.) to do and/or keep up vigorous excerise over any length of time.
What I find furthermore puzzling is that, on the one hand, the results show that – as one might expect – the effects are proportional to the intensity of the excercise but, on the other hand tai chi and qugong which are both distinctly low-intensity turn out to be effective.
Nonetheless, this excellent paper is undoubtedly good news and offers hope for patients who are in desperate need of effective, safe and economical treatments.
So-called alternative medicine (SCAM) interventions are growing in popularity and are even advocated as treatments for long COVID symptoms. However, comprehensive analysis of current evidence in this setting is still lacking. This study aims to review existing published studies on the use of SCAM interventions for patients experiencing long COVID through a systematic review of randomized controlled trials (RCTs).
A comprehensive electronic literature search was performed in multiple databases and clinical trial registries from September 2019 to January 2023. RCTs evaluating efficacy and safety of SCAM for long COVID were included. Methodological quality of each included trial
was appraised with the Cochrane ‘risk of bias’ tool. A qualitative analysis was conducted due to heterogeneity of included studies.
A total of 14 RCTs with 1195 participants were included in this review. Study findings demonstrated that SCAM interventions could benefit patients with long COVID, especially those suffering from
- neuropsychiatric disorders,
- olfactory dysfunction,
- cognitive impairment,
- fatigue,
- breathlessness,
- mild-to-moderate lung fibrosis.
The main interventions reported were:
- self-administered transcutaneous auricular vagus nerve stimulation,
- neuro-meditation,
- dietary supplements,
- olfactory training,
- aromatherapy,
- inspiratory muscle training,
- concurrent training,
- online breathing programs,
- online well-being programs.
The authors concluded that SCAM interventions may be effective, safe, and acceptable to patients with symptoms of long COVID. However, the findings from this systematic review should be interpreted with caution due to various methodological limitations. More rigorous trials focused on CAM for long COVID are warranted in the future.
Such wishy-washy conclusions seem to be popular in the fantasy land of SCAM. Yet, they are, in my view, most ojectionable because:
- they tell us nothing of value;
- that something “MAY BE EFFECTIVE” has been known before and cannot be the result of but is the reason for a systematic review;
- a review of 14 RCTs of almost as many interventions cannot possibly tell us anything about the SAFETY of these treatments;
- it also does not provide evidence of effectiveness and merely indicates a lack of independent replications;
- if the abstract mentions an assessment of the study rigor, one expects that it also informs us about this important aspect.
Once we do come around looking at the methodological quality of the primary studies we realize that it is mostly miserable. This means that the conclusions of the review are not just irritating but plainly misleading. Responsible researchers should have concluded along the following lines:
The quantity and the quality of the evidence are both low. Therefore, the effectiveness and safety of SCAM interventions for long COVID remains unproven.
PS
This project was financially supported by The HEAD Foundation, Singapore and in part by the grant from the NIH R61 AT01218.
Shame on the authors, journal editors, peer-reviewers, and funders of this dangerous nonsense!
Guest post by Ken McLeod
Readers will recall that Barbara O’Neill is an Australian health crank, completely unqualified in anything, who is subject of a Permanent Prohibition Order issued by the New South Wales Health Care Complaints Commission, (HCCC),[1] preventing her from engaging in any health-related activity, including ‘health education,’ in Australia. The NSW Public Health Act 2010 provides that it is an offence for a person to provide ‘health education’ in contravention of a prohibition order, with a fine of $60,500 AUD ($38,151 USD, 36251 Euros) for an individual or imprisonment for 3 years, or both, or $121,000 AUD for a corporation.
For jurisdictional reasons that Order does not apply outside Australia and for several years she been touring the world giving health education lectures. The latest was a lecture tour of Ireland.[2] Despite the thorough debunking of her fruitloop beliefs by the HCCC,[3] she has maintained them and continues to give the ‘health education’ that was so dangerous that it led to the Prohibition Order in Australia.
Her Irish ‘health education’ lectures were live-streamed to people in Australia who paid the 20 Euro fee, and one was recorded by us.[4]
A transcript was made and is available online.[5] Her statements were analysed and some comments are made as follows. Alas, we didn’t have time to take a deep dive of her lecture to find the best references, but the following shows that an amateur with limited time and resources can prove that she does not know what she is talking about and that her advice is dangerous, even life-threatening.
It is up to the health regulators and immigration authorities in each country to act on her activities there, but so far none outside Australia have done so.
So a quick analysis of her ‘lecture’ in Dublin on 27 September 2023 shows that O’Neill has learned nothing from her experience with the HCCC. Some comments:
1. O’Neill and her husband, after the Prohibition Order was issued, changed the name of their facility from ‘Misty Mountain Health Retreat’ to ‘Misty Mountain Lifestyle Retreat’ to avoid the jurisdiction of the HCCC. However on four occasions in her lecture O’Neill referred to it as a ‘health retreat.’ 00:07:23 , 00:15:48, 01:30:04, 01:40:16.
2. At 00:12:53 O’Neill claims that the Amish don’t get autism. That is false, as explained by AP Factcheck. [6]
3. At 00:12:54 O’Neill claims that the Amish, ‘They don’t vaccinate their Children. Did you know that they don’t vaccinate their Children and yet they don’t get autism Very rare. Maybe 1%. And often that’s because of chemical exposure. There is always a reason. So why are vaccinations causing autism? Well, it’s neurotoxins, the neurotoxins. ‘
False; Amish do vaccinate their children. [7] However, studies have documented cases of autism, diabetes and cancer among the Amish, albeit at lower rates in some cases than the broader population and for reasons that are unrelated to their vaccination status. These reasons include the cultural norms and customs that may be playing a role in the reporting style of caregivers. [8] O’Neill is engaging in cherry-picking on a grand scale here.
4. At 00:13:37 O’Neill claims that ‘there are still two more neurotoxins’ (In vaccines.) Because children are still autistic. There’s formaldehyde, and there is aluminium, both neurotoxins.’
This is scaremongering disinformation. The CDC says ‘Formaldehyde is diluted during the vaccine manufacturing process, but residual quantities of formaldehyde may be found in some current vaccines. The amount of formaldehyde present in some vaccines is so small compared to the concentration that occurs naturally in the body that it does not pose a safety concern.’ As for aluminium, the CDC says ‘Ingredients like aluminum salt help boost the body’s response to the vaccine.’ The CDC says that both are safe. [9]
5. At 00:15:01 O’Neill claims ‘did you know that the milk in the supermarket if you give that to a newborn baby cow, that cow will die?’
I can find no reference supporting that and I suggest that it is pure fantasy.
6. At 00:18:29 O’Neill claims that ‘parents discover that they put their trust in the princes and vaccinated their child. Now their child has epilepsy. Now their child has autism.’
This is misleading panic-mongering that is a misrepresentation of the science. The Royal Australian College of General Practitioners says ‘Seizures and status epilepticus can occur within 14 days following administration of inactivated and live-attenuated vaccines. These vaccine-proximate seizures can undermine parental confidence in vaccine safety and affect further vaccination decisions. Vaccine-proximate status epilepticus (VP-SE) is uncommon but may be the first manifestation of genetic developmental epileptic encephalopathies, including Dravet syndrome.’ So ‘epilepsy’ may be first encountered [10] following vaccination but the root cause is genetic.
7. At 00:20:27 O’Neill says that she would like to suggest that no child would be vaccinated, because the fact is, our body was designed to heal itself.
This is pure crazy antivax propaganda, unsupported by the facts.
8. At 00:22:01 O’Neill claims ‘skin cancer has only been around in about the last 80 years, and you know what they’re finding today? That vitamin D deficiency is a big contributing back factor to skin cancer’.
The first claim is false; the science shows that skin cancers have been around ‘since the beginning of time.’ [11]
As for the second claim, the research published at the US National Library of Medicine shows that O’Neill’s advice is dangerous. ‘It is, therefore, preferable and safer to obtain adequate levels of vitamin D through diet than through sun exposure. In fact, it is currently accepted that dietary and supplemental vitamin D is functionally identical to that produced after UV exposure, being more reliable and quantifiable (the risks of keeping high levels of vitamin D have not been extensively studied) source of this vitamin.’ And ‘Neither natural nor artificial sun exposure should be encouraged as the main source of vitamin D.’ [12]
9. At 00:23:18 O’Neill disputes claims that ‘cholesterol causes heart disease. Well, it’s been going for 40 years now, and it still hasn’t proven that. But you know what? It has proven that people with high cholesterol levels don’t get Alzheimer’s.’
O’Neill’s first claim points to the conflicting research as revealed by the Cochrane Collaboration. [13] As for her second claim, the research does not justify her claim that it is ’proven.’ The evidence is conflicting and as the Alzheimer’s Society of the UK say, ‘More research is needed to better understand this relationship and what it can tell us.’ [14] O’Neill’s conviction is not based on evidence.
10. At 00:34:41 O’Neill said that at Dublin airport ‘about 10 days ago,’ she was approached by a man who asked ‘Are you the Australian doctor? And I smiled.’
O’Neill did not correct him and allowed him to be duped into believing she is a real doctor. Despite having no qualifications in anything O’Neill has used the honorific title ‘Dr’ many times in social media,[15] so it is no surprise that he assumed she was a doctor. I can’t help but be confused by her use of the ‘Dr.’ Throughout her lectures she denigrates real doctors, and then tries to boost her credibility by adopting the title.
11. At 00:35:21 she claimed that with ‘epigenetics, you can actually turn your genes on or off.’…. ‘So Michael effectively turned those genes off with castor oil. Castor is very effective for for cataracts. Put it in your eye, one lady said. Is it safe? Does anyone ever ask that of the doctor? Is that drug safe? Then the people have been putting cholesterol in their eyes for centuries. It’s safe.’
Bollocks! As Consumer Lab says ‘Although eye drops containing castor oil may help improve symptoms of dry eye and blepharitis, there is currently no compelling evidence that applying castor oil to the eye can diminish cataracts.’ [16] And there is no evidence that Michael turned the genes off.
12. At 00:40:08 she refers to a woman who recently had a stroke. She says
‘… because she had a stroke, she was put on the protocol she was on put on statins. Cholesterol lowering medication with clear arteries. How much sense does that make? You don’t have. You don’t have to be a rocket scientist to work this out. Trust in your gut feeling trust in this incredible body that God has given you. Her blood was no longer thick. Her arteries are open now. And so she came to our retreat and I said, Well, I can’t tell you what to do. And I have no authority over your medication. Only you, and go. You and your doctor do. But this is what I would do. I would stop the blood thinning medication immediately because that aspirin causes brain bleeds, eye bleeds and stomach bleeds. Got that? And I would stop the statin drugs because that the side effect of statin drugs is Alzheimer’s dementia, uh, memory loss, muscle wasting. And they’ve just added another one, which is breast cancer, because all our sex hormones are made from cholesterols.’
O’Neill told a woman who had suffered a stroke to stop taking her life-saving medication! These medications are prescribed by highly qualified medical specialists based on the research. As the UK Stroke Association says, ‘Blood-thinning medications reduce your risk of stroke by helping to prevent blood clots from forming. You might be prescribed them after a transient ischaemic attack (TIA) or a stroke caused by a blockage (an ischaemic stroke, or clot).’[17] It is clear that O’Neill, who has no qualifications in anything, does not know what she is talking about.
As for her claim that the side effects of statins is breast cancer, the research shows the opposite. ‘While statins do not affect the incidence of most cancers, they do exert significant benefits on recurrence and survival in many cancer types, including breast cancer.’ [18]
13. At 42:48 O’Neill claims ‘If you are on cholesterol lowering medication and many have been deceived….’ As above, it is O’Neill who is doing the deceiving.
14. At 45:09 O’Neill claims that ‘If you stop your cholesterol lowering medication, there will be a side effect. Your memory will return. Your muscles will get stronger. Any little appearances of Alzheimer’s will start to ease.’
As above, the available research does not show that.
15. At 48:57 O’Neill claims ‘Why did they put fluoride in water? The claim was to harden the teeth. Has it hardened the teeth? Not at all. Has it reduced tooth decay? Not at all.’ And ‘But that fluoride is very hard on the kidneys, very hard on the liver.’
The research here is overwhelming; as the CDC says: ‘The CDC named community water fluoridation one of 10 great public health achievements of the 20th century.
‘Many research studies have proven the safety and benefits of fluoridated water. For 75 years people in the United States have been drinking water with added fluoride and enjoying the benefits of better dental health.
‘Drinking fluoridated water keeps teeth strong and reduces cavities (also called tooth decay) by about 25% in children and adults.’
As for O’Neill’s claim that fluoride is very hard on the kidneys, very hard on the liver,’ the research is inconclusive, and in fact the reverse may be true. Research shows ‘Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.’ So the science does not support O’Neill’s certainty.
16. At 48:57 O’Neill claims that ‘all body symptoms and body diseases and shows how dehydrating has a huge factor.’ O’Neill gives no evidence to support that huge claim.
17. At 01:00:20 O’Neill claims that a woman told her ‘I had the vaccine. Now I’ve got clots. Barbara, I had the vaccine. I can’t. I cannot even remember all the diseases that are arising. Have you noticed? And so many people were blackmailed into that vaccine.’ And ‘Is that (COVID19) a crisis? it’s not a crisis at all. And yet we’re seeing so many problems arising.’
O’Neill is dreadfully wrong here. COVID 19 was a crisis. How else would we describe a pandemic that is known to have killed at least 6,961,014 deaths, as reported to the WHO? [19] And what are the problems that we are seeing arising? Outside her imagination, that is.
18. At 01:00:20 O’Neill claims that ‘one man said, Show me the safety studies. They gave him three pages of blank paper. No safety studies, no safety studies at all.’ (On vaccines). And ‘drugs never cure disease.’ And a few lines later, again, ‘Drugs never cure disease.’
The allegation that ‘They (doctors) gave him three pages of blank paper’, is just so deranged. No doctor would do that because there are thousands of studies of vaccine safety.
O’Neill’s claim that there are no safety studies on vaccines is hopelessly wrong and dishonest. It’s one of the many anti-vax lies circulating on the internet, so beloved by the gullible. As the Australian Dept of Health and Aged Care say, ‘Research and testing is an essential part of developing safe and effective vaccines. In Australia, every vaccine must pass strict safety testing before the Therapeutic Goods Administration (TGA) will register it for use. Before vaccines become available to the public, they are tested on thousands of people who take part in large clinical trials.’ [20] It took me a few seconds on the internet to find an interesting research paper on HPV vaccines, including a section on safety. [21] O’Neill could do that so the inevitable conclusion is that she set out to deceive. As for ‘drugs never cure disease,’ that is so bizarre, so whacky, so deluded, that it almost not worth challenging. But I will anyway; medical professionals have seen drugs work billions of times, and I can testify that I was saved from a life-threatening illness due to cephalexin.
19. At 01:10:49 O’Neill claims ‘some (medications) can be stopped immediately, like your statin drugs and your blood thinners. Yeah, what do you take instead of statin drugs? Well, there’s no need, because cholesterol is not a problem.’
O’Neill’s advice here is life-threatening rubbish. As the Mayo Clinic says ‘Abruptly stopping an anticoagulant can increase your risk of a stroke.’ [22] As for her advice on cholesterol, see above.
20. At 01:15:39 O’Neill claims that there was ‘No diabetes on the planet til sugar was well established.’ And lack of nose-breathing causes ‘Chronic fatigue syndrome. There’s one cause; it’s lack of oxygen at the cellular level.’
Humans have gathered sugar since we first became homo sapiens and diabetes has always been a problem for us and other animals.
As for her claim that lack of nose-breathing causes ‘Chronic fatigue syndrome;’ the Mayo Clinic says ‘The cause of ME/CFS is unknown, although there are many theories. Experts believe it might be triggered by a combination of factors.’ They go on to list many possible causes but lack of nose-breathing is not one of them.[23]
21. At 01:26:08 O’Neill claims that a researcher ‘…. could turn cancer cells on and off by the amount of animal, pro and animal protein that he was giving’ and liver cancer could be prevented by ‘a simple diet and cancer weights were very low low compared to the city again, with that high meat diet….’ There is some truth in this, but it does not justify O’Neill’s other advice to avoid prescribed medications.
22. At 01:49:26 O’Neill claims ‘if someone has a rash and they put cortisone on it, what happens to the rash? It’s gone, but But it comes back in about another week. Is that right? Twice as bad.’ And ‘No drug can heal cancer. The body and the body alone when it’s given the right conditions can cause cancer to be conquered in the body.’ And ‘A fever is nothing to fear.’
O’Neill’s claim that ‘No drug can heal cancer’ is demonstrably wrong. Life expectancy following cancer treatment has improved vastly over the decades, largely due to better detection and prescribed medications. As the US National Cancer Institute (NCI) estimates, ‘due to improved detection and treatment, deaths have dropped 41 percent from 1989 to 2018, according to the ACS.’ [24]
As for O’Neill’s claim that ‘a fever is nothing to fear,’ the Victorian Dept of Health says ‘High fever (about 41.5°C or more) is extremely dangerous and could trigger convulsions.’ [25]
23. At 01:53:47 O’Neill claims that drug therapy is not working.
What does O’Neill mean by that? Does she mean that prescribed medication does not work? If she is repeating her earlier claim that ‘drugs never cure disease?’ I repeat my earlier rebuttal. That is so bizarre, so whacky, so deluded, that it almost not worth challenging. But I will anyway; medical professionals have seen drugs work billions of times, and I can testify that I was saved from a life-threatening illness due to cephalexin.
I’ll finish the analysis here because you have suffered enough.
Readers everywhere now have rock-solid evidence that should be presented to their national health regulators, showing that O’Neill, as the HCCC put it, ‘poses a risk to the health and safety of members of the public’ and therefore ‘should be permanently prohibited from providing any health services, whether in a paid or voluntary capacity.’ And you have rock-solid evidence that should be presented to venue managers who have allowed O’Neill to present life-threatening ‘education’ to the public on their premises, asking them to cancel the booking. It’s not hard; it was done in Ireland by members of the public. That led to cancellation of the booking, and a rush by O’Neill’s supporters to find a new venue.
References
1 https://www.hccc.nsw.gov.au/decisions-orders/public-statements-and-warnings/public-statement-and-statement-of-decision-in-relation-to-in-relation-to-mrs-barbara-o-neill
2 https://www.independent.ie/irish-news/controversial-wellness-coach-barbara-oneill-set-to-host-talk-in-ireland-this-month/a1781099169.html
3 https://www.hccc.nsw.gov.au/ArticleDocuments/216/Statement%20of%20Decision%20-%20Mrs%20Barbara%20ONeill.pdf.aspx
4 The video is available at https://rumble.com/v3lt611-barbara-oneill-positive-life-event-27th-september.html and a backup is available at https://www.dropbox.com/scl/fi/vqe9plhgjijunvl22kvb6/Barbara-ONeill-Positive-Life-Event-27th-September.mp4?rlkey=1kjyi9jdl8kfdp8kcdf1p4xba&dl=0
5 https://www.dropbox.com/scl/fi/csl95hg7gomr318nygotx/TRANSCRIPT-BARBARA-O-NEILL-POSITIVE-LIFE-EVENT-DUBLIN-27-SEPT-2023.pdf?rlkey=z2d5uh59fwagzdfdk30hvpauy&dl=0
6 https://apnews.com/article/fact-check-amish-covid-vaccines-cancer-diabetes-autism-356029928165
7 https://apnews.com/article/fact-check-amish-covid-vaccines-cancer-diabetes-autism-356029928165
8https://www.researchgate.net/publication/268144514_Prevalence_Rates_of_Autism_Spectrum_Disorders_Among_the_Old_Order_Amish
9 https://www.cdc.gov/vaccines/vac-gen/additives.htm
10 https://www1.racgp.org.au/ajgp/2020/october/seizures-following-vaccination-in-children
11 https://www.usatoday.com/story/news/factcheck/2023/08/03/false-claim-skin-cancer-has-only-been-around-for-60-years-fact-check/70515019007/
12 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709188/
13 https://s4be.cochrane.org/blog/2018/07/02/cholesterol-and-heart-disease-whats-the-evidence/
14 https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/cholesterol-and-dementia
15 https://www.facebook.com/people/Dr-Barbara-ONeill/100093111507726/
16 https://www.consumerlab.com/answers/castor-oil-eye-drops-for-cataracts/castor-oil-cataracts/
17 https://www.stroke.org.uk/resources/blood-thinning-medication-and-stroke
18 https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-018-1066-z#author-information
19 https://covid19.who.int/
20 https://www.health.gov.au/are-vaccines-safe
21 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565290/
22 https://connect.mayoclinic.org/blog/take-charge-healthy-aging/newsfeed-post/know-the-warning-signs-of-blood-thinner-complications/
23 https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490
24 https://www.healthline.com/health/breast-cancer/survival-facts-statistics#breast-cancer-stages
25 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fever#bhc-content
