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

fraud

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If you go on Twitter you will find that chiropractors are keen like mustard to promote the idea that, after a car accident, you should consult a chiropractor. Here is just one Tweet that might stand for hundreds, perhaps even thousands:

Recovering from a car accident? If you have accident-related injuries such as whiplash, chiropractic care may provide relief. Treatments like spinal manipulation and soft tissue therapy can aid in your recovery.

In case you don’t like Twitter, you could also go on the Internet where you find hundreds of websites that promote the same idea. Here are just two examples:

A frequent injury arising from an automobile accident … is whiplash. After an accident, a chiropractor can help treat resulting issues and pain from the whiplash… Proceeding reduction in swelling and pain, treatment will then focus on manipulation of the spine and other areas.

The primary whiplash treatment for joint dysfunction, spinal manipulation involves the chiropractor gently moving the involved joint into the direction in which it is restricted.

There is no question, chiropractors earn much of their living by treating patients suffering from whiplash (neck injury caused by sudden back and forth movement of the neck often causing neck pain and stiffness, shoulder pain, and headache) after a car accident with spinal manipulation.

Why?

There are two not mutually exclusive possibilities:

  1. They think it is effective.
  2. It brings in good money.

I have no doubt about the latter notion, yet I think we should question the first. Is there really good evidence that chiropractic manipulations are effective for whiplash?

When I was head of the PMR department at the University of Vienna, treating whiplash was my team’s daily bread. At the time, our strategy was to treat each patient according to the whiplash stage and to his/her individual signs and symptoms. Manipulations were generally considered to be contra-indicated. But that was about 30 years ago. Perhaps the evidence has now changed. Perhaps manipulation therapy has been shown to be effective for certain types of whiplash injuries?

To find out, I did a few Medline searches. These did, however, not locate compelling evidence for spinal manipulation as a treatment of any stage of whiplash injuries. Here is an example of the evidence I found:

In 2008, the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force) found limited evidence on the effectiveness of manual therapies, passive physical modalities, or acupuncture for the management of whiplash-associated disorders (WAD) or neck pain and associated disorders (NAD). This review aimed to update the findings of the Neck Pain Task Force, which examined the effectiveness of manual therapies, passive physical modalities, and acupuncture for the management of WAD or NAD. Its findings show the following: Evidence from 15 evaluation studies suggests that for recent neck pain and associated disorders grades I-II, cervical and thoracic manipulation provides no additional benefit to high-dose supervised exercises.

But this is most puzzling!

Why do chiropractors promote their manipulations for whiplash, if there is no compelling evidence that it does more good than harm? Again, there are two possibilities:

  1. They erroneously believe it to be effective.
  2. They don’t care but are in it purely for the money.

Whatever it is – and obviously not all chiropractors would have the same reason – I must point out that, in both cases, they behave unethically. Not being informed about the evidence related to the interventions used clearly violates healthcare ethics, and so does financially not informing and exploiting patients.

 

It has been reported that the US Insurer ‘State Farm’ is fighting a fraudulent scheme that has been exploiting New Jersey’s personal injury protection (PIP) benefits law since 2014. The insurer is seeking to recover $2.6 million in what it claims are fraudulent auto injury claims and a declaratory judgment that it need not pay any further claims submitted by the providers involved in the alleged scheme.

State Farm’s suit accuses 12 chiropractic and spine clinics and doctors of fraud, unjust enrichment, and violations of the New Jersey Insurance Fraud Prevention Act. The insurer alleges these providers used a “predetermined protocol” for all patients and a patient referral system for services that were either not performed or were not medically necessary for the individual patients. Instead, the services were carried out to enrich the defendants by exploiting the patients’ eligibility for PIP benefits, according to the complaint.

The suit accuses the providers of failing to legitimately evaluate patients to determine the true nature of their injuries and of reporting the same or similar findings for all patients to justify a predetermined course of treatment that was substantially the same for all patients. Part of the “predetermined protocol” for patients with soft-tissue injuries of the neck and back consisted of

  • hot and cold packs,
  • chiropractic manipulations,
  • massage,
  • mechanical traction,
  • physical medicine and rehabilitation,
  • and manual therapy.

These treatments were administered to almost every patient on almost every visit, regardless of each patient’s unique circumstances and needs, according to the complaint. The chiropractors are also accused of referring patients to diagnostic clinics, some allegedly illegally owned by the chiropractors, for an “unnecessary and predetermined course of pain management and invasive treatments” including injections. State Farm says they would submit false documentation for each case representing that the treatments were legitimately performed and medically necessary.

The 80-page complaint details case after case where the patient’s responses to questions and tests were the same or similar, allegedly serving as a “pretext to justify” the chiropractors’ wide range of treatments. The defendants in the complaint filed in U.S. District Court for New Jersey are:

  • Tri-County Chiropractic and Rehabilitation Center,
  • Robert Matturro, D.C.,
  • Advanced Spine and Pain Management,
  • Varinder Dhillon, M.D.,
  • Nicholas Rosania, D.C.,
  • Bloomfield UAI,
  • Dov Rand, M.D.,
  • Primary Medical Services,
  • Louis J. Citarelli, M.D.,
  • Chiro Health Center P.C.,
  • Marc Matturro, D.C.
  • Marco Tartaglia, M.D.

_____________________________

This story made me wonder: which of the listed treatments

  • hot and cold packs,
  • chiropractic manipulations,
  • massage,
  • mechanical traction,
  • physical medicine and rehabilitation,
  • and manual therapy

would ever be indicated for patients with soft-tissue injuries of the neck and back? Or more specifically, are chiropractic manipulations indicated or contra-indicated for such problems following a car accident? I fail to see any sound evidence that they are effective. If I am correct, should insurance companies not sue all chiropractors who routinely use manipulations for such cases? If the answer is YES, the sum of 2.6 million might need to be increased by several orders of magnitude.

All healthcare professionals have an ethical obligation to be truthful and act in the best interest of the patient by adhering to the best available evidence. Providing false or misleading information to patients or consumers is thus a breach of medical ethics. In Canada, the authorities have started taking action against nurses that violate these ethical principles.

Now it has been reported that a former registered nurse in West Kelowna has been suspended for four weeks after giving a vulnerable client anti-vaccine information and recommending “alternative pseudoscience” treatments.

According to the terms of a consent agreement posted on the B.C. College of Nurses and Midwives site, Carole Garfield was under investigation for actions that happened in September 2021. The college claims that Garfield contacted the client when she was off duty, using her personal mobile phone and email to give information against the COVID-19 vaccine and recommending so-called alternative medicine (SCAM). The exact nature of the “pseudoscience modalities” Garfield recommended to the client was not listed in the college’s notice.

Garfield’s nursing licence was cancelled back in April, according to the college’s registry. It’s unclear how exactly the four-week suspension will be applied. In addition to her month-long suspension and a public reprimand, Garfield is not allowed to be the sole nurse on duty for six months. She will also be given education about ethics, boundaries, and client confidentiality, as well as the province’s professional nursing standards. “The inquiry committee is satisfied that the terms will protect the public,” read a statement from the college.

In my view, it is high time for professional bodies to act against healthcare professionals who issue misleading information to their patients. In the realm of so-called alternative medicine (SCAM), issuing false or misleading information is extremely common and causes untold harm. Such harm would be largely preventable if the professional bodies in charge would start acting responsibly in the best interest of patients. It is high time that they follow the Canadian example!

The Center for Inquiry (CFI) is a charitable nonprofit organization dedicated to defending science and critical thinking. CFI’s vision is a world in which evidence, science, and compassion—rather than superstition, pseudoscience, or prejudice—guide public policy.

It has been reported that the CFI, through its Office of Consumer Protection from Pseudoscience, warned Amazon.com that the marketing and sale of unapproved homeopathic drugs betrays consumers’ trust and runs afoul of federal law. In a letter sent to the world’s largest online retailer, attorneys for CFI charged that Amazon has legal and moral obligations to end its trade in the prohibited items and urged the company to immediately cease the sale of unapproved drugs marketed as medicine for babies, infants, and children.

In Amazon’s Health Care Products department, a search for “homeopathic” returns more than 10,000 product results–each claiming to treat a host of health issues, ranging from “nerve pain” and “fever” to “surgical wounds” and “fibroids and ovarian cysts.” Marketed with names such as “Boiron RhinAllergy Kids” and “Hyland’s 4Kids Pain Relief,” many items are explicitly sold as medicine for children. However, not one homeopathic drug has been approved by the Food and Drug Administration (FDA) as required by the federal Food, Drug & Cosmetic Act.

“Amazon built its business and public reputation on assurances it prioritizes consumer trust above all else,” says CFI Vice President and General Counsel Nick Little. “It’s impossible to be ‘Earth’s most customer-centric company’ while aggressively promoting thousands of snake oil products to parents. If Amazon truly wants to put its customers first, the company should be protecting them from sellers of sham treatments and faux medicine, not profiting from it.”

The FDA recently issued a warning letter to Amazon over the platform’s prohibited sale of mole and skin tag removal products that lack FDA approval. CFI makes clear that the same prohibitions apply to homeopathic drugs sold on Amazon.com. The letter also highlights deceptive marketing practices used to sell the products, noting that the industry’s own figures found 85 percent of those who purchased a brand of homeopathic product were not aware the item was actually homeopathic.

“Amazon recently announced partnerships to help crack-down on phony wrestling memorabilia,” Little notes. “We think protecting children against harmful homeopathic drugs is a bit more deserving of the company’s attention and hope Amazon accepts our offer to help identify these particularly problematic products for removal.”

You can read CFI’s letter to Amazon here.

Guest post by Ken McLeod

On 07 June 2022, we published an article warning readers of the planned visit to the UK of health crank Barbara O’Neill, ‘A residential health programme that poses “a risk to the health and safety of members of the public.” ‘ We referred to the Prohibition Order that the New South Wales Health Care Complaints Commission has imposed on her:

‘The Commission is satisfied that Mrs O’Neill poses a risk to the health and safety of members of the public and therefore makes the following prohibition order:

Mrs O’Neill is permanently prohibited from providing any health services, as defined in s4 Of the Health Care Complaints Act 1993, whether in a paid or voluntary capacity.’

We showed that O’Neill remains undaunted by such mere technicalities and continues to spruik her nostrums and misinformation, such as that planned for Manna House, Stoke-on-Trent.

One reader did a little bit of digging into O’Neill’s lectures and found something that should alarm anyone; her advocacy of asbestosform Yoni Stones for ‘Balancing Your Hormones.’

So what are ‘Yoni Stones?’ and ‘Why should we be worried?’ we hear you ask. Good questions, so here we go.

0. BACKGROUND:

According to promoters in alternative health industries, ‘Yoni stones,’ also known as ‘Yoni Eggs’ are ‘semi – precious stones carved into the shape of eggs that can be inserted into a woman’s womb space for vaginal wall tightening and energetic cleansing. Yoni Eggs have been used for many decades by the most in-tuned women who know that keeping good vaginal wellness is keeping universal wellness. The more in-tuned a woman is in her femininity the better all her relations will be.’ 1

1. PROMOTION AND SALE:

The following are examples of the promotion and sale of Yoni stones and showing how wrong and dangerous they are.

1.1 ‘La Loba’

A Google search found hundreds of retailers selling them, such as ‘La Loba’ 2 whose website does do not give an address, but are located on the Gold Coast Australia. La Loba sells nephrite jade eggs like this:

La Loba claim that ‘GIA certified means that it’s certified by the Gemological institute of America to be that specific stone. So you know it’s a real stone that is high quality.’ La Loba makes several claims of therapeutic benefit, like:

‘Yoni Eggs Physical Benefits Pelvic Floor Health Assists with incontinence Increases lubrication Builds sensitivity Helps improve Libido Can be used to prepare for childbirth and to heal post childbirth Helps to prevent and improve prolapse Balances hormones by increasing blood flow to the Yoni Increases orgasmic pleasure for yourself and your partner Spiritual Benefits Healing properties of the chosen crystal are absorbed Builds connection with your Yoni Helps one work through any trauma/stagnant energy held… ‘

 

Despite the claims of therapeutic benefits, ‘La Loba’ did not display any regulatory approval from the Australian Therapeutic Goods Administration or US Federal Drug Administration, so we can take it as read that Yoni Stones have not been assessed for safety.

1.2 Barbara O’Neill

The most prominent promoter of Yoni Stones is Barbara O’Neill, of Misty Mountain Lifestyle Retreat, of Bellbrook, New South Wales.

The internet, especially YouTube, is alive with hundreds of her videos promoting all sorts of quackery, but today we can limit ourselves to the dozens of videos in which she promotes Yoni Stones, such as the video of Barbara O’Neill conducting a lecture at Living Springs Alabama, USA. This video 5 ‘Balancing Your Hormones’ has been viewed 43,636 times since it was first published on 3 May 2022.

From the video:

In that video, Barbara O’Neill makes claims that are of concern. From the transcript,6 at 00:44:31, she recommends ‘Yoni Stones,’ and at 00:44:44 ‘… ideally, they’re made out of nephrite.’ (See the above screencap of her whiteboard presentation, bottom left-hand corner.) In the transcript she advises that women should insert them daily for several hours at a time over several months, even years. O’Neill describes Yoni Stones at 00:44:35 in the transcript: “The Chinese dynasty developed Yoni stones to help the young concubines be sexually toned for the emperor. But they’re very popular today, and ideally, they’re made out of nephrite. Jade nephrite. Jade is like a green marble. The nephrite jade is heavy and as you’ll see why that’s important in a minute. But it’s also a smooth marble, so there are no crevices.”

There are several falsehoods in this:

1.2.1 There were many dynasties in Imperial China, but none of them were named ‘The Chinese Dynasty.’

1.2.2 No Imperial Chinese dynasty developed Yoni Stones. It’s marketing hype designed to dupe the gullible. Obstetrician -Gynaecologist Dr Jennifer Gunter 7 and archaeologist Professor Sarah Parcak 8 researched that claim by conducting a search of the online databases of four major Chinese art and archaeology collections in the United States. They identified more than 5000 jade objects viewable in online databases. They found that no vaginal jade eggs were identified, and concluded that:

“No evidence was found to support the claim that vaginal jade eggs were used for any indication in ancient Chinese culture.” 9

1.2.3 As for O’Neill’s claim that there are no crevices and are therefore safe, O’Neill says in the transcript at 00:45:13 ‘….There are two holes in the bottom (of the Yoni Stone) so that a woman can insert dental floss for easy extraction….’ So crevices are out but holes are OK?

The Cleveland Health Clinic published an article 10 on July 30, 2021, by Obstetrician – Gynaecologist Dr Suchetha Kshettry, MD, ‘Think Twice Before Putting a Yoni Egg in Your Vagina. She says that ‘Gemstones like jade and onyx are semi-porous, which means there’s space for bacteria to take up residence within them. Semi-porous materials are difficult to fully clean, too, meaning that bacteria may stick around and fester.’ She listed the following hazards:

Ø Persistent bacterial infections;

Ø Irritation, scratches, tears;

Ø Damage to pelvic floor muscles; Ø toxic shock syndrome that can lead to serious health issues and even death.

Dr Kshettry makes it clear that there is no benefit.

That is supported by Obstetrician -Gynaecologist Dr Jennifer Gunter, who has written that Yoni stones do not balance hormones and have all the risks that Dr Kshettry listed above. 11

Further, California officials prosecuted Gwyneth Paltrow and her company Goop for making the same claims as O’Neill. In an out-of-court settlement, Paltrow’s company agreed to pay $US145,000 ($202,000) in civil penalties. 12

1.2.4. More concerning, nephrite jade is notorious as a dangerous asbestiform prismatic tremolite, a mineral composed of microcrystalline tremolite asbestos. Nephrite is a variety of the calcium, magnesium, and iron-rich amphibole minerals tremolite or actinolite, aggregates of which also make up one form of asbestos. The chemical formula for nephrite is Ca2(Mg, Fe)5Si8O22(OH)2. It is one of two different mineral species called jade. In layman’s terms it is ‘asbestos’ and we would think that it is therefore carcinogenic. Strangely enough, while there is plenty of research on the consequences of inhaling asbestos, there seems to be little or no research on the consequences of inserting it into vaginas.

That may be because scientists thought that it was not a productive area of research because they thought nobody would be stupid enough to do that. (How wrong they were.) Nevertheless, in the absence of definitive research showing that inserting asbestos into vaginas is perfectly safe, promoting that is incredibly irresponsible.

All we could find on the subject was the limited research which examined the dangers to people shaping nephrite jade asbestos:

1.2.4.1. Yang HY, Shie RH, Chen PC. Carving of non-asbestiform tremolite and the risk of lung cancer: a follow-up mortality study in a historical nephrite processing cohort. Occup Environ Med. 2013 Dec;70(12):852-7. doi: 10.1136/oemed-2013-101404. Epub 2013 Sep 18. PMID: 24142973; PMCID: PMC3841744. 13

1.2.4.1.1. The researchers found that nephrite processing led to a significantly increased risk of lung cancer.

1.2.4.2. Bailey et al, ‘The Asbestiform and Prismatic Mineral Growth Habit and Their Relationship to Cancer Studies – A Pictorial Presentation.’ 14

If anyone can find research on the effects of inserting asbestos-form Yoni Stones into vaginas, please let us know in the comments.

2. CONCLUSIONS:

2.1 As if the risks of persistent bacterial infections, irritation, scratches, tears, damage to pelvic floor muscles, toxic shock syndrome, serious health issues and death were not bad enough, Barbara O’Neill’s and other health gurus’ and retailers’ recommendations to insert asbestos stones into vaginas for extended lengths of time is reckless and dangerous. And there is no therapeutic benefit in the use of Yoni Stones.

But that’s Standard Operating Procedure in Alt-Med, so that’s all right then.

So what would health regulators make of this? Should they issue a Public Warning to all users, processors, manufacturers, importers and retailers? Watch this space.

1 https://www.yonieggs.com/

2 https://laloba.com.au/collections/yoni-eggs

3 https://laloba.com.au/collections/yoni-eggs/products/nephrite-jade-eggs?_pos=1&_sid=ab4fad37e&_ss=r

4 https://laloba.com.au/blogs/resources

5https://www.youtube.com/watch?v=z7uATPC-7CY. A backup copy is available on request.

6 Transcript is available at https://www.dropbox.com/s/gwdncg5iwx3a31g/Balancing%20Your%20Hormones%20-%20Barbara%20O%27Neill-%203%20May%202022.mp4-transcript%20%281%29.docx?dl=0

7 https://en.wikipedia.org/wiki/Jen_Gunter

8 https://en.wikipedia.org/wiki/Sarah_Parcak

9 “Vaginal Jade Eggs: Ancient Chinese Practice or Modern Marketing Myth?” Gunter, Jennifer MD*; Parcak, Sarah PhD, Female Pelvic Medicine & Reconstructive Surgery: 1/2 2019 – Volume 25 – Issue 1 – p 1-2, published in Urogynecology – Official Journal of the American Urogynecologic Society. https://journals.lww.com/fpmrs/Abstract/2019/01000/Vaginal_Jade_Eggs__Ancient_Chinese_Practice_or.1.aspx

10 https://health.clevelandclinic.org/are-yoni-eggs-safe/

11 https://drjengunter.com/2017/01/17/dear-gwyneth-paltrow-im-a-gyn-and-your-vaginal-jade-eggs-are-a-bad-idea/

12 https://www.smh.com.au/lifestyle/health-and-wellness/goop-settles-lawsuit-over-purported-benefits-of-jade-eggs-20180906-p5021h.html

13 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841744/

14 Published 2006. Available on request.

While still at Exeter, we had a whole program examining so-called alternative medicines (SCAMs) for weight reduction. I thus can assure you of one thing: there are plenty out there! We also published many papers on the subject. The results can be summarized quite easily:

NONE OF THEM WORK CONVINCINGLY AND MANY ARE OUTRIGHT FRAUDULENT.

So I thought I had seen them all … until I saw this advertisement:

Hourglass S-line Waist Slimming Patch ingredients directly transfers them to your skin which then stimulates your body, kickstarts your metabolism and increases calorific burn. This process tones your skin, busts fat cells giving you a slimmer appearance with radiant looking skin.

Consist of 3 Key Ingredient For Hourglass S-line Waist Slimming Patch:

  1. Ay Tsao
  2. Wormwood
  3. Mint

Ay Tsao is a flowering plant that is mostly cultivated for its root, it decreases inflammation, stimulates digestion, and suppresses your appetite. These properties are effective ways promote weight loss. Experts says that this plant plays a huge role in providing a person with health benefits, determining decongestion and improving blood circulation.

Wormwood is regarded as a useful remedy for liver and gallbladder problems. Wormwood contains strong bitter agents known as absinthin and anabsinthin, which stimulate digestive and gallbladder function. Wormwood is believed to stimulate digestion and relieve spasms in the intestinal tract

Mint play an essential role in losing weight in a healthy way. Mint leaves promote digestion and boost metabolism to help in losing weight. Mint tea is a great refreshing calorie-free beverage to promote weight loss.

This is why Hourglass S-line Waist Slimming Patch is special

  • Effectively prevent forming a waist fat.
  • Accelerate the burning of fat.
  • Maintaining a perfect body continuously.
  • Extracting the essence from pure, safe, and healthy natural plants.
  • Better sleep;
  • Safe for daily use.
  • Relieves gas and bloating.
  • Slim down, and increase your energy levels for a better, healthier life.
  • Made of high-quality material, with good breathability and adhesion.

Natalie’s Hourglass S-line Waist Slimming Patch report

Natalie Having trouble wearing dress because of her weight. She wanted a body that will make a dress look good for her. She gladly found this product online.

Here is the result…

Week 1

“Having a sexy body is always what I wanted. But what I can only do is light exercise. So I decided to use this Hourglass S-line Waist Slimming Patch. In just a week my body felt light. I still have a medium-sized belly but I’ll keep trying. Improvement is important and I see it with this product.”

Week 4

“I’m on day 30 of using this product. I love it. I combined its use with diet and light exercise. This is a good treatment for my muscles because Hourglass S-line Waist Slimming Patch also helps with muscle cramps or pain. I never feel my waist muscles working as well as they do when I’m using this product. I love feeling my body muscles actually moving in there. I literally KNOW this product is working my muscles for me. It’s incredible.”

Week 6

“After a month and a half, the result is great. I am amazed that the product is just as described. It will surely achieve the body that you want!! A must try for everyone, this patch is restrengthening muscles, or to add an extra kick in the gut for your exercise, this is it!”

Natalie Lopez — Toronto, Canada

This Patch saves you tons of money!
Hourglass S-line Waist Slimming Patch all natural ingredients are carefully made to make a huge impact not only to your skin but also saves you tons of money in the long run.

With this product you can avoid expensive sessions, time consuming appointments and you can use this patch at your home that can save transportations fare.

How to Use:

  1. Make sure your waist is dry and clean.
  2. Take 2 pcs patch and tear of the back then stick it to your both side waist.
  3. Remove after 3 – 8 hours a day.

______________________________________

I find it hard to believe that there are people who actually fall for such an advertisement. And the more I think about it, the sadder I feel. There are quite obviously some who believe such nonsense and get ripped off by irresponsible snake-oil salesmen. Not only does the product not work, but some of the ingredients are also potentially toxic.

I hope that my posing this will prevent a few people from wasting their hard-earned money on outright quackery:

None of the claims made in this advertisement is backed by evidence!

In Austria, even some of the most blatant quackery continues to be supported by the country’s medical association. This has been notorious for a very long time, and many rational doctors have opposed this nonsense. Now my friends and colleagues have courageously sent an open letter to the President of the Austrian Medical Association. In order to support their efforts, I have taken the liberty of translating it:

Dr. Johannes Steinhart
President of the Austrian Medical Association
Weihburggasse 10-12
1010 Vienna

 

Dear President Steinhart,

 

In 2014 we founded the “Initiative for Scientific Medicine” with the aim of counteracting the support of pseudo-medicine by medical associations and the Ministry of Health.

We (www.initiative-wissenschaftliche-medizin.at) have been demanding for years that the Austrian Medical Association distance itself from irrational, predominantly esoteric pseudo-medicine and refrain from awarding diplomas in them. We also made these demands on behalf of the supporters of the initiative (currently 1142 supporters, of which 495 are female doctors and 230 natural scientists) during a discussion with the former president Wechselberger in 2015 (unfortunately unsuccessful at the time).

We would like to draw your attention to a resolution of the German Medical Congress 2022 on homeopathy and a court ruling in the first instance in Germany on the subject of bioresonance, which show that our neighbours have obviously begun to treat pseudomedicine for what it is, namely sham medicine.

The 126th German Medical Congress 2022 in Bremen has, among other things, passed a long overdue resolution. The additional title “homeopathy” was deleted from the (model) further training regulations. Prior to this decision, 12 of 17 state medical associations had already taken this decision themselves.

In May 2022 in Reutlingen, two managing directors of a company producing and selling bioresonance devices were sentenced to 2 and 3 years in prison and a fine of 2.5 million euros, and the former sales director to 90 days’ imprisonment for commercial fraud and violation of the Therapeutic Products Advertising Act. The verdict is not yet legally binding. Unfortunately, many Austrian doctors also practice this pseudo-medicine method.

The fact that many colleagues offer esoteric, pseudo-medical “therapies” without proven benefits to their patients and can refer to diplomas and accredited further training courses of the Medical Association/Academy of Physicians is difficult for us to understand, especially in view of the fact that the majority of the accredited further training courses are of high scientific quality. A medical association that argues that such pseudo-medical practices “should better remain in the hands of doctors (as “healers”)” contradicts the principles of evidence-based medicine to which the medical association always refers. The corona pandemic has shown us all the damage potential of science denial.

We believe that the time has also come for the Austrian Medical Association to come clean. We call on the Austrian Medical Association to unreservedly declare its support for scientific medicine, to clearly distance itself from pseudo-medicine, to suspend the awarding of diplomas in pseudo-medicine methods that are far removed from science, and to end the accreditation of pseudo-medicine training courses by the Medical Academy.

We are publishing this open letter on our website and will also publish your reply if you so wish.

 

With collegial greetings

Dr. Theodor Much, Specialist in Dermatology and Venereology, Baden near Vienna
DDr. Viktor Weisshäupl, retired specialist in anaesthesiology and intensive care medicine, Vienna

DIARALIA is a homeopathic remedy for the symptomatic treatment of acute transient diarrhea. It is produced by Boiron, the world’s largest manufacturer of homeopathic remedies. This is how it is currently advertised:

Instructions DIARALIA

Dosage DIARALIA

Adults and children from 6 years

Lozenge 1, 4 to 6 times a day, for a maximum of three days of treatment.
Discontinue treatment as soon as symptoms disappear.

Method and route of administration DIARALIA
Sublingual (tablet to dissolve under the tongue)
In children 18 months to 6 years: dissolve the tablet in a little water before use, because of the risk of aspiration. As soon as the permitted age, dissolve the tablets under the tongue.

Duration of treatment DIARALIA
The duration of treatment should not exceed one week.

In case of overdose DIARALIA

If you have taken more DIARALIA orodispersible tablets that you don” should have:

Consult your doctor or pharmacist immediately.
In case of failure of one or more doses of DIARALIA

If you miss a dose of DIARALIA orodispersible tablets:

Do not take a double dose to make up for the dose that you forgot to take

Pregnancy and lactation with DIARALIA
Ask your doctor or pharmacist before taking any medicine.

In the absence of experimental and clinical data, and as a precautionary measure, the use of this drug should be avoided during pregnancy and lactation.

Composition DIARALIA

Excipients with known effect: This medicinal product contains lactose,
Active substances:
For a 300 mg tablet
Arsenicum album 9CH 1mg
China rubra 5CH 1mg
Podophyllum peltatum 9 CH 1mg
Excipients: sucrose, lactose monohydrate, magnesium stearate

Cons-indication DIARALIA

N” Never use DIARALIA orodispersible tablets:
· In children under 18 months.
· If you are allergic (hypersensitive) to the active substances or to any of the ingredients in CORYZALIA orodispersible tablets.

Possible interactions with DIARALIA

If you are taking or have recently taken any other medicines, including medicines obtained without a prescription, talk to your doctor or pharmacist.

This medication is to be taken between meals.

Adverse DIARALIA

Like all medicines, DIARALIA orodispersible tablets may cause side effects, although not everybody will not matter.
If you notice any side effects not listed in this leaflet, or if the side effects gets serious, please tell your doctor or pharmacist.

Storage conditions DIARALIA

Store at a temperature not exceeding 30 ° C

Precautions and warnings DIARALIA

This medication should not be used in case of vomiting, high fever, blood in the stool.
Any significant diarrhea exposed to the risk of dehydration requiring appropriate rehydration.
If diarrhea persists beyond 3 days, a medical consultation is necessary.
If your doctor has told you have an intolerance to some sugars, contact your doctor before taking this medicine
Use of this medicine is not recommended in patients with galactose intolerance, a Lapp lactase deficiency or malabsorption syndrome glucose or galactose (rare hereditary diseases).

But is there any evidence that DIARALIA works?

I’m glad you asked!

I looked far and wide but found none (if a reader knows of a clinical trial, please let me know).

Jenifer Jacobs (JJ) published a review of 3 studies – all her own! – and concluded that the results from these studies confirm that individualized homeopathic treatment decreases the duration of acute childhood diarrhea and suggest that larger sample sizes be used in future homeopathic research to ensure adequate statistical power. Homeopathy should be considered for use as an adjunct to oral rehydration for this illness. So, some homeopathy fans might claim there is good evidence. But I dispute that.

We all know, of course, that diarrhea can be a symptom of a range of serious conditions. Thus, one should not joke about it. On the contrary, one should diagnose the reason for the symptom and treat it adequately.  And one should certainly not advertise unproven treatments for it; one could even go one step further and claim that anyone who does that is fraudulently endangering the health of the often all too gullible consumer.

Trevor Zierke is a D.C. who published several videos that have gone viral after saying that “literally 99% of my profession” is a scam. “When I say almost all the usual lines chiropractors tell you are lies, I mean almost all of them,” he stated. Zierke then went on to give examples of issues chiropractors allegedly make up, including someone’s spine being “misaligned,” tension on nerves causing health problems, and someone having back pain because their hips are off-center. “Almost all of these aren’t true,” he concluded.

In a follow-up video, he claimed that the reasons most people are told they need to go to a chiropractor are “overblown or just flat out lies proven wrong by research.” He also noted that, while there are many scams, that “doesn’t mean you can’t get help from a chiropractor.”

In a third TikTok video, Zierke offered some valid reasons to see a chiropractor. He said that one can seek help from a chiropractor if one has musculoskeletal pain that has been ongoing for more than one to two days, and that’s about it. He stated that issues that a chiropractor couldn’t really fix include “GI pain, hormonal issues, nutrition,” among others.

In comments, users were largely supportive of Zierke’s message.

One said: “As a physiotherapist, I’ve been trying to tell this but I don’t want to like offend any chiropractor in doing so,” a commenter shared.

“Working in a chiropractic office, this is fair,” a further user wrote. “I have issues that I know an adjustment will help & other pain that would be better stretched/released.”

In an email, Zierke reiterated the intention of his videos: “I would just like to clarify that chiropractors, in general, are not a scam or are inherently scammers (I myself am a practicing chiropractor), but rather a lot of very popular sales tactics, phrases, and wording used to imply patients need treatment, and methods of treatment, have never been proven to be true,” he explained. “When chiropractors say & use these methods stating things that are not factually true—I believe it’s scammy behavior and practices. There are still a lot of very good, honest, and integral chiropractors out there,” he concluded. “They can provide a lot of help and relief to patients. But that’s unfortunately not the majority, and I’ve heard too many stories of people falling victim to some of these scam-like tactics from bad apple chiropractors.”

None of what DC Zierke said can surprise those who have been following my blog. On the contrary, I could add a few recent posts to his criticism of chiropractic, for example:

I rest my case.

Should Acupuncture-Related Therapies be Considered in Prediabetes Control?

No!

If you are pre-diabetic, consult a doctor and follow his/her advice. Do NOT do what acupuncturists or other self-appointed experts tell you. Do NOT become a victim of quackery.

But the authors of a new paper disagree with my view.

So, let’s have a look at the evidence.

Their systematic review was aimed at evaluating the effects and safety of acupuncture-related therapy (AT) interventions on glycemic control for prediabetes. The Chinese researchers searched 14 databases and 5 clinical registry platforms from inception to December 2020. Randomized controlled trials involving AT interventions for managing prediabetes were included.

Of the 855 identified trials, 34 articles were included for qualitative synthesis, 31 of which were included in the final meta-analysis. Compared with usual care, sham intervention, or conventional medicine, AT treatments yielded greater reductions in the primary outcomes, including fasting plasma glucose (FPG) (standard mean difference [SMD] = -0.83; 95% confidence interval [CI], -1.06, -0.61; P < .00001), 2-hour plasma glucose (2hPG) (SMD = -0.88; 95% CI, -1.20, -0.57; P < .00001), and glycated hemoglobin (HbA1c) levels (SMD = -0.91; 95% CI, -1.31, -0.51; P < .00001), as well as a greater decline in the secondary outcome, which is the incidence of prediabetes (RR = 1.43; 95% CI, 1.26, 1.63; P < .00001).

The authors concluded that AT is a potential strategy that can contribute to better glycemic control in the management of prediabetes. Because of the substantial clinical heterogeneity, the effect estimates should be interpreted with caution. More research is required for different ethnic groups and long-term effectiveness.

But this is clearly a positive result!

Why do I not believe it?

There are several reasons:

  • There is no conceivable mechanism by which AT prevents diabetes.
  • The findings heavily rely on Chinese RCTs which are known to be of poor quality and often even fabricated. To trust such research would be a dangerous mistake.
  • Many of the primary studies were designed such that they failed to control for non-specific effects of AT. This means that a causal link between AT and the outcome is doubtful.
  • The review was published in a 3rd class journal of no impact. Its peer-review system evidently failed.

So, let’s just forget about this rubbish paper?

If only it were so easy!

Journalists always have a keen interest in exotic treatments that contradict established wisdom. Predictably, they have been reporting about the new review thus confusing or misleading the public. One journalist, for instance, stated:

Acupuncture has been used for thousands of years to treat a variety of illnesses — and now it could also help fight one of the 21st century’s biggest health challenges.

New research from Edith Cowan University has found acupuncture therapy may be a useful tool in avoiding type 2 diabetes.

The team of scientists investigated dozens of studies covering the effects of acupuncture on more than 3600 people with prediabetes. This is a condition marked by higher-than-normal blood glucose levels without being high enough to be diagnosed as diabetes.

According to the findings, acupuncture therapy significantly improved key markers, such as fasting plasma glucose, two-hour plasma glucose, and glycated hemoglobin. Additionally, acupuncture therapy resulted in a greater decline in the incidence of prediabetes.

The review can thus serve as a prime example for demonstrating how irresponsible research has the power to mislead millions. This is why I have often said that poor research is a danger to public health.

And what can be done about this more and more prevalent problem?

The answer is easy: people need to behave more responsibly; this includes:

  • trialists,
  • review authors,
  • editors,
  • peer-reviewers,
  • journalists.

Yes, the answer is easy in theory – but the practice is far from it!

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