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

malpractice

It has been reported that a young woman’s visit to a chiropractor left her unable to walk due to a torn artery.

Mariah Bond, 29, went to visit a chiropractor in the hope to get some relief from her neck pain. During the appointment, the chiropractor quickly twisted her neck from side to side. “It cracked both ways and I’d seen chiropractor videos so I thought it was normal but when I stood up I got super dizzy,” Mariah recalled. Next, Mariah started profusely vomiting and her hand began to tingle. Then she was rushed to a hospital.

It took a few hours before the doctors could find the diagnosis. “I was still throwing up constantly, it was non-stop. I couldn’t open my eyes because if I did I’d start throwing up because I was so dizzy,” Mariah said. “I was transferred via ambulance to another hospital where they did a CT scan and confirmed that I was having a stroke.”

It turned out that Mariah’s chiropractor dissected an artery in her neck which then limited the blood supply to the brain. Mariah was kept in the hospital for five days while her condition was monitored. During that time, she was left unable to walk. But slowly she did become able to rely on a zimmer frame to get around. “I couldn’t walk properly or correctly use my hands to eat, it was like I was a child. It was very weird. My brain was there but I couldn’t do it,” she stated. “My first stroke was a cerebral stroke and they were saying that I probably had a mini-stroke as I was having weird feelings in my legs. They were very confused because that wasn’t common with the stroke I had, so they said that I probably had two.”

Within a fortnight, Mariah was able to walk again but had to have physiotherapy for two months before she could return to work. After her last CT scan, she received the good news that the dissected vessel had completely healed. She said: “I was very strong-willed at the time because everyone was telling me how well I was handling this. I think my husband was more scared than I was, poor thing.”

Mariah has vowed never to visit a chiropractor again and is doing her best to raise awareness of the damage they can cause. “I was shocked because I’m so young and you don’t really hear about young people having strokes, especially from the chiropractor. I’m pretty paranoid with my neck now. I know I probably shouldn’t be but sometimes if I have a weird feeling in my head, it would probably be called PTSD, I automatically start thinking am I having a stroke? I start freaking out. I’d tell people not to go to a chiropractor. I’ve already told a million people not to do it. Just don’t go or at least don’t let them do your neck.”

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I would be surprised if this case ever got written up as a proper case report and published in a medical journal. We did a survey years ago where we found over 35 cases of severe complications after chiropractic in the UK within a period of 12 months. The most amazing result was that none of these cases had been published. In other words, under-reporting was precisely 100%.

Mariah’s case might be a true rarety, or it might be a fairly common event. It might be a most devastating occurrence, or there could be far worse events.

We simply do not know because under-reporting is huge.

Meanwhile, chiropractors – the professionals who should long have made sure that under-reporting becomes minimal or non-existent – claim that there is no evidence that strokes happen at all or regularly or often. They can do this because the medical literature seems to confirm their opinion. The only reporting system that seems to exist, the “chiropractic patient incident reporting and learning system” (CPiRLS), is for several reasons woefully inadequate and also plagued by under-reporting.

So, what advice can I possibly give to consumers in such a situation? I feel that the only thing one can recommend is to

stay well clear of chiropractors

until they finally present us with sufficient and convincing data.

 

 

Turnera diffusa, known as damiana is a shrub native to southern Texas in the United States, Central America, Mexico, South America, and the Caribbean that produces small, aromatic flowers. Damiana is an ingredient in a traditional Mexican liqueur, which is sometimes used in lieu of triple sec in margaritas. Damiana was included in several 19th-century patent medicines, such as Pemberton’s French Wine Coca. The leaves were omitted from that product’s non-alcoholic counterpart, Coca-Cola.

In folklore, the plant was believed to be an aphrodisiac. I looked for evidence from clinical trials but was unable to find any. However, that does not seem to bother PharmaSGP GmbH which produces a drug called Neradin.

The German advertisement of Neradin tells us that:

Bei sexueller Schwäche wie Erektionsstörungen können auch traditionelle Mittel helfen – ohne die Nebenwirkungen mancher chemischer Potenzmittel. Das pflanzliche Arzneimittel Neradin® nutzt dazu erfolgreich Wirkstoffe der mexikanischen Heilpflanze Damiana (Turnera Diffusa).

Die Vorteile von Neradin® auf einen Blick: Fördert die Potenz des Mannes bei sexueller Schwäche

I translated this into English:

Traditional remedies can also help with sexual weakness such as erectile dysfunction – without the side effects of some chemical sexual enhancers. The herbal medicine Neradin® successfully uses active ingredients from the Mexican medicinal plant Damiana (Turnera Diffusa).

The advantages of Neradin® at a glance: Promotes male potency in case of sexual weakness

The patient information leaflet states that “Niradin is a homeopathic drug” and “one tablet Niradin contains 100mg Turnera Diffusa Trit. D4”.

English language sites concur:

Neradin is a homeopathic medicine. Homeopathy is understood as a regulatory therapy for acute and chronic diseases. The areas of application are derived from the homeopathic drug pictures. The following indications are authorised for this medicinal product: Discomfort caused by sexual weakness

So, what we seem to have here is the following:

  • A pharma firm that advertises a homeopathic product as a herbal drug.
  • A homeopathic remedy that is based on a plant for which there is not a jot of evidence.
  • If there were evidence that the plant helps against erectile dysfunction, its homeopathic dilution would, according to the homeopathic ‘like cures like’ axiom, bring about erectile dysfunction.
  • A dilution (1:10000) that is too low to have any effect, even if it were made of Viagra.

Am I the only one to think that something is not quite right here?

But don’t let it spoil your HAPPY VALENTINE!

Chiropractors are famous for being against COVID vaccinations and other protective measures. This recent case is an apt example.

It has been reported that the tribunal of Alberta’s regulatory body for chiropractors has ruled against Calgary chiropractor, Curtis Wall, for not wearing a mask during the pandemic. The College of Chiropractors of Alberta (CCA) sought to discipline Wall for not wearing a mask at his clinic, not observing two meters of social distancing while unmasked, not installing a plexiglass barrier in his reception area, and not requiring patients to be masked either, beginning around June 2020. In a statement issued Feb. 1, 2023, the CCA’s hearing tribunal wrote: “[T]he Hearing Tribunal has found Dr. Curtis Wall’s conduct does constitute ‘unprofessional conduct’ and their decision for penalty is forthcoming.”

Lawyer James Kitchen who represented Wall, railed against the ruling: “[T]he decision is riddled with errors of fact and law and is so poorly decided it is an embarrassment to the chiropractic profession. It is shocking the lengths the tribunal went to dismiss the evidence of Dr. Wall, three of his patients, and his four expert witnesses while blithely accepting all the evidence of the College…The decision is an egregious manifestation of pre-determined, results-oriented decision-making.”

In an interview, Kitchen said: “I set this whole case up knowing that the tribunal would likely do whatever the college and the college’s expert told him to do. I set the case up such that if the tribunal did that, they would have to make themselves look very foolish to do so. If I’m really putting my cynical hat on, I don’t know if there’s anything that surprises me, really. It should shock me the degree to which they twisted the evidence, left out the evidence. The only thing that surprises me a little bit is the lack of effort they put in to hide their bias.”

The communications manager of the CCA, Dana Myckan, commented: “Pursuant to the Health Professions Act, all Hearing Tribunal decisions are posted publicly on the CCA website. This is the extent of the information that the CCA can share on behalf of the Hearing Tribunal.”

The ruling noted that Wall initially wore a mask, but in June 2020, he “self-diagnosed as having an anxiety disorder. He believed that his self-diagnosis qualified him for a medical exemption from wearing a mask. As a result, he stopped wearing a mask when treating patients.” It added that Wall never contacted the college to let it know his condition or request an exemption, and said Wall’s son also worked at the clinic and did not wear a mask.

Kitchen said Wall could face a suspension of his practice but will appeal this ruling or any attempt to make him pay the CCA’s legal costs, which the college stated during the hearings were in excess of $200,000. Kitchen said a recent court precedent suggests the CCA will be unable to recoup costs in a ruling.

An appeal would be heard by the council of the college, which is the college’s governing body. It consists of five chiropractors elected by their peers along with five members of the public appointed by the government. Should Wall lose there, he could take his case to the Alberta Court of Appeal. Kitchen said Wall will go the distance. “I warned them that this is how I expected it to go. So he was prepared,” Kitchen said. “He’s still pretty dismayed that people could have this much evidence staring them in the face and just ignore it and follow the narrative. It’s hard for him. He’s an idealist. He’s really big on truth and people doing what’s right.”

________________________

To all of this, I have but two questions:

  1. Is the CCA not also guilty of professional misconduct for calling Wall “Dr. Wall” without making it clear that he is not medically trained?
  2. If Wall is “big on truth”, how come he works as a chiropractor?

 

I recently came across a truly baffling article. As it is in German, I translated it for you:

Supply shortages have kept pharmacies on tenterhooks for months, with more than 400 common medicines missing. The German Central Association of Homeopathic Doctors (DZVhÄ) suggests switching to alternative medicine as a solution: “We have homeopathic medicines that have been tried and tested in practice for more than 200 years and can replace many medicines that are currently not available,” says the president of the DZVhÄ , Dr Michaela Geiger.

The DZVhÄ is convinced that homeopathic medical practices can replace fever-reducing medicines, but in many cases also antibiotics and much more. However, Geiger qualifies: “Due to our medical training, we also know that cancer drugs such as the often cited Tamoxifen cannot be replaced by homeopathy”.

The homeopathic doctors respond directly to the sharpest argument of their critics: “But let’s assume that homeopathy only works via the placebo effect, as is being rumored, even then it would be an option, especially if other options are lacking,” says DZVhÄ vice-president Dr. Ulf Riker. Since homeopathically trained doctors can judge the general course of a disease, they can also distinguish a placebo effect from a medicinal effect.

If fever medication for children is lacking, parents should not be deprived of another “therapy option”, Riker said. “If you do not get your conventional fever medication in the coming weeks, visit a specialist pharmacy for naturopathy and homeopathy. If you are due for a medical consultation, experienced homeopathic doctors can prescribe a suitable homeopathic medicine for you,” he says.

Why do I find this so intriguing?

Essentially, what we have learned from the article is the following:

  1. “Tried and tested in practice for more than 200 years” is ‘homeopathy speak’ for “effective”, even if the evidence tells us otherwise.
  2. Homeopathic remedies can replace many evidence-based conventional medications such as fever-reducing medicines, antibiotics, and much more, even if the evidence tells us otherwise.
  3. Homeopaths know that cancer drugs cannot be replaced by homeopathy – except for those homeopaths who seem to have forgotten this simple lesson.
  4. Homeopathic placebos are a realistic option when there is a supply problem with effective drugs, even if the evidence tells us otherwise.
  5. Homeopathically trained doctors can distinguish a placebo effect from a medicinal effect, even if there is no evidence that any clinician can reliably do this.
  6. Homeopathic doctors prescribe suitable homeopathic medicine. Suitable for whom? As it is ineffective, it is unsuitable for the patient. Therefore, Riker is probably talking about the homeopath.

So, what have we really learned from this article? I don’t know about you, but I got the impression that the president and the vice president of the DZVhÄ do not seem to mind putting patients in danger, as long as they can promote homeopathy.

 

Homeopathic remedies are highly diluted formulations without proven clinical benefits, traditionally believed not to cause adverse events. Nonetheless, published literature reveals severe local and non-liver-related systemic side effects. This paper presents the first series on homeopathy-related severe drug-induced liver injury (DILI) from a single center.

A retrospective review of records from January 2019 to February 2022 identified 9 patients with liver injury attributed to homeopathic formulations. Competing causes were comprehensively excluded. Chemical analysis was performed on retrieved formulations using triple quadrupole gas chromatography-mass spectrometry and inductively coupled plasma atomic emission spectroscopy.

Males predominated with a median age of 54 years. The most typical clinical presentation was acute hepatitis, followed by acute on chronic liver failure. All patients developed jaundice, and ascites were notable in one-third of the patients. Five patients had underlying chronic liver disease. COVID-19 prevention was the most common indication for homeopathic use. Probable DILI was seen in 77.8%, and hepatocellular injury predominated (66.7%). Four (44.4%) patients died (3 with chronic liver disease) at a median follow-up of 194 days. Liver histopathology showed necrosis, portal and lobular neutrophilic inflammation, and eosinophilic infiltration with cholestasis. A total of 29 remedies were consumed between 9 patients, and 15 formulations were analyzed. Toxicology revealed industrial solvents, corticosteroids, antibiotics, sedatives, synthetic opioids, heavy metals, and toxic phyto-compounds, even in ‘supposed’ ultra-dilute formulations.

The authors concluded that homeopathic remedies potentially result in severe liver injury, leading to death in those with underlying liver disease. The use of mother tinctures, insufficient dilution, poor manufacturing practices, adulteration and contamination, and the presence of direct hepatotoxic herbals were the reasons for toxicity. Physicians, the public, and patients must realize that Homeopathic drugs are not ‘gentle placebos.’

Over a decade ago, we published a systematic review entitled “Adverse effects of homeopathy: a systematic review of published case reports and case series”:

Aim: The aim of this systematic review was to critically evaluate the evidence regarding the adverse effects (AEs) of homeopathy.

Method: Five electronic databases were searched to identify all relevant case reports and case series.

Results: In total, 38 primary reports met our inclusion criteria. Of those, 30 pertained to direct AEs of homeopathic remedies; and eight were related to AEs caused by the substitution of conventional medicine with homeopathy. The total number of patients who experienced AEs of homeopathy amounted to 1159. Overall, AEs ranged from mild-to-severe and included four fatalities. The most common AEs were allergic reactions and intoxications. Rhus toxidendron was the most frequently implicated homeopathic remedy.

Conclusion: Homeopathy has the potential to harm patients and consumers in both direct and indirect ways. Clinicians should be aware of its risks and advise their patients accordingly.

It caused an outcry from fans of homeopathy who claimed that one cannot insist that homeopathic remedies are ineffective because they contain no active ingredient, while also arguing that they cause severe adverse effects. In a way, they were correct: homeopathic remedies are useless even at causing adverse effects. But this applies only to remedies that are manufactured correctly and that are highly dilute. The trouble is that quality control in homeopathy often seems to be less than adequate. And this is how adverse effects can happen!

The new article from India is an important addition to the literature providing more valuable information about the risks of homeopathy. Its authors were able to do chemical analyses of some of the remedies and could thus show what the reasons for the liver injuries were. The article provides an essential caution for those who delude themselves by assuming that homeopathy is harmless. In fact, the remedies can cause severe problems. But, as we have discussed regularly on this blog, the far greater risk in homeopathy is not the remedy but the homeopath and his/her all too often incompetent advice to patients.

The All-Party Parliamentary Group (APPG) on Beauty and Wellbeing, UK, has undertaken an investigation into the ‘complementary therapies sector’, to consider how the sector can support everyone’s physical health, mental health, and well-being and take pressure off the NHS. In their recent document, they state:

The complementary therapies industry is an integral part of the Personal Care sector, which includes beauty, wellbeing, and alternative therapies. These therapies can be key to supporting everyone’s health and mental wellbeing…

To ensure complementary therapies can adequately support the NHS, we need to attract more talent into the sector and ensure all therapists receive the right training to become highly skilled professionals.

We also need to enhance the perception of the professionalism within the sector, so that it is no longer seen as ‘frivolous and fluffy’ and non-essential. Building awareness and understanding of its value in supporting our nation’s health is one step. However, it also important to crack down on any bad practice and the ‘underground market’ of poor treatment…

The committee makes the following recommendations:

1. The Government must work with NHS England to better promote the benefits of social prescribing with GPs, nurses and other health and care professionals, and how they can refer people to non-clinical complementary therapy services.
2. The Personal Care sector team in the Department for Business, Energy, Industry and Strategy must work with officials within the Department for Health and Social Care responsible for social prescribing to better integrate complementary therapy services into the NHS, and produce guidance to support health professionals and therapists in doing so.
3. The Department for Health and Social Care must undertake or fund research studies to demonstrate the value of integrating complementary therapy services into the NHS through social prescribing.
4. The Department for Education must revisit the gap between the apprentice wage and minimum wage for apprentices aged 19+, and provide financial incentives for employers to take on learners on any ‘job ready ‘qualification.
5. The Government must give Environmental health officers (EHOs) greater powers to act quickly to deal with bad practice and lead a crack-down on tax evading businesses that are driving down prices and undermining legitimate businesses under pressure.

Conclusions
The evidence that we have received during this investigation clearly demonstrate that greater support
and recognition is needed for the complementary therapies sector to ensure that they are able support
everyone’s physical health, mental health and wellbeing and take pressure off the NHS.
We hope the Government will review our recommendations in order to support the complementary
therapies sector and ensure they have adequate funding and acknowledgement.

In case you are wondering what therapies they refer to, here is their complete list of the treatments (including links to what they seem to think about them):

Alexander technique

Aromatherapy

Body massage

Bowen technique

Cranio sacral therapy

Healing

Homeopathy

Hypnotherapy

Kinesiology

Microsystems acupuncture

Naturopathy

Nutritional therapy

Reflexology

Reiki

Shiatsu

Sports massage

Sports therapy

Yoga therapy

This could have made me laugh, had it not been so serious. The committee is composed of MPs who might be full of goodwill. Yet, they seem utterly clueless regarding the ‘complementary therapies sector’. For instance, they seem to be unaware of the evidence for some of the treatments they want to promote, e.g. craniosacral therapy, aromatherapy, Reiki, shiatsu, energy healing, or reflexology (which is far less positive than they seem to assume); and they aim at enhancing the “perception of the professionalism” instead of improving the PROFESSIONALISM of the therapists (which obviously would include adherence to evidence-based practice). And perhaps the committee might have given some thought to the question of whether it is ethical to push dubious therapies onto the unsuspecting public.

I could go on, but the perplexing wooliness of the document speaks for itself, I think.

And in case you are wondering who the MP members of the committee are, here is the list of its members:

• Carolyn Harris MP – Co-Chair
• Judith Cummins MP – Co-Chair
• Jessica Morden MP – Vice-Chair
• Jackie Doyle-Price MP – Vice-Chair
• Peter Dowd MP – Treasurer
• Nick Smith MP – Secretary
• Caroline Nokes MP – Member
• Sarah Champion MP – Member
• Alex Davies-Jones MP – Member
• Kate Osamor MP – Member
• John McNally MP – Member
• Kevan Jones MP – Member
• Gagan Mohindra MP- Member

The Secretariat for this APPG is Dentons Global Advisors with support from the National Hair and Beauty Federation, the Federation of Holistic Therapists and spabreaks.com.

 

PS

Two hours after having posted this, I begin to feel bad about being so dismissive. Let me thus try to do something constructive: I herewith offer to give one or more lectures to the committee about the evidence as it pertains to the therapies they included in their report.

In one of my last posts, I was rather dismissive of veterinary chiropractic.

Was I too harsh?

I did ask readers who disagree with my judgment to send me their evidence.

Sadly, none arrived!

Therefore, I did several further literature searches and found a recent review of the topic. It included 14 studies; 13 were equine and one was a canine study. Seven of these were cohort studies and seven were randomized controlled clinical trials. . Study quality was low (n = 4), moderate (n = 7), and high (n = 3) and included a wide array of outcome parameters with varying levels of efficacy and duration of therapeutic effects, which prevented further meta-analysis. The authors concluded that it was difficult to draw firm conclusions despite all studies reporting positive effects. Optimal technique indications and dosages need to be determined to improve the standardization of these treatment options.

This, I think, can hardly be called good evidence. But I also found this more recent paper:

Chiropractic care is a common treatment modality used in equine practice to manage back pain and stiffness but has limited evidence for treating lameness. The objective of this blinded, controlled clinical trial was to evaluate the effect of chiropractic treatment on chronic lameness and concurrent axial skeleton pain and dysfunction. Two groups of horses with multiple limb lameness (polo) or isolated hind limb lameness (Quarter Horses) were enrolled. Outcome measures included subjective and objective measures of lameness, spinal pain and stiffness, epaxial muscle hypertonicity, and mechanical nociceptive thresholds collected on days 0, 14, and 28. Chiropractic treatment was applied on days 0, 7, 14, and 21. No treatment was applied to control horses. Data was analyzed by a mixed model fit separately for each response variable (p < 0.05) and was examined within each group of horses individually. Significant treatment effects were noted in subjective measures of hind limb and whole-body lameness scores and vertebral stiffness. Limited or inconsistent therapeutic effects were noted in objective lameness scores and other measures of axial skeleton pain and dysfunction. The lack of pathoanatomical diagnoses, multilimb lameness, and lack of validated outcome measures likely had negative impacts on the results.

Great! So, we finally have an RCT of chiropractic for horses. Unfortunately, the study is less than convincing:

  • It included just 20 polo horses plus 18 horses active in ridden or competitive work all suffering from lameness.
  • The authors state that ‘horses were numerically randomized to treatment and control groups’; yet I am not sure what this means.
  • Treatment consisted of high-velocity, low-amplitude, manually applied thrusts to sites of perceived pain or stiffness with the axial and appendicular articulations. Treatment was applied on days 0, 7, 14, and 21 by a single examiner. The control group received no treatment and was restrained quietly for 15 min to simulate the time required for chiropractic treatment. In other words, no placebo controls were used.
  • The validity of the many outcome measures is unknown.
  • The statistical analyses seem odd to me.
  • No correction for multiple statistical tests was done.
  • Most of the outcomes show no significant effect.
  • Overall, there were some small positive treatment effects based on subjective assessment of lameness, but no measurable treatment effects on objective measures of limb lameness.
  • The polo horses began their competition season at the beginning of the study which would have confounded the outcomes.

What does all this tell us about veterinary chiropractic?

Not a lot.

All we can safely say, I think, is that veterinary chiropractic is not evidence-based and that claims to the contrary are certainly ill-informed and most probably of a promotional nature.

Drip IV is “Australia’s first and leading mobile healthcare company specialising in assisting with nutritional deficiencies”. They claim to provide a mobile IV service that is prescribed and tailored individually to your nutritional needs. Treatment plans and customised infusions are determined by a medical team to suit individual requirements. They deliver vitamins, minerals and amino acids directly to the body via the bloodstream, a method they state allows for optimal bioavailability.

These claims are a little puzzling to me, not least because vitamins, minerals and amino acids tailored individually to the nutritional needs of the vast majority of people would mean administering nothing at all. But I guess that virtually every person who consults the service will get an infusion [and pay dearly for it].

The Australian Therapeutic Goods Administration (TGA) seems to have a similarly dim view on Drip IV. The TGA has just issued 20 infringement notices totalling $159,840 to the company and to one of its executive officers. The reason: unlawful advertising of intravenous infusion products to Australian consumers on a company website and social media. Ten notices totalling $133,200 were issued to the company and ten notices totalling $26,640 were issued to an executive officer. The TGA considers the intravenous infusion products to be therapeutic goods because of the claims made about them, and the advertising to be unlawful because the advertisements allegedly:

  • contained prohibited representations, such as claims regarding cancer.
  • contained restricted representations such as that the products would alleviate fatigue caused by COVID-19, assist in the treatment of Graves’ Disease and Alzheimer’s Disease, and support the treatment of autoimmune diseases such as Multiple Sclerosis. No TGA approval had been given to make such claims.
  • referred to ingredients that are prescription only, such as glutathione. Prescription medicines cannot be advertised directly to the public in Australia.
  • contained a statement or picture suggesting or implying the products were ‘TGA Approved’. Advertising of therapeutic goods cannot include a government endorsement.
  • contained a statement or picture expressing that the goods were ‘miraculous’.

Vitamin infusions have become very popular around the globe. There are now thousands of clinics offering this service, and many of them advertise aggressively with claims that are questionable. Here is just one example from the UK:

Modern life is hectic. If you are looking to boost your wellbeing, increase your energy levels, lift your mood and hydrate your body, Vitamin IV Infusions are ideal. Favoured by celebrities such as Madonna, Simon Cowell and Rihanna, Vitamin IV Infusions are an easy, effective way of delivering vitamins, minerals and amino acids directly into your bloodstream via an IV (intravenous) drip. Vitamins are essential for normal growth and staying healthy – but our bodies can’t produce all of the nutrients we need to function and thrive. That’s why more than one in three people take daily vitamin supplements – often without realising that only 15% of the active nutrients consumed orally actually find their way into their bloodstream. With Vitamin IV Infusions, the nutrients enter your bloodstream directly and immediately, and are delivered straight to your cells. We offer four different Vitamin IV Infusions, so you can choose the best combination for your personal needs, while boosting your general health, energy and wellbeing.

My advice to consumers is a little different and considerably less costly:

  1. to ensure you get enough vitamins, minerals, and amino acids, eat a balanced diet;
  2. to boost your well-being, sit down and calculate the savings you made by NOT using such a service;
  3. to increase your energy levels, take a nap;
  4. to lift your mood, recount the money you saved and think of what nice things you might buy with it;
  5. to hydrate your body drink a glass of water.

Perhaps it is time the authorities in all countries had a look at what these clinics are offering and what health claims they are making. Perhaps it is time they act as the TGA just did.

 

The UK medical doctor, Sarah Myhill, has a website where she tells us:

Everyone should follow the general approach to maintaining and restoring good health, which involves eating a paleo ketogenic diet, taking a basic package of nutritional supplements, ensuring a good night’s sleep on a regular basis and getting the right balance between work, exercise and rest. Because we live in an increasingly polluted world, we should probably all be doing some sort of detox regime.

She also happens to sell dietary supplements of all kinds which must surely be handy for all who want to follow her advice. Dr. Myhill boosted her income even further by putting false claims about Covid-19 treatments online. And that got her banned from practicing for nine months after a medical tribunal.

She posted videos and articles advocating taking vitamins and other substances in high doses, without evidence they worked. The General Medical Council (GMC) found her recommendations “undermined public health” and found some of her recommendations had the potential to cause “serious harm” and “potentially fatal toxicity”. The tribunal was told she uploaded a series of videos and articles between March and May 2020, describing substances as “safe nutritional interventions” which she said meant vaccinations were “rendered irrelevant”. But the substances she promoted were not universally safe and have potentially serious health risks associated with them, the panel was told. The tribunal found Dr. Myhill “does not practice evidence-based medicine and may encourage false reassurance in her patients who may believe that they will not catch Covid-19 or other infections if they follow her advice”.

Dr. Myhill previously had a year-long ban lifted after a General Medical Council investigation into her claims of being a “pioneer” in the treatment of chronic fatigue syndrome. In fact, the hearing was told there had been 30 previous GMC investigations into Dr. Myhill, but none had resulted in findings of misconduct.

Dr. Myhill is also a vocal critic of the PACE trial and biopsychosocial model of ME/CFS. Dr. Myhill’s GMC complaint regarding a number of PACE trial authors was first rejected without investigation by the GMC, after Dr. Myhill appealed the GMC stated they would reconsider. Dr. Myhill’s action against the GMC for failing to provide reasoning for not investigating the PACE trial authors is still continuing and began a number of months before the most recent GMC instigation of her practice started.

The recent tribunal concluded: “Given the circumstances of this case, it is necessary to protect members of the public and in the public interest to make an order suspending Dr. Myhill’s registration with immediate effect, to uphold and maintain professional standards and maintain public confidence in the profession.”

The McTimoney College of Chiropractic just announced that it has established a new four-year program in veterinary chiropractic for college students:

It means that those without a prior degree can undertake the training and education necessary to enter this coveted career. To date, animal chiropractors were required to have a prior qualification in human chiropractic or a degree in the relevant sciences.

Applications for the new program are being accepted from September 2023. Students will attend Abingdon-based University, Oxford, and a variety of practical locations, enabling the development of academic knowledge and the application of practical skills together . Modules include anatomy and physiology, veterinary science, practice and professionalism, and clinical skills, with a research dissertation running over the four-year course.

University director Christina Cunliffe said the new program was an exciting step in the development of chiropractic care for animals.

“Building on our decades of experience graduating confident, competent, and highly-skilled animal chiropractors, now is the time to open up this exciting career opportunity to college students.”

For the past 50 years, McTimoney College of Chiropractic has been training and educating human chiropractors to the highest regulatory standards. Over the past 20 years, animal chiropractic has developed to meet the requirements for this gentle, holistic treatment in the veterinary world.

Prospective students are invited to a Open House at McTimoney College of Chiropractic in Abingdon on February 16.

McTimoney Chiropractic for Animals identifies areas of stiffness, asymmetry, and poor range of motion within the skeletal system, particularly the spine and pelvis. This affects the muscles that surround these structures, as well as the nerve impulses that pass from the central nervous system to the periphery of the body. The adjustments are very light and fast, stimulating an instant response in the affected soft tissues and joints, promoting relaxation of muscle spasms, improving nerve function, and helping the skeletal structure regain better symmetry and movement again.

In many cases, animals suffer from underlying conditions such as arthritic changes or degenerative diseases that force them to compensate in their posture and movement in an attempt to remain comfortable. However, these offsets become increasingly entrenched and can be painful or uncomfortable, requiring chiropractic care to provide some relief. In other cases, the animals are working hard or competing and as such accumulate tension and asymmetries due to the demands of their work. Once again, chiropractic care helps relieve pain and promote performance, whether it’s faster speeds over hurdles for racehorses and events, better jumping style in showjumpers, or more extravagant movements for dressage stars.

Two recent graduates of the school’s Master of Animal Handling (Chiropractic) program did not hesitate to recommend the university. Natalie McQuiggan said that she had wanted to do McTimoney Chiropractic from a very young age, “but the process of doing it always seemed really daunting.

“But from the start, the staff and teachers were lovely and welcoming, and queries were answered promptly. I have really enjoyed my two years in the Master of Animal Handling (Chiropractic) program and would recommend anyone thinking of doing it to just do it.”

Pollyanna Fitzgerald said the university offered a supportive and welcoming learning environment, allowing her to grow and develop as a student and future professional. “There is always someone to talk to and offer encouragement when needed. As a student I have learned a lot and have been encouraged to believe in myself and it has been a wonderful place to learn.”

A free webinar, McTimoney’s Animal Chiropractic as a Careeron January 24 at 7:30 p.m. (GMT), is open to those who wish to learn more about the McTimoney technique and its application, and the training paths available to those interested in becoming a McTimoney Animal Chiropractor.

________________________

I think this announcement is puzzling on several levels:

  1. I was unable to find an ‘Abingdon-based University, Oxford’; could it be this institution that is a college and not a university?
  2. Christina Cunliffe seems to be (or has been?) affiliated with the McTimoney College of Chiropractic which is a bit odd, in my opinion.
  3. The college does not have ‘decades of experience’; it was founded only in 2001.
  4. Most importantly, I am unable to find a jot of good evidence that veterinary chiropractic is effective for any condition (see also here, here, and here). In case anyone is aware of any, please let me know. I’d be delighted to revise my judgment.

If I am right, the new course could be a fine example of quackademia where students are ripped off and taught to later rip off the owners of animals after the academically trained quacks have mistreated them.

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