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

naturopathy

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WARNING: after reading this, you might no longer enjoy your favorite breakfast cereal!

‘Biologic living’ is the name John Harvey Kellogg (1852-1943), an influential medical doctor and best-known as the inventor of the cornflakes gave to his health reforms. Biologic living was practiced in Kellogg’s Battle Creek Sanatorium, an institution for re-educating Americans and training of healthcare professionals. Kellogg’s religious beliefs bled into his medicinal practices and the Battle Creek Sanatorium was as much health spar as it was a rehabilitation facility. [1]

In the sanatorium, there was a strict focus on diet which was meant to cure a person of practically all ills, leading to a kind of purity of the soul. Meat and certain spicy, overly flavourful foods, as well as alcoholic beverages, were thought to overexcite the mind and lead to sinful behavior. A bland dull diet was thus recommended. Kellogg intended for ‘cornflakes’ to become the staple of this diet. Other treatments included the following [2]:

  • Vegetarian diet; Kellogg invented an artificial meat substitute based mainly on peanuts, called ‘nuttose’
  • ‘Light bath’, a bath under lights lasting hours, days, sometimes even weeks
  • Regular exercise
  • Various forms of electrotherapy
  • Vibrational therapy
  • Massage therapy
  • Breathing techniques
  • Colonic irrigation delivered by specially designed machines that could deliver 14 liters of water followed by a pint of yogurt, half of which was to be eaten, while the other half would be delivered via a second enema
  • Water cures of various types
  • Sexual abstinence, including various measures to avoid masturbation. For boys, he recommended circumcision without anesthetic, thinking the trauma it caused and several weeks of pain that would follow would curb masturbation. If that did not suffice, Kellogg recommended sewing the foreskin shut, preventing an erection. For girls, he applied carbolic acid to the clitoris as ‘an excellent means of allaying the abnormal excitement.’ He would also recommend binding people’s hands, covering genitalia in specially designed cages, or electroshock therapy, such was his hatred of masturbation.

Biologic living was centered around purity, not merely of the soul but racial purity too. Meat and alcohol were not just bad, they were considered ‘race poisons’. He was a staunch advocate of ‘race suicide’, a term that summed up the fear of white America that their racial purity would be eroded, and they would disappear into ‘inferior races’. Kellogg helped implement a law whereby genetically ‘inferior’ humans such as epileptics or people with a learning disability could be a target. Michigan’s forced sterilization law, which Kellogg himself had a hand in, would not be repealed until 1974.

Today, Kellogg’s biologic living is mostly of historical interest. Yet, it is relevant for understanding some of the more extreme trends in the US related to so-called alternative medicine (SCAM).

 

[1] The Living Temple: Amazon.co.uk: Kellogg, John Harvey: 9781296696375: Books

[2] John Harvey Kellogg And His Anti-Masturbation Cereals | by Danny | Medium

The following press release was published by the AMA on 16/11/2021. I consider it sufficiently relevant to re-publish it here in full and, as it is entirely self-explanatory, without further comment:

At its Special Meeting today, the American Medical Association (AMA) House of Delegates approved a resolution stating that only licensed physicians should determine whether a person should receive a medical exemption from vaccines.

The policy comes in the wake of tens of thousands of people seeking exemptions to state and municipal COVID mandates, contending they have medical reasons for remaining unvaccinated. The new policy states that only licensed physicians should have the medical authority and the power to grant these exemptions.

“Vaccine hesitancy has played an unfortunate role in extending the COVID-19 public emergency. Failing to get vaccinated has resulted in tragic and unnecessary deaths. To protect everyone, we must be sure that a trained, licensed physician is making the judgment on whether a person actually warrants an exemption,” said Willie Underwood III, M.D., M.Sc., M.P.H., a member of the AMA Board of Trustees.

The definition of “medical authority” varies from state to state, with some states allowing alternative practitioners, such as naturopathic providers, to approve vaccine exemptions. Surveys have shown that naturopathic providers and other alternative medicine providers (such as homeopaths and chiropractors) are less likely to recommend vaccines—or even recommend against vaccines—despite scientific evidence of safety and efficacy.

“State policymakers need to limit the definition to physicians who have the training necessary to recognize a medical condition that prevents a patient from receiving a vaccine,” Dr. Underwood said. “We shouldn’t jeopardize public health by listening to unlicensed and untrained providers.”

The AMA already has policy opposing nonmedical (religious, philosophic, or personal belief) exemptions from immunizations, since such exemptions endanger the health of the unvaccinated individual and the health of the community at large. The AMA supports the immunization recommendations of the Advisory Committee on Immunization Practices for all individuals without medical contraindications. It also supports legislation eliminating nonmedical immunization exemptions and encourages state medical associations to seek removal of nonmedical exemptions in states requiring mandatory immunizations.

“One of the unfortunate side effects of the COVID-19 pandemic and misinformation around it is the questioning of vaccine efficacy even though vaccines have nearly wiped out diseases that once plagued us. Physicians must make the argument clearly and loudly based on the science: Vaccines save lives,” Underwood said.

The German paper DIE ZEIT reported about the dire state of the pandemic in Upper Bavaria. In the district of Rosenheim (close to where I grew up), only about 58% of the population are fully vaccinated, far less than the German average.

Why?

The article blames a broad distrust in conventional medicine, the media, and politics. And a pronounced tendency to look for alternatives. Nowhere in Bavaria are there as many Heilpraktiker as in Upper Bavaria. Heilpraktikers are not medical practitioners, they focus on so-called alternative medicine (SCAM) and do not have to prove that they can effectively treat patients, even if that is what the name suggests. “That seems to be a cultural factor in the region. They are already pretty much in their own soup here,” says the director of the local hospital, Jens Deerberg-Wittram. There is much skepticism towards everything that comes from above and a pronounced interest in SCAM in the region, he says.

The gradient runs from north to south through Bavaria. With Heilpraktiker as well as with vaccination. The higher the density of Heilpraktiker, the lower the uptake of immunizations. This is just as true for Corona as for vaccination in general. For measles, the figure for fully vaccinated children in 2019 was 92.3 % in Germany, but in Rosenheim, it was only 83.3 %. “These are all ingredients for the big Corona cake,” says Deerberg-Wittram.

In Rosenheim, vaccination takes place in the local Volkshochschule, the German institution of adult education (as DER SPIEGEL disclosed [with my help] in 2018, these institutions are deeply steeped in woo and the Volkshochschule in Rosenheim even offers a course led by a Heilpraktiker). Although there is only a small, inconspicuous sign in the window outside of the Volkshochschule in Rosenheim, the queue of people wanting to be vaccinated is long. It stretches across the entire first floor; above the heads of the waiting people, the courses on offer flicker on a monitor: Crochet and knitting in the sewing room, integration courses, language courses in English and Spanish at different levels. Yoga for the elderly, Tai Chi.

In a recently published study, the willingness to be vaccinated of parents of underage children and persons without underage children was examined. The study was based on a random sample (telephone survey, n = 2014, survey between 12.11.2020 and 10.12.2020).
The results revealed that parents consistently show a lower propensity to vaccinate with a COVID-19 vaccine than respondents without minor children (54.1% vs. 71.1%). Fathers showed a more pronounced own willingness to vaccinate than mothers. Furthermore, men were more willing than women to have their own child vaccinated with a COVID-19 vaccine.
The overall sample also showed that a rejection of so-called alternative medicine (SCAM) was associated with a significantly higher willingness to be vaccinated. There was also a significant correlation between the attitude towards homeopathy and one’s own willingness to be vaccinated. If homeopathy was supported, the willingness to vaccinate was lower. This correlation between the attitude towards homeopathy and willingness to vaccinate was also evident in the sub-sample of parents. Among the parents, it was again the women who significantly more often had a positive attitude towards homeopathy than men, who more often do not think anything of it.

This new evidence ties in neatly with many of my previous posts on the subject of SCAM and vaccination, for instance:

Collectively, this evidence tells us that:

  • the effect has been shown in many different ways,
  • it can therefore be assumed to be real,
  • it is not confined to COVID vaccinations,
  • it is not confined to one particular branch of SCAM,
  • it even affects MDs (who surely should know better) dabbling in SCAM,
  • it has a long history,
  • it is prevalent in many, if not most countries,
  • it does real harm.

So, the next time someone tells you that SCAM and SCAM practitioners have a positive influence on public health, tell them to think again.

 

Increased intestinal permeability, also often called leaky gut syndrome, has been popularized by some health practitioners, mainly those of so-called alternative medicine (SCAM). There is insufficient evidence to support its existence and the claim that SCAMs are effective treatments of it is unsubstantiated.

This study aims to describe the health-seeking behavior of Australian adults with suspected increased intestinal permeability (IP). A cross-sectional survey was conducted of 589 Australian adults who have been diagnosed with IP or have suspected (undiagnosed) IP.

The majority (56.2%) of participants with suspected IP reported self-diagnosing their condition, with the majority (56.7%) of these participants preferring to be assessed using an accurate method by a general practitioner or naturopath. On average, Australian adults with suspected IP spent 11.1 (95% CI: 9.5, 12.8) years between first suspecting IP and receiving a formal diagnosis. Over the previous 12 months, participants spent an average of $699 on consultation fees, $2176 on dietary supplements for the treatment of IP, and an average of $287 on the assessment of IP. Furthermore, participants who find it difficult to live on their available household income spent significantly more (mean=$2963) on dietary supplements compared to participants who find it easy to live on their available household income ($1918) (p=0.015).

In terms of the preferred method of treating IP, participants ‘strongly prefer’ the use of dietary products (n=392, 82.2%), followed by lifestyle habits (n=357, 76.5%), and dietary supplements (n=324, 68.6%). On the contrary, 82.8% (n=351) of participants ‘slightly prefer’ the use of medications to treat IP, representing the least preferred method of IP treatment.

The authors concluded that the majority of participants experienced a considerable length of time between first suspecting IP and receiving a diagnosis of IP. The out-of-pocket expenditure associated with the management of IP suggests a financial burden for people with suspected IP. The results of this study provide novel patient-centred considerations that can be used to inform a clinical practice guideline for the management of IP.

I would, however, draw a very different conclusion from these data: patients who think they suffer from IP often fall into the hands of SCAM practitioners who assure them to have a non-existing disease and relieve them of their money by treating them with bogus SCAM.

As discussed regularly on this blog, there is plenty of evidence to show that many chiropractors, homeopaths, and naturopaths discourage their patients from getting vaccinated. Now, a further investigation from the US seems to confirm these findings.

This analysis aims to evaluate differences between categories of so-called alternative medicine (SCAM) regarding vaccination behavior among US adults.

The data from the 2017 National Health Interview Survey (NHIS; n = 26,742; response rate 80.7%) was used for this purpose. Prevalences of flu vaccination, consultations with SCAM practitioners in the past 12 months, and their potential interactions were examined.

A total of 42.7% of participants had received the flu vaccination in the past 12 months, 32.4% had seen one or more SCAM practitioners. Users of any type of SCAM were as likely as non-users to have received a flu vaccination (44.8% users versus 41.7% non-users; p = 0,862; adjusted odds ratio [AOR] = 1.01, 95% confidence interval [CI] = 0.95-1.07).

Regarding specific SCAMs, individuals consulting with

  • naturopaths (p < 0.001; AOR = 0.67, 95 %CI = 0.54-0.82),
  • homeopaths (p < 0.001; AOR = 0.55; 95 %CI = 0.44-0.69),
  • chiropractors (p = 0.016; AOR = 0.9, 95 %CI = 0.83-0.98)

were less likely, while other SCAM approaches showed no significant association with flu vaccination behavior. Independent predictors for a flu shot were prior diabetes, cancer, current asthma, kidney disease, overweight and current pregnancy. As well, higher educational level, age, ethnicity, health insurance coverage, and having seen a general physician or medical specialist in the past 12 months were also associated with a higher vaccination rate.

The authors concluded that SCAM users were equally likely to receive an influenza vaccination compared with non-users. Different complementary therapies showed varied associations with vaccination behavior. Further analyses may be needed to distinguish influencing factors among patients’ vaccination behavior.

This investigation confirms the prevalent anti-vax stance within chiropractic, homeopathy, and naturopathy. The effect is strongest by far with homeopaths. Nothing new! We knew this for a very long time. The question is WHAT ARE WE DOING ABOUT IT? Or more specifically, are the professional organizations of these SCAM professions finally going to take any actions against even the most rabid anti-vaxxers in their midst?

And the answer?

You guessed it: NO!

And the irony of all this must not get lost here: chiropractors, homeopaths, naturopaths, and their respective organizations all pride themselves regularly that they attribute particular importance to disease prevention.

Recently, I wrote about the court case of a French naturopath. Last week, the judge has issued his verdict. Miguel Barthéléry was sentenced to a two-year suspended prison term and to a fine of 5 000 Euros. Two cancer patients had died following his treatments and recommendations. Barthéléry was also found guilty of impersonating a doctor and illegally practising medicine. In addition, he was also banned for life from practising as a healthcare professional.

The Paris criminal court found that Miguel Barthéléry had deliberately created confusion about his qualifications by presenting himself as a doctor on the internet and in text messages to the two victims. The defendant had claimed to have a doctorate and a post-doctorate from the United States. The judgment “has the consequence of dissuading all those who engage in the same abuses, they are now warned that we can not do anything with the health of people,” said the judge.

The case had begun in February 2019 with the complaint of the companion of a man who had died two months earlier of testicular cancer. Diagnosed in 2016, the patient had not consulted a doctor but had preferred to follow a “health plan” drawn up by the naturopath. It was based on fasting and cures, raw food, and essential oils. Later, the family of a Belgian physiotherapist, who died of uterine cancer at the age of 39, joined the legal case. However, according to Code Source, the Parisien podcast, the case is more extensive, with seven further suspicious deaths of Barthéléry’s patients.

Barthéléry’s lawyer said that the decision “raises questions more generally about the appreciation that we now have of alternative therapeutic practices, which now seem, although not prohibited by law, to be subject to condemnation by the courts.”

 

I was asked by the ‘Science Media Centre’ (SMC) to provide a short comment on the following press release (which was embargoed until today):

Daily use of cannabidiol (‘CBD’) oil may be linked to lung cancer regression 

… The report authors describe the case of a woman in her 80s, diagnosed with non-small cell lung cancer. She also had mild chronic obstructive pulmonary disease (COPD), osteoarthritis, and high blood pressure, for which she was taking various drugs.

She was a smoker, getting through around a pack plus of cigarettes every week (68 packs/year).

Her tumour was 41 mm in size at diagnosis, with no evidence of local or further spread, so was suitable for conventional treatment of surgery, chemotherapy, and radiotherapy. But the woman refused treatment, so was placed under ‘watch and wait’ monitoring, which included regular CT scans every 3-6 months.

These showed that the tumour was progressively shrinking, reducing in size from 41 mm in June 2018 to 10 mm by February 2021, equal to an overall 76% reduction in maximum diameter, averaging 2.4% a month, say the report authors.

When contacted in 2019 to discuss her progress, the woman revealed that she had been taking CBD oil as an alternative self-treatment for her lung cancer since August 2018, shortly after her original diagnosis.

She had done so on the advice of a relative, after witnessing her husband struggle with the side effects of radiotherapy. She said she consistently took 0.5 ml of the oil, usually three times a day, but sometimes twice.

The supplier had advised that the main active ingredients were Δ9-­tetrahydrocannabinol (THC) at 19.5%, cannabidiol at around 20%, and tetrahydrocannabinolic acid (THCA) at around 24%.

The supplier also advised that hot food or drinks should be avoided when taking the oil as she might otherwise feel stoned. The woman said she had reduced appetite since taking the oil but had no other obvious ‘side effects’. There were no other changes to her prescribed meds, diet, or lifestyle. And she continued to smoke throughout.

This is just one case report, with only one other similar case reported, caution the authors. And it’s not clear which of the CBD oil ingredients might have been helpful.

“We are unable to confirm the full ingredients of the CBD oil that the patient was taking or to provide information on which of the ingredient(s) may be contributing to the observed tumour regression,” they point out.

And they emphasise: “Although there appears to be a relationship between the intake of CBD oil and the observed tumour regression, we are unable to conclusively confirm that the tumour regression is due to the patient taking CBD oil.”

Cannabis has a long ‘medicinal’ history in modern medicine, having been first introduced in 1842 for its analgesic, sedative, anti-inflammatory, antispasmodic and anticonvulsant effects. And it is widely believed that cannabinoids can help people with chronic pain, anxiety and sleep disorders; cannabinoids are also used in palliative care, the authors add.

“More research is needed to identify the actual mechanism of action, administration pathways, safe dosages, its effects on different types of cancer and any potential adverse side effects when using cannabinoids,” they conclude.

The SMC published three invited comments:

Prof David Nutt, The Edmond J Safra Chair in Neuropsychopharmacology, Imperial College London, said: 

“This is one of many such promising single case reports of medical cannabis self-treatment for various cancers.  Such case reports are biologically credible given the adaptogenic nature of the endocannabinoid system.  A case report itself is not sufficient to give any form of proof that one thing caused the other – we need trials for that.  There are some controlled trials already started and more are required to properly explore the potential of medical cannabis in a range of cancers.”

Prof Edzard Ernst, Emeritus Professor of Complementary Medicine, University of Exeter, said: 

“Cannabinoids have been shown to reduce the size of prostate cancer tumours in animal models.  Previous case reports have yielded encouraging findings also in human cancers.  However, case reports cannot be considered to be reliable evidence, and there are currently no data from rigorous clinical trials to suggest that cannabis products will alter the natural history of any cancer.” 

Dr Tom Freeman, Senior Lecturer and Director of the Addiction and Mental Health Group, University of Bath, said: 

“These results are exciting and very encouraging for this patient.  However as a single case study the quality of scientific evidence is low and should not be used to change clinical practice.  People with lung cancer should always seek guidance from a healthcare professional when deciding on an appropriate treatment. 

“The product used by this patient reportedly contained high levels of THC (the intoxicating component of cannabis), and was sourced from outside the UK.  This type of product is very different to most CBD oils which predominantly contain CBD.  Unlike prescribed medicines, CBD wellness products lack assurance of quality, safety or efficacy and should not be used for medicinal purposes.”

The original paper has now been published and can be found here.

The global market for dietary supplements has grown continuously during the past years. In 2019, it amounted to around US$ 353 billion. The pandemic led to a further significant boost in sales. Evidently, many consumers listened to the sly promotion by the supplement industry. Thus they began to be convinced that supplements might stimulate their immune system and thus protect them against COVID-19 infections.

During the pre-pandemic years, the US sales figures had typically increased by about 5% year on year. In 2020, the increase amounted to a staggering 44 % (US$435 million) during the six weeks preceding April 5th, 2020 relative to the same period in 2019. The demand for multivitamins in the US reached a peak in March 2020 when sales figures had risen by 51.2 %. Total sales of vitamins and other supplements amounted to almost 120 million units for that period alone. In the UK, vitamin sales increased by 63 % and, in France, sales grew by around 40–60 % in March 2020 compared to the same period of the previous year.

Vis a vis such impressive sales figures, one should ask whether dietary supplements really do produce the benefit that consumers hope for. More precisely, is there any sound evidence that these supplements protect us from getting infected by COVID-19? In an attempt to answer this question, I conducted several Medline searches. Here are the conclusions of the relevant clinical trials and systematic reviews that I thus found:

Confused?

Me too!

Does the evidence justify the boom in sales of dietary supplements?

More specifically, is there good evidence that the products the US supplement industry is selling protect us against COVID-19 infections?

No, I don’t think so.

So, what precisely is behind the recent sales boom?

It surely is the claim that supplements protect us from Covid-19 which is being promoted in many different ways by the industry. In other words, we are being taken for a (very expensive) ride.

Traditional European Medicine (TEM) is an increasingly popular yet ill-defined term. Like Traditional Chinese Medicine (TCM), it encompasses all the traditional therapies from the respective region. One website describes it with this very odd graph:

On Medline, I found only very few papers on TEM. One article reported about a congress based on the concept of TEM but confusingly called it ‘European Traditional Medicine (ETM). Here are a few excerpts:

… the aim of this congress is to explore and survey, very old and modern traditional based therapies and treatments curing the principles of scientific medicine (). Discussions of the links between ETM and other traditional medicines therefore are mandatory, particularly when considering the importance of traditionally based therapies that are still a source of primary health care to about 70 percent of the world’s population. Connections between traditional medicine and human health have been addressed and commented upon by many national and international political and sanitary bodies because: a) the good health of populations requires enlightened management of our social resources, economic relations, and of the natural world, and b) that many of today’s public-health issues have their roots in lack of scientifically sustainable holistic approach to the patient c) many socioeconomic inequalities and irrational consumption patterns that jeopardize the future economic sustainability of health.

In the same context the conventional biomedical approach to health is based on methods of diagnosing and treating specific pathologies: one pathogen = one disease, an approach that does not take into account connections between diseases, humanity, and some psychological aspects of suffering, and other socioeconomic factors such as poverty and education, and even the connections between disease and the environment in which sick people lives (,).

Other authors, like the one on this website, are much more concrete. Again, a few excerpts must suffice:

Bloodletting
When bloodletting according to Hildegard von Bingen max. 150 ml of blood taken. It is one of the most valuable and fastest detoxification options in TEM. In some people, no blood comes, because the body has no need to excrete something. For others, the doctor may say a lot about human health after the blood has been left for about 2 hours. If the serum is yellowish or whitish, this indicates excess fats. If certain threads form, they are signs of inflammation. Then the doctor gives recommendations for certain herbs and applications.

Wraps and packs
Whether neck wrap or hay flower sack. In TEM, there are many natural remedies made from natural materials (clay, pots) and herbs that support the body’s self-healing powers.

Wyda instead of yoga
Wyda is a holistic philosophy that is about getting in touch with yourself. In doing so, one can relax through flowing exercises and energy sounds, strengthen one’s mind or stimulate the metabolism. The exercises are similar in some ways to yoga. Here you can learn more about European yoga!

Which archetype are you?

In Traditional European Medicine (TEM), the archetype of a human is first determined so that the TEM doctor can coordinate the treatments. There are 4 temperatures:

Sanguine: He is active, open-hearted, energetic and mostly optimistic and cheerful. He is not resentful and does what he enjoys.
Suitable use: cool applications such as chest and liver wrap, whole body rubbings with grape seed and lemon balm oils.
Abandonment: too much sweet and fat, animal foods, sweet alcohol.

Choleric: He has a hot temper, shows leadership qualities, is prone to hyperbole, emotional and outbursts of anger, is extroverted, but often uncontrolled. Suitable application: cooling and calming applications. Massages with thistle, almond and lavender oils.
Avoidance of: too much animal protein, alcohol, hot spices and fatty foods.

Phlegmatic: enjoyment is important to him. He is reliable, can accomplish things, but seldom initiate. To get going causes him problems when he “runs”, then persistently and with energy.
Suitable application: warming and drying applications, warm chest wraps. Abdominal massages with camelina oil, marigold ointment.
Abandonment: too much sweets, milk, whole grains, tropical fruits, pork, too many carbohydrates.

Melancholic: He is an admonisher and a thinker, appreciates beauty and intelligence, is more introverted. He tends to ponder and pessimism, struggling for an activity.
Suitable use: warm applications such as warm chest wraps and liver wrap. Clay in water in the morning relieves gastrointestinal discomfort. Massages with strengthening cedar nut oil.
No: Frozen food, raw food, hard to digest, too much salt and sugar.

Yes, much of this is dangerous nostalgic nonsense that would lead us straight back into the dark ages.

Do we need more of this in so-called alternative medicine (SCAM)?

Definitely not!

TCM was created by Mao as a substitute for real medicine, at a time when China was desperately short of medicine. The creators of TEM have no such reason or motivation. So, why do they do it?

Search me!

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