naturopathy
The attitude of Robert F. Kennedy Jr. (RFKJr.) on science and evidence-based medicine has long been a source for concern, particularly if we consider his total lack of expertise combined with his immense power to influence public health of the US and beyond. Here are several key quotes and recurring themes that define his perspective:
- “The CDC is a subsidiary of the pharmaceutical industry. The agency’s advisory committee is essentially a front for the vaccine manufacturers.”
- “Tony Fauci’s career has been a long-running effort to prioritize the interests of Big Pharma over public health.”
- “The FDA, the NIH, the CDC—all these agencies have become the sock puppets of the industries they are supposed to regulate.”
- “The scientists who are supposed to be the guardians of our children’s health are instead taking money from the companies that are poisoning them.”
- “We are living in an era where ‘evidence-based medicine’ has been replaced by ‘reimbursement-based medicine.’ The data is cooked to favour the product.”
- “I am not anti-vaccine. I am pro-science and pro-safety. I want the same kind of rigorous, double-blind, placebo-controlled testing for vaccines that we require for every other medication.”
- “When people say ‘follow the science,’ they usually mean ‘follow the decree of the person in power.’ Science is a process of constant questioning, not a set of holy commandments.”
- “Consensus is the enemy of science. Science is about dissent; it’s about looking at the outliers and the data that doesn’t fit the narrative.”
- “The minute you say ‘the science is settled,’ you are no longer talking about science; you are talking about religion and totalitarianism.”
- “Public health policy is no longer based on the best available evidence; it’s based on the best available lobbyists.”
- “I don’t necessarily believe all the scientists, because I can read science myself. That’s what I do for a living. I read science critically.”
- “I spent 40 years cross-examining experts… I know how to tell when someone is lying to me about the data.”
- “I am pro-science. I’ve spent my life fighting for science-based policies. What I am against is ‘captured’ science that serves a corporate bottom line.”
- “I advise parents: do your own research… don’t take my word for it, and don’t take the government’s word for it.”
- “I don’t think people should be taking medical advice from me… I think what we’re going to try to do is to lay out the pros and cons… with replicable studies.”
- “People should be skeptical of any medical advice. They need to look at the primary sources, not the summaries provided by the pharmaceutical industry.”
- “Trusting the experts is not a feature of democracy and it’s not a feature of science. It’s a feature of religion and totalitarianism.”
- “We train physicians to wield the latest surgical tools, but not to guide patients on how to stay out of the operating room in the first place.”
- “The science [on nutrition] is indisputable, and the void [in medical training] is clear… future physicians must graduate prepared to prevent disease.”
- “I’m not scared of a germ. I used to snort cocaine off of toilet seats.”
- “One of the worst parts of addiction was my total incapacity to keep contracts with myself. I didn’t want to be someone who woke up every morning thinking about drugs.”
- “All of us have kind of a God-sized hole in us that we’re trying to fill. And addicts… try to fill that hole inside of you with things that change the way you feel about yourself.”
- “You can’t live off the laurels of the spiritual awakening. You have to renew it every day. You have to wake up every day and say ‘reporting for duty sir,’ and give up control every day.”
- “I had a dark spot on my brain scans… doctors concluded I had a tumor. I was scheduled for an operation by the same surgeon who operated on my uncle.”
- “The abnormality was caused by a worm that got into my brain and ate a portion of it and then died.”
- “I probably got it in South Asia… I was traveling in a lot of places where you can get those kinds of parasites.”
- “I have cognitive problems, clearly. I have short-term memory loss, and I have longer-term memory loss that affects me.”
- “It didn’t require treatment. The worm died on its own, and the symptoms cleared up over time.”
- “I recovered from the memory loss and mental fogginess… I have no aftereffects from the parasite.”
- “Questioning my health is a hilarious suggestion, given the competition.”
RFKJr., as U.S. HHS Secretary since early 2025, was tasked by Trump with restoring trust in healthcare agencies. However, polls show trust has further eroded under his leadership, with KFF data indicating widespread disapproval – nearly 60% of adults – and drops in confidence for CDC, FDA, and vaccine info sources. His tenure involved firing CDC vaccine advisors, slashing HHS staff by 25%, revising childhood vaccine schedules (e.g., dropping hep B at birth), and canceling research grants, sparking measles outbreaks and expert backlash. Public health leaders cite these as science-defying moves worsening distrust across parties. Only 37% trust RFK Jr. as a health info source (KFF Jan 2026). Major health organizations, like the WHO and the American Academy of Pediatrics, point to decades of peer-reviewed, large-scale epidemiological studies that contradict the plethora of demonstrably wrong assertions of RFKJr.
One could almost pity RFKJr. for his naive stupidity – I say ‘almost’ because his stance is not just pitiful and embarrassing, it is evidently dangerous. If a chap having a beer in your local pub came out with such nonsense, you would laugh; if RFKJr. does it and then – horror of horrors – tries to act on it, it gets frightfully dangerous for us all.
Conclusion:
Even Trump cannot be as mean as to allow RFKJr. continue the destruction of public health!
He must be replaced before it is too late!
Ita Wegman (22 February 1876 – 4 March 1943) was born 150 years ago today. Together with Rudolf Steiner, she was a central figure in the development of anthroposophic medicine, an approach that interprets illness through spiritual–cosmological concepts. In 1921, Wegman founded the Klinisch-Therapeutisches Institut in Arlesheim, Switzerland—today the Ita Wegman Clinic—the first hospital dedicated to anthroposophic medicine. Practices developed there included rhythmical massage, a gentle bodywork technique intended to “harmonize” physiological rhythms, and mistletoe-based cancer therapy derived from Viscum album, later marketed as Iscador, as well as many other remedies influences by homeopathy. Wegman also co-founded Weleda, which remains a major producer of anthroposophic remedies and cosmetics.
Despite its continued use in parts of Europe, mistletoe therapy (including Iscador) has not demonstrated reliable clinical efficacy in improving cancer survival or tumor outcomes in well-controlled trials. Major systematic reviews conclude that evidence for benefit is inconsistent, methodologically weak, and often biased, with any reported improvements largely limited to subjective quality-of-life measures. It is therefore regarded by mainstream oncology as an unproven therapy rather than an evidence-based treatment. For Wegman’s other therapeutic innovations the evidence is even less convincing.
Her collaboration with Steiner was both professionally formative and personally intense. They met in the early 1900s, and Wegman later credited Steiner with inspiring her decision to pursue medicine relatively late, enrolling at the University of Zurich. From 1919 onward, their cooperation deepened: Steiner supplied esoteric frameworks derived from anthroposophy, while Wegman sought to translate these ideas into clinical practice. Their collaboration culminated in the book “Fundamentals of Therapy” (1925), published shortly after Steiner’s death.
Speculation about a romantic relationship between Wegman and Steiner has persisted for decades. Purported “love letters” dated to 1924 describe expressions of affection, but most scholars regard them as forgeries, citing factual errors, the absence of originals from Steiner archives, and stylistic inconsistencies with Steiner’s documented correspondence. Steiner himself described their bond in karmic terms, claiming a debt from a past incarnation that explained their closeness despite his marriage to Marie von Sivers. Historian Peter Selg and others interpret the relationship as an intense spiritual and intellectual partnership rather than a conventional affair, though contemporaries did circulate rumors.
Steiner died on March 30, 1925, after a prolonged illness. The exact cause remains uncertain and not definitively confirmed as stomach cancer. Wegman provided Steiner’s main care from September 1924 until his death, leaving her clinic to nurse him in his studio at the Goetheanum in Dornach, Switzerland. She is said to have employed anthroposophic approaches, but specific treatments remain sparsely documented in available accounts.
Following Steiner’s death, Wegman’s authority within the movement became increasingly contested. In 1935 she was expelled from the Anthroposophical Society amid internal power struggles and accusations of doctrinal deviation; this expulsion was formally reversed in 2018. Wegman’s political stance during the Nazi period remains controversial. While anthroposophy as a movement was partially suppressed in Nazi Germany, several leading anthroposophists – including Wegman – sought accommodation rather than resistance. Wegman expressed hopes in the early 1930s that National Socialism might support a spiritual renewal of society and did not publicly oppose the regime. Although she was not a member of the Nazi Party and later faced restrictions, her posture is best described as opportunistic accommodation and ideological ambiguity.
Wegman’s collaboration with Steiner created the foundations of anthroposophic medicine. It also generated enduring scientific, ethical, and political controversies – particularly regarding the medical validity of its treatments and its leaders’ responses to authoritarian power after Steiner’s death.
Psoriasis is an immune-mediated inflammatory skin disease. By more than a decade of clinical validation, Jueyin granules (JYG) have demonstrated multi-target synergistic immunomodulatory and anti-inflammatory effects, offering a characteristic Traditional Chinese Medicine (TCM) therapeutic approach for psoriasis.
Aim of this study was to assess the efficacy and safety of oral JYG in treating psoriasis with blood-heat syndrome. Participants with body surface area (BSA) score less than 10 were allocated to receive JYG or placebo treatment in a 1:1 ratio through central area division and block randomization. The primary outcome is reduction of the psoriasis area severity index (PASI) score and proportion of participants achieving a greater than 50 % reduction in PASI scores (PASI50) at week 8.
Between November 2019 and April 2022, 195 participants were randomly assigned to receive JYG (n = 99) or a placebo (n = 96) at five centers. The JYG group demonstrated significantly greater reductions in PASI and BSA scores than the placebo group at week 8 (both P < 0.001) and maintained these improvements at week 16 (P < 0.001 and P = 0.005, respectively). By week 8, 51.09 % of participants in the JYG group achieved PASI50, compared to 20.65 % in the placebo group (P < 0.001). However, there were no statistical differences in dermatology life quality index (DLQI), visual analog scale (VAS) scores, or relapse rate.
The authors concluded that this study provides conclusive evidence that JYG is a safe and effective treatment for patients with mild-to-moderate psoriasis. The current findings support its use as a complementary and alternative therapy for psoriasis.
I think this paper needs a few explanations:
- What are Jueyin granules? This is a formula consisting of eight Chinese herbs (Haliotis diversicolor, Flos Lonicerae Japonicae, Radix Rehmanniae exsiccate, cortex moutan, Herba Hedyotisdiffusae, Folium isatidis, Smilax china L. and Radix Curcumae)
- What is the history? The formula was developed in the 1950s by Han Xia, a Chinese surgeon, and have been used to treat psoriasis for over 50 years by Yueyang Hospital of Integrated Traditional Chinese and Western Medicine.
- How did he develop it? We don’t know.
- Is the formula available outside China? No, not to the best of my knowledge.
- How reliable is this new trial? As we have discussed repeatedly on this blog, there are good reasons to mistrust Chinese studies.
- If we accept the findings nonetheless, are the conclusions valid? No! Firstly, this study cannot establish the safety of the formula. Secondly, a single trial cannot ‘conclusively’ establish the effectiveness of a therapy.
- Why does a respected journal publish such a dubious study? SERACH ME!
This case report details the death of a 59-year-old woman who succumbed to complications from lead poisoning (cerebral edema and encephalopathy) following the use of an herbal cream to treat hemorrhoids.
The patient with a past medical history of prediabetes was admitted to the emergency department after her husband found her experiencing seizure-like activity that morning. She had been in normal health the previous night, but suffered another seizure in the emergency department that lasted about three minutes and was subsequently started on Levetiracetam. During her most recent physical exam one week ago, her lab workup prompted a follow-up with
hematology due to anemia of unknown etiology. This time, her laboratory results indicated an elevated lactate level of 9.3 mmol/L, and her urine drug screen was negative. Additional labs showed elevations in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALKP) while her complete blood count still showed signs of anemia.
During her hospital stay, the patient developed neurogenic shock and diabetes insipidus. On the fourth day, a serum lead level drawn on the second day returned, showing a level greater than 200 µg/dL Physicians considered various potential sources of her lead exposure, including environmental or occupational contact, accidental ingestion or inhalation of lead particles, unregulated imported cosmetics, or contaminated herbal supplements.
After asking about her use of herbal medications, suspicion arose around a hemorrhoid ointment that the patient had recently purchased from Vietnam through a Facebook advertisement. Consequently, chelation therapy with oral succimer and a continuous infusion of ethylenediaminetetraacetic acid
was immediately initiated.
Cao Bôi Trĩ Cây Thầu Dầu (Castor Oil Hemorrhoid Extract) was promoted for the treatment of hemorrhoids via intra-rectal application . Testing by the California Department of Public Health (CDPH) revealed that the hemorrhoid ointment contained 4% lead (39,000 ppm), a highly lethal concentration. Even minimal lead exposure can be harmful and potentially lead to illness or death; thus, it is advised to avoid products likely to contain lead, especially imported items from other countries with inadequate lead testing standards.
As the patient’s condition continued to deteriorate, concerns for brain death arose. After being informed, the patient’s family consented to proceed with brain death testing. A second exam and a nuclear medicine (NM) brain perfusion scan were completed on the eighth day and it shows the absence of brain perfusion. Despite aggressive management, including seizure control, treatment of cerebral edema, and chelation for severe lead poisoning, the patient passed away on the eighth day due to acute neurological complications from severe lead toxicity complicated by cerebral edema.
As we have often discussed, so-called alternative medicines (SCAMs) can often be contaminated with harmful substances including heavy metals such as lead, e.g.:
- Heavy metal poisoning as a result of using Ayurvedic remedies
- If you ask me, Chinese herbal medicines are best avoided
- Death by homeopathy
- Inadequate regulation of Kratom supplements put consumers at risk
- Another death by homeopathy
- Ayurvedic medicines to die for
- Lead and arsenic intoxications due to ‘natural health products’
- How safe are herbal medicines?
- Ayurvedic medicines: efficacy doubtful with considerable risks
- Contamination and adulteration of herbal remedies
- Another death caused by ‘traditional wisdom’
This case underscores the urgent need for stricter regulations and oversight in the herbal medicine industry to prevent such health hazards. Implementing stronger regulatory measures is essential to ensure that all medicinal and cosmetic products are free from harmful contaminants and to safeguard public health against the significant risks associated with SCAMs.
The US stands on the precipice of the destruction of public health. This might be best exemplified by the loss of its measles-free status. In 2000, the U.S. had been classified as having “eliminated” measles, meaning the virus was no longer constantly circulating within its borders. Following a year of record-breaking outbreaks, the Pan American Health Organization (PAHO) is now reviewing whether to officially revoke this status.
The technical definition of losing elimination status is the continuous transmission of the same strain of a virus for more than 12 months. In 2025, the US experienced over 2,400 confirmed cases—the highest count since 1991—driven by major outbreaks in Texas, South Carolina, Arizona, and Utah. While health officials once relied on high vaccination rates to “wall off” imported cases, that protection has now crumbled. National MMR (measles, mumps, and rubella) vaccination rates for kindergartners have fallen below the 95% threshold required for achieving herd immunity. This leaves communities vulnerable to the kind of rapid spread seen over the past year.
The resurgence of measles is inextricably linked to the shift in federal health policy under Robert F. Kennedy Jr., the current Secretary of Health and Human Services (HHS). His influence has transformed vaccine hesitancy in the US from a fringe movement into a pillar of federal discourse. Kennedy has frequently misused his position to question the safety and necessity of the MMR vaccine, at one point suggesting that “natural infection” might be preferable to vaccination—a claim experts call dangerously misleading given that measles can cause encephalitis, permanent hearing loss, and death. Under Kennedy’s leadership, the CDC has been staffed with notorious anti-vaxers and reduced the number of recommended childhood vaccines and emphasized “personal choice” over community mandates. This shift has emboldened several states to loosen school entry requirements, leading to a record number of non-medical vaccine exemptions. By replacing members of the Advisory Committee on Immunization Practices (ACIP) with anti-vaxers, Kennedy has signaled a move away from the decades of scientific consensus that underpinned the 2000 elimination achievement.
Kennedy – who has no medical background and does clearly not understand science – argues that the primary threat to US health is not infectious disease but chronic illness (e.g., diabetes, obesity, and autism), which he feels are linked to environmental factors and food quality. His alternatives include advocating for “real food,” reducing ultra-processed foods, and discouraging the use of seed oils and certain pesticides. He has promoted the consumption of unpasteurized dairy, despite warnings from health officials regarding bacterial risks. He advocates for ending water fluoridation, claiming it contributes to chronic health issues in children. Kennedy also believes that “natural infection” – contracting the disease itself – can be a preferable alternative to vaccination for certain illnesses. He has expressed his support for un- or disproven treatments such as hydroxychloroquine and ivermectin for viral infections, as well as the use of psychedelics and stem cells in broader health contexts. His MAHA plan promotes a “holistic” approach that combines conventional medicine withhis complementary therapies like supplements and acupuncture.
To make matters even worse, the US officially completed its withdrawal from the World Health Organization (WHO) on January 22, 2026. This finalized a process that began on January 20, 2025, when Trump signed Executive Order 14155 on his first day in office. His previous attempt during his 1st term to leave the WHO was reversed by the Biden administration in 2021.
Losing measles-free status is more than a symbolic blow; it has practical and dire consequences. It signals to the world that the US public health infrastructure is failing to contain one of the most contagious diseases known to man. It means that “rare” outbreaks will become a permanent fixture of American life, requiring constant vigilance for infants too young to be vaccinated and the immunocompromised. And it bodes badly, of course, for the time when the next pandemic will emerge.
As the CDC completes its genomic sequencing to determine if the 2025 outbreaks constitute a single, unbroken chain of transmission, the US faces a choice. We are witnessing a “natural experiment” in real-time—one where the cost of Kennedy’s sick ideology is being paid in the form of preventable hospitalizations and lives lost. To put it bluntly: either the US gets rid of Kennedy and swiftly reverses his detrimental initiatives, or many US citizens will suffer ill health and even die because of his actions.
Robert F. Kennedy Jr. has, for many years, promoted claims that contradict established scientific consensus and common sense. Although he often frames his arguments as skepticism towards ‘the establishment’, his positions consistently conflict with the findings of sound science. This has led to widespread criticism from skeptics, scientists, physicians, and public health officials who argue that his rhetoric is steeped in misinformation.
The most prominent example is his long-standing insistence that vaccines cause autism, a claim that has been exhaustively studied and repeatedly disproven. Extensive epidemiological research involving millions of children across multiple countries has found no causal link between vaccination and autism, a conclusion affirmed by organizations such as the CDC and the WHO.
Kennedy has also continued to emphasize theories about mercury-based vaccine preservatives long after those substances were removed from most childhood vaccines, despite autism diagnosis rates continuing to rise—an outcome that directly contradicts his hypothesis and is not supported by sound evidence.
Recently his rejection of scientific consensus also expanded into the COVID-19 era. He characterized COVID vaccines as uniquely dangerous, suggested they could alter human DNA, and implied that public health agencies were concealing mass harm. These claims stand in overt contrast to real-world data from billions of administered doses, which show that serious adverse effects are rare and that vaccination dramatically reduces severe illness and death.
Similar patterns of misinformation appear in his claims about wireless technologies like 5G, which he has linked to immune suppression or cancer despite the well-established fact that such signals are non-ionizing and incapable of damaging DNA.
Underlying many of Kennedy’s positions is a recurring narrative that modern disease is primarily driven by hidden toxins and that public health institutions knowingly suppress cures or evidence of harm. While environmental exposures are a legitimate area of scientific study, Kennedy’s sweeping conclusions – often paired with sympathy for “detox” or so-called alternative medicine (SCAM) – go far beyond what evidence supports.
In conclusion, Kennedy erodes trust in medicine and science, replacing science with insinuations and conspiracy theories. The outcome of his ‘war on science’ has been a normalization of falsehoods that have been tested, rejected, and shown to be harmful. In a nutshell: Kennedy is a danger to all our health and well-being. The sooner he is replaced, the better for science, progress and global health.
I have reported several times previously on my blog that France has a problem with the promotion of unproven therapies into its routine healthcare, e.g.:
- No to the reimbursement of pseudo-therapies! An open letter from France
- Bad news for France: Patrick Hetzel, the new Minister for Higher Education and Research seems to be an anti-scientist
- France outlaws practices which expose patients to a serious health risk
- Dispute about so-called alternative medicine practitioners in France
- Osteopathy in France: widely accepted yet based on little more than wishful thinking
Now three presssure goups promoting unproven treatments seem to have succeeded to arrange a meeting in the French Senate. Therefore, the French ‘Collectif No Fakemed’ together with GEPS, GEMPPI have published an open letter addressed to the President of the Senate. Here is my translation of it:
Ladies and Gentlemen, Mr President of the Senate,
On 22 January, the Group for the Evaluation of Personalised Complementary Therapies (GETCOP) and the National Chamber of Health Practitioners (CNPS), with the support of the initiative of Integrative and Complementary Medicine (CUMIC), three important pressure groups promoting non-conventional care, are organising a meeting at the Senate, through Senator Laurence Muller-Bronn, entitled “Why and how to ensure the safe introduction of health practices? ” (https://archive.is/gsS64).
Let us make no mistake, these associations are seeking to promote and legitimise pseudo-medicines before the Senate and, more broadly, among our fellow citizens. These practices, which have not been proven to be effective, present risks of therapeutic abuse (loss of chance of recovery, undesirable side effects, social cost) and sectarian abuse. These pressure groups thus present legislators with a singular vision of health that runs counter to evidence-based medicine and may influence public decision-making. Indeed, among the announced speakers are well-known promoters of non-conventional practices, often esoteric, some of whom are linked to sectarian groups reported in parliamentary reports or by Miviludes (see below).
At a time when the press and institutions are constantly pointing the finger at these pressure groups, and when the Ministry of Health has launched a study on “Combating obscurantism and misinformation in health”, the results of which will be presented in January, it seems totally inconsistent that the national representation should endorse such an event.
We therefore call on Mr Gérard Larcher, President of the Senate, all senators and the State to ensure that this event, which calls into question the foundations of science and rationality in medicine, is cancelled outright, in accordance with Law No. 2024-420 of 10 May 2024 aimed at strengthening measures to combat sectarian aberrations and supporting victims.
Reference: a few examples of speakers announced for 22 January
– Valérie Broni, administrator of the CNPS, is a personal development coach and mentor. She offers treatments based on a biophotonic process, which has never been validated, that supposedly allows for a quick ‘scan’ of the body by simply recording data from the fingers in order to optimise one’s health. She also practises art therapy, psycho-energetics, Emotional Freedom Technique, Tong Ren, Cardiac Coherence, Matrix Reimprinting, all of which are approaches
identified by Miviludes (https://archive.is/qvFCZ, https://archive.is/eQnLx, https://archive.is/cskFN).
– Henri Tsiang, a Qi Gong teacher, offers a range of therapeutic practices derived from Chinese medicine, none of which are recognised by the Public Health Code: Taoist energy arts, meditation, Dao Yin, therapeutic Qi Gong, Tui Na massage, etc. (https://archive.is/UKvpf, https://archive.is/zThbn, https://urlr.me/Vm2Uga).
– Reza Moghaddassi, a philosopher associated with GETCOP and promoter of the concept of ‘integrative medicine,’ emphasises the role of meditation in healing. He participates in unique meetings such as the ‘International Symposium on Health, Meditation and Consciousness, Healing the Body, Healing the Soul’ (https://archive.is/Jw7vu).
– Dr Bernard Payrau, president of GETCOP and administrator of CNPS, claims affiliation with CERAP, a pseudo-institute of the Fasciatherapy movement, an extension of the Sri Ram Chandra sectarian group (https://urlr.me/a2t5Ce, https://urlr.me/AKtuTn). Fasciatherapy has been particularly
singled out by the press, as well as in the two volumes of Senate Report No. 480 produced on behalf of the Commission of Inquiry into the influence of sectarian movements in the field of health, under the direction of its President, Senator Alain Milon, and its Rapporteur, Senator Jacques Mézard, submitted to the Presidency of the Senate on 3 April 2013 (https://urlr.me/8eSnvg, https://urlr.me/Ty42qc).
– Prof. Fabrice Berna, Vice-President of Training at CUMIC, strongly advocates the integration of alternative medicine into healthcare pathways and the training of future doctors (https://urlr.me/taWAqR), while at the same time questioning the competence of Miviludes (https://archive.is/0AdP2). He is an
important member of a movement targeted by Miviludes, the Free University of Samadeva (https://urlr.me/vxN8sF, https://archive.is/DNLRk).
– Prof. Laurence Verneuil, Vice-President of Research at CUMIC (https://urlr.me/M7bWda), is a member of the Health United movement, whose purpose is to promote a myriad of pseudo-therapies that have not been scientifically validated (https://archive.is/T3LOj). United Health works very regularly with
the Men-Tsee-Khang Tibetan Medical and Astrological Institute, which places astrological analysis of diseases, including cancers and leukaemias, at the centre of its practice (https://urlr.me/vesJyZ, https://urlr.me/6Y8AJR).
Opioid withdrawal involves sympathetic hyperactivity and reduced parasympathetic tone, which standard pharmacological treatments may not adequately address, contributing to relapse vulnerability. This study evaluated yoga as adjuvant therapy to accelerate opioid withdrawal recovery and assess its impact on heart rate variability, anxiety, sleep, and pain.
This 2-arm, early-stage randomized clinical trial was conducted at an addiction medicine inpatient ward in India from April 30, 2023 to March 31, 2024. The outcome assessors and data analyst were blinded to group allocation. Participants included adults aged 18 to 50 years with opioid use disorder experiencing mild to moderate withdrawal symptoms (Clinical Opiate Withdrawal Scale [COWS] scores 4-24). Exclusion criteria included severe withdrawal, neurological conditions affecting autonomic function, severe psychiatric conditions, and recent yoga training. Of 68 individuals screened, 59 were randomized (30 yoga and 29 control participants).
Participants in the yoga group received (A) 10 supervised 45-minute sessions during 14 days alongside (B) standard buprenorphine treatment, including relaxation practices, postures, breathing techniques, and guided relaxation. Participants in the control group received (B) standard buprenorphine treatment only. Co-primary outcomes included time to withdrawal stabilization (COWS score <4) and heart rate variability parameters. Secondary outcomes included anxiety (Hamilton Anxiety Rating Scale), sleep latency, and pain scores. Assessments were conducted at baseline (day 1) and day 15.
Fifty-nine participants (59 male [100%]; mean [SD] age, 25.6 [3.9] years) completed intent-to-treat analysis. Participants in the yoga group recovered faster than those in the control group (hazard ratio [HR], 4.40; 95% CI, 2.40-8.07; P < .001), with a median stabilization time of 5 days (95% CI, 4-6 days) for those in the yoga group vs 9 days (95% CI, 7-13 days) for the control group. Participants in the yoga group showed superior heart rate variability improvements with large effects on low frequency (LF) power (ω2 = 0.16), high frequency (HF) power (ω2 = 0.14), and LF/HF ratio (ω2 = 0.12); all effects were statistically significant (P < .001). Mediation analysis showed that increases in parasympathetic activity accounted for 23% of the treatment effect (indirect HR, 1.38; 95% CI, 1.10-2.03). Anxiety reduction was significantly greater among those in the yoga group (ω2 = 0.28; P < .001), with moderate improvements in sleep latency (a 61-minute reduction; P = .008) and pain (P = .004).
The authors concluded that in this randomized clinical trial, yoga significantly accelerated opioid withdrawal recovery and improved autonomic regulation, anxiety, sleep, and pain. These findings support integrating yoga into withdrawal protocols as a neurobiologically informed intervention addressing core regulatory processes beyond symptom management.
This conclusion is demonstrably wrong, and I am dismayed that a reputable journal published it.
The study followed the infamous ‘A+B versus B’ design. It is infamous because it is seemingly rigorous (“A RANDOMIZED CLINICAL TRIAL”!!!), while invariably generating a positive result for the tested intervention – even if it happens to be nothing more than a placebo tretment. And because of this, it is, in my view, unethical to use it for concluding about the specific effects of the tested intervention. I have explained this so often that I hesitate to do it again:
- Imagine the treatments as two amounts of money.
- Amount (treatmet) A equals £1.
- Amount (treatment) B equals £2.
- If one (the verum) group gets A+B, it will have £3.
- If the other (control) group gets just £2, it will have £2.
- A+B is always more that B.
- If A is a placebo, the A+B > B still applies, due to the existance of placebo effects
- QED!
The crux is obviously that the A+B vs B design only appears to be rigorous but, in fact, does NOT control for placebo effects. Since placebo effects exist, the A+B vs B design must produce a positive result, even if the verum is ineffective and merely generates a placebo response.
As the type of yoga employed in this study is bound to generate a sizable placebo effect, it would easily be enought to cause the observed outcomes. Let me put it even more bluntly: this study design is unable to tell us whether the yoga therapy or a placebo response was responsible for the observed result*.
In view of this, I will re-formuate the first sentence of the conclusion as follows:
In this randomized clinical trial, a placebo effect accelerated opioid withdrawal recovery and improved autonomic regulation, anxiety, sleep, and pain.
But what about the 2nd sentence of the conclusion?
Arguably, it is even worse!
To claim that the findings of one single study sufiice for calling for the integration of the tested treatment into routine healthcare ignores the need for independent replications and is therefore dangerous nonsense.
*(Btw: this is also the reason why it is so popular with pseudoscientists trying to show that their pet therapy works.]
The WHO says it is sifting the wheat from the chaff in order to save lives – but critics fear it is pandering to India and China; this TELEGRAPH article is worth reading in full; here I will merely quote a few passages from it.
Mongolian shamans beat wicker drums to summon ancestral spirits. A Peruvian man in a headdress unleashes a piercing ululation. And a man from Kentucky tells me the body can rid itself of cancer if you eat the right shrubs. It is a line-up one might expect at the healing field at Glastonbury but this is a conference centre in New Delhi and the event has been organised by the World Health Organization; the WHO Global Summit on Traditional Medicine. It’s the second gathering of its kind, following an inaugural meeting in Gujarat in 2023, and the three-day event has drawn hundreds of delegates from around the world. Alongside yoga instructors, aromatherapists, Chinese herbal practitioners and a small army of homeopaths, sit senior WHO officials, leading scientists and health ministers from across Africa, Asia and Latin America. Only Gwyneth Paltrow and her wellness website Goop is missing. They are here to “harness the potential” of traditional medicine, a catch-all term for practices that pre-date, and sit outside, modern evidence-based healthcare; therapies that for the most part have long been dismissed as quackery by mainstream science. What counts as “traditional medicine” ranges from drinking herbal teas to Indian Ayurveda, a holistic “wellness system” combining oils, herbs, homeopathy, yoga and meditation to “balance” and “heal” the body. To critics – and there are many – the scene is absurd.
So why is the WHO – a global authority on evidence-based health – giving a platform to this stuff? Has it fallen victim to the seductive power of TikTok-based wellness like so many of the west’s middle classes? Or has it – as some critics allege – been bought off by the traditional medicine super powers of India and China? …
The WHO says its Summit on Traditional Medicine is essentially about repeating this sifting process for traditional remedies used in other parts of the world. It aims to apply rigorous scientific analysis to all them in order to properly assess their claimed benefits and potential harms. By 2034, it says, it will publish a definitive list of which traditional treatments work – and which don’t. “Working on traditional medicine doesn’t mean we will use shortcuts or endorse things that are unproven,” Dr Sylvie Briand, the WHO’s Chief Scientist, told The Telegraph at the conference in New Delhi. The aim was first to document what traditional treatments existed around the world “and then see what could be more useful to address the disease of this century”.
One idea is that some traditional practices like yoga and meditation, while perhaps not offering direct curative benefits, could play an important role in preventative medicine. After all, so-called non-communicable diseases, often caused by lifestyle factors such as poor diet, chronic stress and a lack of exercise are now by far the biggest killers across the globe. “Many traditional systems of medicine take a holistic view and focus on strengthening the person as a whole, not just treating isolated symptoms,” Dr Sung Chol Kim, Unit Head for Traditional, Complementary and Integrative Medicine at the WHO told The Telegraph in Delhi. But others are sceptical. They fear the WHO, which is struggling for funding in the wake of the US leaving the organisation and widespread aid cuts, is simply pandering to India and China where traditional medicine is big business. Even if well intentioned, they worry that the discovery process the WHO has set in motion will end up promoting and legitimising quackery. “I think highly of the WHO. However, by giving a platform to traditional medicine practitioners who promote treatments that are unproven – or even disproven – such as homeopathy, the organisation risks legitimising quackery. That, in my view, is both unethical and irresponsible,” said Dr Edzard Ernst, a British-German academic who specialises in the study of complementary and alternative medicine…
Even within the WHO, there is tension over what is being platformed at the summit. One senior official, speaking on condition of anonymity, described homeopathy … as “complete nonsense”. “There is not one shred of evidence anywhere, absolutely anywhere, that suggests it works,” the official said, while acknowledging pressure to engage rather than alienate powerful member states. Dr Ernst, the British-German academic, said: “Many experts are puzzled by this attitude. The most likely explanation is that the WHO is bowing to political will instead of science.” ….
Globally, an estimated 4.6 billion people already use some form of traditional medicine. In sub-Saharan Africa, millions rely on traditional healers as their first – and sometimes only – point of care. Its use can delay access to appropriate treatment, and some practices have been linked to the spread of disease. This week, 41 people were reported to have died after undergoing rituals to initiate them into manhood in South Africa, a central part of which involves unsafe and brutal circumcisions. Another example, common in places like Uganda, Benin, and Burkina Faso, includes small skin incisions into which herbs are rubbed – sometimes referred to as “vaccinations” – increasing the risk of HIV transmission through the reuse of razors and knives. Efforts to regulate practitioners are underway, but progress remains slow. Malawi’s Minister for Health and Sanitation, Madalitso Baloyi, said her government wants clear guidance from the WHO. “As a Ministry, we want to ensure [traditional remedies] are tested and quality checked,” she told The Telegraph. She added that, at the moment, traditional medicine is being done “behind closed doors”, and that the WHO process would help bring it into the open where it can be better monitored.
Yet the WHO seems undeterred. “Some traditional remedies will probably be found to be really active and really useful. Others will just be a placebo – for example, you feel better when you drink tea,” said Dr Reeder. The WHO argues that investing in traditional medicine could also help tackle the leading killers of the 21st century: non-communicable diseases such as obesity, diabetes, cardiovascular disease and mental illness. Holistic approaches to wellness incorporating exercise, a more considered diet and stress reduction could complement conventional treatments, placing “an emphasis on prevention over cure,” said Dr Tedros…
This study aimed to evaluate the comparative effectiveness of “fire cupping therapy” (FC) versus electroacupuncture for reducing pain and improving cervical spine range of motion in patients with neck pain due to cervical spondylosis. FC is essentially nothing else than the TCM version of cupping.
Eighty-two participants with neck pain caused by cervical spondylosis were randomly allocated in 1:1 ratio to either the fire cupping (FC) or the electroacupuncture (EA) group. Both groups received treatment at the EX-B2, A-shi, and GB21 acupuncture points. The two-week study assessed pain levels using the Visual Analog Scale (VAS) at 2 points in time post-intervention and evaluated adverse effects weekly.
After 2 weeks of intervention, VAS scores significantly decreased in both the FC group (from 6 (6–7) to 3 (2–3)) and the EA group (from 6 (6–7) to 2 (1–3)) (p<0.001). However, inter-group pain relief was not statistically significant (p = 0.5794, Cohen’s d = 21 0.12; 95% CI [-0.31–0.6]). Both groups showed statistically significant ROM improvement (p<0.001), though the EA group demonstrated better improvement in flexion, extension, and left/right lateral flexion (p<0.05). No adverse effects of FC were reported.
The authors concluded that FC appears to be an effective and safe therapy for neck pain due to cervical spondylosis, showing similar pain relief efficacy with no statistically significant difference compared to electroacupuncture despite a lower treatment dosage. However, due to methodological limitations, these findings should be interpreted with caution and warrant further validation in rigorously designed studies.
I do agree with the authors’ call for caution – but with little else of what they state. Here are some of my concerns:
- A trial comparing two supposedly active treatments is an ‘equivalence study’; and such investigations require much larger sample sizes that 80.
- Equivalence studies only make sense, if one of the two treatments has been shown beyond doubt to be effective; this is not the case for electroacupuncture nor for FC.
- As it stands, the study does not control for placebo effects; thus the findings are in accordance with both treatments being pure placebos.
- A study with 80 patients tells us as good as nothing about the safety of the iterventions; to draw conclusions about safety is thus unwarranted
My conclusion (yet again) is this:
If you design a nonsense study, you are asking for a nonsense result.
