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

risk

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Dr Julian Kenyon is no stranger to this blog:

I met him once or twice in the mid 1990s. Then he was the GP partner of the late George Lewith. It took me not long to find that I thought of the former even less than the latter.

Now it has been reported that Julian Kenyon was struck off the UK medical register. Apparently, he put pressure on a patient with advanced cancer to pay £13,000 for so-called alternative medicine (SCAM), including sound and light therapy. He ran the former Dove Clinic, a private health centre at Twyford, Hampshire and wrongly told his patient: “You have had all the standard treatments and you are running out of treatment options”. Kenyon’s prescription in May 2022 included sonodynamic/photodynamic therapy as well as the supplements cannabidiol, claricell and similase. The patient was asked to pay a further £20,000 if the initial course of treatment was unsuccessful, the tribunal heard.

The Medical Practitioners Tribunal Service (MPTS) ruled that the doctor’s conduct was “wholly unacceptable, morally culpable and disgraceful”. Kenyon told his patient that there was a 10% chance of his stage 4 prostate cancer being cured. This was a “total fabrication”, the MTPS found. The patient “was vulnerable and… made to feel under pressure to have expensive treatment that was not in his best interests”, it added.

Kenyon has form:

  • In 2003, an undercover investigation by the BBC Inside Out programme accused Dr Kenyon of using spurious tests for allergies.
  • In 2013, a tribunal found he failed to give good care.
  • The following year, it said he made a misleading cancer cure claim.

The latest MTPS ruling bars Dr Kenyon from practising medicine in the UK. His former clinic went into liquidation in March 2023 and has debts of more than £154,000, according to Companies House. Despite all this, it was deemed to be “safe” and “effective”, according to its latest Care Quality Commission report, external in 2019.

This prospective cohort study examined the effects of fish oil supplements on the clinical course of cardiovascular disease, from a healthy state to atrial fibrillation, major adverse cardiovascular events, and subsequently death.

The analysis is based on the UK Biobank study (1 January 2006 to 31 December 2010, with follow-up to 31 March 2021 (median follow-up 11.9 years)) including 415 737 participants, aged 40-69 years. Incident cases of atrial fibrillation, major adverse cardiovascular events, and death, identified by linkage to hospital inpatient records and death registries. Role of fish oil supplements in different progressive stages of cardiovascular diseases, from healthy status (primary stage), to atrial fibrillation (secondary stage), major adverse cardiovascular events (tertiary stage), and death (end stage).

Among 415 737 participants free of cardiovascular diseases, 18 367 patients with incident atrial fibrillation, 22 636 with major adverse cardiovascular events, and 22 140 deaths during follow-up were identified. Regular use of fish oil supplements had different roles in the transitions from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death:

  • For people without cardiovascular disease, hazard ratios were 1.13 (95% confidence interval 1.10 to 1.17) for the transition from healthy status to atrial fibrillation and 1.05 (1.00 to 1.11) from healthy status to stroke.
  • For participants with a diagnosis of a known cardiovascular disease, regular use of fish oil supplements was beneficial for transitions from atrial fibrillation to major adverse cardiovascular events (hazard ratio 0.92, 0.87 to 0.98), atrial fibrillation to myocardial infarction (0.85, 0.76 to 0.96), and heart failure to death (0.91, 0.84 to 0.99).

The authors concluded that regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for progression of cardiovascular disease from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements.

I must admit that I am slightly puzzled by this study and its findings. The authors clearly speak of the ‘role’ regular use of fish oil supplements has. This language implies a casual impact. Yet, what we have here are associations, and every 1st year medical student knows that

correlation is not causation.

Other things to note are that:

  • the associations are only very weak;
  • they go in opposite directions depending on the subpopulation that is examined,
  • there is no plausible mechanism of action to explain all this.

Collectively, these facts suggest to me that we are indeed more likely dealing here with a non-causal association and not a causal link. All the more surprising then that the (UK) press took up this paper in a major and occasionally alarmist fashion (the headline in THE TELEGRAPH was Revealed: How cod liver oil could be bad for your health). I learned of it by listening to the BBC headline news.

 

We have discussed the LIGHTNING PROCESS before:

Now, the BBC reports that it is promoted as a treatment of Long-COVID. Oonagh Cousins was offered a free place on a course run by the Lightning Process, which teaches people they can rewire their brains to stop or improve long Covid symptoms quickly. Ms Cousins, who contracted Covid in March 2020, said it “exploits” people.

Ms Cousins had reached a career goal many athletes can only dream of – being selected for the Olympics – when she developed long Covid. By the time the cancelled 2020 Olympic Games in Tokyo were rescheduled for 2021, Ms Cousins was too ill to take part. When she went public with her struggles, she was approached by the Lightning Process. It offered her a free place on a three-day course, which usually costs around £1,000.

“They were trying to suggest that I could think my way out of the symptoms, basically. And I disputed that entirely,” the former rower said. “I had a very clearly physical illness. And I felt that they were blaming my negative thought processes for why I was ill.” She added: “They tried to point out that I had depression or anxiety. And I said ‘I’m not, I’m just very sick’.

In secret recordings by the BBC, coaches can be heard telling patients that almost anyone can recover from long Covid by changing their thoughts, language and actions. Over three days on Zoom, the course taught the ritual that forms the basis of the programme. Every time you experience a symptom or negative thought, you say the word “stop”, make a choice to avoid these symptoms and then do a positive visualisation of a time you felt well. You do this while walking around a piece of paper printed with symbols – a ritual the BBC was told to do as many as 50 times a day.

In some cases the Lightning Process has encouraged participants to increase their activity levels without medical supervision, against official advice – which could make some more unwell, according to NHS guidelines. Lightning Process founder, Dr Phil Parker, who’s not a medical doctor but has a PhD in psychology of health, told us his course was “not a mindset or positive thinking approach,” but one that uses “the brain to influence physiological changes”, backed by peer-reviewed evidence. The coach on the course the BBC attended said “thoughts about your symptoms, your worry about whether it’s ever going to go – that’s what keeps the neurology going. Being in those kind of thoughts is what’s maintaining your symptoms. They’re not caused by a physical thing any more.”

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As I pointed out previously, The Lightning Process  (LP) is a therapy based on ideas from osteopathy, life coaching, and neuro-linguistic programming. LP is claimed to work by teaching people to use their brains to “stimulate health-promoting neural pathways”.

LP teaches individuals to recognize when they are stimulating or triggering unhelpful physiological responses and to avoid these, using a set of standardized questions, new language patterns, and physical movements with the aim of improving a more appropriate response to situations.

Proponents of the ‘LP’ in Norway claim that 90% of all ME patients get better after trying it. However, such claims seem to be more than questionable.

  • In the Norwegian ME association’s user survey from 2012 with 1,096 participants, 164 ME patients stated that they had tried LP. 21% of these patients experienced improvement or great improvement and 48% got worse or much worse.
  • In Norway’s National Research Center in Complementary and Alternative Medicine, NAFKAM’s survey from 2015 amongst 76 patients 8 had a positive effect and 5 got worse or much worse.
  • A survey by the Norwegian research foundation, published in the journal Psykologisk, with 660 participants, showed that 62 patients had tried LP, and 5 were very or fairly satisfied with the results.

Such figures reflect the natural history of the condition and are no evidence that the LP works.

Is there any evidence supporting the LP specifically for long COVID?

My Medline search retrieved just one single paper. Here is the abstract:

As a result of the COVID-19 pandemic, Long COVID (LC) is now prevalent in many countries. Little evidence exists regarding how this chronic condition should be treated, but guidelines suggest for most people it can be managed symptomatically in primary care. The Lightning Process is a trademarked positive psychology focused self-management programme which has shown to be effective in reducing fatigue and accompanying symptoms in other chronic conditions including Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. Here we outline its novel application to two patients with LC who both reported improvements in fatigue and a range of physical and emotional symptoms post-treatment and at 3 months follow-up.

Well, that surely convinced everyone! Except me and, of course, anyone else who can think critically.

So, I look further and find this on the company’s website:

Do you know how it feels to…

  • …be exhausted and tired no matter how much rest you get?
  • …be stuck with re-occurring pain, health symptoms and issues?
  • …get so stressed by almost everything?
  • …feel low and upset much of the time?
  • …want a better life and health but just can’t find anything that works?

If any, or all, of these sound familiar then the Lightning Process, designed by Phil Parker, PhD, could be the answer that you’re looking for.  There are lots of ways you can find out more about the suitability of the Lightning Process for you, have a look through below…

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Let me try to summarise:

  • The LP is promoted as a cure for long-Covid.
  • There is no evidence that LP is effective for it.
  • The claim is that it has been shown to work for ME.
  • There is no evidence that LP is effective for it.
  • A 3-day course costs £1 000.
  • Their website claims it is good for practically everyone.

Does anyone think that LP or its promoters are remotely serious?

I am glad to hear that the Vatican is issueing  new guidelines on supernatural phenomena. The document, compiled by the Vatican’s Dicastery for the Doctrine of the Faith, will lay out rules to assess the truthfulness of supernatural claims. Reports of such phenomena are said to have soared in recent years in an era of social media – sometimes spread through disinformation and rumour. The guidelines are likely to tighten criteria for the screening, analysis, and possible rejection of cases.

Apparitions have been reported across the centuries. Those recognised by the Church have prompted pilgrims, and popes, to visit spots where they are said to have taken place. Millions flock to Lourdes in France, for example, or Fatima in Portugal, where the Virgin Mary is alleged to have appeared to children, promising a miracle – after which crowds are said to have witnessed the sun zig-zagging through the sky. The visitation was officially recognised by the Church in 1930.

But other reports are found by church officials to be baloney. In 2016, an Italian woman began claiming regular apparitions of Jesus and Mary in a small town north of Rome after she brought back a statue from Medjugorje in Bosnia, where the Virgin Mary is also said to have appeared. Crowds prayed before the statue and received messages including warnings against same-sex marriage and abortion. It took eight years for the local bishop to debunk the story.

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Perhaps the Vatican should also have a look at faith healing*, the attempt to bring about healing through divine intervention. The Bible and other religious texts provide numerous examples of divine healing, and believers see this as a proof that faith healing is possible. There are also numerous reports of people suffering from severe diseases, including cancer and AIDS, who were allegedly healed by divine intervention.

Faith healing has no basis in science, is biologically not plausible. Some methodologically flawed studies have suggested positive effects, however, this is not confirmed by sound clinical trials. Several plausible explanations exist for the cases that have allegedly been healed by divine intervention, for instance, spontaneous remission or placebo response. Another explanation is fraud. For instance, the famous German faith healer, Peter Popoff, was exposed in 1986 for using an earpiece to receive radio messages from his wife giving him the home addresses and ailments of audience members which he purported had come from God during his faith healing rallies.

Faith healing may per se be safe, but it can nevertheless do untold indirect harm, and even fatalities are on record: “Faith healing, when added as an adjuvant or alternative aid to medical science, will not necessarily be confined to mere arguments and debates but may also give rise to series of complications, medical emergencies and even result in death.”

Alternatively, the Vatican might look at the healing potential of pilgrimages*, journeys to places considered to be sacred. The pilgrims often do this in the hope to be cured of a disease. The purpose of Christian pilgrimage was summarized by Pope Benedict XVI as follows:

To go on pilgrimage is not simply to visit a place to admire its treasures of nature, art or history. To go on pilgrimage really means to step out of ourselves in order to encounter God where he has revealed himself, where his grace has shone with particular splendour and produced rich fruits of conversion and holiness among those who believe.

There are only few scientific studies of pilgrimages. The purpose of this qualitative research was to explore whether pilgrims visiting Lourdes, France had transcendent experiences. The authors concluded that visiting Lourdes can have a powerful effect on a pilgrim and may include an “out of the ordinary” transcendent experience, involving a sense of relationship with the divine, or experiences of something otherworldly and intangible. There is a growing focus on Lourdes as a place with therapeutic benefits rather that cures: our analysis suggests that transcendent experiences can be central to this therapeutic effect. Such experiences can result in powerful emotional responses, which themselves may contribute to long term well-being. Our participants described a range of transcendent experiences, from the prosaic and mildly pleasant, to intense experiences that affected pilgrims’ lives. The place itself is crucially important, above all the Grotto, as a space where pilgrims perceive that the divine can break through into normal life, enabling closer connections with the divine, with nature and with the self.

Other researchers tested the effects of tap water labelled as Lourdes water versus tap water labelled as tap water found that placebos in the context of religious beliefs and practices can change the experience of emotional salience and cognitive control which is accompanied by connectivity changes in the associated brain networks. They concluded that this type of placebo can enhance emotional-somatic well-being, and can lead to changes in cognitive control/emotional salience networks of the brain.

The risks involved in pilgrimages is their often considerable costs. It is true, as the text above points out that “millions flock to Lourdes in France”. In other words, pilgrimiges are an important source of income, not least for the catholoc church.

A more important risk can be that they are used as an alternative to effective treatments. This, as we all know, can be fatal. As there is no good evidence that pilgrimiges cure diseases, their risk/benefit balance as a treatment of disease cannot be positive.

So, will the new rules of the Vatican curtail the risks on supernatural healing practises? I would not hold my breath!

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* for references see my book from where this text has been borrowed and modified.

Anyone who writes a lively blog like this one is bound to receive all sorts of attacks, accusations, insults, innuendo, etc. I certainly have been claimed or implied to be many things that I am simply and objectively not. Many of them are quite hilarious in their stupidity, in my view. Perhaps it might be fun to list (some of) them.

Here we go (in no particular order).

I am not:

  • woke
  • anti-woke
  • someone who thinks that woke is a useful concept
  • against restricting discussions on certain topics (but I may not be interested in some subjects)
  • an expert on any subject other than so-called alternative medicine (SCAM)
  • like Trump (I think it was D Ullmann who stated that I was like Trump)
  • young (recently, I was repeatedly criticised for being an ‘old white man’)
  • a woman (recently, I was repeatedly criticised for being an ‘old white man’)
  • black (recently, I was repeatedly criticised for being an ‘old white man’)
  • an anti-semite
  • a racist
  • right-wing (I have not even once voted conservative in my life)
  • devoid of experience in SCAM as a patient
  • a researcher who has never practised SCAM
  • someone who has never done any original research
  • someone who does not know what he is talking about
  • unqualified
  • someone who was fired from an academic appointment
  • a pseudoscientist
  • a man who has falsified his research
  • on the payroll of BIG PHARMA
  • receiving any money for running this blog
  • relying on any finacial support other than my pensions
  • a liar
  • a fraud
  • someone who took the Exeter appointment in order to ditch homeopathy
  • out to defame SCAM (I am advocating solid evidence and criticising claims that are not evidence-based)
  • running an evil empire
  • devoid of self-confidence
  • someone who despises women
  • suffering from digestive problems
  • unable to process feelings
  • someone who manipulates data
  • the head of a lobby group
  • perfect (sadly, that’s the only claim nobody ever made).

Have I promised too much?

The list is long and the claims are as funny as they are unfounded. Evidence that (some of) these allegations have indeed been made can be found here, here, here, and here or, if you are really keen and gifted at doing searches, on X [formerly Twitter].

Vertebral artery dissections (VAD) pose a significant risk for strokes, particularly in young adults. This case report details the presentation and management of a 48-year-old patient who was diagnosed with an extracranial VAD following cervical spine manipulation (CSM).

The patient’s symptoms included:

  • acute right-sided ataxia,
  • giddiness,
  • vertigo,
  • nausea,
  • vomiting,
  • persistent pain behind the right ear.

They prompted immediate evaluation. After ruling out acute intracerebral hemorrhages, a computed tomography angiogram (CTA) of the head and neck identified a severe narrowing of the right distal vertebral artery with a string sign at the level of the right C1 loop (V3 segment), indicating an extracranial VAD. This finding was further supported when ultrasound (US) imaging revealed a high resistance flow pattern in the right distal vertebral artery. Furthermore, T2 and diffusion-weighted magnetic resonance imaging (MRI) confirmed a 1.8 cm VAD/hematoma and a 1.4 cm acute/subacute infarct in the right posterior inferior cerebellar artery (PICA) territory.

The authors concluded by stressing the importance of recognizing and addressing that neck pain can be a symptom of musculoskeletal dysfunction or could have neurovascular origins. In this case, the patient’s neck pain may have been musculoskeletal or could have been due to a previous dissection. Thus, differentiation should be considered before cervical spine manipulation.

The link between CSM and arterial dissection is hard to deny. On this blog, we have discussed these issues with depressing regularity, e.g.:

Whether the CSM was the cause of the dissection of a previously intakt artery, or whether the CSM made a pre-existing problem worse, might often be difficult to decide in retrospect. What is crucial in both scenarios, is that CSM carries serious risks. This insight is all the more important, if we consider that the benefits of CSM are minimal or unproven. The inescapable conclusion, therefore, is that the risk/benefit balance of CSM is not positive. In other words, the only sensible advice here is this:

don’t allow chiropractors (who use CSM more often that any other profession), osteopaths, physiotherapists, etc. perform CSMs on your neck.

I have attended numerous ‘Skeptics in the Pub’ (SITP) meetings, either as a member of the audience or as a lecturer. They can be splendid occasions to learn, be entertained, to discuss, and to socialise in a relaxed atmosphere.

The usual format of a SITP meeting includes an invited speaker (often a renouned expert with an international reputation) who gives a talk on a specific topic, followed by a break where people can re-fill their glasses, followed by a long question-and-answer session. Meetings are usually scheduled on a monthly basis. The SITP movement started in 1999 in London. The concept soon spread, and now there are SITP meetings in many countries across the world.

The organisers of the meetings are local enthusiasts who run them on a shoestring. Each attendee pays a small entrance fee or gives a donation. Speakers usually get their expenses paid. As the meetings take place in pubs, there is no expense for room hire.

As I already stated, the concept of SITP is great, no question.

Unfortunately, however, there is also a ‘BUT’.

I have been to SITP meetings that were run perfectly – but I have experienced also the exact opposite, both as a lecturer as well as a attendee. For instance:

  • I have attended meetings where the room was too small and stuffy.
  • I have sat on chairs that seemed like medevial torture instruments.
  • I have suffered through lectures where the technical equipment did not work properly.
  • I have been at meetings that were attended by embarrassingly few people.
  • I have, as an invited speaker, been told retrospectively that my (very modest) expenses could not be paid.

Here is my plea to the organisers of SITP worldwide:

I know you volunteer for this job with enthusiasm and dedication. But PLEASE, do it also with competence. Your speakers are as dedicated as you; often they are top experts. They have a right to be met not just with kindness but also with competence.

So, please advertise each SITP meeting as best as you can; for example, go to your local papers, radio, social media etc. Do not humiliate your speakers by having them lecture in front of a half empty room. Make sure that your technical equipment works and test it thoroughly before your speaker arrives. Do not use locations that are unsuited for such events because they are too small, uncomfortable or poorly ventilated. If you are unable to organise meetings that are good in every respect, it might be better to not run any at all.

Yes, SITP is a great idea in theory. But even a great idea can be destroyed by deficient practice.

 

 

It had been reported that five infants under three months of age have died from whooping cough this year, as cases continue to spread across the country.

The UK Health Security Agency (UKHSA) has reported 1,319 cases of whooping cough in England in March, up from 900 in February and bringing the total for 2024 so far to 2,800.

But there is help!

The “Leading Holistic Health Portal” (LHHP) informs us as follows:

As far as therapeutic medication is concerned, several remedies are available to treat whooping cough that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of whooping cough:

  • Cuprum met – in whooping cough accompanied with convulsions, or when the paroxysms are long and interrupted…
  • Coccus cacti – this remedy has paroxysms of cough with vomiting of clear, ropy mucus, extending in thick, long strings even to the floor…
  • Belladonna – in sudden violent paroxysms of whooping cough, without any expectoration, and the symptoms of cerebral congestion…
  • Spongia Tosta – excellent remedy for whooping cough; dryness of all passages; cough dry, barking croupy like a saw driven through a pine board…
  • Corallium Rubrum – violent spasmodic cough, whooping cough; a very rapid cough, the attacks follows so closely as to almost run in to each other…
  • Aconite – clear ringing whistling whooping cough, excited by burning sticking in larynx and trachea…
  • Arnica Montana – paroxysms of whooping-cough excited by a creeping and soreness in trachea, bronchi or larynx, generally dry, often with expectoration of frothy blood mixed with coagula…
  • Hyoscyamus – shattering spasmodic cough, with frequent, rapidly succeeding cough, excited by ticking, as from adherent mucus…
  • Hepar Sulph – hoarse croupy night cough; deep, dull, whistling cough, in the evening without, in the morning with expectoration of masses of mucus…
  • Drosera – Drosera is one of the remedies praised by Hahnemann; indeed, he once said thatDrosera 30th sufficed to cure nearly every case of whooping cough, a statement which clinical experience has not verified. Drosera, however, will benefit a large number of the cases, if the following indications be present: a barking cough in such frequent paroxysms as to prevent the catching of the breath…
  • Mephitis – Mephitis is useful in a cough with a well marked laryngeal spasm, a whoop…
  • Ipecac – Convulsive cough, where the child stiffness out and becomes blue or pale and loses its breath…
  • Antimonium tartaricum – With this remedy the child is worse when excited or angry, or when eating; the cough culminates in vomiting of mucus and food…
  • Cina –This is not always a worm remedy. It is a most excellent remedy in whooping cough. It has the same rigidity as Ipecac, the child stiffness out and there is a clucking sound in the oesophagus when the little one comes out of the paroxysm…
  • Magnesia phosphorica – This is the prominent Schuesslerian remedy for whooping cough, which begins as does common cold. The attacks are convulsive and nervous, ending in a whoop…

So, why do we have so many cases of whooping cough?

The reason is, of course, the currently very low vaccination rates.

And why are they so low?

Could one reason be that some healthcare practitioners advise us wrongly?

What the LHHP does not tell us is the fact that homeopaths (and other SCAM practitioners) often advise against vaccinating children against whooping cough (and other infections). Take, for instance, this section from an article entitled: “The Homeopathic Option for Whooping Cough“:

In my medical opinion, this overemphasis upon a preventative vaccination strategy is largely due to conventional medicine’s inability to treat whooping cough once it is diagnosed. Physicians understand that antibiotics are likely to have minimal if any effect upon the course of the illness once the cough has set in, and the same applies to cough suppressants. Antibiotic treatment is believed to reduce transmission to others if prescribed at the onset of the illness, but the odds of diagnosing whooping cough at this very early stage are highly unlikely.

Clinical experience indicates that homeopathic medicine is a viable option for pertussis. However, mainstream medicine’s general unwillingness to consider any therapy that is not manufactured by PhRMA tends to blind it to potentially new and/or unexplored treatments. And in the case of homeopathy, there is a long-standing undeniable bias that assumes that it is just not possible that it can work because it defies conventional medical beliefs about the nature of illness and how it can be treated.

Really, a long-standing undeniable bias?

And I thought it was called evidence!

In conclusion, I urge everyone to follow the official recommendations:

The whooping cough vaccine protects babies and children from getting whooping cough. That’s why it’s important to have all the routine NHS vaccinations. The whooping cough vaccine is routinely given as part of the:

If you’re pregnant you should also have the whooping cough vaccine – ideally between 16 and 32 weeks.

To this I might add: beware of the advice by homeopaths and other SCAM-practitioners who recommend against vaccinations.

In the realm of so-called alternative medicine (SCAM), dental amalgam is a big topic. Therefore, we have discussed it several times before, e.g.:

This study evaluated the changes of health complaints after removal of amalgam restorations in patients with health complaints attributed to dental amalgam fillings.

Patients with medically unexplained physical symptoms (MUPS) attributed to dental amalgam (Amalgam cohort) had all their amalgam fillings removed. The participants indicated an intensity of 11 local and 12 general health complaints on numeric rating scales before the treatment and at follow-up after 1 and 5 years.

The comparison groups comprising

  1. a group of healthy individuals
  2. a group of patients with MUPS without symptom attribution to dental amalgam

did not have their amalgam restorations removed.

In the Amalgam cohort, mean symptom intensity was lower for all 23 health complaints at follow-up at 1 year compared to baseline. Statistically significant changes were observed for specific health complaints with effect sizes between 0.36 and 0.68. At the 5-year follow-up, the intensity of symptoms remained consistently lower compared to before the amalgam removal. In the comparison groups, no significant changes of intensity of symptoms of health complaints were observed.

The authors concluded that, after removal of all amalgam restorations, both local and general health complaints were reduced. Since blinding of the treatment was not possible, specific and non-specific treatment effects cannot be separated.

This is an interesting study with a particularly long follow-up. Unfortunately, due to the study’s design, its results tell us very little about causality. The results are perfectly consistent with two entirely different explanations:

  1. Amalgam was the cause of MUPS and therefore removal of amalgam cured the problem permanently.
  2. Amalgam was not the cause of MUPS but the knowledge that the evil substance had finally been removed sufficed for MUPS to disappear.

It is to the credit of the authors that they consider both options.

A word of caution: amalgam removal can lead to a spike in Hg levels in the body!

I know, I have mentioned my concerns before about research into so-called alternative medicine (SCAM) from China, e.g.:

In 2018, China became the country that produces more scientific papers than any other. At present, China’s output stands at over one million articles per year. Yes, I do find this worrying!

On 2/4/2024, I did a few very simple Medline searches. I feel that the findings are remarkable.

Clinical trials of TCM

Between 2000 and 2023 ~ 8000

2000 = 8

2010 = 157

2020 = 1 192

Systematic reviews of TCM

2000 = 1

2010 = 26

2020 = 1 222

This near explosive rate of growth could, of course, be good news. But it isn’t because – as shown here so often before – the findings of Chinese research are worringly unreliable.

As if to confirm my point about the dominance of China, this paper has just been published:

Background: Neuropathic pain (NP) is a common type of pain in clinic. Due to the limited effect of drug treatment, many patients with NP are still troubled by this disease. In recent years, complementary and alternative therapy (CAT) has shown good efficacy in the treatment of NP. As the interest in CAT for NP continues to grow, we conducted a bibliometric study of publications on CAT treatment for NP. The aim of this study is to analyze the development overview, research hotspots and future trends in the field of CAT and NP through bibliometric methodology, so as to provide a reference for subsequent researchers.

Methods: Publications on CAT in the treatment of NP from 2002 to 2022 were retrieved from the Web of Science Core Collection. Relevant countries, institutions, authors, journals, keywords, and references were analyzed bibliometrically using Microsoft Excel 2021, bibliometric platform, VOSviewer, and CiteSpace.

Results: A total of 898 articles from 46 countries were published in 324 journals, and they were contributed by 4455 authors from 1102 institutions. The most influential country and institution are China (n = 445) and Kyung Hee University (n = 63), respectively. Fang JQ (n = 27) and Evidence-Based Complementary and Alternative Medicine (n = 63) are the author and journal with the most publications in this field. The clinical efficacy, molecular biological mechanisms and safety of CAT for NP are currently hot directions. Low back pain, postherpetic neuralgia, acupuncture, and herbal are the hot topics in CAT and NP in recent years.

Conclusion: This study reveals the current status and hotspots of CAT for NP. The study also indicates that the effectiveness and effect mechanism of acupuncture or herbs for treating emotional problems caused by low back pain or postherpetic neuralgia may be a trend for future research.

China is increasingly dominating SCAM research and we all know – or should know by now (see above) – that the results of this research are misleading. I cannot understand why so few people seem to think this is alarming.

 

 

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