risk/benefit
Needle-based acupuncture is used in some detoxification settings. However, its efficacy for illicit drug use disorders remains uncertain because prior reviews often mixed comparator types, co-interventions, or non-needle modalities. This review aimed to evaluate needle-based acupuncture monotherapy using comparator-stratified meta-analysis.
The authors searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM/SinoMed, trial registries, and supplementary sources from inception to September 12, 2025. The quantitative synthesis was restricted to randomized trials of manual acupuncture, electroacupuncture, or needle-insertion auricular acupuncture delivered without concomitant pharmacotherapy or psychotherapy. Although the registered protocol allowed non-randomized comparative studies, none were pooled because of insufficient comparability and a higher risk of confounding. Sensitivity analyses excluded trials with moxibustion co-treatment.
Thirteen randomized trials (n = 1,027) were included in the meta-analysis. For the prespecified primary outcome of withdrawal severity at the end of treatment, acupuncture favored blank/no-acupuncture controls [g = −2.089, 95% confidence interval (CI): −2.869 to −1.309; τ² = 0.712; I² = 82.9%], but the prediction interval (PI) crossed the null (PI: −4.306 to 0.128). Against active non-acupuncture comparators, the pooled effect was imprecise (g = −1.70, 95% CI: −5.43 to 2.02; PI: −23.49 to 20.09). Against sham acupuncture, two comparisons yielded an imprecise estimate (g = −1.45, 95% CI −9.41 to 6.51), and no PI was estimated. Among secondary outcomes, anxiety favored acupuncture over blank/no-acupuncture controls (g = −1.537, 95% CI: −2.047 to −1.026; PI: −2.939 to −0.134), whereas evidence from sham-controlled studies was less certain (g = −0.998, 95% CI: −1.744 to −0.252; PI: −2.828 to 0.832). For depression outcomes, PIs crossed the null in both blank- and sham-controlled analyses. The certainty of the evidence was low to very low.
The authors concluded that acupuncture exhibited favorable average effects on withdrawal severity, but null-crossing PIs limited confidence in the reproducibility of these effects across different settings and treatment protocols. Anxiety was interpreted as a secondary finding. No serious acupuncture-related adverse events were explicitly reported, although surveillance was often passive or insufficiently described.
The review treats acupuncture as “effective” for illicit drug disorders by highlighting short-term improvements in craving or anxiety, while the outcomes that matter for addiction – abstinence, relapse, use frequency, and retention – show no reliable benefit.
This, I think, is a classic case of presenting a negative result as a positive finding!
The review explicitly found no consistent difference between acupuncture and comparators for substance use endpoints, and the apparent positive outcomes were limited by low-quality evidence and publication bias. By foregrounding surrogate outcomes and obscuring the lack of clinically decisive effects, the paper misleads readers into perceiving acupuncture as a viable monotherapy for drug use disorders. Yet the evidence does clearly not support that conclusion.
For several decades, eggs were commonly portrayed as a major cause of raised cholesterol and cardiovascular disease. That position has been substantially revised: current evidence suggests that dietary cholesterol has a relatively modest effect on blood cholesterol in most people, whereas saturated and trans fats are more important determinants of LDL cholesterol and cardiovascular risk.
The physiology is more nuanced than the older “cholesterol-in, cholesterol-out” model implied. The liver does synthesise cholesterol endogenously, and many people compensate for increased dietary cholesterol by reducing hepatic production, but the degree of compensation varies considerably between individuals. For that reason, eggs are not best understood as “heart-healthy” in all circumstances, but rather as a food whose impact depends on the wider dietary pattern and the individual’s metabolic risk profile.
There is stronger support for improving lipid profiles by changing the quality of dietary fat and increasing fibre intake. Replacing saturated fats with unsaturated fats, particularly polyunsaturated fats, is associated with lower LDL cholesterol and a reduced risk of cardiovascular events, while soluble fibre helps lower LDL cholesterol by interrupting enterohepatic bile acid recycling. In practical terms, this means that foods such as olive oil, nuts, seeds, legumes, oats, vegetables, and oily fish are more consistently supported than a narrow focus on single items such as eggs.
Low-carbohydrate and ketogenic diets are more complex. Many people lose weight on them, which may improve some cardiometabolic markers, but a subset of lean individuals show pronounced rises in LDL cholesterol and related atherogenic markers during carbohydrate restriction. Emerging evidence also indicates that gut microbial changes may contribute to altered lipid metabolism, although this area is still developing and should not be overstated.
Highly restrictive “detox” or “alternative” dietary programs are unsupported by clinical evidence and may be nutritionally unbalanced and thus harmful. They might be claimed to “purify” the body or reset metabolism, but heart health is better served by sustainable patterns that improve LDL cholesterol, support fibre intake, and minimise excess saturated fat.
What does all that mean in practice? Here are a few simple rules that follow from the new insights:
- Do not over-emphasize dietary cholesterol (e.g., eggs) as a primary driver of cardiovascular risk.
- Focus instead on reducing saturated and trans fat intake.
- Replace saturated fats with unsaturated fats, especially polyunsaturated fats (e.g., use olive oil, eat nuts and seeds).
- Increase intake of soluble fibre (e.g., oats, legumes, vegetables) to help lower LDL cholesterol.
- Consider overall dietary patterns rather than judging single foods in isolation.
- Recognize that individual responses to dietary cholesterol vary; tailor intake accordingly if lipid levels are a concern.
- Include foods with consistent cardiovascular benefit, such as oily fish, plant-based foods, and whole grains.
- Be cautious with low-carbohydrate or ketogenic diets, particularly if lean, and monitor lipid profiles if following such diets.
- Prioritize sustainable, balanced eating patterns over restrictive or extreme diets.
- Avoid “detox” or alternative dietary regimens lacking clinical evidence, as they are ineffective or harmful.
Key references
- Carson JAS, Lichtenstein AH, Anderson CAM, et al. Dietary cholesterol and cardiovascular risk: a science advisory from the American Heart Association. Circulation. 2020;141:e39–e53.
- Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279–1290.
- Hooper L, Martin N, Jimoh OF, et al. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2020;(5):CD011730.
- British Heart Foundation. Healthy eating – reduce your risk of developing heart disease. 2023. – Search
- NHS. Facts about fat. 2022. – Search
- Ketogenic Diet reduces friendly gut bacteria and raises cholesterol levels
- Gut bacteria can break down cholesterol | Nature Reviews Cardiology
- Healthy eating: applying All Our Health – GOV.UK
On May 27, 2026, the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) announced they are investigating a 3rd multistate outbreak of Salmonella infections linked to moringa powder supplements in 2026. Moringa oleifera supplements (including green powders and capsules) are heavily marketed as a “superfood” and a natural multivitamin powerhouse. They are primarily promoted for:
- Nutritional Support: Providing high concentrations of protein, iron, calcium, and vitamins A, C, and E.
- Energy & Metabolism: Boosting daily vitality and supporting healthy weight management.
- Blood Sugar & Heart Health: Helping to regulate glucose levels, lower cholesterol, and manage blood pressure.
- Immune & Inflammation Support: Using rich antioxidant content (like quercetin) to combat cellular stress and ease joint pain or chronic inflammation.
The agencies re-opened an outbreak investigation originally closed on March 17 after discovering 22 new illnesses from 4 US states. The total now stands at 119 patients across 36 states infected with Salmonella Typhimurium or Salmonella Newport strains, including 32 hospitalizations and no deaths. Illness onset dates range from August 22, 2025, to April 26, 2026.
Among 79 interviewed patients, 70 reported consuming moringa leaf powder products. The recalled product list expanded to include TNvitamins-brand Ultra Potent Complete Green Superfood Moringa capsules and Doctor’s Pride Complete Green Superfood Ultra Potent Moringa capsules distributed by Total Nutrition Inc., plus Why Not Natural Pure Organic Moringa capsules and All Live it Up-brand Super Greens dietary supplement powders.
The new investigation involves Salmonella Typhimurium infections linked to MOGO-brand moringa powder capsules distributed by MOGO Moringa LLC of St. Louis. 18 people infected with the outbreak strain have been reported from 14 states, with illness onset from February 3 to April 7, 2026. Of 8 interviewed individuals, 6 reported consuming moringa powder capsules, including 4 who specifically consumed MOGO-brand products. Seven hospitalizations occurred with no deaths reported. MOGO Moringa LLC has recalled specific lots (#15525AA EXP 6/2027 and #00926AA EXP 1/2028) of MOGO-brand Pure Moringa Oleifera capsules. The FDA is conducting traceback investigations to identify the contamination source and working with state partners to collect samples.
In April 2026, the FDA closed a separate outbreak investigation involving moringa supplements contaminated with “extensively drug-resistant” Salmonella. This outbreak linked to Rosabella-brand moringa powder capsules distributed by Ambrosia Brands LLC resulted in seven illnesses across seven states, with three hospitalizations.
Three moringa-related outbreaks in a single year underscore systemic issues affecting botanical ingredients in the global natural health industry, particularly regarding imported moringa leaf powder contamination. Health officials urge consumers who used moringa products and developed symptoms – diarrhea, abdominal cramps, fever within 12-72 hours – to seek medical attention and inform doctors about potential Salmonella exposure. Healthy adults typically remain ill for 4-7 days. Severe diarrhea may require hospitalization.
Update, 7/6/26:
Following the May 27, 2026, announcements, Total Nutrition Inc. expanded its voluntary recall on June 2 to include Lot 2748 (Exp. 07/2027) for both TNVitamins and Doctor’s Pride brands after a traceability review linked it to previously contaminated raw materials. Meanwhile, the active investigation into MOGO-brand capsules remains unchanged with 18 reported illnesses, and the FDA continues to urge consumers to check their pantries for any remaining Rosabella-brand products from the closed April outbreak. Federal and state health officials are actively working with major online platforms—including Amazon, Walmart, and TikTok Shop—to ensure all recalled moringa supplements are fully removed from the market, while reminding consumers to seek medical care if they experience Salmonella symptoms.
Dr. Toby Rogers, a political economist and fellow at the libertarian Brownstone Institute, ignited a firestorm in March 2026 when he declared the current childhood vaccination program “one of the greatest crimes in human history” (“libertarian” refers to someone who advocates for extreme individual liberty—particularly freedom from government mandates and regulations—believing that the state should be minimized and that individuals should have absolute autonomy over their own bodies, property, and choices without state coercion).
Rogers’ 2026 statement is not an isolated outburst but the culmination of years of vaccine skepticism. After his partner’s son was diagnosed with autism in 2015, Rogers abandoned his original doctoral focus to study autism’s causes, reviewing nearly 1,000 studies over four years. He concluded that vaccines are the primary driver of the autism epidemic. The overwhelming scientific consensus, however, is that vaccines are safe and that autism’s rise stems from improved diagnosis, broader criteria, and complex genetic and environmental factors unrelated to immunization (see the plethora of previous posts on this subject). His PhD thesis, The Political Economy of Autism, and subsequent publications have been widely criticized by the scientific community. Its methodological flaws include:
- selection bias,
- cherry-picking,
- inclusion of weak studies,
- dismissing robust epidemiological research.
Rogers’ 2026 statement elevates personal conviction and contested research over scientific rigor and public health reality. Rogers argues that children receive too many vaccines too early, warning of “cumulative effects” on developing immune systems. Yet the Institute of Medicine has found no evidence of major safety concerns with the current childhood immunization schedule, and the National Academy of Sciences has repeatedly affirmed that vaccines are safe and effective. Rogers dismisses the 22 major studies confirming vaccine safety as “worthless” because they lacked a true unvaccinated control group—a standard that is both ethically impossible and scientifically unnecessary given the massive population data demonstrating vaccine safety over decades.
Rogers’ evidence relies heavily on a handful of independent studies to support his claims. These studies have been criticized for small sample sizes, selection bias, failure to control for confounders, and methodological flaws so severe that some of Rogers’ co-authored papers, such as “Autism Tsunami,” were retracted from peer-reviewed journals. His claim that vaccinated children have dramatically higher rates of autism and chronic disease rests on research that has not withstood independent replication or scrutiny by mainstream scientists. By contrast, the scientific community’s confidence in vaccine safety derives from massive, longitudinal studies involving millions of children, rigorous clinical trials, and decades of population surveillance.
Rogers’ credibility is compromised not least because he is a regular contributor to Children’s Health Defense, an anti-vaccine organization founded by Robert F. Kennedy Jr. that has a long history of spreading debunked claims. Roger’s testimony before the US Senate Subcommittee on Investigations in September 2025, titled “How the Corruption of Science has Impacted Public Perception and Policies Regarding Vaccines,” tried to position him as a whistleblower exposing “flawed science.” In reality, it relied on the same flawed studies and conspiracy narratives that have been repeatedly discredited by the scientific community.
Rogers receives funding from several anti-vaccine and libertarian organizations, though specific salary figures are not publicly disclosed :
- Brownstone Institute is a libertarian think tank founded by economist Jeffrey Tucker that promotes vaccine skepticism, “medical freedom,” and opposition to public health mandates. The institute is funded by libertarian donors and provides fellowships to researchers who align with its ideology.
- Children’s Health Defense is explicitly an anti-vaccine organization led by Mary Holland (CEO) and founded by Robert F. Kennedy Jr. The organization has illuminated funding sources through IRS 990 filings, showing it raised millions of dollars and pays researchers, speakers, and staff. In Rogers’ Senate testimony, he explicitly stated: “Since then I’ve continued my research with Children’s Health Defense, as an independent journalist, and as a Fellow at Brownstone Institute”.
- Rogers also appears at MAHA Institute conferences (Make America Healthy Again), which is aligned with HHS Secretary Robert F. Kennedy Jr.’s movement and features speakers from anti-vaccine organizations including Children’s Health Defense.
Rogers’s financial ties to anti-vaccine organizations create clear conflicts of interest. His research supports the organizational mission of Children’s Health Defense and Brownstone Institute, and his income appears tied to producing content that aligns with these organizations’ anti-vaccine advocacy. The political economy of Rogers’ work is thus ironic: while he critiques the “political economy of autism” and government response, his own research is funded by private organizations with clear ideological and financial incentives to promote vaccine skepticism.
Rogers is not a medical doctor. He has a doctorate in political economy from the University of Sydney and a Master’s in public policy. He holds no medical degree or formal training in medicine, immunology, epidemiology, or vaccine science. His expertise is in political economy, not medical or vaccine research, which means his claims about vaccine safety and autism lack the scientific credentials required to make authoritative medical assertions.
Quackademia, a term created [as far as I remember] by David Colquhoun for the infiltration of quackery into academia, has often been discussed on this blog, e.g.:
- Quackademia in Canada: the first bachelor’s degree in Traditional Chinese Medicine
- Quackademia galore: An Oxford ‘university’ starts a course in ‘veterinary chiropractic’
- Quackademia at its most rampant: the ‘Certificate in Holistic Health and Healing Arts’ (HHHA) at the University of New Mexico
- Another blow to quackademia: TCM course at a Sydney university is to be stopped
- Vienna 2019: the end of quackademia
- Quackademia down under
- Quackademia revisited
- Quackademia
Now growing backlash against quackademia seems to finally emerge also in France – opposition against university programs that give academic legitimacy to unproven so-called alternative medicine (SCAM). The Higher Council for the Evaluation of Research and Higher Education is preparing to review these courses, after criticism that universities are lending credibility to practices that have not been scientifically validated.
Across France, more than 200 university diplomas are said to exist in areas such as reflexology, aromatherapy, auriculotherapy, hypnosis, acupuncture, homeopathy, meditation, and related practices. Critics argue that this amounts to a form of institutional “entryism,” because the university label can make such practices look medically endorsed even when they are not.
The main concern is not just whether these therapies work, but whether universities should be teaching them at all. A January report on health misinformation reportedly recommended banning the academic labeling of healthcare practices that have not been validated, and that recommendation is at the center of the debate. Experts warn that, if a SCAM is scientifically validated, it belongs in medicine; if it is not, it may still be studied, but should not be taught as an academic medical qualification. They also warn that these programs can mislead the public and create a false impression of legitimacy. Yet, some deans and faculty leaders say that certain courses, especially acupuncture, hypnosis, or mindfulness, can be acceptable when used for specific indications and when properly framed. They distinguish those from programs in naturopathy, aromatherapy, or homeopathy, which they see as much harder to justify inside medical faculties.
As the Conference of Medical Deans is preparing to examine the issue rigorously, they should – I feel – also consider the ethical implications. Teaching dangerous nonsense to naive students is not just not academic, it is deeply unethical. If done well, this excercise should lead to a major cleanup of universities regarding SCAM, or at the very least to much tighter rules about what can carry an academic label.
Having observed French quackademia for decades, I am tempted to exclaim:
BETTER LATE THAN NEVER!
The effect of calcium, vitamin D, or combined supplementation on fractures and falls in adults were assessed in this systematic review and meta-analysis. Randomised clinical trials were eligible, if they compared calcium, vitamin D, or combined supplementation with placebo or no treatment in adults (≥18 years) not receiving drug treatment for osteoporosis. The primary outcome was the risk of any fracture. Secondary outcomes included the risk of hip fracture, non-vertebral fracture, vertebral fracture, and falling, as well as the total number of falls. Pairs of reviewers independently screened trials, extracted data, and assessed risk of bias using the second version of Cochrane’s risk of bias tool. Findings were synthesised using random effects meta-analyses and appraised using Grading of Recommendations Assessment, Development and Evaluation, with application of thresholds for absolute effects considered important.
The review included 69 trials involving 153 902 participants. Participants in most of the trials were community dwelling (87%) and not at high risk of fractures or falls (73%). For the primary outcome of any fracture, little to no effect was found from use of calcium supplements (11 trials, 9067 participants; risk ratio 0.91, 95% confidence interval 0.81 to 1.01; moderate certainty), vitamin D supplements (36 trials, 92 045 participants; 1.00, 0.95 to 1.06; high certainty), or combined supplementation (15 trials, 51 126 participants; 0.91, 0.84 to 0.99; high certainty). Calcium, vitamin D, or combined supplementation appeared to have little to no effect on other fracture and fall outcomes, based largely on moderate to high certainty of evidence. The findings remained robust after an extensive exploration of heterogeneity across multiple subgroup analyses. Evidence for high risk patients or those requiring residential care was limited for many outcomes for calcium monotherapy and for combined supplementation.
The authors concluded that, based on absolute risk reductions and thresholds considered clinically meaningful, this review found little to no benefits from use of calcium, vitamin D, or combined supplementation on the prevention of fractures and falls.
An accompanying BMJ editorial points out that observational studies have associated low dietary calcium and low serum levels of vitamin D with low bone density and falls. Consequently, calcium, vitamin D, or combined supplementation has been widely promoted for preventive musculoskeletal health in older adults…
Th editorial concludes that other interventions, such as balance and resistance exercise, and several multicomponent interventions (eg, combining exercise, hazard assessment, or education with other interventions tailored to risk assessment) have been shown to offer meaningful prevention of falls and falls related injuries.
This new systematic review is a prime example for the slaying of a beautiful hypothesis with an ugly fact. But all is not negative – think of the money that can now be saved and put to better use!
Homoeopathy and I is the title of a paper that I published in 2009. My aim was to denounce the popular notion that held I had started my research with a grudge against homeopathy. The honest truth is that – if anything – my attitude was even slightly positive. Here is the key section from this 2009 paper:
In 1993, I was appointed to the world’s first Chair in Complementary Medicine, and it became my job to investigate scientifically all sorts of complementary treatments, including homoeopathy. In the course of this activity, my co-workers and I published numerous articles on homoeopathy. Systematically, reviewing the totality of my publication list, I found a total of 46 papers with ‘homeopathy’ in the title. The following quotes from these articles were selected to best describe my attitude toward homoeopathy at the time:
• Homeopathicremedies are believed by doctors and patients to be almost totally safe (8).
• It might be argued that arnica …is ineffective but homeopathy may still works (9).
•…only 23% of Australian homeopaths believe that immunisation is important (10).
• Homeopathy, I fear, has soon to come up with … more convincing evidence (11)…
• Future evaluations of homeopathy should be performed to a high scientific standard (12)…
•…studies on the safety of the practice of homeopathy must not be ignored (13)…
•…systematic reviews based on Medline searches can lead to similar (possibly slightly less positive) overall conclusions (14)…
•…a detailed eye-witness account claiming that all attempts [by researchers during the ‘Third Reich’] to show that homeopathy works has led to negative results (15).
•…the best way forward is clearly to do rigorous research (16)…
• Thus, the question of whether homeopathy works or not has remained unanswered for 200 years (17).
• The most pressing question, ‘Is homeopathy clinically more effective than placebo’, needs to be answered conclusively (18).
• There is evidence that homeopathic treatment can reduce the duration of ileus (19)…
• Some of the well-argued cases against homeopathy should become essential reading for all homeopaths (20).
•…the published evidence to date does not support the hypothesis that homeopathic remedies … are more efficacious than placebo (21)…
•…homeopathic remedies are associated with the same clinical effects as placebo (22).
•…the picture painted by Linde and colleagues … may well be slightly more positive (23)…
•…[our] goal is to conduct rigorous, impartial research in [homeopathy] (24)
• The claim that homeopathic arnica is efficacious beyond a placebo effect is not supported by rigorous clinical trials (25).
• The results of recent systematic reviews are not uniform (26).
•…at present, the relative efficacy of homeopathic remedies is not known (27).
• The results of recent systematic reviews are obviously far from uniform (28).
•…the trial data … do not suggest that homeopathy is effective (29)…
•…the definitive answer, in my view, has to come from a series of rigorous trials (30).
• Large, multicentre trials of homeopathic remedies … represent the best way of advancing the debate (31).
•…the re-analysis of Linde et al. can be seen as the ultimate epidemiological proof that homeopathic remedies are, in fact, placebos (32).
•…randomised clinical trials … do not allow a firm conclusion as to the effectiveness of homeopathic remedies (33).
•…both homeopaths and university heads of medical departments clearly advocate further research into the effectiveness of homeopathy (34).
•…homeopathy is not different from placebo (35).
•…the best clinical evidence … does not warrant positive recommendations (36).
•…the evidence is insufficient for firm recommendations (37).
•…the results of this trial do not suggest that homeopathic arnica has an advantage over placebo (38)…
-
- This study provides no evidence that adjunctive homeopathic remedies … are superior to placebo(39).
•…this systematic review does not provide clear evidence that the phenomenon of homeopathic aggravations exists (40).
•…Mathie’s methodology was not as strong as it should have been, and this deficit has led to conclusions that may be falsely positive (41).
•…homeopathy may actually be more expensive than good conventional care (42).
•…the proven benefits of highly dilute homeopathic remedies … do not outweight the potential for harm (43).
•… homeopathic remedies are placebos, but homeopaths can be skilled doctors who may significantly help their patients (44).
• Our analysis … found insufficient evidence to support clinical efficacy of homeopathic therapy (45)…
•… promotion can be regrettably misleading, dangerous and counterproductive (46).
•…do we condone treatments because of their popularity or their effectiveness? (47)
•…homeopathy is not based on solid evidence and, over time, this evidence seems to get more negative (48).
• The evidence from rigorous clinical trials … testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition (49).
• There is no evidence at all that homeopathic remedies can change the natural history of any cancer (50).
•…context effects of homeopathy … are entirely sufficient to explain the benefit many patients experience (51)…
• Amongst all the placebos that exist, homeopathy has the potential to be an exceptionally powerful one (52)…
•…recommendations by professional homeopathic associations are not based on the evidence (53)…
[all references can be found in the original paper]
Since then (2009) I – often together with others – have published several further articles with “homeopathy” in the title. This means that my original paper needs updating. Here are the titles of (and links to) these articles (appologies, if I missed a few):
- Should we maintain an open mind about homeopathy?
- Homeopathy
- Homeopathy: what does the “best” evidence tell us?
- Homeopathy, non-specific effects and good medicine.
- A systematic review of homoeopathy for the treatment of fibromyalgia.
- Homeopathy, a “helpful placebo” or an unethical intervention?
- The ethics of British professional homoeopaths.
- Homoeopathy debate. Protecting patients?
- Pharmacists and homeopathic remedies.
- Homeopathy in severe sepsis.
- Call for doctors not to practice homeopathy or refer to homeopaths.
- Homeopathy for eczema: a systematic review of controlled clinical trials.
- The most thorough assessment to date of homeopathy
- Should doctors recommend homeopathy?
If you study these articles, you will find that my arguments around homeopathy remained entirely evidence-based. The overall point is, I hope, clear: I did not embark on my research into homeopathy aiming to disprove it or to dismiss it outright [a claim I still hear with some regularity]. To begin with (in 1993), I was not only open but positively inclined. At all times, however, I was keen to follow the best available evidence. If my attitudes/verdicts became less and less positive, it is merely because the evidence became more and more overtly negative.
This AI-verdict made me wonder: Who is for and who against the critical evaluation of so-called alternative medicine? And I asked a follow-up question:
Can you try to quantify this and give me % figures who is against a critical evaluation of alternative medicine, who is for it, and who is neutral. Can you do this for 1. the general population, 2. proponents of alternative medicine and 3. skeptics?
Here is the reply I got from Gemini:
To quantify these dynamics accurately, we have to look at large-scale sociological data on public attitudes toward science, peer-reviewed medical data (such as surveys by Pew Research, YouGov, and the European Commission), and the behavioral patterns of online discourse.
When it comes to a “critical evaluation” (meaning scientific testing to prove if a therapy works beyond a placebo), the groups break down along very distinct ideological lines. Here is how the percentages estimate across your three requested demographics:
Breakdown of Attitudes Toward Critical Evaluation
1. The General Population
The broader public is largely pragmatic, but a major chunk is passively open to alternative therapies without strictly demanding clinical trial proof.
- Against Critical Evaluation (~15% – 20%): These individuals hold a strong distrust of mainstream pharmaceutical companies and medical institutions. They believe alternative medicine operates on a different “energy” or “holistic paradigm” that standard science is fundamentally incapable of or biased against measuring.
- For Critical Evaluation (~35% – 45%): This group highly values evidence-based medicine, expects consumer safety protection, and agrees that if a therapy claims to cure an illness, it should prove it under a microscope or in a randomized controlled trial.
- Neutral / Passive Consumers (~40% – 50%): This is the massive middle. They don’t track clinical trials, but they will try acupuncture for back pain or take turmeric if a friend recommends it. They view alternative medicine through a lens of “well, it can’t hurt to try,” evaluating it based on personal anecdotes rather than scientific data.
2. Proponents of Alternative Medicine
This group includes dedicated practitioners, wellness influencers, and avid consumers of Complementary and Alternative Medicine (CAM).
- Against Critical Evaluation (~70% – 80%): The vast majority actively resist standard scientific evaluation, often viewing figures like Edzard Ernst as hostile prosecutors rather than objective evaluators. They argue that randomized controlled trials are “too reductionist” to capture holistic healing or claim that clinical science is rigged by corporate interests.
- For Critical Evaluation (~5% – 10%): A small minority of CAM practitioners (often in fields like medical acupuncture or osteopathy) welcome rigorous trials, hoping to find a mechanism of action that will grant them mainstream medical legitimacy and insurance coverage.
- Neutral (~10% – 15%): These are individuals who focus strictly on the individual client experience. They don’t care about data or institutional pushback either way; their attitude is simply “if my client says they feel better, that is the only science I need.”
3. Skeptics & Pro-Science Advocates
This demographic comprises secular organizations, evidence-based medical professionals, and science communicators who actively follow work like Ernst’s.
- Against Critical Evaluation (<1%): Virtually non-existent in this group, as evaluation is their core tenet. The only micro-fraction here might be extreme fringe elements who feel certain alternative therapies are so fundamentally absurd (like breatharianism) that evaluating them is a waste of scientific funding.
- For Critical Evaluation (~90% – 95%): The overwhelming majority. They strongly defend the stance that there is no such thing as “alternative” medicine—there is only medicine that has been proven to work and medicine that hasn’t. They view critical evaluation as an ethical necessity for patient safety.
- Neutral (~5%): A tiny sliver who may agree with the premise of science but feel indifferent about fighting the cultural battle against wellness trends, preferring to let people believe what they want as long as it isn’t directly killing them.
The Reality of the “Viral Sharing Power”
The Disparity: While alternative health advocates outnumber skeptics in raw volume and content creation—churning out high-yield, emotionally comforting narratives—the pro-science corrections achieve highly concentrated “viral bursts.”
When a prominent alternative health claim is cleanly and definitively debunked by data, it provides a highly shareable, “gotcha” piece of content for the large, silent neutral majority and the highly active skeptic network. A data-driven correction acts as a high-utility intellectual tool, allowing regular people to cut through multi-million dollar wellness marketing, which is why a single well-structured critique can match or outpace the reach of thousands of individual wellness posts.
______________________
I know, there are good reasons for being cautious about such AI analyses. Yet, unless someone can point me to more reliable data, I will go with this one – not least because it coincides with my own experience and also because I quite like its findings.
Yesterday, I received a comment that ended stating: “… this site, and quite possibly Edzard, has well and truly lost the plot.” The author has made many comments before that led me to ignore him; so, I did not think twice about what he had to express. Yet, later it started me wondering what people feel about my blog and my work in general. I have to admit that I know very little about these questions. What is more, I have no idea how to find out.
What does one do in such a situation?
Yes, you guessed it, one asks AI. Specifically, I asked AI (Gemini) what people state about me and my work on social media.
Here is the response:
Edzard Ernst, Emeritus Professor of Complementary Medicine at the University of Exeter and the world’s first professor in this field, occupies a highly polarized space in public and academic discourse. Because he evaluates alternative therapies strictly through the lens of evidence-based medicine, opinions of him are cleanly split based on how the observer views the relationship between science and complementary and alternative medicine (CAM).
1. The Pro-Evidence & Skeptical Community
Within mainstream medicine, scientific research, and skeptical organizations, Ernst is widely praised as a heroic, objective defender of public health.
- Rigorous Science First: Proponents point out that Ernst is uniquely qualified to critique CAM because he is formally trained in multiple modalities and practiced them early in his career. Online advocates frequently rally around his blunt philosophy on medicine. As Ernst famously co-wrote in his book Trick or Treatment:
“There is either medicine that is effective or not, medicine that is safe or not. So-called alternative therapies need to be assessed and then classified as good medicines or bogus medicines.”
- The Defender of Patient Safety: On social media, users routinely share his warnings regarding the “indirect harm” of alternative medicine, arguing that unscientific advice can be fatal. Ernst summarized this stance sharply in a peer-reviewed paper: “Alternative practitioner’s claims about ‘root causes’ and holistic care are usually pure nonsense; their pampering may be agreeable, but it can undoubtedly cost lives.”
- A “Whistleblower” Against Pseudo-Science: Proponents view him as a courageous figure who faced severe institutional backlash—including losing his department’s funding after publicly criticizing King Charles III (then the Prince of Wales) for promoting homeopathy. On platforms like Reddit, supporters echo the sentiment that Ernst “stands up for clinical truth when institutions bow to royal influence and political correctness.”
2. The CAM Practitioner & Advocate Community
Among alternative healthcare providers, natural health advocates, and some “integrated medicine” proponents, Ernst is viewed with deep hostility and suspicion.
- “The Scourge of Alternative Medicine”: Detractors frequently use social media to label him as a close-minded dogmatist who is fundamentally biased. A common refrain in CAM forums and X replies accuses him of severe bias: “Ernst does not investigate alternative medicine to see if it works; he designs reviews with the explicit purpose of proving it doesn’t.”
- Accusations of Scientific Flaws: Specific professional groups have actively challenged his data. For example, within the chiropractic community, critics point to his reviews on the dangers of spinal manipulation and claim he misattributed injuries caused by untrained practitioners to qualified chiropractors. In a formal response published in the International Journal of Clinical Practice, chiropractic researchers directly attacked his methodology, stating:
“Ernst, by incorrectly labelling care providers as chiropractors… has added to the over-reporting of deaths… the fact that the care providers were not chiropractors is easily confirmed.”
- Institutional Deafness: On wellness blogs and natural health spaces, critics state that his clinical, data-first approach misses the point of holistic healing entirely. As one practitioner noted in an online debate: “He treats patients like spreadsheets. He completely disregards the mind-body connection, individual patient testimony, and the cold reality that conventional medicine fails millions of people every day, forcing them to look elsewhere.”
While Edzard Ernst is swimming against a massive volume of alternative health advocates who view him as their “nemesis reserving his most poisonous venom for their professions,” his data-driven, pro-science corrections achieve significantly higher viral sharing power among the public.
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Nothing truly new, of course, but quite interesting nevertheless, I thought.
I came across an interesting paper entitled “The Ethics of Tawas and Other Rituals in Medical Practices“. Here is its abstract:
Rituals in medical practice have either been seen as an anthropological aspect of current biomedical processes or as a pre-scientific aspect of complementary and alternative medicine (CAM). In either tendency, the literature has since failed to account for these rituals as rituals—conveyors of meaning, expressions of identity, and even as a rite of passage from illness to wellness. As an alternative to current discussions, this paper presents the case study of tawas, a diagnostic ritual from Philippine traditional medicine that determines personalistic and mystical causes of illnesses. As a non-intrusive procedure, tawas involves incantations and some ritual objects, e.g., rice, candle, axe, etc., that do not pose any direct harm nor benefit to the patient. While complete reliance on tawas at the expense of proper medical procedures could harm patients, the very ritual of tawas itself occupies a limbo within non-beneficence and non-maleficence. Following a Wittgensteinian perspective of treating rituals as meaning-laden human activities, this paper argues that rituals like tawas, much like other rituals embedded in biomedical practices, should be understood as rituals and not as empirical cures, thereby allowing their tolerance in medical practice in general.
The author seems to advocate for the cultural integration of traditional practices like tawas into a broader medical framework. They categorize tawas not as a physiological intervention, but define it as a conveyor of meaning. By addressing the “meaning-laden” aspect of illness, the ritual may address the psychological and social dimensions of a patient’s health, even if it has no effect on their physical pathology.
It is claimed that, since tawas involves non-intrusive objects (candles, rice), it is physically benign. At the same time it is acknowledged that “complete reliance” on tawas could harm patients. From a clinical safety standpoint, the “limbo” is only maintained if the ritual is strictly adjunctive rather than alternative.
The text uses a Wittgensteinian perspective, focusing on rituals as expressions rather than theories. Modern neuroscience suggests that the “ritual” of care—the white coat, the focused attention, the diagnostic process—triggers real neurobiological changes (e.g., dopamine and endorphin release). Aacknowledging the symbolic healing power that rituals have on patient anxiety and the “meaning response,” which can objectively improve health outcomes by reducing cortisol and stress.
The author identifies tawas as a diagnostic ritual which might well be the most contentious point. In science, a “diagnosis” must be reliable and valid. Tawas clearly fails the scientific criteria for validity. The author’s defence is that tawas shouldn’t be judged by those criteria at all. While this might be philosophically sound, in a clinical setting, a “mystical diagnosis” must conflict with a biological one, potentially leading to patient non-compliance with life-saving treatments.
