risk/benefit
The US ‘Public Citizen‘ is an American non-profit, progressive consumer rights advocacy group, and think tank based in Washington, D.C. They recently published an article entitled “FDA Guidance on Homeopathic Drugs: An Ongoing Public Health Failure“. Here are a few excerpts:
In December 2022, the U.S. Food and Drug Administration (FDA) issued new guidance on homeopathic drug products. The guidance states that the agency now “intends to apply a risk-based enforcement approach to the manufacturing, distribution and marketing of homeopathic drug products.”
Under this new risk-based approach, the agency plans to target its enforcement actions against homeopathic drug products marketed without FDA approval that fall within the following limited categories:
- products with reports of injury that, after evaluation, raise potential safety concerns
- products containing or purportedly containing ingredients associated with potentially significant safety concerns (for example, infectious agents or controlled substances)
- products that are not administered orally or topically (for example, injectable drug products and ophthalmic drug products)
- products intended to be used to prevent or treat serious or life-threatening diseases
- products for vulnerable populations, such as immunocompromised individuals, infants and the elderly
- products with significant quality issues (for example, products that are contaminated with foreign materials or objectionable microorganisms)
But this new FDA guidance fails to adequately address the public health threat posed by the agency’s decades-long permissive approach to these illegal drug products.
Under FDA regulations, prescription and over-the-counter (OTC) homeopathic products are considered drugs and are supposed to be subject to the same review and approval requirements as all other prescription and OTC medications. However, under a flawed enforcement policy issued in 1988, the FDA has allowed these drug products to be marketed in the U.S. without agency review or approval. Thus, all products labeled as homeopathic are being marketed without the FDA having evaluated their safety, effectiveness or quality…
… there is no plausible physiologic or medical basis to support the theory underlying homeopathy, nor is there evidence from well-designed, rigorous clinical trials showing that homeopathic drugs are safe and effective.
The FDA should declare unequivocally that all unapproved homeopathic drug products are illegal and direct all manufacturers to immediately remove such products from the market. In the meantime, as we have recommended for many years, consumers should not use homeopathic products. At best, the products are a waste of money, given the lack of any evidence that they are effective. At worst, they could cause serious harm because of the lack of FDA oversight to ensure safety.
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I fully agree with these sentiments. The harm caused by homeopathy is considerable and multi-facetted. Many previous posts have discudded these problems, e.g.:
- Nine cases of severe homeopathy-induced liver injuries
- Another death by homeopathy
- HOMEOPATHY – “It is not just irresponsible, it’s downright dangerous.”
- Adverse effects of homeopathy and aggravations at NAFKAM
- Homeopathy: it’s time to stop the double standards
- Homeopathy can cause serious harm – and finally, the NHS England has realised it
- Vidatox, homeopathy’s answer to cancer or outright fraud?
- Another child has died because of homeopathy
- Doctor homeopaths violate fundamental rules of ethics when practising homeopathy
- ‘Best homeopathy doctor in Delhi’ offers treatment for HIV/AIDS
- DIY-Homeopathy: how to kill your entire family
- The risks of homeopathy?
- The FDA has warned 4 manufacturers of unapproved injectable homeopathic drugs
- Is this the crown of the Corona-idiocy? Nosodes In Prevention And Management Of COVID -19
- The FDA has sent more warning letters to homeopathic manufacturers
- Walmart is being sued for selling homeopathic products
- Homoeopathic remedies may be safe, but do all homeopaths merit this attribute?
- Recommending homeoprophylaxis is unethical, irresponsible and possibly even criminal
- FDA: homeopathic teething remedies were toxic
- “Homeoprophylaxis, the homeopathic vaccine alternative, prevents disease through nosodes.”
- A truly dangerous homeopath
- The scandalous attitude of some homeopaths and their supporters towards immunisations
- Oh yes, let’s have homeopaths as primary care practitioners! But only in a parallel universe,please.
Having warned about the dangers of homeopathy for decades, I feel it is high time for regulators across the world to take appropriate action.
So-called alternative medicine (SCAM) is widely used in Saudi Arabia. One of the common practices is the use of camel urine alone or mixed with camel milk for the treatment of cancer, which is often supported by religious beliefs.
This study observed cancer patients who insisted on using camel urine, and to offer some clinically relevant recommendations. The authors observed 20 cancer patients (15 male, 5 female) from September 2020 to January 2022 who insisted on using camel urine for treatment. They documented the demographics of each patient, the method of administering the urine, reasons for refusing conventional treatment, period of follow-up, and the outcome and side effects.
All the patients had radiological investigations before and after their treatment with camel urine. All of them used a combination of camel urine and camel milk, and their treatment ranged from a few days to 6 months. They consumed an average of 60 ml urine/milk per day. No clinical benefit was observed after the treatment; 2 patients developed brucellosis. Eleven patients changed their mind and accepted conventional antineoplastic treatment and 7 were too weak to receive further treatment; they died from the disease.
The authors concluded that camel urine had no clinical benefits for any of the cancer patients, it may even have caused zoonotic infection. The promotion of camel urine as a traditional medicine should be stopped because there is no scientific evidence to support it.
If you suspected that this was a hoax, you were wrong!
Here is a recent paper on the ‘therapeutic potentials of camel urine’:
Camel urine has traditionally been used to treat multiple human diseases and possesses the most beneficial effects amongst the urine of other animals. However, scientific review evaluating the anticancer, antiplatelet, gastroprotective and hepatoprotective effects of camel urine is still scarce. Thus, this scoping review aimed to provide scientific evidence on the therapeutic potentials of camel urine. Three databases were searched to identify relevant articles (Web of Science, PubMed and Scopus) up to September 2020. Original articles published in English that investigated the effects of camel urine in various diseases were included. The literature search identified six potential articles that met all the inclusion criteria. Three articles showed that camel urine possesses cytotoxic activities against different types of cancer cells. Two studies revealed camel urine’s protective effects against liver toxicity and gastric ulcers, whilst another study showed the role of camel urine as an antiplatelet agent. All studies demonstrated significant positive effects with different effective dosages. Thus, camel urine shows promising therapeutic potential in treating human diseases, especially cancer. However, the standardised dosage and potential side effects should be determined before camel urine could be offered as an alternative treatment.
I have often asked myself the question whether some SCAMs are too absurd to merit scientific study. Over the years, I changed my mind on it; while initially I tended to answer it in the negative, I now think that YES: some ideas – even those that are ancient and, as Charles Windsor would argue, have thus stood the ‘test of time’ – are not worth the effort. Camel urine as a therapy might well be one of them.
Swedish researchers examined the relationship between cognitive ability and prompt COVID-19 vaccination using individual-level data on more than 700,000 individuals in Sweden.
The analyses were based on individual-level data from several administrative registers in Sweden. The study population consisted of all men and women who enlisted for military service in Sweden between 1979 and 1997. During this period, enlistment was mandatory for men the year they turned 18 or 19. Women could not enlist for military service before 1980 but were then allowed to do so on a voluntary basis.
The study population thus covered almost the entire population of Swedish men born between 1962 and 1979, in total 750,381, as well as the sample of women who enlisted during the period of 1980–1997, in total 2703. In addressing the role of confounders, the researchers analyzed the sub-sample of 6750 twin brothers (3375 twin-pairs) in the enlistment records (identified by shared biological mother and year and month of birth).
The results show a strong positive association between cognitive ability and swift vaccination, which remained even after controlling for confounding variables with a twin-design. Consistent with this, the researchers showed that simplifying the vaccination decision through pre-booked vaccination appointments alleviates almost all of the inequality in vaccination behavior.
The authors concluded that the complexity of the vaccination decision may make it difficult for individuals with lower cognitive abilities to understand the benefits of vaccination.
On this blog, we have repeatedly discussed similar or related findings, e.g.:
- What are the reasons for opposing COVID vaccinations?
- Intelligence, Religiosity, SCAM, Vaccination Hesitancy – are there links?
- COVID-19 vaccinations: Prof Walach wants to “dampen the enthusiasm by sober facts”
- Thoughts on the bigotry of vaccination opponents
- More information on homeopaths’ and anthroposophic doctors’ attitude towards vaccinations
- The ‘Trump-Effect’ on vaccination attitudes
- The anti-vaccination movement is financed by the dietary supplement industry
- Andrew Wakefield, Donald Trump, SCAM, and the anti-vaccination cult
I know, it would be politically incorrect, unkind, unhelpful, etc. but is anyone not tempted to simplify the issue by assuming that people who are against (COVID) vaccinations are intellectually challenged?
The American Chiropractic Association Council on Chiropractic Pediatrics (CCP) announced a new diplomate education program focused on pediatric care. The program will include 300 hours of education covering topics such as pediatric development from birth to age 16, adjusting techniques, working diagnosis, clinical application, integrated care and more…
Development of the diplomate education program has been in the works for several years, with contributions from many members of the CCP, including council president Jennifer Brocker, DC, DICCP. At the helm of course development for this education program are Mary Beth Minser, DC, CACCP, and Kris Tohtz, DC, LAc, educational coordinators for CCP. They agreed that the goal of the new program is to provide education that furthers knowledge of chiropractic pediatrics in an evidence-based, integrative way. “We wanted to make sure that we had something that aligned with ACA’s core principles,” Dr. Tohtz said. “Chiropractic-forward, yes, but scientifically focused.”
Dr. Brocker added, “There was a need for more evidence-informed education [in pediatrics]. I felt like the Council was well positioned to take this on because we had the opportunity to build it from scratch, making it what students and practicing doctors need.” …
Drs. Minser and Tohtz are excited that the diplomate program will also include a research component. “There is some lacking information when it comes to pediatric chiropractic,” Dr. Minser explained. She recently participated in the COURSE Study, an international study seeking to fill knowledge gaps in research relating to pediatric chiropractic treatment. “It was a very easy project to do, and pretty exciting to be involved,” she said. “But you have to know how to treat pediatric patients in order to be involved in those research projects. We want doctors and students [in this program] to be able to go through a case study, to be able to extract information for their clinical application from that case study or from research, or, if they would like, to write up case studies so we can get more published.”
“We feel we could really push pediatric chiropractic to a whole new level having doctors that have this type of knowledge base,” Dr. Minser said. “We just want to be the best pediatric chiropractors that we can be, and this diplomate [education] program helps [us] do that.”
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“There is some lacking information when it comes to pediatric chiropractic.”
Really?
I think the evidence is quite clear: chiropractic has nothing to offer for ill children that other, properly trained healthcare professionals would not do better.
“We feel we could really push pediatric chiropractic to a whole new level.”
Why?
“We just want to be the best pediatric chiropractors that we can be.”
In this case, please study the evidence and you will inevitably arrive at the following conclusion:
THE BEST A CHIROPRACTOR CAN DO FOR A SICK CHILD IS TO REFER IT TO A COMPETENT DOCTOR – A DOCTOR OF MEDICINE, NOT CHIROPRACTIC!
‘Chiropractic Economics‘ focuses on “bridging the gap between what doctors of chiropractic learn about healthcare and what they need to know as entrepreneurs who command successful, thriving practices. We are the top-rated resource for chiropractic news, marketing, consulting, financial planning, attracting and retaining patients, and motivating and managing employees. We provide information for practicing chiropractors, with a focus on office management, patient relations, personal development, financial planning, legal, clinical and research data, and wellness and nutrition.”
The magazine recently published an article that is so wonderfully overflowing with BS that I cannot resist showing you a few hilarious excerpts from it:
HOMEOPATHY IS A NATURAL FOR CHIROPRACTORS — because it works with innate intelligence. Each tiny pellet of a homeopathic remedy is like a flash drive full of information that “reinstalls the software,” i.e., it reminds the body that “you know how to have a healthy nervous system” or strong and healthy bones or muscles.
A remedy for patient malady
Homeopathic remedies have much to offer your patients:
- Fast-acting: Some patients will actually feel the effects as soon as they ingest the remedy; it works faster than herbs or vitamins
- Easily available in health food stores, some drug stores and online
- Inexpensive: pennies per dose
- No rebound or withdrawal: Your patient can discontinue it without symptoms recurring
- No drug interactions: It can work well alongside meds and supplements
- Safe: Reactions are rare and serious side effects are unknown.1
Practitioners will benefit as well from recommending homeopathy as this unusual modality will set the chiropractor apart and patients will be grateful for the relief they feel. Homeopathy is available as single remedies, plus more unusual ones are also blended into combination formulas which chiropractors may choose to stock in their office, just as they stock nutritional supplement and glandular formulas.
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How does it work?
Homeopathy is totally safe because there is nothing in it — not even one molecule of its original starting substance — yet it is powerful and fast-acting. How can we make these contradictory claims? Because it is information technology.
The manufacturing process imprints the healing information onto water like recording onto a flash drive. The process takes the starting substance through many stages of dilution (making it safe) and potentizes or energizes it at each step (making it powerful). Water behaves differently at these very high dilutions, becoming coherent or structured, as explained by the newly emerging field of ultra-high dilution physics. Two Nobel laureates have testified that their studies explain how homeopathy works.2
Now let’s look at some specific remedies.
Hypericum for the nervous system
Hypericum is almost a universal remedy for nerve-related symptoms: tingling and numbness, pain shooting along a nerve, and trauma to nerve-rich areas (like hitting a finger with a hammer or slamming it in a car door):
- Arnica for soft tissue trauma: homeopathy’s best-known remedy, Arnica is good for sore muscles, pulled muscles, sports injuries, sprains and strains, and bruising.
- Symphytum for fractures: This is the well-known herbal remedy comfrey, known traditionally as “knit-bone,” used to speed the healing of fractures and reduce bone pain.
- Bryonia for joints that hurt to move. When your patient is splinting or guarding, think bryonia, for a bruised rib that makes it painful to laugh or cough or sneeze, or knees that hurt from walking that make the patient take cautious steps.
- Rhus tox for “rusty gate” joints: This is for your patient who needs to limber up when first getting out of bed, or who needs to swing their leg a few times to loosen it up before getting up from a chair.
- Ruta grav. for connective tissue, cartilage and joints in general: sprains and strains, cracking joints, torn tendons and ligaments, and fascia. It has a special affinity for the knee, like the knee that goes out from under someone and for Baker’s cysts.
Three homeopathically-energized minerals to strengthen and heal bone need to be given in a special 6x potency and are known as cell salts or tissue salts:
- Calcarea fluorica (Calc. fluor.) 6x to soften and dissolve: This remedy can help dissolve bone spurs and hardened or condensed tissues like cataracts.
- Calcarea phosphorica (Calc. phos.) 6x to deposit minerals in the bones: This provides the template to send calcium and other minerals to bones and not deposit them elsewhere in the body.
- Silicea 6x strengthens bone as well as hair, skin and nails; you know silica as a supplement, and as a homeopathic remedy it provides the instructions for silica the mineral to go where it is needed. However, Silica 30c (full strength) can push foreign objects out of the body and should not be given to patients with a rod or plate and screws.
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What could possibly go wrong?
Not much — an “overdose” in homeopathy is not harmful in the long run — in fact, too much of a remedy is pushing the patient too fast in the direction of cure and the long-term result can be positive. It can be uncomfortable in the short run, though.
The body can only process so much of the remedy’s information at once, and if the body is presented with more than it can handle, it pushes back in the form of increased symptoms, the same symptoms the remedy was intended to treat. This is called an “aggravation” in homeopathy. It’s often said that “You have to get worse before you get better” in homeopathy and this is absolutely not true as long as mild to moderate doses are used (the typical 30c dose in health food stores) and the patient is told to stop if the remedy starts to feel too intense. When in doubt, it’s always safe to stop the remedy and start again later.
The bottom line
Start by recommending these few remedies and you are likely to get good feedback from your patients. Or consider stocking combination remedies that include even more unusual remedies.
They may give even better results and keep patients coming back to you for more, since they are only available through professionals. And if you’re feeling exhausted beyond repair, try some Sepia for yourself.
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Yes, this is what a ‘top rated’ chiropractic resource mistakes for information on ‘clinical and research data, and wellness and nutrition’!
I didn’t promise too much, did I?
The case of a 91-year old male patient developing acute neuropathic pain along the sciatic nerve distribution following spinal manipulation has been reported. Manipulative treatment with an Activator Adjusting Instrument (AAI) had been performed. During this treatment, three applications of the AAI were administered. The applications were bilateral (1) over the sacroiliac joint, (2) gluteal area, and (3) paraspinal region just above the iliac crest.
Within 24 hours, the patient developed severe 10/10 pain originating from the left gluteal area at the site of one of the activator deployments with radiation all the way down his left leg to the foot. He was able to maintain distal left leg strength and sensation. Subsequently, the patient developed insomnia, confusion, and adrenal gland dysfunction in response to changes in steroids, gabapentin, and other drugs, thus highlighting some nuances of managing elderly patients with back pain.
Relief was achieved with subsequent physical therapy techniques aimed at relaxing the patient’s deep gluteal muscles, raising the hypothesis of temporary injury to the deep gluteal muscles, with painful contractions resulting in gluteal region pain as well as sciatic nerve inflammation as the nerve passed through that region.
The authors concluded that this clinical case illustrates some of the perils and risks of spinal manipulation, particularly in the elderly, and the need for careful patient selection.
The authors of this (stranely incomplete) case report discuss whether any manipulation was truly necessary or indicated as part of his initial chiropractic treatment plan. They state that, given that complications associated with similar practices are not often reported in the literature, this case highlights important considerations to be made in the elderly given the potential impact of transient/permanent neuropathic pain in that population subset.
Somehow, I doubt that we can be certain that the patient improved due to the physical therapy and not due to the drugs he received. Moreover, I question the authors’ repeated assertions that such adverse effects of chiropractic spinal manipulation are truly rare. Here is a section from our own 2002 systematic review of the subject:
A systematic review of five prospective investigations of the risks of spinal manipulation concluded that mild-to moderate transient adverse reactions occur in approximately half of patients who undergo spinal manipulation. The largest of these studies involved 1058 patients who received a total of 4712 treatments from 102 chiropractors in Norway. At least one adverse reaction was reported by 55% (n 580) of patients. About one quarter (n 1174) of treatments resulted in at least one adverse reaction. The most common reaction reported was local discomfort. Eighty-five percent (n 824) of reactions were described as “mild or moderate” and 1% (n 14) as “unbearable.” Seventy-four percent (n 1052) of reactions disappeared within 24 hours. No serious, permanent complications of spinal manipulation were reported, but follow-up was not described. These results were confirmed by a similar study in Sweden with 625 patients and a smaller one (68 patients) from the United Kingdom …
Non-life-threatening adverse effects after spinal manipulations are not rare – they are merely rarely reported!
This systematic review with meta-analysis of randomized clinical trials (RCTs) estimated the benefits and harms of cervical spinal manipulative therapy (SMT) for treating neck pain. The authors searched the MEDLINE, Cochrane CENTRAL, EMBASE, CINAHL, PEDro, Chiropractic Literature Index bibliographic databases, and grey literature sources, up to June 6, 2022.
RCTs evaluating SMT compared to guideline-recommended and non-recommended interventions, sham SMT, and no intervention for adults with neck pain were eligible. Pre-specified outcomes included pain, range of motion, disability, health-related quality of life.
A total of 28 RCTs could be included. There was very low to low certainty evidence that SMT was more effective than recommended interventions for improving pain at short-term (standardized mean difference [SMD] 0.66; confidence interval [CI] 0.35 to 0.97) and long-term (SMD 0.73; CI 0.31 to 1.16), and for reducing disability at short-term (SMD 0.95; CI 0.48 to 1.42) and long-term (SMD 0.65; CI 0.23 to 1.06). Only transient side effects were found (e.g., muscle soreness).
The authors concluded that there was very low certainty evidence supporting cervical SMT as an intervention to reduce pain and improve disability in people with neck pain.
Harms cannot be adequately investigated on the basis of RCT data. Firstly, because much larger sample sizes would be required for this purpose. Secondly, RCTs of spinal manipulation very often omit reporting adverse effects (as discussed repeatedly on this bolg). If we extend our searches beyond RCTs, we find many cases of serious harm caused by neck manipulations (also as discussed repeatedly on this bolg). Therefore, the conclusion of this review should be corrected:
Low certainty evidence exists supporting cervical SMT as an intervention to reduce pain and improve disability in people with neck pain. The evidence of harm is, however, substantial. It follows that the risk/benefit ratio is not positive. Cervical SMT should therefore be discouraged.
I was asked by NATURE to provide a comment on the WHO Traditional Medicine Global Summit: Towards health and well-being for all which is about to take place in India:
The First WHO Traditional Medicine Global Summit will take place on 17 and 18 August 2023 in Gandhinagar, Gujarat, India. It will be held alongside the G20 health ministerial meeting, to mobilize political commitment and evidence-based action on traditional medicine, which is a first port of call for millions of people worldwide to address their health and well-being needs.
The Global Summit will be co-hosted by WHO and the Government of India, which holds the presidency of the G20 in 2023. It will be a platform for all stakeholders, including traditional medicine workers, users and communities, national policymakers, international organizations, academics, private sector and civil society organizations, to share best practices and game-changing evidence, data and innovation on the contribution of traditional medicine to health and sustainable development.
For centuries, traditional and complementary medicine has been an integral resource for health in households and communities. It has been at the frontiers of medicine and science laying the foundation for conventional medical texts. Around 40% of pharmaceutical products today have a natural product basis, and landmark drugs derive from traditional medicine, including aspirin, artemisinin, and childhood cancer treatments. New research, including on genomics and artificial intelligence are entering the field, and there are growing industries for herbal medicines, natural products, health, wellness and related travel. Currently, 170 Member States reported to WHO on the use of traditional medicine and have requested evidence and data to inform policies, standards and regulation for its safe, cost-effective and equitable use.
In response to this increased global interest and demand, WHO, with the support of the Government of India, established in March 2022 the WHO Global Centre for Traditional Medicine as a knowledge hub with a mission to catalyse ancient wisdom and modern science for the health and well-being of people and the planet. The WHO Traditional Medicine Centre scales up WHO’s existing capacity in traditional medicine and supplements the core WHO functions of governance, norms and country support carried out across the six regional Offices and Headquarters.
The Centre focuses on partnership, evidence, data, biodiversity and innovation to optimize the contribution of traditional medicine to global health, universal health coverage, and sustainable development, and is also guided by respect for local heritages, resources and rights.
A cross-regional expert panel will advise on the Summit’s theme, format, topics and issues to address. All updates will be posted here and on the forthcoming webpages for the First WHO Traditional Medicine Global Summit.
In case you are interested, the programme can be seen here.
And my comment? I am afraid, it was not very encouraging. I doubt that Nature will publish it in full. So, allow me to show you my unabridged comment:
This systematic review and meta-analysis assessed the effectiveness of visceral osteopathy in improving pain intensity, disability and physical function in patients with low-back pain (LBP).
MEDLINE (Pubmed), PEDro, SCOPUS, Cochrane Library and Web of Science databases were searched from inception to February 2022. PICO search strategy was used to identify randomized clinical trials applying visceral techniques in patients with LBP. Eligible studies and data extraction were conducted independently by two reviewers. Quality of the studies was assessed with the Physiotherapy Evidence Database scale, and the risk of bias with Cochrane Collaboration tool. Meta-analyses were conducted using random effects models according to heterogeneity assessed with I2 coefficient. Data on outcomes of interest were extracted by a researcher using RevMan 5.4 software.
Five studies were included in the systematic review involving 268 patients with LBP. The methodological quality of the included ranged from high to low and the risk of bias was high. Visceral osteopathy techniques have shown no improvements in pain intensity (Standardized mean difference (SMD) = -0.53; 95% CI; -1.09, 0.03; I2: 78%), disability (SMD = -0.08; 95% CI; -0.44, 0.27; I2: 0%) and physical function (SMD = -0.26; 95% CI; -0.62, 0.10; I2: 0%) in patients with LBP.
The authors concluded that this systematic review and meta-analysis showed a lack of high-quality studies showing the effectiveness of visceral osteopathy in pain, disability, and physical function in patients with LBP.
Visceral osteopathy (or visceral manipulation) is an expansion of the general principles of osteopathy and involves the manual manipulation by a therapist of internal organs, blood vessels and nerves (the viscera) from outside the body.
Visceral osteopathy was developed by Jean-Piere Barral, a registered Osteopath and Physical Therapist who serves as Director (and faculty) of the Department of Osteopathic Manipulation in Paris, France. He stated that through his clinical work with thousands of patients, he created this modality based on organ-specific fascial mobilization. And through work in a dissection lab, he was able to experiment with visceral manipulation techniques and see the internal effects of the manipulations.[1] According to its proponents, visceral manipulation is based on the specific placement of soft manual forces looking to encourage the normal mobility, tone and motion of the viscera and their connective tissues. These gentle manipulations may potentially improve the functioning of individual organs, the systems the organs function within, and the structural integrity of the entire body.[2] Visceral osteopathy comprises of several different manual techniques firstly for diagnosing a health problem and secondly for treating it.
Several studies have assessed the diagnostic reliability of the techniques involved. The totality of this evidence fails to show that they are sufficiently reliable to be od practical use.[3] Other studies have tested whether the therapeutic techniques used in visceral osteopathy are effective in curing disease or alleviating symptoms. The totality of this evidence fails to show that visceral osteopathy works for any condition.[4]
The treatment itself seems to be safe, yet the risks of visceral osteopathy are nevertheless considerable: if a patient suffers from symptoms related to her inner organs, the therapist is likely to misdiagnose them and subsequently mistreat them. If the symptoms are due to a serious disease, this would amount to medical neglect and could, in extreme cases, cost the patient’s life.
My bottom line: if you see visceral osteopathy being employed anywhere, turn araound and seek proper healthcare whatever your illness might be.
References
[1] https://www.barralinstitute.com/about/jean-pierre-barral.php .
[2] http://www.barralinstitute.co.uk/ .
[3] Guillaud A, Darbois N, Monvoisin R, Pinsault N (2018) Reliability of diagnosis and clinical efficacy of visceral osteopathy: a systematic review. BMC Complement Altern Med 18:65
The increasing demand for fertility treatments has led to the rise of private clinics offering so-called alternative medicine (SCAM) treatments. Even King Charles has recently joined in with this situalion. One of the most frequently offered SCAM infertility treatment is acupuncture. However, there is no good evidence to support the effectiveness of acupuncture in treating infertility.
This study evaluated the scope of information provided by SCAM fertility clinics in the UK. A content analysis was conducted on 200 websites of SCAM fertility clinics in the UK that offer acupuncture as a treatment for infertility. Of the 48 clinics that met the eligibility criteria, the majority of the websites did not provide sufficient information on:
- the efficacy,
- the risks,
- the success rates
of acupuncture for infertility.
The authors concluded that this situation has the potential to infringe on patient autonomy, provide false hope and reduce the chances of pregnancy ever being achieved as fertility declines during the time course of ineffective acupuncture treatment.
The authors are keen to point out that their investigation has certain limitations. The study only analysed the information provided on the clinics’ websites and did not assess the quality of the treatment provided by the clinics.
Therefore, the study’s fndings cannot be generalized to the quality of the acupuncture treatment provided by the clinics.
Nonetheless the paper touches on very important issues: far too many health clinics that offer SCAM for this or that indication operate way outside the ethically (and legally) acceptable norm. They advertise their services without making it clear that they are neither effective nor safe. Desperate consumers thus fall for their promises. In the case of infertility, this might result merely in frustration and loss of (often substantial amounts of) money. In the case of serious disease, such as cancer, this often results in premature death.
It is time, I think, that this entire sector is regualted in a way that it does not endanger the well-being, health, or life of consumers.
