supplements
Mehmet Oz has featured regularly on this blog, e.g.:
- Donald Trump nominated SCAM promoter, Mehmet Oz, to lead the Centers for Medicare and Medicaid Services (CMS)
- Columbia University cut ties with Dr. Mehmet Oz … or did they?
- Quackery promoter, Dr. Mehmet Oz, is running for the U.S. Senate
- Trump, Kennedy and Oz just announced plenty of untruths about autism and its treatment
Currently, he serves in Trump’s administration as “Administrator of the Centers for Medicare & Medicaid Services” (CMS). He also is (or was?) a “Global Advisor & Stakeholder” for the company ‘iHerb’, and was appointed to that role in 2023. The company itself is a global e-commerce platform that was founded in 1996 and has its headquarters in California. iHerb specializes in health and wellness products. iHerb’s mission is to make health and wellness products accessible to everyone. The company operates as a direct-to-consumer retailer. iHerb sells a wide variety of products, including:
- Vitamins, minerals, and supplements (VMS)
- Sports nutrition
- Beauty and personal care products
- Grocery items
- Baby and pet care products
Crucially, iHerb sells several products with leucovorin, i.e. folinic acid, the drug that, even though unproven, is now officially used for autism in the US. As far as I can see, most of the products that Oz promotes are not based on sound evidence.
Based on available information from a financial disclosure analysis, Mehmet Oz’s work as an advisor for ‘iHerb’ has earned him as much as $25 million in company stock. The disclosure, which lists asset values in ranges rather than precise figures, shows that this stock was part of his overall financial portfolio.
Several experts have raised concerns that Oz’s financial interests in various healthcare and supplement companies, including iHerb, could create a conflict of interest. As the Administrator of the Centers for Medicare and Medicaid Services (CMS), a position that oversees a vast budget and a significant portion of the U.S. healthcare system, his past and present ties to the industry have been highlighted as potential issues. The concern is that a government official in such a powerful position could use their influence to benefit their own financial holdings or those of companies they are affiliated with. This is especially relevant given that Medicare Advantage, a program he would oversee, allows customers to use prepaid cards to buy over-the-counter medicines and supplements—a market that companies like iHerb are in.
Mehmet Oz has publicly disclosed his financial interests. A financial filing shows that his investments in ‘iHerb’ represented one of his largest financial holdings. In a filing with the Office of Government Ethics, Oz has committed to divesting his equity holdings in healthcare companies, including his iHerb stock, within 90 days of confirmation. He has also pledged to resign from his advisory role with ‘iHerb’. The Office of Government Ethics has stated that based on its review, it believes Oz is in compliance with applicable laws and regulations concerning conflicts of interest. The situation remains a point of public discussion and has drawn the attention of consumer advocacy groups. For example, the group Public Citizen has asked the Federal Trade Commission (FTC) to investigate whether Oz’s social media posts promoting iHerb violated FTC guidelines on undisclosed endorsements, as his posts did not always clearly state his financial connection to the company.
Based on current public information, there are serious questions and concerns about whether Mehmet Oz has divested all of his interests as pledged, particularly with respect to his holdings in ‘iHerb’. The latest publicly available filings detail his assets and his intent to divest, but do not show the final completed sale. iHerb itself has publicly stated that the company is no longer affiliated with Dr. Oz and is not working with him or the administration. However, this does not independently confirm the liquidation of his personal vested stock.
A failure to timely follow the pledge can and should trigger a chain of events that leads to serious civil and criminal penalties, as well as significant political repercussions.
As predicted in my post yesterday, Donald Trump, Mehmet Oz and Robert F Kennedy Jr made an announcement on Monday at the White House, advising pregnant women to avoid taking paracetamol and claiming that it heightens the risk of autism. As pointed out in yesterday’s post, this assertion is not based on reliable evidence.
Specifically, like a trio of charlatans, they misled the public by claiming that the use of paracetamol during pregnancy is linked to autism and that the US Food and Drug Administration (FDA) would be advising doctors to minimize its use. Also as predicted, they promoted leucovorin as an autism treatment, a claim equally not supported by reliable evidence. Finally, Trump repeated long-debunked claims that ingredients in vaccines or timing shots close together could contribute to rising rates of autism in the U.S., without providing any medical evidence.
Several medical organizations, including the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics, swiftly condemned these statements as “irresponsible” and not backed by sound scientific evidence. They emphasized that a causal link between paracetamol and autism has not been established. New York University bioethicist Art Caplan said it was “the saddest display of a lack of evidence, rumors, recycling old myths, lousy advice, outright lies, and dangerous advice I have ever witnessed by anyone in authority.” Health regulators in other countries, such as the UK and Australia, also reiterated their guidance that paracetamol is safe for use during pregnancy. The overwhelming consensus among the global scientific community is that paracetamol remains the safest pain relief option for pregnant women when used as directed. Untreated pain and fever during pregnancy can pose more significant risks to both the mother and the unborn baby.
Dr. Mehmet Oz, who is of course well-known for making millions by promoting every form of quackery on the planet, discussed the decision to have government health programs like Medicaid and the Children’s Health Insurance Program (CHIP) cover the cost of leucovorin, i.e. folinic acid, for the treatment of autism. He stated that this move would ensure access to the drug for millions of children and that he expected private insurance companies to follow suit. Yet, the use of leucovorin for autism is considered highly controversial, as pointed out in yesterday’s post. It is not widely accepted by the scientific community and, if effective at all, can work only for a small sub-set of autistic patients. Even for them, it is not a cure and would only be helpful for certain symptoms.
So, why mislead the public in this way?
One reason could be that the company, “iHerb” for which Mehmet Oz is “Global Advisor & Stakeholder”, sells no less than 4 supplements with a version of leucovorin. The announcement from the White House and the administration’s push for the drug therefore raise serious questions and concerns about conflicts of interest and corruption.
It has been reported that the US surgeon general nominee, Casey Means, earned hundreds of thousands of dollars promoting supplements and other health and wellness products, details likely to invite new scrutiny about potential conflicts of interest for the author and entrepreneur.
Means, a close ally of health secretary Robert F. Kennedy Jr. and the sister of White House adviser Calley Means, has not yet been scheduled to appear before Congress for her confirmation hearing. But a filing dated Sept. 10 and posted by the Office of Government Ethics suggests her nomination cleared conflict-of-interest checks within the federal government.
The supplements industry has ties with several members of the Trump administration, including Medicaid director Mehmet Oz and health adviser Calley Means. An AP investigation this summer found that Casey Means had repeatedly failed to disclose her partnerships with supplements companies and other businesses promoted in her
newsletter, social media accounts, and elsewhere.
Among the payments included in the new disclosures for newsletter sponsorship and partnership fees are $12,000 from herbal remedies firm Apothekary; $27,431 from algae supplements company ENERGYbits; $16,461 from fiber supplements company Florasophy; $27,000 from probiotics company Pendulum Therapeutics; $46,000 from
supplements company Pique; $536 from prenatal vitamin company WeNatal; and $16,104 from basil seed supplements company Basil Seed Works. Means received a total of more than $130,000 in sponsorship fees from supplement company Amazentis, including a $55,000 book tour sponsorship.
_________________
In May this year, I wrote this about Means:
RFK Jr wrote on X: “The Surgeon General is a symbol of moral authority who stands against the financial and institutional gravities that tend to corporatize medicine. Casey Means was born to hold this job. She will provide our country with ethical guidance, wisdom, and gold-standard medical advice.” Yet her suitability for Surgeon General is a contentious issue.
Means holds a 2014 MD from Stanford University and a bachelor’s degree in human biology. She is an advocate for addressing chronic diseases through nutrition, exercise, and lifestyle changes. Her book “Good Energy”, co-authored with her brother Calley, argues that metabolic dysfunction is a root cause of most chronic illnesses. As a “wellness influencer”, Means has demonstrated an ability to communicate health concepts to a broad audience.
Critics point out that Means dropped out of her residency at Oregon Health & Science University months before completion. This means she is not board-certified and has very limited clinical experience; for instance, she never saw patients without supervision. Her medical license has been inactive since 2024, and she has done as good as no own original research. Unlike past Surgeons General, who had extensive backgrounds in public health administration and infectious disease, Means has no government or public health leadership experience. Her focus is on functional medicine and wellness, both areas that lack rigor and are close to quackery.
It gets worse: Means has expressed skepticism about vaccines, suggesting in a 2024 newsletter that the current vaccine schedule contributes to the decline of pediatric health. Her endorsement of dangerous nonsense like energy healing and raw milk seems worrying. Moreover, Means also co-founded Levels, a company selling continuous glucose monitors to non-diabetics, and markets supplements and other dubious health products. RFKJr’s claim that Means will offer “ethical guidance” seems particularly odd: she has no training in medical ethics and some of her past actions are outright unethical. Physicians like Dr. Neil Stone have therefore called Means “grossly underqualified”.
The Surgeon General must provide science-based guidance, oversee >6,000 officers, and address diverse and serious public health issues. Means’ inexperience and narrow focus limits her effectiveness. Crucially, her history of promoting of vaccine skepticism and quack medicine undermines trust in science-based policies.
In summary, Means seems wholly unsuited for the job of Surgeon General. In the interest of the US public health, her appointment should not be confirmed by the Senate.
SAY NO MORE!
I came across a new systematic review of the herbal remedy, FEVERFEW, as a preventative treatment for migraine. Here is the abstract:
Review just published in ‘The American Journal of Natural Medicines, Facts’
Migraine, a neurological condition, affects approximately 1.1 billion people worldwide, making it the third leading cause of disability. It significantly impacts quality of life and incurs an annual economic burden exceeding $78 billion in the United States. This systematic review and meta-analysis aims to evaluate the efficacy of Feverfew Dietary Supplement in migraine prophylaxis, with migraine frequency considered as the primary outcome. Three trials (n=237) were included in the meta-analysis (MA) of migraine frequency, and an additional three trials were synthesized narratively in the systematic review. In the MA, feverfew showed a non-significant reduction in migraine frequency compared to placebo (Overall effect size, Cohen’s d: -0.19; 95% CI: -0.52 to 0.14; I² = 34%, p = 0.26). These findings suggest that Feverfew might offer some benefit in individual patients, but given the small, non-significant effect size, it should not be recommended as a primary prophylactic agent over established treatments. Feverfew may not be effective as a standalone prophylactic supplement for migraines; however, its potential in combination therapies seems promising and requires further evaluation. Larger trials with standardized parthenolide content and extended durations are necessary to clarify feverfew’s definitive role in migraine prophylaxis.
The subject is no doubt interesting: migraine is a common contition that severely reduces quality of life and is difficult to treat or prevent. Thus an effective herbal remedy would be more than welcome. Based on such considerations, my co-workers and I had conducted a Cochrane review which was last updated in 2015. Here is its abstract:
Background: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews on ‘Feverfew for preventing migraine’ (2004, Issue 1). Feverfew (Tanacetum parthenium L.) extract is a herbal remedy, which has been used for preventing attacks of migraine.
Objectives: To systematically review the evidence from double-blind randomised controlled trials (RCTs) assessing the clinical efficacy and safety of feverfew monopreparations versus placebo for preventing migraine.
Search methods: For this updated version of the review we searched CENTRAL, MEDLINE, EMBASE and AMED to January 2015. We contacted manufacturers of feverfew and checked the bibliographies of identified articles for further trials.
Selection criteria: We included randomised, placebo-controlled, double-blind trials assessing the efficacy of feverfew monopreparations for preventing migraine in patients of any age. We included trials using clinical outcome measures, while we excluded trials focusing exclusively on physiological parameters. There were no restrictions regarding the language of publication.
Data collection and analysis: We systematically extracted data on patients, interventions, methods, outcome measures, results and adverse events. We assessed risk of bias using the Cochrane ‘Risk of bias’ tool and evaluated methodological quality using the Oxford Quality Scale developed by Jadad and colleagues. Two review authors (BW and MHP for this update, MHP and EE for the original version) independently selected studies, assessed methodological quality and extracted data. We resolved disagreements concerning evaluation of individual trials through discussion.
Main results: We identified one new study for this update, resulting in six trials (561 patients) meeting the inclusion criteria. Five of the six trials reported on the main outcome, migraine frequency. Although five of the trials were generally of good methodological quality, all studies were either of unclear or high risk of bias with regards to sample size. Pooled analysis of the results was not possible due to the lack of common outcome measures and heterogeneity between studies in terms of participants, interventions and designs.The most recent trial added to this version of the review is rigorous and larger (n = 218), using a stable feverfew extract at a dose determined by a previous dose-finding trial. It reports that feverfew reduced migraine frequency by 1.9 attacks from 4.8 to 2.9 and placebo by 1.3 from to 4.8 to 3.5 per month, resulting in a difference in effect between feverfew and placebo of 0.6 attacks per month. For the secondary outcome measures intensity and duration of migraine attacks, incidence and severity of nausea and vomiting, and global assessment no statistically significant differences were reported. Results of previous trials are not convincing: three trials reporting positive effects of feverfew are all of small sample size (17 to 60 participants), while two rigorous trials (n = 50, 147) did not find significant differences between feverfew and placebo. Only mild and transient adverse events, most commonly gastrointestinal complaints and mouth ulcers, were reported in the included trials.
Authors’ conclusions: Since the last version of this review, one larger rigorous study has been included, reporting a difference in effect between feverfew and placebo of 0.6 attacks per month. This adds some positive evidence to the mixed and inconclusive findings of the previous review. However, this constitutes low quality evidence, which needs to be confirmed in larger rigorous trials with stable feverfew extracts and clearly defined migraine populations before firm conclusions can be drawn. It appears from the data reviewed that feverfew is not associated with any major safety concerns.
The question that I ask myself is this: what exactly does the new review add to the existing knowledge?
I fear, the answer is VERY LITTLE! Arguably, the new review is even less rigorous, transparent, thorough and informative than our paper.
If that is so, why conduct and publish it?
The process of doing this is an unethical waste of resources, and the habit of publishing redundant papers is irritating and arguably also unethical.
All this would be rather trivial, of course, if not for the fact that this form of science abuse is happening all the time in the realm of so-called alternative medicine. Responsible journal editors and reviewers should remember that they have the duty to prevent it.
We are about half way through 2025 which is an opportune occasion to again check how research-active the various branches of so-called alternative medicine (SCAM) currently are. To get a rough impression, I yesterday went on Medline and did a few very simple searches. They all used this search term:
“2025, [name of therapy in question], clinical trial”.
The findings are, I think, impressive. Here are some SCAM modalities ranked by the number of hits I received:
- dietary supplements 790
- herbal medicine 455
- acupuncture 407
- mindfulness 338
- massage 129
- yoga 98
- tai chi 60
- essential oil 31
- chiropractic 19
- osteopathic manipulative therapy 13
- homeopathy 11
- naturopathy 6
I should stress that not all of these hits are truly clinical trials (Medline is not precise in that), neither does Medline capture all SCAM journals. So, the figures are by no means accurate but they do give a rough picture of what is going on.
And what is going on?
Unsurprisingly, commercial products are heading the list. Acupuncture in the 3rd place might surprize some; here I must add that the 407 articles come to ~90% (my guess) from China. I have often warned on this blog to not take these papers seriously, as they are predominantly promotion rather than science. Mindfulness on the 4th place is, I think, a reflection of the current hype around this therapy.
The rest is as one might expect – except for the dismal ranking of chiropractic, osteopathy, homeopathy and naturopathy. The suggestion here is, I fear, that these practitioners seem to have very little interest in doing research. Why? Perhaps they know that their treatments cannot withstand the rigor of a decent clinical trial?
In fact, with a bit of fantasy, one could even see an interesting correlation between the evidence-base and the research-activity of SCAM: the treatments that are best supported by evidence seem to have the highest level of research-activity. Conversely, the ones that have the weakest evidence-base seem to have the least research going on.
PS
My analysis does, of course, say nothing about the quality of the science which is, as we often discuss here on this blog, frequenlty dismal.
- Homeopaths would, of course, recommend homeopathic preparations of Arnica.
- Fans of homotoxicology might advise to use Traumheel, especially designed for healing traumata fast.
- Herbalists swear by Hamamelis.
- A massage therapist would recommend lymph drainage.
- An aromatherapy might advise Juniper berry for healing.
- A healer would insist on a range of energy healing methods.
- An Ayurvedic professional mighr recomment urine therapy.
- A naturopath could advocate aloe vera.
- A Bach flower specialist would insist on Rescue remedies.
- …
- …
- …
Come to think of it, the only SCAM that SCAM therapist would probably not recommend in Elon’s case is vaginal steaming (which Gwyneth Paltrow is so fond of)!
So, Elon’s choice is enorm; but what about efficacy?
Like most ailments that SCAM is claimed to help with, there is a (not so slight) drawback: the evidence that they actually do any good is absent or very week. For Elon, this might not be a problem (he can afford to waste a few $$). As we have seen, for instance, from his claims about DOGE, he does not believe in evidence any more than in empathy.
PS
Of course, now Elon has other problems. In case you read this, Elon, for dealing with the separation from your former master and guru, Trump, let me recommend to you: Berlin Wall D12 [my bill is in the post].
“What does Trump think about so-called alternative medicine (SCAM)?”
Does anyone know?
Does he even know himself?
Time to ask GROK!
Here is the answer I got when asking exactly that question (the bold print was added by me in an attempt to highlight what I felt was important):
There is no definitive, up-to-date public statement from Donald Trump explicitly outlining his views on alternative medicine as a broad category. However, based on available information from his actions, statements, and policy moves, we can piece together some insights into his stance, particularly during his presidency and recent activities up to May 2025.
Key Points on Trump’s Views and Actions Related to Alternative Medicine:
1 Skepticism of Mainstream Medical Institutions:
- Trump has often expressed distrust toward mainstream medical and scientific establishments, which aligns with sentiments in some alternative medicine communities. For instance, during the COVID-19 pandemic, he promoted unproven treatments like hydroxychloroquine and chloroquine, despite limited scientific evidence supporting their efficacy for COVID-19. His endorsements led to significant increases in prescriptions and public interest, highlighting his influence and willingness to back therapies outside mainstream medical consensus.
- This skepticism is further evidenced by his support for figures like Robert F. Kennedy Jr., who has a history of promoting alternative health perspectives and questioning mainstream medical practices, such as vaccines. Trump appointed RFK Jr. to lead the “Make America Healthy Again” Commission, which focuses on chronic diseases and could potentially explore non-conventional approaches.
2 Support for Experimental and Compassionate Use Treatments:
- Trump has advocated for policies like the “Right-to-Try” legislation, which allows terminally ill patients to access experimental drugs not yet fully approved by the FDA. This reflects a willingness to bypass traditional medical regulatory pathways to provide access to treatments that might be considered alternative or unproven. In his 2018 State of the Union address, he emphasized giving patients a chance to try such treatments, framing it as a matter of patient empowerment.
- During his own COVID-19 treatment in October 2020, Trump received an experimental antibody cocktail from Regeneron under compassionate use rules, which was not widely available to the public. This move raised ethical questions but also showed his openness to non-standard treatments when personally relevant.
3 Limited Direct Engagement with Alternative Medicine:
- There is little evidence that Trump has explicitly endorsed practices like acupuncture, homeopathy, or naturopathy, which are commonly associated with alternative medicine. For example, the Trump Commission on Combating Drug Addiction and the Opioid Crisis (2017) did not reference nonpharmacologic or integrative approaches like acupuncture in its interim report, despite growing mainstream support for such methods in pain management.
- However, a 2025 budget proposal from Trump reportedly included eliminating funding for the National Center for Complementary and Integrative Health (NCCIH), suggesting a lack of priority or potential skepticism toward federally funded research into complementary therapies.
4 Overlap with Alternative Medicine Communities:
- Trump’s rhetoric and appeal have resonated with some alternative medicine communities due to shared distrust of mainstream institutions. A 2020 Washington Post article noted parallels between Trump’s base and alternative medicine advocates, both of whom often reject “mainstream” narratives (e.g., media or medical establishment) in favor of empowerment through “doing your own research.” This ideological overlap doesn’t necessarily mean Trump endorses alternative medicine outright but indicates a cultural alignment with some of its proponents.
- His association with figures like RFK Jr. and Dr. Mehmet Oz, who have at times supported controversial or alternative health ideas, further ties him to this space, though his personal stance remains less explicit.
5 Focus on Patient Empowerment and Deregulation:
- Trump’s broader healthcare agenda emphasizes deregulation, patient choice, and reducing reliance on federal oversight, which could indirectly support alternative medicine by lowering barriers to unorthodox treatments. His executive orders on healthcare, such as those promoting price transparency and flexibility in health plans, align with a philosophy of giving individuals more control over their healthcare decisions, a principle often championed by alternative medicine advocates.
Analysis and Gaps:
- Lack of Explicit Policy on Alternative Medicine: Trump has not articulated a clear, comprehensive stance on alternative medicine as a field (e.g., acupuncture, herbal remedies, or chiropractic care)v His focus has been more on specific unproven treatments (e.g., hydroxychloroquine) or policies that indirectly affect the broader healthcare landscape.
- Context of COVID-19: His promotion of unproven COVID-19 treatments was controversial and led to real-world consequences, such as increased prescriptions and a reported death linked to chloroquine misuse. This suggests a willingness to endorse therapies with limited evidence when they align with his narrative or political goals, but it’s not a blanket endorsement of all alternative medicine.
- Potential Contradictions: The proposed cut to NCCIH funding contrasts with his support for figures like RFK Jr., who might advocate for exploring alternative approaches. This could indicate a pragmatic or inconsistent approach rather than a unified stance.
Conclusion:
Donald Trump’s views on alternative medicine appear to be less about endorsing specific practices and more about a broader distrust of mainstream medical institutions, a focus on patient empowerment, and a willingness to support unproven or experimental treatments in certain contexts. His actions, such as promoting hydroxychloroquine, supporting Right-to-Try, and aligning with figures skeptical of conventional medicine, suggest an openness to non-traditional approaches, particularly when they resonate with his base or personal circumstances. However, his budget proposal to defund the NCCIH indicates he may not prioritize federal support for researching complementary therapies. Without a direct statement from Trump, his stance remains inferred from these actions and associations. For the most current perspective, checking recent statements or posts on platforms like Truth Social could provide further clarity, but as of May 2025, no such explicit statement is widely documented.
____________________
The next question is: WHO CARES?
Why should it matter what the spiritus rector of the KKK bar of human decency thinks?
Sadly, the answer is BECAUSE HE HAS INFLUENCE.
My prediction is that Trump will remain uninterested in SCAM until the moment he sees an oportunity to make millions of it. Let’s hope this never happens!
Donald Trump has recently made a range of appointments in the health sector of the US. They will strongly influence conventional and so-called alternative medicine (SCAM) in the US as well as worldwide. It therefore seems worth to look at the backgrounds and qualifications of these men and women and critically evaluate their fit for leadership roles in healthcare. In part 1 of this series, we looked at Robert F.Kennedy Jr. and David Weldon. Now I will focus on Trumps nominations for Surgeon General
Janette Nesheiwat – Surgeon General
We featured Janette once before. She trained as a family and emergency medicine physician, became the medical director at CityMD and also a Fox News contributor. She has no significant public health leadership experience. As the Surgeon General, she would require shaping national health policy and communicating science to the public, areas where she has no training or experience. She also lacks expertise in public health and epidemiology. Her Fox News role and online vitamin sales raise doubts about her prioritization of evidence-based public health over media-driven health promotion. The Surgeon General is the nation’s leading spokesperson on public health, overseeing the U.S. Public Health Service Commissioned Corps and issuing science-based health advisories. Nesheiwat would be a disaster for such a position.
Nesheiwat’s nomination was eventually withdrawn by Trump. This suggests internal concerns about her fitness for the job.
Casey Means – Surgeon General
RFK Jr wrote on X: “The Surgeon General is a symbol of moral authority who stands against the financial and institutional gravities that tend to corporatize medicine. Casey Means was born to hold this job. She will provide our country with ethical guidance, wisdom, and gold-standard medical advice.” Yet her suitability for Surgeon General is a contentious issue.
Means holds a 2014 MD from Stanford University and a bachelor’s degree in human biology. She is an advocate for addressing chronic diseases through nutrition, exercise, and lifestyle changes. Her book “Good Energy”, co-authored with her brother Calley, argues that metabolic dysfunction is a root cause of most chronic illnesses. As a “wellness influencer”, Means has demonstrated an ability to communicate health concepts to a broad audience.
Robert F. Kennedy Jr. is coming out with so much stupidity, ignorance and quackery that it is getting difficult to keep up. A recent article reported that he touted two particular medications that have not been shown to work as first-line treatments for measles:
- the steroid budesonide,
- the antibiotic clarithromycin.
Kennedy claimed on X that the medications had been instrumental in treating around 300 children in Texas, and told Fox News that doctors prescribing them had seen “very, very good results.”
Consequently, families in Texas have turned to questionable remedies — in some cases, also prompted by the recommendation of two Texas doctors, Dr. Ben Edwards and Dr. Richard Bartlett. Kennedy called Edwards and Bartlett “extraordinary healers” who have “treated and healed” hundreds of children with budesonide and clarithromycin, sharing a photo of himself and the doctors with three Mennonite families whose children had become ill. Two of the families had each recently lost a daughter to measles: 6-year-old Kayley Fehr died in February and 8-year-old Daisy Hildebrand died last week. Neither child was vaccinated.
Edwards, a conventionally trained doctor who has shifted to promoting natural remedies and prayer, has been operating a makeshift clinic in Seminole, offering children these unproven treatments — including, according to a video posted by an anti-vaccine group, while he said he was sick with measles. Edwards has allied himself with the anti-vaccine movement in recent months, hosting influencers and activists on his podcast, including Andrew Wakefield.
“There is no evidence to support the use of either aerosolized budesonide or clarithromycin for treatment of children with measles,” said Dr. Adam Ratner, a spokesman for the American Academy of Pediatrics. Prescribing treatments that have not been vetted in clinical trials amounts to experimenting on patients, added Dr. Susan McLellan, a professor in the infectious diseases division at the University of Texas Medical Branch.
During the measles outbreak, both Edwards and Bartlett have each warned of risks associated with the MMR vaccine: Edwards claimed, falsely, that it causes “potentially” hundreds of deaths a year and Bartlett has said that the complications caused by measles, including brain swelling and pneumonia, can also be caused by the vaccine. In reality, the MMR vaccine, which is only given to children with healthy immune systems, has been overwhelmingly safe since its approval more than five decades ago, and has saved an estimated 94 million lives worldwide.
Public health experts said touting these medications as first-line treatments sends the wrong message. “By mentioning such treatments without that context, RFK Jr. continues to distract away from the prevention measure that incontrovertibly works — the vaccine,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security
A national public health organization is calling for RFK Jr. to resign citing “implicit and explicit bias and complete disregard for science.” Georges Benjamin, executive director of the American Public Health Association, said in a statement that concerns raised during Kennedy’s confirmation hearing last month have been realized, followed by massive reductions in staff at key health agencies.
What’s next? I aslk myself.
Perhaps homeopathy as a savior of the US healthcare system?
Watch this space.
The aim of this recent review was to investigate the efficacy of non-surgical and non-interventional treatments for adults with low back pain compared with placebo. It included all randomised controlled trials evaluating non-surgical and non-interventional treatments compared with placebo or sham in adults (≥18 years) suffering from non-specific low back pain.
Random effects meta-analysis was used to estimate pooled effects and corresponding 95% confidence intervals on outcome pain intensity (0 to 100 scale) at first assessment post-treatment for each treatment type and by duration of low back pain—(sub)acute (<12 weeks) and chronic (≥12 weeks). Certainty of the evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach.
A total of 301 trials (377 comparisons) provided data on 56 different treatments or treatment combinations. One treatment for acute low back pain: (non-steroidal anti-inflammatory drugs (NSAIDs)), and five treatments for chronic low back pain:
- exercise,
- spinal manipulative therapy,
- taping,
- antidepressants,
- transient receptor potential vanilloid 1 (TRPV1) agonists)
were found to be efficacious. However, effect sizes were small and of moderate certainty. Three treatments for acute low back pain (exercise, glucocorticoid injections, paracetamol), and two treatments for chronic low back pain (antibiotics, anaesthetics) were not efficacious and are unlikely to be suitable treatment options; moderate certainty evidence. Evidence is inconclusive for remaining treatments due to small samples, imprecision, or low and very low certainty evidence.
The authors concluded that the current evidence shows that one in 10 non-surgical and non-interventional treatments for low back pain are efficacious, providing only small analgesic effects beyond placebo. The efficacy for the majority of treatments is uncertain due to the limited number of randomised participants and poor study quality. Further high-quality, placebo-controlled trials are warranted to address the remaining uncertainty in treatment efficacy along with greater consideration for placebo-control design of non-surgical and non-interventional treatments.
This is an important analysis, not least because of the fact that the research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The methodology is sound and the results thus seem reliable.
The findings are in keeping with what we have been discussing at nauseam here: no treatment works really well for back pain. For acute symptoms no so-called alternative medicine (SCAM) at all is efficacious. For chronic pain, spinal manipulation therapy (SMT) have small effects. As SMT is neither cheap nor free of risks, excercise is much preferable.
Considering that most SCAMs are heavily promoted for low back pain (e.g. acupuncture, Alexander technique, cupping, Gua Sha, herbal medicine, homeopathy, massage, mind-body therapies, reflexology, Reiki, yoga), this verdict is sobering indeed!
