symptom-relief
Trump and his allies have produced many claims that experts have flagged as false, misleading, or dangerously unscientific. Below is a (probably incomplete) selection:
- In April 2020, Trump suggested during a press briefing that scientists explore whether injecting or “bringing disinfectant inside the body” could treat COVID‑19. Medical experts immediately warned that this would be dangerous or lethal.
- At the same briefing, he also floated the idea of “hitting the body with a very powerful light,” including using UV light inside the body to kill the virus, a suggestion that clinicians stressed had no scientific basis and could be harmful.
- Throughout 2020, Trump repeatedly claimed the virus would “just disappear” like a “miracle,” even as case counts and deaths surged.
- He heavily promoted hydroxychloroquine as a “game changer” long after clinical trials had shown it to be ineffective against COVID‑19 and associated with serious adverse effects.
- In February 2020, Trump claimed the number of COVID‑19 cases in the US would soon be “down to close to zero.”
- Trump frequently claimed that COVID‑19 was “just like the flu,” despite the fact that its mortality rate and impact on health systems were substantially higher.
- In late 2025 and early 2026, the Trump administration falsely claimed that acetaminophen use during pregnancy was linked to a much higher risk of autism, despite the lack of clear evidence and warnings from experts that this messaging was misleading.
- The administration also promoted leucovorin as a treatment for autism, a claim that has little robust evidence and is not supported by mainstream medical guidelines.
- Following the appointment of RFK Jr. to HHS in late 2024, federal vaccine guidance was rolled back in several areas, including flu recommendations for some groups and changes to how RSV and other vaccines were positioned. This created confusion and encouraged a further “decoupling” of some state health policies from traditional CDC guidance.
- Trump has claimed that the noise from wind turbines causes cancer, a statement that has no credible scientific basis.
- Trump has claimed that sea levels will rise by only “1/8 of an inch over the next 200 to 300 years,” contradicting widely accepted projections that show substantially higher rise even over the next 30 years along US coasts.
- Trump has also claimed that the human body is like a battery with a finite amount of energy, and that exercise is harmful because it “depletes” that energy, a view that runs counter to mainstream physiology and public‑health guidance.
- Trump claimed that drinking fizzy diet soda “kills cancer cells” because the drinks kill grass when spilt, implying they might do the same to cancer inside the body.
- In 2026, Dr. Mehmet Oz, as head of CMS, falsely claimed that 5 million New Yorkers were using Medicaid personal‑care services—nearly 75% of all enrolees—when the actual figure is far lower.
- RFK Jr. has spent decades claiming that thimerosal, a mercury‑based preservative in some vaccines, causes autism. Thimerosal was removed from nearly all childhood vaccines in 2001 as a precaution, yet autism rates continued to rise, and large studies have found no causal link.
- RFK Jr. frequently claims that no vaccines have ever been tested against a true saline placebo. In fact, many vaccines have been tested against saline placebos in clinical trials, and others were tested against earlier versions or standard care, in line with evolving ethical standards.
- RFK Jr. pushed for the removal of fluoride from all US water systems, falsely labelling it an “industrial waste” and a key cause of lower IQ, bone fractures, and cancer, despite the bulk of evidence supporting its safety and dental benefits at standard levels.
- RFK Jr. has also falsely claimed that polyunsaturated fats such as canola or soybean oil are toxic and the primary driver of obesity and inflammation in America, a view that contradicts large‑scale dietary and epidemiological data.
- RFK Jr. has falsely claimed that WiFi causes “leaky brain” and that 5G is a tool for mass surveillance and causes cancer, assertions that have no support from mainstream science.
- RFK Jr. has become an advocate for the federal legalisation of raw milk, downplaying the risks of Salmonella, E. coli, and Listeria. Yet pasteurization remains a cornerstone of public‑health measures to prevent foodborne illness.
- RFK Jr. has wrongly suggested a link between the use of SSRIs and the rise in mass shootings, a claim not supported by credible data.
- Janette Nesheiwat (JN), a Fox News contributor and Trump’s nominee for US Surgeon General, withdrew her nomination in May 2025 following allegations that she had significantly misrepresented her credentials. Her official bio and LinkedIn profile claimed she received her medical degree from the University of Arkansas for Medical Sciences; in fact she attended the American University of the Caribbean School of Medicine in St. Maarten.
- JN repeatedly described herself as “double board‑certified,” but investigators found verified certification only in family medicine.
- Casey Means (CM), Trump’s nominee for Surgeon General, is a Stanford‑educated physician who left surgical residency before completion and whose medical license has been inactive since 2019. She has not practiced clinical medicine in years and has limited experience overseeing large‑scale public‑health systems.
- CM has built a profile as a health‑tech entrepreneur and co‑founder of Levels, promoting “functional medicine” and the MAHA movement.
- CM has made strong claims that continuous glucose monitoring and metabolic optimization can prevent or “cure” a wide range of modern diseases, a view that overstates the evidence and oversimplifies complex chronic conditions.
As indicated in the title of this post: if you waant to say healthy, it is wise to ignore the incompetent president and his equally incompetent cronies.
Innovations in both the surgical and medical management of breast cancer over the past few decades have led to reductions in treatment-related morbidity and increases in overall survival. Despite these advancements in surgery, chemotherapy, radiation, endocrine therapy, and immunotherapy, a subset of patients continues to choose so-called alternative medicine (SCAM). The objective of this study was to describe the association of SCAM with survival in patients with breast cancer.
This cohort study analyzed data from the National Cancer Database on female patients diagnosed with breast cancer from 2011 through 2021. Survival time was compared among patients who received conventional treatment, conventional treatment plus SCAM, and SCAM only. Data were analyzed from May 2025 to December 2025.
The primary outcome was 5-year survival. Unadjusted 5-year survival was assessed by Kaplan-Meier analysis, and adjusted survival was assessed with a Cox proportional hazards model controlled for age, race and ethnicity, Charlson Comorbidity index, insurance type, facility type, region, year of diagnosis, cancer stage, and income.
Of 2 169 202 female patients with breast cancer identified, 2 157 219 (median [IQR] age, 62 [52-71] years) were included in the sample. A total of 2 106 665 patients (97.6%) received conventional therapy.
- 273 (<0.1%) received SCAM alone,
- 568 (<0.1%) received a combination of SCAM and coventional therapies,
- 49 713 (2.3%) received no treatment.
Compared with patients treated with conventional therapies, those treated with SCAM alone (adjusted hazard ratio [AHR], 3.67; 95% CI, 3.03-4.44; P < .001) or no treatment (AHR, 3.53; 95% CI, 3.48-3.58; P < .001) had the highest risks for mortality. Patients who received a combination of conventional therapies and SCAM were less likely to receive endocrine therapy (eg, 40.7% vs 65.2% in stage II; P < .001) and radiation (59.5% vs 36.6% in stage II; P < .001) compared with patients treated exclusively with conventional therapies. Receipt of a combination of conventional therapies and SCAM was associated with a higher mortality compared with being treated exclusively with conventional therapy (AHR, 1.45; 95% CI, 1.22-1.72; P < .001).
The authors concluded that, in this cohort study of data from female patients with breast cancer included in the NCDB, the use of SCAM instead of conventional therapies was uncommon but was associated with a reduction in survival time. Further study is warranted.
The full text of this study is worth reading. It shows clearly that patients who use SCAM – even as an additional therapy – tend to skip some live-saving treatments. Why? Possibly because SCAM therapists persuade them that this is a good idea. I have personally seen this happening several times. It means that the SCAM might well be harmless, but the SCAM therapist is not!
The list of investigations showing that SCAM is a risk factor for cancer patients undergoing oncological treatments is growing. The message for patients is important and clear: stay away from SCAM while receiving curative treatment. Later on, during the supportive or palliative phase of care, some forms of SCAM might be helpful for improving cancer patients’ quality of life. For people with a keen interest in this area, I recommend reading my book which attempts to define which forms of SCAM might be beneficial for cancer patients at what stage of the recovery.
Pediatric vertebral artery dissection (VAD) following chiropractic cervical manipulation (CCM) is a rare phenomenon. As chiropractic care of pediatric populations increases internationally, it is imperative to increase awareness of this cause of VAD.
This case-report describes a patient encountered in the Department of Neurological Surgery, Indiana University School of Medicine, USA. He was a 20-month-old male who presented nonspecifically with acute onset of
- lethargy,
- vomiting,
- cyanosis,
- respiratory distress.
Cerebrovascular imaging revealed a luminal irregularity in the V4 segment of the right vertebral artery, consistent with dissection. The patient’s guardian later provided history of taking the child for cervical chiropractic corrections immediately prior to the patient’s presentation to the emergency department.
The patient was managed non-operatively. Intubation was performed due to respiratory distress and managed with fluids, vasopressors, antimicrobials, and high-flow oxygen. The patient was extubated four days after presentation, and pressors were discontinued upon achievement of hemodynamic stability. A few days after extubation, the patient was ambulating and able to interact with objects and caretakers. Aspirin therapy was initiated and continued after discharge. The patient was followed with annual appointments and imaging. At two-year follow-up, CTA demonstrated an asymmetrically small right vertebral artery, accompanied by encephalomalacia of the right posterior occipital lobe. MRA demonstrated diffuse narrowing of the V4 segment of the right vertebral artery, albeit less pronounced than prior MRAs. Aspirin was discontinued by an outside following team due to stability of imaging findings. The parents were advised to avoid contact sports to avoid trauma and recurrent stroke.
The authors found 2 further cases of pediatric VAD in the published literature following CCM. Non-specific presentations were noted in both of them. Appropriate diagnosis of pediatric VAD requires increased surveillance in response to a thorough history and an acknowledgment of the plethora of possible patient presentations and etiologies.
The authors concluded that there is an increasing utilization of chiropractors among the pediatric population. In a pediatric patient with nonspecific symptoms, VAD should be considered as a differential diagnosis when there is a history of CCM.
The authors’ statement that “pediatric vertebral artery dissection (VAD) following chiropractic cervical manipulation (CCM) is a rare phenomenon” should be taken with a pinch of salt. As there is no monitoring, the frequency of adverse effects and complications is essentially unknown. Crucially. the risks of CCM for children is by no means confined to VADs. For a fuller account, I recomment reading my book which has an entire chapter on this very subject.
The key messages about CCM for kids might be summarised in the following simple three facts:
- CCM has no true benefit for children.
- Thus the risk/benefit balance fails to be positive.
- Therefore we should discourage partents from taking their kids to see chiropractors.
In the ever-evolving farce of populist politics, Robert F. Kennedy Jr. has launched yet another crusade, this time to expand access to a group of “natural” peptides that the FDA previously restricted because of safety concerns and inadequate human data. In 2026, that campaign acquired fresh momentum: Kennedy publicly urged the FDA to restore access to roughly 14 of the previously restricted peptides, and reports in late March indicated that the agency was expected to loosen some of those restrictions, though no final rule had yet been published.
Peptides — short chains of amino acids — have become the darlings of the “biohacking” crowd, praised as a fountain of youth and marketed for everything from rapid fat loss to cognitive enhancement. The compounds at the center of this controversy are largely those the FDA placed in Category 2, meaning bulk drug substances that raise significant safety concerns or lack sufficient data to support compounding. That classification effectively bars compounding pharmacies from making them for routine use unless the regulatory status changes.
Among the best-known substances in the dispute are the following:
- BPC-157: Often marketed as the “Body Protection Compound,” it is promoted for gut and tendon repair. The FDA’s concern has centered on the absence of adequate human safety data and unresolved safety questions.
- Thymosin Beta-4 (TB-500): Promoted for injury recovery. It has been flagged because of concerns about growth-related effects and the lack of a proper human evidence base.
- GHK-Cu: Used in some cosmetic products in topical form, but the injectable version has been controversial because of impurity risks and limited safety information.
- CJC-1295: Marketed for growth-hormone stimulation, with safety concerns tied to its endocrine effects and broader cardiovascular uncertainty.
- Ipamorelin: Another growth-hormone-related peptide, restricted because of unresolved safety and manufacturing concerns.
- Ibutamoren (MK-677): Often sold as a “SARM” alternative, though it is not one, and has raised concerns about metabolic and long-term safety.
- AOD-9604: A fragment of human growth hormone marketed for fat loss, but without a robust clinical safety record.
- Dihexa: Promoted for cognitive repair and Alzheimer’s-related claims, despite a lack of adequate human clinical evidence.
- Selank and Semax: Russian-developed nootropics marketed for anxiety and focus, but not supported by the kind of regulatory review expected for routine therapeutic use.
- Melanotan II: Known as the “Barbie drug,” used for tanning and libido, and associated with serious adverse-effect concerns.
- PT-141 (Bremelanotide): An approved version exists as Vyleesi, but compounded versions have raised concerns about dose consistency and safety.
Kennedy has framed the FDA’s crackdown as a kind of conspiracy by “Big Pharma” against so-called alternative medicine (SCAM). In reality, the agency’s restrictions were driven by the absence of convincing clinical data and, in some cases, by serious safety concerns. His push to reopen access presents itself as “liberating” healthcare, but it risks bypassing the very safeguards designed to keep experimental or poorly studied substances from being marketed as remedies.
Many of these compounds are produced in gray-market labs or loosely regulated compounding settings, where contamination and purity problems are a real concern. Peptides are biologically active signaling molecules, not harmless wellness supplements, and altering those signals can produce unpredictable effects, including effects on tumor growth, metabolism, blood pressure, and other systems. And the appeal to “naturalness” is a classic fallacy: a substance being naturally derived says nothing about whether it is safe, effective, or appropriate for widespread use.
The most troubling part of this campaign is the message behind it: distrust expert regulation, trust ideological certainty instead. Kennedy has turned a complex issue of drug safety and compounding oversight into a culture-war emblem. By pushing for broad access to experimental compounds without the normal evidentiary standards, he is not modernizing medicine; he is reviving the logic of patent-medicine quackery, where the promise of a cure mattered more than proof, and where the cure was often more dangerous than the disease.
Some papers on so-called alternative medicine (SCAM) are such that I am almost lost for words. Here is the abstract of such an article:
Background: Autism Spectrum Disorder is a complex neurodevelopmental condition with characteristic
challenges like persistent deficits in social communication, restricted and repetitive behaviors, sensory
processing anomalies. Defined by DSM-5criteria, it affects about 1in 100 children globally and 1in 36 in
united states and poses a significant burden for families and healthcare systems. Research on homoeopathy
and Bach flower Remedies as adjunctive or primary therapies has often explored by families and clinical
interest in complementary and alternative medicine for additional support.
Materials and Methods: A comprehensive study of related review articles, related different components
of Autism spectrum disorder treated with homeopathy treatment, Bach Flower Remedies and
complementary medicine in children were search out. Databases search is PubMed, Google Scholar,
ResearchGate and Web of Science, Scopus and Homoeopathic journal.
Result: Reviewed evidence indicates that no systematic studies have been done to manage autism
spectrum disorder with Bach flower Remedies as an adjuvant or primary treatment along with
homoeopathy. Although individualized homoeopathic treatment has promising results in reducing core
and associated symptoms in children including improvement in social interaction, hyperactivity,
communication and behavioral regulation. Although there is less data available thorough trails, Bach
Flower Remedies especially Rescue remedy that have help in treating the emotional dysregulations and
anxiety that are frequently connected with autism spectrum condition.
Conclusion: The available clinical data on autism spectrum with homoeopathy and Bach flower remedies
is not enough to provide new and sufficient evidence. To overcome this more well-designed study of RCT
and larger sample with standardized procedures will be able to help to this rising burden of autism
spectrum disorder.
In the article itself, the authors state the following: “This review article indicates that both homoeopathy and Bach Flower Remedies are promising adjunct intervention in treatment of Autism spectrum disorder in children especially marked improvement in social interaction, communication, behavioural rigidity, emotional dysregulation and sensory processing. Based on the reviewed data from case series, controlled clinical trials and systematic reviews it can be state that individualized homeopathic treatment leads to clinically relevant improvement in core and associated symptoms of autism spectrum disorder.
Studies on Bach flower remedies specifically in autism spectrum disorder are very less but it suggests that Bach flower remedies offer practically accessible intervention for emotional and behavioural dimension mostly in anxiety, emotional dysregulation, sensory hyperactivity and resistance to change. Evidence from controlled trials and clinical studies shows a statistical and significant in symptom.
Homoeopathy and Bach flower remedies should not replace evidence-based behavioural and development intervention for autism spectrum disorder, but rather be investigation as complementary modalities within an integrative care framework. Despite of growing clinical observations, the field of homoeopathy and Batch Flower remedies in autism spectrum disorder is characterised by substantial and identifiable research gaps that limit the formulation of evidence-based clinical guidelines and urgent research priorities include the multicentric, double-blind RCTs with standardised diagnostic criteria and validated core outcome sets; longitudinal follow-up.”
Bearing in mind that this comes from the “Head of the Department, Department of Practice of Medicine, Bharati Vidyapeeth (Deemed to beUniversity), Homoeopathic Medical College”, this is remarkably embarrassing!
Why?
The review is badly written and poorly done. More importantly, according to the data provided by the authors, there is only one rigorous RCT. Here is its abstract:
Objective: To evaluate the effectiveness of Bach flower remedies in the treatment of children with attention deficit hyperactivity disorder (ADHD), in a double blind prospective controlled study.
Methods: Fourty Children with ADHD, aged 7-11 years, diagnosed according to the DSM criteria, were randomised to Bach flower remedies or placebo treatments for a period of 3 months. Children’s performance was evaluated by the teacher before commencement of treatment and subsequently each month during the study period.
Results: Bach flower remedies have no statistically significant effect when compared to placebo in the treatment of children with ADHD. There was a significant correlation between treatment duration’s and improvement of performance, with no difference between the treatment group compared to the placebo.
Conclusions: There is no statistically significant difference between the effects of Bach flower remedies compared with placebo in the treatment of children with ADHD.
If a head of department nonetheless concludes that “both homoeopathy and Bach Flower Remedies are promising adjunct intervention in treatment of Autism spectrum disorder in children especially marked improvement in social interaction, communication, behavioural rigidity, emotional dysregulation and sensory processing”, it is, I fear, high time to replace him.
I am sure that many of my readers have no idea what ‘Slinding Cupping Therapy’ is. It is a TCM therapy that, according to the authors of this paper, receives much appreciation for treating plaque psoriasis. This study was designed to test the hypothesis that sliding cupping therapy is non-inferior to narrowband ultraviolet B (NBUVB) therapy in improving disease severity in patients with plaque psoriasis.
This prospective trial recruited 60 patients with plaque psoriasis who were randomized to receive either sliding cupping intervention or NBUVB treatment. The cup was moved 30 times for each skin lesion until the target skin area turned purple. The initial dose (mJ/cm2) of ultraviolet radiation b (UVB) was determined based on sun-reactive skin types I through VI, which ranged from 300 mJ/cm2 to 800 mJ/cm2. Both treatments were performed 3 times per week for 8 weeks. The primary endpoint was the percentage reduction in Psoriasis Area and Severity Index (PASI) score at week 8, with secondary endpoints, including Physician’s Global Assessment (PGA), body surface area, visual analogue scale scores, and quality of life measures.
The total response rates were 69% (18/26) and 79% (19/24) for patients receiving sliding cupping intervention and those receiving NBUVB treatment, respectively, which showed no significant difference (P = .526). The PASI scores, body surface area, and PGA were reduced in patients with plaque psoriasis at W0, W4 and W8 after either sliding cupping intervention or NBUVB treatment (P <.001), and these reductions were not significantly different between the patients receiving sliding cupping intervention and those receiving NBUVB treatment at W0, W4, W8, and W12. At W8, the mean percentage reduction in PASI was 62.4% (95% CI, 54.9–69.8) in the sliding cupping group and 66.9% (95% CI, 59.6–74.2) in the NBUVB group, with no significant difference between groups. The total response rates were 69.23% (18/26) and 79.17% (19/24), respectively (P = .526). Patients receiving sliding cupping intervention and those receiving NBUVB treatment did not show statistically significant differences in these outcomes at W0, W4, W8, and W12 (P >.05).
The authors concluded that the overall results suggest that sliding cupping therapy exhibits statistically similar efficacy and safety profiles as NBUVB treatment, especially at 8 weeks after treatment.
Sliding cupping therapy is a form of cupping in which cups producing mild suction are placed on oiled skin and then moved along the body surface, generating a “reverse massage” that lifts rather than compresses the subcutaneous tissues. The negative pressure is thought to increase local blood flow and lymphatic drainage, reduce perceived muscle tension, and temporarily improve range of motion, though high‑quality clinical evidence for most claimed benefits remains limited.
The treatment is used mainly by massage therapists, physiotherapists, and TCM practitioners in musculoskeletal and sports‑rehab settings, as well as in wellness and spa‑oriented clinics; it is commonly applied to the back, shoulders, neck, limbs, and along fascial lines or acupuncture meridians, often for pain, stiffness, “trigger‑point”‑type tension, and post‑exercise recovery. The popularity of this therapy is best characterised as a niche within broader cupping and fascial‑release practice rather than a mainstream standard treatment.
The new study is a text-book example of how to mislead people with seemingly reliable research. The fact that it was grossly under-powered – and not the effectiveness of the sliding cupping therapy – is obviously the cause of the lack of a difference between the effective therapy (NBUVB) and the sliding quackery.
Let me give you an example: say, we compare antibiotics (A) to homeopathy (H) as treatments for bacterial pneumonia. We treat 10 patientsin each group, and 8 of them recover in group A within a week, while in the H-group the amount is 6 (many patients recover even without an effective treatment). We run statistical tests which tell us that the difference is not significant. Thus we falsely conclude that homeopathy is as effective as antibiotics in the treatment of pneumonia. The 2 treatments were, in fact, not equal but the lack of power of the small study failed to detect the existing difference.
It seems rather obvious to me that a similar thing has happened with the above study. Its authors are to be congratulated for cheating so slyly that neither the editors nor the reviewers of the journal ‘Medicine’ managed to see through their simple litte trick.
In recent decades, acupuncture has attracted extensive research spanning an astonishingly wide array of medical conditions, from chronic pain and neurological disorders to infectious diseases and psychiatric ailments. However, the proposed mechanisms of action—ranging from peripheral sensory stimulation to central nervous system modulation—fail to provide a coherent, biologically plausible explanation for efficacy across this disparate spectrum (Zhao et al., 2022; WHO, 2003).
The aim of this post is to examine the breadth of published acupuncture trials, delineate the leading scientific hypotheses for its mode of action, and outline the profound implausibility of these mechanisms universally applying to such varied pathologies, ultimately framing acupuncture as non-specific rather than a specific therapeutic modality (Meissner et al., 2019; Ernst, 2018).
Acupuncture has been subjected to thousands of randomized clinical trials (RCTs) and systematic reviews across virtually every medical specialty. A comprehensive 2022 evidence map published in BMJ Open synthesized 120 systematic reviews, encompassing 1,402 individual RCTs and addressing 77 distinct conditions within 12 broad therapeutic categories (Zhao et al., 2022). These categories include neurological disorders, musculoskeletal conditions, cardiovascular diseases, and beyond, reflecting a research enthusiasm that transcends conventional biomedical boundaries.
Neurological applications dominate, with trials targeting stroke sequelae such as hemiplegia and aphasia, vascular dementia symptoms, migraines, tension headaches, and facial nerve palsies like Bell’s palsy (Li et al., 2022; Zhao et al., 2022; WHO, 2003). Musculoskeletal trials are equally prolific, examining low back pain, knee osteoarthritis, fibromyalgia, tennis elbow (lateral epicondylitis), sciatica, shoulder periarthritis, rheumatoid arthritis, and even gouty arthritis (Li et al., 2022; Zhao et al., 2022; Choi et al., 2019; Lam et al., 2020; WHO, 2003). Cardiovascular research has probed essential hypertension, primary hypotension, and pain from thromboangiitis obliterans (Shanghai Medical Clinic, 2025; WHO, 2003). Gynecological and obstetric domains feature prominently, including dysmenorrhea, labor induction, breech presentation correction, pregnancy-related nausea and vomiting, and fertility enhancement (e.g., improved clinical pregnancy rates in IVF protocols) (Zhao et al., 2022; Shanghai Medical Clinic, 2025; Smith et al., 2021; Carr, 2022; WHO, 2003).
Acupuncture trials also extend to psychiatric conditions like generalized anxiety disorder (especially in perimenopause), depression, and other mental disturbances (Zhao et al., 2022; Zhang et al., 2025; WHO, 2003); respiratory issues such as allergic rhinitis and hay fever (Li et al., 2022; Shanghai Medical Clinic, 2025; WHO, 2003); gastrointestinal disorders including acute and chronic gastritis, biliary colic, and postoperative nausea/vomiting (Zhao et al., 2022; Shanghai Medical Clinic, 2025; WHO, 2003); urogenital and nephrological problems like renal colic and radiation-induced leucopenia (often in renal contexts) (Shanghai Medical Clinic, 2025; WHO, 2003); infectious diseases such as acute bacillary dysentery, pertussis (whooping cough), and epidemic hemorrhagic fever (WHO, 2003); pediatric applications, albeit more limited, for post-extubation pain relief and whooping cough (ClinicalTrials.gov, 2013; WHO, 2003); and oncology support for cancer-related fatigue and chemotherapy/radiation side effects (Zhao et al., 2022; Shanghai Medical Clinic, 2025). Additional niches include ear-nose-throat conditions (e.g., rhinitis), eye disorders, connective tissue diseases, metabolic/nutritional imbalances, and skin pathologies (Zhao et al., 2022; WHO, 2003).
This extraordinarily wide spectrum, drawn from seminal analyses like the World Health Organization’s (WHO) 2003 review of controlled clinical trials (WHO, 2003) and Cochrane overviews on pain (Choi et al., 2019; Lee et al., 2011), clearly demonstrates that acupuncture is considered by its proponents to be a ‘cure all’. This begs the question whether such an assumption can be reasonable. The effect sizes are typically modest, and true acupuncture is often no different from sham interventions (e.g., superficial needling at non-acupoints), suggesting limited specific efficacy (Lee et al., 2011).
The scientific literature proposes a constellation of mechanisms to explain how acupuncture might work, integrating peripheral, spinal, supraspinal, and systemic processes. These are often conceptualized through the “Neural Acupuncture Unit” (NAU) model, which posits low-threshold mechanosensitive afferents (Aδ and C fibers) at acupoints converging with brain networks to elicit bidirectional signaling (Zhang et al., 2012).
- Peripheral and Local Mechanisms. Needle manipulation is claimed to induce immediate tissue responses: adenosine triphosphate (ATP) breakdown to adenosine activates A1 receptors, dampening nociceptor firing (Kelly & Suckley, 2016); axonal reflexes release neuropeptides like substance P and calcitonin gene-related peptide (CGRP), modulating local inflammation; and stromal cells exhibit cytoskeleton remodeling, with collagen fibers “wrapping” around needles to propagate mechanical signals (Kelly & Suckley, 2016; Zhang et al., 2012; Li et al., 2025). The characteristic deqi sensation (aching, soreness) correlates with these events, potentially amplifying sensory input (Staud & Price, 2014).
- Spinal Cord Level. Ascending afferents are said to activate the gate control system, presynaptic inhibition, and diffuse noxious inhibitory controls (DNIC), releasing endogenous opioids (β-endorphin, enkephalins, dynorphins), serotonin, norepinephrine, and acetylcholine to suppress nociceptive transmission in the dorsal horn (Kelly & Suckley, 2016; Zhang et al., 2012; Staud & Price, 2014). This underpins analgesia and autonomic regulation, such as reduced sympathetic outflow (Kelly & Suckley, 2016).
- Central Nervous System Modulation. Functional neuroimaging (fMRI, PET) reveals deactivated limbic hyperactivity (amygdala, anterior cingulate), normalized hypothalamic-pituitary-adrenal (HPA) axis activity, and enhanced prefrontal connectivity, particularly in pain, stress, and mood disorders (Kelly & Suckley, 2016; Zhang et al., 2012; Wang et al., 2025). Top-down expectancy modulates descending inhibitory pathways, integrating with reward and mirror neuron systems (Zhang et al., 2012).
- Systemic and Humoral Effects. Acupuncture is also thought to influence immune homeostasis by shifting cytokine profiles (e.g., ↑IL-10, ↓TNF-α, ↓IL-6), autonomic balance (vagal enhancement), and endocrine axes, providing a basis for visceral, metabolic, and inflammatory conditions (Kelly & Suckley, 2016; Li et al., 2025). Recent integrative studies emphasize network pharmacology, where multi-point stimulation perturbs interconnected pathways (Li et al., 2025).
These potential mechanisms have been empirically observed in animal models and/or human imaging studies. They might offer a partial rationale, primarily for analgesia and stress-related syndromes (Kelly & Suckley, 2016; Zhang et al., 2012). The question, however, is whethr they can provide a full explanation for acupuncture’s efficacy in all the above-named conditions.
No synthesis of these mechanisms plausibly accounts for acupuncture’s claimed benefits across unrelated conditions, exposing a core scientific paradox. Musculoskeletal pain might align with local adenosine/opioid effects and spinal gating (Kelly & Suckley, 2016), but how do these explain microbial clearance in bacillary dysentery, hypertensive vascular remodeling, or synaptic imbalances in major depression? (Meissner et al., 2019; Ernst, 2018). Gynecological infertility involves ovarian endocrinology, distant from needle-evoked sensory cues; infectious pertussis implicates Bordetella immunity, not HPA modulation (WHO, 2003; Meissner et al., 2019). This biological implausibility echoes homeopathy critiques: a single intervention cannot verifiably target such heterogeneous pathophysiologies without invoking non-specific forces (Fabrizio et al., 2010).
Trial data reinforce these doubts: meta-analyses consistently show that verum acupuncture is hardly different from sham acupuncture, and sham elicit up to 80% of verum’s effects (Kelly & Suckley, 2016; Meissner et al., 2019; Fabrizio et al., 2010; Kaptchuk et al., 2013). Such considerations implicate patient and therapist expectations, therapeutic ritual, and patient-practitioner alliance as the true mechanism behing the observed outcomes (Meissner et al., 2019; Kaptchuk et al., 2013). Neuroimaging effects often mirror expectancy manipulations in non-needling studies, suggesting top-down confounds (Fabrizio et al., 2010). Lab phenomena (e.g., adenosine release) occur but yield trivial clinical effects, dwarfed by psychosocial amplification (Fabrizio et al., 2010).
Acupuncture’s elaborate ritual maximizes contextual healing, outperforming inert pills but lacking disease-modifying specificity (Meissner et al., 2019; Ernst, 2018). Paradoxes abound—positive preclinical signals evaporate in blinded RCTs; cultural bias inflates Asian trial positives; poor sham penetration and blinding failures perpetuate illusions (Fabrizio et al., 2010; Ernst, 2018). For non-pain conditions, evidence thins further, with publication bias and flexible outcome reporting inflating apparent successes (Fabrizio et al., 2010).
Acupuncture carries risks including minor issues like bleeding, needle site pain, vegetative reactions (e.g., dizziness or nausea), and symptom aggravation, alongside rarer serious events such as pneumothorax, infections, or organ injury. Overall, at least one adverse event in 9.31% of patients undergoing a treatment series or 7.57% of treatments, with half of these being mild local reactions. Serious adverse events seem to be uncommon. Reliable prevalence figures do not exist because there is no adequate surveillance system in place (Ernst 2006).
Acupuncture’s trial proliferation signals cultural and patient-driven demand rather than mechanistic or evidential triumph. Its broad therapeutic claims by far overreach evidence (Staud & Price, 2014). Rigorous advancement would require objective biomarkers (e.g., cytokine assays, EEG), dose-response optimization, adaptive sham designs, and large pragmatic trials stratifying contextual from specific effects (Zhang et al., 2012; Fabrizio et al., 2010). Until compelling evidence exists, acupuncture remains a testament to human suggestibility’s power, but not a biomedical panacea.
References
- Carr, D. (2022). Acupuncture as Treatment for Female Infertility. Medical Acupuncture, 34(1), 12-21.
- Choi, D., et al. (2019). Cochrane reviews on acupuncture therapy for pain: a snapshot of the current evidence. Systematic Reviews, 8, 231.
- ClinicalTrials.gov. (2013). Pediatric Laser Acupuncture and Renal Biopsy (NCT01879826).
- Ernst, E. (2006). Acupuncture–a critical analysis. J Intern Med, 259(2):125-37.
- Ernst, E. (2018). Acupuncture Research: The Problem. Pain Medicine, 19(6), 1287-1288.
- Fabrizio, P., et al. (2010). Paradoxes in Acupuncture Research: Strategies for Moving Forward. Explore (NY), 6(4), 231-239.
- Kaptchuk, T. J., et al. (2013). Are All Placebo Effects Equal? Placebo Pills, Sham Acupuncture, or Placebo Needle in Irritable Bowel Syndrome. PLoS ONE, 8(7), e67485.
- Kelly, R., & Suckley, S. (2016). Mechanisms of acupuncture. European Journal of Integrative Medicine, 20, 1-11.
- Lam, M., et al. (2020). Acupuncture and Chronic Musculoskeletal Pain. Medical Acupuncture, 32(6), 357-366.
- Lee, M. S., et al. (2011). Acupuncture for pain: an overview of Cochrane reviews. Chinese Journal of Integrative Medicine, 17(3), 187-189.
- Li, T., et al. (2022). Evidence on acupuncture therapies is underused in clinical practice. Frontiers in Medicine.
- Li, Y., et al. (2025). Integrative research on the mechanisms of acupuncture. Neural Regeneration Research.
- Meissner, K., et al. (2019). Acupuncture for the Treatment of Pain – A Mega-Placebo? Frontiers in Neuroscience, 13, 1119.
- Shanghai Medical Clinic. (2025). WHO Approved Acupuncture List of Conditions.
- Smith, C. A., et al. (2021). An Overview of Systematic Reviews of Acupuncture for Respiratory Diseases. Frontiers in Public Health.
- Staud, R., & Price, D. D. (2014). Acupuncture therapy: mechanism of action, efficacy, and safety. International Review of Neurobiology, 111, 171-189.
- Wang, L., et al. (2025). Possible antidepressant mechanism of acupuncture. Frontiers in Neuroscience, 19, 1512073.
- WHO. (2003). Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials.
- Zhang, R., et al. (2012). Neural Acupuncture Unit: A New Concept for Interpreting Effects and Mechanisms of Acupuncture. Evidence-Based Complementary and Alternative Medicine, 2012, 429412.
- Zhang, Y., et al. (2025). Patient-reported outcome tools of acupuncture clinical trials. Journal of Pain Research.
- Zhao, C., et al. (2022). Evidence mapping and overview of systematic reviews of the effects of acupuncture therapies. BMJ Open, 12(6), e056803.
The aim of this study was to determine the effectiveness of spinal manipulation and clinician-supported biopsychosocial self-management vs medical care for adults with increased risk of chronic disabling LBP.
This 2 × 2 factorial randomized clinical trial enrolled participants in 3 research clinics at the Universities of Minnesota and Pittsburgh from November 2018 to May 2023; final follow-up was in June 2024. Adults with acute or subacute LBP at moderate to high risk of chronicity based on the STarT Back tool were randomized to 1 of 4 groups, with interventions lasting up to 8 weeks. Statistical analysis was conducted from November 2024 to June 2025.
These interventions were:
- Spinal manipulation therapy (n = 201),
- supported self-management (n = 305),
- combined supported self-management with spinal manipulation (n = 193),
- guideline-based medical care (n = 301).
Physical therapists and chiropractors provided spinal manipulation and supported self-management.
The 2 primary outcomes averaged over a follow-up of 1 year were monthly low back disability (Roland-Morris Disability Questionnaire) and weekly pain intensity (numerical rating scale). Secondary analysis examined the proportion of participants achieving a 50% or higher reduction in the primary outcome measures.
Among the 1000 participants randomized (mean [SD] age, 47 [16] years; 58% female), 93% completed the trial. The omnibus test for differences across the 4 treatment groups was statistically significant for disability (P = .001; supported self-management, 4.7; spinal manipulation, 5.5; combined supported self-management with spinal manipulation, 4.8; medical care, 5.9) but not pain intensity (P = .16; supported self-management, 2.8; spinal manipulation, 3.0; combined supported self-management with spinal manipulation, 2.8; medical care, 3.0). Averaged over 12 months, LBP disability was significantly lower compared with medical care for supported self-management (mean difference, −1.2 [95% CI, −1.9 to −0.5]) and supported self-management with spinal manipulation (mean difference, −1.1 [95% CI, −1.9 to −0.3]) but not spinal manipulation alone (mean difference, −0.4 [95% CI, −1.2 to 0.4]). Group differences in pain intensity were not statistically significant; point estimates ranged from −0.2 to 0. Both supported self-management groups had higher proportions of patients achieving a 50% or greater reduction in disability (supported self-management, 67%; spinal manipulation, 54%; combined supported self-management with spinal manipulation, 65%; medical care, 54%).
The authors concluded that for patients with acute or subacute LBP at increased risk of chronic disabling LBP, clinician-supported biopsychosocial self-management showed statistically significant but small reductions in disability, but not pain, vs medical care over 1-year follow-up, and spinal manipulation alone showed no significant difference for either outcome.
These findings are very bad news for chiropractors (the profession that uses spinal manipulations more than any other): spinal manipulation does not generate effects that are in the least convincing. This is particularly remarkable, since the study was not blinded. It means that, even the undoubtedly powerful placebo effect associated with spinal manipulation did not render the outcome more favourable.
I said it many times, and I will say it again: For LBP, many therapies generate similarly marginally positive effects but no treatment is truly convincing. In this situation, we should choose one that is at least inexpensive and free of severe adverse effects. And that evidently cannot be spinal manipulation!
Calcaneal spur is a common cause of chronic heel pain and functional disability. This double-blind, randomized, placebo-controlled trial aimed to evaluate the efficacy and safety of individualized homeopathic (IH) medicines compared to placebo (PL) in managing this condition.
128 participants with chronic heel pain from calcaneal spur were randomly assigned to receive either IH (n = 64) or an identical PL (n = 64) for 6 months. Both groups received standard advice on general management (such as foot exercises and contrast baths). The primary outcome was the change in pain intensity from baseline measured on a 100-mm visual analog scale (VAS). The secondary outcome was the change in lower extremity function measured by the Lower Extremity Functional Scale (LEFS). Outcomes were assessed at baseline, 3 months, and 6 months. Analysis was done using an intention-to-treat approach with a mixed-effects model for repeated measures.
The analysis revealed a statistically significant group × time interaction for VAS pain scores (F-value = 35.12, p < 0.001). At 6 months, the IH group showed a significantly greater mean reduction in pain compared to the PL group (mean difference: −33.28; 95% confidence interval [CI]: −44.3 to −22.2; p < 0.001). Similarly, a significant group × time interaction was observed for LEFS scores (F-value = 33.87, p < 0.001). At 6 months, the IH group had a greater improvement in function (mean difference: 13.78; 95% CI: 9.1–18.4; p < 0.001). Both results were clinically significant. No serious adverse events were reported.
The authors concluded that individualized homeopathy resulted in statistically and clinically significant improvements in pain and function for patients with calcaneal spur compared to PL. These findings suggest that homeopathy may be a viable treatment option for this condition.
This study seems well-designed and is clearly documented. I have read it thoroughly and did not find major flaws. Why, then do I have doubts?
- I have never heard of a homeopathy advocating homeopathy for calcaneal spur.
- I don’t see why homeopathy could alleviate pain.
- The paper reads a little bit as being “too good to be true”.
- The study was conducted at the Calcutta Homoeopathic Medical College & Hospital, West Bengal, (India’s retraction rate has recently climbed to third place worldwide (5,412 total), rate 2.0002 per 1,000).
In any case, before we can accept homeopathy as a treatment of pain caused by calcaneal spur, we need an independent confirmation, preferably not from ardent supporters of homeopathy.
Psoriasis is an immune-mediated inflammatory skin disease. By more than a decade of clinical validation, Jueyin granules (JYG) have demonstrated multi-target synergistic immunomodulatory and anti-inflammatory effects, offering a characteristic Traditional Chinese Medicine (TCM) therapeutic approach for psoriasis.
Aim of this study was to assess the efficacy and safety of oral JYG in treating psoriasis with blood-heat syndrome. Participants with body surface area (BSA) score less than 10 were allocated to receive JYG or placebo treatment in a 1:1 ratio through central area division and block randomization. The primary outcome is reduction of the psoriasis area severity index (PASI) score and proportion of participants achieving a greater than 50 % reduction in PASI scores (PASI50) at week 8.
Between November 2019 and April 2022, 195 participants were randomly assigned to receive JYG (n = 99) or a placebo (n = 96) at five centers. The JYG group demonstrated significantly greater reductions in PASI and BSA scores than the placebo group at week 8 (both P < 0.001) and maintained these improvements at week 16 (P < 0.001 and P = 0.005, respectively). By week 8, 51.09 % of participants in the JYG group achieved PASI50, compared to 20.65 % in the placebo group (P < 0.001). However, there were no statistical differences in dermatology life quality index (DLQI), visual analog scale (VAS) scores, or relapse rate.
The authors concluded that this study provides conclusive evidence that JYG is a safe and effective treatment for patients with mild-to-moderate psoriasis. The current findings support its use as a complementary and alternative therapy for psoriasis.
I think this paper needs a few explanations:
- What are Jueyin granules? This is a formula consisting of eight Chinese herbs (Haliotis diversicolor, Flos Lonicerae Japonicae, Radix Rehmanniae exsiccate, cortex moutan, Herba Hedyotisdiffusae, Folium isatidis, Smilax china L. and Radix Curcumae)
- What is the history? The formula was developed in the 1950s by Han Xia, a Chinese surgeon, and have been used to treat psoriasis for over 50 years by Yueyang Hospital of Integrated Traditional Chinese and Western Medicine.
- How did he develop it? We don’t know.
- Is the formula available outside China? No, not to the best of my knowledge.
- How reliable is this new trial? As we have discussed repeatedly on this blog, there are good reasons to mistrust Chinese studies.
- If we accept the findings nonetheless, are the conclusions valid? No! Firstly, this study cannot establish the safety of the formula. Secondly, a single trial cannot ‘conclusively’ establish the effectiveness of a therapy.
- Why does a respected journal publish such a dubious study? SERACH ME!
