The current Cochrane review of acupuncture for polycystic ovary syndrome (PCOS) included 5 RCTs and concluded that thus far, only a limited number of RCTs have been reported. At present, there is insufficient evidence to support the use of acupuncture for treatment of ovulation disorders in women with PCOS.

A new study was aimed at assessing whether active acupuncture, either alone or combined with clomiphene, increases the likelihood of live births among women with PCOS.  A double-blind (clomiphene vs placebo), single-blind (active vs control acupuncture) factorial trial was conducted at 27 hospitals in mainland China between July 6, 2012, and November 18, 2014, with 10 months of pregnancy follow-up until October 7, 2015. Chinese women with polycystic ovary syndrome were randomized in a 1:1:1:1 ratio to 4 groups. Active or control acupuncture administered twice a week for 30 minutes per treatment and clomiphene or placebo administered for 5 days per cycle, for up to 4 cycles. The active acupuncture group received deep needle insertion with combined manual and low-frequency electrical stimulation; the control acupuncture group received superficial needle insertion, no manual stimulation, and mock electricity. The primary outcome was live birth.

Among the 1000 randomized women, 250 were randomized to each group, and 926 women completed the trial. Live births occurred in

• 69 of 235 women (29.4%) in the active acupuncture plus clomiphene group,
• 66 of 236 (28.0%) in the control acupuncture plus clomiphene group,
• 31 of 223 (13.9%) in the active acupuncture plus placebo group,
• 39 of 232 (16.8%) in the control acupuncture plus placebo group.

There was no significant interaction between active acupuncture and clomiphene, so main effects were evaluated. The live birth rate was significantly higher in the women treated with clomiphene than with placebo and not significantly different between women treated with active vs control acupuncture.

The authors concluded that among Chinese women with polycystic ovary syndrome, the use of acupuncture with or without clomiphene, compared with control acupuncture and placebo, did not increase live births. This finding does not support acupuncture as an infertility treatment in such women.

There is much evidence to show that nearly 100% of all acupuncture trials originating from China report positive findings regardless of the condition treated. This led to the assumption by myself and several other experts that such studies are best ignored.

This study is from China and does not report positive results. What is more, it is well-designed and well-reported. This trial therefore is a most laudable exception, and I applaud the authors for their courage and good science.

Does this mean that in future we can trust all Chinese acupuncture trials?

One swallow does not make a summer. And I will remain very sceptical. But perhaps this new study is a sign indicating that things are beginning to change. Perhaps Chinese acupuncture researchers are starting to join the 21st century?

The last time I reported about Kate Birch, I ended my post stating that I became so angry that I was about to write something that I might later regret. Let’s see whether I can restrain myself again.

Kate published another book: The Solution  Homeoprophylaxis: The Vaccine Alternative. Here is the press release for her new rant:

Modern parents and even medical practitioners often pose the question of whether the benefits of reducing the incidence of acute diseases through vaccinations is worth the risks of the increased incidence of immune system imbalanceas a result of those same vaccines. This often leads many into questioning if vaccinations for children are indeed safe.

Despite the fact that most medical practitioners refute the possibility that vaccines can cause harm to the immune system, and that their purpose and efficacy have been instilled in people’s minds for the last 200 years, many parents still are looking for possible alternative ways of preventing and treating infants from the so many forms of infectious, contagious acute diseases.

Certified classical homeopaths and authors Kate Birch and Cilla Whatcott want the world to know that there is an alternative path to the use of vaccination which is a more effective and less expensive method of helping to build immunity towards infectious disease. The Solution ~ Homeoprophylaxis: The Vaccine Alternative offers parents a wealth of useful information on the effective prevention of infectious diseases through homeoprophylaxis. The book introduces the basic principles of HP, and an overview of the immune system and how it iacs intended to work with infectious disease, what vaccines actually do in the immune system and a clinical overview of the homeopathic treatment of childhood eruptive diseases, febrile illnesses, and tropical diseases.

This book is written in simple language to help parents navigate the question of immune system development, infectious disease prevention with homeoprophylaxis and if vaccines are really doing what they are intended to do. The authors clearly explain and differentiate important terminology such as immunology, vaccination, and immunization. What is amazing with this book is that Birch and Whatcott offer the world a different view on disease prevention and the use of HP as an immune system educator, and cite multiple references to clinical research and real time applications of the use of HP for disease prevention.

The Solution is a must-read for every parent, health care provider, and any concerned citizen who has questions about the current day vaccine paradigm. As adverse reactions and associated health problems are becoming more and more prevalent in children after receiving vaccinations The Solution offers another way.

END OF QUOTE

We have discussed homeoprophylaxis (HP) many times before on this blog (see here, here, here, and here, for instance) It seems to be a subject that does not go away. HP-fans tend to claim that:

• conventional vaccinations are dangerous
• conventional vaccinations are ineffective
• the public is being conned by BIG PHARMA
• homeopathy works like vaccination
• highly diluted homeopathic nosodes stimulate the immune system
• highly diluted homeopathic nosodes are effective for the prevention of infectious diseases
• they are much safer than conventional vaccinations

None of this is true!

• highly diluted nosodes do nothing whatsoever
• they cause to quantifiable effects on the immune system
• they do not prevent any disease
• to claim otherwise is irresponsible, unethical, and perhaps even criminal
• the epidemiological ‘evidence’ homeopaths cite for HP is misleading.

The concept of HP lives off the herd immunity we have via conventional vaccinations and, at the same time, endangers this very immunity. It is a danger for both the public and the individual who might believe in it. In my view, promoting HP is unethical, irresponsible and possibly even criminal.

The claim that Cannabis can cure cancer is all over the Internet. Such promotion is regularly enhanced by announcements of VIPs that they intend to try Cannabis when affected by cancer.

As her back pain turned out to be caused by metastases from her earlier breast cancer, Olivia Newton-John now intends to complete a course of photon radiation therapy along with alternative therapies for improving her quality of life. “I decided on my direction of therapies after consultation with my doctors and natural therapists and the medical team at my Olivia Newton-John Cancer Wellness and Research Centre in Melbourne”, she said. Newton-John had been diagnosed with breast cancer in 1992. At that time, she initially tried acupuncture and homeopathy and only later underwent chemotherapy. Olivia Newton-John’s daughter, Chloe Lattanzi, has stated that her mother would now use cannabis oil to aid in her fight against cancer. Lattanzi owns a marijuana farm and said that her mother would use natural healing remedies plus modern medicine in addition to cannabis oil to help her battle the deadly disease for the second time.

So, how realistic is the assumption that Cannabis does anything for cancer patients? Cannabis produces a resin containing pharmacologically active compounds called cannabinoids. Some cannabinoids are known for their psychoactive properties. Cannabis has therefore been used for medicinal and recreational purposed since ancient times. Today, the recreational use of Cannabis is illegal in many states, including the UK.

The main active cannabinoids are delta-9-THC and cannabidiol (CBD); the latter compound may relieve pain, lower inflammation, and decrease anxiety without causing the “high” of delta-9-THC. Cannabis and cannabinoids have been studied in the laboratory and the clinic for relief of pain, nausea and vomiting, anxiety, and loss of appetite. There also is some evidence that they can alleviate the side-effects of cancer therapies. Two cannabinoids have even been approved by the regulators in some countries for the prevention and treatment of chemotherapy-related nausea and vomiting. Some test tube results have suggested that Cannabis can kill cancer cells. However, there are no clinical trials yet, and therefore not enough evidence exists to recommend that patients use Cannabis as a treatment for cancer.

The possibility that Cannabis might be useful for cancer patients currently attracts much original research. The most recent review states that “favorable outcomes are demonstrated for chemotherapy-induced nausea and vomiting and cancer-related pain, with evidence of advantageous neurological interactions. Benefit in the treatment of anorexia, insomnia and anxiety is also suggested. Short- and long-term side effects appear to be manageable and to subside after discontinuation of the drug. Finally, cannabinoids have shown anti-neoplastic effects in preclinical studies in a wide range of cancer cells and some animal models. Further research is needed before cannabis can become a part of evidence-based oncology practice.”

Similarly, the conclusions by our ‘CAMcancer’ initiative were cautious: ” The antiemetic efficacy of the cannabinoid dronabinol (THC), when compared to standard antiemetics that were in use before the development of 5-HT3 antagonists for chemotherapy-induced nausea and vomiting, has been established in a meta-analysis. The question of whether cannabis-based medicines have a place in the era of modern antiemetic medication, e.g. for patients with refractory nausea and vomiting despite antiemetic prophylaxis according to current standards, remains uncertain but warrants further research. Limited evidence is available to support the use of cannabis-based medicines in the therapy of radiotherapy-related nausea and multifactorial nausea in advanced cancer patients. The use of cannabis-based medicines for appetite loss and other symptoms associated with cancer cachexia is still unclear at present, since trial results have not only varied widely but also been criticised for the methodology employed (including diversity in stages of cachexia in the patients included and possibly too a low dose of THC/medical cannabis). For cancer pain, several randomised controlled trials of cannabis-based medicines in cancer patients with various pain syndromes have indicated an analgesic effect comparable to weak opioids. The role of cannabinoid medicines as add-on medication for pain that is insufficiently relieved by strong opioids is currently being investigated in several clinical studies and has shown some promising results so far.”

So, the evidence suggests that Cannabis might be helpful in the supportive and palliative treatment of cancer by reducing some of the symptoms from which cancer patients may suffer. But there is no good evidence to show that it can change the natural history of any type of cancer. Even with the symptomatic use of Cannabis, we need to consider at least two caveats.

Firstly, we have no good evidence to suggest that Cannabis is significantly more effective than conventional therapies. A Cochrane review, for instance concluded that ” Cannabinoids can lead to an increase in appetite in patients with HIV wasting syndrome but the therapy with megestrol acetate is superior to treatment with cannabinoids. The included studies were not of sufficient duration to answer questions concerning the long-term efficacy, tolerability and safety of therapy with cannabis or cannabinoids. Due to the sparse amount of data it is not possible to recommend a favoured use of cannabis or cannabinoids at this point.”

Secondly, the Cannabis trials tend to be of low quality. Another Cochrane review concluded that “Cannabis-based medications may be useful for treating refractory chemotherapy-induced nausea and vomiting. However, methodological limitations of the trials limit our conclusions and further research reflecting current chemotherapy regimens and newer anti-emetic drugs is likely to modify these conclusions.”

Back to Olivia Newton-John; her case is, I think, telling. It seems that, by initially using alternative therapies instead of conventional treatments for her breast cancer in 1992, she worsened her prognosis. Now that the cancer has returned, she has learnt her lesson and opts for the best conventional oncology can offer her. Yet, her liking for alternative medicine has not disappeared completely. This confirms what I have observed all too frequently: for many of its fans, alternative medicine is a belief system that is largely untouchable by evidence.

Belgian researchers (if I remember correctly, I was the external examiner of the PhD of one of them) conducted a survey aimed at examining the beliefs about the cracking sounds often heard during high-velocity low-amplitude (HVLA) thrusts in individuals with and without personal experience of this technique.

The researchers included 100 individuals. Among them, 60 had no history of spinal manipulation, including 40 who were asymptomatic with or without a past history of spinal pain and 20 who had nonspecific spinal pain. The remaining 40 patients had a history of spinal manipulation; among them, 20 were asymptomatic and 20 had spinal pain. Participants attended a one-on-one interview during which they completed a questionnaire about their history of spinal manipulation and their beliefs regarding sounds heard during spinal manipulation.

Mean age was 43.5±15.4 years. The sounds were ascribed to vertebral repositioning by 49% of participants and to friction between two vertebras by 23% of participants; only 9% of participants correctly ascribed the sound to the release of gas. The sound was mistakenly considered to indicate successful spinal manipulation by 40% of participants. No differences in beliefs were found between the groups with and without a history of spinal manipulation.

The authors concluded that certain beliefs have documented adverse effects. This study showed a high prevalence of unfounded beliefs regarding spinal manipulation. These beliefs deserve greater attention from healthcare providers, particularly those who practice spinal manipulation.

So, what causes the sound often heard during spinal manipulation? This is how one chiropractor explains it: “In simple terms, the sound of cavitation means that the vertebrae are being gently and properly realigned. The sound of dissolved air bubbles in the fluid around the vertebrae releasing is what makes the pop.” And this is what another chiro states: “The actual pop is called a cavitation, and it’s the release of gas that makes the popping sound. The joints of the spine are called synovial joints (check out this simple and detailed description here) and they produce a fluid called synovial fluid. Synovial fluid lubricates the joint (for movement) and nourishes it. The byproducts formed in the production of synovial fluid are gasses – oxygen, nitrogen and CO2. When a joint is gapped, or opened up, the gas is released and you hear a distinctive popping sound. It’s very similar to the release of gas bubbles when you cork a champagne bottle, and equally pleasant in its after effects.” Finally NHS Choices tells us this: “During spinal manipulation, you may experience a popping sensation in your joints and hear a popping or cracking sound. It is thought this is caused by gas bubbles in the fluids that surround your joints – this is a normal part of spinal manipulation and other manual treatments.”

In reality the pop is much to do about nothing. If you pull hard on one of your fingers, chances are that you generate the same phenomenon and sound. As with your finger, the pop from the vertebral joints has no therapeutic value.

Guest post by Frank Van der Kooy

The BlueBox^TM homeopathic remedy kit, produced by Pegasus Homeopathics, contains 28 easy-to-use remedies for the treatment of just about everything, and therefore; “The BlueBox™ is a must have for every home”. Their marketing strategy is focussed on children and on the ease-of-mind of their parents, with Pegasus telling us that it: “Treats the whole family from infants to the elderly; Safe for babies as well as pregnant and breast feeding mums; Readily taken by children, no alcohol or nasty-tasting syrups; Can’t overdose – even if a child swallows the contents of a bottle it’s the same as one dose.” One of the 28 remedies in this kit is called Anti-virabac 200C, described as a; “natural antibiotic, safe for those allergic to penicillin. Indications: A homeopathic ‘antibiotic’ for use in viral and bacterial infections, that is best implemented at the earliest stage of the infection. Safe for use in penicillin-allergic individuals.”

There is a lot wrong with this, but let’s just focus on what this remedy contains. It is a mixture of nine homeopathic remedies, including Belladonna 200C and Gunpowder 30C, with the purpose of the latter being; “Localises the infection preventing deeper penetration into tissues.” The 200C and 30C indicates that these substances have been diluted by a factor of 10⁴⁰⁰ and 10⁶⁰ respectively, and consequently neither contain a single molecule of the original substance. This might be a good thing, especially for Belladonna which is a highly poisonous herb, and something that you definitely do not want to give to your children.  Incorrectly diluted Belladonna (in a different homeopathic remedy) has recently been implicated in the deaths of ten infants in the US. As for the Gunpowder 30C, well, some homeopaths are known for diluting the Berlin Wall for the treatment of depression, and a whole host of other conditions, so why not gunpowder?

But let’s step into the mind of a homeopath, and try and explain the logic behind the Gunpowder 30C. Here goes: Gunpowder is used to fire a bullet which will, depending on the entry location,, cause serious harm or death. If you are only wounded, the wound can become infected, the infection might spread throughout your body, and eventually you may die. Using the homeopathic principle of ‘like-cures-like’, it therefore ‘stands to reason’ that when you dilute gunpowder, by a factor of 10⁶⁰, it will localise and prevent the infection from spreading any further. Because the underlined words look alike, it is irrefutable scientific evidence that Gunpowder 30C is a remarkably effective remedy. I am however only guessing here, but it is clear that the amount of science involved is truly mindboggling (any homeopath reading this, please correct me if I am wrong). A quick search reveals that homeopathic gunpowder is more commonly used for the treatment of septic wounds in people and animals, which I guess, makes more sense in a homeopathic sort of way.

Let’s say that I do not have any scientific background and that I’ve decided to buy the BlueBox^TM. Before coming to this decision, I’ve spoken to a homeopath (a specialist), I’ve discussed it with the extremely helpful people at the pharmacy, I’ve read all the info on the website of Pegasus (the producers), and I’ve even gone as far as to read the lengthy WHO report, which recommends that homeopathy should be integrated with conventional healthcare. All-in-all, it paints a very positive picture and I, and many others, will feel confident in the safety and effectiveness of this product. And hence, I will happily give these remedies to my children. Why not?

But what now if my young child die, due to an infection that I’ve treated with anti-virabac 200C? The infection worsened very quickly, within 48 hours, and upon hospitalisation it was already too late to save his life. At the end of the day, this remedy contains nothing other than the diluent, and will do absolutely nothing against any infection. A fact that is reflected in the Australian NHMRC homeopathy report, where they clearly state that: “People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.” Tragically, this happens quite often, with an unknown number of people dying because they have chosen ineffective homeopathic remedies. Gunpowder 30C for the treatment of infectious diseases and/or septic wounds, really? The number of victims is unknown because the BlueBox^TM, and all other homeopathic remedies, are bought over-the-counter. There is no paper trail and hence no system in place to document ‘adverse events’. So, if you or your child dies, the cause of death will simply read infectious disease or septic wound – and that will probably be the end of it.

Who is to blame for this situation?  The homeopath, pharmacist and all other role players are legally doing what they are doing. They are allowed to sell you water as a treatment for many different medical conditions.  You, on the other hand, as a parent who’s child died because of these  ineffective remedies, can however be taken to court and you might even be send to jail – and this is the ‘Homeopathy Paradox’.

This is also where the important role of Vice Chancellors (VC) come into play. They are instrumental in deciding on what path science will take in a specific country. Their role is becoming more important, especially in light of some politicians nowadays resorting to all kinds of alternative facts.  Take someone like Prof Barney Glover, VC of Western Sydney University (WSU), and also the current Chair of ‘Universities Australia – The Voice of Australia’s Universities’. He has influence over the whole scientific landscape in Australia, and quite recently gave a very good speech at the National Press Club,  about the necessity and importance for universities to stand up for facts and the truth, because nobody else will.  This is very encouraging but, unfortunately, very misleading.

Prof Glover was notified in 2015, that he should urgently investigate the National Institute of Complementary Medicine (NICM), because of their continued (in)direct support of homeopathy and many other disproven complementary medicines. For example: the NICM had a big influence in compiling the WHO report, calling for the better integration of homeopathy (implying that it is an effective healthcare system) with conventional healthcare, and by way of their extended network, has tried to discredit and destroy the NHMRC report on homeopathy. Their incorrect and misleading response to the NHMRC report is now being used by homeopaths, all over the world, to continue to mislead the public regarding the effectiveness of homeopathy.

Unfortunately, neither the VC nor anyone else in WSU’s management has yet taken the very important step of standing up for science. Therefore the VC, and others, were nominated for the Bent Spoon Award in 2016. A nomination that they tried to block, but after independent review, did not manage to do so.  VC’s that do not stand up for science can therefore have a far-reaching impact, such as convincing me, who live on the other side of the world, to buy the BlueBox^TM, which in turn, might lead to my child’s death. Let’s call it the ‘butterfly effect’, with a ‘minor’ act (allowing pseudoscience at their university) on one side of the world, causing a lot of carnage on the other side of the world, or the world over.

(The reason for WSUs refusal to investigate the NICM seems to be as simple as increasing their external income. And it works, because quite recently the controversial supplement company Blackmores donated $10 million, and a year or so ago, the extremely controversial organisation, the Jacka Foundation, donated $4 million. These numbers appear to be enough for WSU to continue to hold their hand of protection over the NICM).

WSU is by no means the only university that has put money before science and ethics. Take for example the University of Johannesburg (UJ) who has a ‘Department of Homeopathy’ (they featured on this Blog before – see for instance  here).  A couple of days ago I emailed the Dept. of Homeopathy, asking for advice regarding homeopathic malaria remedies for my 6yo son before we travel to the Kruger park. They advised me that they do not sell it themselves, but that I should contact a specific pharmacy and ask for….wait for it….a banned herbal remedy and for homeopathic antimalarial drops – the latter, of course, does not contain anything other than solvent. This advice comes straight from a University, and although this issue is still unfolding, I am hopeful to have more luck with UJ’s VC – but I am not holding my breath. So, if you happen to work at any one of these two universities, could you kindly forward this article to your VC? For what it is worth.

 

Currently, we witness an unprecedented hype about the ALKALINE DIET. It seems to be everywhere: on TV, radio, in the dailies, magazines, books and the Internet. The diet is being promoted for an amazing array of conditions by a dazzling list of VIPs. To me this merely indicates that very important people have paid very little attention when it was explained to them how the body controls its pH. It seems that VIPs tend listen to stuff that is not only factually incorrect but potentially dangerous. (Perhaps ‘VIP’ stands for ‘very ignorant person’?) This website (one of millions on the subject) is as good an example as any for the level of misinformation that is currently out there:

START OF QUOTE

When a food is ingested, digested, and absorbed, each component of that food will present itself to the kidneys as either an acid-forming compound or a base-forming one. And when the sum total of all the acid-producing and the base-producing micro and macronutrients are tabulated, we’re left with a calculated acid-base load.

One common problem with most industrialized societies is that our diets produce what’s called a “low grade chronic metabolic acidosis.” This means we’re in a chronic state of high acidity. Since the body must, at all costs, operate at a stable pH, any dietary acid load ha to be neutralized by one of a number of homeostatic base-producing mechanisms. Although the pH of the body is maintained, many cells of the body will suffer.

A cancerous cell is acidic. If your body is in a constant state of over-acidification, it becomes impossible for healthy cells to regenerate. Cancer cells thrive in an overly acidic environment. By taking action to become more alkaline, you can make it more difficult for cancer cells to regenerate.

Eating an acid/alkaline balanced diet is the key to staying healthy. Understanding the pH of the foods that you eat is relative to the state of your body’s health.

The goal of the acid alkaline balance diet, also known as the alkaline diet and the alkaline ash diet, is to achieve an optimal balance between acid-forming and alkaline-forming foods. The anti cancer diet greatly reduces the strain on the body’s acid-detoxification systems.

END OF QUOTE  (I corrected several spelling mistakes)

Personally, I don’t care a hoot whether VIPs eat this or any other diet. When it comes to claiming that the ALKALINE DIET can treat or prevent cancer (or other serious conditions) I do, however, get concerned. Such claims will almost inevitably prompt patients to give up their treatments in the hope that the diet will do the trick. In other words, such claims endanger the lives of patients, and I find this intolerable. Tragically, a recent case seems to demonstrate how real this danger is.

So, allow me to put the record straight: there is no evidence that the Alkaline Diet is effective for the prevention or treatment of any disease, particularly not cancer. For those who find this hard to believe (vis a vis the current hype, this would hardly be surprising), here is the evidence.

One systematic review concluded that despite the promotion of the alkaline diet and alkaline water by the media and salespeople, there is almost no actual research to either support or disprove these ideas. This systematic review of the literature revealed a lack of evidence for or against diet acid load and/or alkaline water for the initiation or treatment of cancer. Promotion of alkaline diet and alkaline water to the public for cancer prevention or treatment is not justified.

Another group of researchers evaluated the following diets: raw vegetables and fruits, alkaline diet, macrobiotics, Gerson’s regime, Budwig’s and low carbohydrate or ketogenic diet. They did not find clinical evidence supporting any of the diets. Furthermore, case reports and pre-clinical data point to the potential harm of some of these diets. The authors concluded that considering the lack of evidence of benefits from cancer diets and potential harm by malnutrition, oncologists should engage more in counselling cancer patients on such diets. Our recommendations could be helpful in this process.

So, yet again we are confronted with the fact that the media create attention, hype and misinformation with no real substance whatsoever. It is high time, I think, that journalists are reminded of their duty to report truthfully and responsibly!!!

Health journalists must be reminded of the undeniable fact that misinformation kills people.

I came across this website which contains an undated ‘open letter’ that I find most remarkable – so much so that I feel I have to blog about it. All I did below was to abbreviate its text slightly and to omit its references which can, of course, be looked up in the original. The footnotes in square brackets are mine and refer to my comments below.

START OF QUOTE

It is now estimated that antibiotic resistant infections may kill an estimated [1] 10 million people a year and cost the world’s economies some $100 trillion annually by the year 2050… As some of America’s leading integrative medicine specialists [2], we believe it is time to look anew at a modality called homeopathic medicine.

As physicians [3], we are the first to acknowledge that the diagnostic and surgical tools of conventional medicine are scientific marvels – truly extraordinary and life saving. However, it is also a well-documented fact that many of the drugs currently used by conventional medicine carry risks that are often unacceptable, and in the case of bacterial infections – increasingly ineffective [4].

Signatories, and tens of thousands of our medical colleagues around the world, have repeatedly used homeopathic medicine to effectively and safely treat patients with a wide range of ailments, including serious, and in some cases, life threatening bacterial and viral infections, without the risk of creating further drug resistant organisms [5]. We reached our decision to employ these medicines after careful experimentation and observation, in search of a drug system that relieved suffering without potential toxic side and after-effects [6]…

Twelve independent research laboratories in North America, Russia, Europe and Asia have now confirmed that all classically-prepared homeopathic medicines studied contain various nanostructures, including source and silica nanoparticles which are heterogeneously dispersed in colloidal solution [7]. The above mentioned laboratories and others have found that homeopathic medicines, like modern engineered nanoparticles, have been found to act by modulating biological function of the allostatic stress response network, including cytokines, oxidative stress and heat shock proteins [8]. Additionally, there are hundreds of peer-reviewed studies including randomly controlled trials and large observational studies on individual cells, plants, animals and humans, that show homeopathic medicines are exceptionally safe [9] and have measurable and positive biological and therapeutic effects [10].

Reliable and extensive clinical and public health records have also been carefully examined internationally, looking for evidence of homeopathic medicine’s efficacy during some of the deadliest epidemics of the past 200 years. The main findings of this research show that when homeopathic medicine was employed during these deadly events, mortality rates were routinely very low. This constancy remained regardless of the homeopathic physician, time, place or type of epidemical disease, including diseases carrying a high mortality rate, such as cholera, smallpox, diphtheria, typhoid fever, yellow fever, influenza and pneumonia [11].

…we are calling for a collaborative effort to investigate the efficacy of homeopathic medicine in the treatment of patients with these increasingly dangerous infections whereby homeopathic medicine is used only as an adjunct to conventional therapies [12] …

END OF QUOTE

These are my footnotes, questions and comments:

[1] Does twice ‘estimated’ result in accuracy, according to homeopathic teaching?

[2] Are we impressed by people who call themselves ‘leading specialists’?

[3] I can see many signatories who I would hesitate to call ‘physicians’.

[4] In the case of antibiotics, it is mostly the over-use and not the drug per se that created their ineffectiveness.

[5] Using homeopathic remedies for infections is not effective and therefore also not safe.

[6] If that were true, they would have clinical trial evidence which they clearly have not.

[7] Even if this were true, it would not mean that the nano-particles cause therapeutic effects.

[8] Even if this were true, it would still not necessarily amount to clinical benefit in sick patients; where are the clinical trials showing that homeopathic remedies are effective antibiotics? I am not aware of any. The references provided certainly do not refer to such clinical studies.

[9] Yes, highly dilute homeopathic remedies contain no active ingredients and are therefore unlikely to cause direct adverse effects.

[10] The totality of the evidence from reliable clinical trials fails to show therapeutic effects.

[11] The epidemiological data can be interpreted in several ways, and the majority of non-homeopaths do not share this interpretation.

[12] About 500 clinical trials are available, and their results suffice to call for an end to such research; it’s a waste of resources – resources which are urgently needed to find solutions for the serious problem of antibiotic resistance.

Who is this letter addressed to? I could not find an answer to this question. It seems to be addressed to nobody – perhaps just as well!

Who would sign such an amateurish letter full of mistakes and dangerously misleading statements? The full (and embarrassingly long) list of signatories is here:

Stephen Albin, ND
Nathalie Allen, ND
Lisa Amerine, ND
David Anderson, MD
Kristy L. Anderson , ND
Yumi Ando, MD
A. M. Aurigemma, M.D.
Jyotsna Ayachit , M.D. CCH, DIH
Linda Baker, MD
Michael Baker, ND
Toni Bark, MD
Alex Bekker, MD
Iris Bell , MD, Ph.D.
Paul Bergquist, MD
Brian Berman, MD
Andrea Bitter, MD
Blossom Bitting, ND
Manon Bolliger , ND
Philip Bonnet, MD
Sue Boyle, ND
Mark Breiner, DDS
Maureen Bunce, MD
Anthony Capobianco, DO
Youngran Chung, MD
Mary Alice Cooper, MD
Mary Ellen Coulter, MD
Karin Cseak, DO
Stephen Davidson, DO
Tim Dooley, MD
Michelle Dossette, MD
Joseph Dubroff, ND
Robert Dumont, MD
Ronald Dushkin, MD
Samuelle Easton, ND
Rebecca Elmaleh, MD
Kristy Fassler, ND
Timothy W. Fior , MD
Laura Firetag, ND
Richard D Fischer , DDS, ND, MIAOMT, FAAO
D Fischer , DDS, ND, MIAOMT, FAAO
Mitchell A. Fleisher, M.D., D.Ht.
Ecaterina Floroiu, MD
Gary Fortinsky, DDS
Glenn Frieder, DC
Joyce Frye , DO
Susana Galle, ND, Ph.D.
Juan Gamba, MD
Stewart Garber, DC, Ph.D.
Harold Goodman, DO
George Guess, MD, DHt
Sohilraj Gupta, MD
Regina Gurevich, MD
Robert Hall, MD
Eashwar Hariharan, MD
Alice Harper, ND
Travis Herring, MD
Sharon Herzfeld, MD
Richard Hiltner, MD
Todd Hoover, MD
Torey Ivanic, PA-C
Jennifer Jacobs, MD
Naseem Jagani, MD
Chris Johnson, NS
Bernice Johnson, DC
Sandra Kamiak, MD
Emily Kane, ND
Polina Karmazin , MD
George Keeler , MD
Elena Klimenko, MD
Edward C. Kondrot, MD, MD(H)
Gary Krarcoff, NMD
Christine Kuhlman, ND
J.W. Kwee, MD
Julie Lachman, ND
Janet Lavatin, MD
Gail Littell, ND
Ian Luepker, ND
Linda Madore, ND
Larry Malerba, DO
Christopher Maloney, ND
Ruth Martens, MD, DHt
Robert Melo, MD
Bernardo A Merizalde, M.D.
Stephen A. Messer, MSEd, ND
Jeff Migdow, M.D.
Jacob Mirman, MD
Lucia Elena Mitrofan, MD
David Moreira, MD
Roger Morrison , M.D.
Richard Moskowitz, MD
Anca Nitulescu, MD
Nick Nossaman , MD, DHt
Stephanie Ogura, ND
Jamie Oskin, ND
Roy Ozanne, MD
Donna Panucci , DDS
Pamela Pappas, MD, MD(H)
Iva Peck, MD
Vladimir Petroci, MD
Luigi Pioli, MD
Liliana Plaesu, MD
Wendy Pollock, DC
Molly Punzo, MD
Danny Quaranto, MD
Ignatiadou Radmila, MD
Rakesh Raj, MD
Vinay Ranade, MD
Ioana Razi, MD
Sandy Reider, MD
Karl Robinson, MD
Henry Rostecki, DVM
Todd Rowe, MD MD(H)
DeeAnn Saber, NMD
Andre Saine , ND
Susanne Saltzman, MD
Lisa Samet , ND
Gundi Schulz, ND
Tova Sebaoun, MD
Irene Sebastian, MD
Joel Shepperd , MD
William Shevin , MD, D.Ht.
Jonathan Shore , MD
Hydie Sobel, MD
Rumen Stoychev, MD
Sergio Suárez, MD
Christine Sutton, ND
Michelle Thatcher, NMD
Anja Troje, MD, Ph.D.
Eric Udell, ND M.Ed.
Corey Weinstein, MD
Richard Weintraub, MD
Judith Weiss, MD
Ronald Whitmont, MD
Melanie Whittaker, ND, RN
Jacquelyn Wilson, MD
Linda Woodward, MD

I happen to know several of these ‘leading integrative medicine specialists’. What did they think when composing this letter?

The answer can only be NOT A LOT.

This is so cringingly embarrassing and pathetic that it beggars belief. If ‘integrative medicine’ ever did have anything resembling credibility, these ‘leading specialists’ would have destroyed it with their letter.

Antibiotic resistance is, of course, a huge, complex and very serious problem, and we need to solve it urgently – but surely not with lies, half-truths, wishful thinking and incompetence.

 

Guest post by Frank Van der Kooy

“….the concept of circulation of energy is paramount in Chinese Medicine. The Chinese physicians have always said there’s more than just blood circulating in the body, there’s also energy, human energy of some sort circulating in the body. We don’t know how to measure that yet.”

This is a quote from a radio interview where the wonderful and mysterious world of TCM was explained to the unsuspecting Australian public – this interview took place about 16 years ago. You can find more details regarding this very interesting interview here. From the above quote, it is clear that the circulation of “energy” is paramount to TCM and that, at the time, it could not be measured nor could its existence be shown. The quote, however, ends with the word ‘yet’, indicating there is full support for the notion that this energy field do indeed exist and that it is only a matter of time before it will be detected.

Now, just imagine if someone do indeed discover this energy field with a simple experiment that can be independently reproduced by others. As soon as you can measure it, you can influence it and hence control it, which implies that you will be able to significantly improve and personalise your TCM treatments – and this will almost certainly lead to a Nobel prize in medicine and you might even become stinking rich as well. Fame and fortune up for grabs. It therefore stands to reason that TCM researchers worldwide including those at the National Institute of Complementary Medicine (NICM), the latter who are well funded and have excellent research facilities, would have had more than enough incentive and would’ve spent a significant amount of research effort to detect this energy field in the 16 years since they gave the interview.

So, have they done any research on this very fundamental issue? They can vindicate TCM and for that matter most of complementary medicine if they did, never mind the major improvements in healthcare that might flow from this. The short answer is, no, they haven’t. I am not aware of any study done by any TCM researcher, or anyone at the NICM, past or present, investigating this extremely important issue. So, no progress, but also absolutely no interest in studying this extremely important aspect of TCM. But why is this?

The answer is really quite simple: As soon as you conduct a well-designed experiment you are bound to end up with a yes/no answer – or at least this is what you want. Yes, my hypothesis is correct or no, it is incorrect. Granted, you can also design an experiment that will almost always give you a positive result such as the A + B vs B clinical trial (well known to integrative medicine researchers). But for argument sake, let’s assume that they did study this aspect in a well-designed experiment and that they came up empty handed – which is quite likely because you cannot detect something if it does not exist – this will then be further evidence that the fundamental principles of TCM is absolutely rubbish. And this is of course something that they cannot publish or admit, so it is far better for the TCM researchers and the NICM to completely ignore this issue.

A second reason is that they know damn well that this energy field do not exist but they have to continue to sell this idea to the public in order to import more and more TCM modalities into Australia –  for them it is all about business (it is that $170 billion TCM market that they want to tap into). This is the most likely explanation for their failure to investigate this fundamental principle of TCM.

There is however a couple of other general issues: There is a true believe that this energy field exist because in the TCM world all modalities work – evidence for this concept is that close to a 100% of TCM clinical trials conducted in China gives a positive result. That the NICM and TCM practitioners believe this (either because they truly believe it or they make as if they believe it for the sake of their business interests) can be seen if you look at the long list of medical conditions for which something like Rhino horn is considered to be an effective treatment; “High fever, sun stroke, trauma, mania, convulsion, sore throat, epilepsy, febrile disease, infectious disease, macula, bad skin conditions, subcutaneous bleeding.”  It works for just about everything. And this goes for all TCM modalities. TCM researchers are completely happy to entertain this notion because they are actively trying to sell the energy concept to the public, and once accepted by the public, they will flood the market with TCM modalities.

It is also remarkable to think, and please correct me if I am wrong, that there are still people in China that die due to any medical condition after receiving a specific TCM treatment – if this energy field exist this should not really happen. Granted, due to logistical issues, some people might not receive their lifesaving TCM modalities in time but surely there are people who died even after timely administration of a TCM remedy?  And for that matter, if TCM works so well, why would China import or use modern conventional medicine which is, according to the TCM proponents, ineffective, toxic, expensive etc. Surely, you are not going to replace something that works (TCM) with something that doesn’t work (conventional medicine)! Or is maybe the other way around?

Another interesting aspect regarding TCM is that it seems to be impossible to make a mistake (is it even possible to misdiagnose a patient?). Take acupuncture for example: the theory, or should I say, hypothesis, is that pain is caused by either an excess or deficiency of energy (as explained by the NICM in the very interesting radio interview). Acupuncture restores this energy balance and hence your back pain, which might have been diagnosed as an excess of energy, will now dissipates. But what will happen if an inexperienced acupuncturist use too many, or too few needles and maybe even insert them at the wrong acupoints?  According to the hypothesis, too much energy will now flow from your lower back and this will cause an excess of energy somewhere else (causing pain in that region), but your backpain will still be there because you now have a deficiency of energy in your lower back.  Is this sort of treatment ‘mistakes’ known to happen in acupuncture? Puncturing of an organ or infection due to dirty needles is well known but I am not aware of any examples where the above-mentioned treatment ‘mistakes’ have been documented. If these energy fields do exist this should happen quite regularly. The only explanation that this doesn’t really happen is that these energy fields simply do not exist.

TCM researchers including the NICM have no interest in studying the “energy” aspect of TCM and their only purpose is to sell these pseudoscientific principles to the public. More TCM products means more profit. For the NICM this should pave the way to open their very own TCM hospital in Sydney where the Australian population will be used as guinea pigs. I truly feel sorry for Australians because it appears that it is not only their cricket team that is struggling at the moment, some of their universities are in real trouble because they decided to put profits and pseudoscience, before science, scientific education and the welfare of the public.

When sceptics claim that no positive trials of homeopathy exist, they are clearly mistaken. The truth is that there are plenty of them! But many, if not most are of such poor quality that it is safe to suspect they are false-positives. Here is a recent example of this type of scenario.

This new study investigated the clinical effectiveness of a homeopathic add-on therapy in children with upper respiratory tract infections (URTI). It was designed as a randomized, controlled, multi-national clinical trial. Patients received either on-demand symptomatic standard treatment (ST-group) or the same ST plus a homeopathic medication (Influcid; IFC-group) for 7 days. IFC tablets contain a fixed combination of 6 homeopathic single substances (Aconitum D3, Bryonia D2, Eupatorium perfoliatum D1, Gelsemium D3, Ipecacuanha D3, and Phosphorus D5). IFC was administered according to the following schedule: 8 tablets/day during the first 72 hours, 3 tablets/day during the following 96 hours. Outcome assessment was based on symptom and fever resolution and the Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21).

A total of 261 paediatric (<12 years) patients (130 IFC-group; 131 ST-group) were recruited in Germany and the Ukraine. The IFC-group used less symptomatic medication, their symptoms resolved significantly earlier, they had higher proportions of fever-free children from day 3 onwards, and the WURSS-assessed global disease severity was significantly less during the entire URTI episode.

Days until symptom resolution (WURSS-21 item 1) in both treatment groups.

The light grey (IFC-group) and dark grey (ST-group) lines are polynomial fit curves. The dashed line estimates the between-group difference in the number of days after which 50% of patients had symptom resolution.

Between-group differences (IFC − ST) with 95% confidence intervals in the proportion of patients without fever during the observational period.

A difference (%) greater than zero indicates a higher proportion without fever in the IFC-group. Day 1 = Baseline.

The authors concluded that IFC as add-on treatment in pediatric URTI reduced global disease severity, shortened symptom resolution, and was safe in use.

On the one hand, this study has many features of a rigorous trial. I am sure that homeopaths will praise its quality, sample size, clever statistical analyses, etc. etc. The trial will therefore be cited by enthusiasts as a poof for homeopathy’s effectiveness and for homeopaths’ laudable research efforts.

On the other hand, one only needs to apply a minimum of critical thinking to find that it has been designed such that it cannot possibly generate a negative result. In fact, the paper turns out to be much more of a marketing exercise than a research effort.

The homeopathic remedy was given as an add-on therapy according to a fairly tedious ritual. It is safe to assume that this ritual created expectations on the parents’ side. These expectations alone suffice to account for the small group differences which seemingly favour homeopathy. The study follows the infamous ‘A+B versus B’ design which (as we have discussed ad nauseam on this blog) is extremely likely to generate false positive findings.

Why do researchers nevertheless plan, conduct and publish such studies (in the case of the paper discussed here, they even published their findings twice! Their previous paper included a larger group of patients of all ages and concluded that the homeopathic treatment shortened URTI duration, reduced the use of symptomatic medication, and was well tolerated.)? The answer can be found, I think, in the small print at the end of the paper:

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Robert van Haselen has received a consultancy fee from the Deutsche Homöopathie-Union. Manuela Thinesse-Mallwitz received a fee from the Deutsche Homöopathie-Union for coordinating the study. Vitaliy Maidannyk received a fee from the Deutsche Homöopathie-Union for coordinating the study. Stephen L. Buskin is a member of the Advisory Board of the Deutsche Homöopathie-Union. Stephan Weber received a fee from the Deutsche Homöopathie-Union for contributing to the study. Thomas Keller received a fee from the Deutsche Homöopathie-Union for contributing to the study. Julia Burkart is an employee of the Deutsche Homöopathie-Union, the study sponsor and manufacturer of Influcid. Petra Klement is an employee of the Deutsche Homöopathie-Union, the study sponsor and manufacturer of Influcid.

Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was funded by Deutsche Homöopathie-Union, Karlsruhe, Germany. Deutsche Homöopathie-Union manufactures the homeopathic medicinal product used in this study and provided the publication fee.

I REST MY CASE

Two of my recent posts directly related to the German ‘Heilpraktiker’ (here and here) and to the risks which this profession poses to public health in Germany. As this is a very German phenomenon, it might be time to provide some explanations to my non-German readers.

The German ‘Heilpraktiker’ (literally translated: healing practitioner) is perhaps best understood by its fascinating history. When the Nazis came to power in 1933, German health care was dominated by lay practitioners who were organised in multiple organisations struggling for recognition. The Nazis felt the need to re-organise this situation to bring it under their control. At the same time, the Nazis promoted their concept of ‘Neue Deutsche Heilkunde’ (New German Medicine) which entailed the integration – perhaps more a shot-gun marriage – of conventional and alternative medicine. I have published about the rather bizarre history of the ‘New German Medicine’ in 2001:

The aim of this article is to discuss complementary/alternative medicine (CAM) in the Third Reich. Based on a general movement towards all things natural, a powerful trend towards natural ways of healing had developed in the 19(th)century. By 1930 this had led to a situation where roughly as many lay practitioners of CAM existed in Germany as doctors. To re-unify German medicine under the banner of ‘Neue Deutsche Heilkunde’, the Nazi officials created the ‘Heilpraktiker‘ – a profession which was meant to become extinct within one generation. The ‘flag ship’ of the ‘Neue Deutsche Heilkunde’ was the ‘Rudolf Hess Krankenhaus’ in Dresden. It represented a full integration of CAM and orthodox medicine. An example of systematic research into CAM is the Nazi government’s project to validate homoeopathy. Even though the data are now lost, the results of this research seem to have been negative. Even though there are some striking similarities between today’s CAM and yesterday’s ‘Neue Deutsche Heilkunde’ there are important differences. Most importantly, perhaps, today’s CAM is concerned with the welfare of the individual, whereas the ‘Neue Deutsche Heilkunde’ was aimed at ensuring the dominance of the Aryan race.

The Nazis thus offered to grant all alternative practitioners official recognition by establishing them under the newly created umbrella of ‘Heilpraktiker’. To please the powerful lobby of conventional doctors, they decreed that the ‘Heilpraktiker’ was barred from educating a second generation of this profession. Therefore, the Heilpraktiker was destined to become extinct within decades.

Several of the Nazi rulers were staunch supporters of homeopathy and other forms of alternative medicine. They hoped that alternative medicine would soon have become an established part of ‘New German Medicine’. For a range of reasons, this never happened.

After the war, the Heilpraktiker went to court and won the right to educate their own students. Today they are a profession that uses homeopathy extensively. The German Heilpraktiker has no mandatory medical training; a simple test to show that they know the legal limits of their profession suffices for receiving an almost unrestricted licence for practicing medicine as long as they want.

You may not believe me – many readers of my blog seem to think that I spend my time spinning the truth – therefore let me show you an article by another author on the same subject:

In Germany, the naturopathic practitioner, the “Heilpraktiker”, is allowed to practice medicine, like medically trained physicians. The German heilpraktiker, a specific German phenomenon embedded in the country’s history, practices medicine without being obliged to undertake any medical teaching or training. Anybody 25 years old or older, with a secondary school certificate, and free of disease can participate in a test, conducted by the local health authorities to “exclude danger to the health of the nation.” In the case of failure, this test can be repeated ad libitum. Having passed this test, the heilpraktiker is allowed to practice the whole realm of medicine, except for gynecology, dentistry, prescription of medication, and healing infectious diseases. There is no more state control during the heilpraktiker’s working life, except in those practices applying invasive methods, such as infusions, injections, oxygen therapy, and acupuncture. These practices are inspected by the public health department based on the Infection Protection Act. Although several cases of fatal errors in treatment are known, the greatest risk in the heilpraktiker’s practice is the omission of proper diagnostics and therapies, which is risk by omission. In this paper, the history of the heilpraktiker in Germany as well as the task of the Public Health Departments in testing the candidates are shown. The data of 345 tests from 2004-2007 in the Rhein-Main area are presented, with 53% of the participants failing. Concerning the hygiene control visits, a concept for hygiene was lacking in 79% of 109 practices, while in 49% a concept for cleaning and disinfection was also missing. In 60% of the practices, a dispenser for hand disinfection was lacking. Recommended improvements were quickly performed in most practices. In conclusion, the current legal regulation, i.e., testing the candidates only once before practicing for a lifetime, does not sufficiently protect the population against danger caused by false diagnostics and (invasive) therapy of the heilpraktiker. Considering the population’s increasing interest and use of complementary and alternative medicine (CAM) with a heilpraktiker being frequently consulted, there are growing concerns in health services, regarding (1) how to regulate CAM professions and natural health procedures, (2) how to incorporate safe CAM into school medicine, and (3) how best to protect the public from a wide range of possible CAM-conventional medicine interactions.

There have been very few investigations into the Heipraktiker phenomenon. Recently, however, an excellent book has been published, and here is the abstract of a rare study of the subject:

We investigated to what extent psychiatric inpatients consult Heilpraktiker, i.e. non-academically trained providers of complementary and alternative medicine (CAM), which diagnostic and therapeutic methods Heilpraktiker employ, how patients assess Heilpraictikers’ professional competence, CAM in general and issues of satisfaction for those who have had experience with Heilpraktiker. Four hundred and seventy three patients admitted to a psychiatric university department during a 9-month period filled out a questionnaire developed for this investigation. About one third of the patients had consulted a Heilpraktiker, a quarter of these for their current psychiatric illness. Women were in the majority. Patients with the highest secondary school education consulted Heilpraktiker less often. There was considerable ‘customer loyalty’ towards Heilpraktiker. Largely the same diagnostic and treatment methods were employed for mental illness as for somatic complaints. Except for iridology, exotic or dangerous methods played a secondary role. Patients generally revealed a very positive attitude toward Heilpraktiker and CAM, although methods were rated differently. CAM enjoyed greater appreciation among women and patients who had consulted Heilpraktiker. Patients with personal experience were, on the whole, very satisfied with the professional competence, with the atmosphere in the practice and staff concern for the patient’s well-being. Degree of satisfaction correlated closely with frequency of consultation. More patients with neurotic disorders considered the cost unreasonable than others, despite comparatively frequent visits. Psychiatric patients seek out Heilpraktiker to a considerable degree. Especially those who have relevant experience rank Heilpraktiker highly, in particular due to their ‘psychotherapeutic’ attitude, but professional competence is also valued. Methods of CAM received mixed reviews from patients but are generally seen in a positive light. It is recommended that doctors collecting case history data on their patients also ask about experience with alternative practitioners and treatments.

Unsurprisingly, there are numerous reports of Heilpraktiker doing harm to their patients. However, such cases hardly ever get reported in the medical literature. Because there is no effective post-marketing surveillance system in this area, the frequency of harm is essentially unknown.

In my view, it is high time that German officials cast a critical eye on this sector. The incidents mentioned above seem to confirm the urgency of this view.