Archive for the 'Alternative Medicine' Category

I Had a Chance to Exercise my Skeptical Chops in Real Life the Other Night

It’s not often (in real life) that I get to use all of these skeptical tools and pearls of wisdom that I spend so much time learning about, so when I do get into this type of conversation my heart will start racing and I’ll get excited to where I have to concentrate on keeping a calm demeanor so that I don’t end up coming across as a crazed denialist!

The other night my husband had his friend over, who also happened to be one of my former high school teachers, so we sat around chatting for hours and touched on a lot of different topics. At one point in the conversation Dr. Oz (one of Oprah’s spin-off shows) came up, I guess because teachers get to watch lots of daytime TV during the summer!

I’m in no way a fan of Dr. Oz. I’ve tuned  into a few of his episodes when there’s been nothing else on, and my main reason for disliking him is the way that he talks down to the audience, as if he’s addressing a room full of kindergartners. He gives these ridiculous demonstrations that add nothing to the conversation and dumb down already easy to understand things. Medicine is such an interesting field, and the human body is so diverse and complex that it just makes him look ridiculous to me when he talks to grown adults in a way that would have bored me when I was 10.

But obviously enough people enjoy it, so to each his/her own. What also gets me goat about Dr. Oz is how he lends his credibility to alternative medicines that don’t have supporting evidence (Reiki, for example). I brought this up and that’s what sparked a discussion with my old teacher on alternative medicine.

I wouldn’t say that Teacher (that’s what I’ll call him from now on) was full on into alt med or anything, but he came across as neutral on the subject. He seems like one of those people “in the middle”, who believes in the value of using herbs to treat minor ailments but would turn to actual medicine for big things like cancer. We touched on a lot of things that seem to pop up in every online discussion on alternative medicine, so I think I’ll break it down into some of the areas we hit and what was said.

I’ll just mention that everything I was responding to Teacher with was from memory, and I’m going to write it here as it was said so it’s possible, actually it’s likely, that I was wrong about many things and welcome criticisms and feedback.

1. “The placebo effect is strong, so alternative medicine helps even if it shouldn’t really work” There is a common misconception that the placebo effect is some kind of mind over matter thing, where your brain is actually healing your body, and so doing something like acupuncture is therefore helpful, even though there’s no such thing as “chi” or “meridians” in the body. I was three glasses of wine in, so I wasn’t going to try explaining the placebo effect in detail, especially since I don’t fully understand it sober.

Instead, I talked about how things like acupuncture can be helpful for issues like infertility or back pain because just going to a practitioner, having them pay attention to you and validate your problem, and having something physical done to you can alleviate the stress that might be causing the problem. But relying on these things can get dangerous if you start relying on alt med for problems that need proper medication.

2. Confusing homeopathy with herbal medicine. There are some types of alternative medicine that are so ridiculous that they can’t possibly work, and homeopathy is one of them, but people don’t understand what it actually is and so trust that it must work for whatever reason. Teacher was definitely confusing homeopathy with herbal medicine.  I explained that homeopathy means that the active substance is diluted until there’s not even a molecule of the original substance in the solution, so there’s nothing actually in it that would have an effect.

3. Confusing proper diet with alternative medicine. I’m not really sure that this was what was happening, but at one point when we were having the discussion about using herbal medicine he brought up how cutting milk out of his diet helped him to feel better. Lots of people think of diet and nutrition as alternative medicine, maybe because pretty much every diet book out there will recommend taking some type of supplement. In fact, though, diet and the effect of different foods on the body are studied by science, and therefore perfectly in line with medicine.

4. Pharmaceutical companies are out to make a buck and want you to take medicines you don’t need, so turning to herbs is preferable. Pharmaceutical companies do plenty of shady business, but at least the drugs that they put out have standards for evidence, and will be pulled from the shelves if the drug is shown to be dangerous. With the various herbal supplements out there, they have no standards for evidence if it’s called a supplement, and there aren’t nearly as many strict controls, so you really don’t know how much of the active ingredient is contained in each pill. Not to mention many pharmaceutical companies have gotten into the supplement business, so you’re not necessarily circumventing “big pharma” when you decide to go for alternative remedies. The companies that sell those supplements and natural remedies are in the profit business too!

5. Lots of drugs were developed out of traditional healing substances, so herbal medicine must work. Sure, a lot of drugs came about because the substance used in them was traditionally used in healing the ailment. But the reason why they’re drugs now is because they were subjected to scientific testing and found to work, so the active substance was isolated or synthesized, and put into pills with specific dosages in a bottle that lays out the possible side effects. This doesn’t mean that all traditional herbal medicines work, though. Some are tested and found to do no better than placebo. There may be some out there that will be shown to work once they’re adequately tested, but I wouldn’t rely on those to medicate myself because a) possible side effects are unknown, and b) how would you know how much you need or how long you need to  take  it for if the substance has never been properly tested?

 

That was pretty much it, it was a fantastic discussion and I hope I gave Teacher (and you?) something to think about.

Sorry about the scatter-brained posting!

Sex and the City and the Suzanne Somers

I went and saw Sex and the City 2 with a friend the other night, and I have to say I enjoyed it. It was fun, corny, light-hearted, and the clothing and furniture made it pretty to look at. But I had one major complaint that spoiled it for me, and that is that Samantha’s entire story-line was basically a commercial for Suzanne Somers’s books and alternative medicine anti-aging nonsense.

WARNING: Spoilers ahead!

Samantha is the oldest of the group of four ladies (she’s 52 in this movie), and she’s obsessed with staying young. Right near the beginning of the movie she’s asked what surgeries she’s had done to keep her so young, and she replies that she hasn’t had any, and then proceeds to pull out Suzanne Somers’s book (from memory I think the specific book was Breakthrough: Eight Steps to Wellness) and starts talking about all of the hormones and pills she takes and the creams she rubs on herself and patches she wears.

This becomes her gag throughout, as she’s always constantly either rubbing an expensive-looking cream on herself, or swallowing ridiculous amounts of pills. If you’ve seen the previews you know most of the movie takes place in Abu Dhabi, UAE, and when they arrive at the airport there she has all of her drugs confiscated. From this point on she starts complaining about her menopausal symptoms, and she starts rubbing yams and eating hummus because apparantly they have some natural estrogen or something. To top it all off, near the end of the movie (seriously now, spoilers) a room full of women remove their burkas to reveal youthful looking, New York-style fashion wearing women, who are (surprise!) discussing the Suzanne Somers book in their book club.

What makes it worse is that all four of the stars of the movie are smart, successful women, and they offer her no skepticism apart from a little bit of attitude at the silliness of taking so many pills. It’s sad, especially considering the success that the movie is having, to think that women might watch it and think that if they use all of these undoubtedly expensive products, they too could look like Samantha. I hope that most people would approach this skeptically, but I think that this feature-length commercial will unfortunately lend the semblance of credibility to her alternative therapies.

My heart sank immediately when Samantha first pulled out Somers’s book and started talking about bio-identical hormones, but that’s largely because I read skeptical blogs (like Respectful Insolence), so I had seen a lot of evidence-based responses to Somers’s claims before I saw the movie. But even without that prior knowledge, there were some red flags that anyone’s skeptical side could pick up on:

1. Appeal to Celebrity: taking medical advice from an actress is not prudent. Suzanne Somers is not an expert, so before starting any treatment she recommends make sure to consult your doctor, and read reviews of her treatments by skeptical experts, so that you’re not only getting the information supplied by people who have professional or financial interests in promoting these treatments.

2. Naturalistic Fallacy: When Samantha is having her pills taken from her at the airport, she protests by saying “but they’re all-natural!” This is appealing to the fallacy that since something is natural, it’s safe or good for you, but this just isn’t so. I guess Samantha forgot that other substances, such as cocaine or marijuana, that would be confiscated in airport security are also natural. Many natural substances are poisonous to humans, and even ones that are seen as safe and healthy, like Vitamin D, can be overdosed on. One shouldn’t assume that because Suzanne Somers claims the treatments she endorses are natural (I say “claims” because there’s nothing natural about the process of synthesizing bio-identical hormones), that they are healthy and don’t carry risks.

3. Testimonials: Stories are a convincing way to sell a product, as anyone who’s been sucked in by an infomercial knows. But often products that are promoted with the use of testimonials just aren’t supported by scientific evidence. The Skeptic’s Dictionary has a good article on why testimonials are unreliable forms of evidence: “Anecdotal (Testimonial) Evidence“.

4. Quality of Life: Anyone considering a treatment or a lifestyle change should weigh the pros and cons. If somebody is convinced that the anti-aging methods promoted by Suzanne Somers actually work, they should look at Samantha’s lifestyle in this movie and decide whether all of the time spent counting out pills (she swallowed a whole handfull at one point), rubbing creams on herself, and obsessing over her hormone levels is worth the benefits. Personally, I would take the wrinkles and hot flashes and spend the time I saved by not obsessing over my looks doing things I enjoy. One should also keep in mind that supplements aren’t nearly as regulated as pharmaceuticals, so if you’re on a regime that involves swallowing handfuls of supplements daily, you may be risking exposure to contaminants. More on that here, and here.

5. How Kim Cattrall (the actress that plays Samantha) actually stays young: A red flag that should be obvious to every person who is wondering whether they should start a regime like Samantha’s, is that Kim Cattrall looks like she does without all of the hormone nonsense. I browsed a few websites and interviews done with the actress, and she claims to keep her looks by sticking to a strict diet, exercising at least 30 minutes per day, and using botox (guess who else uses botox? Yup, Suzanne Somers). So it’s possible to look just as good as Kim Cattrall without the use of hormone therapies (that are possibly dangerous and that aren’t supported by science).

I hope that most people who watch the movie would pick up on at least a couple of these red flags, and look into Somers’s claims thoroughly before starting such an over-the-top anti-aging regime. Here are some good places to start if you’re looking for a critical look at the things she’s promoting:

  • Dr. Harriet Hall looks at bioidentical hormones in an article for Skeptic Magazine
  • Quackwatch recommends steering clear of bioidentical hormones
  • Science-Based Pharmacy explores the veracity of claims made about bioidentical hormones
  • Newsweek criticizes Somers’s poor grasp of the science behind the treatments she endorses

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Update on Simon Singh’s Libel Case

I haven’t talked about Simon Singh’s Libel Case much on this blog, but in short, Singh is a science writer who wrote an article that was critical of Chiropractic in The Guardian in 2008. I’ll repost the article below the fold

Simon Singh and his lawyer are greeted by supporters outside of appeals court.

Simon Singh and his lawyer are greeted by supporters outside of appeals court.

(edited to remove the “libelous” word), but the important bit is this:

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

He went on to call these treatments bogus, and rather than responding with evidence to back up their claims, the British Chiropractic Association sued Singh for libel. UK libel laws are crazy in that the burden of proof is put on the defendant, so suing someone for libel carries almost no risk. Usually these cases are settled out of court because of the tremendous stress and expenses put on the defendant. But Singh bravely decided to fight back, which is helping to bring attention to the unjust laws. After all, how can a country have free and open debate over issues such as alternative medicine if it’s so easy for practitioners of questionable methods to silence their critics?

Singh’s case started off with an unfortunate decision to define his use of the word bogus in a way that he didn’t mean it:

The judge held that by the mere use of the word “bogus” Simon Singh was stating that, as a matter of fact, the BCA were being consciously dishonest in promoting chiropractic for those children’s ailments.

Using this definition of bogus, Singh would have to prove that the BCA were being dishonest in order to win his case. That’s pretty much an impossible task, so he appealed that decision and today I got an update from Sense About Science:

Simon said after the hearing: “First of all, thanks to everyone who came to the Court of Appeal today, and everyone who has been so supportive over the last two years. Without your goodwill, I probably would have caved in a long time ago.

I am delighted the Court of Appeal has decided to reconsider the meaning of my article about chiropractic, and I am particularly glad that three such eminent judges will make the ruling. They grilled both sides on all aspects of the appeal. However I should stress that whatever the outcome there is still a long way to go in this libel case. It has been almost two years since the article was published, and yet we are still at a preliminary stage of identifying the meaning of my article. It could easily take another two years before the case is resolved.

More important than my particular case is the case for libel reform and I know that you share my concern on this matter. My greatest desire is that journalists in future should not have to endure such an arduous and expensive libel process, which has already affected the careers of health journalists such as Ben Goldacre, and which is currently bearing down on the eminent cardiologist Peter Wilmshurst. If Peter loses his case then he will be bankrupted. Please continue to spread the word about libel reform.”

Simon’s solicitor Robert Dougans of Bryan Cave LLP said: “It was encouraging to see three such senior judges taking such an interest in the appeal, and the BCA’s counsel was given a thorough grilling by the court.

What was significant was that the Lord Chief Justice said he was surprised that the BCA had not taken the opportunity offered them back in 2008 to publish their side of the story in the Guardian, rather than insisting Simon apologise and beginning proceedings. He also said it was a waste of both parties’ time and effort. I hope that this is borne in mind by MPs when they grapple with the need for libel reform.”

There’s no decision yet, but it’s encouraging that these judges are taking Singh’s appeal seriously. Hopefully they’ll make the right ruling on what he actually meant when he used “bogus” in his article.

Unfortunately after the definition of “bogus” is determined he still has to defend his article, and he could still lose the case. To find out more about his case and how you can help click here.

(Don’t forget that you can read the article that he’s being sued over below the fold, but also please remember that I know very very little about law, so to read some more coherent and detailed information about this case Jack of Kent has a fantastic blog)

Continue reading ‘Update on Simon Singh’s Libel Case’

10:23 – Bringing Awareness to Homeopathy

Homeopathy is: “a form of alternative medicine, first proposed by German physician Samuel Hahnemann in 1796, that treats patients with heavily diluted preparations which are thought to cause effects similar to the symptoms presented.” In other words, if I’m sick, a homeopath would dilute something that caused the symptoms I presented, with the belief that water has a memory.

In reality, homeopathic preparations are just water. Substances are diluted to the point where it’s unlikely that even a single molecule of the original amount remains. Yet homeopathy is a multi-million dollar industry in spite f its utter lack of plausibility or supporting evidence.

The 10:23 campaign is an effort to bring awareness to these facts about homeopathy, with the hopes that informing the public about what homeopathy actually is will help people realize that it’s silly quackery.

There is nothing in homeopathic remidies, and it will do nothing for you (no risks, side effects, or effects. So what’s the harm? Simon Singh explains here, and this is why it’s important to bring awareness to the problem that is homeopathy.

The 10:23 campaign was started by the Merseyside Skeptics (they have an excellent pocast), a UK-based skeptics society, in response to the Boots pharmacies there continuing to sell homeopathic “remidies” to a public that trusts them to sell medicine that works

On January 30th at 10:23 am, they’re having a demonstration that will effectively show how homeopathy really does nothing at all: “more than three hundred homeopathy sceptics nationwide will be taking part in a mass homeopathic ‘overdose’ in protest at Boots’ continued endorsement and sale of homeopathic remedies, and to raise public awareness about the fact that homeopathic remedies have nothing in them.” I think it’s a great idea!

If you want to get involved with the 10:23 campaign, you can fill out this form.

Homeopathy for Emergencies???

Homeopathy is the process by which a tiny drop of an active ingredient is diluted in water until there isn’t even a molecule of the substance left, and then calling that medicine. It’s laughable, it’s pre-scientific magical thinking, it’s completely without evidence, and yet the idea that it works persists.

I recently came across this article, in which the author, who apparantly works at a hospital in India that incorporates homeopathy with traditional medicine, believes that homeopathy is useful in emergency medicine:

I have been hospital-based and practically living on campuses of various hospitals for the last ten years. I can assure you that this is not exactly pleasant; nor has it been a necessity forced on me by circumstances; I have done it only to experience firsthand and at close quarters the power of homeopathy in critical moments of life and death. The experiences have destroyed the last vestiges of doubt about whether homoeopathy works in critical situations. I believed that the Law of Similars of the chronic conditions should work in acute situations too. If it did not, then there were only two conclusions. Either we do not know the way of practicing homeopathy in critical situations or the science of homeopathy was incomplete and had a serious limitation.

Uh-huh…

Homeopathy

Perhaps homeopathy appears to work when used alongside conventional medicine, but IT’S JUST WATER!!! Sometimes satire is the best way to make a point, so have a look at this video to see what would really happen in a homeopathic ER.

Homeopaths Curing Autism

Yeah, right. If a homeopathic preparation ever does anything more than quench someone’s thirst I’ll eat my foot.

Homeopathy is the ridiculous idea that the more you dilute something the more effective it becomes. It’s pure pre-scientific magical thinking, and it should have been laughed into distant memory decades ago. But clever marketing and the draw of making money selling water and sugar pills to an unsuspecting public has made homeopathy a booming industry.

Now, homeopaths are claiming to be able to cure autism. Assholes.

They currently have a film in production: “The first film about the potential of homeopathy to reverse autism is well under way and production is starting this summer on the second – the potential of homeopathy in epidemic diseases.” THERE IS NO POTENTIAL!!! IT’S WATER!!! The film looks to be about families with autistic children who have been treated by homeopaths.

It looks like a crap film though, you can watch the clip here, so hopefully nobody will see it.

But on the website they have a couple telling bits of information that make me think that they must know that they’re being deceitful.

Parents have been reluctant to film their children’s  struggle prior to treatment, so the film lacks good ‘before’ footage of the children filmed so far.

They’re asking you to just trust them. Because someone who peddles snake oil for a living is soooo trustworthy.

Complementary medicine and homeopathy in particular is under increasing pressure to ‘prove’ itself efficacious.

Making a film that tells the story from the homeopathic perspective means that we need to retain final editorial control and therefore we need to raise the funding to make the film.

In other words, “we need your money so we can say whatever we want without the constraints of evidence.”

Isn’t autism hard enough without kooks like Carol Boyce (the filmmaker & a homeopath) peddling false hope?

Echinacea and the Common Cold

I woke up yesterday morning with a brutal cold. Before I began to learn how to use reason and how to look for the evidence, I would just take health care advice based on popular belief. Something I hear all the time, and something that I used to repeat myself, is that you should take echinacea to fight a cold and to boost your immune system.

But if echinacea is so effective, why isn’t there any in my NyQuil?

According to the Wikipedia entry on echinacea, the idea that echinacea helps treat the common cold began when a Swiss herbal supplement maker was incorrectly told that Native American tribes in South Dakota used it for cold prevention.

But despite its questionable beginnings as a cold medicine, it has still become an extremely popular remedy, at least among my friends and family. So is there evidence behind echinacea to convince me that it is efficacious?

This University of Connecticut study claims that “Echinacea, the most popular herbal supplement in the United States, cuts the chances of catching the common cold by 58 percent and reduces the duration of the common cold by 1.4 days.” Sounds good to me! Unfortunately, this study has come under a lot of criticism.

The problem is that it’s a meta-analysis of smaller studies. Meta-analyses can be useful, however in this case critics say that the smaller studies are too dissimilar to be used accurately in a meta-analysis, so this study is not reliable enough to be taken as solid evidence for the efficacy of echinacea.

The gold standard of evidence in medicine is the large, placebo-controlled, double-blinded study. The closest to this type of study that has been done on echinacea is this one, done by the University of Virginia:

In one of the largest, multi-center clinical trials to study the effectiveness of the popular herbal cold supplement, Echinacea, researchers at the University of Virginia Health System have found that it has no effect on treating the common cold.

Turner and colleagues tested the efficacy of Echinacea on 399 volunteers between 2002 and 2004. The volunteers tested were recruited from UVa and were all susceptible to an experimental cold virus, rhinovirus type 39. They were divided into seven different groups and exposed to the cold virus through the nose.

Each group then received either a placebo or one of three possible Echinacea treatments (extracts of the herb originally used by Native Americans and endorsed by the World Health Organization for cold treatment). Volunteers were ‘blinded’ and did not know what treatment they were given. After five days of being studied in an isolated setting, there were no significant effects with Echinacea on the rates of infection or the severity of cold symptoms seen among the study participants. About ninety percent of all participants were infected with the cold virus.

“The results of this study demonstrate that, as tested, the putative active constituents of E. angustifolia do not have clinically significant effects on rhinovirus infection or illness,” Turner wrote in the study.  Researchers from Karl-Franzens-Universitaet in Graz, Austria; the Medical University of South Carolina and Clemson University collaborated on the research.

So no good evidence yet that echinacea does anything for the common cold.

This large trial has also come under criticism, however this time from Dr. Michael Murray, a manufacturer of echinacea. He says that the study used the wrong type of echinacea and in the wrong dosages.

I wonder why Dr. Murray hasn’t funded a study himself to prove the effectiveness of the herb? If he’s so confident in its efficacy then he would be doing himself a favour by proving that it works. Echinacea would become a part of mainstream medicine if it were shown to be effective, it would be recommended by doctors, and Murray would be able to manufacture and sell more.

For now, the burden of providing evidence lies with its advocates. Until they provide reliable evidence that shows that echinacea is good for my health I’ll continue taking my NyQuil to alleviate my cold symptoms, which is proven by science and which outlines its possible side-effects on the box so I can be informed as to any risks it may carry (unlike my bottle of echinacea pills).


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