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!

Every Cold and Flu Treatment That Has Been Recommended to me in the Past Two Months (And What the Evidence Says)

Hey everyone, I’ve been out of the blogging routine for way too long now, so I’m going to try to get back into the swing of things by writing about all of the cold and flu remedies that I’ve been told to try in the past couple of months. I’ve been sick since midway through December. First I had a cold, and just when I was getting over that I caught a nasty cough virus that’s been floating around Winnipeg this winter, and now I have a cold again as well as remnants of that damn cough combined with the return of my asthma. Party! And when you’re coughing and your voice is all nasally people tend to tell you what you need to do to get better.

The following are all of the remedies (alternative and mainstream) that have been recommended to me, as well as the best non-propagandaish information I could find on each:

Vitamin C

• Rose to popularity as a treatment for the common cold in the 1970s after this book by Linus Pauling was published.
  • The Cochrane Collaboration is an organization that looks at the body of evidence for a given health care intervention and publishes reviews based on what the results of multiple trials say when considered as a whole. Here‘s the Vitamin C review. In a nutshell:
    • Regular ingestion of vitamin C had no effect on common cold incidence in the ordinary population.
    • It had a modest, but consistent effect in reducing the duration and severity of common cold symptoms.
  • If vitamin C doesn’t reduce my likelihood of coming down with a cold then I wouldn’t bother with taking a daily supplement, since it’s pretty easy to find foods that contain more than enough vitamin C, however it seems to me that it may be worth it to take 0.2g of Vitamin C per day to reduce the length of a cold.
  • Here‘s a podcast episode on the subject.
• It is also frequently recommended as a way to “boost your immune system”
  • I’ll link to a few articles explaining why the idea that you can boost your immune system is little more than a marketing gimmick, but I’ll try to summarize: if your immune system is working normally it can’t be boosted, but exposure to illnesses (ex. vaccination) will improve your chances of not getting sick. I really think you should read the articles though: One, Two and Three.

Oil of Oregano

• A few different people recommended Oil of Oregano to me, but nobody really had a clear description of what it’s supposed to do, or what illnesses it’s supposed to treat. There are all kinds of claims made about it but the evidence is lacking. Here‘s a good summary from Science-Based Pharmacy:
  “There is no published evidence to demonstrate that that oil of oregano is effective for any medical condition or illness. There is some very limited evidence to suggest that it might be useful for parasite infections – but given the evidence consists of only one study with 14 patients, and no placebo comparison, we really have no idea if the oregano oil was effective. The bottom line is that despite all the marketing, press, and sales, there is no research that exists to demonstrate that oil of oregano does anything useful in or on our bodies.”

Echinacea

• A recent study (published in December, 2010) concluded that “illness duration and severity were not statistically significant with echinacea compared with placebo. These results do not support the ability of this dose of the echinacea formulation to substantively change the course of the common cold.”
• Here‘s an assessment of the evidence for Echinacea by Steve Novella of the Skeptics’ Guide podcast. It’s from 2007, so it was written before that most recent study was published.
• I should mention that I found both of these links on Skeptic North’s article, Coughs, colds and the “appealing but mistaken concept of boosting the immune system”

Garlic

• I think this may have been the first time that somebody recommended garlic to me as a cold remedy, but basically it was just recommended that I eat a ton of garlic. I love garlic, so I have no problem incorporating it into my diet, especially when I’m going to be home sick from work for a few days and nobody has to smell me. But will it treat my cold?
• There is a Cochrane review on the use of garlic for treating the common cold, but there was only one study that fulfilled the criteria for the review and it was a small one (146 participants). The study found that people who took garlic every day for 3 months had fewer colds, but it would take a larger trial to confirm these findings. There were other studies claiming that garlic is helpful in preventing the cold, but they were poor quality so they didn’t meet the Cochrane review standards.
• I wouldn’t take or recommend garlic based on such poor evidence, although I wouldn’t advise against adding it to spaghetti sauce either.

Cold-fX

• I have a friend who swears by Cold-fX, which means that for the past couple of months every time I converse with her and I sniffle or cough she tries pushing it on me. I know she means well, but I’m skeptical of any product that makes vague claims like “strengthens the immune system.” To me, that’s meaningless. It’s also fairly pricey, so it’s not worth it to me to spend money on something that has poor supporting evidence.
• Science-based Pharmacy has an article looking at the evidence related to Cold-fX.
• My Cold-fX loving friend always tells me “when I take it my colds don’t last as long,” but that’s not something that convinces me because: a) colds don’t always last the same length, b) personal testimonials aren’t helpful because there’s no way of knowing whether an individual would have gotten better without the treatment (this is why trials need large numbers and placebo groups), and c) who keeps track of how long their cold is anyways? People recover from colds whether or not they use a treatment, but without proper trials it’s impossible to say for sure whether something like Cold-fX has an effect.

Buckleys/NyQuil/any cough syrup

• Personally, cough syrup did nothing for me. Buckleys provided 5 seconds of cooling in my throat before I had to start coughing again. All it did was put me to sleep, which was definitely welcome. But it made me doubtful that cough syrup does anything to alleviate symptoms.
• I always thought of cough syrups as being efficacious just because they’re pretty mainstream medicine (not that that is a good argument for any treatment), but even Wikipedia has this to say: “There however is no good evidence for or against the use of these medications in those with a cough. Even though they are used by 10% of American children weekly, they are not recommended in children 6 years of age or younger due to lack of evidence showing effect, and concerns of harm.
• The Cochrane review on “over-the-counter medications for acute cough” concludes: “There is no good evidence for or against the effectiveness of OTC medicines in acute cough. The results of this review have to be interpreted with caution due to differences in study characteristics and quality. Studies often showed conflicting results with uncertainty regarding clinical relevance. Higher quality evidence is needed to determine the effectiveness of self-care treatments for acute cough.”

Neti Pot

• I actually can’t talk about the Neti Pot without gagging. The thought of sticking something up my nose and pouring a saline solution through my sinuses to wash snot out into my sink is so off-putting to me that I’ll probably never try it.
• Neti Pots are an example of an alternative medicine practice that has been validated (to an extent), although evidence has shown that using it on a regular basis can increase your risk of sinus infections.

It’s funny that when you’re sick everyone around you puts on their doctor hat – all of a sudden they’re all medical authorities. I have this compulsion too, I recommended my “treatments” of Advil for the sore throat and NyQuil to get some sleep – who knows if that combo is even safe! I think it’s hard to see someone suffering from any kind of illness and not want to help, so we offer up treatments in the hopes that it will make them feel better. Unfortunately this probably does more to line the pockets of drug and supplement companies, who play on peoples’ beliefs in certain treatments in spite of the poor evidence for their efficacy, than it does to soothe the symptoms of a virus.

Post Hoc Ergo Propter Hoc – Why my iPod Didn’t Kill my Computer

Post Hoc Ergo Propter Hoc is Latin for “after this, therefore because of this,” or in other words, associating correlation with causation.

People are notorious for making this error in logic, because when something significant happens we want to be able to know & explain why it happened.

I was guilty of this error the other day when my laptop broke (I lost all of my files, I cried and learned my lesson – back them up!!!). I was going about my computer business as usual, and remembered that my iPod battery was nearly drained, so decided to plug it in. As soon as the cord hit the USB port, the screen went black, it crashed, and I couldn’t turn it back on.

I blamed this crash on the iPod, I even yelled at it and threw the cord against the wall! But when my husband took it in to get fixed, they said it wasn’t possible that the iPod was what caused the problem. Sorry iPod, it was just a coincidence that my computer happened to die at the exact moment that I plugged it in. I think this is a great example that helps to understand why many people buy into the anti-vaccine movement in spite of the complete lack of evidence correlating vaccines with autism.

Just like a certain amount of peoples’ computers will crash shortly after they plug their iPods into their USB ports, a certain number of children will be diagnosed with autism shortly after they are immunized. Just because it happens before, doesn’t mean it was the cause.

There’s a story that Paul Offit, author of Autism’s False Prophets, likes to tell that illustrates this beautifully:

My wife is a privately practicing pediatrician in the suburbs. And she was in the office one day and there was a four-month-old sitting on her mother’s lap. And my wife was drawing a vaccine into a syringe that she was about to give this child. Well, while she was drawing the vaccine into a syringe the child had a seizure, and actually went on to have a permanent seizure disorder—epilepsy. And there had been a family history of epilepsy, so she was certainly at risk for that. If my wife had given that vaccine five minutes earlier, I think there’s no amount of statistical data in the world that would have convinced that mother that anything other than the vaccine caused the seizure, because I think those sort of emotional events are very hard to argue against.

Why You Shouldn’t Buy “Your Shape” by Ubisoft

Ubisoft has a new game for the Wii, and it looks fun! I would actually probably have bought it (since I got a Wii for Christmas) if it weren’t for one very unfortunate detail…Jenny McCarthy is their spokesperson.

This should be a problem for anyone who cares about children, because Jenny McCarthy promotes dangerous anti-vaccine lunacy that kills children.

Among McCarthy’s many weird ideas about health, is her theory that her son’s autism was caused by vaccines. In spite of the fact that this idea has been repeatedly and very thoroughly proven wrong, McCarthy continues to spread her lies.

Please click on and read the links in this post, and decide for yourself whether you want to purchase a product that supports someone who has taken what is probably the single greatest medical advance in history, and turned it into something that scares parents into not immunizing their children.

Here is a post about why you shouldn’t buy any Ubisoft products, and here is one about Jenny McCarthy’s involvement with the game, and who you can contact to complain about this poor choice of spokesperson.

Help spread the word on your blog, or on Twitter (follow me while you’re there @EnlightningLinZ) and send an email to Ubisoft.

As of January 3, 2010

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…

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.

Things I Want to See Before I Die (Part 1)

For some reason I’ve been thinking about my mortality a lot lately, maybe because I recently celebrated a birthday. Since I abandoned my wishful thinking of an afterlife I’ve become more okay with death.  I don’t have irrational fears of hell, I can just shut my eyes and that will be the end.

But the thought that the end is truly the end is also a really sad thought, because we live a time of so much innovation, and I would like to be around to witness it.

I decided that I’m going to make a list of discoveries and advancements that I’d like to see in my lifetime. I hope I can check some of them off soon, and I’ll try to update the list as I think of things…which is why I’m calling this post Part 1.

Here’s the list so far:

1. The discovery of the Higgs-Boson particle
2. Humans back to the Moon
3. Discovery of alien life, hopefully intelligent but bacteria would be cool too!
4. Figuring out what the heck dark matter is
5. Space tourism
6. Nuclear power to replace coal
7. AIDS vaccine

I’ll start off with 7, that’s a pretty ambitious list! Unfortunately I won’t be taking part in discovering or implementing any of these things, but I will idolize the scientists who do so. And I do hope to take part in some space tourism in my lifetime, how awesome would that be?!

What would be on your list?

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).

Open Letter from a Skepchick to Parents Wary of Vaccination

Elyse on Skepchick has written an excellent letter adressed to parents who are being frightened by the anti-vaxxers into thinking that vaccination is dangerous to their children. Spread the word! The anti-vaxxers get too much press, parents with young children need to be informed.

Dear Parents,

If you have not made the decision to vaccinate your child, I urge you to make that decision now. Immunity from painful, disfiguring, and sometimes even deadly diseases is not a gift you should withhold from your child. Your child is, undoubtedly, the greatest love of your life… a love so great that it was unfathomable until you experienced it. And I know that you want to and need to do everything in your power to protect him or her. Which is precisely why you’re hesitant to vaccinate.

Read the full letter here.

An Open Letter to Oprah

Re: the recent news that she would be giving anti-vaccination kook Jenny McCarthy her own show:

http://shirleywho.wordpress.com/2009/05/11/an-open-letter-to-oprah/

I hope she reads it and listens.

Would you take health advice from this?

Vaccinate your children!