Respectful Insolence

A highly revealing quote from a naturopath

Naturopathy is a strange beast in the “alternative medicine” world. From what I’ve been able to tell, it’s a wastebasket specialty with no overarching philosophical underpinnings, as traditional Chinese medicine underpins acupuncture or sympathetic magic underpins homeopathy. Basically, if it’s woo, naturopaths will use it. Acupuncture, TCM, homeopathy, herbalism, nutritional woo, detox, it doesn’t matter. To naturopaths, it’s all good, as long as it isn’t “conventional medicine.” Wait. Not quite. After all naturopaths have been fighting for (and in some cases getting) prescribing authority in at least two Canadian provinces (Ontario and British Columbia), and they’re trying to get that same authority in several states. I can’t quite figure out why they want that authority, given that they claim to have such a superior form of medicine. Maybe it’s because, deep down, they know that science-based medicine is more efficacious. Who knows?

In any case, if there’s one thing that distinguishes naturopathy from science-based medicine, it’s the love-hate relationship that naturopaths have with science. I pointed this out in my post about naturopathic oncology. Simultaneously, it would appear, naturopaths both desperately crave the validation of science, to be taken seriously by science-based physicians, while at the same time they resent science because it doesn’t support their woo.

I recently became aware of a perfect post that illustrates this latter attitude. It’s the bio of a “naturopathic oncologist” named Daniel Rubin. In his bio page, there is an interview with Rubin that contains a very revealing exchange:

AANMC: What is the biggest challenge in your work?

DR: The disease, to put it bluntly. We remain somewhat limited by the scope of our practice, and we must continue to work toward national acceptance of our practice as a valid system of medicine. I also think that one of the greatest challenges we face is the widespread public belief in the scientific method. Medicine cannot create success exclusively through clinical trials. We’re too reliant on the scientific method, and it stands in our way of forging ahead.

That’s right. You heard Rubin right. We physicians rely on the scientific method too much. And Rubin says that as though that were a bad thing! Damn those doctors and their science and the public for believing too strongly in science! Would that it were true! If anything, “conventional” physicians don’t rely on the scientific method nearly enough for my liking, and they are all too prone to reject science when it doesn’t agree with their preconceived notions. That’s one thing my more recent efforts have been geared towards trying to change. Be that as it may, Rubin also misunderstands the scientific method. The scientific method is not just about clinical trials. It is about the whole process from basic science to preclinical models in animals to clinical trials. It’s about the whole enchilada when it comes to the evidence.

Compare this to a statement by another “naturopathic oncologist” named Tim Birdsall three months ago on the American Association of Naturopathic Physicians:

And so I began to ponder the question, “What’s wrong with research?” A part of me becomes enraged at the reductionistic, allopathic, biomedical model, which breaks things down into components so small that all synergism, all interdependence is stripped away, and then declares those components to be ineffective. Another part argues that the wrong component was selected, or was a synthetic form (although in the lung cancer study, they used selenium yeast). But ultimately, I find myself becoming offended because I believe that these therapies work… Whoa! Believe?

That’s right. Believe. If there’s one thing I’ve learned about naturopathy over rthe years, it’s that it’s all about belief, because there’s no real science behind huge swaths of what they do. Naturopaths tend to be very suspicious of science. Their preferred treatments don’t stand up to rigorous scientific testing, but they know that, to be viewed as a profession rather than a bunch of quacks they have to have at least a patina of scientific respectability. That conflict leads to the aforementioned love-hate relationship they have with science.

Come to think of it, if there’s a defining characteristic of a pseudoscientist, it’s a love-hate relationship with science, and for all the same reasons as naturopaths. I wonder if it’s a generalizable principle.

Comments

  1. #1 Todd W.
    September 23, 2010

    Excellent timing on this, Orac. Just this morning, I saw a brief news item on alternatives to the many cold remedies that are no longer on the market (mostly Tylenol products). They had a pharmacist, who also happened to be a naturopath, touting things like oscillococcinum and allium cepa 30C. Perhaps some well-worded comments on the video clip would not go amiss?

  2. #2 René Najera
    September 23, 2010

    So, if I believe I can fly, that gravity thingy will not apply, right?

  3. #3 Todd W.
    September 23, 2010

    @Rene Najera

    Not quite. As we learned from Wile E. Coyote, one must be unaware of what gravity is. Then, one can stand in thin air with impunity. On the other hand, we also learned from that scholar Douglas Adams that if you throw yourself at the ground and miss, you will fly.

  4. #4 BigHeathenMike
    September 23, 2010

    I love how these naturopathic folks shun things like the scientific method (I keep waiting for Larry Moran to jump in and tell me there’s no such thing again) and science in general, but as soon as there’s a trial that shows (usually with tremendous misunderstanding and ignorance) that one of their pet methodologies “works”, they’re all over it and gushing about how “science” has proven that they’re right.

    It would be funny if it weren’t so frustrating at having to talk clients/patients down from it on a daily basis.

  5. #5 René Najera
    September 23, 2010

    @Todd

    Maybe they don’t know what the scientific method is to begin with? You know, like all the people who whine about case-control studies for not being cohort studies, all the while not knowing the difference between them?

    Maybe naturopaths are just misinformed. Maybe. Or maybe they know and are part of a… conspiracy.

  6. #6 Gingerbaker
    September 23, 2010

    The power of wishful thinking is not to be underestimated, whether in medicine, religion, love, or politics.

  7. #7 dcotler
    September 23, 2010

    @4
    More frustating than “talking clients/patients down” is having clients/patients “talk down” to you, the stooge of the “conspiracy” (or co-conspirator).

  8. #8 cervantes
    September 23, 2010

    What is obviously going on with a lot of these folks is that they crave the prestige, and maybe the income, that comes with being a “real” doctor or scientist. But for whatever reason, whether they didn’t want to do the hard work needed to master difficult material, or their circumstances just didn’t allow them to invest the many years of penury required, or maybe they aren’t all that bright, they don’t have the credentials or the intellectual mastery that goes with real training. So going to Bastyr “university” and calling yourself a Doctor of Naturopathic Medicine is a cheap and easy way to get the status you crave.

    Not that hard to understand, really.

  9. #9 viggen
    September 23, 2010

    After all naturopaths have been fighting for (and in some cases getting) prescribing authority… Maybe it’s because, deep down, they know that science-based medicine is more efficacious. Who knows?

    They want the ability to peddle all drugs based on their “superior” woo-ful beliefs. Heaven help us, someone not trained at least as a pharmacist peddling chemicals known to have biological effects… that there is a recipe for disaster.

  10. #10 Kathryn
    September 23, 2010

    One of my art student friends told me she wanted to go to Traditional Chinese Medicine school after college so she could help sick people without having to learn biology to go to medical school. I didn’t know what to say. I mean, if you don’t know biology, you won’t understand why TCM isn’t real.

  11. #11 madder
    September 23, 2010

    Hmmm– naturopathy’s philosophical underpinnings.

    My experience with them is indirect, but here’s what I’ve noticed:

    1) Natural is always better. The definition of “natural” and that than which it is better varies by practitioner.
    2) Yeast is the cause of nearly all your illnesses. Therefore you must remove from your diet all things that yeast eat: sugars, non-clear alcohol, bread, etc. Yes, alcohol is derived from yeast and toxic to them too, but that’s just the ineffable nature of the yeast monsters.
    3) The other cause of nearly all your illnesses is undiagnosed food allergies. They’ll sell you tests to prove it, like cytotoxic screening. Sciency! Mysteriously, these allergies almost always tend to involve meats. The vegetarianism of the movement’s founder, by the way, is pure coincidence.
    4) Food allergies can manifest themselves in any way, often with substantial time delays. If you have the sniffles today, it’s because of the lamb chop you ate five days ago. Same with arthritis, headaches, constipation, … you name it.
    5) Everything unnatural attacks your immune system, which could always use a “boost.”
    6) Those wicked allopathic physicians won’t listen to you, and will just push some toxic pills at you. Instead, you should take large doses of the following supplements, which just happen to be for sale in the front office.
    7) Naturopaths have the answer to all “dis-ease.” If anything goes wrong in your body, you have only yourself to blame for not taking their advice and buying their stuff.

  12. #12 S. Rivlin
    September 23, 2010

    My pet peeve is Medical cannabis, an oxymoronic term that makes those who push it look more and more like neuropaths.

  13. #13 titmouse
    September 23, 2010

    John FrumNIH no bring the cargo research grants because your arstreep sciency is no good.

    You must have a line of little fires by the sides title like “MD” (“ND” is close enough?). And you must have a very tall bamboo sticking up like a tree list of mildly unpleasant physical procedures you perform on the body, like acupuncture, enemas, or bad tasting stuffs.

    Keep trying, you will get it, and the cargo will be yours!

  14. #14 shasta
    September 23, 2010

    those ND schools aren’t cheap… $350 a credit hour. Not to mention all the other fees.

    http://www.ncnm.edu/prospective-students/financial-policies.php#TuiFeePol

  15. #15 cervantes
    September 23, 2010

    From a basic essay on Naturowatch by Barry L. Beyerstein, PhD and Susan Downie:

    Naturopathy is the most eclectic of “alternative” practices. It has changed its methods in response to popular fads and beliefs. It practices no pool of consistent diagnostic or therapeutic methods. The most notable things that unite its practitioners are a penchant for magical thinking, a weak grasp of basic science, and a rejection of scientific biomedicine, which they refer to as “allopathy.” Because naturopathy lacks a coherent rationale, patients can encounter anything from commonsense lifestyle advice — eating a healthy diet, rest, exercise, and stress reduction — to an array of scientifically implausible nostrums and gadgets [1].

    If a glue binds the diverse and changing patchwork of naturopathic practices together, it is espousal of the teachings of the early nineteenth-century romantic movement known as Naturphilosophie. . . .

    A corollary of Naturphilosophie is that in order to comprehend nature one must experience it as a whole — i.e., intuitively rather than objectively and analytically. Openness to one’s subjective feelings is considered the most reliable means of revealing the workings of the natural world. . . .

    In other words, just go by whatever occurs to you.

  16. #16 Pierce Nichols
    September 23, 2010

    @S. Rivlin: I’m inclined to agree with you from a scientific viewpoint, but not from a public policy or political viewpoint. Medical cannabis prepared the ground for the end of the utterly disastrous policy of marijuana prohibition. As bad as altmed is, marijuana prohibition is a far more expensive, deadly, and insidious problem.

    What will probably happen in the long run is that the medically useful compounds in cannabis will be isolated and/or duplicated for the indications where they have some some use and the plant itself will revert to purely recreational use, albeit legally.

  17. #17 angela sodee
    September 23, 2010

    @11 madder

    You forgot to add that even if you are sillly enough to purchase all their supplements, vitamins, detox kits and follow all their directions-when you fail to get better the naturpath will inform you that your ‘disbelief and negative thoughts are interfering with your bodies ability to be healthy’.

  18. #18 Jack
    September 23, 2010

    @16

    What will probably happen in the long run is that the medically useful compounds in cannabis will be isolated and/or duplicated for the indications where they have some some use

    It’s already happened. The compound is called Nabilone and it’s a great second-line agent for chemotherapy-induced nausea.

  19. #19 Dr RJ
    September 23, 2010

    I like the way he drapes a stethoscope around his neck in his photo.

  20. #20 Badger3k
    September 23, 2010

    I like how he says the disease is the biggest challenge. I guess when your “medicine” is worthless, it will be pretty challenging.

  21. #21 S. Rivlin
    September 23, 2010

    Pierce Nichols, Jack,

    Despite the illegality of marijuana and the difficulties the NIH has amassed over the years in providing funds for cannabinoid research, such research has been conducted both in this country (i.e., Eli Lilly) and abroad (i.e., Pharmos). Surprise, surprise! Despite promising results in experimental animals (for instance, brain protection against ischemic/hypoxic damage), none of these cannabinoids has really proved to be a Silver bullet or even an Aluminium one. We know the identity of the endogenous cannabinoids, we have much knowledge about the cannabinoid receptors, we do not really need cannabis to design the right cannabinoid for the desired effects. Look at the slew of modern opiates, none of which is extracted from the poppy plant. If the campaign of the medical cannabis users is about legalization, then, leave it out of medicine. If it is about medicine, do not promote a mixture of dozens, if not hundreds, of compounds, some of which are either poisonous or antagonistic to others, as medicine.

  22. #22 Michael Thomsen
    September 23, 2010

    I am one of those Naturopath and Herbalist you hate so much. I don’t understand this hatred, we help lots of people, not all of course, but many. It is not a burden to the health system, we don’t kill people (not very often anyway). The lack of good research into what we do is mostly a question of lack of funding. Who is going to fund these when there is no money to be made in return?

    Anyway, to answer Madder (who has no direct experience, but still feels he/she knows everything about what we do and believe.

    Those statements are so laughable, and no, we don’t believe any of those statements either.

    If you don’t, by your own admission, know anything about a subject, why do you feel you have to make such statements?

  23. #23 Calli Arcale
    September 23, 2010

    Look at the slew of modern opiates, none of which is extracted from the poppy plant.

    “Opiate” technically means it comes from the poppy plant; “opioid” is the broader category which also includes things which didn’t come from the poppy plant but act in a similar way. Opiates include morphine, codeine, oxycodone, and hydrocodone; these are extremely popular, and are probably the most widely prescribed narcotics for pain control. There is also a global shortage of them; though the US has assured itself a nice tidy supply via Turkey and India (which had the bonus of eradicating the opium trade in Turkey, by giving poppy farmers a legal outlet for their crop), other countries aren’t so fortunate, and lately people have been looking to Afghanistan in hopes the successes in Turkey could be repeated there.

    Non-poppy opioids include fentanyl, methadone, and tramadol. These tend to be more expensive, perhaps in part because of their synthetic nature. (Plants usually make cheaper factories than a team of engineers can.) One thing these have in common is that they were designed by attempting to mimic the structure of naturally occurring chemicals in the poppy plant.

    The poppy is probably not a good example if you want to show why medicinal marijuana is not sensible. Poppies remain heavily cultivated to supply the global demand for pharmaceutical pain relief, and the efficacy of poppy-derived drugs is very well established. That’s not something which, in my opinion, is true of cannibinoids, but I’m willing to wait and see. I’m fine with continuing research.

    Frankly, I wouldn’t mind seeing cocaine be used medicinally again. It was a century ago. If that could be resumed, albeit far more responsibly than it was in those pre-FDA days, perhaps we could free the growers from the tyranny of the drug cartels. But that does not appear likely anytime soon.

  24. #24 Mariah
    September 23, 2010

    @Todd: I wrote to channel 5 this morning after seeing that clip last night. That asshole recommended raw honey to treat sick kids. Raw honey should absolutely NOT be given to babies.

    That was not mentioned. I demanded a correction. We’ll see tonight I suppose.

  25. #25 Michael Thomsen
    September 23, 2010

    I noticed you are a surgeon. Why don’t you do a blog on the export of surgeons from God’s own country (that is the US) to the convict colonies (that is Australia). This surgeon has caused more death and destruction than all the worlds naturopaths put together. Let us get some perspective on these matters:

    They called him Dr Death. A 15-year-old boy’s leg had to be amputated as a result of his poor judgement. He botched a procedure on a young man, leaving him impotent and urinating through his rectum – and with a 30cm surgical clamp embedded in his abdomen. Undeterred by the atrocities he was causing, Dr Death continued to deceive the patients who trusted him to fix their pain. At least 17 people in his care did not survive.

    His patents suffered infections, internatl bleeding from nicked arteries, and mutilation of healthy organs – and they were the lucky ones. More than 200 Australians were adversely affected while in his care.

    Dr Jayant Patel’s reign at Bundaberg Base Hospital ended after two years and he was banned from surgical practice in the United States. A life-threatening combination of the doctor’s manipulative personality and a hospital administration happy to look the other way as long as the dollars were rolling in, meant that Patel’s incompetence went undetected for some time

    FORMER Bundaberg Base Hospital surgeon Jayant Patel has been sentenced to seven years in jail for the deaths of three patients

  26. #26 squirrelelite
    September 24, 2010

    Michael Thomsen,

    I am sorry for anyone who suffers from incompetent medical care, including those patients of Jayant Patel.

    But, the competence or apparent lack thereof of one surgeon is irrelevant to the effectiveness of naturopathy or any of the individual treatment methods it espouses.

    I don’t know what you were comparing when you stated

    This surgeon has caused more death and destruction than all the worlds naturopaths put together.

    but it only took me a few seconds to find a list of 200 people harmed by naturopathy and I found 17 dead on the first screen page.

    http://whatstheharm.net/naturopathy.html

    However, if you really want funds to research the effectiveness of your methods, why don’t you send in a research grant proposal to NCCAM? They’ve been spending billions already and I’m sure they’re looking for promising areas to research.

  27. #27 Chris
    September 24, 2010

    Showing the problems with real medicine and some practitioners does not prove naturapathy works. Showing that your methods work shows that naturapathy works. Squirrelelite has pointed out there is funding to do those tests. Go for it. You have no excuses to whine and moan until you prove your methods work.

    A naturapath told a relative to get off her medications for depression and prescribed her homeopathic remedies (and she had been doing well before). Apparently it didn’t work. She committed suicide a few months ago.

    Why should I not be angry at wanna-be doctors who believe in fairy tales?

  28. #28 Militant Agnostic
    September 24, 2010

    Micheal Thomsen begins with

    I am one of those Naturopath and Herbalist you hate so much

    He then follows it up with a lame ass tu quoque argument followed by a demonstrably false claim.

    Micheal, around here such intellectual dishonesty will earn you contempt. You have already demonstrated you are scoundrel and a jackass all that remains is for you to demonstrate your ignorance of basic biology, chemistry and physics.

  29. #29 Michael Thomsen
    September 24, 2010

    squirrelelite, I was just referring to the fact that popular media (like this blog) loves to mention rouge people who make outrageous statements or practice dangerous medicine, whether they are naturopaths or surgeons.

    I practice a very level headed, no-nonsense naturopathy/herbal medicine based on the traditional use of plant medicines supported by whatever scientific information I can find. I spend many hours every week reading scientific papers. Whenever there is good scientific reason for updating what I do, I will change. Unfortunately there are many poorly trained and misguided naturopaths but there are, I think, more who are doing a very good job with their patients. At least here in Australia.

    I actually tend to call myself a medical herbalist rather than a naturopath because I do share the concerns of the sceptics that many naturopaths are poorly trained and may use ineffective medicines/devices or advice against medical treatment. I can assure you that I would never advice against medical treatment. That is clearly not our role. On analysis, one will have to conclude that naturopathy and herbal medicine is not dangerous in the hands of a well trained and registered herbalist/naturopath.

    The list you refer to is very unscientific. There is too little information to assess those cases. Unfortunately naturopaths are not registered in Australia and I believe that is one reason why we do have some idiots like the two naturopaths mentioned on the list. One was cleared of the patient’s death but still found to be negligent. The second case from Australia concerns a fake naturopath in his mid-seventies who was not properly trained. I totally agree that such cases are tragic and should be prevented from happening. The last Australian case is in relationship to the herb black cohosh. The temporal relationship with the liver disease and the use of black cohosh has been dismissed in this case.
    So the list has two cases from Australia. Both could have been prevented by better regulation of the profession. Both cases related to bad practices of two individuals. I, and my colleagues, do not share or condone those practices.
    My point is this: you don’t condemn surgery because of the actions of Dr Patel, so don’t condemn naturopathy/herbal medicine as whole because of a few quacks.

    In regards to the NCCAM grants. Unfortunately, millions of important research dollars have been wasted, also here in Australia where we have similar (much smaller) grants. Research as you know, are best done by institutions with the right infrastructure, personnel, experience and yet I see grant approvals for studies which are often not clinically relevant. There are studies of poor quality, irrelevant in vitro studies eg one study found significant denaturation of human sperm DNA and reduced viability from the in vitro incubation of hamster sperm with Echinacea…

    The bad science here is not herbal medicine, but the whole idea of such as stupid study. Yet, the results are being used by sceptics to warn of the dangers of herbal medicine!

  30. #30 David N. Brown
    September 24, 2010

    Completely off topic, but Tim Bolen has claimed that “Orac” and Liz Ditz will be added as defendants in the DDI v. Barrett lawsuit. I have been covering his attempts to use the lawsuit to intimidate third parties since July. I’m now going to call for a general counteroffensive, to refute,expose, complain about and/or mock Bolen and ESPECIALLY anyone who reposts his material nonstop.

  31. #31 Michael Thomsen
    September 24, 2010

    Forgot to mention iatrogenic disease:

    225,000 iatrogenic deaths per year constitute the third leading cause of death in the United States, after deaths from cancer and heart disease. The most significant number of these unnecessary deaths, 106,000, were due to the negative effects of properly prescribed drugs, making them the fourth leading cause of death in America.

    Starfield B. Is US health really the best in the world? JAMA. 2000 Jul 26;284(4):483-5.

    Another analysis concluded that between 4% and 18% of consecutive patients experience negative effects in outpatient settings, with:
    116 million extra physician visits
    77 million extra prescriptions
    17 million emergency department visits
    8 million hospitalizations
    3 million long-term admissions
    199,000 additional deaths
    $77 billion in extra costs

    Weingart SN, Wilson RM, Gibberd RW, Harrison B. Epidemiology and medical error. BMJ. 2000;320:774-777

    No matter how you look at it, cost/benefit analysis, economic, human cost, etc this is a far greater issue that needs fixing. If you apply your scientific minds to these figures, you would have to agree that this is what you should spend your time and energy fixing.

  32. #32 Dangerous Bacon
    September 24, 2010

    Michael, citing an example of an incompetent physician does not alter the proven efficacy of medical diagnostics and therapeutics as a whole or invalidate the scientific method. The article that upsets you does not cherry-pick examples of incompetent naturopaths (as tempting and easy as that is); instead it shows how the naturopathic embrace of various forms of woo goes hand in hand with the rejection of the scientific method (at least when the scientific method does not support the woo that naturopaths endorse).

    “Whenever there is good scientific reason for updating what I do, I will change.”

    Can you give some examples of naturopathic treatments which have been discontinued (by yourself or due to recommendations from naturopathic colleges or societies) because they were found to be ineffective and/or hazardous?

    Thank you.

  33. #33 dram_reset
    September 24, 2010

    so Michael, let me get this right, your response to the suggestion that you try to get funding for these important research studies of yours is basically “well, they waste all the money on stupid stuff”? or is it “well it all goes to the Big Science Guys”?

    anyone can easily find thousands upon thousands of studies concerning herbs and herbal extracts, and their efficacy against various diseases and conditions, and you being a “medical herbalist” should know that. in terms of your other comment, i have to say that i, as a tax payer, am much more comfortable with my tax monies going to the big leagues, you know, people who have actual equipment, facilities, and scientific training.

    here’s really how i look at this. I have a nice, solid BA in Anthropology from a top 20 US university. not in a million years would that do a damn thing to help me get into med school, but after doing about 5 minutes of web searching, i can instantly qualify for a “Doctor of Naturopathy” program at any number of institutions. that is worrysome on many, many levels.

    and the only thing i have to say about your iatrogenic death statistics — my god, think what they would be if it were all reiki healers and homeopaths!

  34. #34 Michael Thomsen
    September 24, 2010

    Dangerous Bacon,
    Point taken about the practice. I agree, Naturopathy is not well defined, and is therefore open to all kinds of crazy additions. That is the reason I practice only herbal medicine and nutrition and call myself a medical herbalist. Naturopathy used to mean treatment with diet, exercise and medicinal plants.

    There is no doubt that medicinal plants contains active compounds. There are of course many modern drugs, which are based on natural compounds.

    I think we can agree that cascara has a laxative effect. Some herbs don’t seem to do much, but leaving that aside for now, I think we can agree that medicinal plants contain compounds with medicinal action.

    That means that the real questions are:
    1. How potent are they? This will depend on how the plant was cultivated, extracted and manufactured into a product. It will depend very much on the concentration of the active compounds. This is where many natural products fail.
    2. The second question is how is it applied? Alone or in combination, we know from experience that combinations of herbs sometimes works better so we often mix 3 to 5 herbs together.
    3. The third is why? What are we trying to achieve. This may be the biggest area of misunderstanding and this blog is a difficult forum to explore it properly. But we do have some emerging methodology on how we select and apply our medicinal plants based on the pharmacological action of the plant constituents.
    4. Diagnosis: I rely on the diagnosis of medical practitioners that the patient has seen before coming. I work closely with the patients GP if possible. I don’t use any “alternative’ diagnosis although I do try to see the patient’s problem as part of their whole being and how work, stress, emotions, lack of sleep, etc affects their problem. I don’t for example think that everything just emotional, but I do think there is often an emotional aspect to a problem and attention to both is more likely to produce a better outcome in many cases.

    In regards to updating a practice. Doctors are still prescribing antibotics for viral infections, probably because patients ask for something. Acute otitis media for example. It takes a long time for habits to change.

    One that springs to mind, which unfortunately some still believe in, is the infamous olive oil and lemon cure for gallstones: you drink a litre of oil and take lemon juice and your gall bladder is supposed to contract and expel the stones. (I would never have suggested this in the first place, and it was never taught).

    I don’t recommend Hopi ear candles (never did actually)

    I don’t prescribe shark cartilage, I don’t use Evening primrose oil for eczema (it has been disproven), I don’t recommend Esiac for cancer, I don’t prescribe vitamin C during chemotherapy, I don’t give megadoses of vitamins (I try to prescribe dosages used in clinical trials), I use products which are standardised to contain a guaranteed amount of constituents because I can then at least try to prescribe a dosage which will match that used in a clinical trial (if available) and hope for a more reliable pharmacological action.

    The kind of naturopath I represent does not reject scientific method. We embrace it. Our recent conference on western herbal medicines was a good example. All presentation had attempted to include scientific evidence to support their statements. It is not perfect, but we are trying.

  35. #35 Michael Thomsen
    September 24, 2010

    Chris,
    I am sorry to hear about your relative. I would never try to persuade a patient to come off an antidepressant, if however, they wanted to try an alternative and their doctor agreed, then we could explore alternatives such as St. John’s wort.

    dram_reset,
    sorry if I didn’t explain that clearly. I meant I can’t provide the evidence, I don’t have the research skills or the infrastructure. I am however encourage by the fact that young herbalists are now doing PhDs and trying to validate our medicinal plants and practices. But I am annoyed about the waste of taxpayers dollars going to bad science, hence my reference to the hamster egg and human sperm suggesting that echinacea makes you infertile.

    and I totally agree about the problem of training and registration, but rather than getting rid of naturopaths, let us examine the training and registration issues.

    in regards to reiki, no I don’t believe in reiki, I don’t believe in religion either, but we can’t ban everything. Reiki is a quack but it doesn’t kill people. The issue of recommended against proper medical treatment is related to the practitioner not the modality.

  36. #36 dram_reset
    September 24, 2010

    i really can’t comment on the study you mentioned, whether or not it consisted of “bad science” — and as only an amateur, not sure i would have the qualifications to make such a determination either.

    in regards to reiki, no I don’t believe in reiki, I don’t believe in religion either, but we can’t ban everything. Reiki is a quack but it doesn’t kill people. The issue of recommended against proper medical treatment is related to the practitioner not the modality.

    reiki may well kill you — if you fail to have actual medical care. that’s one of the main dangers with these methods, that they purport to cure diseases but do nothing, and by then it’s often too late.

    just for fun, i went to the American Association of Naturopathic Physicians’ website, did a search for my state.

    First entry claims to be able to reverse autism and cure fibromyalgia, they link it with mercury and “heavy metal toxicity”, they use the full gamut of quacktastic treatments, from chelaton to homeopathy to vitamins to energy healing.

    Second one offers hormone replacement therapy. WITHOUT an MD. Has a nice disclaimer about her not being a real doctor also. Seems to like homeopathy.

    Third, fourth, fifth, same deal. More homeopathy, energy healing, “color and light therapy”, aromatherapy, acupuncture, etc. Strange that they all call themselves “Doctors” and yet that have quack disclaimer going on, stating that they aren’t. They all seem to have skin care going on too, very strange.

    If you’re serious about looking at herbs in medicine, i’d advise getting either a PhD in plant biochemistry or botany, and maybe a MD.

  37. #37 Chris
    September 24, 2010

    You want to be a real doctor, but you don’t have have the brains or guts to go to a real medical school. So you just pretend.

    If you really wanted it to be real, you would actually apply for the tests at NCCAM, The rest is just pointless excuses.

    A real doctor would know that St. John’s Wort is only good for transitional mild depression. Not the disease my relative had. You would know that if you had learned real medicine.

  38. #38 Kit
    September 24, 2010

    Micheal

    It sounds to me like you prescribe based on the know effects of certain herbs, singally or in combination because of their known effects on the human body. It’s almost like you are prescribing drugs, but with out the rigourous quality and dosage control that goes into ‘Big Pharma’ production.

    So why are you against quality control, except for a desire to stick it to the man?

  39. #39 Chris
    September 24, 2010

    Mr. Thomsen, you should be aware that there are real scientists looking at the effects of herbs. Perhaps you might be interested in this blog:
    http://cenblog.org/terra-sigillata/

    I have been through the Medicinal Herb Garden many times, but I know it has limitations. The question is: do you?

  40. #40 Michael Thomsen
    September 24, 2010

    yep, I know my limitations very well and I am not against quality control. In fact, I wish there were better control in regards to the manufacturing of medicinal plant products. It is getting better, but there is a long way to go. GMP manufacturing only came in effect in the US last year I believe. We have had GMP in Australia since 1994 and the quality has improved but not enough. In the meantime I stick to particular practitioner brands which I believe have a much better quality control department than most health food store brands.

    I would never claim to be able to reverse autism or cure fibromyalgia. I would think I could help someone with fibromyalgia quite a bit though. Naturopaths in Australia doesn’t do chelation therapy, it is done by the Integrative Medicine doctors. I don’t believe in faith or colour healing but I do believe that there is something in acupuncture but I don’t know enough about it to comment. Aromatherapy is not that effective unless the oils are taken internally. French doctors practice this kind of therapy and it can be very potent.
    No true herbalist would use hormones, “natural” or otherwise, that is obviously something that MDs prescribe. I believe that the US naturopath are trying to be pseudo-doctors. We don’t to sutures, hormones or manipulations.

    No, you don’t need a PhD in plant chemistry or botany, but the companies making the medicines do. I personally would like to see training where a naturopath received the same training as a doctor in the medical sciences and then specialise in nutrition and medicinal plants. The University of Southern Cross in Lismore, Australia is trying to move towards such an education and they have certainly raised the standard of education.

    The other area of concern is the problem of herb/nutrient and drug interaction. This is the area I am working on right now.
    I hope I have assured some of you that we are not all lunatics and that we actually are concerned about the same issues as you, namely, safety and efficacy.
    cheers
    Michael

    If you’re serious about looking at herbs in medicine, i’d advise getting either a PhD in plant biochemistry or botany, and maybe a MD.

  41. #41 custom usb
    September 24, 2010

    What is obviously going on with a lot of these folks is that they crave the prestige, and maybe the income, that comes with being a “real” doctor or scientist. But for whatever reason, whether they didn’t want to do the hard work needed to master difficult material, or their circumstances just didn’t allow them to invest the many years of penury required, or maybe they aren’t all that bright, they don’t have the credentials or the intellectual mastery that goes with real training. So going to Bastyr “university” and calling yourself a Doctor of Naturopathic Medicine is a cheap and easy way to get the status you crave.

  42. #42 triskelethecat
    September 24, 2010

    It seems to me that Mr Thomsen is a herbalist, not a ND (at least, as NDs “practice” here in the US).

    Perhaps, Mr Thomsen, in this case we are talking in circles. I have no problems with pharmacognosy; it actually is an interest of mine. And for self-limiting problems I may actually go in the herbal direction (chamomile tea for sleep issues, ginger in foods/tea for nausea, sometimes zinc and/or echinacea at the start of a cold,etc). I have some herbal books and am willing to, within reason, use these on myself and my family.

    But for actual, non-self-limiting diseases(diabetes/hypertension), and possible self-limiting illnesses/diseases that could have sequelae(strep throat), I see a physician and get treated with science-based medicine.

    Since your practice, according to your comments, appears to be in conjunction with a physician (hopefully one who is science-based/evidence-based), then I am not uncomfortable with it. But on this blog you may want to use a different title (there are a bunch of NDs who comment here who DO follow the woo).

  43. #43 ambulocetacean
    September 24, 2010

    I wonder whether Mr Thomsen believes in the germ theory of disease or in naturo-woo delusions about energy blockages and the body being able to heal itself of anything.

  44. #44 Katharine
    September 24, 2010

    Re: herbs, I agree on the idea that anyone who wants to investigate the use of natural products in treatment of illnesses/symptoms should do some careful research, maybe do graduate study in pharmacognosy/natural products chemistry, because there are ways to do rigorous research on this and a good deal of the drugs we use are synthesized forms of natural compounds (taxol, atropine, et cetera – taxol comes from the Pacific yew, atropine comes from the belladonna, and quinine comes from cinchona trees). David Kroll, the guy who runs Terra Sigillata, has a background in this. I think naturopathy is a terrible waste of time partially for this reason – research is being done into this and when we find a useful plant medicine does frequently incorporate its products into its treatment ensemble, but it isolates the product that works and leaves out the products that will cause problems.

  45. #45 dean
    September 24, 2010

    … I do believe that there is something in acupuncture but I don’t know enough about it to comment. Aromatherapy is not that effective unless the oils are taken internally.

    So much for Thompson’s claim of following the science.

  46. #46 Todd W.
    September 24, 2010

    @Michael Thomsen

    While I admire the fact that you seem far more science-oriented than the run of the mill naturopaths, I would echo the recommendation that you put some effort into acquiring a PhD or MD in pharmocognosy.

    One of the biggest problems with herbalism (as opposed to refined drugs derived from plants) is that there can be such a huge variability in the potency and purity, even within the same product pack. Then there’s also the little fact that along with the active ingredient that does the good stuff, you also get compounds that can produce negative effects without adding any benefit. That’s one of the things that pharmaceutical companies try to do: identify what compound(s) produce the desired effect, which ones produce negative effects and try to develop a product that has as much of the former with as little of the latter as possible to produce the greatest benefit:risk ratio.

    Herbs are all well and good, but when the natural product (even within the same plant) can have differing concentrations, getting the proper amount can be difficult. You seem to have an interest that could lead you to making some good contributions to medicine, if you put in the educational effort.

  47. #47 Militant Agnostic
    September 24, 2010

    So much for Thompson’s claim of following the science.

    I would cut him some slack on the acupuncture since there appears to be scientific evidence for it until you take a close look at the positive studies. As for the aromatherapy – it the oils are being taken internally it isn’t really aromatherapy anymore.

  48. #48 dean
    September 24, 2010

    I would cut him some slack on the acupuncture since there appears to be scientific evidence for it until you take a close look at the positive studies.

    The hype from those studies make acupuncture appear useful, but that’s it (and I think that’s what you’re saying here). But, somewhere he said “I read a lot of studies” – if he’s read these, it wasn’t with any great care: if he hasn’t, he has no basis for his claim.

    I’m not sure what the point of the aromatherapy stuff was – but would you trust anyone practicing that stuff if he/she told you the oils were safe to ingest?

  49. #49 WLU
    September 24, 2010

    Mr. Thomsen’s comments reflect the accuracy of Orac’s original post – naturopathy is naught but a grab bag with a meaningless title. Is he a “real” naturopath because he tries to use science in his practice? Or is he NOT for the same reason? Doctors have science, biology, anatomy, clinical studies and other evidence-based practices as an underpinning to their practice so ultimately there is a bedrock upon which the edifice rests. Naturopathy has nothing comparable. The fact that Mr. Thomsen can define himself as whatever he wants while being ostensibly trained as a naturopath really illustrates the problem with the “profession” and in fact all alternative medical approaches – when there is no foundation from which to build, how can you tell a “good” naturopath/acupuncturist/homeopath/reiki practitioner from a “bad” one? Are the bad ones only those so incompetent and ideologically motivated that they manage to kill their patients, while the rest merely waste their money? Can it really be a good thing that there are practitioners who, for a nominal fee, deliver essentially untrained counselling combined with ineffective nostroms? Couldn’t Mr. Thomsen do his job better as a doctor who supplemented proven medication with proven herbs for mild conditions?

    The invocation of Starfield 2000 and Weingart et al. 2000 is irksome – where would those patients be without modern medicine? What if instead of vaccination, surgery and medication they had only acupuncture, herbs and homeopathy? In many cases I would guess dead. Yes, iatrogenesis and medical error are problems that are addressed through better evidence, further research, improved practice, monitoring, certification and training. That doctors make mistakes in no way vindicates faith healing, whatever it’s specifics. I don’t claim that because tamoxifen treats cancer, acupuncture is therefore worthless. I recognize that each stands or falls on its own, evidence-based merits. The difference, of course, is that if evidence accumulates that tamoxifen is more harmful than helpful, its use will be abandoned.

  50. #50 rimpal
    September 24, 2010

    I lost my father to naturapathy/magnetotherapy/acupuncture/homeopathy. These fraudulent disciplines are out of place anywhere except in a freak show museum.

  51. #51 Prometheus
    September 24, 2010

    Mr. Thompsen begins his serial diatribe with the following:

    “we [naturopaths] help lots of people, not all of course, but many. It is not a burden to the health system, we don’t kill people (not very often anyway).”

    I, for one, would love to see any data that support the three claims Mr. Thompsen makes in these two sentences:

    [1] Naturopathy is better than placebo (with the caveat that “naturopathy” doesn’t include prescribing regular pharmaceuticals, as it too often does in the US).

    [2] Naturopathy doesn’t kill its patients “very often” (which I would define as less often than real medicine does for patients presenting with the same type and degree of illness).

    [3] Naturopathy isn’t a “burden” on the “health system”. [Note: Mr. Thompsen no doubt means by this that naturopathy isn't covered by private or national health insurance - which is not true in the US, where are growing number of private health insurance plans now cover naturopathy and other magic-based medical care.]

    In my part of the country, naturopaths are licensed by the sate and allowed to prescribe a limited number of real pharmaceuticals – which is a puzzle, since their dogma is that “natural” medicines are inherently superior to any “artificial” drugs. Apart from their use of real pharmaceuticals, however, it is unclear whether the “natural” remedies they use are any more effective – or safe – than the conventional treatments used by real doctors.

    Naturopaths in my state generally stick to treating the “worried well” or provide “adjunctive” treatment for patients already receiving treatment from a real doctor. In this second role, naturopaths have been instrumental in relieving a number of people of their suffering by killing them through their failure to recognise dangerous interactions between their “herbal remedies” – which are often a poorly-characterised mixture of potentially toxic compounds – and real pharmaceuticals.

    As one example, the number of dangerous intra- and post-operative bleeding complications caused by unreported use of “herbal remedies” has prompted the surgeons at my university hospital to require patients to sign a document stating that they are not taking any “natural, herbal or supplemental medications, drugs, or remedies” prior to having surgery. Because the effect on coagulation of so many naturopathic remedies are unknown, most of the surgeons won’t operate on a patient taking them unless it is an emergency.

    This segues nicely into Mr. Thompsen’s claim that naturopathy is safe. Indeed, in later comments, he appears to be claiming that naturopathy is safer than real medical treatments. As I’ve pointed out above, this isn’t necessarily true, although the deaths may be misattributed because naturopathy tends to kill by unexpected drug interactions, clotting dysfunction and delaying diagnosis and/or treatment of serious disorders. Only rarely does naturopathy show up as the proximate cause of death (often through stroke, liver damage or kidney failure).

    Another issue that Mr. Thompsen neatly sidesteps is whether naturopathy is “safer” – if it indeed is safer – only because it is largely ineffective. Unlike homeopathy, however, naturopaths – even when they eschew real pharmaceuticals – are prescribing compounds that often have real physiological effects. Any compound that has physiological effect can cause side effects, injury and death, especially when the person prescribing those compounds is unaware – as Mr. Thompsen appears to be – that this potential exists.

    Finally, naturopathy does create a burden on the “health system” – even if insurance plans and governmental health programs don’t pay for it. Somebody must be paying the naturopaths and paying for their herbal remedies, right? When you add in the complications from herb-drug interactions, delay in diagnosis and treatment and direct complications from naturopathic remedies (not to mention the not-insignificant number of injuries caused by naturopaths mis-prescribing real drugs), the burden of naturopathy on the “health system” is very real.

    So, I’d like to see Mr. Thompsen provide data supporting his claims that naturopathy is effective, safe and cost-effective (I won’t ask him to show that it doesn’t cost anything, since that is clearly nonsense.)

    Not holding my breath, mind you.

    Prometheus

  52. #52 JJM
    September 24, 2010

    @Mr. Thomsen, one reason you can claim to be involved in less patient harm than medicine is that you don’t see seriously ill people who need heroic treatment. Another is that you probably never again see those you have harmed. Finally, most of the herbs you recommend are probably (hopefully) no more active than lettuce.

    Consider “natural” remedies for arthritis. In the UK, a foundation has published a PDF http://www.ebm-first.com/herbal-medicine.html (scroll halfway down the page and read about “Complementary and Alternative Medicines for the treatment of rheumatoid arthritis, osteoarthritis and fibromyalgia.” Most of the treatments are herbal. Of 76 products reviewed, 36 had no reliable research. Only four of the remainder (that’s right, just 4) had some evidence of efficacy in reliable studies. That is not a very good record for herbal therapies.

    Sure, many drugs were developed from herbs; but the traditional herbalist is not generally a good source for effective therapies. In addition to the arthritis example, there is the example of artemisinin which was the only effective drug found by screening more than 100 (some say more than 200) herbs used in China to treat malaria. Furthermore, many drugs are improved versions of compounds found in nature http://www.sciencebasedmedicine.org/?p=6703

  53. #53 Militant Agnostic
    September 24, 2010

    As one example, the number of dangerous intra- and post-operative bleeding complications caused by unreported use of “herbal remedies” has prompted the surgeons at my university hospital to require patients to sign a document stating that they are not taking any “natural, herbal or supplemental medications, drugs, or remedies” prior to having surgery. Because the effect on coagulation of so many naturopathic remedies are unknown, most of the surgeons won’t operate on a patient taking them unless it is an emergency.

    And the resulting complications and deaths get counted as iatrogenic injuries/deaths.

    @46 I suspect that most of the aromatherapy oils are not compounds that were part of the “natural” (hunter gatherer or early agricultural) human diet.

  54. #54 Pablo
    September 24, 2010

    In addition to the arthritis example, there is the example of artemisinin which was the only effective drug found by screening more than 100 (some say more than 200) herbs used in China to treat malaria.

    Did the Chinese not have quinine? It’s natural AND it works!

  55. #55 Pablo
    September 24, 2010

    @46 I suspect that most of the aromatherapy oils are not compounds that were part of the “natural” (hunter gatherer or early agricultural) human diet.

    Is there an “Essence of Cinnamon Roll”?

  56. #56 Vicki
    September 24, 2010

    I assume the Chinese have quinine now, but the plants it comes from aren’t native to that part of the world.

    And, unfortunately, it doesn’t work so well these days, because the parasites have evolved resistance.

  57. #57 Calli Arcale
    September 24, 2010

    Which is why people have been shifting to artemisinin. Artemisinin has actually been used as an antiparasitic for a long time, and not just in China; in fact, the English name for the plant is “wormwood”, and refers to its ancient use in killing intestinal parasites. (It’s also what gives absinthe it’s distinctive color.) Sadly, artemesia resistance is probably not that far behind quinine resistance; it’s really only a matter of time.

  58. #58 squirrelelite
    September 24, 2010

    The current issue of Nature has a good paper on the origins of the malarial parasite. It’s also discussed in the Nature podcast.

    Gathering fecal samples for this study must have been VERY interesting.

    http://www.nature.com/nature/journal/v467/n7314/full/nature09442.html

  59. #59 madder
    September 24, 2010

    Mr. Thomsen–

    The others having rebutted your claims quite thoroughly, I’ll limit myself to addressing your comment directed at me. I wrote that my experience with naturopaths was indirect, not that it was nonexistent; thanks for the obvious misrepresentation. I have never and will never visit one, but several people close to me have, and in my initial ignorance I was quite open to them. What I wrote above represents the aspects of their experience that are consistent at multiple practitioners. If naturopaths don’t believe those statements, why do their patients recite them so often?

    This exchange merely underscores Orac’s main point: naturopathy has no consistent practice. Licensing people to practice under that label is therefore dangerous, and violates the entire notion of state-issued licensing.

  60. #60 custom usb
    September 24, 2010

    This exchange merely underscores Orac’s main point: naturopathy has no consistent practice. Licensing people to practice under that label is therefore dangerous, and violates the entire notion of state-issued licensing.

  61. #61 saved by naturopathy
    September 25, 2010

    Hello there. I thought naturopathic doctors were quacks, too…until I had my own child with serious health problems that over 5 years, no doctor, specialist – pediatrician or allergist or neurological dr., or hospital could help us with. We were prescribed pills, medicines, x-rayed, mri’s, told that she needed steroids injected into her breast bone (causing stunted growth), told that nothing was wrong, given inhalers, given antibiotics every 6 weeks, underwent surgery, …you get the picture. NOTHING worked. My child’s condition worsened over the years, and I never had any sleep because her breathing issues worsened. Well, thank goodness a friend mentioned a naturopathic doctor’s name which had been passed on because of his success… after another food was added to her allergy list, I couldn’t take it any more and tried the ND. I was ready to try even something I was afraid of. WELL – LISTEN CAREFULLY YOU ND HATERS HERE, WITHIN 4 WEEKS THE BLOAT WAS GONE FROM HER FACE AND BODY, NO WHEEZING, 20 POUNDS LOST -NOT FROM DIETING, BECAUSE WE ATE LOTS, JUST DIFFERENTLY. You get the picture. 3 years later, her month long colds turned pneumonia are 2 or 3 day light issues because her immune system is SO STRONG. NDs don’t do all the stuff you are saying up there, there are specialists though – like gps you have to find the right one. But we haven’t been back to a regular doctor in 3 years!! Because WE NOW DON’T NEED ONE. That’s what doctors are afraid of – 1st what they don’t know, 2nd of losing business!! Read this and weep.

  62. #62 kev_s
    September 25, 2010

    @59 ‘saved by naturapathy’ … to summarise your story “It worked for me so it must be true”. You’re right … your comment made me weep.

  63. #63 WLU
    September 25, 2010

    In response to “saved by naturopathy”, let me write an anecdote that you’ll unfortunately never hear.

    I went to doctors and they prescribed me medication for high blood pressure. I didn’t like the side effects, so I went to a naturopath. They told me the medications were harmful and didn’t do any good, so I should stop taking them. They prescribed acupuncture, homeopathy and herbs instead. Six months later my asymptomatic, uncontrolled high blood pressure blew out an aneurysm and I ended up on a long-term care facility unable to feed myself, control my bowels, communicate or think coherently. I died three months later from pneumonia caused by aspirating my saliva. NATUROPATHY KILLED ME!!!!

    The reason we need controlled studies is to let the dead speak – they can’t give anecdotes for or against their experiences, they are dead and therefore you don’t get a true picture of circumstances.

    “ZOMG NATUROPATHS TREATED MY ALLERGIES” is a trope I’ve heard before, and one that only suggests more research needs to be done on allergies. Once it is demonstrated that there are, or are not serious and/or undiagnosed problems in the population, an evidence-based approach can be used to address them.

    An aside – in response to the rallying cry of “Big Pharma” as a stand-in for conspiracies to suppress “natural” cures or whatever, we should use “Little sCAM” (“so-called alternative medicine”). “Little sCAM” represents all the individual practitioners who use conspiracy theories and accusations of conflict of interest to profit from the sales of their often worthless, sometimes dangerous nostroms and diet/exercise advice that adds precisely nothing to the recommendations made by conventional physicians. There is no massive company to accuse, just a bunch of self-interested people who prefer quick profit and glib accusations over hard evidence and unpleasant truths.

  64. #64 Hamburgler
    September 25, 2010

    “to summarise your story “It worked for me so it must be true”. You’re right … your comment made me weep.”

    I think the summary is “It worked for me when nothing else did and now I am healthy.” Are you going to try and argue with success? That should be interesting.

  65. #65 Calli Arcale
    September 25, 2010

    Hamburglar — you can’t argue with success, is that what you’re saying?

    Actually, you can — mostly because there is more to the story. There is always more to the story. The human organism is a very complex system, and just because A was done and then B occurred does not mean that A caused B. You usually need more information to know that.

    Allergies, asthma, chronic childhood infections — these are all major cases in point. Kids are changing dramatically during the first ten to fifteen years of their lives, and it actually is not that unusual for allergies to fade or disappear during that period. I was allergic to peanuts and tree nuts as a child. I’m not now; I eat large amounts of both with no problems. However, I have developed a citrus allergy which I did not have as a young child. Things change.

    Asthma, too, comes and goes. I have that; it runs in my family. It was bad for a while in grade school, then went into remission, flaring up again in junior high, fading so much I forgot how to care for it properly, and then becoming worse again in the last few years. This natural fluctuation unfortunately makes asthma ripe for exploitation because it is so easy to think something has cured it when it fact it has no effect at all. (Note: it is not, however, impossible to evaluate asthma therapies. It just means you need to focus on objective measures and recruit enough study participants to be able to tell if there’s a statistically significant difference. If five people in a group of fifty can be expected to get better anyway, then if only five in your study group get better, it doesn’t look good for the therapy. But if twenty do, then you’ve got something interesting.)

    Childhood infections can be immensely frustrating. Some children are very prone to upper respiratory infections, especially when they are small; the various tubes and passageways and things change as the child grows and the head reshapes with age — this alone can change infection patterns. There is also the problem of populations of infectious agents — if you’re not killing all of the population each time, or if there’s some reservoir in the household, then the child will just keep getting recolonized. Eventually, the infection will probably get beaten, but I know when I get a bladder infection, I usually get several for a few months to a year before the population is finally killed, and then I may go years before the next one.

    So do I argue with success? I don’t argue with the success itself — it’s always good to be well, especially when it’s a kid we’re talking about. But I do ask questions about some of the claims made. If you’ve tried everything but the kitchen sink, and then you go try the kitchen sink and get better, that doesn’t mean the kitchen sink actually fixed anything. It’s just the last thing you tried.

    By the way, to “saved by naturopathy”, be cautious of assuming that your child’s allergies were resolved by strengthening her immune system. If the naturopath really did cure her allergies, it wasn’t by strengthening her immune system. Allergies are themselves an immune response — strengthening the immune system (for real) would make them worse, not better. One of the traditional ways to cure an allergy is desensitization therapy. In some cases, this can be done through diet, depending on the specific allergy, but one must be very cautious — one can also make the allergy worse this way. A naturopath could suggest this, but I would personally prefer working with an allergist — a person who’s entire professional career is devoted to this sort of thing.

  66. #66 titmouse
    September 26, 2010

    That’s what doctors are afraid of – 1st what they don’t know, 2nd of losing business!! Read this and weep.

    Your financial future is better when you’re in a profession based upon facts rather than an “alternative” to facts.

    If new facts are discovered indicating a better way to do things, the fact-based profession simply updates and carries on. It’s not so easy for believers in THE FORCE and other make believe.

  67. #67 Militant Agnostic
    September 26, 2010

    Like Calli I have had many of my childhood allergies disappear. As a child I was hospitalized twice for asthma. Now my asthma has diminished to the point that my inhaler goes past it’s expiry date before it is empty. This occurred long after I stopped taking desensitization treatment and without any “help” from naturopathy,chiropractic or any other woo. Just the natural variation of the condition.

    steroids injected into her breast bone

    .WTF

    I am not in any medical field, but this sounds like utter bullshit to me.

  68. #68 Pablo
    September 26, 2010

    Calli – that is all assuming, of course, that we even accept the claims of the story at face value.

    We have heard countless of times stories of, “My child got a shot and BOOM, suddenly everything changed,” where “suddenly” it appears can range anywhere from hours to a day to 3 months to even a year!

    So another problem with anecdotal stories is that they are often based on faulty descriptions of even how the events occurred, deliberately (to try to be more convincing) or not necessarily so.

    I’d need to see a lot more documentation of what all was attempted and the observations that took place before I would even accept the “it worked when nothing else did” claim. Both ends of that claim are suspect.

  69. #69 madder
    September 26, 2010

    @Pablo:

    And as we learned in the Autism Omnibus case, “suddenly” can even mean “before the shot.”

  70. #70 whale of a time
    September 27, 2010

    Orac: “science-based medicine is more efficacious”

    Todd W: “I would echo the recommendation that you put some effort into acquiring a PhD or MD in pharmocognosy.”

    “Licensing people to practice under that label is therefore dangerous, and violates the entire notion of state-issued licensing.”

    Chris: “You would know that if you had learned real medicine.”

    From Newsweek magazine:

    “Studies suggest that the popular drugs are no more effective than a placebo. In fact, they may be worse…As more and more scientists who study depression and the drugs that treat it are concluding, that suggests that antidepressants are basically expensive Tic Tacs.” http://www.newsweek.com/2010/01/28/the-depressing-news-about-antidepressants.html

    The science and evidence isn’t matching your claims.

    Newsweek article continued:

    “So concluded the JAMA study in January. In an analysis of six large experiments in which, as usual, depressed patients received either a placebo or an active drug, the true drug effect—that is, in addition to the placebo effect—was “nonexistent to negligible” in patients with mild, moderate, and even severe depression…

    As shown by the explicit criticism of drug companies by the authors of the recent JAMA paper, more and more scientists believe it is time to abandon the “don’t ask, don’t tell” policy of not digging too deeply into the reasons for the effectiveness of antidepressants. Maybe it is time to pull back the curtain and see the wizard for what he is. As for Kirsch, he insists that it is important to know that much of the benefit of antidepressants is a placebo effect. If placebos can make people better, then depression can be treated without drugs that come with serious side effects, not to mention costs. Wider recognition that antidepressants are a pharmaceutical version of the emperor’s new clothes, he says, might spur patients to try other treatments. “Isn’t it more important to know the truth?” he asks. Based on the impact of his work so far, it’s hard to avoid answering, “Not to many people.””

    Wow, so the drugs of SBM’ers, PhD’s, and MD’s, that is the “real medicine” as Chris put it, has been shown in studies to be unequivocally not working as claimed?

    What do you all think of that?

  71. #71 WLU
    September 27, 2010

    @whale of a time

    And how did this get found out, assuming it’s even true and not simply shoddy reporting by a popular news agency? Research, with outcome measures, control groups, scientists, a hypothesis and underlying recognition of the complexity of the body. Not by individual pronouncements based on nothing but authority, hoary old wives tales and unquestioned beliefs in “energy” that can’t be measured.

    Assuming your point has anything to it, that doesn’t vindicate naturopathy, homeopathy, acupuncture, reiki, energy work, antivaccination advocacy, etc. Yes, modern medicine is flawed by conflicts of interest and a difficult subject – but that doesn’t mean we bury our heads in the sand and just swallow whole whatever Basyr University happens to publish. The two are unconnected. If depression can be cured by a placebo, then that’s great since it will be generally harmless. Doctors however, will state that openly and continue seeking an actual, effective treatment. Homeopaths will keep insisting their placebo is somehow magic and shut down their curiosity.

  72. #72 Todd W.
    September 27, 2010

    @whale

    IIRC, and this is mentioned in the article you linked to, the study (using, ZOMG, science!) found that antidepressants do work for very severe depression. But I’d say that the study was good, in that it calls into question the physicians’ practice of simply medicating first, asking questions later.

    Science is a messy process. Sometimes, the people doing it make mistakes, sometimes they get it right. But, it is a hell of a lot better than just making up magic and telling people that their bottle of water or sugar pills (just $29.99!) actually does something.

  73. #73 Militant Agnostic
    September 27, 2010

    @ Whale to – So evidence that MDs can fool themselves into believing antidepressants are effective for mild to moderate depression when they are actually ineffective proves what about naturopathy. All it shows it that it is easy for practitioners to be wrong about the effectiveness of their treatments unless these treatments are validated by science rather than by tradition, anecdote and experience. This is hardly an endorsement of naturopthy.

    And what was the article you cited based on? A study in the Journal of the American Medical Association. You cna’t get more “Medical Establishment” than that.

  74. #74 MI Dawn
    September 27, 2010

    @Militant Agnostic (#66): yeah, the “steroids injected into her breastbone” line got me too. NO FREAKING WAY!!! I can’t think of ANY disease where a physician would do this. So, it’s a lovely anectdote, but since I don’t believe 1 line, there is no way I will believe any of the rest. Sorry, ‘saved by naturopathy’. One lie makes me think that the whole story is a lie.

  75. #75 Calli Arcale
    September 27, 2010

    I’m willing to argue on the assumpion that it’s accurately reported, merely because in my opinion, even if we take it at face value, it still doesn’t demonstrate any reason to conclude that naturopathy was effective in this instance or any other.

    But yeah, one must remember always that not only are anecdotes not reliable as data, they aren’t even always true. That’s not to say anybody’s necessarily lying; it’s amazing the kinds of misunderstandings people can develop, even when their doctors are being as clear as they can (which of course they aren’t always).

  76. #76 whale of a time
    September 27, 2010

    WLU – “simply shoddy reporting by a popular news agency?”

    The author of the journal is probably a shoddy reporter: Sharon Begley, widely known for her ability to break down complex scientific theories and write about them in simple prose, returned to Newsweek in March 2007 from the Wall Street Journal, where she wrote the “Science Journal” column for five years.

    Your argument would be more mildly interesting if you would educate yourself first about what your talking about rather than shooting from your hip full of opinion. It’s ironic when you speak thusly when you are commenting in a “science-based” forum. Going by what you say, I guess it would be difficult for the author to assess the conclusions explicitly stated in the studies published in the Journal Of the American Medical Association.

    WLU: “Assuming your point has anything to it…”

    The point of this blog article and the posts is that naturopathic medicine is not efficacious because it doesn’t meet scientific criteria and evidence. My point: if you’re going to measure one group by one standard (scientific criteria and evidence for naturopathic medicine), then that same standard should be used to measure all medicines, including western medicine and the data that goes with it. This is called objectivity and it’s a basic requirement and tenet of scientific evaluation, isn’t it? If scientific data is the criteria to then measure the efficacy of a system of medicine, then I stated that I find it ironic that people here are saying “science-based medicine is more efficacious” when it’s shown that it hasn’t been in this particular case.

    And Todd W. is correct in saying that the article pointed out that “antidepressants do work for very severe depression,” but the article also stated that only 13% of the population is affected with very severe depression. That means 87% of the population is being prescribed drugs that are not efficacious despite claims and FDA-approval that they are. Why are we doing this to the other 83% and exposing them to unneeded risk of side effects?

    In this forum, this type of behavior (making false claims for a drug or system of therapy) is called explicitly called “fraud.”
    Seems fraud is being perpetrated here as well by many “science-based” pharma companies in their claims that antidepressants work.

    My point is the comments here seem to be biased and not objective, i.e., biased against one system of medicine based on lack of scientific data and evidence, while ignoring data and evidence that discredits the use of another system’s therapy.

    Todd W.’s last post is a perfect example. In it he says it’s ok for one system of medicine to make mistakes (though what i actually presented was evidence refuting the efficacy of the drugs for 87% of the depressed) and they should be accepted, while another system should not be accepted based on the same criteria. The goal posts change for western medicine, i.e., not objective.

    And that’s what people don’t seem to see here…

  77. #77 Todd W.
    September 27, 2010

    @whale

    Hey, if you’ve got evidence showing that naturopathy works, let’s see it! If someone presents evidence showing that a given therapy works (preferably replicated in multiple studies), great! If evidence is presented showing that a given therapy does not work (again, with results replicated in multiple studies), then chuck it. That is science-based medicine.

    The anti-depressants that were shown not to work for mild to moderate depression should not be used for mild to moderate depression.

    There is no double-standard being applied here, except in your own misunderstanding of what’s going on.

  78. #78 Calli Arcale
    September 27, 2010

    I don’t want to get too off-topic on the subject of antidepressants, but….

    In this forum, this type of behavior (making false claims for a drug or system of therapy) is called explicitly called “fraud.”
    Seems fraud is being perpetrated here as well by many “science-based” pharma companies in their claims that antidepressants work.

    Oh, absolutely the big pharma companies will stretch the truth, sometimes to the point of overt fraud. That’s why we need a regulatory framework in which to punish them. The system is inadequate, but it’s better than nothing. At least there *is* a way to address the problems.

    But that’s not to say that all manufacturers of anti-depressants are committing fraud by marketing them. I have definitely seen marketing by them which goes beyond the provable claims. I think if I were in charge of regulating these companies, my first step would be to severely tighten the marketing rules. The subtle pushing of off-label uses of these drugs has gotten way out of hand, and curtailing the direct-to-doctor stuff hasn’t really solved it. Marketing people are inventive, and it’s hard to keep up with them.

    But anti-depressants are provably effective for severe, clinical depression. The problem isn’t that. The problem is that’s they’re being marketed mainly for other cases, probably because that’s where the growth potential is. In those cases, the drugs are not effective, and since all drugs have side-effects, the risk-benefit equation looks very bad. Big Pharma can’t take all the blame here; a good chunk of it needs to rest on the doctors who prescribe these drugs inappropriately. I don’t think the doctors are doing it as a short cut, as is often alleged. Rather, I think they’re doing it for the same reason some doctors push unproven alternative remedies — they saw a case where it seemed to work, and now confirmation bias is doing the rest. They are substituting their experience for science. It’s a very human thing to do, but it can cause great harm.

    People here do see that, whale of a time. It’s just not discussed in this particular thread because this particular thread is about a particular naturopath.

  79. #79 Composer99
    September 27, 2010

    Whale:

    You are claiming a double standard that I suspect exists more in your mind than in reality.

    In the fulness of time, MDs and others who practice science-based medicine, however imperfectly, will update their practices to take into account findings such as those reported by Newsweek. Individual MDs who do not – or who fall in with woosters – are routinely excoriated on this blog and its comment threads.

    Compare that to, say, naturopaths, homeopaths or chiropractors, who cling to discredited ‘treatments’ over a century (or more) past their sell-by dates.

  80. #80 T. Bruce McNeely
    September 27, 2010

    steroids injected into her breast bone

    .WTF

    I am not in any medical field, but this sounds like utter bullshit to me.

    I am in the medical field, and it IS utter bullshit. I would trust the rest of this account accordingly.

  81. #81 Prometheus
    September 27, 2010

    The argument advanced by “Whale” condenses to the following:

    Real medicine is not completely safe or completely effective and, in addition, medical practitioners make mistakes and are fooled into believing that treatments work when they don’t. Therefore, naturopathy must be both safe and effective.

    For those who missed it, the “argument” – such as it is – doesn’t provide any proof that naturopathy is either effective or safe. It also provides no proof that naturopathy is better – in any metric – than real medicine.

    Real medicine has its flaws and failures and the practitioners of real medicine are fallible humans, susceptible to all of the illusions and self-deceptions that humans are vulnerable to. However, much – if not most – of real medicine has scientific data showing that it works and is acceptably safe.

    Naturopathy is – so far as I know – also practiced by humans who are just as fallible and susceptible to illusions and self-deceptions as real doctors. However, their dogma is based on nothing more than wishful thinking – that “Nature” has the cure for all human illness. Its treatments have not been tested for efficacy and safety.

    So, the argument – which is endlessly repeated by those who think it is new – comes down this:

    Real medicine, while safe and effective, is not 100% safe and effective. Therefore, we should accept naturopathy, since it hasn’t been shown to be either safe or effective.

    Prometheus

  82. #82 whale of a time
    September 28, 2010

    todd w. and calli, the antidepressants were shown to be no more effective than placebos in mild to SEVERE depression. the only one that it did help, as you originally and correctly stated todd, was that it helped “very severe depression” but you somehow omitted this in your next response.

    composer99: “MDs and others who practice science-based medicine, however imperfectly, will update their practices to take into account findings such as those reported by Newsweek.”

    really? so antidepressants have been taken off the market? that’s news to me. from the Newsweek article and the reaction to the Kirsch, the writer of the JAMA article: “a scientist at a medical school…was warned not to submit a grant proposal with Kirsch if he ever wanted to be funded again….another scientist wrote a paper questioning the effectiveness of antidepressants, citing Kirsch’s work. It was published in a prestigious journal. That ordinarily brings accolades. Instead, his department chair dressed him down and warned him not to become too involved with Kirsch.”

    your idealistic opinion does not match reality. from another article based on reality: “Even when there are clear directions for safety, doctors tend to continue completing tasks in the way they’re used to. Take the insertion of central-line catheters, which deliver medications to sick patients. The Centers for Disease Control and Prevention developed guidelines for preventing infections triggered by the procedure, but compliance is spotty. Every year some 80,000 patients develop central-line infections and about 30,000 die, at a cost of more than $2 billion. A major reason: fatalism. “For decades, harm has been viewed as inevitable rather than preventable,” says Pronovost. “We’ve learned to tolerate it.”
    In 2001 Pronovost created a five-point central-line checklist—boiled down from the CDC’s lengthy guidelines—which includes washing hands and removing catheters when they’re no longer needed. One year after it was instituted at Hopkins, infection rates had dropped to almost zero. A network of Michigan hospitals that adopted the checklist slashed infections by two thirds, saving more than 1,500 lives and $200 million in the first 18 months. Still, a survey released this summer by the Association for Professionals in Infection Control and Epidemiology says the battle to reduce central-line infections continues because hospitals aren’t dedicating the time and educational resources necessary, and health-care leaders aren’t committed to solving the problem. When Pronovost asks nurses if they’d speak up if a senior physician isn’t complying with the checklist, “I am uniformly laughed at,” he says. “They say, ‘Are you nuts?’ ”” http://www.newsweek.com/2010/09/27/how-we-can-prevent-medical-errors.html

    the double standard: from todd w. “Science is a messy process. Sometimes, the people doing it make mistakes, sometimes they get it right.” i’m asssuming that you’re now euphemistically dismissing the deliberate ommission of negative trials as a simply a “mistake?” (“it turned out that about 40 percent of the clinical trials had never been published. That is significantly higher than for other classes of drugs, says Lisa Bero of the University of California; overall, 22 percent of clinical trials of drugs are not published. “By and large,” says Kirsch, “the unpublished studies were those that had failed to show a significant benefit from taking the actual drug.” That’s what you folks here like to call cherry-picking.

    It’s funny though that Orac says the SBM evolved out of evidence-based medicine because of a positive homeopathic trial. Yet for the positive homeopathic trial, it’s not valid and thus the whole system of medicine is dismissed and SBM born out of it. But again, when pharma companies cherry-pick their results, it’s a mistake.

    Prometheus, the fruits of your analysis don’t match my explicitly stated position, though Todd W. caught it quite easily.

    So with the double standards of your “skeptic’s” blog, which seems more like a pseudoskeptic blog by the way people have incorrectly state facts (omission of “severe depression” twice), opine criticism on things they have no idea about (i.e., WLU talking about a former Wall St. science reporter as being shoddy, composer99 and the fiction that SBM immediately institutes corrective measures as if there were some magical homeostatic mechanism that ethically rights all), and the general inability to see that, when false claims are made (antidepressants work for all) and $9.6 billion in sales is made in 2008 on them alone, of which 87% of people won’t receive benefit (from mild to severe depression) = $8.4 billion in tic tac sales, this is pharma woo…

    The pseudoskeptics always find a way to reason away the “mistakes,” i.e., fraud that big pharma is guilty of, which of course if committed by alt meds is “grounds” to dismiss the therapy altogether.

    The only people that suffer in this type of dogmatic and fanatical bias is those that you so fiercely contend that you are trying to represent, the patient.

    True skeptics are objective, they get their facts right, and look at all evidence, not the savory cherry-picked ones.

    A true skeptic seeks to serve all, not their own biases.

  83. #83 Chris
    September 28, 2010

    Finding an error in something does not mean another method is correct. If you wish to show that your pet therapy works, you need to show that it works. That takes work.

    True skeptics are objective, they get their facts right, and look at all evidence, not the savory cherry-picked ones.

    Which you are not.

    You said:

    The pseudoskeptics always find a way to reason away the “mistakes,” i.e., fraud that big pharma is guilty of, which of course if committed by alt meds is “grounds” to dismiss the therapy altogether.

    But you have obviously missed the post about Avastin and breast cancer, or the several posts on pharma ghost writing.

    You write lots of stuff, but say very little of real substance.

    My relative came out of the psyche ward after six weeks feeling the best she had ever been. This was where she got real meds, talk therapy and was actually forced to go on walks (she tended towards staying inside watching TV and avoiding any form of physical exertion). So when released and on her own, she went back to her naturapath who told her that the psychiatrist was wrong. She got off her meds, and then took some 200C stuff.

    She got worse. And now she is dead by her own hand.

  84. #84 whale of a time
    September 28, 2010

    “Finding an error in something does not mean another method is correct.”

    i said: it’s funny the biased double standards that are being used here in the name of “skepticism.” i’ve never said that because one therapy has a flaw that another works.

    where do you come up with this stuff? (please get some sleep.)

  85. #85 whale of a time
    September 28, 2010

    sorry about your relative.

    if said naturopath told her to get off her meds cold turkey, then it was irresponsible. you seem to be implying that naturopathy doesn’t work because of one person’s apparent error in judgment? funny, it’s exactly what i just said in my previous post…mistakes for western medicine = no problem, mistakes happen people are fallible…mistakes for alt med = it doesn’t work.

    pseudoscientific mind, chris.

  86. #86 daijiyobu
    September 28, 2010

    By the way, ND Rubin’s Oncology Association of Naturopathic Physicians

    (see http://www.oncanp.org/nat_onc.html#naturopathic_need )

    labels naturopathy “modern scientific nature cure.”

    Science, science, science.

    -r.c.

  87. #87 whale of a time
    September 28, 2010

    daijiyobu re: “Science, science, science.”

    In 1999 the Institute of Medicine’s landmark report “To Err Is Human” found that as many as 98,000 Americans die every year from preventable medical errors—a number many experts now believe is conservative. Since then, incorrect diagnoses, needless infections, drug mix-ups, and surgical mishaps have piled up as doctors face an onslaught of patients, an abundance of imperfect information, and an ill-served tradition of shaming and blaming individual practitioners when things go wrong. Health care, says Dr. Lucian Leape, a pioneer in patient safety and chair of the Lucian Leape Institute at the National Patient Safety Foundation in Boston, “remains fundamentally unsafe.”

    Now let’s apply your science, science, science criterion and criticism back to western medicine, if you have the objectivity to do so…100 000 deaths/year from PREVENTABLE errors: incorrect diagnoses, needless infections, drug mix-ups, and surgical mishaps.

    How good is this system of medicine based on sciecne measuring when 100 000+ people are dying from preventable causes?

  88. #88 titmouse
    September 28, 2010

    mistakes for western medicine = no problem, mistakes happen people are fallible…mistakes for alt med = it doesn’t work.

    Your attempt to create a brand A verses brand B debate reveals your ignorance of science.

    Notice there is no “western” algebra, geometry, arithmetic, physics, chemistry, biology, etc.

    The rules of evidence used within science are blind to branding categories. The readers here understand this and find you silly. Really, you’ll have better luck selling your nonsense at HuffPo.

  89. #89 whale of a time
    September 28, 2010

    “The rules of evidence used within science are blind to branding categories.”

    right, titmouse, the rules of evidence are blind to branding categories…except in this forum when evidence showing that a major drug of SBM has been shown to be ineffective for mild to severe depression, that’s 87% of all depressed in the U.S., and then fraudulently milking patients of $8.4 billion when they could have saved their money and bought real tic tacs instead.

    where is your blindness to the category of who’s drug it is.

    i see no article on here in this “skeptic” blog on this major article published in the Journal of the American Medical Association because you folks here are simply incapable of being objective = The rules of evidence used within science are blind to branding categories.

    but i guess that’s why you’re called pseudoskeptics..no capacity for objectivity and only the blindness of your own bias and agenda…of course as evidenced by the responses here.

  90. #90 Gray Falcon
    September 28, 2010

    Thai curry contains coconut milk, therefore naturopathy works. That’s what is known as a non sequitur. There’s no logical path from A to B. Substitute “antidepressants are over-prescribed” for A and you get the same issue. For further details on this fallacy, here’s a

  91. #91 Gray Falcon
    September 28, 2010

    Guess I should have hit preview first. Here’s the video. http://www.youtube.com/watch?v=ACbfncBr_MQ&feature=related

  92. #92 Scott
    September 28, 2010

    How good is this system of medicine based on sciecne measuring when 100 000+ people are dying from preventable causes?

    Given that it saved far more than 100k people, very good indeed. Can be improved, certainly. But far, far, far better than naturopathy.

    except in this forum when evidence showing that a major drug of SBM has been shown to be ineffective for mild to severe depression, that’s 87% of all depressed in the U.S., and then fraudulently milking patients of $8.4 billion when they could have saved their money and bought real tic tacs instead.

    From what I’ve seen, most people here AGREE that antidepressants are overprescribed relative to what the evidence justifies. Certainly I’ve not seen anybody in this thread disagreeing. Orac has certainly repeatedly applied large doses of not-so-respectful insolence to mainstream medical practices a new one when the evidence says they’re wrong. And just a bit upthread from Todd W, just as a concrete example:

    The anti-depressants that were shown not to work for mild to moderate depression should not be used for mild to moderate depression.

    And Calli Arcale:

    But anti-depressants are provably effective for severe, clinical depression. The problem isn’t that. The problem is that’s they’re being marketed mainly for other cases, probably because that’s where the growth potential is. In those cases, the drugs are not effective, and since all drugs have side-effects, the risk-benefit equation looks very bad. Big Pharma can’t take all the blame here; a good chunk of it needs to rest on the doctors who prescribe these drugs inappropriately. I don’t think the doctors are doing it as a short cut, as is often alleged. Rather, I think they’re doing it for the same reason some doctors push unproven alternative remedies — they saw a case where it seemed to work, and now confirmation bias is doing the rest. They are substituting their experience for science. It’s a very human thing to do, but it can cause great harm.

    Or in other words: STRAW MAN.

  93. #93 Chris
    September 28, 2010

    Whale, you don’t get it. The real medicine which was a combination of talk therapy, proper pharmaceuticals and actually leaving the house for a walk were working. It was the naturapathy that did not.

    Though that is one anecdote. If you have any real evidence that naturapathy is good for anything present it. Just saying something else is bad is not actual evidence.

  94. #94 Calli Arcale
    September 28, 2010

    See, Chris, he used anecdotes that show medicine is imperfect, but you aren’t allowed to do so, because that would show . . . I’m not sure. whale of a time hasn’t been very clear as to what his/her actual point is, or whether or not it relates to anything which was actually under discussion in this thread.

  95. #95 Dangerous Bacon
    September 28, 2010

    whale keeps going on about the need to be “objective” which is laughable. Human beings by their nature cannot be objective. Fair-minded is the best we can hope for. Part of being fair-minded in whale‘s case would be the recognition that failings in mainstream medicine are routinely discussed here (and I’m sure Orac, as well as every other medical professional who posts here spends considerable time on the job dealing with quality assurance/quality improvement). At the same time, a major focus here is opposing quackery, which while it is not of concern to whale is a subject of considerable interest to us. Attempts at tu quoque distractions are unconvincing. Even if mainstream medicine was the worst thing in the world or even positively Satanic (as its altie critics would have us believe), it does not exempt naturopathy or any other form of woo from criticism and the need to be evidence-based, which it heavily is not.

    whale: “As shown by the explicit criticism of drug companies by the authors of the recent JAMA paper

    Could you cite us examples of explicit criticism of naturopathic practice and supplement companies by altie journals and naturopathic societies? Good luck with that. Woo typically prides itself on the fact that its teachings are handed down largely unchanged over the centuries and views self-criticism and debate within the medical community as a weakness.

  96. #96 Prometheus
    September 28, 2010

    “Whale” (#82) comments:

    “Prometheus, the fruits[?] of your analysis don’t match my explicitly stated position, though Todd W. caught it quite easily.”

    Whale, I didn’t see that you had an explicitly stated position, apart from complaining that real medicine has some flaws and not everybody practising it rigorously uses the scientific method. Was this the comment where Todd W. “caught” your position?

    Todd W. (#77):

    “There is no double-standard being applied here, except in your own misunderstanding of what’s going on.”

    Yes, real medicine has flaws – but it has an ongoing process to correct those mistakes. Real doctors are sometimes fooled into believing something works when it doesn’t and some will persist in doing things that have been shown to not work. That’s the penalty for using human physicians instead of robots.

    Now, how about naturopathy (you know, the topic)? Do naturopaths have a mechanism for evaluating their therapies and weeding out those that don’t work or aren’t safe? Not really.

    Do naturopaths have research centers looking at new therapies that are better, safer or cheaper than what they are using today? No.

    If your real issue is that you’re upset that this ‘blog doesn’t spend as much time attacking the failings of real medicine as it does going after utter nonsense like naturopathy, chiropractic and homeopathy, why don’t you start your own ‘blog and do just that? That way, you could set up your straw men and knock them down as much as you like – and you can moderate into oblivion any comments that disagree with you.

    Prometheus

  97. #97 Scott
    September 28, 2010

    Now, how about naturopathy (you know, the topic)? Do naturopaths have a mechanism for evaluating their therapies and weeding out those that don’t work or aren’t safe? Not really.

    The cynic in me suspects that the reason they don’t is because if they did, they’d quickly weed themselves out of a job. Since there really isn’t ANYTHING they do that’s safe and effective, except for those bits they stole from real medicine…

  98. #98 Composer99
    September 28, 2010

    My comment on science-based practitioners updating their practices:

    In the ful[l]ness of time, MDs and others who practice science-based medicine, however imperfectly, will update their practices to take into account findings such as those reported by Newsweek.

    (spelling error mine)

    Whale of a time attempting to rebut my comment:

    composer99 and the fiction that SBM immediately institutes corrective measures as if there were some magical homeostatic mechanism that ethically rights all

    This is what would be called misrepresentation, or a straw man fallacy.

    Based on:
    - the non sequitur ‘defence’ of naturopathy (nail hit on head by Gray Falcon in #90)
    - the straw men (such as the one set up in my place as per my cut/pastes)
    - a continued lack of supporting evidence (of the rigorous, peer-reviewed kind) for naturopathic remedies (you know, the sort of evidence that the majority of skeptics would request for implausible medical claims)

    I would say that, his accusations notwithstanding, whale of a time is the pseudo-’skeptic’ on this thread.

  99. #99 whale of a time
    September 29, 2010

    what is so difficult with understanding that all i’m saying is that you folks here are biased?

    perhaps your bias doesn’t let you understand it..

    …and thus you keep up with the refrain that my argument is that a fraud in SBM doesn’t mean that naturopathy works (= incorrect pseudoskeptical minds at work).

    let me repeat: you folks are too biased to be true skeptics and hence are pseudoskeptics.

    …and that my friends is a fact…read over the # of errors given as responses to me, e.g.,

    -the Newsweek article was criticized as “shoddy” reporting when given by a seasoned science writer who formerly wrote for the Wall St. Journal
    -misquotes of what the JAMA article actually said, i.e., severe depression was shown in trials to be effectively treated, only very severe depression…c’mon, can we not get the simple facts write when this blog is dedicated to getting the facts write, calli and todd w?
    -people talking naively and idealistically about the medical system and doctors immediately instituting any changes when needed.

    …and the grand poohbah of your own biased woo-woo is that you apparently uphold science that shows when people are being defrauded by unconfirmed medical therapies in the noble cause of protecting the public, yet, if you were truly objective…there would have been an article in your “science” blog (lol) on the major deception of the multibillion dollar fraud being perpertrated by pharma companies in selling drugs that don’t work, as shown by the cherry-picked positive published antidepressant drug trials and the unpublished negative drug trials attained through the Freedom of Information Act.

    you undermine and belittle your own cause with your bias.

    again, my point is not that because acts of SBM fraud are alive and hurting people we can take this as proof that naturopathy works.

    but i’ll say it again…because you are biased, you fall from true skepticism to the realm of pseudoskeptical woo and make a farce of objective science.

  100. #100 whale of a time
    September 29, 2010

    “Human beings by their nature cannot be objective.”

    good job for recognizing that, bacon, that’s why we use objective data.

    and as titmouse says, “The rules of evidence used within science are blind to branding categories.” so why are you not discussing any and all evidence that shows fraud regardless of the category of medicine? by the very fact that you omit SBM from the scrutiny of “the rules of evidence” in your blog shows…

    BIAS

    = the antithesis of science and the flag of woo.

    i hear a train a coming…and it’s coming down the bend…it’s the scienceblog.com and the train is chugging WOO-WOO!

    (…and, no, because pharma fraud exists doesn’t mean that naturopathy works)

  101. #101 T. Bruce McNeely
    September 29, 2010

    Yes, we are biased. We are biased in favour of evidence. Shame on us.

  102. #102 whale of a time
    September 29, 2010

    when the pharma industry’s direct-to-consumer advertising is encouraging people to demand pills to cure conditions that are not diseases (like shyness) or to get through ordinary life problems (like being laid off), can we not smell the woo through the prescription pads and “positive” clinical trials?

    why not do humanity a favor and stop being biased, put on your objective thinking caps and help stop this woo.

    here’s a nice article from the new yorker if you’d like to read: http://www.newyorker.com/arts/critics/atlarge/2010/03/01/100301crat_atlarge_menand?currentPage=all

  103. #103 whale of a time
    September 29, 2010

    “Yes, we are biased. We are biased in favour of evidence. Shame on us.”

    Yes, cherry-picked evidence. So flavorful and satisfying to the bandwagon.

  104. #104 Kathryn
    September 29, 2010

    Why are y’all still feeding this whale troll?

  105. #105 Todd W.
    September 29, 2010

    Ah, I think I get it now. Whale’s got its panties in a bunch because Orac tends to focus on alt-med crap and doesn’t cover crappy mainstream treatments to the same degree. It seems that whale thinks that less coverage means total lack of criticism.

    Newsflash, whale: Orac does occasionally write about mainstream medical treatments that don’t work as well as they were billed to be (or at all). True, he doesn’t cover those as often as alt-med probably for a number of reasons: a) his interests lie in discussing alt-med, b) alt-med stories tend to pop up more frequently, c) a lot of the mainstream medical crap is old news.

    Also, you have created a straw man:

    -people talking naively and idealistically about the medical system and doctors immediately instituting any changes when needed.

    I don’t recall seeing anyone saying that medical practitioners “immediately” change their practice when new evidence comes out. Even Orac has said that doctors are sometimes slow to change. Eventually, however, most of them (and sometimes even all of them) do.

    Go back and read the comments here again after you derailed it with the antidepressant stuff. You will see comments that if the evidence shows antidepressants don’t work for mild to moderate depression, then they shouldn’t be used.

    When it comes down to it, though, this is Orac’s blog. He’ll write what he feels like writing about. If you don’t like that it isn’t all mainstream-criticism all the time, then don’t read it. Go start your own blog.

    And yes, people have biases. Everyone does. If you ask anyone on this thread if they think that a given medical treatment should be changed or abandoned if the evidence suggests that it is useless or possibly detrimental, I bet that almost every one of them would say yes. The only one stuck in a rut, staring at the world through their “just-so” glasses is you.

  106. #106 whale of a time
    September 29, 2010

    “I don’t recall seeing anyone saying that medical practitioners “immediately” change their practice when new evidence comes out.”

    i do. composer99: “MDs and others who practice science-based medicine, however imperfectly, will update their practices to take into account findings such as those reported by Newsweek.” The JAMA article was published in January and their have been few changes, if any…the writers of the article and those associated have been ostracized as mentioned in the article and antidepressants are still being prescribed for depression.

    strawman? “By 2005, one out of every ten[!] Americans had a prescription for an antidepressant. IMS Health, a company that gathers data on health care, reports that in the United States in 2008 a hundred and sixty-four million prescriptions were written for antidepressants, and sales totalled $9.6 billion.”
    is 1 in every 10 Americans seeing a naturopath? no. are 1 in every 10 of your friends on antidepressants? could very well be so. this is what is most affecting the public now, so why doesn’t this blog, a defender of science-based medicine with the best interests of the public in mind, tackle these types of dominating issues?

    i mean antidepressants are so successful, in terms of sales, that “doctors prescribe antidepressants for patients who are not suffering from depression. People take antidepressants for eating disorders, panic attacks, premature ejaculation, and alcoholism.”

    how sweet is that when you can get doctors to prescribe a drug that doesn’t work for most patients as advertised and as passed by the FDA and then you can get them to have doctors prescribe them for conditions outside their “indicated” use? people vs profit?
    Honestly, are you not incensed or at least a little disturbed by this pharma antidepressant crap? For the love of all that’s right and wrong in the world?
    Why doesn’t Orac defend the public against the woo that has reached 1 in 10 Americans with at least one simple article on antidepressants rather than swinging at the strawman of naturopathy? where are the priorities? if he did, you commenters could unleash your usual condescension and ridicule but knowing you, you wouldn’t because…my god…attack and ridicule SBM simply because it’s committed a “mistake” and error as humans are fallible as some of you have suggested??

    where is your concern for all that is right and science-based when the public is intentionally being injured to the tune of almost $10 billion/year?

    Though we have our differences, we can agree that we’re all in the same boat of wanting to keep the safe and healthy by using the science and evidence out there to defuse any fraud, regardless of system of medicine…so, who are we truly defending when we’re biased and ignore this massive fraud committed by pharma companies?

  107. #107 Composer99
    September 29, 2010

    Whale, we have our differences because you are misrepresenting people on this comment thread.

    I would like to direct your attention to my post #99, where I pointed out how you misrepresented my statement ‘in the fullness of time’ to mean ‘immediately’.

    You do it again in your post #106.

    That is the straw man that Todd and myself have suggested you are setting up.

  108. #108 titmouse
    September 29, 2010

    whale,

    It is customary to comment upon the issues raised in the original post.

    Notice that antidepressants are not mentioned in the original post.

    Your off topic perseveration on antidepressants is weird. It’s like you’ve got an axe to grind and you don’t give a poo what everyone else in the room would like to discuss.

    Not a way to win friends and influence people.

    Topic. Stay on it.

  109. #109 Ender
    September 30, 2010

    Both ‘Whaleofatime’ and the people replying to him are failing to have a conversation here.

    Whale of a time is clearly under the impression that the examples of people coming to harm after abandoning medicine for naturopathy were being used to argue that naturopathy is rubbish and shouldn’t be used.

    He responded with evidence of people coming to harm after continuing with medicine, and evidence of medicine that has been found to be inneffective. He reversed the argument he believed people were making and said “If you reject naturopathy on those grounds, you must now reject medicine!”

    But the vast majority of responses have been responding to the argument they think he is making, which is “Medicine has had documented errors and flaws, therefore naturopathy is great”.

    Allow me to clear up the confusion:

    No one is arguing that naturopathy is bad because it has caused harm by drawing people away from effective treatments. But people have responded to the assertion that Naturopathy cannot harm you with examples where it has harmed people.

    Whale is not arguing that medical errors mean that naturopathy is good He is trying to reverse the argument above that no one is making.

    Whale of a Time- the argument for medicine and against naturopathy is not that one or other causes harm, but that medicine is designed to be tested and not instantly but eventually move towards only using treatments which have a known benefit, which have been proven to the best of our scientific ability, and that when treatments that we previously thought were effective are shown to be inneffective or dangerous we stop using them, whereas naturopathy is tested only by each individual provider and his impression of whether treatments are effective, each provider may move on when they discover a modality that is not effective, but the system stays as it is, stuck in a non-improving model and being left behind by medicine.

  110. #110 Prometheus
    October 1, 2010

    Ender makes several excellent points; I’d like to add one more:

    Real medicine is a messy work-in-progress that at any given time has some treatments that will eventually be shown to not work and even a few treatments that have already been shown to be ineffective and are in the process of being abandoned. However, the bulk of real medicine’s therapies are safe and effective. This doesn’t mean that they are 100% safe or 100% effective and it certainly doesn’t mean that there aren’t some practitioners out there who are incompetent, misinformed, deluded or out of date.

    In contrast, naturopathy – even in its “pure” form which eschews the use of “artificial” pharmaceuticals – prescribes plant (and a few animal) products which have real amounts (as opposed to homeopathy) of compounds which have actual physiological effects. This wouldn’t be so frightening if it weren’t for the fact that naturopathic practitioners have no idea what these compounds do (in many cases, nobody knows what they do) and only the vaguest ideas what the concentration of these compounds are in their remedies.

    No wonder so many naturopaths want the privilege to prescribe real pharmaceuticals. Thinking naturopaths must be scared stiff knowing that they are giving their patients unknown mixtures of unknown compounds that have – at best – only poorly-understood physiological effects.

    Unlike homeopathy – which prescribes non-existent (and therefore inherently “safe”) “medicines” using a fantasy-based paradigm – naturopaths are prescribing real, physiologically active and potentially deadly compounds (whose concentrations, physiologic activities and even identities are largely unknown) using a fantasy-based paradigm. The first (homeopathy) is a recipe for relieving the “patient” of the burden of too much money while the second (naturopathy) is a recipe for disaster.

    Finally, as Mr. Thompsen described in his comments, real medicine has mechanisms for identifying treatments that aren’t safe and effective (how else would Mr. Thompsen know about them?) and even practitioners who aren’t safe and effective (ditto) and removing them from practice.

    When was the last time (or the first time) you heard a naturopathic, homeopathic or chiropractic board, organisation or society announce that a therapy their practitioners used was unsafe or ineffective and should be abandoned? I read about that sort of thing from real medicine at least monthly, but I can’t recall ever hearing it from fantasy-based medicine.

    Maybe the reason we “skeptics” focus on “alternative medicine” is that there is already a functional system monitoring real medicine.

    Prometheus

  111. #111 squirrelelite
    October 1, 2010

    I wonder if any naturopaths prescribe oleander extract?

    I watched an old NCIS episode last night where it was used in a couple of murders.

    According to the Wikipedia article it was recommended in ancient medicine. And, of course, it’s All Natural!

    Pliny the Elder in his Naturalis Historia written circa AD 77 claimed that despite its toxicity Oleander was an effective snakebite cure: “…if taken in wine with rue…”.

    Despite a lack of any proven benefits, a range of Oleander-based treatments are being promoted on the Internet and in some alternative medicine circles, drawing a warning letter from the U.S. Food and Drug Administration (FDA). Additionally, a Texas-based biotechnology company is researching oleander as a potential treatment for skin cancers and as well as an anti-viral treatment.

    Oleander is one of the most poisonous plants in the world and contains numerous toxic compounds, many of which are deadly to people, especially young children. (Despite this fact, it is often grown in school yards.) The toxicity of Oleander is considered extremely high, and it has been reported that in some cases only a small amount had lethal or near-lethal effects. The most significant of these toxins are oleandrin and neriine, which are cardiac glycosides. They are present in all parts of the plant, but are most concentrated in the sap, which can block out receptors. High risk circumstances of exposure include children playing with the ornamental shrub, as well as adults or children tasting, chewing, ingesting portions of the plant, and inappropriate medicinal use of plant infusion. Oleander bark contains rosagenin which is known for its strychnine-like effects. The entire plant, including the nectar, is toxic, and any part can cause an adverse reaction. Oleander is also known to hold its toxicity even after drying.

  112. #112 T. Bruce McNeely
    October 1, 2010

    I’m pretty sure they recommend Comfrey. I used to see it in the window of a “Heath Food” store when I was a kid. Here’s what Health Canada has to say about Comfrey:

    http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2003/2003_101-eng.php

    In summary: don’t use it, it’s toxic to your liver.

  113. #113 titmouse
    October 1, 2010

    Real medicine is a messy work-in-progress that at any given time has some treatments that will eventually be shown to not work and even a few treatments that have already been shown to be ineffective and are in the process of being abandoned.

    I’m a little worried that we’re bending over backwards to concede whale’s point about antidepressants, which I’ll try to summarize as best I understand it:

    If doctors were actually science based they would stop prescribing antidepressants to people with mild depression, as recent research showed no benefit for people with mild depression, though there was some benefit for people with severe depression. Given that only 13% of depressed patients are rated as severe, 87% of the people getting antidepressants now should no longer be getting them.

    Yet even with full acceptance of the evidence showing no benefit for antidepressants in patients with mild depression, many patients with mild depression will still be offered the option of a medication trial. Here’s why:

    1. Depression is associated with significant morbidity and mortality (some cancers are less deadly).
    2. We know we will misjudge the severity of someone’s depression a certain percentage of the time.
    3. The newer antidepressants are relative safe.

  114. #114 daijiyobu
    October 2, 2010

    Here’s an interesting AANP Rubin ‘miraculous cure’ cancer video I’ve stumbled across, by the way:

    http://www.youtube.com/watch?v=GraLdXNtaJU

    I’m wondering about the patient’s supposed ‘complete recovery’ from stage III Hodgkin’s [or so] via naturopathic oncology therapy, and what Rubin’s therapeutic intervention exactly was.

    I’m going to guess it was chelation [the video shows an IV].

    Is it possible that all that was done naturopathically wasn’t curative, and the patient coincidentally had a spontaneous remission?

    Since science isn’t that important to him [or them, besides for marketing purposes], the bigger question may be “how could you know ANYTHING reliably?”

    -r.c.

  115. #115 Nanci
    April 5, 2011

    I wonder if any naturopaths prescribe oleander extract?

    I watched an old NCIS episode last night where it was used in a couple of murders.

    According to the Wikipedia article it was recommended in ancient medicine. And, of course, it’s All Natural. Nalai

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