Respectful Insolence

It’s rather odd that I’ll be writing two posts in a row having to do with a chiropractor, given that chiropractic is at best an occasional topic on this blog. Certainly, I don’t hesitate to take on chiropractic when the mood strikes me or, more importantly, when I come across some seriously burning stupid coming from a chiropractor, but other topics tend to dominate my blogging. Let’s just put it this way. Two posts in a row on a cancer quack or about antivaccinationists would be nothing the least bit unusual here, but two posts in a row about chiropractors is.

As regular readers probably recall, my last post was about a rather silly chiropractor named J.C. Smith, who made some rather silly statements regarding the Institute for Science in Medicine. Then I took the Fourth of July off because, well, it’s the Fourth of July and like any red-blooded American I take it off if I possibly can. That includes blogging now. So here we are, the day after the holiday, and over the brief holiday someone forwarded another example of a chiropractor demonstrating the accuracy of my assessment of all too many chiropractors as physical therapists with delusions of grandeur. Of course, that’s not the part that caught my attention so much. After all, chiropractors are constantly making claims that they can treat allergies, asthma, infectious diseases, digestive disorders, and a whole host of systemic diseases and disorders that have nothing to do with the spine or musculoskeletal system. That’s nothing unusual or particularly egregious.

What is particularly egregious is when a major publication in essence parrots the claims of chiropractors, either completely uncritically or with that irritating false balance, the “tell both sides as though they were both valid” fetish that all too many publications and journalists have.

Journalists like Patricia Yollin.

Yollin published just such an example of bad medical journalism a couple of days ago in the SFGate entitled Chiropractor offers hope, treats osteoporosis. It is basically a puff piece that reads far more like an advertisement for a Bay area chiropractor named Lani Simpson than like anything resembling journalism. So how did a chiropractor get involved in osteoporosis, to the point of declaring herself an “expert”? The article describes how right off the bat:

Twenty years ago, Lani Simpson learned she had osteoporosis. She was only 42.

“It terrified me,” she said. “All of a sudden, it made me feel weak. Did it mean I couldn’t jog or play tennis or roller-skate?”

What it meant was that Simpson, a chiropractor who figured she knew quite a bit about the 206 bones in the human body, realized she had a lot more to learn. She is now a clinically certified bone densitometrist – adept at analyzing bone density scans of the hip and spine – and has her own practice in Berkeley, which combines conventional and alternative approaches to address a condition that affects 10 million Americans, 80 percent of them women.

OK. So what we have here is a chiropractor who’s dones some training and now knows how to interpret bone densitometry scans. That’s all it means to be a clinically certified bone densitometrist. For the sake of giving Simpson the benefit of the doubt, I’ll assume that she passed the test to become a Certified Clinical Densitometrist, which according to the International Society for Clinical Densitometry is a “professional designation awarded to individuals who meet specified knowledge requirements measured through a standardized testing process for the interpretation of bone densitometry (offered in the U.S. and internationally).” In other words, apparently Simpson can diagnose osteoporosis and knows how to do DXA scans. That’s all very well and good, but it means nothing. Certainly it doesn’t mean that anything unique to chiropractic is involved.

Indeed, nearly everything I see in the article describing what Simpson does for patients with osteoporosis is, for the most part, consistent with science-based guidelines for treating osteoporosis, all “integrated” (of course!) with woo. For instance, she says that drugs are “overprescribed but sometimes necessary.” Whether it’s true that drugs are “overprescribed” or not, at least she acknowledges that they are necessary at times. I suppose that’s something for a chiropractor. I suppose it’s probably also a good thing that I couldn’t find any evidence that she prescribes spinal manipulation for osteoporosis. Neck manipulation, I would imagine, would in particular be not such a wise idea, particularly if the osteoporosis is bad. In other words, whatever “integration” of science-based medicine and woo Simpson is offering, it has nothing to do with chiropractic. Remember, when D. D. Palmer “discovered” chiropractic 120 years ago, his “theory” stated that misaligned or “subluxated” vertebrae cause “nerve interference” that causes ill health. In brief, chiropractic postulated that removing the “nerve interference” by manipulating the spine to remove blockages of the “innate intelligence” that would maintain health. Yes, it sounds very much like vitalism, with subluxations blocking the flow of “life energy” (a.k.a. qi) and removing subluxations removing those blockages, just as acupuncturists claim that putting tiny needles into specific points can “unblock” the “flow” of qi.

Yes, I know that these days there are a lot of “mixer” chiropractors versus “straight” chiropractors. In “straight” chiropractic, everything is due to vertebral subluxations. It doesnt’ matter if it’s back pain, asthma, allergies, cancer, hypertension, heart disease, autism, or any other condition or disease. Everything. “Mixers” will mix in other woo with pure chiropractic. Clearly, Simpson is a “mixer,” who mixes—excuse me, “integrates”— a bit of conventional medicine with a bit of woo with a bit of back cracking, all in order to produce an “integrative medicine” practice. Or, as some pithily and accurately put it, they pretend to be real doctors. That’s what Simpson is doing: Pretending to be a real doctor.

So what we get is a mix of standard medical therapies, including vitamin D and calcium supplements, plus muscle-strengthening and weight-bearing exercises, plus:

Simpson determined that her client’s osteoporosis was the result of a vitamin D deficiency and premature menopause. Bhonsle said she now takes 1,000 milligrams of vitamin D daily and wears a patch that administers a small dose of bioidentical estrogen, an exact chemical match to the estrogen that humans produce. She walks whenever she can, and eats nuts and calcium-rich yogurt, which is easily digested. As a result, she has gained bone density.

Note that there is no reason to be using “bioidentical” estrogen or “bioidentical hormones.” Moreover, these days, estrogen replacement is not utilized that much anymore because of the potential problems with hormone replacement therapy.

But Simpson’s advice for osteoporosis, at least as presented in this article, is not the real problem. The real problem is that this article not only buys into but promotes the idea that chiropractors are capable of functioning in a primary care role, which is what Simpson appears to be doing, more or less, with her practice for menopause and osteoporosis. Moreover, although the woo content of her website is lower than what I’ve seen for many chiropractors, there’s still quite a bit there. For instance, she seems to think that antiperspirants cause breast cancer:

The most common area to develop breast cancer is in the upper outer quadrant–or in layman’s terms, right next to the armpit. As such, alternative doctors have been arguing for years that there may be a connection between the use of deodorants and the development of breast cancer. It was long thought that the aluminum in antiperspirants might be the culprit (all antiperspirants contain aluminum). However, there is a chemical that is perhaps more deserving of suspicion. Almost all deodorants contain a preservative from the paraben chemical family. On the label it can be listed as methyl-, butyl- or propyl-paraben. It is a known fact that parabens exhibit estrogen-like hormonal activity. The chemical companies do not dispute this, but instead argue that it is such a small amount that it is unlikely to cause breast cancer. Let’s play it safe and not buy into this argument – especially as there is a perfect alternative with no possibility of being carcinogenic.

I’ve dealt with this myth before. The reason that there are more tumors diagnosed in the upper outer quadrant of the breast is because there is more breast ductal tissue there. In other words, the number of cancers is proportional to the amount of breast tissue at risk, and the number of breast cancers diagnosed in the upper outer quadrant is not disproportionate. Nor is there any good evidence to link parabens to breast cancer.

In another article, Simpson claims that hypothyroidism can be…well, see what she says:

While thyroid disease does run in families, the expression of a low functioning thyroid can be caused or worsened by a poor diet, food allergies, adrenal overload (chronic stress), lack of exercise, pregnancy, gluten intolerance and many other triggering factors.

Of course, the most common cause of thyroidism in the U.S. is Hashimoto’s thyroiditis. Other causes include surgery (various thyroidectomies), radiation, viral infections, and some drugs. Worldwide, the number one cause of hypothyroidism is insufficient iodine in the diet, but this is not a problem in the U.S. because of iodinized salt and the addition of iodine to various foods. So, in reality, diet is not a major cause of hypothyroidism, at least not in the U.S. In rarer instances, disorders of the pituitary gland or hypothalamus (secondary and tertiary forms of hypothyroidism) can do it. Of course, gluten intolerance is the woo cause of all disease. Or, at least, so it seems fairly frequently, given how often I see alt-med practitioners blaming virtually every set of symptoms under the sun on gluten intolerance. These days, though, hypothyroidism appears to be the new gluten intolerance, diagnosed by all manner of dubious practitioners on all manner of dubious bases and then treated with—of course!—”bioidentical” hormones, because in alt-med world “bioidentical” is more “natural” and therefore always, always better.

In another article, Simpson blames hypothyroidism on soy products and makes these recommendations:

  • If you do have hypothyroidism, discontinue soy products for 3 months to see if that helps balance your system.
  • If you do eat soy foods stick with fermented soy – tempeh, miso, tamari, natto. These forms are more easily digestible.
  • Make sure soy products are organic and not GMOs (genetically modified organisms)!
  • Keep in mind that the thyroid gland is positively and negatively impacted by the foods we eat. Eat healthy foods and avoid processed carbs and raw cruciferous vegetables.
  • Exercise and do your best to decrease unnecessary stress in your life.
  • Some people are allergic to soy. Pay attention to your body and see if you experience gastrointestinal upset after eating soy.

This is a perfect example of non-evidence-based recommendations mixed with recommendations that are vague and apply to nearly anything, such as to exercise and avoid stress. In fact, there’s no good evidence that soy exacerbates hypothyroidism, although it might interfere with the absorption of thyroid replacement hormone. Even if true, all that means is that people with hypothyroidism shouldn’t eat soy within a few hours of taking their Synthroid. There is some evidence that phytoestrogens in in soy can exacerbate hypothyroidism in patients with inadequate iodine intake, but the evidence is conflicting. It’s certainly not the slam dunk that Simpson implies that it is. And, even if soy were a problem, does it make sense to recommend eating soy forms that are more easily digested if soy actually does interfere with thyroid function and that’s what you’re trying to avoid?

Then, of course, Simpson is into cleanses, even going so far as to offer a 21 day cleanse challenge, complete with “paleo diet” nonsense that includes “paleo meals,” “paleo cleanses” (I didn’t know cave men cleansed), “detox” packets, and, of course, a BPA-free shaker, all for $450 to $650 for three weeks. In return, she promises a whole host of improvements in health that include decreased PMS symptoms, decreased allergy symptoms, and fewer colds and flu.

Lani Simpson is typical of many “mixer” chiropractors in that she seamlessly mixes a little conventional medicine with the woo that is chiropractic with a bunch of other woo ranging from “detox” to “bioidentical” hormones to all sorts of dietary manipulations. Over the last 20 years, she’s made a name for herself in menopause and osteoporosis among “alternative” practitioners, despite no evidence that her recommendations produce any better outcomes than standard medical care—or that they even produce outcomes as good. Meanwhile, she does the talk circuit with other “wellness” practitioners to promote her business, while credulously believing scare stories about the flu vaccine (i.e., Desiree Jennings) and expressing “doubts” about the flu vaccine. This SFGate article portrays her as a trailblazing “expert” in osteoporosis on par with real experts, despite no evidence of her ever having contributed to the peer-reviewed medical literature on the subject, rather than as what she is, a chiropractor playing at being a real doctor.

Comments

  1. #1 tgobbi
    July 5, 2012

    Somehow, during the 30+ years I’ve been fascinated by (and studying) alternative healthcare, chiropractic has become my main interest. I’ve learned many things about chiropractic and chiropractors. Two of them are:

    • Mixers are as much naturopaths as they are chiropractors. Orac says as much in today’s blog.

    •Chiropractic is not a healthcare profession; it’s an elaborate marketing scheme.

    Years ago someone commented that chiropractic has never made a single contribution to the field of human health. This is as true today as it ever was.

  2. #2 Marry Me, Mindy
    July 5, 2012

    So many headbangers in there

    1) She was a chiropractor but knew basically nothing about osteoperosis? Good gravy, what do they even know? Your manipulating bones and don’t even know how they are put together?
    2) Of course it all begs the question, why not just go to a doctor? Wow, she got trained in densiometry? And this her special? Jesus that is part and parcel to osteopaths.
    3) She is on the lecture circuit to tell how she treats hypothyroid and menopause? Your typical internisty deals with those issues all the time and they don’t do lectures. But a chiro does it and suddenly everyone wants to hear about it?

  3. #3 Darwy
    Røde grøde med fløde....but live free or die atm.
    July 5, 2012

    I have a good friend that’s bought into the ‘paleo’ everything hype.

    He’s been practically LIVING at the gym exercising now, but attributes his weight loss, etc to ‘eating like a caveman’ alone.

    I’m like… if it’s just the diet, why do all the guys down at Fitness World know you by name?

    My mother asked me about seeing a chiro for her osteo. I told her she’s better off going to her regular MD and asking for either a bone density test or other workup which won’t rely upon a pile of steaming woo-crap and possibly endanger her health.

  4. #4 Calli Arcale
    July 5, 2012

    On the label it can be listed as methyl-, butyl- or propyl-paraben. It is a known fact that parabens exhibit estrogen-like hormonal activity.

    Interesting that she blames that for breast cancer, given that she happily admits giving bioidentical estrogen to a woman who probably doesn’t benefit from it. Consistency is clearly not her strong suit — then again, if it were, she probably wouldn’t be into integrative medicine, which is by nature inconsistent.

    Orac:

    In fact, there’s no good evidence that soy exacerbates hypothyroidism

    Pity. If it did, maybe my mom wouldn’t have had to go for radioactive iodine to treat her Grave’s Disease. She could’ve just eaten lots of soy.

    And, even if soy were a problem, does it make sense to recommend eating soy forms that are more easily digested if soy actually does interfere with thyroid function and that’s what you’re trying to avoid?

    Well, consistency is clearly not her strong suit. (Nor is thinking about anything terribly hard.)

  5. #5 Denice Walter
    July 5, 2012

    A few things:

    (as an aside) Supposedly, tennis builds bone density- it’s weight bearing, bulids muscle and IIRC, there was a study that showed increased bone density in the forehand arm ( more than what would have been attributable to the fact that forehands utilise the dominant arm).

    As tgobbi states- chiro is elaborate marketting.

    I’m starting to think that all woo-providers are ” mixers” because they toss in SBM, like diet and exercise, which they then use to mis-inform their enraptured audiences by denying that SBM has anything to say about lifestyle, diet, exercise et al. In fact, this little gem of sparkling prevarication is a large part of their argument. It’s also the foot-in-the-door prior to the bait-and-switch.

    Masquerading as doctors ( and sometimes even as psychologists and physicists), in their frenzied play acting and fancy dress routine, enabled by creatiive mis-appropriation of language ( e.g. clinical studies, protocols, counselling, board-certified, researchers, scholars-in-residence ad nauseum) the dissemblers then go even further- they claim that their nonsense is the REAL SCIENCE!

    SBM is compromised corporate science, bought and paid for by BIg Pharma- so are universities; articles in journals are cherry-picked to represent only the offficial position approved by the Orthodoxy ( Oh, shame on you, Dr Fiona!… not at all really) and pharma-based ghost writers are the rule not the exception. SBM lies with statistics… And woo-ticians lie like rugs.

    Continuing in this vein, they maintain that they represent REAL science- i.e. woo-based research-by-proxy- which predominantly ascribes health and “cures” to nutrition, as supplied by healthy foods and supplements ( what they sell as products and via informational books and films) without any contamination by pharmaceutical products. Whereas, I can’t say the same about their supplements.

    In the third act of this farce, health freedom fighters then cries “Prejudice!” and “Discrimination!” because their non-science have been- rightly- ignored by SBM. Some even compare their wretched selves to Mssrs Ghandi, King, Mandela and others. I have a few other personnages I’d prefer to compare them to…

  6. #6 Denice Walter
    July 5, 2012

    Edit:
    health freedom fighters then *cry*…

  7. #7 Eric Lund
    July 5, 2012

    Some even compare their wretched selves to Mssrs Ghandi, King, Mandela and others.

    “Help! Help! I’m being repressed!”

    Comparing themselves to Gandhi et al. is one step removed from the Galileo gambit. Sure, Gandhi et al. spent some time in jail for their beliefs. So, in a way, did Charles Manson and Ted Kaczynski. Not that I’m equating advocating medical woo with first-degree murder–but it’s equally ridiculous to equate it with fighting for freedom. Also, most of these alt-med types haven’t actually gone to jail.

  8. #8 Denice Walter
    July 5, 2012

    @ Eric Lund:

    Oddly enough, these creatures are as white as I am… and have no idea what being treated as second-class institutionally and historically involves.

  9. #9 Phoenix Woman
    July 5, 2012

    I have a good friend that’s bought into the ‘paleo’ everything hype.

    He’s been practically LIVING at the gym exercising now, but attributes his weight loss, etc to ‘eating like a caveman’ alone.

    I’m like… if it’s just the diet, why do all the guys down at Fitness World know you by name?

    The diet might have something to do with it, if he really did cut back on carbs and if the recent research pertaining to carbs and weight gain pans out. But what the Paleo Diet most obviously does, especially if he backs off on fats as well as carbs, is to reduce total caloric intake, and for this simple reason: Meats have 5 kcal/gram, carbs 7 kcal/gram, and fats 9 kcal/gram. In other words, pound for pound, you’re taking in fewer calories on a mainly-meat diet than on a mainly-carb diet, which is what most Americans eat.

    We eat lots of carbs because they’re cheap and store without refrigeration, which mean that they can be shipped long distances and stockpiled at relatively little expense compared to meats and produce. (This is also why the usual economies-of-scale rule doesn’t apply to most produce — you can’t do anything cost-effective to produce to make it last longer than a week or two, so your local store is likely to have produce priced the same or less than the Wal-Mart in the megamall.)

  10. #10 Phoenix Woman
    July 5, 2012

    This is a perfect example of non-evidence-based recommendations mixed with recommendations that are vague and apply to nearly anything, such as to exercise and avoid stress. In fact, there’s no good evidence that soy exacerbates hypothyroidism, although it might interfere with the absorption of thyroid replacement hormone. Even if true, all that means is that people with hypothyroidism shouldn’t eat soy within a few hours of taking their Synthroid. There is some evidence that phytoestrogens in in soy can exacerbate hypothyroidism in patients with inadequate iodine intake, but the evidence is conflicting. It’s certainly not the slam dunk that Simpson implies that it is. And, even if soy were a problem, does it make sense to recommend eating soy forms that are more easily digested if soy actually does interfere with thyroid function and that’s what you’re trying to avoid?

    Remember when soy used to be the miracle superfood? Then the woo-ies found out that it’s used in modern industrial agriculture and of course since modern = bad in their view they did a total 180 on it.

    But here’s what’s really interesting: Most of the woo-ies who didn’t want to give up their edamame decided to claim that all soy wasn’t bad — just the hyper-processed kinds. But Simpson is saying the exact opposite: The fermented kinds are best! (Yes, kiddies, fermentation is processing.)

    And of course all of this is said without a single shred of evidence to back up any of these claims and counterclaims.

  11. #11 M
    July 5, 2012

    This is off topic, but the in mall that is attached to the store where my wife works has a chiropractic kiosk. One of the claims is that if I suffer from cancer, chiropractics can help me.

    HA!

  12. #12 Stu
    July 5, 2012

    Meats have 5 kcal/gram

    Umm… WHAT?
    (Also, are you seriously implying there’s no fat in meat?)

  13. #13 lsm
    July 5, 2012

    A family member of mine married a chiropractor and has been on a fervent 30 year quest to achieve “natural Nirvana” via all the chiropractic protocols. It’s interesting that despite achieving this pure state she has suffered a series of condition including arthritis, cataracts, gout, and cancer; whereas I, in my sloth, have been spared all of those things.

    Genetic predisposition trumps all, and the alt med quest for purity through diet and supplementsfanatically don’t seem to make the connection

    ,
    cateracts, gout, and cancer

  14. #14 Roadstergal
    Yay Area, CA
    July 5, 2012

    M’boy reads SF Gate, and whenever I look over his shoulder, I end up getting fingerprints in my forehead from all the facepalming.

    Ja, that bit about giving women estrogen patches, followed by the bit about the danger of ‘estrogen-like activity’ in deodorants, made me hiccup. I suppose her estrogen patches are blessed with her woo-rays…

  15. #15 lsm
    July 5, 2012

    Sorry about the jumble at the end. Dang new program.

  16. #16 W. Kevin Vicklund
    July 5, 2012

    WARNING! ANECDOTE FOLLOWS!

    I have hypothyroidism (genetic, both sides of family). I also am allergic to soybeans. My hypothyroidism not only didn’t get better after I removed most soy from my diet (nearly impossible to get rid of it completely), it actually got worse. However, the downslide started before I discovered my allergy, and the trajectory did not change until several years later, when I started treatment for hypothyroidism.

  17. #17 Marry Me, Mindy
    July 5, 2012

    I know this is better for a separate thread, but I just switched to chrome and now my recent post links are completely worthless. I tried emptying the cache but it did no good. What is the solution?

  18. #18 Roadstergal
    Yay Area, CA
    July 5, 2012

    Switch back from Chrome? ;)

  19. #19 Mrs Woo
    In the trees
    July 5, 2012

    I dunno, Marry Me, Mindy; I have Chrome and haven’t had any trouble with links, etc., but I didn’t switch to it from something else.

  20. #20 Marry Me, Mindy
    July 5, 2012

    The answer is close out and restart the program after clearing the cache

  21. #21 Composer99
    http://composer99.blogspot.ca
    July 5, 2012

    The caption of the photo at the top of the SFGate article described Lani Simpson as “a leading expert on osteoporosis”.

    I figured such a person would have published a paper or two recently on the topic.

    I did a PubMed search and didn’t find her come up in the first 1,200 hits when searching for ‘osteoporosis’ (as hinted at by Orac at the end of his article).

    Curious.

    (If I get a chance later I will try a more specific search if PubMed lets me).

  22. #22 Mrs Woo
    July 5, 2012

    @Marry Me, Mindy – now you can be the resident expert for the next person to switch browsers! ;-)

  23. #23 Liz Ditz
    Retreating in horror from the woobicon
    July 5, 2012

    “When chiropractors play at being real doctors” could be a recurring feature, Orac. Dr. Novella took a swing at chiropractic neurology but there’s much more to do:

    What is a Board Certified Chiropractic Neurologist?
    Board Certified Chiropractic Neurologists are:

    *Specialists within the chiropractic profession who have completed an intensive three year post-doctoral course of study in neurology(1).
    *Specialists who have successfully demonstrated expertise in the detection and correction of nervous system disorders during a rigorous board examination administered by the American Chiropractic Neurology Board (learn more at http://www.acnb.org.)
    *Specialists who recertify their credentials yearly in order to remain at the forefront of neuroscience and neurological applications.

    Frederick R. Carrick wrote:

    Typically, a chiropractic neurologist serves in the same consulting manner as a medical neurologist. The difference is that the therapies or applications of a chiropractic neurologist do not include drugs or surgery. As a result, certain conditions are more customarily seen by a chiropractic neurologist as opposed to a medical neurologist and vice versa….

    I believe greater opportunities are being created for cooperative relationships between medical neurologists and chiropractic neurologists. Certainly, our training is similar.

  24. #24 Liz Ditz
    still running
    July 5, 2012

    bring back preview, please.

    The missing footnote from my comment

    (1) “intensive three year post-doctoral course of study ” = series of weekend seminars held in airport hotels. The 36-month part is how long it takes to complete the series. Little or no hands-on patient care, and certainly not sustained patient care is in a real medical residency.

  25. #25 Militant Agnostic
    By appointment official supplier of nonsense to HRH the Prince of Wales
    July 5, 2012

    Lix Ditz

    The missing footnote from my comment

    Currently it appears as if it is comment and not the footnote that is missing. The new platform never ceases to amaze.

  26. #26 Liz Ditz
    looking for my comment
    July 5, 2012

    @Militant Agnostic I neglected to note that the comment was held for moderation. It was about chiropractic neurology “the very definition of pseudoscience “

  27. #27 Liz Ditz
    found it!
    July 5, 2012

    In case you are curious, here’s the website for one “chiropractic neurology diplomate” programhttp://www.nwhealth.edu/conted/ind_neuro.html. 20 weekends –you can sit for the exam after 18 weekends –over 3 years and a $7,000 tuition bill.

  28. #28 Liz Ditz
    July 5, 2012

    Or this one. I’ve added some emphasis.

    American Chiropractic Association Council on Diagnosis and Internal Disorders

    DABCI degree = Diplomate of the American Board of Chiropractic Internists

    Welcome to the fastest growing chiropractic primary care organization in the world, dedicated to making chiropractic physicians the natural physicians of choice in America!

    The Council on Diagnosis and Internal Disorders (CDID), established in 1985, is an educational board and specialty council of the American Chiropractic Association that administers and coordinates the post doctoral degree, Diplomate in Diagnosis and Internal Disorders (DABCI). Our physicians are trained in modern medical diagnosis, functional medicine, and natural therapeutics. Chiropractic physicians with a DABCI post doctoral certification utilize conventional medical diagnostics, specialized functional testing, and wholistic medicine diagnostic evaluations.

    DABCI physicians routinely employ methods such as blood laboratory studies, urinalyses, electrocardiograms, vascular doppler ultrasound, spirometry, DEXA bone density testing, salivary assay hormonal and neurotransmitter tests, IgG food allergy testing, diagnostic imaging to include x-ray, CT, MRI, comprehensive gastrointestinal stool analyses, and many other diagnostic tools.

    A DABCI uses therapeutic methods which emphasize conservative and minimally invasive approaches and minimize risk to the patient. Diplomates in diagnosis and internal disorders use treatments such as clinical nutrition, dietetics, exercise, vitamin and mineral supplementation, homeopathic medicine, botanical medicine, acupuncture, natural hormone replacement, and pharmacologic counseling. Many conditions and disease states can be resolved by utililzing these natural methods. The Council on Diagnosis of Internal Disorders promotes our physicians as uniquely qualified to provide this type of comprehensive natural medical care.

    Buckets of woo. It is likewise a 300-hour program.

  29. #29 lilady
    July 5, 2012

    “For the sake of giving Simpson the benefit of the doubt, I’ll assume that she passed the test to become a Certified Clinical Densitometrist, which according to the International Society for Clinical Densitometry is a “professional designation awarded to individuals who meet specified knowledge requirements measured through a standardized testing process for the interpretation of bone densitometry (offered in the U.S. and internationally).”

    Well…I checked out the California licensing board and she is licensed in California as a “Certified Clinical Densitometrist.”

    She seems to have some difficulty remembering what entity “certified” her in densitometry….it was so long ago (2011).

    On her website and on her LinkedIn listing she lists the *certifying* organization as the International Society of Bone Densitometry instead of the International Society of Clinical Densitometry:

    http://www.linkedin.com/in/lanisimpson

    When was the last time that Dr. Simpson told anyone that their bone density test results were perfectly normal and did not require chiropractic treatment?

  30. #30 Science Mom
    http://justthevax.blogspot.com/
    July 5, 2012

    I believe greater opportunities are being created for cooperative relationships between medical neurologists and chiropractic neurologists. Certainly, our training is similar.

    @ Liz, this harkens to their claim that they take as many classroom hours as med students but when you look at their curriculums, not only are most classes taught by other chiros but it takes the students more semesters to get through the roughly-comparable topics as med school. So yes, the same hours but fewer actual courses and not taught by experts. And what they consider as clinical hours, don’t get me started.

  31. #31 CC
    http://curiouschemeng.blogspot.com/
    July 5, 2012

    But here’s what’s really interesting: Most of the woo-ies who didn’t want to give up their edamame decided to claim that all soy wasn’t bad — just the hyper-processed kinds. But Simpson is saying the exact opposite: The fermented kinds are best! (Yes, kiddies, fermentation is processing.)

    Oh, that one’s easy – fermentation is natural processing, not that evil horrible industrial processing.

    Cooking is processing too, as is drying and pickling. That seems to be missed a lot of the time.

  32. #32 Driver Robbie
    Rocking in the corner
    July 5, 2012

    **Warning, anecdote ahead**
    As someone who spends far to much time lifting things up and putting them down (http://www.youtube.com/watch?v=q7gzmoqmL7g) I have to say the “paleo” diet is what most of us follow. We don’t call it that, and it sure isn’t some woo-ish “detox” bs, it’s just lots of lean protein (cooked thanks!), fresh vegetables, seeds and nuts. Healthy eating isn’t some magical liver cleansing, chakra aligning nonsense that the woo-meisters make it out to be, it’s just common sense.

  33. #33 GRichard
    July 5, 2012

    @ Driver Robbie

    “Paleo” works because it’s a healthy diet in the vein of, “Eat food, mostly plants, not too much.”
    It isn’t magical because our ancestors ate it, or because it’s organic or because our bodies are designed to run on it or any of that nonsense. It works because it advocates eating the things you mentioned. It gets people paying attention to what they are putting in their mouths, and directs them to make better choices.

    One of my favorite arguments against the crazy paleo guys is that almonds are domesticated and wild almonds can kill you in fairly short order; does that mean they should be off limits? Of course not.

    Re: chiropractors… I’ve read through some of their course materials. They can spend an order of magnitude more time in class than I did, and it won’t matter because the information being learned is frequently false. When it isn’t, it’s advertising/marketing/schmoozing. Which, honestly, I do wish we had been taught in medical school (at all).

  34. #34 Militant Agnostic
    July 6, 2012

    @CC

    Oh, that one’s easy – fermentation is natural processing, not that evil horrible industrial processing.

    There is a large sect of Alties who consider fermented foods to be the cause of all manner of ills. I think if you followed all the dietary prohibitions in a years worth of of one of the free (overpriced in my opinion) magazines you get in the organic/natural/health food stores, you would die of starvation in short order.

  35. #35 Guerilla Surgeon
    NZ
    July 6, 2012

    You want something funny about false balance?
    Watch this: http://www.youtube.com/watch?v=YMvMb90hem8

  36. #36 Shay
    July 6, 2012

    I look at food foofies and their phobias as the spiritual descendants of the WCTU.

    We never eat cookies because they have yeast
    and one little bite turns a man to a beast

  37. #37 Johnny
    Gee, it's great to be back home...
    July 6, 2012

    For instance, she seems to think that antiperspirants cause breast cancer:

    In addition to the darn fine rebuttal by our host, my Unca Cecil took this issue on back in the early days of Y2K.

    http://www.straightdope.com/columns/read/2540/does-antiperspirant-cause-breast-cancer

    Lani Simpson needs to come into the 21st century.

  38. #38 Denice Walter
    July 6, 2012

    @ Shay:

    Some I follow abhor wheat for its gluten content and persist in their delusion that MOST people are allergic to it especially attributing psychological/ cognitive/ GI problems to it- plus the fact that you can create alcoholic beverage from it seems to annoy them to no end. Some woo- meisters fear alcohol.

    Seriously, where would most of us be without alcohol?

  39. #39 Mephistopheles O'Brien
    July 6, 2012

    Seriously, where would most of us be without alcohol?

    Saudi Arabia, I suppose.

  40. #40 Denice Walter
    July 6, 2012

    @ Mephistopheles O’Brien:

    You realise of course, that I *was* speaking CULTURALLY about the English speaking world- not personally- because I actually drink very little**- and hinting at other excellent developments attributable to alcohol: art, writing, business deals, festivities, social ease, seductions, conceptions et al ( and we all know about the negatives) Still, Saudi Arabia? Oh, I rest my case.

    ** 100 standard sized drinks a year would be a lot for me.

  41. #41 Chemmomo
    Not in a blue law state
    July 6, 2012

    @Denise Walter and Mephistopheles O’Brien

    Seriously, where would most of us be without alcohol?

    Salt Lake City?

  42. #42 Marni
    July 7, 2012

    Want to be even more horrified? I blogged recently about chiropractors playing at being real doctors at the San Francisco Half Marathon, with tragic results.

    http://patientspatienceandpaces.blogspot.com/2012/07/slippery-slope-of-providers.html

  43. #43 Mephistopheles O'Brien
    Fermenting mead
    July 7, 2012

    Chemmomo,

    I passed through the Salt Lake City airport last year and was surprised to find a pub with a local microbrew there. I did not sample it, so have no direct knowledge of the quality of Salt Lake beer.

    Denice Walter – I certainly didn’t think you were hinting that the readership of Respectful Insolence had more than an normal alcoholic intake for places that don’t specifically ban the stuff. We do know that certain readers use other mood or mind altering substances* but…

    *either by inference or based on specific statements.

  44. #44 Chris
    In shock from what I just read...
    July 8, 2012

    … Which was the link that Dr. Marni N. posted.

    Aaack! What! No!

    It is no secret that I have a kid with a genetic heart disorder, and in the last year 911 has been called a couple of times from our house. Each time there were very skilled and well trained EMT professionals. These folks are awesome (and actually quite good at calming down frantic relatives, like me).

    If I found out one was trying to fix my kid’s spine instead of dealing with his tachycardia, I would have been all over with the complaint letters. (side note: which is what I did when I found the anti-vax “Autism File” magazine being sold in the hospital gift shop, it even has Andrew Wakefield listed as medical consultant for its editorial board — it is no longer there).

  45. #45 Chris
    Still in a state of shock..
    July 8, 2012

    What makes it even worse that one of the major sponsors was Kaiser Permanente! A very big health insurance company.

  46. #46 Politicalguineapig
    July 8, 2012

    Ism: Gout’s genetic? I always thought it was dietary. Or is it genetic AND aggravated by certain foods?

  47. #47 Mrs Woo
    July 8, 2012

    @Denice – one incredibly creative explanation for “everyone’s wheat intolerance” was that since all grain crops are now GMO’s our body can’t handle and digest the strangeness of it so it creates increasing difficulties… ~shakes head~

  48. #48 Denice Walter
    July 8, 2012

    @ Mrs Woo:

    I know. However, I’ve ALSO been hearing about wheat being a general problem forever. They do hate that GMO- various groups are attempting labelling requirements- Mike Adams cavorts with one of the best known whose name escapes me at present-( perhapsJeffrey Smith?)

    Woo-entranced folks have varying beliefs about alcoholic beverages: to some, like Gary Null, they are Satan ,” killing millions of brain cells per drink” ( insert your own jibe here) but other proponents of natural health/ food drink organic as well as eating organic; in addition, they might oppose sulfites or other additives in wine.

    Interestingly enough, I seem to have a lot of literature floating around that concerns the organic/ natural movement in wine-making and brewing. He wot dwells in the “axis of me-ville” should probably know a lot about these developments and the Green Gourmand effort which has brought us products like chevre and Brie cultured from organic, raw milk et al.

  49. #49 Shay
    July 8, 2012

    Gad…Denice, I think I’ve mentioned before the recipe for soap-making on an artsy-fartsy site that honest to God calls for buying bars of expensive “organic” soap, shaving them and melting them down, and then pouring them into your own molds. The owner of the site brags that such soap is completely chemical-free.

    I emailed her and pointed out that NOTHING is chemical-free, and she got pissed off and informed me that her regular readers knew what she meant.

  50. #50 Rosemary Lyndall Wemm
    San Leandro, CA, USA
    July 8, 2012

    I am well aware that some chiropracters in the USA (and a lot less in countries like New Zealand and Australia that have decent licensing boards for chiropracters) are woo artists. This is not true of many others who are well trained and offer physical therapies that are at least as good as the conventional kind.

    Having worked in the medical rehabilitation field for many years, I am also aware of the existence of conventionally trained medical practitioners that are also heavily into “woo”. The US medical licensing boards appear to be as hopeless at controlling these anti-scientists as the US chiropractic associations are at controlling the woo practitioners in its own field.

    More conventional forms of adjunctive medical therapy also contain “woo” artists, and treatments that do not work well because they fail to take into account the practicalities and realities of patient compliance. Classic physical therapy is a case in point. According to some Australian based studies (where the PT and the chiropractors are better trained and better policed), PT errors are no less and often worse than chiropractic errors. It is probably similar in the US, but no-one is being funded to do objective studies in this area. There are serious economic disadvantages in doing so, and often severe legal ramifications. There is also the problem of trying to obtain research funding from sources that have a blatant self-interest in the direction and results of such studies.

    What is wrong is that standard medicine is quick to point the finger at the woo artists in fields that they do not control, but slow to acknowledge and denigrate their own quacks or the quacks in supplementary medical systems that they usually refer to.

  51. #51 Calli Arcale
    July 8, 2012

    Shay — hah. Beginners. They’re not making soap; they’re just molding soap somebody else made. I know reenactors; they take great pride in making it entirely from scratch. Including making their own lye from wood ash, and rendering fat from a carcass to make tallow! I’ve never made soap, but if I did, I’d want to do the whole process. It’d be interesting to learn.

  52. #52 Mephistopheles O'Brien
    July 8, 2012

    Rosemary Lyndall Wemm,

    Out of curiosity, if a chiropractor restricts his/her practice to, essentially, science based physical therapy, then why do we need both chiropractors and physical therapists? Shouldn’t the professions be merged, eliminating that which is not backed by good science?

    If you do a quick search of Orac’s blog, you’ll find he regularly discusses people certified in “standard” medicine who are woo artists.

  53. #53 lilady
    July 8, 2012

    @ Rosemary Lyndall Wemm:

    You might want to look at this site, to see how people have been harmed….and people who have died after, receiving treatment from chiropractors:

    http://whatstheharm.net/chiropractic.html

    Chiropractors in the United States do not have the educational background, nor the clinical background that RPTs (Registered Physical Therapists), do. Most of them are on a par with Licensed Massage Therapists…good for a back massage …and nothing more. That’s why they venture far afield of massaging the back…in order to pay back the loans they have incurred for a totally useless *doctorate* degree.

  54. #54 Denice Walter
    July 8, 2012

    @ Shay:
    Ha!
    However, I’m not speaking of the hippie girls/ boys who create organic wines and ales/ beers at home and are, *de rigeur*, ‘artsy’ but instead, the large scale enterprises that cater to that particular clientele- whether it is designated ‘organic’, ‘natural’, ‘sulfite-free’, ‘sustainable” or ‘biodynamic’ ( *a la* Rudolph Steiner) and it is not restricted to the lotus land** of Northern Ca. but *international*, or so I’m told. Similarly, there is a market for artisanal cheeses made of raw and/ or organic milk : many in the French tradition. None of this stuff is cheap.

    ** I’m not making fun: I do- oddly- fit right into their “vibe”- it must be the scenery because it can’t be the woo.

  55. #55 Science Mom
    http://justthevax.blogspot.com/
    July 8, 2012

    Including making their own lye from wood ash, and rendering fat from a carcass to make tallow! I’ve never made soap, but if I did, I’d want to do the whole process. It’d be interesting to learn.

    If you ever do venture into this, I would hope you do it Fight Club style. Now that was some designer soap.

    I really have to laugh at how the weekend threads devolve into (mostly) food discussions. I think it signals how comfortable we are getting.

  56. #56 Mephistopheles O'Brien
    July 8, 2012

    Now that was some designer soap.

    Made of actual designer?

  57. #57 Shay
    July 8, 2012

    I see no reason why fats rendered from designers wouldn’t be as useful as those from other sources.

  58. #58 Science Mom
    http://justthevax.blogspot.com/
    July 8, 2012

    Made of actual designer?

    Heh, you saw the movie right? I’ve wondered any of the Etsy soap makers might use that trick.

  59. #59 Dangerous Bacon
    July 9, 2012

    Rosemary: “Classic physical therapy is a case in point. According to some Australian based studies (where the PT and the chiropractors are better trained and better policed), PT errors are no less and often worse than chiropractic errors.”

    Where the two differ substantially is that PTs don’t typically attempt to treat internal medical complaints, fancy themselves to be nutritional experts or denigrate useful medical treatments (like vaccination). I am unaware of PTs doing forceful neck cracking like chiros, a poorly justified procedure which can cause devastating injury and death through damage to neck arteries. And while physical therapy isn’t exactly pure science, neither does it have a ludicrous basis like chiropractic.

  60. #60 Tony Mach
    July 10, 2012

    “Paleo diet” nonsense? What is so nonsensical about trying to eat what we evolved to eat, and avoid what we are only partially (if at all) adapted to eat? Sure,, there is some BS being mixed in by some (like this detox idiocy) and the data is only sparse so far.

    But sure, if every scientist doing research in the field thinks that the evolutionary environment we have adapted to in the past is not important for our health, and that we can eat whatever food we darn please as long as we don’t kneel over immediately (a position you seem to exemplify), then sure, the data will stay slim.

    In my personal n-1, a paleo diet solved some of my health problems for good, improved some others, but alas brought only temporary relieve to others. Paleo did more for my health (or my mothers health) than all the doctors we’ve seen combined (whom I don’t won’t to live without, BTW). I can only urge everybody to stay skeptical, not to believe anybody (one way or the other) and try to your own n-1.

    And while we are at it: Lean meat is overrated, the vilification of saturated fat is not based on solid data and the real villains are trans-fatty-acids and too much omega-6 fatty-acids. Don’t believe me, go search for references for yourself.

  61. #61 Mrs Woo
    July 10, 2012

    @Tony Mach – which references? You didn’t provide any.

  62. #62 Tony Mach
    July 10, 2012

    I forgot my favorite quote:
    “Nothing in biology makes sense except in the light of evolution”
    Theodosius Dobzhansky

    Mrs. Woo:
    Orac didn’t provide any references that Paleo is nonsense, so why should I? Go look for references for yourself if you are interested.

  63. #63 JGC
    July 10, 2012

    Orac didn’t provide any references that Paleo is nonsense, so why should I?

    Because otherwise your claim will possess little or no credibity–don’t you want us to accept that you’re correct? If so, why would you be reluctant to provide even minimal support for its validity?

    Go look for references for yourself if you are interested.

    As it’s your assertion, Tony, it’s also your responsibility to provide evidence it’s valid–not Mrs. Woo’s.

  64. #64 Chris Hickie
    Tucson, AZ
    July 12, 2012

    Here’s a real dork of a chiropractor where I live (Tucson, AZ): http://azstarnet.com/news/science/article_b4eb1dba-392a-5e5a-a756-56453b391fc7.html

    “Decision to vaccinate can be major dilemma for nervous parents”

    “The true believer”

    David Stender is an adoring and involved father of four children, the owner of Living Well Chiropractic and a devotee of improving health naturally.

    He argues vaccinations are made in part from aborted fetal tissue and tissue of chickens. He says they’re pushed so pharmaceutical companies can profit. He believes the reduction of vaccine-preventable diseases resulted from improvements in sanitation and public heath rather than vaccines.

    Stender, who lives in Oro Valley and gives speeches on natural healing, is a consumer of alternative medical research, on sites such as http://www.mercola.com – run by Illinois-based Dr. Joseph Mercola. The site sells natural supplements and posts links to anti-vaccine articles.

    “I wish they would look at all the data – not just what is put out by special interests,” Stender says. “You can’t ignore the money part of the equation. All I want is vaccine choice. If they had their way, they would force you to inject those toxins into your body.”

    Stender says vaccines didn’t eliminate smallpox. He likens smallpox to the bubonic plague, which hasn’t been eliminated, but has been significantly lessened through improvements in sanitation. However, bubonic plague is spread by the fleas of rats while smallpox was spread through human contact or contaminated bedding or clothing.

  65. #65 Chris Hickie
    Tucson, AZ
    July 12, 2012

    Sorry I screwed the formatting on the last post.

    Thank goodness the chiropractor isn’t into his business selling his supplements for the money part of HIS equation.

    I wouldn’t even trust this dope to crack my neck given his stupidity regarding smallpox.

  66. #66 lilady
    July 12, 2012

    @ Chris Hickie: Did you catch the comment in the article from the guy who heads up an autism group? (“They took the Thimerisol out and substituted aluminum as a preservative”.)

    Reader comments show CIA Parker who posts at AoA and trolls science blogs. She is again claiming her child got encephalitis after a vaccine. When I questioned this and asked her which doctor made the diagnosis and what treatment was provided…she just disappears…only to return a short time later with some more vaccine injuries and other factoids about immunology and vaccines.

  67. #67 Marc Stephens Is Insane
    July 13, 2012

    Curious what the consensus is about chiros who claim to treat migraines? This guy treats both sinus and migraine headaches, carpal tunnel syndrome and fibromyalgia. See the tabs at the top of the page: here’s one page on headaches.

    http://drjohnraymondblog.com/category/headaches/

  68. #68 Antaeus Feldspar
    July 13, 2012

    Tony, there’s a book popular at the place where I work, whose title is relevant to this convo: “What Got You Here Won’t Get You There.”

    “Here” is living long enough to procreate the next generation, which is what evolution aims at. “There” is a much more ambitious goal, living well past child-bearing years in a state of maximum good health. What got our protohominid ancestors “here” will not necessarily get us “there.”

    Consider engine fuels. Suppose that Fuel A burns quickly and delivers huge power to the pistons. It also puts huge strain on the engine so that it burns out in a couple of years. Fuel B burns more slowly and delivers less raw power, but does not damage the engine, so engines may run on Fuel B over thirty years or more of use. Obviously Fuel B is the better fuel for getting “there”, but judging which is the better fuel by “which gets us faster to ‘here’?” gives us the false impression that Fuel A is superior.

    It’s good that when you tried a paleo diet, it had good consequences for your health. But it’s the fallacy of affirming the consequent to conclude “therefore, the paleo diet is right.” If I find that my health improves when I stop eating bacon cheeseburgers, should I conclude that kosher eating is automatically right? Or should I conclude that all the prohibitions of Leviticus are right? or maybe it’s the halal diet which is correct? Which is the correct scope to extrapolate from n=1? The answer to that not-very-trick question is “none.”

  69. #69 John Simms, MD, PhD
    Boston, MA
    July 16, 2012

    It amazes me how uneducated some who claim to be scientific are.

    So much hatred toward a group. I was sent here to read some of the things said against chiropractic physicians. Thanks for the “education”…

    We have DCs who are participating physicians on rotations in our hospital… and we are expanding that program.

  70. #70 Calli Arcale
    July 19, 2012

    You have DCs on rotation at your hospital and you call them physicians? Could you tell me what hospital you are at? I’d like to avoid it should I ever venture to Boston and find myself in need of medical care.

    I do think chiropractors can do some good, and I could see having a couple of them on staff. I know my husband gets good relief of his back pain from his. However, they are definitely not trained as physicians, and representing them as such is irresponsible and misleading. Do you think a nurse working at an urgent care clinic should be called a physician? What about a physical therapist or a clinical psychologist who does not hold an MD (i.e. not a psychiatrist)? What about a massage therapist (a licensed profession in my state)? What about an MRI tech or a radiographer or an LPN? Are they physicians? I wonder how your RNs feel about this, given that they have more training than the chiropractors.

  71. #71 Marc Stephens Is Insane
    July 19, 2012

    Isn’t it funny how there’s no John Simms MD in Boston that shows up anywhere on Google? There is a Dr. John Sims, a vascular neurologist in Boston, but it’s unlikely our Dr. Simms would have misspelled his own name.

    I call shenanigans!

  72. #72 dav
    July 21, 2012

    Today, most practicing chiropractors mix spinal adjustments with other therapies, such as hot or cold treatments, nutritional counseling, and exercise recommendations. They also often use new technologies to find and treat subluxations.

  73. #73 Brad Beyer, D.C.
    Phila PA
    August 9, 2012

    I’ve been a chiropractor for nearly 25 years, and before you begin sharpening your daggers and take aim at the space between my fifth and sixth rib (left anterior, yes that would be dead on the heart), I would first like to say that many, if not most of the negative perceptions of my profession are well deserved and self inflicted. I have met hundreds of chiros throughout my career and I find the experience a little like saying “I have met hundreds of Europeans in the last 25 years” The variation within this profession is dramatic and stark, dating back to the dubious history of the founding events which occurred in 1895 Iowa.

    Many chiros are cultish zealots who take a defiant stance of “prove I’m wrong”, very similar to religious nut jobs. But there are also many within my profession who put the patient first, who try everything they can to alleviate pain, who make no false promises, who don’t wave a garlic clove over a patient’s chest, who don’t throw “auras”out the window to cure diabetes, but basically follow tried and true methods that would be accepted in any pain clinic in the US.

    I totally understand the outrage against this profession. Alot of that outrage is deserved. I’ve felt for a long time that it is poorly policed and poorly monitored, with an “anything goes” oath of conduct.

    Just remember though, there are plenty of level headed, careful, people of science in this profession that find the radical behavior of some chiros to be as offensive as you do. Good discussion.

  74. #74 Tom Croll
    September 10, 2012

    While I agree with the general sentiment, I have to say, I have also been seen by competent, qualified sports injury specialists who use chiropractic methods for temporary pain relief in combination with main stream sports therapies.

    It would be wrong to assume every practitioner is peddling outlandish cures, lost in pseudoscience.