After having written yesterday’s piece about the fallacy known as the appeal to nature, a favorite fallacy of the alternative medicine crowd. The idea that if something is somehow “natural” it must be superior to anything viewed as “unnatural” or “man-made” is deeply ingrained in pseudoscientific medicine. Heck, there’s even a brand of quackery known as “naturopathy” because it supposedly utilizes the “healing power of nature” when in reality is takes what I sometimes call a “Chinese menu” approach to quackery; i.e., one from column A, two from column B, one from homeopathy, two from traditional Chinese medicine. Little did I suspect that I’d so rapidly come across another favorite fallacy beloved of the alt-med crowd. It comes from someone we’ve met before, namely Kate Tietje, who goes under the nom de quack of Modern Alternative Mama. Strangely enough, she’s a rather recent discovery on my part, as I first learned of her in December. Let’s just say she has a major chip on her shoulder that she indulges yet again, this time in a post entitled Why The “Science” Critics are Dangerous.

Before I begin, first let me say that there is one thing she complains about that I do not approve of, either, and that’s the harassment of bloggers at their workplace. Of course, Tietje makes it seem as though the “Science” critics are the only ones who engage in such behavior when my history tells me that there’s plenty of that sort of behavior on Tietje’s side. I’ve lost track of how many times various quacks or quackery supporters have tried to get me in trouble at my job that I don’t even try to count any more. Indeed, Tietje starts her diatribe thusly:

It’s no secret that if you’re into “alternative” choices, there are people who don’t like it.

Just a few weeks ago, a group of doctors called for Dr. Oz to be fired from a staff position at a university because of his TV show — they didn’t like that he makes strong claims for supplements and alternative health products, and felt that this interfered with his ability to be employed as a serious doctor.

(While I’m not a fan of the show personally, nor of the types of claims he makes nor the products he endorses, I don’t see that this impacts his position on staff at a university, provided he isn’t handling that position in the same manner!)

As you recall, I wasn’t too fond of this gambit either. Indeed, as the days rolled on, I thought less and less of it, and it ended up backfiring as I had predicted, with Oz successfully portraying the attack as shills for industry being unhappy with him because he supported labeling GMOs, even as revelations came out about how Dr. Oz was actually looking for some sweet, sweet shilling opportunities himself.

Perhaps the most hilarious thing about Tietje’s entire post is this passage:

It may or may not surprise you that as a popular blogger in the alternative world, I’ve faced the same types of criticism — obviously on a smaller scale. There are entire groups dedicated to “stopping” me. These groups leave comments on my Facebook page almost daily, telling me how “dangerous” I am and linking to some article that’s pro-vaccine, pro-GMO, etc. They regularly — at least a couple times a month — write articles about me and all the “woo” I peddle.

I ignore them, generally, as do many of my colleagues. (Food Babe is another huge target for these people.) But it seems that despite ignoring them they’re only speaking out more and more. They’re doing so more publicly. They’re writing for major media and calling people out.

And you know what? It’s not okay. Which is why I’m taking a stand today. I think these so-called “science” critics are dangerous people. And it’s time everyone knew.

Notice how Tietje likens herself to Mehmet Oz by saying she faces the same types of criticism as he does. Oh, sure, “obviously” it’s on a smaller scale, but she’s just the same. Really. Of course, Dr. Oz, for all his current embrace of quackery, is a real doctor, a real surgeon, a real academic researcher (or at least he was a researcher—and a promising one at that—before he embraced pseudoscience). Kate Tietje, a.k.a. Modern Alternative Mama, on the other hand, has no discernable knowledge or skill in medicine. Well, that’s not quite true. She has knowledge; it’s just that it’s all wrong or misinterpreted. But she loves to talk about health.

Not surprisingly, apparently the incident that set Tietje off was criticism of home birth, leading her to brag that she’s about to do her first home birth, as though that was evidence that home birth is not riskier than hospital birth. I don’t want to get into that whole debate right here and now. (After all, I’m not Amy Tuteur, although I have discussed the issue a couple of times.) What stood out to me is that Tietje makes a bunch of assertions, dismissing the existing literature as being contaminated with “accidental” home births (women who didn’t make it to the hospital), home births attended by “unlicensed and unregulated midwives,” and various other biases, topping it off by saying “The few decently-performed studies we do have show the risk profile is not different between hospital and home, especially for low-risk multiparous women.” Yet, as is so often the case when she pontificates about topics of which she has little understanding, Tietje does not provide a single reference or example, even through a link, apparently because she considers her example “besides the point,” even though it was the issue that set her off on her rant.

Be that as it may, here’s the fallacy:

The real point is, it’s my goal to provide people with another view point. Alternative information. The mainstream isn’t exactly kind to people who choose home birth (or to reject some/all vaccines, or eat only organic, or…). It’s not exactly accurate or remotely unbiased.

There are people looking for that information. People who want to know what “the other side” really thinks about these topics. And they deserve a safe place to go to access that information.

Yes, it’s the fallacy of “I’m just providing an alternative viewpoint.” Or maybe I should call it an excuse or a dodge, because that’s what it is: a strategy for avoiding taking responsibility for what you say and write. Tietje, as I’ve documented, is rabidly antivaccine. She has been known to promote The One Quackery To Rule Them All (homeopathy) regularly on her blog, be it in the form of letting a homeopath advocate using homeopathic teething remedies, misrepresenting the history of homeopathy, or claimed that “homeopathy can help cure allergies.” She also routinely gushes about other forms of woo, such as the GAPS diet, the lates “leaky gut” claims, and, of course, demonizing dairy and gluten (actually claiming that grain in general is a big problem in an ebook).

This is a ploy that all manner of promoters of quackery use. Heck, even Dr. Oz uses it when he tries to claim his show is “not a medical show” but just entertainment. One’s tempted to take him at his word given all the quackery and pseudoscience he’s featured over the years, but in the end it’s a show with Dr. Oz’s name in the title featuring health advice and issues hosted by someone who’s trademarked the term “America’s Doctor” to describe himself after he garnered that monicker in his days of being the go-to guest doctor for Oprah Winfrey’s old talk show. “I’m just providing information,” they’ll say. “I’m just providing an ‘alternative’ viewpoint.” And then you can “make your own choice”:

Unlike these dangerous, insidious trolls, I have no desire to tell you what to do or what choices to make.

My only goal is to provide you with an alternative view point. To share alternative information with you. This might be from personal experience (and I’ll tell you clearly that it is) or it might be from studies (and I link to those when I use them). I’m perfectly, absolutely clear what I’m sharing with you is alternative and where it came from.

But after that? It doesn’t matter to me what you choose. You’re an adult. I can’t know your circumstances. I can’t and won’t force you to choose anything in particular. I would never attack you for doing differently than I do. I would never champion laws that forced you into particular choices. I would never troll you and make anonymous phone calls to get you in trouble because you do differently than I do.

Never.

This is disingenuous in the extreme. Does Tietje honestly expect us to believe her when she affects a studied disinterest in whether or not anyone listens to her viewpoint or is influenced by what she writes? If I were to say that to you, you’d (quite correctly) mock me mercilessly. Of course, I want to influence my readers. I’m arguing for science-based medicine and skepticism and against pseudoscientific medicine and other forms of woo, and I want you not to choose pseudoscience. I make no bones about it. Besides, given how obviously pissed off Tietje is in this post and in some of her other posts where she lambastes critics, advocates of science who criticize her publishing antivaccine pseudoscience and other forms of quackery on her blog, I refuse to believe that she’s so dispassionate that she doesn’t really care that much if she persuades anyone. Nobody—and I mean nobody—writes daily blog posts if she doesn’t care that much whether people are influenced by her.

She’s also hypocritical in the extreme. Earlier in her post she castigates pro-vaccine advocates and pro-science advocates for not taking responsibility if there’s a bad outcome from their advice, such as a bad vaccine reaction or a birth complication in the hospital. For instance, she says, “If you or your child is harmed, mentally or physically, during a hospital birth, no one is going to take the case and sue the doctors.” This is, of course, ridiculous, given that there is a whole class of personal injury attorneys whose business is taking cases like this. In any cae, Tietje contrasts herself to this thusly:

I get blamed all the time for this — “What if someone takes your advice and something bad happens? You should be held responsible.” I believe that we’re all the ones ultimately responsible for our own choices. I provide information; it’s up to you to read more, ask questions, and make a decision to use or ignore it. (And how much “trouble” are you going to get in by trying out one of my remedies for diaper rash, anyway?) You see, in a world where you have the freedom to seek information from many sources, you don’t have to blame anyone.

(And remember that these trolls refuse to take responsibility for poor outcomes, even when they force them on you. I’m not forcing anything on anyone.)

Who do you think is more dangerous, honestly? The one who freely provides you with information (that you may not use or agree with) and supports your right to choose…or the person who tells you there’s only one right answer and tries to censor anything they don’t want you to read?

I think it’s the latter.

Of course, as commenters pointed out, Tietje has been known to ruthlessly moderates her comment section, frequently deleting skeptical comments, even reasonable and polite ones. Then, further down the comment thread after having pointed out that it’s her blog and she doesn’t have to let anyone comment on it if she doesn’t want to (which is true; bloggers can moderate their comments as they see fit as far as I’m concerned), she complains about skeptics “blocking” them and accusing them of hypocrisy. In any case, she basically washes her hands of any responsibility for having advocated a viewpoint with the disingenuous (and convenient) tactic of saying, in essence, it’s all up to you, after having done her best to persuade you that her way is best.

Predictably, Tietje ends by invoking—what else?—freedom, going so far as to refer to skeptics as “anti-freedom bullies.” Yes, it’s the favorite trope of antivaccinationists and quacks, to embrace “freedom” but neglecting to point out that it’s the freedom from pesky government regulation of medicine and freedom to peddle whatever quackery they like that for which they’re actually arguing. Meanwhile, they whine piteously when skeptics exercise their freedom to criticize them, apparently not realizing that freedom of speech does not mean freedom from criticism for that speech. As I said at the beginning, I do not in any way support harassment, but, as Vani Hari (a.k.a. The Food Babe) did in her response to critics, quacks tend to intentionally conflate harassment with reasonable criticism in order to tar those making the reasonable criticism as “bullies” and “harassers.”

I was amused by one suggestion that Tietje makes near the very end of her post, “Use the hashtag #MAMempowered to show that you’re an educated and empowered alternative mama.” No doubt Tietje would consider it “bullying” if anyone used that hashtag in a way of which she doesn’t approve.

Comments

  1. #1 Helianthus
    May 13, 2015

    linking to some article that’s pro-vaccine, pro-GMO, etc. They regularly — at least a couple times a month — write articles about me and all the “woo” I peddle.

    The nerves of people, telling me I’m wrong, and linking to evidence.
    Now, excuse me, I was writing an article about physicians being wrong about vaccines.

    ————–
    Sarcasm aside, I could sort of understand why having critics swarming on one’s blog could be seen as a personal attack.
    Internet is funny this way. Behind you computer, you are simultaneously in your very private fortress of solitude and facing the whole world. The effect could be a bit schizophrenic, if I could use this word.

    That being said, someone posting its opinions on the internet and complaining about other people also posting their opinions is strongly into hypocrisy.

    Eh, Ms Tietje, your critics* are merely providing the information that you are wrong.

    * I mean the polite (or merely insolent) sort of critics. The stalkers, phone-callers and other threat-makers are creepy and belong to the inside of a jail.

  2. #2 Denice Walter
    May 13, 2015

    Oh, the irony!
    *Science critics* are dangerous. Raw milk/ home birth aren’t ( from her site)

    I wonder how devoted mothers like MAM and her sisters, Kat, Kim et al at TMR and AoA, who work so hard for their children’s benefit have time to do all they claim at home and then tweet, blog, do facebook,, write books etc. Perhaps they have super powers.

    Right, they’re providing information- mostly about their own wonderfulness. Spare me.

  3. #3 Denice Walter
    May 13, 2015

    -btw- I noticed that she scrubbed her bio info – 404 error.

  4. #4 stixx23
    May 13, 2015

    I notice she’s the only one using that hashtag at the moment. A whopping seven times!

  5. #5 Butch Pansy
    LeftCoast
    May 13, 2015

    This is a dodge closely akin to JAQing off, i.e. Just Asking Questions. Just sayin’.

  6. #6 sadmar
    On the internet, no one knows I'm thoughtful and kind
    May 13, 2015

    Helanthus:
    Good point on web ‘discourse’! ‘Criticism’ on blogs of all sorts too often IS ad hominem, when it should be substantive — you can be polite to the person, and still vigorously quarrel with their opinion or argue their ‘facts’ are mere tripe.

    KT’s type of disingenuousness is endemic in modern life, though… and is historically Modern in it’s projection that ‘information’ can be separated from purpose, The idea that anything can be “just” information is basically a 19-20th century development, attendent to the rise of empiricism including (to some extent) changing conceptions of the project of science. i’m most familiar with the history journalism, where the notion of “objectivity’ or ‘just the facts’ simply did not exist before the late 1800s, and was birthed from commercial imperatives and the changing political economy of newspaper publishing. (c.f. Schudson, Discovering the News).

    In the technical sense, (c.f.. Shannon and Weaver), EVERYTHING is ‘information’.
    ‘I’m just giving information on alternatives’
    ‘I’m just reporting what Senator Cruz said yesterday.’
    “I’m just reporting the numbers I measured.’

    Such statements always obscure the WHY. Which does not make them equivalent in disingenuousness. All ‘objectivity’ is false, but some more venally so, and some to a certain more arguably justifiable pragmatic end.

    Tietje’s use of this “I’m not responsible’ rhetoric is yet another example that anti-vaxers will appropriate ANY legitimate set of ideas or philosophical arguments and contort them into absurdity in an attempt to make their cult-ish belief-systems appear thoughtful, reasonable, supported by something beyond blind faith. There is no well they will not poison. (Talk about ‘toxins’… sheesh!)

    • #7 Orac
      May 13, 2015

      you can be polite to the person, and still vigorously quarrel with their opinion or argue their ‘facts’ are mere tripe.

      Another issue is that people have a hard time separating their arguments from themselves personally. Thus, if a blogger says to someone like Tietje, “Your argument is a load of fetid dingo’s kidneys, and here’s why,” after which he rattles off reasons, science, and studies to show why what that person said is indeed a load of fetid dingo’s kidneys (yes, believe it or not, I do this sort of thing at times), the target (like Tietje) will often interpret such criticism as an ad hominem attack, an attack on her, rather than a vigorous refutation of her arguments.

  7. #8 Dr Who
    May 13, 2015

    It is incredibly ironic that you criticize Tietje for not providing any links, when a) you didn’t provide any “science” based links to support anything you said, b) it was clearly an opinion based piece, and c) she literally has posted THOUSANDS of links to medical studies, CDC, WHO, and other professional sources on hundreds of other blog posts.

    • #9 Orac
      May 13, 2015

      Thousands? Really? Do tell!

      Of course, I’m a bit more modest in my claims. I’ve been blogging for over ten years now and have discussed in detail more studies than I can imagine, complete with links and references, in many of my literally thousands of posts since 2004. I don’t know if my citations of peer-reviewed studies from the medical literature have reached the “thousands” mark (they’re probably way past there; I’ve just never counted), but they’re easily in the many hundreds range. More importantly, just citing a study is meaningless if you don’t know what the study shows, can’t put it in context with the rest of the biomedical literature, and basically cherry pick the studies you like. These statements all apply to Tietje in spades.

  8. #10 shay
    May 13, 2015

    Dr Who, do you understand what it means when the font in Orac’s post is a different color?

  9. #11 Orac
    May 13, 2015

    Just for yucks, I looked at the IP address Dr. Who is posting from. Sadly, it comes from a hospital. I won’t name the hospital or even the state, but I really hope Dr. Who is not a physician, nurse, or other health care professional.

  10. #12 Todd W.
    http://www.harpocratesspeaks.com
    May 13, 2015

    Okay, so if you choose to have a hospital birth or get a vaccine and suffer a bad outcome, you should blame the doctors, you poor unfortunate soul who is a victim of the pharmaco-medical complex. If you choose to follow Tietje’s advice and suffer a bad outcome, it’s your own damn fault, not hers.

    Do I have that right?

  11. #13 John Snow
    The Wall (Originally King's Landing)
    May 13, 2015

    In the infamous implications suggested by John Oliver, Dr. Oz is, in fact, the biggest piece of shit on his own show. Related to that, Vani Hari (the Food Babe) is a piece of e. coli on Dr. Oz’s shit.

  12. #14 Amy Tuteur, MD
    http://www.skepticalob.com
    May 13, 2015

    They said Galileo was dangerous, too.

    He was, for the same reasons we’re dangerous: science inevitably defeats quackery and superstition..

  13. #15 Sarah A
    May 13, 2015

    So it’s not enough that woo-pushers can create their own little echo chambers where they can simply delete any and all comments that disagree with them, apparently the entire Internet needs to be a “safe place” where no one can correct their misinformation. But it’s the pro-science bloggers and commenters who are “anti-freedom.” Riiiight.

  14. #16 Denice Walter
    May 13, 2015

    ” Thousands? Really? Do tell!”

    Unfortunately, one of the chief loons I survey ( @ PRN) INSISTS that he has’ thousands of studies’ to back his altie dreck: e.g. ” 500 thousand studies” support natural health or “X thousand” to support vitamin C’s efficacy or vaccines cause autism or SSRIs kill -diverse numbers, seemingly at random, are plugged into the aforementioned sentences as if they really meant something. Interestingly, if you listen closely enough, you’ll notice that the numbers CHANGE. ‘100 thousand’ becomes ‘500 thousand’ whilst ‘1200 studies’ become ‘2000’.
    Just like that.

    One of the reasons they’re able to get away with these obvious lies and fabrications is that they know that their devoted fans won’t look it up or if they actually make the effort, they wouldn’t know how to interpret data or results.

    For a laugh, read the references for an altie tome.

    I’m sure you can guess because you already understand how they mangle un-related studies to support their cherished theories.

  15. #17 Denice Walter
    May 13, 2015

    @ John Snow:

    You know nothing, John (sic) Snow.**

    **Actually, you DO- you know a lot AND I TOTALLY AGREE with both you and John Oliver-
    but I always wanted to say that!
    ( all these Johns and Jons. I get mixed up)

  16. #18 Tim RN
    May 13, 2015

    @ #14

    The Galileo Gambit!!
    http://rationalwiki.org/wiki/Galileo_gambit

    I would have expected nothing less.

  17. #19 Johnny
    127.0.0.1
    May 13, 2015

    all these Johns and Jons. I get mixed up.

    Yah, and now we have another Tim, but this one doesn’t seem to a stoned idiot.

    Proper Johnny
    Accept no substitutes

  18. #20 Dangerous Bacon
    May 13, 2015

    I’m confused – how is Tietje supposedly being targeted in the same way as Dr. Oz? Are there nasty corporate shills callling for her firing? Would that mean she’d have to turn in her Alternative Mama badge and decoder ring?

    It’s great when people post lots of links to studies. It’s even better when they understand what those studies say, whether they’re relevant to the subject at hand and make justifiable conclusions.
    On another forum there was a long-winded poster who specialized in irrelevant Gish Galloping, posting incredibly long lists of meaningless journal references. I would sometimes counter by posting a list of references consisting of recent Ig Nobel award winners. Hilarity ensued when he indignantly retorted that my articles didn’t adequately refute his argument.

    And yes, “I’m just providing information” is a not-very-subtle variant of “I’m Just Asking Questions”.

  19. #21 Jane Ostentatious
    May 13, 2015

    I hate to be a total cow, but John/Jon Snow really does know nothing – at least about GoT. Jon Snow never made it to King’s Landing – he lived in Winterfell and then straight to the Wall for that character!

    Other than the geographical GoT stuff – John is quite correct.

  20. #22 Chris
    May 13, 2015

    Perhaps John Snow is doing too much epidemiology to watch GoT:
    http://en.wikipedia.org/wiki/John_Snow_%28physician%29

  21. #23 shay
    May 13, 2015

    Looks pretty good for his age, don’t he?

  22. #24 has
    May 13, 2015

    Orac@7:

    Another issue is that people have a hard time separating their arguments from themselves personally.

    With the likes of Tietje, that’s because there is no difference between the two. Whereas someone like your good self has a life full of concrete achievements to power your sense of self-worth, their entire egos are built from and upon their irrational belief systems, because that’s *all they’ve got*. So of course such people instantly, violently, reflexively attack any and every challenge to their beliefs: because without those beliefs they are *nothing*.

    When shining the brutal cold light of truth into the one place Irrationalists dare not look—into themselves,—it’s wise to pack plenty spare bulbs. 🙂

  23. #25 Katherine Forbes
    May 13, 2015

    The only links Tietje provides on her FB page are to her own blog entries. Try debating with her rationally using either accredited links or your personal views on vaccines. I assure you, you’ll be banned and comments deleted faster than you can say fraud.

  24. #26 Denice Walter
    May 13, 2015

    has is correct:

    the woo-meisters I survey spend a great deal of time listing their credentials- largely spurious, mail-order or self-administered- to their entranced audiences. They accomplished incredible achievements as teenaged inventors, composers or mathematicians ( see Gary Null.com/ HealthRanger.com) and later did phenomenal research at organisations which may not have actually existed or at those of their own creation. Needless to say, their charitable work is beyond measure.

    Their hatred for corrupt, self-satisfied professionals crackles with envy because these guys were not ever acceptable amongst the educated elite themselves. Mike may tell you how grad schools all wanted him but he just couldn’t go ( as though there are no routes for scholars without money) and Gary may preach that his own ‘education’ was vastly superior to that originating from Harvard or Oxford but seriously, folks…

    Indeed, I surmise that these guys believed as teenagers that they were intellectually superior to most people and then were shocked when universities didn’t court them and gladly award them positions on demand. From my own reading of their material- and my experience of testing- I can’t see either of them amongst the higher levels of university graduates. There are too many mis-uses of language, simplistic metaphors and un-subtle, inarticulated characterisations: the attempts at comedy are heavy handed slapstick rather than sophisticated, verbal and spot-on. Often, their reactions to research findings reeks of innumeracy especially when they try to critique results with which they disagree.

    I would venture that perhaps their choice of occupation is in itself a coping strategy to correct low self-esteem that then overshoots into grandiosity. That and making money.

  25. #27 Narad
    May 13, 2015

    she literally has posted THOUSANDS of links to medical studies, CDC, WHO, and other professional sources on hundreds of other blog posts

    By my count, she has 2083 blog posts, but many look to have useless tags (e.g., “blog”), and I’m not seeing a list, so it’s hard to come up with decent sample of her tendencies when making medical claims.

    I feel obligated to share this recipe for bread crumbs, though. I’m not sure which is dumber, the obsession with phytic acid (hence the soaking) or the failure to realize that you can actually use fresh bread to bind forcemeats.

  26. #28 Panacea
    May 13, 2015

    In other words, Denice, they are legends in their own minds 😉

    “She has knowledge; it’s just that it’s all wrong or misinterpreted. ”

    Orac, I think you are too kind to her when you say this.

    If it’s wrong, it’s not knowledge, therefore she knows nothing.

  27. #29 Lurker
    May 13, 2015

    When dealing with the likes of Tietje, who censors their blog comments mercilessly, a useful tactic is to Poe them to the point where they overcompensate.

    The key to this is to seek to blur the line between ‘stereotypical supporter’ and ‘troll’ to the point where the frame of reference itself gets shifted. For example a successful Poe riff about chicken pox parties will have the result that, after you succeed, anyone else who mentions pox parties in comments on her blog, will be considered to be another Poe and asked to prove that they aren’t. This will also have the result of creating an ‘aura’ (sorry, couldn’t resist) of mutual suspicion on her blog, which will tend to drive people away.

  28. #30 Mrs Woo
    May 14, 2015

    I was attempting to explain the affect of misinformation and it’s easy access on the internet, and it created a reaction in Mr Woo that I have never before encountered. Not only did it start an argument, but it created an argument that he attempted to continue for more than 24 hours, even though his points were irrational and off-topic (he said I wanted to end free speech for the whole world, and I hadn’t suggested any form of censorship in my attempt to explain bad information and how it can seem like it comes from a good source or be “backed up” by others in an echo chamber of woo).

    I have written it off to personality changes after a severe stroke and decided to avoid most topics where he disagrees with me unless absolutely necessary. Not sure how we will get through the coming election season.

  29. #31 Mrs Woo
    May 14, 2015

    Someone needs to teach the Kindle spell check grammar. It is constantly replacing my its with it’s.

    I realized that it only seems vaguely on topic. Mr Woo’s reaction and my resulting attempts to address it felt like every “freedom!” argument available was suddenly dumped in my lap. Like the discussed blog above, it was all about “suppressed information” and freedom to tell their truth, no one having to actually take their advice, etc.

    I would love a world where people could be made aware of their cognitive biases and taught to better understand how research and science work. The continuing decline in education in this country is frightening to watch.

  30. #32 Geoff
    Japan
    May 14, 2015

    Sorry, are you saying that leaky gut doesn’t exist?

  31. #33 LW
    May 14, 2015

    apparently the entire Internet needs to be a “safe place”

    I’m coming to detest the terms “safe space” and “unsafe”. They are perfectly appropriate when speaking of physical threats, but if used when speaking of threats to one’s beliefs, they are as irritating to me as fingernails on a blackboard.

  32. #34 Julian Frost
    Gauteng East Rand
    May 14, 2015

    Geoff:

    Sorry, are you saying that leaky gut doesn’t exist?

    Yes. Are you saying that it does? If you are, what’s your proof?
    And don’t say Wakefield.

  33. #35 Mrs Woo
    May 14, 2015

    I just commented there. We will see if she lets it through. If she does, we will see what her excuses are.

    My comment:

    Actually, you list only one side and speak authoritatively, as though you have tested your suggestions for side effects, unwanted outcomes, etc. One reason so many alternative websites use gushing testimonials instead of research is because at least forty percent of people will feel better just because they are treating their illness. They will also suffer from confirmation biases where things that would have happened anyhow are attributed to the treatment rather than natural healing our bodies do.

    You do not list (nor do most other alternative advocates I read) any downside to your suggestions, any possibility that they don’t work. You list your information only thing, tell people do their own research and go to bed at night thrilled to be making money helping people, attributing your success to God blessing your righteousness, certain it must mean everything you share here is right.

    Google for a website “what’s the harm” and really read it and think about it. See, maybe people have gotten lucky in your sphere. My beloved husband is a strong believer in alternative medicine and faith healing. When I was diagnosed with an illness with very few treatment options, he spent more than a hundred dollars a month on promised cures. He also took me to faith healings (still sick).

    We aren’t rich. The thousands wasted on dubious treatments that could have been spent on regular med treatments that were ignored because they said they had side effects, and that they weren’t useful in one hundred percent of patients and that they WEREN’T a cure.

    Money back guarantees? Desperate people who believe in alt-med don’t usually ask for money back. They shrug and say, “That one was no help, must not work for me…” and try the next promised cure.

    Please don’t mock me with diet suggestions (Kate or readers). The cure to “all” diseases is “being alkaline,” a diet of mostly vegetables with a little fruit and lots of expensive supplements. No white anything, obviously. Did that for nearly a year (and was far from happy or satisfied). Have been wheat/gluten free, processed food free, detoxed, cleansed… Someone suggested an exorcism. Talk about offensive. I am a Christian. Was always taught evil couldn’t dwell in Light.

    There can be all kinds of harm. Someone with an authoritative tone, an “I did all my research, am a wonderful, trustworthy human being, but, I encourage you to research, too. Oh – by the way, don’t trust anyone who talks to you about drugs, shots or doctors, they’re all paid off by people who only want you sick, anyhow…” How many people trusting that are honestly going to take “Do your research,” seriously? Better yet, since you already demonized the alternative point of view, the only sources they have been told are trustworthy are the ones that echo YOU. I wonder where that will lead them?

    My poor husband lives in those echo chambers. They have made him scared to death of oral diabetes medication. Instead of managing the diabetes while trying to reduce, he has had two strokes, one life-changing. He is still trying fad diets (diabetic neuropathy from untreated diabetes – oh, don’t worry, he takes $300 a month in supplements guaranteed to work as good as the best diabetes drugs with no side effects! – has made it painful for him to walk, further complicating weight loss, which of course reduces the likelihood of ever controlling his diabetes through losing weight; did I tell you he is over sixty-five?) and lying to his doctor about his average blood sugars because he is afraid to have his blood sugar meds raised above the lowest dose!

    Every website that assures him that they want only the best for him tells him that only herbs and miracle weight loss are safe. They sell him the herbs, the books. They don’t care if he does – they warned him that they are not doctors and he should consult one and or talk to them about the supplements he is taking and that their posts are “information only” and not meant as medical advice.

    I am hoping this makes you and your readers think, just a little. That’s all I ask.

  34. #36 Geoff Morris
    Japan
    May 14, 2015

    I have yet to delve into that particular area but I have seen it mentioned by many sources and listed on reputable sites.

    http://www.sciencedaily.com/releases/2015/04/150402101527.htm

    http://www.sciencedirect.com/science/article/pii/S1074761312003809

    http://www.sciencedaily.com/releases/2014/09/140903161604.htm

    http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1004559

    http://www.journal-of-hepatology.eu/article/S0168-8278(14)00549-2/fulltext

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0081856

    Now, I haven’t read these papers but they all make mention of leaky gut and there are many other papers on pubmed, too.

    I could be wrong but I’m pretty sure that Rob Knight or one of his team made mention of leaky gut in a video I watched earlier this year, too.

  35. #37 Julian Frost
    Gauteng East Rand
    May 14, 2015

    Geoff Morris:

    Now, I haven’t read these papers but they all make mention of leaky gut and there are many other papers on pubmed, too.

    If you haven’t read them, how could you know that they make mention of leaky gut? Did you read somewhere that they did? If so, how do you know that the one claiming they did isn’t wrong or lying?

  36. #38 Dorothy Mantooth
    US/UK
    May 14, 2015

    @Jane Ostentatious: John Snow was born in King’s Landing.

    @Narad: Yes, that made me smile, too (the breadcrumbs). I do make/dry breadcrumbs on occasion, but only so they take up less space in the freezer (I make my own bread, usually, so rather than toss it as it stales I tear it up, dry it, and give it a whirl with my stick blender). Then I forget about them, and shred fresh bread to soak in milk and add to my meatball mixture.

    I’m also amused at her use (and recommendation) of bottled marinades and, to a lesser extent, sauces. I’m not a fanatic and don’t expect everyone to be a good cook, but I also don’t blog about healthy and/or inexpensive eating. If I did, bottled marinades would be one of the first things I’d tell people not to bother with–along with wasting several dollars on jarred spaghetti sauce when it’s just as easy and so much tastier to make your own.

    Sorry, cooking derail over.

  37. #39 Bob
    May 14, 2015

    Good lord, Orac, she’s just providing alternatives! I mean, alternatives to reality, sure. Alternatives to safe and effective medicine. But it’s just speech! When you criticize someone for their speech, you are shitting on the first amendment. Unless the speech is coming from the Big ___ conspiracy. Unless it’s Big Supp, then you can’t criticize them. Basically, don’t disagree with me, because disagreeing with me is morally wrong, for whatever reason is popular right now.

  38. #40 Jerome Viveiros
    Bedford View, Gauteng
    May 15, 2015

    Julian, maybe those papers he linked to are Big In Japan. (Sorry, lame joke.)

    But it is ironic that somebody mentioned a Gish Gallop of links in an earlier comment.

  39. #41 Geoff Morris
    Japan
    May 15, 2015

    Reading and skimming are not the same thing. I searched sciencedaily, Pubmed and PlosOne for mention of leaky gut and opened up the papers, I then skimmed them looking for the term and all of them talk about leaky gut as very real phenomenon and there are many other instances talking about altered gut permeability. I chose only a handful of the papers returned in the result.

    So I’ll ask my question again, you think it’s not real? Is it possible that all these different sources are misinformed? Of course. But also could it be the case that you are misinformed? If not I’m be grateful if you could point me directly to some evidence that leaky gut doesn’t exist.

  40. #42 Gray Falcon
    May 15, 2015

    Geoff Morris: Where do they say that? Specifically? And what exactly do they say?

    If one’s gut is leaking, autism is the least of one’s problems.

  41. #43 Julian Frost
    Gauteng East Rand
    May 15, 2015

    Geoff Morris:

    I then skimmed them looking for the term and all of them talk about leaky gut as [a] very real phenomenon

    Not good enough to just skim. Gray Falcon asked for specifics. So am I.
    What exactly do those papers say about leaky gut?

  42. #44 Geoff Morris
    Japan
    May 15, 2015

    http://www.cmghjournal.org/article/S2352-345X(15)00041-7/fulltext

    “Previous studies have tried to explain the association between intestinal permeability and NAFLD. In an experimental model of NASH, Gäbele et al7 were able to propagate liver injury and inflammation by inducing colitis. They hypothesized that injury to the intestinal epithelium led to increased permeability and passage of bacterial products to the portal vein, leading to enhanced liver injury. Others have shown that obesity itself may lead to altered intestinal permeability through an increase in tumor necrosis factor-α (TNFα) levels and increased intestinal inflammation.8, 9 Furthermore, it has been found that the intestinal microbiome is perturbed in both obesity and NAFLD, which may lead to changes in microbial products and a resultant leaky gut.5, 10, 11”

    “The data showed that the systemic and hepatic levels of TNFα and alanine aminotransferase followed a similar timeline, with an initial rise around day 6 and a subsequent peak at day 21. The histologic changes of NASH, quantified using a modified NAFLD activity score, paralleled these biochemical changes. Other indicators of inflammation, including levels of the cytokines IL-6 and IL-1β, did not show significant changes during this period. Interestingly, increases in intestinal permeability could not be detected until after initial damage to the liver had been identified, suggesting that, at least in this model, leaky gut could not be blamed for the initial insult to the liver. Immunofluorescence microscopy of the small intestines demonstrated disruption of zona occludens-1 on day 10, consistent with the idea that epithelial tight junction injury occurred after the initial liver injury.”

    http://www.sciencedirect.com/science/article/pii/S1074761312003809

    “Importantly, loss of IgA appears to be a unifying mechanism by which depletion of CD4+ T cells and neutralization of TGF-β increases susceptibility to acute mucosal damage in the context of a leaky epithelial barrier. Based on our data, it is clear that IgA-associated responses are critical for immune mediated-compensation during enhanced intestinal permeability. Murine studies have demonstrated an important role for IgA antibodies in immune exclusion. For example, mice deficient in the polymeric immunoglobulin receptor, which are unable to secrete IgA into the gut lumen, display increased mucosal leakiness and antigen uptake (Johansen et al., 1999; Sait et al., 2007). The current study highlights the observations that: (1) IgA production is augmented in mice with a leaky gut barrier, most likely representing a humoral compensatory mechanism in response to the increased antigen uptake across the epithelium, and (2) that regulation of intestinal inflammation in the specific context of increased epithelial permeability and acute mucosal injury relies on IgA-mediated immunity. The exact mechanisms by which IgA antibodies participate in dampening tissue inflammation in JAM-A-deficient mice remain unclear, but may involve increased immune exclusion at the interface between lumen and epithelial cells and/or increased transport of antigens across the epithelium and subsequent recognition and phagocytosis by antigen-presenting cells.”

    http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1004198

    “Intestinal barrier dysfunction, long recognized in HIV patients with advanced disease, includes manifestations of pathogen-negative diarrhea and malabsorption [36]. Indirect assessments of intestinal permeability, through measuring urinary excretion of orally consumed oligosaccharides, demonstrate increased small intestinal permeability in symptomatic AIDS patients and some asymptomatic chronic HIV patients, regardless of therapy status [37], [38]. Notably, increased small intestinal permeability did not correlate with intestinal structural change [37], and, through in vitro impedance spectroscopy and flux analysis of duodenal biopsies, was suggested to be due to a leak flux mechanism [39], alluding to an intestinal barrier defect as a result of tight junction (TJ) down-regulation. Our recent clinical report demonstrated increased small intestinal and colonic permeability in HIV-infected patients, which was not corrected by ART, further implicating intestinal barrier dysfunction as an ongoing pathophysiological change in ART-treated patients [40]. Our current study, using human intestinal biopsies, extends evidence for intestinal damage in SIV infection of non-human primates [41] and explores the molecular mechanisms behind increased intestinal permeability in ART-treated HIV+ patients. We hypothesize that HIV-associated dysregulation in intestinal epithelial cells will lead to TJ down-regulation, resulting in persistent intestinal barrier dysfunction in the ART-treated patients, contributing to microbial translocation and systemic inflammation.”

    http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1004559

    “It is now well established that gut flora and chronic liver diseases are closely interrelated. This association is most evident at late stages of the disease: cirrhosis and impaired liver function are associated with intestinal bacterial overgrowth, small bowel dysmotility, increased gut permeability, and decreased immunological defenses, all of which promote bacterial translocation from the gut to the systemic circulation, leading to infections that in turn aggravate liver dysfunction in a vicious circle [1]. For a long time, the implication of gut flora in the pathophysiology of less advanced chronic liver diseases has been underestimated because technical limitations allow only for the culture of a small fraction of gut bacteria. Recent technological progress and next-generation DNA sequencing have allowed for more sophisticated analysis and sampling of the gut microbiota by culture-independent methods [2]. Thanks to these recent technological advances, knowledge about the role of gut microbiota disruption (dysbiosis) in gut diseases such as colon cancer, inflammatory bowel diseases, and irritable bowel syndrome has greatly increased, with possible new therapeutic strategies. More surprisingly, gut dysbiosis has been implicated in chronic metabolic disorders such as obesity, metabolic syndrome, diabetes, and cardiovascular diseases [3]. Nonalcoholic fatty liver disease (NAFLD) is the liver manifestation of the metabolic syndrome and thus evolves in the same context as these metabolic diseases [4]. It is therefore not surprising that recent literature emphasizes a potential role for gut dysbiosis in the pathophysiology of NAFLD.

    http://www.journal-of-hepatology.eu/article/S0168-8278(14)00549-2/fulltext

    “Another immune system compartment that is also profoundly affected in cirrhosis is GALT, which constitutes the first barrier of defence against antigens and pathogens entering the organism from the intestine. The intestinal lymphoid tissue, distributed in Peyer’s patches and mesenteric lymph nodes (MLN), acts by inducing immunity and tolerance, whereas its effector sites are scattered throughout the lamina propria and mucosal epithelium. In cirrhosis, GALT is under the constant pressure of pathological bacterial translocation and the increased passage of bacterial products that results from a leaky gut and an elevated enteric bacterial load. The consequence of this persistent stimulation is an increased number of activated monocytes, dendritic cells and T lymphocytes at the intestine and MLN [[50], [51], [52], [53]]. In turn, these activated cells cause the augmented expression of pro-/anti-inflammatory cytokines at the lamina propria, mucosal epithelium and MLN, as well as increased phagocytosis by intestinal dendritic cells [[50], [51], [52]]. Bowel decontamination with non-absorbable antibiotics reduces the number of activated immune cells in the intestinal lamina propria and MLN [[50], [51], [52], [53]]. This supports the pathogenetic role of enteric bacteria in intestinal inflammation.”

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0081856

    “The immune reaction and inflammation in response to TB typically involves stimulation of toll-like receptors (TLR) by antigens such as lipoarabinomannan (LAM) grouped under the name pathogen associated molecular patterns (PAMPs). Interestingly, a higher level of pre-ART urinary LAM has been reported in TB-IRIS patients [7]. This finding, along with reports of elevated C-reactive protein (CRP) prior to ART [18,19] and during IRIS event [20,21], supports a possible role for the TLR-pathway in TB-IRIS. However, the potential involvement of gut derived bacterial PAMPs such as LPS and proteins that regulate TLR stimulation by binding PAMPs remains largely unexplored. LPS enters the blood through a phenomenon known as a “leaky gut”, characterized by increased intestinal permeability, which is associated with immune activation in HIV disease [22]. LPS-binding protein (LBP) and soluble CD14 (sCD14) are able to regulate this antigenic stimulation by binding LPS and other PAMPs [23–27] and could therefore influence TB-IRIS inflammation.

    In this study we aimed to find biomarkers for early-onset TB-IRIS in one of the largest TB-IRIS cohorts described to date. We hypothesized that a more pronounced presence of PAMPs from a leaky gut such as LPS could contribute to the cytokine storm in TB-IRIS in a non-TB related manner and that this effect is regulated by plasma proteins that bind PAMPs, which have not been investigated in TB-IRIS before. We report lower plasma levels of LBP before ART initiation but higher levels of LBP during IRIS event. Similarly, the innate cytokine profile showed lower levels before ART and higher levels during TB-IRIS, with IL-6 holding a dominant role. Our results support the theory that dysfunctions in the innate immune system make a large contribution to TB-IRIS pathogenesis.”

    Now can I have less the argumentative blog commenter and some actual answers? I began with a genuine question and hope to find a concise answer without being treated like some oink who doesn’t value evidence and science.

    I stated that I had seen many references to leaky gut yet this blog post claims that it is ‘woo’ and so I was asking for clarification. A simple link or post would suffice.

  43. #45 Geoff Morris
    Japan
    May 15, 2015

    And who mentioned autism? Not me and nor does this post in respect of leaky gut

    “She also routinely gushes about other forms of woo, such as the GAPS diet, the lates “leaky gut” claims, and, of course, demonizing dairy and gluten (actually claiming that grain in general is a big problem in an ebook).”

    Hence my question

  44. #46 Bob
    May 15, 2015

    @Geoff Morris

    There are unfortunately two things people talk about when they reference “leaky gut”. There is the demonstrable phenomenon of increased gut permeability, which can cause serious problems from the accelerated uptake of bacterial endotoxins, and can be a contributing factor in many intestinal diseases.

    There is also “leaky gut syndrome”, wherein alternative medicine practitioners insist without evidence that intestinal permeability is a causative or contributing factor to autism or other diseases. Actual scientists are investigating the influence of gut permeability in autistic animal models, but the alties just skip all that and head straight to selling their treatments.

    I’ve suffered this confusion in person when a scientist starts talking to me about leaky gut and it took me a while to figure out if she was referring to the evidence-based or crazy variety.

  45. #47 Geoff Morris
    Japan
    May 16, 2015

    Cheers Bob for the only useful and relevant response to my question. So it would seem that the author should clarify his point a little more.

  46. #48 LB
    May 16, 2015

    I think the problem might be that most readers of this blog are familiar with the way these diseases are discussed in the skeptical community, the alt-med community, and in actual medicine. Another example is candidasis, which is a systemic yeast infection that people with compromised immune systems can get. Then there’s “candidasis,” which alt-med people will tell you is a systemic infection that affects everyone who is a little chubby and tired and requires an extremely specific diet and bushels of supplements.

    I have hypothyroidism. I recently read what seemed like a pretty reasonable site until I encountered the advice to adopt a gluten-free diet for Hashimoto’s thyroiditis, because gluten and thyroid tissue are so similar that developing a gluten sensitivity means that your immune system destroys your thyroid. really.

  47. #49 TBruce
    May 16, 2015

    LB:
    You’re probably aware that people with Hashimoto’s have an increased risk of coeliac disease as well as other autoimmune disorders. However, a gluten-free diet is of no use in Hashimoto’s alone. Even though it’s The Cure For Everything.

  48. #50 Dangerous Bacon
    May 16, 2015

    I notice from Geoff’s links that increased intestinal permeability (“leaky gut”) is prominently mentioned as a _consequence_ of chronic illness, i.e. in AIDS patients and in those with end-stage cirrhotic livers.

    What tends to induce eye-rolling among the rational is when people make the assumption that “leaky gut” _leads to_ these conditions rather than being caused by them, and offer a variety of unproven treatments and diets for a condition that has not been shown to exist in the vast majority of the target audience (and for whom those diets/supplements would not heal a “leaky gut” if they had one).

  49. #51 Geoff Morris
    Japan
    May 18, 2015

    I just remembered this article from Nature last year

    http://www.nature.com/news/gut-brain-link-grabs-neuroscientists-1.16316

  50. #52 Chris
    May 18, 2015

    What does that have to do with “leaky guts” or Ms. Tietje’s rantings?

  51. #53 Cee Dubya
    somewhere in oil country
    May 19, 2015

    I have had HIV for MANY YEARS, and several times I have developed symptoms indicating its progression in my body.

    I have NEVER taken antiretroviral medication.

    I have a very high IQ.

    I DO AGREE that MOST CAM is quackery.

    The key is to tell the difference between what is evidence based and what is pseudoscientific nonsense.

    Here are my protocols for your consideration. (I am presenting them to you because I need someone with your critical mind to help me understand WHY this protocol works)

    (1) Food Grade H2O2 diluted to less than .01% in all drinking water.
    (2) S Acetyl (Stabilized) Glutathione OR Sublingual Glutathione tablet. 1 tablet 3 times per day.
    (3) Zinc Orotate Tablets (5 mg) 1 tablet 3 times per day.
    (4) Alpha Lipoic Acid (100 mg) 1 tablet 3 times per week.
    (5) Lauricidin (5 caplets after every meal)

    I regularly run intervals on the treadmill, lift weights, do yard work, eat steaks, and work 50 hour weeks.

    I have a tiny bit of belly fat. But I also have muscle tone. I lose the belly fat when I travel and do a lot of walking.

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