White Coat Underground

One of Oprah’s favorite resources for women’s health is Dr. Christiane Northrup, a gynecologist with bizarre ideas about health and disease. On the air, she has disputed the connection between HPV and cervical cancer, an uncontroversial scientific fact. Her un-belief in an important scientific fact is disturbing, but if you dig around her published writing a bit, it’s even scarier. This doctor is to women’s health what Dick Cheney is to human rights.

Northrup on fibroids

Uterine leiomyomas, better known as fibroid tumors, are common, non-cancerous tumors of the uterus. They can be completely asymptomatic, or can cause significant pain, bleeding, and fertility problems. These tumors are fed by hormones such as estrogen and progesterone, and manipulation of these hormones can sometimes help with symptoms. That’s the facts. In Northrup’s world, things are a bit different. If her writing makes you feel a bit like Alice, you’re not alone. It starts with some normal ideas, such as the anatomy of fibroids, etc., but as soon as she starts to talk about cause, we are well down the rabbit hole.

…fibroid tumors represent our creativity that has never been birthed. Fibroids may also result when we are flowing life energy into dead end jobs or relationships we have outgrown. Fibroids are often associated with conflicts about creativity, reproduction, and relationships.

Fibroid tumors are abnormal growths arising from uterine smooth muscle and fed by hormones. The are most assuredly not representative of creativity in utero or any other non-physical idea. To represent them this way is not only wrong but also dangerous, as it may lead women to improper care:

If you have fibroids, ask yourself the following questions: What are the creations within me that I want to put out in the world before I’m no longer here? If anything at all were possible, what would my life look like? If I had six months to live, what relationships would I release from my life immediately? What relationships would I give more of my time and attention to? What relationships truly feed and nourish me? Which ones drain my energy? Write your answers in a journal. Discuss them with supportive friends. Deep within you, you have all the answers you need. You just need to be open to hearing them.

If you’re sitting at the cafe drinking your favorite tea, or maybe wine, such maudlin reflections my be a fun narcissistic exercise, but it is unrelated to your uterine anatomy. But as long as you remember that, the advice isn’t dangerous. Right?

Well, she goes on to talk about some of the standard treatments for fibroids, and mixes in a dose of “bioidentical hormones”, a trendy idea with no scientific merit. But then she really brings the crazy. Her “spiritual and holistic options” are a gamisch of completely unproven modalities that have no basis in fact, much less science. Recommending them to women would be not only unethical, but potentially dangerous.

Better boobs through breathing and balance

Breast cancer, which touches a terribly large percentage of women, is the most feared breast disease, but other less frightening conditions, such as mastitis, also occur. Still, if you ask most women what they fear most, breast cancer is likely to be high on the list. What are Dr. Northrup’s “10 Steps for Creating Breast Health”? Yearly exams? Mammograms? Well…

Step 1: Imagine that your breasts, chest, ribs, lungs, heart, and shoulders are now bathed in the golden white light of healing.

[...]

Step 9: Use the wisdom of mind/body unity.

The body and mind are a seamless unity. And each part of our bodies has its own meaning. The heart, breasts, lungs, and shoulder areas are in the fourth emotional center. The health of this area of the body is affected by our ability to express all emotions fully.

There are still some things about breast cancer screening and prevention we don’t know. The precise effect of current screening tests on survival is still being studied. When to use self-exams, mammography, MRI, or other techniques is an active area of research, but current recommendations are quite good; there is a lot we do know. None of it has to do with “releasing your negative feelings.”

There is something fundamentally misogynist about Northrup’s approach. In addition to being complete fantasy, it is part of the punitive culture of so-called alternative medicine. According to people like her, if a woman is just happy enough, satisfied enough, spiritual enough, then she won’t be unhealthy. So what happens if you get sick? Well, you must not have been good enough. It’s not like that’s a new message for women.

Women don’t get fibroids or breast cancer because of repressed needs, a wandering uterus, or lack of self-esteem. They get these diseases because of a combination of genetic and environmental factors. While we have control over some of the environmental factors (smoking, drinking, etc.) the rest is out of bounds. All the navel-gazing in the world won’t change your genes. Disease isn’t a failure of introspection—it’s biology, and the study of human biology has taken us far in the prevention and treatment of disease.

Comments

  1. #1 T. Bruce McNeely
    June 4, 2009

    Here’s a similar crock o’ feces:
    http://lawofattractionsecrets.com/blog/radical-forgiveness-on-the-john-edwards-affair/

    How do these people have the nerve to say stuff like this?

  2. #2 Anon1
    June 4, 2009

    Of course, smoking reduces the risk of fibroids….

  3. #3 Kathy
    June 4, 2009

    Um, what?!

  4. #4 MonkeyPox
    June 4, 2009

    It also turns a boy into a man!

  5. #5 The Blind Watchmaker
    June 4, 2009

    This is a great companion piece to Gorski’s Oprah piece at Science Based Medicine the other day.

    And she is a billionaire. O-M-G

  6. #6 daedalus2u
    June 4, 2009

    I think the reason that smoking reduces fibroids is because of the cross-talk between NO and CO. Both of them bind to heme, and one of the major NO sensors is soluble guanylyl cyclase, a heme enzyme, but NO binds a few orders of magnitude stronger. ppb levels of NO correspond to ppm levels of CO. The cross talk isn’t exact, but it is close enough to have an effect.

    There are a number of conditions that smoking seems to protect against. I think that many of them are due to the CO/NO cross-talk. A better way is to increase the NO level and avoid the nicotine and the tars both (and the CO because that CO is non-physiologic and while it does stuff, authentic NO has to work better).

  7. #7 Mary
    June 4, 2009

    That any woman watches Oprah and listens to this drivel makes me embarrassed to be a woman.

  8. #8 MonkeyPox
    June 4, 2009

    It’s not like the data is so clear

    http://aje.oxfordjournals.org/cgi/content/full/153/1/20#SEC3

    Smoking may or may not affect risk of developing fibroids, but it’s hardly a treatment. Whatya gonna do, recommend smoking to all women so they don’t get fibroids? Or so that they die of a heart attack before the fibroid is a big deal?

  9. #9 Donna B.
    June 4, 2009

    I just wish that ScienceBloggers could restrain themselves from making spurious connections between medicine/science and politics.

    If there is an actual connection between the science and politics, such as funding, I say go for it! And if you just want to post about politics, that’s fine too.

    But please… cutesy little ‘in-group’ comments such as the one about Cheney at the beginning of this post do no good, and might possibly drive away an otherwise sympathetic conservative leaning person.

  10. #10 Noadi
    June 4, 2009

    Boohoo, he made a political joke on his blog. Welcome to the concept of free speech, if you don’t like it that’s your problem not his.

  11. #11 phisrow
    June 4, 2009

    @Donna B: While I agree that the mention isn’t necessary, are we as a society so far gone that we have to respect the feelings of people who approve of Cheney’s human rights record?

  12. #12 MonkeyPox
    June 4, 2009

    Who the fuck cares? Who decides what’s necessary or not? It’s a goddamm blog, not a fucking formal government document or something. They guy obviously liked the metaphor. So fucking what? If you don’t like it, you think he’s going to change his writing style for you?

  13. #13 Donna B.
    June 5, 2009

    Naodi, phisrow, and MonkeyPox — get over yourselves. Which is more important – accurate health information or taking a snarky dig at Cheney?

    I’m reading and agreeing with 99.9% of the medical/science stuff written on ScienceBlogs, so I’m not asking anyone to change anything for me. I’m merely pointing out that it may be less than ideal to mix gratuitous political insults with solid scientific information.

    If you don’t like that viewpoint – screw you and your idea of free speech not applying to my comments. As for whether anyone’s views of human rights should be respected – why yes. They should. Yours included.

    As for writing style, good grief. Writing style and politics have nothing to do with each other. Good and bad writers are everywhere, right, left, middle, and off the scale. My point is that solid science has nothing to do with politics either.

    The last couple of national popular votes indicate that this country is politically pretty well split down the middle. If someone’s “style” in writing might piss off half the people he hopes to persuade of something important and unrelated to politics, is it worth it to gain minor political “style” points?

    PalMD is more than capable of reading and disregarding my comment should he choose to. I’ll still read what he has to say about science and medicine even if he chooses to ban me.

  14. #14 perceval
    June 5, 2009

    Donna B, I get where you’re coming from. Blogs reflect the writer – they are less neutral and more personal than most of the science writing I know. So Pal will probably keep making cheap jokes about Bush and Cheney – this might even help him with the crunchy liberal granola crowd who is very susceptible to woo (and Northrup). But wouldn’t it be great to have a conservative science / health blogger to add to Pal’s voice? (Incidentally, Orac is conservative-leaning.) What we really need is more advocates for sanity on the whole political spectrum.

  15. #15 natural cynic
    June 5, 2009

    My point is that solid science has nothing to do with politics either.

    Not if one side has a habit of denying scientific realities. [see evolution, global warming, sex education...]

  16. #16 Julius
    June 5, 2009

    Donna B., your opening line of “get over yourselves” is silly, I could say the same straight back to you and we’d quickly degenerate to the level of five-year-old playground fights. So get over yourself!

    And you continue in style with “screw your idea of free speech”. I don’t think anyone denied that you have the *right* to say this, although as per the usual arguments, it’s PalMD’s blog and he has the right to ban you from saying it. Not that he’s likely to do so.

    And to your main point, beyond the fact that “good writing style” doesn’t need cheap political jokes, watering down this sort of writing to remove anything that could be offensive to anyone would make it just dull. Isn’t that what a lot of conservatives like to bang on about – all this dull “political correctness” is taking the fun out of everything, you know. Also, I don’t think it’s done as a calculated move to score any “style points”. In the end it *is* just a personal blog.

    And anyway, the Cheney comment shouldn’t even be hugely divisive – screw all this fluffy “all opinions should be respected” bullshit, anyone who respects Cheney’s views on human rights can go fuck themselves…

  17. #17 AgnosticNews
    June 5, 2009

    Personally, I rather liked the Cheney joke.

    Also, great blog. I’ve been lurking for months.

  18. #18 Anonymous
    June 5, 2009

    This makes me so sad. I actually have a soft spot for Oprah – I remember skipping my afternoon classes as an undergrad in the 80s to watch. She was great back then, like no other talk show. Totally put Phil Donohue to shame. But this is just ridiculously irresponsible and I shudder to think of how many women still hang on her (and her experts’) every word.

    The only time I had fibroids (that I know of) was when I was pregnant. Does that mean I’ve birthed my creativity? Or that my wonderful kids were dead end relationships? The mind boggles.

  19. #19 Kate
    June 5, 2009

    I have to appreciate Northrup for one thing though…

    …she got my 80 yr old Gramma to discuss masturbation.

    (We almost managed to keep straight faces…)

  20. #20 BAllanJ
    June 5, 2009

    Nice to see Oprah doing what she can to deal with some of the current gender inequalities in the USA… in this case she’s on a long term project to address the fact that women live longer than men. Wouldn’t have been my way of bringing these expected life expectancies closer to each other, though.

    [/snark]

  21. #21 SLC
    June 5, 2009

    This may be a stupid question but why is this quack Northrup allowed to practice medicine? How come her license to do so hasn’t been yanked?

  22. #22 PalMD
    June 5, 2009

    It’s very, very difficult to lose your license.

  23. #23 daijiyobu
    June 5, 2009

    Northrup wrote the ‘gushing’ foreword for naturopath Tori Hudson’s “Women’s Ency. of Natural Med.” (ISBN 0879837888; 1999) per:

    “Dr. Hudson brings her years of scientific and clinical expertise [etc., p.ix].”

    Hudson tells us of naturopathy’s essential vitalism [science-ejected basis] in that book:

    “the benefits of natural medicine [{naturopathy}...per] the advantages of a vitalistic, holistic healing art [p.xvi...] naturopathic physicians and other providers of alternative medicine must seek to verify the ‘scientific’ truth of their medicines whenever possible – by research and by modifying the mechanistic model when necessary to suit their vitalistic philosophy [{!!!!} p.xvii].”

    In other words: science is good [only] as long as it supports our sectarian beliefs.

    Hmmm: does not compute — the scientific science-ejected {aka natural medicine}, vitalism figmentation claimed as a subset of science.

    -r.c.

  24. #24 longsmith
    June 5, 2009

    I have a friend who worked for Northrup in Maine for a long time and totally buys into this crap. When I had a cyst we thought might be a fibroid, she suggested this kind of visualization stuff and that maybe I should “dress differently to accommodate my fibroid”. Turned out to be ovarian cancer. To this day we just don’t discuss medical matters.
    Northrup’s clinic still operates in Maine (at least I think it’s hers) and has a totally woo woo website.

  25. #25 rob
    June 5, 2009

    PalMD said: “It’s very, very difficult to lose your license.”

    yes, but very, very easy to lose your grip on reality.

    reminds me of a quote:

    “What a waste it is to lose one’s mind. Or not to have a mind is being very wasteful. How true that is.”

  26. #26 Rogue Epidemiologist
    June 5, 2009

    “Step 1: Imagine that your breasts, chest, ribs, lungs, heart, and shoulders are now bathed in the golden white light of healing.”

    For those of you familiar with Greek myth, this is how Hercules was made…

  27. #27 cm
    June 5, 2009

    My creativity feels unfulfilled, but I’m a man. What disease do I get?

  28. #28 Matthew Cline
    June 6, 2009

    My creativity feels unfulfilled, but I’m a man. What disease do I get?

    That would depend on what the male equivalent of “birthing” creativity is. If it’s making things with your hands, then maybe arthritis or tendonitis in your hands. If the creativity/fertility connection carries over to men, then things like decreased sperm count, impotence, non-cancerous testicular cancers.

  29. #29 Holy Hormones
    June 7, 2009

    I am one of the most creative people I know, and I still got fibroids, must be I wasn’t trying hard enough (grin). Some of Dr. Northrup’s ideas are at least good for a laugh. I am, however, a big believer in bioidentical hormones (yes, I know, very controversial)—without question they saved my life. My personal journey with them is on my blog at holyhormones.blogpsot.com. If you are wondering if my hormones are prescribed by a witch doctor, no, he’s a board certified Internal Medicine specialist who integrates alternative medicine with traditional modalities.

  30. #30 PalMD
    June 7, 2009

    bioidentical hormones (yes, I know, very controversial

    Actually, it’s not at all controversial. No reputable physician thinks it’s anything other than snake oil.

  31. #31 Candace
    June 10, 2009

    While I understand that encouraging women to rely solely on the type of mental and emotional techniques advocated by Northrup and to not first seek the proper conventional medical treatment, I think you are being close-minded about the potential of patients’ mindset and attitudes to significantly impact their health. There are an increasing number of studies that show guided meditations and various thought exercises can benefit many health conditions.

    Your desperate grasping of the ‘objectivity’ of conventional medicine and blatant disdain of anything outside of that is sad. It reminds me of the physicists at the turn of the twentieth century who were certain that the world existed as it had been taught to them, only to soon be radically shook and disproven by what we now know to be quantum mechanics. Open your mind a bit and maybe your patients will also benefit.

    Thanks.

  32. #32 red rabbit
    June 13, 2009

    Go Candace! I hope that was therapeutic.

    Because it was utter nonsense. Obviously a patient’s state of mind is important, but it doesn’t matter if you do directed meditation, get a massage, or watch Kung Fu Panda to acheive some level of comfort with the situation.

    People have been praying and chanting their way through from the Stone Age. And they lived to be maybe 30. Only in the last hundred years with the advent of evidence-based public health and medicine, starting with cholera control in London, has the human span started to lengthen.

    So spare the ranting. Woo doesn’t work.

  33. #33 Candace
    June 15, 2009

    Sorry red rabbit, but where did I ever claim that it makes a difference whether a person uses meditation, massage, or whatever to improve their mental health? What I DID say was the author of this blog is acting mighty righteous in claiming that the exercises that Northrup promotes “are a gamisch of completely unproven modalities that have no basis in fact, much less science.”

    I am not by any means saying we shouldn’t embrace evidence-based public health and medicine. (By the way, I am a PhD trained scientist in biogeochemistry). What I AM saying is that we shouldn’t so harshly and immediately dismiss possible avenues to health that we haven’t established evidence for or against. And, actually, the evidence is building up in favor of the health benefits of meditation and ‘woo’.

    From a 2003 New York Times article.
    http://www.nytimes.com/2003/09/14/magazine/is-buddhism-good-for-your-health.html

    “In the years since Davidson’s fax from the Dalai Lama, the neuroscientific study of Buddhist practices has crossed a threshold of acceptability as a topic worthy of scientific attention. Part of the reason for this lies in new, more powerful brain-scanning technologies that not only can reveal a mind in the midst of meditation but also can detect enduring changes in brain activity months after a prolonged course of meditation. And it hasn’t hurt that some well-known mainstream neuroscientists are now intrigued by preliminary reports of exceptional Buddhist mental skills. Paul Ekman of the University of California at San Francisco and Stephen Kosslyn of Harvard have begun their own studies of the mental capabilities of monks. In addition, a few rigorous, controlled studies have suggested that Buddhist-style meditation in Western patients may cause physiological changes in the brain and the immune system.”

    Didn’t mean to sound like I am ranting, but I just get really frustrated with the smug dismissal of anything ‘wooey’. Please give thinking outside the box a try. You can always go back to the box.

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