The other day I told you about a doctor promoting a dietary supplement for the treatment of HIV, despite the lack of any significant data to support his claims. If there's anything medical bloggers have found over the years is that woo rarely walks alone.
In my post I expressed some incredulity at the fact that Kaiser promotes himself as an internist and HIV expert despite any of the usual formal education required for these designations. Examination of his website reveals that he is also an expert in "longevity", cancer, chronic fatigue, autoimmune disease, and intestinal parasites. Fascinating.
According to Kaiser's website:
Integrative Health Consulting believes that a comprehensive healing program of aggressive natural therapies, combined with standard medical treatment and mind-body healing techniques, is vital to the successful treatment of most serious medical conditions.
Every day I hear from patients and friends with serious diseases who are trying to sort through the piles (pun intended) of unsolicited advice about their serious diseases. When I see bullshit like this, all I can think of is my friends who might read this and be taken in. The statement that "Integrative Health Counseling believes that..." is wonderfully useless. What the company does or does not believe about its offerings is not a good gauge of their utility. What are "aggressive natural therapies" and what data supports their use? As with most questionable medical practices, their program just happens to be good for everything. That's terribly convenient.
Comprehensive Healing Programs consist of recommendations from each of the following seven categories:
1) Diet
2) Vitamins & Nutritional Supplements
3) Herbs & Acupuncture
4) Individualized Exercises Programs
5) Stress Reduction/Positive Attitude
6) Hormone Balancing
7) Medical TherapyThe use of a combination of recommendations from the above categories imparts a far better success rate than the use of one category alone (i.e. medical therapy). When an approach such as this is taken to the treatment of chronic conditions such as cancer, hepatitis, autoimmune disorders, and chronic fatigue syndrome a high success rate is achieved.
Really? How do you know that? So, you're claiming that by combining medical therapy with a bunch of unproven and disproved modalities, you fix people with serious diseases.
These kind of claims are unethical and cruel. And what's up with "intestinal parasites"? Seriously? Kaiser makes the claim that, "in the United States, intestinal infections are the third-leading cause of illness and disease." What the hell does that mean? What is "illness" and what is "disease"? The leading causes of death in the U.S. are heart disease, cancer, and stroke. Actually, I'm not even sure what "cause of disease" means? Cause of what kind of disease? Common serious diseases in the US include diabetes, hypertension, heart disease. One of the most common, although not serious, diseases is the common cold.
He goes on to argue that intestinal parasites are a major cause of illness in the U.S. and that he has special knowledge about the diagnosis and treatment of parasitic diseases.
While local hospital laboratories usually do a decent job at identifying
intestinal parasites, specialty laboratories are able to significantly increase the yield of the test because of their additional expertise.
One of the most common techniques of pseudo-experts is their use of special laboratories to "increase the yield" of the desired results. Whether it's heavy metal tests or testosterone assays, unconventional doctors have a long history of hunting around for labs, basing the quality of the lab on it's ability to produce a positive result rather than the the external validation of its procedures. He says of the lab he prefers:
The test that I routinely order is called a "Comprehensive Parasitology - Random" and it not only looks for intestinal parasites but tests for fungal and
bacterial imbalances in your gut as well. This is not the lab's most expensive test, but it does a very good job at evaluating the health of a person's intestinal system at a reasonable cost (prepay price: $132). Unfortunately, it must be ordered by a physician or other health care practitioner (chiropractor, acupuncturist, etc.).
As we saw in yesterday's post, not only is Kaiser not an infectious disease specialist, he's not board certified in any medical specialty, which puts him in good company with "chiropractor(s), acupuncturist(s), etc."
But the obsession with parasites makes some sense in light of the material presented on his page about "longevity":
The foundation of one's health is based upon a strong gastrointestinal (GI) system.
[...]
The health of your GI system can be improved through a variety of means. These include dietary interventions, vitamin supplementation, pre and pro biotic supplements (such as acidophilus and yogurt), stress reduction, castor oil packs, deep abdominal massage, etc. Improving the health of your GI system can have substantial effects on your overall health and it is often the first system I investigate when putting together an optimal longevity management program.
Does any of that sound familiar to you? The colon is one of the favorite bugaboos of alternative medicine folks, and most of their ideas are bunk.
And what is "longevity management"? When it comes to preventing premature death, there is some data out there: obesity seems to put one at risk for premature death, as does failure to properly prevent and treat diabetes and heart disease. But there is almost certainly an upper limit on how long one can live, even with the best health. But colon health? Really?
I left the door open to see what results will eventually shake out with Kaiser's approach to micronutrient supplementation in HIV disease. It's not implausible, there just isn't any convincing evidence at this point. Kaiser's website doesn't exactly give me confidence in his knowledge of science as the basis of the practice of medicine does not exactly shine through on his website.
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Ah, good ol' ignorance of prior probabilities. He's going on a fishing expedition up his patients' butts. If you run a sufficient number of tests on a patient with no signs or symptoms indicative of anything the tests could detect, you're almost certain to get a few positives and they're almost certain to be false.
Wow. Just wow.
If it looks like a duck, and it walks like a duck... it must quack.
Guess who does Comprehensive Parasitology testing? Our good friends at Doctor's Data!
http://www.doctorsdata.com/test_info.asp?id=26
I'm a CFS patient and after extensive research (which is very difficult considering the cognitive struggles I face) I was able to conclude that anyone interested in my back side has never really looked me straight in the face the entire time I've been talking with them. I have severe problems regulating my food intake not due to what I eat, how much eat or when I eat -- but because for some reason my brain triggers my stomach to send the 'get sick' message instead of the 'you are full message.' It's a wonderful side effect of being an atypical CFS case. There are many things someone with a chronic illness has to figure out and fight along the way of managing illness. Weeding out non scientific assertments and non-medical based claims, unfortunately, is one of them. Another cautionary tale in our American culture?
hmm, he's not listing morgellons, so not all is lost.
I especially like his nonsensical '7 categories.' Vitamins and supplements are in a separate category from herbs? Herbs and acupuncture are a single category?
And what the bleep is "hormone balancing?"
"5) Stress Reduction/Positive Attitude" is always a quack's friend, because "don't worry about the treatments or question them, you need to keep a positive and relaxed attitude." It also helps the quack blame the patient.
I second qetzal: What the bleep is "hormone balancing?"
I don't think I'd give this fellow the price of a cup of coffee.
What's strange is that a lot of the things he mentioned are useful and used in mainstream medicine-but not for the conditions he claims to treat:
1. Diet is a critical component of treatment of diabetes and pre-diabetic states. Specific dietary changes are also good for heart disease, hypertension, hyperlipidemia, etc. Not, unfortunately, all that useful in cancer or HIV. And completely beside the point in parasitic infection unless your diet happens to include tapeworms or something.
2. Vitamins are, of course, used in replacing specific deficiencies and in a few other circumstances such as pernicious anemia, homocysteinemia, pregnancy, and (with arguable success) osteoporosis. Again, parasitic disease...not so much. And so far there are very few situations in which vitamin supplementation in the absence of deficiency is helpful (arguably homocysteinemia and borderline B12 deficiency with dementia.)
3. Acupuncture, eh. No known use. Herbs? Well, we usually prefer to isolate the active ingredient and give that in a standardized dose rather than take the raw herb.
4. Exercise is again a critical element in treatment and prevention of diabetes, cardiac diseae, hypertension, etc. Specific exercises can also help lower back pain, some forms of arthritis, etc. Again, not so much use in cancer, autoimmune disease, etc. Chronic fatigue...maybe.
5. Stress reduction is probably good for most things. Except maybe MS: I seem to remember reading a suggestion that stress reduces MS flairs, possibly by increasing endogenous steroids. This might extend to other autoimmune diseases suggesting that Kaiser may be completely backwards on this one.
6. Hormone balancing. I'm not exactly sure what he means by this. Hormonal therapy such as tamoxifen and LHRH antagonists are useful in some cancers. But it's hard to see gross elimination of hormonal influence, such as in these cases as "balancing". Balancing one's TSH level, perhaps?
7. The mainstay of treatment of most diseases. However, note that I did not say all diseases. Diabetes prevention is best started (at least) with diet and exercise. Lower back pain is probably best treated with physical therapy and specific back strengthening exercises.
So, while Kaiser hits on some useful therapies, he applies them in all the wrong places. Which is worse than useless.