I never thought I'd see it, but I have. After an a decent article on the infiltration of quackademic medicine into American medical centers and a very good article on cancer quackery, Marilyn Marchione of the AP has done it again:
AP IMPACT: $2.5B spent, no alternative med cures
It almost seems as though Ms. Marchione is channeling Orac:
BETHESDA, Md. -- Ten years ago the government set out to test herbal and other alternative health remedies to find the ones that work. After spending $2.5 billion, the disappointing answer seems to be that almost none of them do.
Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer. All proved no better than dummy pills in big studies funded by the National Center for Complementary and Alternative Medicine. The lone exception: ginger capsules may help chemotherapy nausea.As for therapies, acupuncture has been shown to help certain conditions, and yoga, massage, meditation and other relaxation methods may relieve symptoms like pain, anxiety and fatigue.
However, the government also is funding studies of purported energy fields, distance healing and other approaches that have little if any biological plausibility or scientific evidence.
Taxpayers are bankrolling studies of whether pressing various spots on your head can help with weight loss, whether brain waves emitted from a special "master" can help break cocaine addiction, and whether wearing magnets can help the painful wrist problem, carpal tunnel syndrome.
Compare this to what I've written in the past. I've documented the woo funded by NCCAM on multiple occasions. I mean, NCCAM is funding studies of that woo of woos, homeopathy, fer cryin' out loud! I"m glad that the mainstream media is finally noticing.
Indeed, I love this quote:
"There's not all the money in the world and you have to choose" what most deserves tax support, said Barrie Cassileth, integrative medicine chief at Memorial Sloan-Kettering Cancer Center in New York.
"Many of the studies that have been funded I would not have funded because they seem irrational and foolish -- studies on distant healing by prayer and energy healing, studies that are based on precepts and ideas that are contrary to what is known in terms of human physiology and disease," she said.
Dr. Cassileth is one of the foremost boosters of unscientific CAM treatments in the U.S. Indeed, I've written about Dr. Cassileth before. If Dr. Cassileth is saying this sort of stuff about NCCAM, you know it's bad. Real bad. She's a true believer masquerading as a science-based investigator.
Other gems:
"There's been a deliberate policy of never saying something doesn't work. It's as though you can only speak in one direction," and say a different version or dose might give different results, said Dr. Stephen Barrett, a retired physician who runs Quackwatch, a web site on medical scams.
Critics also say the federal center's research agenda is shaped by an advisory board loaded with alternative medicine practitioners. They account for at least nine of the board's 18 members, as required by its government charter. Many studies they approve for funding are done by alternative therapy providers; grants have gone to board members, too.
"It's the fox guarding the chicken coop," said Dr. Joseph Jacobs, who headed the Office of Alternative Medicine, a smaller federal agency that preceded the center's creation. "This is not science, it's ideology on the part of the advocates."
Which is what I've been saying for a while now. I even called upon President Obama to defund NCCAM, not that I think it will ever happen.
The bottom line is that NCCAM is an ideological, not a scientific organization. It exists to validate CAM, not to test whether it works or not. And when it doesn't produce the results its boosters in the legislature, like Tom Harkin, want to see, there's serious trouble.
There's nothing much new in the article, at least not new to you. I've told you much the same thing for years now. But seeing an series of three articles that slam alternative medicine and NCCAM the way these articles did. Ms. Marchione is to be congratulated. Indeed, she could probably use some encouragement right about now. CAMsters will not be pleased at her telling it like it is.
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She is a cracking journalist - all of those pieces you've linked to are excellent, right on the money.
As a working journalist who occasionally covers the health field I've looked at every one of them and said "I wish I'd written that."
She is a cracking journalist - all of those pieces you've linked to are excellent, right on the money.
As a working journalist who occasionally covers the health field I've looked at every one of them and said "I wish I'd written that."
"The bottom line is that NCCAM is an ideological, not a scientific organization. It exists to validate CAM, not to test whether it works or not."
That's a bit harsh. After all, they have largely concluded that these unlikely treatments do not, in fact, work. It seems that somehow, somewhere, some scientific integrity did inadvertently get injected into NCCAM. And it's delicious to see woo-friendly politicians hand money to scientists and get back negative result after negative result.
All of this might actually be of some benefit if people were to stop using treatments that had been found ineffective. Then again, I rather doubt anyone ever started using shark cartilage against cancer on the basis of rigorous evidence, so it's a bit optimistic to think that they'll stop doing so in light of evidence that it doesn't work.
An excellent article, in my view the most damning lines are:
"However, critics say that unlike private companies that face bottom-line pressure to abandon a drug that flops, the federal center is reluctant to admit a supplement may lack merit -- despite a strategic plan pledging not to equivocate in the face of negative findings.
Echinacea is an example. After a large study by a top virologist found it didn't help colds, its fans said the wrong one of the plant's nine species had been tested. Federal officials agreed that more research was needed, even though they had approved the type used in the study."
That shows whose really in charge at NCCAM!
Apologies for the grammatical lapse in my last sentence, I'm clearly not yet fully awake:-(
-That's a bit harsh. After all, they have largely concluded that these unlikely treatments do not, in fact, work-
and therefore more research is needed. Of course.
Neither have their conclusions stopped it being used. So what good is that?
" I've documented the woo funded by NCCAM on multiple occasions. I mean, NCCAM is funding studies of that woo of woos, homeopathy, fer cryin' out loud! "
I'm not going to say the NCCAM couldn't be organised and run a lot better, but I think it's wonderful that they're doing this research. The woomeisters can't complain of a conspiracy of silence when we've spent $2.5bn on countless studies and turned up more or less bupkis. The more studies there are demonstrating that most of these "treatments" are bunk, the better. Obviously it would be better in an ideal world to spend the money on testing treatments that have a realistic chance of working, but we don't live in an ideal world. We live in a world where a huge proportion of the population believes things like homeopathy are efficacious and fraudsters are making vast sums of money.
Thanks for the link. I've just printed it to pdf for future use...wouldn't it be fun to hand out at an alt med fair!
Well, what do you know... somebody actually did some good skeptical journalism. Happeh Day! Err um.. you know.
Marilyn Marchione certainly deserves some kudos for this fine article. And I suspect the awareness-raising done by those who blog against quackery contributes to and supports articles like Marilyn Marchione's.
People keep buying these supplements for a reason; considerable research proves they work.
There are decades of solid science supporting the use of Saw Palmetto for prostate health:
http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=1974&quer…
The same goes for Echinacea:
http://www.lef.org/news/LefDailyNews.htm?NewsID=2511&Section=NUTRITION
From the Echinacea article:
"In contrast, the research that we did on Echinilin(R) was triple- standardized (alkylamide, polysaccharide, cichoric acid). And, the randomized, double-blinded, placebo-controlled human studies showed it to be consistently effective in fighting off cold and flu viruses. We saw a sustained increase in natural killer cells (NK cells) in participants when they were given Echinilin which no doubt contributed to a more active immune system resulting in the destruction of virus-infected cells. The end result was a remarkably high reduction in both severity of symptoms and duration of the infection," says Dr. Barton.
We hope that now all want to be involved in the medical system is improved, but not because they think the medical system is very much less come to trust that these events will reduce the cost and benefit millions of people throughout the country, and they say that things in http://www.findrxonline.com improved from 60% in recent weeks, hopefully this is the case ..
$2.5 billion? Can we call it:
"big cam"
yet?
John writes:
People keep buying these supplements for a reason; considerable research proves they work.
Hey, John? Are you a "big CAM shill"?
I sort of agree with #7 Ginger,
I'm glad these things are being tested. I realize there have been a lot of poor tests by the NCCAM and poor PR coming out of there, but isn't this exactly what you want? Do you want all this woo to get eh shake a scientific testing so we can, once and for all simply say "No, this doesn't work".
And if we are going to fund this activity, I want "expert" CAM practitioners to be involved, in the same way that Randi has the claimants involved in the challenges. It removes the idea that CAM folks will say "Oh well that was just run by a bunch of allopaths". If 1/2 of the 18 were CAM folks, that is perfect, particularly when this is the (completely expected) result.
The problem now lies with Joe Schmoe saying "Well they didn't test Schmoecupuncture, so what I do still works as I say it does"
goalpost shifting
Wow, science is back. I missed it.
So what's your take on this huffpo article on 'natural' supplements? (Also by Marchione.) It strikes me as a good article raising awareness about the risks of contamination in 'natural' supplements.
The article gets one thing wrong,
"...acupuncture has been shown to help certain conditions..."
Even though it doesn't matter where you use the needles, or if the needles even penetrate.
I guess if you consider placebo effective, you can consider acupuncture effective as well.
John,
"People keep buying these supplements for a reason..."
People keep gambling and buying lottery tickets for a reason too, and it's not because research shows they have a good chance of winning. Just because people keep doing something, doesn't mean there is logical, scientific support for their actions.
18: I like to describe the studies as demonstrating that poking people is effective for certain conditions.
"studies on distant healing by prayer and energy healing, studies that are based on precepts and ideas that are contrary to what is known in terms of human physiology and disease," she said."
One of the ways to find out what a person feels is important, is to look at the things they deny. That is some basic psychology principle or the other.
This person goes out of their way to single out energy healing as being impossible.
That implies to people who are worldy wise, that energy healing is possible, and this person does not want anyone to know about it or believe it.
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Guys? I don't know how to tell you this but my daily life proves that human beings have energy, that human beings can emit or project energy, and that human beings react to energy that is projected on to them.
I could sit here for a month telling stories about human energy examples.
You want me to throw out my daily life experiences, and accept the words of unknown men who performed a study that I do not know the details of, which proved my daily life experiences are impossible.
Can't you see how crazy that is?
I tell you what. Let's stop beating around the bush.
Scientists claim Yin Yang Theory is a fallacy. They claim there is nothing to Yin Yang Theory.
Scientist R Stoopid. I can easily prove this by showing you a picture of exactly what Yin Yang Theory is about.
The picture in the link below shows two small children. One of the children has strong Yin. One of the children has weak Yin. As intelligent scientists, you should be able to figure out which is which. You have a 50/50 chance of just getting lucky.
If you read my posts about asthma or other things, I said asthma could be caused by problems with the Yin part of the body. I will further say that generally all health problems are a problem with a weak Yin part of the body.
That additional information should make it easy for you to determine which child has strong Yin and which child has weak yin.
http://www.happehtheory.com/YinExample.png
--------
Now. You scientists have been presented with photographic evidence of what a human being with strong Yin looks like.
What is your scientific response?
Please no buffoonish, clownish, abusive, or hater responses. And please no playground, "I'm ignoring you because you are not part of my clique" behavior.
happeh,
You may witness events that you attribute to energy, and you may witness them on a regular basis. However, the frequency of your witnessing does not in any way relate to the mechanism or cause of the events. I could say that the sun comes up every single morning just after I awake, therefore my awakening is what causes the sun to rise. Hey, I experience it every day. Who cares if a bunch of mathy-physicsy types say otherwise? I know what I've seen, and seeing it a whole bunch must make my perception even more accurate. This is an example of a false premise.
Wow! Could it be that happeh actually made a lick of sense for once?
< >
Too true! We consume, convert, and use food; give off heat; move things with tools like levers and pulleys; and when we're burned we "react" by screaming and trying to get away from the source of the burn. This is all stuff that kids learn about by third grade, incidentally. Way to go, happeh!
Good point, HealthEd. I should clarify that my reference to "energy" in response to happeh was using his/her definition(s). In other words, not actual energy but magic.
Good point, HealthEd. I should clarify that my reference to "energy" in response to happeh was using his/her definition(s). In other words, not actual energy but magic.
Just to point something out to those who are still trying to reason with Happeh... As the following link proves, this is a guy so deluded that he is not capable of understanding the role of perspective in a 2-dimensional photograph.
http://www.happehtheory.com/Anorexia/HappehTheoryAndAnorexiaMainPage.htm
Seriously, read that before you try to rebut him. It is important that we understand the level of mental illness we are dealing with here. In fact, some of his drawings on his website unfortunately remind me of the notebook scribblings of a guy I knew shortly before he jumped out of a second story window to get away from the government agents that were chasing him.... :/ I'm not trying to be mean, either, this is actually kinda worrisome.
James Sweet,
Duly noted. I agree that what you linked to displays something further off than plain illogic or ignorance. I really don't know what to say about it, actually. Sad, strange, and yes, worrisome.
They not only can, they do.
James Sweet: I hadn't actually followed any of your links to Happeh's website before, and I kind of regret following that one. Good grief.
Anyway, I still think it's useful to rebut the claims of people even if you know they're insane and will never ever listen to you. At the very least, you demonstrate to anyone else who might think them credible just how delusional they are.
I find it next to impossible to not consider a variation of Poe's law in regards to happeh.
Can someone please rebut or link to a rebuttal to the comment from "John" as to the testing of echinacea? I've never heard of any positive results and plenty of negative evidence, but he quotes this study at length.
Can someone please rebut or link to a rebuttal to the comment from "John" as to the testing of echinacea? I've never heard of any positive results and plenty of negative evidence, but he quotes this study at length.
Nevermind! I went to the links he gave and it's all from "Life Extension"--gee, they sell SUPPLEMENTS for "life extension" (a subjective term if ever I heard one!).
About a year ago I was visiting UT Southwestern where I saw an announcement seeking volunteers for a saw palmetto clinical trial. I am looking forward to the results of this, but, I have no idea how long something like this takes. I'm guessing four or five years or so. Am I close?
Regarding echinacea. NEJM published this article which concludes that echinacea does not have clinically significant effects on infection with a rhinovirus or on the clinical illness that results from it. Once again, not even the imaginary and, I believe, nonexistent placebo effect.
Discussion with Happeh connintued from here, since "The Infiltration of Woo" is starting to slide down the front page, and Happeh is talking about "energy projection" in comment #21:
If you're talking about electromagnetic energy (which you seem to be when talking about reiki and "energy work"), here's a bit of background: the electromagnetic fields the body produces are generated by voltage-gated ion channels. For example, a nerve cell readies itself for firing by pumping potassium and sodium ions across its membrane so that they're at different concentrations on different sides of the membrane. When a neuron is triggered at one end, the ion gates at that end open up, and the ions flow from the higher concentration to lower, generating a change in voltage. This change in voltage triggers close-by ion gates in the membrane, so they open up, producing their own voltage change, which triggers gates further on down the neuron, and so on, so the signal propagates down the neuron; this is how neurons generate electromagnetic fields.
Now, if you're talking about electromagnetic energy in the above quote, then the reiki practitioner triggering the patient into producing their own energy would mean triggering the patient's nerves into firing or triggering the patient's muscles into contracting. However, I don't think that's what you mean.
Still assuming that you're talking about electromagnetic energy (rather than some sort of "life energy" which is entirely distinct from electromagnetic energy), at most putting electrical fields into a human's body will stimulate neurons and muscle cells. Or, if you're talking about photons, they can heat up the body, stimulate the rods and cones in the retinas into firing, be used in the production of vitamin D, and if of high enough energy (ionizing radiation) can produce free radicals which can have nasty effects like damaging DNA. However, I don't think that's what you're talking about.
There's several problems with this. First, the body (and the cells of which its composed) isn't infinitely sensitive. After a certain distance the electromagnetic fields aren't going to be strong enough to influence the chemical reactions in the body. To get around this problem you'd have to suppose that the body has some sort of antenna and amplification system to pick up the signal. However, nothing of the sort has ever been found, so you'd have to further suppose that it's somehow either escaped the attention of scientists around the world or that scientists have found it but are suppressing its discovery (rather than getting a Nobel prize for it). Even supposing that, you still have the problem that all of the other humans on the planet are generating their own electromagnetic fields, which will drown out the electromagnetic field coming from the reiki practitioner; the patient will be unable to find the lone reiki signal amongst the vast sea of electromagnetic noise created created by all the other humans (and other living organisms with nervous systems).
Matthew Cline - "which will drown out the electromagnetic field coming from the reiki practitioner; the patient will be unable to find the lone reiki signal amongst the vast sea of electromagnetic noise created created by all the other humans (and other living organisms with nervous systems"
First. I am puzzled by your saying the patient "seeks out the reiki signal". Why does the patient have to do anything? Why can't the patient be nothing more than a radio receiver passively receiving a signal? That is one way it can work.
Did you see Star Wars? This character named Darth Vader reached out and choked another man with his energy. I doubt if the man being choked wanted to receive the choking energy.
( And before you go off with your "see how he refers to science fiction", I know for a fact what Darth Vader was depicted as doing is true. I choked out some people the other day by accident when they made me angry. )
Continuing with the radio analogy, a radio tunes into one frequency to get that channels programming. What if every human being had a unique electromagnetic signature? Then a Reiki practitioner could zero in on that electromagnetic signature.
----------------
James Sweet - "It is important that we understand the level of mental illness we are dealing with here."
There are people who have been following me around on the internet for years interfering with what I do. They are not real people. They are people on a mission to interfere with me. James Sweet posts like one of them.
These people post day after day after day of intellectual statements like "It is important that we understand the level of mental illness we are dealing with here." They never explain why I am wrong about whatever it is they think I am wrong about. They just post I am wrong.
Weak minded people who cannot control their own brain are hypnotized by the repetition of James Sweet or the people like him. These weak minded people become the toys of James Sweet and find themselves agreeing with everything he says.
James? I know it is your mission to hound me and prevent people from thinking critically about what I have to say. I have a question maybe you could answer for me.
You and I both know I am right about what I talk about. How do you justify holding back the progress of all humanity by attacking me the way you do? If scientists were to do their job as scientists and try to learn about what I know, all of western science and knowledge about the human body would change.
My knowledge would be just as pivotal as those sex studies released by the Kinsey's back in the day. That information changed the entire western world science for a decade at least, and completely changed the attitudes of society towards sex.
You are attempting to interfere with that kind of human society changing information from being disseminated. Why?
They are not real people.
:( Happeh. Seek help, please.
Just see a therapist and run your ideas past him or her. If you are right, then he/she can help you establish their legitimacy and bring your ideas to the world's attention. Right?
That's not what is meant by "finding the signal amongst the noise". Lets say you're listening to someone speaking on some radio station; there's some static, but not enough to interfere with you understanding what the person is saying. As you get further from where the signal is being broadcast, the signal's strength will decrease but the static's strength will stay the same. At some point the strength of the signal in comparison to the strength of the static will have decreased enough that, listening to that station, you'll not be able to make out the words being spoken (at best only be able to tell that someone is speaking). At that point the signal has been "lost" in the noise, and being lost cannot be "found".
If the reiki practitioner is doing this via photons, they have a certain frequency. If they're doing it via pure electrical fields, then by the time the electrical field has crossed miles of distance any 3-D pattern the fields might have had in the immediate vicinity of the practitioner will have flattened out, and the only pattern left will be change in intensity over time, a wave with a frequency. So, then, the "electromagnetic signature" of the patient doesn't matter, but what frequency they're "tuned into" (assuming that there's some undiscovered or scientist-suppressed biological mechanism for amplifying the signal of ultra-low frequency electromagnetic waves). For the signal not to be drowned out by the electromagnetic fields generated by all the other living animals on the planet, the frequencies that humans are tuned into, and the frequencies at which the reiki practitioners broadcast at, would have to be frequencies at which no living animals besides reiki practitioners broadcast. That is, the reiki practitioners would have to cause their nerves to fire at a frequency which with which nerves never fire anywhere else in nature. While I find this idea to be incredibly implausible, it is one that is testable: do an electroencephalography (EEG) of a reiki practitioner while s/he is doing reiki, and compare the observed brain wave frequencies with the brain wave frequencies of other people. (Not that this is just a conceivable mechanism, not a plausible mechanism)
Next is the issue of only one person receiving the signal. Each person would have to be tuned into a different frequency. If the closest that the personal frequencies of any two people could be was 1 Hertz (Hz), then some person on the planet would have to have a personal frequency of six billion Hertz. No neuron can possibly go anywhere near that. If the closest two people could be was one one millionth of a Hertz, that would still require one person to have a personal frequency of at least 6,000 Hz, and though I'm not a biologist or neurologist, I'm pretty sure that no nerve can fire 6,000 times per second. However, for the moment lets suppose that one one millionth of a Hertz is the spacing between personal frequencies. That gives the Reiki signal a bandwidth of 1/1,000,000 Hertz. Further supposing that the signal has a strength of 1 volt when it arrives at the patient (which is a lot more than the signal actually would be), then for the signal (assuming it's free of noise) to carry one bit of information per second (equivalent to one dot-or-dash of Morse code per second), then whatever in the body is receiving the signal would, according to Hartley's law, would have to be sensitive to electrical fields down to a voltage of one divided by one-followed-by-150,00-zeros, which is just impossible. Basically, with realistic sensitivities, for the reiki practitioner to send just one dot-or-dash to the patient would require at least an hour's worth of work. (This is, of course, ignoring the ridiculousness of an electromagnetic receiver that is sensitive to frequency differences of less than 1/1,000,000 Hz)
So, with that done, lets get back to your hypothesis that the reiki signal induces the patient into producing energy. What kind of energy? If it's more electromagnetic energy, that would mean stimulating the patient's nerves into firing or their muscles into contracting, and I don't think that's what you mean. What type of energy do you think the patient is deficient in, and why do you think so?
Matthew Cline - "So, with that done, lets get back to your hypothesis that the reiki signal induces the patient into producing energy. What kind of energy?"
This is really bothering me. You are asking me for something you know I cannot provide. I would need access to a fully equipped laboratory to do the tests that would provide the information you need. The conversation will go nowhere along this track.
The point of this conversation is that Reiki and other energy therapies do work. For you to ask a regular person about exactly what frequencies of energy etc are being used is unreasonable. That is your job as the scientist with access to the equipment and all of those theories you have.
My job is to convince you that Reiki does cause a physical effect, so that you and your fellows will go to your lab to do the research to provide the answers you desire. In pursuit of my job I offered the possibility of electromagnetic energy to help you scientists get your research started. Maybe it is high energy particles instead.
If you want the answers in terms of your science, then you need to do the work to figure out what is going on. I am here to reassure you that your work will give results if you pursue it intelligently and for a long enough period of time to ensure results.
You don't need to see his evidence... this is not the woo you're looking for... move along.
@Happeh:
If that's why you're talking with me/us, then you're likely wasting your time. Not all of us commenting here are scientists by profession (I'm a computer programmer by profession), and even those who are scientists by profession aren't necessarily in a job that would allow for them to perform studies on reiki. (Unless maybe you're hoping a lurker is a professional scientists who's in a position to be able to do such a study)
Additionally, providing a conceivable (though not plausible) mechanism by which reiki might work isn't going to convince any of us that reiki does work. A conceivable mechanism by which something might work isn't going to get any scientist to expend limited resources investigating that thing, nor will it reassure any scientist that the expenditure of those limited resources will give results.
And a tip: if you're presenting to a scientist a hypothetical mechanism for how distance reiki might work, don't try to shoehorn the mechanism into the electromagnetic force (or any of the other three fundamental forces, or high energy particles, or quantum entanglement), or you'll end up going back-and-forth with technical explanations like we just did.
When I asked that question I didn't realize that you were saying (paraphrased from memory) "the body had a deficit of energy and reiki stimulates the body into producing that energy" as a hypothetical example of how reiki might work. I thought you were claiming that a reiki patient does have a deficit of some energy, and so I was asking what you thought that energy is.
As a long time reader and occasional commenter I see the exact same pattern with these comments as I have with comments on other posts here.
When some brave soul - me on a couple of occasions - cites scientific studies that contradict the 'alternative medicine is just woo' paradigm that post is either a. ignored or b. dismissed based on source of the information. Never do I see a reasoned rebuttal or - gasp- a grudging acceptance that maybe there is some credible evidence for the substance or approach being castigated.
There's a collective glee implicit and often explicit when an alternative approach is 'proven' to be ineffective. One would think that as scientists, doctors and human beings, we would be disappointed that these substances 'don't work'. I never read of disappointment though - just vindication and snark.
In this case John (11) cited articles in Life Extension on saw palmetto and echinachea that demonstrated efficacy. One commenter blasted John because Life Extension sells supplements (presumably then any study promoted by big pharm should be ipso facto ignored).
Yet the saw palmetto article had 21 scientific references. So is there anyone who reads this blog who can make the scientific case that the NCCAM study of saw palmetto trumps the accumulated evidence of the LEF article.
Similarly the LEF article on echinachea quoted a doctor who made the case that the dosage used in the NCCAM study was grossly inadequate based on previous research. Again could someone carefully and scientifically rebut this assertion.
I'll wait for the silence or ad hominem attacks. Maybe I'll be wrong about both this time.
We'll see.
As a long time reader and occasional commenter I see the exact same pattern with these comments as I have with comments on other posts here.
When some brave soul - me on a couple of occasions - cites scientific studies that contradict the 'alternative medicine is just woo' paradigm that post is either a. ignored or b. dismissed based on source of the information. Never do I see a reasoned rebuttal or - gasp- a grudging acceptance that maybe there is some credible evidence for the substance or approach being castigated.
There's a collective glee implicit and often explicit when an alternative approach is 'proven' to be ineffective. One would think that as scientists, doctors and human beings, we would be disappointed that these substances 'don't work'. I never read of disappointment though - just vindication and snark.
In this case John (11) cited articles in Life Extension on saw palmetto and echinachea that demonstrated efficacy. One commenter blasted John because Life Extension sells supplements (presumably then any study promoted by big pharm should be ipso facto ignored).
Yet the saw palmetto article had 21 scientific references. So is there anyone who reads this blog who can make the scientific case that the NCCAM study of saw palmetto trumps the accumulated evidence of the LEF article.
Similarly the LEF article on echinachea quoted a doctor who made the case that the dosage used in the NCCAM study was grossly inadequate based on previous research. Again could someone carefully and scientifically rebut this assertion.
I'll wait for the silence or ad hominem attacks. Maybe I'll be wrong about both this time.
We'll see.
As a long time reader and occasional commenter I see the exact same pattern with these comments as I have with comments on other posts here.
When some brave soul - me on a couple of occasions - cites scientific studies that contradict the 'alternative medicine is just woo' paradigm that post is either a. ignored or b. dismissed based on source of the information. Never do I see a reasoned rebuttal or - gasp- a grudging acceptance that maybe there is some credible evidence for the substance or approach being castigated.
There's a collective glee implicit and often explicit when an alternative approach is 'proven' to be ineffective. One would think that as scientists, doctors and human beings, we would be disappointed that these substances 'don't work'. I never read of disappointment though - just vindication and snark.
In this case John (11) cited articles in Life Extension on saw palmetto and echinachea that demonstrated efficacy. One commenter blasted John because Life Extension sells supplements (presumably then any study promoted by big pharm should be ipso facto ignored).
Yet the saw palmetto article had 21 scientific references. So is there anyone who reads this blog who can make the scientific case that the NCCAM study of saw palmetto trumps the accumulated evidence of the LEF article.
Similarly the LEF article on echinachea quoted a doctor who made the case that the dosage used in the NCCAM study was grossly inadequate based on previous research. Again could someone carefully and scientifically rebut this assertion.
I'll wait for the silence or ad hominem attacks. Maybe I'll be wrong about both this time.
We'll see.
Good morning, oderb:
I, in contrast, have seen dozens of reasoned and referenced responses to comments that are either expressing support of alt med or asking for more information about it. Regular commenters like HCN, Dr. Benway, Rogue Medic, StuV (or is it just plain Stu? Maybe both...), Prometheus and others have written extensively and specifically to address such comments, citing hundreds of references along the way, in a spectrum of tones ranging from helpful concern to arrogant smackdown (the latter usually being quite well deserved, IMO). Not to mention the time and effort that the venerable blog host has devoted to the deconstruction and evaluation of these 'scientific studies you mention'. I'd estimate that at least 75% of the references provided by pro-CAM commenters have already been evaluated by Orac, as a quick blog search will attest.
Well, that's cold, heartless science for ya. The data are the data. Evidence-based medicine, as the name would imply, is informed by the conclusions from reproducible, well-designed experiments testing the efficacy of a given treatment. If the evidence were to support any of these CAM modalities, they would be incorporated into mainstream medicine. Problem is, the CAM just keeps failing. The more light we shine on specific claims of CAM cures, the faster they crumble. Do I feel gleeful satisfaction when these studies come out? Perhaps, but only because of the hope that maybe someone, somewhere, upon reading these results, might choose a tested, effective medical treatment over the fanciful, trumped-up claims of whatever alt med therapy they were considering before it was disproved. It's a basic quality of life issue as far as I'm concerned.
Yeah, pretty much
I don't have time to go through all 21 of the references, but a search of the primary literature reveals someone who did just that
bottom line: Saw Palmetto is no more effective than placebo.
So then we can assume this doctor will be writing a follow up article for NEJM revealing his robust experimental successes with the correct, effective combination of echinacea derived compounds? I'll look forward to it.
So, there you have it. A palpable absence of silence, and nary an ad hominem. Have a great day.
Jennifer, Here's some more evidence for you:
Meta-analysis finds echinacea effective for cold prevention and treatment
A review published in the July, 2007 issue of The Lancet Infectious Diseases concluded that echinacea, an herb commonly used to help prevent and treat the common cold, is effective at both reducing cold incidence and duration. Although the herb has been the subject of controversial study findings, millions of people continue to rely on echinacea to help protect them during cold and flu season.
For the meta-analysis, researchers at the University of Connecticut in Storrs, and Hartford Hospital, also in Connecticut, selected 14 randomized, placebo-controlled trials which evaluated the effect of echinacea on cold incidence among a total of 1,356 participants, and its effect on cold duration in 1,630 subjects. The studies selected examined the effects of Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida.
The analysis found that echinacea use reduced the risk of contracting a cold by 58 percent, and decreased cold duration by an average of 1.4 days. Subgroup analyses examining a specific brand of echinacea, concomitant supplement use, method of cold exposure, and other factors continued to demonstrate a protective effect. (The one study that combined echinacea with other supplements found an 86 percent reduction in cold incidence.)
Link to Lancet study: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(07)70160…
I can't access the full article from home, John, but if memory serves this particular meta-analysis took some big hits from other Lancet readers and the medical community in general for numerous methodological flaws. The largest and best designed Echinacea studies have shown no benefit in preventing or treating the common cold. The grandiose statistics put forth in the Lancet study are simply not supported by the data.
Jennifer, you seem so certain of your belief that all supplements are worthless. At least will you admit the evidence is conflicting and more research is needed to resolve these questions?
You might be surprised to learn that more and more doctors are recommending supplements to their patients:
http://www.lifesupplemented.org/supplements/healthcare_professionals_im…
Argumentum ad Popularum - most doctors are not scientists.
As better quality studies of supplements are performed the benefits of supplements generally disappear.
Hey John, I followed your link and while I was there I took the health survey. I said I exercised a lot and ate healthy, but never took any supplements. Well, they said I was doing well within, as they put it: "the three pillars of healthy eating, dietary supplements and regular exercise."
Funny, I never realized that vitamin supplements were as important as diet and exercise. Whatever did our ancestors do before the brave, non-biased, not for profit, vitamin supplement industry come along?
Hardly an unbiased site, don't you think?
Maybe more doctors are recommending supplements because that's what their patients are demanding. And, like most alternative medicine, it can't hurt because it doesn't really do anything anyway.
I wouldn't define it as a 'belief' so much as an opinion informed by available scientific data. As such, though, it does seem fairly conclusive that supplements in general don't have much impact on human health.
Hmmm...quite a familiar refrain. Um....no. The evidence is not conflicting at all. Every large and/or well-conducted study on the natural remedies that have been specifically mentioned in this thread and in the original AP article has shown no benefit. As for the handful of previous studies suggesting some benefit from these factors, retrospective analysis invariably finds methodological or interpretive flaws. Science is self correcting when it's done properly. That's one of the reasons I love it so.
Undoubtedly true, especially in woo-rich communities like the one I live in. However, this doesn't affect the scientific validity of these treatments one iota.
There seem to be some indications that some supplements may increase mortality. See this, for example.
"As for therapies, acupuncture has been shown to help certain conditions, and yoga, massage, meditation and other relaxation methods may relieve symptoms like pain, anxiety and fatigue"
Well, yoga will have health benefits of exercise, and will also, by increasing flexibility, reduce muscloskeletal pain. I've a trapped nerve that responds really well to yoga.
Maybe I'm just operating on the wrong definition of supplement (i.e. something along the lines of: the substance or an equivalent form thereof can be sold OTC and is thus not regulated by FDA)?
"As such, though, it does seem fairly conclusive that supplements in general don't have much impact on human health."
Maybe it's just your definition of "much impact" (I agree that neither supplements NOR drugs have much effect on the health of someone who is healthy to begin with; "not much" != zero), but I find this statement truely uninformed, offensive or both if it's not just your definition of "much impact".
Did you know that there is zero structural difference between drugs and supplements? Drugs simply tend to offer more benefits and sides per design. They're all just chemical substances...
Are you telling me that there's no evidence in favour of Niacin or fish oil? That they're not being (re-formulated and) sold as drugs these days? Are you telling me that vitamin D and K have not been used effectively as drugs *and* supplements. Calcium? Strontium? Creatine? Topical antioxidants? Polypodium leucotomos? Xylitol? The b1 and b6 vitamers? Should I go on? Do you really think that all those supplements taken together and used correctly don't have "much impact" -- why are they then sold, prescribed and embraced by both "big pharma" and evidence based science?
Well, the other difference is that the FDA requires drugs to go through an evaluation and testing process to ensure that they are safe and that they do what they are purported to do, while there are no such checks and balances on supplements... that's kindof a problem.
Kismet, I'm happy to clarify the statement. Indeed, many of the things you mentioned are used therapeutically when patients are diagnosed with deficiencies in those specific compounds/hormones/whatever (there's that 'evidence based science' for ya). But that is not why most people (like, say, Suzanne Somers) cram hatfuls of capsules down their gullets every day. The health benefits that they are seeking--as touted by the supplement manufacturers--are either grossly overstated or downright false. See, for example:
http://archinte.ama-assn.org/cgi/content/abstract/169/3/294?lookupType=…
A stellar example of 'not even wrong'. Ouch.
I think what Kismet was trying to get at with the "zero structural difference" comment is that there is no theoretical reason why a supplement could not contain pharmacologically active ingredients.
I actually agree, and think this is a point worth driving home: People are all into herbal supplements because they are "natural", but that isn't really a meaningful differentiator. If an herbal supplement has a real pharmacological effect, then it is, in essence, a drug -- with all the same potential for side-effects, etc.
So I disagree that Kismet's statement there is "not even wrong". Even though maybe it is stated clumsily, the central point of that sentence is more or less correct. It's just the conclusion that doesn't follow...
James I think that's probably a fair interpretation, but the statement re: "zero structural difference" is so general as to be completely devoid of meaning (what drugs? what supplements?). As such, I stand by my assessment.
"A stellar example of 'not even wrong'. Ouch."
What do you mean exactly? Niacin and fish oil is sold as a supplement and drug, they're both bioequivalent to the best of my knowledge. (QED?)
What I meant is that both "supplements" and drugs have effects and side-effect, the only difference is in design; most drugs are designed to meet certain goals; they're merely more powerful - per design - featuring more effects and side-effects. In the end supplements are used as drugs and possibly vice versa because they're all just chemical substances.
If you think about Europe and US markets you will see just how blurred the line becomes our drugs (some Rx and some OTC) are sold as supplements over in the US.
Neither is always safer than the other. Neither is always superior.
If we realise that all those substances are "just" chemicals and we don't know how they exactly interact with our body (other than statistically most supplements have less [side-]effects or they would have been withdrawn), we can debunk both extreme statements "supplements are [necessarily] safe" (-> no they're not) and "supplements are [necessarily] useless" (-> no they're not).
I absolutely agree that the benefits that supplements offer to healthy people are minuscle but that applies to basically any intervention including drugs so it's unfair to just speak of supplements, which is the reason why I criticised that statement so heavily. Some benefits are still worthwhile, to me at least.
You are right that some of the mentioned compounds are used to treat deficiencies, but many of them are also used at pharmacological (i.e. supra-physiological) doses and show "drug-like" properties.
Strontium, Calcium and Vitamin K (MK-4) for osteporosis (with vitamin D as an adjuvans).
Or high doses of B1 and B6 vitamers for diabetic complications, although, the latter is only in phase II trials IIRC.
Mechanistically polypodium leucotomos and topical antioxidants have been shown to offer 'sun screen-like' beenfits. Considering that consensus among dermatologists is that the less sun the better (if you keep an eye on vitamin D levels) we can safely extrapolate that they're of value.
etc.
It seems we were both assuming the other one was over-generalising? I hope to offer some perspective.
. Please see:
http://en.wikipedia.org/wiki/Not_even_wrong
Also see my comment at 59. I know what you were trying to say. I was just (admittedly snarkily) emphasizing that your choice of words resulted in an essentially content-free statement. Moving on...
A very pragmatic definition of "supplement" would be "A drug which has been relabeled in order to avoid FDA scrutiny of safety and efficacy."
Not *always* true, but in most cases it works quite well.
Ugh. Sorry for buggering the formatting so egregiously. I must not have closed a quote tag somewhere in there.
Jennifer, actually we don't understand as much biology as we'd like to. That's a theme - it's almost dogma - that is re-iterated quite often by many people from Academia to Big Pharma (e.g. Derek Lowe from 'in the pipeline').
It's not uncommon that mechanisms of action turn out to be completely false and drugs turn out to work somehow, but for completely different reasons. Most mechanisms are not completely understood decades after any Rx drug was launched -- which is one of the reasons why many drugs are recalled (we don't understand all the effects *and* side-effects; think for instance quninolone toxicity). So a "solid understanding", depending on your definition of solid, is not really required.
I get your point that (in theory) a bioequivalent drug would be superior or equal (!) to a supplement because of the stricter controls in place. But a. there are pretty trustworthy supplement companies out there (e.g. AOR) and b. some substances are easy to formulate and companies can offer CoAs (including complete analytical data as to purity and content of any batch). That makes your generalisation once again very unfair; even if it is true most of the time it's definitely not true all of the time.
In the rights hands (e.g. Dr Williams from the "heartscanblog" who is a big advocate of supplement use for reasons of cost-effectiveness) supplements provide outstanding cost/benefit ratios.
If you can get pharmacological effects from cheap supplements you really should go for it...
I agree that if we could get some more (quality) control, without illegalising experimental drugs which some people want to try (and god damn it, they have a right to kill themselves! *g*), better labeling & less lies, etc based on evidence based science the supplement market would be better off and everyone well-served.
I'd appreciate it if the gov did something about outrageous advertising lies!
However, I'm not sure if such regulation is possible without overregulation (e.g. Europe -- most supplements that are useful are illegal, Rx or hard to come by and expensive) or politics (e.g. big pharma influence) or just someone (some bureaucrat?) screwing up (I'm thinking of European 'drug stores' and pharmacies - and I'm serious - they're selling either poison [e.g. mega doses of all the wrong vitamins] or supplements devoid of ANY effects; it's crazy!)
Personally I prefer less regulation, but that's just me; I read the literature before taking my supplements. I suppose more naive people are harmed than science-literate people are helped, unfortunately.
A Google search of 'quinolone toxicity' brings up a lot of what look like crank sites. A PubMed search of same brings up very specific cases of either overdose in children or a relatively rare incidence of cardiac symptoms due to improper dosage or cardiac drug interactions. Perhaps an MD or a PharmD can offer a more informed response, but basically we're back to 'real medicine is not without risks'. Asked and answered.
And importantly, these quality control steps are a. entirely voluntary on the part of the company and b. taken on faith by the consumer in the absence of any regulation thereof.
Indeed, there are a lot of uninformed people out there getting health advice from random websites and anecdote-fueled water cooler conversations. There are also a lot of intelligent, more informed people who nonetheless are fooled by placebo effects, regression to the mean, or cognitive dissonance into believing that an ersatz supplement is actually having some desired effect on their health. Sure, most of the time the only adverse consequence is the inevitable lightening of their wallets. Worse things--much worse--can and do happen, however. Particularly when children end up being treated with such 'natural remedies' instead of receiving genuine medical care.
To be clear, I have no objection to dietary supplements being used when there is a specific medical need, and if consumers can purchase reliably manufactured, effective compounds OTC, as recommended by their doctors, I'm all for it. It's the 'everyone needs Wonder Supplement X to be healthy!!!' marketing blitz that I find objectionable. I guess the bottom line is that supplements, due largely to their lack of regulation, seem ripe for conversion into snake oil. As such, I think the system could and should be improved.
The first part of my comment didn't post, for some reason. To be thorough:
The fact that we have much to learn in the field of life sciences (yay! job security for me!) is uncontested. We are ignorant of many things, it is true. But to say "all those substances are "just" chemicals and we don't know how they exactly interact with our body" is a dramatic overstatement of this ignorance. The reality that most clinical trials cannot be conducted in ways that predict the comprehensive effects/interactions of a drug that will be marketed to a genetically and pharmacologically diverse population is pretty far removed from the suggestion that it's all just a giant crapshoot.
Furthermore, medicine is usually admirably self-correcting in this area. A drug that doesn't do what it's supposed to do, or has dangerous unforseen side effects, is recalled. A drug that does something adverse to a subset of users is dispensed more judiciously. One cannot say the same for supplements or other unregulated compounds. I haven't seen any change in the marketing strategies for glucosamine-chondroitin supplements, for example, despite numerous studies showing these substances have no effect on joint health. The whole Zicam debacle is another case in point.
Just FYI re. Quninolone toxicity, I consider it to be one of the biggest and most recent blunders of FDA and other regulatory bodies. The most important problem is tendon toxicity, which only recently - more than a decade after first quinolones made it to the market (?) - has been officially recognised by the FDA as worthy of a blackbox warning. (1) It's ridiculous how many people have been misled to believe that those antibiotics are equally safe as others that could be used in their place.
It could be a case of a. big pharma suppressing information b. long term side-effects starting to show up late or c. just an FDA screw-up. Might be a combination of all three. (other examples of surprises with long term use might be celecoxib, exubera, possibly rosiglitazone & vytorin, etc; the whole antioxidant/multivitamin-farce is one of the many examples showing that supplements also carry long term risks)
Then there's also the problem of severe reactions leaving people disabled for months or years -- I don't know how often they happen (and how much of it is just hype) or if it is similar to something like penicilin sensitivity. However, it doesn't happen with tetracyclines for instance, still quinolones are sometimes used as first line ABs without justification....
(1) http://www.drugs.com/news/fda-mandates-black-box-warning-some-antibioti…